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Kõre AC, Joonsalu T, Serg M, Pauklin P, Voitk J, Roose I, Eha J, Kampus P. Implications of pulse wave velocity and central pulse pressure in heart failure with reduced ejection fraction. Blood Press 2024; 33:2359932. [PMID: 38819846 DOI: 10.1080/08037051.2024.2359932] [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: 03/05/2024] [Accepted: 05/18/2024] [Indexed: 06/01/2024]
Abstract
BACKGROUND Carotid-femoral pulse wave velocity (cfPWV) and central pulse pressure (PP) are recognised as significant indicators of vascular health and predictors of cardiovascular outcomes. In this study, associations between central hemodynamics and left ventricular (LV) echocardiographic parameters were investigated in subjects with heart failure with reduced ejection fraction (HFrEF), comparing the results to healthy individuals. METHODS AND RESULTS This cross-sectional prospective controlled study included 50 subjects with HFrEF [mean LV ejection fraction (EF) 26 ± 6.5%] and 30 healthy controls (mean LVEF 65.9 ± 5.3%). Pulse wave analysis (PWA) and carotid-femoral pulse wave velocity (cfPWV) were used to measure central hemodynamics and arterial stiffness. The HFrEF group displayed higher cfPWV (8.2 vs. 7.2 m/s, p = 0.007) and lower central (111.3 vs. 121.7 mmHg, p = 0.001) and peripheral (120.1 vs. 131.5 mmHg, p = 0.002) systolic blood pressure. Central pulse pressure (PP) was comparable between the two groups (37.6 vs. 40.4 mmHg, p = 0.169). In the HFrEF group, cfPWV significantly correlated with left ventricular end-diastolic volume (LVEDV) index (mL/m2) and LVEF, with LVEDV index being a significant independent predictor of cfPWV (R2 = 0.42, p = 0.003). Central PP was significantly associated with heart rate, LVEF and LVEDV index, with the latter being a significant independent predictor of central PP (R2 = 0.41, p < 0.001). These correlations were not observed in healthy controls. CONCLUSIONS Significant associations between central hemodynamic measures and LV echocardiographic parameters were identified, suggesting the potential to use PWA and cfPWV as possible tools for managing HFrEF.
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Affiliation(s)
- Anette Caroline Kõre
- Institute of Clinical Medicine, Department of Cardiology, University of Tartu, Tartu, Estonia
| | - Tuuli Joonsalu
- Institute of Clinical Medicine, Department of Cardiology, University of Tartu, Tartu, Estonia
- Tartu University Hospital, Heart Clinic, Tartu, Estonia
| | - Martin Serg
- Institute of Clinical Medicine, Department of Cardiology, University of Tartu, Tartu, Estonia
- North Estonia Medical Centre, Centre of Cardiology, Tallinn, Estonia
| | - Priit Pauklin
- Institute of Clinical Medicine, Department of Cardiology, University of Tartu, Tartu, Estonia
- Tartu University Hospital, Heart Clinic, Tartu, Estonia
| | - Jüri Voitk
- North Estonia Medical Centre, Centre of Cardiology, Tallinn, Estonia
| | - Indrek Roose
- Tartu University Hospital, Heart Clinic, Tartu, Estonia
| | - Jaan Eha
- Institute of Clinical Medicine, Department of Cardiology, University of Tartu, Tartu, Estonia
- Tartu University Hospital, Heart Clinic, Tartu, Estonia
| | - Priit Kampus
- Institute of Clinical Medicine, Department of Cardiology, University of Tartu, Tartu, Estonia
- North Estonia Medical Centre, Centre of Cardiology, Tallinn, Estonia
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Álvarez-Bueno C, Medrano M, Lucerón-Lucas-Torres M, Otero-Luis I, López-López S, Lever-Megina CG, Cavero-Redondo I. Association between pulse wave velocity and white matter hyperintensities among older adults: A meta-analysis of cross-sectional and longitudinal studies. Ageing Res Rev 2024; 101:102501. [PMID: 39303876 DOI: 10.1016/j.arr.2024.102501] [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: 03/20/2024] [Revised: 06/07/2024] [Accepted: 09/08/2024] [Indexed: 09/22/2024]
Abstract
BACKGROUND Higher levels of pulse wave velocity (PWV) have been related with the presence of small vessel disease that could damage the brain, in which white matter hyperintensities (WMH) could be presented as consequence. This meta-analysis aims to examine the cross-sectional and longitudinal associations between PWV and the presence of WMH among older adults. METHODS We searched PubMed, Scopus, and WOS until June 2024. Pooled Odds Ratio (p-OR) were estimated for the cross-sectional and longitudinal associations between PWV and WMH. In addition, we explored whether this associations could be modified by type of PWV measurement and study and sample characteristics. RESULTS The p-OR between PWV and WMH was 1.16 (95 % CI, 1.10-1.22) for the cross-sectional and 1.07 (95 %, 1.00-1.15) for the longitudinal association. Similar figures were found by type of PWV measurement and no one of the explored characteristics modified this associations. CONCLUSIONS This meta-analysis revealed that the presence in and the long-term development of WMHs among older adults are more likely among those with elevated PWV.
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Affiliation(s)
- Celia Álvarez-Bueno
- Universidad de Castilla - La Mancha, Health and Social Research Center, Cuenca, Spain; Facultad de Ciencias de la Salud, Universidad Autónoma de Chile, Talca 7500912, Chile
| | - María Medrano
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid 28029, Spain; ELIKOS Group, Institute for Sustainability and Food Chain Innovation (IS-FOOD), Department of Health Sciences, Public University of Navarre, Pamplona 31006, Spain
| | | | - Iris Otero-Luis
- Universidad de Castilla - La Mancha, Health and Social Research Center, Cuenca, Spain
| | - Samuel López-López
- Castilla-La Mancha Health Services, SESCAM, Cuenca Hospital. C, Hermandad de Donantes de Sangre, 1, Cuenca 16.002, Spain
| | | | - Iván Cavero-Redondo
- Universidad de Castilla - La Mancha, Health and Social Research Center, Cuenca, Spain
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Zhu W, Xiang L, Cao L, Tian Y, Li W, He L. Evaluating the impact of automatic positive airway pressure therapy on cardiovascular risk index and vascular behavior in patients with obstructive sleep apnea: a study on heterogeneity in the therapeutic response. J Clin Sleep Med 2024; 20:1435-1444. [PMID: 38648118 PMCID: PMC11367725 DOI: 10.5664/jcsm.11162] [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] [Indexed: 04/25/2024]
Abstract
STUDY OBJECTIVES This study investigated the impact of automatic positive airway pressure (APAP) therapy on vascular behavior and its potential to lower cardiovascular risk in patients with obstructive sleep apnea (OSA), as well as differentiating APAP therapy heterogeneity. METHODS All participants were diagnosed with OSA by portable monitoring, and pulse wave parameters and cardiac risk composite parameter index were obtained by photoplethysmography before and after APAP. Clustering analysis of pulse wave parameters before APAP in the high-risk population was performed using k-means clustering. Linear regression was used to assess the associations of changes in cardiac risk composite parameter index and pulse wave parameters with clinical characteristics. RESULTS Eighty-two patients with OSA underwent APAP therapy. The cardiac risk composite parameter index after APAP was significantly lower than before APAP (0.38 ± 0.33 and 0.58 ± 0.31, respectively; P < .001). All pulse wave parameters (except irregular pulse) were significantly different (P < .001) in patients with OSA and in the high-risk responders group after vs before APAP. The differences in pulse wave parameters after vs before APAP were not significant in the high-risk nonresponders group, except for the difference between the pulse rate acceleration index and the oxygen saturation index and pulse rate variability. Four clusters were obtained from the clustering analysis of pulse wave parameters before APAP in the high-risk responders group. CONCLUSIONS APAP reduces the cardiac risk composite parameter index in patients with OSA by altering vascular behavior. Overnight photoplethysmography monitoring of pulse wave parameters can be used to assess whether patients with OSA will benefit from APAP. CITATION Zhu W, Xiang L, Cao L, Tian Y, Li W, He L. Evaluating the impact of automatic positive airway pressure therapy on cardiovascular risk index and vascular behavior in patients with obstructive sleep apnea: a study on heterogeneity in the therapeutic response. J Clin Sleep Med. 2024;20(9):1435-1444.
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Affiliation(s)
- Wenjun Zhu
- Department of Respiratory and Critical Care Medicine, The Second Affiliated Hospital of Nanchang University, Nanchang, China
- Department of Respiratory and Sleep Medicine, Peking University People's Hospital, Beijing, China
| | - Lin Xiang
- Department of Respiratory and Critical Care Medicine, The Second Affiliated Hospital of Nanchang University, Nanchang, China
| | - Linna Cao
- Department of Respiratory and Critical Care Medicine, The Second Affiliated Hospital of Nanchang University, Nanchang, China
| | - Yaping Tian
- Department of Respiratory and Critical Care Medicine, The Second Affiliated Hospital of Nanchang University, Nanchang, China
| | - Wenjun Li
- Department of Respiratory and Critical Care Medicine, The Second Affiliated Hospital of Nanchang University, Nanchang, China
| | - Lirong He
- Department of Respiratory and Critical Care Medicine, The Second Affiliated Hospital of Nanchang University, Nanchang, China
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Szołtysek-Bołdys I, Zielińska-Danch W, Łoboda D, Gołba KS, Sarecka-Hujar B. Do Photopletysmographic Parameters of Arterial Stiffness Differ Depending on the Presence of Arterial Hypertension and/or Atherosclerosis? SENSORS (BASEL, SWITZERLAND) 2024; 24:4572. [PMID: 39065969 PMCID: PMC11280487 DOI: 10.3390/s24144572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/28/2024] [Revised: 07/11/2024] [Accepted: 07/12/2024] [Indexed: 07/28/2024]
Abstract
BACKGROUND Hypertension and atherosclerotic cardiovascular diseases (ASCVD) increase cardiovascular risk and worsen patients' prognoses. One early predictor of increased risk is a change in arterial stiffness. This study aimed to evaluate arterial stiffness parameters using the non-invasive photoplethysmography (PPG) method in Polish patients with arterial hypertension (AH) and/or atherosclerosis (AS). METHODS The study group consisted of 333 patients (Caucasians, both sexes, aged 30-85 years old). Patients were analyzed in four groups depending on AH and AS (Group I: patients without AH or AS, Group II: AH patients, Group III: AS patients, and Group IV: AH/AS patients) and, in addition, according to sex and history of SARS-CoV-2 infection. Arterial stiffness parameters, i.e., reflection index (RI), peak-to-peak time (PPT), and stiffness index (SI) were automatically calculated with PPG based on the analysis of the pulse wave contour. RESULTS Mean values of RI and SI were higher in men than women (p < 0.001 each). Diastolic blood pressure (DBP) also differed between sexes (p = 0.010). Mean SI values differed between the study groups (p = 0.038) with the highest SI found in AS/AH patients and the lowest-in patients without AH or AS. The mean SI values were significantly lower in women compared to men in both Group I and Group II (p = 0.006 and p < 0.001, respectively). The mean values of RI were also greater in men than in women in Group I and Group II (p < 0.001 for each group). Regarding COVID-19 history, only HR values differed between patients with and without COVID-19 in AH patients (p = 0.012). In AH patients, men had higher values of RI and SI compared to women (p < 0.001 and p < 0.001). On the other hand, AS women with COVID-19 had significantly greater mean values of SI (9.66 m/s ± 1.61) than men with COVID-19 (7.98 m/s ± 1.09) (p = 0.045). CONCLUSIONS The present study confirmed that sex had a significant impact on arterial stiffness parameters. Both AH and AS affected arterial stiffness. Heart rate was greater in hypertensive patients after COVID-19 compared to hypertensive patients without COVID-19.
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Affiliation(s)
- Izabela Szołtysek-Bołdys
- Department of General and Inorganic Chemistry, Faculty of Pharmaceutical Sciences in Sosnowiec, Medical University of Silesia in Katowice, 41-200 Sosnowiec, Poland; (I.S.-B.); (W.Z.-D.)
| | - Wioleta Zielińska-Danch
- Department of General and Inorganic Chemistry, Faculty of Pharmaceutical Sciences in Sosnowiec, Medical University of Silesia in Katowice, 41-200 Sosnowiec, Poland; (I.S.-B.); (W.Z.-D.)
| | - Danuta Łoboda
- Department of Electrocardiology and Heart Failure, Medical University of Silesia in Katowice, 40-635 Katowice, Poland; (D.Ł.); (K.S.G.)
- Department of Electrocardiology, Upper-Silesian Medical Centre in Katowice, 40-635 Katowice, Poland
| | - Krzysztof S. Gołba
- Department of Electrocardiology and Heart Failure, Medical University of Silesia in Katowice, 40-635 Katowice, Poland; (D.Ł.); (K.S.G.)
- Department of Electrocardiology, Upper-Silesian Medical Centre in Katowice, 40-635 Katowice, Poland
| | - Beata Sarecka-Hujar
- Department of Basic Biomedical Science, Faculty of Pharmaceutical Sciences in Sosnowiec, Medical University of Silesia in Katowice, 41-200 Sosnowiec, Poland
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De Vito F, Fiorentino TV, Facciolo A, Cassano V, Natale MR, Mannino GC, Succurro E, Arturi F, Sciacqua A, Sesti G, Andreozzi F. Association between augmented levels of the gut pro-hormone Proneurotensin and subclinical vascular damage. Sci Rep 2024; 14:15086. [PMID: 38956152 PMCID: PMC11219761 DOI: 10.1038/s41598-024-65992-4] [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: 02/15/2024] [Accepted: 06/26/2024] [Indexed: 07/04/2024] Open
Abstract
Elevated levels of the gut pro-hormone Proneurotensin (proNT) have been found to predict development of cardiovascular disease. However, it is still unknown whether higher proNT levels are associated with subclinical vascular damage. Herein, we investigated the relationship between higher proNT concentrations and augmented pulse pressure (PP) and carotid intima-media thickness (cIMT), indicators of increased arterial stiffness and subclinical atherosclerosis, respectively. Clinical characteristics, PP and cIMT were evaluated in 154 non-diabetic individuals stratified into tertiles according to fasting serum proNT concentrations. We found that, subjects with higher proNT levels exhibited a worse lipid profile and insulin sensitivity, increased C-reactive protein levels, along with higher values of PP and cIMT as compared to the lowest proNT tertile. Prevalence of elevated PP (≥ 60 mmHg) and subclinical carotid atherosclerosis (IMT > 0.9 mm) was increased in the highest tertile of proNT. In a logistic regression analysis adjusted for several confounders, subjects with higher proNT levels displayed a fivefold raised risk of having elevated PP values (OR 5.36; 95%CI 1.04-27.28; P = 0.05) and early carotid atherosclerosis (OR 4.81; 95%CI 1.39-16.57; P = 0.01) as compared to the lowest proNT tertile. In conclusion, higher circulating levels of proNT are a biomarker of subclinical vascular damage independent of other atherosclerotic risk factors.
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Affiliation(s)
- Francesca De Vito
- Department of Medical and Surgical Sciences, University Magna Graecia of Catanzaro, 88100, Catanzaro, Italy
| | - Teresa Vanessa Fiorentino
- Department of Medical and Surgical Sciences, University Magna Graecia of Catanzaro, 88100, Catanzaro, Italy.
| | - Antonio Facciolo
- Department of Medical and Surgical Sciences, University Magna Graecia of Catanzaro, 88100, Catanzaro, Italy
| | - Velia Cassano
- Department of Medical and Surgical Sciences, University Magna Graecia of Catanzaro, 88100, Catanzaro, Italy
| | - Maria Resilde Natale
- Department of Medical and Surgical Sciences, University Magna Graecia of Catanzaro, 88100, Catanzaro, Italy
| | - Gaia Chiara Mannino
- Department of Medical and Surgical Sciences, University Magna Graecia of Catanzaro, 88100, Catanzaro, Italy
| | - Elena Succurro
- Department of Medical and Surgical Sciences, University Magna Graecia of Catanzaro, 88100, Catanzaro, Italy
| | - Franco Arturi
- Department of Medical and Surgical Sciences, University Magna Graecia of Catanzaro, 88100, Catanzaro, Italy
| | - Angela Sciacqua
- Department of Medical and Surgical Sciences, University Magna Graecia of Catanzaro, 88100, Catanzaro, Italy
| | - Giorgio Sesti
- Department of Clinical and Molecular Medicine, University of Rome-Sapienza, 00189, Rome, Italy
| | - Francesco Andreozzi
- Department of Medical and Surgical Sciences, University Magna Graecia of Catanzaro, 88100, Catanzaro, Italy
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Aimagambetova B, Ariko T, Gardener H, Levin B, Sun X, Gutierrez J, Elkind MSV, Wright CB, Rundek T. Association of estimated pulse wave velocity with cognitive function in a multiethnic diverse population: The Northern Manhattan Study. Alzheimers Dement 2024; 20:4903-4913. [PMID: 38895994 PMCID: PMC11247703 DOI: 10.1002/alz.14064] [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: 01/17/2024] [Revised: 05/18/2024] [Accepted: 05/20/2024] [Indexed: 06/21/2024]
Abstract
INTRODUCTION Arterial stiffness is linked to age-related cognitive dysfunction. Estimated pulse wave velocity (ePWV) is associated with cerebrovascular disease. We sought to determine whether ePWV was associated with cognition in a multiethnic population. METHODS We included 1257 participants enrolled in a Northern Manhattan Study magnetic resonance imaging MRI-cognitive study (mean age 64 ± 8 years, 61% women, 67% Hispanic, 18% non-Hispanic Black, 15% non-Hispanic white) and analyzed cognitive performance at two time points, at enrollment and on an average 5.0 ± 0.6 years later. ePWV was calculated using baseline age and blood pressure. Cognition and cognitive change scores were regressed on ePWV in multivariable linear regression models. RESULTS In adjusted models, ePWV (mean 11 ± 2 m/s) was significantly associated with cognition (b = -0.100, 95% CI, -0.120, -0.080) and cognitive change over time (b = -0.063, 95% CI, -0.082, -0.045). Effect modification by race and sex was found. DISCUSSION In this multiethnic population, the associations of ePWV with cognitive performance underline the role of vascular stiffness in age-related cognitive decline. HIGHLIGHTS ePWV is a modest but independent predictor of cognitive function and cognitive decline among older individuals. After adjustment, the ePWV measure was inversely associated with performance and decline in global cognition, processing speed, episodic memory, executive function, and semantic memory. After adjustment, modification of the association between ePWV and change in episodic memory and executive function by race and ethnicity was suggested by a significant interaction term. The association between ePWV and episodic memory decline was stronger in females.
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Affiliation(s)
- Botagoz Aimagambetova
- Evelyn F. McKnight Brain InstituteMiamiFloridaUSA
- Department of NeurologyUniversity of Miami Miller School of MedicineMiamiFloridaUSA
| | - Taylor Ariko
- Evelyn F. McKnight Brain InstituteMiamiFloridaUSA
- Department of Biomedical EngineeringUniversity of MiamiMiamiFloridaUSA
| | - Hannah Gardener
- Evelyn F. McKnight Brain InstituteMiamiFloridaUSA
- Department of NeurologyUniversity of Miami Miller School of MedicineMiamiFloridaUSA
| | - Bonnie Levin
- Evelyn F. McKnight Brain InstituteMiamiFloridaUSA
- Department of NeurologyUniversity of Miami Miller School of MedicineMiamiFloridaUSA
| | - Xiaoyan Sun
- Evelyn F. McKnight Brain InstituteMiamiFloridaUSA
- Department of NeurologyUniversity of Miami Miller School of MedicineMiamiFloridaUSA
| | - Jose Gutierrez
- Department of NeurologyVagelos College of Physicians and SurgeonsColumbia UniversityNew YorkNew YorkUSA
| | - Mitchell SV. Elkind
- Department of NeurologyVagelos College of Physicians and SurgeonsColumbia UniversityNew YorkNew YorkUSA
- Department of EpidemiologyMailman School of Public HealthColumbia UniversityNew YorkNew YorkUSA
| | - Clinton B. Wright
- Stroke BranchDivision of Intramural ResearchNational Institute of Neurological Disorders and StrokeBethesdaMarylandUSA
| | - Tatjana Rundek
- Evelyn F. McKnight Brain InstituteMiamiFloridaUSA
- Department of NeurologyUniversity of Miami Miller School of MedicineMiamiFloridaUSA
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Chuang SY, Liu WL, Cheng HM, Chung RH, Lai CH, Chuang SC, Wu IC, Chang HY, Hsiung CA, Chen WJ, Hsu CC. Pulse pressure is associated with decline in physical function in older adults. Maturitas 2024; 185:108000. [PMID: 38669896 DOI: 10.1016/j.maturitas.2024.108000] [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: 10/18/2023] [Revised: 03/25/2024] [Accepted: 04/15/2024] [Indexed: 04/28/2024]
Abstract
OBJECTIVES This study examined the associations between pulse pressure, hypertension, and the decline in physical function in a prospective framework. STUDY DESIGN The Healthy Aging Longitudinal Study tracked a group of Taiwanese adults aged 55 or more over an average of 6.19 years to assess pulse pressure and decline in physical function, including in handgrip strength, gait speed, and 6-min walking distance, at baseline (2009-2013) and in the second phase of assessments (2013-2020). MAIN OUTCOME MEASURES Pulse pressure was calculated as the difference between systolic and diastolic blood pressure values. Weakness, slowness, and low endurance were defined as decreases of ≥0.23 m/s (one standard deviation) in gait speed, ≥5.08 kg in handgrip strength, and ≥ 57.73 m in a 6-min walk, as determined from baseline to the second phase of assessment. Linear and logistic regressions were employed to evaluate the associations between pulse pressure, hypertension, and decline in physical function. RESULTS Baseline pulse pressure was associated with future handgrip strength (beta = -0.017, p = 0.0362), gait speed (beta = -0.001, p < 0.0001), and 6-min walking distance (beta = -0.470, p < 0001). In multivariable models, only handgrip strength (beta = -0.016, p = 0.0135) and walking speed (beta = -0.001, p = 0.0042) remained significantly associated with future pulse pressure. Older adults with high systolic blood pressure (≥140 mmHg) and elevated pulse pressure (≥60 mmHg) exhibited a significantly increased risk of weakness (odds ratio: 1.30, 95 % confidence interval: 1.08-1.58), slowness (1.29, 1.04-1.59), and diminished endurance (1.25, 1.04-1.50) compared with the reference group, who exhibited systolic blood pressure of <140 mmHg and pulse pressure of <60 mmHg. CONCLUSIONS Among older adults, pulse pressure is associated with a decline in physical function, especially in terms of strength and locomotion.
