1
|
Hou J, Li M, Han J, Yu S, Jia X, Sun F, Zhang Y. Northern Shanghai Study II: systematic assessment and management of early organ damage and its role in preventing and reducing cardiovascular risk-protocol of a prospective study. BMJ Open 2023; 13:e073423. [PMID: 38159946 PMCID: PMC10759065 DOI: 10.1136/bmjopen-2023-073423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Accepted: 11/21/2023] [Indexed: 01/03/2024] Open
Abstract
INTRODUCTION Cardiovascular diseases are the leading cause of death and disease burden in China. However, there is a lack of prospective cohort studies suitable for evaluating early organ damage and its role in preventing and reducing cardiovascular risk among Chinese residents. This study intends to establish the first database based on the phenotypes of all early structural and functional damage of cardiovascular organs in Chinese population. Moreover, a digital follow-up mechanism will be formed, a prospective population cohort will be established, a biological sample bank for early cardiovascular organ damage will be established, and an intervention and management system for early damage of cardiovascular organs will be explored. METHODS AND ANALYSIS This study is a prospective cohort study built on the foundation of the Northern Shanghai Study I. People aged 18-75 years are enrolled. After the recruitment, first, corresponding physical measurements and clinical examinations are conducted to collect cardiovascular risk factors and establish the demographic baseline of the study population. Next, the latest equipment is used to evaluate early structural and functional cardiovascular organ damage including heart, macrovessels, microcirculation, renal function and fundus. Meanwhile, the blood, urine, faeces and other biological samples of participants are collected to establish the cardiometabolic and gut microbiota analysis databases. The population is followed up every 2 years. Comprehensive assessment of early organ damage will be used to predict cardiovascular risk, guide people to change lifestyles to achieve early prevention and provide corresponding treatment recommendations. ETHICS AND DISSEMINATION This study was approved by the Shanghai Tenth People's Hospital Institutional Review Board. All participants signed a written consent form. The results of this study will be disseminated in peer-reviewed journals. Ethics approval: SHYS-IEC-5.0/22k148/P01. TRIAL REGISTRATION NUMBER NCT05435898.
Collapse
Affiliation(s)
- Jingjing Hou
- Department of Cardiology,Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China
| | - Moran Li
- Department of Cardiology,Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China
| | - Jun Han
- Department of Cardiology,Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China
| | - Shikai Yu
- Department of Cardiology,Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China
| | - Xinming Jia
- Clinical Medicine Scientific and Technical Innovation Center,Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China
| | - Fenyong Sun
- Department of Clinical Laboratory Medicine,Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China
| | - Yi Zhang
- Department of Cardiology,Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China
| |
Collapse
|
2
|
Cheng Y, Chen J, Zhao Q, Zhang J, Gao J. Association of carotid wall shear stress measured by vector flow mapping technique with ba-PWV: a pilot study. Front Cardiovasc Med 2023; 10:1293106. [PMID: 38144371 PMCID: PMC10748391 DOI: 10.3389/fcvm.2023.1293106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Accepted: 10/31/2023] [Indexed: 12/26/2023] Open
Abstract
Objective Arterial stiffness is an important tissue biomarker of the progression of atherosclerotic diseases. Brachial-ankle pulse wave velocity (ba-PWV) is a gold standard of arterial stiffness measurement widely used in Asia. Changes in vascular wall shear stress (WSS) lead to artery wall remodeling, which could give rise to an increase in arterial stiffness. The study aimed to explore the association between ba-PWV and common carotid artery (CCA) WSS measured by a newly invented vascular vector flow mapping (VFM) technique. Methods We included 94 subjects free of apparent cardiovascular disease (CVD) and divided them into a subclinical atherosclerosis (SA) group (N = 47) and non subclinical atherosclerosis (NSA) group (N = 47). CCA WSS was measured using the VFM technique. Bivariate correlations between CCA WSS and other factors were assessed with Pearson's, Spearman's, or Kendall's coefficient of correlation, as appropriate. Partial correlation analysis was conducted to examine the influence of age and sex. Multiple linear stepwise regression was used for the analysis of independent determinants of CCA WSS. Receiver operating characteristic (ROC) analysis was performed to find the association between CCA WSS and 10-year CVD risk. Results The overall subjects had a mean age of 47.9 ± 11.2 years, and males accounted for 52.1%. Average systolic CCA WSS was significantly correlated with ba-PWV (r = -0.618, p < 0.001) in the SA group. Multiple linear stepwise regression analysis confirmed that ba-PWV was an independent determinant of average systolic CCA WSS (β = -0.361, p = 0.003). The area under the curve (AUC) of average systolic CCA WSS for 10-year CVD risk ≥10% was 0.848 (p < 0.001) in the SA group. Conclusions Average systolic CCA WSS was significantly correlated with ba-PWV and was associated with 10-year CVD risk ≥10% in the SA group. Therefore, CCA WSS measured by the VFM technique could be used for monitoring and screening subjects with potential CVD risks.
Collapse
Affiliation(s)
- Yi Cheng
- Department of Diagnostic Ultrasound, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Jie Chen
- Department of Diagnostic Ultrasound, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Qing Zhao
- Department of Diagnostic Ultrasound, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Jinghan Zhang
- Department of Diagnostic Ultrasound, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Junyi Gao
- Department of Cardiovascular Medicine, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
| |
Collapse
|
3
|
Zhang H, Cheng Y, Zhang T, Huang Q, Huang L, Shen B. Mean value of pulse pressure: The key feature in ambulatory arterial stiffness index estimation using regression models. Med Eng Phys 2023; 122:104073. [PMID: 38092490 DOI: 10.1016/j.medengphy.2023.104073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2023] [Revised: 11/14/2023] [Accepted: 11/19/2023] [Indexed: 12/18/2023]
Abstract
OBJECTIVE Ambulatory arterial stiffness index (AASI) is an index which indicates arterial stiffness. This work aims to explore the mathematical relationship between AASI and mean value of PP (PP‾), and reveal the importance of PP‾ during AASI estimating. Meanwhile, a well-performing AASI estimation model is presented. METHODS To evaluate AASI, electrocardiograph (ECG) signal, photoplethysmogram (PPG) signal and arterial blood pressure (ABP) are used as the source of AASI estimation. Features are extracted from the above three signals. Meanwhile, fitting curve analysis and regression models are implemented to describe the relationship between AASI and PP‾. RESULTS Among three fitting curves on AASI and PP‾, cubic polynomial curve performs best. The introduction of feature PP‾ in AASI estimation reduced LR's MAE from 0.0556 to 0.0372, SVMR's MAE from 0.0413 to 0.0343 and RFR's MAE from 0.0386 to 0.0256. All three estimation models obtain considerable improvement, especially on the previous worst-performing linear regression. SIGNIFICANCE This work presents the mathematical association between AASI and PP‾. AASI estimation using regression models can be significantly improved by involving PP‾ as its key feature, which is not only meaningful for exploring the connection between vascular elasticity function and pulse pressure, but also hold importance for the diagnosis of cardiovascular arteriosclerosis and atherosclerosis at the early stage.
Collapse
Affiliation(s)
- Haikang Zhang
- School of Health Science and Engineering, University of Shanghai for Science and Technology, Shanghai, China; Shanghai Engineering Research Center of Interventional Medical Device, Shanghai, China
| | - Yunzhang Cheng
- School of Health Science and Engineering, University of Shanghai for Science and Technology, Shanghai, China; Shanghai Engineering Research Center of Interventional Medical Device, Shanghai, China
| | - Tianyi Zhang
- School of Health Science and Engineering, University of Shanghai for Science and Technology, Shanghai, China; Shanghai Engineering Research Center of Interventional Medical Device, Shanghai, China
| | - Qingming Huang
- School of Health Science and Engineering, University of Shanghai for Science and Technology, Shanghai, China; School of Medical Imaging, Shanghai University of Medicine & Health Sciences, China
| | - Luying Huang
- School of Health Science and Engineering, University of Shanghai for Science and Technology, Shanghai, China
| | - Bing Shen
- School of Health Science and Engineering, University of Shanghai for Science and Technology, Shanghai, China; Shanghai Tenth People's Hospital, Shanghai, China; Shanghai Engineering Research Center of Interventional Medical Device, Shanghai, China.
| |
Collapse
|
4
|
Zheng M, Zhang X, Zhao Q, Chen S, Guo X, Wang C, Jonas JB, Wu S, Guo C. The impact of bilateral brachial-ankle pulse wave velocity difference on cardiovascular disease and all-cause mortality. Front Cardiovasc Med 2023; 10:1234325. [PMID: 37868781 PMCID: PMC10588177 DOI: 10.3389/fcvm.2023.1234325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2023] [Accepted: 09/21/2023] [Indexed: 10/24/2023] Open
Abstract
Background This study aims to investigate the association between an elevated bilateral pulse wave velocity difference (BPWVD) and cardiovascular diseases (CVDs) and all-cause mortality. Methods This study included a total of 38,356 participants. A multivariable Cox proportional hazards regression was used to assess the association between high BPWVD and the increased risk of CVDs and all-cause mortality by calculating hazard ratios (HRs) with 95% confidence intervals. Results A total of 1,213 cases of CVDs were identified over a mean duration of 6.19 years, including 886 cases of cerebral infarction (CI), 105 cases of intracerebral hemorrhage (ICH), and 222 cases of myocardial infarction (MI), along with 1,182 cases of all-cause mortality. The median BPWVD was 42 cm/s (19-80 cm/s). After adjusting for all confounders and baseline brachial-ankle PWV (baPWV), our analysis revealed a significant correlation between a higher risk of CVDs, MI, and all-cause mortality with an increase in BPWVD per standard deviation. HRs (95% confidence interval) were found to be 1.06 (1.01-1.11), 1.11 (1.02-1.21), and 1.07 (1.04-1.10), respectively. Among the participants with higher baPWV on the left side, the HRs (95% confidence interval) were 1.08 (1.02-1.14) for CVDs, 1.27 (1.10-1.46) for incident ICH, 1.16 (1.00-1.24) for incident MI, and 1.10 (1.07-1.15) for all-cause mortality, for per standard deviation increase in BPWVD. Conclusions Our findings reveal a significant correlation between elevated BPWVD and the risks of developing CVDs and all-cause mortality. This highlights the importance of thoroughly evaluating BPWVD as a means of detecting individuals at risk for CVDs and mortality.
Collapse
Affiliation(s)
- Mengyi Zheng
- Cardiovascular Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Xinyuan Zhang
- Channing Division of Network Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, United States
| | - Quanhui Zhao
- Department of Cardiology, Kailuan General Hospital, Tangshan, China
| | - Shuohua Chen
- Department of Cardiology, Kailuan General Hospital, Tangshan, China
| | - Xinying Guo
- Cardiovascular Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Chi Wang
- Department of Cardiology, the Sixth Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Jost B. Jonas
- Department of Ophthalmology, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Shouling Wu
- Department of Cardiology, Kailuan General Hospital, Tangshan, China
| | - Caixia Guo
- Cardiovascular Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| |
Collapse
|
5
|
Stone K, Veerasingam D, Meyer ML, Heffernan KS, Higgins S, Maria Bruno R, Bueno CA, Döerr M, Schmidt-Trucksäss A, Terentes-Printzios D, Voicehovska J, Climie RE, Park C, Pucci G, Bahls M, Stoner L. Reimagining the Value of Brachial-Ankle Pulse Wave Velocity as a Biomarker of Cardiovascular Disease Risk-A Call to Action on Behalf of VascAgeNet. Hypertension 2023; 80:1980-1992. [PMID: 37470189 PMCID: PMC10510846 DOI: 10.1161/hypertensionaha.123.21314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/21/2023]
Abstract
This review critiques the literature supporting clinical assessment and management of cardiovascular disease and cardiovascular disease risk stratification with brachial-ankle pulse wave velocity (baPWV). First, we outline what baPWV actually measures-arterial stiffness of both large central elastic arteries and medium-sized muscular peripheral arteries of the lower limb. Second, we argue that baPWV is not a surrogate for carotid-femoral pulse wave velocity. While both measures are dependent on the properties of the aorta, baPWV is also strongly dependent on the muscular arteries of the lower extremities. Increased lower-extremity arterial stiffness amplifies and hastens wave reflections at the level of the aorta, widens pulse pressure, increases afterload, and reduces coronary perfusion. Third, we used an established evaluation framework to identify the value of baPWV as an independent vascular biomarker. There is sufficient evidence to support (1) proof of concept; (2) prospective validation; (3) incremental value; and (4) clinical utility. However, there is limited or no evidence to support (5) clinical outcomes; (6) cost-effectiveness; (8) methodological consensus; or (9) reference values. Fourth, we address future research requirements. The majority of the evaluation criteria, (1) proof of concept, (2) prospective validation, (3) incremental value, (4) clinical utility and (9) reference values, can be supported using existing cohort datasets, whereas the (5) clinical outcomes and (6) cost-effectiveness criteria require prospective investigation. The (8) methodological consensus criteria will require an expert consensus statement. Finally, we finish this review by providing an example of a future clinical practice model.
Collapse
Affiliation(s)
- Keeron Stone
- Centre for Cardiovascular Health and Ageing, Cardiff Metropolitan University, Cardiff, Wales, United Kingdom (K.S.)
- National Cardiovascular Research Network, Wales (K.S.)
| | - Dave Veerasingam
- Cardiothoracic Surgery, Galway University Hospital, Ireland (D.V.)
| | - Michelle L Meyer
- Department of Emergency Medicine, University of North Carolina at Chapel Hill (M.L.M.)
| | | | - Simon Higgins
- Department of Exercise and Sport Science, University of North Carolina, Chapel Hill (S.H., L.S.)
| | - Rosa Maria Bruno
- Université Paris Cité, Inserm, PARCC, France (R.M.B.)
- Clinical Pharmacology Unit, AP-HP, Hôpital européen Georges Pompidou, Paris, France (R.M.B.)
| | - Celia Alvarez Bueno
- Health and Social Research Center, Universidad de Castilla La Mancha, Cuenca, Spain (C.A.B.)
- Universidad Politécnica y Artística del Paraguay, Asunción, Paraguay (C.A.B.)
| | - Marcus Döerr
- Department of Internal Medicine B, University Medicine Greifswald, Germany (M.D., M.B.)
- German Centre for Cardiovascular Research (DZHK), partner site Greifswald, Germany (M.D., M.B.)
| | - Arno Schmidt-Trucksäss
- Department of Sport, Exercise, and Health (A.S.-T.), University of Basel, Switzerland
- Department of Clinical Research, University Hospital Basel (A.S.-T.), University of Basel, Switzerland
| | - Dimitrios Terentes-Printzios
- First Department of Cardiology, Athens Medical School, National and Kapodistrian University of Athens, Hippokration Hospital, Greece (D.T.-P.)
| | - Jūlija Voicehovska
- Internal Diseases Department, Riga Stradins University, Latvia (J.V.)
- Nephrology and Renal Replacement Clinics, Riga East University Hospital, Latvia (J.V.)
| | - Rachel E Climie
- Menzies Institute for Medical Research, University of Tasmania (R.E.C.)
| | - Chloe Park
- MRC Unit for Lifelong Health and Ageing at UCL, Institute of Cardiovascular Science, London, United Kingdom (C.P.)
| | - Giacomo Pucci
- Department of Medicine, University of Perugia, Unit of Internal Medicine, "Santa Maria" Terni Hospital, Italy (G.P.)
| | - Martin Bahls
- German Centre for Cardiovascular Research (DZHK), partner site Greifswald, Germany (M.D., M.B.)
| | - Lee Stoner
- Department of Exercise and Sport Science, University of North Carolina, Chapel Hill (S.H., L.S.)
- Department of Epidemiology, Gillings School of Public Health, University of North Carolina, Chapel Hill (L.S.)
