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Betancor Campos E, Drack F, Dave H, Neuhaus K. Management of a fusiform brachial artery aneurysm associated with birth trauma. BMJ Case Rep 2023; 16:e253814. [PMID: 37080635 PMCID: PMC10124224 DOI: 10.1136/bcr-2022-253814] [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: 04/22/2023] Open
Abstract
Brachial artery aneurysms in children are rare. Surgical treatment is generally recommended.We present the case of a female toddler with a pulsatile swelling on the medial aspect of the right upper arm without history of recent trauma. Medical history revealed a traumatic birth with labour arrest. Postnatally diffuse trunk and arm haematomas as well as a temporary right arm discolouration were detected. Preoperative ultrasound revealed a true brachial artery aneurysm. A full-body MRI ruled out any accompanying lesions. Primary resection and end-to-end anastomosis were performed. Recovery was uneventful. 6-month and 12-month follow-up showed normal motor function and arterial patency; ultrasound also demonstrated harmonious growth of the anastomosed vessel segments.No other publication has associated birth trauma with brachial artery aneurysm yet. Correct diagnosis and prompt curative surgery are key to prevent severe complications. Further reports and data on long-term outcome are needed to optimise clinical management.
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Affiliation(s)
- Eduardo Betancor Campos
- Pediatric Surgery, University Children's Hospital Zürich, Zürich, Switzerland
- Children's Research Center (CRC), Universitats-Kinderspital Zurich, Zürich, Switzerland
| | - Felicia Drack
- Children's Research Center (CRC), Universitats-Kinderspital Zurich, Zürich, Switzerland
- Department of Pediatrics, Division of Emergency Medicine, Universitats-Kinderspital Zurich, Zürich, Switzerland
| | - Hitendu Dave
- Children's Research Center (CRC), Universitats-Kinderspital Zurich, Zürich, Switzerland
- Department of Surgery, Division of Cardiovascular Surgery, Universitats-Kinderspital Zurich, Zürich, Switzerland
| | - Kathrin Neuhaus
- Children's Research Center (CRC), Universitats-Kinderspital Zurich, Zürich, Switzerland
- Department of Surgery, Division of Plastics and Reconstructive Surgery, Universitats-Kinderspital Zurich, Zürich, Switzerland
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Ohmura Y, Ishimori N, Saito A, Yokota T, Horii S, Tokuhara S, Iwabuchi K, Tsutsui H. Natural Killer T Cells Are Involved in Atherosclerotic Plaque Instability in Apolipoprotein-E Knockout Mice. Int J Mol Sci 2021; 22:ijms222212451. [PMID: 34830332 PMCID: PMC8618636 DOI: 10.3390/ijms222212451] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2021] [Revised: 11/15/2021] [Accepted: 11/16/2021] [Indexed: 12/15/2022] Open
Abstract
The infiltration and activation of macrophages as well as lymphocytes within atherosclerotic lesion contribute to the pathogenesis of plaque rupture. We have demonstrated that invariant natural killer T (iNKT) cells, a unique subset of T lymphocytes that recognize glycolipid antigens, play a crucial role in atherogenesis. However, it remained unclear whether iNKT cells are also involved in plaque instability. Apolipoprotein E (apoE) knockout mice were fed a standard diet (SD) or a high-fat diet (HFD) for 8 weeks. Moreover, the SD- and the HFD-fed mice were divided into two groups according to the intraperitoneal injection of α-galactosylceramide (αGC) that specifically activates iNKT cells or phosphate-buffered saline alone (PBS). ApoE/Jα18 double knockout mice, which lack iNKT cells, were also fed an SD or HFD. Plaque instability was assessed at the brachiocephalic artery by the histological analysis. In the HFD group, αGC significantly enhanced iNKT cell infiltration and exacerbated atherosclerotic plaque instability, whereas the depletion of iNKT cells attenuated plaque instability compared to PBS-treated mice. Real-time PCR analyses in the aortic tissues showed that αGC administration significantly increased expressional levels of inflammatory genes such as IFN-γ and MMP-2, while the depletion of iNKT cells attenuated these expression levels compared to those in the PBS-treated mice. Our findings suggested that iNKT cells are involved in the exacerbation of plaque instability via the activation of inflammatory cells and upregulation of MMP-2 in the vascular tissues.
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MESH Headings
- Animals
- Atherosclerosis/etiology
- Atherosclerosis/genetics
- Atherosclerosis/immunology
- Atherosclerosis/pathology
- Brachial Artery/immunology
- Brachial Artery/pathology
- Cell Movement/drug effects
- Diet, High-Fat/adverse effects
- Galactosylceramides/pharmacology
- Gene Expression Regulation
- Interferon-gamma/genetics
- Interferon-gamma/immunology
- Killer Cells, Natural/drug effects
- Killer Cells, Natural/immunology
- Killer Cells, Natural/pathology
- Lymphocyte Activation
- Macrophages/drug effects
- Macrophages/immunology
- Macrophages/pathology
- Male
- Matrix Metalloproteinase 2/genetics
- Matrix Metalloproteinase 2/immunology
- Mice
- Mice, Inbred C57BL
- Mice, Knockout, ApoE
- Plaque, Atherosclerotic/etiology
- Plaque, Atherosclerotic/genetics
- Plaque, Atherosclerotic/immunology
- Plaque, Atherosclerotic/pathology
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Affiliation(s)
- Yoshinori Ohmura
- Department of Cardiovascular Medicine, Hokkaido University Graduate School of Medicine, Kita-15 Nishi-7, Kita-ku, Sapporo 060-8638, Japan; (Y.O.); (A.S.); (T.Y.); (S.T.)
| | - Naoki Ishimori
- Department of Cardiovascular Medicine, Hokkaido University Graduate School of Medicine, Kita-15 Nishi-7, Kita-ku, Sapporo 060-8638, Japan; (Y.O.); (A.S.); (T.Y.); (S.T.)
- Correspondence: ; Tel.: +81-11-706-6973
| | - Akimichi Saito
- Department of Cardiovascular Medicine, Hokkaido University Graduate School of Medicine, Kita-15 Nishi-7, Kita-ku, Sapporo 060-8638, Japan; (Y.O.); (A.S.); (T.Y.); (S.T.)
| | - Takashi Yokota
- Department of Cardiovascular Medicine, Hokkaido University Graduate School of Medicine, Kita-15 Nishi-7, Kita-ku, Sapporo 060-8638, Japan; (Y.O.); (A.S.); (T.Y.); (S.T.)
| | - Shunpei Horii
- Department of Cardiovascular Medicine, National Defense Medical College, Namiki 3-2, Tokorozawa 359-0042, Japan;
| | - Satoshi Tokuhara
- Department of Cardiovascular Medicine, Hokkaido University Graduate School of Medicine, Kita-15 Nishi-7, Kita-ku, Sapporo 060-8638, Japan; (Y.O.); (A.S.); (T.Y.); (S.T.)
| | - Kazuya Iwabuchi
- Department of Immunology, Kitasato University School of Medicine, Kitasato 1-15-1, Minami-ku, Sagamihara 252-0374, Japan;
| | - Hiroyuki Tsutsui
- Department of Cardiovascular Medicine, Kyushu University Graduate School of Medicine, Maidashi 3-1-1, Higashi-ku, Fukuoka 812-8582, Japan;
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3
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Okada A, Murata T, Matin K, Ariyoshi M, Otsuka R, Yamashita M, Suzuki M, Wakiyama R, Tateno K, Suzuki M, Aoyagi H, Uematsu H, Imamura A, Kosaka M, Mizukaki T, Sato T, Kawahara H, Hanada N. Effect of advanced periodontal self-care in patients with early-stage periodontal diseases on endothelial function: An open-label, randomized controlled trial. PLoS One 2021; 16:e0257247. [PMID: 34555048 PMCID: PMC8459983 DOI: 10.1371/journal.pone.0257247] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Accepted: 08/17/2021] [Indexed: 01/10/2023] Open
Abstract
Although a significant association between periodontal disease and atherosclerotic cardiovascular disease has been reported, their cause-to-effect relationship remains controversial. This randomized controlled clinical trial aimed to investigate the effect of advanced self-care on atherosclerotic cardiovascular disease-related vascular function markers flow-mediated brachial artery dilatation (FMD) and serum asymmetric dimethylarginine (ADMA) level in patients with early-stage periodontal disease. The study was designed as a parallel group, 3-month follow-up, open-label, randomized controlled trial. The control group received standard care for periodontal diseases, whereas the test group additionally applied disinfectant using a custom-fabricated prescription tray for advanced self-care twice a day. Overall, 110 patients provided data for FMD and serum ADMA level. No significant improvements in FMD were observed in the control (mean increase, −0.1%; 95% confidence interval [CI], −1.0–0.8; P = 0.805) or test (mean increase, −0.3%; 95% CI, −1.1–0.4; P = 0.398) group. No significant changes in serum ADMA levels were observed (mean reduction, 0.01 μmol/L; 95% CI, −0.00–0.02; P = 0.366 and mean reduction, 0.00 μmol/L; 95% CI, −0.01–0.01; P = 0.349, respectively). No significant between-group differences were found in FMD (mean difference, −0.2%; 95% CI, −1.4–0.9; p = 0.708) or serum ADMA levels (mean difference, 0.01 nmol/L; 95% CI, −0.00–0.03; p = 0.122). Significant improvements in the average probing pocket depth were observed in the control and test groups. The bleeding on probing score in the test group was significantly reduced, while that in the control group was reduced, although not significantly. Periodontal care for a 3-month duration did not provide better endothelial function although improvements of periodontal status in patients with early-stage periodontal diseases. This trial is registered in UMIN Clinical Trials Registry (www.umin.ac.jp/ctr/; ID: UMIN000023395).
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Affiliation(s)
- Ayako Okada
- Department of Translational Research, Tsurumi University School of Dental Medicine, Yokohama, Japan
- Department of Operative Dentistry, Tsurumi University School of Dental Medicine, Yokohama, Japan
| | - Takatoshi Murata
- Department of Translational Research, Tsurumi University School of Dental Medicine, Yokohama, Japan
- * E-mail:
| | - Khairul Matin
- Endowed Department of International Oral Health Science, Tsurumi University School of Dental Medicine, Yokohama, Japan
- Division of Oral Health Sciences, Graduate School of Medical and Dental Sciences, Department of Cariology and Operative Dentistry, Tokyo Medical and Dental University, Tokyo, Japan
| | - Meu Ariyoshi
- Department of Translational Research, Tsurumi University School of Dental Medicine, Yokohama, Japan
- Division of Oral Health Sciences, Graduate School of Medical and Dental Sciences, Department of Cariology and Operative Dentistry, Tokyo Medical and Dental University, Tokyo, Japan
| | - Ryoko Otsuka
- Department of Translational Research, Tsurumi University School of Dental Medicine, Yokohama, Japan
| | - Mamiko Yamashita
- Department of Translational Research, Tsurumi University School of Dental Medicine, Yokohama, Japan
| | - Masayuki Suzuki
- Department of Dental Anesthesiology, Tsurumi University School of Dental Medicine, Yokohama, Japan
| | - Rumi Wakiyama
- Department of Dental Anesthesiology, Tsurumi University School of Dental Medicine, Yokohama, Japan
| | - Ken Tateno
- Department of Dental Anesthesiology, Tsurumi University School of Dental Medicine, Yokohama, Japan
- Department of Anesthesiology, Saitama Medical University Hospital, Iruma-gun, Japan
| | - Megumi Suzuki
- Department of Dental Hygiene, The Nippon Dental University College at Tokyo, Tokyo, Japan
| | | | | | | | - Miki Kosaka
- Department of Translational Research, Tsurumi University School of Dental Medicine, Yokohama, Japan
- Department of Dentistry, Tokyo Children Rehabilitation Hospital, Tokyo, Japan
| | - Tomoko Mizukaki
- Department of Oral and Maxillofacial Surgery, St. Marianna University School of Medicine Kawasaki Municipal Tama Hospital, Kawasaki, Japan
| | - Tsutomu Sato
- Division of Basic Medical Science, Tokai University School of Medicine, Isehara, Japan
- Louis Pasteur Center for Medical Research, Kyoto, Japan
| | - Hiroshi Kawahara
- Department of Dental Anesthesiology, Tsurumi University School of Dental Medicine, Yokohama, Japan
| | - Nobuhiro Hanada
- Department of Translational Research, Tsurumi University School of Dental Medicine, Yokohama, Japan
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Cavit A, Çapkın S, Yılmaz K, Kaleli T. Bilateral brachial artery infiltration by tumoral calcinosis: A case report. Acta Orthop Traumatol Turc 2021; 55:281-284. [PMID: 34100372 PMCID: PMC10566356 DOI: 10.5152/j.aott.2021.20376] [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: 11/02/2020] [Revised: 01/05/2021] [Accepted: 02/25/2021] [Indexed: 11/22/2022]
Abstract
We, herein, presented a rare case of bilateral brachial artery infiltration by tumoral calcinosis located on both elbows. A 58-yearold man presented with a history of painless, palpable solid mass restricting the range of motion of both elbows. These masses were located on the anterior aspect of the elbows and gradually enlarged. After clinical, laboratory and radiological examinations, tumoral calcinosis was suspected, and excisional biopsy was planned for a definite diagnosis. Surgery was first performed on the left elbow. The median nerve was found to be compressed but not infiltrated by the mass. Interestingly, the brachial artery was totally infiltrated throughout the entire mass. Occlusion was observed in the brachial artery located within the mass. The tumor on the left elbow, 8.5 × 5.5 × 2.5 cm in size, was totally excised with approximately 12-cm brachial artery segment. The artery was resected until the healthy tissue was reached. The defect was reconstructed with saphenous vein graft obtained from the ipsilateral lower extremity. The same surgical procedure was performed on the right elbow after 3 months. The tumor size on the right elbow was 7 × 3.5 × 1.7 cm. Approximately 15-cm brachial artery segment was excised, and the defect was reconstructed with saphenous vein graft. Tumoral calcinosis is a rare benign condition that can be located in close relationship with neurovascular structures. In such cases, detailed neurologic and vascular examination, including imaging modalities, for arterial flow is essential to establish a more accurate surgical plan and avoid any unexpected situation during surgery.