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Affiliation(s)
- Shao-Yuan Chuang
- Institute of Population Health Sciences, National Health Research Institutes, Taiwan.
| | - Wen-Ling Liu
- Institute of Population Health Sciences, National Health Research Institutes, Taiwan
| | - Hao-Min Cheng
- Program of Interdisciplinary Medicine (PIM), National Yang Ming Chiao Tung University College of Medicine, Taipei, Taiwan; Division of Faculty Development, Taipei Veterans General Hospital, Taipei, Taiwan; Center for Evidence-based Medicine, Taipei Veterans General Hospital, Taipei, Taiwan; Institute of Public Health, National Yang Ming Chiao Tung University College of Medicine, Taipei, Taiwan; Institute of Health and Welfare Policy, National Yang Ming Chiao Tung University College of Medicine, Taipei, Taiwan
| | - Ren-Hua Chung
- Institute of Population Health Sciences, National Health Research Institutes, Taiwan
| | - Chia-Hung Lai
- Institute of Population Health Sciences, National Health Research Institutes, Taiwan
| | - Shu-Chun Chuang
- Institute of Population Health Sciences, National Health Research Institutes, Taiwan
| | - I-Chien Wu
- Institute of Population Health Sciences, National Health Research Institutes, Taiwan
| | - Hsing-Yi Chang
- Institute of Population Health Sciences, National Health Research Institutes, Taiwan
| | - Chao Agnes Hsiung
- Institute of Population Health Sciences, National Health Research Institutes, Taiwan
| | - Wei J Chen
- Center for Neuropsychiatric Research, National Health Research Institutes, Taiwan; Institute of Epidemiology and Preventive Medicine, National Taiwan University, Taipei, Taiwan
| | - Chih-Cheng Hsu
- Institute of Population Health Sciences, National Health Research Institutes, Taiwan; National Center for Geriatrics and Welfare Research, National Health Research Institutes, Taiwan.
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Tian P, Liu Y, Wang J, Xing L, Huang X, Fu C, Yuan C, Liu P. Correlation of neck circumference, coronary calcification severity and cardiovascular events in Chinese elderly patients with acute coronary syndromes. Atherosclerosis 2024; 394:117242. [PMID: 37679211 DOI: 10.1016/j.atherosclerosis.2023.117242] [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: 02/20/2023] [Revised: 07/11/2023] [Accepted: 08/16/2023] [Indexed: 09/09/2023]
Abstract
BACKGROUND AND AIMS We aimed to investigate whether neck circumference (NC) can predict metabolic syndrome (MetS), coronary calcification and lesion, and major adverse cardiovascular events (MACEs). METHODS A total of 867 patients with acute coronary syndrome (ACS) over 60 years old from the Second Hospital of Shandong University, who had undergone coronary computed tomography, were randomly selected for a retrospective analysis. The subjects were divided into male and female groups, NC quartile 1-4 groups (Q1-Q4 groups), non-multivessel coronary disease (non-MVCD) and multi-vessel coronary disease (MVCD) groups. RESULTS After adjusting for potential confounders, NC was associated with risk factors promoting coronary artery disease (CAD) and coronary artery calcification score (CACS). The severity of CAD increased by 0.202 times and 0.372 times for each unit of NC in male and female groups, respectively. Compared with the lower CACS group, the risk of coronary calcification increased by 0.139 times, and MVCD increased 0.268 times, with each unit increase of NC. Except for all-cause death, there were significant differences between the Q1-Q4 groups in the prevalence of all primary endpoints, cardiogenic death, unexpected re-hospitalization of heart failure, ACS recurrence or unplanned revascularization, and non-fatal stroke (p log-rank <0.01). In view of the overall trend, with the increase of NC quartiles, the prevalence of MACEs gradually increased (all p < 0.01). CONCLUSIONS NC is closely associated with MetS and its components, coronary calcification and lesion degree, and MACEs. NC could be used as surrogate of CACS to predict the coronary condition and prognosis of elderly patients with ACS.
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Affiliation(s)
- Peiqing Tian
- Department of Cardiology, The Second Hospital of Shandong University, Shandong, China; Shenzhen Research Institute of Shandong University, Guangdong, China
| | - Yixuan Liu
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Jiayu Wang
- Department of Cardiology, The Second Hospital of Shandong University, Shandong, China
| | - Liyun Xing
- Department of Cardiology, The Second Hospital of Shandong University, Shandong, China
| | - Xianwei Huang
- Department of Cardiology, The Second Hospital of Shandong University, Shandong, China; Department of Emergency, The First Affiliated Hospital of Xiamen University, Fujian, China
| | - Caihua Fu
- Department of Cardiology, Jinan Municipal Central Hospital Affiliated to Shandong First Medical University, Shandong, China
| | - Cuicui Yuan
- Department of Cardiology, Zhangqiu District People's Hospital of Jinan, Shandong, China
| | - Ping Liu
- Department of Cardiology, The Second Hospital of Shandong University, Shandong, China; Shenzhen Research Institute of Shandong University, Guangdong, China.
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Xing X, Hong J, Alastruey J, Long X, Liu H, Dong WF. Robust arterial compliance estimation with Katz's fractal dimension of photoplethysmography. Front Physiol 2024; 15:1398904. [PMID: 38915780 PMCID: PMC11194390 DOI: 10.3389/fphys.2024.1398904] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2024] [Accepted: 05/21/2024] [Indexed: 06/26/2024] Open
Abstract
Arterial compliance (AC) plays a crucial role in vascular aging and cardiovascular disease. The ability to continuously estimate aortic AC or its surrogate, pulse pressure (PP), through wearable devices is highly desirable, given its strong association with daily activities. While the single-site photoplethysmography (PPG)-derived arterial stiffness indices show reasonable correlations with AC, they are susceptible to noise interference, limiting their practical use. To overcome this challenge, our study introduces a noise-resistant indicator of AC: Katz's fractal dimension (KFD) of PPG signals. We showed that KFD integrated the signal complexity arising from compliance changes across a cardiac cycle and vascular structural complexity, thereby decreasing its dependence on individual characteristic points. To assess its capability in measuring AC, we conducted a comprehensive evaluation using both in silico studies with 4374 virtual human data and real-world measurements. In the virtual human studies, KFD demonstrated a strong correlation with AC (r = 0.75), which only experienced a slight decrease to 0.66 at a signal-to-noise ratio of 15dB, surpassing the best PPG-morphology-derived AC measure (r = 0.41) under the same noise condition. In addition, we observed that KFD's sensitivity to AC varied based on the individual's hemodynamic status, which may further enhance the accuracy of AC estimations. These in silico findings were supported by real-world measurements encompassing diverse health conditions. In conclusion, our study suggests that PPG-derived KFD has the potential to continuously and reliably monitor arterial compliance, enabling unobtrusive and wearable assessment of cardiovascular health.
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Affiliation(s)
- Xiaoman Xing
- School of Biomedical Engineering (Suzhou), Division of Life Sciences and Medicine, University of Science and Technology of China, Suzhou, China
- Suzhou Institute of Biomedical Engineering and Technology, Chinese Academy of Sciences, Suzhou, China
| | - Jingyuan Hong
- Division of Imaging Sciences and Biomedical Engineering, King’s College London, St. Thomas’ Hospital, London, United Kingdom
| | - Jordi Alastruey
- Division of Imaging Sciences and Biomedical Engineering, King’s College London, St. Thomas’ Hospital, London, United Kingdom
| | - Xi Long
- Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, Netherlands
| | - Haipeng Liu
- Centre for Intelligent Healthcare, Coventry University, Coventry, United Kingdom
| | - Wen-Fei Dong
- Suzhou Institute of Biomedical Engineering and Technology, Chinese Academy of Sciences, Suzhou, China
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10
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Vallée A. Heavy Lifetime Cannabis Use and Mortality by Sex. JAMA Netw Open 2024; 7:e2415227. [PMID: 38842807 PMCID: PMC11157356 DOI: 10.1001/jamanetworkopen.2024.15227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2023] [Accepted: 04/05/2024] [Indexed: 06/07/2024] Open
Abstract
Importance The association between mortality and cannabis use remains unclear. Objective To examine sex-stratified associations of cumulative lifetime cannabis use with all-cause, cardiovascular disease (CVD), and cancer mortality in the UK Biobank population. Design, Setting, and Participants This cohort study used data from volunteers in the UK Biobank population. Participant monitoring for mortality in the UK Biobank study commenced from the point of their inclusion between 2006 and 2010 and continued until December 19, 2020. Data regarding the causes of death were sourced from the National Health Service Information Centre. Data were analyzed from inception of study inclusion to December 2020. Exposure Cannabis use status was assessed by questionnaire and categorized as heavy, moderate, low, and never. Main Outcomes and Measures The main outcomes were all-cause, CVD, and cancer mortality. Sex-stratified associations of cumulative lifetime cannabis use with mortality were estimated using Cox proportional hazards regression with adjustment for demographic and clinical variables. Results Among 121 895 participants (54.51% females with mean [SD] age of 55.15 [7.64] years; 45.49% males with mean [SD] age of 56.46 [7.79] years) during an overall median of 11.80 years (IQR, 10.53-13.22 years) of follow-up, 2375 total deaths occurred, including 1411 deaths from CVD and 440 from cancer. In males, after full adjustment, the hazard ratios (HRs) were 1.28 (95% CI, 0.90-1.81) for all-cause mortality, 0.98 (95% CI, 0.43-2.25) for CVD mortality, and 1.09 (95% CI, 0.71-1.67) for cancer mortality among heavy cannabis users compared with never users. In females, after full adjustment, the HRs were 1.49 (95% CI, 0.92-2.40) for all-cause mortality, 2.67 (95% CI, 1.19-4.32) for CVD mortality, and 1.61 (95% CI, 0.91-2.83) for cancer mortality among heavy cannabis users compared with never users. In female current tobacco users, after full adjustment, heavy cannabis use was associated with all-cause mortality (HR, 2.25; 95% CI, 1.12-4.53), CVD mortality (HR, 2.56; 95% CI, 1.43-15.36), and cancer mortality (HR, 3.52; 95% CI, 1.50-8.33) and among never tobacco users was associated with CVD mortality (HR, 2.98; 95% CI, 1.67-6.61). In male current tobacco users, heavy cannabis use was associated with cancer mortality (HR, 2.44; 95% CI, 1.14-5.23). Conclusions and Relevance In this study, a positive association between CVD mortality and heavy lifetime cannabis use was observed among females. Longitudinal studies are needed in general populations to investigate the potential effects of cannabis on mortality.
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Affiliation(s)
- Alexandre Vallée
- Department of Epidemiology and Public Health, Foch Hospital, Suresnes, France
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11
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Han W, Zhang J, Xu Z, Yang T, Huang J, Beevers S, Kelly F, Li G. Could the association between ozone and arterial stiffness be modified by fish oil supplementation? ENVIRONMENTAL RESEARCH 2024; 249:118354. [PMID: 38325778 DOI: 10.1016/j.envres.2024.118354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Revised: 10/10/2023] [Accepted: 01/28/2024] [Indexed: 02/09/2024]
Abstract
BACKGROUND Arterial stiffness (AS) is an important predicting factor for cardiovascular disease. However, no epidemiological studies have ever explored the mediating role of biomarkers in the association between ozone and AS, nor weather fish oil modified such association. METHODS Study participants were drawn from the UK biobank, and a total of 95,699 middle-aged and older adults were included in this study. Ozone was obtained from Community Multiscale Air Quality (CMAQ) model matched to residential addresses, fish oil from self-reported intake, and arterial stiffness was based on device measurements. First, we applied a double robust approach to explore the association between ozone or fish oil intake and arterial stiffness, adjusting for potential confounders at the individual and regional levels. Then, how triglycerides, apolipoprotein B (Apo B)/apolipoprotein A (ApoA) and non-high-density lipoprotein cholesterol (Non-HDL-C) mediate the relationship between ozone and AS. Last, the modifying role of fish oil was further explored by stratified analysis. RESULTS The mean age of participants was 55 years; annual average ozone exposure was associated with ASI (beta:0.189 [95%CI: 0.146 to 0.233], P < 0.001), and compared to participants who did not consume fish oil, fish oil users had a lower ASI (beta: 0.061 [95%CI: -0.111 to -0.010], P = 0.016). The relationship between ozone exposure and AS was mediated by triglycerides, ApoB/ApoA, and Non-HDL-C with mediation proportions ranging from 10.90% to 18.30%. Stratified analysis showed lower estimates on the ozone-AS relationship in fish oil users (P = 0.011). CONCLUSION Ozone exposure was associated with higher levels of arterial stiffness, in contrast to fish oil consumption, which showed a protective association. The association between ozone exposure and arterial stiffness was partially mediated by some biomarkers. In the general population, fish oil consumption might provide protection against ozone-related AS.
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Affiliation(s)
- Wenxing Han
- Department of Occupational and Environmental Health Sciences, Peking University School of Public Health, Beijing, China.
| | - Jin Zhang
- Department of Occupational and Environmental Health Sciences, Peking University School of Public Health, Beijing, China.
| | - Zhihu Xu
- Department of Occupational and Environmental Health Sciences, Peking University School of Public Health, Beijing, China.
| | - Teng Yang
- Department of Occupational and Environmental Health Sciences, Peking University School of Public Health, Beijing, China.
| | - Jing Huang
- Department of Occupational and Environmental Health Sciences, Peking University School of Public Health, Beijing, China; Institute for Global Health and Development, Peking University, Beijing, China.
| | - Sean Beevers
- Environmental Research group, school of public health, Imperial college London, London, UK.
| | - Frank Kelly
- Environmental Research group, school of public health, Imperial college London, London, UK.
| | - Guoxing Li
- Department of Occupational and Environmental Health Sciences, Peking University School of Public Health, Beijing, China; Environmental Research group, school of public health, Imperial college London, London, UK.
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12
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Lohman T, Shenasa F, Sible I, Kapoor A, Engstrom AC, Dutt S, Head E, Sordo L, M Alitin JP, Gaubert A, Nguyen A, Nation DA. The interactive effect of intra-beat and inter-beat blood pressure variability on neurodegeneration in older adults. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2024:2024.05.01.24306724. [PMID: 38746307 PMCID: PMC11092712 DOI: 10.1101/2024.05.01.24306724] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/16/2024]
Abstract
Blood pressure variability (BPV) and arterial stiffness are age-related hemodynamic risk factors for neurodegenerative disease, but it remains unclear whether they exert independent or interactive effects on brain health. When combined with high inter-beat BPV, increased intra-beat BPV indicative of arterial stiffness could convey greater pressure wave fluctuations deeper into the cerebrovasculature, exacerbating neurodegeneration. This interactive effect was studied in older adults using multiple markers of neurodegeneration, including medial temporal lobe (MTL) volume, plasma neurofilament light (NfL) and glial fibrillary acidic protein (GFAP). Older adults (N=105) without major neurological or systemic disease were recruited and underwent brain MRI and continuous BP monitoring to quantify inter-beat BPV through systolic average real variability (ARV) and intra-beat variability through arterial stiffness index (ASI). Plasma NfL and GFAP were assessed. The interactive effect of ARV and ASI on MTL atrophy, plasma NfL, and GFAP was studied using hierarchical linear regression. Voxel-based morphometry (VBM) was used to confirm region-of-interest analysis findings. The interaction between higher ARV and higher ASI was significantly associated with left-sided MTL atrophy in both the region-of-interest and false discovery rate-corrected VBM analysis. The interactive effect was also significantly associated with increased plasma NfL, but not GFAP. The interaction between higher ARV and higher ASI is independently associated with increased neurodegenerative markers, including MTL atrophy and plasma NfL, in independently living older adults. Findings could suggest the increased risk for neurodegeneration associated with higher inter-beat BPV may be compounded by increased intra-beat variability due to arterial stiffness.
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13
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Karakasis P, Nasoufidou A, Sagris M, Fragakis N, Tsioufis K. Vascular Alterations Following COVID-19 Infection: A Comprehensive Literature Review. Life (Basel) 2024; 14:545. [PMID: 38792566 PMCID: PMC11122535 DOI: 10.3390/life14050545] [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: 04/09/2024] [Revised: 04/16/2024] [Accepted: 04/22/2024] [Indexed: 05/26/2024] Open
Abstract
SARS-CoV-2, the causative agent of the ongoing COVID-19 pandemic, has revealed a broader impact beyond the respiratory system, predominantly affecting the vascular system with various adverse manifestations. The infection induces endothelial dysfunction and immune system dysregulation, creating an inflammatory and hypercoagulable state. It affects both microvasculature and macrovasculature, leading to thromboembolic events, cardiovascular manifestations, impaired arterial stiffness, cerebrovascular complications, and nephropathy, as well as retinopathy-frequently observed in cases of severe illness. Evidence suggests that SARS-CoV-2 infection may result in persistent effects on the vascular system, identified as long-term COVID-19. This is characterized by prolonged inflammation, endotheliopathy, and an increased risk of vascular complications. Various imaging modalities, histopathological studies, and diagnostic tools such as video capillaroscopy and magnetic resonance imaging have been employed to visualize vascular alterations. This review aims to comprehensively summarize the evidence concerning short and long-term vascular alterations following COVID-19 infection, investigating their impact on patients' prognosis, and providing an overview of preventive strategies to mitigate associated vascular complications.
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Affiliation(s)
- Paschalis Karakasis
- Second Department of Cardiology, Aristotle University of Thessaloniki, Hippokration General Hospital, 54642 Thessaloniki, Greece; (P.K.); (A.N.); (N.F.)
| | - Athina Nasoufidou
- Second Department of Cardiology, Aristotle University of Thessaloniki, Hippokration General Hospital, 54642 Thessaloniki, Greece; (P.K.); (A.N.); (N.F.)
| | - Marios Sagris
- First Department of Cardiology, National and Kapodistrian University of Athens, Hippokration General Hospital, 11527 Athens, Greece;
| | - Nikolaos Fragakis
- Second Department of Cardiology, Aristotle University of Thessaloniki, Hippokration General Hospital, 54642 Thessaloniki, Greece; (P.K.); (A.N.); (N.F.)
| | - Konstantinos Tsioufis
- First Department of Cardiology, National and Kapodistrian University of Athens, Hippokration General Hospital, 11527 Athens, Greece;
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14
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St. Pierre SR, Kaczmarski B, Peirlinck M, Kuhl E. Sex-specific cardiovascular risk factors in the UK Biobank. Front Physiol 2024; 15:1339866. [PMID: 39165282 PMCID: PMC11333928 DOI: 10.3389/fphys.2024.1339866] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Accepted: 02/26/2024] [Indexed: 08/22/2024] Open
Abstract
The lack of sex-specific cardiovascular disease criteria contributes to the underdiagnosis of women compared to that of men. For more than half a century, the Framingham Risk Score has been the gold standard to estimate an individual's risk of developing cardiovascular disease based on the age, sex, cholesterol levels, blood pressure, diabetes status, and the smoking status. Now, machine learning can offer a much more nuanced insight into predicting the risk of cardiovascular diseases. The UK Biobank is a large database that includes traditional risk factors and tests related to the cardiovascular system: magnetic resonance imaging, pulse wave analysis, electrocardiograms, and carotid ultrasounds. Here, we leverage 20,542 datasets from the UK Biobank to build more accurate cardiovascular risk models than the Framingham Risk Score and quantify the underdiagnosis of women compared to that of men. Strikingly, for a first-degree atrioventricular block and dilated cardiomyopathy, two conditions with non-sex-specific diagnostic criteria, our study shows that women are under-diagnosed 2× and 1.4× more than men. Similarly, our results demonstrate the need for sex-specific criteria in essential primary hypertension and hypertrophic cardiomyopathy. Our feature importance analysis reveals that out of the top 10 features across three sexes and four disease categories, traditional Framingham factors made up between 40% and 50%; electrocardiogram, 30%-33%; pulse wave analysis, 13%-23%; and magnetic resonance imaging and carotid ultrasound, 0%-10%. Improving the Framingham Risk Score by leveraging big data and machine learning allows us to incorporate a wider range of biomedical data and prediction features, enhance personalization and accuracy, and continuously integrate new data and knowledge, with the ultimate goal to improve accurate prediction, early detection, and early intervention in cardiovascular disease management. Our analysis pipeline and trained classifiers are freely available at https://github.com/LivingMatterLab/CardiovascularDiseaseClassification.
