1
|
Kilanowski-Doroh IM, McNally AB, Wong T, Visniauskas B, Blessinger SA, Sugi AI, Richard C, Diaz Z, Horton A, Natale CA, Ogola BO, Lindsey SH. Ovariectomy-Induced Arterial Stiffening Differs From Vascular Aging and Is Reversed by GPER Activation. Hypertension 2024; 81:e51-e62. [PMID: 38445498 PMCID: PMC11023783 DOI: 10.1161/hypertensionaha.123.22024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Accepted: 02/16/2024] [Indexed: 03/07/2024]
Abstract
BACKGROUND Arterial stiffness is a cardiovascular risk factor and dramatically increases as women transition through menopause. The current study assessed whether a mouse model of menopause increases arterial stiffness in a similar manner to aging and whether activation of the G-protein-coupled estrogen receptor could reverse stiffness. METHODS Female C57Bl/6J mice were ovariectomized at 10 weeks of age or aged to 52 weeks, and some mice were treated with G-protein-coupled estrogen receptor agonists. RESULTS Ovariectomy and aging increased pulse wave velocity to a similar extent independent of changes in blood pressure. Aging increased carotid wall thickness, while ovariectomy increased material stiffness without altering vascular geometry. RNA-sequencing analysis revealed that ovariectomy downregulated smooth muscle contractile genes. The enantiomerically pure G-protein-coupled estrogen receptor agonist, LNS8801, reversed stiffness in ovariectomy mice to a greater degree than the racemic agonist G-1. In summary, ovariectomy and aging induced arterial stiffening via potentially different mechanisms. Aging was associated with inward remodeling, while ovariectomy-induced material stiffness independent of geometry and a loss of the contractile phenotype. CONCLUSIONS This study enhances our understanding of the impact of estrogen loss on vascular health in a murine model and warrants further studies to examine the ability of LNS8801 to improve vascular health in menopausal women.
Collapse
Affiliation(s)
| | | | - Tristen Wong
- Department of Pharmacology, Tulane School of Medicine, New Orleans, LA
| | - Bruna Visniauskas
- Department of Pharmacology, Tulane School of Medicine, New Orleans, LA
| | | | | | - Chase Richard
- Department of Pharmacology, Tulane School of Medicine, New Orleans, LA
- Tulane Brain Institute, Tulane University, New Orleans, LA
| | - Zaidmara Diaz
- Department of Pharmacology, Tulane School of Medicine, New Orleans, LA
| | - Alec Horton
- Department of Pharmacology, Tulane School of Medicine, New Orleans, LA
| | | | - Benard O. Ogola
- Vascular Biology Center and Department of Medicine, Medical College of Georgia at Augusta University, Augusta, GA
| | - Sarah H. Lindsey
- Department of Pharmacology, Tulane School of Medicine, New Orleans, LA
- Tulane Brain Institute, Tulane University, New Orleans, LA
| |
Collapse
|
2
|
Salvado R, Santos-Minguez S, Lugones-Sánchez C, Gonzalez-Sánchez S, Tamayo-Morales O, Quesada-Rico JA, Benito R, Rodríguez-Sánchez E, Gómez-Marcos MA, Casado-Vicente V, Guimarães-Cunha P, Hernandez-Rivas JM, Mira A, García-Ortiz L. Gut microbiota and its relationship with early vascular ageing in a Spanish population (MIVAS study). Eur J Clin Invest 2024:e14228. [PMID: 38655910 DOI: 10.1111/eci.14228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2024] [Revised: 04/01/2024] [Accepted: 04/06/2024] [Indexed: 04/26/2024]
Abstract
BACKGROUND Gut microbiota and its by-products are increasingly recognized as having a decisive role in cardiovascular diseases. The aim is to study the relationship between gut microbiota and early vascular ageing (EVA). METHODS A cross-sectional study was developed in Salamanca (Spain) in which 180 subjects aged 45-74 years were recruited. EVA was defined by the presence of at least one of the following: carotid-femoral pulse wave velocity (cf-PWV), cardio-ankle vascular index (CAVI) or brachial-ankle pulse wave velocity (ba-PWV) above the 90th percentile of the reference population. All other cases were considered normal vascular ageing (NVA). MEASUREMENTS cf-PWV was measured by SphygmoCor® System; CAVI and ba-PWV were determined by Vasera 2000® device. Gut microbiome composition in faecal samples was determined by 16S rRNA Illumina sequencing. RESULTS Mean age was 64.4 ± 6.9 in EVA group and 60.4 ± 7.6 years in NVA (p < .01). Women in EVA group were 41% and 53% in NVA. There were no differences in the overall composition of gut microbiota between the two groups when evaluating Firmicutes/Bacteriodetes ratio, alfa diversity (Shannon Index) and beta diversity (Bray-Curtis). Bilophila, Faecalibacterium sp.UBA1819 and Phocea, are increased in EVA group. While Cedecea, Lactococcus, Pseudomonas, Succiniclasticum and Dielma exist in lower abundance. In logistic regression analysis, Bilophila (OR: 1.71, 95% CI: 1.12-2.6, p = .013) remained significant. CONCLUSIONS In the studied Spanish population, early vascular ageing is positively associated with gut microbiota abundance of the genus Bilophila. No relationship was found between phyla abundance and measures of diversity.
Collapse
Affiliation(s)
- Rita Salvado
- Unidad de Investigación de Atención Primaria de Salamanca (APISAL), Gerencia de Atención Primaria de Salamanca, Gerencia Regional de Salud de Castilla y León (SACYL), Instituto de Investigación Biomédica de Salamanca (IBSAL), Salamanca, Spain
| | - Sandra Santos-Minguez
- Instituto de Investigación del Cáncer, Instituto de Biología Molecular y Celular del Cáncer, Universidad de Salamanca-CSIC, Instituto de Investigación Biomédica de Salamanca (IBSAL), Salamanca, Spain
| | - Cristina Lugones-Sánchez
- Unidad de Investigación de Atención Primaria de Salamanca (APISAL), Gerencia de Atención Primaria de Salamanca, Gerencia Regional de Salud de Castilla y León (SACYL), Instituto de Investigación Biomédica de Salamanca (IBSAL), Salamanca, Spain
- Red de Investigación en Cronicidad Atención Primaria y Prevención y Promoción de la Salud (RICAPPS), Barcelona, Spain
| | - Susana Gonzalez-Sánchez
- Unidad de Investigación de Atención Primaria de Salamanca (APISAL), Gerencia de Atención Primaria de Salamanca, Gerencia Regional de Salud de Castilla y León (SACYL), Instituto de Investigación Biomédica de Salamanca (IBSAL), Salamanca, Spain
- Red de Investigación en Cronicidad Atención Primaria y Prevención y Promoción de la Salud (RICAPPS), Barcelona, Spain
| | - Olaya Tamayo-Morales
- Unidad de Investigación de Atención Primaria de Salamanca (APISAL), Gerencia de Atención Primaria de Salamanca, Gerencia Regional de Salud de Castilla y León (SACYL), Instituto de Investigación Biomédica de Salamanca (IBSAL), Salamanca, Spain
- Red de Investigación en Cronicidad Atención Primaria y Prevención y Promoción de la Salud (RICAPPS), Barcelona, Spain
| | - José A Quesada-Rico
- Red de Investigación en Cronicidad Atención Primaria y Prevención y Promoción de la Salud (RICAPPS), Barcelona, Spain
- Facultad de Medicina, Universidad Miguel Hernández de Elche, Sant Joan, D'Alacant, Spain
| | - Rocío Benito
- Instituto de Investigación del Cáncer, Instituto de Biología Molecular y Celular del Cáncer, Universidad de Salamanca-CSIC, Instituto de Investigación Biomédica de Salamanca (IBSAL), Salamanca, Spain
| | - Emiliano Rodríguez-Sánchez
- Unidad de Investigación de Atención Primaria de Salamanca (APISAL), Gerencia de Atención Primaria de Salamanca, Gerencia Regional de Salud de Castilla y León (SACYL), Instituto de Investigación Biomédica de Salamanca (IBSAL), Salamanca, Spain
- Red de Investigación en Cronicidad Atención Primaria y Prevención y Promoción de la Salud (RICAPPS), Barcelona, Spain
- Departamento de Medicina, Universidad de Salamanca, Salamanca, Spain
| | - Manuel A Gómez-Marcos
- Unidad de Investigación de Atención Primaria de Salamanca (APISAL), Gerencia de Atención Primaria de Salamanca, Gerencia Regional de Salud de Castilla y León (SACYL), Instituto de Investigación Biomédica de Salamanca (IBSAL), Salamanca, Spain
- Red de Investigación en Cronicidad Atención Primaria y Prevención y Promoción de la Salud (RICAPPS), Barcelona, Spain
- Departamento de Medicina, Universidad de Salamanca, Salamanca, Spain
| | - Verónica Casado-Vicente
- Centro de Salud Parquesol. Gerencia de Salud Valladolid Oeste, Gerencia Regional de Salud de Castilla y Leon (SACyL), Valladolid, Spain
- Departamento de Medicina, Dermatología and Toxicología, Universidad de Valladolid, Valladolid, Spain
| | - Pedro Guimarães-Cunha
- Life and Health Sciences Research Institute (IICVS) and School of Medicine, Universidade do Minho, Braga, Portugal
- Center for the Research and Treatment of arterial Hypertension and cardiovascular Risk, Hospital Senhora da Oliveira, Guimarães, Portugal
| | - Jesús M Hernandez-Rivas
- Instituto de Investigación del Cáncer, Instituto de Biología Molecular y Celular del Cáncer, Universidad de Salamanca-CSIC, Instituto de Investigación Biomédica de Salamanca (IBSAL), Salamanca, Spain
- Departamento de Medicina, Universidad de Salamanca, Salamanca, Spain
- Departamento de Hematología, Hospital Universitario de Salamanca, Instituto de Investigación Biomédica de Salamanca (IBSAL), Salamanca, Spain
| | - Alex Mira
- Departamento de Salud y Genómica, Fundación FISABIO, Valencia, Spain
- CIBER Centro de Epidemiología y Salud Pública, Madrid, Spain
| | - Luis García-Ortiz
- Unidad de Investigación de Atención Primaria de Salamanca (APISAL), Gerencia de Atención Primaria de Salamanca, Gerencia Regional de Salud de Castilla y León (SACYL), Instituto de Investigación Biomédica de Salamanca (IBSAL), Salamanca, Spain
- Red de Investigación en Cronicidad Atención Primaria y Prevención y Promoción de la Salud (RICAPPS), Barcelona, Spain
- Departamento de Ciencias Biomédicas y del Diagnóstico, Universidad de Salamanca, Salamanca, Spain
| |
Collapse
|
3
|
Christensen KB, Ünsal Ş, Ebbesen MF, Hemstra L, Schlosser A, Rosenstand K, Hansen PBL, Jensen BL, Bloksgaard M, Simonsen U, Sorensen GL. MFAP4-Deficiency Aggravates Age-Induced Changes in Resistance Artery Structure, While Ameliorating Hypertension. Hypertension 2024. [PMID: 38563153 DOI: 10.1161/hypertensionaha.123.22283] [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: 10/26/2023] [Accepted: 03/15/2024] [Indexed: 04/04/2024]
Abstract
BACKGROUND Abnormalities of resistance arteries may play essential roles in the pathophysiology of aging and hypertension. Deficiency of the vascular extracellular matrix protein MFAP4 (microfibrillar-associated protein 4) has previously been observed as protective against aberrant arterial remodeling. We hypothesized that MFAP4-deficiency would reduce age- and hypertension-dependent arterial changes in extracellular matrix composition and stiffening. METHODS Mesenteric arteries were isolated from old (20-23 months) littermate Mfap4+/+ and Mfap4-/- mice, and 2-photon excitation microscopy imaging was used to quantify elastin and collagen volumes and dimensions in the vascular wall. Ten-week-old littermate Mfap4+/+ and Mfap4-/- mice were subjected to 20 days of continuous Ang II (angiotensin II) infusion and hypertension was monitored using invasive blood pressure measurements. Arterial stiffness, responses to vascular constrictors, and myogenic tone were monitored using wire- or pressure myography. Collagen contents were assessed by Western blotting. RESULTS MFAP4 deficiency significantly increased collagen volume and elastin fragmentation in aged mesenteric arteries without affecting arterial stiffness. MFAP4-deficient mice exhibited reduced diastolic pressure in Ang II-induced hypertension. There was no significant effect of MFAP4-deficiency on mesenteric artery structural remodeling or myogenic tone, although collagen content in mesenteric arteries was tendentially increased in hypertensive Mfap4+/+ mice relative to Mfap4-/- mice. Increased efficacy of vasoconstrictors (phenylephrine, thromboxane) and reduced stiffness were observed in Ang II-treated Mfap4-/- mouse mesenteric arteries in ex vivo myography recordings. CONCLUSIONS MFAP4 deficiency reduces the elastin/collagen ratio in the aging resistance artery without affecting arterial stiffness. In contrast, MFAP4-deficiency reduces the stiffness of resistance arteries and ameliorates Ang II-induced hypertension.
Collapse
Affiliation(s)
- Kimmie B Christensen
- Department of Molecular Medicine, Faculty of Health Sciences, University of Southern Denmark, Odense. (K.B.C., S.Ü., L.H., A.S., K.R., P.B.L.H., B.L.J., M.B., G.L.S.)
| | - Şeyda Ünsal
- Department of Molecular Medicine, Faculty of Health Sciences, University of Southern Denmark, Odense. (K.B.C., S.Ü., L.H., A.S., K.R., P.B.L.H., B.L.J., M.B., G.L.S.)
| | - Morten F Ebbesen
- Department of Biochemistry and Molecular Biology, University of Southern Denmark, Odense. (M.E.F.)
| | - Line Hemstra
- Department of Molecular Medicine, Faculty of Health Sciences, University of Southern Denmark, Odense. (K.B.C., S.Ü., L.H., A.S., K.R., P.B.L.H., B.L.J., M.B., G.L.S.)
| | - Anders Schlosser
- Department of Molecular Medicine, Faculty of Health Sciences, University of Southern Denmark, Odense. (K.B.C., S.Ü., L.H., A.S., K.R., P.B.L.H., B.L.J., M.B., G.L.S.)
| | - Kristoffer Rosenstand
- Department of Molecular Medicine, Faculty of Health Sciences, University of Southern Denmark, Odense. (K.B.C., S.Ü., L.H., A.S., K.R., P.B.L.H., B.L.J., M.B., G.L.S.)
| | - Pernille B L Hansen
- Department of Molecular Medicine, Faculty of Health Sciences, University of Southern Denmark, Odense. (K.B.C., S.Ü., L.H., A.S., K.R., P.B.L.H., B.L.J., M.B., G.L.S.)
| | - Boye L Jensen
- Department of Molecular Medicine, Faculty of Health Sciences, University of Southern Denmark, Odense. (K.B.C., S.Ü., L.H., A.S., K.R., P.B.L.H., B.L.J., M.B., G.L.S.)
| | - Maria Bloksgaard
- Department of Molecular Medicine, Faculty of Health Sciences, University of Southern Denmark, Odense. (K.B.C., S.Ü., L.H., A.S., K.R., P.B.L.H., B.L.J., M.B., G.L.S.)
| | - Ulf Simonsen
- Department of Biomedicine, Faculty of Health, Aarhus University, Denmark (U.S.)
| | - Grith L Sorensen
- Department of Molecular Medicine, Faculty of Health Sciences, University of Southern Denmark, Odense. (K.B.C., S.Ü., L.H., A.S., K.R., P.B.L.H., B.L.J., M.B., G.L.S.)
| |
Collapse
|
4
|
Zanuzzi MG, Jeong J, DaCosta DR, Park J. Sex differences in sympathetic activity and pulse wave velocity in adults with chronic kidney disease. Am J Physiol Renal Physiol 2024; 326:F661-F668. [PMID: 38385174 DOI: 10.1152/ajprenal.00308.2023] [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: 10/02/2023] [Revised: 02/14/2024] [Accepted: 02/14/2024] [Indexed: 02/23/2024] Open
Abstract
Chronic kidney disease (CKD) is characterized by sympathetic nervous system (SNS) overactivity that contributes to increased vascular stiffness and cardiovascular risk. Although it is well established that SNS activity and vascular stiffness are substantially elevated in CKD, whether sex differences in autonomic and vascular function exist in CKD remains unknown. We tested the hypothesis that compared with females, males with CKD have higher baseline sympathetic activity that is related to increased arterial stiffness. One hundred twenty-nine participants (96 males and 33 females) with CKD stages III and IV were recruited and enrolled. During two separate study visits, vascular stiffness was assessed by measuring carotid-to-femoral pulse wave velocity (cfPWV), and resting muscle sympathetic nerve activity (MSNA) was measured by microneurography. Males with CKD had higher resting MSNA compared with females with CKD (68 ± 16 vs. 55 ± 14 bursts/100 heart beats, P = 0.005), whereas there was no difference in cfPWV between the groups (P = 0.248). Resting MSNA was not associated with cfPWV in both males and females. In conclusion, males with CKD have higher resting sympathetic activity compared with females with CKD. However, there was no difference in vascular stiffness between the sexes. There was no correlation between resting MSNA and cfPWV, suggesting that non-neural mechanisms may play a greater role in the progression of vascular stiffness in CKD, particularly in females.NEW & NOTEWORTHY Males with chronic kidney disease (CKD) have higher resting muscle sympathetic nerve activity (MSNA) compared with females. There was no correlation between MSNA and carotid-to-femoral pulse wave velocity (cfPWV), suggesting that non-neural mechanisms may play a greater role in the progression of vascular stiffness in CKD. Sex differences in SNS activity may play a mechanistic role in observations from epidemiological studies suggesting greater cardiovascular risk in males compared with females with CKD.
Collapse
Affiliation(s)
- Matias G Zanuzzi
- Division of Renal Medicine, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia, United States
- Department of Veterans Affairs Health Care System, Research Service Line, Decatur, Georgia, United States
| | - Jinhee Jeong
- Division of Renal Medicine, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia, United States
- Department of Veterans Affairs Health Care System, Research Service Line, Decatur, Georgia, United States
| | - Dana R DaCosta
- Division of Renal Medicine, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia, United States
- Department of Veterans Affairs Health Care System, Research Service Line, Decatur, Georgia, United States
| | - Jeanie Park
- Division of Renal Medicine, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia, United States
- Department of Veterans Affairs Health Care System, Research Service Line, Decatur, Georgia, United States
| |
Collapse
|
5
|
Pereira LCC, Chagas P, Barbosa ECD, Barroso WKS, Oliveira AC, Hillesheim SF, Kohlrausch VC, Chemello D. The usefulness of SAGE score in predicting high pulse wave velocity in hypertensive patients: a retrospective cohort study. Front Cardiovasc Med 2024; 11:1227906. [PMID: 38596694 PMCID: PMC11002898 DOI: 10.3389/fcvm.2024.1227906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Accepted: 02/29/2024] [Indexed: 04/11/2024] Open
Abstract
Introduction Aortic stiffness assessed by pulse wave velocity (PWV) is an important predictor to evaluate the risk of hypertensive patients. However, it is underutilized in clinical practice. We aimed to identify the optimal cutoff SAGE score that would indicate a risk PWV ≥ 10 m/s in Brazilian ambulatory hypertensive patients. Materials and methods A retrospective cohort study. Patients underwent central blood pressure measurement using a validated oscillometric device from August 2020 to December 2021. A ROC curve was constructed using the Youden statistic to define the best score to identify those at high risk for PWV ≥ 10 m/s. Results A total of 212 hypertensive individuals were selected. The mean age was 64.0 ± 12.4 years and 57.5% were female. The following comorbidities were present: overweight (47.6%), obesity (34.3%), and diabetes (25.0%). Most of the sample (68.9%) had PWV < 10 m/s. According to Youden's statistic, a cutoff point of 6 provided the optimal combination of sensitivity and specificity for identifying patients with a PWV ≥ 10 m/s. This cutoff achieved sensitivity of 97.0%, and specificity of 82.9%. In clinical practice, however, a cutoff point of 7 (where score values of at least 7 were considered to indicate high risk) had a positive likelihood ratio of 8.2 and a negative likelihood ration of 0.346, making this the ideal choice by accurately excluding patients who are less likely to have PWV ≥ 10 m/s. Conclusion A SAGE score ≥7 identified Brazilian hypertensive patients with a high risk of PWV ≥ 10 m/s.
Collapse
Affiliation(s)
| | - Patrícia Chagas
- Postgraduate Program in Gerontology, Universidade Federal de Santa Maria (UFSM), Santa Maria, Brazil
- Department of Food and Nutrition, Universidade Federal de Santa Maria (UFSM), Santa Maria, Brazil
| | - Eduardo Costa Duarte Barbosa
- Department of Cardiology, Complexo Hospitalar Santa Casa de Misericórdia de Porto Alegre – Cardiologia, Porto Alegre, Brazil
| | - Weimar Kunz Sebba Barroso
- Department of Cardiology, Universidade Federal de Goiás – Liga de Hipertensão Arterial, Goiânia, Brazil
| | - Adriana Camargo Oliveira
- Department of Cardiology, Universidade Federal de Goiás – Liga de Hipertensão Arterial, Goiânia, Brazil
| | - Suélen Feijó Hillesheim
- Postgraduate Program in Gerontology, Universidade Federal de Santa Maria (UFSM), Santa Maria, Brazil
| | | | - Diego Chemello
- Postgraduate Program in Gerontology, Universidade Federal de Santa Maria (UFSM), Santa Maria, Brazil
| |
Collapse
|
6
|
Wu S, Zhao X, Li L, Han X, Liu Q, Chen S, Geng H, VanEvery H, Zhang X. In Utero and Early-Childhood Exposure to the Great Chinese Famine and Adult Arterial Stiffness: A Cross-Sectional Study. Arterioscler Thromb Vasc Biol 2024; 44:755-757. [PMID: 38299354 DOI: 10.1161/atvbaha.124.320666] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2024]
Affiliation(s)
- Shouling Wu
- Department of Cardiology (S.W., X. Zhao, L.L., X.H., Q.L., S.C.), Kailuan General Hospital, Tangshan, China
| | - Xiujuan Zhao
- Department of Cardiology (S.W., X. Zhao, L.L., X.H., Q.L., S.C.), Kailuan General Hospital, Tangshan, China
| | - Lu Li
- Department of Cardiology (S.W., X. Zhao, L.L., X.H., Q.L., S.C.), Kailuan General Hospital, Tangshan, China
| | - Xu Han
- Department of Cardiology (S.W., X. Zhao, L.L., X.H., Q.L., S.C.), Kailuan General Hospital, Tangshan, China
| | - Qian Liu
- Department of Cardiology (S.W., X. Zhao, L.L., X.H., Q.L., S.C.), Kailuan General Hospital, Tangshan, China
| | - Shuohua Chen
- Department of Cardiology (S.W., X. Zhao, L.L., X.H., Q.L., S.C.), Kailuan General Hospital, Tangshan, China
| | - Hemei Geng
- Hospital Infection Management Division (H.G.), Kailuan General Hospital, Tangshan, China
| | | | - Xinyuan Zhang
- Department of Nutrition, Pennsylvania State University, University Park, TX (X. Zhang)
- Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (X. Zhang)
| |
Collapse
|
7
|
Gong Z, Zeng L, Jiang B, Zhu R, Wang J, Li M, Shao A, Lv Z, Zhang M, Guo L, Li G, Sun J, Chen Y. Dynamic cerebral blood flow assessment based on electromagnetic coupling sensing and image feature analysis. Front Bioeng Biotechnol 2024; 12:1276795. [PMID: 38449677 PMCID: PMC10915240 DOI: 10.3389/fbioe.2024.1276795] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2023] [Accepted: 02/07/2024] [Indexed: 03/08/2024] Open
Abstract
Dynamic assessment of cerebral blood flow (CBF) is crucial for guiding personalized management and treatment strategies, and improving the prognosis of stroke. However, a safe, reliable, and effective method for dynamic CBF evaluation is currently lacking in clinical practice. In this study, we developed a CBF monitoring system utilizing electromagnetic coupling sensing (ECS). This system detects variations in brain conductivity and dielectric constant by identifying the resonant frequency (RF) in an equivalent circuit containing both magnetic induction and electrical coupling. We evaluated the performance of the system using a self-made physical model of blood vessel pulsation to test pulsatile CBF. Additionally, we recruited 29 healthy volunteers to monitor cerebral oxygen (CO), cerebral blood flow velocity (CBFV) data and RF data before and after caffeine consumption. We analyzed RF and CBFV trends during immediate responses to abnormal intracranial blood supply, induced by changes in vascular stiffness, and compared them with CO data. Furthermore, we explored a method of dynamically assessing the overall level of CBF by leveraging image feature analysis. Experimental testing substantiates that this system provides a detection range and depth enhanced by three to four times compared to conventional electromagnetic detection techniques, thereby comprehensively covering the principal intracranial blood supply areas. And the system effectively captures CBF responses under different intravascular pressure stimulations. In healthy volunteers, as cerebral vascular stiffness increases and CO decreases due to caffeine intake, the RF pulsation amplitude diminishes progressively. Upon extraction and selection of image features, widely used machine learning algorithms exhibit commendable performance in classifying overall CBF levels. These results highlight that our proposed methodology, predicated on ECS and image feature analysis, enables the capture of immediate responses of abnormal intracranial blood supply triggered by alterations in vascular stiffness. Moreover, it provides an accurate diagnosis of the overall CBF level under varying physiological conditions.