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Affiliation(s)
- Ali Cavit
- Department of Orthopaedics and Traumatology, Hand Surgery, İstanbul Haydarpasa Numune Training and Research Hospital, İstanbul,
Turkey
| | - Sercan Çapkın
- Department of Orthopaedics and Traumatology, Aksaray University, School of Medicine, Aksaray,
Turkey
| | - Kutay Yılmaz
- Department of Orthopaedics and Traumatology, Clinic of Hand Surgery, Uludağ University, School of Medicine, Bursa,
Turkey
| | - Tufan Kaleli
- Department of Orthopaedics and Traumatology, Clinic of Hand Surgery, Uludağ University, School of Medicine, Bursa,
Turkey
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5
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Denton CC, Shah P, Suriany S, Liu H, Thuptimdang W, Sunwoo J, Chalacheva P, Veluswamy S, Kato R, Wood JC, Detterich JA, Khoo MCK, Coates TD. Loss of alpha-globin genes in human subjects is associated with improved nitric oxide-mediated vascular perfusion. Am J Hematol 2021; 96:277-281. [PMID: 33247606 PMCID: PMC10653668 DOI: 10.1002/ajh.26058] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2020] [Accepted: 11/23/2020] [Indexed: 01/19/2023]
Abstract
Alpha thalassemia is a hemoglobinopathy due to decreased production of the α-globin protein from loss of up to four α-globin genes, with one or two missing in the trait phenotype. Individuals with sickle cell disease who co-inherit the loss of one or two α-globin genes have been known to have reduced risk of morbid outcomes, but the underlying mechanism is unknown. While α-globin gene deletions affect sickle red cell deformability, the α-globin genes and protein are also present in the endothelial wall of human arterioles and participate in nitric oxide scavenging during vasoconstriction. Decreased production of α-globin due to α-thalassemia trait may thereby limit nitric oxide scavenging and promote vasodilation. To evaluate this potential mechanism, we performed flow-mediated dilation and microvascular post-occlusive reactive hyperemia in 27 human subjects (15 missing one or two α-globin genes and 12 healthy controls). Flow-mediated dilation was significantly higher in subjects with α-trait after controlling for age (P = .0357), but microvascular perfusion was not different between groups. As none of the subjects had anemia or hemolysis, the improvement in vascular function could be attributed to the difference in α-globin gene status. This may explain the beneficial effect of α-globin gene loss in sickle cell disease and suggests that α-globin gene status may play a role in other vascular diseases.
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Affiliation(s)
- Christopher C. Denton
- Division of Hematology/Oncology, Department of Pediatrics, Childrenʼs Hospital Los Angeles, Los Angeles, California
| | - Payal Shah
- Division of General Pediatrics, Childrenʼs Hospital Los Angeles, Los Angeles, California
| | - Silvie Suriany
- Division of Cardiology, Department of Pediatrics, Children’s Hospital Los Angeles, Los Angeles, California
| | - Honglei Liu
- Division of Cardiology, Department of Pediatrics, Children’s Hospital Los Angeles, Los Angeles, California
| | - Wanwara Thuptimdang
- Department of Biomedical Engineering, University of Southern California, Los Angeles, California
| | - John Sunwoo
- Department of Biomedical Engineering, University of Southern California, Los Angeles, California
| | - Patjanaporn Chalacheva
- Department of Biomedical Engineering, University of Southern California, Los Angeles, California
| | - Saranya Veluswamy
- Division of Hematology/Oncology, Department of Pediatrics, Childrenʼs Hospital Los Angeles, Los Angeles, California
| | - Roberta Kato
- Division of Pulmonology, Department of Pediatrics, Children’s Hospital Los Angeles, Los Angeles, California
| | - John C. Wood
- Division of Cardiology, Department of Pediatrics, Children’s Hospital Los Angeles, Los Angeles, California
| | - Jon A. Detterich
- Division of Cardiology, Department of Pediatrics, Children’s Hospital Los Angeles, Los Angeles, California
| | - Michael C. K. Khoo
- Department of Biomedical Engineering, University of Southern California, Los Angeles, California
| | - Thomas D. Coates
- Division of Hematology/Oncology, Department of Pediatrics, Childrenʼs Hospital Los Angeles, Los Angeles, California
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6
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Newman AAC, Serbulea V, Baylis RA, Shankman LS, Bradley X, Alencar GF, Owsiany K, Deaton RA, Karnewar S, Shamsuzzaman S, Salamon A, Reddy MS, Guo L, Finn A, Virmani R, Cherepanova OA, Owens GK. Multiple cell types contribute to the atherosclerotic lesion fibrous cap by PDGFRβ and bioenergetic mechanisms. Nat Metab 2021; 3:166-181. [PMID: 33619382 PMCID: PMC7905710 DOI: 10.1038/s42255-020-00338-8] [Citation(s) in RCA: 74] [Impact Index Per Article: 24.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Accepted: 12/22/2020] [Indexed: 01/03/2023]
Abstract
Stable atherosclerotic plaques are characterized by a thick, extracellular matrix-rich fibrous cap populated by protective ACTA2+ myofibroblast (MF)-like cells, assumed to be almost exclusively derived from smooth muscle cells (SMCs). Herein, we show that in murine and human lesions, 20% to 40% of ACTA2+ fibrous cap cells, respectively, are derived from non-SMC sources, including endothelial cells (ECs) or macrophages that have undergone an endothelial-to-mesenchymal transition (EndoMT) or a macrophage-to-mesenchymal transition (MMT). In addition, we show that SMC-specific knockout of the Pdgfrb gene, which encodes platelet-derived growth factor receptor beta (PDGFRβ), in Apoe-/- mice fed a Western diet for 18 weeks resulted in brachiocephalic artery lesions nearly devoid of SMCs but with no changes in lesion size, remodelling or indices of stability, including the percentage of ACTA2+ fibrous cap cells. However, prolonged Western diet feeding of SMC Pdgfrb-knockout mice resulted in reduced indices of stability, indicating that EndoMT- and MMT-derived MFs cannot compensate indefinitely for loss of SMC-derived MFs. Using single-cell and bulk RNA-sequencing analyses of the brachiocephalic artery region and in vitro models, we provide evidence that SMC-to-MF transitions are induced by PDGF and transforming growth factor-β and dependent on aerobic glycolysis, while EndoMT is induced by interleukin-1β and transforming growth factor-β. Together, we provide evidence that the ACTA2+ fibrous cap originates from a tapestry of cell types, which transition to an MF-like state through distinct signalling pathways that are either dependent on or associated with extensive metabolic reprogramming.
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Affiliation(s)
- Alexandra A C Newman
- Robert M. Berne Cardiovascular Research Center, University of Virginia School of Medicine, Charlottesville, VA, USA
- Cardiovascular Research Center, New York University Langone Medical Center, NY, New York, USA
- Department of Biochemistry and Molecular Genetics, University of Virginia School of Medicine, Charlottesville, VA, USA
| | - Vlad Serbulea
- Robert M. Berne Cardiovascular Research Center, University of Virginia School of Medicine, Charlottesville, VA, USA
| | - Richard A Baylis
- Robert M. Berne Cardiovascular Research Center, University of Virginia School of Medicine, Charlottesville, VA, USA
- Department of Biochemistry and Molecular Genetics, University of Virginia School of Medicine, Charlottesville, VA, USA
| | - Laura S Shankman
- Robert M. Berne Cardiovascular Research Center, University of Virginia School of Medicine, Charlottesville, VA, USA
| | - Xenia Bradley
- Robert M. Berne Cardiovascular Research Center, University of Virginia School of Medicine, Charlottesville, VA, USA
| | - Gabriel F Alencar
- Robert M. Berne Cardiovascular Research Center, University of Virginia School of Medicine, Charlottesville, VA, USA
- Department of Biochemistry and Molecular Genetics, University of Virginia School of Medicine, Charlottesville, VA, USA
| | - Katherine Owsiany
- Robert M. Berne Cardiovascular Research Center, University of Virginia School of Medicine, Charlottesville, VA, USA
- Department of Biochemistry and Molecular Genetics, University of Virginia School of Medicine, Charlottesville, VA, USA
| | - Rebecca A Deaton
- Robert M. Berne Cardiovascular Research Center, University of Virginia School of Medicine, Charlottesville, VA, USA
| | - Santosh Karnewar
- Robert M. Berne Cardiovascular Research Center, University of Virginia School of Medicine, Charlottesville, VA, USA
| | - Sohel Shamsuzzaman
- Robert M. Berne Cardiovascular Research Center, University of Virginia School of Medicine, Charlottesville, VA, USA
| | - Anita Salamon
- Robert M. Berne Cardiovascular Research Center, University of Virginia School of Medicine, Charlottesville, VA, USA
- Department of Biochemistry and Molecular Genetics, University of Virginia School of Medicine, Charlottesville, VA, USA
| | - Mahima S Reddy
- Robert M. Berne Cardiovascular Research Center, University of Virginia School of Medicine, Charlottesville, VA, USA
| | - Liang Guo
- CVPath Institute, Gaithersburg, MD, USA
| | | | | | - Olga A Cherepanova
- Robert M. Berne Cardiovascular Research Center, University of Virginia School of Medicine, Charlottesville, VA, USA
- Cardiovascular and Metabolic Sciences Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Gary K Owens
- Robert M. Berne Cardiovascular Research Center, University of Virginia School of Medicine, Charlottesville, VA, USA.
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El-Nahas NG, Badawy MM. Isometric Versus Aerobic Training Effects on Vascular Adaptation in Patients with Type 2 Diabetes. Pak J Biol Sci 2020; 22:400-405. [PMID: 31930828 DOI: 10.3923/pjbs.2019.400.405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND AND OBJECTIVE Diabetes is known to be associated with arterial remodeling and dysfunction which predispose to different microvascular complications. This study was aimed to find out the effect of isometric versus aerobic training on vascular adaptation in patients with type 2 diabetes. MATERIALS AND METHODS The study was carried out on 40 type 2 diabetic patients (20 men and 20 women). Patients were selected from the outpatient clinic of El-Agouza Police Authority Hospital. They were assigned into 2 matched and equal groups in number. Group A with mean age of 49.55 years, received unilateral isometric handgrip exercise 22 min per session, 3 sessions per week for 8 weeks and group B with mean age 50.15 years, received aerobic exercise in form of arm ergometry for 30 min, 3 sessions per week for 8 weeks. They were assessed by a Doppler ultrasound for brachial artery adaptation (the brachial artery diameter, blood velocity and shear rate) before and after 8 weeks of training. RESULTS Group A showed significant improvement in brachial artery adaptation as increased brachial artery diameter from 4.28±0.19 to 4.43±0.18, baseline vessel velocity from 7.09±0.41 to 8.62±0.46 and its shear rate from 66.24±4.19 to 77.65±5.27, while in group B who received the aerobic exercise the results showed a minimal change between pre training and post-training results 4.24±0.23 to 4.26±0.21 for brachial artery diameter, 7.26±0.54 to 7.46±0.67 for blood velocity and 67.8±3.16 to 68.81±4.29 for shear rate respectively. CONCLUSION Isometric handgrip exercise improved brachial artery diameter, blood velocity and shear rate in patients with type 2 diabetes.
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Nattero-Chávez L, Redondo López S, Alonso Díaz S, Garnica Ureña M, Fernández-Durán E, Escobar-Morreale HF, Luque-Ramírez M. The peripheral atherosclerotic profile in patients with type 1 diabetes warrants a thorough vascular assessment of asymptomatic patients. Diabetes Metab Res Rev 2019; 35:e3088. [PMID: 30338903 DOI: 10.1002/dmrr.3088] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2018] [Revised: 10/12/2018] [Accepted: 10/15/2018] [Indexed: 01/22/2023]
Abstract
AIMS Epidemiological data on subclinical atherosclerotic disease in type 1 diabetes mellitus (DM1) are scarce. We aimed to estimate the subclinical atherosclerosis profile of asymptomatic patients with DM1 and an abnormal ankle-brachial index (ABI). MATERIAL AND METHODS In a cross-sectional design (ClinicalTrials.gov Identifier: NCT02910271), we estimated ABI in 289 consecutive asymptomatic patients with DM1. An abnormal ABI led to measurements of toe-brachial index (TBI) and peripheral doppler ultrasound (DUS) to diagnose peripheral artery disease (PAD) and/or atherosclerotic carotid plaques (ACP). RESULTS A reduced (≤0.9) or increased (>1.2) ABI was detected in 17 (6%) and 75 (26%) patients, respectively. PAD was confirmed by TBI and DUS in 9 (53%) patients with a reduced ABI and 28 (37%) patients with an increased ABI, resulting in a 12.8% (9.4-17.2) prevalence of asymptomatic PAD. Fourteen patients with an abnormal ABI also exhibited ACP [4.8% (2.9-7.9)], with 64% of these patients showing bilateral disease. Artery stenosis was mild or moderate in 21% and 29% of patients, respectively. Thus, 46 [16% (12-21)] patients showed asymptomatic PAD, ACP, or both. According to our data, we would have to explore three asymptomatic patients with DM1 and normal pulses to unmask one case of PAD, and seven asymptomatic patients showing abnormal ABI values to detect one carotid disease. CONCLUSIONS Peripheral artery disease is often undiagnosed in asymptomatic patients with DM1. However, its presence may change medical management in a substantial percentage of cases, highlighting the potential benefit of a thorough vascular assessment on these patients.
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Affiliation(s)
- Lía Nattero-Chávez
- Department of Endocrinology and Nutrition, Hospital Universitario Ramón y Cajal, Madrid, Spain
- Diabetes, Obesity and Human Reproduction Research Group, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), CIBER Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Spain
| | - Sandra Redondo López
- Department of Vascular Surgery, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - Sara Alonso Díaz
- Department of Endocrinology and Nutrition, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - Marta Garnica Ureña
- Department of Vascular Surgery, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - Elena Fernández-Durán
- Diabetes, Obesity and Human Reproduction Research Group, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), CIBER Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Spain
| | - Héctor F Escobar-Morreale
- Department of Endocrinology and Nutrition, Hospital Universitario Ramón y Cajal, Madrid, Spain
- Diabetes, Obesity and Human Reproduction Research Group, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), CIBER Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Spain
- University of Alcalá, Spain
| | - Manuel Luque-Ramírez
- Department of Endocrinology and Nutrition, Hospital Universitario Ramón y Cajal, Madrid, Spain
- Diabetes, Obesity and Human Reproduction Research Group, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), CIBER Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Spain
- University of Alcalá, Spain
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9
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Troitskaya EA, Velmakin SV, Villevalde SV, Kobalava ZD. [Characteristics and clinical associations of arterial stiffness and subclinical atherosclerosis in patients with rheumatoid arthritis]. Kardiologiia 2019; 58:46-54. [PMID: 30081802] [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] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
UNLABELLED Te aim of the study was to evaluate parameters of arterial stiffness (AS) (carotid-femoral pulse wave velocity (cf PWV), central pulse pressure (PP), cardio-ankle vascular index (CAVI) and stiffness gradient between aorta and brachial artery) and subclinical atherosclerosis (carotid intima-media thickness (CIMT) and ankle-brachial index (ABI)) according to inflammatory activity in patients with R. MATERIALS AND METHODS 85 patients with R (EULAR/ACR 2010) were examined (age 59,7±14,3 years, 64,7% with arterial hypertension (AH). Median duration of R was 7 years. PWV and central pulse wave were assessed by applanation tonometry. Arterial stiffness gradient was calculated as a ratio between carotid-femoral and carotid-radial PWV: its elevation ≥1 was considered as arterial stiffness mismatch. ABI and CAVI were measured by sphygmometry. CIMT was assessed according to the standard protocol, CIMT≥0,9 mm was considered as a subclinical marker of atherosclerosis. p.
