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Schaerlaekens S, Jacobs L, Stobbelaar K, Cos P, Delputte P. All Eyes on the Prefusion-Stabilized F Construct, but Are We Missing the Potential of Alternative Targets for Respiratory Syncytial Virus Vaccine Design? Vaccines (Basel) 2024; 12:97. [PMID: 38250910 PMCID: PMC10819635 DOI: 10.3390/vaccines12010097] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Revised: 01/12/2024] [Accepted: 01/13/2024] [Indexed: 01/23/2024] Open
Abstract
Respiratory Syncytial Virus (RSV) poses a significant global health concern as a major cause of lower respiratory tract infections (LRTIs). Over the last few years, substantial efforts have been directed towards developing vaccines and therapeutics to combat RSV, leading to a diverse landscape of vaccine candidates. Notably, two vaccines targeting the elderly and the first maternal vaccine have recently been approved. The majority of the vaccines and vaccine candidates rely solely on a prefusion-stabilized conformation known for its highly neutralizing epitopes. Although, so far, this antigen design appears to be successful for the elderly, our current understanding remains incomplete, requiring further improvement and refinement in this field. Pediatric vaccines still have a long journey ahead, and we must ensure that vaccines currently entering the market do not lose efficacy due to the emergence of mutations in RSV's circulating strains. This review will provide an overview of the current status of vaccine designs and what to focus on in the future. Further research into antigen design is essential, including the exploration of the potential of alternative RSV proteins to address these challenges and pave the way for the development of novel and effective vaccines, especially in the pediatric population.
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Affiliation(s)
- Sofie Schaerlaekens
- Laboratory for Microbiology, Parasitology and Hygiene, University of Antwerp (UA), Universiteitsplein 1 S.7, 2610 Antwerp, Belgium; (S.S.); (L.J.); (K.S.); (P.C.)
| | - Lotte Jacobs
- Laboratory for Microbiology, Parasitology and Hygiene, University of Antwerp (UA), Universiteitsplein 1 S.7, 2610 Antwerp, Belgium; (S.S.); (L.J.); (K.S.); (P.C.)
| | - Kim Stobbelaar
- Laboratory for Microbiology, Parasitology and Hygiene, University of Antwerp (UA), Universiteitsplein 1 S.7, 2610 Antwerp, Belgium; (S.S.); (L.J.); (K.S.); (P.C.)
- Pediatrics Department, Antwerp University Hospital (UZA), Wilrijkstraat 10, 2650 Edegem, Belgium
| | - Paul Cos
- Laboratory for Microbiology, Parasitology and Hygiene, University of Antwerp (UA), Universiteitsplein 1 S.7, 2610 Antwerp, Belgium; (S.S.); (L.J.); (K.S.); (P.C.)
- Infla-Med Centre of Excellence, University of Antwerp (UA), Universiteitsplein 1 S.7, 2610 Antwerp, Belgium
| | - Peter Delputte
- Laboratory for Microbiology, Parasitology and Hygiene, University of Antwerp (UA), Universiteitsplein 1 S.7, 2610 Antwerp, Belgium; (S.S.); (L.J.); (K.S.); (P.C.)
- Infla-Med Centre of Excellence, University of Antwerp (UA), Universiteitsplein 1 S.7, 2610 Antwerp, Belgium
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Mattke S, Gustavsson A, Jacobs L, Kern S, Palmqvist S, Eriksdotter M, Skoog I, Winblad B, Wimo A, Jönsson L. Estimates of Current Capacity for Diagnosing Alzheimer's Disease in Sweden and the Need to Expand Specialist Numbers. J Prev Alzheimers Dis 2024; 11:155-161. [PMID: 38230728 PMCID: PMC10995070 DOI: 10.14283/jpad.2023.94] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Accepted: 06/05/2023] [Indexed: 01/18/2024]
Abstract
BACKGROUND The emergence of disease-modifying Alzheimer's (AD) treatments provides new hope to patients and families but concerns have been raised about the preparedness of healthcare systems to provide timely access to such treatments because of a combination of a complex diagnostic process and a large prevalent pool. OBJECTIVES We assess the preparedness of Sweden, a high-income country known for its dementia-friendly policies, to diagnose AD patients eligible for treatment within a six-month window, given current capacity for specialist evaluations and biomarker testing. We calculate the investment requirements for Sweden to achieve this target over a timeframe of 20 years. DESIGN Desk research to identify data for population, mortality, disease burden, cost of services and current capacity, expert consultation to inform assumptions about patient journey, and use of a Markov model to predict waiting times. The model simulates the patients' journey through different evaluation stages: initial evaluation by a primary care specialist, neurocognitive testing by an AD specialist, and confirmatory biomarker testing with PET scanning or cerebrospinal fluid (CSF) testing. The model assumes specialist appointments and PET scans are capacity constrained, and patients progress from cognitively normal to MCI and from MCI to dementia in the resulting waiting times. MEASUREMENTS Projected waiting times for diagnosis of eligibility for disease-modifying Alzheimer's treatment from 2023 to 2042 assuming current capacity, assuming 20% of Swedish residents aged 60 years and above would seek an evaluation for cognitive decline. Investments required to scale capacity up to reach target of providing diagnosis within six months on average. RESULTS Initial average waiting times for AD specialist appointments would be around 21 months in 2023 and remain around 55 months through 2042, as demand would continue to outstrip supply throughout the 20-year model horizon. Waiting times for biomarker testing would be stable at less than four weeks, as patients would be held up in the queue for their first specialist consultations, and use of CSF testing is widely accepted in Sweden. An additional 25% of AD specialists would have to be added above the current growth trend to reduce waiting times to less than 6 months at an average annual cost of approximately 805 million SEK. The increased cost of volume of biomarker testing would amount to about 106 million SEK per year. CONCLUSIONS At current capacity, the Swedish healthcare system is unable to provide timely diagnosis of patients eligible for disease-modifying AD treatment. Although future diagnostic technologies, such as digital cognitive assessments and blood tests for the AD pathology, might decrease demand for capacity-constrained services, substantial investments will be required to meet a target of less than six months of waiting time for a diagnosis.
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Affiliation(s)
- S Mattke
- Soeren Mattke, University of Southern California, 635 Downey Way, #505N, Los Angeles, CA 90089, Mobile: +1 202 468 5797,
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Neary JM, Guthrie AP, Jacobs L. Public and industry knowledge and perceptions of US swine industry castration practices. Anim Welf 2023; 32:e79. [PMID: 38487455 PMCID: PMC10936257 DOI: 10.1017/awf.2023.99] [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] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Revised: 10/18/2023] [Accepted: 11/21/2023] [Indexed: 03/17/2024]
Abstract
In the United States (US), surgical castration of male piglets is typically performed without any form of analgesia. This may raise concerns with the public; however, there is no information regarding current public knowledge on swine industry practices in the US. In this study we gained insight into public knowledge and perception on castration with and without analgesia in comparison to knowledge of industry stakeholders on these same topics. Through an online survey, 119 respondents were asked four questions about castration in the US swine industry. Industry respondents were contacted via social media and networking. The general public sample was accessed through Mechanical Turk. Survey responses were categorised by experience (industry vs public). Industry respondents were more aware of practices compared to the general public. Most public respondents were unaware of castration practices and the lack of analgesia use. Respondents from rural communities were more aware of castration practices than (sub)urban communities and more aware of analgesia use than those from urban communities. Those with more education had greater awareness of castration practices (occurrence not frequency). Based on the results from this first US sample, knowledge on industry practices was especially lacking for public respondents, but also for a minority of industry respondents, indicating opportunities for education and further research on the topic.
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Affiliation(s)
- JM Neary
- School of Animal Sciences, Virginia Tech, 175 West Campus Drive, Blacksburg, Virginia24061, USA
| | - AP Guthrie
- Department of Statistics, Virginia Tech, Blacksburg, VA, USA, 250 Drillfield Drive, 24061
| | - L Jacobs
- School of Animal Sciences, Virginia Tech, 175 West Campus Drive, Blacksburg, Virginia24061, USA
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Mamas MA, Roffi M, Fröbert O, Chieffo A, Beneduce A, Matetic A, Tonino PAL, Paunovic D, Jacobs L, Debrus R, El Aissaoui J, van Leeuwen F, Kontopantelis E. Predicting target lesion failure following percutaneous coronary intervention through machine learning risk assessment models. Eur Heart J Digit Health 2023; 4:433-443. [PMID: 38045434 PMCID: PMC10689920 DOI: 10.1093/ehjdh/ztad051] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Revised: 08/22/2023] [Indexed: 12/05/2023]
Abstract
Aims Central to the practice of precision medicine in percutaneous coronary intervention (PCI) is a risk-stratification tool to predict outcomes following the procedure. This study is intended to assess machine learning (ML)-based risk models to predict clinically relevant outcomes in PCI and to support individualized clinical decision-making in this setting. Methods and results Five different ML models [gradient boosting classifier (GBC), linear discrimination analysis, Naïve Bayes, logistic regression, and K-nearest neighbours algorithm) for the prediction of 1-year target lesion failure (TLF) were trained on an extensive data set of 35 389 patients undergoing PCI and enrolled in the global, all-comers e-ULTIMASTER registry. The data set was split into a training (80%) and a test set (20%). Twenty-three patient and procedural characteristics were used as predictive variables. The models were compared for discrimination according to the area under the receiver operating characteristic curve (AUC) and for calibration. The GBC model showed the best discriminative ability with an AUC of 0.72 (95% confidence interval 0.69-0.75) for 1-year TLF on the test set. The discriminative ability of the GBC model for the components of TLF was highest for cardiac death with an AUC of 0.82, followed by target vessel myocardial infarction with an AUC of 0.75 and clinically driven target lesion revascularization with an AUC of 0.68. The calibration was fair until the highest risk deciles showed an underestimation of the risk. Conclusion Machine learning-derived predictive models provide a reasonably accurate prediction of 1-year TLF in patients undergoing PCI. A prospective evaluation of the predictive score is warranted. Registration Clinicaltrial.gov identifier is NCT02188355.
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Affiliation(s)
- Mamas A Mamas
- Keele Cardiovascular Research Group, Centre for Prognosis Research, Institutes of Applied Clinical Science and Primary Care and Health Sciences, Keele University, Keele ST5 5BG, Newcastle, UK
| | - Marco Roffi
- Department of Cardiology, University Hospitals Geneva, Geneva 1205, Switzerland
| | - Ole Fröbert
- Faculty of Health, Örebro University, Örebro 701 82, Sweden
| | - Alaide Chieffo
- Interventional Cardiology Unit, San Raffaele Scientific Institute, Milan 20132, Italy
| | - Alessandro Beneduce
- Interventional Cardiology Unit, San Raffaele Scientific Institute, Milan 20132, Italy
| | - Andrija Matetic
- Keele Cardiovascular Research Group, Centre for Prognosis Research, Institutes of Applied Clinical Science and Primary Care and Health Sciences, Keele University, Keele ST5 5BG, Newcastle, UK
- Department of Cardiology, University Hospital of Split, Split 21000, Croatia
| | - Pim A L Tonino
- Department of Cardiology, Catharina Hospital, Eindhoven 5623, The Netherlands
| | - Dragica Paunovic
- Board of Directors, European Cardiovascular Research Centre (CERC), Massy 91300, France
| | - Lotte Jacobs
- Medical and Clinical Division, Terumo Europe NV, Leuven 3001, Belgium
| | - Roxane Debrus
- Biostatistics Division, Genmab A/S, Copenhagen 1560, Denmark
| | - Jérémy El Aissaoui
- Artificial Intelligence Division, Business and Decision, Woluwe St Lambert, Brusells 1200, Belgium
| | - Frank van Leeuwen
- Medical and Clinical Division, Terumo Europe NV, Leuven 3001, Belgium
| | - Evangelos Kontopantelis
- Division of Informatics, Imaging and Data Sciences, School of Health Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre (MAHSC), University of Manchester, Manchester M13 9PL, UK
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Hill-Kayser CE, Szalda D, Vachani C, Ginsberg J, Hobbie W, Jacobs L, Hampshire MK, Metz JM, Schwartz L. Patterns of Independence in Adolescent/Young Adult (AYA) Survivors of Childhood Cancer Having Received Radiotherapy (RT). Int J Radiat Oncol Biol Phys 2023; 117:e235. [PMID: 37784935 DOI: 10.1016/j.ijrobp.2023.06.1154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) AYA cancer survivors are at risk for missed care opportunities due to transitions of care and movement towards independence. This study was undertaken to evaluate steps towards independence of AYA survivors voluntarily using a free, Internet-based tool for creation of survivorship care plans (SCP). MATERIALS/METHODS A free, publicly accessible tool, Smart-ALACC (Smart Adult Living after Childhood Cancer) was made available on Oncolink.org. Analysis of convenience sample frame was performed with IRB approval. RESULTS From 12/2017-12/2022, 676 AYA survivors utilized the tool; 55% (372) identified as female. Most (75%, 506) were white, 7% (48) Black, 7% (46) Asian, 6% (42) Hispanic, 5% other/ mixed race. Median age was 20y (R <16 - 46y) and median age at diagnosis was 11 y (R <1y - 21). Most common diagnoses were leukemia (31%, 212), lymphoma (21%, 140), sarcoma (14%, 95), CNS (9%, 54), and neuroblastoma (5%, 37). 311 pts (46%) reported having had RT, most commonly brain (PB) (19%, 60), "mantle" (14%, 43), craniospinal (CSI) (12%, 36), total body irradiation (TBI) (11%, 34), and head/ neck (8%, 26). Most (92%, 619) denied recurrence /secondary malignancy. Users reported being students (64%, 434) or working (24% (163)) full-time (20%) or part-time (4%); 4% (25) were neither. Most reported living with parents (71%, 482), 14% (92) with a partner/ spouse, 7% (46) alone, and 4% (30) with a roommate. Most reported using parental insurance (54%, 368), while 24% (163) had their own private insurance, 7% (49) public, and 2% uninsured. Of 466 users 18+ (466), more were employed (34%, 155, p = 0.04), living separately from parents (40%, 168, p < 0.001), and had independent insurance (52%, 184, p = 0.03). Of users 23+ (244), 141 (57%) were being employed (p < 0.001), 83% (153) living separately from parents (p < 0.001), and 165 (67%) had independent insurance (p < 0.001). Among users age 23+, survivors who had received brain RT (CSI, brain, or TBI) were less likely to live separately parents or with a spouse/ partner (p < 0.001), but equally likely to be employed (Table 1). CONCLUSION AYA survivors choosing to use a SCP tool have diagnoses reflective of diagnostic patterns in pediatric oncology; many have had RT expected to be associated with cognitive and developmental late effects. Despite this, trends towards employment and independence were evident in young adult population compared to adolescent; somewhat less so in survivors having had brain RT. These data suggest that AYA survivors display independence from parents and require population directed survivorship support; future efforts should aim to include a more diverse body of users.
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Affiliation(s)
- C E Hill-Kayser
- University of Pennsylvania, Department of Radiation Oncology, Philadelphia, PA
| | - D Szalda
- Children's Hospital of Philadelphia, Philadelphia, PA
| | | | - J Ginsberg
- Children's Hospital of Philadelphia, Philadelphia, PA
| | - W Hobbie
- Children's Hospital of Philadelphia, Philadelphia, PA
| | - L Jacobs
- University of Pennsylvania, Department of Internal Medicine, Division of Oncology, Philadelphia, PA
| | | | - J M Metz
- University of Pennsylvania, Department of Radiation Oncology, Philadelphia, PA
| | - L Schwartz
- Children's Hospital of Philadelphia, Philadelphia, PA
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Jacobs L, Stobbelaar K, Heykers A, Cos P, Delputte P. Subtractive Immunization as a Method to Develop Respiratory Syncytial Virus (RSV)-Specific Monoclonal Antibodies. Antibodies (Basel) 2023; 12:62. [PMID: 37873859 PMCID: PMC10594476 DOI: 10.3390/antib12040062] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Revised: 09/15/2023] [Accepted: 09/21/2023] [Indexed: 10/25/2023] Open
Abstract
Respiratory Syncytial Virus (RSV) is a significant cause of lower respiratory tract infections in the young, the elderly, and in immunodeficient patients. As such, the virus represents an important cause of morbidity and mortality worldwide. Development of monoclonal antibodies against RSV has resulted in a commercial prophylaxis, palivizumab (Synagis®), and different antibodies that have improved our understanding of the structure of the viral proteins. In this study, a different immunization technique, subtractive immunization, was evaluated for its applicability to develop RSV-specific antibodies. One hybridoma which produced antibodies with the strongest staining of RSV infected cells, ATAC-0025, was selected for further characterization. This antibody belongs to the IgG1 class, has neutralizing capacity and recognizes the envelope F-protein. The antibody has a broad reactivity against a range of RSV reference strains and clinical isolates.
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Affiliation(s)
- Lotte Jacobs
- Laboratory for Microbiology, Parasitology and Hygiene, Infla-Med Centre of Excellence, University of Antwerp (UA), Universiteitsplein 1 S.7, 2610 Antwerp, Belgium; (L.J.); (K.S.); (A.H.); (P.C.)
| | - Kim Stobbelaar
- Laboratory for Microbiology, Parasitology and Hygiene, Infla-Med Centre of Excellence, University of Antwerp (UA), Universiteitsplein 1 S.7, 2610 Antwerp, Belgium; (L.J.); (K.S.); (A.H.); (P.C.)
- Pediatrics Department, Antwerp University Hospital (UZA), Wilrijkstraat 10, 2650 Edegem, Belgium
| | - Annick Heykers
- Laboratory for Microbiology, Parasitology and Hygiene, Infla-Med Centre of Excellence, University of Antwerp (UA), Universiteitsplein 1 S.7, 2610 Antwerp, Belgium; (L.J.); (K.S.); (A.H.); (P.C.)
| | - Paul Cos
- Laboratory for Microbiology, Parasitology and Hygiene, Infla-Med Centre of Excellence, University of Antwerp (UA), Universiteitsplein 1 S.7, 2610 Antwerp, Belgium; (L.J.); (K.S.); (A.H.); (P.C.)
| | - Peter Delputte
- Laboratory for Microbiology, Parasitology and Hygiene, Infla-Med Centre of Excellence, University of Antwerp (UA), Universiteitsplein 1 S.7, 2610 Antwerp, Belgium; (L.J.); (K.S.); (A.H.); (P.C.)
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Doolub G, Iannaccone M, Rab T, Routledge H, Aminian A, Chevalier B, Hildick-Smith D, Jacobs L, Kobo O, Roguin A, Chieffo A, Mamas MA. Sex-based treatment and outcomes for coronary bifurcation stenting: A report from the e-ULTIMASTER registry. Catheter Cardiovasc Interv 2023; 102:430-439. [PMID: 37464969 DOI: 10.1002/ccd.30770] [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: 03/19/2023] [Revised: 06/02/2023] [Accepted: 07/09/2023] [Indexed: 07/20/2023]
Abstract
BACKGROUND Percutaneous coronary intervention (PCI) for bifurcation lesions can be technically challenging and is associated with higher risk. There is little data on sex-based differences in strategy and outcomes in bifurcation PCI. AIMS We sought to assess whether differences exist between women and men in the treatment and outcomes of bifurcation PCI. METHODS We collected data on 4006 patients undergoing bifurcation PCI, from the e-ULTIMASTER study, a prospective, multicentre study enrolling patients from 2014 to 2018. We divided the bifurcation cohort according to sex, with 1-year follow-up of outcomes (target lesion failure [TLF], target vessel failure [TVF], and patient-oriented composite endpoint [POCE]). FINDINGS Women were older (69.2 ± 10.9 years vs. 64.4 ± 11.0 years), with a greater burden of cardiovascular comorbidities. For true and non-true bifurcation lesions, women and men were equally likely to undergo a single stent approach (true: 63.2% vs. 63.6%, p = 0.79, non-true: 95.4% vs. 94.3%, p = 0.32), with similar rates of final kissing balloon (FKB) (37.2% vs. 35.5%, p = 0.36) and proximal optimization (POT) (34.4% vs. 34.2%, p = 0.93) in cases where two stents were used. Lastly, after propensity score matching, there was no difference between women and men in the incidence of the composite endpoints of TLF (5.5% vs. 5.2%, RR 1.05 [95% CI 0.77-1.44], p = 0.75), TVF (6.2% vs. 6.3%, RR 0.99 [95% CI 0.74-1.32], p = 0.96), and POCE (9.9% vs. 9.5%, RR 1.05 [95% CI 0.83-1.31], p = 0.70). CONCLUSION In this contemporary, real-world study of bifurcation PCI, we report no difference in stent strategy between women and men, with similar outcomes at 1-year.
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Affiliation(s)
- Gemina Doolub
- Translational Health Sciences, University of Bristol, Bristol, UK
- Keele Cardiovascular Research Group, Keele University, Keele, UK
| | | | - Tanveer Rab
- Emory University School of Medicine, Atlanta, Georgia, USA
| | | | - Adel Aminian
- Centre Hospitalier Universitaire de Charleroi, Charleroi, Belgium
| | - Bernard Chevalier
- Ramsay Générale de Santé, ICPS, Hôpital Jacques Cartier, Massy, France
| | - David Hildick-Smith
- Sussex Cardiac Centre, Brighton and Sussex University Hospitals, Brighton, UK
| | - Lotte Jacobs
- European Medical and Clinical Division, Terumo Europe, Leuven, Belgium
| | - Ofer Kobo
- Hillel Yaffe Medical Centre, Hadera, Israel
| | | | | | - Mamas A Mamas
- Keele Cardiovascular Research Group, Keele University, Keele, UK
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Lourenço-Silva MI, Ulans A, Campbell AM, Almeida Paz ICL, Jacobs L. Social-pair judgment bias testing in slow-growing broiler chickens raised in low- or high-complexity environments. Sci Rep 2023; 13:9393. [PMID: 37296295 PMCID: PMC10256692 DOI: 10.1038/s41598-023-36275-1] [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: 02/24/2023] [Accepted: 05/31/2023] [Indexed: 06/12/2023] Open
Abstract
Impacts of environmental complexity on affective states in slow-growing broiler chickens (Gallus gallus domesticus) are unknown. Chickens' performance in judgment bias tests (JBT) can be limited as they are tested individually, causing fear and anxiety. The objectives were to apply a social-pair JBT to assess the effect of environmental complexity on slow-growing broiler chickens` affective states, and assess the impact of fearfulness, anxiety, and chronic stress on JBT performance. Six-hundred Hubbard Redbro broilers were housed in six low-complexity (similar to commercial) or six high-complexity (permanent and temporary enrichments) pens. Twelve chicken pairs were trained (1 pair/pen, n = 24 chickens) using a multimodal approach (visual and spatial cues), with reward and neutral cues of opposing color and location. Three ambiguous cues were tested: near-positive, middle, and near-neutral cues. Approach and pecking behavior were recorded. Eighty-three percent of chickens (20/24) were successfully trained in 13 days. Fearfulness, anxiety, and chronic stress did not impact chickens' performance. Chickens successfully discriminated between cues. Low-complexity chickens approached the middle cue faster than high-complexity chickens, indicating that they were in a more positive affective state. The environmental complexity provided in this study did not improve affective states in slow-growing broiler chickens compared to a control. A social-pair JBT resulted in excellent learning and testing outcomes in slow-growing broilers.