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Affiliation(s)
- Skyler R. St. Pierre
- Department of Mechanical Engineering, Stanford University, Stanford, CA, United States
| | - Bartosz Kaczmarski
- Department of Mechanical Engineering, Stanford University, Stanford, CA, United States
| | - Mathias Peirlinck
- Department of BioMechanical Engineering, Delft University of Technology, Delft, Netherlands
| | - Ellen Kuhl
- Department of Mechanical Engineering, Stanford University, Stanford, CA, United States
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15
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Zanuzzi MG, Jeong J, DaCosta DR, Park J. Sex differences in sympathetic activity and pulse wave velocity in adults with chronic kidney disease. Am J Physiol Renal Physiol 2024; 326:F661-F668. [PMID: 38385174 PMCID: PMC11208017 DOI: 10.1152/ajprenal.00308.2023] [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: 10/02/2023] [Revised: 02/14/2024] [Accepted: 02/14/2024] [Indexed: 02/23/2024] Open
Abstract
Chronic kidney disease (CKD) is characterized by sympathetic nervous system (SNS) overactivity that contributes to increased vascular stiffness and cardiovascular risk. Although it is well established that SNS activity and vascular stiffness are substantially elevated in CKD, whether sex differences in autonomic and vascular function exist in CKD remains unknown. We tested the hypothesis that compared with females, males with CKD have higher baseline sympathetic activity that is related to increased arterial stiffness. One hundred twenty-nine participants (96 males and 33 females) with CKD stages III and IV were recruited and enrolled. During two separate study visits, vascular stiffness was assessed by measuring carotid-to-femoral pulse wave velocity (cfPWV), and resting muscle sympathetic nerve activity (MSNA) was measured by microneurography. Males with CKD had higher resting MSNA compared with females with CKD (68 ± 16 vs. 55 ± 14 bursts/100 heart beats, P = 0.005), whereas there was no difference in cfPWV between the groups (P = 0.248). Resting MSNA was not associated with cfPWV in both males and females. In conclusion, males with CKD have higher resting sympathetic activity compared with females with CKD. However, there was no difference in vascular stiffness between the sexes. There was no correlation between resting MSNA and cfPWV, suggesting that non-neural mechanisms may play a greater role in the progression of vascular stiffness in CKD, particularly in females.NEW & NOTEWORTHY Males with chronic kidney disease (CKD) have higher resting muscle sympathetic nerve activity (MSNA) compared with females. There was no correlation between MSNA and carotid-to-femoral pulse wave velocity (cfPWV), suggesting that non-neural mechanisms may play a greater role in the progression of vascular stiffness in CKD. Sex differences in SNS activity may play a mechanistic role in observations from epidemiological studies suggesting greater cardiovascular risk in males compared with females with CKD.
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Affiliation(s)
- Matias G Zanuzzi
- Division of Renal Medicine, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia, United States
- Department of Veterans Affairs Health Care System, Research Service Line, Decatur, Georgia, United States
| | - Jinhee Jeong
- Division of Renal Medicine, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia, United States
- Department of Veterans Affairs Health Care System, Research Service Line, Decatur, Georgia, United States
| | - Dana R DaCosta
- Division of Renal Medicine, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia, United States
- Department of Veterans Affairs Health Care System, Research Service Line, Decatur, Georgia, United States
| | - Jeanie Park
- Division of Renal Medicine, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia, United States
- Department of Veterans Affairs Health Care System, Research Service Line, Decatur, Georgia, United States
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16
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Serpelloni S, Williams ME, Caserta S, Sharma S, Rahimi M, Taraballi F. Electrospun Chitosan-Based Nanofibrous Coating for the Local and Sustained Release of Vancomycin. ACS OMEGA 2024; 9:11701-11717. [PMID: 38496925 PMCID: PMC10938330 DOI: 10.1021/acsomega.3c08113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Revised: 02/07/2024] [Accepted: 02/13/2024] [Indexed: 03/19/2024]
Abstract
As the population ages, the number of vascular surgery procedures performed increases. Older adults often have multiple comorbidities, such as diabetes and hypertension, that increase the risk of complications from vascular surgery including vascular graft infection (VGI). VGI is a serious complication with significant morbidity, mortality, and healthcare costs. Here, we aimed to develop a nanofibrous chitosan-based coating for vascular grafts loaded with different concentrations of the vancomycin antibiotic vancomycin (VAN). Blending chitosan with poly(vinyl alcohol) or poly(ethylene oxide) copolymers improved solubility and ease of spinning. Thermal gravimetric analysis and Fourier transform infrared spectroscopy confirmed the presence of VAN in the nanofibrous membranes. Kinetics of VAN release from the nanofibrous mats were evaluated using high-performance liquid chromatography, showing a burst followed by sustained release over 24 h. To achieve longer sustained release, a poly(lactic-co-glycolic acid) coating was applied, resulting in extended release of up to 7 days. Biocompatibility assessment using human umbilical vein endothelial cells demonstrated successful attachment and viability of the nanofiber patches. Our study provides insights into the development of a drug delivery system for vascular grafts aimed at preventing infection during implantation, highlighting the potential of electrospinning as a promising technique in the field of vascular surgery.
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Affiliation(s)
- Stefano Serpelloni
- Center
for Musculoskeletal Regeneration, Houston
Methodist Academic Institute, Houston, Texas 77030-2707, United States
- Department
of Electronics, Information and Bioengineering (DEIB), Politecnico di Milano, Milan 20133, Italy
- Department
of Orthopedics and Sport Medicine, Houston
Methodist Hospital, Houston, Texas 77030-2707, United States
| | - Michael Ellis Williams
- Center
for Musculoskeletal Regeneration, Houston
Methodist Academic Institute, Houston, Texas 77030-2707, United States
- Reproductive
Biology and Gynaecological Oncology Group, Swansea University Medical School, Singleton Park, Swansea SA2 8QA, U.K.
| | - Sergio Caserta
- Department
of Chemical Materials and Industrial Production Engineering, University of Naples Federico II, Naples 80138, Italy
| | - Shashank Sharma
- Department
of Cardiovascular Surgery, Houston Methodist
Hospital, Houston, Texas 77030-2707, United States
| | - Maham Rahimi
- Department
of Cardiovascular Surgery, Houston Methodist
Hospital, Houston, Texas 77030-2707, United States
| | - Francesca Taraballi
- Center
for Musculoskeletal Regeneration, Houston
Methodist Academic Institute, Houston, Texas 77030-2707, United States
- Department
of Orthopedics and Sport Medicine, Houston
Methodist Hospital, Houston, Texas 77030-2707, United States
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17
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Kwon RJ, Cho YH, Park EJ, Lee Y, Lee SY, Choi JI, Lee SR, Son SM. Relationship between Pulse Pressure and Handgrip Strength in the Korean Population: A Nationwide Cross-Sectional Study. J Clin Med 2024; 13:1515. [PMID: 38592346 PMCID: PMC10935154 DOI: 10.3390/jcm13051515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2024] [Revised: 03/05/2024] [Accepted: 03/05/2024] [Indexed: 04/10/2024] Open
Abstract
Background: Sarcopenia is defined as the loss of muscle mass and strength and low physical performance, and it is closely related to the risk of cardiovascular disease and mortality. Pulse pressure (PP) is a biomarker of arterial stiffness and compliance. Elevated PP levels increase the risk of cardiovascular diseases and all-cause mortality. Nevertheless, the association between PP and sarcopenia has not yet been clearly established. Methods: Participant data were extracted from the Korea National Health and Nutrition Examination Survey conducted from 2014 to 2020. The study population was classified into three groups (PP < 40 mmHg, 40 mmHg ≤ PP < 60 mmHg, and PP ≥ 60 mmHg). PP was calculated by deducting the diastolic blood pressure from the systolic blood pressure. For handgrip strength, the maximum value measured with a grip dynamometer was adopted (weak handgrip strength: <28 kg for men, <18 kg for woman; normal handgrip strength: ≥28 kg for men, ≥18 kg for women). To determine the relationship between PP and the prevalence of weak handgrip strength, multiple logistic regression analysis was performed after adjusting for possible confounding factors. Results: The higher PP group had a higher age, body mass index; systolic blood pressure, prevalence of hypertension, diabetes, hyperlipidemia, and metabolic syndrome, and maximum handgrip strength. In all models, the prevalence of weak handgrip strength was significantly higher in the group with PP ≥ 60 mmHg compared to the control group (PP < 40 mmHg). Conclusions: Elevated PP was significantly associated with a higher prevalence of weak muscle strength. Thus, PP monitoring may be used to identify individuals at risk of sarcopenia and is helpful in improving health outcomes.
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Affiliation(s)
- Ryuk Jun Kwon
- Family Medicine Clinic and Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan 50612, Republic of Korea; (R.J.K.)
- Department of Family Medicine, Pusan National University School of Medicine, Yangsan 50612, Republic of Korea
| | - Young Hye Cho
- Family Medicine Clinic and Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan 50612, Republic of Korea; (R.J.K.)
- Department of Family Medicine, Pusan National University School of Medicine, Yangsan 50612, Republic of Korea
| | - Eun-Ju Park
- Family Medicine Clinic and Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan 50612, Republic of Korea; (R.J.K.)
- Department of Family Medicine, Pusan National University School of Medicine, Yangsan 50612, Republic of Korea
| | - Youngin Lee
- Family Medicine Clinic and Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan 50612, Republic of Korea; (R.J.K.)
- Department of Family Medicine, Pusan National University School of Medicine, Yangsan 50612, Republic of Korea
| | - Sang Yeoup Lee
- Family Medicine Clinic and Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan 50612, Republic of Korea; (R.J.K.)
- Department of Medical Education, Pusan National University School of Medicine, Yangsan 50612, Republic of Korea
| | - Jung-In Choi
- Family Medicine Clinic and Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan 50612, Republic of Korea; (R.J.K.)
- Department of Family Medicine, Pusan National University School of Medicine, Yangsan 50612, Republic of Korea
| | - Sae Rom Lee
- Family Medicine Clinic and Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan 50612, Republic of Korea; (R.J.K.)
- Department of Family Medicine, Pusan National University School of Medicine, Yangsan 50612, Republic of Korea
| | - Soo Min Son
- Family Medicine Clinic and Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan 50612, Republic of Korea; (R.J.K.)
- Department of Family Medicine, Pusan National University School of Medicine, Yangsan 50612, Republic of Korea
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18
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Remfry E, Ardissino M, McCracken C, Szabo L, Neubauer S, Harvey NC, Mamas MA, Robson J, Petersen SE, Raisi-Estabragh Z. Sex-based differences in risk factors for incident myocardial infarction and stroke in the UK Biobank. EUROPEAN HEART JOURNAL. QUALITY OF CARE & CLINICAL OUTCOMES 2024; 10:132-142. [PMID: 37218687 PMCID: PMC10904726 DOI: 10.1093/ehjqcco/qcad029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Revised: 03/31/2023] [Accepted: 05/19/2023] [Indexed: 05/24/2023]
Abstract
AIM This study examined sex-based differences in associations of vascular risk factors with incident cardiovascular events in the UK Biobank. METHODS Baseline participant demographic, clinical, laboratory, anthropometric, and imaging characteristics were collected. Multivariable Cox regression was used to estimate independent associations of vascular risk factors with incident myocardial infarction (MI) and ischaemic stroke for men and women. Women-to-men ratios of hazard ratios (RHRs), and related 95% confidence intervals, represent the relative effect-size magnitude by sex. RESULTS Among the 363 313 participants (53.5% women), 8470 experienced MI (29.9% women) and 7705 experienced stroke (40.1% women) over 12.66 [11.93, 13.38] years of prospective follow-up. Men had greater risk factor burden and higher arterial stiffness index at baseline. Women had greater age-related decline in aortic distensibility. Older age [RHR: 1.02 (1.01-1.03)], greater deprivation [RHR: 1.02 (1.00-1.03)], hypertension [RHR: 1.14 (1.02-1.27)], and current smoking [RHR: 1.45 (1.27-1.66)] were associated with a greater excess risk of MI in women than men. Low-density lipoprotein cholesterol was associated with excess MI risk in men [RHR: 0.90 (0.84-0.95)] and apolipoprotein A (ApoA) was less protective for MI in women [RHR: 1.65 (1.01-2.71)]. Older age was associated with excess risk of stroke [RHR: 1.01 (1.00-1.02)] and ApoA was less protective for stroke in women [RHR: 2.55 (1.58-4.14)]. CONCLUSION Older age, hypertension, and smoking appeared stronger drivers of cardiovascular disease in women, whereas lipid metrics appeared stronger risk determinants for men. These findings highlight the importance of sex-specific preventive strategies and suggest priority targets for intervention in men and women.
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Affiliation(s)
- Elizabeth Remfry
- William Harvey Research Institute, NIHR Barts Biomedical Research Centre, Queen Mary University of London, Charterhouse Square, London EC1M 6BQ, UK
| | - Maddalena Ardissino
- National Heart and Lung Institute, Imperial College London, Hammersmith Hospital, London SW3 6LY, UK
| | - Celeste McCracken
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, National Institute for Health Research Oxford Biomedical Research Centre, Oxford University Hospitals NHS Foundation Trust, Oxford OX3 9DU, UK
| | - Liliana Szabo
- William Harvey Research Institute, NIHR Barts Biomedical Research Centre, Queen Mary University of London, Charterhouse Square, London EC1M 6BQ, UK
- Semmelweis University, Heart and Vascular Center, Hungary, Budapest 1122, Hungary
- Barts Heart Centre, St Bartholomew's Hospital, Barts Health NHS Trust, West Smithfield EC1A 7BE, UK
| | - Stefan Neubauer
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, National Institute for Health Research Oxford Biomedical Research Centre, Oxford University Hospitals NHS Foundation Trust, Oxford OX3 9DU, UK
| | - Nicholas C Harvey
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton SO16 6YD, UK
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton SO16 6YD, UK
| | - Mamas A Mamas
- Keele Cardiovascular Research Group, Keele University, Keele ST5 5BG, UK
- Institute of Population Health, University of Manchester, Manchester M13 9NT, UK
| | - John Robson
- Wolfson Institute of Population Health Sciences, Queen Mary University of London, London E1 4NS, UK
| | - Steffen E Petersen
- William Harvey Research Institute, NIHR Barts Biomedical Research Centre, Queen Mary University of London, Charterhouse Square, London EC1M 6BQ, UK
- Barts Heart Centre, St Bartholomew's Hospital, Barts Health NHS Trust, West Smithfield EC1A 7BE, UK
- Health Data Research UK, London NW1 2BE, UK
- Alan Turing Institute, London NW1 2DB, UK
| | - Zahra Raisi-Estabragh
- William Harvey Research Institute, NIHR Barts Biomedical Research Centre, Queen Mary University of London, Charterhouse Square, London EC1M 6BQ, UK
- Barts Heart Centre, St Bartholomew's Hospital, Barts Health NHS Trust, West Smithfield EC1A 7BE, UK
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19
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Sun DY, Wu WB, Wu JJ, Shi Y, Xu JJ, Ouyang SX, Chi C, Shi Y, Ji QX, Miao JH, Fu JT, Tong J, Zhang PP, Zhang JB, Li ZY, Qu LF, Shen FM, Li DJ, Wang P. Pro-ferroptotic signaling promotes arterial aging via vascular smooth muscle cell senescence. Nat Commun 2024; 15:1429. [PMID: 38365899 PMCID: PMC10873425 DOI: 10.1038/s41467-024-45823-w] [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: 07/15/2023] [Accepted: 02/05/2024] [Indexed: 02/18/2024] Open
Abstract
Senescence of vascular smooth muscle cells (VSMCs) contributes to aging-related cardiovascular diseases by promoting arterial remodelling and stiffness. Ferroptosis is a novel type of regulated cell death associated with lipid oxidation. Here, we show that pro-ferroptosis signaling drives VSMCs senescence to accelerate vascular NAD+ loss, remodelling and aging. Pro-ferroptotic signaling is triggered in senescent VSMCs and arteries of aged mice. Furthermore, the activation of pro-ferroptotic signaling in VSMCs not only induces NAD+ loss and senescence but also promotes the release of a pro-senescent secretome. Pharmacological or genetic inhibition of pro-ferroptosis signaling, ameliorates VSMCs senescence, reduces vascular stiffness and retards the progression of abdominal aortic aneurysm in mice. Mechanistically, we revealed that inhibition of pro-ferroptotic signaling facilitates the nuclear-cytoplasmic shuttling of proliferator-activated receptor-γ and, thereby impeding nuclear receptor coactivator 4-ferrtin complex-centric ferritinophagy. Finally, the activated pro-ferroptotic signaling correlates with arterial stiffness in a human proof-of-concept study. These findings have significant implications for future therapeutic strategies aiming to eliminate vascular ferroptosis in senescence- or aging-associated cardiovascular diseases.
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Affiliation(s)
- Di-Yang Sun
- The Center for Basic Research and Innovation of Medicine and Pharmacy (MOE), School of Pharmacy, Second Military Medical University/Naval Medical University, Shanghai, China
- Jinling Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China
| | - Wen-Bin Wu
- The Center for Basic Research and Innovation of Medicine and Pharmacy (MOE), School of Pharmacy, Second Military Medical University/Naval Medical University, Shanghai, China
| | - Jian-Jin Wu
- Department of Vascular and Endovascular Surgery, Changzheng Hospital, Naval Medical University/Second Military Medical University, Shanghai, China
| | - Yu Shi
- Department of Pharmacy, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China
| | - Jia-Jun Xu
- Department of Diving and Hyperbaric Medicine, Naval Special Medical Center, Naval Medical University/Second Military Medical University, Shanghai, China
| | - Shen-Xi Ouyang
- Department of Pharmacy, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China
| | - Chen Chi
- Department of Pharmacy, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China
- Department of Cardiology, School of Medicine, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China
| | - Yi Shi
- Shanghai Key Laboratory of Organ Transplantation, Fudan University, Shanghai, China
- Institute of Clinical Science, Zhongshan Hospital Fudan University, Shanghai, China
| | - Qing-Xin Ji
- Department of Pharmacy, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China
| | - Jin-Hao Miao
- Department of Orthopedic Surgery/Spine Center, Changzheng Hospital Affiliated Hospital of Naval Medical University/Second Military Medical University, Shanghai, China
| | - Jiang-Tao Fu
- The Center for Basic Research and Innovation of Medicine and Pharmacy (MOE), School of Pharmacy, Second Military Medical University/Naval Medical University, Shanghai, China
| | - Jie Tong
- Department of Pharmacy, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China
| | - Ping-Ping Zhang
- The Center for Basic Research and Innovation of Medicine and Pharmacy (MOE), School of Pharmacy, Second Military Medical University/Naval Medical University, Shanghai, China
| | - Jia-Bao Zhang
- The Center for Basic Research and Innovation of Medicine and Pharmacy (MOE), School of Pharmacy, Second Military Medical University/Naval Medical University, Shanghai, China
- The National Demonstration Center for Experimental Pharmaceutical Education, Naval Medical University/Second Military Medical University, Shanghai, China
| | - Zhi-Yong Li
- The Center for Basic Research and Innovation of Medicine and Pharmacy (MOE), School of Pharmacy, Second Military Medical University/Naval Medical University, Shanghai, China
- The National Demonstration Center for Experimental Pharmaceutical Education, Naval Medical University/Second Military Medical University, Shanghai, China
| | - Le-Feng Qu
- Department of Vascular and Endovascular Surgery, Changzheng Hospital, Naval Medical University/Second Military Medical University, Shanghai, China.
| | - Fu-Ming Shen
- Department of Pharmacy, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China.
| | - Dong-Jie Li
- Department of Pharmacy, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China.
| | - Pei Wang
- The Center for Basic Research and Innovation of Medicine and Pharmacy (MOE), School of Pharmacy, Second Military Medical University/Naval Medical University, Shanghai, China.
- The National Demonstration Center for Experimental Pharmaceutical Education, Naval Medical University/Second Military Medical University, Shanghai, China.
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20
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Han BG, Pak D, Kim JS, Sohn Y. The moderating effect of fluid overload on the relationship between the augmentation index and left ventricular diastolic function in patients with CKD. Sci Rep 2024; 14:480. [PMID: 38177252 PMCID: PMC10767097 DOI: 10.1038/s41598-023-50746-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2023] [Accepted: 12/24/2023] [Indexed: 01/06/2024] Open
Abstract
Increased vascular stiffness, fluid overload, and left ventricular diastolic dysfunction (LVDD) are common in patients with chronic kidney disease (CKD). We investigated the potential moderating effect of volume status in the relationship between arterial stiffness and left ventricular (LV) diastolic function in non-dialysis patients with stage 5 CKD. The radial augmentation index at a heart rate of 75 beats/min (rAIx75), overhydration/extracellular water (OH/ECW), and E/e´ ratio were concurrently measured in 152 consecutive patients. Each of these parameters reflects the status of vascular stiffness, fluid balance, and LV diastolic function, respectively. Hierarchical regression analysis demonstrated a significant interaction effect of OH/ECW for all patients (P = 0.015), even after controlling for confounders. In separate analyses, this interaction effect was particularly significant in women (P = 0.010), whereas its significance in patients with diabetes was marginally significant (P = 0.062). Our study suggested that fluid overload could be one of the more aggravating factors of LVDD in patients with CKD who have increased arterial stiffness. Therefore, it is advisable to conduct simultaneous assessments of vascular stiffness, fluid balance, and LV function, particularly in the specific groups mentioned earlier. Our results may serve as evidence applicable to patients with chronic heart failure.