- Center for Health Promotion and Disease Prevention, University of North Carolina at Chapel Hill (L.S.)
| |
Collapse
|
6
|
Yi T, Gao L, Fan F, Jiang Y, Jia J, Zhang Y, Li J, Huo Y. Association between pulse wave velocity and the 10-year risk of atherosclerotic cardiovascular disease in the Chinese population: A community-based study. J Clin Hypertens (Greenwich) 2023; 25:278-285. [PMID: 36794419 PMCID: PMC9994158 DOI: 10.1111/jch.14642] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2022] [Revised: 01/04/2023] [Accepted: 01/19/2023] [Indexed: 02/17/2023]
Abstract
Accumulated evidence has shown that carotid-femoral and brachial-ankle PWV well predict cardiovascular events but it is still unclear if the predictability is same or not. In this cross-sectional study based on a community atherosclerosis cohort in Beijing, China, a total of 5282 participants without previous coronary heart disease and stroke were enrolled from a community atherosclerosis cohort in Beijing, China. The 10-year atherosclerotic cardiovascular disease (ASCVD) risk were calculated by the China-PAR model, and < 5%, 5%-10% and > 10% were defined as low, intermediate, and high risk, respectively. The average baPWV and cfPWV values were 16.63 ± 3.35 m/s and 8.45 ± 1.78 m/s, respectively. The mean 10-year ASCVD risk was 6.98% (interquartile range: 3.90%-12.01%). The patients with low, intermediate, and high 10-year ASCVD risk accounted for 34.84% (1840), 31.94% (1687),, and 33.23% (1755) respectively. Multivariate analysis showed that for every 1 m/s increase in baPWV and cfPWV, the 10-year ASCVD risk increased by 0.60% (95% confidence interval: 0.56%-0.65%, p < .001) and 1.17% (95% confidence interval: 1.09%-1.25%, p < .001), respectively. The diagnostic ability of the baPWV was comparable to the cfPWV (area under the curve: 0.870 [0.860-0.879] vs. 0.871 [0.861-0.881], p = .497). In conclusion, baPWV and cfPWV are positively associated with the 10-year risk of ASCVD in the Chinese community-based population, with a nearly identical association with a high 10-year risk of ASCVD.
Collapse
Affiliation(s)
- Tieci Yi
- Department of Cardiovascular Disease, Peking University First Hospital, Beijing, China.,Institute of Cardiovascular Disease, Peking University First Hospital, Beijing, China.,Hypertension Precision Diagnosis and Treatment Research Center, Peking University First Hospital, Beijing, China
| | - Lan Gao
- Department of Cardiovascular Disease, Peking University First Hospital, Beijing, China.,Institute of Cardiovascular Disease, Peking University First Hospital, Beijing, China.,Hypertension Precision Diagnosis and Treatment Research Center, Peking University First Hospital, Beijing, China
| | - Fangfang Fan
- Department of Cardiovascular Disease, Peking University First Hospital, Beijing, China.,Institute of Cardiovascular Disease, Peking University First Hospital, Beijing, China.,Hypertension Precision Diagnosis and Treatment Research Center, Peking University First Hospital, Beijing, China
| | - Yimeng Jiang
- Department of Cardiovascular Disease, Peking University First Hospital, Beijing, China.,Institute of Cardiovascular Disease, Peking University First Hospital, Beijing, China.,Hypertension Precision Diagnosis and Treatment Research Center, Peking University First Hospital, Beijing, China
| | - Jia Jia
- Institute of Cardiovascular Disease, Peking University First Hospital, Beijing, China.,Hypertension Precision Diagnosis and Treatment Research Center, Peking University First Hospital, Beijing, China
| | - Yan Zhang
- Department of Cardiovascular Disease, Peking University First Hospital, Beijing, China.,Institute of Cardiovascular Disease, Peking University First Hospital, Beijing, China.,Hypertension Precision Diagnosis and Treatment Research Center, Peking University First Hospital, Beijing, China
| | - Jianping Li
- Department of Cardiovascular Disease, Peking University First Hospital, Beijing, China.,Institute of Cardiovascular Disease, Peking University First Hospital, Beijing, China.,Hypertension Precision Diagnosis and Treatment Research Center, Peking University First Hospital, Beijing, China
| | - Yong Huo
- Department of Cardiovascular Disease, Peking University First Hospital, Beijing, China.,Institute of Cardiovascular Disease, Peking University First Hospital, Beijing, China.,Hypertension Precision Diagnosis and Treatment Research Center, Peking University First Hospital, Beijing, China
| |
Collapse
|
7
|
Zhang X, Yang Q, Zheng R, Zhao Z, Li M, Wang T, Xu M, Lu J, Wang S, Lin H, Wang W, Ning G, Bi Y, Xu Y, Chen Y. Sex differences in the risk of arterial stiffness among adults with different glycemic status and modifications by age. J Diabetes 2023; 15:121-132. [PMID: 36650122 PMCID: PMC9934959 DOI: 10.1111/1753-0407.13353] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2022] [Revised: 12/09/2022] [Accepted: 12/28/2022] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Studies indicate lower, comparable, and higher cardiovascular risks in women vs men in normal glucose regulation (NGR), prediabetes, and diabetes, respectively. However, this sex difference is uncertain and aging might play a part. We aimed to estimate sex differences in arterial stiffness in NGR, prediabetes, or diabetes and the potential modifications by age. METHODS We used baseline data of 9618 participants aged ≥40 years in a large community-based cohort study in Shanghai. Glycemic status was determined by history of diabetes, fasting and 2-h post-load glucose levels, and hemoglobin A1c levels. Arterial stiffness was examined by brachial-ankle pulse wave velocity (ba-PWV). Multivariable linear regression analysis was conducted to examine the associations between sex and ba-PWV levels in glycemic and age categories. RESULTS Before adjustment for age, women had lower, comparable, and higher ba-PWV vs men in the NGR, prediabetes, and diabetes groups, respectively. In participants aged 40-59 years, women were associated with lower ba-PWV levels in generally all glycemic strata after adjustment for age and other confounders. In participants aged ≥60 years, women were associated with significantly higher ba-PWV levels (β coefficient = 71.5; 95% confidence interval = 23.4, 119.7) and the sex difference was attenuated in the groups of prediabetes and diabetes with a borderline significant interaction between sex and glycemic status (p for interaction = .068). CONCLUSIONS The sex difference in cardiovascular risks in adults with NGR, prediabetes, or diabetes was dependent on age. Our findings provide new evidence for prioritizing preventive treatment against atherosclerosis in men vs women with different glycemic status.
Collapse
Affiliation(s)
- Xiaoyun Zhang
- Department of Endocrine and Metabolic DiseasesShanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiaotong University School of MedicineShanghaiChina
- Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR ChinaShanghai Key Laboratory for Endocrine Tumor, State Key Laboratory of Medical Genomics, Ruijin Hospital, Shanghai Jiaotong University School of MedicineShanghaiChina
| | - Qianqian Yang
- Department of Endocrine and Metabolic DiseasesShanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiaotong University School of MedicineShanghaiChina
- Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR ChinaShanghai Key Laboratory for Endocrine Tumor, State Key Laboratory of Medical Genomics, Ruijin Hospital, Shanghai Jiaotong University School of MedicineShanghaiChina
| | - Ruizhi Zheng
- Department of Endocrine and Metabolic DiseasesShanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiaotong University School of MedicineShanghaiChina
- Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR ChinaShanghai Key Laboratory for Endocrine Tumor, State Key Laboratory of Medical Genomics, Ruijin Hospital, Shanghai Jiaotong University School of MedicineShanghaiChina
| | - Zhiyun Zhao
- Department of Endocrine and Metabolic DiseasesShanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiaotong University School of MedicineShanghaiChina
- Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR ChinaShanghai Key Laboratory for Endocrine Tumor, State Key Laboratory of Medical Genomics, Ruijin Hospital, Shanghai Jiaotong University School of MedicineShanghaiChina
| | - Mian Li
- Department of Endocrine and Metabolic DiseasesShanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiaotong University School of MedicineShanghaiChina
- Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR ChinaShanghai Key Laboratory for Endocrine Tumor, State Key Laboratory of Medical Genomics, Ruijin Hospital, Shanghai Jiaotong University School of MedicineShanghaiChina
| | - Tiange Wang
- Department of Endocrine and Metabolic DiseasesShanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiaotong University School of MedicineShanghaiChina
- Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR ChinaShanghai Key Laboratory for Endocrine Tumor, State Key Laboratory of Medical Genomics, Ruijin Hospital, Shanghai Jiaotong University School of MedicineShanghaiChina
| | - Min Xu
- Department of Endocrine and Metabolic DiseasesShanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiaotong University School of MedicineShanghaiChina
- Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR ChinaShanghai Key Laboratory for Endocrine Tumor, State Key Laboratory of Medical Genomics, Ruijin Hospital, Shanghai Jiaotong University School of MedicineShanghaiChina
| | - Jieli Lu
- Department of Endocrine and Metabolic DiseasesShanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiaotong University School of MedicineShanghaiChina
- Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR ChinaShanghai Key Laboratory for Endocrine Tumor, State Key Laboratory of Medical Genomics, Ruijin Hospital, Shanghai Jiaotong University School of MedicineShanghaiChina
| | - Shuangyuan Wang
- Department of Endocrine and Metabolic DiseasesShanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiaotong University School of MedicineShanghaiChina
- Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR ChinaShanghai Key Laboratory for Endocrine Tumor, State Key Laboratory of Medical Genomics, Ruijin Hospital, Shanghai Jiaotong University School of MedicineShanghaiChina
| | - Hong Lin
- Department of Endocrine and Metabolic DiseasesShanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiaotong University School of MedicineShanghaiChina
- Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR ChinaShanghai Key Laboratory for Endocrine Tumor, State Key Laboratory of Medical Genomics, Ruijin Hospital, Shanghai Jiaotong University School of MedicineShanghaiChina
| | - Weiqing Wang
- Department of Endocrine and Metabolic DiseasesShanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiaotong University School of MedicineShanghaiChina
- Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR ChinaShanghai Key Laboratory for Endocrine Tumor, State Key Laboratory of Medical Genomics, Ruijin Hospital, Shanghai Jiaotong University School of MedicineShanghaiChina
| | - Guang Ning
- Department of Endocrine and Metabolic DiseasesShanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiaotong University School of MedicineShanghaiChina
- Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR ChinaShanghai Key Laboratory for Endocrine Tumor, State Key Laboratory of Medical Genomics, Ruijin Hospital, Shanghai Jiaotong University School of MedicineShanghaiChina
| | - Yufang Bi
- Department of Endocrine and Metabolic DiseasesShanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiaotong University School of MedicineShanghaiChina
- Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR ChinaShanghai Key Laboratory for Endocrine Tumor, State Key Laboratory of Medical Genomics, Ruijin Hospital, Shanghai Jiaotong University School of MedicineShanghaiChina
| | - Yu Xu
- Department of Endocrine and Metabolic DiseasesShanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiaotong University School of MedicineShanghaiChina
- Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR ChinaShanghai Key Laboratory for Endocrine Tumor, State Key Laboratory of Medical Genomics, Ruijin Hospital, Shanghai Jiaotong University School of MedicineShanghaiChina
| | - Yuhong Chen
- Department of Endocrine and Metabolic DiseasesShanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiaotong University School of MedicineShanghaiChina
- Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR ChinaShanghai Key Laboratory for Endocrine Tumor, State Key Laboratory of Medical Genomics, Ruijin Hospital, Shanghai Jiaotong University School of MedicineShanghaiChina
| |
Collapse
|
8
|
Podrug M, Šunjić B, Koren P, Đogaš V, Mudnić I, Boban M, Jerončić A. What Is the Smallest Change in Pulse Wave Velocity Measurements That Can Be Attributed to Clinical Changes in Arterial Stiffness with Certainty: A Randomized Cross-Over Study. J Cardiovasc Dev Dis 2023; 10:jcdd10020044. [PMID: 36826540 PMCID: PMC9962359 DOI: 10.3390/jcdd10020044] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 01/22/2023] [Accepted: 01/23/2023] [Indexed: 01/27/2023] Open
Abstract
Pulse wave velocity (PWV), a direct measure of arterial stiffness, is a promising biomarker of cardiovascular risk and a cardiovascular surrogate outcome. The resolution for detecting its smallest clinically significant change is dependent on the expected reproducibility, but there is currently no consensus on this. We estimated the PWV reproducibility in a range of intra-subject values that were observed over a 2 week period in a broad range of participants and under clinically relevant experimental conditions (two observers, morning/afternoon sessions, and number of visits) using SphygmoCor and Arteriograph devices. Each participant was recorded 12 times with each device over three visits, one week apart, and two morning and two afternoon recordings were taken per visit. The factors affecting reproducibility and the discrepancies between the consecutive PWV measurements for each device were also examined using multilevel mixed-effect models. We show that current PWV estimation guidance recommending 2 + 1 measurements is suboptimal because the PWV range was outside of the 1 m/s threshold for most of the participants, which is proposed as a minimal clinically important difference. The best reproducibility was yielded with median of four measurements and a 1.1 m/s threshold. Although PWV reproducibility and repeatability are frequently used interchangeably in studies, we demonstrated that despite their relative measures of variability (e.g., coefficient of variation) being comparable, their ranges revealed a clinically significant difference between them. We also found that different physiological variables were predictors of the discrepancy between the consecutive measurements made by the two devices, which is likely due to their distinct modes of operation. The evidence base for PWV reproducibility is limited, and more research is needed to deepen our understanding of the variation in arterial stiffness over time, as well as fluctuations within a population group and in an intervention setting.
Collapse
Affiliation(s)
- Mario Podrug
- Laboratory of Vascular Aging, University of Split School of Medicine, 21000 Split, Croatia
- Department of Health Studies, University of Split, 21000 Split, Croatia
| | - Borna Šunjić
- Laboratory of Vascular Aging, University of Split School of Medicine, 21000 Split, Croatia
- Department of Health Studies, University of Split, 21000 Split, Croatia
| | - Pjero Koren
- Laboratory of Vascular Aging, University of Split School of Medicine, 21000 Split, Croatia
- Department of Psychological Medicine, University of Split School of Medicine, 21000 Split, Croatia
| | - Varja Đogaš
- Department of Psychological Medicine, University of Split School of Medicine, 21000 Split, Croatia
| | - Ivana Mudnić
- Department of Basic and Clinical Pharmacology, University of Split School of Medicine, 21000 Split, Croatia
| | - Mladen Boban
- Department of Basic and Clinical Pharmacology, University of Split School of Medicine, 21000 Split, Croatia
| | - Ana Jerončić
- Laboratory of Vascular Aging, University of Split School of Medicine, 21000 Split, Croatia
- Department of Research in Biomedicine and Health, University of Split School of Medicine, 21000 Split, Croatia
- Correspondence:
| |
Collapse
|
9
|
Park JB, Sharman JE, Li Y, Munakata M, Shirai K, Chen CH, Jae SY, Tomiyama H, Kosuge H, Bruno RM, Spronck B, Kario K, Lee HY, Cheng HM, Wang J, Budoff M, Townsend R, Avolio AP. Expert Consensus on the Clinical Use of Pulse Wave Velocity in Asia. Pulse (Basel) 2022; 10:1-18. [PMID: 36660436 PMCID: PMC9843646 DOI: 10.1159/000528208] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Accepted: 11/10/2022] [Indexed: 11/23/2022] Open
Abstract
Arterial stiffness is a progressive aging process that predicts cardiovascular disease. Pulse wave velocity (PWV) has emerged as a noninvasive, valid, and reliable measure of arterial stiffness and an independent risk predictor for adverse outcomes. However, up to now, PWV measurement has mostly been used as a tool for risk prediction and has not been widely used in clinical practice. This consensus paper aims to discuss multiple PWV measurements currently available in Asia and to provide evidence-based assessment together with recommendations on the clinical use of PWV. For the methodology, PWV measurement including the central elastic artery is essential and measurements including both the central elastic and peripheral muscular arteries, such as brachial-ankle PWV and cardio-ankle vascular index, can be a good alternative. As Asian populations are rapidly aging, timely detection and intervention of "early vascular aging" in terms of abnormally high PWV values are recommended. More evidence is needed to determine if a PWV-guided therapeutic approach will be beneficial to the prevention of cardiovascular diseases beyond current strategies. Large-scale randomized controlled intervention studies are needed to guide clinicians.