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Affiliation(s)
- E A Troitskaya
- Federal State Autonomous Educational Institution of Higher Education, "Peoples' Friendship University of Russia"
| | - S V Velmakin
- Federal State Autonomous Educational Institution of Higher Education, "Peoples' Friendship University of Russia"
| | - S V Villevalde
- Federal State Autonomous Educational Institution of Higher Education, "Peoples' Friendship University of Russia"
| | - Z D Kobalava
- Federal State Autonomous Educational Institution of Higher Education, "Peoples' Friendship University of Russia"
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10
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Seker M, Isen HC, Çevirme N, Aydın S, Bilici A, Bulut H, Yasin AI, Coban E, Demir T, Aliyev A, Kocyigit A, Turk HM. Role of Urotensin-2 in 5-Fluorouracil-Related Arterial Vasoconstriction in Cancer Patients. Oncol Res Treat 2018; 41:545-549. [PMID: 30121640 DOI: 10.1159/000490120] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2018] [Accepted: 05/16/2018] [Indexed: 12/29/2022]
Abstract
BACKGROUND The aim of this study was to identify the possible relationship of 5-fluorouracil (5-FU)-related arterial vasoconstriction with urotensin-2 (UT-2), which has a high potential as an endogenic vasoconstrictor. METHODS We assigned the patients to 1 of 3 groups. Patients in group 1 received a bolus of 5-FU, those in group 2 a continuous infusion (CI) of 5-FU, and those in group 3 no 5-FU, which was also a control group. Pre- and post-treatment UT-2 levels and brachial arterial diameters were measured and recorded in all patients. RESULTS 132 patients were included in the study. Pre- and post-treatment brachial artery diameters were similar in all groups: in group 1 (3.28 ± 0.52 vs. 3.25 ± 0.44 mm, p = 0.740), in group 2 (3.57 ± 0.47 vs. 3.46 ± 0.45 mm, p = 0.441) and in the control group (3.51 ± 0.52 vs. 3.25 ± 0.44 mm, p = 0.818). Pre- and post-treatment UT-2 levels were significantly different in each group: in group 1 (39.5 ± 30.9 vs. 56.7 ± 27.1 ng/ml, p = 0.0001), in group 2 (37.7 ± 33.7 vs. 62.5 ± 37.7 ng/ml, p = 0.0001) and in the control group (52.9 ± 40.2 vs. 60.8 ± 40.7 ng/ml, p = 0.006). CONCLUSION Our findings suggest that UT-2 has a high potential as a vasoconstrictor agent in our bodies and its level increases through a bolus or CI 5-FU. Increased UT-2 levels are likely to play a role in 5-FU-related cardiac toxicity pathogenesis.
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11
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Gülşen F, Samanci C, Memis Durmaz ES, Durmaz E, Tel C, Gencturk M, Ağırman A. Brachial Artery Wall Stiffness Assessment by Shear Wave Elastography: A Promising New Diagnostic Tool for Endothelial Dysfunction Detection. J Ultrasound Med 2018; 37:1977-1983. [PMID: 29363817 DOI: 10.1002/jum.14548] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/14/2017] [Revised: 10/21/2017] [Accepted: 10/30/2017] [Indexed: 06/07/2023]
Abstract
OBJECTIVES This study was designed to measure the changes in brachial artery wall stiffness by shear wave elastography (SWE) and evaluate the accuracy of SWE changes for detection of endothelial dysfunction. METHODS Sixty-five consecutive participants (19 patients with atherosclerosis proven by coronary angiography, 16 healthy young adults, 15 patients with cardiovascular risk factors, and 15 healthy older adults between 50 and 60 years) were prospectively included in this study. They were examined in the same week by SWE, and flow-mediated dilatation was evaluated for each patient. RESULTS The mean flow-mediated dilatation values ± 2 SDs after forearm occlusion were 8.54% ± 1.4% in healthy young adults, 7.61% ± 1.4% in healthy older adults, 5.83% ± 0.7% in patients with risk factors (P < .001), and 3.81% ± 2.4% in patients with atherosclerosis (P < .001, with respect to the risk factor group). There was a significant decrease in stiffness measurements in parallel with the increase in flow-mediated dilatation: 19.9% ± 6.3% in healthy young adults, 16.3% ± 5.1% in healthy older adults, 9.8% ± 5.4% in patients with risk factors (P < .05 with respect to the group with no risk factors), and 7.8% ± 6.4% in patients with atherosclerosis (P < .001 with respect to the healthy older adults). CONCLUSIONS Shear wave elastography in combination with flow-mediated dilatation could be a promising, widely available noninvasive diagnostic tool for detecting endothelial dysfunction.
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Affiliation(s)
- Fatih Gülşen
- Departments of Radiology, Istanbul University, Cerrahpasa Faculty of Medicine, Istanbul, Turkey
| | - Cesur Samanci
- Departments of Radiology, Istanbul University, Cerrahpasa Faculty of Medicine, Istanbul, Turkey
| | | | - Eser Durmaz
- Departments of Cardiology, Istanbul University, Cerrahpasa Faculty of Medicine, Istanbul, Turkey
| | - Cigdem Tel
- Departments of Cardiovascular surgery, Istanbul University, Cerrahpasa Faculty of Medicine, Istanbul, Turkey
| | - Mert Gencturk
- Department of Radiology, Yedikule Surp Pırgiç Armenian Hospital, Istanbul, Turkey
| | - Aysegul Ağırman
- Department of Radiology, Yedikule Surp Pırgiç Armenian Hospital, Istanbul, Turkey
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12
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Lebedeva AM, Mariukhnich EV, Grievel ZS, Nikitskaya EA, Albakova TM, Albakova RM, Ryzhkova EV, Shpektor AV, Margolis LB, Vasilieva EY. [Cytomegalovirus Infection and Endothelial Function in Patients With Acute Myocardial Infarction]. Kardiologiia 2018; 58:41-52. [PMID: 30081808] [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] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
PURPOSE to study elucidate association of active cytomegalovirus (CMV) infection with endothelial dysfunction in patients with acute myocardial infarction (AMI). MATERIALS AND METHODS The study included 42 volunteers without ischemic heart disease (IHD) and 63 patients with AMI. Blood samples for analysis of the deoxyribonucleic acid (DNA) of CMV in plasma by real-time polymerase chain reaction were taken in patients - before coronary angiography, in volunteers - at admission. In addition, in patients with AMI and volunteers without IHD, endothelial function was analyzed using endothelium-dependent vasodilatation (EDVD) test of the brachial artery. RESULTS We showed that in patients with AMI, the concentration of CMV DNA in plasma was statistically significantly increased when compared with that in volunteers without IHD, which reflects active CMV infection - 1185.7 (0; 3003.0) vs. 0 (0; 910.8) copies of DNA / ml plasma (p=0.011). In comparison with volunteers without IHD, patients with AMI also more often had endothelial dysfunction - 11.5 (7.5, 15.2) % vs. 4.4 (0; 9.6) % of cases (p.
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Affiliation(s)
- A M Lebedeva
- Federal State Budgetary Educational Institution of Higher Education, "A. I. Evdokimov Moscow State University for Medicine and Dentistry" of the Ministry of Health of the Russian Federation
| | - E V Mariukhnich
- Federal State Budgetary Educational Institution of Higher Education, "A. I. Evdokimov Moscow State University for Medicine and Dentistry" of the Ministry of Health of the Russian Federation
| | - Z S Grievel
- Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda
| | - E A Nikitskaya
- Federal State Budgetary Educational Institution of Higher Education, "A. I. Evdokimov Moscow State University for Medicine and Dentistry" of the Ministry of Health of the Russian Federation
| | - T M Albakova
- Federal State Budgetary Educational Institution of Higher Education, "A. I. Evdokimov Moscow State University for Medicine and Dentistry" of the Ministry of Health of the Russian Federation
| | - R M Albakova
- Federal State Budgetary Educational Institution of Higher Education, "A. I. Evdokimov Moscow State University for Medicine and Dentistry" of the Ministry of Health of the Russian Federation
| | - E V Ryzhkova
- Federal State Budgetary Educational Institution of Higher Education, "A. I. Evdokimov Moscow State University for Medicine and Dentistry" of the Ministry of Health of the Russian Federation
| | - A V Shpektor
- Federal State Budgetary Educational Institution of Higher Education, "A. I. Evdokimov Moscow State University for Medicine and Dentistry" of the Ministry of Health of the Russian Federation
| | - L B Margolis
- Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda
| | - E Y Vasilieva
- Federal State Budgetary Educational Institution of Higher Education, "A. I. Evdokimov Moscow State University for Medicine and Dentistry" of the Ministry of Health of the Russian Federation
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Karakaya P, Ozdemir B, Mert M, Okuturlar Y. Relation of Paraoxonase 1 Activity with Biochemical Variables, Brachial Artery Intima-Media Thickness in Patients with Diabetes with or without Obesity. Obes Facts 2018; 11:56-66. [PMID: 29439274 PMCID: PMC5869602 DOI: 10.1159/000486513] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2017] [Accepted: 12/21/2017] [Indexed: 01/31/2023] Open
Abstract
AIM The sodium-sparing effect of insulin leads to increase in total sodium pool of the body which is a chronic stimulus for atrial natriuretic peptide (ANP). In our study we aimed to determine the relationship between ANP and microvascular complications of diabetes. METHODS 60 patients, 30-70 years old, with the diagnosis of type 2 diabetes mellitus (DM) are enrolled into the study. Patients with a chronic disease other than DM are excluded. Blood samples for routine biochemical tests are taken after at least 12 h fasting at 8-9 am. Blood samples for glucose and insulin levels are taken 2 h after a standard meal. Blood tubes with EDTA are used for ANP levels. The microvascular complications of the patients are evaluated. RESULTS 32 of the patients had microvascular complications. Age, BMI, waist and hip circumferences, and ANP levels were significantly higher in the group with microvascular complications. There were no significant differences in waist-to-hip ratio, blood glucose, HbA1c, fasting insulin, postprandial insulin, fasting HOMA, postprandial HOMA as well as sodium, potassium, magnesium, calcium and lipid levels between the two groups. When the relationship between ANP and obesity, retinopathy, neuropathy, nephropathy, diabetes time, HbA1c, or sex are evaluated separately, the only significant parameters related to ANP were obesity and retinopathy. CONCLUSION In our study we have found that there was a significant relationship between ANP levels and microvascular complications of diabetes. Future studies are needed to show if ANP is the stimulus of microvascular complication development/progression or only an epiphenomenon.
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Affiliation(s)
- Pinar Karakaya
- *Pinar Karakaya, Department of Endocrinology and Metabolism, Bakırköy Dr. Sadi Konuk Training and Research Hospital, 34100 Istanbul, Turkey,
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Correia M, Marinho A, Mendes C, Antunes L, Gonçalves Ó. True Brachial Artery Aneurysm in a Patient with Vascular Access for Haemodialysis and Kidney Graft. Rev Port Cir Cardiotorac Vasc 2017; 24:184. [PMID: 29701413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Received: 07/18/2017] [Indexed: 06/08/2023]
Abstract
INTRODUCTION True brachial artery aneurysms are rare and some of them have been described as a late complication in patients with vascular access for haemodialysis and kidney graft. The purpose of this paper is to present a clinical case of a patient with a true brachial artery aneurysm and its following treatment. METHODS This case concerns a caucasian male patient with 43 years old who had vesicoureteral reflux at 7 years old, and subsequent end-stage renal disease, and started on haemodialysis at the age of twelve. The patient had homolateral radial and brachiocephalic arteriovenous fistulas (AVF), two sequential kidney grafts and was under immunosuppressant therapy for several years. As part of the medical history he also had bilateral amaurosis, Hepatitis B and C and was submitted to total parathyroidectomy and a following auto-transplant. In the latest years the patient presented with several aneurysms related to the vascular access. After the finding of an anastomotic false aneurysm and venous aneurysms complicating the AVF, the patient had removal of the aneurysms and ligation of the AVF. Later, he was diagnosed, in different times, with two true brachial artery aneurysms. At the time of the diagnosis of the first true aneurysm, the patient presented with local pain and occasional paraesthesias relative to compression symptoms. At physical examination the patient had a brachial pulsatile mass and a palpable radial pulse. The Doppler ultrasound exam revealed a true brachial artery aneurysm with 4,5 cm diameter. After two years, the patient was once again diagnosed with a true brachial artery aneurysm with 3,1 cm diameter. At this time the patient was asymptomatic and had palpable brachial mass and radial pulse. RESULTS At the time of the diagnosis of the first true brachial aneurysm the patient was submitted to partial aneurysmectomy and brachiobrachial graft with PTFE 8. The patency of the graft persisted until the diagnosis of the second aneurysm. After two years, the patient was submitted to partial aneurysmectomy and axilobrachial graft with PTFE 8. During the follow-up period, the patient remained asymptomatic, had palpable radial pulse and the Doppler ultrasound exam confirmed the patency of the graft. CONCLUSION The surveillance of patients with long duration AVF and kidney grafts might be advantageous in the early detection of arterial aneurysms. The surgical treatment in this group of patients is a first treatment option that is associated to a low morbidity.
