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Nordeidet AN, Klevjer M, Øvretveit K, Madssen E, Wisløff U, Brumpton BM, Bye A. Sex-specific and polygenic effects underlying resting heart rate and associated risk of cardiovascular disease. Eur J Prev Cardiol 2024; 31:1585-1594. [PMID: 38437179 PMCID: PMC11412739 DOI: 10.1093/eurjpc/zwae092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Revised: 01/15/2024] [Accepted: 02/29/2024] [Indexed: 03/06/2024]
Abstract
AIMS Resting heart rate (RHR) is associated with cardiovascular disease (CVD) and mortality. This study aimed to identify genetic loci associated with RHR, develop a genome-wide polygenic risk score (PRS) for RHR, and assess associations between the RHR PRS and CVD outcomes, to better understand the biological mechanisms linking RHR to disease. Sex-specific analyses were conducted to potentially elucidate different pathways between the sexes. METHODS AND RESULTS We performed a genome-wide meta-analysis of RHR (n = 550 467) using two independent study populations, The Trøndelag Health Study (HUNT) and the UK Biobank (UKB), comprising 69 155 and 481 312 participants, respectively. We also developed a genome-wide PRS for RHR using UKB and tested for association between the PRS and 13 disease outcomes in HUNT. We identified 403, 253, and 167 independent single nucleotide polymorphisms (SNPs) significantly associated with RHR in the total population, women, and men, respectively. The sex-specified analyses indicated differences in the genetic contribution to RHR and revealed loci significantly associated with RHR in only one of the sexes. The SNPs were mapped to genes enriched in heart tissue and cardiac conduction pathways, as well as disease-pathways, including dilated cardiomyopathy. The PRS for RHR was associated with increased risk of hypertension and dilated cardiomyopathy, and decreased risk of atrial fibrillation. CONCLUSION Our findings provide insight into the pleiotropic effects of the RHR variants, contributing towards an improved understanding of mechanisms linking RHR and disease. In addition, the sex-specific results might contribute to a more refined understanding of RHR as a risk factor for the different diseases.
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Affiliation(s)
- Ada N Nordeidet
- Cardiac Exercise Research Group (CERG), Department of Circulation and Medical Imaging, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Prinsesse Kristinas gate 3, 7030 Trondheim, Norway
| | - Marie Klevjer
- Cardiac Exercise Research Group (CERG), Department of Circulation and Medical Imaging, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Prinsesse Kristinas gate 3, 7030 Trondheim, Norway
- Department of Cardiology, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Karsten Øvretveit
- K.G. Jebsen Center for Genetic Epidemiology, Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Erik Madssen
- Department of Cardiology, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Ulrik Wisløff
- Cardiac Exercise Research Group (CERG), Department of Circulation and Medical Imaging, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Prinsesse Kristinas gate 3, 7030 Trondheim, Norway
- Centre for Research on Exercise, Physical Activity and Health, School of Human Movement and Nutrition Sciences, University of Queensland, St. Lucia, Brisbane, Queensland, Australia
| | - Ben M Brumpton
- K.G. Jebsen Center for Genetic Epidemiology, Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Anja Bye
- Cardiac Exercise Research Group (CERG), Department of Circulation and Medical Imaging, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Prinsesse Kristinas gate 3, 7030 Trondheim, Norway
- Department of Cardiology, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
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Mascarenhas LA, Ji Y, Wang W, Inciardi RM, Parikh RR, Eaton AA, Cheng S, Alonso A, Matsushita K, Shah AM, Solomon SD, Meyer ML, Chen LY, Zhang MJ. Association of central arterial stiffness with atrial myopathy: the Atherosclerosis Risk in Communities (ARIC) study. Hypertens Res 2024:10.1038/s41440-024-01831-3. [PMID: 39117948 DOI: 10.1038/s41440-024-01831-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2024] [Revised: 07/06/2024] [Accepted: 07/10/2024] [Indexed: 08/10/2024]
Abstract
Atrial myopathy-defined as abnormal left atrial (LA) size and function-is associated with an increased risk of atrial fibrillation, heart failure, and dementia. Central arterial stiffness is associated with increased atrial afterload and fibrosis and may be a risk factor for atrial myopathy. We examined the association of carotid-femoral pulse wave velocity (cfPWV) with LA function and assessed potential causal relationships. We included 2825 Atherosclerosis Risk in Communities (ARIC) study participants from Visit 5 (2011-2013). cfPWV was related to echocardiographic LA function continuously per 1-SD and categorically in quartiles. Mendelian randomization (MR) analysis was performed using U.K. Biobank-derived genetic variants associated with arterial stiffness index and cardiac magnetic resonance measures of LA function. When analyzed per SD increment (297.6 cm/s), higher cfPWV was significantly associated with lower LA reservoir and conduit strain (β = -0.53%, 95% CI [-0.81, -0.25] and β = -0.46%, 95% CI [-0.68, -0.25], respectively) after adjusting for demographics, clinical characteristics, systolic blood pressure, and left ventricular (LV) morphology and function. In MR analyses there was a non-significant inverse association of arterial stiffness index with LA total, passive, and active emptying fractions. Higher cfPWV is associated with lower LA reservoir and conduit strain, independent of systolic blood pressure and LV morphology and function. No evidence for a causal relationship between arterial stiffness index and alterations in LA function was found. Future studies should examine the prospective association of central arterial stiffness with LA function alterations.
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Affiliation(s)
- Lorraine A Mascarenhas
- Cardiovascular Division, Department of Medicine, University of Minnesota Medical School, Minneapolis, MN, USA
- Lillehei Heart Institute, University of Minnesota Medical School, Minneapolis, MN, USA
| | - Yuekai Ji
- Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Wendy Wang
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, USA
| | - Riccardo M Inciardi
- Institute of Cardiology, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy
| | - Romil R Parikh
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, USA
| | - Anne A Eaton
- Division of Biostatistics and Health Data Science, School of Public Health, University of Minnesota, Minneapolis, MN, USA
| | - Susan Cheng
- Department of Cardiology, Cedars-Sinai Smidt Heart Institute, Los Angeles, CA, USA
| | - Alvaro Alonso
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Kunihiro Matsushita
- Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Amil M Shah
- Division of Cardiology, Department of Medicine, UT Southwestern Medical Center, Dallas, TX, USA
| | - Scott D Solomon
- Cardiovascular Division, Brigham and Women's Hospital, Boston, MA, USA
| | - Michelle L Meyer
- Department of Emergency Medicine, University of North Carolina at Chapel Hill, North Carolina, USA
| | - Lin Yee Chen
- Cardiovascular Division, Department of Medicine, University of Minnesota Medical School, Minneapolis, MN, USA
- Lillehei Heart Institute, University of Minnesota Medical School, Minneapolis, MN, USA
| | - Michael J Zhang
- Cardiovascular Division, Department of Medicine, University of Minnesota Medical School, Minneapolis, MN, USA.
- Lillehei Heart Institute, University of Minnesota Medical School, Minneapolis, MN, USA.
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3
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Lin CH, Zhang JF, Kuo YW, Kuo CF, Huang YC, Lee M, Lee JD. Assessment of the impact of resting heart rate on the risk of major adverse cardiovascular events after ischemic stroke: a retrospective observational study. BMC Neurol 2024; 24:267. [PMID: 39085779 PMCID: PMC11290262 DOI: 10.1186/s12883-024-03772-3] [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: 01/31/2024] [Accepted: 07/22/2024] [Indexed: 08/02/2024] Open
Abstract
BACKGROUND Although elevated heart rate is a risk factor for cardiovascular morbidity and mortality in healthy people, the association between resting heart rate and major cardiovascular risk in patients after acute ischemic stroke remains debated. This study evaluated the association between heart rate and major adverse cardiovascular events after ischemic stroke. METHODS We conducted a retrospective cohort study analyzing data from the Chang Gung Research Database for 21,655 patients with recent ischemic stroke enrolled between January 1, 2010, and September 30, 2018. Initial in-hospital heart rates were averaged and categorized into 10-beats per minute (bpm) increments. The primary outcome was the composite of hospitalization for recurrent ischemic stroke, myocardial infarction, or all-cause mortality. Secondary outcomes were hospitalization for recurrent ischemic stroke, myocardial infarction, and heart failure. Hazard ratios and 95% confidence intervals (CIs) were estimated using Cox proportional hazards models, using the heart rate < 60 bpm subgroup as the reference. RESULTS After a median follow-up of 3.2 years, the adjusted hazard ratios for the primary outcome were 1.13 (95% CI: 1.01 to 1.26) for heart rate 60-69 bpm, 1.35 (95% CI: 1.22 to 1.50) for heart rate 70-79 bpm, 1.64 (95% CI: 1.47 to 1.83) for heart rate 80-89 bpm, and 2.08 (95% CI: 1.85 to 2.34) for heart rate ≥ 90 bpm compared with the reference group. Heart rate ≥ 70 bpm was associated with increased risk of all secondary outcomes compared with the reference group except heart failure. CONCLUSIONS: Heart rate is a simple measurement with important prognostic implications. In patients with ischemic stroke, initial in-hospital heart rate was associated with major adverse cardiovascular events.
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Affiliation(s)
- Ching-Heng Lin
- Center for Artificial Intelligence in Medicine, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan
- Department of Computer Science and Information Engineering, Chang Gung University, Taoyuan, Taiwan
| | - Jun-Fu Zhang
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
- Department of Computer Science, National Chengchi University, Taipei, Taiwan
| | - Ya-Wen Kuo
- Department of Nursing, Chang Gung University of Science and Technology, Chiayi Campus, Chiayi, Taiwan
- Department of Neurology, Chiayi Chang Gung Memorial Hospital, No.8, W. Sec., Jiapu Rd., Puzi City, Chiayi County, Taiwan (R.O.C.)
| | - Chang-Fu Kuo
- Center for Artificial Intelligence in Medicine, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan
- Department of Computer Science and Information Engineering, Chang Gung University, Taoyuan, Taiwan
- Division of Rheumatology, Allergy and Immunology, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Yen-Chu Huang
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
- Department of Neurology, Chiayi Chang Gung Memorial Hospital, No.8, W. Sec., Jiapu Rd., Puzi City, Chiayi County, Taiwan (R.O.C.)
| | - Meng Lee
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
- Department of Neurology, Chiayi Chang Gung Memorial Hospital, No.8, W. Sec., Jiapu Rd., Puzi City, Chiayi County, Taiwan (R.O.C.)
| | - Jiann-Der Lee
- College of Medicine, Chang Gung University, Taoyuan, Taiwan.
- Department of Neurology, Chiayi Chang Gung Memorial Hospital, No.8, W. Sec., Jiapu Rd., Puzi City, Chiayi County, Taiwan (R.O.C.).
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Lv Q, Yang Y, Lv Y, Wu Q, Hou X, Li L, Ye X, Yang C, Wang S. Long-term effects of different hypoglycemic drugs on carotid intima-media thickness progression: a systematic review and network meta-analysis. Front Endocrinol (Lausanne) 2024; 15:1403606. [PMID: 38883606 PMCID: PMC11176463 DOI: 10.3389/fendo.2024.1403606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2024] [Accepted: 05/15/2024] [Indexed: 06/18/2024] Open
Abstract
Objective The progression of carotid intima-media thickness (cIMT) can partially predict the occurrence of future cardiovascular events. This network meta-analysis compared the effects of 14 antidiabetic drugs (acarbose, alogliptin, exenatide, glibenclamide, glimepiride, ipragliflozin, metformin, nateglinide, pioglitazone, rosiglitazone, sitagliptin, tofoglifozin, troglitazone, voglibose) on the progression of cIMT. Method PubMed, EMBASE, Cochrane Library, and Web of Science were searched to screen all clinical trials of treatment of cIMT with hypoglycemic agents before March 1, 2024. The differences in the changes in cIMT between the treatment group and control group were evaluated. Result After screening 8395 citations, 25 studies (6675 patients) were included. The results indicated that exenatide had the best efficacy in slowing down cIMT progress, and exenatide [MD=-0.13,95%CI (-0.25, -0.01)], alogliptin [MD=-0.08,95%CI (-0.13, -0.02)] and metformin [MD=-0.05, 95%CI (-0.09, -0.02)] are more effective than placebo. Conclusion Long-term treatment of exenatide, alogliptin, and metformin may be more effective than other hypoglycemic drugs in slowing the progression of cIMT. Systematic Review Registration https://www.crd.york.ac.uk/PROSPERO/, identifier CRD42024519474.
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Affiliation(s)
- Qianyu Lv
- Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Yingtian Yang
- Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Yanfei Lv
- School of Management, Fudan University, Shanghai, China
| | - Qian Wu
- Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Xinzheng Hou
- Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Lanlan Li
- Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Xuejiao Ye
- Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Chenyan Yang
- Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Shihan Wang
- Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
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Büschges JC, Schmidt-Trucksäss A, Neuhauser H. Association of blood pressure and heart rate with carotid markers of vascular remodeling in the young: a case for early prevention. J Hypertens 2024; 42:153-160. [PMID: 37796164 DOI: 10.1097/hjh.0000000000003578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/06/2023]
Abstract
OBJECTIVE The association of childhood blood pressure (BP) and heart rate (HR) with intermediate markers of cardiovascular disease several decades later has been shown, but studies on more short-term outcomes are scarce. Using population-based data, this study investigates the association of four BP parameters and HR in childhood with three carotid markers for vascular remodeling one decade later. METHODS At the 11-year follow-up, 4607 participants of the nationwide KiGGS cohort aged 14 to 28 years had semi-automated sonographic carotid intima media thickness (CIMT) measurements. We investigated associations of baseline (age 3-17 years) and follow-up SBP, DBP, mean arterial pressure (MAP), pulse pressure (PP) and resting heart rate (RHR), with CIMT and lumen diameter at or above the 90th percentile and distensibility coefficient at or below the tenth percentile in logistic regressions. Analyses were further adjusted using a composite cardiovascular risk (CVR) score of BMI, triglycerides, total/HDL-cholesterol-ratio and HbA1c. RESULTS SBP, DBP, MAP and RHR were significantly and similarly associated with all carotid measures 11 years later, for example an odds ratio (OR) of 1.17 [confidence interval (CI) 1.06-1.29] for one standard deviation SBP increase with elevated CIMT when adjusting for sex, age and CVR score. Cross-sectionally, the strongest association was found for MAP with reduced distensibility coefficient (OR 1.76; CI 1.59-1.94). CONCLUSION This population-based cohort study shows robust and consistent associations between childhood BP and RHR and three carotid measures of vascular remodeling only one decade later, clearly underscoring the potential importance of preventing high BP already early in the life course.
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Affiliation(s)
- Julia C Büschges
- Robert Koch Institute, Department of Epidemiology and Health Monitoring
- DZHK (German Centre for Cardiovascular Research), partner site Berlin
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Arno Schmidt-Trucksäss
- Department of Sport, Exercise and Health, Division Sports and Exercise Medicine
- Department of Clinical Research, University Hospital Basel, University of Basel, Basel, Switzerland
| | - Hannelore Neuhauser
- Robert Koch Institute, Department of Epidemiology and Health Monitoring
- DZHK (German Centre for Cardiovascular Research), partner site Berlin
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6
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O'Dowd A, Hirst RJ, Setti A, Kenny RA, Newell FN. Individual differences in seated resting heart rate are associated with multisensory perceptual function in older adults. Psychophysiology 2024; 61:e14430. [PMID: 37675755 DOI: 10.1111/psyp.14430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Revised: 08/09/2023] [Accepted: 08/16/2023] [Indexed: 09/08/2023]
Abstract
There is evidence that cardiovascular function can influence sensory processing and cognition, which are known to change with age. However, whether the precision of unisensory and multisensory temporal perception is influenced by cardiovascular activity in older adults is uncertain. We examined whether seated resting heart rate (RHR) was associated with unimodal visual and auditory temporal discrimination as well as susceptibility to the audio-visual Sound Induced Flash Illusion (SIFI) in a large sample of older adults (N = 3232; mean age = 64.17 years, SD = 7.74, range = 50-93; 56% female) drawn from The Irish Longitudinal Study on Ageing (TILDA). Faster seated RHR was associated with better discretization of two flashes (but not two beeps) and increased SIFI susceptibility when the audio-visual stimuli were presented close together in time but not at longer audio-visual temporal offsets. Our findings suggest a significant relationship between cardiovascular activity and the precision of visual and audio-visual temporal perception in older adults, thereby providing novel evidence for a link between cardiovascular function and perceptual function in aging.
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Affiliation(s)
- Alan O'Dowd
- School of Psychology and Institute of Neuroscience, Trinity College Dublin, Dublin, Ireland
- The Irish Longitudinal Study on Ageing, Trinity College Dublin, Dublin, Ireland
| | - Rebecca J Hirst
- School of Psychology and Institute of Neuroscience, Trinity College Dublin, Dublin, Ireland
- The Irish Longitudinal Study on Ageing, Trinity College Dublin, Dublin, Ireland
| | - Annalisa Setti
- The Irish Longitudinal Study on Ageing, Trinity College Dublin, Dublin, Ireland
- School of Applied Psychology, University College Cork, Cork, Ireland
| | - Rose Anne Kenny
- The Irish Longitudinal Study on Ageing, Trinity College Dublin, Dublin, Ireland
- Mercer Institute for Successful Ageing, St. James Hospital, Dublin, Ireland
| | - Fiona N Newell
- School of Psychology and Institute of Neuroscience, Trinity College Dublin, Dublin, Ireland
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Jiang J, Sun X, Chen R, Su Y, Xu W, Cheng C, Zhang S. Association between nighttime heart rate and cardiovascular mortality in patients with implantable cardioverter-defibrillator: A cohort study. Heart Rhythm 2023; 20:1682-1688. [PMID: 37689174 DOI: 10.1016/j.hrthm.2023.08.042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Revised: 08/27/2023] [Accepted: 08/31/2023] [Indexed: 09/11/2023]
Abstract
BACKGROUND Although studies have shown that an increased resting heart rate measured randomly at a single point of the day has been associated with adverse cardiovascular outcomes, the utility of continuous monitoring of nighttime heart rate (NTHR) has remained largely uninvestigated. OBJECTIVE This study aimed to explore the association between NTHR and cardiovascular mortality. METHODS The Study of Home Monitoring System Safety and Efficacy in Cardiac Implantable Electronic Device-implanted Patients, which is a prospective cohort study, enrolled patients with implantable cardioverter-defibrillator (ICD) or cardiac resynchronization therapy defibrillator between 2010 and 2015. Baseline NTHR was measured during the programmed sleep period from 30 to 60 days after implantation. The primary outcome was cardiovascular mortality, fitted by a restricted cubic spline function. RESULTS A total of 534 implantable cardioverter-defibrillator recipients with sinus rhythm during the detection window were included in the study. The mean baseline NTHR was 59.6 ± 8.0 beats/min. During the follow-up period of 60.4 ± 21.8 months, 88 (16.5%) patients experienced cardiovascular mortality. After considering potential confounders, a linear association was observed. Each 1 beat/min increase in NTHR was associated with a 7.8%, 10.1%, and 5.7% increase in the risk of cardiovascular mortality in the total population, patients with heart failure, and patients without heart failure, respectively. CONCLUSION Continuous monitoring of NTHR may identify patients at high risk of cardiovascular mortality in a timely manner, with the potential for "preemptive" action. TRIAL REGISTRATION No. ChiCTR-ONRC-13003695.