Collapse
Affiliation(s)
- Zhiwei Gong
- School of Pharmacy and Bioengineering, Chongqing University of Technology, Chongqing, China
| | - Lingxi Zeng
- School of Pharmacy and Bioengineering, Chongqing University of Technology, Chongqing, China
| | - Bin Jiang
- College of Artificial Intelligence, Chongqing University of Technology, Chongqing, China
| | - Rui Zhu
- School of Pharmacy and Bioengineering, Chongqing University of Technology, Chongqing, China
| | - Junjie Wang
- College of Artificial Intelligence, Chongqing University of Technology, Chongqing, China
| | - Mingyan Li
- College of Artificial Intelligence, Chongqing University of Technology, Chongqing, China
| | - Ansheng Shao
- School of Pharmacy and Bioengineering, Chongqing University of Technology, Chongqing, China
| | - Zexiang Lv
- School of Pharmacy and Bioengineering, Chongqing University of Technology, Chongqing, China
| | - Maoting Zhang
- College of Biomedical Engineering, Army Medical University, Chongqing, China
| | - Lei Guo
- School of Information and Communication Engineering, Dalian University of Technology, Dalian, Liaoning, China
| | - Gen Li
- School of Pharmacy and Bioengineering, Chongqing University of Technology, Chongqing, China
- Department of Neurosurgery, Southwest Hospital, Army Medical University, Chongqing, China
| | - Jian Sun
- College of Biomedical Engineering, Army Medical University, Chongqing, China
| | - Yujie Chen
- Department of Neurosurgery, Southwest Hospital, Army Medical University, Chongqing, China
| |
Collapse
|
8
|
Schellinger IN, Dannert A, Hoffmann A, Chodisetti G, Mattern K, Petzold A, Klöting N, Schuster A, Wagenhäuser MU, Emrich F, Stumvoll M, Hasenfuß G, Raaz U. Angiotensin Receptor-Neprilysin Inhibition (Sacubitril/Valsartan) Reduces Structural Arterial Stiffness in Middle-Aged Mice. J Am Heart Assoc 2024; 13:e032641. [PMID: 38348796 PMCID: PMC11010079 DOI: 10.1161/jaha.123.032641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Accepted: 01/09/2024] [Indexed: 02/21/2024]
Abstract
BACKGROUND Increasing arterial stiffness is a prominent feature of the aging cardiovascular system. Arterial stiffening leads to fundamental alterations in central hemodynamics with widespread detrimental implications for organ function resulting in significant morbidity and death, and specific therapies to address the underlying age-related structural arterial remodeling remain elusive. The present study investigates the potential of the recently clinically available dual angiotensin receptor-neprilysin inhibitor (ARNI) sacubitril/valsartan (LCZ696) to counteract age-related arterial fibrotic remodeling and stiffening in 1-year-old mice. METHODS AND RESULTS Treatment of in 1-year-old mice with ARNI (sacubitril/valsartan), in contrast to angiotensin receptor blocker monotherapy (valsartan) and vehicle treatment (controls), significantly decreases structural aortic stiffness (as measured by in vivo pulse-wave velocity and ex vivo aortic pressure myography). This phenomenon appears, at least partly, independent of (indirect) blood pressure effects and may be related to a direct antifibrotic interference with aortic smooth muscle cell collagen production. Furthermore, we find aortic remodeling and destiffening due to ARNI treatment to be associated with improved parameters of cardiac diastolic function in aged mice. CONCLUSIONS This study provides preclinical mechanistic evidence indicating that ARNI-based interventions may counteract age-related arterial stiffening and may therefore be further investigated as a promising strategy to improve cardiovascular outcomes in the elderly.
Collapse
Affiliation(s)
- Isabel N. Schellinger
- Department of Cardiology and PneumologyHeart Center at the University Medical Center GöttingenGöttingenGermany
- German Center for Cardiovascular Research (DZHK) e.V. Partner site GöttingenGöttingenGermany
- Department for Endocrinology, Nephrology and RheumatologyUniversity Medical Center Leipzig, University of LeipzigLeipzigGermany
| | - Angelika Dannert
- Department of Cardiology and PneumologyHeart Center at the University Medical Center GöttingenGöttingenGermany
| | - Annet Hoffmann
- Department for Endocrinology, Nephrology and RheumatologyUniversity Medical Center Leipzig, University of LeipzigLeipzigGermany
| | - Giriprakash Chodisetti
- Department of Cardiology and PneumologyHeart Center at the University Medical Center GöttingenGöttingenGermany
| | - Karin Mattern
- Department of Cardiology and PneumologyHeart Center at the University Medical Center GöttingenGöttingenGermany
| | - Anne Petzold
- Department of Cardiology and PneumologyHeart Center at the University Medical Center GöttingenGöttingenGermany
| | - Nora Klöting
- Department for Endocrinology, Nephrology and RheumatologyUniversity Medical Center Leipzig, University of LeipzigLeipzigGermany
| | - Andreas Schuster
- Department of Cardiology and PneumologyHeart Center at the University Medical Center GöttingenGöttingenGermany
- German Center for Cardiovascular Research (DZHK) e.V. Partner site GöttingenGöttingenGermany
| | - Markus U. Wagenhäuser
- Department of Vascular and Endovascular SurgeryUniversity Hospital Düsseldorf, Heinrich‐Heine‐UniversityDüsseldorfGermany
| | - Fabian Emrich
- Department of Cardiothoracic and Vascular SurgeryGoethe University Hospital FrankfurtFrankfurtGermany
| | - Michael Stumvoll
- Department for Endocrinology, Nephrology and RheumatologyUniversity Medical Center Leipzig, University of LeipzigLeipzigGermany
| | - Gerd Hasenfuß
- Department of Cardiology and PneumologyHeart Center at the University Medical Center GöttingenGöttingenGermany
- German Center for Cardiovascular Research (DZHK) e.V. Partner site GöttingenGöttingenGermany
| | - Uwe Raaz
- Department of Cardiology and PneumologyHeart Center at the University Medical Center GöttingenGöttingenGermany
- German Center for Cardiovascular Research (DZHK) e.V. Partner site GöttingenGöttingenGermany
| |
Collapse
|
9
|
Vicente-Gabriel S, Lugones-Sánchez C, Tamayo-Morales O, Vicente Prieto A, González-Sánchez S, Conde Martín S, Gómez-Sánchez M, Rodríguez-Sánchez E, García-Ortiz L, Gómez-Sánchez L, Gómez-Marcos MA. Relationship between addictions and obesity, physical activity and vascular aging in young adults (EVA-Adic study): a research protocol of a cross-sectional study. Front Public Health 2024; 12:1322437. [PMID: 38344236 PMCID: PMC10853417 DOI: 10.3389/fpubh.2024.1322437] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Accepted: 01/08/2024] [Indexed: 02/15/2024] Open
Abstract
Background Behavioral and substance addictions are prevalent health problems that, alongside obesity, are linked to reduced physical activity and increased sedentary time. Similarly, arterial stiffness and vascular aging are processes that begin gradually at an early age and are closely associated with morbidity and mortality from cardiovascular diseases. The main objective of this study is to analyze how addictions are related to obesity and body fat distribution, physical activity, sedentary time, arterial stiffness and vascular aging, as well as sleep quality, cognitive function and gender differences in young adults aged between 18 and 34 years. Methods This cross-sectional descriptive observational study will analyze data from 500 subjects (250 men and 250 women) aged 18-34 without cardiovascular disease, selected by simple random sampling with replacement from the urban population of the city center of Salamanca (34,044 people aged 18-34, with 18,450 women and 15,594 men). Behavioral and substance addictions, as well as sleep quality and cognitive impairment will be assessed using questionnaires. The Pittisburg Sleep Quality Index (PSQI) will be used to measure sleep quality and the Ford questionnaire will be used to measure insomnia in response to stress. For obesity, weight, height, waist and hip circumference, body composition will be measured with the Inbody 230® impedance meter. For physical activity and sedentary time, we will use the Actigraph® accelerometer alongside the international physical activity questionnaire (IPAQ) and the Marshall questionnaire. The Sphygmocor System® will be used for pulse wave analysis and carotid-femoral pulse wave velocity (cfPWV), while the Vasera VS-2000® will measure cardio ankle vascular index (CAVI) and brachial-ankle pulse wave velocity (baPWV). Vascular aging will be calculated with the 10th and 90th percentiles of cfPWV or baPWV. Demographic, analytical variables will be collected, as will data to assess vascular, cardiac, renal, and brain injury. Discussion Addictions are on the rise in today's society, affecting the mental health and well-being of those who suffer from them, generating important social problems such as job loss, family dysfunction, debt and social isolation. Together with obesity, they are prevalent health problems in young adults and are associated with lower physical activity and higher sedentary time. Meanwhile, arterial stiffness and vascular aging are processes that begin gradually at an early age and determine morbidity and mortality caused by cardiovascular diseases. The results of this project will allow us to understand the situation regarding behavioral and substance addictions in young adults. Better understanding of these addictions will in turn facilitate the development of more effective prevention strategies and intervention programs, which can then reduce the negative impact at both the individual and societal levels. Clinical trial registration [ClinicalTrials.gov], identifier [NCT05819840].
Collapse
Affiliation(s)
- Sara Vicente-Gabriel
- Primary Care Research Unit of Salamanca (APISAL), Salamanca Primary Care Management, Institute of Biomedical Research of Salamanca (IBSAL), Salamanca, Spain
- Intensive Care Unit, Salamanca University Hospital, Salamanca, Spain
| | - Cristina Lugones-Sánchez
- Primary Care Research Unit of Salamanca (APISAL), Salamanca Primary Care Management, Institute of Biomedical Research of Salamanca (IBSAL), Salamanca, Spain
- Research Network on Chronicity, Primary Care and Health Promotion (RICAPPS), Barcelona, Spain
- Salamanca Primary Care Management, Castilla and León Health Service–SACYL, Salamanca, Spain
| | - Olaya Tamayo-Morales
- Primary Care Research Unit of Salamanca (APISAL), Salamanca Primary Care Management, Institute of Biomedical Research of Salamanca (IBSAL), Salamanca, Spain
- Research Network on Chronicity, Primary Care and Health Promotion (RICAPPS), Barcelona, Spain
| | - Alberto Vicente Prieto
- Primary Care Research Unit of Salamanca (APISAL), Salamanca Primary Care Management, Institute of Biomedical Research of Salamanca (IBSAL), Salamanca, Spain
- Salamanca Primary Care Management, Castilla and León Health Service–SACYL, Salamanca, Spain
| | - Susana González-Sánchez
- Primary Care Research Unit of Salamanca (APISAL), Salamanca Primary Care Management, Institute of Biomedical Research of Salamanca (IBSAL), Salamanca, Spain
- Research Network on Chronicity, Primary Care and Health Promotion (RICAPPS), Barcelona, Spain
| | - Sandra Conde Martín
- Primary Care Research Unit of Salamanca (APISAL), Salamanca Primary Care Management, Institute of Biomedical Research of Salamanca (IBSAL), Salamanca, Spain
- Salamanca Primary Care Management, Castilla and León Health Service–SACYL, Salamanca, Spain
| | - Marta Gómez-Sánchez
- Primary Care Research Unit of Salamanca (APISAL), Salamanca Primary Care Management, Institute of Biomedical Research of Salamanca (IBSAL), Salamanca, Spain
- Home Hospitalization Unit, Marqués de Valdecilla University Hospital, Santander, Spain
| | - Emiliano Rodríguez-Sánchez
- Primary Care Research Unit of Salamanca (APISAL), Salamanca Primary Care Management, Institute of Biomedical Research of Salamanca (IBSAL), Salamanca, Spain
- Research Network on Chronicity, Primary Care and Health Promotion (RICAPPS), Barcelona, Spain
- Salamanca Primary Care Management, Castilla and León Health Service–SACYL, Salamanca, Spain
- Department of Medicine, University of Salamanca, Salamanca, Spain
| | - Luis García-Ortiz
- Primary Care Research Unit of Salamanca (APISAL), Salamanca Primary Care Management, Institute of Biomedical Research of Salamanca (IBSAL), Salamanca, Spain
- Research Network on Chronicity, Primary Care and Health Promotion (RICAPPS), Barcelona, Spain
- Salamanca Primary Care Management, Castilla and León Health Service–SACYL, Salamanca, Spain
- Department of Biomedical and Diagnostic Sciences, University of Salamanca, Salamanca, Spain
| | - Leticia Gómez-Sánchez
- Primary Care Research Unit of Salamanca (APISAL), Salamanca Primary Care Management, Institute of Biomedical Research of Salamanca (IBSAL), Salamanca, Spain
- Emergency Department, La Paz University Hospital, Madrid, Spain
| | - Manuel A. Gómez-Marcos
- Primary Care Research Unit of Salamanca (APISAL), Salamanca Primary Care Management, Institute of Biomedical Research of Salamanca (IBSAL), Salamanca, Spain
- Research Network on Chronicity, Primary Care and Health Promotion (RICAPPS), Barcelona, Spain
- Salamanca Primary Care Management, Castilla and León Health Service–SACYL, Salamanca, Spain
- Department of Medicine, University of Salamanca, Salamanca, Spain
| | | |
Collapse
|
10
|
Hundemer GL, Agharazii M, Madore F, Vaidya A, Brown JM, Leung AA, Kline GA, Larose E, Piché ME, Crean AM, Shaw JLV, Ramsay T, Hametner B, Wassertheurer S, Sood MM, Hiremath S, Ruzicka M, Goupil R. Subclinical Primary Aldosteronism and Cardiovascular Health: A Population-Based Cohort Study. Circulation 2024; 149:124-134. [PMID: 38031887 PMCID: PMC10841691 DOI: 10.1161/circulationaha.123.066389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Accepted: 10/30/2023] [Indexed: 12/01/2023]
Abstract
BACKGROUND Primary aldosteronism, characterized by overt renin-independent aldosterone production, is a common but underrecognized form of hypertension and cardiovascular disease. Growing evidence suggests that milder and subclinical forms of primary aldosteronism are highly prevalent, yet their contribution to cardiovascular disease is not well characterized. METHODS This prospective study included 1284 participants between the ages of 40 and 69 years from the randomly sampled population-based CARTaGENE cohort (Québec, Canada). Regression models were used to analyze associations of aldosterone, renin, and the aldosterone-to-renin ratio with the following measures of cardiovascular health: arterial stiffness, assessed by central blood pressure (BP) and pulse wave velocity; adverse cardiac remodeling, captured by cardiac magnetic resonance imaging, including indexed maximum left atrial volume, left ventricular mass index, left ventricular remodeling index, and left ventricular hypertrophy; and incident hypertension. RESULTS The mean (SD) age of participants was 54 (8) years and 51% were men. The mean (SD) systolic and diastolic BP were 123 (15) and 72 (10) mm Hg, respectively. At baseline, 736 participants (57%) had normal BP and 548 (43%) had hypertension. Higher aldosterone-to-renin ratio, indicative of renin-independent aldosteronism (ie, subclinical primary aldosteronism), was associated with increased arterial stiffness, including increased central BP and pulse wave velocity, along with adverse cardiac remodeling, including increased indexed maximum left atrial volume, left ventricular mass index, and left ventricular remodeling index (all P<0.05). Higher aldosterone-to-renin ratio was also associated with higher odds of left ventricular hypertrophy (odds ratio, 1.32 [95% CI, 1.002-1.73]) and higher odds of developing incident hypertension (odds ratio, 1.29 [95% CI, 1.03-1.62]). All the associations were consistent when assessing participants with normal BP in isolation and were independent of brachial BP. CONCLUSIONS Independent of brachial BP, a biochemical phenotype of subclinical primary aldosteronism is negatively associated with cardiovascular health, including greater arterial stiffness, adverse cardiac remodeling, and incident hypertension.
Collapse
Affiliation(s)
- Gregory L. Hundemer
- Department of Medicine, Division of Nephrology, University of Ottawa, Ottawa, ON, Canada
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada
| | - Mohsen Agharazii
- Department of Medicine, Division of Nephrology, CHU de Québec-Université Laval, Quebec City, QC, Canada
| | - François Madore
- Department of Medicine, Division of Nephrology, Hôpital du Sacré-Coeur de Montréal, Université de Montréal, Montreal, QC, Canada
| | - Anand Vaidya
- Center for Adrenal Disorders, Division of Endocrinology, Diabetes, and Hypertension, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
| | - Jenifer M. Brown
- Division of Cardiovascular Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
| | - Alexander A. Leung
- Department of Medicine, Division of Endocrinology and Metabolism, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Gregory A. Kline
- Department of Medicine, Division of Endocrinology and Metabolism, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Eric Larose
- Department of Medicine, Division of Cardiology, Université Laval, Quebec City, QC, Canada
- Institut Universitaire de Cardiologie et de Pneumologie de Québec-Université Laval, Quebec City, QC, Canada
| | - Marie-Eve Piché
- Department of Medicine, Division of Cardiology, Université Laval, Quebec City, QC, Canada
- Institut Universitaire de Cardiologie et de Pneumologie de Québec-Université Laval, Quebec City, QC, Canada
| | - Andrew M. Crean
- Division of Cardiovascular Medicine, Ottawa Heart Institute, Ottawa, ON, Canada
| | - Julie L. V. Shaw
- Department of Pathology and Laboratory Medicine, Division of Biochemistry, Ottawa Hospital, Ottawa, ON, Canada
- Eastern Ontario Regional Laboratories Association, Ottawa, ON, Canada
| | - Tim Ramsay
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada
| | - Bernhard Hametner
- Center for Health & Bioresources, AIT Austrian Institute of Technology, Vienna, Austria
| | | | - Manish M. Sood
- Department of Medicine, Division of Nephrology, University of Ottawa, Ottawa, ON, Canada
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada
| | - Swapnil Hiremath
- Department of Medicine, Division of Nephrology, University of Ottawa, Ottawa, ON, Canada
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada
| | - Marcel Ruzicka
- Department of Medicine, Division of Nephrology, University of Ottawa, Ottawa, ON, Canada
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada
| | - Rémi Goupil
- Department of Medicine, Division of Nephrology, Hôpital du Sacré-Coeur de Montréal, Université de Montréal, Montreal, QC, Canada
| |
Collapse
|
11
|
Choi R, Narayanan R, Jandu S, Savage W, Kang S, Wodu B, Nandakumar K, Santhanam L, Steppan J. Optimization of resting tension for wire myography in male rat pulmonary arteries. Physiol Rep 2024; 12:e15911. [PMID: 38212292 PMCID: PMC10784191 DOI: 10.14814/phy2.15911] [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: 11/30/2023] [Revised: 12/22/2023] [Accepted: 12/22/2023] [Indexed: 01/13/2024] Open
Abstract
Wire myography to test vasomotor functions of blood vessels ex-vivo are well-established for the systemic circulation, however, there is no consensus on protocols for pulmonary arteries. We created a standardized wire myography protocol for healthy rat PAs and validated this in a pulmonary hypertension (PH) model. Vessels stretched to higher initial tensions (5.0, 7.5 and 10.0 mN) exhibited a uniform response to phenylephrine, a larger dynamic range, and lower EC50 values. The endothelium-mediated relaxation showed that moderate tensions (7.5 and 10.0 mN) produced robust responses with higher maximum relaxation and lower EC50 values. For endothelium independent responses, the higher initial tension groups had lower and more consistent EC50 values than the lower initial tension groups. Pulmonary arteries from rats with PH were more responsive to vasoactive drugs when subjected to a higher initial tension. Notably, vessels in the PH group subjected to 15.0 mN exhibited high dynamic ranges in contractile and relaxation responses without tearing. Lastly, we observed attenuated cholinergic responses in these vessels-consistent with endothelial dysfunction in PH. Therefore, a moderate initial tension of 7.5-10.0 mN is optimal for healthy rat pulmonary arteries and a higher initial tension of 15.0 mN is optimal for pulmonary arteries from animals with PH.