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Affiliation(s)
- Mafalda Correia
- Serviço de Angiologia e Cirurgia Vascular do Centro Hospitalar e Universitário de Coimbra, Portugal
| | - André Marinho
- Serviço de Angiologia e Cirurgia Vascular do Centro Hospitalar e Universitário de Coimbra, Portugal
| | - Carolina Mendes
- Serviço de Angiologia e Cirurgia Vascular do Centro Hospitalar e Universitário de Coimbra, Portugal
| | - Luís Antunes
- Serviço de Angiologia e Cirurgia Vascular do Centro Hospitalar e Universitário de Coimbra, Portugal
| | - Óscar Gonçalves
- Serviço de Angiologia e Cirurgia Vascular do Centro Hospitalar e Universitário de Coimbra, Portugal
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Soares T, Castro-Ferreira R, Rocha Neves J, Neto M, Sousa J, Pinto JP, Gamas L, Cerqueira A, Sampaio S, Teixeira JF. True Brachial Artery Aneurysm after Arteriovenous Fistula for Hemodialysis - Case Report. Rev Port Cir Cardiotorac Vasc 2017; 24:182. [PMID: 29701411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Received: 07/18/2017] [Indexed: 06/08/2023]
Abstract
INTRODUCTION Brachial artery aneurysms are relatively uncommon and generally due to infectious, post-traumatic or iatrogenic etiology. They seem to affect 4.5% of arteriovenous fistula. The usual manifestation is an accidental finding of a pulsatile, painless, and asymptomatic mass. Complications include sac thrombosis, thromboembolic ischaemic events, and disruption with profuse bleeding. METHODS The aim of this study is to present a case of true brachial artery aneurysm in end-stage renal disease patient after arteriovenous fistula creation. RESULTS Sixty-six-year-old men with a past medical history of hypertension, dyslipidemia, smoking and poliquistic renal disease. He started a hemodialysis program in March 2006, using a brachiocephalic fistula on the left upper limb, built in February 2005. Submitted to kidney transplant in June 2010 and subsequent fistula ligation in December 2012. He goes to the emergency service in June 2016 with a pulsatile mass on the medial aspect of the left arm. Pain, redness and heat were present. Radial pulse was palpable. Inflammatory parameters were high and ultrasound revealed a fusiform aneurysm of the brachial artery with partial thrombosis and triphasic flow. An MRI was performed, documenting a brachial artery aneurysm, with 44mm greatest diameter and an extension of 17.5cm. Patient was hospitalized under antibiotic therapy and submitted to a reversed great saphenous vein interposition graft. Discharge from hospital occurred on the 7th postoperative day, with no sensitive or motor deficits and a present radial pulse. CONCLUSION Arterial aneurysm is a rare, but significant complication long after the creation of a hemodialysis access. High flow, immunosuppression and increased resistance following ligation of the AV fistula may accelerate this process.
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Hall MH, Mulukutla S, Kline CE, Samuelsson LB, Taylor BJ, Thayer JF, Krafty RT, Frank E, Kupfer DJ. Objective Sleep Duration Is Prospectively Associated With Endothelial Health. Sleep 2017; 40:2845957. [PMID: 28364470 PMCID: PMC6084747 DOI: 10.1093/sleep/zsw003] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [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] [Accepted: 01/03/2017] [Indexed: 01/25/2023] Open
Abstract
Study Objectives The mechanisms linking short sleep duration to cardiovascular disease (CVD) are poorly understood. Emerging evidence suggests that endothelial dysregulation may lie along the causal pathway linking sleep duration to cardiovascular risk, although current evidence in humans is based on cross-sectional studies. Our objective was to evaluate the prospective association between objectively assessed sleep duration and clinical indices of endothelial health. Methods A total of 141 medically healthy adults underwent an overnight laboratory sleep study when they were between the ages of 21 and 60 years. Total sleep time was objectively assessed by polysomnography at study entry. Endothelial health, including brachial artery diameter (BAD) and flow-mediated dilation (FMD), was measured 18.9 ± 4.6 years later. Medical health and psychiatric status were assessed at both time points. Approximately half of the sample had a lifetime history of major depressive disorder. Results In univariate analyses, shorter sleep duration was associated with increased BAD (β = -0.24, p = .004) and decreased FMD (β = 0.17, p = .042). BAD, but not FMD, remained significantly associated with sleep duration after adjusting for sex, age, body mass index (BMI), smoking, diabetes, hypertension, and lifetime history of major depressive disorder (MDD) at T2. The association between sleep duration and BAD was stronger than the association between BAD and an aggregate measure of CVD risk including three or more of the following risk factors: male sex, age ≥ 65 years, smoker, BMI ≥ 30, diabetes, hypertension, and MDD. Conclusions Objectively assessed short sleep duration was prospectively associated with increased BAD over a 12- to 30-year period.
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Affiliation(s)
- Martica H Hall
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - Suresh Mulukutla
- Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - Christopher E Kline
- Department of Health and Physical Activity, University of Pittsburgh, Pittsburgh, PA
| | | | - Briana J Taylor
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA
| | - Julian F Thayer
- Department of Psychology, Ohio State University, Columbus, OH
| | - Robert T Krafty
- Department of Biostatistics, University of Pittsburgh School of Public Health, Pittsburgh, PA
| | - Ellen Frank
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - David J Kupfer
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA
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Yagi H, Sumino H, Aoki T, Tsunekawa K, Araki O, Kimura T, Nara M, Ogiwara T, Murakami M. Impaired blood rheology is associated with endothelial dysfunction in patients with coronary risk factors. Clin Hemorheol Microcirc 2016; 62:139-50. [PMID: 26444592 PMCID: PMC4927888 DOI: 10.3233/ch-151960] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
To investigate the relationship between blood rheology and endothelial function in patients with coronary risk factors, brachial arterial flow-mediated vasodilatation (FMD), an index of endothelial function and blood passage time (BPT), an index of blood rheology, and fasting blood cell count, glucose metabolism, and plasma fibrinogen, lipid, C-reactive protein, and whole blood viscosity levels were measured in 95 patients with coronary risk factors and 37 healthy controls. Brachial arterial FMD after reactive hyperemia was assessed by ultrasonography. BPT was assessed using the microchannel method. In healthy controls, BPT significantly correlated with FMD (r = - 0.325, p < 0.05), HDL cholesterol (r = - 0.393, p < 0.05), body mass index (BMI; r = 0.530, p < 0.01), and plasma fibrinogen concentration (r = 0.335, p < 0.05). In a multivariate regression analysis adjusted for all clinical variables, BPT remained significantly associated with BMI and fibrinogen, but not with FMD, in healthy controls. In patients with coronary risk factors, BPT significantly correlated with FMD (r = - 0.331, p < 0.01), HDL cholesterol (r = - 0.241, p < 0.05), BMI (r = 0.290, p < 0.01), hematocrit (r = 0.422, p < 0.001), white blood cell count (r = 0.295, p < 0.01), platelet count (r = 0.204, p < 0.05), and insulin (r = 0.210, p < 0.05). In a multivariate regression analysis adjusted for all clinical variables, BPT remained strongly associated with FMD and hematocrit in patients with coronary risk factors. These data indicate that BPT is closely associated with FMD in patients with coronary risk factors and suggest that the measurement of blood rheology using the microchannel method may be useful in evaluating brachial arterial endothelial function as a marker of atherosclerosis in these patients.
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Affiliation(s)
| | - Hiroyuki Sumino
- Corresponding author: Hiroyuki Sumino, MD, Department of Clinical Laboratory Medicine, Gunma University Graduate School of Medicine, 3-39-15 Showa-machi, Maebashi, Gunma 371-8511, Japan. Tel.: +81 27 220 8576; Fax: +81 27 220 8583; E-mail:
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Abstract
Fibromuscular dysplasia (FMD) is a noninflammatory, nonatherosclerotic disease of the vascular system, that can affect intima, media, or adventitia. The dysplasia in these layers leads to decrease in the lumen and increased turbulence leading to diminished flow through the affected portion. The treatment of FMD thus far has been either surgical and/or interventional. The authors describe a patient who presented with painful digits and who was found to have bilateral brachial artery FMD and was treated with balloon angioplasty with complete resolution of symptoms.
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Affiliation(s)
- Raghu Kolluri
- Department of Internal Medicine, Riverside Methodist Hospital, Columbus, OH
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Karagiannis A, Balaska K, Tziomalos K, Gerasimidis T, Karamanos D, Papayeoryiou A, Zamboulis C. Lack of an association between angiotensin converting enzyme gene polymorphism and peripheral arterial occlusive disease. Vasc Med 2016; 9:189-92. [PMID: 15675183 DOI: 10.1191/1358863x04vm5540a] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Numerous factors have been reported to influence the pathogenesis of atherosclerosis. The angiotensin I converting enzyme (ACE) gene is a candidate gene for atherosclerotic-related disease. In the present study, the association between the polymorphism of the ACE gene and peripheral arterial occlusive disease (PAOD) was investigated. Using polymerase chain reaction techniques, 100 patients (age 66.7-7.7 years) with PAOD and 100 age-matched controls were divided into the three ACE genotypes: II, ID and DD (Insertion I and Deletion D). There was no evidence of any association between ACE gene polymorphism and the presence of PAOD (odds ratio 0.759; 95% confidence interval 0.418-1.377). These results indicate an absence of association between DD genotype and PAOD. Further evaluation in a larger population study is required to examine the possibility of an increased risk of PAOD in DD homozygotes.
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Affiliation(s)
- Asterios Karagiannis
- Second Propedeutic Department of Internal Medicine, Surgical Clinic, Aristotle University of Thessaloniki, Hippokration Hospital, Greece.
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Rietzschel ER, De Buyzere ML, Bekaert S, Segers P, De Bacquer D, Cooman L, Van Damme P, Cassiman P, Langlois M, van Oostveldt P, Verdonck P, De Backer G, Gillebert TC. Rationale, design, methods and baseline characteristics of the Asklepios Study. ACTA ACUST UNITED AC 2016; 14:179-91. [PMID: 17446795 DOI: 10.1097/hjr.0b013e328012c380] [Citation(s) in RCA: 122] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
The Asklepios Study is a longitudinal population study focusing on the interplay between ageing, cardiovascular haemodynamics and inflammation in (preclinical) cardiovascular disease. The 2524 participants (1301 women) are a representative cohort of 35-55-year-old individuals, free from overt cardiovascular disease at study initiation, randomly sampled from the twinned Belgian communities of Erpe-Mere and Nieuwerkerken. Baseline examinations (all single-observer, single-device, single-site, single 2-year consecutive timeframe) include: questionnaires, conventional risk factors and biochemistry. Additional phenotypes under study include: (a) vascular structure and function: carotid and femoral atherosclerosis (intima-media thickness, plaque), arterial distension and pressure curves (brachial, carotid, femoral; wall-tracking and applanation tonometry); (b) cardiac structure and function. A novel aspect of the study is 'integrated' non-invasive biomechanical assessment of cardiac, arterial and ventriculovascular function through a combination of modeling, fundamental hydraulical measurements and system identification techniques. Integrated phenotypes result from combining at least two sets of curves (flow/pressure/distension). The value of this 'integrated' haemodynamic phenotype in the detection, prediction and prevention of clinical cardiovascular pathology (atherosclerosis progression, atherothrombosis, development of heart failure) will be tested. A second novel aspect is the systematic determination of peripheral blood leukocyte telomere length as a marker for biological ageing. During follow-up, baseline examinations will be repeated and the incidence of cardiovascular events will be monitored. Sex-specific baseline risk factor and biochemical data are provided in the current analyses. The primary aim is to build a combined dataset that will act as a tool to answer a cluster of questions about ageing, haemodynamics and the emergence of cardiovascular disease, especially the incidence of atherothrombotic events and the development of adverse haemodynamic profiles (arterial stiffening, heart failure). The study will reassess current risk factors and provide a long-term base for the detection of novel (epi)genetic and non-genetic risk factors and for more performant risk stratification modalities. Within these broader goals, a constant will be to strive towards more fundamental mechanistic-haemodynamic insights into cardiovascular disease processes.
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Affiliation(s)
- Ernst-R Rietzschel
- Department of Cardiovascular Diseases, Ghent University Hospital, Ghent, Belgium.
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Norioka N, Takemoto Y, Kobayashi M, Makuuchi A, Yoshikawa J, Yamazaki Y, Kamiyama Y, Shuto T, Yoshiyama M. Low-flow mediated constriction incorporated indices as indicators of cardiovascular risk in smokers. Atherosclerosis 2016; 251:132-138. [PMID: 27318833 DOI: 10.1016/j.atherosclerosis.2016.06.022] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2015] [Revised: 06/09/2016] [Accepted: 06/09/2016] [Indexed: 11/19/2022]
Abstract
BACKGROUND AND AIMS Low-flow-mediated constriction (L-FMC), the endothelial response to reduced blood flow by forearm compression, is present in some smokers. The differences between smokers with and without L-FMC are unclear. It is also unknown whether flow-mediated total dilation (FMTD) or modified flow-mediated dilation (mFMD), both of which incorporate information concerning L-FMC, could be used to estimate cardiovascular risk. We sought to clarify the clinical factors associated with the presence of L-FMC in smokers according to sex and examine whether L-FMC incorporated indices would be better than a conventional index to estimate cardiovascular risk in smokers. METHODS In total, 140 consecutive smokers (58 ± 13 years old) with no coronary heart disease and 48 non-smokers, who comprised the age- and sex-matched control group, were enrolled. RESULTS L-FMC was demonstrated in 33.6% (47/140) and 25% (12/48) of the smokers and non-smokers, respectively. In male smokers, the predictors of the presence of L-FMC were age (p = 0.014), body mass index (BMI) (p = 0.045), and baseline brachial arterial diameter (Dbase) (p = 0.048). In female smokers, there were no predictors of the presence of L-FMC. The correlations between the Framingham risk score (FRS) and %FMTD (r = -0.34) and between FRS and %mFMD (r = -0.33) were stronger than that between FRS and conventional flow-mediated dilation (%cFMD) (r = -0.20). CONCLUSIONS Independent predictors of the presence of L-FMC were age, BMI, and Dbase in male smokers. L-FMC incorporated indices may be good alternatives to cFMD to estimate cardiovascular risk.
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Affiliation(s)
- Naoki Norioka
- Department of Cardiovascular Medicine, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Yasuhiko Takemoto
- Department of Medical Education and General Practice, Osaka City University Graduate School of Medicine, Osaka, Japan.
| | - Masanori Kobayashi
- Department of Medical Education and General Practice, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Ayako Makuuchi
- Department of Medical Education and General Practice, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Junichi Yoshikawa
- Department of Medical Education and General Practice, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Yoichi Yamazaki
- Knowledge Hub of Aichi, Priority Research Project, Aichi Science and Technology Foundation, Toyota, Japan
| | - Yoshimi Kamiyama
- School of Information Science and Technology, Aichi Prefectural University, Nagakute, Japan
| | - Taichi Shuto
- Department of Medical Education and General Practice, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Minoru Yoshiyama
- Department of Cardiovascular Medicine, Osaka City University Graduate School of Medicine, Osaka, Japan
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Abstract
The association between psoriasis and carotid intima-media thickness (CIMT) or impaired flow-mediated dilation (FMD) remains controversial. We aimed to evaluate the extent of subclinical atherosclerosis as measured by CIMT and FMD in patients with psoriasis by conducting a meta-analysis.A systematic literature search was performed using PubMed, Embase, Cochrane databases, China National Knowledge Infrastructure, and VIP databases up to February 2015. Observational studies investigating CIMT or FMD in patients with psoriasis and controls were eligible. Psoriatic patients and controls were at least age- and sex-matched. Random-effects analysis was used to estimate the weighted mean difference (WMD) and 95% confidence interval (CI) between psoriatic patients and controls.A total of 20 studies were identified and analyzed. Meta-analysis showed that psoriatic patients had a significantly thicker CIMT (WMD 0.11 mm; 95% CI 0.08-0.15) and lower FMD (WMD -2.79%; -4.14% to -1.43%) than those in controls. Subgroup analysis indicated that psoriatic arthritis appeared to have less impaired FMD (WMD -2.45%) and thinner CIMT (WMD 0.10 mm). Psoriatic patients with mean age >45 years had much thicker CIMT (WMD 0.13 mm). The impaired FMD (WMD -3.99%) seemed more pronounced in psoriatic patients with mean age <45 years.This meta-analysis suggests that patients with psoriasis are associated with excessive risk of subclinical atherosclerosis. Screening and monitoring CIMT and brachial artery FMD may be recommended to identify a subgroup of psoriatic patients at higher risk for cardiovascular events.
