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Tagawa K, Tsuru Y, Yokoi K, Aonuma T, Hashimoto J. Inverse association between obesity and aortic pressure augmentation is attenuated in women: the Wakuya study. J Hypertens 2024; 42:783-788. [PMID: 38230603 DOI: 10.1097/hjh.0000000000003657] [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: 01/18/2024]
Abstract
OBJECTIVE Pressure wave reflection predicts cardiovascular events in the general population. Obesity is negatively associated with pressure wave reflection. Muscular arterial diameter (responsible for pressure wave reflection) increases with obesity, and obesity-dependent dilation of muscular arteries is attenuated in women compared with men. We investigated the sex differences in the cross-sectional relationship between obesity and pressure wave reflection in a general population cohort. METHODS Tonometric pressure waveforms were recorded in 928 adults (mean age, 56 ± 10 years) to estimate the aortic augmentation index. The BMI was calculated using height and body weight, and waist circumference was recorded at the umbilical level. RESULTS Aortic augmentation index was significantly higher in women than in men. Indices of obesity (BMI and waist circumference) were negatively correlated with the aortic augmentation index in both men and women, even after adjusting for mean arterial pressure (both P < 0.001). Sex and BMI had no synergistic effect on the aortic augmentation index. However, when waist circumference was substituted for BMI, sex and waist circumference had a reciprocal influence on decreasing the aortic augmentation index independent of age, mean arterial pressure, diabetes, and hyperlipidemia (interaction, P = 0.045). CONCLUSION The negative correlation between overweight/obesity and aortic pressure augmentation from peripheral wave reflection is inhibited in women more than in men. Sex differences in aortic pressure augmentation are greater in individuals with central (abdominal) obesity than in those with general obesity.
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Affiliation(s)
- Kaname Tagawa
- Medical Center, Miyagi University of Education, Sendai
- Institute of Health and Sport Sciences, University of Tsukuba, Tsukuba
| | | | | | | | - Junichiro Hashimoto
- Medical Center, Miyagi University of Education, Sendai
- Division of Nephrology, Endocrinology, and Vascular Medicine, Department of Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
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Glin M, Zielinska N, Ruzik K, Karauda P, Konschake M, Olewnik Ł. Morphological variations of the brachial artery and their clinical significance: a systematic review. Surg Radiol Anat 2023; 45:1125-1134. [PMID: 37530816 PMCID: PMC10514101 DOI: 10.1007/s00276-023-03198-5] [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: 05/07/2023] [Accepted: 06/28/2023] [Indexed: 08/03/2023]
Abstract
PURPOSE Morphological variations of the brachial artery are quite commonly discovered in routine dissection and have been the subject of many studies. However, there is a need for a clear classification. This work presents morphological variations of the brachial artery, based on numerous case reports and studies created for the appropriate classification and interpretation among surgeons and radiologists. It also discusses the most important clinical aspects of the given varieties. METHODS The research method is based on the combined interpretation of the researches based on numerous publications concerning both the principles of correctly classifying the described morphological variations of the brachial artery and the resulting clinical implications. This work considers atypical variations such as the presence of the superficial brachial artery, brachoradial artery, accessory brachial artery and absence of the brachial artery. Variations of the brachial artery in relation to the external and internal diameter of the vessel have also been discussed. RESULTS After conducting a complex analysis of the collected data, the fundamental principles for classifying such variability as superficial brachial artery, brachioradial artery and accessory brachial artery were defined. Additionally, clinical implications resulting from the above like the impact of the superficial brachial artery on the median nerve neuropathy and the positive correlation between the brachioradial artery and increased danger of incorrect transradial catheterization were demonstrated. CONCLUSIONS The clinical implications of the atypical arterial pattern within the upper limb are crucial during the angiography and surgical procedures so the variations affect the appropriate diagnosis and surgical intervention. Hence, the knowledge about the morphological variations of the brachial artery should be constantly broadened by radiologists and surgeons to improve the accuracy and effectiveness of the treatment process.
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Affiliation(s)
- Marcin Glin
- Department of Anatomical Dissection and Donation, Medical University of Lodz, Lodz, Poland
| | - Nicol Zielinska
- Department of Anatomical Dissection and Donation, Medical University of Lodz, Lodz, Poland
| | - Kacper Ruzik
- Department of Anatomical Dissection and Donation, Medical University of Lodz, Lodz, Poland
| | - Piotr Karauda
- Department of Anatomical Dissection and Donation, Medical University of Lodz, Lodz, Poland
| | - Marko Konschake
- Department of Anatomy, Histology and Embryology, Institute of Clinical and Functional Anatomy, Medical University Innsbruck (MUI), Innsbruck, Austria
| | - Łukasz Olewnik
- Department of Anatomical Dissection and Donation, Medical University of Lodz, Lodz, Poland
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The effects of high-intensity interval training and moderate-intensity continuous training on visceral fat and carotid hemodynamics parameters in obese adults. J Exerc Sci Fit 2022; 20:355-365. [PMID: 36186829 PMCID: PMC9486563 DOI: 10.1016/j.jesf.2022.09.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Revised: 08/14/2022] [Accepted: 09/02/2022] [Indexed: 11/23/2022] Open
Abstract
Objectives The present study aimed to examine the effects of high-intensity interval training (HIIT) and moderate-intensity continuous training (MICT) on visceral fat and hemodynamic parameters in obese adults. Methods Fifty-two males were included in this study and divided into three groups: HIIT group (n = 21, age = 20.86 ± 1.62 years, BF (%) = 30.10 ± 5.02), MICT group (n = 22, age = 20.76 ± 1.14 years, BF (%) = 30.19 ± 5.76), and control group (CON) (n = 9, age = 21.38 ± 1.77 years, BF (%) = 30.40 ± 5.10). The HIIT and MICT groups received the exercise intervention three to four times per week for eight weeks (HIIT: exercise intensity 80–95% HRmax, circuit; MICT: exercise intensity 60–70% HRmax, running), and the control (CON) group received health education and guidance without exercise intervention. The body compositions and serum lipid indexes were tested to calculated LAP and VAI. The color doppler ultrasound diagnostic technology was used to test the artery diameter and blood velocity before and after the intervention. Based on the test data, MATLAB software and Womersley theory were used to calculate the hemodynamic parameters of the common carotid artery, including wall shear stress, flow rate, blood pressure, oscillatory shear index, elasticity modulus, dynamic resistance, artery diameter, arterial stiffness, circumferential strain and pulsatility index. Results We found that lipid accumulation product (LAP) was significantly decreased in both the HIIT group (p < 0.01) and MICT (p < 0.05) group but not in the CON group (p > 0.05). In contrast, visceral adiposity index (VAI) decreased in both the HIIT and MICT groups and increased in the CON group, although the difference among groups was not significant (p > 0.05). After 8 weeks of intervention, the blood velocity and wall shear stress were greater after HIIT and MICT intervention (p < 0.01). Artery diameter, oscillatory shear index, arterial stiffness, and pulsatility index decreased significantly, and circumferential strain increased significantly in the HIIT group (all, p < 0.01, p < 0.05) but not in the MICT group (p > 0.05). Dynamic resistance was significantly decreased in the MICT group. There was no difference in the CON group after the period of intervention (all, p > 0.05). LAP was positively related to artery diameter (r = 0.48, p = 0.011), blood pressure (r = 0.46, p = 0.002), flow rate (r = 0.31, p = 0.04), oscillatory shear index (r = 0.44, p = 0.03), and elasticity modulus (r = 0.33, p = 0.029) but inversely related to circumferential strain (r = −0.36, p = 0.028). The VAI was also positively associated with artery diameter (r = 0.33, p = 0.03), elasticity modulus (r = 0.38, p = 0.009), and arterial stiffness (r = 0.39, p = 0.012). In addition, the VAI was negatively correlated with the circumferential strain (r = −0.33, p = 0.04). Conclusion The present study demonstrated that both HIIT and MICT exercises for 8 weeks could effectively enhance visceral fat indices and partial hemodynamic parameters. Therefore, HIIT and MICT exert important effects on reducing fat content and improving hemodynamic environment. But HIIT on oscillatory shear index, arterial stiffness, circumferential strain, and pulsatility index was superior to MICT. In addition, there are close correlations between visceral fat and partial hemodynamic parameters of the common carotid artery.