Collapse
Affiliation(s)
- Rira Choi
- Department of Chemical and Biomolecular Engineering, Johns Hopkins University, Baltimore, Maryland, USA
- Department of Anesthesiology and Critical Care Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - Roshini Narayanan
- Department of Biomedical Engineering, Johns Hopkins University, Baltimore, Maryland, USA
| | - Sandeep Jandu
- Department of Anesthesiology and Critical Care Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - William Savage
- Department of Chemical and Biomolecular Engineering, Johns Hopkins University, Baltimore, Maryland, USA
| | - Sara Kang
- Department of Anesthesiology and Critical Care Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - Bulouere Wodu
- Department of Anesthesiology and Critical Care Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - Kavitha Nandakumar
- Department of Anesthesiology and Critical Care Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - Lakshmi Santhanam
- Department of Chemical and Biomolecular Engineering, Johns Hopkins University, Baltimore, Maryland, USA
- Department of Anesthesiology and Critical Care Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
- Department of Biomedical Engineering, Johns Hopkins University, Baltimore, Maryland, USA
| | - Jochen Steppan
- Department of Anesthesiology and Critical Care Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| |
Collapse
|
12
|
Spronck B, Terentes-Printzios D, Avolio AP, Boutouyrie P, Guala A, Jerončić A, Laurent S, Barbosa EC, Baulmann J, Chen CH, Chirinos JA, Daskalopoulou SS, Hughes AD, Mahmud A, Mayer CC, Park JB, Pierce GL, Schutte AE, Urbina EM, Wilkinson IB, Segers P, Sharman JE, Tan I, Vlachopoulos C, Weber T, Bianchini E, Bruno RM. 2024 Recommendations for Validation of Noninvasive Arterial Pulse Wave Velocity Measurement Devices. Hypertension 2024; 81:183-192. [PMID: 37975229 PMCID: PMC10734786 DOI: 10.1161/hypertensionaha.123.21618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Accepted: 10/18/2023] [Indexed: 11/19/2023]
Abstract
BACKGROUND Arterial stiffness, as measured by arterial pulse wave velocity (PWV), is an established biomarker for cardiovascular risk and target-organ damage in individuals with hypertension. With the emergence of new devices for assessing PWV, it has become evident that some of these devices yield results that display significant discrepancies compared with previous devices. This discrepancy underscores the importance of comprehensive validation procedures and the need for international recommendations. METHODS A stepwise approach utilizing the modified Delphi technique, with the involvement of key scientific societies dedicated to arterial stiffness research worldwide, was adopted to formulate, through a multidisciplinary vision, a shared approach to the validation of noninvasive arterial PWV measurement devices. RESULTS A set of recommendations has been developed, which aim to provide guidance to clinicians, researchers, and device manufacturers regarding the validation of new PWV measurement devices. The intention behind these recommendations is to ensure that the validation process can be conducted in a rigorous and consistent manner and to promote standardization and harmonization among PWV devices, thereby facilitating their widespread adoption in clinical practice. CONCLUSIONS It is hoped that these recommendations will encourage both users and developers of PWV measurement devices to critically evaluate and validate their technologies, ultimately leading to improved consistency and comparability of results. This, in turn, will enhance the clinical utility of PWV as a valuable tool for assessing arterial stiffness and informing cardiovascular risk stratification and management in individuals with hypertension.
Collapse
Affiliation(s)
- Bart Spronck
- Department of Biomedical Engineering, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Netherlands (B.S.)
- Macquarie Medical School, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, NSW, Australia (B.S., A.P.A., I.T.)
| | - Dimitrios Terentes-Printzios
- 1st Cardiology Department, Hippokration Hospital, National and Kapodistrian University of Athens, Greece (D.T.-P., C.V.)
| | - Alberto P. Avolio
- Macquarie Medical School, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, NSW, Australia (B.S., A.P.A., I.T.)
| | - Pierre Boutouyrie
- Université Paris Cité, Inserm, Paris Cardiovascular Research Center (PARCC), France (P.B., S.L., R.M.B.)
- Service de Pharmacologie et Hypertension, Assistance Publique–Hôpitaux de Paris (AP–HP), Hôpital Européen Georges Pompidou, Paris, France (P.B., S.L., R.M.B.)
| | - Andrea Guala
- Vall d’Hebron Institut de Recerca, Barcelona, Spain (A.G.)
- Centro de Investigación en Red en Enfermedades Cardiovasculares (CIBER-CV), Instituto de Salud Carlos III, Madrid, Spain (A.G.)
| | - Ana Jerončić
- Laboratory of Vascular Aging and Cardiovascular Prevention, Department of Research in Biomedicine and Health, University of Split School of Medicine, Croatia (A.J.)
| | - Stéphane Laurent
- Université Paris Cité, Inserm, Paris Cardiovascular Research Center (PARCC), France (P.B., S.L., R.M.B.)
- Service de Pharmacologie et Hypertension, Assistance Publique–Hôpitaux de Paris (AP–HP), Hôpital Européen Georges Pompidou, Paris, France (P.B., S.L., R.M.B.)
| | | | - Johannes Baulmann
- Praxis Dres. Gille/Baulmann, Rheinbach, Germany (J.B.)
- Division of Cardiology, Medical University of Graz, Austria (J.B.)
| | - Chen-Huan Chen
- College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan (C.-H.C.)
| | - Julio A. Chirinos
- Cardiovascular Division, University of Pennsylvania Perelman School of Medicine and Hospital of the University of Pennsylvania, Philadelphia, PA (J.A.C.)
| | - Stella S. Daskalopoulou
- Department of Medicine, Research Institute McGill University Health Centre, McGill University, Montreal, QC, Canada (S.S.D.)
| | - Alun D. Hughes
- Department of Population Science and Experimental Medicine, Institute of Cardiovascular Science, University College London, United Kingdom (A.D.H.)
| | - Azra Mahmud
- Department of Internal Medicine, Pharmacology, and Clinical Research, Shalamar Medical and Dental College, Lahore, Pakistan (A.M.)
| | - Christopher C. Mayer
- AIT Austrian Institute of Technology, Center for Health & Bioresources, Medical Signal Analysis, Vienna (C.C.M.)
| | - Jeong Bae Park
- JB Lab and Clinic, Department of Precision Medicine and Biostatistics, Wonju College of Medicine, Yonsei University, Seoul, Republic of Korea (J.B.P.)
| | - Gary L. Pierce
- Department of Health and Human Physiology, University of Iowa, IA (G.L.P.)
| | - Aletta E. Schutte
- School of Population Health, University of New South Wales, Sydney, Australia (A.E.S.)
- The George Institute for Global Health, Sydney, NSW, Australia (A.E.S., I.T.)
| | - Elaine M. Urbina
- Cincinnati Children’s Hospital Medical Center, OH (E.M.U.)
- University of Cincinnati, OH (E.M.U.)
| | - Ian B. Wilkinson
- Experimental Medicine and Therapeutics, University of Cambridge, United Kingdom (I.B.W.)
| | | | - James E. Sharman
- Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, Australia (J.E.S.)
| | - Isabella Tan
- Macquarie Medical School, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, NSW, Australia (B.S., A.P.A., I.T.)
- The George Institute for Global Health, Sydney, NSW, Australia (A.E.S., I.T.)
| | - Charalambos Vlachopoulos
- 1st Cardiology Department, Hippokration Hospital, National and Kapodistrian University of Athens, Greece (D.T.-P., C.V.)
| | - Thomas Weber
- Cardiology Department, Klinikum Wels-Grieskirchen, Austria (T.W.)
| | - Elisabetta Bianchini
- Institute of Clinical Physiology, Italian National Research Council, Pisa (E.B.)
| | - Rosa Maria Bruno
- Université Paris Cité, Inserm, Paris Cardiovascular Research Center (PARCC), France (P.B., S.L., R.M.B.)
- Service de Pharmacologie et Hypertension, Assistance Publique–Hôpitaux de Paris (AP–HP), Hôpital Européen Georges Pompidou, Paris, France (P.B., S.L., R.M.B.)
| |
Collapse
|
13
|
Mitchell GF, Rong J, Larson MG, Korzinski TJ, Xanthakis V, Sigurdsson S, Gudnason V, Launer LJ, Aspelund T, Hamburg NM, Gotal JD, Vasan RS. Vascular Age Assessed From an Uncalibrated, Noninvasive Pressure Waveform by Using a Deep Learning Approach: The AI-VascularAge Model. Hypertension 2024; 81:193-201. [PMID: 37901957 PMCID: PMC10842456 DOI: 10.1161/hypertensionaha.123.21638] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2023] [Accepted: 10/10/2023] [Indexed: 10/31/2023]
Abstract
BACKGROUND Aortic stiffness, assessed as carotid-femoral pulse wave velocity, provides a measure of vascular age and risk for adverse cardiovascular disease outcomes, but it is difficult to measure. The shape of arterial pressure waveforms conveys information regarding aortic stiffness; however, the best methods to extract and interpret waveform features remain controversial. METHODS We trained a convolutional neural network with fixed-scale (time and amplitude) brachial, radial, and carotid tonometry waveforms as input and negative inverse carotid-femoral pulse wave velocity as label. Models were trained with data from 2 community-based Icelandic samples (N=10 452 participants with 31 126 waveforms) and validated in the community-based Framingham Heart Study (N=7208 participants, 21 624 waveforms). Linear regression rescaled predicted negative inverse carotid-femoral pulse wave velocity to equivalent artificial intelligence vascular age (AI-VA). RESULTS The AI-VascularAge model predicted negative inverse carotid-femoral pulse wave velocity with R2=0.64 in a randomly reserved Icelandic test group (n=5061, 16%) and R2=0.60 in the Framingham Heart Study. In the Framingham Heart Study (up to 18 years of follow-up; 479 cardiovascular disease, 200 coronary heart disease, and 213 heart failure events), brachial AI-VA was associated with incident cardiovascular disease adjusted for age and sex (model 1; hazard ratio, 1.79 [95% CI, 1.50-2.40] per SD; P<0.0001) or adjusted for age, sex, systolic blood pressure, total cholesterol, high-density lipoprotein cholesterol, prevalent diabetes, hypertension treatment, and current smoking (model 2; hazard ratio, 1.50 [95% CI, 1.24-1.82] per SD; P<0.0001). Similar hazard ratios were demonstrated for incident coronary heart disease and heart failure events and for AI-VA values estimated from carotid or radial waveforms. CONCLUSIONS Our results demonstrate that convolutional neural network-derived AI-VA is a powerful indicator of vascular health and cardiovascular disease risk in a broad community-based sample.
Collapse
Affiliation(s)
| | - Jian Rong
- Boston University and NHLBI’s Framingham Study, Framingham, MA
| | - Martin G. Larson
- Boston University and NHLBI’s Framingham Study, Framingham, MA
- Department of Biostatistics, Boston University School of Public Health, Boston, MA
| | | | - Vanessa Xanthakis
- Boston University and NHLBI’s Framingham Study, Framingham, MA
- Department of Biostatistics, Boston University School of Public Health, Boston, MA
- Preventive Medicine and Epidemiology, Boston University School of Medicine, Boston Medical Center, Boston, MA
| | | | - Vilmundur Gudnason
- Icelandic Heart Association, Kopavogur, Iceland
- Faculty of Medicine, University of Iceland, Reykjavik, Iceland
| | - Lenore J. Launer
- Intramural Research Program, Laboratory of Epidemiology and Population Sciences, National Institute on Aging, Baltimore, MD
| | - Thor Aspelund
- Icelandic Heart Association, Kopavogur, Iceland
- Faculty of Medicine, University of Iceland, Reykjavik, Iceland
| | - Naomi M. Hamburg
- Evans Department of Medicine, Boston University School of Medicine, Boston, MA
- Whitaker Cardiovascular Institute, Boston University School of Medicine, Boston, MA
| | | | - Ramachandran S. Vasan
- Boston University and NHLBI’s Framingham Study, Framingham, MA
- Preventive Medicine and Epidemiology, Boston University School of Medicine, Boston Medical Center, Boston, MA
- Evans Department of Medicine, Boston University School of Medicine, Boston, MA
- Whitaker Cardiovascular Institute, Boston University School of Medicine, Boston, MA
- University of Texas School of Public Health, San Antonio, TX
| |
Collapse
|
14
|
Arnold L, Haas NA, Jakob A, Fischer J, Massberg S, Deseive S, Oberhoffer FS. Short-Term Changes in Arterial Stiffness Measured by 2D Speckle Tracking in Patients Undergoing Transcatheter Aortic Valve Implantation. J Clin Med 2023; 13:222. [PMID: 38202229 PMCID: PMC10779940 DOI: 10.3390/jcm13010222] [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: 11/04/2023] [Revised: 12/07/2023] [Accepted: 12/22/2023] [Indexed: 01/12/2024] Open
Abstract
Arterial stiffness has received increasing interest as a cardiovascular marker in patients with aortic valve stenosis (AS). So far, studies on the impact of aortic valve replacement (AVR) on arterial stiffness have been equivocal. Two-dimensional speckle tracking (2DST) is a novel, non-invasive method to measure the motion of the vessel wall. In this prospective observational study, we aimed to assess the change in arterial stiffness of the common carotid artery (CCA) measured by 2DST in patients undergoing transcatheter aortic valve implantation (TAVI). A total of 47 patients were included in the study (age 80.04 ± 6.065 years). Peak circumferential strain (CS) was significantly improved after TAVI (4.50 ± 2.292 vs. 5.12 ± 2.958, p = 0.012), as was the peak strain rate (CSR) (0.85 ± 0.567 vs. 1.35 ± 0.710, p = 0.002). Body mass index (BMI), mean arterial pressure (MAP) and hemodynamic parameters were associated with this change. 2DST results did not correlate with aortic pulse wave velocity (aPWV) or augmentation index normalized to heart rate (AIx@75), suggesting a distinct difference between arterial stiffness of the CCA and other stiffness parameters. 2DST seems to be a promising new tool to assess arterial stiffness in TAVI patients.
Collapse
Affiliation(s)
- Leonie Arnold
- Division of Pediatric Cardiology and Intensive Care, University Hospital, LMU Munich, 81377 Munich, Germany
| | - Nikolaus Alexander Haas
- Division of Pediatric Cardiology and Intensive Care, University Hospital, LMU Munich, 81377 Munich, Germany
| | - André Jakob
- Division of Pediatric Cardiology and Intensive Care, University Hospital, LMU Munich, 81377 Munich, Germany
| | - Julius Fischer
- Department of Medicine I, University Hospital, LMU Munich, 81377 Munich, Germany
| | - Steffen Massberg
- Department of Medicine I, University Hospital, LMU Munich, 81377 Munich, Germany
| | - Simon Deseive
- Department of Medicine I, University Hospital, LMU Munich, 81377 Munich, Germany
| | - Felix Sebastian Oberhoffer
- Division of Pediatric Cardiology and Intensive Care, University Hospital, LMU Munich, 81377 Munich, Germany
| |
Collapse
|
15
|
Zota IM, Ghiciuc CM, Cojocaru DC, Dima-Cozma CL, Leon MM, Gavril RS, Roca M, Costache AD, Maștaleru A, Anghel L, Stătescu C, Sascău RA, Mitu F. Changes in Arterial Stiffness in Response to Blood Flow Restriction Resistance Training: A Narrative Review. J Clin Med 2023; 12:7602. [PMID: 38137671 PMCID: PMC10743779 DOI: 10.3390/jcm12247602] [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: 10/18/2023] [Revised: 12/07/2023] [Accepted: 12/08/2023] [Indexed: 12/24/2023] Open
Abstract
Arterial stiffness naturally increases with age and is a known predictor of cardiovascular morbimortality. Blood flow restriction (BFR) training involves decreasing muscle blood flow by applying a strap or a pneumatic cuff during exercise. BFR induces muscle hypertrophy even at low intensities, making it an appealing option for older, untrained individuals. However, BFR use in patients with cardiovascular comorbidities is limited by the increased pressor and chronotropic response observed in hypertensive elderly patients. Furthermore, the impact of BFR on vascular function remains unclear. We conducted a comprehensive literature review according to PRISMA guidelines, summarizing available data on the acute and long-term consequences of BFR training on vascular function. Although evidence is still scarce, it seems that BFR has a mild or neutral long-term impact on arterial stiffness. However, current research shows that BFR can cause an abrupt, albeit transient, increase in PWV and central blood pressure. BFR and, preferably, lower-body BFR, should be prescribed with caution in older populations, especially in hypertensive patients who have an exacerbated muscle metaboreflex pressor response. Longer follow-up studies are required to assess the chronic effect of BFR training on arterial stiffness, especially in elderly patients who are usually unable to tolerate high-intensity resistance exercises.
Collapse
Affiliation(s)
- Ioana Mădălina Zota
- Department of Medical Specialties I, Faculty of Medicine, Grigore T. Popa University of Medicine and Pharmacy, 700111 Iași, Romania; (I.M.Z.); (C.L.D.-C.); (M.M.L.); (R.S.G.); (M.R.); (A.D.C.); (A.M.); (L.A.); (C.S.); (R.A.S.); (F.M.)
| | - Cristina Mihaela Ghiciuc
- Pharmacology, Clinical Pharmacology and Algeziology, Department of Morpho-Functional Sciences II, Faculty of Medicine, Grigore T. Popa University of Medicine and Pharmacy, 700111 Iași, Romania
| | - Doina Clementina Cojocaru
- Department of Medical Specialties I, Faculty of Medicine, Grigore T. Popa University of Medicine and Pharmacy, 700111 Iași, Romania; (I.M.Z.); (C.L.D.-C.); (M.M.L.); (R.S.G.); (M.R.); (A.D.C.); (A.M.); (L.A.); (C.S.); (R.A.S.); (F.M.)
| | - Corina Lucia Dima-Cozma
- Department of Medical Specialties I, Faculty of Medicine, Grigore T. Popa University of Medicine and Pharmacy, 700111 Iași, Romania; (I.M.Z.); (C.L.D.-C.); (M.M.L.); (R.S.G.); (M.R.); (A.D.C.); (A.M.); (L.A.); (C.S.); (R.A.S.); (F.M.)
| | - Maria Magdalena Leon
- Department of Medical Specialties I, Faculty of Medicine, Grigore T. Popa University of Medicine and Pharmacy, 700111 Iași, Romania; (I.M.Z.); (C.L.D.-C.); (M.M.L.); (R.S.G.); (M.R.); (A.D.C.); (A.M.); (L.A.); (C.S.); (R.A.S.); (F.M.)
| | - Radu Sebastian Gavril
- Department of Medical Specialties I, Faculty of Medicine, Grigore T. Popa University of Medicine and Pharmacy, 700111 Iași, Romania; (I.M.Z.); (C.L.D.-C.); (M.M.L.); (R.S.G.); (M.R.); (A.D.C.); (A.M.); (L.A.); (C.S.); (R.A.S.); (F.M.)
| | - Mihai Roca
- Department of Medical Specialties I, Faculty of Medicine, Grigore T. Popa University of Medicine and Pharmacy, 700111 Iași, Romania; (I.M.Z.); (C.L.D.-C.); (M.M.L.); (R.S.G.); (M.R.); (A.D.C.); (A.M.); (L.A.); (C.S.); (R.A.S.); (F.M.)
| | - Alexandru Dan Costache
- Department of Medical Specialties I, Faculty of Medicine, Grigore T. Popa University of Medicine and Pharmacy, 700111 Iași, Romania; (I.M.Z.); (C.L.D.-C.); (M.M.L.); (R.S.G.); (M.R.); (A.D.C.); (A.M.); (L.A.); (C.S.); (R.A.S.); (F.M.)
| | - Alexandra Maștaleru
- Department of Medical Specialties I, Faculty of Medicine, Grigore T. Popa University of Medicine and Pharmacy, 700111 Iași, Romania; (I.M.Z.); (C.L.D.-C.); (M.M.L.); (R.S.G.); (M.R.); (A.D.C.); (A.M.); (L.A.); (C.S.); (R.A.S.); (F.M.)
| | - Larisa Anghel
- Department of Medical Specialties I, Faculty of Medicine, Grigore T. Popa University of Medicine and Pharmacy, 700111 Iași, Romania; (I.M.Z.); (C.L.D.-C.); (M.M.L.); (R.S.G.); (M.R.); (A.D.C.); (A.M.); (L.A.); (C.S.); (R.A.S.); (F.M.)
| | - Cristian Stătescu
- Department of Medical Specialties I, Faculty of Medicine, Grigore T. Popa University of Medicine and Pharmacy, 700111 Iași, Romania; (I.M.Z.); (C.L.D.-C.); (M.M.L.); (R.S.G.); (M.R.); (A.D.C.); (A.M.); (L.A.); (C.S.); (R.A.S.); (F.M.)
| | - Radu Andy Sascău
- Department of Medical Specialties I, Faculty of Medicine, Grigore T. Popa University of Medicine and Pharmacy, 700111 Iași, Romania; (I.M.Z.); (C.L.D.-C.); (M.M.L.); (R.S.G.); (M.R.); (A.D.C.); (A.M.); (L.A.); (C.S.); (R.A.S.); (F.M.)
| | - Florin Mitu
- Department of Medical Specialties I, Faculty of Medicine, Grigore T. Popa University of Medicine and Pharmacy, 700111 Iași, Romania; (I.M.Z.); (C.L.D.-C.); (M.M.L.); (R.S.G.); (M.R.); (A.D.C.); (A.M.); (L.A.); (C.S.); (R.A.S.); (F.M.)
- Academy of Medical Sciences of Romania, Ion C. Brătianu Boulevard No 1, 030167 Bucharest, Romania
| |
Collapse
|
16
|
González LDM, Romero-Orjuela SP, Rabeya FJ, del Castillo V, Echeverri D. Age and vascular aging: an unexplored frontier. Front Cardiovasc Med 2023; 10:1278795. [PMID: 38028481 PMCID: PMC10665864 DOI: 10.3389/fcvm.2023.1278795] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Accepted: 10/03/2023] [Indexed: 12/01/2023] Open
Abstract
Vascular age is an emerging field in cardiovascular risk assessment. This concept includes multifactorial changes in the arterial wall, with arterial stiffness as its most relevant manifestation, leading to increased arterial pressure and pulsatile flow in the organs. Today, the approved test for measuring vascular age is pulse wave velocity, which has been proven to predict cardiovascular events. Furthermore, vascular phenotypes, such as early vascular aging and "SUPERNOVA," representing phenotypic extremes of vascular aging, have been found. The identification of these phenotypes opens a new field of study in cardiovascular physiology. Lifestyle interventions and pharmacological therapy have positively affected vascular health, reducing arterial stiffness. This review aims to define the concepts related to vascular age, pathophysiology, measurement methods, clinical signs and symptoms, and treatment.
