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Streese L, Pichler FA, Hauser C, Hanssen H. Microvascular wall-to-lumen ratio in patients with arterial hypertension: A randomized controlled exercise trial. Microvasc Res 2023; 148:104526. [PMID: 36914089 DOI: 10.1016/j.mvr.2023.104526] [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: 02/06/2023] [Revised: 03/07/2023] [Accepted: 03/07/2023] [Indexed: 03/15/2023]
Abstract
BACKGROUND AND AIMS High blood pressure is one of the main cardiovascular disease risk factors that contribute to vascular remodeling and dysfunction. We aimed to investigate I) group differences of the retinal microstructure between patients with hypertension and healthy individuals and II) the effects of a high-intensity interval training (HIIT) on hypertension-induced microvascular remodeling in patients with hypertension in a randomized controlled trial. METHODS Arteriolar and venular retinal vessel microstructure including retinal vessel wall (RVW), lumen diameter and wall-to-lumen ratio (WLR) of 41 hypertensive patients, treated with anti-hypertensive medication, and 19 normotensive healthy controls were screened based on high-resolution fundoscopies. Patients with hypertension were randomized to a control group receiving standard physical activity recommendations and an intervention group receiving a supervised and walking-based HIIT for eight weeks. Measurements were repeated after the intervention period. RESULTS Hypertensive patients showed thicker arteriolar RVW (28.0 ± 7.7mu vs. 21.4 ± 4.4mu, p = 0.003) and higher arteriolar WLR (58.5 ± 14.8 % vs. 42.5 ± 8.2 %, p < 0.001) compared to normotensive controls. The intervention group showed reductions in arteriolar RVW (β -3.1 (95 % CI, -4.38, -1.78) p < 0.001) and arteriolar WLR (-5.3 (-10.14, -0.39) p = 0.035) compared to the control group. The intervention effects were independent of age, sex, change in blood pressure and change in cardiorespiratory fitness. CONCLUSIONS HIIT in patients with hypertension improves retinal vessel microvascular remodeling after eight weeks of training. In patients with hypertension, screening retinal vessel microstructure by fundoscopy and monitoring efficacy of short-term exercise treatment are sensitive diagnostic approaches to quantify microvascular health in these patients.
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Affiliation(s)
- Lukas Streese
- Department of Sport, Exercise and Health, Medical Faculty, University of Basel, Basel, Switzerland; Faculty of Health Care, Niederrhein University of Applied Sciences, Krefeld, Germany.
| | - Franziska Anna Pichler
- Department of Sport, Exercise and Health, Medical Faculty, University of Basel, Basel, Switzerland
| | - Christoph Hauser
- Department of Sport, Exercise and Health, Medical Faculty, University of Basel, Basel, Switzerland
| | - Henner Hanssen
- Department of Sport, Exercise and Health, Medical Faculty, University of Basel, Basel, Switzerland
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Qiao J, Lawson CM, Rentrup KFG, Kulkarni P, Ferris CF. Evaluating blood-brain barrier permeability in a rat model of type 2 diabetes. J Transl Med 2020; 18:256. [PMID: 32580725 PMCID: PMC7313122 DOI: 10.1186/s12967-020-02428-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2020] [Accepted: 06/18/2020] [Indexed: 11/10/2022] Open
Abstract
Background This is an exploratory study using a novel imaging modality, quantitative ultrashort time-to-echo, contrast enhanced (QUTE-CE) magnetic resonance imaging to evaluate the permeability of the blood–brain barrier in a rat model of type 2 diabetes with the presumption that small vessel disease is a contributing factor to neuropathology in diabetes. Methods The BBZDR/Wor rat, a model of type 2 diabetes, and age-matched controls were studied for changes in blood–brain barrier permeability. QUTE-CE, a quantitative vascular biomarker, generated angiographic images with over 500,000 voxels that were registered to a 3D MRI rat brain atlas providing site-specific information on blood–brain barrier permeability in 173 different brain areas. Results In this model of diabetes, without the support of insulin treatment, there was global capillary pathology with over 84% of the brain showing a significant increase in blood–brain barrier permeability over wild-type controls. Areas of the cerebellum and midbrain dopaminergic system were not significantly affected. Conclusion Small vessel disease as assessed by permeability in the blood–brain barrier in type 2 diabetes is pervasive and includes much of the brain. The increase in blood–brain barrier permeability is a likely contributing factor to diabetic encephalopathy and dementia.
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Affiliation(s)
- Ju Qiao
- Center for Translational NeuroImaging, Northeastern University, Boston, MA, USA
| | | | - Kilian F G Rentrup
- Center for Translational NeuroImaging, Northeastern University, Boston, MA, USA
| | - Praveen Kulkarni
- Center for Translational NeuroImaging, Northeastern University, Boston, MA, USA
| | - Craig F Ferris
- Center for Translational NeuroImaging, Northeastern University, Boston, MA, USA. .,Department of Psychology, Northeastern University, 360 Huntington Ave, Boston, MA, 02115-5000, USA.
