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Liu D, Aziz NA, Imtiaz MA, Pehlivan G, Breteler MMB. Associations of measured and genetically predicted leukocyte telomere length with vascular phenotypes: a population-based study. GeroScience 2024; 46:1947-1970. [PMID: 37782440 PMCID: PMC10828293 DOI: 10.1007/s11357-023-00914-2] [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] [Received: 06/07/2023] [Accepted: 08/15/2023] [Indexed: 10/03/2023] Open
Abstract
Shorter leukocyte telomere length (LTL) is associated with cardiovascular dysfunction. Whether this association differs between measured and genetically predicted LTL is still unclear. Moreover, the molecular processes underlying the association remain largely unknown. We used baseline data of the Rhineland Study, an ongoing population-based cohort study in Bonn, Germany [56.2% women, age: 55.5 ± 14.0 years (range 30 - 95 years)]. We calculated genetically predicted LTL in 4180 participants and measured LTL in a subset of 1828 participants with qPCR. Using multivariable regression, we examined the association of measured and genetically predicted LTL, and the difference between measured and genetically predicted LTL (ΔLTL), with four vascular functional domains and the overall vascular health. Moreover, we performed epigenome-wide association studies of three LTL measures. Longer measured LTL was associated with better microvascular and cardiac function. Longer predicted LTL was associated with better cardiac function. Larger ΔLTL was associated with better microvascular and cardiac function and overall vascular health, independent of genetically predicted LTL. Several CpGs were associated (p < 1e-05) with measured LTL (n = 5), genetically predicted LTL (n = 8), and ΔLTL (n = 27). Genes whose methylation status was associated with ΔLTL were enriched in vascular endothelial signaling pathways and have been linked to environmental exposures, cardiovascular diseases, and mortality. Our findings suggest that non-genetic causes of LTL contribute to microvascular and cardiac function and overall vascular health, through an effect on the vascular endothelial signaling pathway. Interventions that counteract LTL may thus improve vascular function.
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Affiliation(s)
- Dan Liu
- German Center for Neurodegenerative Diseases (DZNE), Population Health Sciences, Bonn, Germany
| | - N Ahmad Aziz
- German Center for Neurodegenerative Diseases (DZNE), Population Health Sciences, Bonn, Germany
- Department of Neurology, Faculty of Medicine, University of Bonn, Bonn, Germany
| | - Mohammed Aslam Imtiaz
- German Center for Neurodegenerative Diseases (DZNE), Population Health Sciences, Bonn, Germany
| | - Gökhan Pehlivan
- German Center for Neurodegenerative Diseases (DZNE), Population Health Sciences, Bonn, Germany
| | - Monique M B Breteler
- German Center for Neurodegenerative Diseases (DZNE), Population Health Sciences, Bonn, Germany.
- Institute for Medical Biometry, Informatics and Epidemiology (IMBIE), Faculty of Medicine, University of Bonn, Bonn, Germany.
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Chen S, Zhang C. Effects of ischaemic post-conditioning on eccentric exercise-induced muscle damage. Biol Sport 2024; 41:27-35. [PMID: 38524812 PMCID: PMC10955728 DOI: 10.5114/biolsport.2024.129483] [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: 04/10/2023] [Revised: 06/09/2023] [Accepted: 07/10/2023] [Indexed: 03/26/2024] Open
Abstract
Exercise-induced muscle damage (EIMD) is a common phenomenon resulting from high-intensity exercise that impairs subsequent performance. Ischaemic post-conditioning (IPOC) is a simple intervention that has been shown to reduce muscle damage after prolonged ischaemia, a condition mechanistically similar to EIMD. The purpose of this study was to determine whether IPOC could alleviate muscle damage after eccentric exercise. Thirty-two young male participants were randomized into either a sham (n = 16) or an IPOC (n = 16) intervention group. Biceps brachii muscle damage was induced by eccentric exercise, with IPOC or sham intervention applied on the dominant arm following exercise (3 cycles of 30 s ischaemia). Visual analogue scale (VAS) pain, arm circumference, muscle thickness, echo-intensity, and microvascular function (using near-infrared spectroscopy) were measured bilaterally at baseline, 24, 48, and 72 hours after eccentric exercise. Biceps curl one repetition maximum (1RM) was also measured. 1RM was higher for the IPOC group at 48 and 72 hours (both p < 0.05). On the dominant arm, VAS pain was lower at 72 hours for the IPOC group (p = 0.039). Muscle thickness was lower at all post-exercise time points for the IPOC group (all p < 0.05). VAS pain, echo-intensity, and arm circumference were elevated on the non-dominant arm in the sham group at 72 hours (all p < 0.05). These parameters all returned to the baseline level for the IPOC group at 72 hours (all p > 0.05IPOC could attenuate the decrease in strength, and alleviate EIMD with both local and remote effects after high-intensity exercise.
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Affiliation(s)
- Si Chen
- School of Physical Education and Sport, Central China Normal University, Wuhan, China
| | - Chuan Zhang
- School of Physical Education and Sport, Central China Normal University, Wuhan, China
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Hong J, Park Y. Microvascular Function and Exercise Training: Functional Implication of Nitric Oxide Signaling and Ion Channels. Pulse (Basel) 2024; 12:27-33. [PMID: 38572498 PMCID: PMC10987185 DOI: 10.1159/000538271] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2023] [Accepted: 02/29/2024] [Indexed: 04/05/2024] Open
Abstract
Background Exercise training elicits indubitable positive adaptation in microcirculation in health and disease populations. An inclusive overview of the current knowledge regarding the effects of exercise on microvascular function consolidates an in-depth understanding of microvasculature. Summary The main physiological function of microvasculature is to maintain optimal blood flow regulation to supply oxygen and nutrition during elevated physical demands in the cardiovascular system. There are several cellular and molecular alterations in resistance vessels in response to exercise intervention, an increase in nitric oxide-mediated vasodilation through the regulation of oxidative stress, inflammatory response, and ion channels in endothelial cells, thus increasing myogenic tone via voltage-gated Ca2+ channels in smooth muscle cells. Key Messages In the review, we postulate that exercise should be considered a medicine for people with diverse diseases through a comprehensive understanding of the cellular and molecular underlying mechanisms in microcirculation through exercise training.
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Affiliation(s)
- Junyoung Hong
- Department of Health and Human Performance, Laboratory of Integrated Physiology, University of Houston, Houston, TX, USA
- Department of Cardiovascular and Metabolic Sciences, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Yoonjung Park
- Department of Health and Human Performance, Laboratory of Integrated Physiology, University of Houston, Houston, TX, USA
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Canto ED, van Deursen L, Hoek AG, Elders PJM, den Ruijter HM, van der Velden J, van Empel V, Serné EH, Eringa EC, Beulens JWJ. Microvascular endothelial dysfunction in skin is associated with higher risk of heart failure with preserved ejection fraction in women with type 2 diabetes: the Hoorn Diabetes Care System Cohort. Cardiovasc Diabetol 2023; 22:234. [PMID: 37658327 PMCID: PMC10474683 DOI: 10.1186/s12933-023-01935-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [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: 06/01/2023] [Accepted: 07/22/2023] [Indexed: 09/03/2023] Open
Abstract
BACKGROUND Microvascular dysfunction plays a crucial role in complications of type 2 diabetes and might contribute to heart failure with preserved ejection fraction (HFpEF), a disease that disproportionally affects women. We aimed to investigate if presence and degree of microvascular dysfunction (MVD) in skin relates to markers of left ventricular diastolic dysfunction (LVDD) and HFpEF risk in adults with type 2 diabetes, and whether sex modifies this association. METHODS We recruited 154 participants (50% women) from the Hoorn Diabetes Care System Cohort, a prospective cohort study, for in vivo evaluation of skin MVD, echocardiography and blood sampling. MVD was assessed by laser speckle contrast analysis combined with iontophoresis of insulin, acetylcholine and sodium nitroprusside (SNP). We performed a cross-sectional analysis of the association between perfusion responses and echocardiographic and clinical markers of LVDD and the H2FPEF score by multivariable linear regression analysis adjusted for confounders. Sex was evaluated as a potential effect modifier and the analysis was stratified. RESULTS Mean age was 67 ± 6y, mean HbA1c 7.6 ± 1.3%. Women were more frequently obese (54.5 vs. 35.1%), had higher NT-proBNP plasma levels (80, IQR:34-165 vs. 46, 27-117 pg/ml) and E/E'(13.3 ± 4.3 vs. 11.4 ± 3.0) than men. Eleven women and three men were diagnosed with HFpEF, and showed lower perfusion response to insulin than those without HFpEF. A lower perfusion response to insulin and acetylcholine was associated with higher HFpEF risk in women, but not men (10% decreased perfusion response was associated with 5.8% [95%CI: 2.3;9.4%] and 5.9% [1.7;10.1%] increase of the H2FPEF score, respectively). A lower perfusion response to SNP was associated with higher pulmonary arterial systolic pressure in men while a lower perfusion response to acetylcholine associated with higher LV mass index in women and with worse LV longitudinal strain in the total population. No significant associations were found between perfusion responses and conventional LVDD markers. CONCLUSIONS Impaired microvascular responses to insulin and acetylcholine in skin confers a higher risk of HFpEF in women with type 2 diabetes. In vivo measures of systemic MVD could represent novel risk markers for HFpEF, opening new avenues for the prevention of HFpEF in type 2 diabetes.
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Affiliation(s)
- Elisa Dal Canto
- Department of Experimental Cardiology, Division Heart and Lungs, UMC Utrecht, Mathias van Geunsgebouw, room 03.03. Postbus 85500 | 3508 GA, Utrecht, The Netherlands
- Department of General Practice and Epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands
| | - L van Deursen
- Department of Epidemiology and Data Science, Amsterdam University Medical Center, location Vrije Universiteit, Amsterdam, The Netherlands
| | - A G Hoek
- Department of Epidemiology and Data Science, Amsterdam University Medical Center, location Vrije Universiteit, Amsterdam, The Netherlands
- Amsterdam Cardiovascular Sciences, Amsterdam, The Netherlands
| | - P J M Elders
- Department of Epidemiology and Data Science, Amsterdam University Medical Center, location Vrije Universiteit, Amsterdam, The Netherlands
- Amsterdam Cardiovascular Sciences, Amsterdam, The Netherlands
- Department of General Practice and Elderly Care Medicine, Amsterdam University Medical Center, Amsterdam, The Netherlands
| | - H M den Ruijter
- Department of Experimental Cardiology, Division Heart and Lungs, UMC Utrecht, Mathias van Geunsgebouw, room 03.03. Postbus 85500 | 3508 GA, Utrecht, The Netherlands
| | - J van der Velden
- Amsterdam Cardiovascular Sciences, Amsterdam, The Netherlands
- Department of Physiology, Amsterdam University Medical Center, Amsterdam, The Netherlands
| | - V van Empel
- Department of Cardiology, CARIM School for Cardiovascular Diseases, Maastricht University Medical Center, Maastricht, The Netherlands
| | - E H Serné
- Department of Vascular Medicine & Diabetes Center, Amsterdam University Medical Center, location Vrije Universiteit, Amsterdam, The Netherlands
| | - E C Eringa
- Amsterdam Cardiovascular Sciences, Amsterdam, The Netherlands.
- Department of Physiology, Amsterdam University Medical Center, Amsterdam, The Netherlands.
- Department of Cardiology, CARIM School for Cardiovascular Diseases, Maastricht University Medical Center, Maastricht, The Netherlands.
| | - J W J Beulens
- Department of Epidemiology and Data Science, Amsterdam University Medical Center, location Vrije Universiteit, Amsterdam, The Netherlands
- Amsterdam Cardiovascular Sciences, Amsterdam, The Netherlands
- Department of Physiology, CARIM School for Cardiovascular Diseases, Maastricht, The Netherlands
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands
- Amsterdam Public Health, Amsterdam, The Netherlands
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Ihsan M, Labidi M, Racinais S. Skeletal muscle oxidative adaptations following localized heat therapy. Eur J Appl Physiol 2023; 123:1629-1635. [PMID: 36952087 PMCID: PMC10363048 DOI: 10.1007/s00421-023-05159-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Accepted: 02/10/2023] [Indexed: 03/24/2023]
Abstract
Repeated heat treatment has been shown to induce oxidative adaptations in cell cultures and rodents, but similar work within human models is scarce. This study investigated the effects of 6 weeks of localized heat therapy on near-infrared spectroscopy-(NIRS) derived indices of muscle oxidative and microvascular function. Twelve physically active participants (8 males and 4 females, age: 34.9 ± 5.9 years, stature: 175 ± 7 cm, body mass: 76.7 ± 13.3 kg) undertook a 6-week intervention, where adhesive heat pads were applied for 8 h/day, 5 days/week, on one calf of each participant, while the contralateral leg acted as control. Prior to and following the intervention, the microvascular function was assessed using NIRS-based methods, where 5 min of popliteal artery occlusion was applied, and the reperfusion (i.e., re-saturation rate, re-saturation amplitude, and hyperemic response) was monitored for 2 min upon release. Participants also performed a 1-min isometric contraction of the plantar flexors (30% maximal voluntary contraction), following which a further 2 min interval was undertaken for the assessment of recovery kinetics. A 20-min time interval was allowed before the assessment protocol was repeated on the contralateral leg. Repeated localized heating of the gastrocnemius did not influence any of the NIRS-derive indices of microvascular or oxidative function (p > 0.05) following 6 weeks of treatment. Our findings indicate that localized heating via the use of adhesive heat pads may not be a potent stimulus for muscle adaptations in physically active humans.