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Shi W, Liu H, Cao L, He Y, Su P, Chen J, Wang M, Li X, Bai S, Tang D. Acute effect of high-intensity interval exercise on vascular endothelial function and possible mechanisms of wall shear stress in young obese males. Front Physiol 2022; 13:966561. [PMID: 36187796 PMCID: PMC9523906 DOI: 10.3389/fphys.2022.966561] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2022] [Accepted: 08/30/2022] [Indexed: 11/24/2022] Open
Abstract
Objective: To investigate the mechanisms of wall shear stress (WSS) responsible for the effects of high-intensity interval exercise (HIIE) on vascular endothelial function in young obese males. Methods: A within-subject study design was used. We examined the response of the reactive hyperemia index (RHI) to acute HIIE in young obese males (n = 20, age = 20.38 ± 1.40 years, body mass index [BMI] = 31.22 ± 3.57, body fat percentage [BF (%)] = 31.76 ± 3.57). WSS was manipulated using 100, 80, or 60 mmHg cuff inflation during the HIIE to determine the proper inflation capable of maintaining WSS near baseline levels. One-way repeated measures analysis of variance and LSD post hoc tests were performed to compare changes in WSS and vascular endothelial function at baseline HIIE and following HIIE using different cuff inflations. Results: There were no significant differences in RHI and WSS between the three cuff inflation values (p > 0.05). WSS was significantly higher in obese male individuals after HIIE and HIIE with 100 mmHg cuff inflation (p = 0.018, p = 0.005) than that at baseline, with no significant differences observed comparing HIIE and HIIE with 100 mmHg inflation (p = 0.23). The RHI after HIIE was significantly higher (p = 0.012) than that at baseline, while no significant differences were detected after HIIE at 100 mmHg (p = 0.91). The RHI was significantly lower after HIIE with 100 mmHg than that after HIIE (p = 0.007). WSS (p = 0.004) and RHI (p = 0.017) were significantly higher after HIIE than that at baseline, while no significant differences were observed after HIIE with either 80 or 60 mmHg cuff inflation (baseline vs. HIIE + 80 mmHg: WSS: p = 0.33, RHI: p = 0.38; baseline vs. HIIE + 60 mmHg: WSS: p = 0.58, RHI: p = 0.45). WSS was similar to HIIE, after HIIE with either 80 or 60 mmHg inflation (p = 0.36, p = 0.40). However, RHI was significantly higher for HIIE than for HIIE with both 80 and 60 mmHg inflation (p = 0.011, p = 0.006). Conclusion: HIIE could significantly improve WSS and vascular endothelial function. HIIE intervention with 60 or 80 mmHg inflation might enhance WSS near the baseline level. HIIE-induced acute changes in WSS may provide the primary physiological stimulus for vascular endothelial adaptation to HIIE in young obese males.
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Affiliation(s)
- Wenxia Shi
- College of P.E. and Sport, Beijing Normal University, Beijing, China
| | - Haibin Liu
- School of Kinesiology and Health Promotion, Dalian University of Technology, Dalian, China
| | - Ling Cao
- Sinopec Research Institute of Petroleum Processing, Beijing, China
| | - Yufeng He
- College of P.E. and Sport, Beijing Normal University, Beijing, China
| | - Pei Su
- College of P.E. and Sport, Beijing Normal University, Beijing, China
| | - Jiangang Chen
- College of P.E. and Sport, Beijing Normal University, Beijing, China
| | - Mengyue Wang
- College of P.E. and Sport, Beijing Normal University, Beijing, China
| | - Xulong Li
- Department of P.E., Qingdao University of Technology, Qingdao, China
| | - Shuang Bai
- Capital Institute of Physical Education and Sports, Beijing, China
| | - Donghui Tang
- College of P.E. and Sport, Beijing Normal University, Beijing, China
- *Correspondence: Donghui Tang,
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Sundholm JKM, Litwin L, Rönö K, Koivusalo SB, Eriksson JG, Sarkola T. Ultra-high frequency ultrasound delineated changes in carotid and muscular artery intima-media and adventitia thickness in obese early middle-aged women. Diab Vasc Dis Res 2022; 19:14791641221094321. [PMID: 35637577 PMCID: PMC9160911 DOI: 10.1177/14791641221094321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Obesity is linked to increased arterial size, carotid intima-media thickness and arterial stiffness. The effects of obesity and body composition on muscular artery intima-media and adventitia thickness has previously not been established. The aim of this study was to explore associations between carotid and muscular artery wall layer thickness with body composition and cardiovascular risk factors in early middle-aged women. This is a cross-sectional study including 199 women aged 40±4 years. Arterial lumen (LD), intima-media (IMT) and adventitia thickness (AT) were measured from carotid, brachial and radial arteries using ultra-high frequency ultrasound (22-71 MHz). Women with obesity had increased IMT in carotid (0.47 vs 0.45 mm), brachial (0.19 vs 0.17 mm) and radial arteries (0.16 vs 0.15 mm) and increased brachial AT (0.14 vs 0.13 mm). In multiple regression models all arterial LD (β-range 0.02-0.03 mm/kg/m2), IMT (β-range 0.91-3.37 µm/kg/m2), AT (β-range 0.73-1.38 µm/kg/m2) were significantly associated with BMI. The IMT of all arteries were significantly associated with systolic blood pressure (β-range 0.36-0.85 µm/mmHg), attenuating the association between IMT and BMI (β-range 0.18-2.24 µm/kg/m2). Obese early middle-aged women have increased arterial intima media thickness and brachial artery adventitia thickness compared to non-obese counterparts. The association between BMI and intima-media thickness is partly mediated through blood pressure levels.
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Affiliation(s)
- Johnny KM Sundholm
- Children’s Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- Minerva Foundation Institute for Medical Research, Helsinki, Finland
- Johnny KM Sundholm, Children’s Hospital, Helsinki University Hospital, Stenbäckinkatu 9, POB 281, FIN-00029, Helsinki 00029, Finland.
| | - Linda Litwin
- Children’s Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- Minerva Foundation Institute for Medical Research, Helsinki, Finland
- Department of Congenital Heart Defects and Pediatric Cardiology, SMDZ in Zabrze, SUM, Katowice, Poland
| | - Kristiina Rönö
- Women’s Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Saila B Koivusalo
- Women’s Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- Department of Gynecology and Obstetrics, University of Turku and Turku University Hospital, Turku Finland
| | - Johan G Eriksson
- Department of General Practice and Primary Health Care, University of Helsinki, and Helsinki University Hospital, Helsinki, Finland
- Folkhälsan Research Center, Helsinki, Finland
- Department of Obstetrics & Gynaecology and Human Potential Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Agency for Science, Technology and Research, Singapore Institute for Clinical Sciences, Singapore, Singapore
| | - Taisto Sarkola
- Children’s Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- Minerva Foundation Institute for Medical Research, Helsinki, Finland
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Gokce N, Karki S, Dobyns A, Zizza E, Sroczynski E, Palmisano JN, Mazzotta C, Hamburg NM, Pernar LI, Carmine B, Carter CO, LaValley M, Hess DT, Apovian CM, Farb MG. Association of Bariatric Surgery With Vascular Outcomes. JAMA Netw Open 2021; 4:e2115267. [PMID: 34251443 PMCID: PMC8276087 DOI: 10.1001/jamanetworkopen.2021.15267] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
IMPORTANCE Bariatric surgical weight loss is associated with reduced cardiovascular mortality; however, the mechanisms underlying this association are incompletely understood. OBJECTIVES To identify variables associated with vascular remodeling after bariatric surgery and to examine how sex, race, and metabolic status are associated with microvascular and macrovascular outcomes. DESIGN, SETTING, AND PARTICIPANTS This population-based longitudinal cohort included 307 individuals who underwent bariatric surgery. Participants were enrolled in the bariatric weight loss program at Boston Medical Center, a large, multi-ethnic urban hospital, with presurgical and postsurgical assessments. Data were collected from December 11, 2001 to August 27, 2019. Data were analyzed in September 2019. EXPOSURE Bariatric surgery. MAIN OUTCOMES AND MEASURES Flow-mediated dilation (FMD) and reactive hyperemia (RH) (as measures of macrovascular and microvascular function, respectively) and clinical variables were measured preoperatively at baseline and at least once postoperatively within 12 months of the bariatric intervention. RESULTS A total of 307 participants with obesity (mean [SD] age, 42 [12] years; 246 [80%] women; 199 [65%] White; mean [SD] body mass index, 46 [8]) were enrolled in this study. Bariatric surgery was associated with significant weight loss and improved macrovascular and microvascular function across subgroups of sex, race, and traditional metabolic syndrome (mean [SD] pre- vs postsurgery weight: 126 [25] kg vs 104 [25] kg; P < .001; mean [SD] pre- vs postsurgery FMD: 9.1% [5.3] vs 10.2% [5.1]; P < .001; mean [SD] pre- vs postsurgery RH: 764% [400] vs 923% [412]; P < .001). Factors associated with change in vascular phenotype correlated most strongly with adiposity markers and several metabolic variables depending on vascular territory (eg, association of weight change with change in RH: estimate, -3.2; 95% CI, -4.7 to -1.8; association of hemoglobin A1c with change in FMD: estimate, -0.5; 95% CI, -0.95 to -0.05). While changes in macrovascular function among individuals with metabolically healthy obesity were not observed, the addition of biomarker assessment using high-sensitivity C-reactive protein plasma levels greater than 2 mg/dL identified participants with seemingly metabolically healthy obesity who had low-grade inflammation and achieved microvascular benefit from weight loss surgery. CONCLUSIONS AND RELEVANCE The findings of this study suggest that bariatric intervention is associated with weight loss and favorable remodeling of the vasculature among a wide range of individuals with cardiovascular risk. Moreover, differences in arterial responses to weight loss surgery by metabolic status were identified, underscoring heterogeneity in physiological responses to adiposity change and potential activation of distinct pathological pathways in clinical subgroups. As such, individuals with metabolically healthy obesity represent a mixed population that may benefit from more refined phenotypic classification.
