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Szczepkowska A, Adjahou S, Papastefanou I, De Pauli M, Nicolaides KH, Charakida M. Maternal vascular indices at 36 weeks' gestation in small and growth restricted fetuses. Ultrasound Obstet Gynecol 2024. [PMID: 38708442 DOI: 10.1002/uog.27678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/27/2024] [Revised: 04/22/2024] [Accepted: 04/23/2024] [Indexed: 05/07/2024]
Abstract
OBJECTIVE To compare maternal vascular indices and hemodynamic parameters at 35-37 weeks' gestation, in pregnancies complicated by small for gestational age (SGA) fetuses and those with fetal growth restriction (FGR). METHODS This was a prospective observational non-intervention study in women with singleton pregnancies attending for a routine hospital visit at 35+0 to 36+6 weeks' gestation. The visit included recording of maternal demographic characteristics and medical history, vascular indices and hemodynamic parameters obtained by a non-invasive operator independent device, including pulse wave velocity, augmention index, cardiac output, stroke volume, central systolic and diastolic blood pressure, total peripheral resistance and fetal heart rate. Hypertensive disorders of pregnancy were excluded and the values in the SGA and FGR groups were compared between them and with unaffected pregnancies. Diagnosis of SGA was based on the birth of a baby with birthweight below the 10th percentile for gestational age. In FGR, in addition to a birthweight below the 10th percentile, at the 35-37 weeks scan Doppler studies had shown that the uterine artery or umbilical artery pulsatility index (PI) was above the 95th percentile for gestational age or the fetal middle cerebral artery PI was below the 5th percentile. RESULTS In the 6,413 women included in the study there were 605 (9.4%) cases of SGA, 133 (2.1%) of FGR and 5,675 (88.5%) unaffected by SGA or FGR. Women with SGA or FGR, compared to unaffected pregnancies, had increased peripheral vascular resistance and reduced cardiac output. Central systolic and diastolic blood pressure were also increased, whereas aortic stiffness assessed by pulse wave velocity and augmentation index did not differ between affected and unaffected pregnancies. In the FGR, compared to the SGA group, central systolic and diastolic blood pressure were higher, whereas, heart rate was lower. CONCLUSIONS In SGA and FGR pregnancies there are deranged maternal hemodynamic responses when these are compared to normal pregnancies. Mothers with FGR babies have higher central blood pressure compared to SGA ones, but it remains unclear whether these differences are driven by the size of the fetus or pathological fetal growth. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- A Szczepkowska
- Harris Birthright Research Centre for Fetal Medicine, King's College, London, UK
| | - S Adjahou
- Harris Birthright Research Centre for Fetal Medicine, King's College, London, UK
| | - I Papastefanou
- Department of Women and Children's Health, School of Life Course and Population Sciences, Faculty of Life Sciences & Medicine, King's College London, London, UK
| | - M De Pauli
- Harris Birthright Research Centre for Fetal Medicine, King's College, London, UK
| | - K H Nicolaides
- Harris Birthright Research Centre for Fetal Medicine, King's College, London, UK
| | - M Charakida
- Harris Birthright Research Centre for Fetal Medicine, King's College, London, UK
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, UK
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Pilt K, Reiu A. Effect of transmural pressure on the estimation of arterial stiffness index from the photoplethysmographic waveform. Med Biol Eng Comput 2024; 62:1049-1059. [PMID: 38123887 DOI: 10.1007/s11517-023-02992-y] [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: 01/04/2022] [Accepted: 12/07/2023] [Indexed: 12/23/2023]
Abstract
The aim of this study was to find the effect of transmural pressure on the determination of the photoplethysmographic (PPG) waveform arterial stiffness index (PPGAI). The study was conducted on 51 subjects without diagnosis of cardiovascular disease, aged between 24 and 74 years. The relation between the transmural pressure, which is the difference between the arterial blood pressure and the PPG sensor contact pressure, and the PPGAI was determined. PPG, beat-to-beat blood pressure, and sensor contact pressure signals were recorded from the index, middle, and ring finger. The PPG sensor contact pressure of the index finger was increased from 20 to 120 mmHg. The aortic augmentation index (AIx@75) was estimated with a SphygmoCor device as a reference. High correlation coefficients r = 0.79 and r = 0.83 between PPGAI and AIx@75, and low PPGAI standard deviations were observed at the transmural pressures of 10 and 20 mmHg, respectively. Transmural pressure of 20 mmHg can be considered suitable for the PPG signal registration and PPGAI calculation for the assessment of arterial stiffness. In summary, the contact pressure of the sensor should be selected according to theblood pressure of the subject finger in order to achieve the transmural pressure suitable for the assessment of PPGAI and arterial stiffness.
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Affiliation(s)
- Kristjan Pilt
- Department of Health Technologies, Tallinn University of Technology, Ehitajate Tee 5, 19086, Tallinn, Estonia.
| | - Andy Reiu
- Department of Health Technologies, Tallinn University of Technology, Ehitajate Tee 5, 19086, Tallinn, Estonia
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Landers-Ramos RQ, Dondero K, Imery I, Reveille N, Zabriskie HA, Dobrosielski DA. Influence of cardiorespiratory fitness and body composition on resting and post-exercise indices of vascular health in young adults. Sports Med Health Sci 2024; 6:54-62. [PMID: 38463670 PMCID: PMC10918352 DOI: 10.1016/j.smhs.2023.11.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Revised: 10/26/2023] [Accepted: 11/13/2023] [Indexed: 03/12/2024] Open
Abstract
Poor cardiorespiratory fitness may mediate vascular impairments at rest and following an acute bout of exercise in young healthy individuals. This study aimed to compare flow mediated dilation (FMD) and vascular augmentation index (AIx75) between young adults with low, moderate, and high levels of cardiorespiratory fitness before and after an acute bout of aerobic exercise. Forty-three participants (22 men; 21 women) between 18 and 29 years of age completed the study. Participants were classified into low, moderate, and high health-related cardiorespiratory fitness groups according to age- and sex-based relative maximal oxygen consumption (V ˙ O2 max) percentile rankings. FMD was performed using Doppler ultrasound and AIx75 was performed using pulse wave analysis at baseline and 60-min after a 30-min bout of treadmill running at 70% V ˙ O2 max. A significant interaction (p = 0.047; ηp2 = 0.142) was observed, with the moderate fitness group exhibiting a higher FMD post-exercise compared with baseline ([6.7% ± 3.1%] vs. [8.5% ± 2.8%], p = 0.028; d = 0.598). We found a significant main effect of group for AIx75 (p = 0.023; ηp2 = 0.168), with the high fitness group exhibiting lower AIx75 compared to low fitness group ([-10% ± 10%] vs. [2% ± 10%], respectively, p = 0.019; g = 1.07). This was eliminated after covarying for body fat percentage (p = 0.489). Our findings suggest that resting FMD and AIx75 responses are not significantly influenced by cardiorespiratory fitness, but FMD recovery responses to exercise may be enhanced in individuals with moderate cardiorespiratory fitness levels.
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Affiliation(s)
| | - Kathleen Dondero
- Towson University, Department of Kinesiology, Towson, MD, USA
- University of Maryland School of Medicine, Department of Physical Therapy and Rehabilitation Sciences, Baltimore, MD, USA
| | - Ian Imery
- Johns Hopkins University, Department of Cell Biology, Baltimore, MD, USA
- University of Florida, Department of Applied Physiology and Kinesiology, Gainesville, FL, USA
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Kasap Demir B, Soyaltın E, Alparslan C, Demircan T, Arslansoyu Çamlar S, Alaygut D, Mutlubaş F, Öncel EP, Yavaşcan Ö, Dündar BN, Karadeniz C. Blood pressure parameters affecting ventricular repolarization in obese children. Pediatr Nephrol 2023; 38:3359-3367. [PMID: 37140711 DOI: 10.1007/s00467-023-05971-5] [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: 01/26/2023] [Revised: 03/29/2023] [Accepted: 03/29/2023] [Indexed: 05/05/2023]
Abstract
BACKGROUND Ventricular repolarization (VR) increases the risk of sudden cardiac death due to ventricular arrhythmia. We aimed to evaluate the blood pressure (BP) parameters affecting VR in obese children. METHODS Obese (BMI ≥ 95p) and healthy children ≥ 120 cm between January 2017 and June 2019 were included. Demographic and laboratory data, peripheral and central BPs evaluated by a device capable of ambulatory blood pressure monitoring (ABPM), and pulse wave analysis were assessed. Electrocardiographic ventricular repolarization indices, left ventricular mass index (LVMI), and relative wall thickness (RWT) were calculated. RESULTS A total of 52 obese and 41 control patients were included. Uric acid, triglyceride, total cholesterol, LDL, and ALT values, systolic and diastolic office BPs, 24-h, daytime and nighttime systolic and mean arterial BPs, daytime diastolic BP SDS levels, daytime and nighttime systolic loads, daytime diastolic load, 24-h, daytime and nighttime central systolic and diastolic BPs, and pulse wave velocity values were significantly higher, whereas 24-h, daytime and nighttime AIx@75 were similar between the groups. fT4 levels of obese cases were significantly lower. QTcd and Tp-ed were higher in obese patients. Although RWT was higher in obese cases, LVMI values and cardiac geometry classifications were similar. The independent factors affecting VR in obese cases were younger age and higher diastolic load at night (B = - 2.83, p = 0.010; B = 0.257, p = 0.007, respectively). CONCLUSION Obese patients have higher peripheral and central BP, arterial stiffness, and higher VR indices that develop before an increase in LVMI. It would be useful to prevent obesity from an early age and follow up nighttime diastolic load to control VR associated sudden cardiac death in obese children. A higher resolution version of the Graphical abstract is available as Supplementary information.
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Affiliation(s)
- Belde Kasap Demir
- Department of Pediatrics, Division of Nephrology, Izmir Katip Çelebi University, Izmir, Turkey.
- Department of Pediatrics, Division of Nephrology, University of Health Sciences Izmir Tepecik Training and Research Hospital, Izmir, Turkey.
| | - Eren Soyaltın
- Department of Pediatrics, Division of Nephrology, Izmir Katip Çelebi University, Izmir, Turkey
- Department of Pediatrics, Division of Nephrology, University of Health Sciences Izmir Tepecik Training and Research Hospital, Izmir, Turkey
| | - Caner Alparslan
- Department of Pediatrics, Division of Nephrology, Izmir Democracy University Buca Seyfi Demirsoy Training and Research Hospital, Izmir, Turkey
| | - Tülay Demircan
- Department of Pediatrics, Division of Cardiology, University of Health Sciences Izmir Tepecik Training and Research Hospital, Izmir, Turkey
| | - Seçil Arslansoyu Çamlar
- Department of Pediatrics, Division of Nephrology, University of Health Sciences Izmir Tepecik Training and Research Hospital, Izmir, Turkey
- Department of Pediatrics, Division of Nephrology, University of Health Sciences Izmir Medical Faculty, Izmir, Turkey
| | - Demet Alaygut
- Department of Pediatrics, Division of Nephrology, University of Health Sciences Izmir Tepecik Training and Research Hospital, Izmir, Turkey
- Department of Pediatrics, Division of Nephrology, University of Health Sciences Izmir Medical Faculty, Izmir, Turkey
| | - Fatma Mutlubaş
- Department of Pediatrics, Division of Nephrology, University of Health Sciences Izmir Tepecik Training and Research Hospital, Izmir, Turkey
- Department of Pediatrics, Division of Nephrology, University of Health Sciences Izmir Medical Faculty, Izmir, Turkey
| | - Elif Perihan Öncel
- Department of Pediatrics, Division of Neurology, Başkent University, Ankara, Turkey
| | - Önder Yavaşcan
- Department of Pediatrics, Division of Nephrology, Istanbul Medipol University, Istanbul, Turkey
| | - Bumin Nuri Dündar
- Department of Pediatrics, Division of Endocrinology, İzmir Katip Çelebi University, İzmir, Turkey
- Department of Pediatrics, Division of Endocrinology, University of Health Sciences Izmir Tepecik Training and Research Hospital, Izmir, Turkey
| | - Cem Karadeniz
- Department of Pediatrics, Division of Cardiology, University of Health Sciences Izmir Tepecik Training and Research Hospital, Izmir, Turkey
- Department of Pediatrics, Division of Cardiology, Izmir Katip Çelebi University, İzmir, Turkey
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Eikås JG, Gerdts E, Halland H, Midtbø H, Cramariuc D, Kringeland E. Arterial Stiffness in Overweight and Obesity: Association with Sex, Age, and Blood Pressure. High Blood Press Cardiovasc Prev 2023; 30:435-443. [PMID: 37505440 PMCID: PMC10600283 DOI: 10.1007/s40292-023-00593-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Accepted: 07/12/2023] [Indexed: 07/29/2023] Open
Abstract
INTRODUCTION Obesity has been associated with increased arterial stiffness. Sex-differences in arterial stiffness in obesity have been less explored. AIM To explore sex-differences in arterial stiffness by applanation tonometry in 323 women and 225 with overweight and obesity, free of cardiovascular disease. METHODS Covariables of arterial stiffness were identified in multivariable linear regression analyses in the total cohort and separately in women and men. RESULTS In the total study cohort, women had higher augmentation pressure (AP) and augmentation index (AIx), and lower carotid-femoral pulse wave velocity (cf-PWV) than men, independent of confounders (all p < 0.001). In sex-specific analyses, higher AP was associated with higher age and 24-hours systolic blood pressure (BP), and with lower heart rate in women (all p < 0.001), and with higher age and BP in men (all p < 0.001). Similarly, higher AIx was associated with higher age and BP, and lower body mass index (BMI) and heart rate in women (all p < 0.05), and with higher age in men (all p < 0.001). Higher cf-PWV correlated with higher age and BP in women (all p < 0.005), and additionally with higher heart rate and non-smoking in men (all p < 0.05). When replacing BMI with waist-hip ratio, higher waist-hip ratio was associated with higher cf-PWV in men only (p < 0.05). CONCLUSIONS Among subjects with overweight and obesity, AP and AIx were higher in women, and cf-PWV was higher in men. Age and 24-hours systolic BP were the main factors associated with arterial stiffness in both sexes, while measures of adiposity had little impact on arterial stiffness.
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Affiliation(s)
- John G Eikås
- Department of Clinical Science, University of Bergen, P.O. Box 7804, 5020, Bergen, Norway.
| | - Eva Gerdts
- Department of Clinical Science, University of Bergen, P.O. Box 7804, 5020, Bergen, Norway
- Department of Heart Disease, Haukeland University Hospital, Bergen, Norway
| | - Hilde Halland
- Department of Clinical Science, University of Bergen, P.O. Box 7804, 5020, Bergen, Norway
- Emergency Care Clinic, Haukeland University Hospital, Bergen, Norway
| | - Helga Midtbø
- Department of Clinical Science, University of Bergen, P.O. Box 7804, 5020, Bergen, Norway
- Department of Heart Disease, Haukeland University Hospital, Bergen, Norway
| | - Dana Cramariuc
- Department of Clinical Science, University of Bergen, P.O. Box 7804, 5020, Bergen, Norway
- Department of Heart Disease, Haukeland University Hospital, Bergen, Norway
| | - Ester Kringeland
- Department of Heart Disease, Haukeland University Hospital, Bergen, Norway
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Chen D, Jenkins AJ, Greenlaw N, Dudman K, Fernandes T, Carty DM, Hughes AD, Januszewski AS, Stehouwer CDA, Petrie JR. Cardiometabolic risk factors, peripheral arterial tonometry and metformin in adults with type 1 diabetes participating in the REducing with MetfOrmin Vascular Adverse Lesions trial. Diab Vasc Dis Res 2023; 20:14791641231183634. [PMID: 37387358 DOI: 10.1177/14791641231183634] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/01/2023] Open
Abstract
BACKGROUND Peripheral arterial tonometry (PAT) provides non-invasive measures of vascular health. Beneficial effects of metformin on vascular function have been reported in youth with type 1 diabetes (T1D). In the REducing with MetfOrmin Vascular Adverse Lesions (REMOVAL) trial in adults with T1D and high cardiovascular risk, we examined: (i) the extent to which routinely-measured cardiometabolic risk factors explain variance in baseline PAT; and (ii) the effects of metformin on PAT measures. METHODS Cross-sectional univariable and multivariable analyses of baseline reactive hyperaemia index (RHI) and augmentation index (AI) (EndoPAT® (Itamar, Israel); and analysis of 36-months metformin versus placebo on vascular tonometry. RESULTS In 364 adults ((mean ± SD) age 55.2 ± 8.5 years, T1D 34.0 ± 10.6 years, HbA1c 64.5 ± 9.0 mmol/mol (8.1 ± 0.8%)), RHI was 2.26 ± 0.74 and AI was 15.9 ± 19.2%. In an exhaustive search, independent associates of (i) RHI were smoking, waist circumference, systolic blood pressure and vitamin B12 (adjusted R2 = 0.11) and (ii) AI were male sex, pulse pressure, heart rate and waist circumference (adjusted R2 = 0.31). Metformin did not significantly affect RHI or AI. CONCLUSION Cardiometabolic risk factors explained only a modest proportion of variance in PAT measures of vascular health in adults with T1D and high cardiovascular risk. PAT measures were not affected by metformin.