Collapse
Affiliation(s)
- Laura del Mar González
- Department of Cardiology, Fundación Cardioinfantil–Instituto de Cardiología, Bogotá, Colombia
| | | | - Fernando J. Rabeya
- School of Medicine and Health Sciences, Universidad del Rosario, Bogotá, Colombia
| | - Valeria del Castillo
- Department of Cardiology, Fundación Cardioinfantil–Instituto de Cardiología, Bogotá, Colombia
| | - Darío Echeverri
- Department of Cardiology, Fundación Cardioinfantil–Instituto de Cardiología, Bogotá, Colombia
| |
Collapse
|
17
|
Miyagi T, Ishida A, Shinzato T, Ohya Y. Arterial Stiffness Is Associated With Small Vessel Disease Irrespective of Blood Pressure in Stroke-Free Individuals. Stroke 2023; 54:2814-2821. [PMID: 37846566 DOI: 10.1161/strokeaha.123.042512] [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: 01/09/2023] [Accepted: 08/03/2023] [Indexed: 10/18/2023]
Abstract
BACKGROUND Arterial stiffness and hypertension are important risk factors for cerebral small vessel disease (CSVD). Clinically, there are hypertensive patients with low pulse wave velocity (PWV) and nonhypertensive individuals with high PWV. We aimed to determine the effects of arterial stiffness on CSVD in normotensive individuals. METHODS An observational cross-sectional study was conducted in 1894 stroke-free participants who underwent brain magnetic resonance imaging and brachial-ankle pulse wave velocity (baPWV) measurements at a health checkup between 2013 and 2020. CSVD was defined as any of following: white matter hyperintensities, cerebral microbleeds, silent lacunar infarcts, and enlarged perivascular spaces. baPWV was measured using an automatic oscillometric device. Participants were divided into 4 groups according to the following cutoff points: low blood pressure (BP, <120/80 mm Hg) with low baPWV (<14.63 m/s, a cutoff value that predicted CSVD); high BP (≥120/80 mm Hg) with low baPWV; low BP with high baPWV (≥14.63 m/s); and high BP with high baPWV. RESULTS The mean age of the participants was 57±13 years (41% women). The prevalence of CSVD was 718 (38%), which was higher in the low BP with high baPWV (56%) and high BP with high baPWV (55%) groups than in the high BP with low baPWV (24%) and low BP with low baPWV (22%) groups. Compared with the low BP with low baPWV group, the low BP with high baPWV group (odds ratio, 1.63 [95% CI, 1.09-2.43]) and the high BP with high baPWV group (odds ratio, 1.86 [95% CI, 1.39-2.49]) had a significantly higher multivariable-adjusted risk for CSVD. CONCLUSIONS Individuals with a high baPWV had a higher prevalence of CSVD, independent of BP status. Higher arterial stiffness is likely to be a more important risk factor for CSVD than BP status in stroke-free individuals.
Collapse
Affiliation(s)
- Tomo Miyagi
- Department of Cardiovascular Medicine, Nephrology and Neurology, Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan (T.M., A.I., Y.O.)
| | - Akio Ishida
- Department of Cardiovascular Medicine, Nephrology and Neurology, Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan (T.M., A.I., Y.O.)
| | | | - Yusuke Ohya
- Department of Cardiovascular Medicine, Nephrology and Neurology, Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan (T.M., A.I., Y.O.)
| |
Collapse
|
18
|
DeJonge SR, DuBose NG, Pilutti LA, Motl RW. Arterial stiffness in persons with multiple sclerosis and controls: Does aerobic fitness account for group differences? Mult Scler 2023; 29:1684-1687. [PMID: 37691520 DOI: 10.1177/13524585231199030] [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] [Indexed: 09/12/2023]
Abstract
Vascular function is worse in multiple sclerosis (MS) than healthy controls perhaps based on differences in aerobic fitness. We compared carotid-femoral pulse wave velocity (cfPWV) and augmentation index (AIx75) between MS and controls while accounting for aerobic fitness. Aerobic fitness was measured as peak oxygen consumption on a recumbent stepper. cfPWV and AIx75 were measured using applanation tonometry. Persons with MS demonstrated lower aerobic fitness and higher cfPWV, but no difference in AIx75 compared with controls. The difference in cfPWV remained statistically significant after controlling for aerobic fitness, suggesting that arterial stiffness might reflect underlying pathophysiology processes of MS.
Collapse
Affiliation(s)
- Sydney R DeJonge
- Department of Kinesiology and Nutrition, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, IL, USA
| | - Noah G DuBose
- Department of Kinesiology and Nutrition, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, IL, USA
| | - Lara A Pilutti
- Interdisciplinary School of Health Sciences, University of Ottawa, Ottawa, ON, Canada
- Brain and Mind Research Institute, University of Ottawa, Ottawa, ON, Canada
| | - Robert W Motl
- Department of Kinesiology and Nutrition, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, IL, USA
| |
Collapse
|
19
|
Tarar BI, Knox A, Dean CA, Brown EC. Resistance training responses across race and ethnicity: a narrative review. Ethn Health 2023; 28:1221-1237. [PMID: 37183720 DOI: 10.1080/13557858.2023.2212147] [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] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Accepted: 05/04/2023] [Indexed: 05/16/2023]
Abstract
OBJECTIVES Although the physiological mechanisms are not fully understood, race/ethnicity differences vary across cardiometabolic disease risk factors. Resistance training (RT) is an effective therapy for improving these risk factors in addition to body composition and physical performance. Thus, the purpose of this study was to determine the effects of RT over time on different racial and ethnic populations across cardiometabolic, body composition, and physical performance outcomes. DESIGN Electronic databases Scopus and PubMed were searched for studies that compared different racial/ethnic responses to RT across cardiometabolic, body composition, and physical performance parameters. Inclusion criteria for the studies were as follows: (1) published in the English language; (2) compared races or ethnicities across cardiometabolic risk factors, body composition, or physical performance variables following a RT intervention; (3) included adults 18 years or older, and (4) included an isolated RT intervention group. RESULTS Nine studies were found that met the inclusion criteria. The identified studies involved cohorts of White American (WA), South Asian, European Chilean, Mapuche Chilean, White Scottish, and African American (AA) males and females. Race/ethnicity differences following a RT intervention were found for fat-free mass preservation and changes in blood pressure, endothelial function, brachial artery stiffness, cardiac autonomic function, inflammatory and oxidative stress markers, insulin sensitivity, body mass index, waist circumference, % body fat, and muscular strength. With the exception of changes in systolic blood pressure and brachial artery stiffness, AAs consistently showed more beneficial adaptations compared to WAs to RT across studies. CONCLUSION Race and ethnicity play a role in how adults adapt to chronic RT. These data may aid in better understanding the social, biological, and environmental factors that likely influenced these racial/ethnic differences in response to RT, assist in creating tailored exercise prescriptions for various racial/ethnic populations, and inform policies for determining resource allocations to address health inequities.
Collapse
Affiliation(s)
- Bilal Ihsan Tarar
- Department of Interdisciplinary Health Sciences, School of Health Sciences, Oakland University, Rochester, MI, USA
| | - Allan Knox
- Department of Exercise Science, College of Arts and Sciences, California Lutheran University, Thousand Oaks, CA, USA
| | - Caress Alithia Dean
- Department of Public and Environmental Wellness, School of Health Sciences, Oakland University, Rochester, MI, USA
| | - Elise Catherine Brown
- Department of Public and Environmental Wellness, School of Health Sciences, Oakland University, Rochester, MI, USA
| |
Collapse
|
20
|
Dorogovtsev VN, Yankevich DS, Gaydashev AE, Martyushev-Poklad AV, Podolskaya JA, Borisov IV, Grechko AV. Preclinical Orthostatic Abnormalities May Predict Early Increase in Vascular Stiffness in Different Age Groups: A Pilot Study. Diagnostics (Basel) 2023; 13:3243. [PMID: 37892064 PMCID: PMC10606479 DOI: 10.3390/diagnostics13203243] [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: 08/30/2023] [Revised: 10/06/2023] [Accepted: 10/10/2023] [Indexed: 10/29/2023] Open
Abstract
Clinical orthostatic hypotension (OH) and hypertension (OHT) are risk factors for arterial hypertension (AH) and cardiovascular diseases (CVD) and are associated with increased vascular stiffness. Preclinical OH and OHT are poorly understood. The main objective was to investigate preclinical orthostatic abnormalities and their association with increased vascular stiffness in different age groups of adults. A specially designed head-up tilt test standardized for hydrostatic column height was used to detect them. Three age groups of clinically healthy subjects were examined. In the group of young adults up to 30 years old, a significant predominance of orthostatic normotension (ONT) and an insignificant number of subjects with preclinical OH and OHT were found. In the age group over 45 years, compared to the group under 30 years, there was a twofold decrease in the proportion of individuals with ONT and a significant increase with preclinical OH and OHT. In all age groups, there was a significant orthostatic increase in vascular stiffness (as measured by the brachial-ankle pulse wave velocity (baPWV), which was recovered to the baseline level when returning to the supine position. Overall, subjects with preclinical OH and OHT had significantly higher baPWV values compared to those with ONT (p = 0.001 and p = 0.002, respectively), with all subjects having vascular stiffness values within normal age-related values.
Collapse
Affiliation(s)
- Victor N. Dorogovtsev
- Federal Research and Clinical Center of Intensive Care Medicine and Rehabilitology, 107031 Moscow, Russia; (D.S.Y.); (A.V.M.-P.); (J.A.P.); (A.V.G.)
| | - Dmitry S. Yankevich
- Federal Research and Clinical Center of Intensive Care Medicine and Rehabilitology, 107031 Moscow, Russia; (D.S.Y.); (A.V.M.-P.); (J.A.P.); (A.V.G.)
| | - Andrey E. Gaydashev
- Problem Scientific Research Laboratory, Smolensk State Medical University, 214019 Smolensk, Russia;
| | - Andrey V. Martyushev-Poklad
- Federal Research and Clinical Center of Intensive Care Medicine and Rehabilitology, 107031 Moscow, Russia; (D.S.Y.); (A.V.M.-P.); (J.A.P.); (A.V.G.)
| | - Julia A. Podolskaya
- Federal Research and Clinical Center of Intensive Care Medicine and Rehabilitology, 107031 Moscow, Russia; (D.S.Y.); (A.V.M.-P.); (J.A.P.); (A.V.G.)
| | - Ilya V. Borisov
- Federal Research and Clinical Center of Intensive Care Medicine and Rehabilitology, 107031 Moscow, Russia; (D.S.Y.); (A.V.M.-P.); (J.A.P.); (A.V.G.)
| | - Andrey V. Grechko
- Federal Research and Clinical Center of Intensive Care Medicine and Rehabilitology, 107031 Moscow, Russia; (D.S.Y.); (A.V.M.-P.); (J.A.P.); (A.V.G.)
| |
Collapse
|
21
|
Tomiyama H, Imai T, Shiina K, Higashi Y, Nakano H, Takahashi T, Fujii M, Matsumoto C, Yamashina A, Chikamori T. Lifelong Heterogeneous Contribution of Cardiovascular Risk Factors to Slow and Fast Progression of Arterial Stiffness. Hypertension 2023; 80:2159-2168. [PMID: 37551598 DOI: 10.1161/hypertensionaha.123.21481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Accepted: 07/23/2023] [Indexed: 08/09/2023]
Abstract
BACKGROUND Although some cardiovascular risk factors (CVRFs) are known to be associated with increased arterial stiffness, increased arterial stiffness does not mediate the cardiovascular risk associated with all CVRFs. Here, based on long-term repeated-measurement data, we examined the association of the lifelong status of each CVRF with the rate of progression of arterial stiffness. METHODS We utilized the data from annual health checkups with the brachial-ankle pulse wave velocity measurements over a 16-year period in middle-aged Japanese occupational cohort. RESULTS Totally, 29 090 brachial-ankle pulse wave velocity data were obtained during the follow-up of 3763 subjects ranging in age from around 30 to 70 years. Smoking, heavy alcohol intake, hypertension, diabetes, hypertriglyceridemia, and hyperuricemia were independently associated with the fast progression of arterial stiffness. Also, lower values in nondisease range in blood pressure, glycosylated hemoglobin A1c, triglyceride, and uric acid were independently associated with the slow progression of arterial stiffness. For body mass index and low-density lipoprotein cholesterol, no clear associations with the progression of arterial stiffness were observed. CONCLUSIONS The present prospective study provided more robust epidemiological evidence for the heterogeneity of the significance of contribution of lifelong status of each CVRF to the slow and fast rate of progression of arterial stiffness. These findings suggest the important need to examine, in further studies, the effects of global early interventions to control the levels of the culprit CVRFs, even from middle age, not only to prevent a fast progression of the arterial stiffness but also to maintain a relatively slow progression of arterial stiffness.
Collapse
Affiliation(s)
- Hirofumi Tomiyama
- Department of Cardiology (H.T., K.S., H.N., T.T., M.F., C.M., T.C.), Tokyo Medical University, Japan
- Division of Preemptive Medicine for Vascular Damage (H.T., K.S.), Tokyo Medical University, Japan
| | - Takumi Imai
- Department of Medical Statistics, Osaka Metropolitan University, Japan (T.I.)
| | - Kazuki Shiina
- Department of Cardiology (H.T., K.S., H.N., T.T., M.F., C.M., T.C.), Tokyo Medical University, Japan
- Division of Preemptive Medicine for Vascular Damage (H.T., K.S.), Tokyo Medical University, Japan
| | - Yukihito Higashi
- Cardiovascular Regeneration and Medicine, Research Institute for Radiation Biology and Medicine, Hiroshima University, Japan (Y.H.)
| | - Hiroki Nakano
- Department of Cardiology (H.T., K.S., H.N., T.T., M.F., C.M., T.C.), Tokyo Medical University, Japan
| | - Takamichi Takahashi
- Department of Cardiology (H.T., K.S., H.N., T.T., M.F., C.M., T.C.), Tokyo Medical University, Japan
| | - Masatsune Fujii
- Department of Cardiology (H.T., K.S., H.N., T.T., M.F., C.M., T.C.), Tokyo Medical University, Japan
| | - Chisa Matsumoto
- Department of Cardiology (H.T., K.S., H.N., T.T., M.F., C.M., T.C.), Tokyo Medical University, Japan
| | - Akira Yamashina
- Department of Nursing, Kiryu University, Gunma, Japan (A.Y.)
| | - Taishiro Chikamori
- Department of Cardiology (H.T., K.S., H.N., T.T., M.F., C.M., T.C.), Tokyo Medical University, Japan
| |
Collapse
|
22
|
Podzolkov VI, Bragina AE, Tarzimanova AI, Ogibenina ES, Shvedov II, Ivannikov AA, Megeneishvili NК, Sutulova AV. [Association between cardio-ankle vascular index and markers of thrombosis in hospitalized patients COVID-19]. TERAPEVT ARKH 2023; 95:548-553. [PMID: 38159004 DOI: 10.26442/00403660.2023.07.202292] [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: 09/28/2023] [Accepted: 09/28/2023] [Indexed: 01/03/2024]
Abstract
AIM To evaluate the relationship between the cardio-ankle vascular index (CAVI) and the marker of procoagulant state - D-dimer in hospitalized patients with coronavirus disease 2019 (COVID-19). MATERIALS AND METHODS This cross-sectional study involved adult patients admitted to the University hospital with clinically diagnosed or laboratory-confirmed COVID-19. We compared groups of patients with normal and elevated CAVI. Univariate and multivariate logistic regression analyses were performed to assess the association between risk factors and elevated D-dimer levels; odds ratios (ORs) with 95% confidence intervals (95% CI) were calculated to determine the strength of association. A p<0.05 was considered statistically significant. RESULTS The study included 152 patients [64 (42.1%) men and 88 (57.9%) women], mean age 59.10±12.74 years. 45 (29.6%) had elevated CAVI. Patients with elevated CAVI were older, had more comorbid diseases, a higher Charlson comorbidity index and D-dimer levels. Age, the comorbidity index, and CAVI above 9.5 were associated with elevated D-dimer levels in patients with COVID-19. In a multivariate logistic regression, CAVI above 9.5 was an independent predictor of increased D-dimer in patients with COVID-19 (OR 2.513, 95% CI 1.050-6.012; p=0.038). CONCLUSION In this study, for the first time, the association between a vascular stiffness marker, elevated CAVI, and increased D-dimer levels in COVID-19 patients was shown. This relationship may be a consequence of endothelial dysfunction and can be used as an additional marker of coagulopathy developing as part of COVID-19.
Collapse
Affiliation(s)
- V I Podzolkov
- Sechenov First Moscow State Medical University (Sechenov University)
| | - A E Bragina
- Sechenov First Moscow State Medical University (Sechenov University)
| | - A I Tarzimanova
- Sechenov First Moscow State Medical University (Sechenov University)
| | - E S Ogibenina
- Sechenov First Moscow State Medical University (Sechenov University)
| | - I I Shvedov
- Sechenov First Moscow State Medical University (Sechenov University)
| | - A A Ivannikov
- Sechenov First Moscow State Medical University (Sechenov University)
| | - N К Megeneishvili
- Sechenov First Moscow State Medical University (Sechenov University)
| | - A V Sutulova
- Sechenov First Moscow State Medical University (Sechenov University)
| |
Collapse
|
23
|
Wu S, Wu Z, Yu D, Chen S, Wang A, Wang A, Gao X. Life's Essential 8 and Risk of Stroke: A Prospective Community-Based Study. Stroke 2023; 54:2369-2379. [PMID: 37466001 DOI: 10.1161/strokeaha.123.042525] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2023] [Accepted: 06/22/2023] [Indexed: 07/20/2023]
Abstract
BACKGROUND Data are lacking regarding cardiovascular health (CVH) with Life's Essential 8 approach and future stroke risk. We sought to elucidate whether the CVH score constructed by the Life's Essential 8 metrics predicted stroke risk in 2 Chinese ongoing cohorts. METHODS This included 41 043 participants of the Kailuan I study and 27 842 participants of the Kailuan II study who were free of cardiovascular disease or cancer in 2014. CVH score (ranged from 0 to 100) was assessed using the Life's Essential 8 metrics (body mass index, cigarette smoking, diet quality, physical activity, sleep health, lipid, blood glucose, and blood pressure). A composite of incident stroke events (ischemic stroke and hemorrhagic stroke) was identified via review of medical records. The follow-up period was calculated from the finishing date of the 2014 survey to either the date of stroke occurrence, death, loss to follow-up, or the end of follow-up (December 31, 2020). We also examined the longitudinal association between the CVH score and arterial stiffness status, as assessed by brachial-ankle pulse wave velocity, in 25 922 participants free of cardiovascular disease during the follow-up. We performed a meta-analysis to assess the association between CVH, based on the 2010 American Heart Association recommendation, and stroke integrating the results of current study and previous studies. RESULTS During a median follow-up of 5.65 years (interquartile range, 5.20-6.09), a total of 1750 incident stroke events were identified in the pooled Kailuan study. The pooled hazard ratios were 0.33 (95% CI, 0.20-0.54) for ideal versus poor health category of CVH (Ptrend<0.0001). Higher CVH scores were also associated with lower brachial-ankle pulse wave velocity values at baseline and slower increments of brachial-ankle pulse wave velocity during follow-up (Ptrend≤0.001 for both). Arterial stiffness mediated 9.07% (95% CI, 5.83%-15.0%) of the total association between CVH and incident stroke. The pooled hazard ratio comparing 2 extreme CVH categories for stroke was 0.45 (95% CI, 0.35-0.59) when including 10 published studies and the current study. CONCLUSIONS The CVH score as assessed by the Life's Essential 8 metrics significantly predicted future stroke risk and arterial stiffness status.
Collapse
Affiliation(s)
- Shouling Wu
- Department of Cardiology, Kailuan General Hospital, Tangshan, People's Republic of China (S.W., S.C.)
| | - Zhijun Wu
- Department of Cardiovascular Medicine, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, People's Republic of China (Z.W.)
| | - Dongmei Yu
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing, People's Republic of China (D.Y.)
| | - Shuohua Chen
- Department of Cardiology, Kailuan General Hospital, Tangshan, People's Republic of China (S.W., S.C.)
| | - Aitian Wang
- Department of Intensive Medicine, Kailuan General Hospital, Tangshan, People's Republic of China (Aitian W.)
| | - Anxin Wang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, People's Republic of China (Anxin W.)
| | - Xiang Gao
- Department of Nutrition and Food Hygiene, School of Public Health, Institute of Nutrition, Fudan University, Shanghai, People's Republic of China (X.G.)
| |
Collapse
|
24
|
Sánchez-Delgado JC, Cohen DD, Camacho-López PA, Carreño-Robayo J, Castañeda-Hernández A, García-González D, Martínez-Bello D, Aroca-Martinez G, Parati G, Lopez-Jaramillo P. Handgrip Strength Is Associated with Specific Aspects of Vascular Function in Individuals with Metabolic Syndrome. Biomedicines 2023; 11:2435. [PMID: 37760876 PMCID: PMC10525985 DOI: 10.3390/biomedicines11092435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 08/16/2023] [Accepted: 08/16/2023] [Indexed: 09/29/2023] Open
Abstract
BACKGROUND Metabolic syndrome (MetS) is a disorder associated with an increased risk for the development of diabetes mellitus and its complications. Lower isometric handgrip strength (HGS) is associated with an increased risk of cardiometabolic diseases. However, the association between HGS and arterial stiffness parameters, which are considered the predictors of morbidity and mortality in individuals with MetS, is not well defined. OBJECTIVE To determine the association between HGS and HGS asymmetry on components of vascular function in adults with MetS. METHODS We measured handgrip strength normalized to bodyweight (HGS/kg), HGS asymmetry, body composition, blood glucose, lipid profile, blood pressure, pulse wave velocity (PWV), reflection coefficient (RC), augmentation index @75 bpm (AIx@75) and peripheral vascular resistance (PVR) in 55 adults with a diagnosis of MetS between 25 and 54 years old. RESULTS Mean age was 43.1 ± 7.0 years, 56.3% were females. HGS/kg was negatively correlated with AIx@75 (r = -0.440), p < 0.05, but these associations were not significant after adjusting for age and sex. However, when interaction effects between sex, HGS/kg and age were examined, we observed an inverse relationship between HGS/kg and AIx@75 in the older adults in the sample, whereas in the younger adults, a weak direct association was found. We also found a significant association between HGS asymmetry and PVR (beta = 30, 95% CI = 7.02; 54.2; p <0.012). CONCLUSIONS Our findings suggest that in people with MetS, maintaining muscle strength may have an increasingly important role in older age in the attenuation of age-related increases in AIx@75-a marker of vascular stiffness-and that a higher HGS asymmetry could be associated with a greater vascular resistance.
Collapse
Affiliation(s)
- Juan Carlos Sánchez-Delgado
- Universidad de Santander, Facultad de Ciencias Médicas y de la Salud, Bucaramanga 680003, Colombia; (D.D.C.); (J.C.-R.); (A.C.-H.); (D.M.-B.)
- Grupo de Investigación Ser Cultura y Movimiento, Universidad Santo Tomás-Bucaramanga, Santander 680001, Colombia;
| | - Daniel D. Cohen
- Universidad de Santander, Facultad de Ciencias Médicas y de la Salud, Bucaramanga 680003, Colombia; (D.D.C.); (J.C.-R.); (A.C.-H.); (D.M.-B.)