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Affiliation(s)
- M I Lourenço-Silva
- Department of Animal Production and Preventive Veterinary Medicine, School of Veterinary Medicine and Animal Sciences (FMVZ), São Paulo State University "Júlio de Mesquita Filho" (UNESP), Botucatu, São Paulo, Brazil
- School of Animal Sciences, Virginia Tech, Blacksburg, VA, 24061, USA
| | - A Ulans
- School of Animal Sciences, Virginia Tech, Blacksburg, VA, 24061, USA
| | - A M Campbell
- School of Animal Sciences, Virginia Tech, Blacksburg, VA, 24061, USA
| | - I C L Almeida Paz
- Department of Animal Production and Preventive Veterinary Medicine, School of Veterinary Medicine and Animal Sciences (FMVZ), São Paulo State University "Júlio de Mesquita Filho" (UNESP), Botucatu, São Paulo, Brazil
| | - L Jacobs
- School of Animal Sciences, Virginia Tech, Blacksburg, VA, 24061, USA.
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Jacobs L, Blatchford RA, de Jong IC, Erasmus MA, Levengood M, Newberry RC, Regmi P, Riber AB, Weimer SL. Enhancing their quality of life: environmental enrichment for poultry. Poult Sci 2022; 102:102233. [PMID: 36351344 PMCID: PMC9647224 DOI: 10.1016/j.psj.2022.102233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Revised: 09/27/2022] [Accepted: 10/02/2022] [Indexed: 11/07/2022] Open
Abstract
Providing environmental enrichments that increase environmental complexity can benefit poultry welfare. This Poultry Science Association symposium paper is structured around four themes on 1) poultry preferences and affective states 2) species-specific behavior, including play behavior and the relationship between behavior, activity level and walking ability, 3) environmental enrichment and its relationship with indicators of welfare, and 4) a case study focusing on the application of enrichments in commercial broiler chicken production. For effective enrichment strategies, the birds' perspective matters most, and we need to consider individual variation, social dynamics, and previous experience when assessing these strategies. Play behavior can be a valuable indicator of positive affect, and while we do not yet know how much play would be optimal, absence of play suggests a welfare deficit. Activity levels and behavior can be improved by environmental modifications and prior research has shown that the activity level of broilers can be increased, at least temporarily, by increasing the environmental complexity. However, more research on impacts of enrichments on birds' resilience, on birds in commercial conditions, and on slow(er)-growing strains is needed. Finally, incorporating farmers' expertise can greatly benefit enrichment design and implementation on commercial farms.
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Affiliation(s)
- L Jacobs
- School of Animal Sciences, Virginia Tech, Blacksburg, VA, USA.
| | - R A Blatchford
- Department of Animal Science, Center for Animal Welfare, University of California, Davis, CA, USA
| | - I C de Jong
- Wageningen Livestock Research, Wageningen, the Netherlands
| | - M A Erasmus
- Department of Animal Sciences, Purdue University, West Lafayette, IA, USA
| | | | - R C Newberry
- Department of Animal and Aquacultural Sciences, Faculty of Biosciences, Norwegian University of Life Sciences, Ås, Norway
| | - P Regmi
- Department of Poultry Science, University of Georgia, Athens, GA, USA
| | - A B Riber
- Department of Animal Science, Aarhus University, Aarhus, Denmark
| | - S L Weimer
- Department of Poultry Science, University of Arkansas, Fayetteville, AR, USA
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Colombo VC, Sluydts V, Mariën J, Vanden Broecke B, Van Houtte N, Leirs W, Jacobs L, Iserbyt A, Hubert M, Heyndrickx L, Goris H, Delputte P, De Roeck N, Elst J, Ariën KK, Leirs H, Gryseels S. SARS-CoV-2 surveillance in Norway rats (Rattus norvegicus) from Antwerp sewer system, Belgium. Transbound Emerg Dis 2022; 69:3016-3021. [PMID: 34224205 PMCID: PMC8447303 DOI: 10.1111/tbed.14219] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Revised: 06/30/2021] [Accepted: 07/02/2021] [Indexed: 12/27/2022]
Abstract
SARS-CoV-2 human-to-animal transmission can lead to the establishment of novel reservoirs and the evolution of new variants with the potential to start new outbreaks in humans. We tested Norway rats inhabiting the sewer system of Antwerp, Belgium, for the presence of SARS-CoV-2 following a local COVID-19 epidemic peak. In addition, we discuss the use and interpretation of SARS-CoV-2 serological tests on non-human samples. Between November and December 2020, Norway rat oral swabs, faeces and tissues from the sewer system of Antwerp were collected to be tested by RT-qPCR for the presence of SARS-CoV-2. Serum samples were screened for the presence of anti-SARS-CoV-2 IgG antibodies using a Luminex microsphere immunoassay (MIA). Samples considered positive were then checked for neutralizing antibodies using a conventional viral neutralization test (cVNT). The serum of 35 rats was tested by MIA showing three potentially positive sera that were later negative by cVNT. All tissue samples of 39 rats analysed tested negative for SARS-CoV-2 RNA. This is the first study that evaluates SARS-CoV-2 infection in urban rats. We can conclude that the sample of rats analysed had never been infected with SARS-CoV-2. However, monitoring activities should continue due to the emergence of new variants prone to infect Muridae rodents.
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Affiliation(s)
- Valeria Carolina Colombo
- Evolutionary Ecology GroupDepartment of BiologyUniversity of AntwerpAntwerpBelgium
- Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET)Buenos AiresArgentina
| | - Vincent Sluydts
- Evolutionary Ecology GroupDepartment of BiologyUniversity of AntwerpAntwerpBelgium
| | - Joachim Mariën
- Evolutionary Ecology GroupDepartment of BiologyUniversity of AntwerpAntwerpBelgium
- Virology UnitDepartment of Biomedical SciencesInstitute of Tropical MedicineAntwerpBelgium
| | - Bram Vanden Broecke
- Evolutionary Ecology GroupDepartment of BiologyUniversity of AntwerpAntwerpBelgium
| | - Natalie Van Houtte
- Evolutionary Ecology GroupDepartment of BiologyUniversity of AntwerpAntwerpBelgium
| | - Wannes Leirs
- Evolutionary Ecology GroupDepartment of BiologyUniversity of AntwerpAntwerpBelgium
| | - Lotte Jacobs
- Laboratory for MicrobiologyParasitology and Hygiene (LMPH)University of AntwerpAntwerpBelgium
| | - Arne Iserbyt
- Evolutionary Ecology GroupDepartment of BiologyUniversity of AntwerpAntwerpBelgium
| | - Marine Hubert
- Evolutionary Ecology GroupDepartment of BiologyUniversity of AntwerpAntwerpBelgium
| | - Leo Heyndrickx
- Virology UnitDepartment of Biomedical SciencesInstitute of Tropical MedicineAntwerpBelgium
| | - Hanne Goris
- Evolutionary Ecology GroupDepartment of BiologyUniversity of AntwerpAntwerpBelgium
| | - Peter Delputte
- Laboratory for MicrobiologyParasitology and Hygiene (LMPH)University of AntwerpAntwerpBelgium
| | - Naomi De Roeck
- Laboratory for MicrobiologyParasitology and Hygiene (LMPH)University of AntwerpAntwerpBelgium
| | - Joris Elst
- Evolutionary Ecology GroupDepartment of BiologyUniversity of AntwerpAntwerpBelgium
| | - Kevin K. Ariën
- Virology UnitDepartment of Biomedical SciencesInstitute of Tropical MedicineAntwerpBelgium
| | - Herwig Leirs
- Evolutionary Ecology GroupDepartment of BiologyUniversity of AntwerpAntwerpBelgium
| | - Sophie Gryseels
- Evolutionary Ecology GroupDepartment of BiologyUniversity of AntwerpAntwerpBelgium
- OD Taxonomy and PhylogenyRoyal Belgian Institute of Natural SciencesBrusselsBelgium
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11
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Boyal R, Buhr R, Harris C, Jacobs L, Bourassa D. Evaluation of mechanical cervical dislocation, captive bolt, carbon dioxide, and electrical methods for individual on-farm euthanasia of broiler breeders. Poult Sci 2022; 101:102000. [PMID: 35901644 PMCID: PMC9334341 DOI: 10.1016/j.psj.2022.102000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Revised: 05/24/2022] [Accepted: 06/06/2022] [Indexed: 11/27/2022] Open
Abstract
Efficacious euthanasia by applying manual cervical dislocation can be difficult on large and mature poultry. The challenge with using manual cervical dislocation is that the strength required to hold heavy poultry and swiftly apply cervical dislocation can be physically impossible for most people. Therefore, alternative methods of euthanasia are needed for mature and large poultry. Mechanical cervical dislocation using the Koechner Euthanizing Device (KED), captive bolt using the Turkey Euthanasia Device (TED), carbon dioxide (CO2), and electrical euthanasia were evaluated for use on 65-wk-old broiler breeders at flock termination. Following application of each method, physiological reflexes including the eye nictitating membrane reflex, mouth gaping, and body movement, broken skin, blood loss, kill success, time to cessation of heartbeat, and blood plasma corticosterone levels were assessed. Birds euthanized using the KED had longer response durations for eye nictitating membrane (91 s) and reflexive mouth gaping (161 s) compared to TED, CO2, and electrical euthanasia (0–7 s). Body movement durations were also longer for KED (214 s) and TED (209 s) than for CO2 and electrical euthanasia (0–8 s). The highest percentages of broken skin (93%) and blood loss (96%) were observed for TED, followed by KED (71%, 68%), then CO2 (0%, 6%) and electrical euthanasia (0%, 3%). No significant differences (P = 0.1781) were observed for kill success rates with 98% for KED, 100% for TED, 97% for CO2, and 100% for electrical euthanasia at 4-min. Time to heartbeat cessation did not differ between KED (659 s), TED (427 s), or CO2 (583 s) euthanasia methods. No heartbeat was detected following electrical euthanasia. Blood plasma corticosterone levels did not differ between preeuthanasia or posteuthanasia from any of the methods applied. Based on these results each euthanasia method is acceptable for use with broiler breeders.
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12
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Cimci M, Polad J, Mamas M, Iniguez-Romo A, Chevalier B, Abhaichand R, Aminian A, Roguin A, Maluenda G, Angioi M, Cassel G, Kuramitsu S, Jacobs L, Debrus R, Malik F, Hildick-Smith D, Laanmets P, Roffi M. Outcomes and regional differences in practice in a worldwide coronary stent registry. Heart 2022; 108:1310-1318. [PMID: 35012960 PMCID: PMC9340045 DOI: 10.1136/heartjnl-2021-320116] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [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: 08/15/2021] [Accepted: 11/08/2021] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE The primary objective was to assess the performance of a new generation thin-strut sirolimus-eluting coronary stent with abluminal biodegradable polymer in an all comer population. The secondary objective was to detail differences in contemporary percutaneous coronary intervention (PCI) practice worldwide. METHODS e-Ultimaster was an all-comer, prospective, global registry (NCT02188355) with independent event adjudication enrolling patients undergoing PCI with the study stent. The primary outcome measure was target lesion failure (TLF) at 1 year, defined as the composite of cardiac death, target vessel myocardial infarction and clinically driven target lesion revascularisation. Data were stratified according to 4 geographical regions. RESULTS A total of 37 198 patients were enrolled (Europe 69.2%, Asia 17.8%, Africa/Middle East 6.6% and South America/Mexico 6.5%) and 1-year follow-up was available for 35 389 patients (95.1%). One-year TLF occurred in 3.2% of the patients, ranging from 2% (Africa/Middle East) to 4.1% (South America/Mexico). In patients with acute coronary syndrome, potent P2Y12 inhibitors were prescribed in 48% of patients at discharge, while at 1 year 72% were on any dual antiplatelet therapy. Lipid-lowering treatment was administered in 80.9% and 75.5% of patients at discharge and 1 year, respectively. Regional differences in the profile of the treated patients as well as in PCI practice were reported. CONCLUSIONS In this investigation with worldwide representation, contemporary PCI using a new generation thin-strut sirolimus-eluting coronary stent with abluminal biodegradable polymer was associated with low 1-year TLF across clinical presentations and continents. Suboptimal adherence to current recommendations around antiplatelet and lipid lowering treatments was detected.
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Affiliation(s)
- Murat Cimci
- Division of Cardiology, University Hospitals Geneva, Geneva, Switzerland
| | - Jawed Polad
- Department of Cardiology, Jeroen Bosch Hospital, 's-Hertogenbosch, The Netherlands
| | - Mamas Mamas
- Keele Cardiovascular Research Group, Center for Prognosis Research, Keele University, Keele, UK.,Department of Cardiology, University Hospital of North Midlands, Stoke-on-Trent, UK
| | | | - Bernard Chevalier
- Ramsay Générale de Santé, Institut Cardiovasculaire Paris Sud, Massy, France
| | - Rajpal Abhaichand
- Department of Cardiology, GKNM Hospital, Coimbatore, Tamil Nadu, India
| | - Adel Aminian
- Department of Cardiology, Centre Hospitalier Universitaire de Charleroi, Charleroi, Belgium
| | - Ariel Roguin
- Departmement of Cardiology, Hillel Yaffe Medical Center, Hadera, Israel.,Faculty of Medicine, Technion Israel Institute of Technology The Ruth and Bruce Rappaport, Haifa, Israel
| | - Gabriel Maluenda
- Cardiology, Hospital Clinico San Borja Arriaran, Santiago, Chile
| | | | - Graham Cassel
- Netcare Milpark Hospital, Johannesburg, South Africa
| | | | - Lotte Jacobs
- Medical and Clinical Division, Terumo Europe NV, Leuven, Belgium
| | - Roxane Debrus
- Medical and Clinical Division, Terumo Europe NV, Leuven, Belgium
| | - Fazila Malik
- National Heart Foundation Hospital and Research Institute, Dhaka, Bangladesh
| | | | - Peep Laanmets
- North Estonia Medical Centre Foundation, Tallinn, Estonia
| | - Marco Roffi
- Division of Cardiology, University Hospitals Geneva, Geneva, Switzerland
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13
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Boogaerts T, Jacobs L, De Roeck N, Van den Bogaert S, Aertgeerts B, Lahousse L, van Nuijs ALN, Delputte P. An alternative approach for bioanalytical assay optimization for wastewater-based epidemiology of SARS-CoV-2. Sci Total Environ 2021; 789:148043. [PMID: 34323818 PMCID: PMC8152210 DOI: 10.1016/j.scitotenv.2021.148043] [Citation(s) in RCA: 6] [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] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Revised: 05/20/2021] [Accepted: 05/21/2021] [Indexed: 05/02/2023]
Abstract
Wastewater-based epidemiology of SARS-CoV-2 could play a role in monitoring the spread of the virus in the population and controlling possible outbreaks. However, sensitive sample preparation and detection methods are necessary to detect trace levels of SARS-CoV-2 RNA in influent wastewater (IWW). Unlike predecessors, method optimization of a SARS-CoV-2 RNA concentration and detection procedure was performed with IWW samples with high viral SARS-CoV-2 RNA loads. This is of importance since the SARS-CoV-2 genome in IWW might have already been subject to in-sewer degradation into smaller genome fragments or might be present in a different form (e.g. cell debris, …). Centricon Plus-70 (100 kDa) centrifugal filter devices resulted in the lowest and most reproducible Ct-values for SARS-CoV-2 RNA. Lowering the molecular weight cut-off did not improve our limit of detection and quantification (approximately 100 copies/μL for all genes). Quantitative polymerase chain reaction (qPCR) was employed for the amplification of the N1, N2, N3 and E-gene fragments. This is one of the first studies to apply digital polymerase chain reaction (dPCR) for the detection of SARS-CoV-2 RNA in IWW. dPCR showed high variability at low concentration levels (100 copies/μL), indicating that variability in bioanalytical methods for wastewater-based epidemiology of SARS-CoV-2 might be substantial. dPCR results in IWW were in line with the results found with qPCR. On average, the N2-gene fragment showed high in-sample stability in IWW for 10 days of storage at 4 °C. Between-sample variability was substantial due to the low native concentrations in IWW. Additionally, the E-gene fragment proved to be less stable compared to the N2-gene fragment and showed higher variability. Freezing the IWW samples resulted in a 10-fold decay of loads of the N2- and E-gene fragment in IWW.
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Affiliation(s)
- Tim Boogaerts
- Toxicological Centre, University of Antwerp, Universiteitsplein 1, 2610 Wilrijk, Belgium.
| | - Lotte Jacobs
- Laboratory for Microbiology, Parasitology and Hygiene, University of Antwerp, Universiteitsplein 1, 2610 Wilrijk, Belgium
| | - Naomi De Roeck
- Laboratory for Microbiology, Parasitology and Hygiene, University of Antwerp, Universiteitsplein 1, 2610 Wilrijk, Belgium
| | - Siel Van den Bogaert
- Laboratory for Microbiology, Parasitology and Hygiene, University of Antwerp, Universiteitsplein 1, 2610 Wilrijk, Belgium
| | - Bert Aertgeerts
- Academic Centre for General Practice, KU Leuven, Kapucijnenvoer 7, 3000 Leuven, Belgium
| | - Lies Lahousse
- Department of Bioanalysis, Ghent University, Ottergemsesteenweg 460, 9000 Ghent, Belgium
| | | | - Peter Delputte
- Laboratory for Microbiology, Parasitology and Hygiene, University of Antwerp, Universiteitsplein 1, 2610 Wilrijk, Belgium
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14
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Anderson MG, Campbell AM, Crump A, Arnott G, Jacobs L. Environmental complexity positively impacts affective states of broiler chickens. Sci Rep 2021; 11:16966. [PMID: 34417475 PMCID: PMC8379235 DOI: 10.1038/s41598-021-95280-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Accepted: 07/16/2021] [Indexed: 02/07/2023] Open
Abstract
Affective state can bias an animal's judgement. Animals in positive affective states can interpret ambiguous cues more positively ("optimistically") than animals in negative affective states. Thus, judgement bias tests can determine an animal's affective state through their responses to ambiguous cues. We tested the effects of environmental complexity and stocking density on affective states of broiler chickens through a multimodal judgement bias test. Broilers were trained to approach reinforced locations signaled by one color and not to approach unreinforced locations signaled by a different color. Trained birds were tested for latencies to approach three ambiguous cues of intermediate color and location. Broilers discriminated between cues, with shorter latencies to approach ambiguous cues closest to the reinforced cue than cues closest to the unreinforced cue, validating the use of the test in this context. Broilers housed in high-complexity pens approached ambiguous cues faster than birds in low-complexity pens-an optimistic judgement bias, suggesting the former were in a more positive affective state. Broilers from high-density pens tended to approach all cues faster than birds from low-density pens, possibly because resource competition in their home pen increased food motivation. Overall, our study suggests that environmental complexity improves broilers' affective states, implying animal welfare benefits of environmental enrichment.
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Affiliation(s)
- M. G. Anderson
- grid.438526.e0000 0001 0694 4940Department of Animal and Poultry Sciences, Virginia Polytechnic Institute and State University, Blacksburg, VA USA
| | - A. M. Campbell
- grid.438526.e0000 0001 0694 4940Department of Animal and Poultry Sciences, Virginia Polytechnic Institute and State University, Blacksburg, VA USA
| | - A. Crump
- grid.13063.370000 0001 0789 5319Centre for Philosophy of Natural and Social Science, London School of Economics and Political Science, London, UK
| | - G. Arnott
- grid.4777.30000 0004 0374 7521School of Biological Sciences, Queen’s University Belfast, Belfast, UK
| | - L. Jacobs
- grid.438526.e0000 0001 0694 4940Department of Animal and Poultry Sciences, Virginia Polytechnic Institute and State University, Blacksburg, VA USA
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15
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de Ronde W, Jacobs L, Smit DL. [Outpatient clinic for users of anabolic androgenic; experiences and practical tools]. Ned Tijdschr Geneeskd 2021; 165:D5715. [PMID: 34346623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
In the Netherlands, an estimated 20,000 men abuse illegal androgens. The confrontation with a patient who uses illegal substances can evoke questions and emotions. We advise not to moralize users of anabolic steroids, but to strive for harm reduction by starting a discussion about the pros and cons of androgen abuse, taking into account your assumptions and judgments about this subject. Underlying psychopathology should be recognized and treated if the user is open to it. We recommend against prescribing anabolic steroids without medical indication and not to perform health checks routinely while the patient continues using anabolic steroids as long as it is not established that this can prevent health damage. If the user reports with health problems, this should be used as a starting point to (re) open the conversation about the advantages and disadvantages of use. Harmful effects of use must be handled according to appropriate guidelines.