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Affiliation(s)
- David Chen
- National Health and Medical Research Council Clinical Trials Centre, University of Sydney, Sydney, NSW, Australia
- Monash School of Medicine, Monash University, Melbourne, VIC, Australia
| | - Alicia J Jenkins
- National Health and Medical Research Council Clinical Trials Centre, University of Sydney, Sydney, NSW, Australia
| | - Nicola Greenlaw
- Robertson Centre for Biostatistics, School of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Katie Dudman
- Robertson Centre for Biostatistics, School of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Tamsin Fernandes
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK
| | - David M Carty
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK
| | - Alun D Hughes
- Institute of Cardiovascular Science, University College London, London, UK
| | - Andrzej S Januszewski
- National Health and Medical Research Council Clinical Trials Centre, University of Sydney, Sydney, NSW, Australia
| | - Coen DA Stehouwer
- Department of Internal Medicine and Cardiovascular Research Institute Maastricht, Maastricht University Medical Centre, Maastricht, Netherlands
| | - John R Petrie
- Robertson Centre for Biostatistics, School of Health and Wellbeing, University of Glasgow, Glasgow, UK
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Tai YL, Marupudi S, Figueroa GA, Russell RD. Hemodynamics and Arterial Stiffness in Response to Oral Glucose Loading in Individuals with Type II Diabetes and Controlled Hypertension. High Blood Press Cardiovasc Prev 2023; 30:175-181. [PMID: 36913100 DOI: 10.1007/s40292-023-00569-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Accepted: 02/21/2023] [Indexed: 03/14/2023] Open
Abstract
INTRODUCTION Type 2 diabetes (T2D), the fastest growing pandemic, is typically accompanied by vascular complications. A central hallmark of both T2D and vascular disease is insulin resistance which causes impaired glucose transport and vasoconstriction concomitantly. Those with cardiometabolic disease display greater variation in central hemodynamics and arterial elasticity, both potent predictors of cardiovascular morbidity and mortality, which may be exacerbated by concomitant hyperglycemia and hyperinsulinemia during glucose testing. Thus, elucidating central and arterial responses to glucose testing in those with T2D may identify acute vascular pathophysiologies triggered by oral glucose loading. AIM This study compared hemodynamics and arterial stiffness to an oral glucose challenge (OGC: 50g glucose) between individuals with and without T2D. 21 healthy (48 ± 10 years) and 20 participants with clinically diagnosed T2D and controlled hypertension (52 ± 8 years) were tested. METHODS Hemodynamics and arterial compliance were assessed at baseline, and 10, 20, 30, 40, 50, and 60 min post-OGC. RESULTS Heart rate increased between 20 and 60 post-OGC in both groups (p < 0.05). Central systolic blood pressure (SBP) decreased in the T2D group between 10 and 50 min post-OGC while central diastolic blood pressure (DBP) decreased in both groups from 20 to 60 post-OGC. Central SBP decreased in T2D between 10 and 50 min post-OGC and central DBP decreased in both groups between 20 and 60 min post-OGC. Brachial SBP decreased between 10 and 50 min in healthy participants, whereas both groups displayed decreases in brachial DBP between 20 and 60 min post-OGC. Arterial stiffness was unaffected. CONCLUSIONS An OGC alters central and peripheral blood pressure in healthy and T2D participants similarly with no changes in arterial stiffness.
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Affiliation(s)
- Yu Lun Tai
- Department of Health and Human Performance, College of Health Professions, University of Texas Rio Grande Valley, Brownsville, TX, USA
| | - Smaran Marupudi
- Department of Health and Human Performance, College of Health Professions, University of Texas Rio Grande Valley, Brownsville, TX, USA
| | - Gabriel A Figueroa
- Department of Health and Human Performance, College of Health Professions, University of Texas Rio Grande Valley, Brownsville, TX, USA
| | - Ryan D Russell
- Department of Health and Human Performance, College of Health Professions, University of Texas Rio Grande Valley, Brownsville, TX, USA.
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Tynjälä A, Harjutsalo V, Jansson Sigfrids F, Groop PH, Gordin D. Higher HbA 1c variability is associated with increased arterial stiffness in individuals with type 1 diabetes. Cardiovasc Diabetol 2023; 22:47. [PMID: 36871019 PMCID: PMC9985852 DOI: 10.1186/s12933-023-01770-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Accepted: 02/13/2023] [Indexed: 03/06/2023] Open
Abstract
BACKGROUND Both long-term glycaemic variability and arterial stiffness have been recognized as cardiovascular risk factors. This study aims to investigate whether an association between these phenomena exists in individuals with type 1 diabetes. METHODS This cross-sectional study included 673 adults (305 men, 368 women) with type 1 diabetes and combined available retrospective laboratory data on HbA1c from the preceding 10 years with outcome data on arterial stiffness and clinical variables from a comprehensive study visit. HbA1c variability was calculated as adjusted standard deviation (adj-HbA1c-SD), coefficient of variation (HbA1c-CV) and average real variability (HbA1c-ARV). As measures of arterial stiffness, carotid-femoral pulse wave velocity (cfPWV; n = 335) and augmentation index (AIx; n = 653) were assessed using applanation tonometry. RESULTS The study population had a mean age of 47.1 (± 12.0) years and a median duration of diabetes of 31.2 (21.2-41.3) years. The median number of HbA1c assessments per individual was 17 (12-26). All three indices of HbA1c variability were significantly correlated with both cfPWV and AIx after adjustment for sex and age (p < 0.001). In separate multivariable linear regression models, adj-HbA1c-SD and HbA1c-CV were significantly associated with cfPWV (p = 0.032 and p = 0.046, respectively) and AIx (p = 0.028 and p = 0.049, respectively), even after adjustment for HbA1c-mean. HbA1c-ARV was not associated with cfPWV or AIx in the fully adjusted models. CONCLUSIONS An association independent of HbA1c-mean was found between HbA1c variability and arterial stiffness, suggesting a need to consider multiple HbA1c metrics in studies assessing cardiovascular risk in type 1 diabetes. Longitudinal and interventional studies are needed to confirm any causal relationship and to find strategies for reducing long-term glycaemic variability.
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Affiliation(s)
- Anniina Tynjälä
- Folkhälsan Institute of Genetics, Folkhälsan Research Center, Helsinki, Finland.,Department of Nephrology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.,Research Program for Clinical and Molecular Metabolism, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Valma Harjutsalo
- Folkhälsan Institute of Genetics, Folkhälsan Research Center, Helsinki, Finland.,Department of Nephrology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.,Research Program for Clinical and Molecular Metabolism, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Fanny Jansson Sigfrids
- Folkhälsan Institute of Genetics, Folkhälsan Research Center, Helsinki, Finland.,Department of Nephrology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.,Research Program for Clinical and Molecular Metabolism, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Per-Henrik Groop
- Folkhälsan Institute of Genetics, Folkhälsan Research Center, Helsinki, Finland. .,Department of Nephrology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland. .,Research Program for Clinical and Molecular Metabolism, Faculty of Medicine, University of Helsinki, Helsinki, Finland. .,Department of Diabetes, Central Clinical School, Monash University, Melbourne, Australia.
| | - Daniel Gordin
- Department of Nephrology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.,Minerva Foundation Institute for Medical Research, Helsinki, Finland.,Joslin Diabetes Center, Harvard Medical School, Boston, MA, USA
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Zheng P, Pilutti LA, DuBose NG, Motl RW. Vascular function and cognition in persons with multiple sclerosis: Preliminary examination. Mult Scler Relat Disord 2023; 71:104578. [PMID: 36805173 DOI: 10.1016/j.msard.2023.104578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 01/25/2023] [Accepted: 02/13/2023] [Indexed: 02/17/2023]
Abstract
BACKGROUND Cognitive dysfunction is one of the most common consequences of multiple sclerosis (MS). Recent studies have noted a high incidence of vascular comorbidity that might be associated with cognitive decline among persons with MS. However, there is a lack of evidence on vascular biomarkers (e.g., arterial stiffness indices) that are associated with cognition in MS. The current study characterized differences in vascular function between persons with MS and healthy controls, and examined the association between vascular and cognitive function in persons with MS compared with healthy controls. RESULTS The MS group had significantly worse cognitive performance and higher cfPWV than healthy controls. There were significant bivariate correlations between the Symbol Digit Modalities Test (SDMT) score with AIx75 (rs = -0.45) and cfPWV (rs = 0.30) in the MS sample, but not in healthy controls. Regression analyses further indicated a nonlinear association between cfPWV and the SDMT in the MS sample (p-values for β coefficients < 0.05; adjusted R2 = 0.10). No significant associations were observed among other cognitive and vascular outcomes. CONCLUSION Our findings suggest significant associations between arterial stiffness and cognitive processing speed in MS. This preliminary examination provides initial, cross-sectional support for future population-based research on cognitive and vascular function in persons with MS. Such results may be clinically important for developing interventions that focus on regulating vascular dysfunction as an early treatment for preventing cognitive impairment in the MS population.
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Affiliation(s)
- Peixuan Zheng
- Department of Kinesiology and Nutrition, University of Illinois Chicago, Chicago, IL, United States.
| | - Lara A Pilutti
- Interdisciplinary School of Health Science, University of Ottawa, Ottawa, Ontario, Canada; Brain and Mind Research Institute, University of Ottawa, Ottawa, Ontario, Canada
| | - Noah G DuBose
- Department of Kinesiology and Nutrition, University of Illinois Chicago, Chicago, IL, United States
| | - Robert W Motl
- Department of Kinesiology and Nutrition, University of Illinois Chicago, Chicago, IL, United States
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Pivac VT, Herceg-Čavrak V, Hojsak I, Mišak Z, Jadrešin O, Kolaček S. Children with inflammatory bowel disease already have an altered arterial pulse wave. Eur J Pediatr 2023; 182:1771-1779. [PMID: 36763192 DOI: 10.1007/s00431-023-04858-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2022] [Revised: 01/20/2023] [Accepted: 02/02/2023] [Indexed: 02/11/2023]
Abstract
Adults with inflammatory bowel disease (IBD) have an increased risk for vascular events. This study aims to evaluate arterial parameters in paediatric IBD. Carotid intima-media thickness (CIMT) was measured by ultrasound, and Arteriograph was used to assess aortic pulse wave velocity (PWVao), brachial and aortic augmentation indexes (AixBrach, AixAo), central systolic blood pressure (SBPao), and heart rate (HR). A total of 161 children were included; 55 (34%) children with newly diagnosed IBD (median age 14.35 (11.88-16.31) years, 53% males), 53(33%) in remission (median age 15.62 (13.46-16.70) years, 66% males), and 53 (33%) controls (median age 14.09 (11.18-14.09) years, 55% males) were recruited into a case-control study. Compared to controls, patients with active disease and those in clinical remission had significantly lower AixBrach and AixAo (P < 0.001, P = 0.009; P < 0.001, P = 0.003). PWVao and CIMT were still normal. HR was higher in both IBD groups than in controls (P < 0.001; P = 0.006). HR positively correlated with disease duration (P = 0.001). In the ordinary least squares regression models, anti-tumour necrosis factor (TNF) α treatment predicted lower peripheral and central systolic blood pressures, in contrast to aminosalicylates and methotrexate. Aminosalicylate treatment predicted increased HR. Conclusion: Children with IBD have an increased heart rate, a lower augmentation index and, therefore, an altered pulse waveform. In paediatric IBD, arterial stiffness and CIMT are still normal, indicating the potential for adequate IBD treatment to preserve arterial health. What is Known: • Adult patients with inflammatory bowel disease (IBD) have increased carotid intima-media thickness and arterial stiffness, which positively correlates with cardiovascular risk and predicts mortality. Adequate treatment, especially anti-tumour necrosis factor (TNF) α medications, lower these risks. • Children with IBD have impaired endothelial function and reduced heart rate (HR) variability. What is New: • Children with IBD have impaired endothelial function and reduced heart rate (HR) variability. • Anti-TNFα treatment in children and adolescents with IBD lowers systolic pressure, whereas methotrexate and aminosalicylates have the opposite effect. Amiynosalyiciylate treatment also increases HR.
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Affiliation(s)
| | - Vesna Herceg-Čavrak
- Children's Hospital Zagreb, Klaićeva 16, Zagreb, Croatia.,Libertas International University, Trg John F Kennedy, Zagreb, Croatia
| | - Iva Hojsak
- Children's Hospital Zagreb, Klaićeva 16, Zagreb, Croatia
| | - Zrinjka Mišak
- Children's Hospital Zagreb, Klaićeva 16, Zagreb, Croatia.,University of Zagreb, School of Medicine, Šalata 3b, Zagreb, Croatia
| | - Oleg Jadrešin
- Children's Hospital Zagreb, Klaićeva 16, Zagreb, Croatia
| | - Sanja Kolaček
- Children's Hospital Zagreb, Klaićeva 16, Zagreb, Croatia.,University of Zagreb, School of Medicine, Šalata 3b, Zagreb, Croatia
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Hahad O, Schmitt VH, Arnold N, Keller K, Prochaska JH, Wild PS, Schulz A, Lackner KJ, Pfeiffer N, Schmidtmann I, Michal M, Schattenberg JM, Tüscher O, Daiber A, Münzel T. Chronic cigarette smoking is associated with increased arterial stiffness in men and women: evidence from a large population-based cohort. Clin Res Cardiol 2023; 112:270-284. [PMID: 36068365 PMCID: PMC9898409 DOI: 10.1007/s00392-022-02092-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Accepted: 08/24/2022] [Indexed: 02/06/2023]
Abstract
BACKGROUND Cigarette smoking is a threat to global human health and a leading cause of the cardiovascular disease (CVD) morbidity and mortality. Importantly, sex-specific differences in smoking-induced arterial stiffness, an early key event in the development of atherosclerotic CVD, remain still elusive. Thus, this study sought out to investigate sex-specific associations between smoking and measures of arterial stiffness. METHODS AND RESULTS Overall, 15,010 participants (7584 men and 7426 women aged 35-74 years) of the Gutenberg Health Study were examined at baseline during 2007-2012. Smoking status, pack-years of smoking, and years since quitting smoking were assessed by a standardized computer-assisted interview. Arterial stiffness and wave reflection were determined by stiffness index (SI) and augmentation index (AI). In the total sample, 45.8% had never smoked, 34.7% were former smokers, and 19.4% were current smokers. Median cumulative smoking exposure was 22.0 pack-years in current male smokers and 16.0 in current female smokers. In general, multivariable linear regression models adjusted for a comprehensive set of confounders revealed that smoking status, pack-years of smoking, and years since quitting smoking were dose-dependently associated with markers of arterial stiffness. In sex-specific analyses, these associations were overall more pronounced in men and SI was stronger related to the male sex, whereas differences between men and women in the case of AI appeared to be less substantial. DISCUSSION The present results indicate that chronic smoking is strongly and dose-dependently associated with increased arterial stiffness in a large population-based cohort regardless of sex but with a stronger association in men.
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Affiliation(s)
- Omar Hahad
- Department of Cardiology-Cardiology I, University Medical Center of the Johannes Gutenberg-University Mainz, Langenbeckstraße 1, 55131, Mainz, Germany. .,German Center for Cardiovascular Research (DZHK), Partner Site Rhine-Main, Mainz, Germany.
| | - Volker H. Schmitt
- Department of Cardiology-Cardiology I, University Medical Center of the Johannes Gutenberg-University Mainz, Langenbeckstraße 1, 55131 Mainz, Germany ,German Center for Cardiovascular Research (DZHK), Partner Site Rhine-Main, Mainz, Germany
| | - Natalie Arnold
- Department of Cardiology-Cardiology I, University Medical Center of the Johannes Gutenberg-University Mainz, Langenbeckstraße 1, 55131 Mainz, Germany ,German Center for Cardiovascular Research (DZHK), Partner Site Rhine-Main, Mainz, Germany ,Department of Cardiology, German Center for Cardiovascular Research (DZHK), partner site Hamburg/Kiel/Luebeck, Hamburg, Germany
| | - Karsten Keller
- Department of Cardiology-Cardiology I, University Medical Center of the Johannes Gutenberg-University Mainz, Langenbeckstraße 1, 55131 Mainz, Germany ,Center for Thrombosis and Hemostasis, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany ,Medical Clinic VII, Department of Sports Medicine, University Hospital Heidelberg, Heidelberg, Germany
| | - Jürgen H. Prochaska
- German Center for Cardiovascular Research (DZHK), Partner Site Rhine-Main, Mainz, Germany ,Center for Thrombosis and Hemostasis, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany ,Preventive Cardiology and Preventive Medicine, Department of Cardiology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Philipp S. Wild
- German Center for Cardiovascular Research (DZHK), Partner Site Rhine-Main, Mainz, Germany ,Center for Thrombosis and Hemostasis, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany ,Preventive Cardiology and Preventive Medicine, Department of Cardiology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Andreas Schulz
- Preventive Cardiology and Preventive Medicine, Department of Cardiology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Karl J. Lackner
- German Center for Cardiovascular Research (DZHK), Partner Site Rhine-Main, Mainz, Germany ,Institute of Clinical Chemistry and Laboratory Medicine, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Norbert Pfeiffer
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Irene Schmidtmann
- Institute of Medical Biostatistics, Epidemiology and Informatics, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Matthias Michal
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Jörn M. Schattenberg
- Metabolic Liver Research Program, I. Department of Medicine, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Oliver Tüscher
- Department of Psychiatry and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Andreas Daiber
- Department of Cardiology-Cardiology I, University Medical Center of the Johannes Gutenberg-University Mainz, Langenbeckstraße 1, 55131 Mainz, Germany ,German Center for Cardiovascular Research (DZHK), Partner Site Rhine-Main, Mainz, Germany
| | - Thomas Münzel
- Department of Cardiology-Cardiology I, University Medical Center of the Johannes Gutenberg-University Mainz, Langenbeckstraße 1, 55131, Mainz, Germany. .,German Center for Cardiovascular Research (DZHK), Partner Site Rhine-Main, Mainz, Germany.