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Affiliation(s)
- Mohammed Ihsan
- Research and Scientific Support, Aspetar Orthopedic and Sports Medicine Hospital, Doha, Qatar.
| | - Mariem Labidi
- Research and Scientific Support, Aspetar Orthopedic and Sports Medicine Hospital, Doha, Qatar
- Education Department, Aspetar Orthopedic and Sports Medicine Hospital, Doha, Qatar
- Faculty of Sport Sciences and Physical Education, CETAPS, University of Rouen, Mont-Saint-Aignan, France
| | - Sebastien Racinais
- Research and Scientific Support, Aspetar Orthopedic and Sports Medicine Hospital, Doha, Qatar
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Escobar S, Peçanha D, Duque M, Duque A, Crahim V, De Lorenzo A, Tibiriçá E. Evaluation of systemic endothelial-dependent and endothelial-independent microvascular reactivity in metabolically healthy obesity: An observational study. Microvasc Res 2023:104553. [PMID: 37230166 DOI: 10.1016/j.mvr.2023.104553] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Revised: 05/18/2023] [Accepted: 05/19/2023] [Indexed: 05/27/2023]
Abstract
BACKGROUND Metabolically healthy obesity (MHO), a phenotype of obesity considered to be of lower cardiovascular risk, is still a controversial concept. This study aimed to investigate the presence of subclinical systemic microvascular dysfunction in individuals with MHO. METHODS This was a cross-sectional study in which 112 volunteers were allocated into three groups: metabolically healthy normal weight (MHNW), MHO, or metabolically unhealthy obesity (MUO). Obesity was defined as a body mass index (BMI) ≥ 30 kg/m2. MHO was defined as the absence of any component of metabolic syndrome, except waist circumference. Microvascular reactivity was evaluated using cutaneous laser speckle contrast imaging. RESULTS Mean age was 33.2 ± 7.66 years. The median BMI in the MHNW, MHO and MUO groups was 23.6, 32.8, and 35.8 kg/m2, respectively. Baseline microvascular conductance values were lower in the MUO group (0.25 ± 0.08 APU/mmHg) than in MHO (0.30 ± 0.10 APU/mmHg) and MHNW groups (0.33 ± 0.12 APU/mmHg) (P = 0.0008). There were no significant differences regarding endothelial-dependent (acetylcholine stimulation or postocclusive reactive hyperemia) or endothelial-independent (sodium nitroprusside stimulation) microvascular reactivity among the groups. CONCLUSIONS Individuals with MUO had lower baseline systemic microvascular flow than those with MHNW or MHO, but endothelium-dependent or endothelium-independent microvascular reactivity were not changed in any of the groups. The relatively young age of the study population, the low frequency of class III obesity, or the strict definition of MHO (absence of any metabolic syndrome criteria) might account for the lack of difference of microvascular reactivity among MHNW, MHO or MUO.
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Affiliation(s)
- Silas Escobar
- National Institute of Cardiology, Rio de Janeiro, Brazil
| | | | - Maíra Duque
- National Institute of Cardiology, Rio de Janeiro, Brazil
| | - Alice Duque
- National Institute of Cardiology, Rio de Janeiro, Brazil
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McGranahan MJ, Kibildis SW, McCully KK, O'Connor PJ. Evaluation of inter-rater and test-retest reliability for near-infrared spectroscopy reactive hyperemia measures. Microvasc Res 2023; 148:104532. [PMID: 36963482 DOI: 10.1016/j.mvr.2023.104532] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Revised: 03/17/2023] [Accepted: 03/20/2023] [Indexed: 03/26/2023]
Abstract
BACKGROUND Near-infrared spectroscopy (NIRS) is a non-invasive tool used to measure blood flow in peripheral tissues. More information on inter-rater agreement and test-retest reliability of NIRS-based reperfusion assessments is needed. PURPOSE To assess inter-rater agreement for NIRS based data analysis, and evaluate the measurement's reliability across days. METHODS On three separate days (average days between visits 1 and 3: 19.4 ± 6.9 days), participants' (N = 15 males, 22 ± 2 yr.) post-occlusion reactive hyperemia (PORH) was measured in the left gastrocnemius muscle using Continuous-Wave NIRS (CW-NIRS). A blood pressure cuff was placed proximal to the knee and inflated to occlude lower leg blood flow for 5 min. The following CW-NIRS parameters were selected: (1) percent saturation in HbO2 (StO2%) at baseline; (2) the O2Hb range used to normalize the NIRS signal; (3) the time for the O2Hb signal to reach 50 % peak post-occlusion hyperemia (T1/2), and (4) the post peak hyperemic O2Hb recovery slope (O2REC-SLP). Absolute agreement between the two analysts was calculated using two-way random effects Intraclass Correlation Coefficients (ICC2,1). Consistency between analysts and across days was calculated using two-way mixed models (ICC3,1). Mean and 95 % confidence intervals (CI) of ICCs are reported. Coefficient of variation (CV) and standard error of the measurement (SEM) are reported. RESULTS The ICC2,1 data indicated "adequate" to "excellent" absolute agreement between the two NIRS analysts. ICC2,3 data indicated "adequate" to "good" reliability across visits. The CV and SEM for rater 1 and rater 2 across visit were StO2 (CV: 3.79 % ± 2.71 % and 4.50 % ± 2.37 %; SEM: 3.42 and 3.82), O2Hb range (CV: 10.50 ± 5.93 and 12.79 ± 12.41; SEM: 3.26 and 4.71), T1/2 (CV: 11.15 % ± 5.52 % and 10.96 % ± 4.50; SEM: 1.22 and 1.11), and O2REC-SLP (CV: 19.49 % ± 9.99 % and 18.45 % ± 9.48 %; SEM: 0.04 and 0.04). CONCLUSION It is concluded that NIRS parameters assessed show adequate reliability between analysts and across three visits. It is recommended, when feasible and because of the absence of 100 % reliability, that investigators employ more than one rater for scoring at least a portion of the data across each trial in a study's control condition in order to have the ability to estimate the magnitude of error attributable to imperfect reliability.
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Affiliation(s)
- Melissa J McGranahan
- University of Georgia, Department of Kinesiology, Athens, GA 30602-6554, United States of America.
| | - Samuel W Kibildis
- University of North Carolina at Greensboro, Department of Kinesiology, Greensboro, NC, United States of America
| | - Kevin K McCully
- University of Georgia, Department of Kinesiology, Athens, GA 30602-6554, United States of America
| | - Patrick J O'Connor
- University of Georgia, Department of Kinesiology, Athens, GA 30602-6554, United States of America
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Coccarelli A, Nelson MD. Modeling Reactive Hyperemia to Better Understand and Assess Microvascular Function: A Review of Techniques. Ann Biomed Eng 2023; 51:479-92. [PMID: 36709231 DOI: 10.1007/s10439-022-03134-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Accepted: 12/25/2022] [Indexed: 01/30/2023]
Abstract
Reactive hyperemia is a well-established technique for the non-invasive evaluation of the peripheral microcirculatory function, measured as the magnitude of limb re-perfusion after a brief period of ischemia. Despite widespread adoption by researchers and clinicians alike, many uncertainties remain surrounding interpretation, compounded by patient-specific confounding factors (such as blood pressure or the metabolic rate of the ischemic limb). Mathematical modeling can accelerate our understanding of the physiology underlying the reactive hyperemia response and guide in the estimation of quantities which are difficult to measure experimentally. In this work, we aim to provide a comprehensive guide for mathematical modeling techniques that can be used for describing the key phenomena involved in the reactive hyperemia response, alongside their limitations and advantages. The reported methodologies can be used for investigating specific reactive hyperemia aspects alone, or can be combined into a computational framework to be used in (pre-)clinical settings.
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Dillon GA, Stanhewicz AE, Serviente C, Flores VA, Stachenfeld N, Alexander LM. Seven days of statin treatment improves nitric-oxide mediated endothelial-dependent cutaneous microvascular function in women with endometriosis. Microvasc Res 2022; 144:104421. [PMID: 35970408 PMCID: PMC9527706 DOI: 10.1016/j.mvr.2022.104421] [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] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 07/26/2022] [Accepted: 08/09/2022] [Indexed: 10/31/2022]
Abstract
INTRODUCTION Endometriosis is associated with systemic inflammation and increased risk of cardiovascular disease (CVD). Endothelial dysfunction is one of the first manifestations of CVD but is unexplored in women with endometriosis. HMG-CoA-reductase inhibitors (statins) exert potent anti-inflammatory effects, and have been proposed as an adjunctive therapy in women with endometriosis. We hypothesized that microvascular endothelial function would be impaired in otherwise healthy women with endometriosis mediated by reduced nitric oxide (NO)-dependent dilation and that short term statin administration would improve endothelial function. METHODS In 8 healthy control (HC: 33 ± 9 yr) and 8 women with endometriosis (EN: 34 ± 9 yr), laser-Doppler flux (LDF) was measured continuously during graded intradermal microdialysis perfusion of the endothelium-dependent agonist acetylcholine (Ach: 10-10-10-1 M) alone and in combination with the NO synthase inhibitor (L-NAME: 0.015 M). 6 EN repeated the microdialysis experiment following 7 days of oral atorvastatin treatment (10 mg). Cutaneous vascular conductance was calculated (CVC = LDF*mmHg-1) and normalized to site-specific maximum (28 mM sodium nitroprusside, 43 °C). The NO-dependent dilation was calculated as the difference between the areas under the dose response curves. RESULTS Ach-induced vasodilation was blunted in women with endometriosis (main effect p < 0.01), indicating impaired endothelial function. NO-dependent vasodilation was also reduced in women with endometriosis (HC: 217 ± 120.3 AUC vs. EN: 88 ± 97 AUC, p = 0.03). Oral atorvastatin improved Ach-induced (main effect p < 0.01) and NO-dependent (295 ± 153 AUC; p = 0.05) vasodilation in women with endometriosis. CONCLUSION Microcirculatory endothelium-dependent vasodilation is impaired in women with endometriosis, mediated in part by reductions in NO. Short-term oral atorvastatin improved endothelium-dependent vasodilation, suggesting that statin therapy may be a viable intervention strategy to mitigate accelerated CVD risk in women with endometriosis.
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Affiliation(s)
- Gabrielle A Dillon
- Noll Laboratory, Department of Kinesiology, The Pennsylvania State University, University Park, PA, United States of America; Center for Healthy Aging, The Pennsylvania State University, University Park, PA, United States of America
| | - Anna E Stanhewicz
- Noll Laboratory, Department of Kinesiology, The Pennsylvania State University, University Park, PA, United States of America; Department of Health and Human Physiology, The University of Iowa, Iowa City, IA, United States of America
| | - Corinna Serviente
- Noll Laboratory, Department of Kinesiology, The Pennsylvania State University, University Park, PA, United States of America; Center for Healthy Aging, The Pennsylvania State University, University Park, PA, United States of America; Department of Kinesiology, University of Massachusetts Amherst, MA, United States of America; Institute for Applied Life Sciences, University of Massachusetts Amherst, MA, United States of America
| | - Valerie A Flores
- Department of Obstetrics, Gynecology and Reproductive Sciences, Yale School of Medicine, New Haven, CT, United States of America
| | - Nina Stachenfeld
- Department of Obstetrics, Gynecology and Reproductive Sciences, Yale School of Medicine, New Haven, CT, United States of America; John B. Pierce Laboratory, Yale University, New Haven, CT, United States of America
| | - Lacy M Alexander
- Noll Laboratory, Department of Kinesiology, The Pennsylvania State University, University Park, PA, United States of America; Center for Healthy Aging, The Pennsylvania State University, University Park, PA, United States of America.
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Leitão R, de Oliveira GV, Rezende C, Volino-Souza M, Mesquita J, de Carvalho LL, Alvares TS. Improved microvascular reactivity after aged garlic extract intake is not mediated by hydrogen sulfide in older adults at risk for cardiovascular disease: a randomized clinical trial. Eur J Nutr 2022; 61:3357-3366. [PMID: 35505122 DOI: 10.1007/s00394-022-02895-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [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: 11/16/2021] [Accepted: 04/12/2022] [Indexed: 11/25/2022]
Abstract
PURPOSE This study aimed to investigate the effects of AGE on microvascular reactivity, systolic blood pressure (SBP), and diastolic blood pressure (DBP) in older individuals at high risk for cardiovascular disease (CVD). Urinary thiosulfate was also investigated as an indirect marker of endogenous hydrogen sulfide (H2S) synthesis. The study was conducted in a randomized, double-blind, crossover, and placebo-controlled way. METHODS Twenty-eight participants (14 male), 67 ± 6 years old with CVD risk factors, ingested 2.4 g of AGE or placebo (PLA). Near-infrared spectroscopy evaluated tissue oxygen saturation (StO2) during a vascular occlusion test (30 s baseline, 5 min occlusion, and 2 min reperfusion). The upslope of StO2 signal after cuff release was calculated to measure microvascular reactivity. Urinary thiosulfate levels were measured using a high-performance liquid chromatography system. RESULTS The upslope of StO2 was significantly faster after AGE (1.01 ± 0.37% s-1) intake compared to PLA (0.83 ± 0.35% s-1; P < 0.001; d = 0.50). Relative changes in Δ% SBP from pre- to post-AGE intake (- 5.17 ± 5.77%) was significantly different compared to Δ% PLA (0.32 ± 5.99%; P = 0.001; d = 0.93). No significant changes in urinary thiosulfate concentrations were observed between interventions. Moreover, no significant gender effect in any parameter assessed was found. CONCLUSION This study demonstrated that a single dose of AGE improved microvascular reactivity in older adults at risk of CVD despite such an effect was not linked with urinary thiosulfate levels. This trial was registered at clinicaltrials.gov as NCT04008693 (May 19, 2020).
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Affiliation(s)
- Renata Leitão
- Nutrition and Exercise Metabolism Research Group, Food and Nutrition Institute, Federal University of Rio de Janeiro, Macaé Campus, Multidisciplinary Center UFRJ-Macaé, Estrada do Imburo, s/n, Macaé, RJ, 27979-000, Brazil
| | - Gustavo Vieira de Oliveira
- Nutrition and Exercise Metabolism Research Group, Food and Nutrition Institute, Federal University of Rio de Janeiro, Macaé Campus, Multidisciplinary Center UFRJ-Macaé, Estrada do Imburo, s/n, Macaé, RJ, 27979-000, Brazil
| | - Cristina Rezende
- Nutrition and Exercise Metabolism Research Group, Food and Nutrition Institute, Federal University of Rio de Janeiro, Macaé Campus, Multidisciplinary Center UFRJ-Macaé, Estrada do Imburo, s/n, Macaé, RJ, 27979-000, Brazil
| | - Mônica Volino-Souza
- Nutrition and Exercise Metabolism Research Group, Food and Nutrition Institute, Federal University of Rio de Janeiro, Macaé Campus, Multidisciplinary Center UFRJ-Macaé, Estrada do Imburo, s/n, Macaé, RJ, 27979-000, Brazil
| | - Jacilene Mesquita
- Nutrition and Exercise Metabolism Research Group, Food and Nutrition Institute, Federal University of Rio de Janeiro, Macaé Campus, Multidisciplinary Center UFRJ-Macaé, Estrada do Imburo, s/n, Macaé, RJ, 27979-000, Brazil
| | - Leandro Lara de Carvalho
- Laboratory of Catalysis and Synthesis of Bioactivity Substances, Federal University of Rio de Janeiro, Estrada do Imburo, s/n, Macaé, 27979-000, RJ, Brazil
| | - Thiago Silveira Alvares
- Nutrition and Exercise Metabolism Research Group, Food and Nutrition Institute, Federal University of Rio de Janeiro, Macaé Campus, Multidisciplinary Center UFRJ-Macaé, Estrada do Imburo, s/n, Macaé, RJ, 27979-000, Brazil.