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Affiliation(s)
- Byoung-Geun Han
- Department of Nephrology, Yonsei University Wonju College of Medicine, Kang-Won, Wonju, Korea
| | - Daewoo Pak
- Division of Data Science, Yonsei University, Kang-Won, Wonju, Korea
| | - Jae-Seok Kim
- Department of Nephrology, Yonsei University Wonju College of Medicine, Kang-Won, Wonju, Korea
| | - Yujin Sohn
- Department of Infectious Disease, Yonsei University Wonju College of Medicine, Kang-Won, Wonju, Korea.
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21
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Scarlatescu AI, Micheu MM, Petre IG, Oprescu N, Mihail AM, Cojocaru ID, Vatasescu RG. Left Ventricular-Arterial Coupling as an Independent Predictor of Adverse Events in Young Patients with ST Elevation Myocardial Infarction-A 3D Echocardiographic Study. Biomedicines 2024; 12:105. [PMID: 38255210 PMCID: PMC10812951 DOI: 10.3390/biomedicines12010105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2023] [Revised: 12/28/2023] [Accepted: 01/02/2024] [Indexed: 01/24/2024] Open
Abstract
Left ventricular-arterial coupling (VAC) is a key determinant of global cardiovascular performance, calculated as the ratio between arterial elastance (EA) and left ventricular end-systolic elastance (EES). Over the years, acute myocardial infarction (STEMI) has remained an important cause of morbidity and mortality worldwide. Although, until recently, it was considered a disease occurring mostly in older patients, its prevalence in the young population is continuously rising. In this study, we aimed to investigate the role of 3D VAC and its derived indices in predicting adverse outcomes in young patients with STEMI. We prospectively enrolled 84 young patients (18-51 years) with STEMI who underwent primary PCI and 28 healthy age and sex-matched controls. A 3D echocardiography was used for non-invasive measurements of end-systolic elastance (EES), arterial elastance (EA), and VAC (EA/EES). The occurrence of major adverse cardiac events (MACE) was assessed one year after the index STEMI. Out of 84 patients, 15.4% had adverse events at 12 months follow-up. Patients were divided into two groups according to the presence or absence of MACE. There were no significant differences in arterial elastance between the two groups. EA was higher in the MACE group but without statistical significance (2.65 vs. 2.33; p = 0.09). EES was significantly lower in the MACE group (1.25 ± 0.34 vs. 1.91 ± 0.56. p < 0.0001) and VAC was higher (2.2 ± 0.62 vs. 1.24 ± 0.29, p < 0.0001). ROC analysis showed that VAC has a better predictive value for MACE (AUC 0.927) compared with EA or EEA but also compared with a classical determinant of LV function (LVEF and LVGLS). A VAC value over 1.71 predicts unfavourable outcome with 83.3% sensitivity and 97.1% specificity. In both univariate and multivariate COX regression analysis, VAC remained an independent predictor for MACE and demonstrated incremental prognostic value over LVEF and LVGLS in the proposed statistical models. In conclusion, 3D VAC is an independent predictor of adverse events in young patients with STEMI at a 12 month follow-ups and could be used for a more accurate risk stratification in the acute phase.
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Affiliation(s)
- Alina Ioana Scarlatescu
- Department of Cardiology, Clinic Emergency Hospital of Bucharest, Calea Floreasca 8, 014461 Bucharest, Romania; (A.I.S.); (I.G.P.); (N.O.); (A.M.M.); (I.D.C.); (R.G.V.)
| | - Miruna Mihaela Micheu
- Department of Cardiology, Clinic Emergency Hospital of Bucharest, Calea Floreasca 8, 014461 Bucharest, Romania; (A.I.S.); (I.G.P.); (N.O.); (A.M.M.); (I.D.C.); (R.G.V.)
| | - Ioana Gabriela Petre
- Department of Cardiology, Clinic Emergency Hospital of Bucharest, Calea Floreasca 8, 014461 Bucharest, Romania; (A.I.S.); (I.G.P.); (N.O.); (A.M.M.); (I.D.C.); (R.G.V.)
- Department IV—Cardio-Thoracic Pathology, Carol Davila University of Medicine and Pharmacy, Eroii Sanitari Bvd. 8, 050474 Bucharest, Romania
| | - Nicoleta Oprescu
- Department of Cardiology, Clinic Emergency Hospital of Bucharest, Calea Floreasca 8, 014461 Bucharest, Romania; (A.I.S.); (I.G.P.); (N.O.); (A.M.M.); (I.D.C.); (R.G.V.)
| | - Ana Maria Mihail
- Department of Cardiology, Clinic Emergency Hospital of Bucharest, Calea Floreasca 8, 014461 Bucharest, Romania; (A.I.S.); (I.G.P.); (N.O.); (A.M.M.); (I.D.C.); (R.G.V.)
| | - Ioana Denise Cojocaru
- Department of Cardiology, Clinic Emergency Hospital of Bucharest, Calea Floreasca 8, 014461 Bucharest, Romania; (A.I.S.); (I.G.P.); (N.O.); (A.M.M.); (I.D.C.); (R.G.V.)
| | - Radu Gabriel Vatasescu
- Department of Cardiology, Clinic Emergency Hospital of Bucharest, Calea Floreasca 8, 014461 Bucharest, Romania; (A.I.S.); (I.G.P.); (N.O.); (A.M.M.); (I.D.C.); (R.G.V.)
- Department IV—Cardio-Thoracic Pathology, Carol Davila University of Medicine and Pharmacy, Eroii Sanitari Bvd. 8, 050474 Bucharest, Romania
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22
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Fu Z, Ma Y, Yang C, Liu Q, Liang J, Weng Z, Li W, Zhou S, Chen X, Xu J, Xu C, Huang T, Zhou Y, Gu A. Association of air pollution exposure and increased coronary artery disease risk: the modifying effect of genetic susceptibility. Environ Health 2023; 22:85. [PMID: 38062446 PMCID: PMC10704645 DOI: 10.1186/s12940-023-01038-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Accepted: 11/29/2023] [Indexed: 12/18/2023]
Abstract
BACKGROUND Both genetic factors and air pollution are risk factors for coronary artery disease (CAD), but their combined effects on CAD are uncertain. The study aimed to comprehensively investigate their separate, combined and interaction effects on the onset of CAD. METHODS We utilized data from the UK Biobank with a recruitment of 487,507 participants who were free of CAD at baseline from 2006 to 2010. We explored the separate, combined effect or interaction association among genetic factors, air pollution and CAD with the polygenic risk score (PRS) and Cox proportional hazard models. RESULTS The hazard ratios (HRs) [95% confidence interval (CI)] of CAD for 10-µg/m3 increases in PM2.5, NO2 and NOx concentrations were 1.25 (1.09, 1.44), 1.03 (1.01, 1.05) and 1.01 (1.00, 1.02), respectively. Participants with high PRS and air pollution exposure had a higher risk of CAD than those with the low genetic risk and low air pollution exposure, and the HRs (95% CI) of CAD in the PM2.5, PM10, NO2 and NOx high joint exposure groups were 1.56 (1.48, 1.64), 1.55(1.48, 1.63), 1.57 (1.49, 1.65), and 1.57 (1.49, 1.65), respectively. Air pollution and genetic factors exerted significant additive effects on the development of CAD (relative excess risk due to the interaction [RERI]: 0.12 (0.05, 0.19) for PM2.5, 0.17 (0.10, 0.24) for PM10, 0.14 (0.07, 0.21) for NO2, and 0.17 (0.10, 0.24) for NOx; attributable proportion due to the interaction [AP]: 0.09 (0.04, 0.14) for PM2.5, 0.12 (0.07, 0.18) for PM10, 0.11 (0.06, 0.16) for NO2, and 0.13 (0.08, 0.18) for NOx). CONCLUSION Exposure to air pollution was significantly related to an increased CAD risk, which could be further strengthened by CAD gene susceptibility. Additionally, there were positive additive interactions between genetic factors and air pollution on the onset of CAD. This can provide a more comprehensive, precise and individualized scientific basis for the risk assessment, prevention and control of CAD.
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Affiliation(s)
- Zuqiang Fu
- State Key Laboratory of Reproductive Medicine and Offspring Health, School of Public Health, Nanjing Medical University, 101 Longmian Avenue, Nanjing, 211166, China
- Collaborative Innovation Center for Cardiovascular Disease Translational Medicine, Nanjing Medical University, Nanjing, China
- Department of Toxicology, Center for Global Health, Nanjing Medical University, Nanjing, China
- School of Public Health, Southeast University, 101 Longmian Avenue, Nanjing, 211166, China
| | - Yuanyuan Ma
- State Key Laboratory of Reproductive Medicine and Offspring Health, School of Public Health, Nanjing Medical University, 101 Longmian Avenue, Nanjing, 211166, China
- Collaborative Innovation Center for Cardiovascular Disease Translational Medicine, Nanjing Medical University, Nanjing, China
- Department of Toxicology, Center for Global Health, Nanjing Medical University, Nanjing, China
| | - Changjie Yang
- State Key Laboratory of Reproductive Medicine and Offspring Health, School of Public Health, Nanjing Medical University, 101 Longmian Avenue, Nanjing, 211166, China
- Collaborative Innovation Center for Cardiovascular Disease Translational Medicine, Nanjing Medical University, Nanjing, China
- Department of Toxicology, Center for Global Health, Nanjing Medical University, Nanjing, China
| | - Qian Liu
- State Key Laboratory of Reproductive Medicine and Offspring Health, School of Public Health, Nanjing Medical University, 101 Longmian Avenue, Nanjing, 211166, China
- Collaborative Innovation Center for Cardiovascular Disease Translational Medicine, Nanjing Medical University, Nanjing, China
- Department of Toxicology, Center for Global Health, Nanjing Medical University, Nanjing, China
| | - Jingjia Liang
- State Key Laboratory of Reproductive Medicine and Offspring Health, School of Public Health, Nanjing Medical University, 101 Longmian Avenue, Nanjing, 211166, China
- Collaborative Innovation Center for Cardiovascular Disease Translational Medicine, Nanjing Medical University, Nanjing, China
- Department of Toxicology, Center for Global Health, Nanjing Medical University, Nanjing, China
| | - Zhenkun Weng
- State Key Laboratory of Reproductive Medicine and Offspring Health, School of Public Health, Nanjing Medical University, 101 Longmian Avenue, Nanjing, 211166, China
- Collaborative Innovation Center for Cardiovascular Disease Translational Medicine, Nanjing Medical University, Nanjing, China
- Department of Toxicology, Center for Global Health, Nanjing Medical University, Nanjing, China
| | - Wenxiang Li
- State Key Laboratory of Reproductive Medicine and Offspring Health, School of Public Health, Nanjing Medical University, 101 Longmian Avenue, Nanjing, 211166, China
- Collaborative Innovation Center for Cardiovascular Disease Translational Medicine, Nanjing Medical University, Nanjing, China
- Department of Toxicology, Center for Global Health, Nanjing Medical University, Nanjing, China
| | - Shijie Zhou
- State Key Laboratory of Reproductive Medicine and Offspring Health, School of Public Health, Nanjing Medical University, 101 Longmian Avenue, Nanjing, 211166, China
- Collaborative Innovation Center for Cardiovascular Disease Translational Medicine, Nanjing Medical University, Nanjing, China
- Department of Toxicology, Center for Global Health, Nanjing Medical University, Nanjing, China
| | - Xiu Chen
- State Key Laboratory of Reproductive Medicine and Offspring Health, School of Public Health, Nanjing Medical University, 101 Longmian Avenue, Nanjing, 211166, China
- Collaborative Innovation Center for Cardiovascular Disease Translational Medicine, Nanjing Medical University, Nanjing, China
- Department of Toxicology, Center for Global Health, Nanjing Medical University, Nanjing, China
| | - Jin Xu
- State Key Laboratory of Reproductive Medicine and Offspring Health, School of Public Health, Nanjing Medical University, 101 Longmian Avenue, Nanjing, 211166, China
- Collaborative Innovation Center for Cardiovascular Disease Translational Medicine, Nanjing Medical University, Nanjing, China
- Department of Toxicology, Center for Global Health, Nanjing Medical University, Nanjing, China
- Department of Maternal, Child, and Adolescent Health, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Cheng Xu
- State Key Laboratory of Reproductive Medicine and Offspring Health, School of Public Health, Nanjing Medical University, 101 Longmian Avenue, Nanjing, 211166, China.
- Collaborative Innovation Center for Cardiovascular Disease Translational Medicine, Nanjing Medical University, Nanjing, China.
- Department of Toxicology, Center for Global Health, Nanjing Medical University, Nanjing, China.
| | - Tao Huang
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, 38 Xueyuan Road, Beijing, 100191, China.
| | - Yong Zhou
- CAS Key Laboratory of Tissue Microenvironment and Tumor, Shanghai Institute of Nutrition and Health, Shanghai Institutes for Biological Sciences, University of Chinese Academy of Sciences, Chinese Academy of Sciences, No. 320 Yueyang Road, Shanghai, 200031, China.
| | - Aihua Gu
- State Key Laboratory of Reproductive Medicine and Offspring Health, School of Public Health, Nanjing Medical University, 101 Longmian Avenue, Nanjing, 211166, China.
- Collaborative Innovation Center for Cardiovascular Disease Translational Medicine, Nanjing Medical University, Nanjing, China.
- Department of Toxicology, Center for Global Health, Nanjing Medical University, Nanjing, China.
- School of Public Health, Southeast University, 101 Longmian Avenue, Nanjing, 211166, China.
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23
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Bosman M, Krüger D, Van Assche C, Boen H, Neutel C, Favere K, Franssen C, Martinet W, Roth L, De Meyer GRY, Cillero-Pastor B, Delrue L, Heggermont W, Van Craenenbroeck EM, Guns PJ. Doxorubicin-induced cardiovascular toxicity: a longitudinal evaluation of functional and molecular markers. Cardiovasc Res 2023; 119:2579-2590. [PMID: 37625456 PMCID: PMC10676457 DOI: 10.1093/cvr/cvad136] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Revised: 06/19/2023] [Accepted: 07/27/2023] [Indexed: 08/27/2023] Open
Abstract
AIMS Apart from cardiotoxicity, the chemotherapeutic doxorubicin (DOX) induces vascular toxicity, represented by arterial stiffness and endothelial dysfunction. Both parameters are of interest for cardiovascular risk stratification as they are independent predictors of future cardiovascular events in the general population. However, the time course of DOX-induced cardiovascular toxicity remains unclear. Moreover, current biomarkers for cardiovascular toxicity prove insufficient. Here, we longitudinally evaluated functional and molecular markers of DOX-induced cardiovascular toxicity in a murine model. Molecular markers were further validated in patient plasma. METHODS AND RESULTS DOX (4 mg/kg) or saline (vehicle) was administered intra-peritoneally to young, male mice weekly for 6 weeks. In vivo cardiovascular function and ex vivo arterial stiffness and vascular reactivity were evaluated at baseline, during DOX therapy (Weeks 2 and 4) and after therapy cessation (Weeks 6, 9, and 15). Left ventricular ejection fraction (LVEF) declined from Week 4 in the DOX group. DOX increased arterial stiffness in vivo and ex vivo at Week 2, which reverted thereafter. Importantly, DOX-induced arterial stiffness preceded reduced LVEF. Further, DOX impaired endothelium-dependent vasodilation at Weeks 2 and 6, which recovered at Weeks 9 and 15. Conversely, contraction with phenylephrine was consistently higher in the DOX-treated group. Furthermore, proteomic analysis on aortic tissue identified increased thrombospondin-1 (THBS1) and alpha-1-antichymotrypsin (SERPINA3) at Weeks 2 and 6. Up-regulated THBS1 and SERPINA3 persisted during follow-up. Finally, THBS1 and SERPINA3 were quantified in plasma of patients. Cancer survivors with anthracycline-induced cardiotoxicity (AICT; LVEF < 50%) showed elevated THBS1 and SERPINA3 levels compared with age-matched control patients (LVEF ≥ 60%). CONCLUSIONS DOX increased arterial stiffness and impaired endothelial function, which both preceded reduced LVEF. Vascular dysfunction restored after DOX therapy cessation, whereas cardiac dysfunction persisted. Further, we identified SERPINA3 and THBS1 as promising biomarkers of DOX-induced cardiovascular toxicity, which were confirmed in AICT patients.
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Affiliation(s)
- Matthias Bosman
- Laboratory of Physiopharmacology, Faculty of Medicine and Health Sciences, Faculty of Pharmaceutical, Biomedical and Veterinary Sciences, Campus Drie Eiken, University of Antwerp, Universiteitsplein 1, Antwerp B-2610, Belgium
| | - Dustin Krüger
- Laboratory of Physiopharmacology, Faculty of Medicine and Health Sciences, Faculty of Pharmaceutical, Biomedical and Veterinary Sciences, Campus Drie Eiken, University of Antwerp, Universiteitsplein 1, Antwerp B-2610, Belgium
| | - Charles Van Assche
- Research Group M4I—Imaging Mass Spectrometry (IMS); Faculty of Health, Medicine and Life Sciences, Maastricht MultiModal Molecular Imaging Institute, Maastricht University, Universiteitssingel 50, 6229 ER, Maastricht, The Netherlands
| | - Hanne Boen
- Research Group Cardiovascular Diseases, GENCOR, University of Antwerp, Antwerp B-2610, Belgium
- Department of Cardiology, Antwerp University Hospital (UZA), Drie Eikenstraat 655, Edegem B-2650, Belgium
| | - Cédric Neutel
- Laboratory of Physiopharmacology, Faculty of Medicine and Health Sciences, Faculty of Pharmaceutical, Biomedical and Veterinary Sciences, Campus Drie Eiken, University of Antwerp, Universiteitsplein 1, Antwerp B-2610, Belgium
| | - Kasper Favere
- Laboratory of Physiopharmacology, Faculty of Medicine and Health Sciences, Faculty of Pharmaceutical, Biomedical and Veterinary Sciences, Campus Drie Eiken, University of Antwerp, Universiteitsplein 1, Antwerp B-2610, Belgium
- Research Group Cardiovascular Diseases, GENCOR, University of Antwerp, Antwerp B-2610, Belgium
- Department of Cardiology, Antwerp University Hospital (UZA), Drie Eikenstraat 655, Edegem B-2650, Belgium
| | - Constantijn Franssen
- Research Group Cardiovascular Diseases, GENCOR, University of Antwerp, Antwerp B-2610, Belgium
- Department of Cardiology, Antwerp University Hospital (UZA), Drie Eikenstraat 655, Edegem B-2650, Belgium
| | - Wim Martinet
- Laboratory of Physiopharmacology, Faculty of Medicine and Health Sciences, Faculty of Pharmaceutical, Biomedical and Veterinary Sciences, Campus Drie Eiken, University of Antwerp, Universiteitsplein 1, Antwerp B-2610, Belgium
| | - Lynn Roth
- Laboratory of Physiopharmacology, Faculty of Medicine and Health Sciences, Faculty of Pharmaceutical, Biomedical and Veterinary Sciences, Campus Drie Eiken, University of Antwerp, Universiteitsplein 1, Antwerp B-2610, Belgium
| | - Guido R Y De Meyer
- Laboratory of Physiopharmacology, Faculty of Medicine and Health Sciences, Faculty of Pharmaceutical, Biomedical and Veterinary Sciences, Campus Drie Eiken, University of Antwerp, Universiteitsplein 1, Antwerp B-2610, Belgium
| | - Berta Cillero-Pastor
- Research Group M4I—Imaging Mass Spectrometry (IMS); Faculty of Health, Medicine and Life Sciences, Maastricht MultiModal Molecular Imaging Institute, Maastricht University, Universiteitssingel 50, 6229 ER, Maastricht, The Netherlands
- Department of Cell Biology-Inspired Tissue Engineering, Institute for Technology-Inspired Regenerative Medicine, Universiteitssingel 40, 6229 ER Maastricht/Room C3.577, PO Box 616, Maastricht 6200 MD, The Netherlands
| | - Leen Delrue
- Department of Cardiology, Cardiovascular Center OLV Hospital Aalst, Moorselbaan 164, Aalst B-9300, Belgium
| | - Ward Heggermont
- Department of Cardiology, Cardiovascular Center OLV Hospital Aalst, Moorselbaan 164, Aalst B-9300, Belgium
- Department of Cardiology, Center for Molecular and Vascular Biology, KU Leuven, Herestraat 49, Leuven B-3000, Belgium
| | - Emeline M Van Craenenbroeck
- Research Group Cardiovascular Diseases, GENCOR, University of Antwerp, Antwerp B-2610, Belgium
- Department of Cardiology, Antwerp University Hospital (UZA), Drie Eikenstraat 655, Edegem B-2650, Belgium
| | - Pieter-Jan Guns
- Laboratory of Physiopharmacology, Faculty of Medicine and Health Sciences, Faculty of Pharmaceutical, Biomedical and Veterinary Sciences, Campus Drie Eiken, University of Antwerp, Universiteitsplein 1, Antwerp B-2610, Belgium
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Claessens PJ, Peeters R, Claessens L, Claessens C, Claessens J, Claessens PM. Pulse wave analysis measurements: important, underestimated and undervalued parameters in cardiovascular health problems. Front Cardiovasc Med 2023; 10:1266258. [PMID: 38028442 PMCID: PMC10653328 DOI: 10.3389/fcvm.2023.1266258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Accepted: 09/25/2023] [Indexed: 12/01/2023] Open
Abstract
Background Central aortic stiffness is established as a reliable measure of cardiovascular disease. While pulse wave velocity (PWV) analysis measures arterial distensibility, risk profile of cardiovascular diseases can be expanded with following pulse wave analysis measurements: central aortic systolic blood pressure (CABPS), central aortic pulse pressure (CAPP), central aortic reflection magnitude (CARM), central aortic augmented pressure (CAAP) and central aortic augmentation index (CAAIx). The aim of this study is to evaluate the clinical usefulness and importance of pulse wave analysis measurements in specific cardiovascular conditions and diseases, both in term of diagnosis and therapeutic monitoring. Methods One thousand sixty-six subjects were included. According to age bracket, four cohorts were investigated-healthy subjects (NL), hypertensive patients (HP), ischemic heart disease (IHD) and valvular heart disease (VHD) patients. Arterial stiffness was analyzed through Sphygmocor XCEL Central Blood Pressure Measurement System and Sphygmocor XCEL PWV Measurement System. Furthermore we observed the pulse wave analysis measurements of 14 patients with diagnose of ADHD who were referred by a child psychiatrist, in order to investigate the initiation of methylphenidate treatment. Results Statistically significant differences were found between NL and HP cohorts, across almost all age brackets, regarding pulse wave analysis measurements. In the risk stratification of arterial stiffness hypertension and especially central aortic blood pressure systolic (CABPS) seems a determining factor. Pulse wave analysis measurements for IHD and VHD cohort comparisons with NL counterparts, revealed non- statistically significant variations. Elevated CAAP, CAAIx and CARM within the youngest age group (0-10 years) in attention-deficit-hyperactivity-disorder (ADHD) patients warrant attention. Conclusions Following such investigations, CABPS appears as a robust predominant factor in problems of arterial stiffness. Pulse wave analysis and PWV are important parameters in the evaluation and monitoring of arterial hypertension and cardiovascular diseases. There is a hypothesis that CAAP could be an important and even decisive parameter in the diagnosis of ADHD. Further investigation needed.
