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Ding X, Sha D, Sun K, Fan Y. Biomechanical insights into the development and optimization of small-diameter vascular grafts. Acta Biomater 2025:S1742-7061(25)00270-3. [PMID: 40239752 DOI: 10.1016/j.actbio.2025.04.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2024] [Revised: 03/22/2025] [Accepted: 04/13/2025] [Indexed: 04/18/2025]
Abstract
Small-diameter vascular grafts (SDVGs; inner diameter ≤6 mm) offer transformative potential for treating cardiovascular diseases, yet their clinical application remains limited due to high rates of complications such as acute thrombosis and intimal hyperplasia (IH), which compromise long-term patency. While advancements in biological and material science have driven progress, the critical role of biomechanical factors-such as hemodynamic forces and mechanical mismatch-in graft failure is often overlooked. This review presents insights from recent clinical trials of SDVG products and summarizes biomechanical contributors to failure, including disturbed flow patterns, mechanical mismatch, and insufficient mechanical strength. We outline essential mechanical performance criteria (e.g., compliance, burst pressure) and evaluation methodologies to assess SDVG performance. Furthermore, we present optimization strategies based on biomechanical principles: (1) graft morphological design optimization to improve hemodynamic stability, (2) structural, material, and fabrication innovations to achieve compliance matching with native arteries, and (3) biomimetic approaches to mimic vascular tissue and promote endothelialization. By systematically addressing these biomechanical challenges, next-generation SDVGs may achieve superior patency, accelerating their clinical translation. This review highlights the necessity of considering biomechanical compatibility in SDVG development, thereby providing initial insights for the clinical translation of SDVG. STATEMENT OF SIGNIFICANCE: Small-diameter vascular grafts (SDVGs) offer transformative potential for cardiovascular disease treatment but face clinical limitations. While significant progress has been made in biological and material innovations, the critical role of biomechanical factors in graft failure has often been underestimated. This review highlights the importance of biomechanical compatibility in SDVG design and performance, emphasizing the need to address disturbed flow patterns, mechanical mismatch, and inadequate mechanical strength. By proposing optimization strategies based on biomechanical principles, such as graft morphological design, compliance matching, and biomimetic approaches, this work provides a roadmap for developing next-generation SDVGs with improved patency. These advancements have the potential to overcome current limitations, accelerate clinical translation, ultimately benefiting patients worldwide.
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Affiliation(s)
- Xili Ding
- Medical Engineering & Engineering Medicine Innovation Center, Hangzhou International Innovation Institute, Beihang University, Hangzhou, 311115, China; Key Laboratory of Biomechanics and Mechanobiology of Ministry of Education, Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological and Medical Engineering, and with the School of Engineering Medicine, Beihang University, Beijing, 100191, China; National Medical Innovation Platform for Industry-Education Integration in Advanced Medical Devices (Interdiscipline of Medicine and Engineering), Key Laboratory of Innovation and Transformation of Advanced Medical Devices of Ministry of Industry and Information Technology, Beihang University, Beijing, 100083, China
| | - Dongyu Sha
- Key Laboratory of Biomechanics and Mechanobiology of Ministry of Education, Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological and Medical Engineering, and with the School of Engineering Medicine, Beihang University, Beijing, 100191, China
| | - Kaixin Sun
- Key Laboratory of Biomechanics and Mechanobiology of Ministry of Education, Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological and Medical Engineering, and with the School of Engineering Medicine, Beihang University, Beijing, 100191, China; National Superior College for Engineers, Beihang University, Beijing, 100191, China
| | - Yubo Fan
- Medical Engineering & Engineering Medicine Innovation Center, Hangzhou International Innovation Institute, Beihang University, Hangzhou, 311115, China; Key Laboratory of Biomechanics and Mechanobiology of Ministry of Education, Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological and Medical Engineering, and with the School of Engineering Medicine, Beihang University, Beijing, 100191, China; National Medical Innovation Platform for Industry-Education Integration in Advanced Medical Devices (Interdiscipline of Medicine and Engineering), Key Laboratory of Innovation and Transformation of Advanced Medical Devices of Ministry of Industry and Information Technology, Beihang University, Beijing, 100083, China.
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Alloisio M, Siika A, Freiholtz D, Franco-Cereceda A, Roy J, Björck HM, Gasser TC. Fracture properties of porcine versus human thoracic aortas from tricuspid/bicuspid aortic valve patients via symmetry-constraint Compact Tension testing. Sci Rep 2025; 15:667. [PMID: 39753641 PMCID: PMC11699116 DOI: 10.1038/s41598-024-83233-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2024] [Accepted: 12/12/2024] [Indexed: 01/06/2025] Open
Abstract
Aneurysm rupture is a life-threatening event, yet its underlying mechanisms remain largely unclear. This study investigated the fracture properties of the thoracic aneurysmatic aorta (TAA) using the symmetry-constraint Compact Tension (symconCT) test and compared results to native and enzymatic-treated porcine aortas' tests. With age, the aortic stiffness increased, and tissues ruptured at lower fracture energy [Formula: see text]. Patients with bicuspid aortic valves were more sensitive to age, had stronger aortas and required more [Formula: see text] than tricuspid valves individuals (peak load: axial loading 4.42 ± 1.56 N vs 2.51 ± 1.60 N; circumferential loading 5.76 ± 2.43 N vs 4.82 ± 1.49 N. Fracture energy: axial loading 1.92 ± 0.60 kJ m-2 vs 0.74 ± 0.50 kJ m-2; circumferential loading 2.12 ± 2.39 kJ m-2 vs 1.47 ± 0.91 kJ m-2). Collagen content partly explained the variability in [Formula: see text], especially in bicuspid cases. Besides the primary crack, TAAs and enzymatic-treated porcine aortas displayed diffuse and shear-dominated dissection and tearing. As human tissue tests resembled enzymatic-treated porcine aortas, microstructural degeneration, including elastin loss and collagen degeneration, seems to be the main cause of TAA wall weakening. Additionally, a tortuous crack developing during the symconCT test reflected intact fracture toughening mechanisms and might characterize a healthier aorta.
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Affiliation(s)
- Marta Alloisio
- Department of Engineering Mechanics, KTH Royal Institute of Technology, Stockholm, Sweden
| | - Antti Siika
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
| | - David Freiholtz
- Section of Cardiothoracic Surgery, Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
- Division of Cardiology, Center for Molecular Medicine, Department of Medicine, Karolinska University Hospital, Karolinska Institutet, Solna, Stockholm, Sweden
| | - Anders Franco-Cereceda
- Section of Cardiothoracic Surgery, Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
| | - Joy Roy
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
- Department of Vascular Surgery, Karolinska University Hospital, Karolinska Institutet, Stockholm, Sweden
| | - Hanna M Björck
- Division of Cardiology, Center for Molecular Medicine, Department of Medicine, Karolinska University Hospital, Karolinska Institutet, Solna, Stockholm, Sweden
| | - T Christian Gasser
- Department of Engineering Mechanics, KTH Royal Institute of Technology, Stockholm, Sweden.
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3
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Fan L, Tang Y, Liu J, Liu Y, Xu Y, Liu J, Liu H, Pang W, Guo Y, Yao W, Zhang T, Peng Q, Zhou J. Mechanical Activation of cPLA2 Impedes Fatty Acid β-Oxidation in Vein Grafts. ADVANCED SCIENCE (WEINHEIM, BADEN-WURTTEMBERG, GERMANY) 2025; 12:e2411559. [PMID: 39587975 PMCID: PMC11744522 DOI: 10.1002/advs.202411559] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/19/2024] [Revised: 11/03/2024] [Indexed: 11/27/2024]
Abstract
High-magnitude cyclic stretch from arterial blood pressure significantly contributes to the excessive proliferation and migration of vascular smooth muscle cells (VSMCs), leading to neointima formation in vein grafts. However, the molecular mechanisms remain unclear. This study highlights the critical role of cytosolic Phospholipase A2 (cPLA2)/ Yin Yang 1 (YY1)/ carnitine palmitoyltransferase 1b (CPT1B) signaling in coordinating VSMC mechanical activation by inhibiting fatty acid β-oxidation. Metabolomic analysis showed that a 15%-1 Hz arterial cyclic stretch, compared to a 5%-1 Hz venous stretch, increased long-chain fatty acids in VSMCs. cPLA2, identified as a mechanoresponsive molecule, produces excessive arachidonic acid (ArAc) under the 15%-1 Hz stretch, inhibiting CPT1B expression, a key enzyme in fatty acid β-oxidation. ArAc promotes transcription factor YY1 degradation, downregulating CPT1B. Inadequate fatty acid oxidation caused by knockdown of CPT1B or YY1, or etomoxir treatment, increased nuclear membrane tension, orchestrating the activation of cPLA2. Overexpressing CPT1B or inhibiting cPLA2 reduced VSMC proliferation and migration in vein grafts, decreasing neointimal hyperplasia. This study uncovers a novel mechanism in lipid metabolic reprogramming in vein grafts, suggesting a new therapeutic target for vein graft hyperplasia.
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Affiliation(s)
- Linwei Fan
- Department of Physiology and PathophysiologySchool of Basic Medical SciencesState Key Laboratory of Vascular Homeostasis and RemodelingDepartment of Cardiology and Institute of Vascular MedicinePeking University Third HospitalNational Health Commission Key Laboratory of Cardiovascular Molecular Biology and Regulatory PeptidesBeijing Key Laboratory of Cardiovascular Receptors ResearchPeking UniversityBeijing100191China
| | - Yuanjun Tang
- Department of Physiology and PathophysiologySchool of Basic Medical SciencesState Key Laboratory of Vascular Homeostasis and RemodelingDepartment of Cardiology and Institute of Vascular MedicinePeking University Third HospitalNational Health Commission Key Laboratory of Cardiovascular Molecular Biology and Regulatory PeptidesBeijing Key Laboratory of Cardiovascular Receptors ResearchPeking UniversityBeijing100191China
| | - Jian Liu
- Shenzhen Bay LaboratoryShenzhen518132China
| | - Yueqi Liu
- Department of Physiology and PathophysiologySchool of Basic Medical SciencesState Key Laboratory of Vascular Homeostasis and RemodelingDepartment of Cardiology and Institute of Vascular MedicinePeking University Third HospitalNational Health Commission Key Laboratory of Cardiovascular Molecular Biology and Regulatory PeptidesBeijing Key Laboratory of Cardiovascular Receptors ResearchPeking UniversityBeijing100191China
| | - Yiwei Xu
- Department of Physiology and PathophysiologySchool of Basic Medical SciencesState Key Laboratory of Vascular Homeostasis and RemodelingDepartment of Cardiology and Institute of Vascular MedicinePeking University Third HospitalNational Health Commission Key Laboratory of Cardiovascular Molecular Biology and Regulatory PeptidesBeijing Key Laboratory of Cardiovascular Receptors ResearchPeking UniversityBeijing100191China
| | - Jiayu Liu
- Department of Physiology and PathophysiologySchool of Basic Medical SciencesState Key Laboratory of Vascular Homeostasis and RemodelingDepartment of Cardiology and Institute of Vascular MedicinePeking University Third HospitalNational Health Commission Key Laboratory of Cardiovascular Molecular Biology and Regulatory PeptidesBeijing Key Laboratory of Cardiovascular Receptors ResearchPeking UniversityBeijing100191China
| | - Han Liu
- Department of Physiology and PathophysiologySchool of Basic Medical SciencesState Key Laboratory of Vascular Homeostasis and RemodelingDepartment of Cardiology and Institute of Vascular MedicinePeking University Third HospitalNational Health Commission Key Laboratory of Cardiovascular Molecular Biology and Regulatory PeptidesBeijing Key Laboratory of Cardiovascular Receptors ResearchPeking UniversityBeijing100191China
| | - Wei Pang
- Department of Physiology and PathophysiologySchool of Basic Medical SciencesState Key Laboratory of Vascular Homeostasis and RemodelingDepartment of Cardiology and Institute of Vascular MedicinePeking University Third HospitalNational Health Commission Key Laboratory of Cardiovascular Molecular Biology and Regulatory PeptidesBeijing Key Laboratory of Cardiovascular Receptors ResearchPeking UniversityBeijing100191China
| | - Yuxuan Guo
- Institute of Cardiovascular SciencesSchool of Basic Medical SciencesState Key Laboratory of Vascular Homeostasis and RemodelingBeijing Key Laboratory of Cardiovascular Receptors ResearchPeking UniversityBeijing100191China
| | - Weijuan Yao
- Department of Physiology and PathophysiologySchool of Basic Medical SciencesState Key Laboratory of Vascular Homeostasis and RemodelingDepartment of Cardiology and Institute of Vascular MedicinePeking University Third HospitalNational Health Commission Key Laboratory of Cardiovascular Molecular Biology and Regulatory PeptidesBeijing Key Laboratory of Cardiovascular Receptors ResearchPeking UniversityBeijing100191China
| | - Tao Zhang
- Department of Vascular SurgeryPeking University People's HospitalBeijing100044China
| | - Qin Peng
- Shenzhen Bay LaboratoryShenzhen518132China
| | - Jing Zhou
- Department of Physiology and PathophysiologySchool of Basic Medical SciencesState Key Laboratory of Vascular Homeostasis and RemodelingDepartment of Cardiology and Institute of Vascular MedicinePeking University Third HospitalNational Health Commission Key Laboratory of Cardiovascular Molecular Biology and Regulatory PeptidesBeijing Key Laboratory of Cardiovascular Receptors ResearchPeking UniversityBeijing100191China
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Guan X, Hu Y, Hao J, Lu M, Zhang Z, Hu W, Li D, Li C. Stress, Vascular Smooth Muscle Cell Phenotype and Atherosclerosis: Novel Insight into Smooth Muscle Cell Phenotypic Transition in Atherosclerosis. Curr Atheroscler Rep 2024; 26:411-425. [PMID: 38814419 DOI: 10.1007/s11883-024-01220-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/20/2024] [Indexed: 05/31/2024]
Abstract
PURPOSE OF REVIEW Our work is to establish more distinct association between specific stress and vascular smooth muscle cells (VSMCs) phenotypes to alleviate atherosclerotic plaque burden and delay atherosclerosis (AS) progression. RECENT FINDING In recent years, VSMCs phenotypic transition has received significant interests. Different stresses were found to be associated with VSMCs phenotypic transition. However, the explicit correlation between VSMCs phenotype and specific stress has not been elucidated clearly yet. We discover that VSMCs phenotypic transition, which is widely involved in the progression of AS, is associated with specific stress. We discuss approaches targeting stresses to intervene VSMCs phenotypic transition, which may contribute to develop innovative therapies for AS.
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Affiliation(s)
- Xiuya Guan
- Innovation Research Institute of Traditional Chinese Medicine, Shandong University of Traditional Chinese Medicine, Jinan, 250355, China
| | - Yuanlong Hu
- First Clinical Medical College, Shandong University of Traditional Chinese Medicine, Jinan, 250355, China
| | - Jiaqi Hao
- Innovation Research Institute of Traditional Chinese Medicine, Shandong University of Traditional Chinese Medicine, Jinan, 250355, China
| | - Mengkai Lu
- Innovation Research Institute of Traditional Chinese Medicine, Shandong University of Traditional Chinese Medicine, Jinan, 250355, China
| | - Zhiyuan Zhang
- Innovation Research Institute of Traditional Chinese Medicine, Shandong University of Traditional Chinese Medicine, Jinan, 250355, China
| | - Wenxian Hu
- Qingdao Hiser Hospital Affiliated of Qingdao University (Qingdao Traditional Chinese Medicine Hospital), Qingdao, 266000, China.
| | - Dongxiao Li
- Experimental Center, Shandong University of Traditional Chinese Medicine, Jinan, 250355, China.
| | - Chao Li
- Innovation Research Institute of Traditional Chinese Medicine, Shandong University of Traditional Chinese Medicine, Jinan, 250355, China.
- Qingdao Hiser Hospital Affiliated of Qingdao University (Qingdao Traditional Chinese Medicine Hospital), Qingdao, 266000, China.