- Department of Physical Education and Sport Sciences, Faculty of Education and Health Sciences, University of Limerick, V94T9PX Limerick, Ireland
| | | | - Javier Carreño-Robayo
- Universidad de Santander, Facultad de Ciencias Médicas y de la Salud, Bucaramanga 680003, Colombia; (D.D.C.); (J.C.-R.); (A.C.-H.); (D.M.-B.)
| | - Alvaro Castañeda-Hernández
- Universidad de Santander, Facultad de Ciencias Médicas y de la Salud, Bucaramanga 680003, Colombia; (D.D.C.); (J.C.-R.); (A.C.-H.); (D.M.-B.)
| | - Daniel García-González
- Grupo de Investigación Ser Cultura y Movimiento, Universidad Santo Tomás-Bucaramanga, Santander 680001, Colombia;
| | - Daniel Martínez-Bello
- Universidad de Santander, Facultad de Ciencias Médicas y de la Salud, Bucaramanga 680003, Colombia; (D.D.C.); (J.C.-R.); (A.C.-H.); (D.M.-B.)
| | - Gustavo Aroca-Martinez
- Facultad de Ciencias de la Salud, Universidad Simón Bolívar, Barranquilla 080002, Colombia;
| | - Gianfranco Parati
- Istituto Auxologico Italuano & University of Milano-Bicocca, Department of Medicine and Surgery, Piazza Brescia, 20149 Milan, Italy
| | - Patricio Lopez-Jaramillo
- Universidad de Santander, Facultad de Ciencias Médicas y de la Salud, Bucaramanga 680003, Colombia; (D.D.C.); (J.C.-R.); (A.C.-H.); (D.M.-B.)
| |
Collapse
|
25
|
Kavsur R, Schaefer C, Stumpf MJ, Weber M, Sugiura A, Becher MU, Zimmer S, Nickenig G, Schahab N. Carotid Stiffness After Transcatheter Aortic Valve Replacement. Angiology 2023:33197231195647. [PMID: 37571920 DOI: 10.1177/00033197231195647] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/13/2023]
Abstract
The present study aimed to analyze common carotid artery strain properties in patients (n = 59) with severe aortic valve stenosis who underwent transcatheter aortic valve replacement (TAVR). Arterial compliance of the common carotid artery was assessed by ultrasound speckle-tracking before and after TAVR. For sub-analysis the study cohort was divided according to aortic valve area <.75 cm2 (n = 30) vs ≥.75 cm2 (n = 29). Comparison of pre- and post-procedural strain variables showed an improvement in median radial velocity (P < .0001), radial displacement (P = .007), circumferential strain (P = .004), radial strain rate (P = .023), and circumferential strain rate (P < .0001), while the increase of radial strain showed a trend (P = .082). Analysis of aortic valve area revealed an inverse correlation between aortic valve area and the differences (post-procedural-pre-procedural values) for radial strain rate, and circumferential strain. Moreover, sub-analysis revealed that the increase of carotid strain variables before and after TAVR were more pronounced in the sub-group of aortic valve area .75 vs ≥.75 cm2. TAVR led to a reduction of arterial wall stiffness of the common carotid artery assessed by ultrasound speckle-tracking. The decrease of arterial wall stiffness after TAVR was more pronounced in more severe aortic valve stenosis.
Collapse
Affiliation(s)
- Refik Kavsur
- Heart Center Bonn, Department of Medicine II, University Hospital Bonn, Bonn, Germany
| | - Christian Schaefer
- Heart Center Bonn, Department of Medicine II, University Hospital Bonn, Bonn, Germany
| | - Max Jonathan Stumpf
- Heart Center Bonn, Department of Medicine II, University Hospital Bonn, Bonn, Germany
| | - Marcel Weber
- Heart Center Bonn, Department of Medicine II, University Hospital Bonn, Bonn, Germany
| | - Atsushi Sugiura
- Heart Center Bonn, Department of Medicine II, University Hospital Bonn, Bonn, Germany
| | - Marc Ulrich Becher
- Heart Center Bonn, Department of Medicine II, University Hospital Bonn, Bonn, Germany
| | - Sebastian Zimmer
- Heart Center Bonn, Department of Medicine II, University Hospital Bonn, Bonn, Germany
| | - Georg Nickenig
- Heart Center Bonn, Department of Medicine II, University Hospital Bonn, Bonn, Germany
| | - Nadjib Schahab
- Heart Center Bonn, Department of Medicine II, University Hospital Bonn, Bonn, Germany
| |
Collapse
|
26
|
Akiyoshi K, Fujimori T, Fu X, Shah AP, Yamaguchi A, Steenbergen C, Santhanam L, Berkowitz D, Tuday E, Baraban JM, Das S. Adenosine A 2A Receptor Regulates microRNA-181b Expression in Aorta: Therapeutic Implications for Large-Artery Stiffness. J Am Heart Assoc 2023:e028421. [PMID: 37421280 PMCID: PMC10382090 DOI: 10.1161/jaha.122.028421] [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: 10/06/2022] [Accepted: 05/05/2023] [Indexed: 07/10/2023]
Abstract
Background The identification of large-artery stiffness as a major, independent risk factor for cardiovascular disease-associated morbidity and death has focused attention on identifying therapeutic strategies to combat this disorder. Genetic manipulations that delete or inactivate the translin/trax microRNA-degrading enzyme confer protection against aortic stiffness induced by chronic ingestion of high-salt water (4%NaCl in drinking water for 3 weeks) or associated with aging. Therefore, there is heightened interest in identifying interventions capable of inhibiting translin/trax RNase activity, as these may have therapeutic efficacy in large-artery stiffness. Methods and Results Activation of neuronal adenosine A2A receptors (A2ARs) triggers dissociation of trax from its C-terminus. As A2ARs are expressed by vascular smooth muscle cells (VSMCs), we investigated whether stimulation of A2AR on vascular smooth muscle cells promotes the association of translin with trax and, thereby increases translin/trax complex activity. We found that treatment of A7r5 cells with the A2AR agonist CGS21680 leads to increased association of trax with translin. Furthermore, this treatment decreases levels of pre-microRNA-181b, a target of translin/trax, and those of its downstream product, mature microRNA-181b. To check whether A2AR activation might contribute to high-salt water-induced aortic stiffening, we assessed the impact of daily treatment with the selective A2AR antagonist SCH58261 in this paradigm. We found that this treatment blocked aortic stiffening induced by high-salt water. Further, we confirmed that the age-associated decline in aortic pre-microRNA-181b/microRNA-181b levels observed in mice also occurs in humans. Conclusions These findings suggest that further studies are warranted to evaluate whether blockade of A2ARs may have therapeutic potential in treating large-artery stiffness.
Collapse
Affiliation(s)
- Kei Akiyoshi
- Department of Anesthesiology and Critical Care Medicine Johns Hopkins School of Medicine Baltimore MD USA
| | - Tomonari Fujimori
- Department of Anesthesiology and Critical Care Medicine Johns Hopkins School of Medicine Baltimore MD USA
| | - Xiuping Fu
- Department of Intelligent Medical Engineering, School of Life Science Tiangong University Tianjin China
| | - Aparna P Shah
- Solomon H. Snyder Department of Neuroscience Johns Hopkins School of Medicine Baltimore MD USA
| | - Atsushi Yamaguchi
- Department of Cardiovascular Surgery, Saitama Medical Center Jichi Medical University Saitama Japan
| | | | - Lakshmi Santhanam
- Department of Anesthesiology and Critical Care Medicine Johns Hopkins School of Medicine Baltimore MD USA
| | - Dan Berkowitz
- Department of Anesthesiology and Perioperative Medicine The University of Alabama at Birmingham Birmingham AL USA
| | - Eric Tuday
- Division of Cardiovascular Medicine, Department of Internal Medicine, School of Medicine University of Utah Salt Lake City UT USA
- Geriatric Research, Education and Clinical Center VA Salt Lake City Health Care System Salt Lake City UT USA
| | - Jay M Baraban
- Department of Intelligent Medical Engineering, School of Life Science Tiangong University Tianjin China
- Department of Psychiatry and Behavioral Sciences Johns Hopkins School of Medicine Baltimore MD USA
| | - Samarjit Das
- Department of Anesthesiology and Critical Care Medicine Johns Hopkins School of Medicine Baltimore MD USA
- Department of Pathology Johns Hopkins School of Medicine Baltimore MD USA
| |
Collapse
|
27
|
Lugones-Sánchez C, Santos-Mínguez S, Salvado R, González-Sánchez S, Tamayo-Morales O, Hoya-González A, Ramírez-Manent JI, Magallón-Botaya R, Quesada-Rico JA, Garcia-Cubillas MD, Rodríguez-Sánchez E, Gómez-Marcos MA, Benito-Sanchez R, Mira A, Hernandez-Rivas JM, Garcia-Ortiz L. Lifestyles, arterial aging, and its relationship with the intestinal and oral microbiota (MIVAS III study): a research protocol for a cross-sectional multicenter study. Front Public Health 2023; 11:1164453. [PMID: 37457284 PMCID: PMC10344706 DOI: 10.3389/fpubh.2023.1164453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Accepted: 05/30/2023] [Indexed: 07/18/2023] Open
Abstract
Background The microbiota is increasingly recognized as a significant factor in the pathophysiology of many diseases, including cardiometabolic diseases, with lifestyles probably exerting the greatest influence on the composition of the human microbiome. The main objectives of the study are to analyze the association of lifestyles (diet, physical activity, tobacco, and alcohol) with the gut and oral microbiota, arterial aging, and cognitive function in subjects without cardiovascular disease in the Iberian Peninsula. In addition, the study will examine the mediating role of the microbiome in mediating the association between lifestyles and arterial aging as well as cognitive function. Methods and analysis MIVAS III is a multicenter cross-sectional study that will take place in the Iberian Peninsula. One thousand subjects aged between 45 and 74 years without cardiovascular disease will be selected. The main variables are demographic information, anthropometric measurements, and habits (tobacco and alcohol). Dietary patterns will be assessed using a frequency consumption questionnaire (FFQ) and the Mediterranean diet adherence questionnaire. Physical activity levels will be evaluated using the International Physical Activity Questionnaire (IPAQ), Marshall Questionnaire, and an Accelerometer (Actigraph). Body composition will be measured using the Inbody 230 impedance meter. Arterial aging will be assessed through various means, including measuring medium intimate carotid thickness using the Sonosite Micromax, conducting analysis with pulse wave velocity (PWA), and measuring pulse wave velocity (cf-PWV) using the Sphygmocor System. Additional cardiovascular indicators such as Cardio Ankle Vascular Index (CAVI), ba-PWV, and ankle-brachial index (Vasera VS-2000®) will also be examined. The study will analyze the intestinal microbiota using the OMNIgene GUT kit (OMR-200) and profile the microbiome through massive sequencing of the 16S rRNA gene. Linear discriminant analysis (LDA), effect size (LEfSe), and compositional analysis, such as ANCOM-BC, will be used to identify differentially abundant taxa between groups. After rarefying the samples, further analyses will be conducted using MicrobiomeAnalyst and R v.4.2.1 software. These analyses will include various aspects, such as assessing α and β diversity, conducting abundance profiling, and performing clustering analysis. Discussion Lifestyle acts as a modifier of microbiota composition. However, there are no conclusive results demonstrating the mediating effect of the microbiota in the relationship between lifestyles and cardiovascular diseases. Understanding this relationship may facilitate the implementation of strategies for improving population health by modifying the gut and oral microbiota. Trial registration clinicaltrials.gov/ct2/show/NCT04924907, ClinicalTrials.gov, identifier: NCT04924907. Registered on 21 April 2021.
Collapse
Affiliation(s)
- Cristina Lugones-Sánchez
- Primary Care Research Unit of Salamanca (APISAL), Salamanca Primary Healthcare Management, Castilla y León Regional Health Authority (SACyL), Institute of Biomedical Research of Salamanca (IBSAL), Salamanca, Spain
- Research Network on Chronicity, Primary Care and Health Promotion (RICAPPS), Salamanca, Spain
| | - Sandra Santos-Mínguez
- Cancer Research Centre, Institute of Biomedical Research of Salamanca (IBSAL), Institute of Molecular and Cellular Biology of Cancer (IBMCC), University of Salamanca-CSIC, Salamanca, Spain
| | - Rita Salvado
- Primary Care Research Unit of Salamanca (APISAL), Salamanca Primary Healthcare Management, Castilla y León Regional Health Authority (SACyL), Institute of Biomedical Research of Salamanca (IBSAL), Salamanca, Spain
| | - Susana González-Sánchez
- Primary Care Research Unit of Salamanca (APISAL), Salamanca Primary Healthcare Management, Castilla y León Regional Health Authority (SACyL), Institute of Biomedical Research of Salamanca (IBSAL), Salamanca, Spain
- Research Network on Chronicity, Primary Care and Health Promotion (RICAPPS), Salamanca, Spain
| | - Olaya Tamayo-Morales
- Primary Care Research Unit of Salamanca (APISAL), Salamanca Primary Healthcare Management, Castilla y León Regional Health Authority (SACyL), Institute of Biomedical Research of Salamanca (IBSAL), Salamanca, Spain
- Research Network on Chronicity, Primary Care and Health Promotion (RICAPPS), Salamanca, Spain
| | - Amaya Hoya-González
- Primary Care Research Unit of Salamanca (APISAL), Salamanca Primary Healthcare Management, Castilla y León Regional Health Authority (SACyL), Institute of Biomedical Research of Salamanca (IBSAL), Salamanca, Spain
| | - José I. Ramírez-Manent
- Research Network on Chronicity, Primary Care and Health Promotion (RICAPPS), Salamanca, Spain
- Calvià Primary Care Center, Balearic Islands Health Research Institute (IDIBSA), Health Service of Balearic Islands, Calvià, Spain
- Department of Medicine, University of the Balearic Islands, Palma de Mallorca, Spain
| | - Rosa Magallón-Botaya
- Research Network on Chronicity, Primary Care and Health Promotion (RICAPPS), Salamanca, Spain
- Institute for Health Research Aragón (IIS Aragón), Zaragoza, Spain
- Department of Medicine, Psychiatry and Dermatology, University of Zaragoza, Zaragoza, Spain
| | - José A. Quesada-Rico
- Research Network on Chronicity, Primary Care and Health Promotion (RICAPPS), Salamanca, Spain
- Department of Clinical Medicine, Miguel Hernandez University of Elche, Sant Joan d'Alacant, Spain
| | - Miriam D. Garcia-Cubillas
- Primary Care Research Unit of Salamanca (APISAL), Salamanca Primary Healthcare Management, Castilla y León Regional Health Authority (SACyL), Institute of Biomedical Research of Salamanca (IBSAL), Salamanca, Spain
| | - Emiliano Rodríguez-Sánchez
- Primary Care Research Unit of Salamanca (APISAL), Salamanca Primary Healthcare Management, Castilla y León Regional Health Authority (SACyL), Institute of Biomedical Research of Salamanca (IBSAL), Salamanca, Spain
- Research Network on Chronicity, Primary Care and Health Promotion (RICAPPS), Salamanca, Spain
- Department of Medicine, University of Salamanca, Salamanca, Spain
| | - Manuel A. Gómez-Marcos
- Primary Care Research Unit of Salamanca (APISAL), Salamanca Primary Healthcare Management, Castilla y León Regional Health Authority (SACyL), Institute of Biomedical Research of Salamanca (IBSAL), Salamanca, Spain
- Research Network on Chronicity, Primary Care and Health Promotion (RICAPPS), Salamanca, Spain
- Department of Medicine, University of Salamanca, Salamanca, Spain
| | - Rocío Benito-Sanchez
- Cancer Research Centre, Institute of Biomedical Research of Salamanca (IBSAL), Institute of Molecular and Cellular Biology of Cancer (IBMCC), University of Salamanca-CSIC, Salamanca, Spain
| | - Alex Mira
- Department of Health and Genomics, FISABIO Foundation, Valencia, Spain
- CIBER Center for Epidemiology and Public Health, Madrid, Spain
| | - Jesus M. Hernandez-Rivas
- Department of Medicine, University of Salamanca, Salamanca, Spain
- Haematology Department, Institute of Biomedical Research of Salamanca (IBSAL), University Hospital of Salamanca, Salamanca, Spain
| | - Luis Garcia-Ortiz
- Primary Care Research Unit of Salamanca (APISAL), Salamanca Primary Healthcare Management, Castilla y León Regional Health Authority (SACyL), Institute of Biomedical Research of Salamanca (IBSAL), Salamanca, Spain
- Research Network on Chronicity, Primary Care and Health Promotion (RICAPPS), Salamanca, Spain
- Department of Biomedical and Diagnostic Sciences, University of Salamanca, Salamanca, Spain
| | | |
Collapse
|
28
|
Ma DJ, Lee H, Choi JM, Park HE, Choi SY, Choi HJ. The role of retinal vessel geometry as an indicator of systemic arterial stiffness assessed by cardio-ankle vascular index. Front Cardiovasc Med 2023; 10:1139557. [PMID: 37416921 PMCID: PMC10321710 DOI: 10.3389/fcvm.2023.1139557] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2023] [Accepted: 05/31/2023] [Indexed: 07/08/2023] Open
Abstract
Objective To determine whether retinal vessel geometry is associated with systemic arterial stiffness, as determined by the cardio-ankle vascular index (CAVI). Methods This single-center retrospective cross-sectional study included 407 eyes of 407 subjects who underwent routine health exams, including CAVI and fundus photography. Retinal vessel geometry was measured using a computer-assisted program (Singapore "I" Vessel Assessment). Subjects were classified into two groups based on CAVI values: high CAVI (≥9) or low CAVI (<9). The main outcome measures included the association of retinal vessel geometry and CAVI value evaluated using multivariable logistic regression models. Results Three hundred forty-three subjects (343, 84.3%) were in the low CAVI group, and 64 (15.7%) subjects were in the high CAVI group. Multivariable logistic linear regression analyses adjusted for age, sex, body mass index, smoking status, mean arterial pressure, and the presence of hypertension, diabetes mellitus, and dyslipidemia showed a significant association between high CAVI values and the following retinal vessel geometry parameters: central retinal arteriolar equivalent caliber (CRAE; adjusted odds ratio [AOR], 0.95; 95% confidence interval [CI], 0.89-1.00; P = 0.043), fractal dimension of arteriolar network (FDa; AOR, 4.21 × 10-4; 95% CI, 2.32 × 10-7-0.77; P = 0.042), and arteriolar branching angle (BAa; AOR, 0.96; 95% CI, 0.93-0.99; P = 0.007). Conclusions Increased systemic arterial stiffness had a significant association with retinal vessel geometry related to arterial narrowing (CRAE), less branching complexity of the arterial tree (FDa), and acute arteriolar bifurcation (BAa).
Collapse
Affiliation(s)
- Dae Joong Ma
- Department of Ophthalmology, Hallym University Kangnam Sacred Heart Hospital, Seoul, Republic of Korea
| | - Heesun Lee
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
- Division of Cardiology, Seoul National University Hospital Healthcare System Gangnam Center, Seoul, Republic of Korea
| | - Ji Min Choi
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
- Division of Gastroenterology, Seoul National University Hospital Healthcare System Gangnam Center, Seoul, Republic of Korea
| | - Hyo Eun Park
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
- Division of Cardiology, Seoul National University Hospital Healthcare System Gangnam Center, Seoul, Republic of Korea
| | - Su-Yeon Choi
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
- Division of Cardiology, Seoul National University Hospital Healthcare System Gangnam Center, Seoul, Republic of Korea
| | - Hyuk Jin Choi
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul, Republic of Korea
- Department of Ophthalmology, Seoul National University Hospital Healthcare System Gangnam Center, Seoul, Republic of Korea
| |
Collapse
|
29
|
Ferigollo A, Chemello D, Pavão TP, Saffi MAL, Dos Santos Stein C, Moresco RN, de Souza LS, Moreira CHC, Signori LU, Chagas P. Anthropometric measurements and their association with endothelial function and arterial stiffness of eutrophic individuals and with overweight. Arch Endocrinol Metab 2023; 67:e000617. [PMID: 37249452 PMCID: PMC10665052 DOI: 10.20945/2359-3997000000617] [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] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Accepted: 12/14/2022] [Indexed: 05/31/2023]
Abstract
Objective The objective of the study was to assess the association of anthropometric measurements with endothelial function and arterial stiffness of eutrophic individuals and with overweight. Subjects and methods A cross-sectional study was carried out with individuals with body mass index (BMI) between 18.5 kg/m2 and < 30 kg/m2, low to intermediate global cardiovascular risk scores, and aged ≥ 18 and < 60 years. We assessed the sociodemographic data, anthropometric variables (body weight, height, circumferences of the waist [WC], neck [NC], hip [HC], sagittal abdominal diameter [SAD], [BMI], waist-to-hip ratio [WHR], and waist-to-height ratio [WHtR]), biochemical parameters (lipid profile and nitric oxide), endothelial function (flow-mediated dilation [FMD], by ultrasound), and arterial stiffness (pulse wave velocity [PWV] and the amplification index [AIx@75] by oscillometry). Thirty-six individuals were included, 18 eutrophic and 18 with overweight, with a mean age of 37.5 ± 10.2 years, mostly at low cardiovascular risk (86.1%), female (80.6%), single (52.8%), employed with formal contracts (44.4%), and with over twelve years of education (88.9%). Results The PWV presented positive and moderate correlation with the WC (r = 0.584; P = 0.001), WHR (r = 0.513; P = 0.001), and WHtR (r = 0.590; P = 0.001), and positive and low correlation with the NC (r = 0.372; P = 0.013) and SAD (r = 0.356; P = 0.033). Moreover, no anthropometric parameter presented a correlation with the AIx@75 or the FMD percentage in the total sample. Conclusion Our findings show that in eutrophic individuals and with overweight the WC, WHR, WHtR, SAD, and NC were positively correlated with the PWV but not to the endothelial function in the overall sample. These are hypothesis-generating findings and they should be replicated in other studies.
Collapse
Affiliation(s)
- Ariélen Ferigollo
- Programa de Pós-graduação em Gerontologia, Universidade Federal de Santa Maria (UFSM), Santa Maria, RS, Brasil
| | - Diego Chemello
- Departamento de Clínica Médica, Universidade Federal de Santa Maria (UFSM), Santa Maria, RS, Brasil
| | - Tábata Pereira Pavão
- Programa de Pós-graduação em Gerontologia, Universidade Federal de Santa Maria (UFSM), Santa Maria, RS, Brasil
| | | | - Carolina Dos Santos Stein
- Programa de Pós-graduação em Ciências Farmacêuticas, Universidade Federal de Santa Maria (UFSM), Santa Maria, RS, Brasil
| | - Rafael Noal Moresco
- Programa de Pós-graduação em Ciências Farmacêuticas, Universidade Federal de Santa Maria (UFSM), Santa Maria, RS, Brasil
| | - Lucas Silva de Souza
- Graduação em Medicina, Universidade Federal de Santa Maria, Santa Maria, RS, Brasil
| | - Carlos Heitor Cunha Moreira
- Departamento de Estomatologia, Divisão de Periodontologia, Faculdade de Odontologia, Universidade Federal de Santa Maria (UFSM), Santa Maria, RS, Brasil
| | - Luis Ulisses Signori
- Departamento de Fisioterapia e Reabilitação, Programa de Pós-graduação em Ciências do Movimento e Reabilitação, Universidade Federal de Santa Maria (UFSM), Santa Maria, RS, Brasil
| | - Patrícia Chagas
- Departamento de Alimentação e Nutrição, Programa de Pós-graduação em Gerontologia, Universidade Federal de Santa Maria (UFSM), Santa Maria, RS, Brasil,
| |
Collapse
|
30
|
Pascual J, DeBlois JP, Ray C, Hametner B, Heffernan KS, Voss MA. Central Hemodynamic Response to Activation of the Vestibular Sympathetic Reflex with Head Down Rotation in Healthy Young Adults. J Appl Physiol (1985) 2023. [PMID: 37199782 DOI: 10.1152/japplphysiol.00107.2023] [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] [Subscribe] [Scholar Register] [Indexed: 05/19/2023] Open
Abstract
The purpose of this study was to assess the effect of vestibular-sympathetic activation on estimated measures of central (aortic) hemodynamic load in young adults. Methods: 31 participants (n=14 female, 17 male) underwent radial tonometry and popliteal Doppler-ultrasound in the prone position with the head in a neutral position and during 10 minutes of head-down rotation (HDR) as a means of activating the vestibular sympathetic reflex. Subjective orthostatic intolerance was assessed utilizing a 10-item orthostatic hypotension questionnaire. Results: There was a reduction in brachial systolic BP during HDR (111±10 vs. 109±9 mmHg, p<0.05), but there was no change in aortic systolic BP (100±9 vs. 99±8 mmHg, p>0.05). Aortic augmentation index (-5±11 vs. -12±12%, p<0.05) and reservoir pressure (28±8 vs. 26±8mmHg, p<0.05) were reduced with a concomitant reduction in popliteal conductance (5.6±0.7 vs. 4.5±0.7 ml/min∙mmHg, p<0.05). Change in aortic systolic BP was associated with subjective orthostatic intolerance score (r = -0.39, p<0.05). Conclusions: Activation of the vestibular sympathetic reflex via HDR resulted in slight reductions in brachial BP concomitant with preservation of aortic BP. Despite peripheral vascular constriction during HDR, there was a reduction in pressure from wave reflections and reservoir pressure. Finally, there was an association between change in aortic systolic BP during HDR and orthostatic intolerance score suggesting that individuals that cannot defend against drops in aortic BP during vestibular sympathetic reflex activation may be more likely to experience higher subjective symptomatology of orthostatic intolerance.