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12
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Lobene AJ, Smiljanec K, Axler MR, Ramos-Gonzalez M, Lennon SL. Greater adherence to healthy dietary patterns is associated with lower diastolic blood pressure and augmentation index in healthy, young adults. Nutr Res 2022; 106:60-71. [PMID: 36126530 PMCID: PMC10335482 DOI: 10.1016/j.nutres.2022.07.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Revised: 07/28/2022] [Accepted: 07/30/2022] [Indexed: 11/20/2022]
Abstract
More than two-thirds of cardiovascular disease (CVD) deaths worldwide are attributable to dietary factors. Blood pressure variability (BPV), endothelial dysfunction, and arterial stiffness are important CVD risk factors. Although studies show a link between consuming a healthy diet and lower BPV and stiffness and improved endothelial function, research in young, healthy adults is scarce. We hypothesized that, in young, healthy adults, diet quality would be inversely associated with BPV and arterial stiffness and positively associated with endothelial function. This cross-sectional study included 56 healthy young adults (34 women/22 men, age 26.7 ± 0.8 years, body mass index 23.4 ± 0.4 kg/m2, blood pressure [BP] 113/69 mmHg). Three-day diet records were used to calculate two Dietary Approaches to Stop Hypertension (DASH) diet scores, the alternative Mediterranean Diet (aMED) score, and the Healthy Eating Index-2015 (HEI-2015) based on the 2015-2020 Dietary Guidelines for Americans. Twenty-four-hour ambulatory BP data were used to calculate average real variability of systolic and diastolic BP. Endothelial function was assessed by flow-mediated dilation, and arterial stiffness was assessed by pulse wave velocity and augmentation index (AIx). Overall, the HEI-2015 was inversely associated with 24-hour diastolic BP (DBP) and daytime DBP, and the aMED score was inversely associated with AIx. In our exploratory analyses, the Fung DASH score was inversely associated with 24-hour DBP and daytime DBP in women, but not men. These findings suggest that consuming a diet that aligns with the DASH diet, the Mediterranean diet, and/or the 2015-2020 Dietary Guidelines for Americans is associated with cardiovascular benefits in healthy, young adults.
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Affiliation(s)
- Andrea J Lobene
- Department of Kinesiology and Applied Physiology, University of Delaware, Newark, DE, 19713.
| | - Katarina Smiljanec
- Department of Kinesiology and Applied Physiology, University of Delaware, Newark, DE, 19713.
| | - Michael R Axler
- Department of Kinesiology and Applied Physiology, University of Delaware, Newark, DE, 19713.
| | - Macarena Ramos-Gonzalez
- Department of Kinesiology and Applied Physiology, University of Delaware, Newark, DE, 19713.
| | - Shannon L Lennon
- Department of Kinesiology and Applied Physiology, University of Delaware, Newark, DE, 19713.
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13
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Hu X, Zhang X, Zhang Z, Li X, Gou Q, Ye R, Chen X. Relationship between lipid parameters and vascular mechanical characteristics among a normotensive population without diabetes mellitus residing at the Qinghai-Tibet plateau: a cross-sectional study. BMC Cardiovasc Disord 2022; 22:357. [PMID: 35931987 PMCID: PMC9356468 DOI: 10.1186/s12872-022-02801-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Accepted: 08/02/2022] [Indexed: 02/08/2023] Open
Abstract
Background There is limited evidence regarding the relationship between lipid parameters and vascular mechanical characteristics in the normotensive population without diabetes mellitus. The aim of this study was to identify an association between lipid parameters and changes in vascular mechanical characteristics between men and women, and in women before and after menopause. Methods Six hundred-seventy patients who underwent vascular functional testing and who fulfilled the inclusion and exclusion criteria were enrolled in our cross-sectional study. All participants were from the Qinghai–Tibet Plateau (Luhuo County, Ganzi Tibetan Autonomous Prefecture, Sichuan Province, China; mean altitude: 3860 m). Trained clinical physicians assessed brachial-ankle pulse wave velocity (Ba-PWV) and augmentation index adjusted to a 75-beats-per-minute heart rate (AIx@75). To investigate the relationship between lipid parameters and vascular mechanical characteristics in different sexes and menstrual stages, partial correlation analysis and multiple linear regression were used. Results The 670 participants comprised 445 women (103 post-menopausal). Mean Ba-PWV and AIx@75 were 1315.56 ± 243.41 cm/s and 25.07% ± 15.84%, respectively. Men had greater Ba-PWV values compared with women (1341.61 ± 244.28 vs 1302.39 ± 242.17 cm/s, respectively; P < 0.05), while AIx@75 values were higher in women compared with men (27.83% ± 15.85% vs 19.64% ± 14.40%, respectively; p < 0.001). In the partial correlation analysis adjusted for age, total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), and non-high-density lipoprotein cholesterol (HDL-C) were associated with Ba-PWV in both men and women (p < 0.05); however, the magnitude was larger in men. Statistical significance was not seen for AIx@75 among both men and women. Multiple linear regression analysis revealed that TC (β = 0.165, p = 0.024) and non-HDL-C (β = 0.151, p = 0.042) remained independent predictors of change in Ba-PWV in men after adjusting for age, mean arterial pressure, waist circumference, hemoglobin, platelet count, fasting blood glucose, estimated glomerular filtration rate, and uric acid. After adjusting for traditional cardiovascular risk factors, pre-menopausal women had a similar association to that of men between LDL-C (β = 0.126, p = 0.030), non-HDL-C (β = 0.144, p = 0.013), TC/HDL-C (β = 0.162, p = 0.005), LDL-C/HDL-C (β = 0.142, p = 0.013) and Ba-PWV; however, post-menopausal women had no association between the lipid parameters and vascular function. Conclusions Overall, TC and non-HDL-C were independent associated factors for vascular compliance alterations evaluated through Ba-PWV in normotensive men. In pre-menopausal women, LDL-C, non-HDL-C, TC/HDL-C and LDL-C/HDL-C were independent associated factors for vascular compliance alterations. After controlling for traditional risk factors, lipid profiles were not associated with these metrics for AIx@75, which can measure the amplification of reflex flow, because of the high number of confounding factors that do not genuinely reflect changes in vascular characteristics. Lipid factors did not appear to be linked to vascular function in post-menopausal women.
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Affiliation(s)
- Xianjin Hu
- Department of Cardiology, West China Hospital, Sichuan University, Chengdu, China
| | - Xin Zhang
- Department of Cardiology, West China Hospital, Sichuan University, Chengdu, China
| | - Zhipeng Zhang
- Department of Cardiology, West China Hospital, Sichuan University, Chengdu, China
| | - Xinran Li
- Department of Cardiology, West China Hospital, Sichuan University, Chengdu, China
| | - Qiling Gou
- Department of Cardiology, West China Hospital, Sichuan University, Chengdu, China
| | - Runyu Ye
- Department of Cardiology, West China Hospital, Sichuan University, Chengdu, China
| | - Xiaoping Chen
- Department of Cardiology, West China Hospital, Sichuan University, Chengdu, China.
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14
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Elsayed MM, Ayman EM. Atorvastatin can delay arterial stiffness progression in hemodialysis patients. Int Urol Nephrol 2022; 54:2969-2976. [PMID: 35585282 PMCID: PMC9534972 DOI: 10.1007/s11255-022-03231-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Accepted: 04/24/2022] [Indexed: 11/13/2022]
Abstract
Purpose Arterial stiffness is one of the vascular pathologies in hemodialysis (HD) patients with increased cardiovascular mortality and morbidity. Few approaches have been tested to reduce arterial stiffness in patients with chronic kidney disease (CKD). We aimed to assess effects of atorvastatin on arterial stiffness in hemodialysis patients. Methods This research is a double-blinded, placebo-controlled, randomized clinical trial which included 50 patients maintained on regular HD. Patients were allocated to receive 10 mg atorvastatin or placebo for 24 weeks. Aortic pulse wave velocity (PWV) as an index of large artery stiffness and augmentation index (AIx) as an index of wave reflections were assessed at baseline and after 6 months in both groups. Results In atorvastatin group at study end, there was no significant difference from baseline findings in aortic PWV (7.86 ± 2.5 vs 7.88 ± 2.6 m/sec; p = 0.136), AIx (26.04 ± 8.5 vs 26.0 ± 8.6%; p = 0.714) and central pulse pressure (PP) (p = 1.0). On the other hand, in placebo group after 24 weeks, aortic PWV (7.80 ± 2.16 vs 7.63 ± 2.1 m/sec; p < 0.001), AIx (25.88 ± 9.4 vs 25.04 ± 9.4%; p < 0.001) increased significantly from baseline measurements but central pulse pressure (PP) (p = 0.870) did not. Also, the change (Δ) in aortic PWV and AIx was significantly higher than the change in the atorvastatin group with p value of < 0.001 and < 0.001, respectively. Conclusions Arterial stiffness parameters remained stable in atorvastatin group but increased significantly in placebo-treated patients suggesting a potential role for atorvastatin to delay arterial stiffness progression in HD patients. Larger randomized clinical trials are needed to confirm these findings. Clinical Trials registration ClinicalTrials.gov NCT04472637.
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Affiliation(s)
- Mohamed Mamdouh Elsayed
- Nephrology and Internal Medicine Department, Faculty of Medicine, Alexandria University, Alkhartoom square, El azareeta, Alexandria, 21131, Egypt.
| | - Elhassan Mohamed Ayman
- Nephrology and Internal Medicine Department, Faculty of Medicine, Alexandria University, Alkhartoom square, El azareeta, Alexandria, 21131, Egypt
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15
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Kaya M, Balasubramanian V, Li JKJ. Inadequacy of Augmentation Index for Monitoring Arterial Stiffness: Comparison with Arterial Compliance and Other Hemodynamic Variables. Cardiovasc Eng Technol 2022; 13:590-602. [PMID: 35102522 DOI: 10.1007/s13239-021-00605-z] [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: 09/11/2020] [Accepted: 12/14/2021] [Indexed: 01/09/2023]
Abstract
PURPOSE Augmentation Index (AIx) is used clinically for monitoring both wave reflections and arterial stiffness, which when increased is a risk factor of cardiovascular mortality and morbidity. We hypothesize that AIx is not solely related to vascular stiffness as described by arterial compliance and other hemodynamic parameters since AIx underestimates wave reflections. METHODS Aortic pressure and flow datasets (n = 42) from mongrel dogs were obtained from our experiments and Mendeley Data under various conditions. Arterial compliances based on the Windkessel model (Ct), the stroke volume (SV) to pulse pressure (PP) ratio (Cv = SV/PP), and at inflection pressure point (CPi) were computed. Other relevant hemodynamic factors are also computed. RESULTS AIx was poorly associated with arterial stiffness calculated from Ct (r = 0.299, p = 0.058) or CPi (r = 0.203, p = 0.203), even when adjusted for heart rates. Ct and Cv were monotonically associated. Alterations in inflection pressure (Pi) did not follow the changes in pulse pressure (PP) (r = 0.475, p = 0.002), and Pi was quantitatively similar to systolic pressure (r = 0.940, p < 0.001). CONCLUSION AIx is neither linearly correlated with arterial stiffness, nor with arterial compliance and several cardiac and arterial parameters have to be considered when AIx is calculated.
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Affiliation(s)
- Mehmet Kaya
- Department of Biomedical and Chemical Engineering and Sciences, Florida Institute of Technology, 150 W University Blvd, Melbourne, FL, 32901, USA.
| | - Vignesh Balasubramanian
- Department of Biomedical and Chemical Engineering and Sciences, Florida Institute of Technology, 150 W University Blvd, Melbourne, FL, 32901, USA
| | - John K-J Li
- Department of Biomedical Engineering and Robert Wood Johnson Medical School, Rutgers University, 599 Taylor Road, Piscataway, NJ, 08854, USA
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Obayashi M, Kobayashi S, Nanno T, Hamada Y, Yano M. Relation between Oscillometric Measurement of Central Hemodynamics and Left Ventricular Hypertrophy in Hypertensive Patients. Pulse (Basel) 2022; 9:116-124. [PMID: 35083178 DOI: 10.1159/000520006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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: 06/09/2021] [Accepted: 09/28/2021] [Indexed: 12/20/2022] Open
Abstract
Introduction The augmentation index (AIx) or central systolic blood pressure (SBP), measured by radial applanation tonometry, has been reported to be independently associated with left ventricular hypertrophy (LVH) in Japanese hypertensive patients. Cuff-based oscillometric measurement of the AIx using Mobil-O-Graph® showed a low or moderate agreement with the AIx measurement with other devices. Methods The AIx measured using the Mobil-O-Graph was validated against the tonometric measurements of the radial AIx measured using HEM-9000AI in 110 normotensive healthy individuals (age, 21-76 years; 50 men). We investigated the relationship between the central hemodynamics assessed using the Mobil-O-Graph and LVH in 100 hypertensive patients (age, 54-75 years; 48 men), presenting a wall thickness of ≥11 mm and ≥10 mm in men and women, respectively. Results Although the Mobil-O-Graph-measured central AIx showed no negative values, it correlated moderately with the HEM-9000AI-measured radial AIx (r = 0.602, p < 0.001) in the normotensive individuals. The hypertensive patients did not show a significant difference in the central SBP between the sexes, but the central AIx was lower in men than in women. The independent determinants influencing left ventricle (LV) mass index (LVMI) (R2 = 0.362; adjusted R2 = 0.329, p < 0.001) were heart rate (β = -0.568 ± 0.149, p < 0.001), central SBP (β = 0.290 ± 0.100, p = 0.005), and aortic root diameter (β = 1.355 ± 0.344, p = 0.001). Age (β = -0.025 ± 0.124, p = 0.841) and the central AIx (β = 0.120 ± 0.131, p = 0.361) were not independently associated with the LVMI. The area under the receiver operator characteristic curve to evaluate the diagnostic performance of the central AIx for the presence of LVH (LVMI >118 g/m2 in men or >108 g/m2 in women) was statistically significant in men (0.875, p < 0.001) but not in women (0.622, p = 0.132). In men, a central AIx of 28.06% had a sensitivity of 83.3% and specificity of 80.0% for detecting LVH. Conclusions AIx measurement in men provided useful prognostic information for the presence of LVH. Pulse-wave analysis assessed using the Mobil-O-Graph may be a valuable tool for detecting LVH in hypertensive patients.
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Affiliation(s)
- Masakazu Obayashi
- Department of Cardiovascular Medicine, Sanyo-Onoda City Hospital, Sanyo-Onoda, Japan
| | - Shigeki Kobayashi
- Division of Cardiology, Department of Medicine and Clinical Science, Yamaguchi University Graduate School of Medicine, Ube, Japan
| | - Takuma Nanno
- Department of Cardiovascular Medicine, Sanyo-Onoda City Hospital, Sanyo-Onoda, Japan
| | - Yoriomi Hamada
- Department of Cardiovascular Medicine, Sanyo-Onoda City Hospital, Sanyo-Onoda, Japan
| | - Masafumi Yano
- Division of Cardiology, Department of Medicine and Clinical Science, Yamaguchi University Graduate School of Medicine, Ube, Japan
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17
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Karadağ MF. Evaluation of augmentation index and pulse wave velocity measurements in central retinal vein occlusion patients with and without hypertension. Int Ophthalmol 2022. [PMID: 35083600 DOI: 10.1007/s10792-022-02237-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Accepted: 01/13/2022] [Indexed: 10/19/2022]
Abstract
PURPOSE To evaluate arterial stiffness using the pulse wave velocity (PWV) and augmentation index (AI) in central retinal vein occlusion (CRVO) patients. METHODS Forty-two CRVO patients (i.e., CRVO group) and 54 healthy controls (i.e., control group) were included in this comparative and cross-sectional study. The PWV, AI and augmentation pressure were measured with a noninvasive, oscillometric method. RESULTS The mean PWV, AI and augmentation pressure values were significantly higher in CRVO patients than in controls (p = 0.024, p < 0.001 and p = 0.001, respectively). The mean augmentation pressure, AI and PWV measurements were not statistically significant between CRVO patients with and without hypertension (p = 0.856 and p < 0.526, p = 0.432, respectively). Age, presence of hypertension, AI and PWV were found to be as independent risk factors of CRVO development (OR = 2.21, 95% CI [1.44, 3.38] and OR = 2.40, 95% CI [1.50, 3.86], OR = 3.2, 95% CI [1.70, 5.60] and OR = 5.70, 95% CI [2.00, 18.50], respectively). CONCLUSION The AI and PWV values were significantly higher in CRVO patients than in controls. These results indicate that similar abnormalities in the arterial wall structure may play an important role in the pathogenesis of the CRVO and cardiovascular diseases. In addition, our findings show that each patient with RVO should be examined in terms of systemic vascular pathologies.
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Ishida K, Morimoto S, Horiuchi S, Kimura M, Ishikawa T, Kimura S, Yamashita K, Takano N, Seki Y, Bokuda K, Sasaki N, Watanabe D, Ichihara A. Comparison of the usefulness of the cardio-ankle vascular index and augmentation index as an index of arteriosclerosis in patients with essential hypertension. Hypertens Res 2021. [PMID: 34934159 DOI: 10.1038/s41440-021-00823-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Revised: 10/29/2021] [Accepted: 11/01/2021] [Indexed: 11/08/2022]
Abstract
Arteriosclerosis leads to various serious diseases that substantially reduce the quality of life. When treating hypertension, it is important to evaluate the degree of arteriosclerosis. In recent years, the cardio-ankle vascular index and augmentation index have been frequently used as indicators of arterial wall sclerosis. However, the superiority of either the cardio-ankle vascular index or the augmentation index as an index of arteriosclerosis remains unclear. Therefore, the present study compared the usefulness of these two indices as an index of arteriosclerosis. Associations between the cardio-ankle vascular index or augmentation index and risk factors for arteriosclerosis and other indices of arteriosclerosis in 535 consecutive patients with essential hypertension were evaluated. The cardio-ankle vascular index was significantly correlated with age, hemoglobin A1c, brain natriuretic peptide, and estimated glomerular filtration rate. In contrast, the augmentation index showed significant correlations only with age, brain natriuretic peptide, and estimated glomerular filtration rate. In addition, these correlations with the augmentation index were generally weaker than those with the cardio-ankle vascular index. The cardio-ankle vascular index, but not the augmentation index, was significantly correlated with flow-mediated dilation, an index of vascular endothelial function, and carotid intima-media thickness, an index of carotid atherosclerosis. Similar results were observed in subgroups stratified by sex and age. These data indicate that the cardio-ankle vascular index is more closely associated with risk factors for arteriosclerosis and other indices of arteriosclerosis than the augmentation index, suggesting that the cardio-ankle vascular index may be superior to the augmentation index as an index of arteriosclerosis.