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5
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Williamson PN, Docherty PD, Jermy M, Steven BM. Literature Survey for In-Vivo Reynolds and Womersley Numbers of Various Arteries and Implications for Compliant In-Vitro Modelling. Cardiovasc Eng Technol 2024; 15:418-430. [PMID: 38499933 PMCID: PMC11319390 DOI: 10.1007/s13239-024-00723-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Accepted: 02/19/2024] [Indexed: 03/20/2024]
Abstract
PURPOSE In-vitro modelling can be used to investigate haemodynamics of arterial geometry and stent implants. However, in-vitro model fidelity relies on precise matching of in-vivo conditions. In pulsatile flow, velocity distribution and wall shear stress depend on compliance, and the Reynolds and Womersley numbers. However, matching such values may lead to unachievable tolerances in phantom fabrication. METHODS Published Reynolds and Womersley numbers for 14 major arteries in the human body were determined via a literature search. Preference was given to in-vivo publications but in-vitro and in-silico values were presented when in-vivo values were not found. Subsequently ascending aorta and carotid artery case studies were presented to highlight the limitations dynamic matching would apply to phantom fabrication. RESULTS Seven studies reported the in-vivo Reynolds and Womersley numbers for the aorta and two for the carotid artery. However, only one study each reported in-vivo numbers for the remaining ten arteries. No in-vivo data could be found for the femoral, superior mesenteric and renal arteries. Thus, information derived in-vitro and in-silico were provided instead. The ascending aorta and carotid artery models required scaling to 1.5× and 3× life-scale, respectively, to achieve dimensional tolerance restrictions. Modelling the ascending aorta with the comparatively high viscosity water/glycerine solution will lead to high pump power demands. However, all the working fluids considered could be dynamically matched with low pump demand for the carotid model. CONCLUSION This paper compiles available human haemodynamic information, and highlights the paucity of information for some arteries. It also provides a method for optimal in-vitro experimental configuration.
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Affiliation(s)
- P N Williamson
- Department of Mechanical Engineering, University of Canterbury, Private Bag 4800, Christchurch, 8140, New Zealand
| | - P D Docherty
- Department of Mechanical Engineering, University of Canterbury, Private Bag 4800, Christchurch, 8140, New Zealand.
- Institute of Technical Medicine, Furtwangen University, Campus Villingen-Schwenningen, Jakob-Kienzle Strasse 17, 78054, Villingen-Schwenningen, Germany.
| | - M Jermy
- Department of Mechanical Engineering, University of Canterbury, Private Bag 4800, Christchurch, 8140, New Zealand
| | - B M Steven
- Department of Mechanical Engineering, University of Canterbury, Private Bag 4800, Christchurch, 8140, New Zealand
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Vargas AI, Tarraf SA, Jennings T, Bellini C, Amini R. Vascular Remodeling During Late-Gestation Pregnancy: An In-Vitro Assessment of the Murine Ascending Thoracic Aorta. J Biomech Eng 2024; 146:071004. [PMID: 38345599 DOI: 10.1115/1.4064744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Indexed: 03/20/2024]
Abstract
Maternal mortality due to cardiovascular disease is a rising concern in the U.S. Pregnancy triggers changes in the circulatory system, potentially influencing the structure of the central vasculature. Evidence suggests a link between a woman's pregnancy history and future cardiovascular health, but our understanding remains limited. To fill this gap, we examined the passive mechanics of the murine ascending thoracic aorta during late gestation. By performing biaxial mechanical testing on the ascending aorta, we were able to characterize the mechanical properties of both control and late-gestation tissues. By examining mechanical, structural, and geometric properties, we confirmed that remodeling of the aortic wall occurred. Morphological and mechanical properties of the tissue indicated an outward expansion of the tissue, as reflected in changes in wall thickness (∼12% increase) and luminal diameter (∼6% increase) at its physiologically loaded state in the pregnant group. With these geometric adaptations and despite increased hemodynamic loads, pregnancy did not induce significant changes in the tensile wall stress at the similar physiological pressure levels of the pregnant and control tissues. The alterations also included reduced intrinsic stiffness in the circumferential direction (∼18%) and reduced structural stiffness (∼26%) in the pregnant group. The observed vascular remodeling maintained the elastic stored energy of the aortic wall under systolic loads, indicating preservation of vascular function. Data from our study of pregnancy-related vascular remodeling will provide valuable insights for future investigations of maternal cardiovascular health.
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Affiliation(s)
- Ana I Vargas
- Department of Bioengineering, Northeastern University, Boston, MA 02115
| | - Samar A Tarraf
- Department of Bioengineering, Northeastern University, Boston, MA 02115
- Northeastern University
| | - Turner Jennings
- Department of Mechanical and Industrial Engineering, Department of Bioengineering, Northeastern University, Boston, MA 02115
- Northeastern University
| | - Chiara Bellini
- Department of Bioengineering, Northeastern University, Boston, MA 02115
| | - Rouzbeh Amini
- Department of Mechanical and Industrial Engineering, Department of Bioengineering, Northeastern University, Boston, MA 02115
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7
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Abatzis-Papadopoulos M, Tigkiropoulos K, Nikas S, Sidiropoulou K, Alexou C, Stavridis K, Karamanos D, Kotsis V, Lazaridis I, Saratzis N. Study Protocol of a Prospective, Monocentric, Single-Arm Study Investigating the Correlation of Endograft Properties with Aortic Stiffness in Abdominal Aortic Aneurysm Patients Subjected to Endovascular Aortic Repair. J Clin Med 2024; 13:2205. [PMID: 38673477 PMCID: PMC11050864 DOI: 10.3390/jcm13082205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2024] [Revised: 04/05/2024] [Accepted: 04/09/2024] [Indexed: 04/28/2024] Open
Abstract
The number of endovascular aortic repairs (EVARs) has surpassed the number of open surgical repairs of abdominal aortic aneurysms (AAAs) worldwide. The available commercial endoprostheses are composed of materials that are stiffer than the native aortic wall. As a consequence, the implantation of stent-graft endoprostheses during EVAR increases aortic rigidity and thus aortic stiffness, resulting in a decrease in abdominal aorta compliance. EVAR has been found to have a possibly harmful effect not only on heart functions but also on other vascular beds, including kidney function, due to the decrease in aortic compliance that it causes. Aortic stiffness is measured by various hemodynamic indices like the pulse wave velocity (PWV), the central aortic pressure (CAP), and the augmentation index (AIx). In the literature, there are increasing numbers of studies investigating the properties of endografts, which are strongly related to increases in aortic stiffness. However, there is a lack of data on whether there is a correlation between the length of various endografts implanted during EVAR and the increase in the PWV, CAP, and AIx postoperatively compared to the preoperative values. The aim of this prospective, observational, monocentric, single-arm study is to investigate the correlation between endograft length and the postoperative increase in the PWV, CAP, and AIx in patients subjected to EVAR. Additionally, this study intends to identify other endograft properties related to increases in the PWV, CAP, and AIx. Other endpoints to be studied are the existence of immediate postoperative myocardial and kidney injury after EVAR. The prediction of cardiovascular events caused by endograft-related increased aortic stiffness could contribute to the improvement of various endograft properties so that the impact of endografts on the native aortic wall can be minimized.
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Affiliation(s)
- Manolis Abatzis-Papadopoulos
- Vascular Unit, 1st University Surgical Department, Papageorgiou General Hospital, Aristotle University of Thessaloniki, 56403 Thessaloniki, Greece; (K.T.); (K.S.); (K.S.); (D.K.); (I.L.); (N.S.)
| | - Konstantinos Tigkiropoulos
- Vascular Unit, 1st University Surgical Department, Papageorgiou General Hospital, Aristotle University of Thessaloniki, 56403 Thessaloniki, Greece; (K.T.); (K.S.); (K.S.); (D.K.); (I.L.); (N.S.)
| | - Spyridon Nikas
- Radiology Department, Papageorgiou General Hospital, 56403 Thessaloniki, Greece;
| | - Katerina Sidiropoulou
- Vascular Unit, 1st University Surgical Department, Papageorgiou General Hospital, Aristotle University of Thessaloniki, 56403 Thessaloniki, Greece; (K.T.); (K.S.); (K.S.); (D.K.); (I.L.); (N.S.)
| | - Christina Alexou
- Cardiothoracic Surgery Department, Papanikolaou General Hospital, 57010 Thessaloniki, Greece;
| | - Kyriakos Stavridis
- Vascular Unit, 1st University Surgical Department, Papageorgiou General Hospital, Aristotle University of Thessaloniki, 56403 Thessaloniki, Greece; (K.T.); (K.S.); (K.S.); (D.K.); (I.L.); (N.S.)
| | - Dimitrios Karamanos
- Vascular Unit, 1st University Surgical Department, Papageorgiou General Hospital, Aristotle University of Thessaloniki, 56403 Thessaloniki, Greece; (K.T.); (K.S.); (K.S.); (D.K.); (I.L.); (N.S.)
| | - Vasilios Kotsis
- 3rd University Department of Internal Medicine, Papageorgiou General Hospital, Aristotle University of Thessaloniki, 56403 Thessaloniki, Greece;
| | - Ioannis Lazaridis
- Vascular Unit, 1st University Surgical Department, Papageorgiou General Hospital, Aristotle University of Thessaloniki, 56403 Thessaloniki, Greece; (K.T.); (K.S.); (K.S.); (D.K.); (I.L.); (N.S.)
| | - Nikolaos Saratzis
- Vascular Unit, 1st University Surgical Department, Papageorgiou General Hospital, Aristotle University of Thessaloniki, 56403 Thessaloniki, Greece; (K.T.); (K.S.); (K.S.); (D.K.); (I.L.); (N.S.)
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Bohoran TA, Parke KS, Graham-Brown MPM, Meisuria M, Singh A, Wormleighton J, Adlam D, Gopalan D, Davies MJ, Williams B, Brown M, McCann GP, Giannakidis A. Resource efficient aortic distensibility calculation by end to end spatiotemporal learning of aortic lumen from multicentre multivendor multidisease CMR images. Sci Rep 2023; 13:21794. [PMID: 38066222 PMCID: PMC10709583 DOI: 10.1038/s41598-023-48986-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Accepted: 12/02/2023] [Indexed: 12/18/2023] Open
Abstract
Aortic distensibility (AD) is important for the prognosis of multiple cardiovascular diseases. We propose a novel resource-efficient deep learning (DL) model, inspired by the bi-directional ConvLSTM U-Net with densely connected convolutions, to perform end-to-end hierarchical learning of the aorta from cine cardiovascular MRI towards streamlining AD quantification. Unlike current DL aortic segmentation approaches, our pipeline: (i) performs simultaneous spatio-temporal learning of the video input, (ii) combines the feature maps from the encoder and decoder using non-linear functions, and (iii) takes into account the high class imbalance. By using multi-centre multi-vendor data from a highly heterogeneous patient cohort, we demonstrate that the proposed method outperforms the state-of-the-art method in terms of accuracy and at the same time it consumes [Formula: see text] 3.9 times less fuel and generates [Formula: see text] 2.8 less carbon emissions. Our model could provide a valuable tool for exploring genome-wide associations of the AD with the cognitive performance in large-scale biomedical databases. By making energy usage and carbon emissions explicit, the presented work aligns with efforts to keep DL's energy requirements and carbon cost in check. The improved resource efficiency of our pipeline might open up the more systematic DL-powered evaluation of the MRI-derived aortic stiffness.
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Affiliation(s)
- Tuan Aqeel Bohoran
- School of Science and Technology, Nottingham Trent University, Nottingham, NG11 8NS, UK
| | - Kelly S Parke
- Department of Cardiovascular Sciences, University of Leicester and the NIHR Leicester Biomedical Research Centre, Glenfield Hospital, Leicester, LE3 9QP, UK
| | - Matthew P M Graham-Brown
- Department of Cardiovascular Sciences, University of Leicester and the NIHR Leicester Biomedical Research Centre, Glenfield Hospital, Leicester, LE3 9QP, UK
| | - Mitul Meisuria
- Department of Cardiovascular Sciences, University of Leicester and the NIHR Leicester Biomedical Research Centre, Glenfield Hospital, Leicester, LE3 9QP, UK
| | - Anvesha Singh
- Department of Cardiovascular Sciences, University of Leicester and the NIHR Leicester Biomedical Research Centre, Glenfield Hospital, Leicester, LE3 9QP, UK
| | - Joanne Wormleighton
- Department of Cardiovascular Sciences, University of Leicester and the NIHR Leicester Biomedical Research Centre, Glenfield Hospital, Leicester, LE3 9QP, UK
| | - David Adlam
- Department of Cardiovascular Sciences, University of Leicester and the NIHR Leicester Biomedical Research Centre, Glenfield Hospital, Leicester, LE3 9QP, UK
| | - Deepa Gopalan
- Imperial College London & Cambridge University Hospitals, Cambridge, CB2 0QQ, UK
| | - Melanie J Davies
- Leicester Diabetes Centre, University of Leicester and the NIHR Leicester Biomedical Research Centre, Leicester General Hospital, Leicester, LE5 4PW, UK
| | - Bryan Williams
- Institute of Cardiovascular Science, University College London (UCL), National Institute for Health Research (NIHR), UCL Hospitals Biomedical Research Centre, London, WC1E 6DD, UK
| | - Morris Brown
- Department of Clinical Pharmacology, William Harvey Research Institute, Queen Mary University of London, London, EC1M 6BQ, UK
| | - Gerry P McCann
- Department of Cardiovascular Sciences, University of Leicester and the NIHR Leicester Biomedical Research Centre, Glenfield Hospital, Leicester, LE3 9QP, UK
| | - Archontis Giannakidis
- School of Science and Technology, Nottingham Trent University, Nottingham, NG11 8NS, UK.
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9
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Tain YL, Hsu CN. Cardiovascular Risks of Hypertension: Lessons from Children with Chronic Kidney Disease. CHILDREN (BASEL, SWITZERLAND) 2022; 9:1650. [PMID: 36360378 PMCID: PMC9688449 DOI: 10.3390/children9111650] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/08/2022] [Revised: 10/25/2022] [Accepted: 10/27/2022] [Indexed: 09/29/2023]
Abstract
Hypertension is the most common complication of chronic kidney disease (CKD) in children, having a strong association with subsequential cardiovascular disease (CVD). In pediatric CKD, a considerable percentage of children with hypertension are undiagnosed or undertreated. Prior research has evaluated structural and functional markers of subclinical CVD and biomarkers in adults with CKD, while ideal biomarkers in pediatrics are still insufficiently studied. The ultimate goal of this review is to summarize what is currently known about state of hypertension, cardiovascular risk factors, and potential CVD markers/biomarkers in children with pre-dialysis CKD. We discuss omics-related biomarkers and the pathophysiologic processes of endothelial dysfunction, kidney injury, oxidative stress and inflammation that are classified by specific biomarkers. Moreover, we illustrate the existing challenges and highlight the paucity of pediatric CKD research to evaluate these CVD biomarkers for future clinical pediatric practice. Thus, achieving clinical utility of CVD biomarkers for use in pediatric CKD remains a significant challenge requiring additional efforts.