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Affiliation(s)
- W de Ronde
- Spaarne Gasthuis, afd. Interne Geneeskunde, Haarlem
- Contact: W. de Ronde
| | - L Jacobs
- Spaarne Gasthuis, afd. Interne Geneeskunde, Haarlem
| | - D L Smit
- Elisabeth-TweeSteden Ziekenhuis, afd. Interne Geneeskunde, Tilburg
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16
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Boogaerts T, Jacobs L, De Roeck N, Van den Bogaert S, Aertgeerts B, Lahousse L, van Nuijs ALN, Delputte P. An alternative approach for bioanalytical assay optimization for wastewater-based epidemiology of SARS-CoV-2. Sci Total Environ 2021; 789:148043. [PMID: 34323818 DOI: 10.1101/2021.02.12.21251626] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Revised: 05/20/2021] [Accepted: 05/21/2021] [Indexed: 05/18/2023]
Abstract
Wastewater-based epidemiology of SARS-CoV-2 could play a role in monitoring the spread of the virus in the population and controlling possible outbreaks. However, sensitive sample preparation and detection methods are necessary to detect trace levels of SARS-CoV-2 RNA in influent wastewater (IWW). Unlike predecessors, method optimization of a SARS-CoV-2 RNA concentration and detection procedure was performed with IWW samples with high viral SARS-CoV-2 RNA loads. This is of importance since the SARS-CoV-2 genome in IWW might have already been subject to in-sewer degradation into smaller genome fragments or might be present in a different form (e.g. cell debris, …). Centricon Plus-70 (100 kDa) centrifugal filter devices resulted in the lowest and most reproducible Ct-values for SARS-CoV-2 RNA. Lowering the molecular weight cut-off did not improve our limit of detection and quantification (approximately 100 copies/μL for all genes). Quantitative polymerase chain reaction (qPCR) was employed for the amplification of the N1, N2, N3 and E-gene fragments. This is one of the first studies to apply digital polymerase chain reaction (dPCR) for the detection of SARS-CoV-2 RNA in IWW. dPCR showed high variability at low concentration levels (100 copies/μL), indicating that variability in bioanalytical methods for wastewater-based epidemiology of SARS-CoV-2 might be substantial. dPCR results in IWW were in line with the results found with qPCR. On average, the N2-gene fragment showed high in-sample stability in IWW for 10 days of storage at 4 °C. Between-sample variability was substantial due to the low native concentrations in IWW. Additionally, the E-gene fragment proved to be less stable compared to the N2-gene fragment and showed higher variability. Freezing the IWW samples resulted in a 10-fold decay of loads of the N2- and E-gene fragment in IWW.
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Affiliation(s)
- Tim Boogaerts
- Toxicological Centre, University of Antwerp, Universiteitsplein 1, 2610 Wilrijk, Belgium.
| | - Lotte Jacobs
- Laboratory for Microbiology, Parasitology and Hygiene, University of Antwerp, Universiteitsplein 1, 2610 Wilrijk, Belgium
| | - Naomi De Roeck
- Laboratory for Microbiology, Parasitology and Hygiene, University of Antwerp, Universiteitsplein 1, 2610 Wilrijk, Belgium
| | - Siel Van den Bogaert
- Laboratory for Microbiology, Parasitology and Hygiene, University of Antwerp, Universiteitsplein 1, 2610 Wilrijk, Belgium
| | - Bert Aertgeerts
- Academic Centre for General Practice, KU Leuven, Kapucijnenvoer 7, 3000 Leuven, Belgium
| | - Lies Lahousse
- Department of Bioanalysis, Ghent University, Ottergemsesteenweg 460, 9000 Ghent, Belgium
| | | | - Peter Delputte
- Laboratory for Microbiology, Parasitology and Hygiene, University of Antwerp, Universiteitsplein 1, 2610 Wilrijk, Belgium
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17
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18
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Jacobs L, Gorovets D, Burleson S, Happersett L, Zhang Z, Hunt M, McBride S, Kollmeier M, Zelefsky M. Predictors of Intra-Fraction Prostate Motion during Stereotactic Body Radiation Therapy (SBRT). Int J Radiat Oncol Biol Phys 2019. [DOI: 10.1016/j.ijrobp.2019.06.1914] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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19
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Hill-Kayser C, Szalda D, Vachani C, Virgilio L, Psihogios A, O'Hagan B, Cope C, velazquez-Martin B, Hobbie W, Ginsberg J, Daniel L, Barakat L, Fleisher L, Jacobs L, Hampshire M, Metz J, Lunsford N, Sabatino S, Schwartz L. Feasibility and Acceptability of Survivorship Care Plans for Adolescent/ Young Adult Survivors of Childhood Cancer. Int J Radiat Oncol Biol Phys 2019. [DOI: 10.1016/j.ijrobp.2019.06.1214] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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20
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Pontillo C, Jacobs L, Staessen JA, Schanstra JP, Rossing P, Heerspink HJL, Siwy J, Mullen W, Vlahou A, Mischak H, Vanholder R, Zürbig P, Jankowski J. A urinary proteome-based classifier for the early detection of decline in glomerular filtration. Nephrol Dial Transplant 2018; 32:1510-1516. [PMID: 27387473 DOI: 10.1093/ndt/gfw239] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2016] [Accepted: 05/02/2016] [Indexed: 12/13/2022] Open
Abstract
Background Chronic kidney disease (CKD) progression is currently assessed by a decline in estimated glomerular filtration rate (eGFR) and/or an increase in urinary albumin excretion (UAE). However, these markers are considered either to be late-stage markers or to have low sensitivity or specificity. In this study, we investigated the performance of the urinary proteome-based classifier CKD273, compared with UAE, in a number of different narrow ranges of CKD severity, with each range separated by an eGFR of 10 mL/min/1.73 m 2 . Methods A total of 2672 patients with different CKD stages were included in the study. Of these, 394 individuals displayed a decline in eGFR of >5 mL/min/1.73 m 2 /year (progressors) and the remaining individuals were considered non-progressors. For all samples, UAE values and CKD273 classification scores were obtained. To assess UAE values and CKD273 scores at different disease stages, the cohort was divided according to baseline eGFRs of ≥80, 70-79, 60-69, 50-59, 40-49, 30-39 and <29 mL/min/1.73 m 2 . In addition, areas under the curve for CKD273 and UAE were calculated. Results In early stage CKD, the urinary proteome-based classifier performed significantly better than UAE in detecting progressors. In contrast, UAE performed better in patients with late-stage CKD. No significant difference in performance was found between CKD273 and UAE in patients with moderately reduced renal function. Conclusions These results suggest that urinary peptides, as combined in the CKD273 classifier, allow the detection of progressive CKD at early stages, a point where therapeutic intervention is more likely to be effective. However, late-stage disease, where irreversible damage of the kidney is already present, is better detected by UAE.
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Affiliation(s)
- Claudia Pontillo
- Mosaiques Diagnostics, Hanover, Germany.,Charité-Universitatsmedizin, Berlin, Germany
| | - Lotte Jacobs
- Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium
| | - Jan A Staessen
- Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium.,R&D VitaK Group, Maastricht University, Maastricht, The Netherlands
| | - Joost P Schanstra
- Institute of Metabolic and Cardiovascular Diseases, Inserm U1048, Toulouse, France.,Université Toulouse III Paul-Sabatier, Toulouse, France
| | - Peter Rossing
- Steno Diabetes Center, Gentofte, Denmark.,University of Aarhus, Aarhus, Denmark.,Center for Basic Metabolic Research, University of Copenhagen, Copenhagen, Denmark
| | - Hiddo J L Heerspink
- Department of Clinical Pharmacy and Pharmacology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | | | | | - Antonia Vlahou
- Biomedical Research Foundation, Academy of Athens, Athens, Greece
| | - Harald Mischak
- Mosaiques Diagnostics, Hanover, Germany.,University of Glasgow, Glasgow, UK
| | - Ray Vanholder
- Nephrology Section, Department of Internal Medicine, Ghent University Hospital, Ghent, Belgium
| | | | - Joachim Jankowski
- Charité-Universitatsmedizin, Berlin, Germany.,Institute for Molecular Cardiovascular Research, University Hospital RWTH, Aachen, Germany.,Department of Pathology, Cardiovascular Research Institute Maastricht (CARIM), University of Maastricht, Maastricht, The Netherlands
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21
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Jacobs L, van der Vlies E, Ten Bokkel Huinink D, Bloemendal H, Intven M, Smits AB, Weusten BLAM, Siersema PD, van Lelyveld N, Los M. Tolerability, Safety, and Outcomes of Neoadjuvant Chemoradiotherapy With Capecitabine for Patients Aged ≥ 70 Years With Locally Advanced Rectal Cancer. Clin Colorectal Cancer 2018; 17:179-186. [PMID: 29661620 DOI: 10.1016/j.clcc.2018.03.004] [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] [Subscribe] [Scholar Register] [Received: 10/24/2017] [Revised: 02/17/2018] [Accepted: 03/05/2018] [Indexed: 12/12/2022]
Abstract
INTRODUCTION In studies of colorectal cancer, the elderly have been frequently underrepresented because comorbid conditions and functional status often lead to study exclusion. For elderly patients with an indication for neoadjuvant chemoradiotherapy (nCRT), physicians usually decide using clinical factors whether nCRT should be offered. The aim of the present retrospective study was to assess the tolerability of nCRT with capecitabine and the surgical outcomes in patients aged ≥ 70 years with locally advanced rectal cancer. PATIENTS AND METHODS Data from 1372 rectal cancer patients diagnosed from 2002 to 2012 at 4 Dutch hospitals were used. Patients aged ≥ 70 years were included if they had received nCRT, and their data were analyzed for treatment deviations, postoperative complications, mortality, disease-free survival (DFS), and overall survival (OS). The data were stratified into 3 age groups (ie, 70-74, 75-79, and ≥ 80 years). RESULTS We identified 447 patients aged ≥ 70 years. Of these patients, 42 had received nCRT, and 37 (88%) had completed nCRT. Radiation dermatitis, fatigue, and diarrhea were reported in 62%, 57%, and 43% of the 42 patients, respectively. Of the 42 patients, 40 (95%) underwent surgery, 1 patient refused resection, and 1 patient died during nCRT of severe mucositis due to dihydropyrimidine dehydrogenase deficiency. The postoperative complication rate was 30%, and the 30-day mortality rate was 0%. A pathologic complete response was found in 7.5%. The 2- and 5-year DFS and OS rates were 58.5% and 40.7% and 81.0% and 58.2%, respectively. CONCLUSION The results of the present multicenter study have shown that if selected on clinical factors, nCRT with capecitabine is safe and well tolerated in elderly patients. No negative effect on surgical outcome was measured, and the beneficial effect (pathologic complete response, DFS, and OS) seemed comparable to that for younger age groups. We believe that elderly patients should not be excluded from nCRT on the basis of age only.
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Affiliation(s)
- Lotte Jacobs
- Department of Gastroenterology and Hepatology, St Antonius Hospital Nieuwegein, Nieuwegein, Netherlands.
| | - Ellen van der Vlies
- Department of Internal Medicine/Oncology, St Antonius Hospital Nieuwegein, Nieuwegein, Netherlands
| | | | - Haiko Bloemendal
- Department of Internal Medicine/Oncology, Meander Medical Center Amersfoort, Amersfoort, Netherlands
| | - Martijn Intven
- Department of Radiotherapy, University Medical Center Utrecht, Utrecht, Netherlands
| | - Anke B Smits
- Department of Surgery, St Antonius Hospital Nieuwegein, Nieuwegein, Netherlands
| | - Bas L A M Weusten
- Department of Gastroenterology and Hepatology, St Antonius Hospital Nieuwegein, Nieuwegein, Netherlands
| | - Peter D Siersema
- Department of Gastroenterology and Hepatology, Radboud University Medical Center Nijmegen, Nijmegen, Netherlands
| | - Niels van Lelyveld
- Department of Gastroenterology and Hepatology, St Antonius Hospital Nieuwegein, Nieuwegein, Netherlands
| | - Maartje Los
- Department of Internal Medicine/Oncology, St Antonius Hospital Nieuwegein, Nieuwegein, Netherlands
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Raaijmakers A, Zhang ZY, Levtchenko E, Simons SH, Cauwenberghs N, Heuvel LPVD, Jacobs L, Staessen JA, Allegaert K. Ibuprofen exposure in early neonatal life does not affect renal function in young adolescence. Arch Dis Child Fetal Neonatal Ed 2018; 103:F107-F111. [PMID: 28615304 DOI: 10.1136/archdischild-2017-312922] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2017] [Revised: 04/27/2017] [Accepted: 04/27/2017] [Indexed: 11/04/2022]
Abstract
INTRODUCTION Ibuprofen exposure results in acute transient renal dysfunction in preterm neonates, but we are unaware of data on long-term renal safety. METHODS In a previously studied cohort of extreme low birth weight (ELBW, <1000 g) cases, the PREMATurity as predictor of children's Cardiovascular-renal Health study generated data on renal function (renal length, estimated glomerular filtration rate based on cystatin C (eGFRcysC) at the age of 11 years. This data set in 93 ELBW cases may also generate data on long-term drug safety on ibuprofen. In this post hoc analysis, we linked markers of renal function in young adolescence in ELBW cases with their perinatal (prenatal maternal, setting at birth, treatment modalities including drug prescription during neonatal stay, neonatal creatinine values, postdischarge growth) characteristics, including but not limited to ibuprofen exposure during neonatal stay. RESULTS Ibuprofen exposure was not associated with significant differences in renal length or eGFRcysC. Moreover, we were unable to identify any other risk factor (perinatal characteristics, postnatal creatinine trends, postdischarge growth) on renal outcome in this cohort. CONCLUSIONS Neonatal exposure to ibuprofen did not affect renal function. Larger studies are needed to explore the confounders of variability in renal function in former ELBW cases. This matters since ELBW relates to risk for hypertension, cardiovascular events and renal disease in later life and identification of risk factors holds the promise of secondary prevention. TRIAL REGISTRATION NUMBER NCT02147457.
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Affiliation(s)
- Anke Raaijmakers
- Department of Pediatrics and Neonatology, University Hospitals Leuven, Leuven, Belgium.,KU Leuven Department of Development and Regeneration, University of Leuven, Leuven, Belgium
| | - Zhen-Yu Zhang
- Department of Pediatrics and Neonatology, University Hospitals Leuven, Leuven, Belgium.,KU Leuven Department of Development and Regeneration, University of Leuven, Leuven, Belgium.,Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium
| | - Elena Levtchenko
- Department of Pediatrics and Neonatology, University Hospitals Leuven, Leuven, Belgium
| | - Sinno Hp Simons
- Department of Pediatrics, Division of Neonatology, Erasmus MC Sophia Children's Hospital, Rotterdam, The Netherlands
| | - Nicholas Cauwenberghs
- Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium
| | | | - Lotte Jacobs
- Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium
| | - Jan A Staessen
- Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium.,R&D Group VitaK, Maastricht University, Maastricht, The Netherlands
| | - Karel Allegaert
- KU Leuven Department of Development and Regeneration, University of Leuven, Leuven, Belgium.,Department of Pediatrics, Division of Neonatology, Erasmus MC Sophia Children's Hospital, Rotterdam, The Netherlands.,Intensive Care and Department of Pediatric Surgery, Erasmus Medical Center Sophia Children's Hospital, Rotterdam, The Netherlands
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23
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Wei FF, Thijs L, Zhang ZY, Jacobs L, Yang WY, Salvi E, Citterio L, Cauwenberghs N, Kuznetsova T, E A Drummen N, Hara A, Manunta P, Li Y, Verhamme P, Allegaert K, Cusi D, Vermeer C, Staessen JA. The risk of nephrolithiasis is causally related to inactive matrix Gla protein, a marker of vitamin K status: a Mendelian randomization study in a Flemish population. Nephrol Dial Transplant 2018; 33:514-522. [PMID: 28340119 DOI: 10.1093/ndt/gfx014] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2016] [Accepted: 01/15/2017] [Indexed: 01/12/2023] Open
Abstract
Background Vitamin K (VK)-dependent γ-glutamate carboxylation and serine phosphorylation activate matrix Gla protein (MGP) to a potent locally acting inhibitor of calcification. Nephrolithiasis represents a process of unwanted calcification associated with substantial mortality and high recurrence rates. We hypothesized that the risk of nephrolithiasis increases with VK shortage, as exemplified by higher plasma levels of desphospho-uncarboxylated MGP (dp-ucMGP). Methods In 1748 randomly recruited Flemish individuals (51.1% women; mean age 46.8 years), we determined dp-ucMGP and the prevalence of nephrolithiasis at baseline (April 1996-February 2015) and its incidence during follow-up until March 2016. We estimated the multivariable-adjusted relative risk associated with the doubling of dp-ucMGP, using logistic or Cox regression. We did a Mendelian randomization analysis using four MGP genotypes as instrumental variables. Results With adjustments applied for sex, age and 24-h urinary volume and calcium excretion, the odds of having prevalent nephrolithiasis [n = 144 (8.2%)] associated with dp-ucMGP was 1.31 [95% confidence interval (CI) 1.04-1.64; P = 0.022]. dp-ucMGP levels were associated (P ≤ 0.001) with MGP variants rs2098435, rs4236 and rs2430692. In the Mendelian analysis, the causal odds ratio was 3.82 (95% CI 1.15-12.7; P = 0.029). The incidence of nephrolithiasis over 12.0 years (median) was 37 cases (0.2%). With similar adjustments as before, the hazard ratio in relation to dp-ucMGP was 2.48 (95% CI 1.71-3.61; P < 0.001). Additional adjustment for a nephrolithiasis propensity score produced consistent results. Conclusion Higher levels of inactive dp-ucMGP may be causally associated with the risk of nephrolithiasis. Whether or not VK deficiency plays a role in these observations remains to be firmly established.
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Affiliation(s)
- Fang-Fei Wei
- Studies Coordinating Centre, Research Unit of Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium
| | - Lutgarde Thijs
- Studies Coordinating Centre, Research Unit of Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium
| | - Zhen-Yu Zhang
- Studies Coordinating Centre, Research Unit of Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium
| | - Lotte Jacobs
- Studies Coordinating Centre, Research Unit of Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium
| | - Wen-Yi Yang
- Studies Coordinating Centre, Research Unit of Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium
| | - Erika Salvi
- Genomics and Bioinformatics Platform at Filarete Foundation, Department of Health Sciences and Graduate School of Nephrology, Division of Nephrology, San Paolo Hospital, University of Milan, Italy
| | - Lorena Citterio
- Division of Nephrology and Dialysis, IRCCS San Raffaele Scientific Institute and School of Nephrology, University Vita-Salute San Raffaele, Milan, Italy
| | - Nicholas Cauwenberghs
- Studies Coordinating Centre, Research Unit of Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium
| | - Tatiana Kuznetsova
- Studies Coordinating Centre, Research Unit of Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium
| | | | - Azusa Hara
- Department of Social Pharmacy and Public Health, Showa Pharmaceutical University, Tokyo, Japan
| | - Paolo Manunta
- Division of Nephrology and Dialysis, IRCCS San Raffaele Scientific Institute and School of Nephrology, University Vita-Salute San Raffaele, Milan, Italy
| | - Yan Li
- Center for Epidemiological Studies and Clinical Trials and Center for Vascular Evaluations, Shanghai Institute of Hypertension, Shanghai Key Laboratory of Hypertension, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Peter Verhamme
- Research Unit of Molecular and Vascular Biology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium
| | - Karel Allegaert
- Research Unit of Organ Systems, KU Leuven Department of Development and Regeneration, University of Leuven, Leuven, Belgium
| | - Daniele Cusi
- Genomics and Bioinformatics Platform at Filarete Foundation, Department of Health Sciences and Graduate School of Nephrology, Division of Nephrology, San Paolo Hospital, University of Milan, Italy
| | - Cees Vermeer
- R&D Group VitaK, Maastricht University, Maastricht, The Netherlands
| | - Jan A Staessen
- Studies Coordinating Centre, Research Unit of Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium
- R&D Group VitaK, Maastricht University, Maastricht, The Netherlands
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24
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Odili AN, Thijs L, Yang WY, Ogedengbe JO, Nwegbu MM, Jacobs L, Wei FF, Feng YM, Zhang ZY, Kuznetsova T, Nawrot TS, Staessen JA. Office and Home Blood Pressures as Determinants of Electrocardiographic Left Ventricular Hypertrophy Among Black Nigerians Compared With White Flemish. Am J Hypertens 2017; 30:1083-1092. [PMID: 29059302 PMCID: PMC5861556 DOI: 10.1093/ajh/hpx114] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2017] [Accepted: 06/15/2017] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND The association of electrocardiographic left ventricular hypertrophy (ECG-LVH) with blood pressure (BP) in Blacks living in sub-Saharan Africa remains poorly documented. METHODS In 225 Black Nigerians and 729 White Flemish, we analyzed QRS voltages and voltage-duration products and 12 criteria diagnostic of ECG-LVH in relation to office BP (mean of 5 consecutive readings) and home BP (duplicate morning and evening readings averaged over 1 week). RESULTS In multivariable analyses, QRS voltage and voltage-duration indexes were generally higher in Blacks than Whites. By using any of 12 criteria, ECG-LVH was more prevalent among Black than White men (54.4% vs. 36.0%) with no ethnic difference among women (17.1%). Precordial voltages and voltage-duration products increased with office and home systolic BP (SBP), and increases were up to 3-fold steeper in Blacks. In Blacks vs. Whites, increases in the Sokolow–Lyon voltage associated with a 10-mm Hg higher SBP were 0.18 mV (95% confidence interval [CI], 0.09–0.26) vs. 0.06 mV (0.02–0.09) and 0.17 mV (0.07–0.28) vs. 0.11 mV (CI, 0.07–0.15) for office and home BP, respectively, with a significant ethnic gradient (P < 0.05). The risk of ECG-LVH increased more with office and home BP in Blacks than Whites. CONCLUSIONS Associations of ECG voltages and voltage-duration products and risk of ECG-LVH with BP are steeper in Black Nigerians compared with a White reference population. In resource-poor settings of sub-Saharan Africa, the ECG in combination with office and home BP is an essential instrument in risk stratification across the entire BP range.