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Affiliation(s)
| | | | | | | | | | - Philip Maria Claessens
- Medical Center “Kloppend Hart Essen-Antwerpen- Schilde”, Antwerp, Belgium
- Department of Cardiology, AZ Monica Deurne, Antwerp, Belgium
- Department of Cardiology, AZ Voorkempen Malle, Antwerp, Belgium
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Staub O, Debonneville A, Stifanelli M, Juffre A, Maillard MP, Gumz ML, Al-Qusairi L. Renal tubular SGK1 is required to achieve blood pressure surge and circadian rhythm. Am J Physiol Renal Physiol 2023; 325:F629-F637. [PMID: 37676758 PMCID: PMC10878722 DOI: 10.1152/ajprenal.00211.2023] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Revised: 08/29/2023] [Accepted: 08/29/2023] [Indexed: 09/09/2023] Open
Abstract
Blood pressure (BP) follows a circadian pattern that rises during the active phase of the day (morning surge) and decreases during the inactive (night dipping) phase of the day. The morning surge coincides with increased circulating glucocorticoids and aldosterone, ligands for glucocorticoid receptors and mineralocorticoid receptors, respectively. Serum- and glucocorticoid-induced kinase 1 (SGK1), a clock-controlled and glucocorticoid receptor- and mineralocorticoid receptor-induced gene, plays a role in BP regulation in human and animal models. However, the role of SGK1 in BP circadian regulation has not yet been demonstrated. Using telemetry, we analyzed BP in the inducible renal tubule-specific Sgk1Pax8/LC1 model under basal K+ diet (1% K+) and high-K+ diet (HKD; 5% K+). Our data revealed that, under basal conditions, renal SGK1 plays a minor role in BP regulation; however, after 1 wk of HKD, Sgk1Pax8/LC1 mice exhibited significant defects in diastolic BP (DBP), including a blunted surge, a decreased amplitude, and reduced day/night differences. After prolonged HKD (7 wk), Sgk1Pax8/LC1 mice had lower BP than control mice and exhibited reduced DBP amplitude, together with decreased DBP day/night differences and midline estimating statistic of rhythm (MESOR). Interestingly, renal SGK1 deletion increased pulse pressure, likely secondary to an increase in circulating aldosterone. Taken together, our data suggest that 1) the kidney plays a significant role in setting the BP circadian rhythm; 2) renal tubule SGK1 mediates the BP surge and, thus, the day/night BP difference; 3) long-term renal SGK1 deletion results in lower BP in mutant compared with control mice; and 4) renal SGK1 indirectly regulates pulse pressure due to compensatory alterations in aldosterone levels.NEW & NOTEWORTHY Dysregulation of blood pressure (BP) circadian rhythm is associated with metabolic, cardiovascular, and kidney diseases. Our study provides experimental evidence demonstrating, for the first time, that renal tubule serum- and glucocorticoid-induced kinase 1 (SGK1) plays an essential role in inducing the BP surge. Inhibitors and activators of SGK1 signaling are parts of several therapeutic strategies. Our findings highlight the importance of the drug intake timing to be in phase with SGK1 function to avoid dysregulation of BP circadian rhythm.
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Affiliation(s)
- Olivier Staub
- Department of Biomedical Sciences, University of Lausanne, Lausanne, Switzerland
| | - Anne Debonneville
- Department of Biomedical Sciences, University of Lausanne, Lausanne, Switzerland
| | - Matteo Stifanelli
- Department of Biomedical Sciences, University of Lausanne, Lausanne, Switzerland
| | - Alexandria Juffre
- Division of Nephrology, Department of Physiology and Aging, College of Medicine, University of Florida, Gainesville, Florida, United States
- Center for Integrative Cardiovascular and Metabolic Diseases, University of Florida, Gainesville, Florida, United States
| | - Marc P Maillard
- Division of Nephrology, Lausanne University Hospital, Lausanne, Switzerland
| | - Michelle L Gumz
- Division of Nephrology, Department of Physiology and Aging, College of Medicine, University of Florida, Gainesville, Florida, United States
- Center for Integrative Cardiovascular and Metabolic Diseases, University of Florida, Gainesville, Florida, United States
| | - Lama Al-Qusairi
- Department of Biomedical Sciences, University of Lausanne, Lausanne, Switzerland
- Division of Nephrology, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States
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Vallée A. Added value of arterial stiffness index for the 10-year atherosclerotic cardiovascular disease risk determination in a middle-aged population-based study. Clin Res Cardiol 2023; 112:1679-1689. [PMID: 37650913 DOI: 10.1007/s00392-023-02267-4] [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: 04/20/2023] [Accepted: 07/12/2023] [Indexed: 09/01/2023]
Abstract
OBJECTIVE Atherosclerotic cardiovascular disease (ASCVD) is considered the leading cause of mortality worldwide. Arterial stiffness, measured by arterial stiffness index (ASI), could be a main predictor in target damage of organs. Uncertainty remains regarding the contribution of ASI to estimated ASCVD risk. This study investigates the added value of ASI in ASCVD risk determination using the general UK Biobank middle-aged population. METHODS Among 100,598 participants from the UK Biobank population, ASI was assessed and associations between ASCVD risk were stratified by sex and estimated using multiple linear and logistic regressions adjusted for heart rate, physical activity, alcohol status, smocking pack years, BMI categories and CKD. RESULTS Males presented higher ASCVD risk than females (8.58% vs. 2.82%, p < 0.001) and higher ASI levels (9.50 m/s vs. 7.00 m/s, p < 0.001). The Youden index was determined at 9.70 m/s in males (p < 0.001) and 10.46 m/s in females (p < 0.001). Among females, participants with ASI > 10.46 m/s showed higher ASCVD risk than others (3.64% vs. 2.56%, p < 0.001), similar results were observed for males (9.92% vs. 7.21%, p < 0.001). In males, ASI showed significant added value information when including overall covariates (AUC = 0.695 vs. AUC = 0.663, p < 0.001). Similar results were observed in females (AUC = 0.693 vs. AUC = 0.687, p = 0.001). In both genders, for the association between ASI and ASCVD risk, nonlinear relationships were observed with higher accuracies than linear models. CONCLUSION Further studies should investigate ASCVD risk stratification management depending on ASI measurement.
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Affiliation(s)
- Alexandre Vallée
- Department of Epidemiology and Public Health, Foch Hospital, 92150, Suresnes, France.
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Yilmaz G, Ong JL, Ling LH, Chee MWL. Insights into vascular physiology from sleep photoplethysmography. Sleep 2023; 46:zsad172. [PMID: 37379483 PMCID: PMC10566244 DOI: 10.1093/sleep/zsad172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Revised: 05/19/2023] [Indexed: 06/30/2023] Open
Abstract
STUDY OBJECTIVES Photoplethysmography (PPG) in consumer sleep trackers is now widely available and used to assess heart rate variability (HRV) for sleep staging. However, PPG waveform changes during sleep can also inform about vascular elasticity in healthy persons who constitute a majority of users. To assess its potential value, we traced the evolution of PPG pulse waveform during sleep alongside measurements of HRV and blood pressure (BP). METHODS Seventy-eight healthy adults (50% male, median [IQR range] age: 29.5 [23.0, 43.8]) underwent overnight polysomnography (PSG) with fingertip PPG, ambulatory blood pressure monitoring, and electrocardiography (ECG). Selected PPG features that reflect arterial stiffness: systolic to diastolic distance (∆T_norm), normalized rising slope (Rslope) and normalized reflection index (RI) were derived using a custom-built algorithm. Pulse arrival time (PAT) was calculated using ECG and PPG signals. The effect of sleep stage on these measures of arterial elasticity and how this pattern of sleep stage evolution differed with participant age were investigated. RESULTS BP, heart rate (HR) and PAT were reduced with deeper non-REM sleep but these changes were unaffected by the age range tested. After adjusting for lowered HR, ∆T_norm, Rslope, and RI showed significant effects of sleep stage, whereby deeper sleep was associated with lower arterial stiffness. Age was significantly correlated with the amount of sleep-related change in ∆T_norm, Rslope, and RI, and remained a significant predictor of RI after adjustment for sex, body mass index, office BP, and sleep efficiency. CONCLUSIONS The current findings indicate that the magnitude of sleep-related change in PPG waveform can provide useful information about vascular elasticity and age effects on this in healthy adults.
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Affiliation(s)
- Gizem Yilmaz
- Centre for Sleep and Cognition, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Ju Lynn Ong
- Centre for Sleep and Cognition, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Lieng-Hsi Ling
- Department of Cardiology, National University Heart Centre, National University Health System, Singapore and
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Michael W L Chee
- Centre for Sleep and Cognition, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
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Yazdani B, Kleber ME, Delgado GE, Yücel G, Asgari A, Gerken AL, Daschner C, Ayasse N, März W, Wanner C, Krämer BK. Blood Pressure and Mortality in the 4D Study. Kidney Blood Press Res 2023; 48:678-687. [PMID: 37806305 PMCID: PMC10627490 DOI: 10.1159/000533136] [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: 05/08/2023] [Accepted: 07/17/2023] [Indexed: 10/10/2023] Open
Abstract
INTRODUCTION Systolic blood pressure (SBP), diastolic blood pressure (DBP), and mean arterial pressure (MAP) are risk factors for cardiovascular mortality (CVM). Pulse pressure (PP) is an easily available parameter of vascular stiffness, but its impact on CVM in chronic dialysis patients with diabetes is unclear. METHODS Therefore, we have examined the predictive value of baseline, predialytic PP, SBP, DBP, and MAP in the German Diabetes and Dialysis (4D) study, a prospective, randomized, double-blind trial enrolling 1,255 patients with type 2 diabetes on hemodialysis in 178 German dialysis centers. RESULTS Mean age was 66.3 years, mean blood pressure 146/76 mm Hg, mean time suffering from diabetes 18.1 years, and mean time on maintenance dialysis 8.3 months. Considered as continuous variables, PP, MAP, SBP, and DBP could not provide a significant mortality prediction for either cardiovascular or all-cause mortality. After dividing the cohort into corresponding tertiles, we also did not detect any significant mortality prediction for PP, SBP, DBP, or MAP, both for all-cause mortality and CVM after adjusting for age and sex. Nevertheless, when comparing the HR plots of the corresponding blood pressure parameters, a pronounced U-curve was seen for PP for both all-cause mortality and CVM, with the trough range being 70-80 mm Hg. DISCUSSION In patients with end-stage renal disease and long-lasting diabetes mellitus predialytic blood pressure parameters at study entry are not predictive for mortality, presumably because there is a very high rate of competing mortality risk factors, resulting in overall very high rates of all-cause and CVM that may no longer be significantly modulated by blood pressure control.
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Affiliation(s)
- Babak Yazdani
- Fifth Department of Medicine, University Medical Center Mannheim UMM, Faculty of Medicine of the University of Heidelberg, Mannheim, Germany
| | - Marcus E. Kleber
- Fifth Department of Medicine, University Medical Center Mannheim UMM, Faculty of Medicine of the University of Heidelberg, Mannheim, Germany
- SYNLAB MVZ Humangenetik Mannheim, Mannheim, Germany
| | - Graciela E. Delgado
- Fifth Department of Medicine, University Medical Center Mannheim UMM, Faculty of Medicine of the University of Heidelberg, Mannheim, Germany
- Center for Preventive Medicine and Digital Health Baden-Württemberg (CPDBW), Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Gökhan Yücel
- First Department of Medicine, University Medical Center Mannheim UMM, Faculty of Medicine of the University of Heidelberg, Mannheim, Germany
| | | | - Andreas L.H. Gerken
- Department of Surgery, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Clara Daschner
- Fifth Department of Medicine, University Medical Center Mannheim UMM, Faculty of Medicine of the University of Heidelberg, Mannheim, Germany
| | - Niklas Ayasse
- Fifth Department of Medicine, University Medical Center Mannheim UMM, Faculty of Medicine of the University of Heidelberg, Mannheim, Germany
| | - Winfried März
- Fifth Department of Medicine, University Medical Center Mannheim UMM, Faculty of Medicine of the University of Heidelberg, Mannheim, Germany
- Synlab Academy, SYNLAB Holding Deutschland GmbH, Mannheim, Germany
| | - Christoph Wanner
- Division of Nephrology, Department of Medicine, University Hospital of Würzburg and the Comprehensive Heart Failure Center, Würzburg, Germany
| | - Bernhard K. Krämer
- Fifth Department of Medicine, University Medical Center Mannheim UMM, Faculty of Medicine of the University of Heidelberg, Mannheim, Germany
- Center for Preventive Medicine and Digital Health Baden-Württemberg (CPDBW), Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
- European Center for Angioscience ECAS, Faculty of Medicine of the University of Heidelberg, Mannheim, Germany
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Kumar SM, Vaishali K, Maiya GA, Shivashankar K, Shashikiran U. Analysis of time-domain indices, frequency domain measures of heart rate variability derived from ECG waveform and pulse-wave-related HRV among overweight individuals: an observational study. F1000Res 2023; 12:1229. [PMID: 37799491 PMCID: PMC10548108 DOI: 10.12688/f1000research.139283.1] [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] [Accepted: 08/23/2023] [Indexed: 10/07/2023] Open
Abstract
Background: Research on the compatibility of time domain indices, frequency domain measurements of heart rate variability obtained from electrocardiogram (ECG) waveforms, and pulse wave signal (pulse rate variability; PRV) features is ongoing. The promising marker of cardiac autonomic function is heart rate variability. Recent research has looked at various other physiological markers, leading to the emergence of pulse rate variability. The pulse wave signal can be studied for variations to understand better changes in arterial stiffness and compliance, which are key indicators of cardiovascular health. Methods: 35 healthy overweight people were included. The Lead II electrocardiogram (ECG) signal was transmitted through an analog-to-digital converter (PowerLab 8/35 software, AD Instruments Pty. Ltd., New South Wales, Australia). This signal was utilized to compute Heart Rate Variability (HRV) and was sampled at a rate of 1024 Hz. The same AD equipment was also used to capture a pulse signal simultaneously. The right index finger was used as the recording site for the pulse signal using photoplethysmography (PPG) technology. Results: The participants' demographic data show that the mean age was 23.14 + 5.27 years, the mean weight was 73.68 + 7.40 kg, the mean body fat percentage was 32.23 + 5.30, and the mean visceral fat percentage was 4.60 + 2.0. The findings revealed no noticeable difference between the median values of heart rate variability (HRV) and PRV. Additionally, a strong correlation was observed between HRV and PRV. However, poor agreement was observed in the measurement of PRV and HRV. Conclusion: All indices of HRV showed a greater correlation with PRV. However, the level of agreement between HRV and PRV measurement was poor. Hence, HRV cannot be replaced with PRV and vice-versa.
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Affiliation(s)
- Sinha Mukesh Kumar
- Department of Physiotherapy, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, Karnataka, 576104, India
| | - K. Vaishali
- Department of Physiotherapy, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, Karnataka, 576104, India
| | - G. Arun Maiya
- Department of Physiotherapy, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, Karnataka, 576104, India
| | - K.N. Shivashankar
- Department of Medicine, Kasturba Medical college, Manipal Academy of Higher Education, Manipal, Karnataka, 576104, India
| | - U. Shashikiran
- Department of Medicine, Dr. TMA Pai Hospital, Udupi, Manipal Academy of Higher Education, Manipal, Karnataka, 576104, India
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Lai KY, Webster C, Gallacher JE, Sarkar C. Associations of Urban Built Environment with Cardiovascular Risks and Mortality: a Systematic Review. J Urban Health 2023; 100:745-787. [PMID: 37580546 PMCID: PMC10447831 DOI: 10.1007/s11524-023-00764-5] [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] [Accepted: 06/28/2023] [Indexed: 08/16/2023]
Abstract
With rapid urbanization, built environment has emerged as a set of modifiable factors of cardiovascular disease (CVD) risks. We conducted a systematic review to synthesize evidence on the associations of attributes of urban built environment (e.g. residential density, land use mix, greenness and walkability) with cardiovascular risk factors (e.g. hypertension and arterial stiffness) and major CVD events including mortality. A total of 63 studies, including 31 of cross-sectional design and 32 of longitudinal design conducted across 21 geographical locations and published between 2012 and 2023 were extracted for review. Overall, we report moderately consistent evidence of protective associations of greenness with cardiovascular risks and major CVD events (cross-sectional studies: 12 of 15 on hypertension/blood pressure (BP) and 2 of 3 on arterial stiffness; and longitudinal studies: 6 of 8 on hypertension/BP, 7 of 8 on CVD mortality, 3 of 3 on ischemic heart disease mortality and 5 of 8 studies on stroke hospitalization or mortality reporting significant inverse associations). Consistently, walkability was associated with lower risks of hypertension, arterial stiffness and major CVD events (cross-sectional studies: 11 of 12 on hypertension/BP and 1 of 1 on arterial stiffness; and longitudinal studies: 3 of 6 on hypertension/BP and 1 of 2 studies on CVD events being protective). Sixty-seven percent of the studies were rated as "probably high" risk of confounding bias because of inability to adjust for underlying comorbidities/family history of diseases in their statistical models. Forty-six percent and 14% of the studies were rated as "probably high" risk of bias for exposure and outcome measurements, respectively. Future studies with robust design will further help elucidate the linkages between urban built environment and cardiovascular health, thereby informing planning policies for creating healthy cities.
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Affiliation(s)
- Ka Yan Lai
- Healthy High Density Cities Lab, HKUrbanLab, The University of Hong Kong, Knowles Building, Pokfulam Road, Hong Kong Special Administrative Region, China.
- Department of Urban Planning and Design, Faculty of Architecture, The University of Hong Kong, Knowles Building, Pokfulam Road, Hong Kong Special Administrative Region, China.
| | - Chris Webster
- Healthy High Density Cities Lab, HKUrbanLab, The University of Hong Kong, Knowles Building, Pokfulam Road, Hong Kong Special Administrative Region, China
- Department of Urban Planning and Design, Faculty of Architecture, The University of Hong Kong, Knowles Building, Pokfulam Road, Hong Kong Special Administrative Region, China
- Urban Systems Institute, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - John Ej Gallacher
- Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford, OX3 7JX, UK
| | - Chinmoy Sarkar
- Healthy High Density Cities Lab, HKUrbanLab, The University of Hong Kong, Knowles Building, Pokfulam Road, Hong Kong Special Administrative Region, China
- Department of Urban Planning and Design, Faculty of Architecture, The University of Hong Kong, Knowles Building, Pokfulam Road, Hong Kong Special Administrative Region, China
- Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford, OX3 7JX, UK
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Vallée A. Association between tobacco smoking and alcohol consumption with arterial stiffness. J Clin Hypertens (Greenwich) 2023; 25:757-767. [PMID: 37408141 PMCID: PMC10423766 DOI: 10.1111/jch.14669] [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: 03/23/2023] [Revised: 05/03/2023] [Accepted: 05/06/2023] [Indexed: 07/07/2023]
Abstract
Few investigations have been performed between tobacco smoking, alcohol, and arterial stiffness. The purpose of our study was to investigate the association between smoking use and alcohol with arterial stiffness index (ASI) in a middle-age population. Smoking pack-years and cigarettes per day were defined as alcohol consumption in units/day. Sex associations between smoking and alcohol with ASI were estimated using multiple linear regressions. Interactions and synergistic effects were investigating. 98 039 individuals of the UK Biobank cohort were included (45 457 men and 52 582 women). ASI levels were higher in men than in women (9.91 vs. 8.71 m/s, p < .001), and showed higher relationship to smoking tobacco in multiple linear regression models in women than in men (FDR logworth 78.4 vs. 52.7). The findings revealed that ASI was higher among current smokers than never smokers in both sex and after adjustment for all covariates (in men 10.4 vs. 9.6 and in women 9.5 vs. 8.5 m/s, p < .001). Alcohol consumption per day was positively associated with higher levels of ASI in both sex, but with a less relationship (FDR logworth for men = 2.8, for women = 2.5). An interaction was observed between smoking information and alcohol in men but not in women. Synergistic effects were observed by adding smoking information on alcohol consumption models in men and women (p = .029, p < .001, respectively). Smoking and alcohol were associated with higher ASI in both sex but with a higher relationship among women. The findings suggest the importance of considering smoking and alcohol consumption cessation in cardiovascular diseases prevention.