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Affiliation(s)
- You-Lin Tain
- Division of Pediatric Nephrology, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 833, Taiwan
- College of Medicine, Chang Gung University, Taoyuan 333, Taiwan
| | - Chien-Ning Hsu
- Department of Pharmacy, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 833, Taiwan
- School of Pharmacy, Kaohsiung Medical University, Kaohsiung 807, Taiwan
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10
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Seime T, van Wanrooij M, Karlöf E, Kronqvist M, Johansson S, Matic L, Gasser TC, Hedin U. Biomechanical Assessment of Macro-Calcification in Human Carotid Atherosclerosis and Its Impact on Smooth Muscle Cell Phenotype. Cells 2022; 11:3279. [PMID: 36291144 PMCID: PMC9600867 DOI: 10.3390/cells11203279] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Revised: 10/14/2022] [Accepted: 10/17/2022] [Indexed: 12/13/2023] Open
Abstract
Intimal calcification and vascular stiffening are predominant features of end-stage atherosclerosis. However, their role in atherosclerotic plaque instability and how the extent and spatial distribution of calcification influence plaque biology remain unclear. We recently showed that extensive macro calcification can be a stabilizing feature of late-stage human lesions, associated with a reacquisition of more differentiated properties of plaque smooth muscle cells (SMCs) and extracellular matrix (ECM) remodeling. Here, we hypothesized that biomechanical forces related to macro-calcification within plaques influence SMC phenotype and contribute to plaque stabilization. We generated a finite element modeling (FEM) pipeline to assess plaque tissue stretch based on image analysis of preoperative computed tomography angiography (CTA) of carotid atherosclerotic plaques to visualize calcification and soft tissues (lipids and extracellular matrix) within the lesions. Biomechanical stretch was significantly reduced in tissues in close proximity to macro calcification, while increased levels were observed within distant soft tissues. Applying this data to an in vitro stretch model on primary vascular SMCs revealed upregulation of typical markers for differentiated SMCs and contractility under low stretch conditions but also impeded SMC alignment. In contrast, high stretch conditions in combination with calcifying conditions induced SMC apoptosis. Our findings suggest that the load bearing capacities of macro calcifications influence SMC differentiation and survival and contribute to atherosclerotic plaque stabilization.
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Affiliation(s)
- Till Seime
- Vascular Surgery, Department of Molecular Medicine and Surgery, Karolinska Institute, 17164 Stockholm, Sweden
| | - Max van Wanrooij
- Solid Mechanics, School of Engineering Sciences, KTH Royal Institute of Technology, 10044 Stockholm, Sweden
| | - Eva Karlöf
- Vascular Surgery, Department of Molecular Medicine and Surgery, Karolinska Institute, 17164 Stockholm, Sweden
| | - Malin Kronqvist
- Vascular Surgery, Department of Molecular Medicine and Surgery, Karolinska Institute, 17164 Stockholm, Sweden
| | - Staffan Johansson
- Biochemistry & Cell & Tumor Biology, Department of Medical Biochemistry and Microbiology, Uppsala University, 75123 Uppsala, Sweden
| | - Ljubica Matic
- Vascular Surgery, Department of Molecular Medicine and Surgery, Karolinska Institute, 17164 Stockholm, Sweden
| | - T. Christian Gasser
- Solid Mechanics, School of Engineering Sciences, KTH Royal Institute of Technology, 10044 Stockholm, Sweden
| | - Ulf Hedin
- Vascular Surgery, Department of Molecular Medicine and Surgery, Karolinska Institute, 17164 Stockholm, Sweden
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11
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Tokgoz A, Wang S, Sastry P, Sun C, Figg NL, Huang Y, Bennett MR, Sinha S, Gillard JH, Sutcliffe MPF, Teng Z. Association of Collagen, Elastin, Glycosaminoglycans, and Macrophages With Tissue Ultimate Material Strength and Stretch in Human Thoracic Aortic Aneurysms: A Uniaxial Tension Study. J Biomech Eng 2022; 144:101001. [PMID: 35274123 DOI: 10.1115/1.4054060] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2020] [Indexed: 11/08/2022]
Abstract
Fiber structures and pathological features, e.g., inflammation and glycosaminoglycan (GAG) deposition, are the primary determinants of aortic mechanical properties which are associated with the development of an aneurysm. This study is designed to quantify the association of tissue ultimate strength and extensibility with the structural percentage of different components, in particular, GAG, and local fiber orientation. Thoracic aortic aneurysm (TAA) tissues from eight patients were collected. Ninety-six tissue strips of thickened intima, media, and adventitia were prepared for uni-extension tests and histopathological examination. Area ratios of collagen, elastin, macrophage and GAG, and collagen fiber dispersion were quantified. Collagen, elastin, and GAG were layer-dependent and the inflammatory burden in all layers was low. The local GAG ratio was negatively associated with the collagen ratio (r2 = 0.173, p < 0.05), but positively with elastin (r2 = 0.037, p < 0.05). Higher GAG deposition resulted in larger local collagen fiber dispersion in the media and adventitia, but not in the intima. The ultimate stretch in both axial and circumferential directions was exclusively associated with elastin ratio (axial: r2 = 0.186, p = 0.04; circumferential: r2 = 0.175, p = 0.04). Multivariate analysis showed that collagen and GAG contents were both associated with ultimate strength in the circumferential direction, but not with the axial direction (collagen: slope = 27.3, GAG: slope = -18.4, r2 = 0.438, p = 0.002). GAG may play important roles in TAA material strength. Their deposition was found to be associated positively with the local collagen fiber dispersion and negatively with ultimate strength in the circumferential direction.
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Affiliation(s)
- Aziz Tokgoz
- Department of Engineering, University of Cambridge, Cambridge CB2 1TN, UK
| | - Shuo Wang
- Department of Radiology, University of Cambridge, Cambridge CB2 1TN, UK; Digital Medical Research Center, School of Basic Medical Sciences, Fudan University, Shanghai 200437, China; Shanghai Key Laboratory of MICCAI, Shanghai, China
| | - Priya Sastry
- Division of Cardiovascular Medicine, Department of Medicine, University of Cambridge, Cambridge CB2 1TN, UK
| | - Chang Sun
- Department of Radiology, University of Cambridge, Cambridge CB2 1TN, UK
| | - Nichola L Figg
- Digital Medical Research Center, School of Basic Medical Sciences, Fudan University, Shanghai 200437, China
| | - Yuan Huang
- Department of Radiology, University of Cambridge, Cambridge CB2 1TN, UK; Centre for Mathematical and Statistical Analysis of Multimodal Clinical Imaging, University of Cambridge, Cambridge CB2 1TN, UK
| | - Martin R Bennett
- Division of Cardiovascular Medicine, Department of Medicine, University of Cambridge, Cambridge CB2 1TN, UK
| | - Sanjay Sinha
- Division of Cardiovascular Medicine, Department of Medicine, University of Cambridge, Cambridge CB2 1TN, UK
| | | | - Michael P F Sutcliffe
- Department of Engineering, University of Cambridge, Trumpington Street, Cambridge CB2 1PZ, UK
| | - Zhongzhao Teng
- Department of Engineering, University of Cambridge, Cambridge CB2 1TN, UK; Department of Radiology, University of Cambridge, Level 5, Box 218, Addenbrooke's Hospital, Hills Road, Cambridge CB2 0QQ, UK; Beijing Advanced Innovation Center for Biomedical Engineering, Beihang University, Beijing 100083, China; Nanjing Jingsan Medical Science and Technology, Ltd., Jiangsu, China
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12
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Association of arterial stiffness with coronary artery calcium score in the general-population: the Swedish CArdioPulmonary bioImage study. J Hypertens 2022; 40:933-939. [PMID: 35142741 DOI: 10.1097/hjh.0000000000003096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVES Coronary artery calcium score (CACS) is a marker of subclinical atherosclerosis. However, there is little data related to the association between arterial stiffness and CACS in the general population. The aim of this study was to explore the association between carotid femoral-pulse wave velocity (c-f PWV), a widely accepted marker of arterial stiffness, and CACS. METHODS Participants with complete measurements on c-f PWV, CACS and confounding variables from the Swedish CArdioPulmonary bioImage Study (SCAPIS) cohort were included in the final study population (n = 8725). CACS was divided into three categories (≤10, >10 and ≤100, and >100) and multinomial logistic regression was performed to explore the association between these categories of CACS and quartiles of c-f PWV, and for per one standard deviation (SD) increment of c-f PWV. RESULTS CACS ≤10, >10 and ≤100, and >100 were present in 69.3, 17.8 and 12.9% of the study population, respectively. The odds ratio (OR) for CACS >100 for the fourth quartile (Q4) of c-f PWV vs. Q1 (reference category) was 1.62 (95% confidence interval [CI] 1.25-2.12) after adjustments. One standard deviation increase in c-f PWV was independently associated with a higher odds of having a CACS category >100 (OR: 1.25, 95% CI 1.14-1.36) in the final multivariable model. CONCLUSION c-f PWV is positively associated with increased risk of higher CACS, and can be valuable in identifying individuals at risk for sub-clinical atherosclerosis. VIDEO ABSTRACT http://links.lww.com/HJH/B863.
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Comparative Effect of Antihypertensive Drugs in Improving Arterial Stiffness in Hypertensive Adults (RIGIPREV Study). A Protocol for Network Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182413353. [PMID: 34948959 PMCID: PMC8702004 DOI: 10.3390/ijerph182413353] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Revised: 12/06/2021] [Accepted: 12/14/2021] [Indexed: 11/19/2022]
Abstract
(1) Background: Arterial stiffness is closely and bi-directionally related to hypertension and is understood as both a cause and a consequence of hypertension. Several studies suggest that antihypertensive drugs may reduce arterial stiffness. Therefore, effective prescription of antihypertensive drugs should consider both blood pressure and arterial stiffness. The aim of this protocol is to provide a review comparing the effects of different types of antihypertensive drug interventions on the reduction of arterial stiffness in hypertensive subjects. (2) Methods: The literature search will be performed through the MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, and Web of Science databases. Randomised clinical trials assessing the effect of antihypertensive drug interventions on arterial stiffness measured in subjects with hypertension will be included. A frequentist network meta-analysis will be performed to determine the comparative effects of different antihypertensive drugs. (3) Results: The findings of this study will be published in a peer-reviewed journal. (4) Conclusions: This study will provide evidence for health care professionals on the efficacy of different antihypertensive drugs in decreasing arterial stiffness; in addition, it will analyse the efficacy of the drugs not only in terms of arterial stiffness but also in terms of blood pressure treatment.
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14
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Effects of Contact Pressure in Reflectance Photoplethysmography in an In Vitro Tissue-Vessel Phantom. SENSORS 2021; 21:s21248421. [PMID: 34960512 PMCID: PMC8706036 DOI: 10.3390/s21248421] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Revised: 11/30/2021] [Accepted: 12/13/2021] [Indexed: 12/02/2022]
Abstract
With the continued development and rapid growth of wearable technologies, PPG has become increasingly common in everyday consumer devices such as smartphones and watches. There is, however, minimal knowledge on the effect of the contact pressure exerted by the sensor device on the PPG signal and how it might affect its morphology and the parameters being calculated. This study explores a controlled in vitro study to investigate the effect of continually applied contact pressure on PPG signals (signal-to-noise ratio (SNR) and 17 morphological PPG features) from an artificial tissue-vessel phantom across a range of simulated blood pressure values. This experiment confirmed that for reflectance PPG signal measurements for a given anatomical model, there exists an optimum sensor contact pressure (between 35.1 mmHg and 48.1 mmHg). Statistical analysis shows that temporal morphological features are less affected by contact pressure, lending credit to the hypothesis that for some physiological parameters, such as heart rate and respiration rate, the contact pressure of the sensor is of little significance, whereas the amplitude and geometric features can show significant change, and care must be taken when using morphological analysis for parameters such as SpO2 and assessing autonomic responses.
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15
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Basirun C, Ferlazzo ML, Howell NR, Liu GJ, Middleton RJ, Martinac B, Narayanan SA, Poole K, Gentile C, Chou J. Microgravity × Radiation: A Space Mechanobiology Approach Toward Cardiovascular Function and Disease. Front Cell Dev Biol 2021; 9:750775. [PMID: 34778261 PMCID: PMC8586646 DOI: 10.3389/fcell.2021.750775] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2021] [Accepted: 10/11/2021] [Indexed: 12/12/2022] Open
Abstract
In recent years, there has been an increasing interest in space exploration, supported by the accelerated technological advancements in the field. This has led to a new potential environment that humans could be exposed to in the very near future, and therefore an increasing request to evaluate the impact this may have on our body, including health risks associated with this endeavor. A critical component in regulating the human pathophysiology is represented by the cardiovascular system, which may be heavily affected in these extreme environments of microgravity and radiation. This mini review aims to identify the impact of microgravity and radiation on the cardiovascular system. Being able to understand the effect that comes with deep space explorations, including that of microgravity and space radiation, may also allow us to get a deeper understanding of the heart and ultimately our own basic physiological processes. This information may unlock new factors to consider with space exploration whilst simultaneously increasing our knowledge of the cardiovascular system and potentially associated diseases.
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Affiliation(s)
- Carin Basirun
- School of Biomedical Engineering, Faculty of Engineering and Information Technology, University of Technology Sydney, Sydney, NSW, Australia
- Australian Nuclear Science and Technology Organisation, Lucas Heights, NSW, Australia
| | - Melanie L. Ferlazzo
- Australian Nuclear Science and Technology Organisation, Lucas Heights, NSW, Australia
- Inserm, U1296 Unit, Radiation: Defense, Health and Environment, Centre Léon Bérard, Lyon, France
| | - Nicholas R. Howell
- Australian Nuclear Science and Technology Organisation, Lucas Heights, NSW, Australia
| | - Guo-Jun Liu
- Australian Nuclear Science and Technology Organisation, Lucas Heights, NSW, Australia
- Discipline of Medical Imaging and Radiation Sciences, Faculty of Medicine and Health, Brain and Mind Centre, The University of Sydney, Camperdown, NSW, Australia
| | - Ryan J. Middleton
- Australian Nuclear Science and Technology Organisation, Lucas Heights, NSW, Australia
| | - Boris Martinac
- Molecular Cardiology and Biophysics Division, Victor Chang Cardiac Research Institute, Sydney, NSW, Australia
| | - S. Anand Narayanan
- Department of Nutrition and Integrative Physiology, Florida State University, Tallahassee, FL, United States
| | - Kate Poole
- EMBL Australia Node in Single Molecule Science, Faculty of Medicine, School of Medical Sciences, University of New South Wales, Sydney, NSW, Australia
| | - Carmine Gentile
- School of Biomedical Engineering, Faculty of Engineering and Information Technology, University of Technology Sydney, Sydney, NSW, Australia
- Faculty of Medicine and Health, Sydney Medical School, The University of Sydney, Sydney, NSW, Australia
| | - Joshua Chou
- School of Biomedical Engineering, Faculty of Engineering and Information Technology, University of Technology Sydney, Sydney, NSW, Australia
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Jensen LF, Bentzon JF, Albarrán-Juárez J. The Phenotypic Responses of Vascular Smooth Muscle Cells Exposed to Mechanical Cues. Cells 2021; 10:2209. [PMID: 34571858 PMCID: PMC8469800 DOI: 10.3390/cells10092209] [Citation(s) in RCA: 38] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Revised: 08/17/2021] [Accepted: 08/23/2021] [Indexed: 12/12/2022] Open
Abstract
During the development of atherosclerosis and other vascular diseases, vascular smooth muscle cells (SMCs) located in the intima and media of blood vessels shift from a contractile state towards other phenotypes that differ substantially from differentiated SMCs. In addition, these cells acquire new functions, such as the production of alternative extracellular matrix (ECM) proteins and signal molecules. A similar shift in cell phenotype is observed when SMCs are removed from their native environment and placed in a culture, presumably due to the absence of the physiological signals that maintain and regulate the SMC phenotype in the vasculature. The far majority of studies describing SMC functions have been performed under standard culture conditions in which cells adhere to a rigid and static plastic plate. While these studies have contributed to discovering key molecular pathways regulating SMCs, they have a significant limitation: the ECM microenvironment and the mechanical forces transmitted through the matrix to SMCs are generally not considered. Here, we review and discuss the recent literature on how the mechanical forces and derived biochemical signals have been shown to modulate the vascular SMC phenotype and provide new perspectives about their importance.
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Affiliation(s)
- Lise Filt Jensen
- Atherosclerosis Research Unit, Department of Clinical Medicine, Aarhus University, 8200 Aarhus, Denmark; (L.F.J.); (J.F.B.)
| | - Jacob Fog Bentzon
- Atherosclerosis Research Unit, Department of Clinical Medicine, Aarhus University, 8200 Aarhus, Denmark; (L.F.J.); (J.F.B.)