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Affiliation(s)
- Jiang Jiang
- State Key Laboratory of Cardiovascular Disease, Arrhythmia Center, National Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xuerong Sun
- Heart Center and Beijing Key Laboratory of Hypertension, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
| | - Ruohan Chen
- State Key Laboratory of Cardiovascular Disease, Arrhythmia Center, National Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yangang Su
- Department of Cardiology, Cardiology, Shanghai Institute of Cardiovascular Diseases, Fudan University, Shanghai, China
| | - Wei Xu
- Department of Cardiology, Nanjing Drum Tower Hospital, Nanjing, China
| | - Chendi Cheng
- Department of Cardiovascular Medicine, the Second Xiangya Hospital of Central South University, Changsha, China.
| | - Shu Zhang
- State Key Laboratory of Cardiovascular Disease, Arrhythmia Center, National Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
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Sigl M, Winter L, Schumacher G, Helmke SC, Shchetynska-Marinova T, Amendt K, Duerschmied D, Hohneck AL. Comparison of Functional and Morphological Estimates of Vascular Age. In Vivo 2023; 37:2178-2187. [PMID: 37652489 PMCID: PMC10500512 DOI: 10.21873/invivo.13317] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Revised: 06/01/2023] [Accepted: 06/02/2023] [Indexed: 09/02/2023]
Abstract
BACKGROUND/AIM Vascular age (VA) is an emerging metric in preventive cardiovascular (CV) medicine. VA can be derived from morphological parameters such as carotid intima-media thickness (CIMT), or functional parameters such as pulse wave analysis (PWA), which celebrates its 100th birthday. This study aimed to investigate whether the results of both approaches are comparable. PATIENTS AND METHODS On the occasion of the double 100th anniversary of PWA and the Mannheim Clinic, 100 volunteers underwent a) bilateral CIMT assessment using high-resolution ultrasound and b) oscillometric PWA at the brachial forearm site. The respective VAs were calculated using previously published equations. RESULTS Median age of the participants was 53.6 years (range=39.8-62.6 years), and 56% were female. Median CIMT was 632.5 μm (range=548.8-730.0 μm). Median PWA-derived VA was 55.3 years (36.5-70.5 years). Different values were obtained for CIMT-derived VA, depending on the reference cohort used as calculation basis, ranging from median 43.7 (26.2-59.5 years) to median 64.0 years (43.5-82.1 years). In 46% of the participants divergent VAs were found, that is, the calculated age was higher according to one method and lower according to the other. Correlation analysis revealed a strong dependence of VA (both PWA- and CIMT-derived) and chronological age, as well as an increase in CV risk factors and the detection of plaques with age. CONCLUSION Different approaches for estimating VA are not comparable and often produce contradictory results. The current methods and their validity must be critically assessed if they are not standardized.
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Affiliation(s)
- Martin Sigl
- Department of Cardiology, Angiology, Haemostaseology and Medical Intensive Care, University Medical Centre Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
- European Center for AngioScience (ECAS) and German Center for Cardiovascular Research (DZHK) partner site Heidelberg/Mannheim, Mannheim, Germany
| | - Laura Winter
- Department of Cardiology, Angiology, Haemostaseology and Medical Intensive Care, University Medical Centre Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
- European Center for AngioScience (ECAS) and German Center for Cardiovascular Research (DZHK) partner site Heidelberg/Mannheim, Mannheim, Germany
| | | | | | - Tetyana Shchetynska-Marinova
- Department of Cardiology, Angiology, Haemostaseology and Medical Intensive Care, University Medical Centre Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
- European Center for AngioScience (ECAS) and German Center for Cardiovascular Research (DZHK) partner site Heidelberg/Mannheim, Mannheim, Germany
| | - Klaus Amendt
- Department of Cardiology, Angiology, Haemostaseology and Medical Intensive Care, University Medical Centre Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
- European Center for AngioScience (ECAS) and German Center for Cardiovascular Research (DZHK) partner site Heidelberg/Mannheim, Mannheim, Germany
| | - Daniel Duerschmied
- Department of Cardiology, Angiology, Haemostaseology and Medical Intensive Care, University Medical Centre Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
- European Center for AngioScience (ECAS) and German Center for Cardiovascular Research (DZHK) partner site Heidelberg/Mannheim, Mannheim, Germany
| | - Anna Lena Hohneck
- Department of Cardiology, Angiology, Haemostaseology and Medical Intensive Care, University Medical Centre Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany;
- European Center for AngioScience (ECAS) and German Center for Cardiovascular Research (DZHK) partner site Heidelberg/Mannheim, Mannheim, Germany
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Kamimura D, Tamura K. Resting heart rate as a possible biomarker and target to prevent future cardiovascular disease in type 2 diabetes patients (HTR-2023-0066.R2). Hypertens Res 2023; 46:1160-1162. [PMID: 36890273 DOI: 10.1038/s41440-023-01251-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 02/16/2023] [Accepted: 02/17/2023] [Indexed: 03/10/2023]
Affiliation(s)
- Daisuke Kamimura
- Department of Medical Science and Cardiorenal Medicine, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Kouichi Tamura
- Department of Medical Science and Cardiorenal Medicine, Yokohama City University Graduate School of Medicine, Yokohama, Japan.
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10
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Photoplethysmographic Measurement of Arterial Stiffness in Polish Patients with Long-COVID-19 Syndrome-The Results of a Cross-Sectional Study. Diagnostics (Basel) 2022; 12:diagnostics12123189. [PMID: 36553195 PMCID: PMC9777579 DOI: 10.3390/diagnostics12123189] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 11/30/2022] [Accepted: 12/14/2022] [Indexed: 12/23/2022] Open
Abstract
The coronavirus disease 2019 (COVID-19) is associated with an increase in the incidence of cardiovascular diseases (CVD) that persists even several months after the onset of infection. COVID-19 may also have an impact on arterial stiffness, which is a risk factor for CVD. We aimed to analyze if and to what extent arterial stiffness measured by photoplethysmography differed among COVID-19 convalescents depending on the acute phase severity and time elapsed since disease onset. A total of 225 patients (mean age 58.98 ± 8.57 years, 54.7% women) were analyzed after COVID-19 hospitalization at the Cardiac Rehabilitation Department of the Ustron Health Resort (Poland). In the entire study population, no differences were found in the mean values of stiffness index (SI) and reflection index (RI) depending on the severity of the acute COVID-19 and the time since the onset of the disease. There were no differences in the heart rate (HR) according to the severity of acute COVID-19; the mean HR was higher in patients who had COVID-19 less than 12 weeks before the study than in convalescents more than 24 weeks after the acute disease (p = 0.002). The mean values of SI and RI were higher in men than in women (p < 0.001), while the heart rate (HR) was similar in both sexes (p = 0.286). However, multiple linear regression analyses after adjusting for factors influencing arterial stiffness, i.e., sex, age, body mass index, smoking status, hypertension, diabetes, the severity of the acute COVID-19, and the time from the disease onset, confirmed that age, sex, time from disease onset, and diabetes are the most important determinants that could influence arterial stiffness.
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11
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Xu D, Zhu X, Huo J, Xie X, Huang C, Fang X, Yin T. A Nomogram for Predicting the Risk of Critical Limb Ischemia in Adults with Hypertension: A Retrospective Study. Int J Gen Med 2022; 15:8205-8216. [PMID: 36425355 PMCID: PMC9680988 DOI: 10.2147/ijgm.s342448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Accepted: 10/27/2022] [Indexed: 11/19/2022] Open
Abstract
Purpose Peripheral arterial disease (PAD) presenting with underlying hypertension (HTN) poses a higher risk of bilateral lower limb amputation than PAD patients without HTN. While the role of HTN management of PAD patients has received limited attention. We analyzed the clinical characteristics of PAD in adults with HTN and explored risk factors for PAD to construct a nomogram for evaluating critical limb ischemia (CLI) and lesion severity. Methods Patients and Methods Between January 2014 and December 2019, we retrospectively evaluated 1886 patients with peripheral artery disease with coexisting HTN. Patients were randomly divided into training (n = 1320, 70%) and validation cohorts (n = 566, 30%), and according to the subjective experience of PAD [Fontaine classification (I-II vs III-IV)], patients were further classified into intermittent claudication (IC) and CLI groups. LASSO regression and multivariate Cox proportional hazard analyses were used to construct a nomogram using variables defined in the training cohort, which was validated in the validation cohort. The evaluation of the predictive discriminative, accuracy and clinical application are further analyzed. Results In the training cohort, optimal independent factors included age, male sex, body mass index, diabetes mellitus, heart rate, triglyceride, and uric acid (AM-BDHTU), which were included in the nomogram predicting the CLI risk (all P < 0.05). The C-index values for CLI risk in PAD with HTN patients were 0.729 (95% CI: 0.704-0.807) and 0.728 (95% CI: 0.652-0.744) in the training and validation sets, respectively. Calibration curves indicated good consistency between predicted and actual outcomes. DCA confirmed the clinical utility of the diagnostic model. Conclusion The AM-BDHTU nomogram, constructed and validated using simple to obtain clinical variables, when combined with the Fontaine classification, effectively predicts the risk of CLI among PAD patients with HTN.
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Affiliation(s)
- Dong Xu
- Department of Vascular Surgery, Affiliated Hangzhou First People’s Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, People’s Republic of China
| | - Xu Zhu
- Department of Cardiology, Jiangsu Province Hospital and Nanjing Medical University, First Affiliated Hospital, Nanjing, Jiangsu, People’s Republic of China
| | - Junyu Huo
- Department of Cardiology, Jiangsu Province Hospital and Nanjing Medical University, First Affiliated Hospital, Nanjing, Jiangsu, People’s Republic of China
| | - Xupin Xie
- Department of Vascular Surgery, Affiliated Hangzhou First People’s Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, People’s Republic of China
| | - Changpin Huang
- Department of Vascular Surgery, Affiliated Hangzhou First People’s Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, People’s Republic of China
| | - Xin Fang
- Department of Vascular Surgery, Affiliated Hangzhou First People’s Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, People’s Republic of China
| | - Ting Yin
- Intensive Care Unit, Affiliated Hangzhou First People’s Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, People’s Republic of China
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12
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Imahori Y, Vetrano DL, Xia X, Grande G, Ljungman P, Fratiglioni L, Qiu C. Association of resting heart rate with cognitive decline and dementia in older adults: A population-based cohort study. Alzheimers Dement 2022; 18:1779-1787. [PMID: 34859936 DOI: 10.1002/alz.12495] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Revised: 09/09/2021] [Accepted: 09/15/2021] [Indexed: 01/28/2023]
Abstract
INTRODUCTION Resting heart rate (RHR) predicts future risk for cardiovascular disease (CVD). However, longitudinal studies investigating the relationship of RHR with cognitive decline are scarce. METHODS This population-based cohort study included 2147 participants (age≥60) in SNAC-K who were free of dementia and regularly followed from 2001-2004 to 2013-2016. RHR was assessed with electrocardiogram. Dementia was diagnosed following the Diagnostic and Statistical Manual of Mental Disorders 4th Revision criteria. Global cognitive function was assessed using Mini-Mental State Examination (MMSE). Data were analyzed using Cox and linear mixed-effects models. RESULTS RHR≥80 (vs. 60-69) bpm was associated with a multi-adjusted hazard ratio of 1.55 (95% confidence interval 1.06-2.27) for dementia. The association remained significant after excluding participants with prevalent and incident CVDs. Similarly, RHR≥80 bpm was associated with a multi-adjusted β-coefficient of -0.13 (-0.21 to -0.04) for MMSE score. DISCUSSION Higher RHR is associated with increased risk for dementia and faster cognitive decline independent of CVDs in a general population of elderly people.
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Affiliation(s)
- Yume Imahori
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden
| | - Davide L Vetrano
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden.,Centro Medicina dell'Invecchiamento, Fondazione Policlinico "A- Gemelli" IRCCS and Catholic University of Rome, Rome, Italy
| | - Xin Xia
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden
| | - Giulia Grande
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden
| | - Petter Ljungman
- Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden.,Department of Cardiology, Danderyd Hospital, Stockholm, Sweden
| | - Laura Fratiglioni
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden.,Stockholm Gerontology Research Center, Stockholm, Sweden
| | - Chengxuan Qiu
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden
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Wang SL, Li W, Li TF, Liang X, Yan YL, Liu SY. QRISK3-based analysis of cardiovascular risk factors in patients with long-term but well-controlled systemic lupus erythematosus. Am J Transl Res 2022; 14:3247-3260. [PMID: 35702101 PMCID: PMC9185081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Accepted: 03/31/2022] [Indexed: 06/15/2023]
Abstract
Systemic lupus erythematosus (SLE) is a multisystem inflammatory disease of unknown etiology. Corticosteroids and immunosuppressive agents are the principal forms of treatment for this condition. While cardiovascular disease (CVD) is known to be a major cause of death in patients with SLE, there has been no improvement over the last few decades with regard to diagnosis, treatment, or prognosis. The QRISK3 algorithm is a new algorithm that includes SLE-related risk factors; this tool can predict the risk of CVD over a ten-year period. In this study, involving 180 patients, we compared the performance of the Framingham risk score, the recalibrated risk prediction SCORE, and QRISK3 for the assessment of CVD in patients with a long course of disease and low disease activity. Then, we used a more efficient algorithm, QRISK3 to identify the risk factors for CVD. This was a prospective and cross-sectional study involving 116 patients. All patients fulfilled the ACR criteria. The systemic lupus erythematosus disease activity index 2000 (SLEDAI-2K) is widely used to assess disease activity in SLE patients; patients with a SLEDAI-2K less than or equal to 4 are considered to be stable. Thus, we defined well-controlled patients as those with a SLEDAI-2K score less than or equal to 4. The dose of glucocorticoid (GC) that patients received was less or equal to 10 mg per day. We recorded and assessed a range of traditional risk factors, current treatments, comorbidities, data at the time of onset, and SLE-related evaluations. The QRISK3 score, and the relative risk (RR) that this score defined, were used to estimate the risk of CVD in patients with SLE. According to these relative risks, the patients were divided into low- (n=28), intermediate- (n=46), and high-relative risk (n=31) groups for subgroup analysis. Of the 116 patients enrolled, 105 were eligible to be assessed for the risk of CVD. By univariate analyses, the RR was significantly related with age at the time of enrolment (p<0.001), age at onset (p<0.001), resting heart rate (RHR) (p<0.001), present dose of GCs (p<0.001), present SLEDAI-2K (p=0.015), aerobic exercise (p<0.001), initial SLEDAI-2K (p<0.001), and initial dose of GCs (p=0.048). In the multiple linear regression model, the RR of CVD was significantly correlated with the initial SLEDAI-2K score (β=2.112, p<0.001), initial dose of GCs (β=-0.009, p=0.041), resting heart rate (β=0.241, p=0.003) and age at onset (β=-0.208, p=0.004). Pearson's correlation showed that RHR was significantly associated with aerobic exercise (r=-0.322, p=0.001). Subgroup analysis further identified a positive correlation between the history of nephritis, metabolic syndrome (MetS), aerobic exercise, present dose of GCs, and the RR of CVD. Patients with long-term but well-controlled SLE had a high relative risk of CVD and that this was associated with resting heart rate (P=0.003), history of lupus nephritis (P<0.001), initial SLEDAI-2K score (P<0.001), and metabolic syndrome (P=0.017). However, age at onset (P<0.001), use of hydroxychloroquine (P=0.30) and Mycophenolate mofetil (P=0.01), and the initial dose of glucocorticoid (P=0.049), were protective factors. Younger SLE patients had a significantly higher relative risk of CVD than older patients (p<0.001). QRISK3 detected more SLE patients at high risk of CVD when compared to the Framingham and recalibrate SCORE. To reduce the risk of CVD in SLE patients, measures should be taken both during the initial stages of disease and for long-term management.