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Abstract
There is a growing body of interest in cardiac microvascular function because it plays an important role in various cardiac disease conditions. Therefore, efforts have been made to develop non-invasive techniques to measure microvascular function. In this issue of the journal, Guerraty et al developed a micro-SPECT-based approach to assess microvascular function in in vivo mice. They applied two independent approaches to measure microvascular function: (1) myocardial blood flow measurement using 99mTc-sestamibi as a flow tracer and (2) intramyocardial blood volume measurement using 99mTc-red blood cells. Although there are issues to be addressed, they provided an important framework for non-invasive assessment of microvascular function in mice, where a number of disease models are readily available. Thus, their approaches are encouraging for facilitating better understanding of pathophysiology underlying microvascular disease models, and thereby the development of therapeutic options in future.
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Affiliation(s)
- Ichiro Matsunari
- Division of Nuclear Medicine, Department of Radiology, Saitama Medical University Hospital, 38 Morohongo, Moroyama, Iruma-gun, Saitama, 350-0495, Japan.
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12
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Sabapathy M, Tan F, Al Hussein S, Jaafar H, Brocherie F, Racinais S, Ihsan M. Effect of heat pre-conditioning on recovery following exercise-induced muscle damage. Curr Res Physiol 2021; 4:155-162. [PMID: 34746835 PMCID: PMC8562196 DOI: 10.1016/j.crphys.2021.06.002] [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: 01/18/2021] [Revised: 05/29/2021] [Accepted: 06/01/2021] [Indexed: 12/04/2022] Open
Abstract
This study investigated the influence of heat pre-conditioning on the recovery of muscle torque, microvascular function, movement economy and stride mechanics following exercise-induced muscle damage (EIMD). Twenty male participants were equally assigned to a control (CON) and an experimental group (HEAT), and performed a 30-min downhill run (DHR) to elicit EIMD. HEAT group received three consecutive days of heat exposure (45.1 ± 3.2 min of hot water immersion at 42 °C) prior to DHR. Microvascular function (near-infrared spectroscopy), maximal voluntary contraction (MVC) torque of the knee extensors, as well as two treadmill-based steady-state runs performed below (SSR-1) and above (SSR-2) the first ventilatory threshold were assessed prior to DHR and repeated for four consecutive days post-DHR (D1-POST to D4-POST). The decline in MVC torque following EIMD was attenuated in HEAT compared with CON at D1-POST (p = 0.037), D3-POST (p = 0.002) and D4-POST (p = 0.022). Muscle soreness increased in both CON and HEAT, but was significantly attenuated in HEAT compared with CON at D2-POST (p = 0.024) and D3-POST (p = 0.013). Microvascular function decreased in CON from D1-POST to D3-POST (p = 0.009 to 0.018), and was lower compared with HEAT throughout D1-POST to D3-POST (p = 0.003 to 0.017). Pre-heat treatment decreased the magnitude of strength loss and muscle soreness, as well as attenuated the decline in microvascular function following EIMD. Heat treatment appears a promising pre-conditioning strategy when embarking on intensified training periods or competition. Three days of heat pre-conditioning decreases the extent of strength loss, soreness and microvascular function after EIMD. Pre heat treatment might be a promising preconditioning tool prior to intensified training periods or competition. Heat tretament may positively impact activities of daily living, training quality and adherence to training programs.
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Affiliation(s)
- Murali Sabapathy
- Sport Physiology, Sport Science and Medicine, Singapore Sport Institute, Republic of Singapore
- Department of Physiology, Yong Loo Lin School of Medicine, National University of Singapore, Republic of Singapore
| | - Frankie Tan
- Sport Physiology, Sport Science and Medicine, Singapore Sport Institute, Republic of Singapore
- Department of Physiology, Yong Loo Lin School of Medicine, National University of Singapore, Republic of Singapore
| | - Shadiq Al Hussein
- Sport Physiology, Sport Science and Medicine, Singapore Sport Institute, Republic of Singapore
- Department of Physiology, Yong Loo Lin School of Medicine, National University of Singapore, Republic of Singapore
| | - Haiyum Jaafar
- Football Science and Medicine, Football Association of Singapore, Republic of Singapore
| | - Franck Brocherie
- Laboratory Sport, Expertise and Performance (EA 7370), French Institute of Sport (INSEP), Paris, France
| | - Sebastien Racinais
- Research and Scientific Support, Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Qatar
| | - Mohammed Ihsan
- Sport Physiology, Sport Science and Medicine, Singapore Sport Institute, Republic of Singapore
- Research and Scientific Support, Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Qatar
- Human Potential Translational Research Program, Yong Loo Lin School of Medicine, National University of Singapore, Republic of Singapore
- Corresponding author. Human Potential Translational Research Program, Yong Loo Lin School of Medicine, National University of Singapore, Republic of Singapore. 10 Medical Drive, 117597, Singapore.
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13
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Mahfouz RA, Abdelhamed M, Galal I, Elsanan M. Usefulness of Stress-Derived E/e' Ratio in Asymptomatic Hypertensive Patients. Pulse (Basel) 2021; 8:92-98. [PMID: 34307205 DOI: 10.1159/000511217] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Accepted: 08/25/2020] [Indexed: 11/19/2022] Open
Abstract
Purpose We sought to investigate the usefulness of stress echocardiography-derived E/e' in predicting subclinical atherosclerosis in asymptomatic hypertensive patients. Materials and Methods 71 newly diagnosed untreated hypertensive patients (48 ± 13 years, 65% males) and 30 age- and sex-matched healthy controls were recruited. Resting and exercise echocardiography was performed to assess resting diastolic blood pressure and the diastolic stress parameters. Coronary flow reserve (CFR) was evaluated as well. Results Based on CFR values, newly diagnosed, untreated hypertensives were stratified into hypertensives with microvascular dysfunction (MVD; 34 patients had CFR <2.0) and those without MVD (37 patients had CFR ≥2.0). Patients with MVD had a significantly higher C-reactive protein level (p < 0.05) and lower metabolic equivalent values (p < 0.05). With resting echocardiography, only the left atrial volume index (LAVI) was significantly increased in those with MVD compared with those without MVD and controls (p < 0.05). With exercise echo, the E/e' was significantly increased in MVD patients compared with those without MVD and controls (p < 0.001). Importantly, the percentage of subjects with exercise E/e' ≥15 was 76.5% (26 patients in the group with MVD), 4.1% (3 patients in the group without MVD), and 0% in controls. At univariate analysis, high-sensitivity C-reactive protein (p < 0.05), LAVI (p < 0.05), and exercise E/e' (p < 0.001) were independently associated with reduced CFR. On the other hand, at multivariate analysis, only exercise E/e' was the independent predictor of reduced CFR in newly diagnosed hypertensives. Conclusion We have demonstrated significant associations between exercise-derived raised left ventricular pressure and coronary MVD in newly diagnosed untreated hypertensive patients. Herein, we supposed that exercise-derived E/e' could predict subclinical atherosclerosis and might be a risk parameter for newly diagnosed untreated hypertensive patients.
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Affiliation(s)
- Ragab A Mahfouz
- Department of Cardiology, Zagazig University Hospital, Zagazig, Egypt
| | | | - Islam Galal
- Department of Cardiology, Zagazig University Hospital, Zagazig, Egypt
| | - Moataz Elsanan
- Department of Cardiology, Zagazig University Hospital, Zagazig, Egypt
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14
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McGarity-Shipley EC, Schmitter SM, Williams JS, King TJ, McPhee IAC, Pyke KE. The impact of repeated, local heating-induced increases in blood flow on lower limb endothelial function in young, healthy females. Eur J Appl Physiol 2021. [PMID: 34251539 DOI: 10.1007/s00421-021-04749-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2021] [Accepted: 06/15/2021] [Indexed: 10/20/2022]
Abstract
PURPOSE The purpose of the present study was to examine the effect of repeated, single leg heating on lower limb endothelial function. METHODS Macrovascular function was assessed with superficial femoral artery (SFA) reactive hyperemia flow-mediated dilation (RH-FMD) and sustained stimulus FMD (SS-FMD). Calf microvascular function was assessed as the peak and area under the curve of SFA reactive hyperemia (RH). Participants (n = 13 females, 23 ± 2 yrs) had one leg randomized to the single leg heating intervention (EXP; other leg: control (CON)). The EXP leg underwent 8 weeks of single leg heating via immersion in 42.5 ℃ water for five 35-min sessions/week. At weeks 0, 2, 4, 6, and 8, SFA RH-FMD, SS-FMD (shear stress increased via plantar flexion exercise), and SFA RH flow were measured. RESULTS None of the variables changed with repeated, single leg heating (interaction week*limb RH-FMD: p = 0.076; SS-FMD: p = 0.958; RH flow p = 0.955). Covariation for the shear stress stimulus did not alter the FMD results. CONCLUSION Eight weeks of single leg heating did not change SFA endothelial or calf microvascular function. These results are in contrast with previous findings that limb heating improves upper limb endothelial function.
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15
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Souza LV, de Almeida SS, De Meneck F, Thomazini F, Araujo RC, Franco do MC. Polymorphism of the bradykinin type 2 receptor gene modulates blood pressure profile and microvascular function in prepubescent children. Peptides 2021; 137:170491. [PMID: 33412234 DOI: 10.1016/j.peptides.2020.170491] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Revised: 12/20/2020] [Accepted: 12/22/2020] [Indexed: 11/20/2022]
Abstract
Previous reports reveal that +9/-9 polymorphism of the bradykinin B2 receptor (BDKRB2) is suggestive of cardiometabolic diseases. The aim of this study was to examine the impact of BDKRB2 + 9/-9 polymorphism genotypes on the blood pressure parameters and microvascular function in prepubescent children. We screened for BDKRB2 + 9/-9 polymorphism in the DNA of 145 children (86 boys and 59 girls), and its association with body composition, blood pressure levels, biochemical parameters, and endothelial function was determined. No significant association of the BDKRB2 genotypes with gender (P=0.377), race (P=0.949) or family history of cardiovascular disease (CVD) (P=0.858) was observed. Moreover, we did not identify any interaction between BDKRB2 genotypes with a phenotype of obesity (P=0.144). Children carrying the +9/+9 genotype exhibited a significant linear trend with higher levels of systolic blood pressure and pulse pressure (P<0.001). Moreover, the presence of +9 allele resulted in a decrease of reactive hyperemia index, showing a decreasing linear trend from -9/-9 to +9/+9, wherein this parameter of endothelial function was the lowest in the +9/+9 children, intermediate in the +9/-9 children, and the highest in the -9/-9 children (P<0.001). There was a significant inverse correlation between reactive hyperemia index and systolic blood pressure (r= - 0.348, P< 0.001) and pulse pressure (r= - 0.399, P< 0.001). Our findings indicate that the +9/+9 BDKRB2 genotype was associated with high blood pressure and microvascular dysfunction in prepubescent Brazilian children.
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Affiliation(s)
- Livia Victorino Souza
- Division of Nephrology, Medicine Department, School of Medicine, Federal University of São Paulo, São Paulo, Brazil
| | | | - Franciele De Meneck
- Division of Nephrology, Medicine Department, School of Medicine, Federal University of São Paulo, São Paulo, Brazil
| | - Fernanda Thomazini
- Division of Translational Medicine, School of Medicine, Federal University of São Paulo, São Paulo, Brazil
| | - Ronaldo Carvalho Araujo
- Biophysical Department, School of Medicine, Federal University of São Paulo, São Paulo, Brazil
| | - Maria Carmo Franco do
- Division of Nephrology, Medicine Department, School of Medicine, Federal University of São Paulo, São Paulo, Brazil.
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16
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Sidsworth DA, Sellers SL, Reutens-Hernandez JP, Dunn EA, Gray SL, Payne GW. Impact of sex on microvascular reactivity in a murine model of diet-induced obesity and insulin resistance. Heliyon 2021; 7:e06217. [PMID: 33644477 PMCID: PMC7895723 DOI: 10.1016/j.heliyon.2021.e06217] [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: 06/18/2020] [Revised: 10/26/2020] [Accepted: 02/04/2021] [Indexed: 11/24/2022] Open
Abstract
The association of obesity with cardiovascular disease is well established. However, the interplay of obesity and vascular dysfunction in peripheral tissues such as skeletal muscle, which plays a key in role metabolic homeostasis, requires further study. In particular, there is a paucity of data with regard to sex-differences. Therefore, using a murine model (C57BL/6) of high-fat diet-induced obesity and insulin resistance, we investigated changes in vascular function in gluteus maximus muscle of female and male mice. Diet-induced obesity resulted in alterations in microvascular function. Obese male mice displayed impaired vasoconstriction in second order arterioles compared to lean, male mice, whereas arterioles of obese, female mice displayed significant impairments of both vasodilation and vasoconstrictor responses compared to lean, female mice. Overall, this study identifies distinct differences in how obesity impacts the female and male murine response to skeletal muscle vascular function. This work advances our understanding of sex-specific risk of metabolic complications of obesity and indicates the need for expansion of this study as well as detailed investigation of sex-specific differences in obesity pathology in the future.