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Kulthinee S, Nernpermpisooth N, Poomvanicha M, Satiphop J, Chuang-Ngu T, Kaleeluan N, Thawnashom K, Manin A, Kongchan R, Yinmaroeng K, Kitipawong P, Chotimol P. Cold Pressor Test Influences the Cardio-Ankle Vascular Index in Healthy Overweight Young Adults. Pulse (Basel) 2021; 9:30-37. [PMID: 34722353 DOI: 10.1159/000517617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Accepted: 05/29/2021] [Indexed: 11/19/2022] Open
Abstract
Objective The cold pressor test (CPT) has been shown a potential sympathoexcitatory stimulus which increases aortic pulse wave velocity and the aortic augmentation index, suggesting that noninvasively, arterial stiffness parameters are altered by the CPT. The cardio-ankle vascular index (CAVI) is widely used for reflecting arterial stiffness, and the ankle-brachial index (ABI) for evaluating peripheral artery disease in obesity. We aimed to assess CAVI and ABI in overweight young adults in the context of sympathetic activation by using the CPT. Methods 160 participants were divided into 2 groups: 86 normal-weight (body mass index [BMI] 18.50-22.99 kg/m2) and 74 overweight (BMI ≥23 kg/m2). The CPT was performed by immersing a participant's left hand into cold water (3-5°C) for 3 min, and CAVI and ABI assessment. Results At baseline, the CAVI in the overweight group was significantly less than that in the normal-weight group (5.79 ± 0.85 vs. 6.10 ± 0.85; p < 0.05). The mean arterial pressure (MAP) for overweight was significantly greater than that for normal-weight subjects (93.89 ± 7.31 vs. 91.10 ± 6.72; p < 0.05). During the CPT, the CAVI increased in both normal-weight and overweight subjects, the CAVI value was greater during the CPT in overweight subjects by 14.36% (6.62 ± 0.95 vs. 5.79 ± 0.85, p < 0.05) and in normal-weight subjects by 8.03% (6.59 ± 1.20 vs. 6.10 ± 0.85, p < 0.05) than those baseline values. The CPT evoked an increase in systolic blood pressure (SBP), diastolic BP (DBP), heart rate (HR,) and pulse pressure (PP) in both groups. After a 4-min CPT period, the CAVI returned values similar to the baseline values in both groups, and the SBP, DBP, MAP, and PP in overweight participants were significantly higher than those in normal-weight participants. However, there was no significant difference in the ABI at baseline, during CPT, and post-CPT in either group. Conclusions Our results indicated that the CAVI was influenced by sympathetic activation response to the CPT in both normal-weight and overweight young adults. Specifically, during the CPT, the percentage change of the CAVI in overweight response was greater in normal-weight participants than baseline values in each group. The ABI was not found significantly associated with CPT. These findings suggesting that sympathoexcitatory stimulus by CPT influence CAVI results.
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Affiliation(s)
- Supaporn Kulthinee
- Chulabhorn International College of Medicine, Thammasat University, Pathum Thani, Thailand
| | - Nitirut Nernpermpisooth
- Department of Cardio-Thoracic Technology, Faculty of Allied Health Sciences, Naresuan University, Phitsanulok, Thailand
| | - Montatip Poomvanicha
- Department of Cardio-Thoracic Technology, Faculty of Allied Health Sciences, Naresuan University, Phitsanulok, Thailand
| | - Jidapa Satiphop
- Department of Cardio-Thoracic Technology, Faculty of Allied Health Sciences, Naresuan University, Phitsanulok, Thailand
| | - Thizanamadee Chuang-Ngu
- Department of Cardio-Thoracic Technology, Faculty of Allied Health Sciences, Naresuan University, Phitsanulok, Thailand
| | - Napaporn Kaleeluan
- Department of Cardio-Thoracic Technology, Faculty of Allied Health Sciences, Naresuan University, Phitsanulok, Thailand
| | - Kittisak Thawnashom
- Department of Medical Technology, Faculty of Allied Health Sciences, Naresuan University, Phitsanulok, Thailand
| | - Anuchit Manin
- Cardiac Centre, Naresuan University Hospital, Faculty of Medicine, Naresuan University, Phitsanulok, Thailand
| | - Rosarin Kongchan
- Cardiac Centre, Naresuan University Hospital, Faculty of Medicine, Naresuan University, Phitsanulok, Thailand
| | - Kingkarn Yinmaroeng
- Chulabhorn International College of Medicine, Thammasat University, Pathum Thani, Thailand
| | - Peerapong Kitipawong
- Chulabhorn International College of Medicine, Thammasat University, Pathum Thani, Thailand
| | - Phatiwat Chotimol
- Department of Cardio-Thoracic Technology, Faculty of Allied Health Sciences, Naresuan University, Phitsanulok, Thailand
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Holewijn S, Vermeulen JJM, van Helvert M, van de Velde L, Reijnen MMPJ. Validation of Central Pressure Estimation in Patients with an Aortic Aneurysm Before and After Endovascular Repair. Cardiovasc Eng Technol 2021; 13:265-278. [PMID: 34585343 DOI: 10.1007/s13239-021-00574-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Accepted: 08/10/2021] [Indexed: 10/20/2022]
Abstract
PURPOSE The aim of this study was to investigate if non-invasive central pressure estimations are accurate in patients with an abdominal aortic aneurysm, before and after endovascular repair. Secondary evaluation was if measurement-accuracy was dependent on anatomical characteristics. METHODS Procedural invasive and non-invasive pressure-measurements were performed simultaneously both before and after endovascular repair in 20 patients with an infrarenal abdominal aortic aneurysm. Invasive catheter measurements were performed in the abdominal aorta. A tonometric device was used to perform non-invasive pressure-wave-analysis at the radial artery. A generalized transfer-function was used to generate an ascending aortic waveform for both measurements, allowing for direct comparison. RESULTS Pre-treatment the mean differences between methods were - 5.5 mmHg (p = .904), - 11.8 (p < .001), and - 7.2 mmHg (p = .124) for central systolic, diastolic, and mean pressure, respectively. The accuracy was dependent of aneurysm sac volume and intraluminal thrombus volume. Post-treatment limits of agreement were smaller for all pressure parameters compared to pre-treatment. The mean differences were 6.5 mmHg (p = .007), - 6.4 (p < .020), and 1.6 mmHg (p = .370) for central systolic, diastolic, and mean pressure, respectively. CONCLUSION In untreated AAA's the accuracy of non-invasive central pressure estimation was acceptable (mean difference between 5 and 10 mmHg) when compared to invasive pressures, but dependent of AAA characteristics. After EVAR the accuracy of central pressure estimation improved (reduction of 75% of the mean difference between pre and post measurements) TRIAL REGISTRATION NUMBER: NCT03469388; 3-5-2018.
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Affiliation(s)
- S Holewijn
- Vascular Center, Department of Surgery, Rijnstate, P.O. Box 9555, 6800 TA, Arnhem, The Netherlands.
| | - J J M Vermeulen
- Vascular Center, Department of Surgery, Rijnstate, P.O. Box 9555, 6800 TA, Arnhem, The Netherlands.,Department of Physiology, Radboud Institute for Health Sciences, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - M van Helvert
- Vascular Center, Department of Surgery, Rijnstate, P.O. Box 9555, 6800 TA, Arnhem, The Netherlands.,MultiModality Medical Imaging Group, TechMed Centre, University of Twente, Enschede, The Netherlands
| | - L van de Velde
- Vascular Center, Department of Surgery, Rijnstate, P.O. Box 9555, 6800 TA, Arnhem, The Netherlands.,MultiModality Medical Imaging Group, TechMed Centre, University of Twente, Enschede, The Netherlands
| | - M M P J Reijnen
- Vascular Center, Department of Surgery, Rijnstate, P.O. Box 9555, 6800 TA, Arnhem, The Netherlands.,MultiModality Medical Imaging Group, TechMed Centre, University of Twente, Enschede, The Netherlands
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21
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Vermeulen EA, de Jong HBT, Blomjous AGA, Eelderink C, Hoekstra T, Elders PJM, de Borst MH, Vervloet MG, van Ballegooijen AJ, Beulens JW. Magnesium intake and vascular structure and function: the Hoorn Study. Eur J Nutr 2021. [PMID: 34491389 DOI: 10.1007/s00394-021-02667-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Accepted: 08/20/2021] [Indexed: 11/30/2022]
Abstract
Purpose Circulating and dietary magnesium have been shown to be inversely associated with the prevalence of cardiovascular disease (CVD) and mortality in both high and low-risk populations. We aimed to examine the association between dietary magnesium intake and several measures of vascular structure and function in a prospective cohort. Methods We included 789 participants who participated in the vascular screening sub-cohort of the Hoorn Study, a population-based, prospective cohort study. Baseline dietary magnesium intake was estimated with a validated food frequency questionnaire and categorised in energy-adjusted magnesium intake tertiles. Several measurements of vascular structure and function were performed at baseline and most measurements were repeated after 8 years of follow-up (n = 432). Multivariable linear and logistic regression was performed to study the cross-sectional and longitudinal associations of magnesium intake and intima-media thickness (IMT), augmentation index (Aix), pulse wave velocity (PWV), flow-mediated dilatation (FMD), and peripheral arterial disease (PAD). Results Mean absolute magnesium intake was 328 ± 83 mg/day and prior CVD and DM2 was present in 55 and 41% of the participants, respectively. Multivariable regression analyses did not demonstrate associations between magnesium intake and any of the vascular outcomes. Participants in the highest compared to the lowest magnesium intake tertile demonstrated in fully adjusted cross-sectional analyses a PWV of −0.21 m/s (95% confidence interval −1.95, 1.52), a FMD of −0.03% (−0.89, 0.83) and in longitudinal analyses an IMT of 0.01 mm (−0.03, 0.06), an Aix of 0.70% (−1.69, 3.07) and an odds ratio of 0.84 (0.23, 3.11) for PAD Conclusion We did not find associations between dietary magnesium intake and multiple markers of vascular structure and function, in either cross-sectional or longitudinal analyses. Supplementary Information The online version contains supplementary material available at 10.1007/s00394-021-02667-0.
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22
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Wray S, Lascano E, Negroni J, Fischer EC. Relationship between Augmentation Index and Wall Thickening Fraction during Hypotension in an Animal Model of Myocardial Ischemia-Reperfusion and Heart Failure. Curr Hypertens Rev 2021; 17:121-130. [PMID: 34225634 DOI: 10.2174/1573402117666210322161445] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2020] [Revised: 10/29/2020] [Accepted: 12/21/2020] [Indexed: 11/22/2022]
Abstract
AIMS Non-invasive indices to evaluate left ventricular changes during ischemic heart failure are needed to quantify the myocardial impairment and the effectiveness of therapeutic manoeuvres. The aims of this work were to calculate the Wall Thickening Fraction (WTF) and the Augmentation Index (AIx) and to assess the relationship between WTF and AIx using data obtained from an animal model with heart failure followed by a myocardial ischemia stage and a reperfusion stage. METHODS Nine Corriedale sheep that had been monitored for 10 minutes during a basal stage underwent 5-minute myocardial ischemia, followed by 60-minute reperfusion. Seven of them were subjected to an induced heart failure through an overdose of halothane, two of which were treated with intra-aortic counterpulsation during the reperfusion stage. The remaining two animals were monitored during their ischemia-reperfusion stage. RESULTS Data obtained in the 5 animals suffering from heart failure followed by myocardial ischemia showed that: a) heart failure induction determined decrease in cardiac output, cardiac index and systolic and diastolic aortic pressure (AoP) with respect to their basal values (p<0.05), b) myocardial ischemia decreased the WTF compared with basal and induced heart failure values (p<0.05), c) during the reperfusion stage accompanied by induced heart failure, WTF increased with respect to values observed during the ischemia induction stage (p<0.05); nevertheless, basal values were not recovered after reperfusion (p<0.05). During this 60-minute stage, systolic and diastolic AoP values were lower (p<0.05) than those at the basal stage. CONCLUSION AIx and WTF values calculated from synchronically recorded values of aortic pressure and left ventricular wall thickness during the reperfusion stage in all animals (n = 9) showed a negative correlation (p<0.05). Analysed data provided evidence of a negative relationship between a left ventricular index of myocardial function and an arterial index obtained from AoP waves.
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Affiliation(s)
- Sandra Wray
- Instituto de Medicina Traslacional, Trasplante y Bioingeniería (IMeTTyB), Universidad Favaloro-CONICET, Solís 453, C1078AAI, Buenos Aires, Argentina
| | - Elena Lascano
- Instituto de Medicina Traslacional, Trasplante y Bioingeniería (IMeTTyB), Universidad Favaloro-CONICET, Solís 453, C1078AAI, Buenos Aires, Argentina
| | - Jorge Negroni
- Instituto de Medicina Traslacional, Trasplante y Bioingeniería (IMeTTyB), Universidad Favaloro-CONICET, Solís 453, C1078AAI, Buenos Aires, Argentina
| | - Edmundo C Fischer
- Instituto de Medicina Traslacional, Trasplante y Bioingeniería (IMeTTyB), Universidad Favaloro-CONICET, Solís 453, C1078AAI, Buenos Aires, Argentina
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23
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Berger M, Fesler P, Roubille C. Arterial stiffness, the hidden face of cardiovascular risk in autoimmune and chronic inflammatory rheumatic diseases. Autoimmun Rev 2021; 20:102891. [PMID: 34229047 DOI: 10.1016/j.autrev.2021.102891] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Accepted: 04/22/2021] [Indexed: 12/30/2022]
Abstract
BACKGROUND AND OBJECTIVE Cardiovascular diseases (CVD) are the leading causes of death in chronic inflammatory rheumatic diseases and are not solely explained by the increased prevalence of cardiovascular (CV) risk factors in this population. Arterial stiffness, assessed primarily by pulse wave velocity (PWV) and more indirectly by augmentation index (AIx), is a surrogate marker of CVD that should be considered. The objective of this review was to investigate the relationship between arterial stiffness and chronic inflammatory and/or autoimmune diseases. METHODS We performed a systemic literature review of articles published in Medline from January 2012 to April 2020 restricted to English languages and to human adults. We selected relevant articles about the relationship between arterial stiffness and rheumatoid arthritis, systemic lupus erythematosus, psoriasis, Sjogren's syndrome and ankylosing spondylitis. For each selected article, data on PWV and AIx were extracted and factors that may have an impact on arterial stiffness were identified. RESULTS A total of 214 references were identified through database searching and 82 of them were retained for analysis. Arterial stiffness is increased in chronic inflammatory and autoimmune diseases. Traditional CV risk factors such as hypertension and dyslipidemia accentuate this relationship. Current data are insufficient to determine whether disease activity significantly influences arterial stiffness, whereas disease duration seems rather critical. TNF-alpha inhibitors and cardiorespiratory fitness tend to decrease arterial stiffness. Finally, increased arterial stiffness leads to diastolic dysfunction, which is the main mechanism of heart failure in chronic inflammatory rheumatic diseases. CONCLUSION CV risk assessment in chronic inflammatory and autoimmune diseases should also rely on PWV and AIx.
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24
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McNarry MA, Lester L, Ellins EA, Halcox JP, Davies G, Winn CON, Mackintosh KA. Asthma and high-intensity interval training have no effect on clustered cardiometabolic risk or arterial stiffness in adolescents. Eur J Appl Physiol 2021; 121:1967-1978. [PMID: 33778908 PMCID: PMC8192411 DOI: 10.1007/s00421-020-04590-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Accepted: 12/17/2020] [Indexed: 12/18/2022]
Abstract
PURPOSE Cardiometabolic risk, including arterial stiffness, is increasing in youth. Those with asthma are suggested to be particularly at risk of cardiovascular disease. Efficient and effective strategies are required to prevent the atherosclerotic process in youth. The purpose of this study was to investigate the effect of 6 months high-intensity interval training (HIIT) on cardiometabolic risk in youth with and without asthma. METHODS 65 adolescents (31 mild asthma; 34 non-asthma) were recruited, 32 (16 asthma) of whom were randomly allocated to receive HIIT three times per week for 6 months. At baseline, mid-intervention, post-intervention and at a 3-month follow-up, anthropometric, metabolic and vascular determinants of cardiometabolic risk were assessed. Following principal component analysis (PCA), linear mixed models were used to assess the influence of asthma, HIIT and their interaction. RESULTS Seven factors were identified which explained 88% of the common variance shared among the parameters. Those with asthma demonstrated lower arterial stiffness factor scores mid-intervention (P = 0.047) and lower cholesterol factor scores post-intervention (P = 0.022) but there was no effect of the intervention, or interaction effects, on any PCA-identified factor, at any time-point. HIIT was associated with a lower low-density lipoprotein and diastolic blood pressure at mid-intervention. DISCUSSION Neither arterial stiffness nor clustered cardiometabolic risk are influenced by HIIT in adolescents with or without asthma, despite important changes in blood lipid and pressure profiles. Blood pressure, augmentation and pulse wave velocity should be considered physiologically distinct constructs and as potential markers of cardiovascular health.