Collapse
Affiliation(s)
- Jeong Bae Park
- JB Lab and Clinic, And Department of Precision Medicine and Biostatistics, Yonsei University, Wonju College of Medicine, Seoul, Republic of Korea
| | - James E. Sharman
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - Yan Li
- Shanghai Institute of Hypertension, Ruijin Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Masanori Munakata
- Research Center for Lifestyle-related Disease, Tohoku Rosai Hospital, Sendai, Japan
| | - Kohji Shirai
- Research Center, Seijinkai, Mihama Hospital, Chiba, Japan
| | - Chen-Huan Chen
- Department of Medicine, National Yang Ming Chiao Tung University College of Medicine, Taipei, Taiwan
| | - Sae Young Jae
- Department of Sport Science, University of Seoul, Seoul, Republic of Korea
| | | | - Hisanori Kosuge
- Department of Cardiology, Tokyo Medical University, Tokyo, Japan
| | - Rosa Maria Bruno
- Université Paris Cité, INSERM, PARCC, Paris, France
- Pharmacology Unit, AP-HP, Hôpital Européen Georges Pompidou, Paris, France
| | - Bart Spronck
- Department of Biomedical Engineering, CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, The Netherlands
- Macquarie Medical School, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, New South Wales, Australia
| | - Kazuomi Kario
- Department of Medicine, Jichi Medical University School of Medicine (JMU), Shimotsuke, Japan
| | - Hae Young Lee
- Department of Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Hao-Min Cheng
- Division of Faculty Development, Taipei Veterans General Hospital, Ph.D. Program of Interdisciplinary Medicine (PIM), National Yang Ming Chiao Tung University, College of Medicine, Taipei, Taiwan
| | - Jiguang Wang
- Shanghai Institute of Hypertension, Ruijin Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Matthew Budoff
- Department of Medicine, Lundquist Institute at Harbor-UCLA, Torrance, California, USA
| | - Raymond Townsend
- Department of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Alberto P. Avolio
- Macquarie Medical School, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, New South Wales, Australia
| |
Collapse
|
10
|
Liu B, Gao L, Zheng B, Yang Y, Jia J, Sun P, Jiang Y, Li K, Liu J, Chen C, Li J, Fan F, Zhang Y, Huo Y. Comparison of carotid-femoral and brachial-ankle pulse wave velocity in association with carotid plaque in a Chinese community-based population. J Clin Hypertens (Greenwich) 2022; 24:1568-1576. [PMID: 36428228 PMCID: PMC9731589 DOI: 10.1111/jch.14602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Revised: 10/20/2022] [Accepted: 11/04/2022] [Indexed: 11/28/2022]
Abstract
Pulse wave velocity (PWV) is the most widely used measurement of arterial stiffness in clinical practice. This study aimed to evaluate and compare the relationships between carotid-femoral pulse wave velocity (cfPWV) and brachial-ankle PWV (baPWV) and the presence of carotid plaque. This study was designed cross-sectionally and included 6027 participants from a community-based cohort in Beijing. Logistic regression analyses were performed to evaluate and compare the associations of cfPWV and baPWV with the presence of carotid plaque. The mean (SD) cfPWV and baPWV were 8.55 ± 1.83 and 16.79 ± 3.36, respectively. The prevalence of carotid plaque was 45.26% (n = 2728). Both cfPWV (per 1 m/s increase: OR = 1.11, 95% CI: 1.07-1.16) and baPWV (OR = 1.04, 95% CI: 1.02-1.06) were independently associated with carotid plaque after adjusting for various confounders. Compared with bottom quartile (cfPWV ≤7.31 m/s and baPWV ≤14.44 m/s), the top quartile of cfPWV and baPWV had a significantly higher prevalence of carotid plaque (for cfPWV: OR = 1.59, 95% CI: 1.32-1.92; for baPWV: OR = 1.53, 95% CI: 1.26-1.86). However, the relationship of baPWV and carotid plaque was nonlinear, with a positive trend only when baPWV < 16.85 m/s. When comparing relationships between PWV indices and carotid plaque in one model, both cfPWV and baPWV were significantly associated with carotid plaque in participants with baPWV < 16.85 m/s; however, only cfPWV was independently associated with carotid plaque in participants with baPWV ≥16.85 m/s. Both cfPWV and baPWV were significantly associated with carotid plaque in the Chinese community-based population. Furthermore, cfPWV was more strongly correlated with carotid plaque than baPWV in participants with baseline baPWV ≥16.85 m/s.
Collapse
Affiliation(s)
- Bo Liu
- Department of CardiologyPeking University First HospitalBeijingChina
| | - Lan Gao
- Department of CardiologyPeking University First HospitalBeijingChina
| | - Bo Zheng
- Department of CardiologyPeking University First HospitalBeijingChina,Institute of Cardiovascular DiseasePeking University First HospitalBeijingChina
| | - Ying Yang
- Department of CardiologyPeking University First HospitalBeijingChina,Echocardiography Core LabInstitute of Cardiovascular Disease at Peking University First HospitalBeijingChina
| | - Jia Jia
- Department of CardiologyPeking University First HospitalBeijingChina,Institute of Cardiovascular DiseasePeking University First HospitalBeijingChina
| | - Pengfei Sun
- Department of CardiologyPeking University First HospitalBeijingChina
| | - Yimeng Jiang
- Department of CardiologyPeking University First HospitalBeijingChina
| | - Kaiyin Li
- Department of CardiologyPeking University First HospitalBeijingChina
| | - Jiahui Liu
- Department of CardiologyPeking University First HospitalBeijingChina
| | - Chuyun Chen
- Department of CardiologyPeking University First HospitalBeijingChina
| | - Jianping Li
- Department of CardiologyPeking University First HospitalBeijingChina,Institute of Cardiovascular DiseasePeking University First HospitalBeijingChina
| | - Fangfang Fan
- Department of CardiologyPeking University First HospitalBeijingChina,Institute of Cardiovascular DiseasePeking University First HospitalBeijingChina
| | - Yan Zhang
- Department of CardiologyPeking University First HospitalBeijingChina,Institute of Cardiovascular DiseasePeking University First HospitalBeijingChina
| | - Yong Huo
- Department of CardiologyPeking University First HospitalBeijingChina,Institute of Cardiovascular DiseasePeking University First HospitalBeijingChina
| |
Collapse
|
11
|
Saigusa T, Watanabe K, Hada Y, Ishii K, Kameda W, Susa S, Ishizawa K, Ishihara H. Cardio-ankle vascular index is more closely associated than brachial-ankle pulse wave velocity with arterial damage and risk of cardiovascular disease in patients with diabetes. BMC Cardiovasc Disord 2022; 22:365. [PMID: 35945498 PMCID: PMC9364514 DOI: 10.1186/s12872-022-02800-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2021] [Accepted: 08/02/2022] [Indexed: 11/15/2022] Open
Abstract
Background This study aimed to compare the usefulness of arterial stiffness parameters, cardio-ankle vascular index (CAVI) and brachial-ankle pulse wave velocity (baPWV), for evaluating arterial damage and risk of cardiovascular disease (CVD) in subjects with diabetes. Methods The study subjects were 277 patients with type 1 or type 2 diabetes. All subjects were evaluated for vascular stiffness using CAVI (n = 154) or baPWV (n = 123). Carotid intima-media thickness (IMT) and the Suita score were also measured because these are established risk factors for future CVD. Associations of both CAVI and baPWV with these established parameters were evaluated in all subjects, and then in 174 subjects with adjustment for covariates by using propensity score matching. Results In all subjects, CAVI and baPWV correlated significantly with both IMT (r = 0.462, P < 0.001, and r = 0.212, P = 0.019, respectively) and the Suita score (r = 0.573, P < 0.001, and r = 0.373, P < 0.001, respectively). The correlation between CAVI and IMT was more significant than that between baPWV and IMT (Z = 2.33, P = 0.020). Similarly, the correlation between CAVI and the Suita score was more significant than that between baPWV and the Suita score (Z = 2.13, P = 0.033). After adjustment by propensity score matching, significant correlations between CAVI and IMT (r = 0.432 P < 0.001) and between CAVI and the Suita score (r = 0.544, P < 0.001) were preserved, though only the association between baPWV and the Suita score was significant (r = 0.289, P = 0.007) while that between baPWV and IMT showed no significance. Again, CAVI showed a significant association with the Suita score than baPWV (Z = 2.02, P = 0.043). Conclusions CAVI is more closely associated than baPWV with arterial damage and risk of CVD in patients with diabetes. Supplementary Information The online version contains supplementary material available at 10.1186/s12872-022-02800-9.
Collapse
Affiliation(s)
- Taro Saigusa
- Division of Diabetes and Metabolic Diseases, Department of Internal Medicine, Nihon University School of Medicine, 30-1 Oyaguchikami-cho, Itabashi-ku, 173-8610, Tokyo, Japan
| | - Kentaro Watanabe
- Division of Diabetes and Metabolic Diseases, Department of Internal Medicine, Nihon University School of Medicine, 30-1 Oyaguchikami-cho, Itabashi-ku, 173-8610, Tokyo, Japan. .,Department of Neurology, Hematology, Metabolism, Endocrinology and Diabetology, Yamagata University Faculty of Medicine, 2-2-2 Iida-nishi, 990-9585, Yamagata, Japan.
| | - Yurika Hada
- Department of Neurology, Hematology, Metabolism, Endocrinology and Diabetology, Yamagata University Faculty of Medicine, 2-2-2 Iida-nishi, 990-9585, Yamagata, Japan
| | - Kota Ishii
- Department of Neurology, Hematology, Metabolism, Endocrinology and Diabetology, Yamagata University Faculty of Medicine, 2-2-2 Iida-nishi, 990-9585, Yamagata, Japan
| | - Wataru Kameda
- Department of Neurology, Hematology, Metabolism, Endocrinology and Diabetology, Yamagata University Faculty of Medicine, 2-2-2 Iida-nishi, 990-9585, Yamagata, Japan
| | - Shinji Susa
- Department of Neurology, Hematology, Metabolism, Endocrinology and Diabetology, Yamagata University Faculty of Medicine, 2-2-2 Iida-nishi, 990-9585, Yamagata, Japan
| | - Kenichi Ishizawa
- Department of Neurology, Hematology, Metabolism, Endocrinology and Diabetology, Yamagata University Faculty of Medicine, 2-2-2 Iida-nishi, 990-9585, Yamagata, Japan
| | - Hisamitsu Ishihara
- Division of Diabetes and Metabolic Diseases, Department of Internal Medicine, Nihon University School of Medicine, 30-1 Oyaguchikami-cho, Itabashi-ku, 173-8610, Tokyo, Japan
| |
Collapse
|
12
|
Chao H, He Y, Wang Q, Bai Y, Avolio A, Deng X, Zuo J. Comparison of Influence of Blood Pressure and Carotid-Femoral Pulse Wave Velocity on Target Organ Damage in Hypertension. Front Cardiovasc Med 2022; 9:934747. [PMID: 35865385 PMCID: PMC9294321 DOI: 10.3389/fcvm.2022.934747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Accepted: 06/15/2022] [Indexed: 11/13/2022] Open
Abstract
Objectives Assessment of target organ damage (TOD) is an important part of the diagnosis and evaluation of hypertension. Carotid-femoral pulse wave velocity (cf-PWV) is considered to be the gold-standard for noninvasive arterial stiffness assessment. This study aims to analyze the risk of TOD in people with different phenotypes of peripheral blood pressure and cf-PWV. Methods The study cohort was recruited from December 2017 to September 2021 at Ruijin Hospital in Shanghai. It was divided into 4 groups according to peripheral blood pressure (pBP) and cf-PWV. TOD was assessed as carotid intima-media thickness (CIMT), chronic kidney disease (CKD), urinary albumin-creatinine ratio (ACR), estimated glomerular filtration rate (eGFR) and left ventricular mass index (LVMI). Results A total of 1,257 subjects (mean age 53.13 ± 12.65 years, 64.2% males) was recruited. Age, body mass index (BMI) and fasting blood glucose (FBG), as well as peripheral systolic blood pressure (pSBP), peripheral diastolic blood pressure (pDBP), peripheral pulse pressure (pPP) were significantly different in the four groups (P < 0.01). eGFR, ACR, LVMI and CIMT were significantly different among different groups (P < 0.01). The risk of ACR abnormality was significantly higher in the group with elevated pBP (P = 0.005, OR 2.264, 95%CI 1.277–4.016; and in the group with elevated pBP and cf-PWV (P = 0.003, OR 1.482, 95%CI 1.144–1.920), while left ventricular hypertrophy (LVH) was significantly higher in the group with elevated cf-PWV (P = 0.002, OR 1.868, 95%CI 1.249–2.793). Conclusion Different profiles based on the status of PBP and cf-PWV associated with different TOD. Individuals with higher pBP have an increased risk of ACR abnormality, while individuals with only cf-PWV elevated have a higher risk of LVH.
Collapse
Affiliation(s)
- Huijuan Chao
- Department of Geriatrics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yan He
- Department of Cardiovascular Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Qian Wang
- Department of Geriatrics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yaya Bai
- Department of Geriatrics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Alberto Avolio
- Macquarie Medical School, Faculty of Medicine Health and Human Sciences, Macquarie University, Sydney, NSW, Australia
| | - Xueqin Deng
- Department of Geriatrics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Xueqin Deng
| | - Junli Zuo
- Department of Geriatrics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Macquarie Medical School, Faculty of Medicine Health and Human Sciences, Macquarie University, Sydney, NSW, Australia
- *Correspondence: Junli Zuo
| |
Collapse
|
13
|
Piotrowicz K, Klich-Rączka A, Skalska A, Gryglewska B, Grodzicki T, Gąsowski J. Pulse Wave Velocity and Sarcopenia in Older Persons-A Systematic Review and Meta-Analysis. Int J Environ Res Public Health 2022; 19. [PMID: 35682063 DOI: 10.3390/ijerph19116477] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Revised: 05/21/2022] [Accepted: 05/23/2022] [Indexed: 01/27/2023]
Abstract
Sarcopenia and cardiovascular disease share some of the pathophysiologic mechanisms. Sarcopenia is likewise an important feature of frailty and the one potentially related to cardiovascular pathology. Previously, the relationship between arterial stiffness and frailty has been established. In this study, we conducted a systematic review and a meta-analysis of studies where the relationship between pulse wave velocity (PWV) and sarcopenia has been addressed. We included six cross-sectional studies that enrolled 5476 participants. Using the WebPlotDigitizer, RevMan5, and SAS 9.4, we extracted or calculated the summary statistics. We then calculated standardized mean differences (SMD) of PWV in the sarcopenic and non-sarcopenic participants. The pooled SMD was 0.73 (95% CI 0.39−1.08, p < 0.0001, I2 = 90%) indicating higher value in the sarcopenic subjects. The three studies that presented odds ratios for sarcopenia as a function of PWV homogenously indicated a greater probability of concomitant sarcopenia with higher values of PWV. Greater stiffness of the aorta is associated with sarcopenia. It is impossible to establish the causation. However, the plausible explanation is that increased stiffness may translate into or be an intermediary phenotype of common vascular and muscle damage. On the other hand, sarcopenia, which shares some of the inflammatory mechanisms with cardiovascular disease, may wind up the age-related large arterial remodeling.