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Affiliation(s)
- Na Fang
- From the Institute of Molecular Biology & Translational Medicine, the Affiliated People's Hospital, Jiangsu University, Zhenjiang, Jiangsu, PR China
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23
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Pranik NB, Goncharov SV, Gurianova VL, Maidannik VG, Khaitovych MV, Moibenko AA, Dosenko VE. ASSOSIATION ANALYSYS OF 11 POLYMORPHISMS OF SNPS WITH ENDOTHELIUM DEPENDENT VASODILATATION IN CHILDREN WITH DIABETES MELLITUS TYPE 1. ACTA ACUST UNITED AC 2016. [PMID: 29537199 DOI: 10.15407/fz62.01.043] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
We have studied the association with the level of the endothelium dependent vasodilatation (EDVD) among 11 single nucleotide polymorphisms (SNPs) of 10 genes in 45 children suffering from diabetes mellitus type 1. Following polymorphisms have been studied: G894→T of the eNOS exon 7 and Т-786→С of the eNOS promotor, А1266→G of the Eln exon 16, Т-381→C of the NPPB promotor, І\D of the ACE, Arg60→His of the LMP2, Met235→Thr of the AGT, A1166→C of the ATR1, C-1562→T of the MMP9, C-1306→T of the MMP2, and С-8→G of the PSMA6. It was shown that children with genotypes G/T by eNOS (G894→T), G/G by Eln (А1266→G), C/C by NPPB (Т-381→C) and І/D by ACE genes have lower EDVD (Р<0,05) than patients with others allelic variants of these genes, and this does not depend on duration of the disease, level of glicated hemoglobin and initial diameter of a humeral (brachial) artery. The combination of the above-stated genotypes influences most significantly on EDVD decrease (r=0,61; Р<0,01), comparing to each genotype separately.
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MESH Headings
- Adolescent
- Brachial Artery/metabolism
- Brachial Artery/pathology
- Child
- Cysteine Endopeptidases/genetics
- Cysteine Endopeptidases/metabolism
- Diabetes Mellitus, Type 1/complications
- Diabetes Mellitus, Type 1/genetics
- Diabetes Mellitus, Type 1/metabolism
- Diabetes Mellitus, Type 1/pathology
- Dilatation, Pathologic/complications
- Dilatation, Pathologic/genetics
- Dilatation, Pathologic/metabolism
- Dilatation, Pathologic/pathology
- Endothelium, Vascular/metabolism
- Endothelium, Vascular/pathology
- Female
- Gene Expression
- Genotype
- Humans
- Male
- Matrix Metalloproteinase 2/genetics
- Matrix Metalloproteinase 2/metabolism
- Matrix Metalloproteinase 9/genetics
- Matrix Metalloproteinase 9/metabolism
- Nerve Tissue Proteins/genetics
- Nerve Tissue Proteins/metabolism
- Nitric Oxide Synthase Type III/genetics
- Nitric Oxide Synthase Type III/metabolism
- Peptidyl-Dipeptidase A/genetics
- Peptidyl-Dipeptidase A/metabolism
- Polymorphism, Single Nucleotide
- Proteasome Endopeptidase Complex/genetics
- Proteasome Endopeptidase Complex/metabolism
- Receptors, Atrial Natriuretic Factor/genetics
- Receptors, Atrial Natriuretic Factor/metabolism
- Tropoelastin/genetics
- Tropoelastin/metabolism
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24
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Oliveira OP, Araujo Júnior E, Lima JW, Salustiano EM, Ruano R, Martins WP, Costa FDS. Flow-mediated dilation of brachial artery and endothelial dysfunction in pregnant women with preeclampsia: a case control study. Minerva Ginecol 2015; 67:307-313. [PMID: 25476264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
AIM Aim of the present study was to evaluate the association between endothelial dysfunction, evaluated through flow-mediated dilation (FMD) of the brachial artery, and preeclampsia. METHODS A case-control prospective cross-sectional study was conducted on 81 pregnant women of between 20 and 39 weeks and 5 days, among whom 40 had preeclampsia and 41 were controls. The right brachial artery was identified using color Doppler, between 2 and 5 cm above the cubital fold. The diameter of the brachial artery was measured by calculating the distance between the proximal and distal intima (D1) during diastoles. Ischemia was caused for five minutes and the artery measurement was repeated 60 seconds after ending the compression (D2), during diastoles. The FMD (%) was calculated through the equation: (D2-D1)/D1 × 100. The association between independent variables and the presence of preeclampsia was estimated through odds ratios (OR) and their 95% confidence intervals (95% CI). RESULTS Seventy-five percent of the pregnant women with preeclampsia and 26.8% of the normotensive women presented reduction in the diameter of the brachial artery (OR = 8.18; 95% CI: 2.74-25.04) (P = 0.000). A greater proportion of the pregnant women with pre-eclampsia (42.1% vs. 14.3%) had a history of a mother with hypertension during pregnancy (OR = 4.36; 95% CI: 0.89-23.51) (P = 0.045). CONCLUSION We identified an association between endothelial dysfunction, evaluated through FMD of the brachial artery, and preeclampsia.
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Affiliation(s)
- O P Oliveira
- Department of Epidemiology, State University of Ceará (UECE), Fortaleza‑CE, Brazil -
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25
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Allon M, Robbin ML, Umphrey HR, Young CJ, Deierhoi MH, Goodman J, Hanaway M, Lockhart ME, Barker-Finkel J, Litovsky S. Preoperative arterial microcalcification and clinical outcomes of arteriovenous fistulas for hemodialysis. Am J Kidney Dis 2015; 66:84-90. [PMID: 25700554 PMCID: PMC4485585 DOI: 10.1053/j.ajkd.2014.12.015] [Citation(s) in RCA: 27] [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: 08/06/2014] [Accepted: 11/19/2014] [Indexed: 01/08/2023]
Abstract
BACKGROUND Arteriovenous fistulas (AVFs) often fail to mature, but the mechanism of AVF nonmaturation is poorly understood. Arterial microcalcification is common in patients with chronic kidney disease (CKD) and may limit vascular dilatation, thereby contributing to early postoperative juxta-anastomotic AVF stenosis and impaired AVF maturation. This study evaluated whether preexisting arterial microcalcification adversely affects AVF outcomes. STUDY DESIGN Prospective study. SETTING & PARTICIPANTS 127 patients with CKD undergoing AVF surgery at a large academic medical center. PREDICTORS Preexisting arterial microcalcification (≥1% of media area) assessed independently by von Kossa stains of arterial specimens obtained during AVF surgery and by preoperative ultrasound. OUTCOMES Juxta-anastomotic AVF stenosis (ascertained by ultrasound obtained 4-6 weeks postoperatively), AVF nonmaturation (inability to cannulate with 2 needles with dialysis blood flow ≥ 300mL/min for ≥6 sessions in 1 month within 6 months of AVF creation), and duration of primary unassisted AVF survival after successful use (time to first intervention). RESULTS Arterial microcalcification was present by histologic evaluation in 40% of patients undergoing AVF surgery. The frequency of a postoperative juxta-anastomotic AVF stenosis was similar in patients with or without preexisting arterial microcalcification (32% vs 42%; OR, 0.65; 95% CI, 0.28-1.52; P=0.3). AVF nonmaturation was observed in 29%, 33%, 33%, and 33% of patients with <1%, 1% to 4.9%, 5% to 9.9%, and ≥10% arterial microcalcification, respectively (P=0.9). Sonographic arterial microcalcification was found in 39% of patients and was associated with histologic calcification (P=0.001), but did not predict AVF nonmaturation. Finally, among AVFs that matured, unassisted AVF maturation (time to first intervention) was similar for patients with and without preexisting arterial microcalcification (HR, 0.64; 95% CI, 0.35-1.21; P=0.2). LIMITATIONS Single-center study. CONCLUSIONS Arterial microcalcification is common in patients with advanced CKD, but does not explain postoperative AVF stenosis, AVF nonmaturation, or AVF failure after successful cannulation.
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Affiliation(s)
- Michael Allon
- Division of Nephrology, University of Alabama at Birmingham, Birmingham, AL.
| | - Michelle L Robbin
- Department of Radiology, University of Alabama at Birmingham, Birmingham, AL
| | - Heidi R Umphrey
- Department of Radiology, University of Alabama at Birmingham, Birmingham, AL
| | - Carlton J Young
- Division of Transplant Surgery, University of Alabama at Birmingham, Birmingham, AL
| | - Mark H Deierhoi
- Division of Transplant Surgery, University of Alabama at Birmingham, Birmingham, AL
| | - Jeremy Goodman
- Division of Transplant Surgery, University of Alabama at Birmingham, Birmingham, AL
| | - Michael Hanaway
- Division of Transplant Surgery, University of Alabama at Birmingham, Birmingham, AL
| | - Mark E Lockhart
- Department of Radiology, University of Alabama at Birmingham, Birmingham, AL
| | | | - Silvio Litovsky
- Department of Pathology, University of Alabama at Birmingham, Birmingham, AL
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26
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Guan JL, Jiang W, Wang HY, Zeng H, Zhang SM, Wang G, Mao JM. [Multiple effect of simvastatin on vascular endothelium of hypercholesterolemia patients]. Beijing Da Xue Xue Bao Yi Xue Ban 2014; 46:703-706. [PMID: 25331390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
OBJECTIVE To observe the multiple influence of cholesterol-lowering drug (simvastatin) on ankle brachial index (ABI), flow-mediated dilation (FMD) and nitroglycerin-mediated dilation (NMD) of brachial artery blood vessel endothelium, and plasma level of monocyte chemotactic protein 1 (MCP-1) of hypercholesterolemia patients without coronary heart disease (CHD). METHODS In the study, 51 patients with hypercholesterolemia application were treated with simvastatin (20 mg/d) therapy for 12 weeks. The metabolic index, ankle brachial index (ABI), FMD of brachial artery blood vessel endothelium detected by color doppler ultrasound instrument, the NMD of artery endothelial and the level of MCP 1 were measured before and after therapy respectively. All the results were analyzed and compared with another 30 cases of hypercholesterolemia patients selected without simvastatin treatment. RESULTS After simvastatin therapy, the TC (total cholesterol) and LDL-C (low density lipoprotein cholesterin) levels were reduced apparently,the values decreased from the original (6.06 ± 1.03) mmol/L and (3.60 ± 0.82) mmol/L to (4.98 ± 1.34) mmol/L and (3.41 ± 0.10) mmol/L respectively (P<0.01, P< 0.05). Compared with no simvastatin treatment, the bilateral ABI levels were significantly elevated. The right side of ABI (ABIR) elevated from 1.11 ± 0.06 to 1.19 ± 0.07, and the left side of ABI (ABIL) also elevated from 1.12 ± 0.06 to 1.19 ± 0.10 (both sides were P<0.01). The FMD significantly increased from 7.75% ± 11.30% to 14.20% ± 15.39% (P < 0.05). The plasma levels of MCP-1 were apparently reduced from (112.0 ± 7.8) ng/L to (108.9 ± 6.2) ng/L (P < 0.05). All these items showed no obvious change within the control group. CONCLUSION The API, FMD and plasma levels of MCP-1 of hypercholesterolemia patients without clear coronary heart disease can be improved by simvastatin treatment.
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Affiliation(s)
- Jing-lin Guan
- Peking University Health Science Center Hospital, Beijing 100191, China
| | - Wen Jiang
- Peking University Health Science Center Hospital, Beijing 100191, China
| | - Huai-yu Wang
- Peking University School of Basic Medical Science, Beijing 100191, China
| | - Hui Zeng
- Department of Cardiology, Peking Univeristy Third Hospial, Beijing 100191, China
| | - Su-min Zhang
- Peking University Health Science Center Hospital, Beijing 100191, China
| | - Guang Wang
- Department of Endocrinology, Beijing Chaoyang Hospital, Capital Medical University, Beijing, 100020, China
| | - Jie-ming Mao
- Department of Cardiology, Peking Univeristy Third Hospial, Beijing 100191, China
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27
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Sarafidis PA, Georgianos PI, Karpetas A, Bikos A, Korelidou L, Tersi M, Divanis D, Tzanis G, Mavromatidis K, Liakopoulos V, Zebekakis PE, Lasaridis A, Protogerou AD. Evaluation of a novel brachial cuff-based oscillometric method for estimating central systolic pressure in hemodialysis patients. Am J Nephrol 2014; 40:242-50. [PMID: 25322847 DOI: 10.1159/000367791] [Citation(s) in RCA: 58] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2014] [Accepted: 08/20/2014] [Indexed: 11/19/2022]
Abstract
BACKGROUND/AIMS Elevated wave reflections and arterial stiffness, as well as ambulatory blood pressure (BP) are independent predictors of cardiovascular risk in end-stage-renal-disease. This study is the first to evaluate in hemodialysis patients the validity of a new ambulatory oscillometric device (Mobil-O-Graph, IEM, Germany), which estimates aortic BP, augmentation index (AIx) and pulse wave velocity (PWV). METHODS Aortic SBP (aSBP), heart rate-adjusted AIx (AIx(75)) and PWV measured with Mobil-O-Graph were compared with the values from the most widely used tonometric device (Sphygmocor, ArtCor, Australia) in 73 hemodialysis patients. Measurements were made in a randomized order after 10 min of rest in the supine position at least 30 min before a dialysis session. Brachial BP (mercury sphygmomanometer) was used for the calibration of Sphygmocor's waveform. RESULTS Sphygmocor-derived aSBP and AIx(75) did not differ from the relevant Mobil-O-Graph measurements (aSBP: 136.3 ± 19.6 vs. 133.5 ± 19.3 mm Hg, p = 0.068; AIx(75): 28.4 ± 9.3 vs. 30.0 ± 11.8%, p = 0.229). The small difference in aSBP is perhaps explained by a relevant difference in brachial SBP used for calibration (146.9 ± 20.4 vs. 145.2 ± 19.9 mm Hg, p = 0.341). Sphygmocor PWV was higher than Mobil-O-Graph PWV (10.3 ± 3.4 vs. 9.5 ± 2.1 m/s, p < 0.01). All 3 parameters estimated by Mobil-O-Graph showed highly significant (p < 0.001) correlations with the relevant measurements of Sphygmocor (aSBP, r = 0.770; AIx(75), r = 0.400; PWV, r = 0.739). The Bland-Altman Plots for aSBP and AIx(75) showed acceptable agreement between the two devices and no evidence of systemic bias for PWV. CONCLUSION As in other populations, acceptable agreement between Mobil-O-Graph and Sphygmocor was evident for aSBP and AIx(75) in hemodialysis patients; PWV was slightly underestimated by Mobil-O-Graph.