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Affiliation(s)
- Augustine N Odili
- Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium
- Department of Internal Medicine, Faculty of Clinical Sciences, College of Health Sciences University of Abuja, Nigeria
| | - Lutgarde Thijs
- Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium
| | - Wen-Yi Yang
- Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium
| | - John O Ogedengbe
- Department of Internal Medicine, Faculty of Clinical Sciences, College of Health Sciences University of Abuja, Nigeria
- Department of Human Physiology, Faculty of Basic Medical Sciences, College of Health Sciences, University of Abuja, Nigeria
| | - Maxwell M Nwegbu
- Department of Chemical Pathology, Faculty of Basic Clinical Sciences, College of Health Sciences, University of Abuja, Nigeria
| | - Lotte Jacobs
- Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium
| | - Fang-Fei Wei
- Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium
| | - Ying-Mei Feng
- Beijing Key Laboratory of Diabetes Prevention and Research, Department of Endocrinology, Lu He Hospital, Capital Medical University, Beijing, China
| | - Zhen-Yu Zhang
- Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium
| | - Tatiana Kuznetsova
- Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium
| | - Tim S Nawrot
- Centre for Environmental Sciences, University of Hasselt, Diepenbeek, Belgium
| | - Jan A Staessen
- Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium
- R&D Group VitaK, Maastricht University, Maastricht, The Netherlands
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25
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Pontillo C, Zhang ZY, Schanstra JP, Jacobs L, Zürbig P, Thijs L, Ramírez-Torres A, Heerspink HJ, Lindhardt M, Klein R, Orchard T, Porta M, Bilous RW, Charturvedi N, Rossing P, Vlahou A, Schepers E, Glorieux G, Mullen W, Delles C, Verhamme P, Vanholder R, Staessen JA, Mischak H, Jankowski J. Prediction of Chronic Kidney Disease Stage 3 by CKD273, a Urinary Proteomic Biomarker. Kidney Int Rep 2017; 2:1066-1075. [PMID: 29130072 PMCID: PMC5669285 DOI: 10.1016/j.ekir.2017.06.004] [Citation(s) in RCA: 67] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
Introduction CKD273 is a urinary biomarker, which in advanced chronic kidney disease predicts further deterioration. We investigated whether CKD273 can also predict a decline of estimated glomerular filtration rate (eGFR) to <60 ml/min per 1.73 m2. Methods In analyses of 2087 individuals from 6 cohorts (46.4% women; 73.5% with diabetes; mean age, 46.1 years; eGFR ≥ 60 ml/min per 1.73 m2, 100%; urinary albumin excretion rate [UAE] ≥20 μg/min, 6.2%), we accounted for cohort, sex, age, mean arterial pressure, diabetes, and eGFR at baseline and expressed associations per 1-SD increment in urinary biomarkers. Results Over 5 (median) follow-up visits, eGFR decreased more with higher baseline CKD273 than UAE (1.64 vs. 0.82 ml/min per 1.73 m2; P < 0.0001). Over 4.6 years (median), 390 participants experienced a first renal endpoint (eGFR decrease by ≥10 to <60 ml/min per 1.73 m2), and 172 experienced an endpoint sustained over follow-up. The risk of a first and sustained renal endpoint increased with UAE (hazard ratio ≥ 1.23; P ≤ 0.043) and CKD273 (≥ 1.20; P ≤ 0.031). UAE (≥20 μg/min) and CKD273 (≥0.154) thresholds yielded sensitivities of 30% and 33% and specificities of 82% and 83% (P ≤ 0.0001 for difference between UAE and CKD273 in proportion of correctly classified individuals). As continuous markers, CKD273 (P = 0.039), but not UAE (P = 0.065), increased the integrated discrimination improvement, while both UAE and CKD273 improved the net reclassification index (P ≤ 0.0003), except for UAE per threshold (P = 0.086). Discussion In conclusion, while accounting for baseline eGFR, albuminuria, and covariables, CKD273 adds to the prediction of stage 3 chronic kidney disease, at which point intervention remains an achievable therapeutic target.
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Affiliation(s)
- Claudia Pontillo
- Mosaiques Diagnostics GmbH, Hannover, Germany
- Charité-Universitätsmedizin, Berlin, Germany
| | - Zhen-Yu Zhang
- Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Diseases, University of Leuven, Leuven, Belgium
| | - Joost P. Schanstra
- Institute of Cardiovascular and Metabolic Disease, Institut National de la Santé et de la Recherche Médicale (INSERM), Toulouse, France
- Université Toulouse III Paul-Sabatier, Toulouse, France
| | - Lotte Jacobs
- Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Diseases, University of Leuven, Leuven, Belgium
| | | | - Lutgarde Thijs
- Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Diseases, University of Leuven, Leuven, Belgium
| | | | - Hiddo J.L. Heerspink
- Department of Clinical Pharmacy and Pharmacology, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands
| | | | - Ronald Klein
- Department of Ophthalmology and Visual Sciences, University of Wisconsin School of Medicine and Public Health, Madison Wisconsin, USA
| | - Trevor Orchard
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Massimo Porta
- Department of Medical Sciences, University of Turin, Torino, Italy
| | - Rudolf W. Bilous
- Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, UK
| | - Nishi Charturvedi
- Institute of Cardiovascular Sciences, University College London, London, UK
| | - Peter Rossing
- Steno Diabetes Centre, Gentofte, Denmark
- Faculty of Health, University of Aarhus, Aarhus, Denmark
- Faculty of Health, University of Copenhagen, Copenhagen, Denmark
| | - Antonia Vlahou
- Biotechnology Division, Biomedical Research Foundation, Academy of Athens, Athens, Greece
| | - Eva Schepers
- Nephrology Section, Department of Internal Medicine, Ghent University Hospital, Ghent, Belgium
| | - Griet Glorieux
- Nephrology Section, Department of Internal Medicine, Ghent University Hospital, Ghent, Belgium
| | - William Mullen
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK
| | - Christian Delles
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK
| | - Peter Verhamme
- Centre for Molecular and Vascular Biology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium
| | - Raymond Vanholder
- Nephrology Section, Department of Internal Medicine, Ghent University Hospital, Ghent, Belgium
| | - Jan A. Staessen
- Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Diseases, University of Leuven, Leuven, Belgium
- R&D Group VitaK, Maastricht University, Maastricht, The Netherlands
- Correspondence: Jan A. Staessen, Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Diseases, University of Leuven, Campus Sint Rafaël, Kapucijnenvoer 35, Box 7001, BE-3000 Leuven, Belgium.Studies Coordinating CentreResearch Unit Hypertension and Cardiovascular EpidemiologyKU Leuven Department of Cardiovascular DiseasesUniversity of LeuvenCampus Sint RafaëlKapucijnenvoer 35, Box 7001BE-3000 LeuvenBelgium
| | - Harald Mischak
- Mosaiques Diagnostics GmbH, Hannover, Germany
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK
| | - Joachim Jankowski
- University Hospital, Rheinisch-Westfälische Technische Hochschule Aachen, Aachen, Germany
- Department of Pathology, Cardiovascular Research Institute Maastricht, Maastricht University, Maastricht, The Netherlands
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Efremov L, Yang WY, Jacobs L, Thijs L, Kuznetsova T, Struijker-Boudier HAJ, Staessen JA. Post-processing reproducibility of the structural characteristics of the common carotid artery in a Flemish population. Artery Res 2017; 19:9-17. [PMID: 28868090 PMCID: PMC5567409 DOI: 10.1016/j.artres.2017.04.007] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Introduction Common carotid artery (CCA) intima-media thickness (IMT), lumen diameter, and maximum plaque thickness were assessed on ultrasound images. The objective of the study was to evaluate the intra- and inter-reader reproducibility of the measurements following a standardised protocol. Methods Two readers performed the off-line measurements on B-mode ultrasound images of the distal CCA, in a randomly selected subset (n = 60) from a Flemish population cohort (FLEMENGHO). We calculated the coefficient of variation, the interclass correlation coefficient (ICC) and reproducibility according to the Bland–Altman method. Results The intra-reader bias for the measurements of left and right side CCA IMT were −0.003 ± 0.04 mm (p = 0.55) and 0.01 ± 0.04 mm (p = 0.03), respectively. The intra-reader bias of the lumen diameter was −0.04 ± 0.25 mm (p = 0.27) for the left and 0.02 ± 0.22 mm (p = 0.45) for the right side. The measurements for the maximum plaque thickness showed no intra-reader differences with bias 0.07 ± 0.2 mm (p = 0.26) for the left and −0.03 ± 0.2 mm (p = 0.55) for the right side. The inter-reader analysis showed good reproducibility for the left and right side CCA IMT with bias 0.004 ± 0.06 mm (p = 0.57) and −0.008 ± 0.05 mm (p = 0.19), respectively, but the lumen diameter measurements showed inter-reader differences, with bias 0.17 ± 0.27 mm (p < 0.0001) for the left and 0.10 ± 0.21 mm (p = 0.0006) for the right side. The inter-reader bias for the maximum plaque thickness were 0.07 ± 0.2 mm (p = 0.21) and −0.1 ± 0.4 mm (p = 0.26) for the left and right side, respectively. Conclusion The results demonstrated a reliable reproducibility of carotid wall structural measurements, allowing for an adequate further analysis of the entire population cohort. The reproducibility of carotid arterial characteristics was evaluated. A sample of participants was chosen from a population cohort. The readers followed a standardised protocol, using commercially available software. The reproducibility of all characteristics was satisfactory.
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Affiliation(s)
- Ljupcho Efremov
- Studies Coordinating Centre, Research Unit of Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium
| | - Wen-Yi Yang
- Studies Coordinating Centre, Research Unit of Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium
| | - Lotte Jacobs
- Studies Coordinating Centre, Research Unit of Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium
| | - Lutgarde Thijs
- Studies Coordinating Centre, Research Unit of Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium
| | - Tatiana Kuznetsova
- Studies Coordinating Centre, Research Unit of Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium
| | | | - Jan A Staessen
- Studies Coordinating Centre, Research Unit of Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium.,R & D Group VitaK, Maastricht University, Maastricht, The Netherlands
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27
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Markoska K, Pejchinovski M, Pontillo C, Zürbig P, Jacobs L, Smith A, Masin-Spasovska J, Stojceva-Taneva O, Polenakovic M, Magni F, Mischak H, Spasovski G. Urinary peptide biomarker panel associated with an improvement in estimated glomerular filtration rate in chronic kidney disease patients. Nephrol Dial Transplant 2017; 33:751-759. [DOI: 10.1093/ndt/gfx263] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2017] [Accepted: 07/09/2017] [Indexed: 01/21/2023] Open
Affiliation(s)
| | | | - Claudia Pontillo
- Department of Clinical Proteomics, Mosaiques Diagnostics, Hanover, Germany
| | - Petra Zürbig
- Department of Clinical Proteomics, Mosaiques Diagnostics, Hanover, Germany
| | - Lotte Jacobs
- Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium
| | - Andrew Smith
- Unit of Proteomics, Department of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
| | | | | | | | - Fulvio Magni
- Unit of Proteomics, Department of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
| | - Harald Mischak
- Department of Clinical Proteomics, Mosaiques Diagnostics, Hanover, Germany
| | - Goce Spasovski
- Department of Nephrology, Medical Faculty, University of Skopje, Skopje, Macedonia
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Zhang ZY, Ravassa S, Pejchinovski M, Yang WY, Zürbig P, López B, Wei FF, Thijs L, Jacobs L, González A, Voigt JU, Verhamme P, Kuznetsova T, Díez J, Mischak H, Staessen JA. A Urinary Fragment of Mucin-1 Subunit α Is a Novel Biomarker Associated With Renal Dysfunction in the General Population. Kidney Int Rep 2017; 2:811-820. [PMID: 28920100 PMCID: PMC5589115 DOI: 10.1016/j.ekir.2017.03.012] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2016] [Revised: 03/04/2017] [Accepted: 03/31/2017] [Indexed: 01/14/2023] Open
Abstract
INTRODUCTION Sequencing peptides included in the urinary proteome identifies the parent proteins and may reveal mechanisms underlying the pathophysiology of chronic kidney disease. METHODS In 805 randomly recruited Flemish individuals (50.8% women; mean age, 51.1 years), we determined the estimated glomerular filtration rate (eGFR) from serum creatinine using the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation. We categorized eGFR according to the National Kidney Foundation Kidney Disease Outcomes Quality Initiative guideline. We analyzed 74 sequenced urinary peptides with a detectable signal in more than 95% of participants. Follow-up measurements of eGFR were available in 597 participants. RESULTS In multivariable analyses, baseline eGFR decreased (P ≤ 0.022) with urinary fragments of mucin-1 (standardized association size expressed in ml/min/1.73 m2, -4.48), collagen III (-2.84), and fibrinogen (-1.70) and was bi-directionally associated (P ≤ 0.0006) with 2 urinary collagen I fragments (+2.28 and -3.20). The eGFR changes over 5 years (follow-up minus baseline) resulted in consistent estimates (P ≤ 0.025) for mucin-1 (-1.85), collagen (-1.37 to 1.43) and fibrinogen (-1.45) fragments. Relative risk of having or progressing to eGFR <60 ml/min/1.73 m2 was associated with mucin-1. Partial least-squares analysis confirmed mucin-1 as the strongest urinary marker associated with decreased eGFR, with a score of 2.47 compared with 1.80 for a collagen I fragment as the next contender. Mucin-1 predicted eGFR decline to <60 ml/min/1.73 m2 over and above microalbuminuria (P = 0.011) and retained borderline significance (P = 0.05) when baseline eGFR was accounted for. DISCUSSION In the general population, mucin-1 subunit α, an extracellular protein that is shed from renal tubular epithelium, is a novel biomarker associated with renal dysfunction.
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Affiliation(s)
- Zhen-Yu Zhang
- Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Diseases, University of Leuven, Leuven, Belgium
| | - Susana Ravassa
- Program of Cardiovascular Diseases, Centre for Applied Medical Research, University of Navarra, Navarra Institute for Health Research, Pamplona, Spain.,CIBERCV, Carlos III Institute of Health, Madrid, Spain
| | | | - Wen-Yi Yang
- Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Diseases, University of Leuven, Leuven, Belgium
| | - Petra Zürbig
- Mosaiques Diagnostic and Therapeutics AG, Hannover, Germany
| | - Begoña López
- Program of Cardiovascular Diseases, Centre for Applied Medical Research, University of Navarra, Navarra Institute for Health Research, Pamplona, Spain.,CIBERCV, Carlos III Institute of Health, Madrid, Spain
| | - Fang-Fei Wei
- Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Diseases, University of Leuven, Leuven, Belgium
| | - Lutgarde Thijs
- Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Diseases, University of Leuven, Leuven, Belgium
| | - Lotte Jacobs
- Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Diseases, University of Leuven, Leuven, Belgium
| | - Arantxa González
- Program of Cardiovascular Diseases, Centre for Applied Medical Research, University of Navarra, Navarra Institute for Health Research, Pamplona, Spain.,CIBERCV, Carlos III Institute of Health, Madrid, Spain
| | - Jens-Uwe Voigt
- Research Unit Cardiology, KU Leuven Department of Cardiovascular Diseases, University of Leuven, Leuven, Belgium
| | - Peter Verhamme
- Centre for Molecular and Vascular Biology, KU Leuven Department of Cardiovascular Diseases, University of Leuven, Leuven, Belgium
| | - Tatiana Kuznetsova
- Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Diseases, University of Leuven, Leuven, Belgium
| | - Javier Díez
- Program of Cardiovascular Diseases, Centre for Applied Medical Research, University of Navarra, Navarra Institute for Health Research, Pamplona, Spain.,CIBERCV, Carlos III Institute of Health, Madrid, Spain.,Department of Cardiology and Cardiac Surgery, University of Navarra Clinic, Pamplona, Spain
| | - Harald Mischak
- Mosaiques Diagnostic and Therapeutics AG, Hannover, Germany.,BHF Glasgow Cardiovascular Research Centre, University of Glasgow, Glasgow, United Kingdom
| | - Jan A Staessen
- Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Diseases, University of Leuven, Leuven, Belgium.,R&D Group VitaK, Maastricht University, Maastricht, The Netherlands
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Jacobs L, Delezie E, Duchateau L, Goethals K, Vermeulen D, Buyse J, Tuyttens FAM. Fit for transport? Broiler chicken fitness assessment for transportation to slaughter. Anim Welf 2017. [DOI: 10.7120/09627286.26.3.335] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Yang W, Zhang Z, Thijs L, Bijnens E, Janssen B, Vanpoucke C, Cauwenberghs N, Wei F, Jacobs L, Luttun A, Verhamme P, Van Hecke E, Kuznetsova T, Nawrot T, Staessen J. P2510Left ventricular function in relation to chronic residential air pollution in a general population. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx502.p2510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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31
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Fadl El Mula F, Feng Y, Jacobs L, Larstorp A, Persu A, Kjeldsen S, Staessen J. 2220Sham or no-sham control in trials of renal denervation for treatment resistant hypertension: a systematic meta-analysis. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx502.2220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
| | - Y. Feng
- Capital Medical University, Beijing, China People's Republic of
| | - L. Jacobs
- University of Leuven, KU Leuven Department of Cardiovascular Sciences, Leuven, Belgium
| | | | - A. Persu
- Universite Catholique de Louvain, Brussels, Belgium
| | - S.E. Kjeldsen
- Oslo University Hospital, and University of Oslo, Oslo, Norway
| | - J.A. Staessen
- University of Leuven, KU Leuven Department of Cardiovascular Sciences, Leuven, Belgium
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Melgarejo JD, Maestre GE, Thijs L, Asayama K, Boggia J, Casiglia E, Hansen TW, Imai Y, Jacobs L, Jeppesen J, Kawecka-Jaszcz K, Kuznetsova T, Li Y, Malyutina S, Nikitin Y, Ohkubo T, Stolarz-Skrzypek K, Wang JG, Staessen JA. Prevalence, Treatment, and Control Rates of Conventional and Ambulatory Hypertension Across 10 Populations in 3 Continents. Hypertension 2017; 70:50-58. [PMID: 28483916 PMCID: PMC11003768 DOI: 10.1161/hypertensionaha.117.09188] [Citation(s) in RCA: 47] [Impact Index Per Article: 6.7] [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: 02/01/2017] [Revised: 02/14/2017] [Accepted: 04/07/2017] [Indexed: 01/19/2023]
Abstract
Hypertension is a major global health problem, but prevalence rates vary widely among regions. To determine prevalence, treatment, and control rates of hypertension, we measured conventional blood pressure (BP) and 24-hour ambulatory BP in 6546 subjects, aged 40 to 79 years, recruited from 10 community-dwelling cohorts on 3 continents. We determined how between-cohort differences in risk factors and socioeconomic factors influence hypertension rates. The overall prevalence was 49.3% (range between cohorts, 40.0%-86.8%) for conventional hypertension (conventional BP ≥140/90 mm Hg) and 48.7% (35.2%-66.5%) for ambulatory hypertension (ambulatory BP ≥130/80 mm Hg). Treatment and control rates for conventional hypertension were 48.0% (33.5%-74.1%) and 38.6% (10.1%-55.3%) respectively. The corresponding rates for ambulatory hypertension were 48.6% (30.5%-71.9%) and 45.6% (18.6%-64.2%). Among 1677 untreated subjects with conventional hypertension, 35.7% had white coat hypertension (23.5%-56.2%). Masked hypertension (conventional BP <140/90 mm Hg and ambulatory BP ≥130/80 mm Hg) occurred in 16.9% (8.8%-30.5%) of 3320 untreated subjects who were normotensive on conventional measurement. Exclusion of participants with diabetes mellitus, obesity, hypercholesterolemia, or history of cardiovascular complications resulted in a <9% reduction in the conventional and 24-hour ambulatory hypertension rates. Higher social and economic development, measured by the Human Development Index, was associated with lower rates of conventional and ambulatory hypertension. In conclusion, high rates of hypertension in all cohorts examined demonstrate the need for improvements in prevention, treatment, and control. Strategies for the management of hypertension should continue to not only focus on preventable and modifiable risk factors but also consider societal issues.