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Affiliation(s)
- Noyan Gokce
- Department of Medicine and Whitaker Cardiovascular Institute, Boston University School of Medicine, Boston, Massachusetts
| | - Shakun Karki
- Department of Medicine and Whitaker Cardiovascular Institute, Boston University School of Medicine, Boston, Massachusetts
| | - Alyssa Dobyns
- Department of Medicine and Whitaker Cardiovascular Institute, Boston University School of Medicine, Boston, Massachusetts
| | - Elaina Zizza
- Department of Medicine and Whitaker Cardiovascular Institute, Boston University School of Medicine, Boston, Massachusetts
| | - Emily Sroczynski
- Department of Medicine and Whitaker Cardiovascular Institute, Boston University School of Medicine, Boston, Massachusetts
| | - Joseph N. Palmisano
- Department of Public Health, Boston University School of Medicine, Boston, Massachusetts
| | - Celestina Mazzotta
- Department of Medicine and Whitaker Cardiovascular Institute, Boston University School of Medicine, Boston, Massachusetts
| | - Naomi M. Hamburg
- Department of Medicine and Whitaker Cardiovascular Institute, Boston University School of Medicine, Boston, Massachusetts
| | - Luise I. Pernar
- Department of General Surgery, Boston University School of Medicine, Boston, Massachusetts
| | - Brian Carmine
- Department of General Surgery, Boston University School of Medicine, Boston, Massachusetts
| | - Cullen O. Carter
- Department of General Surgery, Boston University School of Medicine, Boston, Massachusetts
| | - Michael LaValley
- Department of Public Health, Boston University School of Medicine, Boston, Massachusetts
| | - Donald T. Hess
- Department of General Surgery, Boston University School of Medicine, Boston, Massachusetts
| | - Caroline M. Apovian
- Section of Endocrinology, Diabetes, Nutrition, and Weight Management, Department of Medicine, Boston Medical Center and Boston University School of Medicine, Boston, Massachusetts
| | - Melissa G. Farb
- Department of Medicine and Whitaker Cardiovascular Institute, Boston University School of Medicine, Boston, Massachusetts
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Slusher AL, Fico BG, Dodge KM, Garten RS, Ferrandi PJ, Rodriguez AA, Pena G, Huang CJ. Impact of acute high-intensity interval exercise on plasma pentraxin 3 and endothelial function in obese individuals-a pilot study. Eur J Appl Physiol 2021; 121:1567-1577. [PMID: 33638689 DOI: 10.1007/s00421-021-04632-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Accepted: 02/05/2021] [Indexed: 12/11/2022]
Abstract
PURPOSE Pentraxin 3 (PTX3) has been shown to be a predictor of endothelial dysfunction in patients with increased risk of cardiovascular disease (CVD) (e.g., obesity). Circulating PTX3 concentrations are dysregulated in obese individuals and are elevated following acute aerobic exercise. High-intensity interval exercise (HIIE) has been demonstrated to be as effective as continuous moderate-intensity exercise in improving endothelial function, as indicated by brachial artery flow-mediated dilation (BAFMD), in patients with CVD. Therefore, the purpose of this study was to examine the effect of acute HIIE on plasma PTX3 and BAFMD responses in obese individuals. METHODS Eight obese and six normal-weight young males participated in acute HIIE (4 intervals of 4 min at 80-90% of VO2max; 3 min of active recovery at 50-60% VO2max). Plasma PTX3 and BAFMD were measured prior to, immediately following exercise, and one and 2 hours into recovery. RESULTS Plasma PTX3 concentrations significantly increased following HIIE, yet the PTX3 response to HIIE was significantly blunted in obese compared to normal-weight participants. While the kinetic responses of BAFMD were also significantly different in obese compared to normal-weight participants, similar increases above the baseline were observed 2 hours into recovery in both groups. Finally, plasma PTX3 concentrations were not associated with BAFMD at baseline or in response to HIIE. CONCLUSION The utilization of HIIE may serve as a time-efficient exercise prescription strategy to transiently improve endothelial function, independent of elevated plasma PTX3 concentrations, in obese individuals.
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Affiliation(s)
- Aaron L Slusher
- School of Kinesiology, University of Michigan, Ann Arbor, MI, 48109, USA.
| | - Brandon G Fico
- Department of Kinesiology and Health Education, The University of Texas at Austin, Austin, TX, 78712, USA
| | - Katelyn M Dodge
- Exercise Biochemistry Laboratory, Department of Exercise Science and Health Promotion, Florida Atlantic University, Boca Raton, FL, 33431, USA
| | - Ryan S Garten
- Department of Kinesiology and Health Sciences, Virginia Commonwealth University, Richmond, VA, 23284, USA
| | - Peter J Ferrandi
- College of Graduate Health Sciences, The University of Tennessee Health Science Center, Memphis, TN, 38163, USA
| | - Alexandra A Rodriguez
- Exercise Biochemistry Laboratory, Department of Exercise Science and Health Promotion, Florida Atlantic University, Boca Raton, FL, 33431, USA
| | - Gabriel Pena
- Department of Kinesiology, University of Maryland-College Park, College Park, MD, 20742, USA
| | - Chun-Jung Huang
- Exercise Biochemistry Laboratory, Department of Exercise Science and Health Promotion, Florida Atlantic University, Boca Raton, FL, 33431, USA
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8
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Cooper LL, Musani SK, Moore JA, Clarke VA, Yano Y, Cobbs K, Tsao CW, Butler J, Hall ME, Hamburg NM, Benjamin EJ, Vasan RS, Mitchell GF, Fox ER. Clinical Associations of Vascular Stiffness, Microvascular Dysfunction, and Prevalent Cardiovascular Disease in a Black Cohort: The Jackson Heart Study. J Am Heart Assoc 2020; 9:e017018. [PMID: 32873113 PMCID: PMC7726980 DOI: 10.1161/jaha.120.017018] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Background Measures of vascular dysfunction are related to adverse cardiovascular disease (CVD) outcomes in non‐Hispanic, White populations; however, data from Black individuals are limited. We aimed to investigate the associations between novel hemodynamic measures and prevalent CVD in a sample of Black individuals. Methods and Results Among older Black participants of the Jackson Heart Study, we assessed noninvasive vascular hemodynamic measures using arterial tonometry and Doppler ultrasound. We assessed 5 measures of aortic stiffness and wave reflection (carotid‐femoral pulse wave velocity, pulse wave velocity ratio, forward pressure wave amplitude, central pulse pressure, and augmentation index), and 2 measures of microvascular function (baseline and hyperemic brachial flow velocity). Using multivariable logistic regression models, we examined the relations between vascular hemodynamic measures and prevalent CVD. In models adjusted for traditional CVD risk factors, higher carotid‐femoral pulse wave velocity (odds ratio [OR],1.25; 95% CI, 1.01–1.55; P=0.04), lower augmentation index (OR, 0.84; 95% CI, 0.70–0.99; P=0.05), and lower hyperemic brachial flow velocity (OR, 0.77; 95% CI, 0.65–0.90; P=0.001) were associated with higher odds of CVD. After further adjustment for hypertension treatment, lower augmentation index (OR, 0.84; 95% CI, 0.70–0.99; P=0.04) and hyperemic brachial flow velocity (OR, 0.79; 95% CI, 0.67–0.94; P=0.006), but not carotid‐femoral pulse wave velocity (OR, 1.23; 95% CI, 0.99–1.051; P=0.06), were associated with higher odds of CVD. Conclusions In a sample of older Black individuals, more severe microvascular damage and aortic stiffness were associated with prevalent CVD. Further research on hemodynamic mechanisms that contribute to cardiovascular risk among older Black individuals is merited.