Collapse
|
14
|
Wang T, Fan F, Gong Y, Gao L, Liu Z, Jia J, Liu M, Jiang Y, Zhang Y, Li J. Comparison of brachial-ankle pulse wave velocity and carotid-femoral pulse wave velocity in association with albuminuria in a community of Beijing: a cross-sectional study. J Hum Hypertens 2022; 37:412-418. [PMID: 35474137 DOI: 10.1038/s41371-022-00697-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2021] [Revised: 03/15/2022] [Accepted: 04/12/2022] [Indexed: 11/09/2022]
Abstract
This study was performed to investigate and compare the association of albuminuria with the brachial-ankle pulse wave velocity (baPWV) and carotid-femoral pulse wave velocity (cfPWV) in a community-based population in Beijing. Subjects were enrolled from a follow-up survey conducted in 2018 from an atherosclerosis cohort in Shijingshan district, Beijing, China. The baPWV and cfPWV were measured using a BP-203 RPE III arteriosclerosis detection device and PulsePen, respectively. Albuminuria was defined as a urinary albumin-creatinine ratio of ≥30 mg/g. A multivariate logistic regression model was used to evaluate the impacts of different PWV measurements on the prevalence of albuminuria. In total, 5605 subjects were included in the analyses. Their mean age was 62.22 ± 7.55 years, and the prevalence of albuminuria was 8.22%. In the multivariate logistic regression model adjusted for potential covariates, both baPWV (odds ratio [OR], 1.06; 95% confidence interval [CI], 1.03-1.10; P < 0.001) and cfPWV (OR, 1.07; 95% CI, 1.01-1.14; P = 0.018) were significantly associated with albuminuria. Furthermore, when baPWV and cfPWV were entered into the logistic regression model simultaneously, only baPWV was significantly associated with albuminuria using either continuous value (OR, 1.05; 95% CI, 1.01-1.10; P = 0.007) or classified into quartiles (highest vs. lowest value group: OR, 1.55; 95% CI, 1.01-2.37; P for trend = 0.019). Both cfPWV and baPWV were positively associated with albuminuria, while baPWV had a stronger relationship than cfPWV. Thus, baPWV measurement could be considered for the purpose of community health screening.
Collapse
Affiliation(s)
- Ting Wang
- Department of Cardiology, Peking University First Hospital, Beijing, People's Republic of China.,Institute of Cardiovascular Disease, Peking University First Hospital, Beijing, People's Republic of China
| | - Fangfang Fan
- Department of Cardiology, Peking University First Hospital, Beijing, People's Republic of China.,Institute of Cardiovascular Disease, Peking University First Hospital, Beijing, People's Republic of China
| | - Yanjun Gong
- Department of Cardiology, Peking University First Hospital, Beijing, People's Republic of China.,Institute of Cardiovascular Disease, Peking University First Hospital, Beijing, People's Republic of China
| | - Lan Gao
- Department of Cardiology, Peking University First Hospital, Beijing, People's Republic of China.,Institute of Cardiovascular Disease, Peking University First Hospital, Beijing, People's Republic of China
| | - Zhihao Liu
- Department of Cardiology, Peking University First Hospital, Beijing, People's Republic of China.,Institute of Cardiovascular Disease, Peking University First Hospital, Beijing, People's Republic of China
| | - Jia Jia
- Department of Cardiology, Peking University First Hospital, Beijing, People's Republic of China.,Institute of Cardiovascular Disease, Peking University First Hospital, Beijing, People's Republic of China
| | - Mengyuan Liu
- Department of Cardiology, Peking University First Hospital, Beijing, People's Republic of China.,Institute of Cardiovascular Disease, Peking University First Hospital, Beijing, People's Republic of China
| | - Yimeng Jiang
- Department of Cardiology, Peking University First Hospital, Beijing, People's Republic of China.,Institute of Cardiovascular Disease, Peking University First Hospital, Beijing, People's Republic of China
| | - Yan Zhang
- Department of Cardiology, Peking University First Hospital, Beijing, People's Republic of China. .,Institute of Cardiovascular Disease, Peking University First Hospital, Beijing, People's Republic of China.
| | - Jianping Li
- Department of Cardiology, Peking University First Hospital, Beijing, People's Republic of China. .,Institute of Cardiovascular Disease, Peking University First Hospital, Beijing, People's Republic of China.
| |
Collapse
|
15
|
Bai Y, Wang Q, Cheng D, Hu Y, Chao H, Avolio A, Tang B, Zuo J. Comparison of Risk of Target Organ Damage in Different Phenotypes of Arterial Stiffness and Central Aortic Blood Pressure. Front Cardiovasc Med 2022; 9:839875. [PMID: 35497999 PMCID: PMC9046870 DOI: 10.3389/fcvm.2022.839875] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Accepted: 03/14/2022] [Indexed: 11/18/2022] Open
Abstract
Objectives The aim of this study was to explore the risk of target organ damage (TOD) in different groups based on carotid-femoral pulse wave velocity (cfPWV) and central aortic blood pressure (CBP) in different populations. Methods The study cohort was divided into four groups according to the status of cfPWV and CBP [Group (cfPWV/CBP): high cfPWV and high CBP; Group (cfPWV): high cfPWV and normal CBP; Group (CBP): normal cfPWV and high CBP; Group (control): normal cfPWV and normal CBP]. TOD was determined by the assessment of carotid intima-media thickness (CIMT) abnormality, chronic kidney disease (CKD), microalbuminuria, and left ventricular hypertrophy (LVH). Results A total of 1,280 patients (mean age 53.14 ± 12.76 years, 64.1% male patients) were recruited in this study. Regarding Group (control) as reference, LVH was significantly higher in Group (cfPWV) and Group (CBP) [OR 2.406, 95% CI (1.301–4.452), P < 0.05; OR 2.007, 95% CI (1.335–3.017), P < 0.05]; microalbuminuria was significantly higher in Group (cfPWV/CBP) and Group (CBP) [OR 3.219, 95% CI (1.630–6.359), P < 0.05; OR 3.156, 95% CI (1.961–5.079), P < 0.05]. With age stratified by 60 years, the risk of CKD was significantly higher in Group (cfPWV/CBP) [OR 4.019, 95% CI (1.439–11.229), P < 0.05]. Conclusion Different phenotypes based on the status of cfPWV and CBP were associated with different TOD. Individuals with both cfPWV and CBP elevated have a higher risk of microalbuminuria.
Collapse
Affiliation(s)
- Yaya Bai
- Department of Geriatrics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Qian Wang
- Department of Geriatrics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Di Cheng
- Department of Geriatrics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yueliang Hu
- Department of Geriatrics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Huijuan Chao
- Department of Geriatrics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Alberto Avolio
- Department of Biomedical Sciences, Faculty of Medicine, Health and Human Sciences, Macquarie (University) Medical School, Sydney, NSW, Australia
| | - Biwen Tang
- Department of Geriatrics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- *Correspondence: Biwen Tang
| | - Junli Zuo
- Department of Geriatrics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Department of Biomedical Sciences, Faculty of Medicine, Health and Human Sciences, Macquarie (University) Medical School, Sydney, NSW, Australia
- Junli Zuo
| |
Collapse
|
16
|
He D, Gao L, Yang Y, Jia J, Jiang Y, Sun P, Liu B, Li J, Fan F, Zhang Y, Huo Y. Brachial-ankle pulse wave velocity as a measurement for increased carotid intima-media thickness: A comparison with carotid-femoral pulse wave velocity in a Chinese community-based cohort. J Clin Hypertens (Greenwich) 2022; 24:409-417. [PMID: 35213771 PMCID: PMC8989757 DOI: 10.1111/jch.14448] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Revised: 02/01/2022] [Accepted: 02/11/2022] [Indexed: 01/02/2023]
Abstract
Carotid‐femoral pulse wave velocity (cfPWV) and brachial‐ankle pulse wave velocity (baPWV) act as two most frequently applied indicators to evaluate arterial stiffness. Limited studies have systematically compared the relationships between cfPWV/baPWV and increased carotid intima‐media thickness (cIMT). This study aimed to investigate the associations of the two PWV indices with cIMT in a Chinese community‐based population. A total of 6026 Chinese participants from an atherosclerosis cohort were included in our analysis. Increased cIMT was defined as the maximum of cIMT > 0.9 mm in end‐systolic period of carotid artery. Mean (SD) cfPWV and baPWV were 8.55±1.83 and 16.79±3.35 m/s, respectively. The prevalence of increased cIMT was 59.58%. In multivariable logistic regression, both PWVs were independently associated with increased cIMT after adjustment for various confounders (for 1 m/s increase of cfPWV: OR = 1.07, 95% CI: 1.02‐1.11; for 1 m/s increase of baPWV: OR = 1.03, 95% CI: 1.00‐1.05). The highest cfPWV and baPWV quartile groups had higher prevalence of increased cIMT when compared with the lowest quartile groups (for cfPWV: OR = 1.28, 95% CI: 1.06‐1.55; for baPWV: OR = 1.23, 95% CI: 1.00‐1.50). However, when both PWVs were added into multivariable model simultaneously, only cfPWV was associated with odds of increased cIMT. Subgroup analyses further showed cfPWV was more strongly associated with increased cIMT than baPWV in males, participants aged ≥65 years, and those with other cardiovascular risk factors. In conclusion, both cfPWV and baPWV are associated with increased cIMT in a Chinese community‐based population. Furthermore, cfPWV is more strongly correlated with increased cIMT compared to baPWV.
Collapse
Affiliation(s)
- Danmei He
- Department of Cardiology, Peking University First Hospital, Beijing, China
| | - Lan Gao
- Department of Cardiology, Peking University First Hospital, Beijing, China
| | - Ying Yang
- Department of Cardiology, Peking University First Hospital, Beijing, China.,Echocardiography Core Lab, Institute of Cardiovascular Disease at Peking University First Hospital, Beijing, China
| | - Jia Jia
- Department of Cardiology, Peking University First Hospital, Beijing, China.,Institute of Cardiovascular Disease, Peking University First Hospital, Beijing, China
| | - Yimeng Jiang
- Department of Cardiology, Peking University First Hospital, Beijing, China
| | - Pengfei Sun
- Department of Cardiology, Peking University First Hospital, Beijing, China
| | - Bo Liu
- Department of Cardiology, Peking University First Hospital, Beijing, China
| | - Jianping Li
- Department of Cardiology, Peking University First Hospital, Beijing, China.,Institute of Cardiovascular Disease, Peking University First Hospital, Beijing, China
| | - Fangfang Fan
- Department of Cardiology, Peking University First Hospital, Beijing, China.,Institute of Cardiovascular Disease, Peking University First Hospital, Beijing, China
| | - Yan Zhang
- Department of Cardiology, Peking University First Hospital, Beijing, China.,Institute of Cardiovascular Disease, Peking University First Hospital, Beijing, China
| | - Yong Huo
- Department of Cardiology, Peking University First Hospital, Beijing, China
| |
Collapse
|
17
|
Bernardi S, Grillo A, Antonello RM, Cola MF, Dobrinja C, Fabris B, Giudici F. Meta-analysis on the association between thyroid hormone disorders and arterial stiffness. J Endocr Soc 2022; 6:bvac016. [PMID: 35284772 PMCID: PMC8907416 DOI: 10.1210/jendso/bvac016] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Indexed: 11/23/2022] Open
Abstract
Context Aortic stiffness is an emerging predictor of cardiovascular morbidity and mortality. Current data about the effect of subclinical and overt thyroid hormone disorders on aortic stiffness are often conflicting. Objective Primary outcome was to investigate if subclinical and overt thyroid hormone disorders were associated with aortic stiffness. Secondary outcome was to identify disease effect modifiers. Methods Data sources were PubMed, Google Scholar, SCOPUS, Web of Sciences, and the Cochrane Library. Eligible studies included reports of pulse wave velocity (PWV), which is the gold standard method for measuring aortic stiffness, in patients with subclinical and overt thyroid disorders. Two investigators independently identified eligible studies and extracted data. Pooled mean difference was the summary effect measure. Data were presented in forest plots with outlier and influential case diagnostics. Univariate meta-regression analysis was used to identify effect modifiers. Results Eleven observational studies were selected, including 1239 patients with subclinical hypothyroidism, 81 patients with overt hypothyroidism, 338 patients with thyrotoxicosis, and 12 715 controls. PWV was significantly higher in subclinical (P < .001) and overt hypothyroidism (P < .001), as well as in patients with thyrotoxicosis (P = .027) compared with controls. Age was an effect modifier in hypothyroid patients. Conclusion This study shows that both overt and subclinical hypothyroidism as well as thyrotoxicosis were associated with an increase of aortic stiffness. The impact of treatment of these conditions on aortic stiffness should be assessed in clinical trials.
Collapse
Affiliation(s)
- Stella Bernardi
- Department of Medical Sciences, University of Trieste, Trieste, Italy
- Operative Unit of Medicina Clinica, ASUGI (Azienda Sanitaria Universitaria Giuliano Isontina), Cattinara Hospital, Trieste, Italy
| | - Andrea Grillo
- Department of Medical Sciences, University of Trieste, Trieste, Italy
- Operative Unit of Medicina Clinica, ASUGI (Azienda Sanitaria Universitaria Giuliano Isontina), Cattinara Hospital, Trieste, Italy
| | | | - Marco Fabio Cola
- Department of Medical Sciences, University of Trieste, Trieste, Italy
| | - Chiara Dobrinja
- Department of Medical Sciences, University of Trieste, Trieste, Italy
- Operative Unit of Chirurgia Generale, ASUGI (Azienda Sanitaria Universitaria Giuliano Isontina), Cattinara Hospital, Trieste, Italy
| | - Bruno Fabris
- Department of Medical Sciences, University of Trieste, Trieste, Italy
- Operative Unit of Medicina Clinica, ASUGI (Azienda Sanitaria Universitaria Giuliano Isontina), Cattinara Hospital, Trieste, Italy
| | - Fabiola Giudici
- Department of Medical Sciences, University of Trieste, Trieste, Italy
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Padova, Italy
| |
Collapse
|
18
|
Huang M, Li J, Zhao X, Chen S, Li X, Jiang W. Relationship between vascular ageing and left ventricular geometry in patients with newly diagnosed primary aldosteronism. Front Endocrinol (Lausanne) 2022; 13:961882. [PMID: 36004338 PMCID: PMC9393336 DOI: 10.3389/fendo.2022.961882] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2022] [Accepted: 07/18/2022] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Changes in left ventricular (LV) geometry are early manifestations of cardiac damage. The relationship between vascular aging and LV geometry has been reported. However, in newly diagnosed primary aldosteronism (PA), with more severe target organ damage than essential hypertension, the relationship between vascular aging and LV geometry has never been described. METHODS We conducted a retrospective study among newly diagnosed PA from 1 January 2017 to 30 September 2021 at the Third Xiangya Hospital. The data of vascular aging parameters were collected, including ankle-brachial index (ABI), brachial-ankle pulse wave velocity (baPWV), and carotid intima-media thickness (cIMT). Echocardiography data were collected to assess LV geometry patterns. RESULTS A total of 146 patients with newly diagnosed PA were included. The mean age was 44.77 ± 9.79 years, and 46.58% participants were women. Linear regression analysis adjusting all potential confounders showed that cIMT was significantly associated with LV mass index (LVMI) (β=0.164, P=0.028) and baPWV was significantly associated with relative wall thickness (RWT) (β= 0.00005, P=0.025). Multifactorial adjusted logistic regression analysis demonstrated that cIMT was significantly associated with LV hypertrophy (LVH) (OR=7.421, 95%CI: 1.717-815.688, P=0.021) and baPWV was significantly associated with LV concentric geometry (LVCG) (OR=1.003, 95%CI: 1.001-1.006, P=0.017). CONCLUSION baPWV was significantly associated with LVCG and cIMT was significantly associated with LVH in newly diagnosed PA. This study provides insights on the importance of baPWV measurement and cIMT measurement in early assessment of cardiac damage in newly diagnosed PA.