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Affiliation(s)
- M A McNarry
- Applied Sports, Technology, Exercise and Medicine Research Centre, College of Engineering, Swansea University, Bay Campus, Swansea, SA1 8EN, UK.
| | - L Lester
- School of Human Sciences, University of Western Australia, Perth, 6009, Australia
| | - E A Ellins
- Swansea University Medical School, Swansea University, Swansea, SA2 8PP, UK
| | - J P Halcox
- Swansea University Medical School, Swansea University, Swansea, SA2 8PP, UK
| | - G Davies
- Swansea University Medical School, Swansea University, Swansea, SA2 8PP, UK
| | - C O N Winn
- Applied Sports, Technology, Exercise and Medicine Research Centre, College of Engineering, Swansea University, Bay Campus, Swansea, SA1 8EN, UK
| | - K A Mackintosh
- Applied Sports, Technology, Exercise and Medicine Research Centre, College of Engineering, Swansea University, Bay Campus, Swansea, SA1 8EN, UK
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25
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Way KL, Lee AS, Twigg SM, Johnson NA. The effect of acute aerobic exercise on central arterial stiffness, wave reflections, and hemodynamics in adults with diabetes: A randomized cross-over design. J Sport Health Sci 2021; 10:499-506. [PMID: 32444343 PMCID: PMC8343005 DOI: 10.1016/j.jshs.2020.02.009] [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] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/06/2019] [Revised: 12/21/2019] [Accepted: 01/22/2020] [Indexed: 05/21/2023]
Abstract
BACKGROUND Individuals with diabetes have greater central arterial stiffness, wave reflections, and hemodynamics, all of which promote the accelerated cardiovascular pathology seen in this population. Acute aerobic exercise has been shown to be an effective strategy for reducing central arterial stiffness, wave reflections, and hemodynamics in healthy individuals; however, the effects of acute aerobic exercise in reducing these outcomes is not well established in people with diabetes. Recently, implementation of high-intensity interval exercise (HIIE) has shown superior improvements in cardiovascular health outcomes when compared to traditional aerobic exercise. Yet, the effect of HIIE on the aforementioned outcomes in people with diabetes is not known. The purpose of this study was to (i) describe the central arterial stiffness, wave reflections, and hemodynamic responses to a bout of HIIE and moderate-intensity continuous exercise (MICE) in adults with diabetes; and (ii) compare the effects of HIIE and MICE on the aforementioned outcomes. METHODS A total of 24 adult men and women (aged 29-59 years old) with type 1 (n = 12) and type 2 (n = 12) diabetes participated in a randomized cross-over study. All participants completed the following protocols: (i) HIIE: cycling for 4 × 4 min at 85%-95% of heart rate peak (HRpeak), interspersed with 3 min of active recovery at 60%-70%HRpeak; (ii) MICE: 33 min of continuous cycling at 60%-70%HRpeak; and (iii) control (CON): lying quietly in a supine position for 30 min. RESULTS A significant group × time effect was found for changes in central systolic blood pressure (F = 3.20, p = 0.01) with a transient reduction for the HIIE group but not for the MICE or CON groups. There was a significant group × time effect for changes in augmentation index at a heart rate of 75 beats/min (F = 2.32, p = 0.04) with a decrease following for HIIE and MICE but not for CON. For all other measures of central arterial stiffness and hemodynamics, no significant changes were observed (p > 0.05). CONCLUSION A bout of HIIE appears to lead to a greater transient reduction in central systolic blood pressure than the reduction observed following MICE; however, both HIIE and MICE improved augmentation index at a heart rate of 75 beats/min in people with diabetes. There was no significant difference in response to HIIE and MICE in all outcomes. This provides preliminary evidence on the role of HIIE on such outcomes in people with diabetes.
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Affiliation(s)
- Kimberley L Way
- Faculty of Medicine and Health, Discipline of Exercise and Sports Science, University of Sydney, Lidcombe, NSW 2141, Australia; Charles Perkins Centre, University of Sydney, Camperdown, NSW 2006, Australia; Boden Collaboration for Obesity, Nutrition, Exercise and Eating Disorders, University of Sydney, Camperdown, NSW 2006, Australia.
| | - Angela S Lee
- Charles Perkins Centre, University of Sydney, Camperdown, NSW 2006, Australia; Faculty of Medicine and Health, Central Clinical School, University of Sydney, Camperdown, NSW 2006, Australia; Department of Endocrinology, Diabetes Centre, Royal Prince Alfred Hospital, Sydney, NSW 2050, Australia
| | - Stephen M Twigg
- Charles Perkins Centre, University of Sydney, Camperdown, NSW 2006, Australia; Faculty of Medicine and Health, Central Clinical School, University of Sydney, Camperdown, NSW 2006, Australia; Department of Endocrinology, Diabetes Centre, Royal Prince Alfred Hospital, Sydney, NSW 2050, Australia
| | - Nathan A Johnson
- Faculty of Medicine and Health, Discipline of Exercise and Sports Science, University of Sydney, Lidcombe, NSW 2141, Australia; Charles Perkins Centre, University of Sydney, Camperdown, NSW 2006, Australia; Boden Collaboration for Obesity, Nutrition, Exercise and Eating Disorders, University of Sydney, Camperdown, NSW 2006, Australia
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26
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Birukov A, Cuadrat R, Polemiti E, Eichelmann F, Schulze MB. Advanced glycation end-products, measured as skin autofluorescence, associate with vascular stiffness in diabetic, pre-diabetic and normoglycemic individuals: a cross-sectional study. Cardiovasc Diabetol 2021; 20:110. [PMID: 34176469 PMCID: PMC8236143 DOI: 10.1186/s12933-021-01296-5] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Accepted: 05/03/2021] [Indexed: 02/06/2023] Open
Abstract
Background Advanced glycation end-products are proteins that become glycated after contact with sugars and are implicated in endothelial dysfunction and arterial stiffening. We aimed to investigate the relationships between advanced glycation end-products, measured as skin autofluorescence, and vascular stiffness in various glycemic strata. Methods We performed a cross-sectional analysis within the European Prospective Investigation into Cancer and Nutrition (EPIC)-Potsdam cohort, comprising n = 3535 participants (median age 67 years, 60% women). Advanced glycation end-products were measured as skin autofluorescence with AGE-Reader™, vascular stiffness was measured as pulse wave velocity, augmentation index and ankle-brachial index with Vascular Explorer™. A subset of 1348 participants underwent an oral glucose tolerance test. Participants were sub-phenotyped into normoglycemic, prediabetes and diabetes groups. Associations between skin autofluorescence and various indices of vascular stiffness were assessed by multivariable regression analyses and were adjusted for age, sex, measures of adiposity and lifestyle, blood pressure, prevalent conditions, medication use and blood biomarkers. Results Skin autofluorescence associated with pulse wave velocity, augmentation index and ankle-brachial index, adjusted beta coefficients (95% CI) per unit skin autofluorescence increase: 0.38 (0.21; 0.55) for carotid-femoral pulse wave velocity, 0.25 (0.14; 0.37) for aortic pulse wave velocity, 1.00 (0.29; 1.70) for aortic augmentation index, 4.12 (2.24; 6.00) for brachial augmentation index and − 0.04 (− 0.05; − 0.02) for ankle-brachial index. The associations were strongest in men, younger individuals and were consistent across all glycemic strata: for carotid-femoral pulse wave velocity 0.36 (0.12; 0.60) in normoglycemic, 0.33 (− 0.01; 0.67) in prediabetes and 0.45 (0.09; 0.80) in diabetes groups; with similar estimates for aortic pulse wave velocity. Augmentation index was associated with skin autofluorescence only in normoglycemic and diabetes groups. Ankle-brachial index inversely associated with skin autofluorescence across all sex, age and glycemic strata. Conclusions Our findings indicate that advanced glycation end-products measured as skin autofluorescence might be involved in vascular stiffening independent of age and other cardiometabolic risk factors not only in individuals with diabetes but also in normoglycemic and prediabetic conditions. Skin autofluorescence might prove as a rapid and non-invasive method for assessment of macrovascular disease progression across all glycemic strata. Supplementary Information The online version contains supplementary material available at 10.1186/s12933-021-01296-5.
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Affiliation(s)
- Anna Birukov
- Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbrücke, Arthur-Scheunert-Allee 114-116, 14558, Nuthetal, Germany. .,German Center for Diabetes Research (DZD), München-Neuherberg, Germany.
| | - Rafael Cuadrat
- Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbrücke, Arthur-Scheunert-Allee 114-116, 14558, Nuthetal, Germany.,German Center for Diabetes Research (DZD), München-Neuherberg, Germany
| | - Elli Polemiti
- Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbrücke, Arthur-Scheunert-Allee 114-116, 14558, Nuthetal, Germany.,German Center for Diabetes Research (DZD), München-Neuherberg, Germany
| | - Fabian Eichelmann
- Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbrücke, Arthur-Scheunert-Allee 114-116, 14558, Nuthetal, Germany.,German Center for Diabetes Research (DZD), München-Neuherberg, Germany
| | - Matthias B Schulze
- Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbrücke, Arthur-Scheunert-Allee 114-116, 14558, Nuthetal, Germany. .,German Center for Diabetes Research (DZD), München-Neuherberg, Germany. .,Institute of Nutritional Science, University of Potsdam, Nuthetal, Germany.
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27
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Cheung CP, Coates AM, Currie KD, King TJ, Mountjoy ML, Burr JF. Examining the relationship between arterial stiffness and swim-training volume in elite aquatic athletes. Eur J Appl Physiol 2021; 121:2635-2645. [PMID: 34132871 DOI: 10.1007/s00421-021-04736-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Accepted: 06/05/2021] [Indexed: 11/28/2022]
Abstract
PURPOSE Factors such as prone body position, hydrostatic pressure, and intermittent breath-holding subject aquatic athletes to unique physical and environmental stressors during swimming exercise. The relationship between exposure to aquatic exercise and both arterial stiffness and wave reflection properties is not well-understood. This study assessed central artery stiffness and wave reflection properties in elite pool-swimmers (SW), long-distance open-water swimmers (OW), and water polo players (WP) to examine the relationship between these variables and aquatic exercise. METHODS Athletes competing in SW, OW and WP events at the FINA World Championships were recruited. Carotid-femoral pulse wave velocity, and pulse wave analysis were used to quantify arterial stiffness, and central wave reflection properties. RESULTS Athletes undertook differing amounts of weekly swimming distance in training according to their discipline (SW: 40.2 ± 21.1 km, OW: 59.7 ± 28.4 km, WP: 11.4 ± 6.3 km; all p < 0.05). Pulse wave velocity (Males [SW: 6.0 ± 0.6 m/s, OW: 6.5 ± 0.8 m/s, WP: 6.7 ± 0.9 m/s], Females [SW: 5.4 ± 0.6 m/s, OW: 5.3 ± 0.5 m/s, WP: 5.2 ± 0.8 m/s; p = 0.4]) was similar across disciplines for females but was greater in male WP compared to male SW (p = 0.005). Augmentation index (Males [SW: - 3.4 ± 11%, OW: - 9.6 ± 6.4%, WP: 1.7 ± 10.9%], Females [SW: 3.5 ± 13.5%, OW: - 13.2 ± 10.7%, WP: - 2.8 ± 10.7%]) was lower in male OW compared to WP (p = 0.03), and higher in female SW compared to OW (p = 0.002). Augmentation index normalized to a heart rate of 75 bpm was inversely related to weekly swim distance in training (r = - 0.27, p = 0.004). CONCLUSIONS This study provides evidence that the central vasculature of elite aquatic athletes differs by discipline, and this is associated with training load.
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Affiliation(s)
- Christian P Cheung
- Human Health and Nutritional Sciences, University of Guelph, 50 Stone Road E, Guelph, ON, N1G2W1, Canada
| | - Alexandra M Coates
- Human Health and Nutritional Sciences, University of Guelph, 50 Stone Road E, Guelph, ON, N1G2W1, Canada
| | | | - Trevor J King
- Human Health and Nutritional Sciences, University of Guelph, 50 Stone Road E, Guelph, ON, N1G2W1, Canada
| | | | - Jamie F Burr
- Human Health and Nutritional Sciences, University of Guelph, 50 Stone Road E, Guelph, ON, N1G2W1, Canada.
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Sapp RM, Chesney CA, Eagan LE, Evans WS, Zietowski EM, Prior SJ, Hagberg JM, Ranadive SM. Changes in circulating microRNA and arterial stiffness following high-intensity interval and moderate intensity continuous exercise. Physiol Rep 2021; 8:e14431. [PMID: 32358919 PMCID: PMC7195557 DOI: 10.14814/phy2.14431] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Accepted: 04/10/2020] [Indexed: 12/14/2022] Open
Abstract
High‐intensity interval (HII) exercise elicits distinct vascular responses compared to a matched dose of moderate intensity continuous (MOD) exercise. However, the acute effects of HII compared to MOD exercise on arterial stiffness are incompletely understood. Circulating microRNAs (ci‐miRs) may contribute to the vascular effects of exercise. We sought to determine exercise intensity‐dependent changes in ci‐miR potentially underlying changes in arterial stiffness. Ten young, healthy men underwent well‐matched, 30‐min HII and MOD exercise bouts. RT‐qPCR was used to determine the levels of seven vascular‐related ci‐miRs in serum obtained immediately before and after exercise. Arterial stiffness measures including carotid to femoral pulse wave velocity (cf‐PWV), carotid arterial compliance and β‐stiffness, and augmentation index (AIx and AIx75) were taken before, 10min after and 60min after exercise. Ci‐miR‐21‐5p, 126‐3p, 126‐5p, 150‐5p, 155‐5p, and 181b‐5p increased after HII exercise (p < .05), while ci‐miR‐150‐5p and 221‐3p increased after MOD exercise (p = .03 and 0.056). One hour after HII exercise, cf‐PWV trended toward being lower compared to baseline (p = .056) and was significantly lower compared to 60min after MOD exercise (p = .04). Carotid arterial compliance was increased 60min after HII exercise (p = .049) and was greater than 60min after MOD exercise (p = .02). AIx75 increased 10 min after both HII and MOD exercise (p < .05). There were significant correlations between some of the exercise‐induced changes in individual ci‐miRs and changes in cf‐PWV and AIx/AIx75. These results support the hypotheses that arterial stiffness and ci‐miRs are altered in an exercise intensity‐dependent manner, and ci‐miRs may contribute to changes in arterial stiffness.
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Affiliation(s)
- Ryan M Sapp
- Department of Kinesiology, School of Public Health, University of Maryland, College Park, MD, USA
| | - Catalina A Chesney
- Department of Kinesiology, School of Public Health, University of Maryland, College Park, MD, USA
| | - Lauren E Eagan
- Department of Kinesiology, School of Public Health, University of Maryland, College Park, MD, USA
| | - William S Evans
- Department of Kinesiology, School of Public Health, University of Maryland, College Park, MD, USA
| | - Evelyn M Zietowski
- Department of Kinesiology, School of Public Health, University of Maryland, College Park, MD, USA.,Department of Biology, University of Maryland, College Park, MD, USA
| | - Steven J Prior
- Department of Kinesiology, School of Public Health, University of Maryland, College Park, MD, USA.,Baltimore Veterans Affairs Geriatric Research, Education and Clinical Center, Baltimore, MD, USA
| | - James M Hagberg
- Department of Kinesiology, School of Public Health, University of Maryland, College Park, MD, USA
| | - Sushant M Ranadive
- Department of Kinesiology, School of Public Health, University of Maryland, College Park, MD, USA
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Tolstov SN, Salov IA, Kiselev AR, Rebrov AP. Evaluating daily profile of central aortic pressure and reflected pulse wave parameters in climacteric women. BMC Cardiovasc Disord 2021; 21:246. [PMID: 34011280 PMCID: PMC8136159 DOI: 10.1186/s12872-021-02064-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Accepted: 05/10/2021] [Indexed: 11/10/2022] Open
Abstract
Introduction Structural and functional changes of the vascular wall in women occur already at the very early stages of reproductive aging. An emergence of applanation tonometry made it possible to evaluate arterial stiffness and central hemodynamic parameters non-invasively, which considerably expanded the information that had been provided previously by invasive methods used for studying these parameters during cardiac catheterization. Whereas a few studies have assessed central aortic pressure (CAP) parameters and reflected pulse wave in women at different phases of their reproductive aging, none investigated the daily profile of CAP and reflected pulse wave parameters in women undergoing different stages of the menopause. Background: assessment of the daily variability in CAP and daily profile of amplification and augmentation of pulse blood pressure (PBP) in women at different menopause phases. Methods The study involved 384 climacteric women. The first group included 168 women undergoing perimenopause, the second group comprised of 216 women in their early postmenopausal stage. A 24-h blood pressure (BP) monitoring in the brachial artery and aorta (BPLab® Vasotens® system, Petr Telegin LLC, Russia) was performed via the measurements of the following indicators: systolic blood pressure (SBP), pulse blood pressure (PBP), central aortic systolic pressure (CASP), central aortic pulse pressure (CAPP), aortic augmentation index (AIxao), and pulse pressure amplification (PPA). Results When investigating PPA values in the brachial artery and aorta, we detected smaller amplification and higher aortic augmentation index at night than in daytime, which reflected a disproportionately higher CAP level during night hours. This pattern was more pronounced in postmenopausal women. We calculated the logistic regression equation (adjusted R2 = 0.49, log-likelihood = − 50.3, chi-square (19) = 97.6, p < 0.001), in which dependent variable was represented by the menopausal status, whereas body mass index with all indicators of a 24-h BP monitoring represented independent variables. In this model, two indicators (body mass index and AIxao) were, independently of each other, associated significantly with the menopause phases. Differences among women at various climacteric phases in terms of remaining indicators of a 24-h BP monitoring, apparently, matched the differences in their body mass index values. Conclusion Rising CAP, in combination with declining PPA and augmenting reflected pulse wave amplitude, may be associated with an increased risk of cardiovascular complications.
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Affiliation(s)
- Sergey N Tolstov
- Department of Therapy with Courses in Cardiology, Functional Diagnostic and Geriatrics, Saratov State Medical University, Saratov, Russia
| | - Igor A Salov
- Department of Obstetrics and Gynecology, Saratov State Medical University, Saratov, Russia
| | - Anton R Kiselev
- Department of Innovative Cardiological Information Technology, Institute of Cardiological Research, Saratov State Medical University, Saratov, Russia. .,Coordinating Center for Fundamental Research, National Medical Research Center for Therapy and Preventive Medicine, Moscow, Russia.
| | - Andrey P Rebrov
- Department of Hospital Therapy, Saratov State Medical University, Saratov, Russia
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Chu Z, Wei Y, Hao Y, Wang J, Huang F, Hou M. Clinical effectiveness of fish oil on arterial stiffness: A systematic review and meta-analysis of randomized controlled trials. Nutr Metab Cardiovasc Dis 2021; 31:1339-1348. [PMID: 33741211 DOI: 10.1016/j.numecd.2020.12.033] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [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: 10/02/2020] [Revised: 12/03/2020] [Accepted: 12/15/2020] [Indexed: 12/29/2022]
Abstract
AIMS The increase of arterial stiffness is an independent risk factor for cardiovascular diseases (CVD). Fish oil supplementation was shown to reduce the risk of CVD outcomes. However, the effects of fish oil on arterial stiffness remains controversial. This meta-analysis summarized existing randomized clinical trials (RCTs) to determine whether fish oil can affect arterial stiffness in adults. DATA SYNTHESIS Systematic searches were performed using the PubMed/Medline, EMbase, Cochrane database, Clinical trials, and Web of Science. All RCTs assessed the effect of fish oil intervention on carotid to femoral-Pulse Wave Velocity (cf-PWV), brachial to ankle-PWV (ba-PWV), augmentation index (AIx) and AIx75 were considered. A fixed-effect model was used to calculate the pooled effect. A total of 14 RCTs were included. The pooled data analysis showed that fish oil significantly reduced PWV levels (SMD: -0.145, 95%CI: -0.265 to -0.033, P = 0.012) compared to the control group. In subgroup analyses, a significant decrease in PWV was found in trials that fish oil with low dosages (≤1.8 g/d), short time (<24 weeks), low DHA to EPA ratio (DHA/EPA<1) and among young participant (<50 years old). Besides, the effect of fish oil was more obvious in ba-PWV compared to cf-PWV. In contrast, the effect of fish oil supplementation on AIx (WMD: -0.588%, 95% CI: -2.745 to 1.568, P = 0.593) and AIx75 (WMD: 0.542%, 95% CI: -1.490 to 2.574, P = 0.601) was nonsignificant. CONCLUSIONS The current study showed that fish oil supplementation had a beneficial effect on pulse wave velocity.