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Affiliation(s)
- Shuo-Lin Wang
- Department of Rheumatology, First Affiliated Hospital of Zhengzhou University Zhengzhou, Henan, China
| | - Wei Li
- Department of Rheumatology, First Affiliated Hospital of Zhengzhou University Zhengzhou, Henan, China
| | - Tian-Fang Li
- Department of Rheumatology, First Affiliated Hospital of Zhengzhou University Zhengzhou, Henan, China
| | - Xu Liang
- Department of Rheumatology, First Affiliated Hospital of Zhengzhou University Zhengzhou, Henan, China
| | - Ye-Lan Yan
- Department of Rheumatology, First Affiliated Hospital of Zhengzhou University Zhengzhou, Henan, China
| | - Sheng-Yun Liu
- Department of Rheumatology, First Affiliated Hospital of Zhengzhou University Zhengzhou, Henan, China
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Ryffel CP, Eser P, Marcin T, Herrsche D, Brugger N, Trachsel LD, Wilhelm M. Young endurance training starting age in non-elite athletes is associated with higher proximal aortic distensibility. Open Heart 2022; 9:openhrt-2021-001771. [PMID: 35264414 PMCID: PMC8915284 DOI: 10.1136/openhrt-2021-001771] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Accepted: 01/09/2022] [Indexed: 12/15/2022] Open
Abstract
Objective Decreased proximal aortic distensibility (AD) is known to significantly predict all-cause mortality and cardiovascular events among individuals without overt cardiovascular disease. This cross-sectional study investigated the association of endurance training (ET) parameters, namely, ET starting age, ET years and yearly ET volume with AD in non-elite endurance athletes. Methods Healthy, normotensive, male Caucasian participants of a 10-mile race were assessed with a 2D echocardiogram and comprehensive interview. Ascending aortic diameters were measured simultaneously with pulse pressure. Aortic strain, AD and aortic stiffness index were calculated. Predictors of AD were investigated among training parameters by linear regression models corrected for age, resting heart rate, stroke volume index and mean blood pressure. Results Ninety-two of 121 athletes (aged 42±8 years) had sufficient echocardiogram quality and were used for analysis. ET starting age (range 6–52 years) and years of ET (range 2–46 years) were highly collinear and used in two separate models for AD. Significant factors for AD were ET starting age, 10-mile race time and resting heart rate in model I, and age, years of ET, 10-mile race time and heart rate in model II (all p<0.01). Conclusions In our cohort of healthy, non-elite, middle-aged runners, AD was significantly higher in athletes with younger ET starting age or more years of ET (in the model adjusted for confounders). In the model with years of ET, age had a negative contribution to AD, suggesting that with older age, the benefit of more years of ET on AD decreased. Future studies assessing the effect of exercise training on arterial properties should include training starting age.
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Affiliation(s)
- Christoph P Ryffel
- Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Prisca Eser
- Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Thimo Marcin
- Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Dario Herrsche
- Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.,Exercise Physiology Lab, Institute of Human Movement Sciences and Sport, ETH Zurich, Zurich, Switzerland
| | - Nicolas Brugger
- Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Lukas D Trachsel
- Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Matthias Wilhelm
- Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
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15
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Bi H, Zhang Y, Qin P, Wang C, Peng X, Chen H, Zhao D, Xu S, Wang L, Zhao P, Lou Y, Hu F. Association of Chinese Visceral Adiposity Index and Its Dynamic Change With Risk of Carotid Plaque in a Large Cohort in China. J Am Heart Assoc 2021; 11:e022633. [PMID: 34970911 PMCID: PMC9075187 DOI: 10.1161/jaha.121.022633] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Background We aimed to evaluate the association between the Chinese visceral adiposity index (CVAI) and its dynamic change and risk of carotid plaque based on a large Chinese cohort. Methods and Results This cohort included 23 522 participants aged 20 to 80 years without elevated carotid intima‐media thickness and carotid plaque at baseline and who received at least 2 health checkups. CVAI was calculated at baseline and at every checkup. The dynamic change in CVAI was calculated by subtracting CVAI at baseline from that at the last follow‐up. Cox proportional hazard regression model was used to estimate hazard ratios (HRs) and 95% CIs. The restricted cubic spline was applied to model the dose‐response association between CVAI and carotid plaque risk. During the 82 621 person‐years of follow‐up, 5987 cases of carotid plaque developed (7.25/100 person‐years). We observed a significant positive correlation between CVAI and carotid plaque risk (HR, 1.53; 95% CI, 1.48–1.59 [P<0.001]) in a nonlinear dose‐response pattern (Pnonlinearity<0.001). The sensitivity analyses further confirmed the robustness of the results. The association was significant in all subgroup analyses stratified by sex, hypertension, and fatty liver disease except for the diabetes subgroup. The association between CVAI and carotid plaque risk was much higher in men than in women. No significant association was identified between change in CVAI and carotid plaque risk. Conclusions CVAI was positively associated with carotid plaque risk in a nonlinear dose‐response pattern in this study. Individuals should keep their CVAI within a normal level to prevent the development of carotid plaque.
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Affiliation(s)
- Haoran Bi
- Department of Epidemiology and Biostatistics School of Public Health Xuzhou Medical University Xuzhou Jiangsu People's Republic of China
| | - Yanyan Zhang
- Department of Biostatistics and Epidemiology School of Public Health Shenzhen University Health Science Center Shenzhen Guangdong People's Republic of China
| | - Pei Qin
- Department of Biostatistics and Epidemiology School of Public Health Shenzhen University Health Science Center Shenzhen Guangdong People's Republic of China
| | - Changyi Wang
- Department of Non-communicable Disease Prevention and Control Shenzhen Nanshan Center for Chronic Disease Shenzhen Guangdong People's Republic of China
| | - Xiaolin Peng
- Department of Non-communicable Disease Prevention and Control Shenzhen Nanshan Center for Chronic Disease Shenzhen Guangdong People's Republic of China
| | - Hongen Chen
- Department of Non-communicable Disease Prevention and Control Shenzhen Nanshan Center for Chronic Disease Shenzhen Guangdong People's Republic of China
| | - Dan Zhao
- Department of Non-communicable Disease Prevention and Control Shenzhen Nanshan Center for Chronic Disease Shenzhen Guangdong People's Republic of China
| | - Shan Xu
- Department of Non-communicable Disease Prevention and Control Shenzhen Nanshan Center for Chronic Disease Shenzhen Guangdong People's Republic of China
| | - Li Wang
- Department of Non-communicable Disease Prevention and Control Shenzhen Nanshan Center for Chronic Disease Shenzhen Guangdong People's Republic of China
| | - Ping Zhao
- Department of Health Management Beijing Xiaotangshan Hospital Beijing People's Republic of China
| | - Yanmei Lou
- Department of Health Management Beijing Xiaotangshan Hospital Beijing People's Republic of China
| | - Fulan Hu
- Department of Biostatistics and Epidemiology School of Public Health Shenzhen University Health Science Center Shenzhen Guangdong People's Republic of China
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Hohneck AL, Fries P, Stroeder J, Schneider G, Schirmer SH, Reil JC, Böhm M, Laufs U, Custodis F. Effects of selective heart rate reduction with ivabradine on LV function and central hemodynamics in patients with chronic coronary syndrome. IJC HEART & VASCULATURE 2021; 34:100757. [PMID: 33851006 PMCID: PMC8024658 DOI: 10.1016/j.ijcha.2021.100757] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Revised: 02/28/2021] [Accepted: 03/03/2021] [Indexed: 11/30/2022]
Abstract
OBJECTIVES We assessed left ventricular (LV) function and central hemodynamic effects in patients with a heart rate (HR) at rest of ≥70 beats per minute (bpm) and chronic coronary syndrome (CCS) after long-term treatment with ivabradine compared to placebo by cardiac magnetic resonance (CMR) imaging. METHODS AND RESULTS In a randomized, double-blinded, prospective cross-over design, 23 patients (18 male, 5 female) were treated with ivabradine (7.5 mg bid) or placebo for 6 months. CMR imaging was performed at baseline and after 6 and 12 months to determine LV functional parameters.Mean resting HR on treatment with ivabradine was 58 ± 8.2 bpm and 70.2 ± 8.3 bpm during placebo (p < 0.0001).There was no difference in systolic LV ejection fraction (ivabradine 57.4 ± 11.2% vs placebo 53.0 ± 10.9%, p = 0.18), indexed end-diastolic (EDVi) or end-systolic volumes (ESVi). Indexed stroke volume (SVi) (ml/m2) remained unchanged after treatment with ivabradine. Volume time curve parameters reflecting systolic LV function (peak ejection rate and time) were unaffected by ivabradine, while both peak filling rate (PFR) and PFR/EDV were significantly increased. Mean aortic velocity (cm/s) was significantly reduced during treatment with ivabradine (ivabradine 6.7 ± 2.7 vs placebo 9.0 ± 3.4, p = 0.01). Aortic flow parameters were correlated to parameters of vascular stiffness. The strongest correlation was revealed for mean aortic velocity with aortic distensibility (AD) (r = -0.86 [-0.90 to -0.85], p < 0.0001). CONCLUSION Long-term reduction of HR with ivabradine in patients with CCS improved diastolic function and reduced mean aortic flow velocity.
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Key Words
- ACS, acute coronary syndrome
- AD, aortic distensibility
- Arterial stiffness
- CAD, coronary artery disease
- CCS, chronic coronary syndrome
- CMR, cardiac magnetic resonance
- CV, cardiovascular
- Chronic coronary syndrome
- EDV, end-diastolic
- EF, ejection fraction
- ESC, European Society of Cardiology
- ESV, end-systolic
- FMD, flow mediated dilation
- HFpEF, heart failure with preserved ejection fraction
- HFrEF, heart failure with reduced ejection fraction
- HR, heart rate
- HRR, heart rate reduction
- Heart rate reduction
- Hemodynamics
- LV, left ventricular
- MRI, magnetic resonance imaging
- PER, peak ejection rate
- PET, peak ejection time
- PFR, peak filling rate
- PFT, peak filling time
- PWV, pulse wave velocity
- RHR, resting heart rate
- SV, stroke volume
- VTC, volume-time curve
- bpm, beats per minute
- cf, carotid-femoral
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Affiliation(s)
- Anna Lena Hohneck
- First Department of Medicine, University Medical Centre Mannheim (UMM), Faculty of Medicine Mannheim, University of Heidelberg and DZHK (German Centre for Cardiovascular Research) Partner Site Heidelberg/Mannheim, Mannheim, Germany
| | - Peter Fries
- Clinic for Diagnostic and Interventional Radiology, Saarland University Medical Center, Saarland University, Homburg/Saar, Germany
| | - Jonas Stroeder
- Clinic for Diagnostic and Interventional Radiology, Saarland University Medical Center, Saarland University, Homburg/Saar, Germany
| | - Günther Schneider
- Clinic for Diagnostic and Interventional Radiology, Saarland University Medical Center, Saarland University, Homburg/Saar, Germany
| | | | - Jan-Christian Reil
- Second Department of Medicine, University Hospital Schleswig-Holstein Location Lübeck, Lübeck, Germany
| | - Michael Böhm
- Department of Internal Medicine III, Saarland University Medical Center, Saarland University, Homburg/Saar, Germany
| | - Ulrich Laufs
- Clinic and Polyclinic for Cardiology, University of Leipzig, Leipzig, Germany
| | - Florian Custodis
- Department of Internal Medicine III, Saarland University Medical Center, Saarland University, Homburg/Saar, Germany
- Department of Internal Medicine II, Klinikum Saarbrücken, Saarbrücken, Germany
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Koska J, Migrino RQ, Chan KC, Cooper-Cox K, Reaven PD. The Effect of Exenatide Once Weekly on Carotid Atherosclerosis in Individuals With Type 2 Diabetes: An 18-Month Randomized Placebo-Controlled Study. Diabetes Care 2021; 44:1385-1392. [PMID: 33495294 PMCID: PMC8247511 DOI: 10.2337/dc20-2014] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Accepted: 11/23/2020] [Indexed: 02/03/2023]
Abstract
OBJECTIVE Glucagon-like peptide 1 receptor agonists (GLP-1RAs) improved multiple proatherogenic risk factors and reduced cardiovascular events in recent clinical trials, suggesting that they may slow progression of atherosclerosis. We tested whether exenatide once weekly reduces carotid plaque progression in individuals with type 2 diabetes. RESEARCH DESIGN AND METHODS In a double-blind, pragmatic trial, 163 participants were randomized (2:1) to exenatide (n = 109) or placebo (n = 54). Changes in carotid plaque volume and composition were measured at 9 and 18 months by multicontrast 3 Tesla MRI. Fasting and post-high-fat meal plasma glucose and lipids, and endothelial function responses, were measured at 3, 9, and 18 months. RESULTS Exenatide reduced hemoglobin A1c (HbA1c) (estimated difference vs. placebo 0.55%, P = 0.0007) and fasting and postmeal plasma glucose (19 mg/dL, P = 0.0002, and 25 mg/dL, P < 0.0001, respectively). Mean (SD) change in plaque volume in the exenatide group (0.3% [2%]) was not different from that in the placebo group (-2.2% [8%]) (P = 0.4). The change in plaque volume in the exenatide group was associated with changes in HbA1c (r = 0.38, P = 0.0004), body weight, and overall plasma glucose (r = 0.29, P = 0.007 both). There were no differences in changes in plaque composition, body weight, blood pressure, fasting and postmeal plasma triglycerides, and endothelial function between the groups. CONCLUSIONS Exenatide once weekly for up to 18 months improved fasting and postprandial glycemic control but did not modify change in carotid plaque volume or composition. This study raises the possibility that short-term antiatherosclerotic effects may not play a central role in the cardiovascular benefits of GLP-1RAs.
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Affiliation(s)
- Juraj Koska
- Phoenix Veterans Affairs Health Care System, Phoenix, AZ
| | | | - Keith C Chan
- Phoenix Veterans Affairs Health Care System, Phoenix, AZ
| | | | - Peter D Reaven
- Phoenix Veterans Affairs Health Care System, Phoenix, AZ
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Chang YK, Fan HC, Lim PS, Chuang SY, Hsu CC. The relationship between resting heart rate and new-onset microalbuminuria in people with type 2 diabetes: An 8-year follow-up study. Diabet Med 2021; 38:e14436. [PMID: 33095935 PMCID: PMC8246976 DOI: 10.1111/dme.14436] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Revised: 10/10/2020] [Accepted: 10/16/2020] [Indexed: 11/29/2022]
Abstract
AIMS Microalbuminuria is an indicator of adverse cardiovascular events and chronic kidney disease. Studies have described an elevated resting heart rate as a risk factor for microalbuminuria in people with cardiovascular disease, but none have clarified its role in microalbuminuria development in people with type 2 diabetes. Therefore, this study investigated the relationship between resting heart rate and new-onset microalbuminuria in type 2 diabetes. METHODS A total of 788 people from a glycaemic control trial in Taiwan were enrolled. Microalbuminuria was defined as a fasting urine albumin-to-creatinine ratio ≥30 mg/g in two consecutive urine tests. Resting heart rate and other covariates were measured at baseline. The quartile of resting heart rates, categorized as <70, 70-74, 75-80 and >80 beats/min, was used for analysis. Cox proportional hazard models were used to evaluate the association between resting heart rate and risk of microalbuminuria. RESULTS During the follow-up period, 244 people (31%) developed microalbuminuria. Those who developed microalbuminuria had a longer diabetes duration (median = 3.0 vs. 2.0 years, p < 0.001), higher rate of hypertension (77% vs. 66%, p = 0.003), higher rate of angiotensin-converting enzyme inhibitor/angiotensin receptor blocker treatment (50% vs. 38%, p = 0.001) and higher baseline HbA1c level (70 vs. 64 mmol/mol, 8.6 vs. 8.0%, p < 0.001). After adjusting for demographics, metabolic profiles and inflammatory markers, developing microalbuminuria was significantly associated with baseline resting heart rate of 70-74, 75-80 and >80 beats/min (with hazard ratios [95% CI] of 2.05 [1.32, 3.18], 2.10 [1.32, 3.32] and 1.62 [1.01, 2.59], respectively) compared to resting heart rates <70 beats/min. An average increased risk of microalbuminuria for increment of 10 beats/min was about 24% among those with hypertension (with hazard ratios of 1.24 [1.05, 1.47] in the multivariable Cox model). CONCLUSIONS This prospective cohort study showed that resting heart rate may be an associative risk factor for developing microalbuminuria in type 2 diabetes.
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Affiliation(s)
- Y. K. Chang
- Department of Medical ResearchTungsTaichung MetroHarbor HospitalTaichungTaiwan
- Department of NursingJenteh Junior College of Medicine, Nursing and ManagementMiaoliTaiwan
| | - H. C. Fan
- Department of Medical ResearchTungsTaichung MetroHarbor HospitalTaichungTaiwan
- Department of PediatricsTungsTaichung MetroHarbor HospitalTaichungTaiwan
- Department of RehabilitationJenteh Junior College of Medicine, Nursing and ManagementMiaoliTaiwan
| | - P. S. Lim
- Division of Renal MedicineTungsTaichung MetroHarbor HospitalTaichungTaiwan
| | - S. Y. Chuang
- Institute of Population Health SciencesNational Health Research InstitutesMiaoliTaiwan
| | - C. C. Hsu
- Institute of Population Health SciencesNational Health Research InstitutesMiaoliTaiwan
- Department of Health Services AdministrationChina Medical UniversityTaichungTaiwan
- Department of Family MedicineMin‐Sheng General HospitalTaoyuanTaiwan
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Zhou D, Li Z, Shi G, Zhou J. Effect of heart rate on hospital mortality in critically ill patients may be modified by age: a retrospective observational study from large database. Aging Clin Exp Res 2021; 33:1325-1335. [PMID: 32638341 DOI: 10.1007/s40520-020-01644-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2020] [Accepted: 06/25/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND Heart rate has been found associated with mortality in critically ill patients. However, whether the association differs between the elderly and non-elderly patients was unknown. METHODS We conducted a retrospective observational study of adult patients admitted to the intensive care unit (ICU) in the United States. Demographic, vital signs, laboratory tests, and interventions were extracted and compared between the elderly and non-elderly patients. The main exposure was heart rate, the proportion of time spent in heart rate (PTS-HR) was calculated. The primary outcome was hospital mortality. The multivariable logistic regression model was performed to assess the relationship between PTS-HR and hospital mortality, and interaction between PTS-HR and age categories was explored. RESULTS 104,276 patients were included, of which 52,378 (50.2%) were elderly patients and 51,898 (49.8%) were non-elderly patients. The median age was 66 (IQR 54-76) years. After adjusting for confounders, PTS-HR < 60 beats per minute (bpm) (OR 0.972, 95% CI [0.945, 0.998], p = 0.031, Pinteraction = 0.001) and 60-80 bpm (OR 0.925, 95% CI [0.912, 0.938], p < 0.001, Pinteraction = 0.553) were associated with decreased risk of mortality; PTS-HR 80-100 bpm was associated with decreased mortality in the non-elderly patients (OR 0.955, 95% CI [0.941,0.975], p < 0.001) but was associated with increased mortality in the very elderly patients (OR 1.018, 95% CI [1.003,1.029], p = 0.017, Pinteraction < 0.001). PTS-HR > 100 bpm (OR 1.093, 95% CI [1.081,1.105], p < 0.001, Pinteraction = 0.004) was associated with increased mortality. CONCLUSIONS The effect of heart rate on hospital mortality differs between the elderly and non-elderly critically ill patients.