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Affiliation(s)
- Jesus D Melgarejo
- From the Laboratorio de Neurociencias and Instituto Cardiovascular, Universidad del Zulia, Maracaibo, Venezuela (J.M., G.E.M.); Department of Biomedical Sciences, University of Texas Rio Grande Valley School of Medicine, Brownsville (G.E.M.); Graduate School of Pharmaceutical Sciences, Tohoku University, Sendai, Japan (K.A., Y.I.); Studies Coordinating Centre, Department of Hygiene and Public Health, Teikyo University School of Medicine, Tokyo, Japan (K.A., T.O.); Centro de Nefrología and Departamento de Fisiopatología, Hospital de Clínicas, Universidad de la República, Montevideo, Uruguay (J.B.); Department of Medicine, University of Padua, Italy (E.C.); the Steno Diabetes Center Copenhagen, Gentofte and RCPH, Centre for Health, Capital Region of Denmark, Denmark (T.W.H.); KU Leuven Department of Cardiovascular Sciences, University of Leuven, Belgium (L.J., T.K., L.T., J.A.S.); Department of Medicine, Glostrup Hospital, University of Copenhagen, Denmark (J.J.); The First Department of Cardiology, Interventional Electrocardiology and Hypertension, Jagiellonian University Medical College, Krakow, Poland (K.K.J., K.S.S.); Research Unit Hypertension and Cardiovascular Epidemiology, Center for Epidemiological Studies and Clinical Trials and Center for Vascular Evaluation, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, China (Y.L., J.-G.W.); Institute of Internal and Preventive Medicine, Novosibirsk, Russia (T.K., S.M., Y.N.); and R & D Group VitaK, Maastricht University, The Netherlands (JAS)
| | - Gladys E Maestre
- From the Laboratorio de Neurociencias and Instituto Cardiovascular, Universidad del Zulia, Maracaibo, Venezuela (J.M., G.E.M.); Department of Biomedical Sciences, University of Texas Rio Grande Valley School of Medicine, Brownsville (G.E.M.); Graduate School of Pharmaceutical Sciences, Tohoku University, Sendai, Japan (K.A., Y.I.); Studies Coordinating Centre, Department of Hygiene and Public Health, Teikyo University School of Medicine, Tokyo, Japan (K.A., T.O.); Centro de Nefrología and Departamento de Fisiopatología, Hospital de Clínicas, Universidad de la República, Montevideo, Uruguay (J.B.); Department of Medicine, University of Padua, Italy (E.C.); the Steno Diabetes Center Copenhagen, Gentofte and RCPH, Centre for Health, Capital Region of Denmark, Denmark (T.W.H.); KU Leuven Department of Cardiovascular Sciences, University of Leuven, Belgium (L.J., T.K., L.T., J.A.S.); Department of Medicine, Glostrup Hospital, University of Copenhagen, Denmark (J.J.); The First Department of Cardiology, Interventional Electrocardiology and Hypertension, Jagiellonian University Medical College, Krakow, Poland (K.K.J., K.S.S.); Research Unit Hypertension and Cardiovascular Epidemiology, Center for Epidemiological Studies and Clinical Trials and Center for Vascular Evaluation, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, China (Y.L., J.-G.W.); Institute of Internal and Preventive Medicine, Novosibirsk, Russia (T.K., S.M., Y.N.); and R & D Group VitaK, Maastricht University, The Netherlands (JAS)
| | - Lutgarde Thijs
- From the Laboratorio de Neurociencias and Instituto Cardiovascular, Universidad del Zulia, Maracaibo, Venezuela (J.M., G.E.M.); Department of Biomedical Sciences, University of Texas Rio Grande Valley School of Medicine, Brownsville (G.E.M.); Graduate School of Pharmaceutical Sciences, Tohoku University, Sendai, Japan (K.A., Y.I.); Studies Coordinating Centre, Department of Hygiene and Public Health, Teikyo University School of Medicine, Tokyo, Japan (K.A., T.O.); Centro de Nefrología and Departamento de Fisiopatología, Hospital de Clínicas, Universidad de la República, Montevideo, Uruguay (J.B.); Department of Medicine, University of Padua, Italy (E.C.); the Steno Diabetes Center Copenhagen, Gentofte and RCPH, Centre for Health, Capital Region of Denmark, Denmark (T.W.H.); KU Leuven Department of Cardiovascular Sciences, University of Leuven, Belgium (L.J., T.K., L.T., J.A.S.); Department of Medicine, Glostrup Hospital, University of Copenhagen, Denmark (J.J.); The First Department of Cardiology, Interventional Electrocardiology and Hypertension, Jagiellonian University Medical College, Krakow, Poland (K.K.J., K.S.S.); Research Unit Hypertension and Cardiovascular Epidemiology, Center for Epidemiological Studies and Clinical Trials and Center for Vascular Evaluation, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, China (Y.L., J.-G.W.); Institute of Internal and Preventive Medicine, Novosibirsk, Russia (T.K., S.M., Y.N.); and R & D Group VitaK, Maastricht University, The Netherlands (JAS)
| | - Kei Asayama
- From the Laboratorio de Neurociencias and Instituto Cardiovascular, Universidad del Zulia, Maracaibo, Venezuela (J.M., G.E.M.); Department of Biomedical Sciences, University of Texas Rio Grande Valley School of Medicine, Brownsville (G.E.M.); Graduate School of Pharmaceutical Sciences, Tohoku University, Sendai, Japan (K.A., Y.I.); Studies Coordinating Centre, Department of Hygiene and Public Health, Teikyo University School of Medicine, Tokyo, Japan (K.A., T.O.); Centro de Nefrología and Departamento de Fisiopatología, Hospital de Clínicas, Universidad de la República, Montevideo, Uruguay (J.B.); Department of Medicine, University of Padua, Italy (E.C.); the Steno Diabetes Center Copenhagen, Gentofte and RCPH, Centre for Health, Capital Region of Denmark, Denmark (T.W.H.); KU Leuven Department of Cardiovascular Sciences, University of Leuven, Belgium (L.J., T.K., L.T., J.A.S.); Department of Medicine, Glostrup Hospital, University of Copenhagen, Denmark (J.J.); The First Department of Cardiology, Interventional Electrocardiology and Hypertension, Jagiellonian University Medical College, Krakow, Poland (K.K.J., K.S.S.); Research Unit Hypertension and Cardiovascular Epidemiology, Center for Epidemiological Studies and Clinical Trials and Center for Vascular Evaluation, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, China (Y.L., J.-G.W.); Institute of Internal and Preventive Medicine, Novosibirsk, Russia (T.K., S.M., Y.N.); and R & D Group VitaK, Maastricht University, The Netherlands (JAS)
| | - José Boggia
- From the Laboratorio de Neurociencias and Instituto Cardiovascular, Universidad del Zulia, Maracaibo, Venezuela (J.M., G.E.M.); Department of Biomedical Sciences, University of Texas Rio Grande Valley School of Medicine, Brownsville (G.E.M.); Graduate School of Pharmaceutical Sciences, Tohoku University, Sendai, Japan (K.A., Y.I.); Studies Coordinating Centre, Department of Hygiene and Public Health, Teikyo University School of Medicine, Tokyo, Japan (K.A., T.O.); Centro de Nefrología and Departamento de Fisiopatología, Hospital de Clínicas, Universidad de la República, Montevideo, Uruguay (J.B.); Department of Medicine, University of Padua, Italy (E.C.); the Steno Diabetes Center Copenhagen, Gentofte and RCPH, Centre for Health, Capital Region of Denmark, Denmark (T.W.H.); KU Leuven Department of Cardiovascular Sciences, University of Leuven, Belgium (L.J., T.K., L.T., J.A.S.); Department of Medicine, Glostrup Hospital, University of Copenhagen, Denmark (J.J.); The First Department of Cardiology, Interventional Electrocardiology and Hypertension, Jagiellonian University Medical College, Krakow, Poland (K.K.J., K.S.S.); Research Unit Hypertension and Cardiovascular Epidemiology, Center for Epidemiological Studies and Clinical Trials and Center for Vascular Evaluation, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, China (Y.L., J.-G.W.); Institute of Internal and Preventive Medicine, Novosibirsk, Russia (T.K., S.M., Y.N.); and R & D Group VitaK, Maastricht University, The Netherlands (JAS)
| | - Edoardo Casiglia
- From the Laboratorio de Neurociencias and Instituto Cardiovascular, Universidad del Zulia, Maracaibo, Venezuela (J.M., G.E.M.); Department of Biomedical Sciences, University of Texas Rio Grande Valley School of Medicine, Brownsville (G.E.M.); Graduate School of Pharmaceutical Sciences, Tohoku University, Sendai, Japan (K.A., Y.I.); Studies Coordinating Centre, Department of Hygiene and Public Health, Teikyo University School of Medicine, Tokyo, Japan (K.A., T.O.); Centro de Nefrología and Departamento de Fisiopatología, Hospital de Clínicas, Universidad de la República, Montevideo, Uruguay (J.B.); Department of Medicine, University of Padua, Italy (E.C.); the Steno Diabetes Center Copenhagen, Gentofte and RCPH, Centre for Health, Capital Region of Denmark, Denmark (T.W.H.); KU Leuven Department of Cardiovascular Sciences, University of Leuven, Belgium (L.J., T.K., L.T., J.A.S.); Department of Medicine, Glostrup Hospital, University of Copenhagen, Denmark (J.J.); The First Department of Cardiology, Interventional Electrocardiology and Hypertension, Jagiellonian University Medical College, Krakow, Poland (K.K.J., K.S.S.); Research Unit Hypertension and Cardiovascular Epidemiology, Center for Epidemiological Studies and Clinical Trials and Center for Vascular Evaluation, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, China (Y.L., J.-G.W.); Institute of Internal and Preventive Medicine, Novosibirsk, Russia (T.K., S.M., Y.N.); and R & D Group VitaK, Maastricht University, The Netherlands (JAS)
| | - Tine W Hansen
- From the Laboratorio de Neurociencias and Instituto Cardiovascular, Universidad del Zulia, Maracaibo, Venezuela (J.M., G.E.M.); Department of Biomedical Sciences, University of Texas Rio Grande Valley School of Medicine, Brownsville (G.E.M.); Graduate School of Pharmaceutical Sciences, Tohoku University, Sendai, Japan (K.A., Y.I.); Studies Coordinating Centre, Department of Hygiene and Public Health, Teikyo University School of Medicine, Tokyo, Japan (K.A., T.O.); Centro de Nefrología and Departamento de Fisiopatología, Hospital de Clínicas, Universidad de la República, Montevideo, Uruguay (J.B.); Department of Medicine, University of Padua, Italy (E.C.); the Steno Diabetes Center Copenhagen, Gentofte and RCPH, Centre for Health, Capital Region of Denmark, Denmark (T.W.H.); KU Leuven Department of Cardiovascular Sciences, University of Leuven, Belgium (L.J., T.K., L.T., J.A.S.); Department of Medicine, Glostrup Hospital, University of Copenhagen, Denmark (J.J.); The First Department of Cardiology, Interventional Electrocardiology and Hypertension, Jagiellonian University Medical College, Krakow, Poland (K.K.J., K.S.S.); Research Unit Hypertension and Cardiovascular Epidemiology, Center for Epidemiological Studies and Clinical Trials and Center for Vascular Evaluation, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, China (Y.L., J.-G.W.); Institute of Internal and Preventive Medicine, Novosibirsk, Russia (T.K., S.M., Y.N.); and R & D Group VitaK, Maastricht University, The Netherlands (JAS)
| | - Yutaka Imai
- From the Laboratorio de Neurociencias and Instituto Cardiovascular, Universidad del Zulia, Maracaibo, Venezuela (J.M., G.E.M.); Department of Biomedical Sciences, University of Texas Rio Grande Valley School of Medicine, Brownsville (G.E.M.); Graduate School of Pharmaceutical Sciences, Tohoku University, Sendai, Japan (K.A., Y.I.); Studies Coordinating Centre, Department of Hygiene and Public Health, Teikyo University School of Medicine, Tokyo, Japan (K.A., T.O.); Centro de Nefrología and Departamento de Fisiopatología, Hospital de Clínicas, Universidad de la República, Montevideo, Uruguay (J.B.); Department of Medicine, University of Padua, Italy (E.C.); the Steno Diabetes Center Copenhagen, Gentofte and RCPH, Centre for Health, Capital Region of Denmark, Denmark (T.W.H.); KU Leuven Department of Cardiovascular Sciences, University of Leuven, Belgium (L.J., T.K., L.T., J.A.S.); Department of Medicine, Glostrup Hospital, University of Copenhagen, Denmark (J.J.); The First Department of Cardiology, Interventional Electrocardiology and Hypertension, Jagiellonian University Medical College, Krakow, Poland (K.K.J., K.S.S.); Research Unit Hypertension and Cardiovascular Epidemiology, Center for Epidemiological Studies and Clinical Trials and Center for Vascular Evaluation, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, China (Y.L., J.-G.W.); Institute of Internal and Preventive Medicine, Novosibirsk, Russia (T.K., S.M., Y.N.); and R & D Group VitaK, Maastricht University, The Netherlands (JAS)
| | - Lotte Jacobs
- From the Laboratorio de Neurociencias and Instituto Cardiovascular, Universidad del Zulia, Maracaibo, Venezuela (J.M., G.E.M.); Department of Biomedical Sciences, University of Texas Rio Grande Valley School of Medicine, Brownsville (G.E.M.); Graduate School of Pharmaceutical Sciences, Tohoku University, Sendai, Japan (K.A., Y.I.); Studies Coordinating Centre, Department of Hygiene and Public Health, Teikyo University School of Medicine, Tokyo, Japan (K.A., T.O.); Centro de Nefrología and Departamento de Fisiopatología, Hospital de Clínicas, Universidad de la República, Montevideo, Uruguay (J.B.); Department of Medicine, University of Padua, Italy (E.C.); the Steno Diabetes Center Copenhagen, Gentofte and RCPH, Centre for Health, Capital Region of Denmark, Denmark (T.W.H.); KU Leuven Department of Cardiovascular Sciences, University of Leuven, Belgium (L.J., T.K., L.T., J.A.S.); Department of Medicine, Glostrup Hospital, University of Copenhagen, Denmark (J.J.); The First Department of Cardiology, Interventional Electrocardiology and Hypertension, Jagiellonian University Medical College, Krakow, Poland (K.K.J., K.S.S.); Research Unit Hypertension and Cardiovascular Epidemiology, Center for Epidemiological Studies and Clinical Trials and Center for Vascular Evaluation, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, China (Y.L., J.-G.W.); Institute of Internal and Preventive Medicine, Novosibirsk, Russia (T.K., S.M., Y.N.); and R & D Group VitaK, Maastricht University, The Netherlands (JAS)
| | - Jørgen Jeppesen
- From the Laboratorio de Neurociencias and Instituto Cardiovascular, Universidad del Zulia, Maracaibo, Venezuela (J.M., G.E.M.); Department of Biomedical Sciences, University of Texas Rio Grande Valley School of Medicine, Brownsville (G.E.M.); Graduate School of Pharmaceutical Sciences, Tohoku University, Sendai, Japan (K.A., Y.I.); Studies Coordinating Centre, Department of Hygiene and Public Health, Teikyo University School of Medicine, Tokyo, Japan (K.A., T.O.); Centro de Nefrología and Departamento de Fisiopatología, Hospital de Clínicas, Universidad de la República, Montevideo, Uruguay (J.B.); Department of Medicine, University of Padua, Italy (E.C.); the Steno Diabetes Center Copenhagen, Gentofte and RCPH, Centre for Health, Capital Region of Denmark, Denmark (T.W.H.); KU Leuven Department of Cardiovascular Sciences, University of Leuven, Belgium (L.J., T.K., L.T., J.A.S.); Department of Medicine, Glostrup Hospital, University of Copenhagen, Denmark (J.J.); The First Department of Cardiology, Interventional Electrocardiology and Hypertension, Jagiellonian University Medical College, Krakow, Poland (K.K.J., K.S.S.); Research Unit Hypertension and Cardiovascular Epidemiology, Center for Epidemiological Studies and Clinical Trials and Center for Vascular Evaluation, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, China (Y.L., J.-G.W.); Institute of Internal and Preventive Medicine, Novosibirsk, Russia (T.K., S.M., Y.N.); and R & D Group VitaK, Maastricht University, The Netherlands (JAS)
| | - Kalina Kawecka-Jaszcz
- From the Laboratorio de Neurociencias and Instituto Cardiovascular, Universidad del Zulia, Maracaibo, Venezuela (J.M., G.E.M.); Department of Biomedical Sciences, University of Texas Rio Grande Valley School of Medicine, Brownsville (G.E.M.); Graduate School of Pharmaceutical Sciences, Tohoku University, Sendai, Japan (K.A., Y.I.); Studies Coordinating Centre, Department of Hygiene and Public Health, Teikyo University School of Medicine, Tokyo, Japan (K.A., T.O.); Centro de Nefrología and Departamento de Fisiopatología, Hospital de Clínicas, Universidad de la República, Montevideo, Uruguay (J.B.); Department of Medicine, University of Padua, Italy (E.C.); the Steno Diabetes Center Copenhagen, Gentofte and RCPH, Centre for Health, Capital Region of Denmark, Denmark (T.W.H.); KU Leuven Department of Cardiovascular Sciences, University of Leuven, Belgium (L.J., T.K., L.T., J.A.S.); Department of Medicine, Glostrup Hospital, University of Copenhagen, Denmark (J.J.); The First Department of Cardiology, Interventional Electrocardiology and Hypertension, Jagiellonian University Medical College, Krakow, Poland (K.K.J., K.S.S.); Research Unit Hypertension and Cardiovascular Epidemiology, Center for Epidemiological Studies and Clinical Trials and Center for Vascular Evaluation, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, China (Y.L., J.-G.W.); Institute of Internal and Preventive Medicine, Novosibirsk, Russia (T.K., S.M., Y.N.); and R & D Group VitaK, Maastricht University, The Netherlands (JAS)
| | - Tatiana Kuznetsova
- From the Laboratorio de Neurociencias and Instituto Cardiovascular, Universidad del Zulia, Maracaibo, Venezuela (J.M., G.E.M.); Department of Biomedical Sciences, University of Texas Rio Grande Valley School of Medicine, Brownsville (G.E.M.); Graduate School of Pharmaceutical Sciences, Tohoku University, Sendai, Japan (K.A., Y.I.); Studies Coordinating Centre, Department of Hygiene and Public Health, Teikyo University School of Medicine, Tokyo, Japan (K.A., T.O.); Centro de Nefrología and Departamento de Fisiopatología, Hospital de Clínicas, Universidad de la República, Montevideo, Uruguay (J.B.); Department of Medicine, University of Padua, Italy (E.C.); the Steno Diabetes Center Copenhagen, Gentofte and RCPH, Centre for Health, Capital Region of Denmark, Denmark (T.W.H.); KU Leuven Department of Cardiovascular Sciences, University of Leuven, Belgium (L.J., T.K., L.T., J.A.S.); Department of Medicine, Glostrup Hospital, University of Copenhagen, Denmark (J.J.); The First Department of Cardiology, Interventional Electrocardiology and Hypertension, Jagiellonian University Medical College, Krakow, Poland (K.K.J., K.S.S.); Research Unit Hypertension and Cardiovascular Epidemiology, Center for Epidemiological Studies and Clinical Trials and Center for Vascular Evaluation, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, China (Y.L., J.-G.W.); Institute of Internal and Preventive Medicine, Novosibirsk, Russia (T.K., S.M., Y.N.); and R & D Group VitaK, Maastricht University, The Netherlands (JAS)
| | - Yan Li
- From the Laboratorio de Neurociencias and Instituto Cardiovascular, Universidad del Zulia, Maracaibo, Venezuela (J.M., G.E.M.); Department of Biomedical Sciences, University of Texas Rio Grande Valley School of Medicine, Brownsville (G.E.M.); Graduate School of Pharmaceutical Sciences, Tohoku University, Sendai, Japan (K.A., Y.I.); Studies Coordinating Centre, Department of Hygiene and Public Health, Teikyo University School of Medicine, Tokyo, Japan (K.A., T.O.); Centro de Nefrología and Departamento de Fisiopatología, Hospital de Clínicas, Universidad de la República, Montevideo, Uruguay (J.B.); Department of Medicine, University of Padua, Italy (E.C.); the Steno Diabetes Center Copenhagen, Gentofte and RCPH, Centre for Health, Capital Region of Denmark, Denmark (T.W.H.); KU Leuven Department of Cardiovascular Sciences, University of Leuven, Belgium (L.J., T.K., L.T., J.A.S.); Department of Medicine, Glostrup Hospital, University of Copenhagen, Denmark (J.J.); The First Department of Cardiology, Interventional Electrocardiology and Hypertension, Jagiellonian University Medical College, Krakow, Poland (K.K.J., K.S.S.); Research Unit Hypertension and Cardiovascular Epidemiology, Center for Epidemiological Studies and Clinical Trials and Center for Vascular Evaluation, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, China (Y.L., J.-G.W.); Institute of Internal and Preventive Medicine, Novosibirsk, Russia (T.K., S.M., Y.N.); and R & D Group VitaK, Maastricht University, The Netherlands (JAS)
| | - Sofia Malyutina
- From the Laboratorio de Neurociencias and Instituto Cardiovascular, Universidad del Zulia, Maracaibo, Venezuela (J.M., G.E.M.); Department of Biomedical Sciences, University of Texas Rio Grande Valley School of Medicine, Brownsville (G.E.M.); Graduate School of Pharmaceutical Sciences, Tohoku University, Sendai, Japan (K.A., Y.I.); Studies Coordinating Centre, Department of Hygiene and Public Health, Teikyo University School of Medicine, Tokyo, Japan (K.A., T.O.); Centro de Nefrología and Departamento de Fisiopatología, Hospital de Clínicas, Universidad de la República, Montevideo, Uruguay (J.B.); Department of Medicine, University of Padua, Italy (E.C.); the Steno Diabetes Center Copenhagen, Gentofte and RCPH, Centre for Health, Capital Region of Denmark, Denmark (T.W.H.); KU Leuven Department of Cardiovascular Sciences, University of Leuven, Belgium (L.J., T.K., L.T., J.A.S.); Department of Medicine, Glostrup Hospital, University of Copenhagen, Denmark (J.J.); The First Department of Cardiology, Interventional Electrocardiology and Hypertension, Jagiellonian University Medical College, Krakow, Poland (K.K.J., K.S.S.); Research Unit Hypertension and Cardiovascular Epidemiology, Center for Epidemiological Studies and Clinical Trials and Center for Vascular Evaluation, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, China (Y.L., J.-G.W.); Institute of Internal and Preventive Medicine, Novosibirsk, Russia (T.K., S.M., Y.N.); and R & D Group VitaK, Maastricht University, The Netherlands (JAS)
| | - Yuri Nikitin
- From the Laboratorio de Neurociencias and Instituto Cardiovascular, Universidad del Zulia, Maracaibo, Venezuela (J.M., G.E.M.); Department of Biomedical Sciences, University of Texas Rio Grande Valley School of Medicine, Brownsville (G.E.M.); Graduate School of Pharmaceutical Sciences, Tohoku University, Sendai, Japan (K.A., Y.I.); Studies Coordinating Centre, Department of Hygiene and Public Health, Teikyo University School of Medicine, Tokyo, Japan (K.A., T.O.); Centro de Nefrología and Departamento de Fisiopatología, Hospital de Clínicas, Universidad de la República, Montevideo, Uruguay (J.B.); Department of Medicine, University of Padua, Italy (E.C.); the Steno Diabetes Center Copenhagen, Gentofte and RCPH, Centre for Health, Capital Region of Denmark, Denmark (T.W.H.); KU Leuven Department of Cardiovascular Sciences, University of Leuven, Belgium (L.J., T.K., L.T., J.A.S.); Department of Medicine, Glostrup Hospital, University of Copenhagen, Denmark (J.J.); The First Department of Cardiology, Interventional Electrocardiology and Hypertension, Jagiellonian University Medical College, Krakow, Poland (K.K.J., K.S.S.); Research Unit Hypertension and Cardiovascular Epidemiology, Center for Epidemiological Studies and Clinical Trials and Center for Vascular Evaluation, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, China (Y.L., J.-G.W.); Institute of Internal and Preventive Medicine, Novosibirsk, Russia (T.K., S.M., Y.N.); and R & D Group VitaK, Maastricht University, The Netherlands (JAS)
| | - Takayoshi Ohkubo
- From the Laboratorio de Neurociencias and Instituto Cardiovascular, Universidad del Zulia, Maracaibo, Venezuela (J.M., G.E.M.); Department of Biomedical Sciences, University of Texas Rio Grande Valley School of Medicine, Brownsville (G.E.M.); Graduate School of Pharmaceutical Sciences, Tohoku University, Sendai, Japan (K.A., Y.I.); Studies Coordinating Centre, Department of Hygiene and Public Health, Teikyo University School of Medicine, Tokyo, Japan (K.A., T.O.); Centro de Nefrología and Departamento de Fisiopatología, Hospital de Clínicas, Universidad de la República, Montevideo, Uruguay (J.B.); Department of Medicine, University of Padua, Italy (E.C.); the Steno Diabetes Center Copenhagen, Gentofte and RCPH, Centre for Health, Capital Region of Denmark, Denmark (T.W.H.); KU Leuven Department of Cardiovascular Sciences, University of Leuven, Belgium (L.J., T.K., L.T., J.A.S.); Department of Medicine, Glostrup Hospital, University of Copenhagen, Denmark (J.J.); The First Department of Cardiology, Interventional Electrocardiology and Hypertension, Jagiellonian University Medical College, Krakow, Poland (K.K.J., K.S.S.); Research Unit Hypertension and Cardiovascular Epidemiology, Center for Epidemiological Studies and Clinical Trials and Center for Vascular Evaluation, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, China (Y.L., J.-G.W.); Institute of Internal and Preventive Medicine, Novosibirsk, Russia (T.K., S.M., Y.N.); and R & D Group VitaK, Maastricht University, The Netherlands (JAS)
| | - Katarzyna Stolarz-Skrzypek
- From the Laboratorio de Neurociencias and Instituto Cardiovascular, Universidad del Zulia, Maracaibo, Venezuela (J.M., G.E.M.); Department of Biomedical Sciences, University of Texas Rio Grande Valley School of Medicine, Brownsville (G.E.M.); Graduate School of Pharmaceutical Sciences, Tohoku University, Sendai, Japan (K.A., Y.I.); Studies Coordinating Centre, Department of Hygiene and Public Health, Teikyo University School of Medicine, Tokyo, Japan (K.A., T.O.); Centro de Nefrología and Departamento de Fisiopatología, Hospital de Clínicas, Universidad de la República, Montevideo, Uruguay (J.B.); Department of Medicine, University of Padua, Italy (E.C.); the Steno Diabetes Center Copenhagen, Gentofte and RCPH, Centre for Health, Capital Region of Denmark, Denmark (T.W.H.); KU Leuven Department of Cardiovascular Sciences, University of Leuven, Belgium (L.J., T.K., L.T., J.A.S.); Department of Medicine, Glostrup Hospital, University of Copenhagen, Denmark (J.J.); The First Department of Cardiology, Interventional Electrocardiology and Hypertension, Jagiellonian University Medical College, Krakow, Poland (K.K.J., K.S.S.); Research Unit Hypertension and Cardiovascular Epidemiology, Center for Epidemiological Studies and Clinical Trials and Center for Vascular Evaluation, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, China (Y.L., J.-G.W.); Institute of Internal and Preventive Medicine, Novosibirsk, Russia (T.K., S.M., Y.N.); and R & D Group VitaK, Maastricht University, The Netherlands (JAS)
| | - Ji-Guang Wang
- From the Laboratorio de Neurociencias and Instituto Cardiovascular, Universidad del Zulia, Maracaibo, Venezuela (J.M., G.E.M.); Department of Biomedical Sciences, University of Texas Rio Grande Valley School of Medicine, Brownsville (G.E.M.); Graduate School of Pharmaceutical Sciences, Tohoku University, Sendai, Japan (K.A., Y.I.); Studies Coordinating Centre, Department of Hygiene and Public Health, Teikyo University School of Medicine, Tokyo, Japan (K.A., T.O.); Centro de Nefrología and Departamento de Fisiopatología, Hospital de Clínicas, Universidad de la República, Montevideo, Uruguay (J.B.); Department of Medicine, University of Padua, Italy (E.C.); the Steno Diabetes Center Copenhagen, Gentofte and RCPH, Centre for Health, Capital Region of Denmark, Denmark (T.W.H.); KU Leuven Department of Cardiovascular Sciences, University of Leuven, Belgium (L.J., T.K., L.T., J.A.S.); Department of Medicine, Glostrup Hospital, University of Copenhagen, Denmark (J.J.); The First Department of Cardiology, Interventional Electrocardiology and Hypertension, Jagiellonian University Medical College, Krakow, Poland (K.K.J., K.S.S.); Research Unit Hypertension and Cardiovascular Epidemiology, Center for Epidemiological Studies and Clinical Trials and Center for Vascular Evaluation, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, China (Y.L., J.-G.W.); Institute of Internal and Preventive Medicine, Novosibirsk, Russia (T.K., S.M., Y.N.); and R & D Group VitaK, Maastricht University, The Netherlands (JAS)
| | - Jan A Staessen
- From the Laboratorio de Neurociencias and Instituto Cardiovascular, Universidad del Zulia, Maracaibo, Venezuela (J.M., G.E.M.); Department of Biomedical Sciences, University of Texas Rio Grande Valley School of Medicine, Brownsville (G.E.M.); Graduate School of Pharmaceutical Sciences, Tohoku University, Sendai, Japan (K.A., Y.I.); Studies Coordinating Centre, Department of Hygiene and Public Health, Teikyo University School of Medicine, Tokyo, Japan (K.A., T.O.); Centro de Nefrología and Departamento de Fisiopatología, Hospital de Clínicas, Universidad de la República, Montevideo, Uruguay (J.B.); Department of Medicine, University of Padua, Italy (E.C.); the Steno Diabetes Center Copenhagen, Gentofte and RCPH, Centre for Health, Capital Region of Denmark, Denmark (T.W.H.); KU Leuven Department of Cardiovascular Sciences, University of Leuven, Belgium (L.J., T.K., L.T., J.A.S.); Department of Medicine, Glostrup Hospital, University of Copenhagen, Denmark (J.J.); The First Department of Cardiology, Interventional Electrocardiology and Hypertension, Jagiellonian University Medical College, Krakow, Poland (K.K.J., K.S.S.); Research Unit Hypertension and Cardiovascular Epidemiology, Center for Epidemiological Studies and Clinical Trials and Center for Vascular Evaluation, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, China (Y.L., J.-G.W.); Institute of Internal and Preventive Medicine, Novosibirsk, Russia (T.K., S.M., Y.N.); and R & D Group VitaK, Maastricht University, The Netherlands (JAS).