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Affiliation(s)
- Zhenyu Chu
- Department of Emergency Intensive Care Unit, The First Affiliated Hospital of Soochow University, Jiangsu, China
| | - Yao Wei
- Department of Emergency Intensive Care Unit, The First Affiliated Hospital of Soochow University, Jiangsu, China
| | - Yan Hao
- Department of Emergency Intensive Care Unit, The First Affiliated Hospital of Soochow University, Jiangsu, China
| | - Jun Wang
- Department of Emergency Intensive Care Unit, The First Affiliated Hospital of Soochow University, Jiangsu, China
| | - Fang Huang
- Department of Emergency Intensive Care Unit, The First Affiliated Hospital of Soochow University, Jiangsu, China
| | - Miao Hou
- Department of Cardiology, Children's Hospital of Soochow University, Suzhou, Jiangsu, China, University, Suzhou, Jiangsu, China.
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Abstract
Reflected pressure waves are key to the understanding of vascular ageing, a prominent factor in major cardiovascular events. Several different metrics have been proposed to index the effect of wave reflection on the pressure waveform and thereby serve as an indicator of vascular ageing. The extent to which these indices are influenced by factors other than vascular health remains a matter of concern. In this paper, we use transmission-line theory to derive a mathematical model for the reflection time (Trefl), and the augmentation index (AI), assuming a general extended model of the arterial system. Then, we test the proposed model against values reported in the literature. Finally, we discuss insights from the model to common observations in the literature such as age-related "shift" in the reflection site, the variation of AI with heart rate, and the flattening of Trefl in older participants.
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Affiliation(s)
- Rashid Afkhami
- School of Engineering, The Unviersity of Newcastle, Australia.
| | - Sarah Johnson
- School of Engineering, The Unviersity of Newcastle, Australia.
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32
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Afkhami R, Wong R, Ramadan S, Walker FR, Johnson S. Indexing Cerebrovascular Health Using Transcranial Doppler Ultrasound. Ultrasound Med Biol 2021; 47:919-927. [PMID: 33494950 DOI: 10.1016/j.ultrasmedbio.2020.12.022] [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] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Revised: 11/26/2020] [Accepted: 12/21/2020] [Indexed: 06/12/2023]
Abstract
Transcranial Doppler (TCD) blood flow velocity has been extensively used in biomedical research as it provides a cost-effective and relatively simple approach to assess changes in cerebral blood flow dynamics and track cerebrovascular health status. In this article we introduce a new TCD-based timing index, TITCD, as an indicator of vascular stiffening and vascular health. We investigate the correlations of the new index and the existing indices, namely the pulsatility index and the augmentation index, with age, cardiorespiratory fitness (CRF) and magnetic resonance imaging (MRI) blood flow pulsatility index (PIMRI). Notably, the new index showed stronger correlations with CRF (r = -0.79) and PIMRI (r = 0.53) compared with the augmentation index (r = -0.65 with CRF and no significant correlation with PIMRI) and the pulsatility index (no significant correlations with CRF or PIMRI), and a similar correlation with age as the augmentation index. The clearer relationship of the proposed timing index with vascular aging factors underlines its utility as an early indicator of vascular stiffening.
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Affiliation(s)
- Rashid Afkhami
- School of Electrical Engineering & Computing, University of Newcastle, Callaghan, New South Wales, Australia.
| | - Rachel Wong
- School of Biomedical Sciences & Pharmacy, University of Newcastle, Callaghan, New South Wales, Australia
| | - Saadallah Ramadan
- School of Health Science, University of Newcastle, Callaghan, New South Wales, Australia
| | - Frederick Rohan Walker
- School of Biomedical Sciences & Pharmacy, University of Newcastle, Callaghan, New South Wales, Australia
| | - Sarah Johnson
- School of Electrical Engineering & Computing, University of Newcastle, Callaghan, New South Wales, Australia
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33
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Nardone M, Miner S, McCarthy M, Edgell H. Standard exercise stress testing attenuates peripheral microvascular function in patients with suspected coronary microvascular dysfunction. BMC Sports Sci Med Rehabil 2021; 13:18. [PMID: 33640014 PMCID: PMC7913424 DOI: 10.1186/s13102-021-00246-8] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Accepted: 02/17/2021] [Indexed: 12/13/2022]
Abstract
BACKGROUND The effect of exercise on the microvasculature of patients with suspected coronary microvascular dysfunction (CMD), assessed by reactive hyperemia peripheral arterial tonometry (RH-PAT; EndoPAT), is unknown. The present study aimed to determine if standard clinical exercise stress testing (GXT) affected peripheral microvascular function, as determined by the reactive hyperemia index (RHI and LnRHI), in patients with suspected CMD. METHODS In a cross-sectional study, patients (n = 76) were grouped based on whether the GXT was performed; 1) prior to (exercisers; n = 30), or 2) after the vascular assessment (non-exercisers; n = 46). Patients with an adenosine index of microvascular resistance > 25, adenosine coronary flow reserve (CFR) < 2.0, and/or acetylcholine CFR < 1.5 were considered to have CMD (n = 42). RHI and LnRHI quantified finger pulse amplitude hyperemia following 5 min of forearm ischemia. RESULTS LnRHI was lower in patients with CMD compared to patients without CMD, while LnRHI was also lower in exercisers compared to non-exercisers (LnRHI: CMD Non-Exercisers: 0.63 ± 0.25; CMD Exercisers: 0.54 ± 0.19; No CMD Non-Exercisers: 0.85 ± 0.23; No CMD Exercisers: 0.63 ± 0.26; Condition and Exercise Main Effects: Both P < 0.01). In patients who did not exercise prior to the vascular assessment, the receiver operating characteristic curve (ROC) for LnRHI to predict CMD was 0.76 (95% CI: 0.62-0.91; P < 0.01). However, in patients who performed exercise prior to the vascular assessment, the ROC for LnRHI to predict CMD was 0.60 (95% CI: 0.40-0.81; P = 0.34). CONCLUSIONS CMD is associated with impaired peripheral microvascular function and preceding acute exercise is associated with further reductions of LnRHI. Further, acute exercise abolished the capacity for RH-PAT to predict the presence of CMD in patients with chest pain and non-obstructive coronary arteries. RH-PAT measurements in patients with suspected CMD should not be conducted after exercise has been performed.
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Affiliation(s)
- Massimo Nardone
- School of Kinesiology and Health Science, York University, 355 Norman Bethune College, Toronto, Ontario, Canada
| | - Steven Miner
- School of Kinesiology and Health Science, York University, 355 Norman Bethune College, Toronto, Ontario, Canada
- Southlake Regional Health Center, Newmarket, Ontario, Canada
| | - Mary McCarthy
- Southlake Regional Health Center, Newmarket, Ontario, Canada
| | - Heather Edgell
- School of Kinesiology and Health Science, York University, 355 Norman Bethune College, Toronto, Ontario, Canada.
- Southlake Regional Health Center, Newmarket, Ontario, Canada.
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34
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Jones DR, Chew DP, Horsfall MJ, Sinhal AR, Joseph MX, Baker RA, Bennetts JS, Selvanayagam JB, Russell AE, De Pasquale CG, Lehman SJ. Impact of increased augmentation index and valvuloarterial impedance on symptom recovery after aortic valve replacement for severe aortic stenosis. Int J Cardiol Heart Vasc 2021; 32:100705. [PMID: 33457492 PMCID: PMC7797943 DOI: 10.1016/j.ijcha.2020.100705] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Revised: 12/05/2020] [Accepted: 12/12/2020] [Indexed: 12/03/2022]
Abstract
Background Aortic stenosis (AS) is a common valvular disorder with a large symptomatic burden resulting from increased myocardial workload due to valvular obstruction. The contribution of increased afterload from arterial stiffness on symptoms is uncertain. The purpose of this analysis was to determine the symptomatic impact of arterial stiffness as determined by Applanation Tonometry. Methods Eighty-eight patients with severe AS undergoing intervention with transcatheter aortic valve replacement (TAVR) (n = 65) or surgical aortic valve replacement (SAVR) (n = 23) were prospectively enrolled. Symptoms were recorded using the NYHA Class, Kansas City Cardiomyopathy Questionnaire (KCCQ) and a 6 min walk test (6MWT) at baseline, and 1- and 6-months post intervention. Pulse Wave Analysis (PWA) using Applanation Tonometry was performed at all reviews, including the augmentation index (AIx). Results Patients undergoing TAVR were older, with worse renal function and lower aortic valve areas, but were otherwise similar. There was no significant difference between the augmentation index of our AS population compared with an age matched reference population (p = 0.89). Symptoms significantly improved after intervention according to NYHA Class, KCCQ and 6MWT. Additionally, with adjustment, the initial augmentation index correlated with the final KCCQ (Coeff. = −0.383, p = 0.02) and NYHA Class (Coeff. = 0.012, p = 0.03) and a baseline AIx value in the top quartile resulted in a significantly worse final KCCQ (95.1 v 85.2, p = 0.048) relative to the bottom 3 quartiles. Conclusions According to our analysis, an elevated baseline AIx is associated with a poorer symptomatic recovery after aortic valve intervention and so is worthy of consideration when assessing potential symptomatic benefit.
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Affiliation(s)
- Dylan R Jones
- Flinders University, Adelaide, SA, Australia.,Flinders Medical Centre, Adelaide, SA, Australia
| | - Derek P Chew
- Flinders University, Adelaide, SA, Australia.,Flinders Medical Centre, Adelaide, SA, Australia
| | - Matthew J Horsfall
- Flinders University, Adelaide, SA, Australia.,Flinders Medical Centre, Adelaide, SA, Australia
| | | | | | - Robert A Baker
- Flinders University, Adelaide, SA, Australia.,Flinders Medical Centre, Adelaide, SA, Australia
| | - Jayme S Bennetts
- Flinders University, Adelaide, SA, Australia.,Flinders Medical Centre, Adelaide, SA, Australia
| | - Joseph B Selvanayagam
- Flinders University, Adelaide, SA, Australia.,Flinders Medical Centre, Adelaide, SA, Australia
| | | | - Carmine G De Pasquale
- Flinders University, Adelaide, SA, Australia.,Flinders Medical Centre, Adelaide, SA, Australia
| | - Sam J Lehman
- Flinders University, Adelaide, SA, Australia.,Flinders Medical Centre, Adelaide, SA, Australia
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Alidadi M, Sahebkar A, Eslami S, Vakilian F, Jarahi L, Alinezhad-Namaghi M, Arabi SM, Vakili S, Tohidinezhad F, Nikooiyan Y, Norouzy A. The Effect of Curcumin Supplementation on Pulse Wave Velocity in Patients with Metabolic Syndrome: A Randomized, Double-Blind, Placebo-Controlled Trial. Adv Exp Med Biol 2021; 1308:1-11. [PMID: 33861432 DOI: 10.1007/978-3-030-64872-5_1] [Citation(s) in RCA: 14] [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] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Cardiovascular disease is a leading cause of death in many societies. Arterial stiffness is an initial sign of structural and functional changes in the arterial wall. Pulse wave velocity (PWV) is the gold standard for non-invasive evaluation of aortic stiffness and a modifiable cardiovascular risk factor. Curcumin is a major component of turmeric with known anti-inflammatory and anti-oxidative effects. Since arterial stiffness is affected by inflammation and oxidative stress, it may be improved by curcumin supplementation. The purpose of this clinical trial was to investigate the potential effects of curcumin on improving arterial stiffness in patients with metabolic syndrome. This placebo-controlled, double-blind, randomized clinical trial was conducted among metabolic syndrome patients. Sixty-six eligible individuals were randomly assigned to active intervention or control groups. The active intervention group received curcumin supplement at a dose of 500 mg daily for 12 weeks, whereas the control group received placebo capsule. Physical activity, daily dietary energy intake, anthropometric body composition, and biochemical hemodynamic and arterial stiffness parameters were evaluated at baseline and at the end of the study. Body weight decreased significantly in the curcumin group compared to placebo. Also, curcumin intervention improved PWV, which remained significant after adjustment for potential confounding factors (p = 0.011). The current clinical trial demonstrated that daily intake of 500 mg of curcumin for 12 weeks can lead to the improvement of arterial stiffness and weight management among subjects with metabolic syndrome.
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Affiliation(s)
- Mona Alidadi
- Department of Nutrition, Faculty of medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Amirhossein Sahebkar
- Applied Biomedical Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.,Biotechnology Research Center, Pharmaceutical Technology Institute, Mashhad University of Medical Sciences, Mashhad, Iran.,School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran.,Polish Mother's Memorial Hospital Research Institute (PMMHRI), Lodz, Poland
| | - Saeid Eslami
- Polish Mother's Memorial Hospital Research Institute (PMMHRI), Lodz, Poland
| | - Farveh Vakilian
- Department of Cardiology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Lida Jarahi
- Department of Community Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Maryam Alinezhad-Namaghi
- Department of Nutrition, Faculty of medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Seyed Mostafa Arabi
- Department of Nutrition, Faculty of medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Saba Vakili
- Medical Genetics Research Centre, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Fariba Tohidinezhad
- Department of Medical Informatics, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Yasaman Nikooiyan
- Medical Student, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Abdolreza Norouzy
- Department of Nutrition, Faculty of medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
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36
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Kim HL, Koo BK, Joo SK, Kim W. Association of arterial stiffness with the histological severity of nonalcoholic fatty liver disease. Hepatol Int 2020; 14:1048-1056. [PMID: 33269420 DOI: 10.1007/s12072-020-10108-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2020] [Accepted: 11/09/2020] [Indexed: 12/30/2022]
Abstract
BACKGROUND Although arterial stiffness has been reported to be associated with nonalcoholic fatty liver disease (NAFLD), previous studies have relied only on noninvasive assessments for the diagnosis of NAFLD. This study attempted to investigate the association of arterial stiffness with the histological severity of NAFLD. METHODS We analyzed data from a biopsy-proven prospective NAFLD cohort. Augmentation index corrected for a heart rate of 75 bpm (AI@75) was obtained using applanation tonometry of the radial artery. RESULTS A total of 154 patients (mean age 55.2 years; females 55.8%) with biopsy-proven NAFLD were analyzed. Patients with higher AI@75 (≥ 76%) showed more severe grades of lobular and portal inflammation and hepatocellular ballooning, and more advanced stages of fibrosis compared to those with lower AI@75 (< 76%) (p < 0.05 for each). The presence of nonalcoholic steatohepatitis (NASH) (adjusted odds ratio [aOR] 2.48; 95% confidence interval [CI] 1.31-6.16; p = 0.008), lobular inflammation (aOR 2.03; 95% CI 1.09-3.78; p = 0.025) hepatocellular ballooning (aOR 2.82; 95% CI 1.23-6.43; p = 0.014), and significant fibrosis (≥ F2) (aOR 3.42; 95% CI 1.50-7.79; p = 0.003) were independently associated with higher AI@75 (≥ 76%) even after adjustment for confounders. CONCLUSION Arterial stiffness as indicated by higher AI@75 was associated with more severe NAFLD histology. This adds to the evidence for the association between increased arterial stiffness and NAFLD.
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Affiliation(s)
- Hack-Lyoung Kim
- Division of Cardiology, Department of Internal Medicine, Boramae Medical Center, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Bo Kyung Koo
- Division of Endocrinology, Department of Internal Medicine, Boramae Medical Center, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Sae Kyung Joo
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Boramae Medical Center, Seoul National University College of Medicine, 20, Boramae-ro 5-gil, Dongjak-gu, Seoul, 07061, Republic of Korea
| | - Won Kim
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Boramae Medical Center, Seoul National University College of Medicine, 20, Boramae-ro 5-gil, Dongjak-gu, Seoul, 07061, Republic of Korea.
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Harber MP, McCurry A, Carlini N, Kistler B, Fleenor BS. Caffeine ingestion alters central hemodynamics following aerobic exercise in middle-aged men. Eur J Appl Physiol 2020; 121:435-443. [PMID: 33098463 DOI: 10.1007/s00421-020-04521-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2020] [Accepted: 10/01/2020] [Indexed: 12/21/2022]
Abstract
PURPOSE To examine the acute influence of caffeine on post-exercise central blood pressures, arterial stiffness, and wave reflection properties. METHODS In a double-blind randomized placebo-controlled crossover study design, ten middle-aged males (55 ± 5 year) completed two exercise trials after ingestion of caffeine (400 mg) or placebo. Measurements were taken before and 30 min post-ingestion via cuff-based pulse wave analysis (PWA) and carotid-femoral pulse wave velocity (PWV). Participants performed a 40-min cycling bout at 70% HRmax with matched workloads between trials. PWA and PWV were reassessed 30 min post-exercise. RESULTS Prior to exercise, compared to placebo, caffeine increased brachial systolic blood pressure (bSBP) (+ 12.3 ± 2.4 mmHg; p = 0.004), brachial diastolic blood pressure (bDBP) (+ 7.7 ± 0.9 mmHg; p = 0.011), central systolic blood pressure (cSBP) (+ 11.1 ± 2.1 mmHg; p = 0.005) and central diastolic blood pressure (cDBP) (+ 7.6 ± 1.0 mmHg; p = 0.012). PWV was higher 30 min after pill ingestion (p = 0.021 for time) with a trend for a greater increase in caffeine (p = 0.074 for interaction). bSBP (p = 0.036) and cSBP (p = 0.007) were lower after exercise but remained higher (both p < 0.001) in caffeine compared to placebo. PWV remained higher (p = 0.023) after exercise in caffeine compared to placebo but was not influenced by exercise. At rest, augmentation pressure (AP) and index (AIx) were not influenced by caffeine ingestion. Conversely, AIx was lower (p = 0.009) after exercise in placebo only. CONCLUSION In healthy and active middle-aged men, pre-exercise caffeine ingestion led to higher central and peripheral systolic blood pressures, PWV and AIx at 30 min post-exercise, indicating an increased left ventricular workload which may have implications for cardiovascular event risk.