Collapse
Affiliation(s)
| | | | | | | | - Xiaogang Li
- *Correspondence: Xiaogang Li, ; Weihong Jiang,
| | | |
Collapse
|
19
|
Alonso-Domínguez R, Sánchez-Aguadero N, Patino-Alonso MC, Agudo-Conde C, de Cabo-Laso Á, Gómez-Sánchez M, Gómez-Sánchez L, Rodríguez-Sánchez E, García-Ortiz L, Gómez-Marcos MA. Association between measurements of arterial stiffness and target organ damage in a general Spanish population. Ann Med 2021; 53:345-356. [PMID: 33533280 PMCID: PMC7877984 DOI: 10.1080/07853890.2021.1881812] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2020] [Accepted: 01/21/2021] [Indexed: 11/29/2022] Open
Abstract
INTRODUCTION Little is known about the relationship between arterial stiffness and cardiovascular target organ damage (TOD) in the general population. The aim was to analyse the relationship between different measurements of arterial stiffness and TOD, in a general Spanish population without a history of cardiovascular event. MATERIALS AND METHODS Transversal descriptive study. Through stratified random sampling, a total of 501 individuals were included. Carotid-femoral pulse wave velocity (cf-PWV) was measured using a SphygmoCor System®, the cardio-ankle vascular index (CAVI) was determined with aVasera VS-1500® and brachial-ankle pulse wave velocity (ba-PWV)was calculated through a validated equation. RESULTS The average age was 55.84 ± 14.26.The percentage of vascular TOD, left ventricular hypertrophy (LVH) and renal TOD was higher in men (p < .001). A positive correlation was obtained between carotid intima-media thickness (c-IMT) and the measurements of vascular function. In the model 1 of the logistic regression analysis, cf-PWV was associated with vascular TOD (OR = 1.15, p = .040), ba-PWV was associated with vascular TOD (OR = 1.20, p = .010) and LVH (OR = 1.12, p = .047). CONCLUSIONS The different measurements of arterial stiffness are highly associated with each other. Moreover, cf-PWV and ba-PWV were associated with vascular TOD, and ba-PWV with LVH, although they disappear when adjusting for cardiovascular risk factors. Key Messages There is a strong correlation between the different measurements of vascular structure and function. Carotid-femoral and brachial-ankle pulse wave velocity were positively associated with vascular target organ damage, the latter was also positively associated with left ventricular hypertrophy. This associations disappear when adjusting for cardiovascular risk factors.
Collapse
Affiliation(s)
- Rosario Alonso-Domínguez
- Biomedical Research Institute of Salamanca (IBSAL), Primary Care Research Unit of Salamanca (APISAL), Health Service of Castile and Leon (SACyL), Salamanca, Spain
- Department of Nursing and Physiotherapy, University of Salamanca, Salamanca, Spain
| | - Natalia Sánchez-Aguadero
- Biomedical Research Institute of Salamanca (IBSAL), Primary Care Research Unit of Salamanca (APISAL), Health Service of Castile and Leon (SACyL), Salamanca, Spain
- Department of Nursing and Physiotherapy, University of Salamanca, Salamanca, Spain
| | - María C. Patino-Alonso
- Biomedical Research Institute of Salamanca (IBSAL), Primary Care Research Unit of Salamanca (APISAL), Health Service of Castile and Leon (SACyL), Salamanca, Spain
- Department of Statistics, University of Salamanca, Salamanca, Spain
| | - Cristina Agudo-Conde
- Biomedical Research Institute of Salamanca (IBSAL), Primary Care Research Unit of Salamanca (APISAL), Health Service of Castile and Leon (SACyL), Salamanca, Spain
| | - Ángela de Cabo-Laso
- Biomedical Research Institute of Salamanca (IBSAL), Primary Care Research Unit of Salamanca (APISAL), Health Service of Castile and Leon (SACyL), Salamanca, Spain
| | - Marta Gómez-Sánchez
- Biomedical Research Institute of Salamanca (IBSAL), Primary Care Research Unit of Salamanca (APISAL), Health Service of Castile and Leon (SACyL), Salamanca, Spain
| | - Leticia Gómez-Sánchez
- Biomedical Research Institute of Salamanca (IBSAL), Primary Care Research Unit of Salamanca (APISAL), Health Service of Castile and Leon (SACyL), Salamanca, Spain
| | - Emiliano Rodríguez-Sánchez
- Biomedical Research Institute of Salamanca (IBSAL), Primary Care Research Unit of Salamanca (APISAL), Health Service of Castile and Leon (SACyL), Salamanca, Spain
- Iberian Network on Arterial Structure, Central Hemodynamics and Neurocognition, Portugal and Spain
- Department of Medicine, University of Salamanca, Salamanca, Spain
| | - Luis García-Ortiz
- Biomedical Research Institute of Salamanca (IBSAL), Primary Care Research Unit of Salamanca (APISAL), Health Service of Castile and Leon (SACyL), Salamanca, Spain
- Iberian Network on Arterial Structure, Central Hemodynamics and Neurocognition, Portugal and Spain
- Department of Medicine, University of Salamanca, Salamanca, Spain
- Department of Biomedical and Diagnostic Sciences, University of Salamanca, Salamanca, Spain
| | - Manuel A. Gómez-Marcos
- Biomedical Research Institute of Salamanca (IBSAL), Primary Care Research Unit of Salamanca (APISAL), Health Service of Castile and Leon (SACyL), Salamanca, Spain
- Iberian Network on Arterial Structure, Central Hemodynamics and Neurocognition, Portugal and Spain
- Department of Medicine, University of Salamanca, Salamanca, Spain
| | | |
Collapse
|
20
|
Lyu Y, Yu S, Chi C, Teliewubai J, Li J, Blacher J, Pu J, Zhang Y, Xu Y. Associations of Walking Activity With Hypertensive Mediated Organ Damage in Community-Dwelling Elderly Chinese: The Northern Shanghai Study. Front Cardiovasc Med 2021; 8:734766. [PMID: 34746252 PMCID: PMC8566667 DOI: 10.3389/fcvm.2021.734766] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Accepted: 09/13/2021] [Indexed: 11/26/2022] Open
Abstract
Background: Walking, as the most common campaign in older people, is recommended to improve their cardiovascular health. However, the direct association between weekly walking activity and asymptomatic hypertensive mediated organ damage (HMOD) remains unclear. Methods: 2,830 community-dwelling elderly subjects (over 65 years) in northern Shanghai were recruited from 2014 to 2018. Weekly walking activity was assessed by International Physical Activity Questionnaires (IPAQ). Within the framework of comprehensive cardiovascular examinations, HMOD, including left ventricular mass index, peak transmitral pulsed Doppler velocity/early diastolic tissue Doppler velocity, creatinine clearance rate, urinary albumin–creatinine ratio, carotid-femoral pulse wave velocity (cf-PWV), carotid intima–media thickness (CIMT), arterial plaque, and ankle-brachial index (ABI), were all evaluated. Results: 1,862 (65.8%) participants with weekly walking activity showed lower CIMT, lower cf-PWV, fewer abnormal ABI, and lower prevalence of hypertension and coronary heart disease (p < 0.05). Walking activity was negatively correlated with age and smokers (correlation coefficient: −0.066, −0.042; both p < 0.05). After adjusting for cardiovascular risk factors and concomitant diseases, walking activity was significantly associated with better indicator of most vascular HMOD in multivariate logistic regressions, including arterial stiffness [odds ratio (OR) = 0.75, p = 0.01], increased CIMT (OR = 0.70, p = 0.03), and peripheral artery disease (OR = 0.72, p = 0.005), but not cardiac or renal HMOD. Subgroup analysis further showed that walking duration ≥1 h/day was significantly associated with decreased risk of most vascular HMOD after adjustment for confounders and moderate-to-vigorous physical activity based on IPAQ (all p < 0.05). Conclusions: In the community-dwelling elderly Chinese, there was a significant negative association of weekly walking activity with vascular HMOD, but not cardiac or renal HMOD. Increased daily walking duration, but not walking frequency, was significantly associated with improved vascular HMOD. Hence, increasing daily walking duration seems to encourage a healthy lifestyle in terms of vascular protection. Clinical Trial Registration:ClinicalTrials.gov, identifier: NCT02368938.
Collapse
Affiliation(s)
- Yuyan Lyu
- Department of Cardiology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Shikai Yu
- Department of Cardiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China
| | - Chen Chi
- Department of Cardiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China
| | - Jiadela Teliewubai
- Department of Cardiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China
| | - Jue Li
- Department of Prevention, Tongji University School of Medicine, Shanghai, China.,Key Laboratory of Arrhythmias, Ministry of Education, Tongji University School of Medicine, Shanghai, China
| | - Jacques Blacher
- Department of Therapeutics, Paris-Descartes University, Paris, France.,AP-HP, Paris, France.,Diagnosis and Therapeutic Center, Hôtel-Dieu, Paris, France
| | - Jun Pu
- Department of Cardiology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Yi Zhang
- Department of Cardiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China
| | - Yawei Xu
- Department of Cardiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China
| |
Collapse
|
21
|
Kwak S, Kim HL, In M, Lim WH, Seo JB, Kim SH, Zo JH, Kim MA. Associations of Brachial-Ankle Pulse Wave Velocity With Left Ventricular Geometry and Diastolic Function in Untreated Hypertensive Patients. Front Cardiovasc Med 2021; 8:647491. [PMID: 34041281 PMCID: PMC8143267 DOI: 10.3389/fcvm.2021.647491] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Accepted: 04/13/2021] [Indexed: 11/23/2022] Open
Abstract
Background: Although brachial-ankle pulse wave velocity (baPWV) is simple and convenient, its usefulness as an initial screening test for hypertensive patients is not well-known. This study aimed to investigate the association of baPWV with left ventricular (LV) geometry and diastolic function in treatment-naive hypertensive patients. Methods: A total of 202 untreated hypertensive patients (mean age, 62 years; males, 51.5%) without documented cardiovascular diseases were prospectively enrolled. Both baPWV and transthoracic echocardiography were performed on the same day before antihypertensive treatment. Results: In multiple linear regression analysis after adjustment for potential confounders, baPWV had significant correlations with structural measurements of LV including relative wall thickness (β = 0.219, P = 0.021) and LV mass index (β = 0.286, P = 0.002), and four diastolic parameters including septal e′ velocity (β = −0.199, P = 0.018), E/e′ (β = 0.373, P < 0.001), left atrial volume index (β = 0.334, P < 0.001), and maximal velocity of tricuspid regurgitation (β = 0.401, P < 0.001). The baPWV was significantly increased in patients with LV hypertrophy, abnormal LV remodeling, or diastolic dysfunction, compared to those without (P = 0.008, P = 0.035, and P < 0.001, respectively). In the receiver operating characteristic curve analysis, the discriminant ability of baPWV in predicting LV hypertrophy and diastolic dysfunction had an area under the curve of 0.646 (95% confidence interval 0.544–0.703, P = 0.004) and 0.734 (95% confidence interval 0.648–0.800, P < 0.001), respectively. Conclusion: baPWV was associated with parameters of LV remodeling and diastolic function in untreated hypertensive patients. The baPWV could be a useful screening tool for the early detection of adverse cardiac features among untreated hypertensive patients.
Collapse
Affiliation(s)
- Soongu Kwak
- Division of Cardiology, Department of Internal Medicine, Boramae Medical Center, Seoul National University College of Medicine, Seoul, South Korea
| | - Hack-Lyoung Kim
- Division of Cardiology, Department of Internal Medicine, Boramae Medical Center, Seoul National University College of Medicine, Seoul, South Korea
| | - Minjae In
- Seoul National University College of Medicine, Seoul, South Korea
| | - Woo-Hyun Lim
- Division of Cardiology, Department of Internal Medicine, Boramae Medical Center, Seoul National University College of Medicine, Seoul, South Korea
| | - Jae-Bin Seo
- Division of Cardiology, Department of Internal Medicine, Boramae Medical Center, Seoul National University College of Medicine, Seoul, South Korea
| | - Sang-Hyun Kim
- Division of Cardiology, Department of Internal Medicine, Boramae Medical Center, Seoul National University College of Medicine, Seoul, South Korea
| | - Joo-Hee Zo
- Division of Cardiology, Department of Internal Medicine, Boramae Medical Center, Seoul National University College of Medicine, Seoul, South Korea
| | - Myung-A Kim
- Division of Cardiology, Department of Internal Medicine, Boramae Medical Center, Seoul National University College of Medicine, Seoul, South Korea
| |
Collapse
|
22
|
Fang H, Liu C, Cavdar O. The relation between submaximal aerobic exercise improving vascular elasticity through loss of visceral fat and antihypertensive. Clin Exp Hypertens 2021; 43:203-210. [PMID: 33233955 DOI: 10.1080/10641963.2020.1847127] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Purpose: We sought to observe the effect of submaximal aerobic exercise on abdominal obesity in hypertension patients and to clarify a correlation between blood pressure improvement and visceral fat, along with arterial elasticity. Materials and Methods: According to the treatment plan, the patients were divided into two groups: the combined treatment group and the single drug group. During the training period, the subjects in the combined treatment group performed a 60 min treadmill exercise at 65% of Pmax. PWV was measured using blood pressure pulse-wave detectors before and after treatment. We assessed carotid stiffness and visceral fat area by B‑mode ultrasonography. Results: The 24-h SBP and DBP changed significantly in the two groups in the pre- and post-treatment comparison. Significant statistical differences among SBP and DBP in the two groups of combination therapy and drug therapy after 12 months were demonstrated. Visceral fat area was significantly reduced in the combination therapy group compared to the drug therapy group at the last assessment. Compared with the drug group, arterial compliance in the combination therapy group was higher after treatment. Blood pressure showed significant positive correlation with visceral fat area, PWV, β‑stiffness, Ep, and PWVβ in the combination therapy group. Conclusion: The combination of drug therapy and is more effective than just pursuing single drug treatment of hypertension in patients with abdominal obesity. Submaximal aerobic exercise contributes to anti-hypertension. The main mechanism of anti-hypertension in combination with drug therapy and submaximal aerobic exercise is the improvement of vascular elasticity and decreased central body-fat distribution.
Collapse
Affiliation(s)
- Hong Fang
- Department of Cardiology, Tongji Hospital, School of Medicine, Tongji University , Shanghai, China
| | - Chi Liu
- National clinical research center for aging and medicine, Jing an district Central Hospital , Shanghai, China
| | - Omer Cavdar
- Department of Cardiology, Tongji Hospital, School of Medicine, Tongji University , Shanghai, China
| |
Collapse
|
23
|
Li X, Lu L, Chen J, Zhang C, Chen H, Huang H. New Insight into the Mechanisms of Ginkgo Biloba Extract in Vascular Aging Prevention. Curr Vasc Pharmacol 2020; 18:334-345. [PMID: 31223090 DOI: 10.2174/1570161117666190621150725] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2019] [Revised: 05/07/2019] [Accepted: 05/14/2019] [Indexed: 02/07/2023]
Abstract
BACKGROUND Aging-associated vascular dysfunction promotes cardiovascular diseases. Recently, Ginkgo biloba extract (GBE) has attracted considerable attention in the prevention of aged vasculature. METHODS This review discusses the pathophysiological alterations in aged vasculature and the underlying mechanisms of GBE in vascular aging suppression. RESULTS Both arterial stiffening and endothelial dysfunction are critical aging-related vascular phenotypes that result in the progression of cardiovascular diseases in the general population. Consistent oxidative stress and inflammatory reaction lead to vascular dysfunction. GBE ameliorates aging-related vascular dysfunction, due to its antioxidant and anti-inflammatory properties. The main effects of GBE in aged vasculature might be associated with the longevity signaling pathways. GBE also attenuates the progression of vascular aging in diabetes mellitus via regulation of glucose and lipid metabolism. CONCLUSION GBE plays an important role in the prevention of vascular aging process. It is a promising therapeutic approach to ameliorate aging-related vascular dysfunction and cardiovascular diseases.