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Markoska K, Pejchinovski M, Pontillo C, Zürbig P, Jacobs L, Masin-Spasovska J, Stojceva-Taneva O, Mischak H, Spasovski G. SO016URINARY PEPTIDE BIOMARKER PANEL ASSOCIATED WITH IMPROVEMENT IN eGFR IN CKD PATIENTS. Nephrol Dial Transplant 2017. [DOI: 10.1093/ndt/gfx102.so016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Jacobs L, Persu A, Huang QF, Lengelé JP, Thijs L, Hammer F, Yang WY, Zhang ZY, Renkin J, Sinnaeve P, Wei FF, Pasquet A, Fadl Elmula FEM, Carlier M, Elvan A, Wunder C, Kjeldsen SE, Toennes SW, Janssens S, Verhamme P, Staessen JA. Results of a randomized controlled pilot trial of intravascular renal denervation for management of treatment-resistant hypertension. Blood Press 2017; 26:321-331. [DOI: 10.1080/08037051.2017.1320939] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Affiliation(s)
- Lotte Jacobs
- Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium
| | - Alexandre Persu
- Division of Cardiology, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium
- Pole of Cardiovascular Research, Institut de Recherche Expérimentale et Clinique, Université Catholique de Louvain, Brussels, Belgium
| | - Qi-Fang Huang
- Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium
| | - Jean-Philippe Lengelé
- Division of Cardiology, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium
- Department of Nephrology, Grand Hôpital de Charleroi, Gilly, Belgium
| | - Lutgarde Thijs
- Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium
| | - Frank Hammer
- Division of Radiology, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium
| | - Wen-Yi Yang
- Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium
| | - Zhen-Yu Zhang
- Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium
| | - Jean Renkin
- Division of Cardiology, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium
- Pole of Cardiovascular Research, Institut de Recherche Expérimentale et Clinique, Université Catholique de Louvain, Brussels, Belgium
| | - Peter Sinnaeve
- Division of Cardiology, University Hospitals Leuven, Leuven, Belgium
| | - Fang-Fei Wei
- Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium
| | - Agnès Pasquet
- Division of Cardiology, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium
| | | | - Marc Carlier
- Department of Cardiology, Grand Hôpital de Charleroi, Gilly, Belgium
| | - Arif Elvan
- Department of Cardiology, Isala Hospital, Zwolle, The Netherlands
| | - Cora Wunder
- Department of Forensic Toxicology, Institute of Legal Medicine, University of Frankfurt, Frankfurt, Germany
| | - Sverre E. Kjeldsen
- Department of Cardiology, Oslo University Hospital Ullevål, Oslo, Norway
| | - Stefan W. Toennes
- Department of Forensic Toxicology, Institute of Legal Medicine, University of Frankfurt, Frankfurt, Germany
| | - Stefan Janssens
- Division of Cardiology, Department Internal Medicine, University Hospitals Leuven, Leuven, Belgium
| | - Peter Verhamme
- Division of Cardiology, Department Internal Medicine, University Hospitals Leuven, Leuven, Belgium
- Centre for Molecular and Vascular Biology, Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium
| | - Jan A. Staessen
- Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium
- R&D Group VitaK, Maastricht University, Maastricht, The Netherlands
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Jacobs L, Efremov L, Ferreira JP, Thijs L, Yang WY, Zhang ZY, Latini R, Masson S, Agabiti N, Sever P, Delles C, Sattar N, Butler J, Cleland JGF, Kuznetsova T, Staessen JA, Zannad F. Risk for Incident Heart Failure: A Subject-Level Meta-Analysis From the Heart "OMics" in AGEing (HOMAGE) Study. J Am Heart Assoc 2017; 6:JAHA.116.005231. [PMID: 28465299 PMCID: PMC5524083 DOI: 10.1161/jaha.116.005231] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background To address the need for personalized prevention, we conducted a subject‐level meta‐analysis within the framework of the Heart “OMics” in AGEing (HOMAGE) study to develop a risk prediction model for heart failure (HF) based on routinely available clinical measurements. Methods and Results Three studies with elderly persons (Health Aging and Body Composition [Health ABC], Valutazione della PREvalenza di DIsfunzione Cardiaca asinTOmatica e di scompenso cardiaco [PREDICTOR], and Prospective Study of Pravastatin in the Elderly at Risk [PROSPER]) were included to develop the HF risk function, while a fourth study (Anglo‐Scandinavian Cardiac Outcomes Trial [ASCOT]) was used as a validation cohort. Time‐to‐event analysis was conducted using the Cox proportional hazard model. Incident HF was defined as HF hospitalization. The Cox regression model was evaluated for its discriminatory performance (area under the receiver operating characteristic curve) and calibration (Grønnesby‐Borgan χ2 statistic). During a follow‐up of 3.5 years, 470 of 10 236 elderly persons (mean age, 74.5 years; 51.3% women) developed HF. Higher age, BMI, systolic blood pressure, heart rate, serum creatinine, smoking, diabetes mellitus, history of coronary artery disease, and use of antihypertensive medication were associated with increased HF risk. The area under the receiver operating characteristic curve of the model was 0.71, with a good calibration (χ2 7.9, P=0.54). A web‐based calculator was developed to allow easy calculations of the HF risk. Conclusions Simple measurements allow reliable estimation of the short‐term HF risk in populations and patients. The risk model may aid in risk stratification and future HF prevention strategies.
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Affiliation(s)
- Lotte Jacobs
- Research Unit of Hypertension and Cardiovascular Epidemiology, Studies Coordinating Centre, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Belgium
| | - Ljupcho Efremov
- Research Unit of Hypertension and Cardiovascular Epidemiology, Studies Coordinating Centre, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Belgium
| | - João Pedro Ferreira
- INSERM, Centre d'Investigations Cliniques Plurithe'matique 1433, INSERM U1116, CHRU de Nancy, F-CRIN INI-CRCT, Universite' de Lorraine, Nancy, France
| | - Lutgarde Thijs
- Research Unit of Hypertension and Cardiovascular Epidemiology, Studies Coordinating Centre, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Belgium
| | - Wen-Yi Yang
- Research Unit of Hypertension and Cardiovascular Epidemiology, Studies Coordinating Centre, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Belgium
| | - Zhen-Yu Zhang
- Research Unit of Hypertension and Cardiovascular Epidemiology, Studies Coordinating Centre, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Belgium
| | - Roberto Latini
- Department of Cardiovascular Research, IRCCS - Istituto di Ricerche Farmacologiche "Mario Negri", Milan, Italy
| | - Serge Masson
- Department of Cardiovascular Research, IRCCS - Istituto di Ricerche Farmacologiche "Mario Negri", Milan, Italy
| | - Nera Agabiti
- Department of Epidemiology, Lazio Regional Health Service, Rome, Italy
| | - Peter Sever
- International Centre for Circulatory Health, Imperial College London, London, United Kingdom
| | - Christian Delles
- Institute of Cardiovascular and Medical Sciences, BHF Glasgow Cardiovascular Research Centre, University of Glasgow, United Kingdom
| | - Naveed Sattar
- Institute of Cardiovascular and Medical Sciences, BHF Glasgow Cardiovascular Research Centre, University of Glasgow, United Kingdom
| | - Javed Butler
- Division of Cardiology, Stony Brook University, Stony Brook, NY
| | - John G F Cleland
- National Heart and Lung Institute, Imperial College London, London, United Kingdom.,Cardiology Department, Castle Hill Hospital, University of Hull, United Kingdom
| | - Tatiana Kuznetsova
- Research Unit of Hypertension and Cardiovascular Epidemiology, Studies Coordinating Centre, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Belgium
| | - Jan A Staessen
- Research Unit of Hypertension and Cardiovascular Epidemiology, Studies Coordinating Centre, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Belgium
| | - Faiez Zannad
- INSERM, Centre d'Investigations Cliniques Plurithe'matique 1433, INSERM U1116, CHRU de Nancy, F-CRIN INI-CRCT, Universite' de Lorraine, Nancy, France
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Yang WY, Petit T, Cauwenberghs N, Zhang ZY, Sheng CS, Thijs L, Salvi E, Izzi B, Vandenbriele C, Wei FF, Gu YM, Jacobs L, Citterio L, Delli Carpini S, Barlassina C, Cusi D, Hoylaerts MF, Verhamme P, Kuznetsova T, Staessen JA. PEAR1 is not a major susceptibility gene for cardiovascular disease in a Flemish population. BMC Med Genet 2017; 18:45. [PMID: 28449647 PMCID: PMC5408434 DOI: 10.1186/s12881-017-0411-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [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: 02/17/2017] [Accepted: 04/20/2017] [Indexed: 12/19/2022]
Abstract
Background Platelet Endothelial Aggregation Receptor 1 (PEAR1), a membrane protein highly expressed in platelets and endothelial cells, plays a role in platelet contact-induced activation, sustained platelet aggregation and endothelial function. Previous reports implicate PEAR1 rs12041331 as a variant influencing risk in patients with coronary heart disease. We investigated whether genetic variation in PEAR1 predicts cardiovascular outcome in a white population. Methods In 1938 participants enrolled in the Flemish Study on Environment, Genes and Health Outcomes (51.3% women; mean age 43.6 years), we genotyped 9 tagging SNPs in PEAR1, measured baseline cardiovascular risk factors, and recorded Cardiovascular disease incidence. For SNPs, we contrasted cardiovascular disease incidence of minor-allele heterozygotes and homozygotes (variant) vs. major-allele homozygotes (reference) and for haplotypes carriers vs. non-carriers. In adjusted analyses, we accounted for family clusters and baseline covariables, including sex, age, body mass index, mean arterial pressure, the total-to-HDL cholesterol ratio, smoking and drinking, antihypertensive drug treatment, and history of cardiovascular disease and diabetes mellitus. Results Over a median follow-up of 15.3 years, 238 died and 181 experienced a major cardiovascular endpoint. The multivariable-adjusted hazard ratios of eight PEAR1 SNPs, including rs12566888, ranged from 0.87 to 1.07 (P ≥0.35) and from 0.78 to 1.30 (P ≥0.15), respectively. The hazard ratios of three haplotypes with frequency ≥10% ranged from 0.93 to 1.11 (P ≥0.49) for mortality and from 0.84 to 1.03 (P ≥0.29) for a cardiovascular complications. These results were not influenced by intake of antiplatelet drugs, nonsteroidal anti-inflammatory drugs, or both (P-values for interaction ≥ 0.056). Conclusions In a White population, we could not replicate previous reports from experimental studies or obtained in patients suggesting that PEAR1 might be a susceptibility gene for cardiovascular complications. Electronic supplementary material The online version of this article (doi:10.1186/s12881-017-0411-x) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Wen-Yi Yang
- Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences,, University of Leuven, Campus Sint Rafaël, Kapucijnenvoer 35, Box 7001, BE-3000, Leuven, Belgium
| | - Thibault Petit
- Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences,, University of Leuven, Campus Sint Rafaël, Kapucijnenvoer 35, Box 7001, BE-3000, Leuven, Belgium.,Cardiology, Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium
| | - Nicholas Cauwenberghs
- Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences,, University of Leuven, Campus Sint Rafaël, Kapucijnenvoer 35, Box 7001, BE-3000, Leuven, Belgium
| | - Zhen-Yu Zhang
- Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences,, University of Leuven, Campus Sint Rafaël, Kapucijnenvoer 35, Box 7001, BE-3000, Leuven, Belgium
| | - Chang-Sheng Sheng
- Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences,, University of Leuven, Campus Sint Rafaël, Kapucijnenvoer 35, Box 7001, BE-3000, Leuven, Belgium
| | - Lutgarde Thijs
- Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences,, University of Leuven, Campus Sint Rafaël, Kapucijnenvoer 35, Box 7001, BE-3000, Leuven, Belgium
| | - Erika Salvi
- Genomics and Bioinformatics Platform at Filarete Foundation, Department of Health Sciences and Graduate School of Nephrology, Division of Nephrology, San Paolo Hospital, University of Milan, Milan, Italy
| | - Benedetta Izzi
- Department of Cardiovascular Sciences, Centre for Molecular and Vascular Biology, University of Leuven, Leuven, Belgium
| | - Christophe Vandenbriele
- Department of Cardiovascular Sciences, Centre for Molecular and Vascular Biology, University of Leuven, Leuven, Belgium
| | - Fang-Fei Wei
- Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences,, University of Leuven, Campus Sint Rafaël, Kapucijnenvoer 35, Box 7001, BE-3000, Leuven, Belgium
| | - Yu-Mei Gu
- Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences,, University of Leuven, Campus Sint Rafaël, Kapucijnenvoer 35, Box 7001, BE-3000, Leuven, Belgium
| | - Lotte Jacobs
- Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences,, University of Leuven, Campus Sint Rafaël, Kapucijnenvoer 35, Box 7001, BE-3000, Leuven, Belgium
| | - Lorena Citterio
- Division of Nephrology and Dialysis, IRCCS San Raffaele Scientific Institute, University Vita-Salute San Raffaele, Milan, Italy
| | - Simona Delli Carpini
- Division of Nephrology and Dialysis, IRCCS San Raffaele Scientific Institute, University Vita-Salute San Raffaele, Milan, Italy
| | - Cristina Barlassina
- Genomics and Bioinformatics Platform at Filarete Foundation, Department of Health Sciences and Graduate School of Nephrology, Division of Nephrology, San Paolo Hospital, University of Milan, Milan, Italy
| | - Daniele Cusi
- Genomics and Bioinformatics Platform at Filarete Foundation, Department of Health Sciences and Graduate School of Nephrology, Division of Nephrology, San Paolo Hospital, University of Milan, Milan, Italy
| | - Marc F Hoylaerts
- Department of Cardiovascular Sciences, Centre for Molecular and Vascular Biology, University of Leuven, Leuven, Belgium
| | - Peter Verhamme
- Department of Cardiovascular Sciences, Centre for Molecular and Vascular Biology, University of Leuven, Leuven, Belgium
| | - Tatiana Kuznetsova
- Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences,, University of Leuven, Campus Sint Rafaël, Kapucijnenvoer 35, Box 7001, BE-3000, Leuven, Belgium
| | - Jan A Staessen
- Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences,, University of Leuven, Campus Sint Rafaël, Kapucijnenvoer 35, Box 7001, BE-3000, Leuven, Belgium. .,R&D Group VitaK, Maastricht University, Maastricht, The Netherlands.
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Fadl Elmula FEM, Feng YM, Jacobs L, Larstorp AC, Kjeldsen SE, Persu A, Staessen JA. Sham or no sham control: that is the question in trials of renal denervation for resistant hypertension. A systematic meta-analysis. Blood Press 2017; 26:195-203. [DOI: 10.1080/08037051.2017.1311769] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Affiliation(s)
- Fadl Elmula M. Fadl Elmula
- Department of Cardiology, Internal Medicine and Medical Biochemistry, Oslo University Hospital, Ullevaal, Norway
- Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Ying-Mei Feng
- Beijing Key Laboratory of Diabetes Prevention and Research, Department of Endocrinology, Luhe Hospital, Capital Medical University, Beijing, China
| | - Lotte Jacobs
- Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium
| | - Anne C. Larstorp
- Department of Cardiology, Internal Medicine and Medical Biochemistry, Oslo University Hospital, Ullevaal, Norway
| | - Sverre E. Kjeldsen
- Department of Cardiology, Internal Medicine and Medical Biochemistry, Oslo University Hospital, Ullevaal, Norway
- Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Alexandre Persu
- Pole of Cardiovascular Research, Institut de Recherche Expérimentale et Clinique, Bruxelles, Begium
- Division of Cardiology, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium
| | - Jan A. Staessen
- Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium
- R & D Vitak Group, Maastricht University, Maastricht, The Netherlands
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Jacobs L, Meek DB, van Heukelom J, Bollen TL, Siersema PD, Smits AB, Tromp E, Los M, Weusten BL, van Lelyveld N. Comparison of MRI and colonoscopy in determining tumor height in rectal cancer. United European Gastroenterol J 2017; 6:131-137. [PMID: 29435323 PMCID: PMC5802669 DOI: 10.1177/2050640617707090] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2017] [Accepted: 03/29/2017] [Indexed: 01/11/2023] Open
Abstract
Background and aim Endoscopy and magnetic resonance imaging (MRI) are used routinely in the diagnostic and preoperative work-up of rectal cancer. We aimed to compare colonoscopy and MRI in determining rectal tumor height. Methods Between 2002 and 2012, all patients with rectal cancer with available MRIs and endoscopy reports were included. All MRIs were reassessed for tumor height by two abdominal radiologists. To obtain insight in techniques used for endoscopic determination of tumor height, a survey among regional endoscopists was conducted. Results A total of 211 patients with rectal cancer were included. Tumor height was significantly lower when assessed by MRI than by endoscopy with a mean difference of 2.5 cm (95% CI: 2.1-2.8). Although the agreement between tumor height as measured by MRI and endoscopy was good (intraclass correlation coefficient (ICC) 0.7 (95% CI: 0.7-0.8)), the 95% limits of agreement varied from -3.0 cm to 8.0 cm. In 45 patients (21.3%), tumors were regarded as low by MRI and middle-high by endoscopy. MRI inter- and intraobserver agreements were excellent with an ICC of 0.8 (95% CI: 0.7-0.9) and 0.9 (95% CI: 0.9-1.0), respectively. The survey showed no consensus among endoscopists as to how to technically measure tumor height. Conclusion This study showed large variability in rectal tumor height as measured by colonoscopy and MRI. Since MRI measurements showed excellent inter- and intraobserver agreement, we suggest using tumor height measurement by MRI for diagnostic purposes and treatment allocation.