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Affiliation(s)
- Pantelis A Sarafidis
- Department of Nephrology, Hippokration Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
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28
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Sapienza P, Borrelli V, Ciardi A, Sterpetti AV, Biacchi D, Tartaglia E, Di Marzo L. Late occurrence of brachial artery aneurysm after the closure of a long-standing vascular access for hemodialysis: a pathogenetic hypothesis. J Cardiovasc Surg (Torino) 2014; 55:445-447. [PMID: 24172601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Affiliation(s)
- P Sapienza
- Department of Surgery "Pietro Valdoni", "La Sapienza" University, Rome, Italy - paolo.sapienza@unirom
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29
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Kappus RM, Fahs CA, Smith D, Horn GP, Agiovlasitis S, Rossow L, Jae SY, Heffernan KS, Fernhall B. Obesity and overweight associated with increased carotid diameter and decreased arterial function in young otherwise healthy men. Am J Hypertens 2014; 27:628-34. [PMID: 24048148 DOI: 10.1093/ajh/hpt152] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [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: 01/27/2023] Open
Abstract
BACKGROUND Obesity is linked to cardiovascular disease, stroke, increased mortality and vascular remodeling. Although increased arterial diameter is associated with multiple cardiovascular risk factors and obesity, it is unknown whether lumen enlargement is accompanied by unfavorable vascular changes in young and otherwise healthy obese individuals. The purpose of this study was to compare carotid and brachial artery diameter, blood pressure, arterial stiffness, and endothelial function in young, apparently healthy, normal-weight, overweight, and obese male subjects. METHODS One hundred sixty-five male subjects (27.39±0.59 years) were divided into 3 groups (normal weight, overweight, and obese) according to body mass index. Subjects underwent cardiovascular measurements to determine arterial diameter, function, and stiffness. RESULTS After adjusting for age, the obese group had significantly greater brachial, carotid, and aortic pressures, brachial pulse wave velocity, carotid intima media thickness, and carotid arterial diameter compared with both the overweight and normal-weight groups. CONCLUSIONS Obesity is associated with a much worse arterial profile, as an increased carotid lumen size was accompanied by higher blood pressure, greater arterial stiffness, and greater carotid intima media thickness in obese compared with overweight or normal-weight individuals. These data suggest that although obesity may be a factor in arterial remodeling, such remodeling is also accompanied by other hemodynamic and arterial changes consistent with reduced arterial function and increased cardiovascular risk.
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Affiliation(s)
- Rebecca M Kappus
- Integrative Physiology Laboratory, University of Illinois at Chicago, Chicago, Illinois
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30
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Cooper DC, Ziegler MG, Milic MS, Ancoli-Israel S, Mills PJ, Loredo JS, von Känel R, Dimsdale JE. Endothelial function and sleep: associations of flow-mediated dilation with perceived sleep quality and rapid eye movement (REM) sleep. J Sleep Res 2014; 23:84-93. [PMID: 24033699 PMCID: PMC3947135 DOI: 10.1111/jsr.12083] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2013] [Accepted: 07/13/2013] [Indexed: 01/22/2023]
Abstract
Endothelial function typically precedes clinical manifestations of cardiovascular disease and provides a potential mechanism for the associations observed between cardiovascular disease and sleep quality. This study examined how subjective and objective indicators of sleep quality relate to endothelial function, as measured by brachial artery flow-mediated dilation (FMD). In a clinical research centre, 100 non-shift working adults (mean age: 36 years) completed FMD testing and the Pittsburgh Sleep Quality Index, along with a polysomnography assessment to obtain the following measures: slow wave sleep, percentage rapid eye movement (REM) sleep, REM sleep latency, total arousal index, total sleep time, wake after sleep onset, sleep efficiency and apnea-hypopnea index. Bivariate correlations and follow-up multiple regressions examined how FMD related to subjective (i.e., Pittsburgh Sleep Quality Index scores) and objective (i.e., polysomnography-derived) indicators of sleep quality. After FMD showed bivariate correlations with Pittsburgh Sleep Quality Index scores, percentage REM sleep and REM latency, further examination with separate regression models indicated that these associations remained significant after adjustments for sex, age, race, hypertension, body mass index, apnea-hypopnea index, smoking and income (Ps < 0.05). Specifically, as FMD decreased, scores on the Pittsburgh Sleep Quality Index increased (indicating decreased subjective sleep quality) and percentage REM sleep decreased, while REM sleep latency increased (Ps < 0.05). Poorer subjective sleep quality and adverse changes in REM sleep were associated with diminished vasodilation, which could link sleep disturbances to cardiovascular disease.
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Affiliation(s)
- Denise C. Cooper
- Health Services Research and Development, VA Puget Sound Health Care System
| | - Michael G. Ziegler
- Department of Medicine, University of California-San Diego, La Jolla, CA
| | - Milos S. Milic
- Department of Medicine, University of California-San Diego, La Jolla, CA
| | | | - Paul J. Mills
- Department of Psychiatry, University of California-San Diego, La Jolla, CA
| | - José S. Loredo
- Department of Medicine, University of California-San Diego, La Jolla, CA
| | - Roland von Känel
- Division of Psychosomatic Medicine, Department of General Internal Medicine, Inselspital, Bern University Hospital, and University of Bern, Switzerland
| | - Joel E. Dimsdale
- Department of Psychiatry, University of California-San Diego, La Jolla, CA
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31
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Panagouli E, Anagnostopoulou S, Venieratos D. Bilateral asymmetry of the highly bifurcated brachial artery variation. Rom J Morphol Embryol 2014; 55:469-472. [PMID: 24970004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
High bifurcation of the brachial artery seems to be a common variation, which can occur in many different forms, and some of them might be rather rare. We report an unusual case of bilateral high bifurcation of the brachial artery in a male cadaver. On the right arm, high origin of the ulnar artery as superficial ulnar artery was observed. The brachial artery continued and divided at the level of the elbow into radial and common interosseous artery. On the left arm, a high bifurcation of the common interosseous artery occurred, while the rest of the brachial artery continued and at the level of the elbow bifurcated into radial and superficial ulnar artery. In both arms, the common interosseous artery followed the branching pattern of the normal ulnar artery. The so formed superficial ulnar arteries gave each four common palmar digital arteries. This case is being reported for the bilaterally different variational anatomy of the upper limb arteries.
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Affiliation(s)
- Eleni Panagouli
- Department of Anatomy, Medical School, University of Athens, Greece;
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Chen S, Wu R, Huang Y, Zheng F, Ou Y, Tu X, Zhang Y, Gao Y, Chen X, Zheng T, Yang Q, Wan Z, Zhang Y, Sun X, Liu G, Deng C. Insulin resistance is an independent determinate of ED in young adult men. PLoS One 2013; 8:e83951. [PMID: 24391852 PMCID: PMC3877124 DOI: 10.1371/journal.pone.0083951] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2013] [Accepted: 11/11/2013] [Indexed: 01/25/2023] Open
Abstract
Background Insulin resistance (IR) triggers endothelial dysfunction, which contributes to erectile dysfunction (ED) and cardiovascular disease. Aim To evaluate whether IR was related to ED in young adult patients. Methods A total of 283 consecutive men complaining of ED at least six months were enrolled, with a full medical history, physical examination, and laboratory tests collected. Quantitative Insulin Sensitivity Check Index (QUICKI) was used to determine IR. The severity of ED was assessed by IIEF-5 questionnaire. Endothelial function was assessed by ultrasonographic examination of brachial artery flow mediated dilation (FMD). Results IR was detected in 52% patients. Subjects with IR had significant higher total cholesterol, triglycerides, low density lipoprotein-cholesterol (LDL-c), glycated haemoglobin (HBA1c), high sensitivity C-reactive protein (hs-CRP) and body mass index (BMI), but showed significant lower IIEF-5 score, FMD%, high density lipoprotein -cholesterol (HDL-c), testosterone, sex hormone binding globulin (SHBG) levels than patients without IR. Multiple regression analysis showed QUICKI and testosterone were independent predictors of IIEF-5 score. Furthermore, the incidence of IR was correlated with the severity of ED. Conclusions Compared with other CVFs, IR was found as the most prevalent in our subjects. Besides, IR was independently associated with ED and its severity, suggesting an adverse effect of insulin resistance on erectile function.
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Affiliation(s)
- Shengfu Chen
- Department of Urology, First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong Province, China
| | - Rongpei Wu
- Department of Urology, First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong Province, China
| | - Yanping Huang
- Department of Urology, Shanghai Institute of Andrology, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Fufu Zheng
- Department of Urology, First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong Province, China
| | - Yangbin Ou
- Department of Urology, First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong Province, China
| | - Xiangan Tu
- Department of Urology, First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong Province, China
| | - Yadong Zhang
- Department of Urology, First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong Province, China
| | - Yong Gao
- Department of Urology, First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong Province, China
| | - Xin Chen
- Department of Urology, First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong Province, China
| | - Tao Zheng
- Department of Urology, First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong Province, China
| | - Qiyun Yang
- Department of Urology, First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong Province, China
| | - Zi Wan
- Department of Urology, First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong Province, China
| | - Yuanyuan Zhang
- Wake Forest University, Institute for Regenerative Medicine, Winston-Salem, North Carolina, United States of America
| | - Xiangzhou Sun
- Department of Urology, First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong Province, China
- * E-mail: (XS); (GL); (CD)
| | - Guihua Liu
- Department of Urology, First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong Province, China
- Wake Forest University, Institute for Regenerative Medicine, Winston-Salem, North Carolina, United States of America
- * E-mail: (XS); (GL); (CD)
| | - Chunhua Deng
- Department of Urology, First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong Province, China
- * E-mail: (XS); (GL); (CD)
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Sedlak TL, Johnson BD, Pepine CJ, Reis SE, Bairey Merz CN. Brachial artery constriction during brachial artery reactivity testing predicts major adverse clinical outcomes in women with suspected myocardial ischemia: results from the NHLBI-sponsored women's ischemia Syndrome Evaluation (WISE) Study. PLoS One 2013; 8:e74585. [PMID: 24058592 PMCID: PMC3776820 DOI: 10.1371/journal.pone.0074585] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2013] [Accepted: 08/06/2013] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Limited brachial artery (BA) flow-mediated dilation during brachial artery reactivity testing (BART) has been linked to increased cardiovascular risk. We report on the phenomenon of BA constriction (BAC) following hyperemia. OBJECTIVES To determine whether BAC predicts adverse CV outcomes and/or mortality in the women's ischemic Syndrome Evaluation Study (WISE). Further, as a secondary objective we sought to determine the risk factors associated with BAC. METHODS We performed BART on 377 women with chest pain referred for coronary angiography and followed for a median of 9.5 years. Forearm ischemia was induced with 4 minutes occlusion by a cuff placed distal to the BA and inflated to 40mm Hg > systolic pressure. BAC was defined as >4.8% artery constriction following release of the cuff. The main outcome was major adverse events (MACE) including all-cause mortality, non-fatal MI, non-fatal stroke, or hospitalization for heart failure. RESULTS BA diameter change ranged from -20.6% to +44.9%, and 41 (11%) women experienced BAC. Obstructive CAD and traditional CAD risk factors were not predictive of BAC. Overall, 39% of women with BAC experienced MACE vs. 22% without BAC (p=0.004). In multivariate Cox proportional hazards regression, BAC was a significant independent predictor of MACE (p=0.018) when adjusting for obstructive CAD and traditional risk factors. CONCLUSIONS BAC predicts almost double the risk for major adverse events compared to patients without BAC. This risk was not accounted for by CAD or traditional risk factors. The novel risk marker of BAC requires further investigation in women.
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Affiliation(s)
- Tara L. Sedlak
- Department of Medicine, Vancouver General Hospital, Vancouver, British Columbia, Canada
| | - B. Delia Johnson
- Department of Epidemiology, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
| | - Carl J. Pepine
- Department of Medicine, University of Florida, Gainesville, Florida, United States of America
| | - Steven E. Reis
- Department of Epidemiology, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
| | - C. Noel Bairey Merz
- Department of Medicine, Cedars-Sinai Heart Institute, Los Angeles, California, United States of America
- * E-mail:
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Bosworth C, Sachs MC, Duprez D, Hoofnagle AN, Ix JH, Jacobs DR, Peralta CA, Siscovick DS, Kestenbaum B, de Boer IH. Parathyroid hormone and arterial dysfunction in the multi-ethnic study of atherosclerosis. Clin Endocrinol (Oxf) 2013; 79:429-36. [PMID: 23402353 PMCID: PMC3664253 DOI: 10.1111/cen.12163] [Citation(s) in RCA: 60] [Impact Index Per Article: 5.5] [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: 11/30/2012] [Revised: 12/20/2012] [Accepted: 01/29/2013] [Indexed: 12/15/2022]
Abstract
OBJECTIVE High circulating concentrations of parathyroid hormone (PTH) have been associated with increased risks of hypertension, left ventricular hypertrophy, congestive heart failure and cardiovascular mortality. Impaired arterial function is a potential mechanism for these associations. We tested whether serum PTH concentration is associated with measures of arterial function. DESIGN Cross-sectional study. PARTICIPANTS A total of 6545 persons without clinical cardiovascular disease participating in the community-based Multi-Ethnic Study of Atherosclerosis. MEASUREMENTS Brachial artery flow-mediated dilation (FMD) as well as aortic pulse pressure and arterial pulse parameters derived from Windkessel modelling of the radial pressure waveform. RESULTS Higher serum PTH concentration was associated with lower brachial artery FMD (mean difference -0·09% per 10 pg/ml PTH), higher aortic pulse pressure (0·53 mmHg per 10 pg/ml) and reduced Windkessel capacitive index C1 (large artery elasticity, -0·12 ml/mmHg × 10 per 10 pg/ml), adjusting for potential confounding variables (all P-values ≤ 0·001). These relationships were independent of serum calcium concentration, serum 25-hydroxyvitamin D concentration and estimated glomerular filtration rate and were consistent across relevant participant subgroups. Associations of PTH with aortic pulse pressure and capacitive index C1 were attenuated after adjustment for blood pressure. Serum PTH concentration was not associated with the oscillatory index C2 (small artery elasticity). CONCLUSIONS Higher serum PTH concentration was associated with impaired endothelial function, increased aortic pulse pressure and decreased capacitive index C1 in a large, diverse, community-based population. These relationships may help explain previously observed associations of elevated PTH with cardiovascular disease.
