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Sista A, Ittermann T, Gross S, Markus MRP, Stone K, Stoner L, Friedrich N, Dörr M, Bahls M. Sex and resting heart rate influence the relation between arterial stiffness and cardiac structure and function - insights from the general population. J Hum Hypertens 2025; 39:254-261. [PMID: 40055513 PMCID: PMC11985342 DOI: 10.1038/s41371-025-01000-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2024] [Revised: 01/17/2025] [Accepted: 02/25/2025] [Indexed: 04/12/2025]
Abstract
Arterial stiffness, a risk factor for cardiovascular disease, can be measured using pulse wave velocity (PWV) and augmentation index (AIx). We studied sex-specific associations between carotid-femoral PWV (cfPWV), brachial-ankle PWV (baPWV), aortic PWV (aoPWV), aortic (aoAIx), and brachial (baAIx) AIx with echocardiographic parameters. Data of 1150 participants of the Study of Health in Pomerania (SHIP-Trend 1; 530 men; median age 53 years; inter quartile range (IQR) 44 to 64) were used. Echocardiography assessed common structural and functional cardiac parameters. PWV and AIx were measured using the Vascular Explorer. Multivariable linear regression models were applied. In men, a higher brAIx was related to a greater right ventricular diameter (RV) (β 0.037; CI 0.003 to 0.148). A one m/s higher baPWV was associated with a smaller RV (β -0.037; CI -0.168 to -0.021) and right ventricular outflow tract (RVOT; β -0.029; CI -0.141 to -0.026). In men, a higher aoAIx (β 0.028; CI 0.01 to 0.122) and brAIx (β 0.029; CI 0.017 to 0.13) were associated with a greater RVOT. In women, a one m/s higher aoPWV (β 0.025; CI 0.006 to 0.105) was associated with a larger RV and a one m/s higher baPWV (β -0.031; CI -0.124 to -0.001) was inversely related to RVOT. In women, PWV associated with right ventricular dimensions, while in men, baPWV and AIx were related to right ventricular parameters. This suggests potentially sex-specific relations between PWV and cardiac structure and function.
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Affiliation(s)
- Anna Sista
- Department of Internal Medicine B, University Medicine Greifswald, Greifswald, Germany
- German Centre for Cardiovascular Research (DZHK), partner site Greifswald, Greifswald, Germany
| | - Till Ittermann
- German Centre for Cardiovascular Research (DZHK), partner site Greifswald, Greifswald, Germany
- Department of Community Medicine SHIP-KEF, University Medicine Greifswald, Greifswald, Germany
| | - Stefan Gross
- Department of Internal Medicine B, University Medicine Greifswald, Greifswald, Germany
- German Centre for Cardiovascular Research (DZHK), partner site Greifswald, Greifswald, Germany
| | - Marcello R P Markus
- Department of Internal Medicine B, University Medicine Greifswald, Greifswald, Germany
- German Centre for Cardiovascular Research (DZHK), partner site Greifswald, Greifswald, Germany
| | - Keeron Stone
- Cardiff School of Sport and Health Sciences, Cardiff Metropolitan University, Llandaff Campus, Western Avenue, Cardiff, CF5 2YB, Wales, UK
- National Cardiovascular Research Network (NCRN), Cardiff, Wales, UK
| | - Lee Stoner
- Department of Epidemiology, Gillings School of Public Health, University of North Carolina, Chapel Hill, NC, USA
- Center for Health Promotion and Disease Prevention, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Nele Friedrich
- Department of Internal Medicine B, University Medicine Greifswald, Greifswald, Germany
- Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Marcus Dörr
- Department of Internal Medicine B, University Medicine Greifswald, Greifswald, Germany
- German Centre for Cardiovascular Research (DZHK), partner site Greifswald, Greifswald, Germany
| | - Martin Bahls
- Department of Internal Medicine B, University Medicine Greifswald, Greifswald, Germany.
- German Centre for Cardiovascular Research (DZHK), partner site Greifswald, Greifswald, Germany.