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Affiliation(s)
- Lotte Jacobs
- Department of Gastroenterology and Hepatology, St Antonius Hospital Nieuwegein, The Netherlands
| | - David B Meek
- Department of Radiology, St Antonius Hospital Nieuwegein, The Netherlands
| | - Joost van Heukelom
- Department of Gastroenterology and Hepatology, St Antonius Hospital Nieuwegein, The Netherlands
| | - Thomas L Bollen
- Department of Radiology, St Antonius Hospital Nieuwegein, The Netherlands
| | - Peter D Siersema
- Department of Gastroenterology and Hepatology, University Medical Center Utrecht, The Netherlands.,Department of Gastroenterology and Hepatology, Radboud University Medical Center Nijmegen, The Netherlands
| | - Anke B Smits
- Department of Surgery, St Antonius Hospital Nieuwegein, The Netherlands
| | - Ellen Tromp
- Department of Epidemiology and Statistics, St Antonius Hospital Nieuwegein, The Netherlands
| | - Maartje Los
- Department of Internal Medicine/Oncology, St Antonius Hospital Nieuwegein, The Netherlands
| | - Bas Lam Weusten
- Department of Gastroenterology and Hepatology, St Antonius Hospital Nieuwegein, The Netherlands.,Department of Gastroenterology and Hepatology, University Medical Center Utrecht, The Netherlands
| | - Niels van Lelyveld
- Department of Gastroenterology and Hepatology, St Antonius Hospital Nieuwegein, The Netherlands
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Nomura K, Asayama K, Jacobs L, Thijs L, Staessen JA. Renal function in relation to sodium intake: a quantitative review of the literature. Kidney Int 2017; 92:67-78. [PMID: 28412019 DOI: 10.1016/j.kint.2016.11.032] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [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: 06/30/2016] [Revised: 11/22/2016] [Accepted: 11/29/2016] [Indexed: 01/10/2023]
Abstract
We undertook a quantitative literature review to search for evidence underpinning current guidelines proposing a reduction of sodium intake to less than 2.4 g/d for the management of chronic kidney disease. We searched PubMed for peer-reviewed articles published from January 1980 through May 2016. Two investigators screened 5072 publications and extracted data from 36, including 11 cross-sectional and 5 longitudinal observational studies and 20 intervention trials. Within-study effect sizes were pooled and standardized to a sodium gradient of 100 mmol/d by using inverse-variance weighted random effects models. Among cross-sectional studies, the pooled odds ratio for albuminuria was 1.23 (95% confidence interval [CI], 0.92-1.64, P = 0.16), and the pooled mean difference in glomerular filtration rate amounted to 8.5 ml/min (CI, -2.3 to 19.2 ml/min; P = 0.12). In the cohort studies, the pooled relative risk of a renal endpoint was 1.08 (CI, 0.92-1.29; P = 0.35). In the intervention trials (median duration, 14 days [range, 4-186 days]), the mean differences in estimated glomerular filtration rate and albuminuria (high vs. low sodium intake) averaged 4.6 ml/min (CI, 3.4-5.8 ml/min; P < 0.0001) and 53% (CI, 21-84; P = 0.001), respectively. Cochran's Q statistic indicated significant heterogeneity among cross-sectional studies for both estimated glomerular filtration rate and albuminuria (P < 0.0001) and among intervention trials for albuminuria (P = 0.04). In conclusion, there is no robust evidence suggesting that long-term reduction of salt intake would prevent chronic kidney disease or delay its progression. However, our current findings, which were mainly obtained in people with slight renal impairment, cannot be extrapolated to patients with moderate or severe chronic kidney disease.
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Affiliation(s)
- Kyoko Nomura
- Department of Hygiene and Public Health, Teikyo University School of Medicine, Tokyo, Japan
| | - Kei Asayama
- Department of Hygiene and Public Health, Teikyo University School of Medicine, Tokyo, Japan; Department of Planning for Drug Development and Clinical Evaluation, Tohoku University Graduate School of Pharmaceutical Sciences, Sendai, Japan
| | - Lotte Jacobs
- Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium
| | - Lutgarde Thijs
- Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium
| | - Jan A Staessen
- Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium; R&D Group VitaK, Maastricht University, Maastricht, The Netherlands.
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Raaijmakers A, Zhang ZY, Claessens J, Cauwenberghs N, van Tienoven TP, Wei FF, Jacobs L, Levtchenko E, Pauwels S, Kuznetsova T, Allegaert K, Staessen JA. Does Extremely Low Birth Weight Predispose to Low-Renin Hypertension? Hypertension 2017; 69:443-449. [DOI: 10.1161/hypertensionaha.116.08643] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2016] [Revised: 11/21/2016] [Accepted: 12/22/2016] [Indexed: 11/16/2022]
Abstract
Low birth weight and prematurity are risk factors for hypertension in adulthood. Few studies in preterm or full-term born children reported on plasma renin activity (PRA). We tested the hypothesis that renin might modulate the incidence of hypertension associated with prematurity. We enrolled 93 prematurely born children with birth weight <1000 g and 87 healthy controls born at term, who were all examined at ≈11 years. Renal length and glomerular filtration rate derived from serum cystatin C were 0.28 cm (95% confidence interval, 0.09–0.47) and 11.5 mL/min per 1.73 m
2
(6.4–16.6) lower in cases, whereas their systolic/diastolic blood pressure (BP) was 7.5 mm Hg (4.8–10.3)/4.0 mm Hg (2.1–5.8) higher (
P
<0.001 for all). The odds of having systolic prehypertension or systolic hypertension associated with extreme low birth weight were 6.43 (2.52–16.4;
P
<0.001) and 10.9 (2.46–48.4;
P
=0.002). Twenty-four hours of urinary sodium excretion was similar in cases and controls (102.1 versus 106.8 mmol;
P
=0.47). Sodium load per nephron was estimated as sodium excretion divided by kidney length (mmol/cm). PRA was 0.54 ng/mL per hour (0.23–0.85;
P
=0.001) lower in cases. PRA, systolic BP, and sodium load were available in 43 cases and 56 controls. PRA decreased with systolic BP (slope −0.022 ng/mL per hour/
−
mm Hg
;
P
=0.048), but was unrelated to sodium load (slope +0.13 mmol/cm
−
mm Hg
;
P
=0.54). The slope of PRA on systolic BP was similar (
P
=0.17) in cases and controls. In conclusion, extremely low birth weight predisposes young adolescents to low-renin hypertension, but does not affect the inverse association between PRA and BP.
Clinical Trial Registration—
URL:
https://www.clinicaltrials.gov
. Unique identifier: NCT02147457.
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Affiliation(s)
- Anke Raaijmakers
- Departments of Pediatrics and Neonatology (A.R., E.L.) and Laboratory Medicine (J.C., S.P.), University Hospitals Leuven, Belgium; KU Leuven Department of Development and Regeneration (A.R., E.L., K.A.) and Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences (Z.-Y.Z., N.C., F.-F.W., L.J., T.K., J.A.S.), University of Leuven, Belgium; Department of Sociology, Vrije Universiteit Brussel, Belgium (T.P. v.T.); R&D Group VitaK, Maastricht
| | - Zhen-Yu Zhang
- Departments of Pediatrics and Neonatology (A.R., E.L.) and Laboratory Medicine (J.C., S.P.), University Hospitals Leuven, Belgium; KU Leuven Department of Development and Regeneration (A.R., E.L., K.A.) and Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences (Z.-Y.Z., N.C., F.-F.W., L.J., T.K., J.A.S.), University of Leuven, Belgium; Department of Sociology, Vrije Universiteit Brussel, Belgium (T.P. v.T.); R&D Group VitaK, Maastricht
| | - Jolien Claessens
- Departments of Pediatrics and Neonatology (A.R., E.L.) and Laboratory Medicine (J.C., S.P.), University Hospitals Leuven, Belgium; KU Leuven Department of Development and Regeneration (A.R., E.L., K.A.) and Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences (Z.-Y.Z., N.C., F.-F.W., L.J., T.K., J.A.S.), University of Leuven, Belgium; Department of Sociology, Vrije Universiteit Brussel, Belgium (T.P. v.T.); R&D Group VitaK, Maastricht
| | - Nicholas Cauwenberghs
- Departments of Pediatrics and Neonatology (A.R., E.L.) and Laboratory Medicine (J.C., S.P.), University Hospitals Leuven, Belgium; KU Leuven Department of Development and Regeneration (A.R., E.L., K.A.) and Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences (Z.-Y.Z., N.C., F.-F.W., L.J., T.K., J.A.S.), University of Leuven, Belgium; Department of Sociology, Vrije Universiteit Brussel, Belgium (T.P. v.T.); R&D Group VitaK, Maastricht
| | - Theun Pieter van Tienoven
- Departments of Pediatrics and Neonatology (A.R., E.L.) and Laboratory Medicine (J.C., S.P.), University Hospitals Leuven, Belgium; KU Leuven Department of Development and Regeneration (A.R., E.L., K.A.) and Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences (Z.-Y.Z., N.C., F.-F.W., L.J., T.K., J.A.S.), University of Leuven, Belgium; Department of Sociology, Vrije Universiteit Brussel, Belgium (T.P. v.T.); R&D Group VitaK, Maastricht
| | - Fang-Fei Wei
- Departments of Pediatrics and Neonatology (A.R., E.L.) and Laboratory Medicine (J.C., S.P.), University Hospitals Leuven, Belgium; KU Leuven Department of Development and Regeneration (A.R., E.L., K.A.) and Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences (Z.-Y.Z., N.C., F.-F.W., L.J., T.K., J.A.S.), University of Leuven, Belgium; Department of Sociology, Vrije Universiteit Brussel, Belgium (T.P. v.T.); R&D Group VitaK, Maastricht
| | - Lotte Jacobs
- Departments of Pediatrics and Neonatology (A.R., E.L.) and Laboratory Medicine (J.C., S.P.), University Hospitals Leuven, Belgium; KU Leuven Department of Development and Regeneration (A.R., E.L., K.A.) and Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences (Z.-Y.Z., N.C., F.-F.W., L.J., T.K., J.A.S.), University of Leuven, Belgium; Department of Sociology, Vrije Universiteit Brussel, Belgium (T.P. v.T.); R&D Group VitaK, Maastricht
| | - Elena Levtchenko
- Departments of Pediatrics and Neonatology (A.R., E.L.) and Laboratory Medicine (J.C., S.P.), University Hospitals Leuven, Belgium; KU Leuven Department of Development and Regeneration (A.R., E.L., K.A.) and Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences (Z.-Y.Z., N.C., F.-F.W., L.J., T.K., J.A.S.), University of Leuven, Belgium; Department of Sociology, Vrije Universiteit Brussel, Belgium (T.P. v.T.); R&D Group VitaK, Maastricht
| | - Steven Pauwels
- Departments of Pediatrics and Neonatology (A.R., E.L.) and Laboratory Medicine (J.C., S.P.), University Hospitals Leuven, Belgium; KU Leuven Department of Development and Regeneration (A.R., E.L., K.A.) and Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences (Z.-Y.Z., N.C., F.-F.W., L.J., T.K., J.A.S.), University of Leuven, Belgium; Department of Sociology, Vrije Universiteit Brussel, Belgium (T.P. v.T.); R&D Group VitaK, Maastricht
| | - Tatiana Kuznetsova
- Departments of Pediatrics and Neonatology (A.R., E.L.) and Laboratory Medicine (J.C., S.P.), University Hospitals Leuven, Belgium; KU Leuven Department of Development and Regeneration (A.R., E.L., K.A.) and Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences (Z.-Y.Z., N.C., F.-F.W., L.J., T.K., J.A.S.), University of Leuven, Belgium; Department of Sociology, Vrije Universiteit Brussel, Belgium (T.P. v.T.); R&D Group VitaK, Maastricht
| | - Karel Allegaert
- Departments of Pediatrics and Neonatology (A.R., E.L.) and Laboratory Medicine (J.C., S.P.), University Hospitals Leuven, Belgium; KU Leuven Department of Development and Regeneration (A.R., E.L., K.A.) and Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences (Z.-Y.Z., N.C., F.-F.W., L.J., T.K., J.A.S.), University of Leuven, Belgium; Department of Sociology, Vrije Universiteit Brussel, Belgium (T.P. v.T.); R&D Group VitaK, Maastricht
| | - Jan A. Staessen
- Departments of Pediatrics and Neonatology (A.R., E.L.) and Laboratory Medicine (J.C., S.P.), University Hospitals Leuven, Belgium; KU Leuven Department of Development and Regeneration (A.R., E.L., K.A.) and Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences (Z.-Y.Z., N.C., F.-F.W., L.J., T.K., J.A.S.), University of Leuven, Belgium; Department of Sociology, Vrije Universiteit Brussel, Belgium (T.P. v.T.); R&D Group VitaK, Maastricht
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Chen K, Liu J, Zhu L, Song E, Su F, Jacobs L. Abstract P2-01-09: The development of nomograms to predict axillary lymph node status in breast cancer patients. Cancer Res 2017. [DOI: 10.1158/1538-7445.sabcs16-p2-01-09] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
This abstract was withdrawn by the authors.
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Affiliation(s)
- K Chen
- Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China; Johns Hopkins Hospital, Johns Hopkins University, Baltimore
| | - J Liu
- Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China; Johns Hopkins Hospital, Johns Hopkins University, Baltimore
| | - L Zhu
- Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China; Johns Hopkins Hospital, Johns Hopkins University, Baltimore
| | - E Song
- Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China; Johns Hopkins Hospital, Johns Hopkins University, Baltimore
| | - F Su
- Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China; Johns Hopkins Hospital, Johns Hopkins University, Baltimore
| | - L Jacobs
- Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China; Johns Hopkins Hospital, Johns Hopkins University, Baltimore
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Arepally A, Tully M, Stein L, Jacobs L, Rubin R, Bosley M, Citron S, Shrestha R. Frequency of complete pathological necrosis in HCC of explanted livers: radioembolization with resin vs drug-eluting beads with doxorubicin. J Vasc Interv Radiol 2017. [DOI: 10.1016/j.jvir.2016.12.770] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Yang WY, Zhang ZY, Thijs L, Cauwenberghs N, Wei FF, Jacobs L, Luttun A, Verhamme P, Kuznetsova T, Nawrot TS, Staessen JA. Left Ventricular Structure and Function in Relation to Environmental Exposure to Lead and Cadmium. J Am Heart Assoc 2017; 6:JAHA.116.004692. [PMID: 28151401 PMCID: PMC5523767 DOI: 10.1161/jaha.116.004692] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
Background Experimental studies have demonstrated that lead and cadmium have direct toxic effects on the myocardium, but the few human studies are limited by design, assessment of exposure, and use of heart failure as a late‐stage endpoint. Methods and Results In a prospective population study, we studied the association of left ventricular (LV) function with blood lead (BPb) and 24‐hour urinary cadmium (UCd). In 179 participants randomly recruited from a Flemish population (50.3% women; mean age 39.1 years), geometric mean BPb and UCd at enrollment (1985‐2000) were 0.20 μmol/L and 6.1 nmol, respectively. We assessed systolic and diastolic LV function 11.9 years (median) later (2005‐2010) by using Doppler imaging of the transmitral blood flow and the mitral annular movement and speckle tracking. In multivariable‐adjusted linear regression, LV systolic function decreased with BPb. For a doubling of exposure, estimates were −0.392% for global longitudinal strain (P=0.034), −0.618% and −0.113 s−1 for regional longitudinal strain (P=0.028) and strain rate (P=0.008), and −0.056 s−1 for regional radial strain rate (P=0.050). Regional longitudinal strain rate (−0.066 s−1, P=0.009) and regional radial strain (−2.848%, P=0.015) also decreased with UCd. Models including both exposure indexes did not allow differentiating whether LV dysfunction was predominately related to BPb or UCd. Diastolic LV function was not associated with BPb or UCd (P≥0.159). Conclusions Although effect sizes were small, our results suggest that environmental exposure to lead, cadmium, or both might be a risk factor for systolic LV dysfunction, a condition often proceeding to heart failure.
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Affiliation(s)
- Wen-Yi Yang
- Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Belgium
| | - Zhen-Yu Zhang
- Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Belgium
| | - Lutgarde Thijs
- Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Belgium
| | - Nicholas Cauwenberghs
- Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Belgium
| | - Fang-Fei Wei
- Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Belgium
| | - Lotte Jacobs
- Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Belgium
| | - Aernout Luttun
- Centre for Molecular and Vascular Biology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Belgium
| | - Peter Verhamme
- Centre for Molecular and Vascular Biology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Belgium
| | - Tatiana Kuznetsova
- Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Belgium
| | - Tim S Nawrot
- Centre for Environmental Sciences, University of Hasselt, Belgium
| | - Jan A Staessen
- Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Belgium .,R & D Group VitaK, Maastricht University, Maastricht, The Netherlands
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Zhang ZY, Ravassa S, Yang WY, Petit T, Pejchinovski M, Zürbig P, López B, Wei FF, Pontillo C, Thijs L, Jacobs L, González A, Koeck T, Delles C, Voigt JU, Verhamme P, Kuznetsova T, Díez J, Mischak H, Staessen JA. Diastolic Left Ventricular Function in Relation to Urinary and Serum Collagen Biomarkers in a General Population. PLoS One 2016; 11:e0167582. [PMID: 27959898 PMCID: PMC5154519 DOI: 10.1371/journal.pone.0167582] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2016] [Accepted: 11/16/2016] [Indexed: 01/15/2023] Open
Abstract
Current knowledge on the pathogenesis of diastolic heart failure predominantly rests on case-control studies involving symptomatic patients with preserved ejection fraction and relying on invasive diagnostic procedures including endomyocardial biopsy. Our objective was to gain insight in serum and urinary biomarkers reflecting collagen turnover and associated with asymptomatic diastolic LV dysfunction. We randomly recruited 782 Flemish (51.3% women; 50.5 years). We assessed diastolic LV function from the early and late diastolic peak velocities of the transmitral blood flow and of the mitral annulus. By sequencing urinary peptides, we identified 70 urinary collagen fragments. In serum, we measured carboxyterminal propeptide of procollagen type 1 (PICP) as marker of collagen I synthesis and tissue inhibitor of matrix metalloproteinase type 1 (TIMP-1), an inhibitor of collagen-degrading enzymes. In multivariable-adjusted analyses with Bonferroni correction, we expressed effect sizes per 1-SD in urinary collagen I (uCI) or collagen III (uCIII) fragments. In relation to uCI fragments, e’ decreased by 0.183 cm/s (95% confidence interval, 0.017 to 0.350; p = 0.025), whereas E/e’ increased by 0.210 (0.067 to 0.353; p = 0.0012). E/e’ decreased with uCIII by 0.168 (0.021 to 0.316; p = 0.018). Based on age-specific echocardiographic criteria, 182 participants (23.3%) had subclinical diastolic LV dysfunction. Partial least squares discriminant analysis contrasting normal vs. diastolic LV dysfunction confirmed the aforementioned associations with the uCI and uCIII fragments. PICP and TIMP-1 increased in relation to uCI (p<0.0001), whereas these serum markers decreased with uCIII (p≤0.0006). Diastolic LV dysfunction was associated with higher levels of TIMP-1 (653 vs. 696 ng/mL; p = 0.013). In a general population, the non-invasively assessed diastolic LV function correlated inversely with uCI and serum markers of collagen I deposition, but positively with uCIII. These observations generalise previous studies in patients to randomly recruited people, in whom diastolic LV function ranged from normal to subclinical impairment, but did not encompass overt diastolic heart failure.
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Affiliation(s)
- Zhen-Yu Zhang
- Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Diseases, University of Leuven, Leuven, Belgium
| | - Susana Ravassa
- Program of Cardiovascular Diseases, Centre for Applied Medical, University of Navarra, Pamplona, Spain
- Instituto de Investigación Sanitaria de Navarra, Pamplona, Spain
| | - Wen-Yi Yang
- Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Diseases, University of Leuven, Leuven, Belgium
| | - Thibault Petit
- Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Diseases, University of Leuven, Leuven, Belgium
| | | | - Petra Zürbig
- Mosaiques Diagnostic and Therapeutics AG, Hannover, Germany
| | - Begoña López
- Program of Cardiovascular Diseases, Centre for Applied Medical, University of Navarra, Pamplona, Spain
- Instituto de Investigación Sanitaria de Navarra, Pamplona, Spain
| | - Fang-Fei Wei
- Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Diseases, University of Leuven, Leuven, Belgium
| | | | - Lutgarde Thijs
- Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Diseases, University of Leuven, Leuven, Belgium
| | - Lotte Jacobs
- Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Diseases, University of Leuven, Leuven, Belgium
| | - Arantxa González
- Program of Cardiovascular Diseases, Centre for Applied Medical, University of Navarra, Pamplona, Spain
- Instituto de Investigación Sanitaria de Navarra, Pamplona, Spain
| | - Thomas Koeck
- Mosaiques Diagnostic and Therapeutics AG, Hannover, Germany
| | - Christian Delles
- BHF Glasgow Cardiovascular Research Centre, University of Glasgow, Glasgow, United Kingdom
| | - Jens-Uwe Voigt
- Research Unit Cardiology, KU Leuven Department of Cardiovascular Diseases, University of Leuven, Leuven, Belgium
| | - Peter Verhamme
- Centre for Molecular and Vascular Biology, KU Leuven Department of Cardiovascular Diseases, University of Leuven, Leuven, Belgium
| | - Tatiana Kuznetsova
- Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Diseases, University of Leuven, Leuven, Belgium
| | - Javier Díez
- Program of Cardiovascular Diseases, Centre for Applied Medical, University of Navarra, Pamplona, Spain
- Instituto de Investigación Sanitaria de Navarra, Pamplona, Spain
- Department of Cardiology and Cardiac Surgery, University of Navarra Clinic, University of Navarra, Pamplona, Spain
| | - Harald Mischak
- Mosaiques Diagnostic and Therapeutics AG, Hannover, Germany
- BHF Glasgow Cardiovascular Research Centre, University of Glasgow, Glasgow, United Kingdom
| | - Jan A. Staessen
- Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Diseases, University of Leuven, Leuven, Belgium
- R&D Group VitaK, Maastricht University, Maastricht, The Netherlands
- * E-mail: ,
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Ferreira JP, Girerd N, Pellicori P, Duarte K, Girerd S, Pfeffer MA, McMurray JJV, Pitt B, Dickstein K, Jacobs L, Staessen JA, Butler J, Latini R, Masson S, Mebazaa A, Rocca HPBL, Delles C, Heymans S, Sattar N, Jukema JW, Cleland JG, Zannad F, Rossignol P. Renal function estimation and Cockroft-Gault formulas for predicting cardiovascular mortality in population-based, cardiovascular risk, heart failure and post-myocardial infarction cohorts: The Heart 'OMics' in AGEing (HOMAGE) and the high-risk myocardial infarction database initiatives. BMC Med 2016; 14:181. [PMID: 27829460 PMCID: PMC5103492 DOI: 10.1186/s12916-016-0731-2] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2016] [Accepted: 10/26/2016] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Renal impairment is a major risk factor for mortality in various populations. Three formulas are frequently used to assess both glomerular filtration rate (eGFR) or creatinine clearance (CrCl) and mortality prediction: body surface area adjusted-Cockcroft-Gault (CG-BSA), Modification of Diet in Renal Disease Study (MDRD4), and the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation. The CKD-EPI is the most accurate eGFR estimator as compared to a "gold-standard"; however, which of the latter is the best formula to assess prognosis remains to be clarified. This study aimed to compare the prognostic value of these formulas in predicting the risk of cardiovascular mortality (CVM) in population-based, cardiovascular risk, heart failure (HF) and post-myocardial infarction (MI) cohorts. METHODS Two previously published cohorts of pooled patient data derived from the partners involved in the HOMAGE-consortium and from four clinical trials - CAPRICORN, EPHESUS, OPTIMAAL and VALIANT - the high risk MI initiative, were used. A total of 54,111 patients were included in the present analysis: 2644 from population-based cohorts; 20,895 from cardiovascular risk cohorts; 1801 from heart failure cohorts; and 28,771 from post-myocardial infarction cohorts. Participants were patients enrolled in the respective cohorts and trials. The primary outcome was CVM. RESULTS All formulas were strongly and independently associated with CVM. Lower eGFR/CrCl was associated with increasing CVM rates for values below 60 mL/min/m2. Categorical renal function stages diverged in a more pronounced manner with the CG-BSA formula in all populations (higher χ2 values), with lower stages showing stronger associations. The discriminative improvement driven by the CG-BSA formula was superior to that of MDRD4 and CKD-EPI, but remained low overall (increase in C-index ranging from 0.5 to 2 %) while not statistically significant in population-based cohorts. The integrated discrimination improvement and net reclassification improvement were higher (P < 0.05) for the CG-BSA formula compared to MDRD4 and CKD-EPI in CV risk, HF and post-MI cohorts, but not in population-based cohorts. The CKD-EPI formula was superior overall to MDRD4. CONCLUSIONS The CG-BSA formula was slightly more accurate in predicting CVM in CV risk, HF, and post-MI cohorts (but not in population-based cohorts). However, the CG-BSA discriminative improvement was globally low compared to MDRD4 and especially CKD-EPI, the latter offering the best compromise between renal function estimation and CVM prediction.