- Experimental Pathology of Atherosclerosis Laboratory, Spanish National Center for Cardiovascular Research (CNIC), 28029 Madrid, Spain
- Steno Diabetes Center Aarhus, Department of Clinical Medicine, Aarhus University, 8200 Aarhus, Denmark
| | - Julian Albarrán-Juárez
- Atherosclerosis Research Unit, Department of Clinical Medicine, Aarhus University, 8200 Aarhus, Denmark; (L.F.J.); (J.F.B.)
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17
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Physiological cyclic stretch up-regulates angiotensin-converting enzyme 2 expression to reduce proliferation and migration of vascular smooth muscle cells. Biosci Rep 2021; 40:225043. [PMID: 32463098 PMCID: PMC7295630 DOI: 10.1042/bsr20192012] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2019] [Revised: 04/29/2020] [Accepted: 05/13/2020] [Indexed: 12/24/2022] Open
Abstract
Angiotensin-converting enzyme 2 (ACE2) is considered as an endogenous negative regulator of renin–angiotensin system (RAS), exerting multiple cardiovascular protective roles. Whether mechanical stretch modulates ACE2 expression remains unknown. The present study aimed at investigating whether ACE2 is involved in physiological stretch (10% elongation, 1 Hz) mediated cellular functions and the underlying mechanism. Cultured human aortic smooth muscle cells (HASMCs) were exposed to 10% stretch for indicated time, and real-time PCR and Western blot analysis showed 10% stretch increased ACE2 expression and activity significantly compared with static conditions and increased Ang-(1-7) level, but decreased Ang II level; Brdu incorporation assay and Scratch test showed that ACE2 was involved in the inhibition of HASMCs proliferation and migration by 10% stretch; the Dual-Luciferase Reporter Assay demonstrated that 10% increased ACE2 promoter activity, but had no effect on ACE2 mRNA stability; kinase inhibition study and Electrophoretic mobility shift assay (EMSA) showed that JNK1/2 and PKCβII pathway, as well as their downstream transcription factors, AP-1 and NF-κB, were involved in 10% stretch induced ACE2 expression. In conclusion, our study indicates ACE2 is a mechanosensitive gene, and may represent a potential therapeutic target for mechanical forces related vascular diseases.
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18
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Williamson PN, Docherty PD, Yazdi SG, Khanafer A, Kabaliuk N, Jermy M. PIV Analysis of Haemodynamics Distal to the Frozen Elephant Trunk Stent Surrogate. Cardiovasc Eng Technol 2021; 12:373-386. [PMID: 33675018 DOI: 10.1007/s13239-021-00521-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Accepted: 01/13/2021] [Indexed: 11/30/2022]
Abstract
PURPOSE The Frozen Elephant Trunk (FET) stent is a hybrid endovascular device that may be implemented in the event of an aneurysm or aortic dissection of the aortic arch or superior descending aorta. A Type 1B endoleak can lead to intrasaccular flow during systole and has been identified as a known failure of the FET stent graft. The purpose was to develop in-vitro modelling techniques to enable the investigation of the known failure. METHODS A silicone aortic phantom and 3D printed surrogate stent graft were manufactured to investigate the haemodynamics of a Type 1B endoleak. Physiological pulsatile flow dynamics distal to the surrogate stent graft were investigated in-vitro using Particle Image Velocimetry (PIV). RESULTS PIV captured recirculation zones and an endoleak distal to the surrogate stent graft. The endoleak was developed at the peak of systole and sustained until the onset of diastole. The endoleak was asymmetric, indicating a potential variation in the phantom artery wall thickness or stent alignment. Recirculation was identified on the posterior dorsal line during late systole. CONCLUSIONS The identification of the Type 1B endoleak proved that in-vitro modelling can be used to investigate complex compliance changes and wall motions. The recirculation may indicate the potential for long term intimal layer inflammatory issues such as atherosclerosis. These results may aid future remediation techniques or stent design. Further development of the methods used in this experiment may assist with the future testing of stents prior to animal or human trial.
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Affiliation(s)
- Petra N Williamson
- Department of Mechanical Engineering, University of Canterbury, Private Bag 4800, Christchurch, 8041, New Zealand
| | - Paul D Docherty
- Department of Mechanical Engineering, University of Canterbury, Private Bag 4800, Christchurch, 8041, New Zealand. .,Institute of Technical Medicine, Furtwangen University, Campus Villingen-Schwenningen, Jakob-Kienzle Strasse 17, 78054, Villingen-Schwenningen, Germany.
| | - Sina G Yazdi
- Department of Mechanical Engineering, University of Canterbury, Private Bag 4800, Christchurch, 8041, New Zealand
| | - Adib Khanafer
- Vascular, Endovascular & Renal Transplant Unit, Christchurch Hospital, Canterbury District Health Board, Riccarton Avenue, Christchurch, 8053, New Zealand.,Christchurch School of Medicine, University of Otago, Dunedin, New Zealand
| | - Natalia Kabaliuk
- Department of Mechanical Engineering, University of Canterbury, Private Bag 4800, Christchurch, 8041, New Zealand
| | - Mark Jermy
- Department of Mechanical Engineering, University of Canterbury, Private Bag 4800, Christchurch, 8041, New Zealand
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Morioka T, Mori K, Emoto M. Is Stiffness Parameter β Useful for the Evaluation of Atherosclerosis?~ Its Clinical Implications, Limitations, and Future Perspectives ~. J Atheroscler Thromb 2021; 28:435-453. [PMID: 33583910 PMCID: PMC8193788 DOI: 10.5551/jat.rv17047] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Atherosclerosis comprises two components, atherosis and sclerosis, characterized by morphological wall thickening and functional stiffening, respectively, of the arterial wall. In recent years, much interest has been directed to the role of functional changes in large arteries, i.e., increased stiffness or decreased elasticity, on the development of cardiovascular diseases. In fact, the clinical evaluation of arterial stiffness is increasingly performed in patients with cardiovascular risk factors. Local arterial stiffness is measured using an ultrasound technique implemented with an echo-tracking system at the common carotid and femoral arteries. Several indices of local arterial stiffness are obtained by ultrasound, among which stiffness parameter β is unique because it is the least affected by blood pressure at the time of measurement. Evidence from cross-sectional studies indicates that increased stiffness parameter β is associated with a number of cardiovascular risk factors, such as older age, smoking, insufficient physical activity, hypertension, obesity, metabolic syndrome, insulin resistance, type 2 diabetes, chronic kidney disease, and comorbid cardiovascular disease. Results from several prospective observational studies also suggest that carotid stiffness parameter β is a useful surrogate marker of cardiovascular events and/or mortality, although the results differ depending on the characteristics of the study subjects. Furthermore, several interventional studies have shown that carotid stiffness parameter β improved after lifestyle modification or drug treatment. In this review, we summarize the current evidence of stiffness parameter β of the carotid artery and discuss its clinical implications as a marker of vascular health or as a predictor of cardiovascular outcomes.
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Affiliation(s)
- Tomoaki Morioka
- Department of Metabolism, Endocrinology and Molecular Medicine, Osaka City University Graduate School of Medicine
| | - Katsuhito Mori
- Department of Nephrology, Osaka City University Graduate School of Medicine
| | - Masanori Emoto
- Department of Metabolism, Endocrinology and Molecular Medicine, Osaka City University Graduate School of Medicine
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Alsharari R, Lip GYH, Shantsila A. Assessment of Arterial Stiffness in Patients With Resistant Hypertension: Additional Insights Into the Pathophysiology of This Condition? Am J Hypertens 2020; 33:107-115. [PMID: 31608357 DOI: 10.1093/ajh/hpz169] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2019] [Revised: 09/24/2019] [Accepted: 10/10/2019] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Good understanding of the pathophysiological mechanism(s) of resistant hypertension (RH) and the relationship to vascular dysfunction is important for optimal blood pressure control. METHODS AND RESULTS The aim of this review article is to summarize the available data on the methods of arterial stiffness assessment, and their usefulness in RH. Several studies that provide information on the noninvasive methods of evaluation of arterial stiffness have been discussed; specifically, pulse wave velocity (PWV) and augmentation index (AIx) tests. Increased arterial stiffness, elevated AIx, and impaired endothelial function all act as indicators and predictors of cardiovascular events in patients with hypertension (HTN). CONCLUSION Our review suggests that PWV and AIx are impaired in patients with severe HTN. Early assessment of these characteristics can potentially be of value in patients with RH.
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Affiliation(s)
- Reem Alsharari
- Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart & Chest Hospital, Liverpool, United Kingdom
- Cardiovascular technology department, College of Applied Medical Sciences, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Kingdom of Saudi Arabia
| | - Gregory Y H Lip
- Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart & Chest Hospital, Liverpool, United Kingdom
- Aalborg Thrombosis Research Unit, Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Alena Shantsila
- Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart & Chest Hospital, Liverpool, United Kingdom
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21
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Kropidlowski C, Meier-Schroers M, Kuetting D, Sprinkart A, Schild H, Thomas D, Homsi R. CMR based measurement of aortic stiffness, epicardial fat, left ventricular myocardial strain and fibrosis in hypertensive patients. IJC HEART & VASCULATURE 2020; 27:100477. [PMID: 32099896 PMCID: PMC7026624 DOI: 10.1016/j.ijcha.2020.100477] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2017] [Revised: 01/06/2020] [Accepted: 01/24/2020] [Indexed: 12/17/2022]
Abstract
Introduction A combined assessment of different parameters of cardiovascular (CV) risk and prognosis can be supportive and performed with cardiac magnetic resonance (CMR). Aortic stiffness, epicardial fat volume (EFV), left ventricular (LV) strain and fibrosis were evaluated within a single CMR examination and results were related to the presence of hypertension (HTN) and diabetes mellitus (DM). Methods 20 healthy controls (57.2 ± 8.2 years(y); 26.2 ± 3.9 kg/m2), 31 hypertensive patients without DM (59.6 ± 6.7 y; 28.4 ± 4.7 kg/m2) and 12 hypertensive patients with DM (58.8 ± 9.9y; 30.7 ± 6.3 kg/m2) were examined at 1.5Tesla. Aortic stiffness was evaluated by calculation of aortic pulse wave velocity (PWV), EFV by a 3D-Dixon sequence. Longitudinal & circumferential systolic myocardial strain (LS; CS) were analyzed and T1-relaxation times (T1) were determined to detect myocardial fibrosis. Results EFV was highest in hypertensive patients with diabetes (78.4 ± 28.0 ml/m2) followed by only hypertensive patients (64.2 ± 27.3 ml/m2) and lowest in controls (50.3 ± 22.7 ml/m2; p < 0.05). PWV was higher in hypertensive patients with diabetes (9.8 ± 3.3 m/s) compared to only hypertensive patients (8.6 ± 1.7 m/s; p < 0.05) and to controls (8.1 ± 1.9 m/s; p < 0.05). LS&CS were worse in hypertensive patients with diabetes (LS:-20.9 ± 5.1% and CS: -24.4 ± 5.7%) compared to both only hypertensive patients (LS: -24.7 ± 4.6%; CS: -27.1 ± 5.0%; p < 0.05) and to controls (LS: -25.5 ± 3.8; CS: -28.3 ± 4.1%; p < 0.05). Both hypertensive groups with and without DM had higher T1́s (994.0 ± 43.2 ms; 991.6 ± 35.5 ms) than controls (964.6 ± 40.3 ms; p < 0.05). Conclusion CMR revealed increased aortic stiffness and EFV in hypertensive patients, which were even higher in the presence of DM. Also signs of LV myocardial fibrosis and a reduced strain were revealed. These parameters support the assessment of CV risk and prognosis. They can accurately be measured with CMR within a single examination when normally different techniques are needed.
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Affiliation(s)
| | | | - Daniel Kuetting
- Department of Radiology, University of Bonn, Sigmund-Freud-Str. 25, 53127 Bonn, Germany
| | - Alois Sprinkart
- Department of Radiology, University of Bonn, Sigmund-Freud-Str. 25, 53127 Bonn, Germany
| | - Hans Schild
- Department of Radiology, University of Bonn, Sigmund-Freud-Str. 25, 53127 Bonn, Germany
| | - Daniel Thomas
- Department of Radiology, University of Bonn, Sigmund-Freud-Str. 25, 53127 Bonn, Germany
| | - Rami Homsi
- Department of Radiology, University of Bonn, Sigmund-Freud-Str. 25, 53127 Bonn, Germany
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Reindl M, Tiller C, Holzknecht M, Lechner I, Hein N, Pamminger M, Henninger B, Mayr A, Feistritzer HJ, Klug G, Bauer A, Metzler B, Reinstadler SJ. Aortic Stiffness and Infarct Healing in Survivors of Acute ST-Segment-Elevation Myocardial Infarction. J Am Heart Assoc 2020; 9:e014740. [PMID: 32003271 PMCID: PMC7033867 DOI: 10.1161/jaha.119.014740] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Background In survivors of acute ST‐segment–elevation myocardial infarction (STEMI), increased aortic stiffness is associated with worse clinical outcome; however, the underlying pathomechanisms are incompletely understood. We aimed to investigate associations between aortic stiffness and infarct healing using comprehensive cardiac magnetic resonance imaging in patients with acute STEMI. Methods and Results This was a prospective observational study including 103 consecutive STEMI patients treated with primary percutaneous coronary intervention. Pulse wave velocity (PWV), the reference standard for aortic stiffness assessment, was determined by a validated phase‐contrast cardiac magnetic resonance imaging protocol within the first week after STEMI. Infarct healing, defined as relative infarct size reduction from baseline to 4 months post‐STEMI, was determined using late gadolinium‐enhanced cardiac magnetic resonance. Median infarct size significantly decreased from 17% of left ventricular mass (interquartile range 9% to 28%) at baseline to 12% (6% to 17%) at 4‐month follow‐up (P<0.001). Relative infarct size reduction was 36% (interquartile range 15% to 52%). Patients with a reduction >36% were younger (P=0.01) and had lower baseline NT‐proBNP (N‐terminal pro–B‐type natriuretic peptide) concentrations (P=0.047) and aortic PWV values (P=0.003). In a continuous (odds ratio 0.64 [95% CI, 0.49–0.84]; P=0.001) as well as categorical (PWV <7 m/s; odds ratio 4.80 [95% CI, 1.89–12.20]; P=0.001) multivariable logistic regression model, the relation between aortic PWV and relative infarct size reduction remained significant after adjustment for baseline infarct size, age, NT‐proBNP, and C‐reactive protein. Conclusions Aortic PWV independently predicted infarct size reduction as assessed by cardiac magnetic resonance, revealing a novel pathophysiological link between aortic stiffness and adverse infarct healing during the early phase after STEMI treated with contemporary primary percutaneous coronary intervention.
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Affiliation(s)
- Martin Reindl
- University Clinic of Internal Medicine III Cardiology and Angiology Medical University of Innsbruck Austria
| | - Christina Tiller
- University Clinic of Internal Medicine III Cardiology and Angiology Medical University of Innsbruck Austria
| | - Magdalena Holzknecht
- University Clinic of Internal Medicine III Cardiology and Angiology Medical University of Innsbruck Austria
| | - Ivan Lechner
- University Clinic of Internal Medicine III Cardiology and Angiology Medical University of Innsbruck Austria
| | - Nicolas Hein
- University Clinic of Internal Medicine III Cardiology and Angiology Medical University of Innsbruck Austria
| | - Mathias Pamminger
- University Clinic of Radiology Medical University of Innsbruck Austria
| | | | - Agnes Mayr
- University Clinic of Radiology Medical University of Innsbruck Austria
| | - Hans-Josef Feistritzer
- Department of Internal Medicine/Cardiology Heart Center Leipzig at University of Leipzig Germany
| | - Gert Klug
- University Clinic of Internal Medicine III Cardiology and Angiology Medical University of Innsbruck Austria
| | - Axel Bauer
- University Clinic of Internal Medicine III Cardiology and Angiology Medical University of Innsbruck Austria
| | - Bernhard Metzler
- University Clinic of Internal Medicine III Cardiology and Angiology Medical University of Innsbruck Austria
| | - Sebastian J Reinstadler
- University Clinic of Internal Medicine III Cardiology and Angiology Medical University of Innsbruck Austria
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Cavinato C, Badel P, Krasny W, Avril S, Morin C. Experimental Characterization of Adventitial Collagen Fiber Kinematics Using Second-Harmonic Generation Imaging Microscopy: Similarities and Differences Across Arteries, Species and Testing Conditions. MULTI-SCALE EXTRACELLULAR MATRIX MECHANICS AND MECHANOBIOLOGY 2020. [DOI: 10.1007/978-3-030-20182-1_5] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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Reklou A, Katsiki N, Karagiannis A, Athyros V. Effects of Lipid Lowering Drugs on Arterial Stiffness: One More Way to Reduce Cardiovascular Risk? Curr Vasc Pharmacol 2019; 18:38-42. [DOI: 10.2174/1570161117666190121102323] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2018] [Revised: 01/10/2019] [Accepted: 01/10/2019] [Indexed: 01/12/2023]
Abstract
Arterial stiffness (AS) is considered an independent predictor of cardiovascular disease
(CVD) events. Among lipid lowering drugs, statins have a beneficial effect on AS, independent of their
hypolipidaemic effect. Based on 3 meta-analyses and other studies, this effect is compound- and doserelated.