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Affiliation(s)
- Danielle A Sidsworth
- Northern Medical Program, University of Northern British Columbia, Prince George, BC, V2N 4Z9, Canada
| | - Stephanie L Sellers
- Centre for Heart Lung Innovation & Department of Radiology, University of British Columba & St. Paul's Hospital, Vancouver, BC, V6Z 1Y6, Canada
| | | | - Elizabeth A Dunn
- Northern Medical Program, University of Northern British Columbia, Prince George, BC, V2N 4Z9, Canada
| | - Sarah L Gray
- Northern Medical Program, University of Northern British Columbia, Prince George, BC, V2N 4Z9, Canada
| | - Geoffrey W Payne
- Northern Medical Program, University of Northern British Columbia, Prince George, BC, V2N 4Z9, Canada
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17
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Theodorakopoulou MP, Schoina M, Sarafidis P. Assessment of Endothelial and Microvascular Function in CKD: Older and Newer Techniques, Associated Risk Factors, and Relations with Outcomes. Am J Nephrol 2020; 51:931-949. [PMID: 33311014 DOI: 10.1159/000512263] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [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: 09/10/2020] [Accepted: 10/12/2020] [Indexed: 12/17/2022]
Abstract
BACKGROUND Endothelium is the inner cellular lining of the vessels that modulates multiple biological processes including vasomotor tone, permeability, inflammatory responses, hemostasis, and angiogenesis. Endothelial dysfunction, the basis of atherosclerosis, is characterized by an imbalance between endothelium-derived relaxing factors and endothelium-derived contracting factors. SUMMARY Starting from the semi-invasive venous occlusion plethysmography, several functional techniques have been developed to evaluate microvascular function and subsequently used in patients with CKD. Flow-mediated dilatation of the forearm is considered to be the "gold standard," while in the last years, novel, noninvasive methods such as laser speckle contrast imaging and near-infrared spectroscopy are scarcely used. Moreover, several circulating biomarkers of endothelial function have been used in studies in CKD patients. This review summarizes available functional methods and biochemical markers for the assessment of endothelial and microvascular function in CKD and discusses existing evidence on their associations with comorbid conditions and outcomes in this population. Key Messages: Accumulated evidence suggests that endothelial dysfunction occurs early in CKD and is associated with target organ damage, progression of renal injury, cardiovascular events, and mortality. Novel methods evaluating microvascular function can offer a detailed, real-time assessment of underlying phenomena and should be increasingly used to shed more light on the role of endothelial dysfunction on cardiovascular and renal disease progression in CKD.
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Affiliation(s)
- Marieta P Theodorakopoulou
- Department of Nephrology, Hippokration Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Maria Schoina
- Department of Nephrology, Hippokration Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Pantelis Sarafidis
- Department of Nephrology, Hippokration Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece,
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18
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Herring N, Tapoulal N, Kalla M, Ye X, Borysova L, Lee R, Dall'Armellina E, Stanley C, Ascione R, Lu CJ, Banning AP, Choudhury RP, Neubauer S, Dora K, Kharbanda RK, Channon KM. Neuropeptide-Y causes coronary microvascular constriction and is associated with reduced ejection fraction following ST-elevation myocardial infarction. Eur Heart J 2020; 40:1920-1929. [PMID: 30859228 PMCID: PMC6588241 DOI: 10.1093/eurheartj/ehz115] [Citation(s) in RCA: 47] [Impact Index Per Article: 11.8] [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: 08/02/2018] [Revised: 10/23/2018] [Accepted: 02/18/2019] [Indexed: 12/11/2022] Open
Abstract
Aims The co-transmitter neuropeptide-Y (NPY) is released during high sympathetic drive, including ST-elevation myocardial infarction (STEMI), and can be a potent vasoconstrictor. We hypothesized that myocardial NPY levels correlate with reperfusion and subsequent recovery following primary percutaneous coronary intervention (PPCI), and sought to determine if and how NPY constricts the coronary microvasculature. Methods and results Peripheral venous NPY levels were significantly higher in patients with STEMI (n = 45) compared to acute coronary syndromes/stable angina ( n = 48) or with normal coronary arteries (NC, n = 16). Overall coronary sinus (CS) and peripheral venous NPY levels were significantly positively correlated (r = 0.79). STEMI patients with the highest CS NPY levels had significantly lower coronary flow reserve, and higher index of microvascular resistance measured with a coronary flow wire. After 2 days they also had significantly higher levels of myocardial oedema and microvascular obstruction on cardiac magnetic resonance imaging, and significantly lower ejection fractions and ventricular dilatation 6 months later. NPY (100–250 nM) caused significant vasoconstriction of rat microvascular coronary arteries via increasing vascular smooth muscle calcium waves, and also significantly increased coronary vascular resistance and infarct size in Langendorff hearts. These effects were blocked by the Y1 receptor antagonist BIBO3304 (1 μM). Immunohistochemistry of the human coronary microvasculature demonstrated the presence of vascular smooth muscle Y1 receptors. Conclusion High CS NPY levels immediately after reperfusion correlate with microvascular dysfunction, greater myocardial injury, and reduced ejection fraction 6 months after STEMI. NPY constricts the coronary microcirculation via the Y1 receptor, and antagonists may be a useful PPCI adjunct therapy. ![]()
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Affiliation(s)
- Neil Herring
- Department of Physiology, Anatomy and Genetics, Burdon Sandersn Cardiac Science Centre, University of Oxford, Parks Road, Oxford OX13PT, UK.,Department of Cardiovascular Medicine, British Heart Foundation Centre of Research Excellence, University of Oxford, John Radcliffe Hospital, Headley Way, Oxford, UK
| | - Nidi Tapoulal
- Department of Physiology, Anatomy and Genetics, Burdon Sandersn Cardiac Science Centre, University of Oxford, Parks Road, Oxford OX13PT, UK
| | - Manish Kalla
- Department of Physiology, Anatomy and Genetics, Burdon Sandersn Cardiac Science Centre, University of Oxford, Parks Road, Oxford OX13PT, UK.,Department of Cardiovascular Medicine, British Heart Foundation Centre of Research Excellence, University of Oxford, John Radcliffe Hospital, Headley Way, Oxford, UK
| | - Xi Ye
- Department of Pharmacology, University of Oxford, Mansfield Road, Oxford UK
| | - Lyudmyla Borysova
- Department of Pharmacology, University of Oxford, Mansfield Road, Oxford UK
| | - Regent Lee
- Department of Cardiovascular Medicine, British Heart Foundation Centre of Research Excellence, University of Oxford, John Radcliffe Hospital, Headley Way, Oxford, UK
| | - Erica Dall'Armellina
- Department of Cardiovascular Medicine, British Heart Foundation Centre of Research Excellence, University of Oxford, John Radcliffe Hospital, Headley Way, Oxford, UK.,Oxford Acute Vascular Imaging Centre, Department of Cardiovascular Medicine, University of Oxford, John Radcliffe Hospital, Headley Way, Oxford UK
| | | | - Raimondo Ascione
- Bristol Heart Institute, Bristol Royal Infirmary, and Faculty of Health Sciences, University of Bristol, Horfield Road, Bristol UK
| | - Chieh-Ju Lu
- Department of Physiology, Anatomy and Genetics, Burdon Sandersn Cardiac Science Centre, University of Oxford, Parks Road, Oxford OX13PT, UK
| | - Adrian P Banning
- Department of Cardiovascular Medicine, British Heart Foundation Centre of Research Excellence, University of Oxford, John Radcliffe Hospital, Headley Way, Oxford, UK.,National Institute for Health Research (NIHR) Biomedical Research Centre, Oxford University Hospitals NHS Foundation Trust, John Radcliffe Hospital, Headley Way Oxford, UK
| | - Robin P Choudhury
- Department of Cardiovascular Medicine, British Heart Foundation Centre of Research Excellence, University of Oxford, John Radcliffe Hospital, Headley Way, Oxford, UK.,Oxford Acute Vascular Imaging Centre, Department of Cardiovascular Medicine, University of Oxford, John Radcliffe Hospital, Headley Way, Oxford UK
| | - Stefan Neubauer
- Department of Cardiovascular Medicine, British Heart Foundation Centre of Research Excellence, University of Oxford, John Radcliffe Hospital, Headley Way, Oxford, UK.,National Institute for Health Research (NIHR) Biomedical Research Centre, Oxford University Hospitals NHS Foundation Trust, John Radcliffe Hospital, Headley Way Oxford, UK
| | - Kim Dora
- Department of Pharmacology, University of Oxford, Mansfield Road, Oxford UK
| | - Rajesh K Kharbanda
- Department of Cardiovascular Medicine, British Heart Foundation Centre of Research Excellence, University of Oxford, John Radcliffe Hospital, Headley Way, Oxford, UK.,National Institute for Health Research (NIHR) Biomedical Research Centre, Oxford University Hospitals NHS Foundation Trust, John Radcliffe Hospital, Headley Way Oxford, UK
| | - Keith M Channon
- Department of Cardiovascular Medicine, British Heart Foundation Centre of Research Excellence, University of Oxford, John Radcliffe Hospital, Headley Way, Oxford, UK.,National Institute for Health Research (NIHR) Biomedical Research Centre, Oxford University Hospitals NHS Foundation Trust, John Radcliffe Hospital, Headley Way Oxford, UK
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19
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DeBlois JP, Lefferts WK, Heffernan KS. Influence of sprint exercise on aortic pulse wave velocity and femoral artery shear patterns. Eur J Appl Physiol 2020; 120:2635-47. [PMID: 32880701 DOI: 10.1007/s00421-020-04483-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Accepted: 08/25/2020] [Indexed: 10/23/2022]
Abstract
PURPOSE Aortic stiffness may affect shear patterns in the peripheral vasculature. This study examined if sprint exercise, which typically increases aortic stiffness is associated with increased peripheral retrograde blood flow and impaired microvascular function. METHODS Twenty participants (10 women; age: 27 ± 5 years) underwent arterial stiffness, shear rate, and microvascular function assessment at three time points: baseline; following time control; ~ 2 min post a 30-s cycle ergometer sprint against 7.0% body mass. Aortic stiffness was assessed using carotid-femoral pulse wave velocity (cfPWV). Superficial femoral artery (SFA) diameter and blood velocity were assessed using Doppler-ultrasound and were used to calculate shear rates and resistance index (RI). SFA wave reflections were obtained via wave intensity analysis. Vastus medialis microvascular function was measured as tissue saturation index reactivity pre-post exercise via near-infrared spectroscopy. RESULTS cfPWV increased by + 0.8 ± 0.7 m·s-1 following exercise (p < 0.001). Retrograde shear was reduced following exercise compared with time control (- 4.9 ± 3.8 s-1; p < 0.001), while tissue saturation index was increased post-exercise from baseline (+ 2.3 ± 4.6%; p = 0.04). Reductions in SFA wave reflections (- 1.70 ± 1.96 aU) and RI (- 0.17 ± 0.13 aU) were also noted following exercise (p < 0.001). CONCLUSION These data suggest sprint exercise-mediated changes in peripheral shear patterns and microvascular function in the exercised vasculature occur independent from increases in aortic stiffness. Exercise-induced reductions in SFA retrograde shear may be related to decreased wave reflections and peripheral vascular resistance.
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20
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D'Amario D, Restivo A, Leone AM, Vergallo R, Migliaro S, Canonico F, Galli M, Trani C, Burzotta F, Aurigemma C, Niccoli G, Buffon A, Montone RA, Flex A, Franceschi F, Tinelli G, Limbruno U, Francese F, Ceccarelli I, Borovac JA, Porto I, Crea F. Ticagrelor and preconditioning in patients with stable coronary artery disease (TAPER-S): a randomized pilot clinical trial. Trials 2020; 21:192. [PMID: 32066489 PMCID: PMC7027127 DOI: 10.1186/s13063-020-4116-7] [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: 04/04/2019] [Accepted: 01/29/2020] [Indexed: 02/18/2023] Open
Abstract
Background Ticagrelor is a reversibly binding, direct-acting, oral, P2Y12 antagonist used for the prevention of atherothrombotic events in patients with coronary artery disease (CAD). Ticagrelor blocks adenosine reuptake through the inhibition of equilibrative nucleoside transporter 1 (ENT-1) on erythrocytes and platelets, thereby facilitating adenosine-induced physiological responses such as an increase in coronary blood flow velocity. Meanwhile, adenosine plays an important role in triggering ischemic preconditioning through the activation of the A1 receptor. Therefore, an increase in ticagrelor-enhanced adenosine bioavailability may confer beneficial effects through mechanisms related to preconditioning activation and improvement of coronary microvascular dysfunction. Methods To determine whether ticagrelor can trigger ischemic preconditioning and influence microvascular function, we designed this prospective, open-label, pilot study that enrolled patients with stable multivessel CAD requiring staged, fractional flow reserve (FFR)-guided percutaneous coronary intervention (PCI). Participants will be randomized in 1:1 ratios either to ticagrelor (loading dose (LD) 180 mg, maintenance dose (MD) 90 mg bid) or to clopidogrel (LD 600 mg, MD 75 mg) from 3 to 1 days before the scheduled PCI. The PCI operators will be blinded to the randomization arm. The primary endpoint is the delta (difference) between ST segment elevations (in millimeters, mm) as assessed by intracoronary electrocardiogram (ECG) during the two-step sequential coronary balloon inflation in the culprit vessel. Secondary endpoints are 1) changes in coronary flow reserve (CFR), index of microvascular resistance (IMR), and FFR measured in the culprit vessel and reference vessel at the end of PCI, and 2) angina score during inflations. This study started in 2018 with the aim of enrolling 100 patients. Based on the rate of negative FFR up to 30% and a drop-out rate up to 10%, we expect to detect an absolute difference of 4 mm among the study arms in the mean change of ST elevation following repeated balloon inflations. All study procedures were reviewed and approved by the Ethical Committee of the Catholic University of Sacred Heart. Discussion Ticagrelor might improve ischemia tolerance and microvascular function compared to clopidogrel, and these effects might translate to better long-term clinical outcomes. Trial registration EudraCT No. 2016–004746-28. No. NCT02701140. Trial status Information provided in this manuscript refers to the definitive version (n. 3.0) of the study protocol, dated 31 October 2017, and includes all protocol amendments. Recruitment started on 18 September 2018 and is currently ongoing. The enrollment is expected to be completed by the end of 2019. Trial sponsor Fondazione Policlinico Universitario A. Gemelli – Roma, Polo di Scienze Cardiovascolari e Toraciche, Largo Agostino Gemelli 8, 00168 Rome, Italy.