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García-Domínguez M. Pathological and Inflammatory Consequences of Aging. Biomolecules 2025; 15:404. [PMID: 40149940 PMCID: PMC11939965 DOI: 10.3390/biom15030404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2025] [Revised: 03/08/2025] [Accepted: 03/10/2025] [Indexed: 03/29/2025] Open
Abstract
Aging is a complex, progressive, and irreversible biological process that entails numerous structural and functional changes in the organism. These changes affect all bodily systems, reducing their ability to respond and adapt to the environment. Chronic inflammation is one of the key factors driving the development of age-related diseases, ultimately causing a substantial decline in the functional abilities of older individuals. This persistent inflammatory state (commonly known as "inflammaging") is characterized by elevated levels of pro-inflammatory cytokines, an increase in oxidative stress, and a perturbation of immune homeostasis. Several factors, including cellular senescence, contribute to this inflammatory milieu, thereby amplifying conditions such as cardiovascular disease, neurodegeneration, and metabolic disorders. Exploring the mechanisms of chronic inflammation in aging is essential for developing targeted interventions aimed at promoting healthy aging. This review explains the strong connection between aging and chronic inflammation, highlighting potential therapeutic approaches like pharmacological treatments, dietary strategies, and lifestyle changes.
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Affiliation(s)
- Mario García-Domínguez
- Program of Immunology and Immunotherapy, CIMA-Universidad de Navarra, 31008 Pamplona, Spain;
- Department of Immunology and Immunotherapy, Clínica Universidad de Navarra, 31008 Pamplona, Spain
- Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), 28029 Madrid, Spain
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Osser G, Osser B, Toth C, Miuța CC, Marconi GR, Bondar LI. Exploring the Relationship Between Ejection Fraction, Arterial Stiffness, NT-proBNP, and Hospitalization Risk in Heart Failure Patients. Diagnostics (Basel) 2024; 14:2885. [PMID: 39767246 PMCID: PMC11675150 DOI: 10.3390/diagnostics14242885] [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: 11/11/2024] [Revised: 12/11/2024] [Accepted: 12/20/2024] [Indexed: 01/11/2025] Open
Abstract
Background/Objectives: Heart failure (HF) remains a leading cause of hospitalization and morbidity. Arterial stiffness, measured by pulse wave velocity (PWV) and the augmentation index (AIx), has been linked to HF severity and prognosis. This study investigates the relationship between clinical parameters, biochemical indicators, and arterial stiffness in hospitalized patients with HF, aiming to identify predictors of hospitalization and improve patient management. Methods: This cross-sectional study included 98 patients admitted with HF: 53 with acutely decompensated HF (sudden worsening of symptoms) and 45 with chronic HF (stable symptoms of HF). Clinical and biochemical parameters, including ejection fraction (EF), N-terminal prohormone of brain natriuretic peptide (NT-proBNP) levels, and arterial stiffness indicators (PWV and AIx), were measured at admission. During follow-up, 59 patients required re-hospitalization due to acutely decompensated HF, while 39 remained outpatients without further hospitalization. The relationship between these parameters was analyzed using Pearson correlation coefficients, and multiple Cox regression analysis was conducted to identify independent predictors of re-hospitalization. Results: A significant negative correlation between EF and PWV was found (r = -0.853, 95% CI [-0.910, -0.764]), suggesting an association between improved heart function (higher EF) and reduced arterial stiffness (lower PWV). A moderate positive correlation between EF and AIx (r = 0.626, 95% CI [0.473, 0.805]) suggests that, while higher EF is associated with increased AIx, the relationship is weaker compared to EF and PWV. This may reflect differing contributions of vascular and myocardial factors to HF severity. Hospitalized patients exhibited significantly poorer clinical and biochemical profiles, including higher NT-proBNP levels (p < 0.001) and worse blood pressure (BP) measurements (systolic and diastolic, p < 0.01). Multiple Cox regression analysis identified PWV, Aix, and NT-proBNP as independent predictors of re-hospitalization in HF patients, with significant hazard ratios: PWV (HR = 1.15, p = 0.02), AIx (HR = 1.03, p = 0.02), and NT-proBNP (HR = 1.0001, p < 0.01). Conclusions: Arterial stiffness indices (PWV and AIx), EF, and NT-proBNP were identified as significant predictors of re-hospitalization in HF patients. These findings suggest that integrating arterial stiffness measurements into routine clinical assessments may enhance the risk stratification and inform targeted interventions to reduce hospitalizations and improve outcomes.
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Affiliation(s)
- Gyongyi Osser
- Faculty of Physical Education and Sport, “Aurel Vlaicu” University of Arad, 310130 Arad, Romania; (G.O.); (B.O.); (C.T.); (G.R.M.)
| | - Brigitte Osser
- Faculty of Physical Education and Sport, “Aurel Vlaicu” University of Arad, 310130 Arad, Romania; (G.O.); (B.O.); (C.T.); (G.R.M.)
- Doctoral School of Biomedical Sciences, University of Oradea, 410087 Oradea, Romania;
| | - Csongor Toth
- Faculty of Physical Education and Sport, “Aurel Vlaicu” University of Arad, 310130 Arad, Romania; (G.O.); (B.O.); (C.T.); (G.R.M.)