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Affiliation(s)
| | - Solomon K Musani
- Department of Medicine Division of Cardiovascular Diseases University of Mississippi Medical Center Jackson MS
| | - Josiah A Moore
- Department of Medicine Division of Cardiovascular Diseases University of Mississippi Medical Center Jackson MS.,Tougaloo College Jackson MS
| | | | - Yuichiro Yano
- Department of Family Medicine and Community Health Duke University Durham NC
| | - Keith Cobbs
- Department of Medicine Division of Cardiovascular Diseases University of Mississippi Medical Center Jackson MS
| | - Connie W Tsao
- Boston University and NHLBI's Framingham Heart Study Framingham MA.,Department of Medicine Cardiovascular Division Beth Israel Deaconess Medical Center and Harvard Medical School Boston MA
| | - Javed Butler
- Department of Medicine Division of Cardiovascular Diseases University of Mississippi Medical Center Jackson MS
| | - Michael E Hall
- Department of Medicine Division of Cardiovascular Diseases University of Mississippi Medical Center Jackson MS
| | - Naomi M Hamburg
- Evans Department of Medicine Boston University School of Medicine Boston MA.,Whitaker Cardiovascular Institute Boston University School of Medicine Boston MA
| | - Emelia J Benjamin
- Boston University and NHLBI's Framingham Heart Study Framingham MA.,Sections of Cardiology, Preventive Medicine and Epidemiology Department of Medicine Boston University School of Medicine Boston MA
| | - Ramachandran S Vasan
- Evans Department of Medicine Boston University School of Medicine Boston MA.,Whitaker Cardiovascular Institute Boston University School of Medicine Boston MA.,Sections of Cardiology, Preventive Medicine and Epidemiology Department of Medicine Boston University School of Medicine Boston MA.,Department of Epidemiology Boston University School of Public Health Boston MA
| | | | - Ervin R Fox
- Department of Medicine Division of Cardiovascular Diseases University of Mississippi Medical Center Jackson MS
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9
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Cooper LL, Musani SK, Washington F, Moore J, Tripathi A, Tsao CW, Hamburg NM, Benjamin EJ, Vasan RS, Mitchell GF, Fox ER. Relations of Microvascular Function, Cardiovascular Disease Risk Factors, and Aortic Stiffness in Blacks: The Jackson Heart Study. J Am Heart Assoc 2019; 7:e009515. [PMID: 30371273 PMCID: PMC6474961 DOI: 10.1161/jaha.118.009515] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background Blacks have more severe endothelial dysfunction and aortic stiffening as compared with whites. We aimed to investigate the association between aortic stiffness and microvascular function in the black community. Methods and Results We assessed the association between forearm vascular reactive hyperemia (an indicator of microvascular function) and aortic stiffness in 1458 black participants (N=965 [66% women]; mean age: 66±11 years) in the Jackson Heart Study. We evaluated 2 measures of aortic stiffness: brachial pulse pressure and carotid-femoral pulse wave velocity. Using high-resolution ultrasound and Doppler, we evaluated brachial blood flow at baseline and during reactive hyperemia after 5 minutes of forearm ischemia. Multiple cardiovascular risk factors were significantly related to baseline and hyperemic brachial flow velocity. Women had lower baseline flow across the entire age spectrum. During hyperemia, we observed a significant age-sex interaction for flow velocity ( P=0.02). Female sex was protective against microvascular dysfunction among younger participants, but older women exhibited a greater attenuation of the hyperemic flow reserve. In multivariable models that adjusted for cardiovascular disease risk factors and mean arterial pressure, higher carotid-femoral pulse wave velocity (β=-0.106±0.033; P=0.001 was related to lower baseline flow. However, during reactive hyperemia, elevated brachial pulse pressure (β=-0.070±0.031; P=0.03) and carotid-femoral pulse wave velocity (β=-0.128±0.030; P<0.001) were both related to attenuated brachial flow velocity. Conclusions In a sample of blacks, higher aortic stiffness and pressure pulsatility were associated with lower flow reserve during reactive hyperemia, beyond changes attributable to traditional cardiovascular disease risk factors alone.
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Affiliation(s)
| | - Solomon K Musani
- 2 Division of Cardiovascular Diseases Department of Medicine University of Mississippi Medical Center Jackson MS
| | - Floyd Washington
- 2 Division of Cardiovascular Diseases Department of Medicine University of Mississippi Medical Center Jackson MS
| | - Jonathan Moore
- 2 Division of Cardiovascular Diseases Department of Medicine University of Mississippi Medical Center Jackson MS.,3 Washington University School of Arts and Sciences St. Louis MO
| | - Avnish Tripathi
- 4 Institute of Molecular Cardiology University of Louisville KY
| | - Connie W Tsao
- 5 Boston University and NHLBI's Framingham Heart Study Framingham MA.,6 Cardiovascular Division Department of Medicine Beth Israel Deaconess Medical Center and Harvard Medical School Boston MA
| | - Naomi M Hamburg
- 7 Evans Department of Medicine Boston University School of Medicine Boston MA.,8 Whitaker Cardiovascular Institute Boston University School of Medicine Boston MA
| | - Emelia J Benjamin
- 5 Boston University and NHLBI's Framingham Heart Study Framingham MA.,9 Sections of Cardiology, Preventive Medicine and Epidemiology Department of Medicine Boston University Schools of Medicine Boston MA.,10 Department of Epidemiology Boston University School of Public Health Boston MA
| | - Ramachandran S Vasan
- 7 Evans Department of Medicine Boston University School of Medicine Boston MA.,8 Whitaker Cardiovascular Institute Boston University School of Medicine Boston MA.,9 Sections of Cardiology, Preventive Medicine and Epidemiology Department of Medicine Boston University Schools of Medicine Boston MA.,10 Department of Epidemiology Boston University School of Public Health Boston MA
| | | | - Ervin R Fox
- 2 Division of Cardiovascular Diseases Department of Medicine University of Mississippi Medical Center Jackson MS
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10
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Moon I, Jin KN, Kim HL, Suh HJ, Lim WH, Seo JB, Kim SH, Zo JH, Kim MA. Association of arterial stiffness with aortic calcification and tortuosity. Medicine (Baltimore) 2019; 98:e16802. [PMID: 31415390 PMCID: PMC6831173 DOI: 10.1097/md.0000000000016802] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Impact of arterial stiffness on aortic morphology has not been well evaluated. We sought to investigate the association of brachial-ankle pulse wave velocity (baPWV) with aortic calcification and tortuosity.A total of 181 patients (65.4 ± 10.4 years, males 59.7%) who underwent computed tomographic angiography and baPWV measurement within 1 month of study entry were retrospectively reviewed. Aortic calcification was quantified by the calcium scoring software system. Aortic tortuosity was defined as the length of the midline in the aorta divided by the length of linear line from the aortic root to the distal end of the thoraco-abdominal aorta. In simple correlation analyses, baPWV was correlated with aortic calcification (r = 0.36, P < .001) and tortuosity (r = 0.16, P = .030). However, these significances disappeared after controlling for confounders in multivariate analyses. Factors showing an independent association with aortic calcification were age (β = 0.37, P < .001), hypertension (β = 0.19, P = .003), diabetes mellitus (β = 0.12, P = .045), smoking (β = 0.17, P = .016), and estimated glomerular filtration rate (β = -0.25, P = .002). Factors showing an independent association with aortic tortuosity were age (β = 0.34, P < .001), body mass index (β = -0.19, P = .018), and diabetes mellitus (β = -0.21, P = .003).In conclusion, baPWV reflecting arterial stiffness was not associated with aortic calcification and tortuosity. Traditional cardiovascular risk factors were more influential to aortic geometry. Further studies with a larger sample size are needed to confirm our results.