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20
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One-year change in resting heart rate and subsequent risk of hypertension in healthy Chinese adults. Blood Press Monit 2021; 26:39-45. [PMID: 32701565 DOI: 10.1097/mbp.0000000000000472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Changes in baseline resting heart rate (RHR) appear to predict new-onset hypertension (NOH). However, RHR is a dynamic anthropometric parameter; thus, the association between changes in RHR and NOH requires further investigation. METHODS We studied 10 403 participants who were initially normotensive and who had at least one routine health examination at baseline and 1 year later during 2011-2016. We compared the RHR between the baseline and 1-year follow-up. We defined hypertension as SBP ≥140 mmHg or DBP ≥90 mmHg. Participants were divided into three groups: RHR decreased, RHR unchanged [from 0 to 10 beats per minute (bpm)], and RHR increased ≥10 bpm. Cox regression analysis was performed to calculate relative risk with 95% confidence intervals (CIs) for the association between NOH and RHR change. RESULTS During a mean follow-up period of 2.42 years, 1173 (11.28%) participants developed hypertension. After adjusting for age, sex, SBP, DBP, RHR and other confounders obtained at baseline, and compared with participants with unchanged RHR, participants with decreased RHR had a 17% decreased risk of NOH (adjusted hazard ratio: 0.83, 95% CI 0.73-0.95), whereas subjects with RHR that increased ≥10 bpm had a 23% increased risk of NOH (adjusted hazard ratio: 1.23, 95% CI 1.04-1.46). CONCLUSION A 1-year increase in RHR for initially normotensive subjects is an independent risk factor for subsequent hypertension.
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21
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Whelton SP, McEvoy JW, Shaw L, Psaty BM, Lima JAC, Budoff M, Nasir K, Szklo M, Blumenthal RS, Blaha MJ. Association of Normal Systolic Blood Pressure Level With Cardiovascular Disease in the Absence of Risk Factors. JAMA Cardiol 2021; 5:1011-1018. [PMID: 32936272 DOI: 10.1001/jamacardio.2020.1731] [Citation(s) in RCA: 122] [Impact Index Per Article: 40.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Importance The risk of atherosclerotic cardiovascular disease (ASCVD) at currently defined normal systolic blood pressure (SBP) levels in persons without ASCVD risk factors based on current definitions is not well defined. Objective To examine the association of SBP levels with coronary artery calcium and ASCVD in persons without hypertension or other traditional ASCVD risk factors based on current definitions. Design, Setting, and Participants A cohort of 1457 participants free of ASCVD from the Multi-Ethnic Study of Atherosclerosis who were without dyslipidemia (low-density lipoprotein cholesterol level ≥160 mg/dL or high-density lipoprotein cholesterol level <40 mg/dL), diabetes (fasting glucose level ≥126 mg/dL), treatment for hyperlipidemia or diabetes, or current tobacco use, and had an SBP level between 90 and 129 mm Hg. Participants receiving hypertension medication were excluded. Coronary artery calcium was classified as absent or present and adjusted hazard ratios (aHRs) were calculated for incident ASCVD. The study was conducted from March 27, 2018, to February 12, 2020. Exposures Systolic blood pressure. Main Outcomes and Measures Presence or absence of coronary artery calcium and incident ASCVD events. Results Of the 1457 participants, 894 were women (61.4%); mean (SD) age was 58.1 (9.8) years and mean (SD) follow-up was 14.5 (3.9) years. There was an increase in traditional ASCVD risk factors, coronary artery calcium, and incident ASCVD events with increasing SBP levels. The aHR for ASCVD was 1.53 (95% CI, 1.17-1.99) for every 10-mm Hg increase in SBP levels. Compared with persons with SBP levels 90 to 99 mm Hg, the aHR for ASCVD risk was 3.00 (95% CI, 1.01-8.88) for SBP levels 100 to 109 mm Hg, 3.10 (95% CI, 1.03-9.28) for SBP levels 110 to 119 mm Hg, and 4.58 (95% CI, 1.47-14.27) for SBP levels 120 to 129 mm Hg. Conclusions and Relevance Beginning at an SBP level as low as 90 mm Hg, there appears to be a stepwise increase in the presence of coronary artery calcium and the risk of incident ASCVD with increasing SBP levels. These results highlight the importance of primordial prevention for SBP level increase and other traditional ASCVD risk factors, which generally seem to have similar trajectories of graded increase in risk within values traditionally considered to be normal.
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Affiliation(s)
- Seamus P Whelton
- Division of Cardiology, Johns Hopkins Ciccarone Center for Prevention of Cardiovascular Disease, Baltimore, Maryland
| | - John W McEvoy
- Division of Cardiology, Johns Hopkins Ciccarone Center for Prevention of Cardiovascular Disease, Baltimore, Maryland.,National Institute for Preventive Cardiology and National University of Ireland, Galway Campus, Galway, Ireland
| | - Leslee Shaw
- Department of Medicine, Emory University School of Medicine, Atlanta, Georgia
| | - Bruce M Psaty
- Cardiovascular Health Research Unit, Departments of Medicine, and Epidemiology, and Health Services, University of Washington, Seattle.,Kaiser Permanente Washington Health Research Institute, Seattle
| | - Joao A C Lima
- Division of Cardiology, Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Matthew Budoff
- Department of Medicine, Harbor UCLA Medical Center, Los Angeles, California
| | - Khurram Nasir
- Division of Cardiology, Johns Hopkins Ciccarone Center for Prevention of Cardiovascular Disease, Baltimore, Maryland.,Section of Cardiovascular Medicine, Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut
| | - Moyses Szklo
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Roger S Blumenthal
- Division of Cardiology, Johns Hopkins Ciccarone Center for Prevention of Cardiovascular Disease, Baltimore, Maryland
| | - Michael J Blaha
- Division of Cardiology, Johns Hopkins Ciccarone Center for Prevention of Cardiovascular Disease, Baltimore, Maryland
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Carotid Beta Stiffness Association with Thyroid Function. J Clin Med 2021; 10:jcm10030420. [PMID: 33499200 PMCID: PMC7865481 DOI: 10.3390/jcm10030420] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2020] [Revised: 01/19/2021] [Accepted: 01/20/2021] [Indexed: 01/26/2023] Open
Abstract
Background: Thyroid hormone modulation of cardiovascular function has been associated with cardiovascular disease. Recent evidence suggests that free thyroxine (FT4) levels are associated with an increase in systemic arterial stiffness, but little is known about the effects of FT4 at the local level of the common carotid artery. β-stiffness index is a local elastic parameter usually determined by carotid ultrasound imaging. Methods: We conducted a cross-sectional analysis in the ProgeNIA cohort, including 4846 subjects across a broad age range. For the purpose of this study, we excluded subjects with increased thyrotropin (TSH) levels and those treated with levothyroxine or thyrostatic. We assessed β stiffness, strain, wall–lumen ratio, carotid cross-sectional area (CSA), and stress and flow in the right common carotid artery. We tested whether FT4, heart rate, and their interactions were associated with carotid parameters. Results: FT4 was positively and independently associated with β stiffness index (β = 0.026, p = 0.041), and had a negative association with strain (β = −0.025, p = 0.009). After adding heart rate and the interaction between FT4 and heart rate to the model, FT4 was still associated with the β stiffness index (β = 0.186, p = 0.06), heart rate was positively associated with the stiffness index (β = 0.389, p < 0.001) as well as their interaction (β = 0.271, p = 0.007). Conclusion: This study suggests that higher FT4 levels increase arterial stiffness at the common carotid level, consistent with a detrimental effect on elastic arteries. The effect of FT4 is likely to be primarily attributable to its effect on heart rate.
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Effects of heart rate reduction with ivabradine on vascular stiffness and endothelial function in chronic stable coronary artery disease. J Hypertens 2020; 37:1023-1031. [PMID: 30672832 DOI: 10.1097/hjh.0000000000001984] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
INTRODUCTION Epidemiological and clinical studies have shown a relevant association between heart rate and cardiovascular mortality. Experimental studies identified vascular effects of heart rate reduction with the If channel inhibitor ivabradine. Therefore, the effects of heart rate reduction on endothelial function and indices of arterial stiffness were examined in patients with stable coronary artery disease in a prospective, placebo-controlled clinical crossover study. METHODS AND RESULTS Twenty-three patients (18 men and 5 women) with a resting heart rate (HR) of at least 70 beats per minute (bpm) and stable coronary artery disease were enrolled in this study. In a cross-over design, all patients were treated with ivabradine (Iva, 7.5 mg b.i.d.) and placebo for 6 months each. Iva reduced heart rate by 11.4 bpm (Iva 58.8 ± 8.2 bpm vs. placebo 70.2 ± 8.3 bpm, P < 0.0001). Augmentation index (AIx75), carotid-femoral pulse wave velocity (cfPWV) and central aortic blood pressure were measured using applanation tonometry (SphygmoCor). HRR by Iva increased AIx75 by 12.4% (Iva 24.3 ± 10.5% vs. placebo 21.3 ± 10.1%, P < 0.05) and reduced cfPWV by 14.1% (Iva 6.3 ± 1.7 m/s vs. placebo 7.3 ± 1.4 m/s, P < 0.01). Iva increased mean central blood pressure by 7.8% (Iva 107.5 ± 15.4 mmHg vs. placebo 99.1 ± 12.2 mmHg, P < 0.001). Endothelial function was determined measuring the flow-mediated vasodilation (FMD) of the brachial artery. HRR by Iva increased FMD by 18.5% (Iva 7.3 ± 2.2% vs. placebo 6.0 ± 2.0%, P < 0.001). Aortic distensibility was characterized by MRI. HRR by Iva increased aortic distensibility by 33.3% (Iva 0.003 ± 0.001/mmHg vs. placebo 0.002 ± 0.010/mmHg, P < 0.01) and circumferential cyclic strain by 37.1% (Iva 0.062 ± 0.027 vs. placebo 0.039 ± 0.018, P < 0.0001). CONCLUSION Heart rate reduction with Iva increased endothelium-dependent vasodilation and reduced arterial stiffness in patients with stable CAD. These findings corroborate and expand the results collected in experimental studies and indicate the importance of heart rate as a determinant of vascular function.
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Zarzeczny R, Polak A, Nawrat-Szołtysik A, Manasar A. Associations between the serum levels of selected bone turnover markers and biological traits in nursing home women aged 80+ without inflammation. A pilot study. Exp Gerontol 2020; 137:110970. [PMID: 32428562 DOI: 10.1016/j.exger.2020.110970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Revised: 04/27/2020] [Accepted: 05/13/2020] [Indexed: 11/26/2022]
Abstract
BACKGROUND Bone turnover markers (BTM) reflect the status of bone remodeling processes responsible for bone mineral density. The existing body of evidence that osseous tissue can interact with many other body tissues and organs suggests that the cross-talks can lead to different relationships. The biological traits associated with BTMs have not been thoroughly studied in the elderly despite bone turnover being known to increase with age. OBJECTIVE To determine whether the C-terminal crosslinking telopeptides of type I collagen (CTXI) and the serum levels of total (TAP) and bone-specific (BAP) alkaline phosphatase are associated with the biological traits in nursing home women aged 80-92 years without inflammation and, if so, to indicate the best predictors of these BTM's blood concentrations. METHODS A group of 64 female volunteers aged 80 years and older, the residents of nursing homes, were screened for the study. Fifty two women were ineligible as they met the exclusion criteria. As a result, the study group consisted of 12 participants (85.1 ± 3.9 years; 58.1 ± 8.7 kg; 1.52 ± 0.06 m), all having blood C-reactive protein (CRP) levels below 3 mg/l. Also assessed were the participants' morphology, glucose and insulin levels, lipid profiles, CTXI, TAP, and BAP. Other measured parameters included body composition, resting heart rate and arterial blood pressure, isometric knee extension peak torque (IKEPT), and walking capacity (6-min walk test). The statistical analysis was performed using Pearson's correlation coefficients, the Benjamini-Hochberg procedure, and a stepwise multiple regression analysis with backward elimination. RESULTS Inverse correlations were found between CTX-I and hemoglobin concentration (HGB) (r = -0.680; p = .015), red blood cells count (RBC) (r = -0.664; p = .019), fat-free mass (r = -0.633; p = .027), body weight (r = -0.589; p = .044), and total cholesterol (r = -0.581; p = .048). The multiple regression analysis of CTX-I showed that body weight was the only independent variable that was statistically significant (r2 = 0.346; p < .05; SEE = 0.347 ng/ml). BAP was positively correlated with double product (DP) (r = 0.742; p = .006), RBC (r = 0.650; p = .022), HGB (r = 0.637; p = .026), mean arterial pressure (MAP) (r = 0.622; p = .031), diastolic blood pressure (DBP) (r = 0.612; p = .034), body height (r = 0.603; p = .038), IKEPT (r = 0.565; p = .056), and systolic blood pressure (SBP) (r = 0.538; p = .071). BAP, a dependent variable, was the most closely correlated with DP (r2 = 0.550; p < .01; SEE = 9.161 U/l). TAP was also significantly associated with DP (r = 0.775; p = .003), with the association being stronger than between BAP and DP (r2 = 0.600; p < .01; SEE = 1000.5 beats/min*mm Hg). CONCLUSIONS In relatively healthy the oldest-old nursing home women without inflammation, total body weight was the best predictor of bone resorption shown by the CTX-I concentration, whereas the rate pressure product (DP) turned out to best predict osteoblastic activity determinable from serum alkaline phosphatase activity. The results of the study suggest that the activity of serum TAP and BAP can be enhanced by different mechanisms.
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Affiliation(s)
- Ryszard Zarzeczny
- Chair of Biomedical Sciences, Józef Piłsudski University of Physical Education, 34 Marymoncka str., 00-968 Warsaw 45, Poland.
| | - Anna Polak
- Chair of Physiotherapy Basics, The Jerzy Kukuczka Academy of Physical Education in Katowice, 72A Mikołowska str., 40-065 Katowice, Poland.
| | - Agnieszka Nawrat-Szołtysik
- Chair of Physiotherapy Basics, The Jerzy Kukuczka Academy of Physical Education in Katowice, 72A Mikołowska str., 40-065 Katowice, Poland.
| | - Ahmed Manasar
- Silesians Analytical Laboratories in Katowice, 1 Żelazna str., 40-851 Katowice, Poland.
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Zhao MX, Zhao Q, Zheng M, Liu T, Li Y, Wang M, Yao S, Wang C, Chen YM, Xue H, Wu S. Effect of resting heart rate on the risk of all-cause death in Chinese patients with hypertension: analysis of the Kailuan follow-up study. BMJ Open 2020; 10:e032699. [PMID: 32161155 PMCID: PMC7066611 DOI: 10.1136/bmjopen-2019-032699] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2019] [Revised: 12/11/2019] [Accepted: 01/08/2020] [Indexed: 01/17/2023] Open
Abstract
OBJECTIVE Previous studies have shown that an elevated heart rate is associated with a higher risk of cardiovascular events. This study aimed to prospectively examine the relationship between resting heart rate (RHR) and all-cause mortality in Chinese patients with hypertension. DESIGN An observational, prospective and population-based cohort study. SETTING The Kailuan cohort study was conducted in Tangshan City in northern China. PARTICIPANTS We enrolled 46 561 patients who did not receive beta-blocker treatment and were diagnosed with hypertension for the first time during an employee health examination in Kailuan Group in 2006 and 2008. OUTCOME The primary outcome of this study was all-cause mortality. METHODS The patients in this study were followed for 9.25±1.63 years. All patients were followed up face to face every 2 years. According to the distribution of RHR in the study population, RHR was categorised into five groups on the basis of quintiles: Q1: RHR ≤68 beats per minute (bpm); Q2: RHR >68 and ≤72 bpm; Q3: RHR >72 and ≤76 bpm; Q4: RHR >76 and ≤82 bpm; Q5: RHR >82 bpm. Cox proportional hazards model, which was adjusted for traditional risk factors, was used. RESULTS During follow-up, 4751 deaths occurred. After adjustment for potential confounders, restricted cubic spline regression showed that the risk of all-cause mortality increased with heart rate. In multivariate Cox regression analyses adjusted for age, sex and major covariates, the HR for all-cause mortality was 1.31 (95% CI 1.27 to 1.33) in the highest quintile group (Q5) compared with the lowest quintile group (Q1). CONCLUSION An increase in RHR is a long-term risk factor of all-cause mortality in Chinese patients with hypertension. TRIAL REGISTRATION NUMBER ChiCTR-TNC-11001489.