Collapse
Affiliation(s)
- Justin Pascual
- Department of Nutrition, Falk College of Sport and Human Dynamics, Syracuse University, Syracuse, NY, United States
| | - Jacob P DeBlois
- Department of Exercise Science, Falk College of Sport and Human Dynamics, Syracuse University, Syracuse, NY, United States
| | - Chester Ray
- Department of Nutrition and Integrative Physiology, Florida State University, Tallahassee, FL, United States
| | - Bernhard Hametner
- Center for Health & Bioresources, AIT Austrian Institute of Technology, Vienna, Austria
| | - Kevin S Heffernan
- Department of Exercise Science, Falk College of Sport and Human Dynamics, Syracuse University, Syracuse, NY, United States
| | - Margaret A Voss
- Department of Nutrition, Falk College of Sport and Human Dynamics, Syracuse University, Syracuse, NY, United States
| |
Collapse
|
31
|
Abstract
The endothelium is considered to be the gatekeeper of the vessel wall, maintaining and regulating vascular integrity. In patients with chronic kidney disease, protective endothelial cell functions are impaired due to the proinflammatory, prothrombotic and uremic environment caused by the decline in kidney function, adding to the increase in cardiovascular complications in this vulnerable patient population. In this review, we discuss endothelial cell functioning in healthy conditions and the contribution of endothelial cell dysfunction to cardiovascular disease. Further, we summarize the phenotypic changes of the endothelium in chronic kidney disease patients and the relation of endothelial cell dysfunction to cardiovascular risk in chronic kidney disease. We also review the mechanisms that underlie endothelial changes in chronic kidney disease and consider potential pharmacological interventions that can ameliorate endothelial health.
Collapse
Affiliation(s)
- Constance C F M J Baaten
- Institute for Molecular Cardiovascular Research (IMCAR), University Hospital RWTH Aachen, Aachen, Germany (C.C.F.M.J.B., S.V., H.N.)
- Department of Biochemistry, Cardiovascular Research Institute Maastricht, Maastricht University, Maastricht, the Netherlands (C.C.F.M.J.B., H.N.)
| | - Sonja Vondenhoff
- Institute for Molecular Cardiovascular Research (IMCAR), University Hospital RWTH Aachen, Aachen, Germany (C.C.F.M.J.B., S.V., H.N.)
| | - Heidi Noels
- Institute for Molecular Cardiovascular Research (IMCAR), University Hospital RWTH Aachen, Aachen, Germany (C.C.F.M.J.B., S.V., H.N.)
- Department of Biochemistry, Cardiovascular Research Institute Maastricht, Maastricht University, Maastricht, the Netherlands (C.C.F.M.J.B., H.N.)
| |
Collapse
|
32
|
Pewowaruk RJ, Colebank MJ, Spronck B, Korcarz CE, Gepner AD. Biomechanics models predict increasing smooth muscle tone as a novel therapeutic target for central arterial dysfunction in hypertension. J Hypertens 2023; 41:572-579. [PMID: 36728092 PMCID: PMC9992290 DOI: 10.1097/hjh.0000000000003370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
INTRODUCTION Vasodilation can paradoxically increase arterial stiffness in older, hypertensive adults. This study modeled increasing smooth muscle tone as a therapeutic strategy to improve central arterial dysfunction in hypertension using participant-specific simulations. METHODS Participant-specific models of the carotid artery were parameterized from vascular ultrasound measures of nitroglycerin-induced vasodilation in 18 hypertensive veterans. The acute changes in carotid artery mechanics were simulated for changes of ±2, ±4, and ±6% in smooth muscle tone and ±5, ±10, and ±15 mmHg in mean arterial pressure (MAP). The chronic carotid artery adaptations were simulated based on the hypothesis that the carotid artery will remodel wall-cross sectional area to maintain mechanical homeostasis. RESULTS A 6% increase in smooth muscle tone acutely decreased carotid pulse wave velocity from 6.89 ± 1.24 m/s to 5.83 ± 1.73 m/s, and a 15 mmHg decrease in MAP decreased carotid pulse wave velocity to 6.17 ± 1.23 m/s. A 6% increase in smooth muscle tone acutely decreased wall stress from 76.2 ± 12.3 to 64.2 ± 10.4 kPa, and a 15 mmHg decrease in MAP decreased wall stress to 60.6 ± 10.7 kPa. A 6% increase in smooth muscle tone chronically decreased wall cross-sectional area from 18.3 ± 5.4 to 15.2 ± 4.9 mm 2, and a 15 mmHg decrease in MAP decreased wall cross-sectional area to 14.3 ± 4.6 mm 2 . CONCLUSION In participant-specific simulation, increasing smooth muscle tone can have a stronger or equivalent effect on carotid artery mechanics compared with decreasing blood pressure. Increasing central arterial smooth muscle tone may be a novel therapeutic target to improve central arterial dysfunction in older, hypertensive adults and should be a focus of future research.
Collapse
Affiliation(s)
- Ryan J Pewowaruk
- William S. Middleton Memorial Veterans Hospital
- Division of Cardiovascular Medicine, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
| | - Mitchel J Colebank
- Department of Biomedical Engineering, Irvine - Edwards Lifesciences Foundation Cardiovascular Innovation and Research Center, University of California, Irvine, California, USA
| | - Bart Spronck
- Department of Biomedical Engineering, CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, The Netherlands
| | - Claudia E Korcarz
- Division of Cardiovascular Medicine, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
| | - Adam D Gepner
- William S. Middleton Memorial Veterans Hospital
- Division of Cardiovascular Medicine, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
| |
Collapse
|
33
|
Pewowaruk R, Korcarz C, De Boer I, Kestenbaum B, Heckbert SR, Tedla YG, Gepner AD. Carotid Artery Stiffness Mechanisms Are Associated With End Organ Damage and All-Cause Mortality: MESA (Multi-Ethnic Study of Atherosclerosis). J Am Heart Assoc 2023; 12:e027517. [PMID: 36974771 PMCID: PMC10122904 DOI: 10.1161/jaha.122.027517] [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: 03/29/2023]
Abstract
Background Arterial stiffness can be separated into 2 main mechanisms: (1) load-dependent stiffening from higher blood pressure and (2) structural stiffening due to remodeling of the vessel wall. The relationship between stiffness mechanisms and end organ damage is unknown. Methods and Results MESA (Multi-Ethnic Study of Atherosclerosis) participants with carotid ultrasound were included in this study (n=6147). Carotid pulse wave velocity (cPWV) was calculated to represent total stiffness. Structural stiffness was calculated by adjusting cPWV to a 120/80 mm Hg blood pressure with participant-specific models. Load-dependent stiffness was the difference of total and structural stiffness. Associations with incident chronic kidney disease (CKD), dementia, and mortality were assessed with adjusted Cox models. During 14.3±4.8 years of follow-up, 773 CKD events, 535 dementia events, and 1529 deaths occurred. Total cPWV was associated with mortality (hazard ratio [HR], per 1 m/s, 1.04 [95% CI, 1.01-1.08], P=0.02) and dementia (HR, 1.06 [95% CI, 1.01-1.12], P=0.03) but not CKD (HR, 1.03 [95% CI, 0.98-1.08], P=0.33). Structural cPWV was significantly associated with mortality (HR, 1.04 [95% CI, 1.00-1.08], P=0.04) but not CKD (HR, 1.00 [95% CI, 0.94-1.05], P=0.86) or dementia (HR, 1.06 [95% CI, 0.99-1.13], P=0.06). Load-dependent cPWV was significantly associated with CKD (HR, 1.38 [95% CI, 1.17-1.63], P<0.001) but not mortality (HR, 1.11 [95% CI, 0.99-1.25], P=0.07) or dementia (HR, 1.14 [95% CI, 0.94-1.38], P=0.19). Conclusions The mechanisms of arterial stiffness were associated with all-cause mortality and CKD. Structural stiffness was associated with all-cause mortality, and load-dependent stiffness was associated with CKD. Total stiffness was associated with dementia but load-dependent and structural stiffness were not.
Collapse
Affiliation(s)
- Ryan Pewowaruk
- University of Wisconsin School of Medicine and Public Health Madison WI
- William S. Middleton Memorial Veteran's Hospital Madison WI
| | - Claudia Korcarz
- University of Wisconsin School of Medicine and Public Health Madison WI
| | - Ian De Boer
- University of Washington School of Medicine Seattle WI
| | | | | | - Yacob G Tedla
- Vanderbilt University School of Medicine Nashville TN
| | - Adam D Gepner
- University of Wisconsin School of Medicine and Public Health Madison WI
- William S. Middleton Memorial Veteran's Hospital Madison WI
| |
Collapse
|
34
|
Zeijen VJ, Feyz L, Kardys I, Geleijnse ML, Van Mieghem NM, Zijlstra F, Lafeber M, Van Der Geest RJ, Hirsch A, Daemen J. Association between renal sympathetic denervation and arterial stiffness: the ASORAS study. J Hypertens 2023; 41:476-485. [PMID: 36655697 PMCID: PMC9894147 DOI: 10.1097/hjh.0000000000003361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
OBJECTIVES Renal sympathetic denervation (RDN) reduces blood pressure (BP). However, one out of three patients does not exhibit a significant BP response to the therapy. This study investigates the association between noninvasive vascular stiffness indices and RDN-mediated BP reduction. METHODS In this prospective, single-arm pilot study, patients with systolic office BP at least 140 mmHg, mean 24-h systolic ambulatory blood pressure (ABP) at least 130 mmHg and at least three prescribed antihypertensive drugs underwent radiofrequency RDN. The primary efficacy endpoint was temporal evolution of mean 24-h systolic ABP throughout 1-year post RDN (measured at baseline and 3-6-12 months). Effect modification was studied for baseline ultrasound carotid-femoral and magnetic resonance (MR) pulse wave velocity (PWV), MR aortic distensibility, cardiac MR left ventricular parameters and clinical variables. Statistical analyses were performed using linear mixed-effects models, and effect modification was assessed using interaction terms. RESULTS Thirty patients (mean age 62.5 ± 10.7 years, 50% women) with mean 24-h ABP 146.7/80.8 ± 13.7/12.0 mmHg were enrolled. Following RDN, mean 24-h systolic ABP changed with -8.4 (95% CI: -14.5 to -2.3) mmHg/year ( P = 0.007). Independent effect modifiers were CF-PWV [+2.7 (0.3 to 5.1) mmHg/year change in outcome for every m/s increase in CF-PWV; P = 0.03], daytime diastolic ABP [-0.4 (-0.8 to 0.0) mmHg/year per mmHg; P = 0.03], age [+0.6 (0.2 to 1.0) mmHg/year per year of age; P = 0.006], female sex [-14.0 (-23.1 to -5.0) mmHg/year as compared with men; P = 0.003] and BMI [+1.2 (0.1 to 2.2) mmHg/year per kg/m 2 ; P = 0.04]. CONCLUSION Higher CF-PWV at baseline was associated with a smaller reduction in systolic ABP following RDN. These findings could contribute to improve identification of RDN responders.
Collapse
Affiliation(s)
| | | | | | | | | | | | - Melvin Lafeber
- Department of Internal and Vascular Medicine, Erasmus University Medical Center, Rotterdam
| | | | - Alexander Hirsch
- Department of Cardiology
- Department of Radiology and Nuclear Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands
| | | |
Collapse
|
35
|
Hoshi R, Santos I, Bittencourt M, Dantas E, Andreão R, Mill J, Lotufo P, Benseñor I. Association of coronary artery calcium with heart rate variability in the Brazilian Longitudinal Study of Adult Health - ELSA-Brasil. Braz J Med Biol Res 2023; 56:e12364. [PMID: 36856251 PMCID: PMC9974082 DOI: 10.1590/1414-431x2023e12364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Accepted: 12/27/2022] [Indexed: 03/02/2023] Open
Abstract
Current data shows that the autonomic and vascular systems can influence each other. However, only a few studies have addressed this association in the general population. We aimed to investigate whether heart rate variability (HRV) was associated with coronary artery calcium (CAC) in a cross-sectional analysis of the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). We examined baseline data from 3138 participants (aged 35 to 74 years) without previous cardiovascular disease who underwent CAC score assessment and had validated HRV recordings. Prevalent CAC was defined as a CAC score>0, and HRV analyses were performed over 5-min segments. We detected CAC score>0 in 765 (24.4%) participants. Subgroup analyses in older participants (≥49 years) adjusted for sociodemographic and clinical variables revealed that CAC score>0 was associated with lower values of standard deviation of NN intervals (SDNN) (odds ratio [OR]=1.32; 95%CI: 1.05,1.65), root mean square of successive differences between adjacent NN intervals (RMSSD) (OR=1.28; 95%CI: 1.02,1.61), and low frequency (LF) (OR=1.53, 95%CI: 1.21,1.92). Interaction analysis between HRV indices and sex in age-stratified groups revealed significant effect modification: women showed increased OR for prevalent CAC in the younger group, while for men, the associations were in the older group. In conclusion, participants aged ≥49 years with low SDNN, RMSSD, and LF values were more likely to present prevalent CAC, suggesting a complex interaction between these markers in the pathogenesis of atherosclerosis. Furthermore, our results suggested that the relationship between CAC and HRV might be sex- and age-related.
Collapse
Affiliation(s)
- R.A. Hoshi
- Centro de Estudos Clínicos e Epidemiológicos do Hospital Universitário, Universidade de São Paulo, São Paulo, SP, Brasil
| | - I.S. Santos
- Centro de Estudos Clínicos e Epidemiológicos do Hospital Universitário, Universidade de São Paulo, São Paulo, SP, Brasil
| | - M.S. Bittencourt
- Centro de Estudos Clínicos e Epidemiológicos do Hospital Universitário, Universidade de São Paulo, São Paulo, SP, Brasil
| | - E.M. Dantas
- Departamento de Ciências Biológicas, Universidade Federal do Vale do São Francisco, Petrolina, PE, Brasil
| | - R.V. Andreão
- Departamento de Engenharia Elétrica, Instituto Federal do Espírito Santo, Vitória, ES, Brasil
| | - J.G. Mill
- Departamento de Ciências Fisiológicas, Universidade Federal do Espírito Santo, Vitória, ES, Brasil
| | - P.A. Lotufo
- Centro de Estudos Clínicos e Epidemiológicos do Hospital Universitário, Universidade de São Paulo, São Paulo, SP, Brasil
| | - I.M. Benseñor
- Centro de Estudos Clínicos e Epidemiológicos do Hospital Universitário, Universidade de São Paulo, São Paulo, SP, Brasil
| |
Collapse
|
36
|
Abstract
BACKGROUND An association between blood pressure and aortic stiffness is well known, but ambiguity remains as to whether one precedes the other. This study aimed to investigate the association of aortic stiffness with contemporaneous versus historic blood pressure and direction of causality between aortic stiffening and hypertension in female twins. METHODS Aortic stiffness, measured by carotid-femoral pulse wave velocity (PWV), and mean arterial pressure (MAP) was recorded in 2037 female TwinsUK participants (mean age: 62.4±9.7 years) at a single time point. A subset of 947 participants had repeat PWV and MAP measures (mean interval 5.5±1.7 years) with additional historic MAP (mean interval 6.6±3.3 years before baseline). RESULTS Cross-sectional multivariable linear regression analysis confirmed PWV significantly associated with age and MAP. In longitudinal analysis, annual progression of PWV was not associated with historic MAP (standardized beta coefficient [β]=-0.02, P=0.698), weakly associated with baseline MAP (β=0.09, P=0.049) but strongly associated with progression (from baseline to most recent measurement) of MAP (β= 0.26, P<0.001). Progression of MAP associated with both baseline and progression of PWV (β=0.13, P=0.003 and β=0.24, P<0.001, respectively). CONCLUSIONS Progression of aortic stiffness associates more strongly with contemporaneous MAP compared with historic MAP. In contrast, progression of MAP is associated with prior arterial stiffness. These findings suggest a bidirectional relationship between arterial stiffness and blood pressure, and that lowering blood pressure may prevent a cycle of arterial stiffening and hypertension.
Collapse
Affiliation(s)
- Louise Keehn
- Department of Clinical Pharmacology, King’s College London British Heart Foundation Centre, St Thomas’ Hospital (L.K., P.C., M.C.)
| | - Massimo Mangino
- NIHR Biomedical Research Centre at Guy’s and St Thomas’ Foundation Trust, London (M.M.)
- Department of Twin Research and Genetic Epidemiology, King’s College London, St Thomas Hospital (M.M., T.S.)
| | - Tim Spector
- Department of Twin Research and Genetic Epidemiology, King’s College London, St Thomas Hospital (M.M., T.S.)
| | - Phil Chowienczyk
- Department of Clinical Pharmacology, King’s College London British Heart Foundation Centre, St Thomas’ Hospital (L.K., P.C., M.C.)
| | - Marina Cecelja
- Department of Clinical Pharmacology, King’s College London British Heart Foundation Centre, St Thomas’ Hospital (L.K., P.C., M.C.)
| |
Collapse
|
37
|
Abstract
BACKGROUND Dysbiosis of gut microbiota plays a pivotal role in vascular dysfunction and microbial diversity was reported to be inversely correlated with arterial stiffness. However, the causal role of gut microbiota in the progression of arterial stiffness and the specific species along with the molecular mechanisms underlying this change remain largely unknown. METHODS Participants with elevated arterial stiffness and normal controls free of medication were matched for age and sex. The microbial composition and metabolic capacities between the 2 groups were compared with the integration of metagenomics and metabolomics. Subsequently, Ang II (angiotensin II)-induced and humanized mouse model were employed to evaluate the protective effect of Flavonifractor plautii (F plautii) and its main effector cis-aconitic acid. RESULTS Human fecal metagenomic sequencing revealed a significantly high abundance and centrality of F plautii in normal controls, which was absent in the microbial community of subjects with elevated arterial stiffness. Moreover, blood pressure only mediated part of the effect of F plautii on lower arterial stiffness. The microbiome of normal controls exhibited an enhanced capacity for glycolysis and polysaccharide degradation, whereas, those of subjects with increased arterial stiffness were characterized by increased biosynthesis of fatty acids and aromatic amino acids. Integrative analysis with metabolomics profiling further suggested that increased cis-aconitic acid served as the main effector for the protective effect of F plautii against arterial stiffness. Replenishment with F plautii and cis-aconitic acid improved elastic fiber network and reversed increased pulse wave velocity through the suppression of MMP-2 (matrix metalloproteinase-2) and inhibition of MCP-1 (monocyte chemoattractant protein-1) and NF-κB (nuclear factor kappa-B) activation in both Ang II-induced and humanized model of arterial stiffness. CONCLUSIONS Our translational study identifies a novel link between F plautii and arterial function and raises the possibility of sustaining vascular health by targeting gut microbiota.
Collapse
Affiliation(s)
- Shiyun Luo
- Guangdong Provincial Key Laboratory of Food, Nutrition and Health, and Department of Nutrition (S.L., Y.Z., S.Z., L.L., B.Y., J.F., M.X.), School of Public Health, Sun Yat-sen University (Northern Campus), Guangzhou, Guangdong Province, China
| | - Yawen Zhao
- Guangdong Provincial Key Laboratory of Food, Nutrition and Health, and Department of Nutrition (S.L., Y.Z., S.Z., L.L., B.Y., J.F., M.X.), School of Public Health, Sun Yat-sen University (Northern Campus), Guangzhou, Guangdong Province, China
| | - Shanshan Zhu
- Guangdong Provincial Key Laboratory of Food, Nutrition and Health, and Department of Nutrition (S.L., Y.Z., S.Z., L.L., B.Y., J.F., M.X.), School of Public Health, Sun Yat-sen University (Northern Campus), Guangzhou, Guangdong Province, China
| | - Ludi Liu
- Guangdong Provincial Key Laboratory of Food, Nutrition and Health, and Department of Nutrition (S.L., Y.Z., S.Z., L.L., B.Y., J.F., M.X.), School of Public Health, Sun Yat-sen University (Northern Campus), Guangzhou, Guangdong Province, China.,Department of Statistics and Epidemiology (L.L., B.Y.), School of Public Health, Sun Yat-sen University (Northern Campus), Guangzhou, Guangdong Province, China
| | - Ken Cheng
- XJTLU Wisdom Lake Academy of Pharmacy, Xi'an Jiaotong-Liverpool University, Suzhou, China (K.C., Y.H.)
| | - Bingqi Ye
- Guangdong Provincial Key Laboratory of Food, Nutrition and Health, and Department of Nutrition (S.L., Y.Z., S.Z., L.L., B.Y., J.F., M.X.), School of Public Health, Sun Yat-sen University (Northern Campus), Guangzhou, Guangdong Province, China.,Department of Statistics and Epidemiology (L.L., B.Y.), School of Public Health, Sun Yat-sen University (Northern Campus), Guangzhou, Guangdong Province, China
| | - Yueyuan Han
- XJTLU Wisdom Lake Academy of Pharmacy, Xi'an Jiaotong-Liverpool University, Suzhou, China (K.C., Y.H.)
| | - Jiahua Fan
- Guangdong Provincial Key Laboratory of Food, Nutrition and Health, and Department of Nutrition (S.L., Y.Z., S.Z., L.L., B.Y., J.F., M.X.), School of Public Health, Sun Yat-sen University (Northern Campus), Guangzhou, Guangdong Province, China
| | - Min Xia
- Guangdong Provincial Key Laboratory of Food, Nutrition and Health, and Department of Nutrition (S.L., Y.Z., S.Z., L.L., B.Y., J.F., M.X.), School of Public Health, Sun Yat-sen University (Northern Campus), Guangzhou, Guangdong Province, China
| |
Collapse
|
38
|
Hatamnejad MR, Karvandi M, Jodatfar F, Ebrahimi N, Shojaeian F, Baradaran Ghavami S, Balaii H, Moeeni M, Rajabnia M, Shahrokh S, Asadzadeh Aghdaei H. Evaluation of adalimumab effects on left ventricle performance by echocardiography indexes among patients with immunosuppressant refractory ulcerative colitis. Front Med (Lausanne) 2023; 9:1008711. [PMID: 36687438 PMCID: PMC9853977 DOI: 10.3389/fmed.2022.1008711] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Accepted: 12/05/2022] [Indexed: 01/09/2023] Open
Abstract
Background and aims Inflammatory bases lead to a simultaneous flourishing of cardiovascular complications with inflammatory bowel disease (IBD). As a released cytokine, tumor necrosis factor-α (TNF-α) can either disrupt or preserve cardiovascular performance. Due to this controversy, this study aimed to appraise the short-term anti-TNF (adalimumab [ADA]) relics on cardiac function by gauging the echocardiography indexes in patients with immunosuppressant refractory ulcerative colitis (UC). Methods All cases with a definite diagnosis of UC were included based on providing written informed consent and owning the severe form of active disease (Mayo score ≥7), which did not dampen with immunosuppressant. Patients were excluded in the case of previous cardiac ailments/risk factors and prior related surgical or pharmaceutical intervention. Transthoracic echocardiography (TTE) was carried out before and 3 months after biological regimen allocation and changes in indexes [ejection fraction (EF), left ventricular end-diastolic volume (LVEDV)/left ventricular end-systolic volume (LVESV), and global longitudinal strain (GLS) in standard parasternal short axis from mid-ventricular level, two-, three-, and four-chamber apical long axes] were compared via statistical analyses. Results The study consisted of 13 (65%) men and 7 (35%) women, with a mean age of 36.54 ± 11.3 years. Participants mainly possessed Montreal class I (45%) and an average of 3.25 years of disease duration. The intervention significantly controlled inflammation [endoscopic Mayo score (P = 0.001), partial Mayo score (P = 0.001), and C-reactive protein (P = 0.001)]. Endoscopic and clinical remission was obtained in 7 (35%) and 9 (45%) patients, respectively; however, no significant discrepancy related to the LVEDV (P = 0.86), LVESV (P-value = 0.25), EF (P-value = 0.06), and GLS in standard parasternal short axis (P = 0.73), long axis [apical 2-chamber (P-value = 0.61), apical 3-chamber (P-value = 0.15), and apical 4-chamber (P-value = 0.19) views] was observed before and after the intervention. Furthermore, no statistically significant correlation between disease activity and cardiac function was found, neither before nor after ADA administration. Conclusion The present perusal found no deterioration in left ventricular function indexes with ADA intervention among patients with IBD without cardiac ailment. Thus, prescribing the anti-TNF to alleviate the inflammation can be carried out with less concern about cardiac consequences and considering other adverse traces in the target group.