Collapse
Affiliation(s)
- Xiaoxue Li
- Department of Cardiology, The Eighth Affiliated Hospital, Sun Yat-sen University, Shenzhen, China
| | - Liuyi Lu
- Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Department of Cardiology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Jie Chen
- Department of Radiation Oncology, Sun Yat-sen Memorial Hospital of Sun Yat-sen University, Guangzhou, China
| | - Chao Zhang
- Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Department of Cardiology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Hong Chen
- Vascular Biology Program and Department of Surgery, Boston Children's Hospital, Harvard Medical School, Boston, MA 02115, United States
| | - Hui Huang
- Department of Cardiology, The Eighth Affiliated Hospital, Sun Yat-sen University, Shenzhen, China.,Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Department of Cardiology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| |
Collapse
|
24
|
Pan FF, Xu CC, Hu TJ, Fu GX, Zhong Y. Carotid plague formation is associated with ankle-brachial index in elderly people. Aging Clin Exp Res 2020; 32:2217-2223. [PMID: 31760610 DOI: 10.1007/s40520-019-01415-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2019] [Accepted: 11/12/2019] [Indexed: 10/25/2022]
Abstract
AIMS This study aimed at examining whether ankle-brachial index (ABI) and brachial-ankle pulse wave velocity (baPWV) were independently associated with carotid Intima-media thickness (CIMT) or carotid artery plaque (CAP) in elderly people. METHODS A cross-sectional analysis was performed in 155 individuals aged over 75 years who underwent the measurements of ABI and baPWV. Low ABI was defined as ABI ≤ 1.0. High baPWV was defined as baPWV > 2000 cm/s. The CIMT and CAP were measured with a B-mode tomographic ultrasound system. RESULTS Neither ABI nor baPWV was associated with CIMT in this elderly population. The group with low ABI (≤ 1.0) was significantly associated with a higher prevalence of carotid plaque (P = 0.001), while the relationship between baPWV and prevalence of carotid plaque was not found. Linear regression analysis showed that the value of ABI was significantly associated with the thickness of carotid plaque. Even in the full adjusted model, each 0.01unit ABI decreasing still increased 0.1663 mm of carotid plaque thickness (P = 0.004). Logistic Regression Analysis demonstrated that ABI lower than 1.0 had predictive value in the formation of carotid plaque with top quartile thickness (OR 2.834, 95% CI 1.131-7.099, P = 0.026). Furthermore, individuals with low ABI (≤ 1.0) were more likely to form hypoechoic carotid plaques according to ultrasonography. CONCLUSION Low ABI but not high baPWV was associated with the formation of carotid plaque. Furthermore, ABI was significantly associated with the thickness and morphology of carotid plaque in elderly people.
Collapse
|
25
|
Fontecave-Jallon J, Tanguy S. Inductive Plethysmography for aortic Pulse Wave Velocity. Annu Int Conf IEEE Eng Med Biol Soc 2020; 2020:2711-2714. [PMID: 33018566 DOI: 10.1109/embc44109.2020.9175329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Aortic stiffening is a process that is linked to cardiovascular risk factor increase. Then, aortic stiffness evaluation is considered as a good index of the evolution of pathophysiological situations, including myocardial infarction, heart failure, atherosclerosis or stroke. Today, pulse wave velocity (PWV) measurement is considered as the gold standard for evaluation of arterial stiffness. However, most of the current measurement techniques of PWV consider the time for the blood pressure pulse to propagate through a combined length of arteries and give access to arterial PWV. Therefore, none of the available techniques focuses only on the aorta. In the present context of smart clothes development, Inductive Plethsymography (IP) can be an interesting alternative for aortic PWV measure, since it has recently been shown that combination of thoracic and abdominal IP recordings can give cardiac information. We therefore investigate the potential of IP for aortic PWV measurement. In this preliminary study, a comparative analysis of PWV estimated from IP and PWV evaluated from the arm has been carried out on 11 healthy volunteers. Results show a significant linear correlation between both measures (r = 0.86, p<0.001), promising for future investigations on pathological populations.
Collapse
|
26
|
Abstract
Apart from the result of multiple diseases as well as aging, arterial stiffness (AS) predicts cardiovascular disease (CVD), especially in patients with chronic kidney disease (CKD). Patients with CKD have high CVD prevalence, and an extraordinarily high risk for CVD might be related to nontraditional risk factors, including AS. The mechanism of AS development could be attributed to oxidative stress, inflammation, uremic milieu (e.g., uremic toxins), vascular calcification, and cumulative effects of traditional cardiovascular risk factors on arteries such as diabetes mellitus or hypertension. There were a variety of non-invasive techniques to measure AS. One of these techniques is carotid–femoral pulse wave velocity, which is the reference measurement of AS and is related to long-term CVD outcomes. AS progression has corresponding medical treatments with modest beneficial results. This review briefly discusses the risk factors, measurements, and treatments associated with AS.
Collapse
Affiliation(s)
- Jen-Pi Tsai
- School of Medicine, Tzu Chi University, Hualien, Taiwan.,Division of Nephrology, Department of Internal Medicine, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chiayi, Taiwan
| | - Bang-Gee Hsu
- School of Medicine, Tzu Chi University, Hualien, Taiwan.,Division of Nephrology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan
| |
Collapse
|
27
|
Li Y, Marais L, Khettab H, Quan Z, Aasmul S, Leinders R, Schüler R, Morrissey PE, Greenwald S, Segers P, Vanslembrouck M, Bruno RM, Boutouyrie P, O’Brien P, de Melis M, Baets R. Silicon photonics-based laser Doppler vibrometer array for carotid-femoral pulse wave velocity (PWV) measurement. Biomed Opt Express 2020; 11:3913-3926. [PMID: 33014575 PMCID: PMC7510919 DOI: 10.1364/boe.394921] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Revised: 06/12/2020] [Accepted: 06/13/2020] [Indexed: 06/01/2023]
Abstract
Pulse wave velocity (PWV) is a reference measure for aortic stiffness, itself an important biomarker of cardiovascular risk. To enable low-cost and easy-to-use PWV measurement devices that can be used in routine clinical practice, we have designed several handheld PWV sensors using miniaturized laser Doppler vibrometer (LDV) arrays in a silicon photonics platform. The LDV-based PWV sensor design and the signal processing protocol to obtain pulse transit time (PTT) and carotid-femoral PWV in a feasibility study in humans, are described in this paper. Compared with a commercial reference PWV measurement system, measuring arterial pressure waveforms by applanation tonometry, LDV-based displacement signals resulted in more complex signals. However, we have shown that it is possible to identify reliable fiducial points for PTT calculation using the maximum of the 2nd derivative algorithm in LDV-based signals, comparable to those obtained by the reference technique, applanation tonometry.
Collapse
Affiliation(s)
- Yanlu Li
- Photonics Research Group, Ghent University-imec, Technologiepark-Zwijnaarde 126, 9052, Ghent, Belgium
- Center for Nano- and Biophotonics, Ghent University, Technologiepark-Zwijnaarde 126, 9052, Ghent, Belgium
| | - Louise Marais
- INSERM U970, Université de Paris, Assistance Publique Hôpitaux de Paris, Paris, France
| | - Hakim Khettab
- INSERM U970, Université de Paris, Assistance Publique Hôpitaux de Paris, Paris, France
| | - Zhiheng Quan
- Photonic Packaging Group, Tyndall National Institute, Lee Maltings Complex Dyke Parade, T12R5CP, Cork, Ireland
| | - Soren Aasmul
- Medtronic Bakken Research Center, Endepolsdomein 5, 6229 GW, Maastricht, The Netherlands
| | - Rob Leinders
- Medtronic Bakken Research Center, Endepolsdomein 5, 6229 GW, Maastricht, The Netherlands
| | - Ralf Schüler
- SIOS Messtechnik GmbH, Am Vogelherd 46, 98693, Ilmenau, Germany
| | - Padraic E. Morrissey
- Photonic Packaging Group, Tyndall National Institute, Lee Maltings Complex Dyke Parade, T12R5CP, Cork, Ireland
| | - Stephen Greenwald
- Blizard Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, E1 2AT, London, UK
| | - Patrick Segers
- IBiTech-bioMMeda, Ghent University, De Pintelaan 185, 9000, Ghent, Belgium
| | - Michael Vanslembrouck
- Photonics Research Group, Ghent University-imec, Technologiepark-Zwijnaarde 126, 9052, Ghent, Belgium
- Center for Nano- and Biophotonics, Ghent University, Technologiepark-Zwijnaarde 126, 9052, Ghent, Belgium
| | - Rosa M. Bruno
- INSERM U970, Université de Paris, Assistance Publique Hôpitaux de Paris, Paris, France
| | - Pierre Boutouyrie
- INSERM U970, Université de Paris, Assistance Publique Hôpitaux de Paris, Paris, France
| | - Peter O’Brien
- Photonic Packaging Group, Tyndall National Institute, Lee Maltings Complex Dyke Parade, T12R5CP, Cork, Ireland
| | - Mirko de Melis
- Medtronic Bakken Research Center, Endepolsdomein 5, 6229 GW, Maastricht, The Netherlands
| | - Roel Baets
- Photonics Research Group, Ghent University-imec, Technologiepark-Zwijnaarde 126, 9052, Ghent, Belgium
- Center for Nano- and Biophotonics, Ghent University, Technologiepark-Zwijnaarde 126, 9052, Ghent, Belgium
| |
Collapse
|
28
|
Lou YM, Liao MQ, Wang CY, Chen HE, Peng XL, Zhao D, Gao XP, Xu S, Wang L, Ma JP, Ping Z, Zeng FF. Association between brachial-ankle pulse wave velocity and risk of type 2 diabetes mellitus: results from a cohort study. BMJ Open Diabetes Res Care 2020; 8:e001317. [PMID: 32699113 PMCID: PMC7375424 DOI: 10.1136/bmjdrc-2020-001317] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Revised: 06/10/2020] [Accepted: 06/12/2020] [Indexed: 12/23/2022] Open
Abstract
INTRODUCTION Brachial-ankle pulse wave velocity (ba-PWV), as a simple and easily measured marker of arterial stiffness, has not been prospectively explored for its role in type 2 diabetes mellitus (T2DM) risk among the general population. This study aimed to explore the association between baseline ba-PWV value and new-onset T2DM among Chinese adults. RESEARCH DESIGN AND METHODS Using data from Xiaotangshan Hospital, we conducted a prospective cohort study among those who underwent annual or biennial health check-up examinations and who had their ba-PWV measured from 2009 to 2016. We explored the risk of new-onset T2DM across ba-PWV tertiles using Cox proportional-hazards regression analysis. RESULTS Of 6122 adults (68.9% male; mean age: 51.0 (SD 13.0) years) without T2DM and with ba-PWV measured at baseline, 599 participants developed T2DM during an average of 3.8 (SD 2.3) years of follow-up. After multivariable adjustment, ba-PWV was positively related to T2DM risk (p for trend=0.008). Compared with the lowest ba-PWV tertile, the HRs and their 95% CIs were 1.57 (1.18 to 2.10) for the second and 1.66 (1.24 to 2.22) for the third tertile. The risk across ba-PWV tertiles increased steadily from 1000 cm/s to 1400 cm/s and then reached a plateau. Subgroup analyses indicated a significantly higher risk among those aged <65 years and current smokers (p for interactions: <0.001 and 0.006). CONCLUSIONS Our findings suggest that ba-PWV might be a useful and independent predictor of new-onset T2DM with ba-PWV ranging between 1000 cm/s and 1400 cm/s, especially among younger individuals and current smokers.
Collapse
Affiliation(s)
- Yan-Mei Lou
- Department of Health Management, Beijing Xiao Tang Shan Hospital, Beijing, China
| | - Min-Qi Liao
- Department of Epidemiology, Jinan University, Guangzhou, China
| | - Chang-Yi Wang
- Department of Non-communicable Disease Prevention and Control, Shenzhen Nanshan Center for Chronic Disease Control, Shenzhen, China
| | - Hong-En Chen
- Department of Non-communicable Disease Prevention and Control, Shenzhen Nanshan Center for Chronic Disease Control, Shenzhen, China
| | - Xiao-Lin Peng
- Department of Non-communicable Disease Prevention and Control, Shenzhen Nanshan Center for Chronic Disease Control, Shenzhen, China
| | - Dan Zhao
- Department of Non-communicable Disease Prevention and Control, Shenzhen Nanshan Center for Chronic Disease Control, Shenzhen, China
| | - Xu-Ping Gao
- Department of Epidemiology, Jinan University, Guangzhou, China
| | - Shan Xu
- Department of Non-communicable Disease Prevention and Control, Shenzhen Nanshan Center for Chronic Disease Control, Shenzhen, China
| | - Li Wang
- Department of Non-communicable Disease Prevention and Control, Shenzhen Nanshan Center for Chronic Disease Control, Shenzhen, China
| | - Jian-Ping Ma
- Department of Non-communicable Disease Prevention and Control, Shenzhen Nanshan Center for Chronic Disease Control, Shenzhen, China
| | - Zhao Ping
- Department of Health Management, Beijing Xiao Tang Shan Hospital, Beijing, China
| | - Fang-Fang Zeng
- Department of Epidemiology, Jinan University, Guangzhou, China
| |
Collapse
|
29
|
Maimaitiaili R, Teliewubai J, Zhao S, Tang J, Chi C, Zhang Y, Xu Y. Relationship Between Vascular Aging and Left Ventricular Concentric Geometry in Community-Dwelling Elderly: The Northern Shanghai Study. Clin Interv Aging 2020; 15:853-863. [PMID: 32606625 PMCID: PMC7283487 DOI: 10.2147/cia.s248816] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2020] [Accepted: 05/05/2020] [Indexed: 01/19/2023] Open
Abstract
Purpose There have been few recent studies regarding vascular aging and its relationship with left ventricular (LV) geometry. Moreover, the association of abnormal LV geometry with various kinds of vascular aging has not yet been systematically analyzed. Thus, this study aimed to further elucidate this relationship. Materials and Methods In this study, 3363 older participants (43.6% male, aged 71.1±5.9 years; 56.4% female, aged 71.1±6.1 years) derived from the Northern Shanghai Study were enrolled. Vascular aging criteria included arteriosclerosis, defined as carotid-femoral pulse wave velocity >10 m/s or brachial-ankle pulse wave velocity >1800 cm/s, and peripheral atherosclerosis, defined as ankle-brachial index <0.9, carotid artery intima-media thickness (cIMT) greater than 0.9 mm, or carotid plaque indicating carotid artery abnormality. Micro-albuminuria was defined as urinary albumin-to-creatinine ratio >30 mg/g. Decreased estimated glomerular filtration rate (eGFR) was defined as eGFR <60 mL/min/1.73 m2. Results When vascular aging parameters were respectively adjusted for age and sex, arteriosclerosis, micro-albuminuria, and peripheral atherosclerosis were significantly associated with concentric remodeling, eccentric LV hypertrophy (LVH), and concentric LVH (P<0.045) but not with decreased eGFR or abnormal cIMT and presence of plaque. Peripheral atherosclerosis was strongly associated with LV concentric geometry (LVCG) when considering other covariates (risk factors, diseases, and treatments) (P<0.012). Conclusion Vascular aging parameters such as arteriosclerosis, micro-albuminuria, and peripheral atherosclerosis are significantly and independently associated with LVCG in community-dwelling older Chinese population, suggesting the importance of vascular aging during early clinical assessment of abnormal LV geometry change and serious cardiovascular events.
Collapse
Affiliation(s)
- Rusitanmujiang Maimaitiaili
- Department of Cardiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, People's Republic of China
| | - Jiadela Teliewubai
- Department of Cardiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, People's Republic of China
| | - Song Zhao
- Department of Cardiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, People's Republic of China
| | - Jiamin Tang
- Department of Cardiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, People's Republic of China
| | - Chen Chi
- Department of Cardiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, People's Republic of China
| | - Yi Zhang
- Department of Cardiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, People's Republic of China
| | - Yawei Xu
- Department of Cardiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, People's Republic of China
| |
Collapse
|
30
|
Abstract
The large elastic arteries fulfill an important role in buffering the cyclical changes in blood pressure, which result from intermittent ventricular ejection. With aging and accrual of cardiovascular risk factors, the elastic arteries stiffen, and this process holds a number of deleterious consequences for the cardiovascular system and major organs. Indeed, arterial stiffness is now recognized as an important, independent determinant of cardiovascular disease risk. Additional, important information concerning the mechanisms underlying arterial stiffening has come from longitudinal studies of arterial stiffness. More recently, attention has focused on the role of peripheral, muscular arteries in cardiovascular disease risk prediction and, in particular, the clinical consequences of reversal of the normal gradient of arterial stiffness between central and peripheral arteries, with aging and disease.