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Affiliation(s)
- Mao Xiang Zhao
- Department of Cardiology, Chinese PLA General Hospital, Beijing, China
| | - Quanhui Zhao
- Department of Cardiology, Kailuan General Hospital, Tangshan, Hebei, China
| | - Mengyi Zheng
- North China University of Science and Technology, Tangshan, Hebei, China
| | - Tong Liu
- North China University of Science and Technology, Tangshan, Hebei, China
| | - Yao Li
- Department of Cardiology, Chinese PLA General Hospital, Beijing, China
| | - Miao Wang
- Department of Cardiology, Chinese PLA General Hospital, Beijing, China
| | - Siyu Yao
- Department of Cardiology, Chinese PLA General Hospital, Beijing, China
| | - Chi Wang
- Department of Cardiology, Chinese PLA General Hospital, Beijing, China
| | - Yan-Ming Chen
- Department of Cardiology, Chinese PLA General Hospital, Beijing, China
| | - Hao Xue
- Department of Cardiology, Chinese PLA General Hospital, Beijing, China
| | - Shouling Wu
- Department of Cardiology, Kailuan General Hospital, Tangshan, Hebei, China
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Peng L, Bi S, Liu X, Long T, Zhao Y, Li F, Yang T, Zhang C. Association between depressive symptoms and arterial stiffness: a cross-sectional study in the general Chinese population. BMJ Open 2020; 10:e033408. [PMID: 32114467 PMCID: PMC7050321 DOI: 10.1136/bmjopen-2019-033408] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVES To determine the independent relationship between depressive symptoms and arterial stiffness in the general Chinese population, and to explore possible interactive factors in the relationship. DESIGN A cross-sectional study. SETTING AND PARTICIPANTS Consecutive participants who received routine health physical examination in an affiliated hospital of a comprehensive university in Hunan Province, China, between September 2013 and March 2014 were examined. After exclusion of subjects not meeting the criteria, a total of 1334 subjects aged 22-77 years were recruited for final analysis. MEASURES The Patient Health Questionnaire-9 was employed to assess the degree of depressive symptoms: 0-4 no depressive symptoms, 5-9 mild depressive symptoms and 10-27 moderate to severe depressive symptoms. Brachial-ankle pulse wave velocity (baPWV) was measured to determine arterial stiffness. RESULTS There was a slight increase in baPWV across elevated degrees of depressive symptoms (p=0.025). Multivariate linear regression analysis revealed that mild depressive symptoms and moderate to severe depressive symptoms were independently associated with baPWV compared with no depressive symptoms after adjusting for baseline confounders (beta-coefficient: 40.3, 95% CI 6.6 to 74.1; beta-coefficient: 87.7, 95% CI 24.0 to 151.5, respectively). Further stratified analyses indicated that the relationship between degree of depressive symptoms and baPWV was predominant in subjects who had normal or normal-high blood pressure, or combined with hypertension (p for interaction=0.016), or in subjects with diabetes mellitus (p for interaction=0.004), examined in multivariate linear regressions. In addition, after adjustment, a significant association between moderate to severe depressive symptoms and baPWV was also found in female subjects younger than 60 years, although the interactive effect was not significant (p for interaction=0.056). CONCLUSIONS Depressive symptoms are independently associated with arterial stiffness, especially in subjects whose blood pressures are beyond the optimal range and combined with diabetes mellitus.
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Affiliation(s)
- Liming Peng
- Department of Cardiology, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Sisi Bi
- Department of Cardiology, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Xiangwei Liu
- Department of Cardiology, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Tianyi Long
- Department of Cardiology, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Yixia Zhao
- Department of Cardiology, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Fei Li
- Department of Cardiology, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Tianlun Yang
- Department of Cardiology, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Chenglong Zhang
- Department of Cardiology, Xiangya Hospital, Central South University, Changsha, Hunan, China
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Shiba S, Shiba A. Association between non-obesity and health state among young Japanese male university students. J Phys Ther Sci 2020; 32:79-84. [PMID: 32082034 PMCID: PMC7008022 DOI: 10.1589/jpts.32.79] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2019] [Accepted: 10/29/2019] [Indexed: 12/11/2022] Open
Abstract
[Purpose] The obesity rate in both males and females has been lower in Japan than in
other countries. However, the prevalence of metabolic syndrome-related risk factors is not
low when compared with that in Western countries. In this study, we aimed to evaluate the
health state of young, non-obese adults in Japan. [Participants and Methods] We recruited
20 young, non-obese Japanese male university students and examined the maximum oxygen
consumption, physical activity, and components of metabolic syndrome. We evaluated the
physical activity level and dietary habits of the participants through a questionnaire
survey. [Results] The questionnaire survey revealed that 70% participants had non-standard
dietary habits, 55% did not engage in any regular exercise, and 25% were inactive. On
examination, 20% participants had at least one positive risk factor for metabolic
syndrome. The homeostatic model assessment of insulin resistance and triglyceride values
did not correlate with the body mass index of the participants; however, the values were
inversely related to the maximum oxygen consumption levels. [Conclusion] Even participants
with normal body mass index had poor dietary habits and a lack of exercise. Our results
confirmed that even non-obese Japanese individuals have certain health risks and that
having higher maximum oxygen consumption has beneficial effects in preventing the risk
factors of severe and life-threatening diseases.
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Affiliation(s)
- Sumiko Shiba
- Department of Physical Therapy, Konan Women's University: 2-23-6 Morikita-machi, Higashinada-ku, Kobe City, Hyogo 658-0001, Japan
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Liu JJ, Liu S, Gurung RL, Ang K, Ee Tang W, Sum CF, Tavintharan S, Hadjadj S, Lim SC. Arterial Stiffness Modulates the Association of Resting Heart Rate With Rapid Renal Function Decline in Individuals With Type 2 Diabetes Mellitus. Arterioscler Thromb Vasc Biol 2019; 39:2437-2444. [DOI: 10.1161/atvbaha.119.313163] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Objective:
Resting heart rate (RHR) has been associated with cardiovascular risk, but data on renal outcomes are still scarce. We aimed to study the association of RHR with rapid renal function decline (RRFD) and to explore whether the association of RHR with RRFD is modulated by arterial stiffness in individuals with type 2 diabetes mellitus.
Approach and Results:
One thousand one hundred forty-two Asian people with type 2 diabetes mellitus were followed for 3.9±0.9 years in a regional hospital and a primary care facility. RRFD was defined as eGFR decline of 5 mL/min per 1.73 m2 or greater per year. Arterial stiffness was assessed by carotid-femoral pulse wave velocity. One hundred sixty-eight participants (15%) were classified as having RRFD. Participants with elevated RHR were younger, had higher levels of HbA1c, albuminuria, C-reactive protein, and pulse wave velocity. Compared with the lowest quartile, participants in quartile 4 had a higher risk for RRFD after adjustment for known risk factors (adjusted odds ratio 1.91 [1.11–3.28]). RHR improved discrimination and net reclassification for prediction of RRFD above traditional risk factors. Remarkably, arterial stiffness modulated the association of RHR with RRFD (
P
for interaction =0.03). RHR was significantly associated with risk of RRFD only in those with increased arterial stiffness (pulse wave velocity above age-reference value 7.7 m/s).
Conclusions:
RHR independently predicts RRFD, and the association is modulated by arterial stiffness. An elevated heart rate may be one factor in the spectrum of cardiovascular risk factors associated with renal functional impairment, especially in those with type 2 diabetes mellitus and an increased arterial stiffness.
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Affiliation(s)
- Jian-Jun Liu
- From the Clinical Research Unit, Khoo Teck Puat Hospital, Singapore (J.-J.L., S.L., R.L.G., K.A.)
| | - Sylvia Liu
- From the Clinical Research Unit, Khoo Teck Puat Hospital, Singapore (J.-J.L., S.L., R.L.G., K.A.)
| | - Resham L Gurung
- From the Clinical Research Unit, Khoo Teck Puat Hospital, Singapore (J.-J.L., S.L., R.L.G., K.A.)
| | - Keven Ang
- From the Clinical Research Unit, Khoo Teck Puat Hospital, Singapore (J.-J.L., S.L., R.L.G., K.A.)
| | | | - Chee Fang Sum
- Diabetes Centre, Admiralty Medical Centre, Singapore (F.S., S.T., S.C.L.)
| | | | - Samy Hadjadj
- L’institut du thorax, INSERM, CNRS, UNIV Nantes, CHU Nantes, France (S.H.)
| | - Su Chi Lim
- Diabetes Centre, Admiralty Medical Centre, Singapore (F.S., S.T., S.C.L.)
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore (S.C.L.)
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29
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Papaioannou TG, Oikonomou E, Lazaros G, Christoforatou E, Vogiatzi G, Tsalamandris S, Chasikidis C, Kalambogias A, Mystakidi VX, Galiatsatos N, Santouri M, Latsios G, Deftereos S, Tousoulis D. The influence of resting heart rate on pulse wave velocity measurement is mediated by blood pressure and depends on aortic stiffness levels: insights from the Corinthia study. Physiol Meas 2019; 40:055005. [DOI: 10.1088/1361-6579/ab165f] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
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30
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Mao W, Jin X, Wang H, Ye Y, Zhang L, Gu S, Wang J, Ning G, Mu Y. The Association between Resting Heart Rate and Urinary Albumin/Creatinine Ratio in Middle-Aged and Elderly Chinese Population: A Cross-Sectional Study. J Diabetes Res 2019; 2019:9718370. [PMID: 31534974 PMCID: PMC6732617 DOI: 10.1155/2019/9718370] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Accepted: 07/29/2019] [Indexed: 01/01/2023] Open
Abstract
OBJECTIVE In general population, resting heart rate (RHR) is associated with cardiovascular disease. However, its relation to chronic kidney disease (CKD) is debated. We therefore investigated the relationship between RHR and urinary albumin/creatinine ratio (UACR, an indicator of early kidney injury) in general population at different levels of blood pressure and blood glucose. METHODS We screened out 32,885 subjects from the REACTION study after excluding the subjects with primary kidney disease, heart disease, tumor history, related drug application, and important data loss. The whole group was divided into four groups (Q1: RHR ≤ 71, Q2: 72 ≤ RHR ≤ 78, Q3: 79 ≤ RHR ≤ 86, and Q4: 87 ≤ RHR) according to the quartile of average resting heart rate. The renal function was evaluated by UACR (divided by quartiles of all data in the center to which the subject belonged). Ordinary logistic regression was carried out to explore the association between RHR and UACR at diverse blood pressure and blood glucose levels. RESULTS The subjects with higher RHR quartile tend to have a higher UACR, even multifactors were adjusted. After stratifying the subjects according to blood pressure and blood glucose, the positive relationship between RHR and UACR remained in the subjects with normal blood pressure and normal glucose tolerance, while in the hypertension (SBP ≥ 140 mmHg and/or DBP ≥ 90 mmHg) group and the diabetic mellitus (FPG ≥ 7.0 mmol/L and/or PPG ≥ 11.1 mmol/L) group, the relationship disappeared. In the subjects without hypertension, compared with the Q1 group, the UACR is significant higher in the Q3 group (OR: 1.11) and the Q4 group (OR: 1.22). In the subjects with normal glucose tolerance (NGT), compared with the Q1 group, the UACR is significantly higher in the Q3 group (OR: 1.13) and the Q4 group (OR: 1.19). CONCLUSIONS The population with higher RHR tend to have a higher UACR in the normal blood pressure group and the normal glucose tolerance group.
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Affiliation(s)
- Wenfeng Mao
- Department of Endocrinology, Chinese People's Liberation Army General Hospital, No. 28 Fuxing Road, Beijing 100853, China
- School of Medicine, Nankai University, No. 94 Weijin Road, Tianjin 300071, China
| | - Xinye Jin
- Department of Endocrinology, Chinese People's Liberation Army General Hospital, No. 28 Fuxing Road, Beijing 100853, China
| | - Haibin Wang
- Department of Endocrinology, Chinese People's Liberation Army General Hospital, No. 28 Fuxing Road, Beijing 100853, China
| | - Yingnan Ye
- Department of Endocrinology, Chinese People's Liberation Army General Hospital, No. 28 Fuxing Road, Beijing 100853, China
- School of Medicine, Nankai University, No. 94 Weijin Road, Tianjin 300071, China
| | - Linxi Zhang
- Department of Endocrinology, Chinese People's Liberation Army General Hospital, No. 28 Fuxing Road, Beijing 100853, China
| | - Shi Gu
- Department of Endocrinology, Chinese People's Liberation Army General Hospital, No. 28 Fuxing Road, Beijing 100853, China
- School of Medicine, Nankai University, No. 94 Weijin Road, Tianjin 300071, China
| | - Jie Wang
- Department of Endocrinology, Chinese People's Liberation Army General Hospital, No. 28 Fuxing Road, Beijing 100853, China
- School of Medicine, Nankai University, No. 94 Weijin Road, Tianjin 300071, China
| | - Guang Ning
- Department of Endocrinology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200025, China
| | - Yiming Mu
- Department of Endocrinology, Chinese People's Liberation Army General Hospital, No. 28 Fuxing Road, Beijing 100853, China
- School of Medicine, Nankai University, No. 94 Weijin Road, Tianjin 300071, China
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31
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Huo Y, Chen H, Kassab GS. Acute Tachycardia Increases Aortic Distensibility, but Reduces Total Arterial Compliance Up to a Moderate Heart Rate. Front Physiol 2018; 9:1634. [PMID: 30510518 PMCID: PMC6252350 DOI: 10.3389/fphys.2018.01634] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2017] [Accepted: 10/29/2018] [Indexed: 12/02/2022] Open
Abstract
Background: The differential effects of rapid cardiac pacing on small and large vessels have not been well-established. The objective of this study was to investigate the effect of pacing-induced acute tachycardia on hemodynamics and arterial stiffness. Methods: The pressure and flow waves in ascending aorta and femoral artery of six domestic swine were recorded simultaneously at baseline and heart rates (HR) of 135 and 155 beats per minutes (bpm) and analyzed by the models of Windkessel and Womersley types. Accordingly, the flow waves were simultaneously measured at carotid and femoral arteries to quantify aortic pulse wave velocity (PWV). The arterial distensibility was identified in small branches of coronary, carotid and femoral arteries with diameters of 300–600 μm by ex vivo experiments. Results: The rapid pacing in HR up to 135 bpm reduced the total arterial compliance, stroke volume, systemic pulse pressure, and central systolic pressure by 36 ± 17, 38 ± 26, 29 ± 16, and 23 ± 12%, respectively, despite no statistical difference of mean aortic pressure, cardiac output, peripheral resistance, and vascular flow patterns. The pacing also resulted in a decrease of distensibility of small muscular arteries, but an increase of aortic distensibility. Pacing from 135 to 155 bpm had negligible effects on systemic and local hemodynamics and arterial stiffness. Conclusions: There is an acute mismatch in the response of aorta and small arteries to pacing from basal HR to 135 bpm, which may have important pathological implications under chronic tachycardia conditions.
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Affiliation(s)
- Yunlong Huo
- PKU-HKUST Shenzhen-Hongkong Institution, Shenzhen, China.,Department of Mechanics and Engineering Science, College of Engineering, Peking University, Beijing, China
| | - Huan Chen
- California Medical Innovations Institute, San Diego, CA, United States
| | - Ghassan S Kassab
- California Medical Innovations Institute, San Diego, CA, United States
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32
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Sarajlic P, Fridén C, Lund LH, Manouras A, Venkateshvaran A, Larsson SC, Nordgren B, Opava CH, Lundberg IE, Bäck M. Enhanced ventricular-arterial coupling during a 2-year physical activity programme in patients with rheumatoid arthritis: a prospective substudy of the physical activity in rheumatoid arthritis 2010 trial. J Intern Med 2018; 284:664-673. [PMID: 29143384 DOI: 10.1111/joim.12715] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
OBJECTIVE To establish how guided physical activity in patients with rheumatoid arthritis (RA) without known cardiovascular disease affected vascular and cardiac function, and how these two entities were prospectively interconnected in this patient group. METHODS Prospective substudy of 29 participants in the Physical Activity in RA (PARA) 2010 trial. All subjects were examined at baseline, at year 1 and 2 with measures of pulse wave velocity and arterial augmentation index, as well as echocardiographic evaluation of diastolic parameters and ventricular-arterial coupling. Muscle strength and aerobic exercise capacity were assessed at baseline and yearly. All participants performed physiotherapist-guided aerobic and muscle strength exercise during 2 years and were reminded through SMS to report physical activity progress. RESULTS This cohort of patients with RA exhibited increased vascular stiffness despite normal blood pressure. At baseline, lower muscle strength was associated with increased vascular stiffness (β = 0.68; P = 0.004), whereas lower aerobic working capacity was associated with left ventricular diastolic dysfunction (β = 0.85; P = 0.03). There was a significant positive correlation between vascular stiffness and diastolic dysfunction at baseline (R2 = 0.64) and for the changes in those parameters observed during 2 years of guided physical activity. Finally, a significant improvement in ventricular-arterial coupling was observed after exercise (P < 0.001). CONCLUSION These results indicate that although differentially associated with physical capacity parameters, improved vascular stiffness and improved diastolic dysfunction are interrelated, and that an optimization of the ventricular-arterial coupling may contribute to the beneficial effects of physical activity in patients with RA.