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Affiliation(s)
- Matthew P Harber
- Clinical Exercise Physiology, Human Performance Laboratory, Ball State University, Muncie, IN, 47306, USA.
| | - Allison McCurry
- Clinical Exercise Physiology, Human Performance Laboratory, Ball State University, Muncie, IN, 47306, USA
| | - Nicholas Carlini
- Clinical Exercise Physiology, Human Performance Laboratory, Ball State University, Muncie, IN, 47306, USA
| | - Brandon Kistler
- Nutrition and Dietetics, Ball State University, Muncie, IN, USA
| | - Bradley S Fleenor
- Clinical Exercise Physiology, Human Performance Laboratory, Ball State University, Muncie, IN, 47306, USA
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Demir A, Öztürk Ş, Ekmekçi AH, Demir K, Avcı A, Eren F, Sivri M. Decrease in Pulse Wave Velocity is Associated with Clinical Improvement in Patients with Ischemic Stroke. J Stroke Cerebrovasc Dis 2020; 29:105206. [PMID: 33066902 DOI: 10.1016/j.jstrokecerebrovasdis.2020.105206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Revised: 07/22/2020] [Accepted: 07/23/2020] [Indexed: 10/23/2022] Open
Abstract
BACKGROUND Arterial stiffness is an independent determinant of cardiovascular and cerebrovascular risks. The relationship between the increase in arterial stiffness parameters and the severity of stroke has been shown in previous studies. We aimed to investigate the association between clinical improvement and changes in arterial stiffness parameters in patients presenting acute ischemic stroke. METHODS A total of 107 patients were enrolled in this study. On the first and seventh day of the hospitalization, 24 h non-invasive blood pressure was monitored and arterial stiffness parameters were measured. The National Institutes of Health Stroke Scale (NIHSS) was used to determine the severity of stroke, and the Modified Rankin Scale was used to determine dependency and to evaluate functional improvements. RESULTS Arterial stiffness parameters of augmentation index (AIx@75) and pulse wave velocity (PWV) were significantly higher in patients who died during hospitalization than patients who were discharged (respectively p <0.001, p = 0.04). In the group with clinical improvement, PWV values measured on the seventh day were significantly lower than PWV values measured on the first day (p = 0.032). When the changes in PWV value measured on the first and seventh day for both groups were analyzed using mixed ANOVA test, p value were significant (p = 0.033). Multivariate binary logistic regression analyses showed that negatively change in PWV and CDBP independently predicts the clinical improvement. CONCLUSIONS Increased AIx@75 and PWV appear to be associated with higher in-hospital mortality rates in patients with acute ischemic stroke. Additionally, clinical improvement in patients with ischemic stroke is associated with a decrease in PWV .
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Affiliation(s)
- Ayşegül Demir
- Department of Neurology, Konya Education Research Hospital, 04240, Konya, Turkey
| | - Şerefnur Öztürk
- Department of Neurology, Selcuk University Faculty of Medicine, 04240, Konya, Turkey
| | - Ahmet Hakan Ekmekçi
- Department of Neurology, Selcuk University Faculty of Medicine, 04240, Konya, Turkey
| | - Kenan Demir
- Department of Cardiology, Selcuk University Faculty of Medicine, 04240, Konya, Turkey.
| | - Ahmet Avcı
- Department of Cardiology, Zonguldak Bülent Ecevit University Faculty of Medicine, 67100, Zonguldak, Turkey
| | - Fettah Eren
- Department of Neurology, Konya Education Research Hospital, 04240, Konya, Turkey
| | - Mesut Sivri
- Departmant of Radiology, Ankara City Hospital, 06800, Ankara, Turkey
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Piña AA, Shadiow J, Tobi Fadeyi A, Chavez A, Hunter SD. The acute effects of vinyasa flow yoga on vascular function, lipid and glucose concentrations, and mood. Complement Ther Med 2020; 56:102585. [PMID: 33197660 DOI: 10.1016/j.ctim.2020.102585] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2020] [Revised: 09/28/2020] [Accepted: 09/30/2020] [Indexed: 10/23/2022] Open
Abstract
While the chronic effects of certain styles of yoga on cardiometabolic factors have been investigated, little is known about the acute effects of a single yoga session on these outcomes. Moreover, vinyasa yoga's potential to modulate cardiometabolic outcomes has not been established. The purpose of this study is to determine the acute effects of a vinyasa yoga session on arterial stiffness, wave reflection, lipid and glucose concentrations, and mood in adults with prior yoga experience. Thirty yoga practitioners with a minimum of 3 months of practice experience were enrolled into the study. Carotid-femoral pulse wave velocity (cf-PWV), augmentation index (AIx), lipid profile, glucose concentrations, and mood (Positive and Negative Affect Scale) were assessed at baseline and immediately following a 1 -h vinyasa yoga session. After the yoga session, participants had significantly lower AIx (p < 0.001), non-HDL cholesterol (p < 0.05), and negative affect (p < 0.01) compared to baseline. These results highlight the efficacy of a single bout of yoga in altering wave reflection while improving mood and lipid concentrations in healthy adults with a history of yoga practice.
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Affiliation(s)
- Alexander A Piña
- Cardiovascular Physiology Laboratory, Texas State University, Department of Health and Human Performance, San Marcos, TX, United States
| | - James Shadiow
- Cardiovascular Physiology Laboratory, Texas State University, Department of Health and Human Performance, San Marcos, TX, United States
| | - A Tobi Fadeyi
- Cardiovascular Physiology Laboratory, Texas State University, Department of Health and Human Performance, San Marcos, TX, United States
| | - Anabel Chavez
- Cardiovascular Physiology Laboratory, Texas State University, Department of Health and Human Performance, San Marcos, TX, United States
| | - Stacy D Hunter
- Cardiovascular Physiology Laboratory, Texas State University, Department of Health and Human Performance, San Marcos, TX, United States.
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Gujral UP, Mehta A, Sher S, Uphoff I, Kumar S, Hayek SS, Ko YA, Martin GS, Gibbons GH, Quyyumi AA. Ethnic differences in subclinical vascular function in South Asians, Whites, and African Americans in the United States. Int J Cardiol Heart Vasc 2020; 30:100598. [PMID: 32793802 PMCID: PMC7408720 DOI: 10.1016/j.ijcha.2020.100598] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Revised: 06/29/2020] [Accepted: 07/20/2020] [Indexed: 11/19/2022]
Abstract
BACKGROUND South Asians are a high-risk ethnic group for cardiovascular disease despite having lower levels of conventional cardiovascular risk factors such as obesity and smoking. Ethnic differences in pulse wave reflections, arterial stiffness, and subclinical atherosclerosis as measured using augmentation index (AIX), pulse wave velocity (PWV), and carotid intima-media thickness (CIMT) may reflect some of this excess risk. METHODS We conducted a cross-sectional analysis of pooled data from three community-based sources in Atlanta, Georgia, USA. Data on 530 South Asians collected from local health fairs was compared with data on 507 White and 192 African Americans from the Emory Predictive Health Initiative and 351 White and 382 African Americans from the Morehouse and Emory Team up to Eliminate Health Disparities Study. RESULTS Linear regression models adjusted for age, sex, smoking, MAP, fasting glucose, TC, HDL-C, creatinine, and body mass index were used to assess the relationship between ethnicity and vascular function measures. In fully adjusted models, South Asians had higher heart rate corrected AIX as compared with Whites and African Americans (by 5.47%, p < 0.01 and 3.50%, p < 0.01; respectively), but lower PWV (by 0.51 m/s, p < 0.01 and 0.72 m/s, p < 0.01; respectively) and lower CIMT (by 0.02 mm p = 0.03 and 0.04 mm p < 0.01; respectively). CONCLUSIONS Systemic pulse wave reflections, independent of other risk factors, are higher in South Asians as compared with Whites and African Americans. Future research is needed to determine whether higher AIX explains the increased cardiovascular risk among South Asians.
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Affiliation(s)
- Unjali P. Gujral
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Anurag Mehta
- Emory Clinical Cardiovascular Research Institute, Division of Cardiology, Department of Medicine, Emory University School of Medicine, Atlanta, GA, USA
| | - Salman Sher
- Emory Clinical Cardiovascular Research Institute, Division of Cardiology, Department of Medicine, Emory University School of Medicine, Atlanta, GA, USA
| | - Irina Uphoff
- Emory Clinical Cardiovascular Research Institute, Division of Cardiology, Department of Medicine, Emory University School of Medicine, Atlanta, GA, USA
| | - Saket Kumar
- Ohio State University, Wexner Medical Center, Department of Emergency Medicine, USA
| | - Salim S. Hayek
- Frankel Cardiovascular Center, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Yi-An Ko
- Emory Clinical Cardiovascular Research Institute, Division of Cardiology, Department of Medicine, Emory University School of Medicine, Atlanta, GA, USA
- Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Greg S. Martin
- Division of Pulmonary, Allergy, Critical Care, and Sleep Medicine, Department of Medicine, Emory University School of Medicine, Atlanta, GA, USA
| | - Gary H. Gibbons
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, USA
| | - Arshed A. Quyyumi
- Emory Clinical Cardiovascular Research Institute, Division of Cardiology, Department of Medicine, Emory University School of Medicine, Atlanta, GA, USA
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Roeder M, Thiel S, Baumann F, Sievi NA, Rohrbach M, Kohler M, Gaisl T. Increased augmentation index in patients with Ehlers-Danlos syndrome. BMC Cardiovasc Disord 2020; 20:417. [PMID: 32933483 PMCID: PMC7493396 DOI: 10.1186/s12872-020-01684-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2019] [Accepted: 08/25/2020] [Indexed: 01/06/2023] Open
Abstract
Background Ehlers-Danlos Syndrome (EDS) comprises a heterogeneous group of diseases characterized by joint hypermobility, connective tissue friability, and vascular fragility. Reliable prognostic factors predicting vascular disease progression (e.g. arterial aneurysms, dissections, and ruptures) in EDS patients are still missing. Recently, applanation tonometry derived augmentation index (AIx), an indirect marker of arterial stiffness, has shown to be positively associated with progression of aortic disease in Marfan syndrome. In this study, we assessed aortic AIx in patients with EDS and matched healthy controls. Methods We performed noninvasive applanation tonometry in 61 adults with EDS (43 women and 18 men aged 39.3 ± 14.6 years) and 61 age-, gender-, height-, and weight-matched healthy controls. Radial artery pulse waveforms were recorded and analyzed using the SphygmoCor System (AtCor Medical, Sydney, NSW, Australia). Calculated AIx was adjusted to a heart rate of 75/min. Groups were compared and association between AIx and EDS was determined by univariate and multivariate regression analysis. Results EDS patients were categorized in classical type EDS (34%), hypermobile type EDS (43%), vascular type EDS (5%), or remained unassignable (18%) due to overlapping features. EDS patients showed a significantly increased aortic AIx compared to healthy controls (22.8% ± 10.1 vs 14.8% ± 14.0, p < 0.001). EDS showed a positive association with AIx; independent of age, sex, height, blood pressure, medication, and pack years of smoking. Conclusions Patients with EDS showed elevated AIx, indicating increased arterial stiffness when compared to healthy controls. Further investigations are needed in order to assess the prognostic value of increased AIx for cardiovascular outcomes in patients with EDS.
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Affiliation(s)
- Maurice Roeder
- Department of Pulmonology, University Hospital Zurich, Rämistrasse 100, 8091, Zurich, Switzerland
| | - Sira Thiel
- Department of Pulmonology, University Hospital Zurich, Rämistrasse 100, 8091, Zurich, Switzerland
| | - Frederic Baumann
- Clinical and Interventional Angiology, University Hospital Zurich, Zurich, Switzerland
| | - Noriane A Sievi
- Department of Pulmonology, University Hospital Zurich, Rämistrasse 100, 8091, Zurich, Switzerland
| | - Marianne Rohrbach
- Division of Metabolism and Children's Research Center University Children's Hospital Zurich, Zurich, Switzerland
| | - Malcolm Kohler
- Department of Pulmonology, University Hospital Zurich, Rämistrasse 100, 8091, Zurich, Switzerland. .,Centre for Interdisciplinary Sleep Research, University of Zurich, Zurich, Switzerland.
| | - Thomas Gaisl
- Department of Pulmonology, University Hospital Zurich, Rämistrasse 100, 8091, Zurich, Switzerland
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Dimitroulas T, Baniotopoulos P, Pagkopoulou E, Soulaidopoulos S, Nightingale P, Sandoo A, Karagiannis A, Douglas K, Sachinidis A, Garyfallos A, Kitas G. Subclinical atherosclerosis in systemic sclerosis and rheumatoid arthritis: a comparative matched-cohort study. Rheumatol Int 2020; 40:1997-2004. [PMID: 32772133 DOI: 10.1007/s00296-020-04677-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Accepted: 08/03/2020] [Indexed: 01/28/2023]
Abstract
Systemic autoimmune inflammatory disorders confer a higher risk of cardiovascular (CV) disease leading to increased morbidity and mortality and reduced life expectancy compared to the general population. CV risk in systemic sclerosis (SSc) has not been studied extensively but surrogate markers of atherosclerosis namely carotid intima media thickness (cIMT) and pulse wave velocity (PWV) are impaired in some but not all studies in SSc patients. The aim of this study was to investigate the prevalence of subclinical atherosclerosis assessed by cIMT and PWV between two well-characterized SSc and Rheumatoid Arthritis (RA) cohorts. Consecutive SSc patients attending the Scleroderma Clinic were compared with RA patients recruited in the Dudley Rheumatoid Arthritis Co-morbidity Cohort (DRACCO), a prospective study examining CV burden in RA. Augmentation Index (Aix75) and cIMT were measured in all participants. Propensity score matching was utilised to select patients from the two cohorts with similar demographic characteristics, CV risk factors and inflammatory load. Unpaired analysis was performed using unpaired t test for continuous variables and χ2 test for dichotomous variables. Statistical analysis was repeated using paired t test for continuous normal variables and McNemar's test for dichotomous variables. Fifty five age- and sex-matched SSc and RA patients were included in the analysis. No difference was demonstrated between SSc and RA subjects regarding cIMT (0.66 mm vs 0.63 mm, respectively) and Aix75% measurements (33.4 vs 31.7, respectively) neither in paired (p = 0.623 for cIMT and p = 0.204 for Aix%) nor in unpaired t test analysis (p = 0.137 for cIMT and p = 0.397 for AIx%). The results of this comparative study show that subclinical atherosclerosis is comparable between SSc and RA, a systemic disease with well-defined high atherosclerotic burden. Such findings underscore the importance of CV risk management in SSc in parallel with other disease-related manifestations.
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Affiliation(s)
- Theodoros Dimitroulas
- Fourth Department of Internal Medicine, Medical School, Hippokration General Hospital, Aristotle University of Thessaloniki, Konstantinoupoleos Str. 49, Thessaloníki, Greece.
| | | | - Eleni Pagkopoulou
- Fourth Department of Internal Medicine, Medical School, Hippokration General Hospital, Aristotle University of Thessaloniki, Konstantinoupoleos Str. 49, Thessaloníki, Greece
| | - Stergios Soulaidopoulos
- Fourth Department of Internal Medicine, Medical School, Hippokration General Hospital, Aristotle University of Thessaloniki, Konstantinoupoleos Str. 49, Thessaloníki, Greece.,First Department of Cardiology, Hippokration Hospital, Medical School of Athens University, Athens, Greece
| | - Peter Nightingale
- Wolfson Computer Labaratory, University Hospitals of Birmingham, Birmingham, NHS FT, UK
| | - Aamer Sandoo
- School of Sport, Health and Exercise Sciences, Bangor University, George Building, Bangor, Gwynedd, LL57 2PZ, Wales, UK.,Department of Rheumatology, Dudley Group NHS FT, Russells Hall Hospital, Pensnett Road, Dudley, DY1 2HQ, UK
| | - Asterios Karagiannis
- Second Propedeutic Department of Internal Medicine, Medical School, Hippokration General Hospital, Aristotle University of Thessaloniki, Thessaloníki, Greece
| | - Karen Douglas
- Department of Rheumatology, Dudley Group NHS FT, Russells Hall Hospital, Pensnett Road, Dudley, DY1 2HQ, UK
| | - Athanasios Sachinidis
- Department of Pharmacognosy-Pharmacology, School of Pharmacy, Aristotle University, Thessaloníki, Greece
| | - Alexandros Garyfallos
- Fourth Department of Internal Medicine, Medical School, Hippokration General Hospital, Aristotle University of Thessaloniki, Konstantinoupoleos Str. 49, Thessaloníki, Greece
| | - George Kitas
- Department of Rheumatology, Dudley Group NHS FT, Russells Hall Hospital, Pensnett Road, Dudley, DY1 2HQ, UK.,Arthritis Research UK Centre for Epidemiology, University of Manchester, Manchester, UK
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Okamoto T, Hashimoto Y, Kobayashi R. Isometric handgrip training reduces blood pressure and wave reflections in East Asian, non-medicated, middle-aged and older adults: a randomized control trial. Aging Clin Exp Res 2020; 32:1485-1491. [PMID: 31463925 DOI: 10.1007/s40520-019-01330-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2019] [Accepted: 08/17/2019] [Indexed: 10/26/2022]
Abstract
PURPOSE The aim of this study was to investigate the effects of isometric handgrip (IHG) training on central and peripheral blood pressure (BP) and wave reflections in East Asian non-medicated middle-aged and older adults. METHODS Twenty-two men and women (mean age 65 ± 11 years) who were not actively involved in regular resistance or endurance training were randomly assigned to a group that did IHG and a control (CON) group. The IHG training was comprised of four unilateral 2-min isometric contractions at 30% of maximal voluntary contraction using a programmed handgrip dynamometer with 1-min rest periods for 5 days per week for 8 weeks. RESULTS Baseline central systolic BP (cSBP), brachial systolic BP (bSBP), brachial diastolic BP (bDBP), and the augmentation index (AIx) (via an automated applanation tonometric system) did not differ significantly between the groups. Compared to baseline, cSBP, bSBP, bDBP, and AIx decreased significantly after the 8-week study period in the IHG group (P < 0.05). No significant changes in central and peripheral BP and AIx were observed in the CON group. CONCLUSIONS These results suggest that IHG training could reduce central and peripheral BP and wave reflections in East Asian non-medicated middle-aged and older adults.