Collapse
Affiliation(s)
- Mohammad Reza Hatamnejad
- Department of Basic and Molecular Epidemiology of Gastrointestinal Disorders, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mersedeh Karvandi
- Department of Cardiovascular Imaging Research, Taleghani Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fateme Jodatfar
- Department of Cardiology, Taleghani Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran,Fateme Jodatfar ✉
| | - Nastaran Ebrahimi
- Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fatemeh Shojaeian
- Department of Surgical Pathology, Sol Goldman Pancreatic Cancer Research Center, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Shaghayegh Baradaran Ghavami
- Department of Basic and Molecular Epidemiology of Gastrointestinal Disorders, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hedieh Balaii
- Department of Basic and Molecular Epidemiology of Gastrointestinal Disorders, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mahdi Moeeni
- Department of Cardiology, Seyed-ol Shohada Hospital, Urmia University of Medical Sciences, Urmia, Iran
| | - Mohsen Rajabnia
- Non-Communicable Disease Research Center, Alborz University of Medical Sciences, Karaj, Iran
| | - Shabnam Shahrokh
- Department of Basic and Molecular Epidemiology of Gastrointestinal Disorders, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran,*Correspondence: Shabnam Shahrokh ✉
| | - Hamid Asadzadeh Aghdaei
- Department of Basic and Molecular Epidemiology of Gastrointestinal Disorders, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| |
Collapse
|
39
|
Nayor M, Gajjar P, Murthy VL, Miller P, Velagaleti RS, Larson MG, Vasan RS, Lewis GD, Mitchell GF, Shah RV. Blood Pressure Responses During Exercise: Physiological Correlates and Clinical Implications. Arterioscler Thromb Vasc Biol 2023; 43:163-173. [PMID: 36384270 PMCID: PMC9780190 DOI: 10.1161/atvbaha.122.318512] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Accepted: 11/08/2022] [Indexed: 11/18/2022]
Abstract
BACKGROUND Abnormal blood pressure (BP) responses to exercise can predict adverse cardiovascular outcomes, but their optimal measurement and definitions are poorly understood. We combined frequently sampled BP during cardiopulmonary exercise testing with vascular stiffness assessment to parse cardiac and vascular components of exercise BP. METHODS Cardiopulmonary exercise testing with BP measured every two minutes and resting vascular tonometry were performed in 2858 Framingham Heart Study participants. Linear regression was used to analyze sex-specific exercise BP patterns as a function of arterial stiffness (carotid-femoral pulse wave velocity) and cardiac-peripheral performance (defined by peak O2 pulse). RESULTS Our sample was balanced by sex (52% women) with mean age 54±9 years and 47% with hypertension. We observed variability in carotid-femoral pulse wave velocity and peak O2 pulse across individuals with clinically defined exercise hypertension (peak systolic BP [SBP] in men ≥210 mm Hg; in women ≥190 mm Hg). Despite similar resting SBP and cardiometabolic profiles, individuals with higher peak O2 pulse displayed higher peak SBP (P≤0.017) alongside higher fitness levels (P<0.001), suggesting that high peak exercise SBP in the context of high peak O2 pulse may in fact be favorable. Although both higher (favorable) O2 pulse and higher (adverse) arterial stiffness were associated with greater peak SBP (P<0.0001 for both), the magnitude of association of carotid-femoral pulse wave velocity with peak SBP was higher in women (sex-carotid-femoral pulse wave velocity interaction P<0.0001). In sex-specific models, exercise SBP measures accounting for workload (eg, SBP during unloaded exercise, SBP at 75 watts, and SBP/workload slope) were directly associated with the adverse features of greater arterial stiffness and lower peak O2 pulse. CONCLUSIONS Higher peak exercise SBP reflects a complex trade-off between arterial stiffness and cardiac-peripheral performance that differs by sex. Studies of BP responses to exercise accounting for vascular and cardiac physiology may illuminate mechanisms of hypertension and clarify clinical interpretation of exercise BP.
Collapse
Affiliation(s)
- Matthew Nayor
- Cardiovascular Medicine Section, Department of Medicine, Boston University School of Medicine, Boston, MA
- Preventive Medicine and Epidemiology Section, Department of Medicine, Boston University School of Medicine, Boston, MA
- Boston University’s and National Heart, Lung, and Blood Institute’s Framingham Heart Study, Framingham, MA
| | - Priya Gajjar
- Cardiovascular Medicine Section, Department of Medicine, Boston University School of Medicine, Boston, MA
| | - Venkatesh L. Murthy
- Division of Cardiovascular Medicine, Department of Medicine, University of Michigan, Ann Arbor
- Frankel Cardiovascular Center, University of Michigan, Ann Arbor
| | - Patricia Miller
- Department of Biostatistics, Boston University School of Public Health, Boston, MA
| | - Raghava S. Velagaleti
- Boston University’s and National Heart, Lung, and Blood Institute’s Framingham Heart Study, Framingham, MA
- Cardiology Section, Department of Medicine, Boston VA Healthcare System, West Roxbury, Massachusetts
| | - Martin G. Larson
- Boston University’s and National Heart, Lung, and Blood Institute’s Framingham Heart Study, Framingham, MA
- Department of Biostatistics, Boston University School of Public Health, Boston, MA
| | - Ramachandran S. Vasan
- Cardiovascular Medicine Section, Department of Medicine, Boston University School of Medicine, Boston, MA
- Preventive Medicine and Epidemiology Section, Department of Medicine, Boston University School of Medicine, Boston, MA
- Boston University’s and National Heart, Lung, and Blood Institute’s Framingham Heart Study, Framingham, MA
- University of Texas School of Public Health San Antonio, and Departments of Medicine and Population Health Sciences, University of Texas Health Science Center, San Antonio, TX
- Department of Epidemiology, Boston University School of Public Health, and the Center for Computing and Data Sciences, Boston University, Boston, MA
| | - Gregory D. Lewis
- Cardiology Division and Pulmonary Critical Care Unit, Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | | | - Ravi V. Shah
- Vanderbilt Translational and Clinical Research Center, Cardiology Division, Vanderbilt University Medical Center, Nashville, TN
| |
Collapse
|
40
|
McCallinhart PE, Lee YU, Lee A, Anghelescu M, Tonniges JR, Calomeni E, Agarwal G, Lincoln J, Trask AJ. Dissociation of pulse wave velocity and aortic wall stiffness in diabetic db/db mice: The influence of blood pressure. Front Physiol 2023; 14:1154454. [PMID: 37035668 PMCID: PMC10080125 DOI: 10.3389/fphys.2023.1154454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Accepted: 03/10/2023] [Indexed: 04/11/2023] Open
Abstract
Introduction: Vascular stiffness is a predictor of cardiovascular disease and pulse wave velocity (PWV) is the current standard for measuring in vivo vascular stiffness. Mean arterial pressure is the largest confounding variable to PWV; therefore, in this study we aimed to test the hypothesis that increased aortic PWV in type 2 diabetic mice is driven by increased blood pressure rather than vascular biomechanics. Methods and Results: Using a combination of in vivo PWV and ex vivo pressure myography, our data demonstrate no difference in ex vivo passive mechanics, including outer diameter, inner diameter, compliance (Db/db: 0.0094 ± 0.0018 mm2/mmHg vs. db/db: 0.0080 ± 0.0008 mm2/mmHg, p > 0.05 at 100 mmHg), and incremental modulus (Db/db: 801.52 ± 135.87 kPa vs. db/db: 838.12 ± 44.90 kPa, p > 0.05 at 100 mmHg), in normal versus diabetic 16 week old mice. We further report no difference in basal or active aorta biomechanics in normal versus diabetic 16 week old mice. Finally, we show here that the increase in diabetic in vivo aortic pulse wave velocity at baseline was completely abolished when measured at equivalent pharmacologically-modulated blood pressures, indicating that the elevated PWV was attributed to the concomitant increase in blood pressure at baseline, and therefore "stiffness." Conclusions: Together, these animal model data suggest an intimate regulation of blood pressure during collection of pulse wave velocity when determining in vivo vascular stiffness. These data further indicate caution should be exerted when interpreting elevated PWV as the pure marker of vascular stiffness.
Collapse
Affiliation(s)
- Patricia E. McCallinhart
- Abigail Wexner Research Institute, Nationwide Children’s Hospital, Columbus, OH, United States
- Center for Cardiovascular Research, Nationwide Children’s Hospital, Columbus, OH, United States
| | - Yong Ung Lee
- Abigail Wexner Research Institute, Nationwide Children’s Hospital, Columbus, OH, United States
- Tissue Engineering Program and Surgical Research, Columbus, OH, United States
| | - Avione Lee
- Abigail Wexner Research Institute, Nationwide Children’s Hospital, Columbus, OH, United States
- Tissue Engineering Program and Surgical Research, Columbus, OH, United States
| | - Mircea Anghelescu
- Department of Biomedical Sciences, Philadelphia College of Osteopathic Medicine (PCOM), Suwanee, GA, United States
| | - Jeffrey R. Tonniges
- Biophysics Graduate Program at The Ohio State University, Columbus, OH, United States
| | - Ed Calomeni
- Dorothy M. Davis Heart and Lung Research Institute, College of Medicine, The Ohio State University, Columbus, OH, United States
| | - Gunjan Agarwal
- Biophysics Graduate Program at The Ohio State University, Columbus, OH, United States
- Dorothy M. Davis Heart and Lung Research Institute, College of Medicine, The Ohio State University, Columbus, OH, United States
| | - Joy Lincoln
- Abigail Wexner Research Institute, Nationwide Children’s Hospital, Columbus, OH, United States
- Center for Cardiovascular Research, Nationwide Children’s Hospital, Columbus, OH, United States
- Department of Pediatrics, College of Medicine, The Ohio State University, Columbus, OH, United States
| | - Aaron J. Trask
- Abigail Wexner Research Institute, Nationwide Children’s Hospital, Columbus, OH, United States
- Center for Cardiovascular Research, Nationwide Children’s Hospital, Columbus, OH, United States
- Dorothy M. Davis Heart and Lung Research Institute, College of Medicine, The Ohio State University, Columbus, OH, United States
- Department of Pediatrics, College of Medicine, The Ohio State University, Columbus, OH, United States
- *Correspondence: Aaron J. Trask,
| |
Collapse
|
41
|
Anthoulakis C, Mamopoulos A. Augmentation index and pulse wave velocity in normotensive versus preeclamptic pregnancies: a prospective case-control study using a new oscillometric method. Ann Med 2022; 54:1-10. [PMID: 34935572 PMCID: PMC8725835 DOI: 10.1080/07853890.2021.2014553] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
OBJECTIVES The objective of this study was to investigate whether oscillometric AS measurements are different in pregnant women with and without preeclampsia (PE). STUDY DESIGN This was a prospective case-control study in singleton pregnancies that had been diagnosed with PE (n = 46) versus normotensive controls (n = 46) between 2014 and 2019. In the case group, pregnancies complicated by PE were classified as either early-onset (<34 weeks of gestation) or late-onset (≥34 weeks of gestation) PE and subgroup analysis was performed. MAIN OUTCOME MEASURES Pulse wave velocity (PWV), augmentation index (Alx), and Alx at a heart rate of 75 beats per minute (Alx-75) were measured using a brachial cuff-based automatic oscillometric device (Mobil-O-Graph 24 h PWA). RESULTS In pregnancies complicated by PE, in comparison with normotensive pregnancies, there were significant differences in PWV (p ˂ .001), and Alx-75 (p ˂ .001). In pregnancies complicated by early-onset PE, in comparison with pregnancies complicated by late-onset PE, there were significant differences in PWV (p = .006), and Alx-75 (p = .009). There was no significant difference in Alx in either of the analyses. CONCLUSIONS PWV and Alx-75 are higher in pregnancies complicated by PE, in comparison with normotensive pregnancies, as well as in early-onset PE, in comparison with late-onset PE.Key messagesPulse wave velocity is higher in pregnancies complicated by preeclampsia.Augmentation index at a heart rate of 75 beats per minute is higher in pregnancies complicated by preeclampsia.Arterial stiffness assessment is a promising risk-stratification tool for future cardiovascular complications but further studies are required.
Collapse
Affiliation(s)
- Christos Anthoulakis
- First Department of Obstetrics & Gynecology, "Papageorgiou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Apostolos Mamopoulos
- Third Department of Obstetrics & Gynecology, Hippokration (Ippokrateio) General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| |
Collapse
|
42
|
Kuller LH, Snitz BE, Hughes TM, Chang Y, Cohen AD, Mathis CA, Aizenstein HJ, Lopez OL. Low untreated systolic blood pressure over 18 years is associated with survival free of dementia age 90. Alzheimers Dement 2022; 18:2176-2187. [PMID: 35089640 PMCID: PMC9787390 DOI: 10.1002/alz.12493] [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] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Accepted: 08/11/2021] [Indexed: 01/31/2023]
Abstract
INTRODUCTION We hypothesized that lower untreated systolic blood pressure (SBP) would be associated with a lower risk of dementia and death up to age 95. METHODS SBP measured between 2000 and 2006 was evaluated in relationship to dementia risk and brain biomarkers from 2009-2020 (n = 177) in the Gingko Evaluation of Memory Study (GEMS), mean age 95 in 2020. Participants had measurements of brain amyloid beta (Aβ) and repeat clinical-cognitive evaluations every 6 months. RESULTS By 2020, only 9 of 177 patients (5%) were alive and cognitively unimpaired (CU). Mean SBP from 2000 to 2006 was 120 mm Hg for nine alive/CU, 125 mm Hg for alive/mild cognitive impairment (MCI), and 130 mm Hg for alive/dementia (P = .03). The amount of Aβ was directly related to SBP levels. In multivariate analysis, Aβ+ in 2009 and thinner cortex were significant predictors of dementia. Excluding Aβ, SBP became a significant predictor of dementia. DISCUSSION Low SBP untreated by antihypertensive medications was associated with significant decreased risk of dementia and less Aβ.
Collapse
Affiliation(s)
- Lewis H. Kuller
- Department of EpidemiologyGraduate School of Public HealthUniversity of PittsburghPittsburghPennsylvaniaUSA
| | - Beth E. Snitz
- Department of NeurologyUniversity of PittsburghPittsburghPennsylvaniaUSA
| | - Timothy M. Hughes
- Department of Internal MedicineSection on Gerontology and Geriatric MedicineWake Forest School of MedicineWinston‐SalemNorth CarolinaUSA
| | - Yuefang Chang
- Department of NeurosurgeryUniversity of PittsburghPittsburghPennsylvaniaUSA
| | - Ann D. Cohen
- Department of PsychiatryUniversity of PittsburghPittsburghPennsylvaniaUSA
| | - Chester A. Mathis
- Department of RadiologyUniversity of PittsburghPittsburghPennsylvaniaUSA
| | | | - Oscar L. Lopez
- Department of NeurologyUniversity of PittsburghPittsburghPennsylvaniaUSA
- Department of PsychiatryUniversity of PittsburghPittsburghPennsylvaniaUSA
| |
Collapse
|
43
|
Mensah E, Ali K, Banya W, Kirkham FA, Mengozzi M, Ghezzi P, Rajkumar C. FRailty and Arterial stiffness - the role of oXidative stress and Inflammation (FRAXI study). Biomark Insights 2022; 17:11772719221130719. [PMID: 36275839 PMCID: PMC9583202 DOI: 10.1177/11772719221130719] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Accepted: 09/16/2022] [Indexed: 11/08/2022] Open
Abstract
Objective There is an association between frailty and arterial stiffness. However, arterial stiffness does not uniformly correlate with the spectrum of frailty states. Both oxidative stress and inflammaging contribute to vascular ageing. There are no human studies exploring links between arterial stiffness, oxidative stress, inflammaging and frailty. Our objective is to investigate arterial stiffness and inflammaging as predictors of frailty states. Methods An observational longitudinal cohort study will be used to examine the association between arterial stiffness, oxidative stress and inflammation in 50 older adults (⩾70 years) with clinical frailty scores (CFS) ⩽6 over 6 months. All study measurements will be taken at baseline. Frailty assessment will include hand-grip strength, timed-up and go test, mini-mental state examination, geriatric depression scale and sarcopenia using body composition measurements with Tanita®. Arterial stiffness measurements will include carotid-femoral pulse wave velocity (cfPWV) and carotid-radial pulse wave velocity (crPWV) using Complior (Alam Medical, France). CAVI device will measure Cardio-ankle vascular index and ankle brachial index (ABI). Oxidative stress blood markers nitrotyrosine (NT) and 8-hydroxy-2'-deoxyguanosin (8-oxo-dG) and inflammation markers high-sensitive C-reactive protein (hs-CRP) and interlukin-6(IL-6) will be measured at baseline and 6 month along with lipid profile and glycated haemoglobin. Results data analysis plan Descriptive statistics for continuous data using means and standard deviations for normality distributed variables or medians and inter-quartile ranges for skewed variables will be used. Participants will be categorised into CFS 1-3, and CFS 4-6. Categorical data will use frequencies and comparison between groups. Change in frailty between the groups over 6 months will be compared using paired t-test. Simple linear regression will be done between frailty measures, arterial stiffness, inflammation and oxidative stress biomarkers. Significance will be at P < .05. Conclusion This study data will inform a larger, multi-centre study exploring further the interplay between frailty, biomarkers and arterial stiffness parameters.
Collapse
Affiliation(s)
- Ekow Mensah
- Brighton and Sussex Clinical Trials
Unit, University Hospitals Sussex NHS Trust, Brighton, UK,Ekow Mensah, Brighton and Sussex Clinical
Trials Unit, University Hospitals Sussex NHS Trust, Audrey Emerton Building,
Eastern Road, Brighton, BN2 5BE, UK.
| | - Khalid Ali
- Brighton and Sussex Clinical Trials
Unit, University Hospitals Sussex NHS Trust, Brighton, UK,Department of Medicine, Brighton and
Sussex Medical School, University of Sussex, Brighton, UK
| | - Winston Banya
- Research Office, Royal Brompton and
Harefield Clinical Group, Guy’s and St. Thomas’ NHS Foundation Trust, London,
UK
| | - Frances Ann Kirkham
- Brighton and Sussex Clinical Trials
Unit, University Hospitals Sussex NHS Trust, Brighton, UK
| | - Manuela Mengozzi
- Department of Medicine, Brighton and
Sussex Medical School, University of Sussex, Brighton, UK
| | | | - Chakravarthi Rajkumar
- Brighton and Sussex Clinical Trials
Unit, University Hospitals Sussex NHS Trust, Brighton, UK,Department of Medicine, Brighton and
Sussex Medical School, University of Sussex, Brighton, UK
| |
Collapse
|
44
|
Cohen JB, Mitchell GF, Gill D, Burgess S, Rahman M, Hanff T, Ramachandran VS, Mutalik K, Townsend RR, Chirinos JA. Arterial Stiffness and Diabetes Risk in Framingham Heart Study and UK Biobank. Circ Res 2022; 131:545-554. [PMID: 35946401 PMCID: PMC7613487 DOI: 10.1161/circresaha.122.320796] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Accepted: 07/26/2022] [Indexed: 01/26/2023]
Abstract
BACKGROUND Microvascular damage from large artery stiffness (LAS) in pancreatic, hepatic, and skeletal muscles may affect glucose homeostasis. Our goal was to evaluate the association between LAS and the risk of type 2 diabetes using prospectively collected, carefully phenotyped measurements of LAS as well as Mendelian randomization analyses. METHODS Carotid-femoral pulse wave velocity (CF-PWV) and brachial and central pulse pressure were measured in 5676 participants of the FHS (Framingham Heart Study) without diabetes. We used Cox proportional hazards regression to evaluate the association of CF-PWV and pulse pressure with incident diabetes. We subsequently performed 2-sample Mendelian randomization analyses evaluating the associations of genetically predicted brachial pulse pressure with type 2 diabetes in the UKBB (United Kingdom Biobank). RESULTS In FHS, individuals with higher CF-PWV were older, more often male, and had higher body mass index and mean arterial pressure compared to those with lower CF-PWV. After a median follow-up of 7 years, CF-PWV and central pulse pressure were associated with an increased risk of new-onset diabetes (per SD increase, multivariable-adjusted CF-PWV hazard ratio, 1.36 [95% CI, 1.03-1.76]; P=0.030; central pulse pressure multivariable-adjusted CF-PWV hazard ratio, 1.26 [95% CI, 1.08-1.48]; P=0.004). In United Kingdom Biobank, genetically predicted brachial pulse pressure was associated with type 2 diabetes, independent of mean arterial pressure (adjusted odds ratio, 1.16 [95% CI, 1.00-1.35]; P=0.049). CONCLUSIONS Using prospective cohort data coupled with Mendelian randomization analyses, we found evidence supporting that greater LAS is associated with increased risk of developing diabetes. LAS may play an important role in glucose homeostasis and may serve as a useful marker of future diabetes risk.