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Affiliation(s)
- P Sarajlic
- Department of Medicine Solna, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
| | - C Fridén
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
| | - L H Lund
- Department of Medicine Solna, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden.,Heart and Vascular Theme Division of Heart Failure, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
| | - A Manouras
- Department of Medicine Solna, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden.,Heart and Vascular Theme Division of Heart Failure, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
| | - A Venkateshvaran
- Department of Medicine Solna, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden.,Heart and Vascular Theme Division of Heart Failure, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
| | - S C Larsson
- Institute of Environmental Medicine, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
| | - B Nordgren
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
| | - C H Opava
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
| | - I E Lundberg
- Department of Medicine Solna, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden.,Rheumatology Unit, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
| | - M Bäck
- Department of Medicine Solna, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden.,Heart and Vascular Theme Division of Valvular and Coronary Disease, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
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33
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Patton DM, Li T, Hétu MF, Day AG, Preece E, Matangi MF, Johri AM. Speckle tracking carotid artery circumferential strain is a marker of arterial sclerosis but not coronary atherosis. JOURNAL OF CLINICAL ULTRASOUND : JCU 2018; 46:575-581. [PMID: 30105752 DOI: 10.1002/jcu.22632] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/30/2017] [Revised: 07/03/2018] [Accepted: 07/13/2018] [Indexed: 06/08/2023]
Abstract
PURPOSE Circumferential speckle tracking carotid artery strain is a novel method of quantifying vessel wall stiffness. We hypothesized that carotid wall stiffness would be associated with carotid intimal medial thickening (a medial process associated with risk factors), but not coronary artery disease (an intimal process). METHODS Bilateral carotid artery ultrasound was conducted on outpatients who had previously undergone elective coronary angiography. Mean carotid artery far wall circumferential strain (FWCS) was assessed for correlations with coronary angiographic stenosis, cardiac risk factors, carotid intima-media thickness (CIMT), and carotid plaque. RESULTS One hundred and sixty five (165) patients were studied. No significant association was found between the presence of coronary artery disease on angiography and mean FWCS. FWCS was higher in current tobacco smokers. In addition, carotid strain was found to decrease with increased age (r = -0.33, P < 0.001). When adjusted for pulse pressure (PP), FWCS/PP was negatively correlated with mean CIMT (r = -0.29, P = 0.002) and bulb maximum plaque height (r = -0.27, P = 0.004). Hypertension and diabetes were associated with decreased FWCS/PP (increased wall stiffness). CONCLUSIONS While no clear relationship between carotid strain and coronary artery disease was observed, increased CIMT, carotid plaque, and cardiac risk factors were associated with decreased carotid strain. Further work is required to explore the relationship between carotid strain and cardiovascular events.
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Affiliation(s)
- Daniel M Patton
- Division of Cardiology, Cardiovascular Imaging Network at Queen's, Department of Medicine, Queen's University, Kingston, Ontario, Canada
| | - Terry Li
- Division of Cardiology, Cardiovascular Imaging Network at Queen's, Department of Medicine, Queen's University, Kingston, Ontario, Canada
| | - Marie-France Hétu
- Division of Cardiology, Cardiovascular Imaging Network at Queen's, Department of Medicine, Queen's University, Kingston, Ontario, Canada
| | - Andrew G Day
- Division of Cardiology, Cardiovascular Imaging Network at Queen's, Department of Medicine, Queen's University, Kingston, Ontario, Canada
| | - Erika Preece
- Division of Cardiology, Cardiovascular Imaging Network at Queen's, Department of Medicine, Queen's University, Kingston, Ontario, Canada
| | | | - Amer M Johri
- Division of Cardiology, Cardiovascular Imaging Network at Queen's, Department of Medicine, Queen's University, Kingston, Ontario, Canada
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34
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Amoakwa K, Fashanu OE, Tibuakuu M, Zhao D, Guallar E, Whelton SP, O'Neal WT, Post WS, Budoff MJ, Michos ED. Resting heart rate and the incidence and progression of valvular calcium: The Multi-Ethnic Study of Atherosclerosis (MESA). Atherosclerosis 2018; 273:45-52. [PMID: 29677630 PMCID: PMC5949274 DOI: 10.1016/j.atherosclerosis.2018.04.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2017] [Revised: 03/05/2018] [Accepted: 04/05/2018] [Indexed: 12/16/2022]
Abstract
BACKGROUND AND AIMS Left-sided valvular calcification is associated with cardiovascular disease (CVD) morbidity and mortality. Resting heart rate (RHR) may influence valvular calcium progression through shear stress. Whether RHR, an established CVD risk factor, is associated with valvular calcium progression is unknown. We assessed whether RHR predicts incidence and progression of mitral annular calcium (MAC) and aortic valve calcium (AVC) in a community-based cohort free of CVD at baseline. METHODS RHR was obtained from baseline electrocardiograms of 5498 MESA participants. MAC and AVC were quantified using Agatston scoring from cardiac computed tomography scans obtained at baseline and at a second examination during follow-up. We examined associations of RHR with incident MAC/AVC and annual change in MAC/AVC scores, after adjusting for demographics, CVD risk factors, physical activity, and atrioventricular nodal blocker use. RESULTS At baseline, participants had mean age of 62 ± 10 years and mean RHR of 63 ± 10 bpm; 12.3% and 8.9% had prevalent AVC and MAC, respectively. Over a median of 2.3 years, 4.1% and 4.5% developed incident AVC and MAC, respectively. Each 10 bpm higher RHR was significantly associated with incident MAC [Risk Ratio 1.17 (95% CI 1.03-1.34)], but not incident AVC. However, RHR was associated with AVC progression [β = 1.62 (0.45-2.80) Agatston units/year for every 10 bpm increment], but not MAC progression. CONCLUSIONS Higher RHR was associated with MAC incidence and AVC progression, independent of traditional CVD risk factors. Future studies are needed to determine whether modification of RHR through lifestyle or pharmacologic interventions can reduce valvular calcium incidence or progression.
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Affiliation(s)
| | - Oluwaseun E Fashanu
- Ciccarone Center for the Prevention of Cardiovascular Disease, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Martin Tibuakuu
- Ciccarone Center for the Prevention of Cardiovascular Disease, Johns Hopkins School of Medicine, Baltimore, MD, USA; Department of Medicine, St. Luke's Hospital, Chesterfield, MO, USA
| | - Di Zhao
- Ciccarone Center for the Prevention of Cardiovascular Disease, Johns Hopkins School of Medicine, Baltimore, MD, USA; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Eliseo Guallar
- Ciccarone Center for the Prevention of Cardiovascular Disease, Johns Hopkins School of Medicine, Baltimore, MD, USA; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Seamus P Whelton
- Ciccarone Center for the Prevention of Cardiovascular Disease, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Wesley T O'Neal
- Department of Medicine, Division of Cardiology, Emory University School of Medicine, Atlanta, GA, USA
| | - Wendy S Post
- Ciccarone Center for the Prevention of Cardiovascular Disease, Johns Hopkins School of Medicine, Baltimore, MD, USA; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Matthew J Budoff
- Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Los Angeles, CA, USA
| | - Erin D Michos
- Ciccarone Center for the Prevention of Cardiovascular Disease, Johns Hopkins School of Medicine, Baltimore, MD, USA; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
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35
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Weir-McCall JR, Liu-Shiu-Cheong PS, Struthers AD, Lipworth BJ, Houston JG. Disconnection of pulmonary and systemic arterial stiffness in COPD. Int J Chron Obstruct Pulmon Dis 2018; 13:1755-1765. [PMID: 29881265 PMCID: PMC5978466 DOI: 10.2147/copd.s160077] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
Abstract
Background Both pulmonary arterial stiffening and systemic arterial stiffening have been described in COPD. The aim of the current study was to assess pulse wave velocity (PWV) within these two arterial beds to determine whether they are separate or linked processes. Materials and methods In total, 58 participants with COPD and 21 healthy volunteers (HVs) underwent cardiac magnetic resonance imaging (MRI) and were tested with a panel of relevant biomarkers. Cardiac MRI was used to quantify ventricular mass, volumes, and pulmonary (pulse wave velocity [pPWV] and systemic pulse wave velocity [sPWV]). Results Those with COPD had higher pPWV (COPD: 2.62 vs HV: 1.78 ms−1, p=0.006), higher right ventricular mass/volume ratio (RVMVR; COPD: 0.29 vs HV: 0.25 g/mL, p=0.012), higher left ventricular mass/volume ratio (LVMVR; COPD: 0.78 vs HV: 0.70 g/mL, p=0.009), and a trend toward a higher sPWV (COPD: 8.7 vs HV: 7.4 ms−1, p=0.06). Multiple biomarkers were elevated: interleukin-6 (COPD: 1.38 vs HV: 0.58 pg/mL, p=0.02), high-sensitivity C-reactive protein (COPD: 6.42 vs HV: 2.49 mg/L, p=0.002), surfactant protein D (COPD: 16.9 vs HV: 9.13 ng/mL, p=0.001), N-terminal pro-brain natriuretic peptide (COPD: 603 vs HV: 198 pg/mL, p=0.001), and high-sensitivity troponin I (COPD: 2.27 vs HV: 0.92 pg/mL, p<0.001). There was a significant relationship between sPWV and LVMVR (p=0.01) but not pPWV (p=0.97) nor between pPWV and RVMVR (p=0.27). Conclusion Pulmonary arterial stiffening and systemic arterial stiffening appear to be disconnected and should therefore be considered independent processes in COPD. Further work is warranted to determine whether both these cause an increased morbidity and mortality and whether both can be targeted by similar pharmacological therapy or whether different strategies are required for each.
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Affiliation(s)
- Jonathan R Weir-McCall
- Division of Molecular and Clinical Medicine, Medical Research Institute, University of Dundee, Dundee, UK
| | | | - Allan D Struthers
- Division of Molecular and Clinical Medicine, Medical Research Institute, University of Dundee, Dundee, UK
| | - Brian J Lipworth
- Scottish Centre for Respiratory Research, Medical Research Institute, University of Dundee, Dundee, UK
| | - J Graeme Houston
- Division of Molecular and Clinical Medicine, Medical Research Institute, University of Dundee, Dundee, UK
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36
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Hu J, Teng CG, Chu GP, Han D, Fu H, Zhou YK, Wang Q, Wang B, Shen H, Liu F, Yang HB. Effects of resting heart rate on blood pressure and hypertension in Chinese children: findings from blood pressure surveillance program. Clin Exp Hypertens 2018; 41:1-7. [PMID: 29553835 DOI: 10.1080/10641963.2018.1451537] [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: 01/11/2018] [Revised: 02/28/2018] [Accepted: 03/07/2018] [Indexed: 01/13/2023]
Abstract
The purpose of this study was to analyze the association between resting heart rate (RHR) and prevalence of hypertension in Chinese children and to identify if this association was mediated by body mass index (BMI). The data of 5445 children who participated in the Blood Pressure Surveillance Program (2011-2017) were analyzed in this study. Children were divided into four groups according to quartiles of RHR in boys and girls, respectively. Compared to those in the first quartile, boys and girls in the fourth quartile were 3.06 (95% CI 2.12, 4.41) and 4.94 (95% CI 3.21, 7.61) times more likely to have hypertension, respectively. Meanwhile, every 10 beats per minute (bpm) increase in RHR was associated with a 41% (95% CI 1.27, 1.56) and 66% (95% CI 1.49, 1.85) greater risk of hypertension in boys and girls, respectively. There were no significant interactions between RHR and BMI on the prevalence of hypertension. This study confirms the existence of a relationship between elevated RHR and increased risk of hypertension in children, independent of BMI. An elevated RHR could be considered as a risk factor for the risk assessment of hypertension, no matter from a clinical setting or a public health perspective.
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Affiliation(s)
- Jia Hu
- a Suzhou Center for Disease Prevention and Control , Suzhou , Jiangsu , China
| | - Chen-Gang Teng
- a Suzhou Center for Disease Prevention and Control , Suzhou , Jiangsu , China
| | - Guang-Ping Chu
- b Health Center for Women and Children of Gusu District , Suzhou , Jiangsu , China
| | - Di Han
- a Suzhou Center for Disease Prevention and Control , Suzhou , Jiangsu , China
| | - Han Fu
- c Xi'an Center for Disease Control and Prevention , Xi'an , Shaanxi , China
| | - Yi-Kai Zhou
- d MOE Key Lab of Environment and Health , Institute of Environmental Medicine, School of Public Health, Tongji Medical College, Huazhong University of Science & Technology , Wuhan , Hubei , China
| | - Qi Wang
- e Department of Epidemiology and Biostatistics, School of Public Health , Tongji Medical College, Huazhong University of Science and Technology , Wuhan , Hubei , China
| | - Bo Wang
- a Suzhou Center for Disease Prevention and Control , Suzhou , Jiangsu , China
| | - Hui Shen
- a Suzhou Center for Disease Prevention and Control , Suzhou , Jiangsu , China
| | - Fang Liu
- a Suzhou Center for Disease Prevention and Control , Suzhou , Jiangsu , China
| | - Hai-Bing Yang
- a Suzhou Center for Disease Prevention and Control , Suzhou , Jiangsu , China
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37
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Xiao H, Tan I, Butlin M, Li D, Avolio AP. Mechanism underlying the heart rate dependency of wave reflection in the aorta: a numerical simulation. Am J Physiol Heart Circ Physiol 2018; 314:H443-H451. [DOI: 10.1152/ajpheart.00559.2017] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Affiliation(s)
- Hanguang Xiao
- Chongqing Key Laboratory of Modern Photoelectric Detection Technology and Instrument, Chongqing Key Laboratory of Fiber Optic Sensor and Photodetector, Chongqing University of Technology, Chongqing, China
| | - Isabella Tan
- Department of Biomedical Sciences, Faculty of Medicine and Health Sciences, Macquarie University, New South Wales, Australia
| | - Mark Butlin
- Department of Biomedical Sciences, Faculty of Medicine and Health Sciences, Macquarie University, New South Wales, Australia
| | - Decai Li
- Sichuan Mianyang 404 Hospital, Mianyang, Sichuan Province, China
| | - Alberto P. Avolio
- Department of Biomedical Sciences, Faculty of Medicine and Health Sciences, Macquarie University, New South Wales, Australia
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38
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Nakanishi K, Jin Z, Homma S, Elkind MSV, Rundek T, Lee SC, Tugcu A, Yoshita M, DeCarli C, Wright CB, Sacco RL, Di Tullio MR. Association Between Heart Rate and Subclinical Cerebrovascular Disease in the Elderly. Stroke 2017; 49:319-324. [PMID: 29284731 DOI: 10.1161/strokeaha.117.019355] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2017] [Revised: 11/07/2017] [Accepted: 11/27/2017] [Indexed: 01/20/2023]
Abstract
BACKGROUND AND PURPOSE Although increased heart rate (HR) is a predictor of cardiovascular events and mortality, its possible association with subclinical cerebrovascular disease, which is prevalent in the elderly, has not been evaluated. This study aimed to investigate the association of daytime, nighttime, 24-hour HR, and HR variability with subclinical cerebrovascular disease in an elderly cohort without history of stroke. METHODS The study cohort consisted of 680 participants (mean age, 73±7 years; 42% men) in sinus rhythm who underwent 24-hour ambulatory blood pressure and HR monitoring, 2-dimensional echocardiography, and brain magnetic resonance imaging as part of the CABL study (Cardiac Abnormalities and Brain Lesion). Subclinical cerebrovascular disease was defined as silent brain infarcts and white matter hyperintensity volume (WMHV). The relationship of HR measures with the presence of silent brain infarct and upper quartile of log WMHV (log WMHV4) was analyzed. RESULTS Presence of silent brain infarct was detected in 93 participants (13.7%); mean log WMHV was -0.92±0.93 (median, -1.05; min, -5.88; max, 1.74). Multivariate analysis showed that only nighttime HR (adjusted odds ratio, 1.29 per 10 bpm; 95% confidence interval, 1.03-1.61; P=0.026) was significantly associated with log WMHV4, independent of traditional cardiovascular risk factors, ambulatory systolic blood pressure, and echocardiographic parameters. No similar association was observed for daytime HR and HR variability. There was no significant association between all HR measures and silent brain infarct. CONCLUSIONS In a predominantly elderly cohort, elevated nighttime HR was associated with WMHV, suggesting an independent role of HR in subclinical cerebrovascular disease.
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Affiliation(s)
- Koki Nakanishi
- From the Department of Medicine (K.N., S.H., S.C.L., A.T., M.R.D.T.), Department of Biostatistics (Z.J.), and Departments of Neurology and Epidemiology (M.S.V.E.), Columbia University, New York, NY; Department of Neurology (T.R., C.B.W., R.L.S.), Department of Public Health Sciences (T.R., C.B.W., R.L.S.), and Department of Human Genetics (R.L.S.), Miller School of Medicine, University of Miami, FL; Department of Neurology, Hokuriku National Hospital, Nanto, Japan (M.Y.); and Department of Neurology, University of California at Davis (C.D.)
| | - Zhezhen Jin
- From the Department of Medicine (K.N., S.H., S.C.L., A.T., M.R.D.T.), Department of Biostatistics (Z.J.), and Departments of Neurology and Epidemiology (M.S.V.E.), Columbia University, New York, NY; Department of Neurology (T.R., C.B.W., R.L.S.), Department of Public Health Sciences (T.R., C.B.W., R.L.S.), and Department of Human Genetics (R.L.S.), Miller School of Medicine, University of Miami, FL; Department of Neurology, Hokuriku National Hospital, Nanto, Japan (M.Y.); and Department of Neurology, University of California at Davis (C.D.)
| | - Shunichi Homma
- From the Department of Medicine (K.N., S.H., S.C.L., A.T., M.R.D.T.), Department of Biostatistics (Z.J.), and Departments of Neurology and Epidemiology (M.S.V.E.), Columbia University, New York, NY; Department of Neurology (T.R., C.B.W., R.L.S.), Department of Public Health Sciences (T.R., C.B.W., R.L.S.), and Department of Human Genetics (R.L.S.), Miller School of Medicine, University of Miami, FL; Department of Neurology, Hokuriku National Hospital, Nanto, Japan (M.Y.); and Department of Neurology, University of California at Davis (C.D.)
| | - Mitchell S V Elkind
- From the Department of Medicine (K.N., S.H., S.C.L., A.T., M.R.D.T.), Department of Biostatistics (Z.J.), and Departments of Neurology and Epidemiology (M.S.V.E.), Columbia University, New York, NY; Department of Neurology (T.R., C.B.W., R.L.S.), Department of Public Health Sciences (T.R., C.B.W., R.L.S.), and Department of Human Genetics (R.L.S.), Miller School of Medicine, University of Miami, FL; Department of Neurology, Hokuriku National Hospital, Nanto, Japan (M.Y.); and Department of Neurology, University of California at Davis (C.D.)
| | - Tatjana Rundek
- From the Department of Medicine (K.N., S.H., S.C.L., A.T., M.R.D.T.), Department of Biostatistics (Z.J.), and Departments of Neurology and Epidemiology (M.S.V.E.), Columbia University, New York, NY; Department of Neurology (T.R., C.B.W., R.L.S.), Department of Public Health Sciences (T.R., C.B.W., R.L.S.), and Department of Human Genetics (R.L.S.), Miller School of Medicine, University of Miami, FL; Department of Neurology, Hokuriku National Hospital, Nanto, Japan (M.Y.); and Department of Neurology, University of California at Davis (C.D.)