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Affiliation(s)
| | - Kwang Nam Jin
- Department of Radiology, Boramae Medical Center, Seoul National University College of Medicine, Seoul, Republic of Korea
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11
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Perim RR, Amorim MR, Bonagamba TLLGH, Machado BH. Previous exposure to chronic intermittent hypoxia blunts the development of one-kidney, one-clip hypertension in rats. Exp Physiol 2018; 103:473-482. [DOI: 10.1113/ep086734] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2017] [Accepted: 01/10/2018] [Indexed: 12/13/2022]
Affiliation(s)
- Raphael R. Perim
- Department of Physiology, School of Medicine of Ribeirão Preto; University of São Paulo; Ribeirão Preto SP 14049-900 Brazil
| | - Mateus R. Amorim
- Department of Physiology, School of Medicine of Ribeirão Preto; University of São Paulo; Ribeirão Preto SP 14049-900 Brazil
| | - The Late Leni G. H. Bonagamba
- Department of Physiology, School of Medicine of Ribeirão Preto; University of São Paulo; Ribeirão Preto SP 14049-900 Brazil
| | - Benedito H. Machado
- Department of Physiology, School of Medicine of Ribeirão Preto; University of São Paulo; Ribeirão Preto SP 14049-900 Brazil
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12
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Maruhashi T, Soga J, Fujimura N, Idei N, Mikami S, Iwamoto Y, Iwamoto A, Kajikawa M, Matsumoto T, Oda N, Kishimoto S, Matsui S, Hashimoto H, Aibara Y, Yusoff FM, Hidaka T, Kihara Y, Chayama K, Noma K, Nakashima A, Goto C, Tomiyama H, Takase B, Kohro T, Suzuki T, Ishizu T, Ueda S, Yamazaki T, Furumoto T, Kario K, Inoue T, Koba S, Watanabe K, Takemoto Y, Hano T, Sata M, Ishibashi Y, Node K, Maemura K, Ohya Y, Furukawa T, Ito H, Ikeda H, Yamashina A, Higashi Y. Brachial artery diameter as a marker for cardiovascular risk assessment: FMD-J study. Atherosclerosis 2017; 268:92-98. [PMID: 29195110 DOI: 10.1016/j.atherosclerosis.2017.11.022] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2017] [Revised: 10/30/2017] [Accepted: 11/21/2017] [Indexed: 11/19/2022]
Abstract
BACKGROUND AND AIMS Baseline brachial artery (BBA) diameter has been reported to be a potential confounding factor of flow-mediated vasodilation (FMD). The purpose of this study was to evaluate the relationships between BBA diameter and cardiovascular risk factors and compare the diagnostic accuracy of BBA diameter in subjects without cardiovascular risk factors and patients with cardiovascular disease (CVD) with that of FMD. METHODS We measured BBA diameter and FMD in 5695 male subjects. In addition, we retrospectively investigated the incidence of cardiovascular events using another population sample consisting of 440 male subjects, to compare the accuracy of BBA diameter with that of FMD in predicting cardiovascular events. RESULTS BBA diameter and FMD significantly correlated with age, body mass index, systolic blood pressure, diastolic blood pressure, triglycerides, high-density lipoprotein cholesterol, and glucose as well as Framingham risk score. The prevalence of cardiovascular risk factors and CVD increased with the increase in BBA diameter and FMD. Area under the curve (AUC) value of the receiver operating characteristic (ROC) curve for BBA diameter to diagnose subjects without cardiovascular risk factors (0.59 vs. 0.62, p = 0.001) or patients with CVD (0.58 vs. 0.64, p < 0.001) was significantly lower than that for FMD. In the retrospective study, the AUC value of the ROC curve for BBA diameter to predict first major cardiovascular events was significantly lower than that of FMD (0.50 vs. 0.62, p = 0.03). CONCLUSIONS In men, BBA diameter was inferior to FMD for assessment of cardiovascular risk.
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Affiliation(s)
- Tatsuya Maruhashi
- Department of Cardiovascular Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Junko Soga
- Department of Cardiovascular Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Noritaka Fujimura
- Department of Cardiovascular Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Naomi Idei
- Department of Cardiovascular Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Shinsuke Mikami
- Department of Cardiovascular Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Yumiko Iwamoto
- Department of Cardiovascular Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Akimichi Iwamoto
- Department of Cardiovascular Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Masato Kajikawa
- Department of Cardiovascular Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Takeshi Matsumoto
- Department of Cardiovascular Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Nozomu Oda
- Department of Cardiovascular Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Shinji Kishimoto
- Department of Cardiovascular Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Shogo Matsui
- Department of Cardiovascular Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Haruki Hashimoto
- Department of Cardiovascular Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Yoshiki Aibara
- Department of Cardiovascular Regeneration and Medicine, Research Institute for Radiation Biology and Medicine, Hiroshima University, Hiroshima, Japan
| | - Farina Mohamad Yusoff
- Department of Cardiovascular Regeneration and Medicine, Research Institute for Radiation Biology and Medicine, Hiroshima University, Hiroshima, Japan
| | - Takayuki Hidaka
- Department of Cardiovascular Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Yasuki Kihara
- Department of Cardiovascular Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Kazuaki Chayama
- Department of Gastroenterology and Metabolism, Biomedical Sciences, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Kensuke Noma
- Department of Cardiovascular Regeneration and Medicine, Research Institute for Radiation Biology and Medicine, Hiroshima University, Hiroshima, Japan; Division of Regeneration and Medicine, Hiroshima University Hospital, Hiroshima, Japan
| | - Ayumu Nakashima
- Division of Regeneration and Medicine, Hiroshima University Hospital, Hiroshima, Japan
| | - Chikara Goto
- Hiroshima International University, Hiroshima, Japan
| | | | - Bonpei Takase
- Division of Biomedical Engineering, National Defense Medical College Research Institute, Tokorozawa, Japan
| | - Takahide Kohro
- Department of Cardiology, Tokyo Medical University, Tokyo, Japan
| | - Toru Suzuki
- Cardiovascular Medicine, University of Leicester, Leicester, UK
| | - Tomoko Ishizu
- Cardiovascular Division, Institute of Clinical Medicine, University of Tsukuba, Ibaraki, Japan
| | - Shinichiro Ueda
- Department of Clinical Pharmacology and Therapeutics, University of the Ryukyu School of Medicine, Okinawa, Japan
| | - Tsutomu Yamazaki
- Clinical Research Support Center, Faculty of Medicine, The University of Tokyo, Tokyo, Japan
| | - Tomoo Furumoto
- Department of Cardiovascular Medicine, Hokkaido University Graduate School of Medicine, Hokkaido, Japan
| | - Kazuomi Kario
- Division of Cardiovascular Medicine, Jichi Medical University School of Medicine, Tochigi, Japan
| | - Teruo Inoue
- Department of Cardiovascular Medicine, Dokkyo Medical University, Mibu, Tochigi, Japan
| | - Shinji Koba
- Department of Medicine, Division of Cardiology, Showa University School of Medicine, Tokyo, Japan
| | - Kentaro Watanabe
- Department of Neurology, Hematology, Metabolism, Endocrinology and Diabetology (DNHMED), Yamagata University School of Medicine, Yamagata, Japan
| | - Yasuhiko Takemoto
- Department of Internal Medicine and Cardiology, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Takuzo Hano
- Department of Medical Education and Population-based Medicine, Postgraduate School of Medicine, Wakayama Medical University, Wakayama, Japan
| | - Masataka Sata
- Department of Cardiovascular Medicine, Institute of Health Biosciences, The University of Tokushima Graduate School, Tokushima, Japan
| | - Yutaka Ishibashi
- Department of General Medicine, Shimane University Faculty of Medicine, Izumo, Japan
| | - Koichi Node
- Department of Cardiovascular and Renal Medicine, Saga University, Saga, Japan
| | - Koji Maemura
- Department of Cardiovascular Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Yusuke Ohya
- The Third Department of Internal Medicine, University of the Ryukyus, Okinawa, Japan
| | - Taiji Furukawa
- Department of Internal Medicine, Teikyo University School of Medicine, Tokyo, Japan
| | - Hiroshi Ito
- Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Japan
| | - Hisao Ikeda
- Faculty of Fukuoka Medical Technology, Teikyo University, Omuta, Japan
| | - Akira Yamashina
- Department of Cardiology, Tokyo Medical University, Tokyo, Japan
| | - Yukihito Higashi
- Department of Cardiovascular Regeneration and Medicine, Research Institute for Radiation Biology and Medicine, Hiroshima University, Hiroshima, Japan; Division of Regeneration and Medicine, Hiroshima University Hospital, Hiroshima, Japan.