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Affiliation(s)
- Cortney Bosworth
- Division of Nephrology and Kidney Research Institute, Department of Medicine, University of Washington, Seattle, WA, USA
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Knight DR, Smith AH, Schroeder RL, Huang C, Beebe DA, Sokolowski SA, Wang M. Effects of age on noninvasive assessments of vascular function in nonhuman primates: implications for translational drug discovery. J Transl Med 2013; 11:101. [PMID: 23607770 PMCID: PMC3644259 DOI: 10.1186/1479-5876-11-101] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2012] [Accepted: 04/09/2013] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Endothelium-dependent flow mediated dilation (FMD) and pulse-wave velocity (PWV), are used as measures of vascular health and predictors of cardiovascular risk in clinical studies, and both are age-dependent. Numbers of circulating endothelial microparticles (EMPs) and endothelial progenitor cells (EPCs) are also associated with cardiovascular risk, but independent of age in humans. The use of these measurements for pre-clinical assessment of drug cardiovascular safety and efficacy in non-human primates (NHPs) may promote the translation of drug-induced effects on vascular function to clinic outcomes. However, in NHPs, the age effects on the non-invasive measurements of FMD and PWV and the relationship of EMPs/EPCs with FMD are unknown. METHODS A non-invasive, clinically-relevant approach to assess FMD and PWV was used to examine their relationship with age and with EMPs/EPCs in NHPs. The effects on FMD of nicotine and rosiglitazone were evaluated in senescent primates in an effort to validate our FMD method for pre-clinical assessment of vascular function. RESULTS FMD and PWV methods were established in a colony (n = 25) of metabolically healthy, cynomolgus monkeys ranging in age from 6 to 26 years. FMD, defined as the percent change, at 1 min of cuff release, from baseline vascular diameter (0.15 ± 0.03 cm), had a strong, negative correlation with age (r = -0.892, p < 0.0001), ranging from 6% to 33%. PWV positively correlated with age (r = 0.622, p < 0.002) in the same healthy monkeys. Nicotine and rosiglitazone, were evaluated in subsets of senescent primates (mean age 16.3 ± 1.5[SEM] years). Rosiglitazone significantly improved FMD (21.0 ± 1.6% vs. vehicle 16.3 ± 1.6%, p < 0.01) without changing baseline diameters, and coincided with a significant increase in circulating numbers of endothelial progenitor cells (CD45-CD31 + CD34 + VEGFR2+ 7.1 ± 1.3 vs. 4.8 ± 1.1 counts/μl) and a decrease in endothelial microparticles (CD45-CD42a-CD54+ 26.7 ± 11.1 vs. 62.2 ± 9.8 counts/μl)(p < 0.05). Conversely, FMD was significantly reduced with nicotine (8.7 ± 1.4% vs. vehicle 20.1 ± 2.2%, p < 0.05). CONCLUSIONS Adult NHPs demonstrate the characteristic linear relationship between age and vascular function using the non-invasive clinically-related measurements of FMD and PWV. However, numbers of circulating EMPs and EPCs did not correlate with age. Endothelial function assessed with FMD, together with EMPs/EPCs assessment, may serve as a novel approach for translational research and therapeutic discovery. Age should be considered in the study design or data analyses when FMD or PWV is used in NHPs.
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Affiliation(s)
- Delvin R Knight
- Pfizer Worldwide Research and Development, Cardiovascular and Metabolic Diseases Research Unit, Pfizer Inc, Groton, CT 06340, USA
| | - Andrew H Smith
- Pfizer Worldwide Research and Development, Cardiovascular and Metabolic Diseases Research Unit, Pfizer Inc, Groton, CT 06340, USA
| | - Richard L Schroeder
- Pfizer Worldwide Research and Development, Cardiovascular and Metabolic Diseases Research Unit, Pfizer Inc, Groton, CT 06340, USA
| | - Chunli Huang
- Pfizer Worldwide Research and Development, Cardiovascular and Metabolic Diseases Research Unit, Pfizer Inc, Groton, CT 06340, USA
| | - David A Beebe
- Pfizer Worldwide Research and Development, Cardiovascular and Metabolic Diseases Research Unit, Pfizer Inc, Groton, CT 06340, USA
| | - Sharon A Sokolowski
- Pfizer Worldwide Research and Development, Cardiovascular and Metabolic Diseases Research Unit, Pfizer Inc, Groton, CT 06340, USA
| | - Miao Wang
- Pfizer Worldwide Research and Development, Cardiovascular and Metabolic Diseases Research Unit, Pfizer Inc, Groton, CT 06340, USA
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Cuypers J, Leirgul E, Larsen TH, Berg A, Omdal TR, Greve G. Assessment of vascular reactivity in the peripheral and coronary arteries by Cine 3T-magnetic resonance imaging in young normotensive adults after surgery for coarctation of the aorta. Pediatr Cardiol 2013; 34:661-9. [PMID: 23064837 DOI: 10.1007/s00246-012-0522-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2012] [Accepted: 09/11/2012] [Indexed: 01/22/2023]
Abstract
This study aimed to investigate whether coarctation of the aorta in infancy indicates an altered vascular reactivity in the peripheral and coronary arteries apart from the secondary effect of hypertension or other complications of the disease. Patients with repaired coarctation of the aorta have a high prevalence of premature cardiovascular complications. The etiology still is not fully understood, and the cause is most likely multifactorial. Endothelial function was assessed by peripheral flow mediated dilation (FMD) and coronary flow reserve (CFR) in a study of 10 control subjects and 10 patients with a successfully repaired coarctation of the aorta (mean age, 20.9 years; 20.5 years after repair). No one had re- or rest-coarctation of the aorta, hypertension, pathologic blood pressure response during exercise, or associated cardiac malformations such as bicuspid aortic valve. CFR was achieved by phase-contrast velocity encoding cine magnetic resonance imaging in the coronary sinus before and during infusion with adenosine (0.14 mg/kg/min). FMD was measured in the brachial artery before and after 5 min of arterial occlusion. A normal CFR and FMD was found in both groups. Most studies have been conducted with large, unselected groups. The current study group represented the best outcome of the coarctation spectrum (i.e., patients with no evidence of a residual gradient across the coarctation site or systemic hypertension). The findings reassuringly suggest that significant endothelial dysfunction and atherosclerotic changes were not present in this selected cohort.
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Affiliation(s)
- Jochem Cuypers
- Department of Clinical Medicine, University of Bergen, 5021, Bergen, Norway.
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Tan H, Li X, Chen W, Chen Y, Wei X, Yang Y, Zhang H, Jin Q. Effects of losartan on the mobilization of endothelial progenitor cells and improvement of endothelial function. Ann Clin Lab Sci 2013; 43:402-406. [PMID: 24247796] [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] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Through investigating the effect of the angiotensin receptor blocker (ARB) losartan on the number of endothelial progenitor cells (EPCs) and blood flow-mediated endothelium-dependent function (FMD) in the peripheral blood of patients with coronary heart disease (CHD), we found that FMD was improved and the number of circulating EPCs increased in the ARB treatment group (P <0.05). In addition, the increase in the number of EPCs was positively correlated with the improvement of FMD in the ARB treatment group (r = 0.52, P <0.01). These findings suggest that losartan may mobilize EPCs in the peripheral blood, improving endothelial function in CHD.
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Affiliation(s)
- Hong Tan
- Department of Cardiology, the General Hospital of Ji'nan Military Region, Ji'nan 250031, Shangdong, China; e mail:
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Kadowaki M, Hashimoto M, Nakashima M, Fukata M, Odashiro K, Uchida Y, Shimono N. Radial mycotic aneurysm complicated with infective endocarditis caused by Streptococcus sanguinis. Intern Med 2013; 52:2361-5. [PMID: 24126401 DOI: 10.2169/internalmedicine.52.0747] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Peripheral mycotic aneurysm is a rare complication of infective endocarditis. We herein report the case of a 61-year-old man with a mycotic aneurysm in the left brachial artery, that appeared during treatment with antibiotics against infective endocarditis caused by Streptococcus sanguinis. After confirming the collateral blood flow on arteriography, we resected the aneurysm and performed valvuloplasty, annuloplasty and coronary artery bypass grafting. The patient has been in good condition without complications, such as motor dysfunction or neuropathy.
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Affiliation(s)
- Masako Kadowaki
- Department of Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Science, Japan
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Kar S, Gopaldas RR, Kumar A. Acute aortic dissection and stroke in multivessel fibromuscular dysplasia. Tex Heart Inst J 2013; 40:88-90. [PMID: 23467036 PMCID: PMC3568275] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Fibromuscular dysplasia is a rare, nonatherosclerotic, noninflammatory vascular disease that typically affects women between the ages of 20 and 60 years. Although any artery can be affected, fibromuscular dysplasia most commonly affects the renal and carotid arteries. Fibromuscular dysplasia of the renal arteries usually presents with hypertension, while carotid or vertebral artery disease causes transient ischemic attacks, strokes, or dissection. Fibromuscular dysplasia of the brachial arteries is extremely uncommon. It can induce extremity ischemia, nerve compression, or both-causing coldness, discoloration, pain, ulceration or gangrene of the fingers, paresthesias, or paralysis. We report a rare case of multivessel fibromuscular dysplasia manifested by acute stroke in association with type I aortic dissection, which progressed rapidly to ascending aortic false aneurysmal development that necessitated arch replacement. Outcomes of aortic arch replacement in this setting are currently unknown. Therefore, our case might well offer some insight.
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Affiliation(s)
- Subrata Kar
- Division of Cardiovascular Medicine, University of Missouri Hospital-Columbia School of Medicine, Columbia, Missouri 65212, USA.
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Aloi M, Tromba L, Di Nardo G, Dilillo A, Del Giudice E, Marocchi E, Viola F, Civitelli F, Berni A, Cucchiara S. Premature subclinical atherosclerosis in pediatric inflammatory bowel disease. J Pediatr 2012; 161:589-94.e1. [PMID: 22579000 DOI: 10.1016/j.jpeds.2012.03.043] [Citation(s) in RCA: 60] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2011] [Revised: 02/28/2012] [Accepted: 03/22/2012] [Indexed: 12/11/2022]
Abstract
OBJECTIVES To investigate the risk for developing an early endothelial dysfunction based on increased intima media thickness (IMT) and reduced flow-mediated dilation (FMD) in children with inflammatory bowel disease (IBD), and to evaluate the role of traditional and nontraditional risk factors in determining premature atherosclerosis. STUDY DESIGN We studied 27 patients with Crohn's disease (CD) and 25 patients with ulcerative colitis (UC) (mean age, 15.2 years; mean duration of disease, 48.05 months); 31 subjects served as controls. Demographic data (age, sex, family history of diabetes, cardiovascular disease, hypertension, hypercholesterolemia), traditional risk factors for atherosclerosis (blood pressure, body mass index, active and passive smoking, dyslipidemia), and UC and CD activity indexes (Pediatric Ulcerative Colitis Activity Index and Pediatric Crohn's Disease Activity Index, respectively) were collected. The IMT of the carotid arteries was measured by high-resolution B-mode ultrasound, and endothelial function was evaluated by FMD in the brachial artery in response to reactive hyperemia. RESULTS Compared with controls, patients with CD had significantly greater exposure to passive smoking and had lower body mass index and high-density lipoprotein cholesterol values. IMT was significantly higher in patients than controls (P < .0001), and the percentage of FMD was significantly lower in both patients with CD (P < .0001) and patients with UC (P < .01) versus controls. In multivariate analysis, diagnosis of IBD was an independent risk factor for atherosclerosis. CONCLUSION Premature endothelial dysfunction occurs in pediatric IBD. This represents a new challenge in the management of pediatric IBD, leading to prevention strategies of cardiovascular disease.
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Affiliation(s)
- Marina Aloi
- Department of Pediatrics, Pediatric Gastroenterology and Liver Unit, Sapienza University of Rome, Rome, Italy
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King S, Vanicek N, Mockford KA, Coughlin PA. The effect of a 3-month supervised exercise programme on gait parameters of patients with peripheral arterial disease and intermittent claudication. Clin Biomech (Bristol, Avon) 2012; 27:845-51. [PMID: 22663776 DOI: 10.1016/j.clinbiomech.2012.05.002] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2012] [Revised: 05/09/2012] [Accepted: 05/09/2012] [Indexed: 02/07/2023]
Abstract
BACKGROUND The management of peripheral arterial disease with intermittent claudication includes angioplasty, pharmaceutical therapy, risk factor modification and exercise therapy. Supervised exercise programmes are used sporadically but may improve the distance that an individual with claudication can walk. The purpose of this study was to evaluate the effectiveness of a 3-month supervised exercise programme on improving gait parameters in patients with intermittent claudication. METHODS 12 participants were recruited (mean (SD) - age: 67.3 (6.8) years, height: 1.67 (0.09) m, mass: 79.4 (14.0) kg, ankle brachial pressure index: 0.73 (0.17)) from the local vascular unit and enrolled in a supervised exercise programme. Kinematic and kinetic data were collected at the following time points: pain-free walking, initial claudication pain, absolute claudication pain and after a patient-defined rest period. Data were collected before and after the 3-month supervised exercise programme. FINDINGS No significant differences were found in any of the gait parameters post-intervention including pain-free walking speed (P=0.274), peak hip extension (P=0.125), peak ankle plantarflexion (P=0.254), or first vertical ground reaction force peak (P=0.654). No significant gait differences were found across different levels of pain pre- or post-intervention. INTERPRETATION The lack of improvement post-intervention observed suggests that the current exercise protocol was not tailored to elicit significant improvements in patients with intermittent claudication, specifically. The results indicate that exercise programmes may show improved results post-intervention if they are longer in duration and varied in intensity. Further research into more detailed muscle and biomechanical adaptations is needed to inform exercise programmes specific to this population.