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Affiliation(s)
- Alexandre Vallée
- Department of Epidemiology‐Data‐BiostatisticsDelegation of Clinical Research and Innovation (DRCI)Foch HospitalSuresnesFrance
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Bani Hani S, Ahmad M. Effective Prediction of Mortality by Heart Disease Among Women in Jordan Using the Chi-Squared Automatic Interaction Detection Model: Retrospective Validation Study. JMIR Cardio 2023; 7:e48795. [PMID: 37471126 PMCID: PMC10401188 DOI: 10.2196/48795] [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: 05/07/2023] [Revised: 06/23/2023] [Accepted: 06/26/2023] [Indexed: 07/21/2023] Open
Abstract
BACKGROUND Many current studies have claimed that the actual risk of heart disease among women is equal to that in men. Using a large machine learning algorithm (MLA) data set to predict mortality in women, data mining techniques have been used to identify significant aspects of variables that help in identifying the primary causes of mortality within this target category of the population. OBJECTIVE This study aims to predict mortality caused by heart disease among women, using an artificial intelligence technique-based MLA. METHODS A retrospective design was used to retrieve big data from the electronic health records of 2028 women with heart disease. Data were collected for Jordanian women who were admitted to public health hospitals from 2015 to the end of 2021. We checked the extracted data for noise, consistency issues, and missing values. After categorizing, organizing, and cleaning the extracted data, the redundant data were eliminated. RESULTS Out of 9 artificial intelligence models, the Chi-squared Automatic Interaction Detection model had the highest accuracy (93.25%) and area under the curve (0.825) among the build models. The participants were 62.6 (SD 15.4) years old on average. Angina pectoris was the most frequent diagnosis in the women's extracted files (n=1,264,000, 62.3%), followed by congestive heart failure (n=764,000, 37.7%). Age, systolic blood pressure readings with a cutoff value of >187 mm Hg, medical diagnosis (women diagnosed with congestive heart failure were at a higher risk of death [n=31, 16.58%]), pulse pressure with a cutoff value of 98 mm Hg, and oxygen saturation (measured using pulse oximetry) with a cutoff value of 93% were the main predictors for death among women. CONCLUSIONS To predict the outcomes in this study, we used big data that were extracted from the clinical variables from the electronic health records. The Chi-squared Automatic Interaction Detection model-an MLA-confirmed the precise identification of the key predictors of cardiovascular mortality among women and can be used as a practical tool for clinical prediction.
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Affiliation(s)
- Salam Bani Hani
- Clinical Nursing Department, School of Nursing, The University of Jordan, Amman, Jordan
| | - Muayyad Ahmad
- Clinical Nursing Department, School of Nursing, The University of Jordan, Amman, Jordan
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Vallée A. Arterial stiffness and biological parameters: A decision tree machine learning application in hypertensive participants. PLoS One 2023; 18:e0288298. [PMID: 37418473 DOI: 10.1371/journal.pone.0288298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Accepted: 06/23/2023] [Indexed: 07/09/2023] Open
Abstract
Arterial stiffness, measured by arterial stiffness index (ASI), could be considered a main denominator in target organ damage among hypertensive subjects. Currently, no reported ASI normal references have been reported. The index of arterial stiffness is evaluated by calculation of a stiffness index. Predicted ASI can be estimated regardless to age, sex, mean blood pressure, and heart rate, to compose an individual stiffness index [(measured ASI-predicted ASI)/predicted ASI]. A stiffness index greater than zero defines arterial stiffness. Thus, the purpose of this study was 1) to determine determinants of stiffness index 2) to perform threshold values to discriminate stiffness index and then 3) to determine hierarchical associations of the determinants by performing a decision tree model among hypertensive participants without CV diseases. A study was conducted from 53,363 healthy participants in the UK Biobank survey to determine predicted ASI. Stiffness index was applied on 49,452 hypertensives without CV diseases to discriminate determinants of positive stiffness index (N = 22,453) from negative index (N = 26,999). The input variables for the models were clinical and biological parameters. The independent classifiers were ranked from the most sensitives: HDL cholesterol≤1.425 mmol/L, smoking pack years≥9.2pack-years, Phosphate≥1.172 mmol/L, to the most specifics: Cystatin c≤0.901 mg/L, Triglycerides≥1.487 mmol/L, Urate≥291.9 μmol/L, ALT≥22.13 U/L, AST≤32.5 U/L, Albumin≤45.92 g/L, Testosterone≥5.181 nmol/L. A decision tree model was performed to determine rules to highlight the different hierarchization and interactions between these classifiers with a higher performance than multiple logistic regression (p<0.001). The stiffness index could be an integrator of CV risk factors and participate in future CV risk management evaluations for preventive strategies. Decision trees can provide accurate and useful classification for clinicians.
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Affiliation(s)
- Alexandre Vallée
- Department of Epidemiology and Public Health, Foch hospital, Suresnes, France
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Vallée A. Association between lifetime cannabis use and arterial stiffness in a middle-aged general population. J Hypertens 2023; 41:658-669. [PMID: 36878471 DOI: 10.1097/hjh.0000000000003389] [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: 03/08/2023]
Abstract
BACKGROUND No studies have investigated the association between arterial stiffness index (ASI) and cannabis use. The purpose of this study is to examine sex-stratified associations of cannabis use and ASI levels in a middle-aged general population. METHODS Cannabis use of 46 219 volunteers of the middle-aged UK Biobank population was assessed by questionnaire and investigates several aspects of cannabis use (lifetime, frequency and current status). Associations between cannabis use and ASI were estimated using sex multiple linear regressions. Covariates were tobacco status, diabetes dyslipidaemia, alcohol status, BMI categories, hypertension, mean blood pressure and heart rate. RESULTS Men presented higher ASI levels compared with women (respectively, 9.826 vs. 8.578 m/s, P < 0.001), a higher heavy lifetime cannabis users (4.0 vs. 1.9%, P < 0.001), higher current cannabis users (3.1 vs. 1.7%, P < 0.001), higher current smokers (8.4 vs. 5.8%, P < 0.001) and higher alcohol users (95.6 vs. 93.4%, P < 0.001). After adjustment for all covariates in sex models, heavy lifetime cannabis users were associated with higher ASI levels in men [b = 0.19, 95% confidence interval (0.02; 0.35)] but not in women [b = -0.02 (-0.23; 0.19)]. Current cannabis users were associated with higher ASI levels in men [b = 0.17 (0.01; 0.32)] but not in women [b = -0.01 (-0.20; 0.18)] and among cannabis users, every day frequency was associated with increased ASI levels in men [b = 0.29 (0.07; 0.51)] but not in women [b = 0.10 (-0.17; 0.37)]. CONCLUSION The observed association between cannabis use and ASI could participate in accurate and appropriate cardiovascular risk reduction strategies among cannabis users.
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Affiliation(s)
- Alexandre Vallée
- Department of Epidemiology-Data-Biostatistics, Delegation of Clinical Research and Innovation (DRCI), Foch Hospital, Suresnes, France
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Abstract
Vascular age is determined by functional and structural changes in the arterial wall. When measured by its proxy, pulse wave velocity, it has been shown to predict cardiovascular and total mortality. Disconcordance between chronological and vascular age might represent better or worse vascular health. Cell senescence is caused by oxidative stress and sustained cell replication. Senescent cells acquire senescence-associated secretory phenotype. Oxidative stress, endothelial dysfunction, dysregulation of coagulation and leucocyte infiltration are observed in the aging endothelium. All of these mechanisms lead to increased vascular calcification and stiffness. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) can involve the vascular endothelium. It enters cells using angiotensin-converting enzyme 2 (ACE-2) receptors, which are abundant in endothelial cells. The damage this virus does to the endothelium can be direct or indirect. Indirect damage is caused by hyperinflammation. Direct damage results from effects on ACE-2 receptors. The reduction of ACE-2 levels seen during coronavirus disease 2019 (COVID-19) infection might cause vasoconstriction and oxidative stress. COVID-19 and vascular aging share some pathways. Due to the novelty of the virus, there is an urgent need for studies that investigate its long-term effects on vascular health.
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Affiliation(s)
- Ignas Badaras
- Faculty of Medicine, Vilnius University, Vilnius, Lithuania,Ignas Badaras, Faculty of Medicine, Vilnius
University, M. K. Ciurlionio g. 21/27, LT-03101, Vilnius 01513, Lithuania.
| | - Agnė Laučytė-Cibulskienė
- Department of Nephrology, Skåne University
Hospital, Malmö, Sweden,Department of Clinical Sciences, Lund University, Malmö, Sweden
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36
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Wood A, Antonopoulos A, Chuaiphichai S, Kyriakou T, Diaz R, Al Hussaini A, Marsh AM, Sian M, Meisuria M, McCann G, Rashbrook VS, Drydale E, Draycott S, Polkinghorne MD, Akoumianakis I, Antoniades C, Watkins H, Channon KM, Adlam D, Douglas G. PHACTR1 modulates vascular compliance but not endothelial function: a translational study. Cardiovasc Res 2023; 119:599-610. [PMID: 35653516 PMCID: PMC10064844 DOI: 10.1093/cvr/cvac092] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Revised: 05/09/2022] [Accepted: 05/19/2022] [Indexed: 11/13/2022] Open
Abstract
AIMS The non-coding locus at 6p24 located in Intron 3 of PHACTR1 has consistently been implicated as a risk allele in myocardial infarction and multiple other vascular diseases. Recent murine studies have identified a role for Phactr1 in the development of atherosclerosis. However, the role of PHACTR1 in vascular tone and in vivo vascular remodelling has yet to be established. The aim of this study was to investigate the role of PHACTR1 in vascular function. METHODS AND RESULTS Prospectively recruited coronary artery disease (CAD) patients undergoing bypass surgery and retrospectively recruited spontaneous coronary artery dissection (SCAD) patients and matched healthy volunteers were genotyped at the PHACTR1 rs9349379 locus. We observed a significant association between the PHACTR1 loci and changes in distensibility in both the ascending aorta (AA = 0.0053 ± 0.0004, AG = 0.0041 ± 0.003, GG = 0.0034 ± 0.0009, P < 0.05, n = 58, 54, and 7, respectively) and carotid artery (AA = 12.83 ± 0.51, AG = 11.14 ± 0.38, GG = 11.69 ± 0.66, P < 0.05, n = 70, 65, and 18, respectively). This association was not observed in the descending aorta or in SCAD patients. In contrast, the PHACTR1 locus was not associated with changes in endothelial cell function with no association between the rs9349379 locus and in vivo or ex vivo vascular function observed in CAD patients. This finding was confirmed in our murine model where the loss of Phactr1 on the pro-atherosclerosis ApoE-/- background did not alter ex vivo vascular function. CONCLUSION In conclusion, we have shown a role for PHACTR1 in arterial compliance across multiple vascular beds. Our study suggests that PHACTR1 has a key structural role within the vasculature.
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Affiliation(s)
- Alice Wood
- Department of Cardiovascular Sciences, Glenfield Hospital, Leicester, UK
- National Institute for Health Research (NIHR) Leicester Biomedical Research Centre, Glenfield Hospital, Leicester, UK
| | - Alexios Antonopoulos
- BHF Centre of Research Excellence, Division of Cardiovascular Medicine, Radcliffe Department of Medicine, John Radcliffe Hospital, University of Oxford, Oxford OX3 9DU, UK
| | - Surawee Chuaiphichai
- BHF Centre of Research Excellence, Division of Cardiovascular Medicine, Radcliffe Department of Medicine, John Radcliffe Hospital, University of Oxford, Oxford OX3 9DU, UK
- Wellcome Trust Centre for Human Genetics, University of Oxford, Roosevelt Drive, Oxford, UK
| | - Theodosios Kyriakou
- BHF Centre of Research Excellence, Division of Cardiovascular Medicine, Radcliffe Department of Medicine, John Radcliffe Hospital, University of Oxford, Oxford OX3 9DU, UK
- Wellcome Trust Centre for Human Genetics, University of Oxford, Roosevelt Drive, Oxford, UK
| | - Rebeca Diaz
- BHF Centre of Research Excellence, Division of Cardiovascular Medicine, Radcliffe Department of Medicine, John Radcliffe Hospital, University of Oxford, Oxford OX3 9DU, UK
- Wellcome Trust Centre for Human Genetics, University of Oxford, Roosevelt Drive, Oxford, UK
| | - Abtehale Al Hussaini
- Department of Cardiovascular Sciences, Glenfield Hospital, Leicester, UK
- National Institute for Health Research (NIHR) Leicester Biomedical Research Centre, Glenfield Hospital, Leicester, UK
| | - Anna-Marie Marsh
- Department of Cardiovascular Sciences, Glenfield Hospital, Leicester, UK
- National Institute for Health Research (NIHR) Leicester Biomedical Research Centre, Glenfield Hospital, Leicester, UK
| | - Manjit Sian
- Department of Cardiovascular Sciences, Glenfield Hospital, Leicester, UK
- National Institute for Health Research (NIHR) Leicester Biomedical Research Centre, Glenfield Hospital, Leicester, UK
| | - Mitul Meisuria
- Department of Cardiovascular Sciences, Glenfield Hospital, Leicester, UK
- National Institute for Health Research (NIHR) Leicester Biomedical Research Centre, Glenfield Hospital, Leicester, UK
| | - Gerry McCann
- Department of Cardiovascular Sciences, Glenfield Hospital, Leicester, UK
- National Institute for Health Research (NIHR) Leicester Biomedical Research Centre, Glenfield Hospital, Leicester, UK
| | - Victoria S Rashbrook
- BHF Centre of Research Excellence, Division of Cardiovascular Medicine, Radcliffe Department of Medicine, John Radcliffe Hospital, University of Oxford, Oxford OX3 9DU, UK
- Wellcome Trust Centre for Human Genetics, University of Oxford, Roosevelt Drive, Oxford, UK
| | - Edward Drydale
- BHF Centre of Research Excellence, Division of Cardiovascular Medicine, Radcliffe Department of Medicine, John Radcliffe Hospital, University of Oxford, Oxford OX3 9DU, UK
- Wellcome Trust Centre for Human Genetics, University of Oxford, Roosevelt Drive, Oxford, UK
| | - Sally Draycott
- BHF Centre of Research Excellence, Division of Cardiovascular Medicine, Radcliffe Department of Medicine, John Radcliffe Hospital, University of Oxford, Oxford OX3 9DU, UK
- Wellcome Trust Centre for Human Genetics, University of Oxford, Roosevelt Drive, Oxford, UK
| | - Murray David Polkinghorne
- BHF Centre of Research Excellence, Division of Cardiovascular Medicine, Radcliffe Department of Medicine, John Radcliffe Hospital, University of Oxford, Oxford OX3 9DU, UK
| | - Ioannis Akoumianakis
- BHF Centre of Research Excellence, Division of Cardiovascular Medicine, Radcliffe Department of Medicine, John Radcliffe Hospital, University of Oxford, Oxford OX3 9DU, UK
| | - Charalambos Antoniades
- BHF Centre of Research Excellence, Division of Cardiovascular Medicine, Radcliffe Department of Medicine, John Radcliffe Hospital, University of Oxford, Oxford OX3 9DU, UK
| | - Hugh Watkins
- BHF Centre of Research Excellence, Division of Cardiovascular Medicine, Radcliffe Department of Medicine, John Radcliffe Hospital, University of Oxford, Oxford OX3 9DU, UK
- Wellcome Trust Centre for Human Genetics, University of Oxford, Roosevelt Drive, Oxford, UK
| | - Keith M Channon
- BHF Centre of Research Excellence, Division of Cardiovascular Medicine, Radcliffe Department of Medicine, John Radcliffe Hospital, University of Oxford, Oxford OX3 9DU, UK
- Wellcome Trust Centre for Human Genetics, University of Oxford, Roosevelt Drive, Oxford, UK
| | - David Adlam
- Department of Cardiovascular Sciences, Glenfield Hospital, Leicester, UK
- National Institute for Health Research (NIHR) Leicester Biomedical Research Centre, Glenfield Hospital, Leicester, UK
| | - Gillian Douglas
- BHF Centre of Research Excellence, Division of Cardiovascular Medicine, Radcliffe Department of Medicine, John Radcliffe Hospital, University of Oxford, Oxford OX3 9DU, UK
- Wellcome Trust Centre for Human Genetics, University of Oxford, Roosevelt Drive, Oxford, UK
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37
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Woolf EK, Terwoord JD, Litwin NS, Vazquez AR, Lee SY, Ghanem N, Michell KA, Smith BT, Grabos LE, Ketelhut NB, Bachman NP, Smith ME, Le Sayec M, Rao S, Gentile CL, Weir TL, Rodriguez-Mateos A, Seals DR, Dinenno FA, Johnson SA. Daily blueberry consumption for 12 weeks improves endothelial function in postmenopausal women with above-normal blood pressure through reductions in oxidative stress: a randomized controlled trial. Food Funct 2023; 14:2621-2641. [PMID: 36847333 DOI: 10.1039/d3fo00157a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2023]
Abstract
Estrogen-deficient postmenopausal women have oxidative stress-mediated suppression of endothelial function that is exacerbated by high blood pressure. Previous research suggests blueberries may improve endothelial function through reductions in oxidative stress, while also exerting other cardiovascular benefits. The objective of this study was to examine the efficacy of blueberries to improve endothelial function and blood pressure in postmenopausal women with above-normal blood pressure, and to identify potential mechanisms for improvements in endothelial function. A randomized, double-blind, placebo-controlled, parallel-arm clinical trial was performed, where postmenopausal women aged 45-65 years with elevated blood pressure or stage 1-hypertension (total n = 43, endothelial function n = 32) consumed 22 g day-1 of freeze-dried highbush blueberry powder or placebo powder for 12 weeks. Endothelial function was assessed at baseline and 12 weeks through ultrasound measurement of brachial artery flow-mediated dilation (FMD) normalized to shear rate area under the curve (FMD/SRAUC) before and after intravenous infusion of a supraphysiologic dose of ascorbic acid to evaluate whether FMD improvements were mediated by reduced oxidative stress. Hemodynamics, arterial stiffness, cardiometabolic blood biomarkers, and plasma (poly)phenol metabolites were assessed at baseline and 4, 8, and 12 weeks, and venous endothelial cell protein expression was assessed at baseline and 12 weeks. Absolute FMD/SRAUC was 96% higher following blueberry consumption compared to baseline (p < 0.05) but unchanged in the placebo group (p > 0.05), and changes from baseline to 12 weeks were greater in the blueberry group than placebo (+1.09 × 10-4 ± 4.12 × 10-5vs. +3.82 × 10-6 ± 1.59 × 10-5, p < 0.03, respectively). The FMD/SRAUC response to ascorbic acid infusion was lower (p < 0.05) at 12 weeks compared to baseline in the blueberry group with no change in the placebo group (p > 0.05). The sum of plasma (poly)phenol metabolites increased at 4, 8, and 12 weeks in the blueberry group compared to baseline, and were higher than the placebo group (all p < 0.05). Increases in several plasma flavonoid and microbial metabolites were also noted. No major differences were found for blood pressure, arterial stiffness, blood biomarkers, or endothelial cell protein expression following blueberry consumption. These findings suggest daily consumption of freeze-dried blueberry powder for 12 weeks improves endothelial function through reduced oxidative stress in postmenopausal women with above-normal blood pressure. The clinical trial registry number is NCT03370991 (https://clinicaltrials.gov).