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Chen L, Sun J, Hippe DS, Balu N, Yuan Q, Yuan I, Zhao X, Li R, He L, Hatsukami TS, Hwang JN, Yuan C. Quantitative assessment of the intracranial vasculature in an older adult population using iCafe. Neurobiol Aging 2019; 79:59-65. [PMID: 31026623 DOI: 10.1016/j.neurobiolaging.2019.02.027] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [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: 10/22/2018] [Revised: 02/04/2019] [Accepted: 02/28/2019] [Indexed: 01/11/2023]
Abstract
Comprehensive quantification of intracranial artery features may help us assess and understand variations of blood supply during brain development and aging. We analyzed vasculature features of 163 participants (age 56-85 years, mean of 71) from a community study to investigate if any of the features varied with age. Three-dimensional time-of-flight magnetic resonance angiography images of these participants were processed in IntraCranial artery feature extraction technique (a recently developed technique to obtain quantitative features of arteries) to divide intracranial vasculatures into anatomical segments and generate 8 morphometry and intensity features for each segment. Overall, increase in age was found negatively associated with number of branches and average order of intracranial arteries while positively associated with tortuosity, which remained after adjusting for cardiovascular risk factors. The associations with number of branches and average order were consistently found between 3 main intracranial artery regions, whereas the association with tortuosity appeared to be present only in middle cerebral artery/distal arteries. The combination of time-of-flight magnetic resonance angiography and IntraCranial artery feature extraction technique may provide an effective way to study vascular conditions and changes in the aging brain.
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Affiliation(s)
- Li Chen
- Department of Electrical Engineering, University of Washington, Seattle, WA, USA
| | - Jie Sun
- Department of Radiology, University of Washington, Seattle, WA, USA
| | - Daniel S Hippe
- Department of Radiology, University of Washington, Seattle, WA, USA
| | - Niranjan Balu
- Department of Radiology, University of Washington, Seattle, WA, USA
| | - Quan Yuan
- Department of Neurology, Xuanwu hospital, Capital Medical University, Beijing, China
| | | | - Xihai Zhao
- Biomedical Engineering, Tsinghua University, Beijing, China
| | - Rui Li
- Biomedical Engineering, Tsinghua University, Beijing, China
| | - Le He
- Biomedical Engineering, Tsinghua University, Beijing, China
| | | | - Jenq-Neng Hwang
- Department of Electrical Engineering, University of Washington, Seattle, WA, USA
| | - Chun Yuan
- Department of Radiology, University of Washington, Seattle, WA, USA.
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Csincsik L, MacGillivray TJ, Flynn E, Pellegrini E, Papanastasiou G, Barzegar-Befroei N, Csutak A, Bird AC, Ritchie CW, Peto T, Lengyel I. Peripheral Retinal Imaging Biomarkers for Alzheimer's Disease: A Pilot Study. Ophthalmic Res 2018; 59:182-192. [PMID: 29621759 DOI: 10.1159/000487053] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [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: 12/28/2017] [Accepted: 01/19/2018] [Indexed: 12/16/2022]
Abstract
PURPOSE To examine whether ultra-widefield (UWF) retinal imaging can identify biomarkers for Alzheimer's disease (AD) and its progression. METHODS Images were taken using a UWF scanning laser ophthalmoscope (Optos P200C AF) to determine phenotypic variations in 59 patients with AD and 48 healthy controls at baseline (BL). All living participants were invited for a follow-up (FU) after 2 years and imaged again (if still able to participate). All participants had blood taken for genotyping at BL. Images were graded for the prevalence of age-related macular degeneration-like pathologies and retinal vascular parameters. Comparison between AD patients and controls was made using the Student t test and the χ2 test. RESULTS Analysis at BL revealed a significantly higher prevalence of a hard drusen phenotype in the periphery of AD patients (14/55; 25.4%) compared to controls (2/48; 4.2%) [χ2 = 9.9, df = 4, p = 0.04]. A markedly increased drusen number was observed at the 2-year FU in patients with AD compared to controls. There was a significant increase in venular width gradient at BL (zone C: 8.425 × 10-3 ± 2.865 × 10-3 vs. 6.375 × 10-3 ± 1.532 × 10-3, p = 0.008; entire image: 8.235 × 10-3 ± 2.839 × 10-3 vs. 6.050 × 10-3 ± 1.414 × 10-3, p = 0.004) and a significant decrease in arterial fractal dimension in AD at BL (entire image: 1.250 ± 0.086 vs. 1.304 ± 0.089, p = 0.049) with a trend for both at FU. CONCLUSIONS UWF retinal imaging revealed a significant association between AD and peripheral hard drusen formation and changes to the vasculature beyond the posterior pole, at BL and after clinical progression over 2 years, suggesting that monitoring pathological changes in the peripheral retina might become a valuable tool in AD monitoring.
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Affiliation(s)
- Lajos Csincsik
- School of Medicine, Dentistry and Biomedical Science, Queen's University, Belfast, United Kingdom.,UCL Institute of Ophthalmology, London, United Kingdom
| | - Thomas J MacGillivray
- VAMPIRE Project, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, United Kingdom.,Edinburgh Imaging, University of Edinburgh, Edinburgh, United Kingdom
| | - Erin Flynn
- School of Medicine, Dentistry and Biomedical Science, Queen's University, Belfast, United Kingdom.,The George Washington University, School of Medicine and Health Sciences, Washington, District of Columbia, USA
| | - Enrico Pellegrini
- VAMPIRE Project, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, United Kingdom.,OPTOS plc, Dunfermline, United Kingdom
| | | | | | - Adrienne Csutak
- UCL Institute of Ophthalmology, London, United Kingdom.,Department of Ophthalmology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Alan C Bird
- UCL Institute of Ophthalmology, London, United Kingdom
| | - Craig W Ritchie
- Centre for Dementia Prevention, University of Edinburgh, Edinburgh, United Kingdom
| | - Tunde Peto
- School of Medicine, Dentistry and Biomedical Science, Queen's University, Belfast, United Kingdom.,NIHR Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust and UCL, London, United Kingdom
| | - Imre Lengyel
- School of Medicine, Dentistry and Biomedical Science, Queen's University, Belfast, United Kingdom.,UCL Institute of Ophthalmology, London, United Kingdom
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