Potent statins at high doses are more effective than less powerful statins. Ezetimibe (± statin)
also seems to decrease AS in patients with dyslipidaemia. Fibrates have no effect on AS. Proprotein
convertase subtilisin/kexin type 9 (PCSK9) inhibitors have data that beneficially affect all AS risk factors,
suggesting a beneficial effect on artery compliance. However, there is no direct measurement of
their effect on AS indices. In patients with dyslipidaemia, prescribing high dose statins (± ezetimibe)
will not only decrease low-density lipoprotein cholesterol levels but also improve AS (in addition to
other effects). This effect on AS may contribute to the observed reduction in vascular events.
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Affiliation(s)
- Andromachi Reklou
- Second Propedeutic Department of Internal Medicine, Hippocration Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Niki Katsiki
- Second Propedeutic Department of Internal Medicine, Hippocration Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Asterios Karagiannis
- Second Propedeutic Department of Internal Medicine, Hippocration Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Vasilios Athyros
- Second Propedeutic Department of Internal Medicine, Hippocration Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
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Logan JG, Kim SS, Lee M, Byon HD, Yeo S. Effects of Static Stretching Exercise on Lumbar Flexibility and Central Arterial Stiffness. J Cardiovasc Nurs 2019; 33:322-328. [PMID: 29369122 DOI: 10.1097/jcn.0000000000000460] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND Previous studies have demonstrated that arterial stiffness is associated with lumbar flexibility (LF). Stretching exercise targeted to improve LF may have a beneficial effect on reducing arterial stiffness. OBJECTIVES We examined the effects of a single bout of a structured, static stretching exercise on arterial stiffness, LF, peripheral and central blood pressure (BP), and heart rate (HR) and tested the association between LF and central arterial stiffness. METHOD The study had a pretest-posttest design without a control group. Thirty healthy women followed a video demonstration of a 30-minute whole-body stretching exercise. Carotid-femoral pulse wave velocity (cf-PWV), augmentation index, LF, peripheral and central BP, and HR were measured before and after the stretching exercise. RESULTS One bout of a static stretching exercise significantly reduced cf-PWV (t29 = 2.708, P = .011) and HR (t29 = 7.160, P = .000) and increased LF (t29 = 12.248, P < .000). Augmentation index and peripheral and central BP also decreased but did not reach statistical significance. Despite no association found between cf-PWV and LF, the larger increase in LF the subjects had, the larger decrease in cf-PWV they had after exercise (r = 0.500, P = .005). CONCLUSIONS Study findings highlight the potential benefit of a static stretching exercise on central arterial stiffness, an independent predictor of cardiovascular morbidity. Static stretching exercise conducted in the sitting position may be used as an effective intervention to reduce cardiovascular risk after a cardiac event or for patients whose sympathetic function should not be overly activated or whose gaits are not stable.
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Affiliation(s)
- Jeongok G Logan
- Jeongok G. Logan, PhD, MSN, RN Assistant Professor, University of Virginia School of Nursing, Charlottesville. Suk-Sun Kim, PhD, MSN, RN Assistant Professor, Ewha Womans University College of Nursing, Seoul, Korea. Mijung Lee, PhD(c), MSN, RN Doctoral Student, University of Virginia School of Nursing, Charlottesville. Ha Do Byon, PhD, MS, MPH, RN Assistant Professor, University of Virginia School of Nursing, Charlottesville. SeonAe Yeo, PhD, WHNP-BC, FAAN Professor, University of North Carolina at Chapel Hill School of Nursing
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Smith ER, Hewitson TD, Holt SG. Diagnostic Tests for Vascular Calcification. Adv Chronic Kidney Dis 2019; 26:445-463. [PMID: 31831123 DOI: 10.1053/j.ackd.2019.07.001] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2019] [Revised: 07/22/2019] [Accepted: 07/28/2019] [Indexed: 02/06/2023]
Abstract
Vascular calcification (VC) is the heterogeneous endpoint of multiple vascular insults, which varies by arterial bed, the layer of the arterial wall affected, and is propagated by diverse cellular and biochemical mechanisms. A variety of in vivo and ex vivo techniques have been applied to the analysis of VC in preclinical studies, but clinical examination has principally relied on a number of noninvasive and invasive imaging modalities for detection and quantitation. Most imaging methods suffer from suboptimal spatial resolution, leading to the inability to distinguish medial from intimal VC and insufficient sensitivity to detect microcalcifications that are indicative of active mineral deposition and of vulnerable plaques which may be prone to rupture. Serum biomarkers lack specificity for VC and cannot discriminate pathology. Overall, uncertainties surrounding the sensitivity and specificity of different VC testing modalities, the absence of a clear cause-effect relationship, and lack of any evidence-based diagnostic or therapeutic protocols in relation to VC testing in chronic kidney disease has yielded weak or ungraded recommendations for their use in clinical practice. While VC is recognized as a key manifestation of chronic kidney disease-mineral and bone disorder and those with an increasing burden of VC are considered to be at higher cardiovascular risk, routine screening is not currently recommended.
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Petrák O, Rosa J, Holaj R, Štrauch B, Krátká Z, Kvasnička J, Klímová J, Waldauf P, Hamplová B, Markvartová A, Novák K, Michalský D, Widimský J, Zelinka T. Blood Pressure Profile, Catecholamine Phenotype, and Target Organ Damage in Pheochromocytoma/Paraganglioma. J Clin Endocrinol Metab 2019; 104:5170-5180. [PMID: 31009053 DOI: 10.1210/jc.2018-02644] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2018] [Accepted: 04/16/2019] [Indexed: 02/05/2023]
Abstract
CONTEXT Impaired diurnal blood pressure (BP) variability is related to higher cardiovascular risk. OBJECTIVE To assess diurnal variability of BP and its relation to target organ damage (TOD) and catecholamine phenotype in a consecutive sample of pheochromocytoma/paraganglioma (PPGL). DESIGN We included 179 patients with PPGL All patients underwent 24 hours of ambulatory BP monitoring to determine dipping status. Differences in plasma metanephrine or urine adrenaline were used to distinguish catecholamine biochemical phenotype. To evaluate TOD, renal functions, presence of left ventricle hypertrophy (LVH), and the subgroup (n = 111) carotid-femoral pulse wave velocity (PWV) were assessed. Structural equation modeling was used to find the relationship among nocturnal dipping, catecholamine phenotype, and TOD parameters. RESULTS According to the nocturnal dipping, patients were divided into the three groups: dippers (28%), nondippers (40%), and reverse dippers (32%). Reverse dippers were older (P < 0.05), with a higher proportion of noradrenergic (NA) phenotype (P < 0.05), a higher prevalence of diabetes mellitus (P < 0.05), and sustained arterial hypertension (P < 0.01) and its duration (P < 0.05), as opposed to the other groups. All parameters of TOD were more pronounced only in reverse dippers compared with nondippers and dippers. The presence of NA phenotype (=absence of adrenaline production) was associated with reverse dipping and TOD (LVH and PWV). CONCLUSIONS Patients with reverse dipping had more substantial TOD compared with other groups. The NA phenotype plays an important role, not only in impaired diurnal BP variability but also independently from dipping status in more pronounced TOD of heart and vessels.
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Affiliation(s)
- Ondřej Petrák
- Center of Hypertension, Third Department of Medicine, First Faculty of Medicine and General Faculty Hospital, Charles University in Prague, Prague 2, Czech Republic
| | - Ján Rosa
- Center of Hypertension, Third Department of Medicine, First Faculty of Medicine and General Faculty Hospital, Charles University in Prague, Prague 2, Czech Republic
| | - Robert Holaj
- Center of Hypertension, Third Department of Medicine, First Faculty of Medicine and General Faculty Hospital, Charles University in Prague, Prague 2, Czech Republic
| | - Branislav Štrauch
- Center of Hypertension, Third Department of Medicine, First Faculty of Medicine and General Faculty Hospital, Charles University in Prague, Prague 2, Czech Republic
| | - Zuzana Krátká
- Center of Hypertension, Third Department of Medicine, First Faculty of Medicine and General Faculty Hospital, Charles University in Prague, Prague 2, Czech Republic
| | - Jan Kvasnička
- Center of Hypertension, Third Department of Medicine, First Faculty of Medicine and General Faculty Hospital, Charles University in Prague, Prague 2, Czech Republic
| | - Judita Klímová
- Center of Hypertension, Third Department of Medicine, First Faculty of Medicine and General Faculty Hospital, Charles University in Prague, Prague 2, Czech Republic
| | - Petr Waldauf
- Department of Anesthesiology, University Hospital Královské Vinohrady and Third Faculty of Medicine, Charles University in Prague, Prague 2, Czech Republic
| | - Barbora Hamplová
- Center of Hypertension, Third Department of Medicine, First Faculty of Medicine and General Faculty Hospital, Charles University in Prague, Prague 2, Czech Republic
| | - Alice Markvartová
- Center of Hypertension, Third Department of Medicine, First Faculty of Medicine and General Faculty Hospital, Charles University in Prague, Prague 2, Czech Republic
| | - Květoslav Novák
- Department of Urology, First Faculty of Medicine and General Faculty Hospital, Charles University in Prague, Prague 2, Czech Republic
| | - David Michalský
- First Department of Surgery, First Faculty of Medicine and General Faculty Hospital, Charles University in Prague, Prague 2, Czech Republic
| | - Jiří Widimský
- Center of Hypertension, Third Department of Medicine, First Faculty of Medicine and General Faculty Hospital, Charles University in Prague, Prague 2, Czech Republic
| | - Tomáš Zelinka
- Center of Hypertension, Third Department of Medicine, First Faculty of Medicine and General Faculty Hospital, Charles University in Prague, Prague 2, Czech Republic
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Validation of simple measures of aortic distensibility based on standard 4-chamber cine CMR: a new approach for clinical studies. Clin Res Cardiol 2019; 109:454-464. [PMID: 31302712 PMCID: PMC7098938 DOI: 10.1007/s00392-019-01525-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2019] [Accepted: 07/02/2019] [Indexed: 02/05/2023]
Abstract
Objective Aortic distensibility (AD) represents a well-established parameter of aortic stiffness. It remains unclear, however, whether AD can be obtained with high reproducibility in standard 4-chamber cine CMR images of the descending aorta. This study investigated the intra- and inter-observer agreement of AD based on different angles of the aorta and provided a sample size calculation of AD for future trials. Methods Thirty-one patients underwent CMR. Angulation of the descending aorta was performed to obtain strictly transversal and orthogonal cross-sectional aortic areas. AD was obtained both area and diameter based. Results For area-based values, inter-observer agreement was highest for 4-chamber AD (ICC 0.97; 95% CI 0.93–99), followed by orthogonal AD (ICC 0.96; 95% CI 0.91–98) and transversal AD (ICC 0.93; 95% CI 0.80–97). For diameter-based values, agreement was also highest for 4-chamber AD (ICC 0.97; 95% CI 0.94–99), followed by orthogonal AD (ICC 0.96; 95% CI 0.92–98) and transversal AD (ICC 0.91; 95% CI 0.77–96). Bland–Altman plots confirmed a small variation among observers. Sample size calculation showed a sample size of 12 patients to detect a change in 4-chamber AD of 1 × 10−3 mmHg−1 with either the area or diameter approach. Conclusion AD measurements are highly reproducible and allow an accurate and rapid assessment of arterial compliance from standard 4-chamber cine CMR. Graphic abstract ![]()
Electronic supplementary material The online version of this article (10.1007/s00392-019-01525-8) contains supplementary material, which is available to authorized users.
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Prisby R, Ross J, Opdenaker L, McLane MA, Lee S, Sun X, Guderian S. Discovery of a bone-like blood particle in the peripheral circulation of humans and rodents. Microcirculation 2019; 26:e12579. [PMID: 31246334 DOI: 10.1111/micc.12579] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2018] [Revised: 06/01/2019] [Accepted: 06/21/2019] [Indexed: 12/25/2022]
Abstract
OBJECTIVE To characterize ossified bone marrow blood vessels and confirm the presence of ossified particles (OSP) in humans and rodents. METHODS Human bone marrow blood vessels were processed for scanning and transmission electron microscopy. Whole blood samples were collected from younger (26-39 years; n = 6) and older (55-63 years; n = 6) volunteers and male Fischer-344 rats (1 month, n = 7; 6 months, n = 7; 12 months, n = 7; 18-months, n = 6; 24 months, n = 8). OSP in the whole blood samples were sorted and imaged with microscopy to determine diameter, circularity, and solidity. Additionally, the chemical composition of OSP was determined via elemental analysis. RESULTS SEM revealed two types of ossified bone marrow blood vessels: that is, "transitioning" and "ossified." OSP were adhered to the surface of transitioning vessels and theoretically gain access to and circulate within the blood. The majority of OSP were ≤15 μm in diameter, but many were of sufficient size to serve as emboli (ie, >15 μm).OSP were predominately oblong in shape and several had jagged tips and edges. CONCLUSIONS We introduce a novel, bone-like blood particle that may be diagnostic of bone marrow blood vessel ossification. Further, OSP may associate with several disease states (eg, atherosclerosis).
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Affiliation(s)
- Rhonda Prisby
- Department of Kinesiology, University of Texas at Arlington, Arlington, Texas
| | - Jean Ross
- Delaware Biotechnology Institute, University of Delaware, Newark, Delaware
| | - Lynn Opdenaker
- Center for Translational Cancer Research, Helen F. Graham Cancer Center and Research Institute at Christiana Care Health System, Newark, Delaware
| | - Mary Ann McLane
- Department of Medical and Molecular Sciences, University of Delaware, Newark, Delaware
| | - Seungyong Lee
- Department of Kinesiology, University of Texas at Arlington, Arlington, Texas
| | - Xiangle Sun
- Flow Cytometry & LCM Core Facility, University of North Texas Health Science Center, Fort Worth, Texas
| | - Sophie Guderian
- Department of Kinesiology and Applied Physiology, University of Delaware, Newark, Delaware
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Endothelial retinoblastoma protein reduces abdominal aortic aneurysm development via promoting DHFR/NO pathway-mediated vasoprotection. Mol Cell Biochem 2019; 460:29-36. [DOI: 10.1007/s11010-019-03567-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2019] [Accepted: 05/27/2019] [Indexed: 02/07/2023]
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Association of Endothelial Function with Parental Hypertension in Normotensive-Obese African-American Women: A Pilot Study. Adv Prev Med 2019; 2019:5854219. [PMID: 30863643 PMCID: PMC6378072 DOI: 10.1155/2019/5854219] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2018] [Revised: 12/21/2018] [Accepted: 01/14/2019] [Indexed: 12/31/2022] Open
Abstract
Obese African-American (AA) women are at high risk of hypertension (HT) and cardiovascular disease (CVD). Flow-mediated dilation (FMD) and arterial augmentation index (AI) are measures of endothelial function and arterial stiffness. Whether endothelial function and arterial stiffness predict risk of HT or CVD in obese African-American women with, versus without, parental histories of HT and whether aerobic exercise is an effective countermeasure remain unclear. The capacity for FMD is partly heritable. Therefore, we tested the hypotheses that less FMD and greater AI may be found in normotensive-obese, young-adult (18-26 year-old) AA women with hypertensive parents (n=10) than in a matched control group with normotensive parents (n=10) and that a single bout of aerobic exercise improves both endothelial function and arterial stiffness, with less improvement in the women with hypertensive parents. We studied each subject while at rest, 20 min before and 20 min after, 30 min of aerobic exercise. The exercise-induced changes and parental hypertension-related differences in AI were not significant. The exercise increased FMD in both of the groups with no significant difference in magnitude between the women with hypertensive and normotensive parents. FMD was significantly less in the women with hypertensive parents than in the women with normotensive parents after, but not before, the exercise (mean ±95% confidence interval of 11.3 ± 4.9% vs. 15.6 ± 4.9%, P=0.05). These findings suggest that a 30-min bout of aerobic exercise may improve FMD and unmask endothelial dysfunction in normotensive-obese, young-adult AA women with parental histories of HT. Future studies should determine whether regular aerobic exercise protects obese AA women from the endothelial dysfunction associated with diabetes and prevents CVD in this high-risk population.