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Affiliation(s)
- Stephanie King
- Department of Sport, Health & Exercise Science, University of Hull, UK
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Urbina EM, Gao Z, Khoury PR, Martin LJ, Dolan LM. Insulin resistance and arterial stiffness in healthy adolescents and young adults. Diabetologia 2012; 55:625-31. [PMID: 22193511 PMCID: PMC3269756 DOI: 10.1007/s00125-011-2412-1] [Citation(s) in RCA: 62] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2011] [Accepted: 11/21/2011] [Indexed: 12/26/2022]
Abstract
AIMS/HYPOTHESIS Increased arterial stiffness is a risk factor for adverse cardiovascular events in adults with obesity-related insulin resistance (IR) or type 2 diabetes mellitus. Adolescents with type 2 diabetes have stiffer vessels. Whether stiffness is increased in obesity/IR in youth is not known. We sought to determine if IR was a determinant of arterial stiffness in youth, independent of obesity and cardiovascular risk factors. METHODS We measured cardiovascular risk factors, IR, adipocytokines and arterial stiffness (brachial artery distensibility [BrachD], pulse wave velocity [PWV]) and wave reflection (augmentation index [AIx]) in 343 adolescents and young adults without type 2 diabetes (15-28 years old, 47% male, 48% non-white). Individuals <85th percentile of BMI were classified as lean (n = 232). Obese individuals were grouped by HOMA index as not insulin resistant (n = 46) or insulin resistant (n = 65) by the 90th percentile for HOMA for lean. Mean differences were evaluated by ANOVA. Multivariate models evaluated whether HOMA was an independent determinant of arterial stiffness. RESULTS Risk factors deteriorated from lean to obese to obese/insulin resistant (all p ≤ 0.017). Higher AIx, lower BrachD and higher PWV indicated increased arterial stiffness in obese and obese/insulin-resistant participants. HOMA was not an independent determinant. Age, sex, BMI and BP were the most consistent determinants, with HDL-cholesterol playing a role for BrachD and leptin for PWV (AIx R²= 0.34; BrachD R² = 0.37; PWV R² = 0.40; all p ≤ 0.02). CONCLUSIONS/INTERPRETATION Although IR is associated with increased arterial stiffness, traditional cardiovascular risk factors, especially obesity and BP, are the major determinants of arterial stiffness in healthy young people.
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Affiliation(s)
- E M Urbina
- Department of Pediatrics, Preventive Cardiology, Cincinnati Children's Hospital Medical Center and the University of Cincinnati, 3333 Burnet Avenue, MLC-7002, Cincinnati, OH 45229, USA.
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Blum A, Zarqh O, Peleg A, Sirchan R, Blum N, Salameh Y, Ganaem M. Vascular inflammation and endothelial dysfunction in fracture healing. Am J Orthop (Belle Mead NJ) 2012; 41:87-91. [PMID: 22482094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Angiogenesis is an important step in bone fracture healing. In this article, we report on the healing of long bone fractures, and the involvement of the vascular and the inflammatory systems in the process. We conducted a prospective study of 20 healthy adults with traumatic long bone fracture. One week after fracture, and then 1 month later, we evaluated markers of inflammation: vascular responsiveness (brachial endothelial function and ankle brachial index) and inflammatory and cytokine levels osteopontin [OPN], E-selectin, and vascular endothelial growth factor [VEGF]). Long bone fractures caused intense vascular and inflammatory responses, represented by high levels of OPN, Eselectin, and VEGF. In vivo measurements demonstrated severe endothelial dysfunction, which could support the idea that the vascular system is recruited to build new blood vessels that support bone regeneration.
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Affiliation(s)
- Arnon Blum
- Department of Medicine, Baruch Padeh Poria Hospital, Lower Galilee, Israel.
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Vernon LT, Babineau DC, Demko CA, Lederman MM, Wang X, Toossi Z, Weinberg A, Rodriguez B. A prospective cohort study of periodontal disease measures and cardiovascular disease markers in HIV-infected adults. AIDS Res Hum Retroviruses 2011; 27:1157-66. [PMID: 21443451 PMCID: PMC3206743 DOI: 10.1089/aid.2010.0320] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
The determinants of HIV-associated cardiovascular disease (CVD) are not well understood. Periodontal disease (PD) has been linked to CVD but this connection has not been examined in HIV infection. We followed a cohort of HIV-infected adults to ascertain whether PD was associated with carotid artery intima media thickness (IMT) and brachial artery flow-mediated dilation (FMD). We performed a longitudinal observational study of HIV-infected adults on HAART for <2 years with no known heart disease. PD was characterized clinically and microbiologically. Cardiovascular disease was assessed by IMT/FMD. Linear mixed models assessed cross-sectional and longitudinal associations between PD and FMD/IMT. Forty three HIV(+) adults completed a median of 24 (6-44) months on the study. Defining delta to be the change in a variable between baseline and a follow-up time, longitudinally, on average and after adjusting for change in time, CVD-specific and HIV-specific potential confounding covariates, a 1-log(10) increase in delta Porphyromonas gingivalis was associated with a 0.013 mm increase in delta IMT (95% CI: 0.0006-0.0262; p=0.04). After adjusting for the same potential confounding covariates, a 10% increase in delta gingival recession was associated with a 2.3% increase in delta FMD (95% CI: 0.4-4.2; p=0.03). In a cohort of HIV-infected adults, an increase in subgingival Porphyromonas gingivalis, a known periodontal pathogen, was significantly associated with longitudinal increases in IMT, while increased gingival recession, which herein may represent PD resolution, was significantly associated with longitudinal improvement in FMD. In the context of HIV infection, PD may contribute to CVD risk. Intervention studies treating PD may help clarify this association.
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Affiliation(s)
- Lance T Vernon
- Case Western Reserve University School of Dental Medicine, Department of Biological Sciences, Cleveland, Ohio 44106-4905, USA.
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Kylintireas I, Shirodaria C, Lee JMS, Cunningon C, Lindsay A, Francis J, Robson MD, Neubauer S, Channon KM, Choudhury RP. Multimodal cardiovascular magnetic resonance quantifies regional variation in vascular structure and function in patients with coronary artery disease: relationships with coronary disease severity. J Cardiovasc Magn Reson 2011; 13:61. [PMID: 22017860 PMCID: PMC3256113 DOI: 10.1186/1532-429x-13-61] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [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: 04/27/2011] [Accepted: 10/21/2011] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Cardiovascular magnetic resonance (CMR) of the vessel wall is highly reproducible and can evaluate both changes in plaque burden and composition. It can also measure aortic compliance and endothelial function in a single integrated examination. Previous studies have focused on patients with pre-identified carotid atheroma. We define these vascular parameters in patients presenting with coronary artery disease and test their relations to its extent and severity. METHODS AND RESULTS 100 patients with CAD [single-vessel (16%); two-vessel (39%); and three-vessel (42%) non-obstructed coronary arteries (3%)] were studied. CAD severity and extent was expressed as modified Gensini score (mean modified score 12.38 ± 5.3). A majority of carotid plaque was located in the carotid bulb (CB). Atherosclerosis in this most diseased segment correlated modestly with the severity and extent of CAD, as expressed by the modified Gensini score (R = 0.251, P < 0.05). Using the AHA plaque classification, atheroma class also associated with CAD severity (rho = 0.26, P < 0.05). The distal descending aorta contained the greatest plaque, which correlated with the degree of CAD (R = 0.222; P < 0.05), but with no correlation with the proximal descending aorta, which was relatively spared (R = 0.106; P = n. s.). Aortic distensibility varied along its length with the ascending aorta the least distensible segment. Brachial artery FMD was inversely correlated with modified Gensini score (R = -0.278; P < 0.05). In multivariate analysis, distal descending aorta atheroma burden, distensibility of the ascending aorta, carotid atheroma class and FMD were independent predictors of modified Gensini score. CONCLUSIONS Multimodal vascular CMR shows regional abnormalities of vascular structure and function that correlate modestly with the degree and extent of CAD.
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Affiliation(s)
- Ilias Kylintireas
- Department of Cardiovascular Medicine, University of Oxford and Oxford Centre for Clinical Magnetic Resonance Research (OCMR), Oxford, UK
| | - Cheerag Shirodaria
- Department of Cardiovascular Medicine, University of Oxford and Oxford Centre for Clinical Magnetic Resonance Research (OCMR), Oxford, UK
| | - Justin MS Lee
- Department of Cardiovascular Medicine, University of Oxford and Oxford Centre for Clinical Magnetic Resonance Research (OCMR), Oxford, UK
| | - Colin Cunningon
- Department of Cardiovascular Medicine, University of Oxford and Oxford Centre for Clinical Magnetic Resonance Research (OCMR), Oxford, UK
| | - Alistair Lindsay
- Department of Cardiovascular Medicine, University of Oxford and Oxford Centre for Clinical Magnetic Resonance Research (OCMR), Oxford, UK
| | - Jane Francis
- Department of Cardiovascular Medicine, University of Oxford and Oxford Centre for Clinical Magnetic Resonance Research (OCMR), Oxford, UK
| | - Matthew D Robson
- Department of Cardiovascular Medicine, University of Oxford and Oxford Centre for Clinical Magnetic Resonance Research (OCMR), Oxford, UK
| | - Stefan Neubauer
- Department of Cardiovascular Medicine, University of Oxford and Oxford Centre for Clinical Magnetic Resonance Research (OCMR), Oxford, UK
| | - Keith M Channon
- Department of Cardiovascular Medicine, University of Oxford and Oxford Centre for Clinical Magnetic Resonance Research (OCMR), Oxford, UK
| | - Robin P Choudhury
- Department of Cardiovascular Medicine, University of Oxford and Oxford Centre for Clinical Magnetic Resonance Research (OCMR), Oxford, UK
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Montalcini T, Gorgone G, Gazzaruso C, Garzaniti A, Pujia A. Large brachial artery diameter and diabetes in post-menopausal women. Nutr Metab Cardiovasc Dis 2011; 21:830-834. [PMID: 20674310 DOI: 10.1016/j.numecd.2010.02.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2009] [Revised: 12/21/2009] [Accepted: 02/04/2010] [Indexed: 11/17/2022]
Abstract
BACKGROUND AND AIM Vascular remodelling is one of the possible compensatory mechanisms in response to artery wall injury. It was demonstrated that post-menopausal women with carotid atherosclerosis had a larger brachial artery diameter (BAD) than women without carotid plaques. Therefore, it is possible to hypothesise that artery enlargement could be a marker of early atherosclerosis. To investigate the eventual association between carotid and brachial artery diameter and disease affecting the vascular wall, we performed a case-control study in post-menopausal women with or without type II diabetes mellitus. METHODS AND RESULTS We enrolled 28 cases (with diabetes) and 56 controls (without diabetes) matched for age and carotid atherosclerosis presence and severity. On the t-test, women with diabetes showed significantly larger brachial and common carotid artery diameters and, as expected, higher plasma glucose level and homeostasis model assessment (HOMA) than women without diabetes. On the univariate analysis, only plasma glucose level results correlated to BAD in the whole sample. Multivariate analysis confirmed that diabetes was a good predictor of brachial and carotid artery diameter, while age, systolic blood pressure and triglycerides were correlated only to the carotid diameter. CONCLUSIONS Our data confirm that vascular remodelling is a systemic process occurring in conditions related to atherosclerosis, such as type II diabetes. Indeed, artery diameter could be a marker of early response of vessel wall to injury.
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Williams R, Brook R, Bard R, Conner T, Shin H, Burnett R. Impact of personal and ambient-level exposures to nitrogen dioxide and particulate matter on cardiovascular function. Int J Environ Health Res 2011; 22:71-91. [PMID: 21711166 PMCID: PMC3259186 DOI: 10.1080/09603123.2011.588437] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
This work explored the association between nitrogen dioxide (NO(2)) and PM(2.5) components with changes in cardiovascular function in an adult non-smoking cohort. The cohort consisted of 65 volunteers participating in the US EPA's Detroit Exposure and Aerosol Research Study (DEARS) and a University of Michigan cardiovascular sub-study. Systolic and diastolic blood pressure (SBP, DBP), heart rate (HR), brachial artery diameter (BAD), brachial artery flow-mediated dilatation (FMD) and nitroglycerin-mediated arterial dilatation (NMD) were collected by in-home examinations. A maximum of 336 daily environmental and health effect observations were obtained. Daily potassium air concentrations were associated with significant decreases in DBP (-0.0447 mmHg/ng/m(3) ± 0.0132, p = 0.0016, lag day 0) among participants compliant with the personal monitoring protocol. Personal NO(2) exposures resulted in significant changes in BAD (e.g., 0.0041 mm/ppb ± 0.0019, p = 0.0353, lag day 1) and FMD (0.0612 ± 0.0235, p = 0.0103, lag day 0) among other findings.
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Affiliation(s)
- Ron Williams
- National Exposure Research Laboratory, U.S. Environmental Protection Agency (US EPA), Research Triangle Park, NC, USA.
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Harrison DK, Greenidge AR, Landis RC. Skin SO₂ measurement using visible lightguide spectrophotometry in a black population: a feasibility study. Adv Exp Med Biol 2011; 701:277-82. [PMID: 21445798 DOI: 10.1007/978-1-4419-7756-4_37] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/17/2023]
Abstract
The aim of the study was to investigate the influence of melanin content on the visible wavelength range spectrophotometric measurement of SO(2) in the skin of normal healthy black and white volunteers. The reactive hyperaemia induced by a 5-minute period of tourniquet occlusion of the brachial artery, as manifested in the change in skin SO(2), was compared with the reactive hyperaemia index (RHI) and arterial stiffness index (AI) as measured using the Endo-PAT2000® peripheral arterial tonometry device. Further measurements were carried out on a diabetic patient with critical ischaemia. The measurements in the normal volunteers and the patient showed that there that there was no correlation between SO(2) and melanin index (r(2) = 0.02). There was a poor correlation between the degree of reactive hyperaemia as assessed using tissue SO(2) measurement and the parameters derived using the Endo-PAT2000® device. Measurements on the critically ischaemic lower limb of the diabetic patient revealed a mean medial/lateral SO(2) of 26.3% and a degree of tissue hypoxia (the percentage of recordings with an SO(2) of 15% or less) of 16.2%. This pilot study demonstrated that the measurement of tissue SO(2) in the skin of black subjects is feasible, not only under conditions of normal perfusion, but also in critical limb ischaemia.
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Affiliation(s)
- David K Harrison
- Regional Medical Physics Department, University Hospital of North Durham, Durham, UK.
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