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Jeon YJ, Cho SMJ, Lee YJ, Kim HC, Jung SJ. Depressive symptoms, its sub-factors, and augmentation index: the modifying effects according to inflammatory markers. J Affect Disord 2020; 272:380-387. [PMID: 32553381 DOI: 10.1016/j.jad.2020.03.174] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2019] [Revised: 02/25/2020] [Accepted: 03/29/2020] [Indexed: 11/19/2022]
Abstract
Background This study aimed to investigate the association between depression and the augmentation index (AIx), and to further investigate whether there is a difference in this association according to the patients' inflammatory status. Methods This study included 458 men and 815 women (mean age: 49.35 years), a community-dwelling and middle-aged Korean population. The Korean version of the Beck Depression Inventory-II (BDI-II) was used to assess depressive symptoms. Arterial stiffness was evaluated via an AIx normalized to 75 beats/min. We confirmed two factors from BDI-II after conducting a factor analysis. Multiple regression models were used after adjusting for socio-demographic factors, lifestyle factors, systolic blood pressure, diabetes history, and body mass index. We further stratified the data according to inflammatory biomarkers with cutoffs of the 75th percentile. Results There was a significant positive association between the BDI-II score and arterial stiffness (ß= 0.09, p-value=0.037). In women, the somatic-affective factor showed a stronger positive association (ß= 0.20, p-value=0.018) with arterial stiffness than the cognitive factor (ß= 0.12, p-value=0.148). There was no significant association in men (ß= -0.01, p-value=0.943). In subgroup analyses, women showed significant positive associations between the somatic affective factor of depressive symptoms on and arterial stiffness according to both inflammatory markers (IL-6: ß= 0.17, p-value=0.039; hs-CRP: ß= 0.17, p-value=0.094) Limitations The design of the cross-sectional study limits causal interpretation. Conclusion Depression and its somatic-affective factor were positively associated with arterial stiffness in women. Inflammatory status may be involved in modifying the association between depressive symptoms, its sub-factors, and AIx.
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Affiliation(s)
- Ye Jin Jeon
- Department of Public Health, Yonsei University Graduate School, Seoul, Korea
| | - So Mi Jemma Cho
- Department of Public Health, Yonsei University Graduate School, Seoul, Korea
| | - Yu Jin Lee
- Department of Public Health, Yonsei University Graduate School, Seoul, Korea
| | - Hyeon Chang Kim
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, South Korea; Cardiovascular and Metabolic Diseases Etiology Research Center, Yonsei University College of Medicine, Seoul, Korea
| | - Sun Jae Jung
- Department of Public Health, Yonsei University Graduate School, Seoul, Korea; Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, South Korea; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, United States.
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Abstract
The use of electronic cigarettes has increased exponentially since its introduction onto the global market in 2006. However, short- and long-term health effects remain largely unknown due to the novelty of this product. The present study examines the acute effects of e-cigarette aerosol inhalation, with and without nicotine, on vascular and pulmonary function in healthy volunteers. Seventeen healthy subjects inhaled electronic cigarette aerosol with and without nicotine on two separate occasions in a double-blinded crossover fashion. Blood pressure, heart rate, and arterial stiffness measured by pulse wave velocity and pulse wave analysis were assessed at baseline, and then at 0 h, 2 h, and 4 h following exposure. Dynamic spirometry and impulse oscillometry were measured following vascular assessments at these time points, as well as at 6 h following exposure. e-Cigarette aerosol with nicotine caused a significant increase in heart rate and arterial stiffness. Furthermore, e-cigarette aerosol-containing nicotine caused a sudden increase in flow resistance as measured by impulse oscillometry, indicating obstruction of the conducting airways. Both aerosols caused an increase in blood pressure. The present study indicates that inhaled e-cigarette aerosol with nicotine has an acute impact on vascular and pulmonary function. Thus, chronic usage may lead to long-term adverse health effects. Further investigation is warranted.
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Aziz M, Gannarapu S, Humayun C, Siddiqui U, Nasir K, Aneni EC. Association of particles of lipoprotein subclasses with arterial stiffness in a high-risk working population: the Baptist Employee Healthy Heart Study (BEHHS). Egypt Heart J 2020; 72:12. [PMID: 32193785 PMCID: PMC7082444 DOI: 10.1186/s43044-020-00046-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2020] [Accepted: 02/25/2020] [Indexed: 11/30/2022] Open
Abstract
Background Arterial stiffness is an independent predictor of cardiovascular disease (CVD) morbidity and mortality. A risk factor-independent association of arterial stiffness with traditional lipids has been described extensively, but it is still unclear whether an independent relationship exists between arterial stiffness and particles of lipoprotein subclasses. Methods The Baptist Employee Healthy Heart Study (BEHHS) is a lifestyle intervention study examining the effects of web-based programs on reducing CVD risk in high-risk persons. Participants had their brachial arterial augmentation index (AI, a measure arterial stiffness) assessed using the EndoPAT 2000 device. Cardio IQ™ ion mobility lipoprotein fractionation was utilized for measurement of particles of lipoprotein subclasses. Results The population consisted of 182 participants, (74% women, 49% Hispanic) with a mean age of 52 ± 9 years. There was a significant trend association between quartiles of AI and total cholesterol, HDL-c, large LDL-p, small IDL-p, large IDL-p, and all subclasses of HDL particles (total HDL-p, small HDL-p, and large HDL-p). In logistic regression analysis, only HDL-c, total LDL-p, large LDL-p, small IDL-p, large IDL-p, total HDL-p, small HDL-p, and large HDL-p demonstrated significant independent association with AI. Conclusion Several lipoprotein subclasses demonstrate independent significant associations with arterial stiffness. A safe and relatively inexpensive blood test may be useful in identifying subclinical atherosclerosis process in a relatively young high CVD risk population. Trial registration ClinicalTrials.gov, NCT01912209. Registered July 31, 2013
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Affiliation(s)
- Muhammad Aziz
- Family Medicine Center, West Kendall Baptist Hospital, Miami, FL, USA.,Center for Healthcare Advancement & Outcomes, Baptist Health South Florida, 9555 SW 162nd Ave. MAB, Suite 103, Miami, FL, 33196, USA.,Florida International University, Department of Humanities, Health, and Society (HHS), Herbert Wertheim College of Medicine, Miami, FL, USA
| | - Swetha Gannarapu
- Center for Healthcare Advancement & Outcomes, Baptist Health South Florida, 9555 SW 162nd Ave. MAB, Suite 103, Miami, FL, 33196, USA
| | - Choudhry Humayun
- Center for Healthcare Advancement & Outcomes, Baptist Health South Florida, 9555 SW 162nd Ave. MAB, Suite 103, Miami, FL, 33196, USA
| | - Usman Siddiqui
- Center for Healthcare Advancement & Outcomes, Baptist Health South Florida, 9555 SW 162nd Ave. MAB, Suite 103, Miami, FL, 33196, USA
| | - Khurram Nasir
- Center for Healthcare Advancement & Outcomes, Baptist Health South Florida, 9555 SW 162nd Ave. MAB, Suite 103, Miami, FL, 33196, USA.,Center for Outcomes Research and Evaluation, Yale-New Haven Hospital, New Haven, CT, 06510, USA.,Johns Hopkins University, Johns Hopkins Ciccarone Center for Prevention of Heart Disease, Baltimore, MD, USA
| | - Ehimen C Aneni
- Center for Healthcare Advancement & Outcomes, Baptist Health South Florida, 9555 SW 162nd Ave. MAB, Suite 103, Miami, FL, 33196, USA. .,Internal Medicine, Section of Cardiovascular Medicine, Yale-New Haven Hospital, New Haven, CT, 06510, USA.
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Uemura K, Nishikawa T, Kawada T, Sugimachi M. Comprehensive analysis of effective reflection distance and its association with wave reflection strength under diverse hemodynamic conditions in anesthetized dogs. J Biomech 2020; 104:109753. [PMID: 32209244 DOI: 10.1016/j.jbiomech.2020.109753] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2019] [Revised: 03/10/2020] [Accepted: 03/13/2020] [Indexed: 11/27/2022]
Abstract
Pressure wave reflection is associated with cardiovascular risk. The conceptual distance to a theoretical major reflection site, termed effective reflection distance (ERD), has been associated with aging and augmentation index (AIx) clinically. However, it remains unclear whether and how ERD varies and associates with AIx when the hemodynamic condition is acutely perturbed in a patient. The objective of this study was to address this issue in rigorously controlled animal experiments. In 13 anesthetized dogs, we measured arterial pressure, aortic flow and femoral arterial flow, while altering the hemodynamic condition over wide ranges by administering zatebradine (bradycardic agent), nitroprusside (vasodilator), noradrenaline (vasoconstrictor), dobutamine (inotrope), and dextran (volume-expander). Using the measured data, we determined ERD based on an arterial model comprising a tube with a complex frequency-dependent load (ERDTL), which has been considered a physiologically valid model. We also determined ERD based on wave separation (ERDWSA) and pressure-based analyses (ERDAW). ERDTL was shortened significantly in response to nitroprusside or dobutamine infusion, and was significantly and negatively associated with AIx in multiple regression analysis using pooled data. ERDWSA or ERDAW did not necessarily correlate with ERDTL in terms of responses to drug administration or association with AIx. In conclusion, under diverse hemodynamic conditions, ERDTL changes sensitively and shows physiologically reasonable association with AIx. This result substantiates the importance of paying close attention to medications during clinical analysis of wave reflection. Caution is required when using ERDWSA or ERDAW as an alternative to ERDTL.
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Affiliation(s)
- Kazunori Uemura
- Department of Cardiovascular Dynamics, National Cerebral and Cardiovascular Center, Suita 564-8565, Japan.
| | - Takuya Nishikawa
- Department of Cardiovascular Dynamics, National Cerebral and Cardiovascular Center, Suita 564-8565, Japan
| | - Toru Kawada
- Department of Cardiovascular Dynamics, National Cerebral and Cardiovascular Center, Suita 564-8565, Japan
| | - Masaru Sugimachi
- Department of Cardiovascular Dynamics, National Cerebral and Cardiovascular Center, Suita 564-8565, Japan
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Kaya M, Balasubramanian V, K-J Li J. Augmentation index in the assessment of wave reflections and systolic loading. Comput Biol Med 2019; 113:103418. [PMID: 31493580 DOI: 10.1016/j.compbiomed.2019.103418] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2019] [Revised: 08/26/2019] [Accepted: 08/26/2019] [Indexed: 01/17/2023]
Abstract
BACKGROUND Augmentation index (AIx) is used to quantify the augmented systolic aortic pressure that impedes ventricular ejection. Its use as an index of wave reflections is questionable. We hypothesize that AIx is quantitatively different from the reflection coefficient under varied physiological conditions. METHODS 42 datasets of aortic pressure and flow waveforms were obtained during induced hypertension (methoxamine infusion) and vasodilation (nitroprusside infusion) in our mongrel dog experiments (n = 5) and from Mendeley data during various interventions (vasoconstrictors, vasodilators, pacing, stimulation, hemorrhage and hemodilution). Wave reflections and principal components of reflection coefficients were computed for comparison to AIx and heart rate normalized AIx. RESULTS: Principal reflection coefficient, Γ1, increased in hypertension and decreased in vasodilation, hemorrhage and hemodilution. AIx followed the trend in many cases but was consistently lower than Γ1 in almost all the subjects. The Bland-Altman analysis also showed that both AIx and normalized AIx underestimated Γ1. The relationship between augmentation index and reflection coefficient was explained by a linear regression model (r2 = 0.23, p < 0.01) in which AIx followed directional changes in Γ1 and the normalization of AIx resulted in a linear model that explained less variation in the relationship between AIx and Γ1. CONCLUSION AIx is a reasonable clinical trend indicator, albeit not an accurate surrogate measure of the amount of wave reflections.
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Einstein S, Pilt K, Palmar M, Meigas K, Viigimaa M. Aortic Augmentation Index is Dependent on Bodyside in Healthy Young Subjects. High Blood Press Cardiovasc Prev 2019; 26:375-82. [PMID: 31420833 DOI: 10.1007/s40292-019-00335-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2019] [Accepted: 07/31/2019] [Indexed: 10/26/2022] Open
Abstract
INTRODUCTION Aortic augmentation index (AIx) is a commonly used measure to evaluate the arterial stiffness of large elastic arteries. It has been used as an indicator for cardiovascular risk in clinical practice. AIM To evaluate the difference in the aortic AIx assessed from the left and the right hand in a group of healthy young adults using SphygmoCor and Arteriograph devices. METHODS 32 subjects were enrolled in this study (27 ± 7 years), 16 male and 16 female volunteers participated. Equally, half of the gender groups were left-handed and another half right-handed. RESULTS It was found that the aortic AIx values assessed from the pressure waveforms of the right and the left hand are different and significantly higher in the left hand. Using a SphygmoCor device, the mean difference between the aortic AIx values from the right and the left hand among the whole study group was found - 4.78 ± 4.31% and using an Arteriograph the aortic AIx values were - 3.92 ± 3.90%. Aortic AIx values assessed from the right and the left hand were linearly related to each other for both devices. Moreover, it was found that the values of the aortic. CONCLUSIONS AIx are independent of the subject's handedness. It has to be pointed out that subjects who cannot be subjected to assessment of the aortic AIx from one side of the body could have different AIx values estimated from the recorded pressure waveform from the other bodyside.
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Perrault R, Omelchenko A, Taylor CG, Zahradka P. Establishing the interchangeability of arterial stiffness but not endothelial function parameters in healthy individuals. BMC Cardiovasc Disord 2019; 19:190. [PMID: 31387535 PMCID: PMC6685177 DOI: 10.1186/s12872-019-1167-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2018] [Accepted: 07/23/2019] [Indexed: 12/15/2022] Open
Abstract
Background Development of instruments capable of detecting early stage vascular disease has increased interest in employing arterial stiffness (e.g. pulse wave velocity (PWV), augmentation index (AIx)) and endothelial dysfunction (e.g. reactive hyperemia index (RHI)) to diagnose atherosclerotic disease before occurrence of a cardiovascular event. However, amongst the equipment designed for this purpose, there is insufficient information regarding each of these parameters to establish appropriate cutoffs to distinguish between healthy and unhealthy blood vessels. To address these limitations, the study was designed to establish the upper arterial stiffness and endothelial function thresholds in a healthy population, by comparing the outputs from different instruments capable of measuring PWV, AIx and RHI. Methods A systematic comparison of PWV, AIx and RHI was conducted to determine the inter-relationships between these parameters of vascular functionality. Outputs were obtained non-invasively using three instruments, the VP-1000 (VP), SphygmoCor (SC), and EndoPAT (EP), in 40 apparently healthy males and females. Results Correlations were found between the brachial-ankle PWV and radial-ankle PWV (by VP and SC), and PWV (VP) with AIx (SC). The interchangeability of these outputs was demonstrated by the Bland Altman test, making it feasible to extrapolate cut-offs for radial-ankle PWV and AIx equivalent to brachial-ankle PWV that signify healthy vessels. In contrast, RHI showed no association with AIx, suggesting these endothelial and arterial parameters are functionally distinct. Conclusions It was concluded that it is possible to compare the vascular function outputs of different instruments and identify healthy from unhealthy vessels, even though the approaches for quantifying the underlying physiological processes may differ. In this way, non-invasive determination of arterial function could be a new paradigm for detecting existing early stage asymptomatic atherosclerotic disease in individuals using techniques that are amenable to the clinical setting. Electronic supplementary material The online version of this article (10.1186/s12872-019-1167-3) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Raissa Perrault
- Canadian Centre for Agri-Food Research in Health and Medicine, St. Boniface Albrechtsen Research Centre, 351 Tache Avenue, Winnipeg, MB, R2H 2A6, Canada.,Department of Physiology and Pathophysiology, Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada
| | - Alexander Omelchenko
- Canadian Centre for Agri-Food Research in Health and Medicine, St. Boniface Albrechtsen Research Centre, 351 Tache Avenue, Winnipeg, MB, R2H 2A6, Canada
| | - Carla G Taylor
- Canadian Centre for Agri-Food Research in Health and Medicine, St. Boniface Albrechtsen Research Centre, 351 Tache Avenue, Winnipeg, MB, R2H 2A6, Canada.,Department of Physiology and Pathophysiology, Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada.,Department of Food and Human Nutritional Sciences, Faculty of Agriculture and Food Science, University of Manitoba, Winnipeg, Canada
| | - Peter Zahradka
- Canadian Centre for Agri-Food Research in Health and Medicine, St. Boniface Albrechtsen Research Centre, 351 Tache Avenue, Winnipeg, MB, R2H 2A6, Canada. .,Department of Physiology and Pathophysiology, Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada. .,Department of Food and Human Nutritional Sciences, Faculty of Agriculture and Food Science, University of Manitoba, Winnipeg, Canada.
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