Collapse
Affiliation(s)
- Shikai Yu
- From the Department of Cardiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, China (S.Y.).,Division of Experimental Medicine and Immunotherapeutics, University of Cambridge, United Kingdom (S.Y., C.M.M.)
| | - Carmel M McEniery
- Division of Experimental Medicine and Immunotherapeutics, University of Cambridge, United Kingdom (S.Y., C.M.M.)
| |
Collapse
|
31
|
Galal H, Ammar M, Ismail M, Elshazly A. Echocardiographic assessment of aortic pulse wave velocity as a diagnostic and prognostic parameter for left ventricular diastolic dysfunction. Minerva Cardioangiol 2020; 68:313-318. [PMID: 32100985 DOI: 10.23736/s0026-4725.20.05101-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Aortic pulse wave velocity (PWV) is a standard measurement of aortic stiffness. It has been suggested that increased arterial stiffness promotes left ventricular diastolic dysfunction (LVDD). We designed this study to evaluate role of aortic PWV as a new diagnostic parameter for LVDD by correlation with echocardiographic LVDD indices and to evaluate its prognostic value in patients with LVDD by correlation with brain natriuretic peptide (BNP). METHODS One hundred patients with age >50 were divided into two groups: case group consisted of 80 patients with asymptomatic LVDD with EF ≥50% while controlgroup consisted of 20 patients with normal LVDD. BNP blood test and echocardiography with assessment of aortic PWV were done. RESULTS Mean age was 59±7.47 vs. 57±6.35 years in case and control groups respectively (P= 0.73), 38 (47.5%) males in case vs. 9 (45%) in control (P=0.84). Aortic PWV showed positive correlation with E/e' (r=0.957, P<0.001), tricuspid regurgitation (TR) velocity (r=0.941, P<0.001), and LA volume index (r=0.947, P<0.001). Negative correlation with septal e' (r=-0.970, P<0.001) and lateral e' (r=-0.932, P<0.001) were reported. Moreover, positive correlation with plasma BNP (r=0.958, P<0.001) was reported. The area under the ROC curve for aortic PWV to detect DD was 0.86 (95% CI, 0.76-0.98; P<0.001) and the optimal cutoff point of 12.5 m/s produced 92.3% sensitivity and 75.0% specificity with an accuracy of 89.0%. CONCLUSIONS Echocardiographic assessment of aortic PWV appears not only to be a sensitive and reliable for LVDD detection but also has a promising prognostic value in patients with LVDD.
Collapse
Affiliation(s)
- Haitham Galal
- Department of Cardiology, Ain Shams University, Cairo, Egypt -
| | - Mohammed Ammar
- Department of Cardiology, Ain Shams University, Cairo, Egypt
| | - Magdy Ismail
- Department of Cardiology, Ain Shams University, Cairo, Egypt
| | - Ahmed Elshazly
- Department of Cardiology, Ain Shams University, Cairo, Egypt
| |
Collapse
|
32
|
Yu J, Sun H, Shang F, Wu H, Shi H, Ren L, He Y, Zhang M, Peng H. Association Between Glucose Metabolism And Vascular Aging In Chinese Adults: A Cross-Sectional Analysis In The Tianning Cohort Study. Clin Interv Aging 2019; 14:1937-1946. [PMID: 31806949 PMCID: PMC6842737 DOI: 10.2147/cia.s223690] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2019] [Accepted: 10/28/2019] [Indexed: 12/31/2022] Open
Abstract
Aim Fasting glucose has been associated with vascular aging, but the association between HbA1c and vascular aging has been limitedly studied in Chinese and other ethnic populations. We aimed to examine this association in a large sample of Chinese adults. Methods In the Tianning Cohort (N=5142), fasting glucose, HbA1c, carotid-femoral pulse wave velocity (cfPWV), and pulse pressure (PP) were measured. Vascular aging was defined as having the highest quartile level of cfPWV or PP. We applied quantile regression models to examine the association between glucose metabolism and vascular aging. Results The median cfPWV was significantly increased as increasing quintiles of fasting glucose (β=0.14, P<0.001) and HbA1c (β=0.07, P=0.0056), respectively. Per 1-mmol/L increment of fasting glucose was significantly associated with a higher risk of having vascular aging defined by cfPWV (OR=1.05, P=0.022), PP (OR=1.06, P=0.048), or either (OR=1.08, P=0.002). Similarly, per 1% increment of HbA1c was significantly associated with a higher risk of having vascular aging defined by cfPWV (OR=1.06, P=0.044), PP (OR=1.10, P=0.012), or either (OR=1.12, P=0.042). Conclusion Glucose metabolism was significantly and positively associated with vascular aging in Chinese adults, but the causality is uncertain.
Collapse
Affiliation(s)
- Jia Yu
- Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, Suzhou, People's Republic of China
| | - Hongyan Sun
- Center for Disease Prevention and Control of Tianning District, Changzhou, People's Republic of China
| | - Fei Shang
- Center for Disease Prevention and Control of Tianning District, Changzhou, People's Republic of China
| | - Haishu Wu
- Center for Disease Prevention and Control of Tianning District, Changzhou, People's Republic of China
| | - Hongfei Shi
- Center for Disease Prevention and Control of Tianning District, Changzhou, People's Republic of China
| | - Liyun Ren
- Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, Suzhou, People's Republic of China
| | - Yan He
- Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, Suzhou, People's Republic of China
| | - Mingzhi Zhang
- Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, Suzhou, People's Republic of China
| | - Hao Peng
- Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, Suzhou, People's Republic of China
| |
Collapse
|
33
|
Vasan RS, Short MI, Niiranen TJ, Xanthakis V, DeCarli C, Cheng S, Seshadri S, Mitchell GF. Interrelations Between Arterial Stiffness, Target Organ Damage, and Cardiovascular Disease Outcomes. J Am Heart Assoc 2019; 8:e012141. [PMID: 31303106 PMCID: PMC6662123 DOI: 10.1161/jaha.119.012141] [Citation(s) in RCA: 56] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Background Excess transmission of pressure pulsatility caused by increased arterial stiffness may incur microcirculatory damage in end organs (target organ damage [TOD]) and, in turn, elevate risk for cardiovascular disease (CVD) events. Methods and Results We related arterial stiffness measures (carotid‐femoral pulse wave velocity, mean arterial pressure, central pulse pressure) to the prevalence and incidence of TOD (defined as albuminuria and/or echocardiographic left ventricular hypertrophy) in up to 6203 Framingham Study participants (mean age 50±15 years, 54% women). We then related presence of TOD to incident CVD in multivariable Cox regression models without and with adjustment for arterial stiffness measures. Cross‐sectionally, greater arterial stiffness was associated with a higher prevalence of TOD (adjusted odds ratios ranging from 1.23 to 1.54 per SD increment in arterial stiffness measure, P<0.01). Prospectively, increased carotid‐femoral pulse wave velocity was associated with incident albuminuria (odds ratio per SD 1.28, 95% CI, 1.02–1.61; P<0.05), whereas higher mean arterial pressure and central pulse pressure were associated with incident left ventricular hypertrophy (odds ratio per SD 1.37 and 1.45, respectively; P<0.01). On follow‐up, 297 of 5803 participants experienced a first CVD event. Presence of TOD was associated with a 33% greater hazard of incident CVD (95% CI, 0–77%; P<0.05), which was attenuated upon adjustment for baseline arterial stiffness measures by 5–21%. Conclusions Elevated arterial stiffness is associated with presence of TOD and may partially mediate the relations of TOD with incident CVD. Our observations in a large community‐based sample suggest that mitigating arterial stiffness may lower the burden of TOD and, in turn, clinical CVD.
Collapse
Affiliation(s)
- Ramachandran S Vasan
- 1 National Heart, Lung, and Blood Institute's and Boston University's Framingham Heart Study Framingham MA.,2 Section of Preventive Medicine Department of Medicine Boston University School of Medicine Boston MA.,3 Section of Cardiology Department of Medicine Boston University School of Medicine Boston MA.,4 Department of Epidemiology Boston University School of Public Health Boston MA
| | - Meghan I Short
- 5 Department of Biostatistics Boston University School of Public Health Boston MA
| | - Teemu J Niiranen
- 1 National Heart, Lung, and Blood Institute's and Boston University's Framingham Heart Study Framingham MA.,6 Department of Medicine Turku University Hospital and University of Turku Finland.,7 Department of Public Health Solutions National Institute for Health and Welfare Turku Finland
| | - Vanessa Xanthakis
- 1 National Heart, Lung, and Blood Institute's and Boston University's Framingham Heart Study Framingham MA.,2 Section of Preventive Medicine Department of Medicine Boston University School of Medicine Boston MA.,5 Department of Biostatistics Boston University School of Public Health Boston MA
| | | | - Susan Cheng
- 1 National Heart, Lung, and Blood Institute's and Boston University's Framingham Heart Study Framingham MA.,9 Smidt Heart Institute Cedars-Sinai Medical Center Los Angeles CA
| | - Sudha Seshadri
- 1 National Heart, Lung, and Blood Institute's and Boston University's Framingham Heart Study Framingham MA.,10 Biggs Institute for Alzheimer's Disease University of Texas Health Sciences Center at San Antonio TX
| | | |
Collapse
|
34
|
Abstract
Early detection of subclinical atherosclerosis is important to reduce patients' cardiovascular risk. However, current diagnostic strategy focusing on traditional risk factors or using risk scoring is not satisfactory. Non-invasive imaging tools also have limitations such as cost, time, radiation hazard, renal toxicity, and requirement for specialized techniques or instruments. There is a close interaction between arterial stiffness and atherosclerosis. Increased luminal pressure and shear stress by arterial stiffening causes endothelial dysfunction, accelerates the formation of atheroma, and stimulates excessive collagen production and deposition in the arterial wall, leading to the progression of atherosclerosis. Pulse wave velocity (PWV), the most widely used measure of arterial stiffness, has emerged as a useful tool for the diagnosis and risk stratification of cardiovascular disease (CVD). The measurement of PWV is simple, non-invasive, and reproducible. There have been many clinical studies and meta-analyses showing the association between PWV and coronary/cerebral/carotid atherosclerosis. More importantly, longitudinal studies have shown that PWV is a significant risk factor for future CVD independent of well-known cardiovascular risk factors. The measurement of PWV may be a useful tool to select subjects at high risk of developing subclinical atherosclerosis or CVD especially in mass screening.
Collapse
Affiliation(s)
- Hack-Lyoung Kim
- Division of Cardiology, Department of Internal Medicine, Boramae Medical Center, Seoul National University College of Medicine, Seoul, South Korea
| | - Sang-Hyun Kim
- Division of Cardiology, Department of Internal Medicine, Boramae Medical Center, Seoul National University College of Medicine, Seoul, South Korea
| |
Collapse
|
35
|
Abstract
Early detection of subclinical atherosclerosis is important to reduce patients' cardiovascular risk. However, current diagnostic strategy focusing on traditional risk factors or using risk scoring is not satisfactory. Non-invasive imaging tools also have limitations such as cost, time, radiation hazard, renal toxicity, and requirement for specialized techniques or instruments. There is a close interaction between arterial stiffness and atherosclerosis. Increased luminal pressure and shear stress by arterial stiffening causes endothelial dysfunction, accelerates the formation of atheroma, and stimulates excessive collagen production and deposition in the arterial wall, leading to the progression of atherosclerosis. Pulse wave velocity (PWV), the most widely used measure of arterial stiffness, has emerged as a useful tool for the diagnosis and risk stratification of cardiovascular disease (CVD). The measurement of PWV is simple, non-invasive, and reproducible. There have been many clinical studies and meta-analyses showing the association between PWV and coronary/cerebral/carotid atherosclerosis. More importantly, longitudinal studies have shown that PWV is a significant risk factor for future CVD independent of well-known cardiovascular risk factors. The measurement of PWV may be a useful tool to select subjects at high risk of developing subclinical atherosclerosis or CVD especially in mass screening.
Collapse
Affiliation(s)
- Hack-Lyoung Kim
- Division of Cardiology, Department of Internal Medicine, Boramae Medical Center, Seoul National University College of Medicine, Seoul, South Korea
| | - Sang-Hyun Kim
- Division of Cardiology, Department of Internal Medicine, Boramae Medical Center, Seoul National University College of Medicine, Seoul, South Korea
| |
Collapse
|
36
|
Jaalkhorol M, Fujita Y, Kouda K, Tamaki J, Komatsu M, Dongmei N, Sato Y, Tachiki T, Yura A, Kajita E, Kagamimori S, Iki M. Low bone mineral density is associated with an elevated risk of developing increased arterial stiffness: A 10-year follow-up of Japanese women from the Japanese Population-based Osteoporosis (JPOS) cohort study. Maturitas 2019; 119:39-45. [DOI: 10.1016/j.maturitas.2018.11.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2018] [Revised: 10/24/2018] [Accepted: 11/02/2018] [Indexed: 12/31/2022]
|
37
|
Logan JG, Kang H, Lobo JM, Sohn MW, Lin GM, Lima JAC, Punjabi NM, Redline S, Kwon Y. Actigraphy-based sleep characteristics and aortic stiffness: the Multi-Ethnic Study of Atherosclerosis. ACTA ACUST UNITED AC 2018; 12:841-849. [PMID: 30396853 DOI: 10.1016/j.jash.2018.09.008] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2018] [Revised: 08/16/2018] [Accepted: 09/19/2018] [Indexed: 12/21/2022]
Abstract
The study aimed to examine the association between objective estimates of sleep duration and quality and aortic stiffness while accounting for the potential confounding effect of sleep-disordered breathing. Participants were part of the Multi-Ethnic Study of Atherosclerosis Sleep study. Sleep duration and quality were assessed by 7-day wrist actigraphy, sleep-disordered breathing by home polysomnography, and aortic stiffness by magnetic resonance imaging-based aortic pulse wave velocity (aPWV), ascending and descending aorta distensibility. Aortic stiffness of participants with "normal" sleep duration (6-8 hours) were compared with those of "short" (<6 hours) and "long" sleep duration (>8 hours) adjusting for common cardiovascular risk factors and apnea-hypopnea index. The sample consisted of 908 participants (mean age 68.4 ± 9.1 years, 55.3% female). There was a significant linear trend of increased aPWV across short (n = 252), normal (n = 552), and long sleep durations (n = 104) (P for trend = .008). Multivariable analysis showed that people with short sleep duration had 0.94 m/s lower aPWV (95% CI: -1.54, -0.35), compared with those with normal sleep duration. In this ethnically diverse community cohort, habitual short sleep duration as estimated by actigraphy was associated with lower aortic stiffness.
Collapse
Affiliation(s)
- Jeongok G Logan
- Assistant Professor, University of Virginia School of Nursing, Charlottesville, VA, USA.
| | - Hyojung Kang
- Research Assistant Professor, Systems and Information Engineering, University of Virginia, Charlottesville, VA, USA
| | - Jennifer Mason Lobo
- Assistant Professor, Division of Biomedical Informatics, Department of Public Health Sciences, University of Virginia, Charlottesville, VA, USA
| | - Min-Woong Sohn
- Associate Professor, Department of Public Health Sciences, University of Virginia, Charlottesville, VA, USA
| | - Gen-Min Lin
- Assistant Professor, Department of Medicine, Hualien Armed Forces General Hospital, Hualien, Taiwan
| | - Joao A C Lima
- Professor of Medicine, School of Medicine, Johns Hopkins University, Baltimore, MD, USA
| | - Naresh M Punjabi
- Professor, Johns Hopkins Medicine, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Susan Redline
- Peter C. Farrell Professor of Sleep Medicine, Harvard Medical School, Boston, MA, USA
| | - Younghoon Kwon
- Assistant Professor, University of Virginia, Fontaine Research Park, Charlottesville, VA, USA
| |
Collapse
|
38
|
Ji H, Xiong J, Yu S, Chi C, Bai B, Teliewubai J, Lu Y, Zhang Y, Xu Y. Measuring the Carotid to Femoral Pulse Wave Velocity (Cf-PWV) to Evaluate Arterial Stiffness. J Vis Exp 2018. [PMID: 29781986 DOI: 10.3791/57083] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
For the elderly, arterial stiffening is a good marker for aging evaluation and it is recommended that the arterial stiffness be determined noninvasively by the measurement of carotid to femoral pulse wave velocity (cf-PWV) (Class I; Level of Evidence A). In literature, numerous community-based or disease-specific studies have reported that higher cf-PWV is associated with increased cardiovascular risk. Here, we discuss strategies to evaluate arterial stiffness with cf-PWV. Following the well-defined steps detailed here, e.g., proper position operator, distance measurement, and tonometer position, we will obtain a standard cf-PWV value to evaluate arterial stiffness. In this paper, a detailed stepwise method to record a good quality PWV and pulse wave analysis (PWA) using a non-invasive tonometry-based device will be discussed.