| | - Seitetz C Lee
- From the Department of Medicine (K.N., S.H., S.C.L., A.T., M.R.D.T.), Department of Biostatistics (Z.J.), and Departments of Neurology and Epidemiology (M.S.V.E.), Columbia University, New York, NY; Department of Neurology (T.R., C.B.W., R.L.S.), Department of Public Health Sciences (T.R., C.B.W., R.L.S.), and Department of Human Genetics (R.L.S.), Miller School of Medicine, University of Miami, FL; Department of Neurology, Hokuriku National Hospital, Nanto, Japan (M.Y.); and Department of Neurology, University of California at Davis (C.D.)
| | - Aylin Tugcu
- From the Department of Medicine (K.N., S.H., S.C.L., A.T., M.R.D.T.), Department of Biostatistics (Z.J.), and Departments of Neurology and Epidemiology (M.S.V.E.), Columbia University, New York, NY; Department of Neurology (T.R., C.B.W., R.L.S.), Department of Public Health Sciences (T.R., C.B.W., R.L.S.), and Department of Human Genetics (R.L.S.), Miller School of Medicine, University of Miami, FL; Department of Neurology, Hokuriku National Hospital, Nanto, Japan (M.Y.); and Department of Neurology, University of California at Davis (C.D.)
| | - Mitsuhiro Yoshita
- From the Department of Medicine (K.N., S.H., S.C.L., A.T., M.R.D.T.), Department of Biostatistics (Z.J.), and Departments of Neurology and Epidemiology (M.S.V.E.), Columbia University, New York, NY; Department of Neurology (T.R., C.B.W., R.L.S.), Department of Public Health Sciences (T.R., C.B.W., R.L.S.), and Department of Human Genetics (R.L.S.), Miller School of Medicine, University of Miami, FL; Department of Neurology, Hokuriku National Hospital, Nanto, Japan (M.Y.); and Department of Neurology, University of California at Davis (C.D.)
| | - Charles DeCarli
- From the Department of Medicine (K.N., S.H., S.C.L., A.T., M.R.D.T.), Department of Biostatistics (Z.J.), and Departments of Neurology and Epidemiology (M.S.V.E.), Columbia University, New York, NY; Department of Neurology (T.R., C.B.W., R.L.S.), Department of Public Health Sciences (T.R., C.B.W., R.L.S.), and Department of Human Genetics (R.L.S.), Miller School of Medicine, University of Miami, FL; Department of Neurology, Hokuriku National Hospital, Nanto, Japan (M.Y.); and Department of Neurology, University of California at Davis (C.D.)
| | - Clinton B Wright
- From the Department of Medicine (K.N., S.H., S.C.L., A.T., M.R.D.T.), Department of Biostatistics (Z.J.), and Departments of Neurology and Epidemiology (M.S.V.E.), Columbia University, New York, NY; Department of Neurology (T.R., C.B.W., R.L.S.), Department of Public Health Sciences (T.R., C.B.W., R.L.S.), and Department of Human Genetics (R.L.S.), Miller School of Medicine, University of Miami, FL; Department of Neurology, Hokuriku National Hospital, Nanto, Japan (M.Y.); and Department of Neurology, University of California at Davis (C.D.)
| | - Ralph L Sacco
- From the Department of Medicine (K.N., S.H., S.C.L., A.T., M.R.D.T.), Department of Biostatistics (Z.J.), and Departments of Neurology and Epidemiology (M.S.V.E.), Columbia University, New York, NY; Department of Neurology (T.R., C.B.W., R.L.S.), Department of Public Health Sciences (T.R., C.B.W., R.L.S.), and Department of Human Genetics (R.L.S.), Miller School of Medicine, University of Miami, FL; Department of Neurology, Hokuriku National Hospital, Nanto, Japan (M.Y.); and Department of Neurology, University of California at Davis (C.D.)
| | - Marco R Di Tullio
- From the Department of Medicine (K.N., S.H., S.C.L., A.T., M.R.D.T.), Department of Biostatistics (Z.J.), and Departments of Neurology and Epidemiology (M.S.V.E.), Columbia University, New York, NY; Department of Neurology (T.R., C.B.W., R.L.S.), Department of Public Health Sciences (T.R., C.B.W., R.L.S.), and Department of Human Genetics (R.L.S.), Miller School of Medicine, University of Miami, FL; Department of Neurology, Hokuriku National Hospital, Nanto, Japan (M.Y.); and Department of Neurology, University of California at Davis (C.D.).
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Vargas-Hitos JA, Soriano-Maldonado A, Martínez-Bordonado J, Sánchez-Berná I, Fernández-Bergés D, Sabio JM. Association of Resting Heart Rate With Arterial Stiffness and Low-Grade Inflammation in Women With Systemic Lupus Erythematosus. Angiology 2017; 69:672-676. [PMID: 29232972 DOI: 10.1177/0003319717746525] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
Resting heart rate (RHR) is associated with arterial stiffness, inflammation, and cardiovascular (CV) and all-cause mortality in the general population and in patients at high CV risk. We assessed the association of RHR with arterial stiffness and low-grade inflammation (LGI) in a cross-sectional study that included 101 women with systemic lupus erythematosus (SLE) without a history of CV disease or arrhythmia or who were under treatment that may cause bradycardia. Pulse wave velocity (PWV; a measure of arterial stiffness), RHR, and markers of LGI (ie, C-reactive protein, fibrinogen, erythrocyte sedimentation rate, insulin, and homeostatic model assessment index) were measured. The patients with the highest RHR (quartile 4; mean RHR = 87.2 bpm) had a PWV 0.61 m/s (95% confidence interval [CI]: 0.08-1.14; P = .024) greater than patients with the lowest RHR (quartile 1; RHR = 63.0 bpm), independent of age, systolic blood pressure, disease activity, smoking, and being physically inactive. Similarly, patients with the highest RHR (quartile 4) showed a significantly less favorable clustered LGI index than patients in quartile 1 ( b = .58; 95% CI: 0.212-0.948; P = .002). Higher RHR is associated with greater arterial stiffness and LGI in women with SLE. Further research to determine the prognostic value of RHR in this population is warranted.
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Affiliation(s)
- José Antonio Vargas-Hitos
- 1 Systemic Autoimmune Diseases Unit, Department of Internal Medicine, Virgen de las Nieves University Hospital, Granada, Spain.,* Dr Vargas-Hitos and Dr Soriano-Maldonado contributed equally to this work
| | - Alberto Soriano-Maldonado
- 2 Department of Education, Faculty of Education Sciences, University of Almería, Almería, Spain.,3 SPORT Research Group (CTS-1024), CERNEP Research Center, University of Almería, Almería, Spain.,* Dr Vargas-Hitos and Dr Soriano-Maldonado contributed equally to this work
| | - Josefa Martínez-Bordonado
- 1 Systemic Autoimmune Diseases Unit, Department of Internal Medicine, Virgen de las Nieves University Hospital, Granada, Spain
| | - Isabel Sánchez-Berná
- 1 Systemic Autoimmune Diseases Unit, Department of Internal Medicine, Virgen de las Nieves University Hospital, Granada, Spain
| | - Daniel Fernández-Bergés
- 4 Area de Salud Don Benito-Villanueva, Unidad de Investigación, Programa de Enfermedades Cardiovasculares (PERICLES), Grupo Investigación Multidisciplinar Extremeño (GRIMEX), Villanueva de la Serena, Badajoz, Spain
| | - José Mario Sabio
- 1 Systemic Autoimmune Diseases Unit, Department of Internal Medicine, Virgen de las Nieves University Hospital, Granada, Spain
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Yu J, Dai L, Zhao Q, Liu X, Chen S, Wang A, Su Z, Wu S. Association of Cumulative Exposure to Resting Heart Rate with Risk of Stroke in General Population: The Kailuan Cohort Study. J Stroke Cerebrovasc Dis 2017; 26:2501-2509. [DOI: 10.1016/j.jstrokecerebrovasdis.2017.05.037] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2017] [Revised: 05/22/2017] [Accepted: 05/28/2017] [Indexed: 01/29/2023] Open
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Hu J, Shen H, Chu GP, Fu H, Huang FF, Zheng YM, Han D, Zhou YK, Wang Q, Wang B, Teng CG, Liu F, Yang HB. Association of elevated resting pulse rate with increased risk of hypertension development in children: A prospective study in Suzhou, China. Medicine (Baltimore) 2017; 96:e7696. [PMID: 28796052 PMCID: PMC5556218 DOI: 10.1097/md.0000000000007696] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND Elevated resting heart rate (RHR) or resting pulse rate (RPR) is associated with increased risk of hypertension development. However, information is limited to adults. The purpose of this study is to analyze this association among Chinese children in a prospective design. METHODS A total of 4861 children who participated in the Blood Pressure Surveillance Program (2011-2017) were selected in this research. To investigate the association between RPR and hypertension development, children were divided into 4 groups according to the quartiles of RPR at baseline. Odds ratios (ORs) with 95% confidence intervals (CIs) were calculated using logistic regression model. RESULTS Over a mean follow-up of 3.0 ± 0.1 years, there were 384 cases of incident hypertension. Compared to boys and girls in the 1st quartile, those in the 4th quartile were 1.73 (95% CI 1.13, 2.65), 2.22 (95% CI 1.43, 3.45) times more likely to have hypertension, respectively. Every 10 bpm increase in RPR was associated with a 26% greater risk of hypertension development in boys (OR: 1.26; 95% CI 1.10, 1.44), while this risk was 1.28 (95% CI 1.13, 1.44) in girls. Baseline blood pressure (BP) and body mass index (BMI) did not have significant interactions with RPR on risk of hypertension development. CONCLUSION This study confirms the relationship between elevated RPR and increased risk of hypertension development in children, independent of confounders including baseline BP and BMI. An elevated RPR could be considered as a risk factor for the assessment of hypertension, no matter from a clinical setting or a public health perspective.
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Affiliation(s)
- Jia Hu
- Suzhou Center for Disease Prevention and Control
| | - Hui Shen
- Suzhou Center for Disease Prevention and Control
| | - Guang-Ping Chu
- Health Center for Women and Children of Gusu District, Suzhou, Jiangsu
| | - Han Fu
- Xi’an Center for Disease Control and Prevention, Xi’an, Shaanxi Province
| | | | | | - Di Han
- Suzhou Center for Disease Prevention and Control
| | - Yi-Kai Zhou
- MOE Key Lab of Environment and Health, Institute of Environmental Medicine
| | - Qi Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Bo Wang
- Suzhou Center for Disease Prevention and Control
| | | | - Fang Liu
- Suzhou Center for Disease Prevention and Control
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Jae SY, Kurl S, Laukkanen JA, Yoon ES, Choi YH, Fernhall B, Franklin BA. Relation of heart rate recovery after exercise testing to coronary artery calcification. Ann Med 2017; 49:404-410. [PMID: 28166422 DOI: 10.1080/07853890.2017.1292044] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND We examined whether slow heart rate recovery (HRR) after exercise testing as an estimate of impaired autonomic function is related to coronary artery calcification (CAC), an emerging marker of coronary atherosclerosis. METHODS We evaluated 2088 men who participated in a health-screening program that included measures of CAC and peak or symptom-limited cardiopulmonary exercise testing. HRR was calculated as the difference between peak heart rate (HR) during exercise testing and the HR at 2 min of recovery after peak exercise. We measured CAC using multidetector computed tomography to calculate the Agatston coronary artery calcium score. Advanced CAC was defined as a mean CAC >75th percentile for each age group. RESULTS HRR was negatively correlated with CAC (r = -.14, p < .01). After adjusting for conventional risk factors, participants in the lowest quartile of HRR (<38 bpm) were 1.59 times (95% CI: 1.17-2.18; p < .05) more likely to have advanced CAC than their counterparts in the highest quartile of HRR (>52 bpm). Each 1 bpm decrease in HRR was associated with 1% increase in advanced CAC after adjusting for potential confounders. CONCLUSIONS An attenuated HRR after exercise testing is associated with advanced CAC, independent of coronary risk factors and other related hemodynamic response. KEY MESSAGES Slow heart rate recovery (HRR) after maximal exercise testing, indicating decreased autonomic function, is associated with an increased risk of cardiovascular event and mortality. Slow HRR has been linked with the occurrence of malignant ventricular arrhythmias, but it remains unclear whether slow HRR is associated with an increased risk of coronary artery calcification (CAC), an emerging marker of coronary atherosclerosis. An attenuated HRR after exercise testing was associated with advanced CAC, independent of coronary risk factors and other potential hemodynamic confounder, supporting the hypothesis that slow HRR is related to the burden of atherosclerotic coronary artery disease.
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Affiliation(s)
- Sae Young Jae
- a Department of Sport Science , University of Seoul , Seoul , South Korea
| | - Sudhir Kurl
- b Department of Medicine , Institute of Public Health and Clinical Nutrition, University of Eastern Finland , Kuopio , Finland
| | - Jari A Laukkanen
- b Department of Medicine , Institute of Public Health and Clinical Nutrition, University of Eastern Finland , Kuopio , Finland
| | - Eun Sun Yoon
- a Department of Sport Science , University of Seoul , Seoul , South Korea
| | - Yoon-Ho Choi
- c Center for Health Promotion, Samsung Medical Center , School of Medicine, Sungkyunkwan University , Seoul , South Korea
| | - Bo Fernhall
- d Department of Kinesiology and Nutrition , University of Illinois at Chicago , Chicago , IL , USA
| | - Barry A Franklin
- e Preventive Cardiology and Cardiac Rehabilitation , William Beaumont Hospital , Royal Oak , MI , USA
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Effects of cardiac timing and peripheral resistance on measurement of pulse wave velocity for assessment of arterial stiffness. Sci Rep 2017; 7:5990. [PMID: 28729696 PMCID: PMC5519778 DOI: 10.1038/s41598-017-05807-x] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2017] [Accepted: 06/05/2017] [Indexed: 11/09/2022] Open
Abstract
To investigate the effects of heart rate (HR), left ventricular ejection time (LVET) and wave reflection on arterial stiffness as assessed by pulse wave velocity (PWV), a pulse wave propagation simulation system (PWPSim) based on the transmission line model of the arterial tree was developed and was applied to investigate pulse wave propagation. HR, LVET, arterial elastic modulus and peripheral resistance were increased from 60 to 100 beats per minute (bpm), 0.1 to 0.45 seconds, 0.5 to 1.5 times and 0.5 to 1.5 times of the normal value, respectively. Carotid-femoral PWV (cfPWV) and brachial-ankle PWV (baPWV) were calculated by intersecting tangent method (cfPWVtan and baPWVtan), maximum slope (cfPWVmax and baPWVmax), and using the Moens-Korteweg equation ([Formula: see text] and [Formula: see text]). Results showed cfPWV and baPWV increased significantly with arterial elastic modulus but did not increase with HR when using a constant elastic modulus. However there were significant LVET dependencies of cfPWVtan and baPWVtan (0.17 ± 0.13 and 0.17 ± 0.08 m/s per 50 ms), and low peripheral resistance dependencies of cfPWVtan, cfPWVmax, baPWVtan and baPWVmax (0.04 ± 0.01, 0.06 ± 0.04, 0.06 ± 0.03 and 0.09 ± 0.07 m/s per 10% peripheral resistance), respectively. This study demonstrated that LVET dominates the effect on calculated PWV compared to HR and peripheral resistance when arterial elastic modulus is constant.
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Yu AR, Hasjim B, Yu LE, Gabriel C, Anshus A, Lee JB, Louthan MJ, Kim EC, Lee K, Tse C, Keown T, Lahham S, Alvarado M, Bunch S, Gari A, Fox JC. Comparison of ultrasound-measured properties of the common carotid artery to tobacco smoke exposure in a cohort of Indonesian patients. World J Emerg Med 2017; 8:177-183. [PMID: 28680513 DOI: 10.5847/wjem.j.1920-8642.2017.03.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND The purpose of this study was to use point-of-care ultrasound (POCUS) to investigate the relationship between tobacco smoke exposure and the characteristics of the common carotid artery (CCA). The effect of both primary and secondary smoking on CCA properties was evaluated. METHODS We performed a prospective cross-sectional study across 20 primary care clinics in Bandung, West Java, Indonesia in July 2016. Point of care ultrasound was performed on a convenience sample of Indonesian patients presenting to clinic. The CCA wall stiffness and carotid intima-media thickness (CIMT) were measured during diastole and systole. These measurements were correlated with smoke exposure and cardiovascular disease. RESULTS We enrolled 663 patients in the study, with 426 patients enrolled in the smoking category and 237 patients enrolled in the second-hand smoke category. There was an overall positive correlation with the measured lifestyle factors and the ultrasound-measured variables in the group of individuals who smoked. For all variables, age seemed to contribute the most out of all of the lifestyle factors for the positive changes in CIMT and CCA wall stiffness. CONCLUSION Our data yielded correlations between CCA properties and cardiovascular risk, as well as between CIMT and arterial stiffness. We were also able to demonstrate an increase in thickness of the CIMT in patients who have been exposed by tobacco through the use of ultrasound. Further large scale studies comparing patients with multiple cardiac risk factors need to be performed to confirm the utility of ultrasound findings of cardiovascular disease and stroke.