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Affiliation(s)
- D D'Amario
- Fondazione Policlinico A. Gemelli IRCCS - Università Cattolica del Sacro Cuore, Largo Agostino Gemelli 8, 00168, Rome, Italy
| | - A Restivo
- Fondazione Policlinico A. Gemelli IRCCS - Università Cattolica del Sacro Cuore, Largo Agostino Gemelli 8, 00168, Rome, Italy
| | - A M Leone
- Fondazione Policlinico A. Gemelli IRCCS - Università Cattolica del Sacro Cuore, Largo Agostino Gemelli 8, 00168, Rome, Italy
| | - R Vergallo
- Fondazione Policlinico A. Gemelli IRCCS - Università Cattolica del Sacro Cuore, Largo Agostino Gemelli 8, 00168, Rome, Italy
| | - S Migliaro
- Fondazione Policlinico A. Gemelli IRCCS - Università Cattolica del Sacro Cuore, Largo Agostino Gemelli 8, 00168, Rome, Italy
| | - F Canonico
- Fondazione Policlinico A. Gemelli IRCCS - Università Cattolica del Sacro Cuore, Largo Agostino Gemelli 8, 00168, Rome, Italy
| | - M Galli
- Fondazione Policlinico A. Gemelli IRCCS - Università Cattolica del Sacro Cuore, Largo Agostino Gemelli 8, 00168, Rome, Italy
| | - C Trani
- Fondazione Policlinico A. Gemelli IRCCS - Università Cattolica del Sacro Cuore, Largo Agostino Gemelli 8, 00168, Rome, Italy
| | - F Burzotta
- Fondazione Policlinico A. Gemelli IRCCS - Università Cattolica del Sacro Cuore, Largo Agostino Gemelli 8, 00168, Rome, Italy
| | - C Aurigemma
- Fondazione Policlinico A. Gemelli IRCCS - Università Cattolica del Sacro Cuore, Largo Agostino Gemelli 8, 00168, Rome, Italy
| | - G Niccoli
- Fondazione Policlinico A. Gemelli IRCCS - Università Cattolica del Sacro Cuore, Largo Agostino Gemelli 8, 00168, Rome, Italy
| | - A Buffon
- Fondazione Policlinico A. Gemelli IRCCS - Università Cattolica del Sacro Cuore, Largo Agostino Gemelli 8, 00168, Rome, Italy
| | - R A Montone
- Fondazione Policlinico A. Gemelli IRCCS - Università Cattolica del Sacro Cuore, Largo Agostino Gemelli 8, 00168, Rome, Italy
| | - A Flex
- Fondazione Policlinico A. Gemelli IRCCS - Università Cattolica del Sacro Cuore, Largo Agostino Gemelli 8, 00168, Rome, Italy
| | - F Franceschi
- Fondazione Policlinico A. Gemelli IRCCS - Università Cattolica del Sacro Cuore, Largo Agostino Gemelli 8, 00168, Rome, Italy
| | - G Tinelli
- Fondazione Policlinico A. Gemelli IRCCS - Università Cattolica del Sacro Cuore, Largo Agostino Gemelli 8, 00168, Rome, Italy
| | - U Limbruno
- Dipartimento Cardio neuro vascolare, Azienda USL Toscana Sud-est, Ospedale di Grosseto, Grosseto, Italy
| | - F Francese
- Fondazione Policlinico A. Gemelli IRCCS - Università Cattolica del Sacro Cuore, Largo Agostino Gemelli 8, 00168, Rome, Italy
| | - I Ceccarelli
- Fondazione Policlinico A. Gemelli IRCCS - Università Cattolica del Sacro Cuore, Largo Agostino Gemelli 8, 00168, Rome, Italy
| | - J A Borovac
- Department of Pathophysiology, University of Split School of Medicine (USSM) and University Hospital Center Split (UHC Split), Split, Croatia
| | - I Porto
- Ospedale Policlinico San Martino IRCCS, Università degli Studi di Genova, Genoa, Italy.
| | - F Crea
- Fondazione Policlinico A. Gemelli IRCCS - Università Cattolica del Sacro Cuore, Largo Agostino Gemelli 8, 00168, Rome, Italy.
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21
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Kim K, Brothers RM. Acute consumption of flavanol-rich cocoa beverage improves attenuated cutaneous microvascular function in healthy young African Americans. Microvasc Res 2019; 128:103931. [PMID: 31654654 DOI: 10.1016/j.mvr.2019.103931] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2019] [Revised: 09/08/2019] [Accepted: 09/22/2019] [Indexed: 12/24/2022]
Abstract
Flavanols have beneficial effects on vascular health and we have recently demonstrated that cerebral vasodilatory capacity in healthy young African Americans (AA) is improved with acute flavanol intake relative to aged-matched Caucasian Americans (CA). However, whether the positive benefits of acute flavanol consumption would also be present in the cutaneous microvascular circulation of AA remains unknown. Thus, we hypothesized that acute consumption of flavanol-rich cocoa (FC) would improve the previously reported reduced cutaneous microvascular responses to local heating in young AA. Seven AA and seven CA participated in this double-blind crossover study. Data were collected on two different days, separated by a minimum of one week. Two intradermal microdialysis membranes were inserted in the forearm and each site was randomly assigned to receive lactated Ringer's solution or NO synthase (NOS) inhibitor. Participants were randomly assigned to consume either a non-flavanol containing (NF) beverage or FC beverage. Cutaneous vascular conductance (CVC) was calculated as cutaneous blood flux/mean arterial pressure and normalized as % maximal CVC (%CVCmax). The difference in %CVCmax between the Ringer's site and NOS inhibited site was calculated to assess NO contribution (Δ %CVCmax). In the Ringer's site, acute consumption of FC beverage improved %CVCmax during 39 °C heating when compared to NF beverage in AA (NF: 36 ± 6 vs. FC: 47 ± 5%CVCmax; P < .01) while there was similar %CVCmax during 39 °C heating between beverages in CA (NF: 55 ± 4 vs. FC: 59 ± 5%CVCmax; P = .40). During 39 °C heating, NO contribution was significantly higher with FC beverage than NF beverage in AA (NF: 27 ± 5 vs. FC: 35 ± 4 Δ %CVCmax; P = .03) while there was similar NO contribution between beverages in CA (NF: 42 ± 4 vs. FC: 45 ± 4 Δ %CVCmax; P = .36). This data suggests that acute consumption of FC could be a therapeutic solution to improve an attenuated microvascular function in young AA.
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Affiliation(s)
- Kiyoung Kim
- Department of Pharmacology & Experimental Therapeutics and the Whitaker Cardiovascular Institute, Boston University School of Medicine, Boston, MA, United States of America
| | - R Matthew Brothers
- Department of Kinesiology, The University of Texas at Arlington, Arlington, TX, United States of America.
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22
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Skinner S, Connes P, Sigaudo-Roussel D, Lo M, Liu KL, Nader E, Josset-Lamaugarny A, Charrin E, Martin C, Romanet-Faes C, Diaw M, Pialoux V, Fromy B. Altered blood rheology and impaired pressure-induced cutaneous vasodilation in a mouse model of combined type 2 diabetes and sickle cell trait. Microvasc Res 2018; 122:111-116. [PMID: 30513282 DOI: 10.1016/j.mvr.2018.11.014] [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] [Received: 09/17/2018] [Revised: 11/28/2018] [Accepted: 11/30/2018] [Indexed: 02/08/2023]
Abstract
OBJECTIVE Type 2 diabetes (T2D)-related vascular dysfunction and hemorheological abnormalities could possibly be amplified by sickle cell trait (SCT). These alterations could potentially increase the risk of vascular complications in individuals with combined T2D and SCT. Therefore, this study used a mouse model to determine whether vascular function and blood rheology were more severely altered in combined T2D and SCT than in T2D or SCT alone. METHODS Townes transgenic mice with or without SCT received a 12-week high fat high sucrose or standard diet to create models of combined T2D-SCT, T2D, SCT, and controls. Pressure-induced vasodilation (PIV) and sodium nitroprusside (SNP)-mediated vasodilation in-vivo, and hemorheological parameters were measured. RESULTS No significant differences in blood viscosity, hematocrit, erythrocyte deformability, or PIV were observed between the control and T2D mice, or the control and SCT mice. However, blood viscosity, erythrocyte deformability, and PIV were significantly altered in the T2D-SCT mice compared to the control mice. There were no differences in SNP response between the groups. CONCLUSIONS Although neither T2D nor SCT alone had significant effects on blood rheology parameters or vascular function, combined T2D-SCT mice had significantly altered blood rheology and significantly impaired vascular function.
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Affiliation(s)
- Sarah Skinner
- LIBM EA7424, UCBL 1, Villeurbanne, France; Labex GR-Ex, Paris, France
| | - Philippe Connes
- LIBM EA7424, UCBL 1, Villeurbanne, France; Labex GR-Ex, Paris, France; Institut Universitaire de France, Paris, France.
| | | | - Ming Lo
- UMR 5305 CNRS, Lyon, France; Université de Lyon 1, UMR 5305, Lyon, France
| | - Kiao Ling Liu
- UMR 5305 CNRS, Lyon, France; Université de Lyon 1, UMR 5305, Lyon, France
| | - Elie Nader
- LIBM EA7424, UCBL 1, Villeurbanne, France; Labex GR-Ex, Paris, France
| | | | | | - Cyril Martin
- LIBM EA7424, UCBL 1, Villeurbanne, France; Labex GR-Ex, Paris, France
| | | | - Mor Diaw
- Laboratory of Physiology and Functional Exploration, FMPO, UCAD, Dakar, Senegal
| | - Vincent Pialoux
- LIBM EA7424, UCBL 1, Villeurbanne, France; Labex GR-Ex, Paris, France; Institut Universitaire de France, Paris, France
| | - Bérengère Fromy
- UMR 5305 CNRS, Lyon, France; Université de Lyon 1, UMR 5305, Lyon, France
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23
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Huxley VH, Kemp SS, Schramm C, Sieveking S, Bingaman S, Yu Y, Zaniletti I, Stockard K, Wang J. Sex differences influencing micro- and macrovascular endothelial phenotype in vitro. J Physiol 2018; 596:3929-3949. [PMID: 29885204 DOI: 10.1113/jp276048] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [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: 04/27/2018] [Accepted: 05/30/2018] [Indexed: 12/12/2022] Open
Abstract
KEY POINTS Endothelial dysfunction is an early hallmark of multiple disease states that also display sex differences with respect to age of onset, frequency and severity. Results of in vivo studies of basal and stimulated microvascular barrier function revealed sex differences that are difficult to ascribe to specific cells or environmental factors. The present study evaluated endothelial cells (EC) isolated from macro- and/or microvessels of reproductively mature rats under the controlled conditions of low-passage culture aiming to test the assumption that EC phenotype would be sex independent. The primary finding was that EC, regardless of where they are derived, retain a sex-bias in low-passage culture, independent of varying levels of reproductive hormones. The implications of the present study include the fallacy of expecting a universal set of mechanisms derived from study of EC from one sex and/or one vascular origin to apply uniformly to all EC under unstimulated conditions, and no less in disease. ABSTRACT Vascular endothelial cells (EC) are heterogeneous with respect to phenotype, reflecting at least the organ of origin, location within the vascular network and physical forces. As an independent influence on EC functions in health or aetiology, susceptibility, and progression of dysfunction in numerous disease states, sex has been largely ignored. The present study focussed on EC isolated from aorta (macrovascular) and skeletal muscle vessels (microvascular) of age-matched male and female rats under identical conditions of short-term (passage 4) culture. We tested the hypothesis that genomic sex would not influence endothelial growth, wound healing, morphology, lactate production, or messenger RNA and protein expression of key proteins (sex hormone receptors for androgen and oestrogens α and β; platelet endothelial cell adhesion molecule-1 and vascular endothelial cadherin mediating barrier function; αv β3 and N-cadherin influencing matrix interactions; intracellular adhesion molecule-1 and vascular cell adhesion molecule-1 mediating EC/white cell adhesion). The hypothesis was rejected because the EC origin (macro- vs. microvessel) and sex influenced multiple phenotypic characteristics. Statistical model analysis of EC growth demonstrated an hierarchy of variable importance, recapitulated for other phenotypic characteristics, with predictions assuming EC homogeneity < sex < vessel origin < sex and vessel origin. Furthermore, patterns of EC mRNA expression by vessel origin and by sex did not predict protein expression. Overall, the present study demonstrated that accurate assessment of sex-linked EC dysfunction first requires an understanding of EC function by position in the vascular tree and by sex. The results from a single EC tissue source/species/sex cannot provide universal insight into the mechanisms regulating in vivo endothelial function in health, and no less in disease.
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Affiliation(s)
- Virginia H Huxley
- National Center for Gender Physiology, University of Missouri-Columbia, Columbia, MO, USA.,Department of Medical Pharmacology and Physiology, University of Missouri-Columbia, Columbia, MO, USA.,Dalton Cardiovascular Research Center, University of Missouri-Columbia, Columbia, MO, USA
| | - Scott S Kemp
- National Center for Gender Physiology, University of Missouri-Columbia, Columbia, MO, USA.,Department of Medical Pharmacology and Physiology, University of Missouri-Columbia, Columbia, MO, USA
| | - Christine Schramm
- National Center for Gender Physiology, University of Missouri-Columbia, Columbia, MO, USA.,Department of Medical Pharmacology and Physiology, University of Missouri-Columbia, Columbia, MO, USA
| | - Steve Sieveking
- National Center for Gender Physiology, University of Missouri-Columbia, Columbia, MO, USA.,Department of Medical Pharmacology and Physiology, University of Missouri-Columbia, Columbia, MO, USA
| | - Susan Bingaman
- National Center for Gender Physiology, University of Missouri-Columbia, Columbia, MO, USA.,Department of Medical Pharmacology and Physiology, University of Missouri-Columbia, Columbia, MO, USA
| | - Yang Yu
- National Center for Gender Physiology, University of Missouri-Columbia, Columbia, MO, USA
| | - Isabella Zaniletti
- Department of Statistics, University of Missouri-Columbia, Columbia, MO, USA
| | - Kevin Stockard
- National Center for Gender Physiology, University of Missouri-Columbia, Columbia, MO, USA.,Department of Medical Pharmacology and Physiology, University of Missouri-Columbia, Columbia, MO, USA
| | - Jianjie Wang
- National Center for Gender Physiology, University of Missouri-Columbia, Columbia, MO, USA.,Department of Biomedical Sciences, Missouri State University, Springfield, MO, USA
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24
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Hoshino M, Yonetsu T, Murai T, Kanaji Y, Usui E, Hada M, Hamaya R, Kanno Y, Lee T, Kakuta T. Influence of visual-functional mismatch on coronary flow profiles after percutaneous coronary intervention: a propensity score-matched analysis. Heart Vessels 2018; 33:1129-1138. [PMID: 29627899 DOI: 10.1007/s00380-018-1161-1] [Citation(s) in RCA: 4] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2017] [Accepted: 03/30/2018] [Indexed: 11/24/2022]
Abstract
The aims of this study are to clarify whether discrepancies between angiographic and fractional flow reserve (FFR) measurements (visual-functional mismatch) influence coronary flow profiles after percutaneous coronary intervention. While current guidelines FFR-guided revascularization, clinical practice most commonly relies on angiographic evaluation, which may under- or over-estimate the functional relevance of the lesion. Our retrospective analysis involved 274 vessels from 264 patients with stable angina pectoris who underwent FFR, index of microvascular resistance, and coronary flow reserve (CFR) measurements before and after PCI. Visual-functional concordance and discordance (reverse mismatch) were defined as angiographic stenosis > 50% with FFR ≤ 0.80 and angiographic stenosis ≤ 50% with FFR ≤ 0.80, respectively. Propensity score-matched cohort included 132 lesions (66 lesions: concordant findings, 66 lesions: reverse mismatch). The change in coronary flow profiles after PCI was assessed in terms of FFR, CFR, index of microvascular resistance (IMR), and mean transit time (Tmn). Compared with concordant territories, reverse mismatch territories were associated with lower pre-PCI IMR, higher pre-PCI CFR, greater minimum lumen diameter and smaller reference diameter (all comparisons, P < 0.05). After propensity score matching, the prevalence and extent of coronary flow improvement after PCI, evaluated by CFR and Tmn, were both remained significantly greater in concordant territories (all comparisons, P < 0.05). The prevalence and extent of coronary flow improvement after PCI assessed by the physiologic indices was significantly greater in visual-functional concordant lesions, suggesting that these coronary physiologic changes were associated with discrepancy between angiographic measurements.