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James BD, Allen JB. Vascular Endothelial Cell Behavior in Complex Mechanical Microenvironments. ACS Biomater Sci Eng 2018; 4:3818-3842. [PMID: 33429612 DOI: 10.1021/acsbiomaterials.8b00628] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
The vascular mechanical microenvironment consists of a mixture of spatially and temporally changing mechanical forces. This exposes vascular endothelial cells to both hemodynamic forces (fluid flow, cyclic stretching, lateral pressure) and vessel forces (basement membrane mechanical and topographical properties). The vascular mechanical microenvironment is "complex" because these forces are dynamic and interrelated. Endothelial cells sense these forces through mechanosensory structures and transduce them into functional responses via mechanotransduction pathways, culminating in behavior directly affecting vascular health. Recent in vitro studies have shown that endothelial cells respond in nuanced and unique ways to combinations of hemodynamic and vessel forces as compared to any single mechanical force. Understanding the interactive effects of the complex mechanical microenvironment on vascular endothelial behavior offers the opportunity to design future biomaterials and biomedical devices from the bottom-up by engineering for the cellular response. This review describes and defines (1) the blood vessel structure, (2) the complex mechanical microenvironment of the vascular endothelium, (3) the process in which vascular endothelial cells sense mechanical forces, and (4) the effect of mechanical forces on vascular endothelial cells with specific attention to recent works investigating the influence of combinations of mechanical forces. We conclude this review by providing our perspective on how the field can move forward to elucidate the effects of the complex mechanical microenvironment on vascular endothelial cell behavior.
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Affiliation(s)
- Bryan D James
- Department of Materials Science & Engineering, University of Florida, 100 Rhines Hall, PO Box 116400, Gainesville, Florida 32611, United States.,Institute for Computational Engineering, University of Florida, 300 Weil Hall, PO Box 116550, Gainesville, Florida 32611, United States
| | - Josephine B Allen
- Department of Materials Science & Engineering, University of Florida, 100 Rhines Hall, PO Box 116400, Gainesville, Florida 32611, United States.,Institute for Cell and Tissue Science and Engineering, 300 Weil Hall, PO Box 116550, Gainesville, Florida 32611, United States
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Seibert FS, Bernhard F, Stervbo U, Vairavanathan S, Bauer F, Rohn B, Pagonas N, Babel N, Jankowski J, Westhoff TH. The Effect of Microgravity on Central Aortic Blood Pressure. Am J Hypertens 2018; 31:1183-1189. [PMID: 30052726 DOI: 10.1093/ajh/hpy119] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2018] [Accepted: 07/23/2018] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Blood pressure has been traditionally measured at peripheral arteries. In the past decade, evidence has grown that central aortic blood pressure may be a more powerful predictor for cardiovascular events, but data on its regulation are rare. The present work examines the impact of microgravity on central blood pressure for the first time. METHODS We performed 7 parabolic flights with 22 seconds of weightlessness in each parabola. Hemodynamic parameters including central systolic blood pressure were measured noninvasively in a free-floating position in 20 healthy subjects (19-43 years of age). RESULTS Arterial elasticity at rest was normal in all participants (augmentation index 14% (interquartile range (IQR) 10-22), pulse wave velocity 5.2 m/s (IQR 5.0-5.4)). Transition of 1g to 0g led to a significant increase of central systolic blood pressure from 124 (IQR 118-133) to 127 (IQR 119-133) mm Hg (P = 0.017). Cardiac index augmented significantly from 2.5 (IQR 2.2-2.8) to 2.7 (IQR 2.3-3.0) l/min/m2 (P < 0.001), while peripheral vascular resistance showed a decrease from 1.30 (IQR 1.14-1.48) to 1.25 (IQR 1.15-1.40) s × mm Hg/ml (P = 0.037). Peripheral systolic blood pressure did not change significantly (P > 0.05). CONCLUSION Whereas there is a multitude of studies on the effects of microgravity on peripheral blood pressure, this study provides first data on central aortic blood pressure. An acute loss of gravity leads to a central blood volume shift with an augmentation of cardiac output. In healthy subjects with normal arterial stiffness, the compensatory decrease of peripheral resistance does not outweigh this effect resulting in an increase of central blood pressure.
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Affiliation(s)
- Felix S Seibert
- Medical Department I, University Hospital, Marien Hospital Herne, Ruhr-University of Bochum, Bochum, Germany
| | - Fabian Bernhard
- Medical Department I, University Hospital, Marien Hospital Herne, Ruhr-University of Bochum, Bochum, Germany
| | - Ulrik Stervbo
- Medical Department I, University Hospital, Marien Hospital Herne, Ruhr-University of Bochum, Bochum, Germany
| | - Sinthuya Vairavanathan
- Medical Department I, University Hospital, Marien Hospital Herne, Ruhr-University of Bochum, Bochum, Germany
| | - Frederic Bauer
- Medical Department I, University Hospital, Marien Hospital Herne, Ruhr-University of Bochum, Bochum, Germany
| | - Benjamin Rohn
- Medical Department I, University Hospital, Marien Hospital Herne, Ruhr-University of Bochum, Bochum, Germany
| | - Nikolaos Pagonas
- Medical Department I, University Hospital, Marien Hospital Herne, Ruhr-University of Bochum, Bochum, Germany
| | - Nina Babel
- Medical Department I, University Hospital, Marien Hospital Herne, Ruhr-University of Bochum, Bochum, Germany
| | - Joachim Jankowski
- Institute for Molecular Cardiovascular Research, RWTH Aachen University, Aachen, Germany
| | - Timm H Westhoff
- Medical Department I, University Hospital, Marien Hospital Herne, Ruhr-University of Bochum, Bochum, Germany
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Lemogoum D, Halle MP, Mboule RD, Van de Borne P, Bika Lele EC, Kamdem F, Doualla MS, Luma H, Hermans MP, Van Bortel L. Arterial stiffness in black African ancestry patients with chronic kidney disease living in Cameroon. Cardiovasc Diagn Ther 2018; 8:450-459. [PMID: 30214860 DOI: 10.21037/cdt.2018.04.04] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Background Increased aortic pulse wave velocity (PWV), a direct measure of arterial stiffness (AS) is an independent predictor of cardiovascular events (CVEs) in chronic kidney disease (CKD) patients. This study assessed the patterns of PWV among Cameroonian patients with CKD in whom that marker of early vascular aging has not been explored so far. Methods We enrolled 150 Black African patients (mean age: 52±15 years, 56.7% males) with CKD in a cross-sectional study conducted at Douala General Hospital, Douala, Cameroon. Sociodemographic, anthropometric and biologic variables, blood pressure (BP) and PWV were recorded in all participants. Estimated aortic PWV was measured using a Mobil-O-Graph automatic brachial oscillometric device. Results PWV increased with aging (P<0.0001), and PWV adjusted for age, sex, body mass index and mean arterial BP (MAP) was higher in non-dialysed (n=90) than in hemodialysed (n=60) patients, even in pre-dialysis: 8.5±2.0 vs. 7.9±1.4 m/s (P=0.026); and in post-dialysis: 8.5±2.0 vs. 7.8±1.5 m/s (P=0.008). The mean PWV of all study participants was 8.2±1.8 m/s, with 61.3% of patients having a PWV ≥8.2 m/s, indicative of subclinical damage to the aorta, which was more pronounced in non-dialysis (67.8%) than in hemodialysis (53.3%) patients (P=0.033). Multivariable analysis performed in all participants revealed that advanced age, MAP and tobacco use were independently associated with PWV (all P<0.05). Conclusions Our findings suggest increased AS in Cameroonian CKD non-dialyzed as compared to dialyzed patients. Slower PWV in patients on maintenance hemodialysis suggests improvement of aortic distensibility following dialysis. However, further large-scale studies are needed to confirm our findings and to improve understanding of the underlying mechanisms of arterial stiffening in black African ancestry patients with CKD.
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Affiliation(s)
- Daniel Lemogoum
- Faculty of medicine and Pharmaceutical Sciences, University of Douala, Douala, Cameroon.,ULB-Erasme Hospital, Université Libre de Bruxelles, Brussels, Belgium.,Cameroon Heart Foundation, Douala, Cameroon
| | - Marie Patrice Halle
- Faculty of medicine and Pharmaceutical Sciences, University of Douala, Douala, Cameroon.,Department of Internal Medicine, Douala General Hospital, Douala, Cameroon
| | - Ruth Dione Mboule
- Faculty of medicine and Pharmaceutical Sciences, University of Douala, Douala, Cameroon.,Cameroon Heart Foundation, Douala, Cameroon
| | | | | | - Felicité Kamdem
- Faculty of medicine and Pharmaceutical Sciences, University of Douala, Douala, Cameroon.,Department of Internal Medicine, Douala General Hospital, Douala, Cameroon
| | | | - Henry Luma
- Department of Internal Medicine, Douala General Hospital, Douala, Cameroon
| | - Michel P Hermans
- Endocrinology and Nutrition Unit, Cliniques Universitaires St-Luc, Université Catholique de Louvain, Avenue Hippocrate, Brussels, Belgium
| | - Luc Van Bortel
- Heymans Institute of Pharmacology, Ghent University, Ghent, Belgium
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Zeigler ZS, Birchfield N, Moreno K, James D, Swan P. Fatness and Fluctuating Body Weight: Effect on Central Vasculature. Biores Open Access 2018; 7:90-100. [PMID: 29892497 PMCID: PMC5994146 DOI: 10.1089/biores.2017.0044] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
Weight Cycling (WC) is a prevalent behavior associated with adverse cardiovascular (CV) health. However, a 2010 review on the effects of WC and blood pressure (BP) determined that there was not enough evidence to draw definitive conclusions. Central BP is the principal predictor of CV risk compared to peripheral BP. The influence that WC may have specifically on central BP is unknown. Cross-sectional observation of self-reported history of WC on measures of CV health was undertaken. Seventy-five women completed a Weight and Lifestyle Inventory questionnaire, which is considered a reliable index of WC (r = 0.87, p < 0.001). Measures of visceral fat, BP, arterial stiffness, and VO2peak were taken. Regression equations were used to assess primary predictors of these outcomes. Seventy-five middle aged (39 ± 11 years), obese (32 ± 7 kg/m2), and relatively unfit (24 ± 8 ml·kg-1 min-1) women completed the study. Visceral fat was the strongest predictor of brachial systolic blood pressure (SBP; r2 = 0.283), brachial diastolic blood pressure (DBP; r2 = 0.176), central SBP (r2 = 0.375), and augmentation index (AIx; r2 = 0.535, all p < 0.001). VO2peak was the strongest predictor of central DBP (r2 = 0.062, p = 0.036) and augmentation pressure (AP; r2 = 0.491, p < 0.001). Weight cycling index was associated with visceral fat (r = 0.521, p < 0.001). Visceral fat was a mediator between WC and central SBP (confidence interval [CI] = 0.0053-0.0602), AP (CI = 0.0507-0.4915), AIx (CI = 0.0025-0.0699), and carotid-femoral pulse wave velocity (CI = 0.0115-0.1227; all p < 0.05). WC may increase visceral fat accumulation, which was associated with increased central SBP and measures of arterial stiffness.
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Affiliation(s)
- Zachary S. Zeigler
- College of Science, Engineering, and Technology, Grand Canyon University, Phoenix, Arizona
| | - Natasha Birchfield
- School of Nutrition and Health Promotion, Arizona State University, Phoenix, Arizona
| | - Karen Moreno
- School of Nutrition and Health Promotion, Arizona State University, Phoenix, Arizona
| | - Darith James
- School of Nutrition and Health Promotion, Arizona State University, Phoenix, Arizona
| | - Pamela Swan
- School of Nutrition and Health Promotion, Arizona State University, Phoenix, Arizona
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Ouédraogo V, Connes P, Tripette J, Tiendrébéogo AJF, Sow AK, Diaw M, Seck M, Diop M, Hallab M, Belue R, Samb A, Ba A, Lefthériotis G. Pulse wave velocity is lower in trained than in untrained sickle cell trait carriers. Clin Hemorheol Microcirc 2018; 69:417-424. [PMID: 29660907 DOI: 10.3233/ch-170310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Sickle cell trait (SCT) is a benign condition of sickle cell disease. Nevertheless, previous reports showed that SCT carriers have increased blood viscosity and decreased vascular reactivity compared to non-SCT carrier. The benefit of regular exercise on vascular function has been well documented in the general population but no study focused on the SCT population. PURPOSE The aim of our study was to compare arterial stiffness and blood viscosity between trained and untrained SCT carriers, as well as a group of untrained non-SCT. METHODS Arterial stiffness (finger-toe pulse wave velocity) and blood viscosity were evaluated in untrained non-SCT carriers (n = 10), untrained SCT carriers (n = 23) and trained SCT carriers (n = 17) who reported at least 10 hours of physical exercise per week. RESULTS Untrained SCT carriers had higher pulse wave velocity (p = 0.032) and blood viscosity (p < 0.001) than their trained counterparts. In addition, untrained SCT carriers had higher blood viscosity (p < 0.001) than the untrained non-SCT group. A positive association was noted between blood viscosity and pulse wave velocity in the whole study population. CONCLUSION Our study suggests that regular exercise may be beneficial for the vascular function of SCT carriers.