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13
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Bretón-Romero R, Wang N, Palmisano J, Larson MG, Vasan RS, Mitchell GF, Benjamin EJ, Vita JA, Hamburg NM. Cross-Sectional Associations of Flow Reversal, Vascular Function, and Arterial Stiffness in the Framingham Heart Study. Arterioscler Thromb Vasc Biol 2016; 36:2452-2459. [PMID: 27789476 DOI: 10.1161/atvbaha.116.307948] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2016] [Accepted: 10/16/2016] [Indexed: 11/16/2022]
Abstract
OBJECTIVE Experimental studies link oscillatory flow accompanied by flow reversal to impaired endothelial cell function. The relation of flow reversal with vascular function and arterial stiffness remains incompletely defined. APPROACH AND RESULTS We measured brachial diastolic flow patterns along with vasodilator function in addition to tonometry-based central and peripheral arterial stiffness in 5708 participants (age 47±13 years, 53% women) in the Framingham Heart Study Offspring and Third Generation cohorts. Brachial artery diastolic flow reversal was present in 35% of the participants. In multivariable regression models, the presence of flow reversal was associated with lower flow-mediated dilation (3.9±0.2 versus 5.0±0.2%; P<0.0001) and reactive hyperemic flow velocity (50±0.99 versus 57±0.93 cm/s; P<0.0001). The presence of flow reversal (compared with absence) was associated with higher central aortic stiffness (carotid-femoral pulse wave velocity 9.3±0.1 versus 8.9±0.1 m/s), lower muscular artery stiffness (carotid-radial pulse wave velocity 9.6±0.1 versus 9.8±0.1 m/s), and higher forearm vascular resistance (5.32±0.03 versus 4.66±0.02 log dyne/s/cm5; P<0.0001). The relations of diastolic flow velocity with flow-mediated dilation, aortic stiffness, and forearm vascular resistance were nonlinear, with a steeper decline in vascular function associated with increasing magnitude of flow reversal. CONCLUSIONS In our large, community-based sample, brachial artery flow reversal was common and associated with impaired vasodilator function and higher aortic stiffness. Our findings are consistent with the concept that flow reversal may contribute to vascular dysfunction.
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Affiliation(s)
- Rosa Bretón-Romero
- From the Boston University's and the National Heart, Lung, and Blood Institute's Framingham Heart Study (M.G.L., R.S.V., E.J.B.), MA; Cardiology (R.S.V., E.J.B., J.A.V., N.M.H.) and Preventive Medicine Sections (R.S.V., E.J.B.), and Whitaker Cardiovascular Institute, School of Medicine (R.B.-R., R.S.V., E.J.B., J.A.V., N.M.H.), School of Public Health (N.W., J.P., M.G.L., R.S.V., E.J.B.), and Departments of Mathematics and Statistics (M.G.L.), Boston University, MA; and Cardiovascular Engineering Inc, Norwood, MA (G.F.M.)
| | - Na Wang
- From the Boston University's and the National Heart, Lung, and Blood Institute's Framingham Heart Study (M.G.L., R.S.V., E.J.B.), MA; Cardiology (R.S.V., E.J.B., J.A.V., N.M.H.) and Preventive Medicine Sections (R.S.V., E.J.B.), and Whitaker Cardiovascular Institute, School of Medicine (R.B.-R., R.S.V., E.J.B., J.A.V., N.M.H.), School of Public Health (N.W., J.P., M.G.L., R.S.V., E.J.B.), and Departments of Mathematics and Statistics (M.G.L.), Boston University, MA; and Cardiovascular Engineering Inc, Norwood, MA (G.F.M.)
| | - Joseph Palmisano
- From the Boston University's and the National Heart, Lung, and Blood Institute's Framingham Heart Study (M.G.L., R.S.V., E.J.B.), MA; Cardiology (R.S.V., E.J.B., J.A.V., N.M.H.) and Preventive Medicine Sections (R.S.V., E.J.B.), and Whitaker Cardiovascular Institute, School of Medicine (R.B.-R., R.S.V., E.J.B., J.A.V., N.M.H.), School of Public Health (N.W., J.P., M.G.L., R.S.V., E.J.B.), and Departments of Mathematics and Statistics (M.G.L.), Boston University, MA; and Cardiovascular Engineering Inc, Norwood, MA (G.F.M.)
| | - Martin G Larson
- From the Boston University's and the National Heart, Lung, and Blood Institute's Framingham Heart Study (M.G.L., R.S.V., E.J.B.), MA; Cardiology (R.S.V., E.J.B., J.A.V., N.M.H.) and Preventive Medicine Sections (R.S.V., E.J.B.), and Whitaker Cardiovascular Institute, School of Medicine (R.B.-R., R.S.V., E.J.B., J.A.V., N.M.H.), School of Public Health (N.W., J.P., M.G.L., R.S.V., E.J.B.), and Departments of Mathematics and Statistics (M.G.L.), Boston University, MA; and Cardiovascular Engineering Inc, Norwood, MA (G.F.M.)
| | - Ramachandran S Vasan
- From the Boston University's and the National Heart, Lung, and Blood Institute's Framingham Heart Study (M.G.L., R.S.V., E.J.B.), MA; Cardiology (R.S.V., E.J.B., J.A.V., N.M.H.) and Preventive Medicine Sections (R.S.V., E.J.B.), and Whitaker Cardiovascular Institute, School of Medicine (R.B.-R., R.S.V., E.J.B., J.A.V., N.M.H.), School of Public Health (N.W., J.P., M.G.L., R.S.V., E.J.B.), and Departments of Mathematics and Statistics (M.G.L.), Boston University, MA; and Cardiovascular Engineering Inc, Norwood, MA (G.F.M.)
| | - Gary F Mitchell
- From the Boston University's and the National Heart, Lung, and Blood Institute's Framingham Heart Study (M.G.L., R.S.V., E.J.B.), MA; Cardiology (R.S.V., E.J.B., J.A.V., N.M.H.) and Preventive Medicine Sections (R.S.V., E.J.B.), and Whitaker Cardiovascular Institute, School of Medicine (R.B.-R., R.S.V., E.J.B., J.A.V., N.M.H.), School of Public Health (N.W., J.P., M.G.L., R.S.V., E.J.B.), and Departments of Mathematics and Statistics (M.G.L.), Boston University, MA; and Cardiovascular Engineering Inc, Norwood, MA (G.F.M.)