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Affiliation(s)
- Emily K Woolf
- Department of Food Science and Human Nutrition, Colorado State University, Fort Collins, CO, USA.
| | - Janée D Terwoord
- Department of Health and Exercise Science, Colorado State University, Fort Collins, CO, USA
| | - Nicole S Litwin
- Department of Food Science and Human Nutrition, Colorado State University, Fort Collins, CO, USA.
| | - Allegra R Vazquez
- Department of Food Science and Human Nutrition, Colorado State University, Fort Collins, CO, USA.
| | - Sylvia Y Lee
- Department of Food Science and Human Nutrition, Colorado State University, Fort Collins, CO, USA.
| | - Nancy Ghanem
- Department of Food Science and Human Nutrition, Colorado State University, Fort Collins, CO, USA.
| | - Kiri A Michell
- Department of Food Science and Human Nutrition, Colorado State University, Fort Collins, CO, USA.
| | - Brayden T Smith
- Department of Food Science and Human Nutrition, Colorado State University, Fort Collins, CO, USA.
| | - Lauren E Grabos
- Department of Food Science and Human Nutrition, Colorado State University, Fort Collins, CO, USA.
| | - Nathaniel B Ketelhut
- Department of Health and Exercise Science, Colorado State University, Fort Collins, CO, USA
| | - Nate P Bachman
- Department of Health and Exercise Science, Colorado State University, Fort Collins, CO, USA
| | - Meghan E Smith
- Department of Health and Exercise Science, Colorado State University, Fort Collins, CO, USA
| | - Melanie Le Sayec
- Department of Nutritional Sciences, School of Life Course and Population Sciences, King's College London, London, England, UK
| | - Sangeeta Rao
- Department of Clinical Sciences, Colorado State University, Fort Collins, CO, USA
| | - Christopher L Gentile
- Department of Food Science and Human Nutrition, Colorado State University, Fort Collins, CO, USA.
| | - Tiffany L Weir
- Department of Food Science and Human Nutrition, Colorado State University, Fort Collins, CO, USA.
| | - Ana Rodriguez-Mateos
- Department of Nutritional Sciences, School of Life Course and Population Sciences, King's College London, London, England, UK
| | - Douglas R Seals
- Department of Integrative Physiology, University of Colorado, Boulder, CO, USA
| | - Frank A Dinenno
- Department of Health and Exercise Science, Colorado State University, Fort Collins, CO, USA
| | - Sarah A Johnson
- Department of Food Science and Human Nutrition, Colorado State University, Fort Collins, CO, USA.
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38
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Xin Z, Huang J, Cao Q, Wang J, He R, Hou T, Ding Y, Lu J, Wang T, Zhao Z, Wang W, Ning G, Xu M, Bi Y, Xu Y, Li M. Risk of subclinical atherosclerosis across metabolic transition in individuals with or without fatty liver disease: a prospective cohort study. Nutr Metab (Lond) 2023; 20:15. [PMID: 36899397 PMCID: PMC10007748 DOI: 10.1186/s12986-023-00734-3] [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: 10/24/2022] [Accepted: 02/22/2023] [Indexed: 03/12/2023] Open
Abstract
BACKGROUND Metabolic dysfunction is a major determinant in the progression of fatty liver disease. It is pivotal to evaluate the metabolic status and subsequent transition in fatty liver population and to identify the risk of subclinical atherosclerosis. METHODS The prospective cohort study included 6260 Chinese community residents during 2010-2015. Fatty liver was determined as hepatic steatosis (HS) by ultrasonography. Metabolic unhealthy (MU) status was defined as having diabetes and/or ≥ 2 metabolic risk factors. Participants were categorized into 4 groups according to the combination of metabolic healthy (MH)/MU and fatty liver status (MHNHS, MUNHS, MHHS and MUHS). Subclinical atherosclerosis was assessed by elevated brachial-ankle pulse wave velocity, pulse pressure and/or albuminuria. RESULTS 31.3% of the participants had fatty liver disease and 76.9% were in MU status. During a 4.3-year follow-up, 24.2% of participants developed composite subclinical atherosclerosis. Multivariable adjusted odds ratios for composite subclinical atherosclerosis risk were (1.66 [1.30-2.13]) in MUNHS group and (2.57 [1.90-3.48]) in MUHS group. It seemed that participants with fatty liver disease were more prone to be remained in MU status (90.7% vs.50.8%) and less likely to regress to MH status (4.0% vs. 8.9%). Fatty liver participants progressed to (3.11 [1.23-7.92]) or maintained MU status (4.87 [3.25-7.31]) significantly impelled the development of the composite risk, while regressing to MH status (0.15 [0.04-0.64]) were more intended to mitigate the risk. CONCLUSIONS The current study emphasized the importance of assessing metabolic status and its dynamic changes, especially in the fatty liver population. Regressing from MU to MH status not only benefited the systematic metabolic profile but also ameliorated future cardiometabolic complications.
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Affiliation(s)
- Zhuojun Xin
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the People's Republic of China, Shanghai Key Laboratory for Endocrine TumorState Key Laboratory of Medical GenomicsShanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Ruijin 2Nd Road, Shanghai, 200025, China
| | - Jiaojiao Huang
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the People's Republic of China, Shanghai Key Laboratory for Endocrine TumorState Key Laboratory of Medical GenomicsShanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Ruijin 2Nd Road, Shanghai, 200025, China
| | - Qiuyu Cao
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the People's Republic of China, Shanghai Key Laboratory for Endocrine TumorState Key Laboratory of Medical GenomicsShanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Ruijin 2Nd Road, Shanghai, 200025, China
| | - Jialu Wang
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the People's Republic of China, Shanghai Key Laboratory for Endocrine TumorState Key Laboratory of Medical GenomicsShanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Ruijin 2Nd Road, Shanghai, 200025, China
| | - Ruixin He
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the People's Republic of China, Shanghai Key Laboratory for Endocrine TumorState Key Laboratory of Medical GenomicsShanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Ruijin 2Nd Road, Shanghai, 200025, China
| | - Tianzhichao Hou
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the People's Republic of China, Shanghai Key Laboratory for Endocrine TumorState Key Laboratory of Medical GenomicsShanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Ruijin 2Nd Road, Shanghai, 200025, China
| | - Yi Ding
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the People's Republic of China, Shanghai Key Laboratory for Endocrine TumorState Key Laboratory of Medical GenomicsShanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Ruijin 2Nd Road, Shanghai, 200025, China
| | - Jieli Lu
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the People's Republic of China, Shanghai Key Laboratory for Endocrine TumorState Key Laboratory of Medical GenomicsShanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Ruijin 2Nd Road, Shanghai, 200025, China
| | - Tiange Wang
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the People's Republic of China, Shanghai Key Laboratory for Endocrine TumorState Key Laboratory of Medical GenomicsShanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Ruijin 2Nd Road, Shanghai, 200025, China
| | - Zhiyun Zhao
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the People's Republic of China, Shanghai Key Laboratory for Endocrine TumorState Key Laboratory of Medical GenomicsShanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Ruijin 2Nd Road, Shanghai, 200025, China
| | - Weiqing Wang
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the People's Republic of China, Shanghai Key Laboratory for Endocrine TumorState Key Laboratory of Medical GenomicsShanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Ruijin 2Nd Road, Shanghai, 200025, China
| | - Guang Ning
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the People's Republic of China, Shanghai Key Laboratory for Endocrine TumorState Key Laboratory of Medical GenomicsShanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Ruijin 2Nd Road, Shanghai, 200025, China
| | - Min Xu
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the People's Republic of China, Shanghai Key Laboratory for Endocrine TumorState Key Laboratory of Medical GenomicsShanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Ruijin 2Nd Road, Shanghai, 200025, China
| | - Yufang Bi
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
- Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the People's Republic of China, Shanghai Key Laboratory for Endocrine TumorState Key Laboratory of Medical GenomicsShanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Ruijin 2Nd Road, Shanghai, 200025, China.
| | - Yu Xu
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
- Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the People's Republic of China, Shanghai Key Laboratory for Endocrine TumorState Key Laboratory of Medical GenomicsShanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Ruijin 2Nd Road, Shanghai, 200025, China.
| | - Mian Li
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
- Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the People's Republic of China, Shanghai Key Laboratory for Endocrine TumorState Key Laboratory of Medical GenomicsShanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Ruijin 2Nd Road, Shanghai, 200025, China.
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39
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Kaluba L, Chikopela T, Goma F, Malambo M, Mutale W, Heimburger DC, Koethe JR. Vascular dysfunction and body mass index in African adults with HIV. BMC Cardiovasc Disord 2023; 23:64. [PMID: 36737679 PMCID: PMC9896806 DOI: 10.1186/s12872-023-03093-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Accepted: 01/24/2023] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Impaired vascular compliance is common among persons with HIV (PWH) and a risk factor for cardiovascular disease (CVD), though many studies documenting this are from regions with a high prevalence of overweight and obesity. The prevalence and characteristics of impaired vascular compliance among PWH with low body mass index (BMI) is not well described, particularly in sub-Saharan Africa (SSA) where the majority of PWH live, a low BMI is more common, and the burden of CVD is rising. AIM To assess non-invasive vascular compliance measurements, including augmentation index (AIX), pulse wave velocity (PWV) and pulse waveforms, in underweight, normal weight, and overweight PWH on long-term antiretroviral therapy (ART) in SSA. METHODS A cross-sectional study among PWH on ART at the University Teaching Hospital in Lusaka, Zambia. All participants had been on a regimen of efavirenz, emtricitabine, and tenofovir disoproxil fumarate for five or more years. Carotid-femoral PWV (cfPWV), carotid-radial PWV (crPWV), and the corresponding augmentation indexes (cfAIX and crAIX), were measured in all participants, in addition to aortic pressure waveforms, classified as type A, B, C and D according to reflected wave timings and amplitude. Multiple linear regression assessed relationships between demographic and clinical factors with vascular measurement endpoints. RESULTS Ninety one PWH on long-term ART were enrolled; 38 (42%) were underweight (BMI < 18.5 kg/m2), 43 (47%) were normal weight (18.5-24.9 kg/m2) and 10 (11%) were overweight (> 25 kg/m2). Median age was 41, 40 and 40 years, among the three groups, respectively, and the proportion of women increased with BMI level. Overweight participants had a 39% higher cfAIX compared to normal-weight participants, while being underweight was associated with 27% lower cfAIX, after adjusting for age, sex and blood pressure (P = 0.02 and P = 0.01, respectively), but measurements of cfPWV, crPWV and crAIX did not differ. CONCLUSION Underweight PWH in SSA had lower cfAIX measurements compared to normal weight individuals, indicating less arterial stiffness. However, similar cfPWV, crPWV and crAIX values among the underweight and overweight PWH suggest a low BMI may not confer substantial protection against impaired vascular compliance as a contributor to CVD risk among individuals on ART.
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Affiliation(s)
- Longa Kaluba
- School of Medicine, Cavendish University Zambia, Lusaka, Zambia.
| | - Theresa Chikopela
- Department of Human Physiology, Faculty of Medicine, Lusaka Apex University, Lusaka, Zambia
| | - Fastone Goma
- grid.12984.360000 0000 8914 5257Department of Physiological Sciences, School of Medicine, University of Zambia, Lusaka, Zambia
| | - Mordecai Malambo
- grid.468776.c0000 0004 5346 0270School of Medicine, Cavendish University Zambia, Lusaka, Zambia
| | - Wilbroad Mutale
- grid.12984.360000 0000 8914 5257Department of Health Policy and Management, School of Public Health, University of Zambia, Lusaka, Zambia
| | - Douglas C. Heimburger
- grid.412807.80000 0004 1936 9916Vanderbilt Institute for Global Health and Department of Medicine, Vanderbilt University Medical Centre, Nashville, TN USA ,grid.12984.360000 0000 8914 5257Department of Internal Medicine, School of Medicine, University of Zambia, Lusaka, Zambia
| | - John R. Koethe
- grid.412807.80000 0004 1936 9916Vanderbilt Institute for Global Health and Department of Medicine, Vanderbilt University Medical Centre, Nashville, TN USA
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Cunningham JW, Di Achille P, Morrill VN, Weng LC, Hoan Choi S, Khurshid S, Nauffal V, Pirruccello JP, Solomon SD, Batra P, Ho JE, Philippakis AA, Ellinor PT, Lubitz SA. Machine Learning to Understand Genetic and Clinical Factors Associated With the Pulse Waveform Dicrotic Notch. CIRCULATION. GENOMIC AND PRECISION MEDICINE 2023; 16:e003676. [PMID: 36580284 PMCID: PMC9975074 DOI: 10.1161/circgen.121.003676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/12/2021] [Accepted: 09/30/2022] [Indexed: 12/30/2022]
Abstract
BACKGROUND Absence of a dicrotic notch on finger photoplethysmography is an easily ascertainable and inexpensive trait that has been associated with age and prevalent cardiovascular disease. However, the trait exists along a continuum, and little is known about its genetic underpinnings or prognostic value for incident cardiovascular disease. METHODS In 169 787 participants in the UK Biobank, we identified absent dicrotic notch on photoplethysmography and created a novel continuous trait reflecting notch smoothness using machine learning. Next, we determined the heritability, genetic basis, polygenic risk, and clinical relations for the binary absent notch trait and the newly derived continuous notch smoothness trait. RESULTS Heritability of the continuous notch smoothness trait was 7.5%, compared with 5.6% for the binary absent notch trait. A genome-wide association study of notch smoothness identified 15 significant loci, implicating genes including NT5C2 (P=1.2×10-26), IGFBP3 (P=4.8×10-18), and PHACTR1 (P=1.4×10-13), compared with 6 loci for the binary absent notch trait. Notch smoothness stratified risk of incident myocardial infarction or coronary artery disease, stroke, heart failure, and aortic stenosis. A polygenic risk score for notch smoothness was associated with incident cardiovascular disease and all-cause death in UK Biobank participants without available photoplethysmography data. CONCLUSIONS We found that a machine learning derived continuous trait reflecting dicrotic notch smoothness on photoplethysmography was heritable and associated with genes involved in vascular stiffness. Greater notch smoothness was associated with greater risk of incident cardiovascular disease. Raw digital phenotyping may identify individuals at risk for disease via specific genetic pathways.
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Affiliation(s)
- Jonathan W. Cunningham
- Cardiovascular Division, Brigham & Women’s Hospital, Boston
- Cardiovascular Disease Initiative, The Broad Institute of MIT & Harvard, Cambridge
| | - Paolo Di Achille
- Data Sciences Platform, The Broad Institute of MIT & Harvard, Cambridge
| | - Valerie N. Morrill
- Cardiovascular Disease Initiative, The Broad Institute of MIT & Harvard, Cambridge
| | - Lu-Chen Weng
- Cardiovascular Disease Initiative, The Broad Institute of MIT & Harvard, Cambridge
- Cardiovascular Research Center, Massachusetts General Hospital
| | - Seung Hoan Choi
- Cardiovascular Disease Initiative, The Broad Institute of MIT & Harvard, Cambridge
| | - Shaan Khurshid
- Cardiovascular Disease Initiative, The Broad Institute of MIT & Harvard, Cambridge
- Demoulas Center for Cardiac Arrhythmias, Massachusetts General Hospital
| | - Victor Nauffal
- Cardiovascular Division, Brigham & Women’s Hospital, Boston
- Cardiovascular Disease Initiative, The Broad Institute of MIT & Harvard, Cambridge
| | - James P Pirruccello
- Cardiovascular Disease Initiative, The Broad Institute of MIT & Harvard, Cambridge
- Division of Cardiology, Massachusetts General Hospital
| | | | - Puneet Batra
- Data Sciences Platform, The Broad Institute of MIT & Harvard, Cambridge
| | - Jennifer E. Ho
- Cardiovascular Disease Initiative, The Broad Institute of MIT & Harvard, Cambridge
- CardioVascular Institute and Division of Cardiology, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA
| | | | - Patrick T. Ellinor
- Cardiovascular Disease Initiative, The Broad Institute of MIT & Harvard, Cambridge
- Cardiovascular Research Center, Massachusetts General Hospital
- Demoulas Center for Cardiac Arrhythmias, Massachusetts General Hospital
| | - Steven A. Lubitz
- Cardiovascular Disease Initiative, The Broad Institute of MIT & Harvard, Cambridge
- Cardiovascular Research Center, Massachusetts General Hospital
- Demoulas Center for Cardiac Arrhythmias, Massachusetts General Hospital
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Ji Y, Du S, Tang C, Song J, Gu X. The Value of RBP4 in Assessing Coronary Artery Elasticity in Patients with Coronary Heart Disease and Type 2 Diabetes Mellitus. Rev Cardiovasc Med 2023; 24:33. [PMID: 39077416 PMCID: PMC11273123 DOI: 10.31083/j.rcm2402033] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Revised: 11/17/2022] [Accepted: 11/18/2022] [Indexed: 07/31/2024] Open
Abstract
Background Existing research has shown that retinol binding protein (RBP4) has an impairing effect on arterial elasticity and induces insulin resistance, but the clinical value of RBP4 in patients with coronary heart disease (CHD) combined with type 2 diabetes mellitus (T2DM) has not been investigated. This study sought to compare the complexity of coronary artery lesions and coronary artery elasticity between patients with CHD combined with T2DM and those with CHD without T2DM, analyze the risk factors affecting coronary artery elasticity, and investigate the value of RBP4 in assessing coronary artery elasticity in patients with CHD and T2DM. Methods A total of 130 patients with confirmed CHD were consecutively enrolled, including 38 patients with CHD combined with T2DM and 92 patients with CHD without T2DM. Basic clinical data, laboratory findings, coronary angiography and intravascular ultrasound (IVUS) imaging data, and Gensini scores and coronary artery elasticity parameters were calculated in both groups. Elasticity parameters included: stiffness parameter ( β ), pressure-strain elastic modulus ( E p ), distensibility coefficient (DC), and compliance coefficient (CC). Multiple linear regression equations were established with elasticity parameters as dependent variables to explore the factors influencing coronary artery elasticity parameters in patients within the two groups. Results Compared with patients in the CHD without T2DM group, patients in the CHD combined with T2DM group had higher RBP4 levels, Gensini scores, β and E p values, and lower DC and CC values. Linear regression analysis showed that Gensini score increased with higher β and E p values and decreased with higher DC and CC values. In all patients in the CHD and CHD combined with T2DM groups, RBP4 was an independent risk factor for β values after correction for confounders by multiple linear regression analysis, whereas in patients in the CHD without T2DM group, the effect of RBP4 on β values was not statistically different. Conclusions RBP4 was an independent risk factor of coronary artery elasticity in CHD patients with T2DM and in overall CHD patients, but it did not affect coronary artery elasticity in CHD patients without T2DM.
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Affiliation(s)
- Yanjing Ji
- Department of Cardiology, No. 904 Hospital of Joint Logistics Support Force of PLA, 214000 Wuxi, Jiangsu, China
| | - Shiyu Du
- Department of Cardiology, the second affiliated hospital of Soochow University, 215000 Suzhou, Jiangsu, China
| | - Chao Tang
- Department of Cardiology, the second affiliated hospital of Soochow University, 215000 Suzhou, Jiangsu, China
| | - Jinyou Song
- Department of Cardiology, the second affiliated hospital of Soochow University, 215000 Suzhou, Jiangsu, China
| | - Xiaosong Gu
- Department of Cardiology, the second affiliated hospital of Soochow University, 215000 Suzhou, Jiangsu, China
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Wang CJ, Noble PB, Elliot JG, James AL, Wang KCW. From Beneath the Skin to the Airway Wall: Understanding the Pathological Role of Adipose Tissue in Comorbid Asthma-Obesity. Compr Physiol 2023; 13:4321-4353. [PMID: 36715283 DOI: 10.1002/cphy.c220011] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
This article provides a contemporary report on the role of adipose tissue in respiratory dysfunction. Adipose tissue is distributed throughout the body, accumulating beneath the skin (subcutaneous), around organs (visceral), and importantly in the context of respiratory disease, has recently been shown to accumulate within the airway wall: "airway-associated adipose tissue." Excessive adipose tissue deposition compromises respiratory function and increases the severity of diseases such as asthma. The mechanisms of respiratory impairment are inflammatory, structural, and mechanical in nature, vary depending on the anatomical site of deposition and adipose tissue subtype, and likely contribute to different phenotypes of comorbid asthma-obesity. An understanding of adipose tissue-driven pathophysiology provides an opportunity for diagnostic advancement and patient-specific treatment. As an exemplar, the potential impact of airway-associated adipose tissue is highlighted, and how this may change the management of a patient with asthma who is also obese. © 2023 American Physiological Society. Compr Physiol 13:4321-4353, 2023.
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Affiliation(s)
- Carolyn J Wang
- School of Human Sciences, The University of Western Australia, Crawley, Western Australia, Australia
| | - Peter B Noble
- School of Human Sciences, The University of Western Australia, Crawley, Western Australia, Australia
| | - John G Elliot
- School of Human Sciences, The University of Western Australia, Crawley, Western Australia, Australia.,Department of Pulmonary Physiology and Sleep Medicine, West Australian Sleep Disorders Research Institute, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia
| | - Alan L James
- Department of Pulmonary Physiology and Sleep Medicine, West Australian Sleep Disorders Research Institute, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia.,Medical School, The University of Western Australia, Nedlands, Western Australia, Australia
| | - Kimberley C W Wang
- School of Human Sciences, The University of Western Australia, Crawley, Western Australia, Australia.,Telethon Kids Institute, The University of Western Australia, Nedlands, Western Australia, Australia
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Ye X, Wang Y, Zou Y, Tu J, Tang W, Yu R, Yang S, Huang P. Associations of socioeconomic status with infectious diseases mediated by lifestyle, environmental pollution and chronic comorbidities: a comprehensive evaluation based on UK Biobank. Infect Dis Poverty 2023; 12:5. [PMID: 36717939 PMCID: PMC9885698 DOI: 10.1186/s40249-023-01056-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Accepted: 01/16/2023] [Indexed: 01/31/2023] Open
Abstract
BACKGROUND Socioeconomic status (SES) inequity was recognized as a driver of some certain infectious diseases. However, few studies evaluated the association between SES and the burden of overall infections, and even fewer identified preventable mediators. This study aimed to assess the association between SES and overall infectious diseases burden, and the potential roles of factors including lifestyle, environmental pollution, chronic disease history. METHODS We included 401,009 participants from the UK Biobank (UKB) and defined the infection status for each participant according to their diagnosis records. Latent class analysis (LCA) was used to define SES for each participant. We further defined healthy lifestyle score, environment pollution score (EPS) and four types of chronic comorbidities. We used multivariate logistic regression to test the associations between the four above covariates and infectious diseases. Then, we performed the mediation and interaction analysis to explain the relationships between SES and other variables on infectious diseases. Finally, we employed seven types of sensitivity analyses, including considering the Townsend deprivation index as an area level SES variable, repeating our main analysis for some individual or composite factors and in some subgroups, as well as in an external data from the US National Health and Nutrition Examination Survey, to verify the main results. RESULTS In UKB, 60,771 (15.2%) participants were diagnosed with infectious diseases during follow-up. Lower SES [odds ratio (OR) = 1.5570] were associated with higher risk of overall infections. Lifestyle score mediated 2.9% of effects from SES, which ranged from 2.9 to 4.0% in different infection subtypes, while cardiovascular disease (CVD) mediated a proportion of 6.2% with a range from 2.1 to 6.8%. In addition, SES showed significant negative interaction with lifestyle score (OR = 0.8650) and a history of cancer (OR = 0.9096), while a significant synergy interaction was observed between SES and EPS (OR = 1.0024). In subgroup analysis, we found that males and African (AFR) with lower SES showed much higher infection risk. Results from sensitivity and validation analyses showed relative consistent with the main analysis. CONCLUSIONS Low SES is shown to be an important risk factor for infectious disease, part of which may be mediated by poor lifestyle and chronic comorbidities. Efforts to enhance health education and improve the quality of living environment may help reduce burden of infectious disease, especially for people with low SES.