- Doctoral School of Biomedical Sciences, University of Oradea, 410087 Oradea, Romania;
| | - Caius Calin Miuța
- Faculty of Physical Education and Sport, “Aurel Vlaicu” University of Arad, 310130 Arad, Romania; (G.O.); (B.O.); (C.T.); (G.R.M.)
| | - Gabriel Roberto Marconi
- Faculty of Physical Education and Sport, “Aurel Vlaicu” University of Arad, 310130 Arad, Romania; (G.O.); (B.O.); (C.T.); (G.R.M.)
| | - Laura Ioana Bondar
- Doctoral School of Biomedical Sciences, University of Oradea, 410087 Oradea, Romania;
- Department of Biology and Life Sciences, “Vasile Goldiș” Western University of Arad, 310048 Arad, Romania
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Most A, Kraushaar L, Dörr O, Keranov S, Hoelscher S, Weber R, Akdogan E, Groesser V, Husain-Syed F, Nef H, Hamm CW, Bauer P. Association of central blood pressure with an exaggerated blood pressure response to exercise among elite athletes. Eur J Appl Physiol 2024; 124:1239-1252. [PMID: 37987923 PMCID: PMC10955016 DOI: 10.1007/s00421-023-05353-7] [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: 07/06/2023] [Accepted: 10/30/2023] [Indexed: 11/22/2023]
Abstract
PURPOSE The systolic blood pressure/workload (SBP/MET) slope was recently reported to be a reliable parameter to identify an exaggerated blood pressure response (eBPR) in the normal population and in athletes. However, it is unclear whether an eBPR correlates with central blood pressure (CBP) and vascular function in elite athletes. METHODS We examined 618 healthy male elite athletes (age 25.8 ± 5.1 years) of mixed sports with a standardized maximum exercise test. CBP and vascular function were measured non-invasively with a validated oscillometric device. The SBP/MET slope was calculated and the threshold for an eBPR was set at > 6.2 mmHg/MET. Two groups were defined according to ≤ 6.2 and > 6.2 mmHg/MET, and associations of CBP and vascular function with the SBP/MET slope were compared for each group. RESULTS Athletes with an eBPR (n = 180, 29%) displayed a significantly higher systolic CBP (102.9 ± 7.5 vs. 100 ± 7.7 mmHg, p = 0.001) but a lower absolute (295 ± 58 vs. 384 ± 68 W, p < 0.001) and relative workload (3.14 ± 0.54 vs. 4.27 ± 1.1 W/kg, p < 0.001) compared with athletes with a normal SBP/MET slope (n = 438, 71%). Systolic CBP was positively associated with the SBP/MET slope (r = 0.243, p < 0.001). In multiple logistic regression analyses, systolic CBP (odds ratio [OR] 1.099, 95% confidence interval [CI] 1.045-1.155, p < 0.001) and left atrial volume index (LAVI) (OR 1.282, CI 1.095-1.501, p = 0.002) were independent predictors of an eBPR. CONCLUSION Systolic CBP and LAVI were independent predictors of an eBPR. An eBPR was further associated with a lower performance level, highlighting the influence of vascular function on the BPR and performance of male elite athletes.
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Affiliation(s)
- Astrid Most
- Department of Cardiology and Angiology, Justus Liebig University Giessen, 35390, Giessen, Germany
| | | | - Oliver Dörr
- Department of Cardiology and Angiology, Justus Liebig University Giessen, 35390, Giessen, Germany
| | - Stanislav Keranov
- Department of Cardiology and Angiology, Justus Liebig University Giessen, 35390, Giessen, Germany
| | - Sophie Hoelscher
- Department of Cardiology and Angiology, Justus Liebig University Giessen, 35390, Giessen, Germany
| | - Rebecca Weber
- Department of Cardiology and Angiology, Justus Liebig University Giessen, 35390, Giessen, Germany
| | - Ebru Akdogan
- Department of Cardiology and Angiology, Justus Liebig University Giessen, 35390, Giessen, Germany
| | - Vincent Groesser
- Department of Cardiology and Angiology, Justus Liebig University Giessen, 35390, Giessen, Germany
| | - Faeq Husain-Syed
- Department of Internal Medicine, Member of the German Center for Lung Research, Universities of Giessen and Marburg Lung Center, Justus Liebig University Giessen, Giessen, Germany
| | - Holger Nef
- Department of Cardiology and Angiology, Justus Liebig University Giessen, 35390, Giessen, Germany
| | - Christian W Hamm
- Department of Cardiology and Angiology, Justus Liebig University Giessen, 35390, Giessen, Germany
- Department of Cardiology, Kerckhoff Heart and Thorax Center, Bad Nauheim, Germany
- German Center for Cardiovascular Research (DZHK), Rhein-Main Partner Site, Bad Nauheim, Germany
| | - Pascal Bauer
- Department of Cardiology and Angiology, Justus Liebig University Giessen, 35390, Giessen, Germany.