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Affiliation(s)
- Masahiro Hoshino
- Department of Cardiovascular Medicine, Tsuchiura Kyodo General Hospital, 4-1-1, Otsuno, Tsuchiura, Ibaraki, 300-0028, Japan
| | - Taishi Yonetsu
- Department of Cardiovascular Medicine, Tsuchiura Kyodo General Hospital, 4-1-1, Otsuno, Tsuchiura, Ibaraki, 300-0028, Japan
| | - Tadashi Murai
- Department of Cardiovascular Medicine, Tsuchiura Kyodo General Hospital, 4-1-1, Otsuno, Tsuchiura, Ibaraki, 300-0028, Japan
| | - Yoshihisa Kanaji
- Department of Cardiovascular Medicine, Tsuchiura Kyodo General Hospital, 4-1-1, Otsuno, Tsuchiura, Ibaraki, 300-0028, Japan
| | - Eisuke Usui
- Department of Cardiovascular Medicine, Tsuchiura Kyodo General Hospital, 4-1-1, Otsuno, Tsuchiura, Ibaraki, 300-0028, Japan
| | - Masahiro Hada
- Department of Cardiovascular Medicine, Tsuchiura Kyodo General Hospital, 4-1-1, Otsuno, Tsuchiura, Ibaraki, 300-0028, Japan
| | - Rikuta Hamaya
- Department of Cardiovascular Medicine, Tsuchiura Kyodo General Hospital, 4-1-1, Otsuno, Tsuchiura, Ibaraki, 300-0028, Japan
| | - Yoshinori Kanno
- Department of Cardiovascular Medicine, Tsuchiura Kyodo General Hospital, 4-1-1, Otsuno, Tsuchiura, Ibaraki, 300-0028, Japan
| | - Tetsumin Lee
- Department of Cardiovascular Medicine, Tsuchiura Kyodo General Hospital, 4-1-1, Otsuno, Tsuchiura, Ibaraki, 300-0028, Japan
| | - Tsunekazu Kakuta
- Department of Cardiovascular Medicine, Tsuchiura Kyodo General Hospital, 4-1-1, Otsuno, Tsuchiura, Ibaraki, 300-0028, Japan.
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25
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Kim K, Hurr C, Patik JC, Matthew Brothers R. Attenuated cutaneous microvascular function in healthy young African Americans: Role of intradermal l-arginine supplementation. Microvasc Res 2018; 118:1-6. [PMID: 29408444 DOI: 10.1016/j.mvr.2018.02.001] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [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: 11/01/2017] [Revised: 01/03/2018] [Accepted: 02/01/2018] [Indexed: 11/17/2022]
Abstract
It has been established that endothelial function in conduit vessels is reduced in young African Americans (AA) relative to Caucasian Americans (CA). However, less is known regarding endothelial function in microvasculature of young AA. We hypothesized that microvascular function in response to local heating of skin is attenuated in young AA relative to age-matched CA due largely to the lack of NO bioavailability, which is in turn improved by intradermal l-arginine supplementation and/or inhibition of arginase. Nine AA and nine CA adults participated in this study. Participants were instrumented with four microdialysis membranes in the cutaneous vasculature of one forearm and were randomly assigned to receive 1) lactated Ringer's solution as a control site; 2) 20 mM NG-nitro-l-arginine (l-NAME) to inhibit NO synthase activity; 3) 10 mM l-arginine to local supplement l-arginine; or 4) a combination of 5.0 mM (S)-(2‑boronoethyl)-l-cysteine-HCL (BEC) and 5.0 mM Nω-hydroxy-nor-l-arginine (nor-NOHA) at a rate of 2.0 μl/min to locally inhibit arginase activity. Cutaneous vascular conductance (CVC) was calculated as red blood cell flux divided by mean arterial pressure. All CVC data were presented as a percentage of maximal CVC (%CVCmax) that was determined by maximal cutaneous vasodilation induced by 44 °C heating plus sodium nitroprusside administration. The response during the 42 °C local heating plateau was blunted in the AA at the control site (CA: 84 ± 12 vs. AA: 62 ± 6 vs. %CVCmax; P < 0.001). This response was improved in AA at the l-arginine site (Control: 62 ± 6 vs. l-arginine: 70 ± 18%CVCmax; P < 0.05) but not in the arginase inhibited site (Control: 62 ± 6 vs. Arginase inhibited: 62 ± 13%CVCmax; P = 0.91). In addition, the AA group had an attenuated NO contribution to the plateau phase during 42 °C local heating relative to the CA group (CA: 56 ± 14 vs. AA: 44 ± 6 Δ %CVCmax; P < 0.001). These findings suggest that 1) cutaneous microvascular function in response to local heating is blunted in young AA when compared to age-matched young CA; 2) this attenuated response is partly related to decrease in NO bioavailability in young AA; and 3) a local infusion of l-arginine, but not arginase inhibition, improves cutaneous microvascular responses to local heating in young AA relative to CA.
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Affiliation(s)
- Kiyoung Kim
- Department of Pathology, The University of Alabama at Birmingham, United States
| | - Chansol Hurr
- Department of Pharmacology and Physiology, George Washington University, United States
| | - Jordan C Patik
- Department of Kinesiology, The University of Texas at Arlington, United States
| | - R Matthew Brothers
- Department of Kinesiology, The University of Texas at Arlington, United States.
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26
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Abstract
A number of studies consistently report higher rates of all clinical outcomes including postinfarction mortality, need for repeat revascularization, and reinfarction in women with cardiovascular diseases than in men. As well, the gender gap in the prevalence of cardiovascular diseases decreases progressively with increasing age. Yet, the diagnosis and treatment of these diseases differ between genders and women remain underdiagnosed for coronary heart disease. In a recent retrospective analysis we showed that, along with vessel under study and age, gender is a determinant of adenosine responses during studies of fractional flow reserve, an effect that was probably due to differences in microvascular function and that influenced the interpretation of fractional flow reserve data. These data demonstrate that not only the clinical presentation is different, but also the diagnostic approach to coronary artery disease might differ between sexes.A gap still exists in the understanding of the mechanisms, awareness, and treatment of coronary artery disease in women, but also, as we show, in the application of diagnostic modalities that are well established in men.
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27
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Dipla K, Triantafyllou A, Grigoriadou I, Kintiraki E, Triantafyllou GA, Poulios P, Vrabas IS, Zafeiridis A, Douma S, Goulis DG. Impairments in microvascular function and skeletal muscle oxygenation in women with gestational diabetes mellitus: links to cardiovascular disease risk factors. Diabetologia 2017; 60:192-201. [PMID: 27722775 DOI: 10.1007/s00125-016-4129-7] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2016] [Accepted: 09/15/2016] [Indexed: 01/11/2023]
Abstract
AIMS/HYPOTHESIS Gestational diabetes mellitus (GDM) is a risk factor for the development of endothelial dysfunction and cardiovascular disease. However, in vivo microvascular endothelial function in GDM has not been investigated. This study aimed to examine, using near-infrared spectroscopy (NIRS), whether: (1) there are differences in microvascular reactivity and skeletal muscle oxygen consumption (m[Formula: see text]) at rest and during exercise between GDM and uncomplicated pregnancies; and (2) there is an association of NIRS indices with macrovascular function and cardiovascular disease risk factors. METHODS Twenty-nine pregnant women (13 with GDM and 16 women with uncomplicated pregnancy, 28 ± 2 gestational weeks) underwent arterial stiffness (pulse wave velocity [PWV]) and 24 h ambulatory BP (24 h BP) evaluation. NIRS continuously monitored, non-invasively, changes in muscle oxygenated and deoxygenated haemoglobin and tissue O2 saturation index (TSI, %) during arterial occlusion/reperfusion and intermittent handgrip exercise. m[Formula: see text] and vascular reactivity indices were calculated. RESULTS During occlusion and reperfusion, women with GDM exhibited slower TSI response (occlusion slope: -0.06 ± 0.02 vs -0.10 ± 0.04, in GDM and controls, respectively; reperfusion slope: 0.65 ± 0.26 vs 1.05 ± 0.41, respectively), lower m[Formula: see text] (1.3 ± 1.2 vs 3.8 ± 2.3 μmol l-1 min-1) and blunted hyperaemia (ΔTSI 6.8 ± 2.9 vs 9.5 ± 3.4) compared with controls (p < 0.01). Despite similar handgrip strength in the GDM and control groups (29.1 ± 8.1 vs 26.2 ± 10.4 kg, respectively), during repeated forearm contractions, women with GDM presented a blunted TSI response (6.5 ± 3.9 vs 19.2 ± 10.9; p < 0.01) and a reduced capacity to maintain the predetermined handgrip (23.4 ± 2.9 vs 27.4 ± 3.8%, p < 0.05). NIRS indices correlated with PWV, 24 h BP and blood glucose concentration earlier in pregnancy (r = 0.40-0.60; p < 0.05). CONCLUSIONS/INTERPRETATION Women with GDM exhibited a characteristic blunted TSI curve, showing alterations in muscle oxygenation and microvascular responsiveness compared with women with uncomplicated pregnancies. These alterations were manifested during exercise and possibly contribute to the reduced exercise tolerance in GDM. NIRS indices correlated with macrovascular indices (arterial stiffness) and 24 h BP.
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Affiliation(s)
- Konstantina Dipla
- Laboratory of Exercise Physiology and Biochemistry, Department of Physical Education and Sports Science at Serres, Aristotle University of Thessaloniki, Ippokratous 22, Agios Ioannis, Serres, 62110, Greece.
| | - Areti Triantafyllou
- Third Department of Internal Medicine, Papageorgiou Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Iris Grigoriadou
- Laboratory of Exercise Physiology and Biochemistry, Department of Physical Education and Sports Science at Serres, Aristotle University of Thessaloniki, Ippokratous 22, Agios Ioannis, Serres, 62110, Greece
| | - Evangelia Kintiraki
- Unit of Reproductive Endocrinology, First Department of Obstetrics and Gynaecology, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Georgios A Triantafyllou
- Third Department of Internal Medicine, Papageorgiou Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Pavlos Poulios
- Third Department of Internal Medicine, Papageorgiou Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Ioannis S Vrabas
- Laboratory of Exercise Physiology and Biochemistry, Department of Physical Education and Sports Science at Serres, Aristotle University of Thessaloniki, Ippokratous 22, Agios Ioannis, Serres, 62110, Greece
| | - Andreas Zafeiridis
- Laboratory of Exercise Physiology and Biochemistry, Department of Physical Education and Sports Science at Serres, Aristotle University of Thessaloniki, Ippokratous 22, Agios Ioannis, Serres, 62110, Greece
| | - Stella Douma
- Third Department of Internal Medicine, Papageorgiou Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Dimitrios G Goulis
- Unit of Reproductive Endocrinology, First Department of Obstetrics and Gynaecology, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece
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28
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Park KH, Sun T, Diez-Delhoyo F, Liu Z, Yang SW, Lennon RJ, Herrmann J, Gulati R, Rodriguez-Porcel M, Lerman LO, Lerman A. Association between coronary microvascular function and the vasa vasorum in patients with early coronary artery disease. Atherosclerosis 2016; 253:144-149. [PMID: 27626971 DOI: 10.1016/j.atherosclerosis.2016.08.031] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2016] [Revised: 08/01/2016] [Accepted: 08/23/2016] [Indexed: 11/28/2022]
Abstract
BACKGROUND AND AIMS The vasa vasorum (VV) plays a role in the initial phase of atherosclerosis, and abnormalities in microvascular function may be sensitive measures of the early development of atherosclerosis. The current study was designed to access the association between coronary microvascular function and VV density in patients undergoing cardiac catheterization. METHODS Twenty-four patients with early coronary artery disease underwent endothelium-dependent (coronary blood flow, CBF) and endothelium-independent (coronary flow velocity reserve, CFVR) coronary microvascular function testing, and optical coherence tomography (OCT) imaging of the left anterior descending coronary artery (LAD). Using an intracoronary Doppler guidewire, CBF was examined by evaluating changes in blood flow in response to acetylcholine and CFVR in response to adenosine. VV density (VV volume/vessel volume × 100, %VV) of the proximal 10 mm of the LAD was quantified by OCT. RESULTS The median values (Q1, Q3) of CFVR, % changes in CBF in response to acetylcholine, and the %VV were 2.70 (2.30, 2.90), -16.82 (-42.34, 54.52), and 2.62 (2.35, 3.35), respectively. %VV correlated inversely with CBF (r = -0.614, p = 0.001) and directly with CFVR (r = 0.423, p = 0.040). Multivariate analysis showed that only %VV was significantly correlated with CBF and the association was independent of other clinical variables, Framingham risk score, body mass index, and a family history of coronary heart disease. CONCLUSIONS This study demonstrates that VV density has negative correlation with endothelium-dependent microvascular function in patients with early coronary atherosclerosis. These observations link adventitial VV structure and function to microvascular dysfunction in early coronary atherosclerosis.
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Affiliation(s)
- Kyoung-Ha Park
- Division of Cardiovascular Diseases, Mayo Clinic, Rochester, MN, USA; Division of Cardiovascular Disease, Hallym University Medical Center, Anyang, South Korea
| | - Tao Sun
- Division of Cardiovascular Diseases, Mayo Clinic, Rochester, MN, USA
| | | | - Zhi Liu
- Division of Cardiovascular Diseases, Mayo Clinic, Rochester, MN, USA
| | - Shi-Wei Yang
- Division of Cardiovascular Diseases, Mayo Clinic, Rochester, MN, USA
| | - Ryan J Lennon
- Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, MN, USA
| | - Joerg Herrmann
- Division of Cardiovascular Diseases, Mayo Clinic, Rochester, MN, USA
| | - Rajiv Gulati
- Division of Cardiovascular Diseases, Mayo Clinic, Rochester, MN, USA
| | | | - Lilach O Lerman
- Division of Nephrology and Hypertension, Mayo Clinic, Rochester, MN, USA
| | - Amir Lerman
- Division of Cardiovascular Diseases, Mayo Clinic, Rochester, MN, USA.