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Affiliation(s)
- Xiangyu Ye
- grid.89957.3a0000 0000 9255 8984Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Yidi Wang
- grid.89957.3a0000 0000 9255 8984Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Yixin Zou
- grid.89957.3a0000 0000 9255 8984Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Junlan Tu
- grid.89957.3a0000 0000 9255 8984Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Weiming Tang
- grid.89957.3a0000 0000 9255 8984Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China ,grid.410711.20000 0001 1034 1720Institute of Global Health and Infectious Diseases, University of North Carolina, Chapel Hill, CA USA
| | - Rongbin Yu
- grid.89957.3a0000 0000 9255 8984Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Sheng Yang
- grid.89957.3a0000 0000 9255 8984Department of Biostatistics, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Peng Huang
- grid.89957.3a0000 0000 9255 8984Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China
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Moore JS, Nesbit MA, Moore T. Appraisal of Cardiovascular Risk Factors, Biomarkers, and Ocular Imaging in Cardiovascular Risk Prediction. Curr Cardiol Rev 2023; 19:72-81. [PMID: 37497700 PMCID: PMC10636798 DOI: 10.2174/1573403x19666230727101926] [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: 09/30/2022] [Revised: 05/12/2023] [Accepted: 06/15/2023] [Indexed: 07/28/2023] Open
Abstract
Cardiovascular disease remains a leading cause of death worldwide despite the use of available cardiovascular disease risk prediction tools. Identification of high-risk individuals via risk stratification and screening at sub-clinical stages, which may be offered by ocular screening, is important to prevent major adverse cardiac events. Retinal microvasculature has been widely researched for potential application in both diabetes and cardiovascular disease risk prediction. However, the conjunctival microvasculature as a tool for cardiovascular disease risk prediction remains largely unexplored. The purpose of this review is to evaluate the current cardiovascular risk assessment methods, identifying gaps in the literature that imaging of the ocular microcirculation may have the potential to fill. This review also explores the themes of machine learning, risk scores, biomarkers, medical imaging, and clinical risk factors. Cardiovascular risk classification varies based on the population assessed, the risk factors included, and the assessment methods. A more tailored, standardised and feasible approach to cardiovascular risk prediction that utilises technological and medical imaging advances, which may be offered by ocular imaging, is required to support cardiovascular disease prevention strategies and clinical guidelines.
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Affiliation(s)
- Julie S. Moore
- School of Biomedical Sciences, Ulster University, York St, Belfast BT15 1ED, United Kingdom
- Integrated Diagnostics Laboratory, Ulster University, 3-5a Frederick St, Belfast, Northern Ireland, United Kingdom
| | - M. Andrew Nesbit
- School of Biomedical Sciences, Ulster University, York St, Belfast BT15 1ED, United Kingdom
- Integrated Diagnostics Laboratory, Ulster University, 3-5a Frederick St, Belfast, Northern Ireland, United Kingdom
| | - Tara Moore
- School of Biomedical Sciences, Ulster University, York St, Belfast BT15 1ED, United Kingdom
- Integrated Diagnostics Laboratory, Ulster University, 3-5a Frederick St, Belfast, Northern Ireland, United Kingdom
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Wang X, Chen G, Huang Z, Zang Y, Cai Z, Ding X, Chen Z, Lan Y, Li W, Fang W, Wu W, Chen Z, Wu S, Chen Y. Effect of Aerobic Exercise on Arterial Stiffness in Individuals with Different Smoking Statuses. Int J Sports Med 2023; 44:48-55. [PMID: 36332620 PMCID: PMC9815950 DOI: 10.1055/a-1925-7588] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
This study aimed to investigate the immediate effects of acute bout of aerobic exercise on arterial stiffness in individuals with different smoking statuses. A total of 940 male individuals (mean age of 36.82±7.76 years) in the Kailuan study cohort were selected to participate in the fifth National Physical Fitness Monitoring. All participants completed measurements of brachial - ankle pulse wave velocity (baPWV) before and after twice-quantitative cycle ergometer exercise. Four groups were defined: (1) non-smokers (n=231), (2) former smokers (n=165), (3) light smokers (1-10 cigarettes/day, n=254), (4) heavy smokers (>10 cigarettes/day, n=290). Generalized linear models were established to analyze between-group differences in the change in baPWV before and after acute aerobic exercise in individuals with different smoking statuses. Overall, after acute aerobic exercise, baPWV was immediately decreased significantly (-33.55 cm/s [95% CI, - 39.69 to -27.42]). Compared with non-smokers, former smokers, light smokers, and heavy smokers showed a greater decrease in baPWV (-12.17 cm/s [95%CI, - 30.08 to 5.75], - 18.43 cm/s [95%CI, -34.69 to - 2.16], and -22.46 cm/s [95%CI, - 38.39 to - 6.54]) respectively. There is a transient decrease in baPWV in individuals with different smoking statuses. Compared with non-smokers, baPWV decreased more significantly in light and heavy smokers.
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Affiliation(s)
- Xianxuan Wang
- Department of Cardiology, Second Affiliated Hospital of Shantou University Medical College, Shantou, China
| | - Guanzhi Chen
- Second Clinical College, China Medical University, Shenyang,
China
| | - Zegui Huang
- Department of Cardiology, Second Affiliated Hospital of Shantou
University Medical College, Shantou, China
| | - Yiran Zang
- Graduate School, North China University of Science and Technology,
Tangshan, China
| | - Zefeng Cai
- Department of Cardiology, Second Affiliated Hospital of Shantou
University Medical College, Shantou, China
| | - Xiong Ding
- School of Public Health, North China University of Science and
Technology, Tangshan, China
| | - Zekai Chen
- Department of Epidemiology, University Medical Centre Groningen,
Groningen, Netherlands
| | - Yulong Lan
- Department of Cardiology, Second Affiliated Hospital of Shantou
University Medical College, Shantou, China
| | - Weijian Li
- Department of Cardiology, Second Affiliated Hospital of Shantou
University Medical College, Shantou, China
| | - Wei Fang
- Department of Cardiology, Second Affiliated Hospital of Shantou
University Medical College, Shantou, China
| | - Weiqiang Wu
- Department of Cardiology, Second Affiliated Hospital of Shantou
University Medical College, Shantou, China
| | - Zhichao Chen
- Department of Cardiology, Second Affiliated Hospital of Shantou
University Medical College, Shantou, China
| | - Shouling Wu
- Department of Cardiology, Kailuan General Hospital, Tangshan,
China
| | - Youren Chen
- Department of Cardiology, Second Affiliated Hospital of Shantou University Medical College, Shantou, China
- Correspondence Mr. Youren Chen Department of CardiologySecond Affiliated Hospital of Shantou University Medical
CollegeNo.69, Dongxia North Road515000
ShantouChina
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Cecelja M, Ruijsink B, Puyol‐Antón E, Li Y, Godwin H, King AP, Razavi R, Chowienczyk P. Aortic Distensibility Measured by Automated Analysis of Magnetic Resonance Imaging Predicts Adverse Cardiovascular Events in UK Biobank. J Am Heart Assoc 2022; 11:e026361. [PMID: 36444831 PMCID: PMC9851433 DOI: 10.1161/jaha.122.026361] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Accepted: 08/04/2022] [Indexed: 11/30/2022]
Abstract
Background Automated analysis of cardiovascular magnetic resonance images provides the potential to assess aortic distensibility in large populations. The aim of this study was to compare the prediction of cardiovascular events by automated cardiovascular magnetic resonance with those of other simple measures of aortic stiffness suitable for population screening. Methods and Results Aortic distensibility was measured from automated segmentation of aortic cine cardiovascular magnetic resonance using artificial intelligence in 8435 participants. The associations of distensibility, brachial pulse pressure, and stiffness index (obtained by finger photoplethysmography) with conventional risk factors was examined by multivariable regression and incident cardiovascular events by Cox proportional-hazards regression. Mean (±SD) distensibility values for men and women were 1.77±1.15 and 2.10±1.45 (P<0.0001) 10-3 mm Hg-1, respectively. There was a good correlation between automatically and manually obtained systolic and diastolic aortic areas (r=0.980 and r=0.985, respectively). In regression analysis, distensibility associated with age, mean arterial pressure, heart rate, weight, and plasma glucose but not male sex, cholesterol or current smoking. During an average follow-up of 2.8±1.3 years, 86 participants experienced cardiovascular events 6 of whom died. Higher distensibility was associated with reduced risk of cardiovascular events (adjusted hazard ratio [HR], 0.61 per log unit of distensibility; P=0.016). There was no evidence of an association between pulse pressure (adjusted HR 1.00; P=0.715) or stiffness index (adjusted HR, 1.02; P=0.535) and risk of cardiovascular events. Conclusions Automated cardiovascular magnetic resonance-derived aortic distensibility may be incorporated into routine clinical imaging. It shows a similar association to cardiovascular risk factors as other measures of arterial stiffness and predicts new-onset cardiovascular events, making it a useful tool for the measurement of vascular aging and associated cardiovascular risk.
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Affiliation(s)
- Marina Cecelja
- King’s College London British Heart Foundation Centre, Department of Clinical PharmacologySt Thomas’ HospitalLondonUnited Kingdom
| | - Bram Ruijsink
- School of Bioengineering and Imaging SciencesKing’s College LondonLondonUnited Kingdom
| | - Esther Puyol‐Antón
- School of Bioengineering and Imaging SciencesKing’s College LondonLondonUnited Kingdom
| | - Ye Li
- King’s College London British Heart Foundation Centre, Department of Clinical PharmacologySt Thomas’ HospitalLondonUnited Kingdom
| | - Harriet Godwin
- King’s College London British Heart Foundation CentreSchool of Cardiovascular Medicine & Sciences, Department of CardiologyLondonUnited Kingdom
| | - Andrew P. King
- School of Bioengineering and Imaging SciencesKing’s College LondonLondonUnited Kingdom
| | - Reza Razavi
- School of Bioengineering and Imaging SciencesKing’s College LondonLondonUnited Kingdom
| | - Phil Chowienczyk
- King’s College London British Heart Foundation Centre, Department of Clinical PharmacologySt Thomas’ HospitalLondonUnited Kingdom
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Chou CH, Yin JH, Lin YK, Yang FC, Chu TW, Chuang YC, Lin CW, Peng GS, Sung YF. The optimal pulse pressures for healthy adults with different ages and sexes correlate with cardiovascular health metrics. Front Cardiovasc Med 2022; 9:930443. [PMID: 36545016 PMCID: PMC9760735 DOI: 10.3389/fcvm.2022.930443] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Accepted: 11/10/2022] [Indexed: 12/07/2022] Open
Abstract
Background Pulse pressure (PP) may play a role in the development of cardiovascular disease, and the optimal PP for different ages and sexes is unknown. In a prospective cohort, we studied subjects with favorable cardiovascular health (CVH), proposed the mean PP as the optimal PP values, and demonstrated its relationship with healthy lifestyles. Methods and results Between 1996 and 2016, a total of 162,636 participants (aged 20 years or above; mean age 34.9 years; 26.4% male subjects; meeting criteria for favorable health) were recruited for a medical examination program. PP in male subjects was 45.6 ± 9.4 mmHg and increased after the age of 50 years. PP in female subjects was 41.8 ± 9.5 mmHg and increased after the age of 40 years, exceeding that of male subjects after the age of 50 years. Except for female subjects with a PP of 40-70 mmHg, PP increase correlates with both systolic blood pressure (BP) increase and diastolic BP decrease. Individuals with mean PP values are more likely to meet health metrics, including body mass index (BMI) <25 kg/m2 (chi-squared = 9.35, p<0.01 in male subjects; chi-squared = 208.79, p < 0.001 in female subjects) and BP <120/80 mmHg (chi-squared =1,300, p < 0.001 in male subjects; chi-squared =11,000, p < 0.001 in female subjects). We propose a health score (Hscore) based on the sum of five metrics (BP, BMI, being physically active, non-smoking, and healthy diet), which significantly correlates with the optimal PP. Conclusion The mean PP (within ±1 standard deviation) could be proposed as the optimal PP in the adult population with favorable CVH. The relationship between health metrics and the optimal PP based on age and sex was further demonstrated to validate the Hscore.
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Affiliation(s)
- Chung-Hsing Chou
- Department of Neurology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan,Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan
| | - Jiu-Haw Yin
- Department of Neurology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan,Division of Neurology, Department of Internal Medicine, Taipei Veterans General Hospital, Hsinchu, Taiwan
| | - Yu-Kai Lin
- Department of Neurology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan,Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan
| | - Fu-Chi Yang
- Department of Neurology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Ta-Wei Chu
- Department of Obstetrics and Gynecology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan,MJ Health Screening Center, Taipei, Taiwan
| | | | - Chia Wen Lin
- MJ Health Research Foundation, MJ Group, Taipei, Taiwan
| | - Giia-Sheun Peng
- Department of Neurology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan,Division of Neurology, Department of Internal Medicine, Taipei Veterans General Hospital, Hsinchu, Taiwan
| | - Yueh-Feng Sung
- Department of Neurology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan,*Correspondence: Yueh-Feng Sung
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Clayton ZS, Ade CJ, Dieli-Conwright CM, Mathelier HM. A bench to bedside perspective on anthracycline chemotherapy-mediated cardiovascular dysfunction: challenges and opportunities. A symposium review. J Appl Physiol (1985) 2022; 133:1415-1429. [PMID: 36302155 PMCID: PMC9762976 DOI: 10.1152/japplphysiol.00471.2022] [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: 08/12/2022] [Revised: 10/20/2022] [Accepted: 10/21/2022] [Indexed: 01/11/2023] Open
Abstract
Cardiovascular diseases (CVD) are the leading cause of death worldwide and the risk of developing CVD is markedly increased following anthracycline chemotherapy treatment. Anthracyclines are an essential component of the cancer treatment regimen used for common forms of cancer in male and female children, adolescents, young adults, and older adults. Increased CVD risk with anthracyclines occurs, in part, due to vascular dysfunction-impaired endothelial function and arterial stiffening. These features of vascular dysfunction also play a major role in other common disorders observed following anthracycline treatment, including chronic kidney disease, dementia, and exercise intolerance. However, the mechanisms by which anthracycline chemotherapy induces and sustains vascular dysfunction are incompletely understood. This budding area of biomedical research is termed cardio-oncology, which presents the unique opportunity for collaboration between physicians and basic scientists. This symposium, presented at Experimental Biology 2022, provided a timely update on this important biomedical research topic. The speakers presented observations made at levels from cells to mice to humans treated with anthracycline chemotherapeutic agents using an array of translational research approaches. The speaker panel included a diverse mix of female and male investigators and unique insight from a cardio-oncology physician-scientist. Particular emphasis was placed on challenges and opportunities in this field as well as mechanisms that could be viewed as therapeutic targets leading to novel treatment strategies.
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Affiliation(s)
- Zachary S Clayton
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, Colorado
| | - Carl J Ade
- Department of Kinesiology, Kansas State University, Manhattan, Kansas
| | - Christina M Dieli-Conwright
- Division of Population Sciences, Department of Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts
| | - Hansie M Mathelier
- Penn Medicine, University of Pennsylvania Health System, Philadelphia, Pennsylvania
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Changes in Arterial Stiffness in Response to Various Types of Exercise Modalities: A Narrative Review on Physiological and Endothelial Senescence Perspectives. Cells 2022; 11:cells11223544. [PMID: 36428973 PMCID: PMC9688701 DOI: 10.3390/cells11223544] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Revised: 10/31/2022] [Accepted: 11/01/2022] [Indexed: 11/12/2022] Open
Abstract
Arterial stiffness is a reliable independent predictor of cardiovascular events. Exercise training might enhance arterial compliance through improved metabolic health status. Different modes of exercise may have different effects on arterial stiffness. However, the interactions among different modes of exercise on endothelial senescence, the development of arterial vascular stiffness, and the associated molecular mechanisms are not completely understood. In this narrative review, we evaluate the current evidence focusing on the effects of various exercise modes on arterial stiffness and vascular health, and the known underlying physiological mechanisms are discussed as well. Here, we discuss the most recent evidence of aerobic exercise, high-intensity interval training (HIIT), and resistance exercise (RE) on arterial stiffness and endothelial senescence in physiological and cellular studies. Indeed, aerobic, HIIT, and progression RE-induced arterial compliance may reduce arterial stiffness by effectively promoting nitric oxide (NO) bioavailability and reducing endothelial senescence. However, the transient increase in inflammation and sympathetic activation may contribute to the temporary elevation in arterial stiffness following whole-body high-intensity acute resistance exercise.
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Chen TY, Kao CW, Cheng SM, Chang YC. A web-based self-care program to promote healthy lifestyles and control blood pressure in patients with primary hypertension: A randomized controlled trial. J Nurs Scholarsh 2022; 54:678-691. [PMID: 35674370 DOI: 10.1111/jnu.12792] [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: 01/28/2022] [Revised: 05/19/2022] [Accepted: 05/25/2022] [Indexed: 12/15/2022]
Abstract
BACKGROUND Hypertension is a major risk factor for cardiovascular diseases, which contributes to the worldwide mortality rate. Successful blood pressure control requires adherence to medications and lifestyle modifications. However, motivating patients with primary hypertension to change and sustain behaviors long-term is challenging. A web-based self-care program centered on self-efficacy theory could provide feedback for effective control of blood pressure. PURPOSE To examine the effect of a web-based self-care program for patients with primary hypertension on cardiovascular risk-factors (pulse pressure and lipids), self-efficacy, and self-care behaviors (medication adherence and lifestyle). DESIGN A two-armed randomized controlled trial with 3-month and 6-month follow-ups. SETTING AND PARTICIPANTS A total of 222 patients with primary hypertension were recruited between February 2017 and August 2018 at a cardiology clinic of a medical center in Taipei, Taiwan. METHODS Eligible patients were randomized by permuted block randomization into the intervention group (n = 111) and control group (n = 111). Patients in the intervention group received a 6-month web-based self-care program, based on the theory of self-efficacy, while patients in the control group received usual care. Baseline and outcome measures (3 and 6 months) included self-efficacy, evaluated with the Chinese version of the 6-item Self-Efficacy for Managing Chronic Diseases (SEMC6), self-care, using subscales of the Hypertension Self-Care Activity Level Effects Scale (H-SCALE) for lifestyle and medication adherence, and blood pressure and serum lipid data, collected through web-based self-reports and chart review. Generalized estimating equations evaluated the effects of the intervention. FINDINGS At baseline, the control group had higher scores on the SEMC6, and lower cholesterol (HDL) compared with the intervention group (t = -2.70, p < 0.05; and t = 1.76, p < 0.05, respectively). Pulse pressure decreased significantly (β = -20.30, 95% CI -23.76, -16.83), and serum triglycerides and low-density lipoprotein cholesterol levels were significantly lower compared with controls at 6 months (all p < 0.001). At 6 months, the intervention group had significantly higher mean scores for the SEMC6 compared with the control group (β = 21.84, 95% confidence interval [CI] 19.25, 24.42) and H-SCALE subscale for medication adherence, diet, weight management, and physical activity compared with controls at 6 months (all, p < 0.001). CONCLUSIONS AND CLINICAL RELEVANCE The greatest benefit of this program was allowing participants to immediately consult with the researchers about self-care issues via the website. Lifestyles vary from person to person; therefore, the individuality of each participant was considered when providing feedback. We provided devising interventions for participants that would increase their confidence in self-care for hypertension and ultimately achieve home blood pressure control. We encourage incorporating this program into standard clinical care for patients with hypertension.
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Affiliation(s)
- Ting-Yu Chen
- Department of Nursing, Chang Gung University of Science and Technology, Chiayi, Taiwan
| | - Chi-Wen Kao
- School of Nursing, National Defense Medical Center, Taipei, Taiwan
| | - Shu-Meng Cheng
- Division of Cardiology, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Yue-Cune Chang
- Department of Mathematics, Tamkang University, Taipei, Taiwan
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