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Affiliation(s)
- Valentin Ouédraogo
- Laboratoire de Physiologie Humaine, Faculté de Médecine, de Pharmacie et d'Odontologie, UCAD, Sénégal
| | - Philippe Connes
- Laboratoire LIBM EA7424, Equipe "Biologie vasculaire et du globule rouge", Université Claude Bernard Lyon 1, Villeurbanne, France; Laboratoire d'Excellence sur le Globule Rouge (GR-Ex), Paris, France; Institut Universitaire de France, Paris, France
| | - Julien Tripette
- Ochanomizu University, 2-1-1 Otsuka, Bunkyo District, Tokyo, Japan
| | | | - Abdou Khadir Sow
- Laboratoire de Physiologie Humaine, Faculté de Médecine, de Pharmacie et d'Odontologie, UCAD, Sénégal
| | - Mor Diaw
- Laboratoire de Physiologie Humaine, Faculté de Médecine, de Pharmacie et d'Odontologie, UCAD, Sénégal
| | - Moussa Seck
- Laboratoire d'Hémato-Immunologie, FMPO, UCAD, Dakar, Sénégal
| | - Mountaga Diop
- Institut National Supérieur de l'Education Populaire et du Sport, UCAD, Dakar, Sénégal
| | - Magid Hallab
- Hôpital Universitaire de Nantes, Place Ricordeau, Nantes, France
| | - Rhonda Belue
- The Pennsylvania State University, University Park, PA, USA
| | - Abdoulaye Samb
- Laboratoire de Physiologie Humaine, Faculté de Médecine, de Pharmacie et d'Odontologie, UCAD, Sénégal.,Unité Mixte Internationale (UMI 3189), "Environnement, Santé, Sociétés" CNRS, UCAD, CNRST, USTTB, UGB, Dakar, Sénégal
| | - Abdoulaye Ba
- Laboratoire de Physiologie Humaine, Faculté de Médecine, de Pharmacie et d'Odontologie, UCAD, Sénégal.,Unité Mixte Internationale (UMI 3189), "Environnement, Santé, Sociétés" CNRS, UCAD, CNRST, USTTB, UGB, Dakar, Sénégal
| | - Georges Lefthériotis
- Laboratoire de Biologie Neuro-vasculaire et Mitochondriale Intégrée UMR CNRS 6214 - Inserm, Faculté de Médecine Angers, Angers, France
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Kim HJ, Kang E, Oh YK, Kim YH, Han SH, Yoo TH, Chae DW, Lee J, Ahn C, Oh KH. The association between soluble klotho and cardiovascular parameters in chronic kidney disease: results from the KNOW-CKD study. BMC Nephrol 2018; 19:51. [PMID: 29506503 PMCID: PMC5838864 DOI: 10.1186/s12882-018-0851-3] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2017] [Accepted: 02/20/2018] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Klotho, a protein linked to aging, has emerged as a pivotal player in mineral bone metabolism and might explain the relationship between chronic kidney disease (CKD) and cardiovascular disease (CVD). The present study aimed to investigate the association between serum klotho and cardiac parameters from a large-scale Korean CKD cohort. METHODS We analyzed 2101 participants from KoreaN Cohort Study for Outcome in Patients With Chronic Kidney Disease (KNOW-CKD) cohort who had been measured for serum klotho levels. Left ventricular hypertrophy evaluated by left ventricular mass index (LVMI) and arterial stiffness measured by brachial-to-ankle pulse wave velocity (baPWV) were explored as cardiovascular parameters. RESULTS Patients were 53.6 ± 12.2 years old and 61.1% were male. The mean estimated glomerular filtration rate (eGFR) was 53.0 ± 30.7 mL/min/1.73m2. The median serum klotho level was 536 (interquartile range [IQR]: 420-667) pg/mL. Advanced CKD stages were associated with lower serum klotho levels (P < 0.001, P for linear trend < 0.001). Ascending quartiles of klotho were significantly associated with decreased LMVI (P < 0.001, P for linear trend< 0.001). A multivariable linear regression model showed serum klotho had a significant inverse association with LVMI (β - 0.04; 95% CI [confidence interval] -0.004, - 0.00007; P = 0.041). However, there was no significant association between serum klotho and baPWV after adjustment (β 0.003; 95% CI -0.04, 0.05; P = 0.876). TRIAL REGISTRATION This trial was registered on ClinicalTrials.gov on 28 June 2012 ( NCT01630486 ). CONCLUSIONS Serum klotho was an independent biomarker of LVMI, but not arterial stiffness.
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Affiliation(s)
- Hyo Jin Kim
- Department of Internal Medicine, Dongguk University College of Medicine, Gyeongju-si, Gyeongsangbuk-do, South Korea
| | - Eunjeong Kang
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Yun Kyu Oh
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Yeong Hoon Kim
- Department of Internal Medicine, Inje University, Busan Paik Hospital, Busan, South Korea
| | - Seung Hyeok Han
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, South Korea
| | - Tae Hyun Yoo
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, South Korea
| | - Dong-Wan Chae
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Joongyub Lee
- Medical Research Collaborating Center, Seoul National University Hospital and Seoul, National University College of Medicine, Seoul, South Korea
| | - Curie Ahn
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Kook-Hwan Oh
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.
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Aston PJ, Christie MI, Huang YH, Nandi M. Beyond HRV: attractor reconstruction using the entire cardiovascular waveform data for novel feature extraction. Physiol Meas 2018; 39:024001. [PMID: 29350622 PMCID: PMC5831644 DOI: 10.1088/1361-6579/aaa93d] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Advances in monitoring technology allow blood pressure waveforms to be collected at sampling frequencies of 250-1000 Hz for long time periods. However, much of the raw data are under-analysed. Heart rate variability (HRV) methods, in which beat-to-beat interval lengths are extracted and analysed, have been extensively studied. However, this approach discards the majority of the raw data. OBJECTIVE Our aim is to detect changes in the shape of the waveform in long streams of blood pressure data. APPROACH Our approach involves extracting key features from large complex data sets by generating a reconstructed attractor in a three-dimensional phase space using delay coordinates from a window of the entire raw waveform data. The naturally occurring baseline variation is removed by projecting the attractor onto a plane from which new quantitative measures are obtained. The time window is moved through the data to give a collection of signals which relate to various aspects of the waveform shape. MAIN RESULTS This approach enables visualisation and quantification of changes in the waveform shape and has been applied to blood pressure data collected from conscious unrestrained mice and to human blood pressure data. The interpretation of the attractor measures is aided by the analysis of simple artificial waveforms. SIGNIFICANCE We have developed and analysed a new method for analysing blood pressure data that uses all of the waveform data and hence can detect changes in the waveform shape that HRV methods cannot, which is confirmed with an example, and hence our method goes 'beyond HRV'.
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Affiliation(s)
- Philip J Aston
- Department of Mathematics, University of Surrey, Guildford, Surrey GU2 7XH, United Kingdom
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Defective p27 phosphorylation at serine 10 affects vascular reactivity and increases abdominal aortic aneurysm development via Cox-2 activation. J Mol Cell Cardiol 2018; 116:5-15. [PMID: 29408196 DOI: 10.1016/j.yjmcc.2018.01.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2017] [Revised: 01/10/2018] [Accepted: 01/15/2018] [Indexed: 12/31/2022]
Abstract
Phosphorylation at serine 10 (S10) is the major posttranslational modification of the tumor suppressor p27, and is reduced in both human and mouse atherosclerosis. Moreover, a lack of p27-phospho-S10 in apolipoprotein E-null mice (apoE-/-) leads to increased high-fat diet-induced atherosclerosis associated with endothelial dysfunction and augmented leukocyte recruitment. In this study, we analyzed whether p27-phospho-S10 modulates additional endothelial functions and associated pathologies. Defective p27-phospho-S10 increases COX-2 activity in mouse aortic endothelial cells without affecting other key regulators of vascular reactivity, reduces endothelium-dependent dilation, and increases arterial contractility. Lack of p27-phospho-S10 also elevates aortic COX-2 expression and thromboxane A2 production, increases aortic lumen diameter, and aggravates angiotensin II-induced abdominal aortic aneurysm development in apoE-/- mice. All these abnormal responses linked to defective p27-phospho-S10 are blunted by pharmacological inhibition of COX-2. These results demonstrate that defective p27-phospho-S10 modifies endothelial behavior and promotes aneurysm formation via COX-2 activation.
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Ott C, Franzen KF, Graf T, Weil J, Schmieder RE, Reppel M, Mortensen K. Renal denervation improves 24-hour central and peripheral blood pressures, arterial stiffness, and peripheral resistance. J Clin Hypertens (Greenwich) 2018; 20:366-372. [DOI: 10.1111/jch.13193] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2017] [Revised: 10/23/2017] [Accepted: 11/07/2017] [Indexed: 11/29/2022]
Affiliation(s)
- Christian Ott
- Department of Nephrology and Hypertension; Friedrich-Alexander Universität Erlangen-Nürnberg; Erlangen Germany
| | - Klaas F. Franzen
- Campus Lübeck Medizinische Klinik III; Universitätsklinikum Schleswig-Holstein; Lübeck Germany
| | - Tobias Graf
- Campus Lübeck Medizinische Klinik II; Universitätsklinikum Schleswig-Holstein; Lübeck Germany
| | | | - Roland E. Schmieder
- Department of Nephrology and Hypertension; Friedrich-Alexander Universität Erlangen-Nürnberg; Erlangen Germany
| | - Michael Reppel
- Campus Lübeck Medizinische Klinik II; Universitätsklinikum Schleswig-Holstein; Lübeck Germany
- Cardiology Landsberg; Landsberg Germany
| | - Kai Mortensen
- Campus Lübeck Medizinische Klinik II; Universitätsklinikum Schleswig-Holstein; Lübeck Germany
- Cardiology Practice; Kiel Germany
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Chemokines protect vascular smooth muscle cells from cell death induced by cyclic mechanical stretch. Sci Rep 2017; 7:16128. [PMID: 29170451 PMCID: PMC5701048 DOI: 10.1038/s41598-017-15867-8] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2016] [Accepted: 11/03/2017] [Indexed: 01/08/2023] Open
Abstract
The pulsatile nature of blood flow exposes vascular smooth muscle cells (VSMCs) in the vessel wall to cyclic mechanical stretch (CMS), which evokes VSMC proliferation, cell death, phenotypic switching, and migration, leading to vascular remodeling. These responses have been observed in many cardiovascular diseases; however, the underlying mechanisms remain unclear. We have revealed that CMS of rat aortic smooth muscle cells (RASMCs) causes JNK- and p38-dependent cell death and that a calcium channel blocker and angiotensin II receptor antagonist decreased the phosphorylation of JNK and p38 and subsequently decreased cell death by CMS. In the present study, we showed that the expression of Cxcl1 and Cx3cl1 was induced by CMS in a JNK-dependent manner. The expression of Cxcl1 was also induced in VSMCs by hypertension produced by abdominal aortic constriction (AAC). In addition, antagonists against the receptors for CXCL1 and CX3CL1 increased cell death, indicating that CXCL1 and CX3CL1 protect RASMCs from CMS-induced cell death. We also revealed that STAT1 is activated in RASMCs subjected to CMS. Taken together, these results indicate that CMS of VSMCs induces inflammation-related gene expression, including that of CXCL1 and CX3CL1, which may play important roles in the stress response against CMS caused by hypertension.
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Collagen fibre characterisation in arterial tissue under load using SALS. J Mech Behav Biomed Mater 2017; 75:359-368. [DOI: 10.1016/j.jmbbm.2017.07.036] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2017] [Revised: 07/13/2017] [Accepted: 07/25/2017] [Indexed: 01/06/2023]
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Feistritzer HJ, Klug G, Reinstadler SJ, Reindl M, Niess L, Nalbach T, Kremser C, Mayr A, Metzler B. Prognostic Value of Aortic Stiffness in Patients After ST-Elevation Myocardial Infarction. J Am Heart Assoc 2017; 6:JAHA.117.005590. [PMID: 28887316 PMCID: PMC5634252 DOI: 10.1161/jaha.117.005590] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND High aortic stiffness has been shown to be a strong predictor of morbidity and mortality in the general population and several patient cohorts. However, in patients after ST-elevation myocardial infarction, the prognostic value of high aortic stiffness is unknown so far. METHODS AND RESULTS This prospective observational study included 160 consecutive patients with first acute ST-elevation myocardial infarction. Aortic pulse wave velocity (PWV) was measured 2 (interquartile range 2-4 days) days after infarction using cardiac magnetic resonance imaging. The primary end point was defined as a composite end point of major adverse cardiac and cerebrovascular events (MACCE) comprising death, nonfatal myocardial reinfarction, new congestive heart failure, and stroke. During a median follow-up of 1.2 years (interquartile range 1.0-3.1 years), 19 (12%) MACCE events occurred. Kaplan-Meier analysis showed a significantly lower MACCE-free survival in patients with high PWV (PWV >7.3 m/s, log-rank P=0.003). Multivariable Cox regression analysis revealed PWV >7.3 m/s to be an independent predictor of MACCE after adjustment for age, sex, mean blood pressure, N-terminal pro-brain natriuretic peptide levels, presence of multivessel disease, and left ventricular stroke volume (hazard ratios ≥3.5; 95% confidence interval 1.4-13.3; all P≤0.018). In reclassification analysis the addition of PWV to a risk model comprising major clinical prognostic parameters led to a net reclassification improvement of 0.11 (95% confidence interval 0.06-0.17; P<0.001). CONCLUSIONS Increased aortic stiffness is an independent predictor of MACCE after acute ST-elevation myocardial infarction. Moreover, the assessment of aortic stiffness in addition to classical risk factors significantly improved early risk stratification.
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Affiliation(s)
- Hans-Josef Feistritzer
- University Clinic of Internal Medicine III, Cardiology and Angiology, Medical University of Innsbruck, Austria
| | - Gert Klug
- University Clinic of Internal Medicine III, Cardiology and Angiology, Medical University of Innsbruck, Austria
| | - Sebastian J Reinstadler
- University Clinic of Internal Medicine III, Cardiology and Angiology, Medical University of Innsbruck, Austria
| | - Martin Reindl
- University Clinic of Internal Medicine III, Cardiology and Angiology, Medical University of Innsbruck, Austria
| | - Lea Niess
- University Clinic of Internal Medicine III, Cardiology and Angiology, Medical University of Innsbruck, Austria
| | - Timo Nalbach
- University Clinic of Internal Medicine III, Cardiology and Angiology, Medical University of Innsbruck, Austria
| | - Christian Kremser
- University Clinic of Radiology, Medical University of Innsbruck, Austria
| | - Agnes Mayr
- University Clinic of Radiology, Medical University of Innsbruck, Austria
| | - Bernhard Metzler
- University Clinic of Internal Medicine III, Cardiology and Angiology, Medical University of Innsbruck, Austria
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Prasad B, St Onge JR, McCarron MCE, Goyal K, Dehghani P. The Impact on Central Blood Pressure and Arterial Stiffness Post Renal Denervation in Patients With Stage 3 and 4 Chronic Kidney Disease: The Prairie Renal Denervation Study. Can J Kidney Health Dis 2017; 4:2054358117719028. [PMID: 28835849 PMCID: PMC5528937 DOI: 10.1177/2054358117719028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2016] [Accepted: 05/15/2017] [Indexed: 11/17/2022] Open
Abstract
Background: Central aortic blood pressures and arterial stiffness are better indicators of cardiovascular outcomes than brachial blood pressures. However, their response to renal denervation (RDN) in patients with stage 3 and stage 4 chronic kidney disease (CKD) has not yet been examined. Objective: To evaluate the impact of RDN on central blood pressures, brachial (office and ambulatory) blood pressures, arterial stiffness, glomerular filtration rate (GFR), 24-hour urine protein, and selective cardiac parameters observed on echocardiograms. Design: Single-center, single-arm with pre-RDN/post-RDN follow-up. Setting: Patients are being recruited from the multidisciplinary CKD clinic. Patients: Fifty consecutive patients with stage 3 or stage 4 CKD and resistant hypertension, with no radiological or laboratory evidence of secondary causes of hypertension. Measurements: The key measurements are central blood pressures, pulse wave velocity, ambulatory 24-hour blood pressure, office blood pressures on BP Tru, GFR, 24-hour urine protein and sodium, blood pressure medication, and doses. Methods: For our primary outcome, we will compare changes in central blood pressures from baseline to 6 months post RDN using a paired t test or Mann-Whitney U test. Secondary outcomes will examine changes in central blood pressures from baseline to 3, 12, 18, and 24 months post RDN as well as changes in office pressures, GFR, 24-hour urine protein and sodium, and medications at all time points using mixed-model analyses of variance or Friedman test. Multiple regression may be used to control for potential covariates. Limitations: Single-center study, with no sham arm. Conclusions: Aortic blood pressure, rather than brachial blood pressure, optimally reflects the load placed on the left ventricle. Aortic blood pressure is also better associated with cardiovascular outcomes. If our study shows a preferential decrease in central blood pressures and improvements in cardiac parameters on echocardiograms post RDN, this may influence the way in which blood pressures are managed in clinics and offices. Trial Registration: ClinicalTrials.gov (NCT01832233)
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Affiliation(s)
- Bhanu Prasad
- Section of Nephrology, Department of Medicine, Regina Qu'Appelle Health Region, Saskatchewan, Canada
| | - Jennifer Rose St Onge
- Research and Performance Support, Regina Qu'Appelle Health Region, Saskatchewan, Canada
| | - Michelle C E McCarron
- Research and Performance Support, Regina Qu'Appelle Health Region, Saskatchewan, Canada
| | - Kunal Goyal
- Department of Radiology, Regina Qu'Appelle Health Region, Saskatchewan, Canada
| | - Payam Dehghani
- Section of Cardiology, Department of Medicine, Regina Qu'Appelle Health Region, Saskatchewan, Canada
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45
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Ouédraogo V, Soleti R, Signolet I, Diaw M, Hallab M, Samb A, Andriantsitohaina R, Ba A, Lefthériotis G. [Impact of sickle cell trait on arterial stiffness in African subjects]. JOURNAL DE MÉDECINE VASCULAIRE 2017; 42:14-20. [PMID: 28705443 DOI: 10.1016/j.jdmv.2017.01.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/10/2016] [Accepted: 12/12/2016] [Indexed: 10/19/2022]
Abstract
Sickle cell trait (SCT) is the benign condition of sickle cell disease. Often asymptomatic, the carriers of the sickle cell trait have hemorheological disturbances with increased oxidative stress compared to healthy subjects. These disturbances can lead to structural and functional changes in large vessels. The aim of the study was to measure arterial stiffness, an independent marker of subclinical atherosclerosis, SCT carriers compared to sickle cell anemia (SCA) subjects. Nine SCT carriers aged 32±9 years (7 men) were compared to 14 SCA subjects aged 29±9 years (2 men) and 22 control subjects aged 34±9 years (11 men) recruited by the National blood transfusion center (CNTS) in Dakar (Senegal). Arterial stiffness was assessed by measurement of the finger-toe pulse wave velocity (PWVft) using pOpmètre® (Axelife SAS-France). The cardiovascular risk (CVR) was assessed according to the Framingham Laurier score. The SCT carriers had a higher PWVft (m/s) than SCA subjects (8.2±2.2 vs 6.1±0.9m/s, P=0.004) but not different from that of healthy controls (8.2±2.2 vs 7.4±1.8m/s, P=0.33). Linear regression showed a positive relationship between PWVft and the pulse pressure (PP) (P˂0.001; r2=0.39; F=13.20). The results show that the SCT carriers have stiffer arteries than SCA subjects. Linear regressions adjusted for age, mean arterial pressure (MAP) and PP, showed that only age and PP were independently correlated with arterial stiffness in the entire population.