| | - Emelia J Benjamin
- From the Boston University's and the National Heart, Lung, and Blood Institute's Framingham Heart Study (M.G.L., R.S.V., E.J.B.), MA; Cardiology (R.S.V., E.J.B., J.A.V., N.M.H.) and Preventive Medicine Sections (R.S.V., E.J.B.), and Whitaker Cardiovascular Institute, School of Medicine (R.B.-R., R.S.V., E.J.B., J.A.V., N.M.H.), School of Public Health (N.W., J.P., M.G.L., R.S.V., E.J.B.), and Departments of Mathematics and Statistics (M.G.L.), Boston University, MA; and Cardiovascular Engineering Inc, Norwood, MA (G.F.M.)
| | - Joseph A Vita
- From the Boston University's and the National Heart, Lung, and Blood Institute's Framingham Heart Study (M.G.L., R.S.V., E.J.B.), MA; Cardiology (R.S.V., E.J.B., J.A.V., N.M.H.) and Preventive Medicine Sections (R.S.V., E.J.B.), and Whitaker Cardiovascular Institute, School of Medicine (R.B.-R., R.S.V., E.J.B., J.A.V., N.M.H.), School of Public Health (N.W., J.P., M.G.L., R.S.V., E.J.B.), and Departments of Mathematics and Statistics (M.G.L.), Boston University, MA; and Cardiovascular Engineering Inc, Norwood, MA (G.F.M.)
| | - Naomi M Hamburg
- From the Boston University's and the National Heart, Lung, and Blood Institute's Framingham Heart Study (M.G.L., R.S.V., E.J.B.), MA; Cardiology (R.S.V., E.J.B., J.A.V., N.M.H.) and Preventive Medicine Sections (R.S.V., E.J.B.), and Whitaker Cardiovascular Institute, School of Medicine (R.B.-R., R.S.V., E.J.B., J.A.V., N.M.H.), School of Public Health (N.W., J.P., M.G.L., R.S.V., E.J.B.), and Departments of Mathematics and Statistics (M.G.L.), Boston University, MA; and Cardiovascular Engineering Inc, Norwood, MA (G.F.M.).
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14
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Nguyen PL, Jarolim P, Basaria S, Zuflacht JP, Milian J, Kadivar S, Graham PL, Hyatt A, Kantoff PW, Beckman JA. Androgen deprivation therapy reversibly increases endothelium-dependent vasodilation in men with prostate cancer. J Am Heart Assoc 2015; 4:jah3918. [PMID: 25896892 PMCID: PMC4579953 DOI: 10.1161/jaha.115.001914] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Background Androgen deprivation therapy (ADT) is a standard treatment for patients with aggressive prostate cancer. Although ADT improves survival, it increases the risk of diabetes. Emerging evidence suggests that ADT increases adverse cardiovascular events as early as 3 months after initiation in patients with cardiovascular disease, but the mechanism is unknown. We hypothesized that ADT may impair endothelium‐dependent vasodilation due to increases in lipids and insulin resistance and may provide a link for heightened cardiovascular risk in this population. Methods and Results We prospectively evaluated conduit artery endothelium‐dependent and ‐independent vasodilation, lipids, and insulin resistance in 16 consecutively treated men (mean age 66±7 years; 25% with diabetes) with prostate cancer before and after 3 months of ADT. High‐resolution B‐mode ultrasound was used to assess flow‐mediated (endothelium‐dependent) and nitroglycerine‐mediated (endothelium‐independent) brachial artery vasodilation. ADT significantly increased insulin resistance, total cholesterol, HDL, and LDL. Endothelium‐dependent vasodilation was greater at 3 months than at baseline (10.8% [interquartile range: 7.7% to 14.6%] versus 8.9% [interquartile range: 4.0% to 12.6%], respectively; P=0.046, allometric P=0.037). Nitroglycerine‐mediated vasodilation did not change from baseline (P>0.2). The subset of participants on ADT for 6 months returned for reevaluation at 1 year. In this group, endothelium‐dependent vasodilation increased from baseline to 3 months and returned to baseline 6 months after ADT withdrawal (9.4% [interquartile range: 6.9% to 10.9%], 11.6% [interquartile range: 7.9% to 15.2%], and 9.0% [interquartile range: 5.1% to 12.5%], respectively; P=0.05). Conclusions In contrast to our expectation, ADT improved endothelium‐dependent vasodilation and its cessation returned endothelium‐dependent vasodilation to baseline. Determining the mechanism of this change requires further investigation.
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Affiliation(s)
- Paul L Nguyen
- Radiation Oncology, Brigham and Women's Hospital and Dana-Farber Cancer Institute, Boston, MA (P.L.N., P.L.G., A.H.)
| | - Petr Jarolim
- Department of Pathology, Brigham and Women's Hospital, Boston, MA (P.J.)
| | - Shehzad Basaria
- Endocrinology, Brigham and Women's Hospital, Boston, MA (S.B.)
| | - Jonah P Zuflacht
- Cardiovascular Division, Brigham and Women's Hospital, Boston, MA (J.P.Z., J.M., S.K., J.A.B.)
| | - Jessica Milian
- Cardiovascular Division, Brigham and Women's Hospital, Boston, MA (J.P.Z., J.M., S.K., J.A.B.)
| | - Samoneh Kadivar
- Cardiovascular Division, Brigham and Women's Hospital, Boston, MA (J.P.Z., J.M., S.K., J.A.B.)
| | - Powell L Graham
- Radiation Oncology, Brigham and Women's Hospital and Dana-Farber Cancer Institute, Boston, MA (P.L.N., P.L.G., A.H.)
| | - Andrew Hyatt
- Radiation Oncology, Brigham and Women's Hospital and Dana-Farber Cancer Institute, Boston, MA (P.L.N., P.L.G., A.H.)
| | - Philip W Kantoff
- Medical Oncology, Dana-Farber Cancer Institute, Boston, MA (P.W.K.)
| | - Joshua A Beckman
- Cardiovascular Division, Brigham and Women's Hospital, Boston, MA (J.P.Z., J.M., S.K., J.A.B.)
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15
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Modelling and subject-specific validation of the heart-arterial tree system. Ann Biomed Eng 2014; 43:222-37. [PMID: 25341958 DOI: 10.1007/s10439-014-1163-9] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2014] [Accepted: 10/11/2014] [Indexed: 10/24/2022]
Abstract
A modeling approach integrated with a novel subject-specific characterization is here proposed for the assessment of hemodynamic values of the arterial tree. A 1D model is adopted to characterize large-to-medium arteries, while the left ventricle, aortic valve and distal micro-circulation sectors are described by lumped submodels. A new velocity profile and a new formulation of the non-linear viscoelastic constitutive relation suitable for the {Q, A} modeling are also proposed. The model is firstly verified semi-quantitatively against literature data. A simple but effective procedure for obtaining subject-specific model characterization from non-invasive measurements is then designed. A detailed subject-specific validation against in vivo measurements from a population of six healthy young men is also performed. Several key quantities of heart dynamics-mean ejected flow, ejection fraction, and left-ventricular end-diastolic, end-systolic and stroke volumes-and the pressure waveforms (at the central, radial, brachial, femoral, and posterior tibial sites) are compared with measured data. Mean errors around 5 and 8%, obtained for the heart and arterial quantities, respectively, testify the effectiveness of the model and its subject-specific characterization.
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The association of brachial artery diameter with noncalcified coronary plaque burden in apparently healthy individuals. Coron Artery Dis 2014; 24:657-62. [PMID: 24077324 DOI: 10.1097/mca.0000000000000034] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Coronary atherosclerosis has been associated with systemic arterial remodeling even in nonatherosclerotic vessels. However, it is not known whether systemic remodeling is differentially associated with the cumulative atherosclerotic process, reflected by putatively quiescent calcified plaque (CP), or with active atherosclerosis, consisting of noncalcified plaque (NCP). We thus examined the association of brachial artery diameter (BAD), an artery that does not suffer clinical atherosclerosis, with the presence and the extent of coronary CP and NCP. METHODS We studied 688 apparently healthy, asymptomatic participants from 350 families with a history of early-onset coronary artery disease (<60 years of age) by measuring coronary artery disease risk factors and coronary plaque using dual-source computed tomographic angiography. Plaque volumes were quantified using a validated automated method. BAD was measured during diastole using B-mode ultrasound. The association of resting BAD with any detectable plaque, and log-transformed CP and NCP volumes if detectable, was tested using generalized estimating equations adjusted for age, sex, race, current smoking, diabetes, hypertension, BMI, and non-HDL and HDL cholesterol. RESULTS Higher quintiles of BAD were associated with greater age and male sex (both P<0.001). In the fully adjusted analysis, CP volume was not associated with BAD (P=0.65) but a 1 ml greater NCP volume was associated with a 0.65 mm larger BAD (P=0.027). CONCLUSION Our results suggest that systemic arterial remodeling of nonatherosclerotic arteries is a dynamic process that is correlated with the extent of putatively active atherosclerotic processes in distant beds but not with inactive accumulated plaque burden.