Collapse
Affiliation(s)
- Hongwei Ji
- Department of Cardiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine
| | - Jing Xiong
- Department of Cardiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine
| | - Shikai Yu
- Department of Cardiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine
| | - Chen Chi
- Department of Cardiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine
| | - Bin Bai
- Department of Cardiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine
| | - Jiadela Teliewubai
- Department of Cardiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine
| | - Yuyan Lu
- Department of Cardiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine
| | - Yi Zhang
- Department of Cardiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine;
| | - Yawei Xu
- Department of Cardiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine;
| |
Collapse
|
39
|
Shimada S, Matsuura M, Yamaguchi T, Hama J. Analyzing the association between aortic regurgitation and atherosclerosis: is pulse pressure a cause of atherosclerosis? Clin Exp Hypertens 2018; 40:796-802. [PMID: 29400568 DOI: 10.1080/10641963.2018.1433195] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
If pulse pressure, one of the mechanical stresses, is a risk factor for atherosclerotic cardiovascular disease, then atherosclerosis should be progressive in aortic regurgitation which is a representative disease with increased pulse pressure. This cross-sectional study included 1,149 patients. We examined the influence of aortic regurgitation on maximum intima-media thickness or brachial-ankle pulse wave velocity. The degree of aortic regurgitation was classified into 4 grades by color Doppler examination. There were 177 patients with aortic regurgitation. Pulse pressure was significantly higher in patients with aortic regurgitation than in those without it. On multiple regression analysis, aortic regurgitation was not found to be a significant independent variable for maximum intima-media thickness [standard partial regression coefficient: aortic regurgitation = grade 1, 0.011, P = 0.7635; aortic regurgitation ≥ grade 2, -0.034, P = 0.3289] and brachial-ankle pulse wave velocity [standard partial regression coefficient: aortic regurgitation = grade1, -0.043, P = 0.1197; aortic regurgitation ≥ grade2, 0.002, P = 0.9358] after adjusting for age, sex, body mass index, presence or absence of cardiovascular disease, antihypertensive treatment, diabetes, dyslipidemia, and smoking. These results found no causal association between aortic regurgitation and atherosclerosis, and were a contradiction to the opinion that pulse pressure was a risk factor of atherosclerosis.
Collapse
Affiliation(s)
- Seijiro Shimada
- a Department of Cardiology, Faculty of Medicine, Sakai Hospital , Kindai University , Osaka , Japan
| | - Masayosi Matsuura
- a Department of Cardiology, Faculty of Medicine, Sakai Hospital , Kindai University , Osaka , Japan
| | - Takahiro Yamaguchi
- a Department of Cardiology, Faculty of Medicine, Sakai Hospital , Kindai University , Osaka , Japan
| | - Junkichi Hama
- a Department of Cardiology, Faculty of Medicine, Sakai Hospital , Kindai University , Osaka , Japan
| |
Collapse
|
40
|
Lee WH, Hsu PC, Chu CY, Chen SC, Lee HH, Chen YC, Lee MK, Lee CS, Yen HW, Lin TH, Voon WC, Lai WT, Sheu SH, Kuo PL, Su HM. Association of renal systolic time intervals with brachial-ankle pulse wave velocity. Int J Med Sci 2018; 15:1235-1240. [PMID: 30123062 PMCID: PMC6097254 DOI: 10.7150/ijms.24451] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2017] [Accepted: 03/02/2018] [Indexed: 12/23/2022] Open
Abstract
Aims: The renal systolic time intervals (STIs), including renal pre-ejection period (PEP), renal ejection time (ET), and renal PEP/renal ET measured by renal Doppler ultrasound, were associated with poor cardiac function and adverse cardiac outcomes. However, the relationship between renal hemodynamic parameters and arterial stiffness in terms of brachial-ankle pulse wave velocity (baPWV) has never been evaluated. The aim of this study was to assess the relationship between renal STIs and baPWV. Methods: This cross-sectional study enrolled 230 patients. The renal hemodynamics was measured from Doppler ultrasonography and baPWV was measured from ABI-form device by an oscillometric method. Results: Patients with baPWV ≧ 1672 cm/s had a higher value of renal resistive index (RI) and lower values of renal PEP and renal PEP/ET (all P< 0.001). In univariable analysis, baPWV was significantly associated with renal RI, renal PEP, and renal PEP/renal ET (all P< 0.001). In multivariable analysis, renal PEP (unstandardized coefficient β = -3.185; 95% confidence interval = -5.169 to -1.201; P = 0.002) and renal PEP/renal ET (unstandardized coefficient β = -5.605; 95% CI = -10.217 to -0.992; P = 0.018), but not renal RI, were still the independent determinants of baPWV. Conclusion: Our results found that renal PEP and renal PEP/renal ET were independently associated with baPWV. Hence, renal STIs measured from renal echo may have a significant correlation with arterial stiffness.
Collapse
Affiliation(s)
- Wen-Hsien Lee
- Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.,Division of Cardiology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.,Department of Internal Medicine, Kaohsiung Municipal Hsiao-Kang Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.,Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Po-Chao Hsu
- Division of Cardiology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.,Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Chun-Yuan Chu
- Division of Cardiology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.,Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Szu-Chia Chen
- Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.,Department of Internal Medicine, Kaohsiung Municipal Hsiao-Kang Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.,Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Hung-Hao Lee
- Division of Cardiology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Ying-Chih Chen
- Division of Cardiology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.,Department of Internal Medicine, Kaohsiung Municipal Hsiao-Kang Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Meng-Kuang Lee
- Division of Cardiology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.,Department of Internal Medicine, Kaohsiung Municipal Hsiao-Kang Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Chee-Siong Lee
- Division of Cardiology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.,Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Hsueh-Wei Yen
- Division of Cardiology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.,Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Tsung-Hsien Lin
- Division of Cardiology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.,Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Wen-Chol Voon
- Division of Cardiology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.,Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Wen-Ter Lai
- Division of Cardiology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.,Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Sheng-Hsiung Sheu
- Division of Cardiology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.,Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Po-Lin Kuo
- Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Ho-Ming Su
- Division of Cardiology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.,Department of Internal Medicine, Kaohsiung Municipal Hsiao-Kang Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.,Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| |
Collapse
|
41
|
Canepa M, Artom N, Ameri P, Carbone F, Montecucco F, Ghigliotti G, Brunelli C, Dallegri F, Pende A, Pisciotta L. Short-term effect of rosuvastatin treatment on arterial stiffness in individuals with newly-diagnosed heterozygous familial hypercholesterolemia. Int J Cardiol 2017; 255:215-220. [PMID: 29290422 DOI: 10.1016/j.ijcard.2017.12.051] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2017] [Revised: 12/04/2017] [Accepted: 12/16/2017] [Indexed: 01/27/2023]
Affiliation(s)
- Marco Canepa
- Cardiovascular Unit, Department of Internal Medicine, Ospedale Policlinico San Martino, Genova, University of Genova, Largo Benzi 10, 16132 Genova, Italy
| | - Nathan Artom
- First Clinic of Internal Medicine, Department of Internal Medicine, Ospedale Policlinico San Martino, Genova, University of Genova, Largo Benzi 10, 16132 Genova, Italy
| | - Pietro Ameri
- Cardiovascular Unit, Department of Internal Medicine, Ospedale Policlinico San Martino, Genova, University of Genova, Largo Benzi 10, 16132 Genova, Italy
| | - Federico Carbone
- First Clinic of Internal Medicine, Department of Internal Medicine, Ospedale Policlinico San Martino, Genova, University of Genova, Largo Benzi 10, 16132 Genova, Italy
| | - Fabrizio Montecucco
- First Clinic of Internal Medicine, Department of Internal Medicine, Ospedale Policlinico San Martino, Genova, University of Genova, Largo Benzi 10, 16132 Genova, Italy
| | - Giorgio Ghigliotti
- Cardiovascular Unit, Department of Internal Medicine, Ospedale Policlinico San Martino, Genova, University of Genova, Largo Benzi 10, 16132 Genova, Italy
| | - Claudio Brunelli
- Cardiovascular Unit, Department of Internal Medicine, Ospedale Policlinico San Martino, Genova, University of Genova, Largo Benzi 10, 16132 Genova, Italy
| | - Franco Dallegri
- First Clinic of Internal Medicine, Department of Internal Medicine, Ospedale Policlinico San Martino, Genova, University of Genova, Largo Benzi 10, 16132 Genova, Italy
| | - Aldo Pende
- First Clinic of Internal Medicine, Department of Internal Medicine, Ospedale Policlinico San Martino, Genova, University of Genova, Largo Benzi 10, 16132 Genova, Italy
| | - Livia Pisciotta
- First Clinic of Internal Medicine, Department of Internal Medicine, Ospedale Policlinico San Martino, Genova, University of Genova, Largo Benzi 10, 16132 Genova, Italy.
| |
Collapse
|
42
|
Liu Z, Wu K, Dai X, Che Q, Chen S, Jia J, Li J, Huo Y, Zhang Y, Chen D. Grading effect of abnormal glucose status on arterial stiffness and a new threshold of 2-h post-load glucose based on a Chinese community study. J Diabetes Investig 2017; 9:616-622. [PMID: 28862798 PMCID: PMC5934263 DOI: 10.1111/jdi.12741] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2017] [Revised: 08/03/2017] [Accepted: 08/27/2017] [Indexed: 12/18/2022] Open
Abstract
AIMS/INTRODUCTION To investigate the relationship between various glucose metabolic status and arterial stiffness, and further explore the threshold of blood glucose indices for the risk of arterial stiffness. MATERIALS AND METHODS The present cross-sectional study included 4,851 individuals from a Chinese community. Overnight fasting blood glucose and 2-h post-load glucose were sampled. Arterial stiffness was measured as brachial-ankle pulse wave velocity. The association was examined using generalized linear regression models. The threshold effect was explored using two piecewise linear regression models by the smoothing plot. RESULTS After adjustment for covariates, isolated impaired fasting glucose, isolated impaired glucose tolerance, combined glucose intolerance and newly diagnosed diabetes mellitus were associated with a greater risk of arterial stiffness compared with normal glucose tolerance (B = 18.09, 95% confidence interval [CI] 0.42-35.76, P = 0.045; B = 28.51, 95% CI: 3.40-53.62, P = 0.026; B = 60.70, 95% CI: 38.37-83.04, P < 0.001; B = 95.06, 95% CI: 71.88-118.25, P < 0.001, respectively). Furthermore, there was a non-linear relationship between 2-h post-load glucose and arterial stiffness. A threshold for 2-h post-load glucose of 6.14 mmol/L was observed for the risk of arterial stiffness. CONCLUSIONS Impaired fasting glucose, impaired glucose tolerance, combined glucose intolerance and newly diagnosed diabetes mellitus were related to a greater risk of arterial stiffness compared with normal glucose levels. A threshold for 2-h post-load glucose of 6.14 mmol/L probably exists for the risk of arterial stiffness.
Collapse
Affiliation(s)
- Zhi‐Ke Liu
- Department of Epidemiology and BiostatisticsSchool of Public HealthPeking University Health Science CenterBeijingChina
| | - Ke‐Ye Wu
- Department of Epidemiology and BiostatisticsSchool of Public HealthPeking University Health Science CenterBeijingChina
| | - Xiao‐Tong Dai
- Department of Epidemiology and BiostatisticsSchool of Public HealthPeking University Health Science CenterBeijingChina
| | - Qian‐Zi Che
- Department of Epidemiology and BiostatisticsSchool of Public HealthPeking University Health Science CenterBeijingChina
| | - Si Chen
- Department of Epidemiology and BiostatisticsSchool of Public HealthPeking University Health Science CenterBeijingChina
| | - Jia Jia
- Department of CardiologyPeking University First HospitalBeijingChina
| | - Jian‐Ping Li
- Department of CardiologyPeking University First HospitalBeijingChina
| | - Yong Huo
- Department of CardiologyPeking University First HospitalBeijingChina
| | - Yan Zhang
- Department of CardiologyPeking University First HospitalBeijingChina
| | - Da‐Fang Chen
- Department of Epidemiology and BiostatisticsSchool of Public HealthPeking University Health Science CenterBeijingChina
| |
Collapse
|
43
|
Ji H, Zhang H, Xiong J, Yu S, Chi C, Bai B, Li J, Blacher J, Zhang Y, Xu Y. eGFRs from Asian-modified CKD-EPI and Chinese-modified CKD-EPI equations were associated better with hypertensive target organ damage in the community-dwelling elderly Chinese: the Northern Shanghai Study. Clin Interv Aging 2017; 12:1297-1308. [PMID: 28860731 PMCID: PMC5571820 DOI: 10.2147/cia.s141102] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background With increasing age, estimated glomerular filtration rate (eGFR) decline is a frequent manifestation and is strongly associated with other preclinical target organ damage (TOD). In literature, many equations exist in assessing patients’ eGFR. However, these equations were mainly derived and validated in the population from Western countries, which equation should be used for risk stratification in the Chinese population remains unclear, as well as their comparison. Considering that TOD is a good marker for risk stratification in the elderly, in this analysis, we aimed to investigate whether the recent eGFR equations derived from Asian and Chinese are better associated with preclinical TOD than the other equations in elderly Chinese. Methods A total of 1,599 community-dwelling elderly participants (age >65 years) in northern Shanghai were prospectively recruited from June 2014 to August 2015. Conventional cardiovascular risk factors were assessed, and hypertensive TOD including left ventricular mass index (LVMI), carotid–femoral pulse wave velocity (cf-PWV), carotid intima-media thickness (IMT), ankle–brachial index (ABI) and urine albumin to creatinine ratio (UACR) was evaluated for each participant. Participant’s eGFR was calculated from the Modification of Diet in Renal Disease (MDRD), Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI), Chinese-abbreviated MDRD (c-aMDRD), Asian-modified CKD-EPI (aCKD-EPI) equation and Chinese-modified CKD-EPI (cCKD-EPI) equation. Results In multivariate regression analysis, only eGFRs from aCKD-EPI were significantly and inversely associated with carotid IMT (P=0.005). In multivariate logistic models, decreased eGFR from all the equations were significantly associated with lower ABI (P<0.001), microalbuminuria (P=0.02 to P<0.001) and increased cf-PWV (P<0.001). Only decreased eGFRs from aCKD-EPI and cCKD-EPI equations were significantly associated with increased IMT (both crude P<0.05). In the receiver operator characteristic (ROC) analysis, only aCKD-EPI and cCKD-EPI equations presented significant associations with all the listed preclinical TODs (P-value from <0.05 to <0.001). Conclusion In community-dwelling elderly Chinese, eGFRs from aCKD-EPI and cCKD-EPI equations are better associated with preclinical TOD. aCKD-EPI and cCKD-EPI equations should be preferred when making risk assessment.
Collapse
Affiliation(s)
- Hongwei Ji
- Department of Cardiology, Shanghai Tenth People's Hospital
| | - Han Zhang
- Department of Cardiology, Shanghai Tenth People's Hospital
| | - Jing Xiong
- Department of Cardiology, Shanghai Tenth People's Hospital
| | - Shikai Yu
- Department of Cardiology, Shanghai Tenth People's Hospital
| | - Chen Chi
- Department of Cardiology, Shanghai Tenth People's Hospital
| | - Bin Bai
- Department of Cardiology, Shanghai Tenth People's Hospital
| | - Jue Li
- Department of Prevention, Tongji University School of Medicine, Shanghai, People's Republic of China
| | - Jacques Blacher
- Paris Descartes University, AP-HP, Diagnosis and Therapeutic Center, Hôtel-Dieu, Paris, France
| | - Yi Zhang
- Department of Cardiology, Shanghai Tenth People's Hospital
| | - Yawei Xu
- Department of Cardiology, Shanghai Tenth People's Hospital
| |
Collapse
|