Collapse
Affiliation(s)
- Jordana B. Cohen
- Renal-Electrolyte and Hypertension Division, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Department of Biostatistics, Epidemiology, and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | | | - Dipender Gill
- Department of Epidemiology and Biostatistics, School of Public Health, MRC Centre for Environment and Health, Imperial College London, London, UK
| | - Stephen Burgess
- Medical Research Council Biostatistics Unit, School of Clinical Medicine, University of Cambridge, Cambridge, UK
- Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Mahboob Rahman
- Department of Medicine, Case Western University, University Hospitals Case Medical Center, Cleveland, OH, USA
| | - Thomas Hanff
- Division of Cardiovascular Medicine, University of Utah School of Medicine, Salt Lake City, UT, USA
| | - Vasan S. Ramachandran
- Department of Medicine, Boston University School of Medicine, Boston, MA, USA
- Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA
- Framingham Heart Study, Framingham, MA, USA
| | | | - Raymond R. Townsend
- Renal-Electrolyte and Hypertension Division, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Julio A. Chirinos
- Division of Cardiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| |
Collapse
|
45
|
Ma B, Melton E, Wiener R, Zhou N, Wu W, Lai L, Wang C, Costa KD, Qiu H. Age and Blood Pressure Contribute to Aortic Cell and Tissue Stiffness Through Distinct Mechanisms. Hypertension 2022; 79:1777-1788. [PMID: 35766034 PMCID: PMC9308762 DOI: 10.1161/hypertensionaha.121.18950] [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] [Indexed: 11/16/2022]
Abstract
BACKGROUND Aortic stiffening is strongly associated with both aging and hypertension, but the underlying mechanisms remain unclear. We hypothesized that aging-induced aortic stiffness is mediated by a mechanism differing from hypertension. METHODS We conducted comprehensive in vivo and in vitro experiments using multiple rat models to dissect the different mechanisms of aortic stiffening mediated by aging and hypertension. RESULTS A time-course study in spontaneously hypertensive rats (SHR) and Wistar-Kyoto (WKY) normotensive rats showed more pronounced aging-associated aortic stiffening in SHR versus WKY. Angiotensin II-induced hypertension was associated with more significant aortic stiffening in older versus young WKY rats. Hypertension aggravated aging effects on aortic wall thickness and extracellular matrix content, indicating combinational effects of aging and hypertension on aortic stiffening. Intrinsic stiffness of isolated aortic vascular smooth muscle cells (VSMCs) increased with age in WKY rats, although no significant difference between older SHR and older WKY VSMCs was observed in 2-dimensional culture, reconstituted 3-dimensional tissues were stiffer for older SHR versus older WKY. A selective inhibitor that reduced hypertension-mediated aortic stiffening did not decrease age-related stiffening in aortic VSMCs and aortic wall. Integrin β1 and SM22 (smooth muscle-specific SM22 protein) expression were negligibly changed in WKY VSMCs during aging but were markedly increased by hypertension in older versus young WKY VSMCs. A notable shift of filamin isoforms from B to A was detected in older WKY VSMCs. CONCLUSIONS Our results indicate distinct mechanisms mediating aging-associated aortic VSMC and vessel stiffness, providing new insights into aortic stiffening and the pathogenesis of hypertension in the elderly.
Collapse
Affiliation(s)
- Ben Ma
- Center for Molecular and Translational Medicine, Institute of Biomedical Sciences, Georgia State University, Atlanta, GA (B.M., E.M., W.W., L.L., H.Q.).,Division of Physiology, Department of Basic Sciences (B.M., N.Z., H.Q.), School of Medicine, Loma Linda University, CA
| | - Elaina Melton
- Center for Molecular and Translational Medicine, Institute of Biomedical Sciences, Georgia State University, Atlanta, GA (B.M., E.M., W.W., L.L., H.Q.)
| | - Robert Wiener
- Department of Medicine (Cardiology), Cardiovascular Research Institute, Icahn School of Medicine at Mount Sinai, New York, NY (R.W., K.D.C.)
| | - Ning Zhou
- Division of Physiology, Department of Basic Sciences (B.M., N.Z., H.Q.), School of Medicine, Loma Linda University, CA
| | - Wenqian Wu
- Center for Molecular and Translational Medicine, Institute of Biomedical Sciences, Georgia State University, Atlanta, GA (B.M., E.M., W.W., L.L., H.Q.)
| | - Lo Lai
- Center for Molecular and Translational Medicine, Institute of Biomedical Sciences, Georgia State University, Atlanta, GA (B.M., E.M., W.W., L.L., H.Q.)
| | - Charles Wang
- Department of Basic Sciences & Center for Genomics (C.W.), School of Medicine, Loma Linda University, CA
| | - Kevin D Costa
- Department of Medicine (Cardiology), Cardiovascular Research Institute, Icahn School of Medicine at Mount Sinai, New York, NY (R.W., K.D.C.)
| | - Hongyu Qiu
- Center for Molecular and Translational Medicine, Institute of Biomedical Sciences, Georgia State University, Atlanta, GA (B.M., E.M., W.W., L.L., H.Q.).,Division of Physiology, Department of Basic Sciences (B.M., N.Z., H.Q.), School of Medicine, Loma Linda University, CA
| |
Collapse
|
46
|
Zhu Z, Chen Y, Wang W, Wang Y, Hu W, Shang X, Liao H, Shi D, Huang Y, Ha J, Tan Z, Kiburg KV, Zhang X, Tang S, Yu H, Yang X, He M. Association of Retinal Age Gap With Arterial Stiffness and Incident Cardiovascular Disease. Stroke 2022; 53:3320-3328. [PMID: 35880520 DOI: 10.1161/strokeaha.122.038809] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Retinal parameters could reflect systemic vascular changes. With the advances of deep learning technology, we have recently developed an algorithm to predict retinal age based on fundus images, which could be a novel biomarker for aging and mortality. Therefore, we aim to investigate associations of retinal age gap with arterial stiffness index and incident cardiovascular disease (CVD). METHODS A deep learning model was trained based on 19 200 fundus images of 11 052 participants without any medical history at baseline to predict the retinal age. Retinal age gap (retinal age predicted minus chronological age) was generated for the remaining 35 917 participants. Regression models were used to assess the association between retinal age gap and arterial stiffness index. Cox proportional hazards regression models and restricted cubic splines were used to explore the association between retinal age gap and incident CVD. RESULTS We found each 1-year increase in retinal age gap was associated with increased arterial stiffness index (β=0.002 [95% CI, 0.001-0.003]; P<0.001). After a median follow-up of 5.83 years (interquartile range: 5.73-5.97), 675 (2.00%) developed CVD. In the fully adjusted model, each 1-year increase in retinal age gap was associated with a 3% increase in the risk of incident CVD (hazard ratio=1.03 [95% CI, 1.01-1.06]; P=0.014). In the restricted cubic splines analysis, the risk of incident CVD increased significantly when retinal age gap reached 1.21 (hazard ratio=1.05 [95% CI, 1.00-1.10]; P-overall <0.0001; P-nonlinear=0.0681). CONCLUSIONS We found that retinal age gap was significantly associated with arterial stiffness index and incident CVD events, supporting the potential of this novel biomarker in identifying individuals at high risk of future CVD events.
Collapse
Affiliation(s)
- Zhuoting Zhu
- Department of Ophthalmology, Guangdong Academy of Medical Sciences, Guangdong Provincial People's Hospital, Guangzhou, China (Z.Z., X.S., Y.H., X.Z., S.T., H.Y., X.Y., M.H.).,Department of Ophthalmology, Centre for Eye Research Australia, University of Melbourne, Australia (Z.Z., W.H., J.H., Z.T., K.V.K., M.H.).,Ophthalmology, Department of Surgery, University of Melbourne, Australia (Z.Z., W.H., M.H.)
| | - Yifan Chen
- John Radcliffe Hospital, Oxford University Hospitals NHS Foundation Trust, United Kingdom (Y.C.)
| | - Wei Wang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China (W.W., Y.W., D.S., M.H.)
| | - Yueye Wang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China (W.W., Y.W., D.S., M.H.)
| | - Wenyi Hu
- Department of Ophthalmology, Centre for Eye Research Australia, University of Melbourne, Australia (Z.Z., W.H., J.H., Z.T., K.V.K., M.H.).,Ophthalmology, Department of Surgery, University of Melbourne, Australia (Z.Z., W.H., M.H.)
| | - Xianwen Shang
- Department of Ophthalmology, Guangdong Academy of Medical Sciences, Guangdong Provincial People's Hospital, Guangzhou, China (Z.Z., X.S., Y.H., X.Z., S.T., H.Y., X.Y., M.H.)
| | - Huan Liao
- Neural Regeneration Group, Institute of Reconstructive Neurobiology, University of Bonn, Germany (H.L.)
| | - Danli Shi
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China (W.W., Y.W., D.S., M.H.)
| | - Yu Huang
- Department of Ophthalmology, Guangdong Academy of Medical Sciences, Guangdong Provincial People's Hospital, Guangzhou, China (Z.Z., X.S., Y.H., X.Z., S.T., H.Y., X.Y., M.H.)
| | - Jason Ha
- Department of Ophthalmology, Centre for Eye Research Australia, University of Melbourne, Australia (Z.Z., W.H., J.H., Z.T., K.V.K., M.H.)
| | - Zachary Tan
- Department of Ophthalmology, Centre for Eye Research Australia, University of Melbourne, Australia (Z.Z., W.H., J.H., Z.T., K.V.K., M.H.)
| | - Katerina V Kiburg
- Department of Ophthalmology, Centre for Eye Research Australia, University of Melbourne, Australia (Z.Z., W.H., J.H., Z.T., K.V.K., M.H.)
| | - Xueli Zhang
- Department of Ophthalmology, Guangdong Academy of Medical Sciences, Guangdong Provincial People's Hospital, Guangzhou, China (Z.Z., X.S., Y.H., X.Z., S.T., H.Y., X.Y., M.H.)
| | - Shulin Tang
- Department of Ophthalmology, Guangdong Academy of Medical Sciences, Guangdong Provincial People's Hospital, Guangzhou, China (Z.Z., X.S., Y.H., X.Z., S.T., H.Y., X.Y., M.H.)
| | - Honghua Yu
- Department of Ophthalmology, Guangdong Academy of Medical Sciences, Guangdong Provincial People's Hospital, Guangzhou, China (Z.Z., X.S., Y.H., X.Z., S.T., H.Y., X.Y., M.H.)
| | - Xiaohong Yang
- Department of Ophthalmology, Guangdong Academy of Medical Sciences, Guangdong Provincial People's Hospital, Guangzhou, China (Z.Z., X.S., Y.H., X.Z., S.T., H.Y., X.Y., M.H.)
| | - Mingguang He
- Department of Ophthalmology, Guangdong Academy of Medical Sciences, Guangdong Provincial People's Hospital, Guangzhou, China (Z.Z., X.S., Y.H., X.Z., S.T., H.Y., X.Y., M.H.).,Department of Ophthalmology, Centre for Eye Research Australia, University of Melbourne, Australia (Z.Z., W.H., J.H., Z.T., K.V.K., M.H.).,Ophthalmology, Department of Surgery, University of Melbourne, Australia (Z.Z., W.H., M.H.).,State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China (W.W., Y.W., D.S., M.H.)
| |
Collapse
|
47
|
Salvi P, Grillo A, Gautier S, Montaguti L, Brunacci F, Severi F, Salvi L, Pretolani E, Parati G, Benetos A. Haemodynamic Adaptive Mechanisms at High Altitude: Comparison between European Lowlanders and Nepalese Highlanders. J Clin Med 2022; 11. [PMID: 35807128 DOI: 10.3390/jcm11133843] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Revised: 06/22/2022] [Accepted: 06/27/2022] [Indexed: 12/10/2022] Open
Abstract
Background: Exposure to high altitudes determines several adaptive mechanisms affecting in a complex way the whole cardiovascular, respiratory, endocrine systems because of the hypobaric hypoxic condition. The aim of our study was to evaluate the circulatory adaptive mechanisms at high altitudes, during a scientific expedition in the Himalayas. Methods: Arterial distensibility was assessed measuring carotid-radial and carotid-femoral pulse wave velocity. Tests were carried out at several altitudes, from 1350 to 5050 m above sea level, on 8 lowlander European researchers and 11 highlander Nepalese porters. Results: In Europeans, systolic blood pressure and pulse pressure increased slightly but significantly with altitude (p < 0.05 and p < 0.001, respectively). Norepinephrine showed a significant increase after the lowlanders had spent some time at high altitude (p < 0.001). With increasing altitude, a progressive increase in carotid-radial and carotid-femoral pulse wave velocity values was observed in lowlanders, showing a particularly significant increase (p < 0.001) after staying at high altitude (carotid-radial pulse wave velocity, median value (interquartile range) from 9.2 (7.9−10.0) to 11.2 (10.9−11.8) m/s and carotid-femoral pulse wave velocity from 8.5 (7.9−9.0) to 11.3 (10.9−11.8) m/s). At high altitudes (3400 and 5050 m above sea level), no significant differences were observed between highlanders and lowlanders in hemodynamic parameters (blood pressure, carotid-radial and carotid-femoral pulse wave velocity). Conclusions: The progressive arterial stiffening with altitude observed in European lowlanders could explain the increase in systolic and pulse pressure values observed at high altitudes in this ethnic group. Further studies are needed to evaluate the role of aortic stiffening in the pathogenesis of acute mountain sickness.
Collapse
|
48
|
Heffernan KS, Stoner L, Meyer ML, Loprinzi PD. Association Between Estimated Pulse Wave Velocity and Cognitive Performance in Older Black and White Adults in NHANES. J Alzheimers Dis 2022; 88:985-993. [PMID: 35754267 DOI: 10.3233/jad-220042] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
BACKGROUND Aging-associated cognitive decline is greater in non-Hispanic Black (NHB) adults than non-Hispanic White (NHW) adults. An important risk factor for cognitive decline with aging is arterial stiffening, though the importance to racial variation remains poorly understood. OBJECTIVE We examined the association of an estimate of arterial stiffness with cognitive function in a bi-racial sample of 60-85-year-old adults (N = 3,616, 26.5% NHB) enrolled in the National Health and Nutrition Examination Survey (NHANES) between 1999-2002 and 2011-2014. METHODS As a measure of vascular aging, pulse wave velocity was estimated (ePWV) using an equation incorporating age and mean arterial pressure and expressed as m/s. Using the digit symbol substitution test (DSST), cognitive function was expressed as the number of correctly matched symbols (out of 133) within 120 s. Linear regression models examined associations between ePWV and DSST. RESULTS In models that adjusted for sex, education, smoking, body mass index, history of cardiovascular disease, and hypertension, ePWV was inversely associated with DSST score in NHB adults (β= -3.47, 95% CI = -3.9 to -3.0; p < 0.001) and NHW adults (β= -3.51, 95% CI = -4.4 to -2.6; p < 0.001). CONCLUSION ePWV is inversely associated with a measure of cognitive function in older Black and White adults. ePWV may be a useful measure of vascular aging that can offer insight into cognitive aging.
Collapse
Affiliation(s)
- Kevin S Heffernan
- Department of Exercise Science, Syracuse University, Syracuse NY, USA
| | - Lee Stoner
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Michelle L Meyer
- Department of Emergency Medicine, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Paul D Loprinzi
- Department of Health, Exercise Science and Recreation Management, University of Mississippi, Oxford MS, USA
| |
Collapse
|
49
|
Baran J, Niewiara Ł, Podolec J, Siedliński M, Józefczuk E, Bernacik A, Badacz R, Przewłocki T, Pieniążek P, Żmudka K, Legutko J, Kabłak-Ziembicka A. Serum and Vascular Stiffness Biomarkers Associated with the Severity of Degenerative Aortic Valve Stenosis and Cardiovascular Outcomes. J Cardiovasc Dev Dis 2022; 9. [PMID: 35735822 DOI: 10.3390/jcdd9060193] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Revised: 06/07/2022] [Accepted: 06/16/2022] [Indexed: 11/20/2022] Open
Abstract
Background: Although degenerative aortic valve stenosis (DAS) is the most prevalent growth-up congestive heart valve disease, still little known about relationships between DAS severity, vascular stiffness (VS), echocardiographic parameters, and serum biomarkers in patients undergoing transcatheter (TAVR) or surgical aortic valve replacement (SAVR). The objective of this study was to identify biomarkers associated with DAS severity, and those that are associated with cardiovascular death (CVD) and episodes of chronic heart failure (CHF) exacerbation. Methods: A total of 137 patients with initially moderate-to-severe DAS were prospectively evaluated for the relationship between DAS severity, baseline VS, and serum biomarkers (uPAR, GDF-15, Gal-3, IL-6Rα, ET-1, PCSK9, RANTES/CCL5, NT-proBNP, and hs-TnT), and were followed-up for 48 months. The prognostic significance of each variable for CVD and CHF risk was measured by hazard ratio of risk (HR), which was calculated by Cox’s proportional hazard model. Results: DAS severity showed correlations with IL-6Rα (r = 0.306, p < 0.001), uPAR (r = 0.184, p = 0.032), and NT-proBNP (r = −0.389, p < 0.001). Levels of ET-1 and Gal-3 were strongly correlated with VS parameters (r = 0.674, p < 0.001; r = 0.724, p < 0.001). Out of 137 patients, 20 were referred to TAVR, 88 to SAVR, and 29 to OMT. In TAVR patients, the highest levels of ET-1, Gal-3, and VS were found as compared to other patients. The highest incidence of CVD was observed in patients who underwent TAVR (35%), compared to SAVR (8%) and OMT (10.3%) (p = 0.004). In a multivariate analysis, ET-1 occurred predictive of CVD risk (HR 25.1, p = 0.047), while Gal-3 > 11.5 ng/mL increased the risk of CHF exacerbation episodes requiring hospital admission by 12%. Conclusions: Our study indicated that ET-1 and Gal-3 levels may be associated with the outcomes in patients with DAS.
Collapse
|
50
|
Amore L, Alghisi F, Pancaldi E, Pascariello G, Cersosimo A, Cimino G, Bernardi N, Calvi E, Lombardi CM, Sciatti E, Vizzardi E, Metra M. Study of endothelial function and vascular stiffness in patients affected by dilated cardiomyopathy on treatment with sacubitril/valsartan. Am J Cardiovasc Dis 2022; 12:125-135. [PMID: 35873182 PMCID: PMC9301027] [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] [Subscribe] [Scholar Register] [Received: 01/08/2022] [Accepted: 06/02/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND The multiple beneficial effects of sacubitril/valsartan in the treatment of heart failure with reduced ejection fraction are vastly known, but still no or few mentions have been made regarding its effects on endothelial dysfunction and arterial stiffness. PATIENTS AND METHODS To understand more deeply if sacubitril/valsartan may have a role on endothelial function and arterial stiffness, 15 patients with dilated cardiomyopathy with reduced left ventricular ejection fraction (LVEF) were evaluated through transthoracic echocardiography, peripheral arterial tonometry (EndoPAT®) and applanation tonometry (SphygmoCor® Px system). These noninvasive exams were performed at the beginning of the study and after 6 months of sacubitril/valsartan treatment. RESULTS Aortic stiffness parameters didn't differ after 6 months of treatment. Augmentation pressure (P=0.889), augmentation index (P=0.906) and sphygmic wave velocity (P=0.263) increased slightly, but they weren't found to be statistically significant. Systolic, diastolic, and differential central arterial pressure didn't differ at the beginning and at the end of the study. RHI (reactive hyperemia index) increased significantly after 6 months (P=0.001) as well as augmentation index corrected for 75 bpm. Ejection fraction (32.21% ± 5.7 to 38.43% ± 8.4; P=0.010) and diastolic dysfunction degree (P=0.021) improved. There was an improvement in mitral regurgitation that wasn't statistically significant (P=0.116). TAPSE didn't change while pulmonary systolic arterial pressure increased, although not significantly (22.83 mmHg ± 4 to 27.33 mmHg ± 6; P=0.068) and within the normal range values. CONCLUSIONS Even though in a study with a limited number of patients, sacubitril/valsartan improved endothelial function, left ventricular function, MR, and diastolic function significantly in patients with dilated cardiomyopathy and reduced LVEF. It showed no effects on vascular stiffness.
Collapse
Affiliation(s)
- Ludovica Amore
- Institute of Cardiology, Department of Medical and Surgical Specialities, Radiological Sciences, and Public Health, University of Brescia, Spedali Civili di Brescia Brescia, Italy
| | - Fabio Alghisi
- Institute of Cardiology, Department of Medical and Surgical Specialities, Radiological Sciences, and Public Health, University of Brescia, Spedali Civili di Brescia Brescia, Italy
| | - Edoardo Pancaldi
- Institute of Cardiology, Department of Medical and Surgical Specialities, Radiological Sciences, and Public Health, University of Brescia, Spedali Civili di Brescia Brescia, Italy
| | - Greta Pascariello
- Institute of Cardiology, Department of Medical and Surgical Specialities, Radiological Sciences, and Public Health, University of Brescia, Spedali Civili di Brescia Brescia, Italy
| | - Angelica Cersosimo
- Institute of Cardiology, Department of Medical and Surgical Specialities, Radiological Sciences, and Public Health, University of Brescia, Spedali Civili di Brescia Brescia, Italy
| | - Giuliana Cimino
- Institute of Cardiology, Department of Medical and Surgical Specialities, Radiological Sciences, and Public Health, University of Brescia, Spedali Civili di Brescia Brescia, Italy
| | - Nicola Bernardi
- Institute of Cardiology, Department of Medical and Surgical Specialities, Radiological Sciences, and Public Health, University of Brescia, Spedali Civili di Brescia Brescia, Italy
| | - Emiliano Calvi
- Institute of Cardiology, Department of Medical and Surgical Specialities, Radiological Sciences, and Public Health, University of Brescia, Spedali Civili di Brescia Brescia, Italy
| | - Carlo Mario Lombardi
- Institute of Cardiology, Department of Medical and Surgical Specialities, Radiological Sciences, and Public Health, University of Brescia, Spedali Civili di Brescia Brescia, Italy
| | - Edoardo Sciatti
- Institute of Cardiology, Department of Medical and Surgical Specialities, Radiological Sciences, and Public Health, University of Brescia, Spedali Civili di Brescia Brescia, Italy
| | - Enrico Vizzardi
- Institute of Cardiology, Department of Medical and Surgical Specialities, Radiological Sciences, and Public Health, University of Brescia, Spedali Civili di Brescia Brescia, Italy
| | - Marco Metra
- Institute of Cardiology, Department of Medical and Surgical Specialities, Radiological Sciences, and Public Health, University of Brescia, Spedali Civili di Brescia Brescia, Italy
| |
Collapse
|