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Kappus RM, Fahs CA, Smith D, Horn GP, Agiovlasitis S, Rossow L, Jae SY, Heffernan KS, Fernhall B. Obesity and overweight associated with increased carotid diameter and decreased arterial function in young otherwise healthy men. Am J Hypertens 2014; 27:628-34. [PMID: 24048148 DOI: 10.1093/ajh/hpt152] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND Obesity is linked to cardiovascular disease, stroke, increased mortality and vascular remodeling. Although increased arterial diameter is associated with multiple cardiovascular risk factors and obesity, it is unknown whether lumen enlargement is accompanied by unfavorable vascular changes in young and otherwise healthy obese individuals. The purpose of this study was to compare carotid and brachial artery diameter, blood pressure, arterial stiffness, and endothelial function in young, apparently healthy, normal-weight, overweight, and obese male subjects. METHODS One hundred sixty-five male subjects (27.39±0.59 years) were divided into 3 groups (normal weight, overweight, and obese) according to body mass index. Subjects underwent cardiovascular measurements to determine arterial diameter, function, and stiffness. RESULTS After adjusting for age, the obese group had significantly greater brachial, carotid, and aortic pressures, brachial pulse wave velocity, carotid intima media thickness, and carotid arterial diameter compared with both the overweight and normal-weight groups. CONCLUSIONS Obesity is associated with a much worse arterial profile, as an increased carotid lumen size was accompanied by higher blood pressure, greater arterial stiffness, and greater carotid intima media thickness in obese compared with overweight or normal-weight individuals. These data suggest that although obesity may be a factor in arterial remodeling, such remodeling is also accompanied by other hemodynamic and arterial changes consistent with reduced arterial function and increased cardiovascular risk.
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Affiliation(s)
- Rebecca M Kappus
- Integrative Physiology Laboratory, University of Illinois at Chicago, Chicago, Illinois
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Mohler ER, Sibley AA, Stein R, Davila-Roman V, Wyatt H, Badellino K, Rader DJ, Klein S, Foster GD. Endothelial function and weight loss: comparison of low-carbohydrate and low-fat diets. Obesity (Silver Spring) 2013; 21:504-9. [PMID: 23404949 PMCID: PMC3630284 DOI: 10.1002/oby.20055] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2011] [Accepted: 08/10/2012] [Indexed: 01/22/2023]
Abstract
OBJECTIVE The effect of weight loss on obesity-associated endothelial dysfunction is not clear because of conflicting data, demonstrating both improvement and no change in endothelial function after weight loss in obese subjects. A 2-year prospective study (n = 121) was conducted to examine: (1) the effect of obesity and weight loss (either a low-carbohydrate or and low-fat diet) on flow mediated vasodilatation (FMD), a measure of endothelial function. DESIGN AND METHODS Participants reduced body weight by 7.1% ± 4.4%, 8.7% ± 6.8%, 7.1% ± 7.8%, and 4.1% ± 7.7% at 3, 6, 12, and 24 months, respectively with no significant differences between the low-fat and low-carbohydrate groups. RESULTS Endothelial function was inversely correlated with waist circumference, triglyceride level, and directly correlated with leptin in obese persons prior to weight loss. These weight losses did not confer any improvements in FMD. There were no differences between the low-fat and low-carbohydrate diets in FMD at any time point. At 6 months (r = 0.26, P = 0.04) and 1 year (r =0.28, P = 0.03), there were positive correlations between change in FMD and change in leptin but not at 2 years. CONCLUSION There was no significant improvement in endothelial function after 7.1% ± 7.8% weight loss at 1 year and 4.1% ± 7.7% at 2 years, achieved by either a low carbohydrate or a low fat diet.
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Affiliation(s)
- Emile R Mohler
- Department of Medicine, Cardiovascular Division, Section of Vascular Medicine, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, USA.
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Brostow DP, Hirsch AT, Collins TC, Kurzer MS. The role of nutrition and body composition in peripheral arterial disease. Nat Rev Cardiol 2012; 9:634-43. [PMID: 22922595 DOI: 10.1038/nrcardio.2012.117] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Peripheral arterial disease (PAD) has not been as extensively investigated as other cardiovascular diseases. However, the available data suggest that nutrition-based treatment strategies have the potential to reduce the cost-economic burden of PAD substantially. Abdominal obesity is associated with PAD and prospective and cross-sectional studies have shown that a low dietary intake of folate and reduced synthesis of vitamin D are associated with an increased risk of PAD and severe walking impairment in patients who have the disease. However, dietary patterns that are associated with decreased cardiovascular risk might protect against PAD. A small number of clinical trials have provided evidence that increased intakes of niacin and insoluble fiber might be associated with decreased levels of LDL cholesterol and thrombogenic biomarkers, as well as increased serum levels of HDL cholesterol in patients with PAD. However, little evidence that antioxidants, vitamins B(6) and B(12), or essential fatty acid supplements improve clinical outcomes in these patients exists. Overall, data on the effects of nutrition, body composition, and nutritional supplementation on the risk, progression, and prognosis of PAD are scarce. Further research into these areas is required to allow the development of evidence-based nutritional guidelines for the prevention and treatment of the disease.
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Affiliation(s)
- Diana P Brostow
- Department of Food Science and Nutrition, University of Minnesota, 1334 Eckles Avenue, Saint Paul, MN 55108, USA
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Christou DD, Pierce GL, Walker AE, Hwang MH, Yoo JK, Luttrell M, Meade TH, English M, Seals DR. Vascular smooth muscle responsiveness to nitric oxide is reduced in healthy adults with increased adiposity. Am J Physiol Heart Circ Physiol 2012; 303:H743-50. [PMID: 22821988 DOI: 10.1152/ajpheart.00394.2012] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Vascular smooth muscle responsiveness to nitric oxide, as assessed by nitroglycerin-induced dilation (NID), is impaired in clinical cardiovascular disease, but its relation to adiposity is unknown. We determined the relation of NID to total and abdominal adiposity in healthy adults varying widely in adiposity. In 224 men and women [age, 18-79 years; body mass index (BMI), 16.4-42.2 kg/m(2)], we measured NID (brachial artery dilation to 0.4 mg sublingual nitroglycerin), total body adiposity [BMI and percent body fat (percent BF via dual-energy X-ray absorptiometry)], and indexes of abdominal adiposity [waist circumference (WC) and waist-to-hip ratio (WHR)]. In a subgroup (n = 74), we also measured total abdominal fat (TAF), abdominal visceral fat (AVF), and subcutaneous fat (ASF) using computed tomography. Based on multiple linear regression, NID was negatively related to BMI [part correlation coefficient (r(part)) = -0.19, P = 0.004] and abdominal adiposity (WC, r(part) = -0.22; WHR, r(part) = -0.19; TAF, r(part) = -0.36; AVF, r(part) = -0.36; and ASF, r(part) = -0.30; all P ≤ 0.009) independent of sex, but only tended to be related to total percent BF (r(part) = -0.12, P = 0.07). In a subgroup of subjects with the highest compared with the lowest amount of AVF, NID was 35% lower (P = 0.003). Accounting for systolic blood pressure, HDL cholesterol, glucose, insulin resistance, adiponectin, and brachial artery diameter reduced or abolished some of the relations between NID and adiposity. In conclusion, NID is or tends to be negatively associated with measures of total adiposity (BMI and percent BF, respectively) but is consistently and more strongly negatively associated with abdominal adiposity. Adiposity may influence NID in part via other cardiovascular risk factors.
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Affiliation(s)
- Demetra D Christou
- Department of Applied Physiology and Kinesiology, University of Florida, Gainesville, USA
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