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Affiliation(s)
- V Ouédraogo
- Laboratoire de physiologie humaine, faculté de médecine, de pharmacie et d'odontologie, UCAD, BP 5005, Dakar-Fann, Sénégal.
| | - R Soleti
- Laboratoire Inserm U1063-SOPAM, université d'Angers, 49933 Angers cedex 9, France
| | - I Signolet
- Laboratoire de biochimie, CHU d'Angers, 49933 Angers cedex, France
| | - M Diaw
- Laboratoire de physiologie humaine, faculté de médecine, de pharmacie et d'odontologie, UCAD, BP 5005, Dakar-Fann, Sénégal
| | - M Hallab
- Hôpital universitaire de Nantes, place Ricordeau, 44000 Nantes, France
| | - A Samb
- Laboratoire de physiologie humaine, faculté de médecine, de pharmacie et d'odontologie, UCAD, BP 5005, Dakar-Fann, Sénégal; Unité mixte internationale (UMI 3189), « Environnement, Santé, Sociétés », CNRS, UCAD, CNRST, USTTB, UGB, Dakar, Sénégal
| | - R Andriantsitohaina
- Laboratoire Inserm U1063-SOPAM, université d'Angers, 49933 Angers cedex 9, France
| | - A Ba
- Laboratoire de physiologie humaine, faculté de médecine, de pharmacie et d'odontologie, UCAD, BP 5005, Dakar-Fann, Sénégal; Unité mixte internationale (UMI 3189), « Environnement, Santé, Sociétés », CNRS, UCAD, CNRST, USTTB, UGB, Dakar, Sénégal
| | - G Lefthériotis
- Laboratoire de biologie neurovasculaire et mitochondriale intégrée, UMR CNRS 6214-Inserm 1083, faculté de médecine, 49045 Angers, France
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Vongpromek R, Bos S, Ten Kate GJR, Bujo H, Jiang M, Nieman K, Schneider W, Roeters van Lennep JE, Verhoeven AJM, Sijbrands EJG, Mulder MT. Soluble LR11 associates with aortic root calcification in asymptomatic treated male patients with familial hypercholesterolemia. Atherosclerosis 2017. [PMID: 28637586 DOI: 10.1016/j.atherosclerosis.2017.06.018] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
BACKGROUND AND AIMS Despite statin treatment, a high prevalence of severe vascular calcification is found in patients with familial hypercholesterolemia (FH). We assessed the relation between the circulating soluble form of low-density lipoprotein receptor relative with 11 ligand-binding repeats (sLR11), a risk factor for cardiovascular disease, and vascular calcification in asymptomatic statin-treated heterozygous FH patients. METHODS In 123 asymptomatic heterozygous FH patients (age 40-69 years), aortic root (ARC), aortic valve (AVC) and coronary artery calcification (CAC) were determined with CT-based calcium scoring expressed in Agatston units. Plasma sLR11 levels were measured by sandwich ELISA. RESULTS Seventy-three patients displayed ARC, 48 had AVC and 96 CAC. Plasma sLR11 levels were positively correlated with the presence of ARC (r = 0.2, p = 0.03), but not with AVC or CAC. The correlation between sLR11 levels and ARC was restricted to male FH patients (r = 0.31, p = 0.006). Multivariate logistic analyses showed that the association of plasma sLR11 with the presence of ARC was independent of other determinants (Adjusted Odds Ratio, 2.01 (95% CI = 1.28-3.16) p = 0.002). CONCLUSIONS Plasma sLR11 is associated with ARC in male FH patients and may be mechanistically involved in the differential distribution of atherosclerotic lesions in the vasculature.
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Affiliation(s)
- Ranitha Vongpromek
- Department of Internal Medicine, Laboratory of Vascular Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Sven Bos
- Department of Internal Medicine, Laboratory of Vascular Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Gert-Jan R Ten Kate
- Department of Cardiology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Hideaki Bujo
- Department of Clinical-Laboratory and Experimental-Research Medicine, Toho University, Sakura Medical Center, Sakura, Japan
| | - Meizi Jiang
- Department of Clinical-Laboratory and Experimental-Research Medicine, Toho University, Sakura Medical Center, Sakura, Japan
| | - Koen Nieman
- Department of Cardiology, Erasmus University Medical Center, Rotterdam, The Netherlands; Department of Radiology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Wolfgang Schneider
- Department of Medical Biochemistry, Medical University of Vienna, Max. F. Perutz Laboratories, Vienna, Austria
| | - Jeanine E Roeters van Lennep
- Department of Internal Medicine, Laboratory of Vascular Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Adrie J M Verhoeven
- Department of Internal Medicine, Laboratory of Vascular Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Eric J G Sijbrands
- Department of Internal Medicine, Laboratory of Vascular Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Monique T Mulder
- Department of Internal Medicine, Laboratory of Vascular Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands.
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Mariaca AF, Valdueza JM, Gaebel C, Gomez-Choco M. Simultaneous transient global amnesia and right MCA stroke after Valsalva manoeuvre. BMJ Case Rep 2017; 2017:bcr-2016-218990. [PMID: 28433970 DOI: 10.1136/bcr-2016-218990] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
A 61-year-old man suffered an episode of transient confusion and anterograde amnesia after a Valsalva-related manoeuvre. The MRI diffusion weighted imaging (DWI) sequences showed a left hippocampal and two right parietal lesions that were deemed as acute. The MR angiography disclosed a high-grade stenosis in the right middle cerebral artery as was described by a transcranial colour-coded ultrasound as well. Ultrasound investigation of the jugular veins showed a right jugular venous reflux after a Valsalva manoeuvre. The patient was diagnosed with transient global amnesia based on clinical grounds and the right parietal lesions were considered as silent strokes. The Valsalva manoeuvre could have played as a common trigger for both diseases.
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Affiliation(s)
| | | | - Christian Gaebel
- Radiology, Neurological Center, Segeberger Kliniken, Bad Segeberg, Germany
| | - Manuel Gomez-Choco
- Department of Neurology, Hospital Sant Joan Despi Moises Broggi, Sant Joan Despi, Spain
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48
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Yan H, Ranadive SM, Lane-Cordova AD, Kappus RM, Behun MA, Cook MD, Woods JA, Wilund KR, Baynard T, Halliwill JR, Fernhall B. Effect of acute aerobic exercise and histamine receptor blockade on arterial stiffness in African Americans and Caucasians. J Appl Physiol (1985) 2017; 122:386-395. [PMID: 27979988 DOI: 10.1152/japplphysiol.01115.2015] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2015] [Revised: 11/28/2016] [Accepted: 12/07/2016] [Indexed: 11/22/2022] Open
Abstract
African Americans (AA) exhibit exaggerated central blood pressure (BP) and arterial stiffness measured by pulse wave velocity (PWV) in response to an acute bout of maximal exercise compared with Caucasians (CA). However, whether potential racial differences exist in central BP, elastic, or muscular arterial distensibility after submaximal aerobic exercise remains unknown. Histamine receptor activation mediates sustained postexercise hyperemia in CA but the effect on arterial stiffness is unknown. This study sought to determine the effects of an acute bout of aerobic exercise on central BP and arterial stiffness and the role of histamine receptors, in AA and CA. Forty-nine (22 AA, 27 CA) young and healthy subjects completed the study. Subjects were randomly assigned to take either histamine receptor antagonist or control placebo. Central blood BP and arterial stiffness measurements were obtained at baseline, and at 30, 60, and 90 min after 45 min of moderate treadmill exercise. AA exhibited greater central diastolic BP, elevated brachial PWV, and local carotid arterial stiffness after an acute bout of submaximal exercise compared with CA, which may contribute to their higher risk of cardiovascular disease. Unexpectedly, histamine receptor blockade did not affect central BP or PWV in AA or CA after exercise, but it may play a role in mediating local carotid arterial stiffness. Furthermore, histamine may mediate postexercise carotid arterial dilation in CA but not in AA. These observations provide evidence that young and healthy AA exhibit an exaggerated hemodynamic response to exercise and attenuated vasodilator response compared with CA.NEW & NOTEWORTHY African Americans are at greater risk for developing cardiovascular disease than Caucasians. We are the first to show that young and healthy African Americans exhibit greater central blood pressure, elevated brachial stiffness, and local carotid arterial stiffness following an acute bout of submaximal exercise compared with Caucasians, which may contribute to their higher risk of cardiovascular disease. Furthermore, African Americans exhibit attenuated vasodilator response compared with Caucasians.
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Affiliation(s)
- Huimin Yan
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Champaign, Illinois; .,Department of Exercise and Health Sciences, University of Massachusetts Boston, Boston, Massachusetts
| | - Sushant M Ranadive
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Champaign, Illinois
| | - Abbi D Lane-Cordova
- Integrative Physiology Laboratory, Department of Kinesiology and Nutrition, University of Illinois at Chicago, Chicago, Illinois
| | - Rebecca M Kappus
- Department of Health and Exercise Science, Appalachian State University, Boone, North Carolina; and
| | - Michael A Behun
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Champaign, Illinois
| | - Marc D Cook
- Integrative Physiology Laboratory, Department of Kinesiology and Nutrition, University of Illinois at Chicago, Chicago, Illinois
| | - Jeffrey A Woods
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Champaign, Illinois
| | - Kenneth R Wilund
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Champaign, Illinois
| | - Tracy Baynard
- Integrative Physiology Laboratory, Department of Kinesiology and Nutrition, University of Illinois at Chicago, Chicago, Illinois
| | - John R Halliwill
- Department of Human Physiology, University of Oregon, Eugene, Oregon
| | - Bo Fernhall
- Integrative Physiology Laboratory, Department of Kinesiology and Nutrition, University of Illinois at Chicago, Chicago, Illinois
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49
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Chirakarnjanakorn S, Navaneethan SD, Francis GS, Tang WHW. Cardiovascular impact in patients undergoing maintenance hemodialysis: Clinical management considerations. Int J Cardiol 2017; 232:12-23. [PMID: 28108129 DOI: 10.1016/j.ijcard.2017.01.015] [Citation(s) in RCA: 51] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2016] [Revised: 12/29/2016] [Accepted: 01/03/2017] [Indexed: 12/23/2022]
Abstract
Patients undergoing maintenance hemodialysis develop both structural and functional cardiovascular abnormalities. Despite improvement of dialysis technology, cardiovascular mortality of this population remains high. The pathophysiological mechanisms of these changes are complex and not well understood. It has been postulated that several non-traditional, uremic-related risk factors, especially the long-term uremic state, which may affect the cardiovascular system. There are many cardiovascular changes that occur in chronic kidney disease including left ventricular hypertrophy, myocardial fibrosis, microvascular disease, accelerated atherosclerosis and arteriosclerosis. These structural and functional changes in patients receiving chronic dialysis make them more susceptible to myocardial ischemia. Hemodialysis itself may adversely affect the cardiovascular system due to non-physiologic fluid removal, leading to hemodynamic instability and initiation of systemic inflammation. In the past decade there has been growing awareness that pathophysiological mechanisms cause cardiovascular dysfunction in patients on chronic dialysis, and there are now pharmacological and non-pharmacological therapies that may improve the poor quality of life and high mortality rate that these patients experience.
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Affiliation(s)
- Srisakul Chirakarnjanakorn
- Kaufman Center for Heart Failure, Heart and Vascular Institute, Cleveland Clinic, Cleveland, OH, United States; Division of Cardiology, Department of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Sankar D Navaneethan
- Section of Nephrology, Department of Medicine, Baylor College of Medicine, Houston, TX, United States
| | - Gary S Francis
- Division of Cardiovascular Disease, University of Minnesota, United States
| | - W H Wilson Tang
- Kaufman Center for Heart Failure, Heart and Vascular Institute, Cleveland Clinic, Cleveland, OH, United States.
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50
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Wang J, Hosoda M, Tshikudi DM, Hajjarian Z, Nadkarni SK. Intraluminal laser speckle rheology using an omni-directional viewing catheter. BIOMEDICAL OPTICS EXPRESS 2017; 8:137-150. [PMID: 28101407 PMCID: PMC5231287 DOI: 10.1364/boe.8.000137] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/27/2016] [Revised: 12/04/2016] [Accepted: 12/05/2016] [Indexed: 05/27/2023]
Abstract
A number of disease conditions in luminal organs are associated with alterations in tissue mechanical properties. Here, we report a new omni-directional viewing Laser Speckle Rheology (LSR) catheter for mapping the mechanical properties of luminal organs without the need for rotational motion. The LSR catheter incorporates multiple illumination fibers, an optical fiber bundle and a multi-faceted mirror to permit omni-directional viewing of the luminal wall. By retracting the catheter using a motor-drive assembly, cylindrical maps of tissue mechanical properties are reconstructed. Evaluation conducted in a test phantom with circumferentially-varying mechanical properties demonstrates the capability of the LSR catheter for the accurate mechanical assessment of luminal organs.
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Affiliation(s)
- Jing Wang
- Wellman Center for Photomedicine, Harvard Medical School and Massachusetts General Hospital, MA 02114, USA
- Authors contributed equally to this work
| | - Masaki Hosoda
- Wellman Center for Photomedicine, Harvard Medical School and Massachusetts General Hospital, MA 02114, USA
- Healthcare Optics Research Laboratory, Canon U.S.A., Inc., Cambridge, MA 02139, USA
- Authors contributed equally to this work
| | - Diane M. Tshikudi
- Wellman Center for Photomedicine, Harvard Medical School and Massachusetts General Hospital, MA 02114, USA
| | - Zeinab Hajjarian
- Wellman Center for Photomedicine, Harvard Medical School and Massachusetts General Hospital, MA 02114, USA
| | - Seemantini K. Nadkarni
- Wellman Center for Photomedicine, Harvard Medical School and Massachusetts General Hospital, MA 02114, USA
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