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Mekonnen G, Hayek SS, Mehta PK, Li Q, Mahar E, Mou L, Kenkre TS, Petersen JW, Azarbal B, Samuels B, Anderson RD, Sedlak T, Zaya M, Agarwal M, Haftbaradaran A, Minissian M, Handberg E, Pepine CJ, Cogle CR, Bairey Merz CN, Waller EK, Quyyumi AA. Circulating progenitor cells and coronary microvascular dysfunction: Results from the NHLBI-sponsored Women's Ischemia Syndrome Evaluation - Coronary Vascular Dysfunction Study (WISE-CVD). Atherosclerosis 2016; 253:111-7. [PMID: 27596135 DOI: 10.1016/j.atherosclerosis.2016.08.026] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2015] [Revised: 08/14/2016] [Accepted: 08/23/2016] [Indexed: 12/21/2022]
Abstract
BACKGROUND AND AIMS Ischemia stimulates a reparative response resulting in mobilization of circulating progenitor cells (CPCs). We hypothesized that women with chronic myocardial ischemia from coronary microvascular disease (CMD) will mobilize CPCs. METHODS In 123 women with ischemic symptoms and signs but no obstructive coronary artery disease (CAD) enrolled in the Women's Ischemia Syndrome Evaluation - Coronary Vascular Dysfunction Study (WISE-CVD), we measured coronary flow reserve (CFR) in response to intracoronary adenosine. Peripheral blood CPCs were measured using flow cytometry for expression of CD34, CD133, CXCR4, and VEGFR2. RESULTS Subjects were 53 ± 11 years, BMI 30 ± 8; 44% hypertensive, 11% diabetic, 23% hyperlipidemic and 7% smokers. Lower CFR correlated inversely with higher levels of hematopoietic-enriched CD34+ (r = -0.23, p = 0.011), CD34+/CD133+ (r = -0.24, p = 0.008), and CD34+/CXCR4+ (r = -0.19, p = 0.036) cells. In multivariable regression analyses, after adjusting for traditional cardiovascular risk factors, lower CFR remained significantly associated with elevated levels of CD34+ (β -0.18, p = 0.042), CD34+/CD133+ (β -0.24, p = 0.036), and CD34+/CXCR4+ (β -0.22, p = 0.050) cells. We found no association between CFR and CD34+/VEGFR2+ cells. CONCLUSIONS In women with non-obstructive CAD, impaired CFR is associated with higher levels of CPCs, suggesting that chronic myocardial ischemia from CMD stimulates CPC mobilization. The functional significance of elevated CPCs in these subjects requires further investigation as a potential biomarker and treatment target.
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Karatzi K, Aissopou EK, Tsirimiagou C, Fatmeli E, Sfikakis PP, Protogerou AD. Association of consumption of dairy products and meat with retinal vessel calibers in subjects at increased cardiovascular risk. Nutr Metab Cardiovasc Dis 2016; 26:752-757. [PMID: 27139515 DOI: 10.1016/j.numecd.2016.03.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2015] [Revised: 03/10/2016] [Accepted: 03/10/2016] [Indexed: 11/26/2022]
Abstract
BACKGROUND AND AIMS Association of dairy products and meat consumption with macrocirculation is previously described, but such association with microcirculation is poorly investigated. We aimed to test the hypothesis that the consumption of high- and low-fat dairy products as well as red, white, and processed meat is associated with retinal vessel calibers in adults at an increased risk of cardiovascular disease (CVD). METHODS AND RESULTS In consecutive subjects (n = 181, age: 51.3 ± 12.4 years, 51.4% women) without CVD and diabetes mellitus but with increased CVD risk, we obtained digital left and right retinal images. These images were assessed with validated software to determine central retinal arteriolar and venular equivalents and the arteriolar to venular ratio (CRAE, CRVE, and AVR, respectively). The consumption of dairy products and meat was assessed through 24-h recalls in all volunteers. After adjustment for potential confounders, the following findings were obtained: (i) low-fat milk and yogurt were positively associated with CRAE (b=0.145, p=0.031 left; b=0.141, p=0.038 right) and inversely associated with CRVE (b=-0.155, p=0.026 left; b=-0.146, p=0.041 right); (ii) low-fat cheese was positively associated with CRAE (b=0.164, p=0.011 left and b=0.155, p=0.017 right); and (iii) red meat was inversely associated with CRAE (b=-0.143, p=0.032 left; b=-0.114, p=0.050 right). High-fat milk, yogurt, and cheese or white and processed meat were not found to be associated with retinal vessel calibers. CONCLUSIONS High consumption of low-fat milk, yogurt, and cheese and low consumption of red meat could be beneficial for retinal microvascular health. Prospective studies are needed to verify these findings.
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Affiliation(s)
- K Karatzi
- Department of Nutrition and Dietetics, Harokopio University of Athens, Athens, Greece; Hellenic Foundation for Cardiovascular Health and Nutrition, Athens, Greece.
| | - E K Aissopou
- Hellenic Foundation for Cardiovascular Health and Nutrition, Athens, Greece; Cardiovascular Unit, 1st Department of Propaedeutic Medicine, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - C Tsirimiagou
- Department of Nutrition and Dietetics, Harokopio University of Athens, Athens, Greece
| | - E Fatmeli
- Department of Nutrition and Dietetics, Harokopio University of Athens, Athens, Greece
| | - P P Sfikakis
- Cardiovascular Unit, 1st Department of Propaedeutic Medicine, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - A D Protogerou
- Hellenic Foundation for Cardiovascular Health and Nutrition, Athens, Greece; Cardiovascular Unit, 1st Department of Propaedeutic Medicine, Medical School, National and Kapodistrian University of Athens, Athens, Greece
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Zhang X, Staimer N, Tjoa T, Gillen DL, Schauer JJ, Shafer MM, Hasheminassab S, Pakbin P, Longhurst J, Sioutas C, Delfino RJ. Associations between microvascular function and short-term exposure to traffic-related air pollution and particulate matter oxidative potential. Environ Health 2016; 15:81. [PMID: 27460097 PMCID: PMC4962442 DOI: 10.1186/s12940-016-0157-5] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [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] [Received: 11/20/2015] [Accepted: 06/08/2016] [Indexed: 05/19/2023]
Abstract
BACKGROUND Short-term exposure to ambient air pollution has been associated with acute increases in cardiovascular hospitalization and mortality. However, causative chemical components and underlying pathophysiological mechanisms remain to be clarified. We hypothesized that endothelial dysfunction would be associated with mobile-source (traffic) air pollution and that pollutant components with higher oxidative potential to generate reactive oxygen species (ROS) would have stronger associations. METHODS We carried out a cohort panel study in 93 elderly non-smoking adults living in the Los Angeles metropolitan area, during July 2012-February 2014. Microvascular function, represented by reactive hyperemia index (RHI), was measured weekly for up to 12 weeks (N = 845). Air pollutant data included daily data from regional air-monitoring stations, five-day average PM chemical components and oxidative potential in three PM size-fractions, and weekly personal nitrogen oxides (NOx). Linear mixed-effect models estimated adjusted changes in microvascular function with exposure. RESULTS RHI was inversely associated with traffic-related pollutants such as ambient PM2.5 black carbon (BC), NOx, and carbon monoxide (CO). An interquartile range change increase (1.06 μg/m(3)) in 5-day average BC was associated with decreased RHI, -0.093 (95 % CI: -0.151, -0.035). RHI was inversely associated with other mobile-source components/tracers (polycyclic aromatic hydrocarbons, elemental carbon, and hopanes), and PM oxidative potential as quantified in two independent assays (dithiothreitol and in vitro macrophage ROS) in accumulation and ultrafine PM, and transition metals. CONCLUSIONS Our findings suggest that short-term exposures to traffic-related air pollutants with high oxidative potential are major components contributing to microvascular dysfunction.
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Affiliation(s)
- Xian Zhang
- Department of Epidemiology, School of Medicine, University of California, Irvine, Irvine 224 Irvine Hall, Irvine, CA 92617-7555 USA
| | - Norbert Staimer
- Department of Epidemiology, School of Medicine, University of California, Irvine, Irvine 224 Irvine Hall, Irvine, CA 92617-7555 USA
| | - Tomas Tjoa
- Department of Epidemiology, School of Medicine, University of California, Irvine, Irvine 224 Irvine Hall, Irvine, CA 92617-7555 USA
| | - Daniel L. Gillen
- Department of Statistics, School of Information and Computer Sciences, University of California, Irvine, Irvine, CA USA
| | - James J. Schauer
- Environmental Chemistry and Technology Program, University of Wisconsin-Madison, Madison, WI USA
| | - Martin M. Shafer
- Environmental Chemistry and Technology Program, University of Wisconsin-Madison, Madison, WI USA
| | - Sina Hasheminassab
- Department of Civil and Environmental Engineering, Viterbi School of Engineering, University of Southern California, Los Angeles, CA USA
| | - Payam Pakbin
- Department of Civil and Environmental Engineering, Viterbi School of Engineering, University of Southern California, Los Angeles, CA USA
| | - John Longhurst
- Susan Samueli Center for Integrative Medicine, and Cardiology Division, Department of Medicine, School of Medicine, University of California, Irvine, Irvine, CA USA
| | - Constantinos Sioutas
- Department of Civil and Environmental Engineering, Viterbi School of Engineering, University of Southern California, Los Angeles, CA USA
| | - Ralph J. Delfino
- Department of Epidemiology, School of Medicine, University of California, Irvine, Irvine 224 Irvine Hall, Irvine, CA 92617-7555 USA
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Olsen RH, Pedersen LR, Snoer M, Christensen TE, Ghotbi AA, Hasbak P, Kjaer A, Haugaard SB, Prescott E. Coronary flow velocity reserve by echocardiography: feasibility, reproducibility and agreement with PET in overweight and obese patients with stable and revascularized coronary artery disease. Cardiovasc Ultrasound 2016; 14:22. [PMID: 27267255 DOI: 10.1186/s12947-016-0066-3] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2016] [Accepted: 06/01/2016] [Indexed: 11/15/2022] Open
Abstract
Background Coronary flow velocity reserve (CFVR) measured by transthoracic Doppler echocardiography of the LAD is used to assess microvascular function but validation studies in clinical settings are lacking. We aimed to assess feasibility, reproducibility and agreement with myocardial flow reserve (MFR) measured by PET in overweight and obese patients. Methods Participants with revascularized coronary artery disease were examined by CFVR. Subgroups were examined by repeated CFVR (reproducibility) or Rubidium-82-PET (agreement). To account for time variation, results were computed for scans performed within a week (1-week) and for all scans regardless of time gap (total) and to account for scar tissue for patients with and without previous myocardial infarction (MI). Results Eighty-six patients with median BMI 30.9 (IQR 29.4–32.9) kg × m−2 and CFVR 2.29 (1.90–2.63) were included. CFVR was feasible in 83 (97 %) using a contrast agent in 14 %. For reproducibility overall (n = 21) limits of agreement (LOA) were (−0.75;0.71), within-subjects coefficient of variation (CV) 11 %, and reliability 0.84. For reproducibility within 1-week (n = 13) LOA were (−0.33;0.25), within-subjects CV 5 %, and reliability 0.97. Agreement with MFR of the LAD territory (n = 35) was without significant bias and overall LOA were (−1.40;1.46). Agreement was best for examinations performed within 1-week of participants without MI of the LAD-territory (n = 12); LOA = (−0.68;0.88). Conclusions CFVR was highly feasible with a good reproducibility on par with other contemporary measures applied in cardiology. Agreement with MFR was acceptable, though discrepancy related to prior MI has to be considered. CFVR of LAD is a valid tool in overweight and obese patients.
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West SL, O'Gorman CS, Elzibak AH, Caterini J, Noseworthy MD, Rayner T, Hamilton J, Wells GD. Skeletal muscle microvascular function in girls with Turner syndrome. BBA Clin 2015; 3:25-30. [PMID: 26676172 PMCID: PMC4661506 DOI: 10.1016/j.bbacli.2014.12.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/30/2014] [Revised: 12/02/2014] [Accepted: 12/03/2014] [Indexed: 01/15/2023]
Abstract
BACKGROUND Exercise intolerance is prevalent in individuals with Turner Syndrome (TS). We recently demonstrated that girls with TS have normal aerobic but altered skeletal muscle anaerobic metabolism compared to healthy controls (HC). The purpose of this study was to compare peripheral skeletal muscle microvascular function in girls with TS to HC after exercise. We hypothesized that girls with TS would have similar muscle blood-oxygen level-dependent (BOLD) magnetic resonance imaging (MRI) signal responses during recovery from exercise compared to HC. METHODS Thirteen TS participants and 8 HC completed testing. BOLD MRI was used to measure skeletal muscle microvascular response during 60 second recovery, following 60 s of exercise at 65% of maximal workload. Exercise and recovery were repeated four times, and the BOLD signal time course was fit to a four-parameter sigmoid function. RESULTS Participants were 13.7 ± 3.1 years old and weighed 47.9 ± 14.6 kg. The mean change in BOLD signal intensity following exercise at the end of recovery, the mean response time of the function/the washout of deoxyhemoglobin, and the mean half-time of recovery were similar between the TS and HC groups. CONCLUSIONS Our results demonstrate that compared to HC, peripheral skeletal muscle microvascular function following exercise in girls with TS is not impaired. GENERAL SIGNIFICANCE This study supports the idea that the aerobic energy pathway is not impaired in children with TS in response to submaximal exercise. Other mechanisms are likely responsible for exercise intolerance in TS; this needs to be further investigated.