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Chen YL, Wang JG. Blood Pressure Variability and Left Ventricular Diastolic Dysfunction. Am J Hypertens 2024; 37:163-164. [PMID: 37996098 DOI: 10.1093/ajh/hpad114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Accepted: 11/21/2023] [Indexed: 11/25/2023] Open
Affiliation(s)
- Yi-Lin Chen
- Department of Cardiovascular Medicine, The Shanghai Institute of Hypertension, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Ji-Guang Wang
- Department of Cardiovascular Medicine, The Shanghai Institute of Hypertension, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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Kim HL. The Value of Serial Measurement of Arterial Stiffness in Cardiovascular Disease. Rev Cardiovasc Med 2024; 25:7. [PMID: 39077652 PMCID: PMC11262365 DOI: 10.31083/j.rcm2501007] [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: 08/24/2023] [Revised: 09/26/2023] [Accepted: 10/10/2023] [Indexed: 07/31/2024] Open
Abstract
Clinically assessing arterial stiffness is valuable because it aids in predicting future cardiovascular events. There are several methods for measuring arterial stiffness, including pulse wave velocity (PWV), augmentation index, and pulse pressure. Numerous studies have shown that these indicators of arterial stiffness possess prognostic value for various patient groups as well as the general population. In cross-sectional studies, arterial stiffness was also linked to organ damage indices. However, most studies related to arterial stiffness have relied on a single measurement. Taking multiple serial measurements of arterial stiffness offers several advantages. Through repeated assessments, one can confirm the variability of arterial stiffness and observe changes over time, which is beneficial for understanding its pathophysiology. Such repeated measurements are also invaluable in evaluating the efficacy of interventions aimed at improving arterial stiffness. However, caution is needed, as there is no standardized method for measuring arterial stiffness. For instance, with PWV, the values can be influenced by numerous external factors. Therefore, the external conditions during the measurement must be noted. It's essential to recognize the pros and cons of repeated arterial stiffness measurements and integrate them effectively into clinical practice.
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Affiliation(s)
- Hack-Lyoung Kim
- Division of Cardiology, Department of Internal Medicine, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul National University College of Medicine, 07061 Seoul, Republic of Korea
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Kim HL, Kim MA. Sex Differences in Coronary Artery Disease: Insights From the KoRean wOmen'S chest pain rEgistry (KoROSE). Korean Circ J 2023; 53:655-676. [PMID: 37880830 PMCID: PMC10625849 DOI: 10.4070/kcj.2023.0205] [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: 08/02/2023] [Accepted: 08/08/2023] [Indexed: 10/27/2023] Open
Abstract
Interest in sex differences in coronary artery disease (CAD) has been steadily increasing. Concurrently, most of the data on these differences have primarily been Western-oriented. The KoRean wOmen'S chest pain rEgistry (KoROSE), started in 2011, has since published numerous research findings. This review aims to summarize the reported differences between men and women in CAD, integrating data from KoROSE. Cardiovascular risk in postmenopausal women escalates dramatically due to the decrease in estrogen levels, which normally offer cardiovascular protective effects. Lower estrogen levels can lead to abdominal obesity, insulin resistance, increased blood pressure, and endothelial dysfunction in older women. Upon analyzing patients with CAD, women are typically older and exhibit more cardiovascular risk factors than men. Diagnosing CAD in women tends to be delayed due to their symptoms being more atypical than men's. While in-hospital outcome was similar between sexes, bleeding complications after percutaneous coronary intervention occur more frequently in women. The differences in long-term prognosis for CAD patients between men and women are still a subject of ongoing debate. Pregnancy and reproductive factors also play a significant role as risk factors for cardiovascular disease in women. A notable sex disparity exists, with women found to use fewer cardiovascular protective drugs and undergo fewer interventional or surgical procedures than men. Additionally, women participate less frequently than men in clinical research. Through concerted efforts to increase awareness of sex differences and mitigate sex disparity, personalized treatment can be provided. This approach can ultimately improve patient prognosis.
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Affiliation(s)
- Hack-Lyoung Kim
- Division of Cardiology, Department of Internal Medicine, Seoul National University College of Medicine, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, Korea
| | - Myung-A Kim
- Division of Cardiology, Department of Internal Medicine, Seoul National University College of Medicine, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, Korea.
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