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Affiliation(s)
- João Pedro Ferreira
- INSERM, Centre d'Investigations Cliniques Plurithématique 1433, INSERM U1116, Université de Lorraine, CHRU de Nancy, F-CRIN INI-CRCT, Nancy, France
| | - Nicolas Girerd
- INSERM, Centre d'Investigations Cliniques Plurithématique 1433, INSERM U1116, Université de Lorraine, CHRU de Nancy, F-CRIN INI-CRCT, Nancy, France
| | - Pierpaolo Pellicori
- Academic Cardiology Unit, University of Hull, Castle Hill Hospital, Kingston upon Hull, UK
| | - Kevin Duarte
- Université de Lorraine, Institut Elie Cartan de Lorraine, UMR 7502,, Vandoeuvre-lès-Nancy, F-54506, France.,CNRS, Institut Elie Cartan de Lorraine, UMR 7502,, Vandoeuvre-lès-Nancy, F-54506, France.,Team BIGS, INRIA, Villers-lès-Nancy, F-54600, France
| | - Sophie Girerd
- INSERM, Centre d'Investigations Cliniques Plurithématique 1433, INSERM U1116, Université de Lorraine, CHRU de Nancy, F-CRIN INI-CRCT, Nancy, France
| | - Marc A Pfeffer
- Division of Cardiovascular Medicine, Brigham & Women's Hospital, Harvard Medical School, Boston, Massachusetts, 02115, USA
| | - John J V McMurray
- BHF Cardiovascular Research Centre, University of Glasgow, Glasgow, Scotland, UK
| | - Bertram Pitt
- Department of Medicine, University of Michigan School of Medicine, Ann Arbor, MA, USA.,ASH Comprehensive Hypertension Center, Division of Endocrinology, Diabetes, and Metabolism, Department of Medicine, The University of Chicago, Chicago, IL, USA
| | - Kenneth Dickstein
- Department of Cardiology, University of Bergan, Stavanger University Hospital, Stavanger, Norway
| | - Lotte Jacobs
- Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium
| | - Jan A Staessen
- Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium
| | - Javed Butler
- Cardiology Division, Stony Brook University, Stony Brook, NY, USA
| | - Roberto Latini
- Laboratory of Cardiovascular Clinical Pharmacology, IRCCS - Istituto di Ricerche Farmacologiche 'Mario Negri', Milan, Italy
| | - Serge Masson
- Laboratory of Cardiovascular Clinical Pharmacology, IRCCS - Istituto di Ricerche Farmacologiche 'Mario Negri', Milan, Italy
| | - Alexandre Mebazaa
- Hôpital Lariboisière, Université Paris Diderot, Inserm 942, Paris, France
| | - Hans Peter Brunner-La Rocca
- Cardiovascular Research Institute Maastricht, Maastricht University Medical Centre, Maastricht, The Netherlands Department of Cardiology, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Christian Delles
- BHF Cardiovascular Research Centre, University of Glasgow, Glasgow, Scotland, UK
| | - Stephane Heymans
- Department of Cardiology, Maastricht University Medical Center, Postbox 5800, 6202, AZ, Maastricht, The Netherlands
| | - Naveed Sattar
- BHF Cardiovascular Research Centre, University of Glasgow, Glasgow, Scotland, UK
| | - J Wouter Jukema
- Department of Cardiology and Einthoven Laboratory for Experimental Vascular Medicine, Leiden University Medical Center, Leiden, The Netherlands.,Interuniversity Cardiology Institute of the Netherlands, Utrecht, The Netherlands
| | - John G Cleland
- National Heart and Lung Institute, Imperial College London (Royal Brompton and Harefield Hospitals) Department of Cardiology, Castle Hill Hospital, University of Hull, Hull, UK
| | - Faiez Zannad
- INSERM, Centre d'Investigations Cliniques Plurithématique 1433, INSERM U1116, Université de Lorraine, CHRU de Nancy, F-CRIN INI-CRCT, Nancy, France
| | - Patrick Rossignol
- INSERM, Centre d'Investigations Cliniques Plurithématique 1433, INSERM U1116, Université de Lorraine, CHRU de Nancy, F-CRIN INI-CRCT, Nancy, France. .,Centre d'Investigations Cliniques-INSERM CHU de Nancy, Institut Lorrain du Cœur et des Vaisseaux Louis Mathieu, 4 Rue du Morvan, 54500, Vandoeuvre lès Nancy, France.
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Wei FF, Drummen NEA, Thijs L, Jacobs L, Herfs M, Van't Hoofd C, Vermeer C, Staessen JA. Vitamin-K-Dependent Protection of the Renal Microvasculature: Histopathological Studies in Normal and Diseased Kidneys. Pulse (Basel) 2016; 4:85-91. [PMID: 27752480 DOI: 10.1159/000448008] [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] [Subscribe] [Scholar Register] [Received: 05/13/2016] [Revised: 06/25/2016] [Indexed: 12/18/2022] Open
Abstract
Vitamin-K-dependent carboxylation of matrix Gla protein (MGP) protects the macrocirculation against calcification. We recently reported in a multiethnic population study that the estimated glomerular filtration rate, a microvascular trait, decreased and the risk of chronic kidney disease increased with higher circulating levels of inactive dephospho-uncarboxylated MGP, a marker of vitamin K deficiency. These findings highlighted the possibility that vitamin K might have a beneficial effect on the renal microcirculation. To substantiate these epidemiological findings, we undertook a pilot study, in which we stained renal tissue samples obtained by biopsy from 2 healthy kidney donors and 4 patients with nephropathy for carboxylated and uncarboxylated MGP and calcium deposits. Three patients had renal calcifications, which were consistently associated with carboxylated and uncarboxylated MGP. Normal renal tissue was devoid of microcalcifications and staining for carboxylated and uncarboxylated MGP. Pending confirmation in a larger study covering a wider range of renal pathologies, these histopathological findings suggest that MGP might inhibit calcification not only in large arteries, as was known before, but in renal tissue as well, thereby highlighting potentially new avenues for promoting renal health, for instance by vitamin K supplementation.
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Affiliation(s)
- Fang-Fei Wei
- Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium
| | - Nadja E A Drummen
- R & D Group VitaK, Maastricht University, Maastricht, The Netherlands
| | - Lutgarde Thijs
- Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium
| | - Lotte Jacobs
- Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium
| | - Marjolein Herfs
- R & D Group VitaK, Maastricht University, Maastricht, The Netherlands
| | | | - Cees Vermeer
- R & D Group VitaK, Maastricht University, Maastricht, The Netherlands
| | - Jan A Staessen
- Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium; R & D Group VitaK, Maastricht University, Maastricht, The Netherlands
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Ha D, Schlenz A, Jacobs L, Lehn K, Jensen R, Rivera N, Han S, Araujo A, Beristain-Barajas A, Kim K, Geronimo L, Wilkes M. Assessing contraceptive use in Nicaragua: a cross-sectional survey
comparing social attitudes, access, education, and modern contraceptive use
in women of reproductive age in rural and urban clinics. Ann Glob Health 2016. [DOI: 10.1016/j.aogh.2016.04.634] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Lehn K, Jensen R, Rivera N, Ha D, Schlenz A, Jacobs L, Soucy Z. Assessing point of care ultrasound in Nicaragua: A survey of utility,
access, training, and interest amongst health care providers in rural and
urban centers. Ann Glob Health 2016. [DOI: 10.1016/j.aogh.2016.04.303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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49
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Wei FF, Zhang ZY, Petit T, Cauwenberghs N, Gu YM, Thijs L, Raaijmakers A, Jacobs L, Yang WY, Allegaert K, Kuznetsova T, Verhamme P, Struijker-Boudier HAJ, Li Y, Asayama K, Staessen JA. Retinal microvascular diameter, a hypertension-related trait, in ECG-gated vs. non-gated images analyzed by IVAN and SIVA. Hypertens Res 2016; 39:886-892. [DOI: 10.1038/hr.2016.81] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2015] [Revised: 04/19/2016] [Accepted: 05/22/2016] [Indexed: 11/09/2022]
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Wei FF, Zhang ZY, Thijs L, Yang WY, Jacobs L, Cauwenberghs N, Gu YM, Kuznetsova T, Allegaert K, Verhamme P, Li Y, Struijker-Boudier HAJ, Staessen JA. Conventional and Ambulatory Blood Pressure as Predictors of Retinal Arteriolar Narrowing. Hypertension 2016; 68:511-20. [PMID: 27324224 PMCID: PMC4956676 DOI: 10.1161/hypertensionaha.116.07523] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [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: 03/14/2016] [Accepted: 05/22/2016] [Indexed: 01/07/2023]
Abstract
Supplemental Digital Content is available in the text. At variance with the long established paradigm that retinal arteriolar narrowing trails hypertension, several longitudinal studies, all based on conventional blood pressure (CBP) measurement, proposed that retinal arteriolar narrowing indicates heightened microvascular resistance and precedes hypertension. In 783 randomly recruited Flemish (mean age, 38.2 years; 51.3% women), we investigated to what extent CBP and daytime (10 am to 8 pm) ambulatory blood pressure (ABP) measured at baseline (1989–2008) predicted the central retinal arteriolar equivalent (CRAE) in retinal photographs obtained at follow-up (2008–2015). Systolic/diastolic hypertension thresholds were 140/90 mm Hg for CBP and 135/85 mm Hg for ABP. In multivariable-adjusted models including both baseline CBP and ABP, CRAE after 10.3 years (median) of follow-up was unrelated to CBP (P≥0.14), whereas ABP predicted CRAE narrowing (P≤0.011). Per 1-SD increment in systolic/diastolic blood pressure, the association sizes were −0.95 µm (95% confidence interval, −2.20 to 0.30)/−0.75 µm (−1.93 to 0.42) for CBP and −1.76 µm (−2.95 to −0.58)/−1.48 µm (−2.61 to −0.34) for ABP. Patients with ambulatory hypertension at baseline (17.0%) had smaller CRAE (146.5 versus 152.6 µm; P<0.001) at follow-up. CRAE was not different (P≥0.31) between true normotension (normal CBP and ABP; prevalence, 77.6%) and white-coat hypertension (elevated CBP and normal ABP, 5.4%) and between masked hypertension (normal CBP and elevated ABP, 10.2%) and hypertension (elevated CBP and ABP, 6.8%). In conclusion, the paradigm that retinal arteriolar narrowing precedes hypertension can be explained by the limitations of CBP measurement, including nonidentification of masked and white-coat hypertension.
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Affiliation(s)
- Fang-Fei Wei
- From the Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences (F.-F.W., Z.-Y.Z, L.T., W.-Y.Y, L.J., N.C., Y.-M.G., T.K., J.A.S.), Department of Development and Regeneration (K.A.), Centre for Molecular and Vascular Biology, KU Leuven Department of Cardiovascular Sciences (P.V.), University of Leuven, Leuven, Belgium; Center for Epidemiological Studies and Clinical Trials and Center for Vascular Evaluations, Shanghai Institute of Hypertension, Shanghai Key Laboratory of Hypertension, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China (Y.L.); and Department of Pharmacology (H.A.J.S.-B.) and R&D Group VitaK (J.A.S.), Maastricht University, Maastricht, The Netherlands
| | - Zhen-Yu Zhang
- From the Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences (F.-F.W., Z.-Y.Z, L.T., W.-Y.Y, L.J., N.C., Y.-M.G., T.K., J.A.S.), Department of Development and Regeneration (K.A.), Centre for Molecular and Vascular Biology, KU Leuven Department of Cardiovascular Sciences (P.V.), University of Leuven, Leuven, Belgium; Center for Epidemiological Studies and Clinical Trials and Center for Vascular Evaluations, Shanghai Institute of Hypertension, Shanghai Key Laboratory of Hypertension, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China (Y.L.); and Department of Pharmacology (H.A.J.S.-B.) and R&D Group VitaK (J.A.S.), Maastricht University, Maastricht, The Netherlands
| | - Lutgarde Thijs
- From the Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences (F.-F.W., Z.-Y.Z, L.T., W.-Y.Y, L.J., N.C., Y.-M.G., T.K., J.A.S.), Department of Development and Regeneration (K.A.), Centre for Molecular and Vascular Biology, KU Leuven Department of Cardiovascular Sciences (P.V.), University of Leuven, Leuven, Belgium; Center for Epidemiological Studies and Clinical Trials and Center for Vascular Evaluations, Shanghai Institute of Hypertension, Shanghai Key Laboratory of Hypertension, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China (Y.L.); and Department of Pharmacology (H.A.J.S.-B.) and R&D Group VitaK (J.A.S.), Maastricht University, Maastricht, The Netherlands
| | - Wen-Yi Yang
- From the Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences (F.-F.W., Z.-Y.Z, L.T., W.-Y.Y, L.J., N.C., Y.-M.G., T.K., J.A.S.), Department of Development and Regeneration (K.A.), Centre for Molecular and Vascular Biology, KU Leuven Department of Cardiovascular Sciences (P.V.), University of Leuven, Leuven, Belgium; Center for Epidemiological Studies and Clinical Trials and Center for Vascular Evaluations, Shanghai Institute of Hypertension, Shanghai Key Laboratory of Hypertension, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China (Y.L.); and Department of Pharmacology (H.A.J.S.-B.) and R&D Group VitaK (J.A.S.), Maastricht University, Maastricht, The Netherlands
| | - Lotte Jacobs
- From the Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences (F.-F.W., Z.-Y.Z, L.T., W.-Y.Y, L.J., N.C., Y.-M.G., T.K., J.A.S.), Department of Development and Regeneration (K.A.), Centre for Molecular and Vascular Biology, KU Leuven Department of Cardiovascular Sciences (P.V.), University of Leuven, Leuven, Belgium; Center for Epidemiological Studies and Clinical Trials and Center for Vascular Evaluations, Shanghai Institute of Hypertension, Shanghai Key Laboratory of Hypertension, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China (Y.L.); and Department of Pharmacology (H.A.J.S.-B.) and R&D Group VitaK (J.A.S.), Maastricht University, Maastricht, The Netherlands
| | - Nicholas Cauwenberghs
- From the Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences (F.-F.W., Z.-Y.Z, L.T., W.-Y.Y, L.J., N.C., Y.-M.G., T.K., J.A.S.), Department of Development and Regeneration (K.A.), Centre for Molecular and Vascular Biology, KU Leuven Department of Cardiovascular Sciences (P.V.), University of Leuven, Leuven, Belgium; Center for Epidemiological Studies and Clinical Trials and Center for Vascular Evaluations, Shanghai Institute of Hypertension, Shanghai Key Laboratory of Hypertension, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China (Y.L.); and Department of Pharmacology (H.A.J.S.-B.) and R&D Group VitaK (J.A.S.), Maastricht University, Maastricht, The Netherlands
| | - Yu-Mei Gu
- From the Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences (F.-F.W., Z.-Y.Z, L.T., W.-Y.Y, L.J., N.C., Y.-M.G., T.K., J.A.S.), Department of Development and Regeneration (K.A.), Centre for Molecular and Vascular Biology, KU Leuven Department of Cardiovascular Sciences (P.V.), University of Leuven, Leuven, Belgium; Center for Epidemiological Studies and Clinical Trials and Center for Vascular Evaluations, Shanghai Institute of Hypertension, Shanghai Key Laboratory of Hypertension, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China (Y.L.); and Department of Pharmacology (H.A.J.S.-B.) and R&D Group VitaK (J.A.S.), Maastricht University, Maastricht, The Netherlands
| | - Tatiana Kuznetsova
- From the Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences (F.-F.W., Z.-Y.Z, L.T., W.-Y.Y, L.J., N.C., Y.-M.G., T.K., J.A.S.), Department of Development and Regeneration (K.A.), Centre for Molecular and Vascular Biology, KU Leuven Department of Cardiovascular Sciences (P.V.), University of Leuven, Leuven, Belgium; Center for Epidemiological Studies and Clinical Trials and Center for Vascular Evaluations, Shanghai Institute of Hypertension, Shanghai Key Laboratory of Hypertension, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China (Y.L.); and Department of Pharmacology (H.A.J.S.-B.) and R&D Group VitaK (J.A.S.), Maastricht University, Maastricht, The Netherlands
| | - Karel Allegaert
- From the Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences (F.-F.W., Z.-Y.Z, L.T., W.-Y.Y, L.J., N.C., Y.-M.G., T.K., J.A.S.), Department of Development and Regeneration (K.A.), Centre for Molecular and Vascular Biology, KU Leuven Department of Cardiovascular Sciences (P.V.), University of Leuven, Leuven, Belgium; Center for Epidemiological Studies and Clinical Trials and Center for Vascular Evaluations, Shanghai Institute of Hypertension, Shanghai Key Laboratory of Hypertension, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China (Y.L.); and Department of Pharmacology (H.A.J.S.-B.) and R&D Group VitaK (J.A.S.), Maastricht University, Maastricht, The Netherlands
| | - Peter Verhamme
- From the Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences (F.-F.W., Z.-Y.Z, L.T., W.-Y.Y, L.J., N.C., Y.-M.G., T.K., J.A.S.), Department of Development and Regeneration (K.A.), Centre for Molecular and Vascular Biology, KU Leuven Department of Cardiovascular Sciences (P.V.), University of Leuven, Leuven, Belgium; Center for Epidemiological Studies and Clinical Trials and Center for Vascular Evaluations, Shanghai Institute of Hypertension, Shanghai Key Laboratory of Hypertension, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China (Y.L.); and Department of Pharmacology (H.A.J.S.-B.) and R&D Group VitaK (J.A.S.), Maastricht University, Maastricht, The Netherlands
| | - Yan Li
- From the Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences (F.-F.W., Z.-Y.Z, L.T., W.-Y.Y, L.J., N.C., Y.-M.G., T.K., J.A.S.), Department of Development and Regeneration (K.A.), Centre for Molecular and Vascular Biology, KU Leuven Department of Cardiovascular Sciences (P.V.), University of Leuven, Leuven, Belgium; Center for Epidemiological Studies and Clinical Trials and Center for Vascular Evaluations, Shanghai Institute of Hypertension, Shanghai Key Laboratory of Hypertension, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China (Y.L.); and Department of Pharmacology (H.A.J.S.-B.) and R&D Group VitaK (J.A.S.), Maastricht University, Maastricht, The Netherlands
| | - Harry A J Struijker-Boudier
- From the Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences (F.-F.W., Z.-Y.Z, L.T., W.-Y.Y, L.J., N.C., Y.-M.G., T.K., J.A.S.), Department of Development and Regeneration (K.A.), Centre for Molecular and Vascular Biology, KU Leuven Department of Cardiovascular Sciences (P.V.), University of Leuven, Leuven, Belgium; Center for Epidemiological Studies and Clinical Trials and Center for Vascular Evaluations, Shanghai Institute of Hypertension, Shanghai Key Laboratory of Hypertension, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China (Y.L.); and Department of Pharmacology (H.A.J.S.-B.) and R&D Group VitaK (J.A.S.), Maastricht University, Maastricht, The Netherlands
| | - Jan A Staessen
- From the Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences (F.-F.W., Z.-Y.Z, L.T., W.-Y.Y, L.J., N.C., Y.-M.G., T.K., J.A.S.), Department of Development and Regeneration (K.A.), Centre for Molecular and Vascular Biology, KU Leuven Department of Cardiovascular Sciences (P.V.), University of Leuven, Leuven, Belgium; Center for Epidemiological Studies and Clinical Trials and Center for Vascular Evaluations, Shanghai Institute of Hypertension, Shanghai Key Laboratory of Hypertension, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China (Y.L.); and Department of Pharmacology (H.A.J.S.-B.) and R&D Group VitaK (J.A.S.), Maastricht University, Maastricht, The Netherlands.
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