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Affiliation(s)
- Allen R Yu
- School of Medicine, University of California, Irvine, USA
| | - Bima Hasjim
- School of Medicine, University of California, Irvine, USA
| | - Luke E Yu
- School of Medicine, University of California, Irvine, USA
| | | | | | - Jonathan B Lee
- School of Medicine, University of California, Irvine, USA
| | | | - Esther C Kim
- School of Medicine, University of California, Irvine, USA
| | - Katrina Lee
- School of Medicine, University of California, Irvine, USA
| | - Christina Tse
- School of Medicine, University of California, Irvine, USA
| | - Thomas Keown
- School of Medicine, University of California, Irvine, USA
| | - Shadi Lahham
- Department of Emergency Medicine, University of California, Irvine, USA
| | - Maili Alvarado
- Department of Emergency Medicine, University of California, Irvine, USA
| | - Steven Bunch
- Department of Emergency Medicine, University of California, Irvine, USA
| | - Abdulatif Gari
- Department of Emergency Medicine, University of California, Irvine, USA
| | - J Christian Fox
- School of Medicine, University of California, Irvine, USA.,Department of Emergency Medicine, University of California, Irvine, USA
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Montero D, Dandanell S, Oberholzer L, Keiser S, Breenfeldt-Andersen A, Haider T, Merlini M, Meinild-Lundby AK, Lundby C. Combined effects of physical inactivity and acute hyperglycemia on arterial distensibility. Vasc Med 2017. [PMID: 28643554 DOI: 10.1177/1358863x17712103] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Arterial distensibility, an independent predictor of cardiovascular events, is transiently increased with acute hyperglycemia (AHG) in healthy individuals. Whether this response interacts with physical inactivity remains unknown. We examined the effects of short-term bed rest (BR) on the response of carotid artery distensibility (CD) to AHG, and the influence of underlying changes in insulin resistance and blood volume. CD was assessed with ultrasonography before as well as 30 and 120 minutes following ingestion of 75 g of glucose prior to and after 3 days of BR in 15 healthy male volunteers. Plasma insulin/glucose concentrations and blood volumes were concomitantly determined. On day 4 of BR, blood volume was re-established to pre-BR levels by albumin infusion and CD and insulin/glucose concentrations were determined as in the previous experimental days. Basal CD was not affected by BR. AHG increased CD before and after BR but reached a higher peak increment after BR (12% vs 60% at 30 min OGTT, p=0.028). BR also increased the plasma insulin concentration during AHG ( p=0.007). In regression analyses, plasma insulin and glucose concentrations were positively correlated to CD, particularly after BR ( r=0.31, p<0.05). Restoration of the BR-induced loss (5%) in blood volume did not affect the response of CD to AHG. In conclusion, short-term physical inactivity strongly accentuates the initial increase in CD in response to AHG in healthy individuals. This effect is associated with concomitant increases in circulating insulin concentration attributable to early insulin resistance.
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Affiliation(s)
- David Montero
- 1 Zurich Center for Integrative Human Physiology (ZIHP), Institute of Physiology, University of Zurich, Zurich, Switzerland.,2 University Heart Center, Department of Cardiology, University Hospital Zurich, Zurich, Switzerland
| | - Sune Dandanell
- 1 Zurich Center for Integrative Human Physiology (ZIHP), Institute of Physiology, University of Zurich, Zurich, Switzerland
| | - Laura Oberholzer
- 1 Zurich Center for Integrative Human Physiology (ZIHP), Institute of Physiology, University of Zurich, Zurich, Switzerland
| | - Stefanie Keiser
- 1 Zurich Center for Integrative Human Physiology (ZIHP), Institute of Physiology, University of Zurich, Zurich, Switzerland
| | - Andreas Breenfeldt-Andersen
- 1 Zurich Center for Integrative Human Physiology (ZIHP), Institute of Physiology, University of Zurich, Zurich, Switzerland
| | - Thomas Haider
- 1 Zurich Center for Integrative Human Physiology (ZIHP), Institute of Physiology, University of Zurich, Zurich, Switzerland
| | - Mario Merlini
- 3 Center for Molecular Cardiology, University of Zurich, Zurich, Switzerland
| | - Anne-Kristine Meinild-Lundby
- 1 Zurich Center for Integrative Human Physiology (ZIHP), Institute of Physiology, University of Zurich, Zurich, Switzerland
| | - Carsten Lundby
- 1 Zurich Center for Integrative Human Physiology (ZIHP), Institute of Physiology, University of Zurich, Zurich, Switzerland
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Nikolovska Vukadinović A, Vukadinović D, Borer J, Cowie M, Komajda M, Lainscak M, Swedberg K, Böhm M. Heart rate and its reduction in chronic heart failure and beyond. Eur J Heart Fail 2017. [DOI: 10.1002/ejhf.902] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Affiliation(s)
| | - Davor Vukadinović
- Klinik für Innere Medizin III; der Universität des Saarlandes; Homburg/Saar Germany
| | - Jeffrey Borer
- Division of Cardiovascular Medicine and the Howard Gilman Institute for Heart Valve Disease and the Schiavone Institute for Cardiovascular Translational Research; State University of New York Downstate Medical Center; New York NY USA
| | | | | | - Mitja Lainscak
- Department of Cardiology, Department of Research and Education; Celje Slovenia
| | - Karl Swedberg
- Department of Molecular and Clinical Medicine, Sahlgrenska Academy; University of Gothenburg; Göteborg Sweden
| | - Michael Böhm
- Klinik für Innere Medizin III; der Universität des Saarlandes; Homburg/Saar Germany
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47
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Aladin AI, Al Rifai M, Rasool SH, Keteyian SJ, Brawner CA, Blumenthal RS, Blaha MJ, Al-Mallah MH, McEvoy JW. Relation of Resting Heart Rate to Incident Atrial Fibrillation (from the Henry Ford Hospital Exercise Testing Project). Am J Cardiol 2017; 119:262-267. [PMID: 28126149 DOI: 10.1016/j.amjcard.2016.09.047] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2016] [Revised: 09/23/2016] [Accepted: 09/23/2016] [Indexed: 10/20/2022]
Abstract
Autonomic nervous system (ANS) dysfunction plays a role in atrial fibrillation (AF) initiation. Cardiorespiratory fitness modulates ANS function and is inversely associated with resting heart rate (RHR) and risk of AF. Thus, we sought to study the association between RHR, as a surrogate for ANS function, and incident AF independent of exercise capacity (EC). We analyzed 51,436 subjects without previous AF who underwent a clinically indicated exercise stress test. Incident AF was ascertained through claims files. RHR was measured before stress testing, and EC was estimated by peak metabolic equivalents of task. We studied the association between RHR categories (<70, 70 to 85 [reference], and >85 beats/min) and incident AF using Cox models adjusted for risk factors and for EC. We tested for interaction between RHR and age, gender, smoking, and EC. Mean (SD) age was 53 (13) years, 53% were men, and 28% were black. Participants with RHR <70 beats/min were older, more likely to be men, have higher EC, and more likely to smoke but less likely to have diabetes and hypertension. Over a median of 5.5 years, RHR <70 beats/min was associated with 14% increased risk of AF (95 CI 6% to 25%) in fully adjusted models, whereas RHR >85 beats/min was not associated with AF risk after adjusting for EC. Results for RHR analyzed continuously and by quartile were similar. No interaction was seen. In conclusion, subjects with low RHR at all levels of EC are at increased risk of AF and may benefit from heart rhythm surveillance, particularly in the presence of other AF risk factors.
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Zhao Q, Li H, Wang A, Guo J, Yu J, Luo Y, Chen S, Tao L, Li Y, Li A, Guo X, Wu S. Cumulative Resting Heart Rate Exposure and Risk of All-Cause Mortality: Results from the Kailuan Cohort Study. Sci Rep 2017; 7:40212. [PMID: 28067310 PMCID: PMC5220288 DOI: 10.1038/srep40212] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2016] [Accepted: 12/05/2016] [Indexed: 11/26/2022] Open
Abstract
The relationship between cumulative exposure to resting heart rate (cumRHR) and mortality remain unclear in the general population. In the Kailuan cohort study, resting heart rate (RHR) was repeatedly measured at baseline and at years 2 and 4 by electrocardiogram among 47,311 adults aged 48.70 ± 11.68. The cumRHR was defined as the summed average RHR between two consecutive examinations multiplied by the time interval between with two examinations [(beats/min) * year]. A higher RHR was defined as ≥80 beats/min, and the number of visits with a higher RHR was counted. During a median of 4.06 years of follow-up, a total of 1,025 participants died. After adjusting for major traditional cardiovascular risk factors and baseline RHR, the hazard ratio for the highest versus lowest quartile of cumRHR was 1.39 (95% CI: 1.07–1.81) for all-cause mortality. Each 1-SD increment in cumRHR was associated with a 37% (HR: 1.37, 95% CI: 1.23–1.52) increased risk of death and displayed a J-shaped relationship. Compared with no exposure, adults who had a higher RHR at all 3 study visits were associated with a 1.86-fold higher risk (95% CI: 1.33–2.61) of mortality. In summary, cumulative exposure to higher RHR is independently associated with an increased risk of mortality.
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Affiliation(s)
- Quanhui Zhao
- Graduate School, North China University of Science and Technology, Tangshan, China.,Department of Cardiology, Kailuan Hospital, North China University of Science and Technology, Tangshan, China
| | - Haibin Li
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China.,Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, China
| | - Anxin Wang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Jin Guo
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China.,Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, China
| | - Junxing Yu
- Graduate School, North China University of Science and Technology, Tangshan, China.,Department of Cardiology, Kailuan Hospital, North China University of Science and Technology, Tangshan, China
| | - Yanxia Luo
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China.,Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, China
| | - Shuohua Chen
- Department of Cardiology, Kailuan Hospital, North China University of Science and Technology, Tangshan, China
| | - Lixin Tao
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China.,Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, China
| | - Yuqing Li
- Department of Rheumatology, Kailuan Hospital, North China University of Science and Technology, Tangshan, China
| | - Aiping Li
- Department of Surgery, Kailuan Hospital, North China University of Science and Technology, Tangshan, China
| | - Xiuhua Guo
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China.,Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, China
| | - Shouling Wu
- Department of Cardiology, Kailuan Hospital, North China University of Science and Technology, Tangshan, China
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49
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Li K, Yao C, Yang X, Dong L. Effect of Resting Heart Rate on All-Cause Mortality and Cardiovascular Events According to Age. J Am Geriatr Soc 2016; 65:989-994. [PMID: 28039873 DOI: 10.1111/jgs.14714] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
OBJECTIVES To examine whether the association between resting heart rate (RHR) and all-cause mortality and cardiovascular events differs according to age. DESIGN Prospective cohort. SETTING Community in Beijing, China. PARTICIPANTS Individuals aged 40 and older without cardiovascular disease at baseline (N = 6,209). MEASUREMENTS Trained investigators interviewed participants using a standard questionnaire to obtain information on demographic characteristics, medical history and lifestyle risk factors in 1991. RHR was evaluated according to quartiles (<72, 72-76, 76-84, ≥84 beats/min). Cox regression models were used to assess the associations between RHR and all-cause mortality and cardiovascular events. RESULTS During a mean follow-up of 8.3 years, 840 subjects died, and 676 experienced a cardiovascular event. Higher RHR was significantly associated with all-cause mortality (P trend < .001) and cardiovascular events (P trend = .002) in older (≥60) but not younger (<60) participants (both P trend > .05). There were significant modifying effects of age on the association between RHR and all-cause mortality (P interaction < .001) and cardiovascular events (P interaction =.002). Similar results were observed after exclusion of individuals who died (n = 100) or had a cardiovascular event (n = 45) during the first 2 years of follow-up. CONCLUSION High RHR appears to be an independent determinant of all-cause mortality and cardiovascular events in older but not younger individuals.
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Affiliation(s)
- Kuibao Li
- Heart Center of Beijing, Chaoyang Hospital, Capital Medical University, Beijing, China
| | - Chonghua Yao
- Beijing Centers for Disease Control and Prevention, Anzhen Hospital, Capital Medical University, Beijing, China
| | - Xinchun Yang
- Heart Center of Beijing, Chaoyang Hospital, Capital Medical University, Beijing, China
| | - Lei Dong
- Beijing Centers for Disease Control and Prevention, Anzhen Hospital, Capital Medical University, Beijing, China
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50
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Chen S, Li W, Jin C, Vaidya A, Gao J, Yang H, Wu S, Gao X. Resting Heart Rate Trajectory Pattern Predicts Arterial Stiffness in a Community-Based Chinese Cohort. Arterioscler Thromb Vasc Biol 2016; 37:359-364. [PMID: 27908892 DOI: 10.1161/atvbaha.116.308674] [Citation(s) in RCA: 51] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2016] [Accepted: 11/08/2016] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To examine whether the long-term resting heart rate (RHR) pattern can predict the risk of having arterial stiffness in a large ongoing cohort. APPROACH AND RESULTS This community-based cohort included 12 554 participants in the Kailun study, who were free of myocardial infarction, stroke, arrhythmia, and cancer. We used latent mixture modeling to identify RHR trajectories in 2006, 2008, and 2010. We used multivariate linear regression model to examine the association between RHR trajectory patterns and the risk of having arterial stiffness, which was assessed by brachial-ankle pulse wave velocity in 2010 to 2016. We adjusted for possible confounding factors, including socioeconomic status, lifestyle factors, use of medications, comorbidities, and serum concentrations of lipids, glucose, and high-sensitivity C-reactive proteins. We identified 5 distinct RHR trajectory patterns based on their 2006 status and on the pattern of change during 2006 to 2010 (low-stable, moderate-stable, moderate-increasing, elevated-decreasing, and elevated-stable). We found that individuals with elevated-stable RHR trajectory pattern had the highest brachial-ankle pulse wave velocity value and individuals with the low-stable RHR trajectory pattern had the lowest value (adjusted mean difference=157 cm/s; P<0.001). Adjusted odds ratio for risk of having arterial stiffness (brachial-ankle pulse wave velocity ≥1400 cm/s) was 4.14 (95% confidence interval, 2.61-6.57) relative to these 2 extreme categories. Consistently, a higher average RHR, a higher annual RHR increase rate, and a higher RHR variability were all associated with a higher risk of having arterial stiffness. CONCLUSIONS Long-term RHR pattern is a strong predictor of having arterial stiffness.
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Affiliation(s)
- Shuohua Chen
- From the Health Care Center, Kailuan Medical Group, Tangshan, China (S.C.); Vanderbilt Heart and Vascular Institute, Vanderbilt University Medical Center, Nashville, TN (W.L.); Department of Cardiology (C.J., J.G., S.W.) and Department of Surgery (H.Y.), Kailuan General Hospital, Tangshan, China; Division of Endocrinology, Diabetes, and Hypertension, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (A.V.); and Department of Nutritional Sciences, The Pennsylvania State University, University Park (X.G.)
| | - Weijuan Li
- From the Health Care Center, Kailuan Medical Group, Tangshan, China (S.C.); Vanderbilt Heart and Vascular Institute, Vanderbilt University Medical Center, Nashville, TN (W.L.); Department of Cardiology (C.J., J.G., S.W.) and Department of Surgery (H.Y.), Kailuan General Hospital, Tangshan, China; Division of Endocrinology, Diabetes, and Hypertension, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (A.V.); and Department of Nutritional Sciences, The Pennsylvania State University, University Park (X.G.)
| | - Cheng Jin
- From the Health Care Center, Kailuan Medical Group, Tangshan, China (S.C.); Vanderbilt Heart and Vascular Institute, Vanderbilt University Medical Center, Nashville, TN (W.L.); Department of Cardiology (C.J., J.G., S.W.) and Department of Surgery (H.Y.), Kailuan General Hospital, Tangshan, China; Division of Endocrinology, Diabetes, and Hypertension, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (A.V.); and Department of Nutritional Sciences, The Pennsylvania State University, University Park (X.G.)
| | - Anand Vaidya
- From the Health Care Center, Kailuan Medical Group, Tangshan, China (S.C.); Vanderbilt Heart and Vascular Institute, Vanderbilt University Medical Center, Nashville, TN (W.L.); Department of Cardiology (C.J., J.G., S.W.) and Department of Surgery (H.Y.), Kailuan General Hospital, Tangshan, China; Division of Endocrinology, Diabetes, and Hypertension, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (A.V.); and Department of Nutritional Sciences, The Pennsylvania State University, University Park (X.G.)
| | - Jingli Gao
- From the Health Care Center, Kailuan Medical Group, Tangshan, China (S.C.); Vanderbilt Heart and Vascular Institute, Vanderbilt University Medical Center, Nashville, TN (W.L.); Department of Cardiology (C.J., J.G., S.W.) and Department of Surgery (H.Y.), Kailuan General Hospital, Tangshan, China; Division of Endocrinology, Diabetes, and Hypertension, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (A.V.); and Department of Nutritional Sciences, The Pennsylvania State University, University Park (X.G.)
| | - Hui Yang
- From the Health Care Center, Kailuan Medical Group, Tangshan, China (S.C.); Vanderbilt Heart and Vascular Institute, Vanderbilt University Medical Center, Nashville, TN (W.L.); Department of Cardiology (C.J., J.G., S.W.) and Department of Surgery (H.Y.), Kailuan General Hospital, Tangshan, China; Division of Endocrinology, Diabetes, and Hypertension, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (A.V.); and Department of Nutritional Sciences, The Pennsylvania State University, University Park (X.G.)
| | - Shouling Wu
- From the Health Care Center, Kailuan Medical Group, Tangshan, China (S.C.); Vanderbilt Heart and Vascular Institute, Vanderbilt University Medical Center, Nashville, TN (W.L.); Department of Cardiology (C.J., J.G., S.W.) and Department of Surgery (H.Y.), Kailuan General Hospital, Tangshan, China; Division of Endocrinology, Diabetes, and Hypertension, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (A.V.); and Department of Nutritional Sciences, The Pennsylvania State University, University Park (X.G.)
| | - Xiang Gao
- From the Health Care Center, Kailuan Medical Group, Tangshan, China (S.C.); Vanderbilt Heart and Vascular Institute, Vanderbilt University Medical Center, Nashville, TN (W.L.); Department of Cardiology (C.J., J.G., S.W.) and Department of Surgery (H.Y.), Kailuan General Hospital, Tangshan, China; Division of Endocrinology, Diabetes, and Hypertension, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (A.V.); and Department of Nutritional Sciences, The Pennsylvania State University, University Park (X.G.).
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