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Affiliation(s)
- Sarah L West
- Faculty of Kinesiology and Physical Education, The University of Toronto, Canada ; Physiology and Experimental Medicine, The Hospital for Sick Children, Canada
| | - Clodagh S O'Gorman
- Physiology and Experimental Medicine, The Hospital for Sick Children, Canada ; Division of Endocrinology, The Hospital for Sick Children, The University of Toronto, Canada
| | - Alyaa H Elzibak
- Physiology and Experimental Medicine, The Hospital for Sick Children, Canada
| | - Jessica Caterini
- Faculty of Kinesiology and Physical Education, The University of Toronto, Canada
| | - Michael D Noseworthy
- School of Biomedical Engineering, McMaster University, Canada ; Department of Electrical and Computer Engineering, McMaster University, Canada
| | - Tammy Rayner
- Department of Diagnostic Imaging, The Hospital for Sick Children, Canada
| | - Jill Hamilton
- Division of Endocrinology, The Hospital for Sick Children, The University of Toronto, Canada
| | - Greg D Wells
- Faculty of Kinesiology and Physical Education, The University of Toronto, Canada ; Physiology and Experimental Medicine, The Hospital for Sick Children, Canada
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Choi WG, Kim SH, Yoon HS, Lee EJ, Kim DW. Impact of an endothelial progenitor cell capturing stent on coronary microvascular function: comparison with drug-eluting stents. Korean J Intern Med 2015; 30:42-8. [PMID: 25589834 PMCID: PMC4293562 DOI: 10.3904/kjim.2015.30.1.42] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [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: 01/13/2014] [Revised: 06/02/2014] [Accepted: 06/30/2014] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND/AIMS Although drug-eluting stents (DESs) effectively reduce restenosis following percutaneous coronary intervention (PCI), they also delay re-endothelialization and impair microvascular function, resulting in adverse clinical outcomes. Endothelial progenitor cell (EPC) capturing stents, by providing a functional endothelial layer on the stent, have beneficial effects on microvascular function. However, data on coronary microvascular function in patients with EPC stents versus DESs are lacking. METHODS Seventy-four patients who previously underwent PCI were enrolled in this study. Microvascular function was evaluated 6 months after PCI based on the index of microvascular resistance (IMR) and the coronary flow reserve (CFR). IMR was calculated as the ratio of the mean distal coronary pressure at maximal hyperemia to the inverse of the hyperemic mean transit time (hTmn). The CFR was calculated by dividing the hTmn by the baseline mean transit time. RESULTS Twenty-one patients (age, 67.2 ± 9.6 years; male:female, 15:6) with an EPC stent and 53 patients (age, 61.5 ± 14.7 years; male:female, 40:13) with second-generation DESs were included in the study. There were no significant differences in the baseline clinical and angiographic characteristics of the two groups. Angiography performed 6 months postoperatively did not show significant differences in their CFR values. However, patients with the EPC stent had a significantly lower IMR than patients with second-generation DESs (median, 25.5 [interquartile range, 12.85 to 28.18] vs. 29.0 [interquartile range, 15.42 to 39.23]; p = 0.043). CONCLUSIONS Microvascular dysfunction was significantly improved after 6 months in patients with EPC stents compared to those with DESs. The complete re-endothelialization achieved with the EPC stent may provide clinical benefits over DESs, especially in patients with microvascular dysfunction.
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Affiliation(s)
- Woong Gil Choi
- Division of Cardiology, Department of Internal Medicine, Konkuk University School of Medicine, Chungju, Korea
| | - Soo Hyun Kim
- Division of Cardiology, Department of Internal Medicine, Konkuk University School of Medicine, Chungju, Korea
| | - Hyung Seok Yoon
- Division of Cardiology, Department of Internal Medicine, Konkuk University School of Medicine, Chungju, Korea
| | - Eun Joo Lee
- Division of Cardiology, Department of Internal Medicine, Konkuk University School of Medicine, Chungju, Korea
| | - Dong Woon Kim
- Division of Cardiology, Department of Internal Medicine, Chungbuk National University Hospital, Cheongju, Korea
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Caliskan Z, Gokturk HS, Caliskan M, Gullu H, Ciftci O, Ozgur GT, Guven A, Selcuk H. Impaired coronary microvascular and left ventricular diastolic function in patients with inflammatory bowel disease. Microvasc Res 2015; 97:25-30. [PMID: 25128749 DOI: 10.1016/j.mvr.2014.08.003] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2014] [Revised: 08/05/2014] [Accepted: 08/07/2014] [Indexed: 01/08/2023]
Abstract
BACKGROUND AND AIM Increased incidence of coronary vascular events in patients with inflammatory bowel disease (IBD) is known. However, the association between coronary microvascular function and IBD has not been fully defined. We aimed to investigate whether coronary flow reserve (CFR) and left ventricular diastolic function were impaired in IBD patients. METHODS Seventy-two patients with IBD (36 patients with ulcerative colitis [UC] and 36 Crohn's disease [CD]) were registered. Each subject was evaluated after a minimum 15-day attack-free period. For the control group, 36 age- and sex-matched healthy volunteers were included into the study. IBD clinical disease activity in UC was assessed by the Truelove-Witts Index (TWAS) and in CD by the Crohn's Disease Activity Index (CDAI). In each subject, CFR was measured through transthoracic Doppler echocardiography. RESULTS Compared to the controls, the CD group and UC group had significantly higher high-sensitivity C-reactive protein (hs-CRP) and erythrocyte sedimentation rate. Baseline diastolic peak flow velocity (DPFV) of the left anterior descending artery (LAD) was significantly higher in the IBD group (24.1±3.9 vs. 22. 4±2.9, p<0.05), and hyperemic DPFV (56.1±12.5 vs. 70.6±15.3, p<0.05) and CFR (2.34±0.44 vs. 3.14±0.54, p<0.05) were significantly lower in the IBD group than in the control group. In stepwise linear regression analysis, hs-CRP and lateral Em/Am ratio were independently correlated with CFR. CONCLUSION CFR, reflecting coronary microvascular function, is impaired in patients with IBD. CFR and left ventricular diastolic function parameters are well correlated with hs-CRP.
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Assero G, Satriano C, Lupo G, Anfuso CD, Marletta G, Alberghina M. Impaired coronary microvascular and left ventricular diastolic function in patients with inflammatory bowel disease. Microvasc Res 2014; 68:209-20. [PMID: 15501240 DOI: 10.1016/j.mvr.2004.08.003] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [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: 05/25/2004] [Indexed: 12/14/2022]
Abstract
BACKGROUND AND AIM Increased incidence of coronary vascular events in patients with inflammatory bowel disease (IBD) is known. However, the association between coronary microvascular function and IBD has not been fully defined. We aimed to investigate whether coronary flow reserve (CFR) and left ventricular diastolic function were impaired in IBD patients. METHODS Seventy-two patients with IBD (36 patients with ulcerative colitis [UC] and 36 Crohn's disease [CD]) were registered. Each subject was evaluated after a minimum 15-day attack-free period. For the control group, 36 age- and sex-matched healthy volunteers were included into the study. IBD clinical disease activity in UC was assessed by the Truelove-Witts Index (TWAS) and in CD by the Crohn's Disease Activity Index (CDAI). In each subject, CFR was measured through transthoracic Doppler echocardiography. RESULTS Compared to the controls, the CD group and UC group had significantly higher high-sensitivity C-reactive protein (hs-CRP) and erythrocyte sedimentation rate. Baseline diastolic peak flow velocity (DPFV) of the left anterior descending artery (LAD) was significantly higher in the IBD group (24.1±3.9 vs. 22. 4±2.9, p<0.05), and hyperemic DPFV (56.1±12.5 vs. 70.6±15.3, p<0.05) and CFR (2.34±0.44 vs. 3.14±0.54, p<0.05) were significantly lower in the IBD group than in the control group. In stepwise linear regression analysis, hs-CRP and lateral Em/Am ratio were independently correlated with CFR. CONCLUSION CFR, reflecting coronary microvascular function, is impaired in patients with IBD. CFR and left ventricular diastolic function parameters are well correlated with hs-CRP.
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Affiliation(s)
- Giovanna Assero
- Department of Biochemistry, University of Catania, 95125 Catania, Italy
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Vecchiati A, Tellatin S, Angelini A, Iliceto S, Tona F. Coronary microvasculopathy in heart transplantation: Consequences and therapeutic implications. World J Transplant 2014; 4:93-101. [PMID: 25032098 PMCID: PMC4094955 DOI: 10.5500/wjt.v4.i2.93] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2013] [Revised: 01/11/2014] [Accepted: 03/12/2014] [Indexed: 02/05/2023] Open
Abstract
Despite the progress made in the prevention and treatment of rejection of the transplanted heart, cardiac allograft vasculopathy (CAV) remains the main cause of death in late survival transplanted patients. CAV consists of a progressive diffuse intimal hyperplasia and the proliferation of vascular smooth muscle cells, ending in wall thickening of epicardial vessels, intramyocardial arteries (50-20 μm), arterioles (20-10 μm), and capillaries (< 10 μm). The etiology of CAV remains unclear; both immunologic and non-immunologic mechanisms contribute to endothelial damage with a sustained inflammatory response. The immunological factors involved are Human Leukocyte Antigen compatibility between donor and recipient, alloreactive T cells and the humoral immune system. The non-immunological factors are older donor age, ischemia-reperfusion time, hyperlipidemia and CMV infections. Diagnostic techniques that are able to assess microvascular function are lacking. Intravascular ultrasound and fractional flow reserve, when performed during coronary angiography, are able to detect epicardial coronary artery disease but are not sensitive enough to assess microvascular changes. Some authors have proposed an index of microcirculatory resistance during maximal hyperemia, which is calculated by dividing pressure by flow (distal pressure multiplied by the hyperemic mean transit time). Non-invasive methods to assess coronary physiology are stress echocardiography, coronary flow reserve by transthoracic Doppler echocardiography, single photon emission computed tomography, and perfusion cardiac magnetic resonance. In this review, we intend to analyze the mechanisms, consequences and therapeutic implications of microvascular dysfunction, including an extended citation of relevant literature data.
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Justo ML, Claro C, Vila E, Herrera MD, Rodriguez-Rodriguez R. Microvascular disorders in obese Zucker rats are restored by a rice bran diet. Nutr Metab Cardiovasc Dis 2014; 24:524-531. [PMID: 24361072 DOI: 10.1016/j.numecd.2013.10.032] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2013] [Revised: 10/22/2013] [Accepted: 10/23/2013] [Indexed: 01/19/2023]
Abstract
BACKGROUND AND AIM Nutritional-based approaches aimed to prevent microvascular dysfunction associated to obesity present potential advantages over pharmacological strategies. Our aim was to test whether a rice bran enzymatic extract (RBEE)-supplemented diet could attenuate microvascular alterations in obese rats. METHODS AND RESULTS Lean and obese Zucker rats were fed standard diet supplemented or not with 1% and 5% RBEE for 20 weeks. Functional studies were performed in small mesenteric arteries in isometric myograph. Immunoblotting and fluorescence studies were made in arterial homogenates and arterial sections, respectively. RBEE-supplementation restored microvascular function in obese rats through a marked increase in NO and endothelial-derived hyperpolarizing factor contribution by up-regulation of eNOS and calcium-activated potassium channels expression, respectively, in association to a substantial reduction of microvascular inflammation and superoxide anion formation. These data agrees with the beneficial actions of RBEE on dyslipidemia, hyperinsulinemia and hypertension in obesity. CONCLUSION The multi-factorial properties of RBEE-diet, especially for restoring the function of small resistance arteries shows this dietary-based approach to be a promising candidate for prevention of microvascular alterations in obesity, which are crucial in cardiovascular events in obese subjects.
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Affiliation(s)
- M L Justo
- Department of Pharmacology, School of Pharmacy, University of Seville, Seville, Spain
| | - C Claro
- Department of Pharmacology, School of Pharmacy, University of Seville, Seville, Spain
| | - E Vila
- Departament de Farmacologia, Terapèutica i Toxicologia, Facultat de Medicina, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - M D Herrera
- Department of Pharmacology, School of Pharmacy, University of Seville, Seville, Spain
| | - R Rodriguez-Rodriguez
- Department of Pharmacology, School of Pharmacy, University of Seville, Seville, Spain.
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He GX, Tan W. High-dose atorvastatin pretreatment could diminishes microvascular impairment in patients undergoing elective percutaneous coronary intervention. J Geriatr Cardiol 2014; 10:355-60. [PMID: 24454329 PMCID: PMC3888918 DOI: 10.3969/j.issn.1671-5411.2013.04.013] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/29/2013] [Revised: 12/08/2013] [Accepted: 12/15/2013] [Indexed: 11/18/2022]
Abstract
Objectives High-dose statins pretreatment is reasonable before percutaneous coronary intervention (PCI) to reduce the risk of periprocedural myocardial injury. However, the mechanism underlying this protective effect has not been elucidated. The aim of this study is to evaluate the effects of high-dose atorvastatin pretreatment on microvascular function and myocardial injury after elective PCI. Methods Eighty four patients underwent elective PCI were randomly assigned to high-dose atorvastatin (40 mg/d) and low-dose atorvastatin (20 mg/d) treatment for 7 days before PCI. The index of microcirculatory resistance (IMR) was measured by an intracoronary ressure/temperature sensor-tipped guidewire at maximal hyperemia after PCI. Fractional flow reserve (FFR) was measured before and after procedure. Troponin I levels were obtained at baseline and 20–24 h after procedure. Results IMR values were significantly lower in high-dose group when compared to low-dose group (16.5 ± 6.1 vs. 31.2 ± 16.0, P < 0.001). Pre-PCI troponin I levels between the two groups were similar (0.028 ± 0.05 vs. 0.022 ± 0.04, P = 0.55). However, post-PCI troponin I levels in high-dose group were significantly lower than low-dose group (0.11 ± 0.02 vs. 0.16 ± 0.09, P < 0.001). Multivariate analysis identified maximum inflation pressure > 20 atm as an independent predictor of IMR > 32 (Odds ratio (OR): 3.3, 95% confidence intervals (95%CI): 1.3–8.5, P = 0.02). High-dose atorvastatin was the only independent protective factor of IMR > 32 (OR: 0.29, 95%CI: 0.11–0.74, P = 0.01). Conclusions The present study confirmed that diminishing microvascular impairment is one of the mechanism underlying protecting effect of high-dose statins pretreatment from myocardial injury during PCI. These suggest that high-dose statin pretreatment is reasonable in patients undergoing elective PCI.
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Affiliation(s)
- Gui-Xin He
- Department of Cardiology, the First Affiliated Hospital of Guangxi University of Chinese Medicine, 89-9 Dongge Road, Qingxiu District, Nanning 530023, Guangxi Province, China
| | - Wei Tan
- Department of Cardiology, the First Affiliated Hospital of Guangxi University of Chinese Medicine, 89-9 Dongge Road, Qingxiu District, Nanning 530023, Guangxi Province, China
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