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Daniele A, Lucas SJE, Rendeiro C. Variability of flow-mediated dilation across lower and upper limb conduit arteries. Eur J Appl Physiol 2024; 124:3265-3278. [PMID: 38878074 PMCID: PMC11519148 DOI: 10.1007/s00421-024-05517-z] [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: 11/06/2023] [Accepted: 05/23/2024] [Indexed: 10/30/2024]
Abstract
Endothelial dysfunction is an early predictor of atherosclerosis and cardiovascular disease. Flow-mediated dilation (FMD) is the gold standard to assess endothelial function in humans. FMD reproducibility has been mainly assessed in the brachial artery (BA) with limited research in lower limb arteries. The purpose of this study was to compare FMD reproducibility in the upper limb BA and lower limb superficial femoral artery (SFA) in young healthy adults.Fifteen young healthy adults (nine males; six females) underwent FMD, resting diameter, velocity, and shear rate measurements on three occasions to determine intra-and inter-day reproducibility in both BA and SFA, assessed by coefficient of variation (CV), intraclass correlation coefficient (ICC), and Bland-Altman plots.BA FMD CVs (intra-day: 4.2%; inter-day: 8.7%) and ICCs (intra-day: 0.967; inter-day: 0.903) indicated excellent reproducibility and reliability, while for SFA FMD, both CVs (intra-day: 11.6%; inter-day: 26.7%) and ICCs (intra-day: 0.898; inter-day: 0.651) showed good/moderate reproducibility and reliability. BA FMD was significantly more reproducible than SFA FMD (p < 0.05). Diameter reproducibility was excellent and similar between arteries, while resting velocity and shear rate have lower reproducibility in the BA compared to SFA. Bland-Altman plots displayed no proportional and fixed bias between measurements.In summary, SFA FMD is less reproducible than BA FMD, with identical volume of ultrasound training. Given the increasing interest in using SFA FMD to test the efficacy of interventions targeting lower limb's vascular health and as a potential biomarker for peripheral arterial disease risk, future studies should ensure higher levels of training for adequate reproducibility.
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Affiliation(s)
- Alessio Daniele
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, B15 2TT, UK
| | - Samuel J E Lucas
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, B15 2TT, UK
- Centre for Human Brain Health, University of Birmingham, Birmingham, UK
| | - Catarina Rendeiro
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, B15 2TT, UK.
- Centre for Human Brain Health, University of Birmingham, Birmingham, UK.
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Ghaderian M, Ahmadi A, Navabfar N, Sabri MR, Dehghan B, Mahdavi C. Investigation of flow-mediated vasodilatation (FMD) and comparison with carotid intima-media thickness (CIMT) in children with cyanotic congenital heart disease. ARYA ATHEROSCLEROSIS 2024; 20:1-8. [PMID: 39165852 PMCID: PMC11331552 DOI: 10.48305/arya.2023.42047.2917] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Accepted: 11/20/2023] [Indexed: 08/22/2024]
Abstract
BACKGROUND There is a high mortality rate in cyanotic patients with congenital heart disease (CHD) due to cardiovascular complications. The cardiovascular prognosis is negatively affected by endothelium dysfunction, increased arterial stiffness, and impaired vascular system. This study aimed to determine carotid intimal mean thickness (CIMT) and flow-mediated dilatation (FMD) in a group of children with cyanotic CHD (CCHD). METHODS FMD and CIMT were evaluated for 45 children with CHKD and 38 patients who did not have CHKD over the period 2021 to 2022, as part of this case-control study. In terms of age and gender, the case group has been compared to controls. RESULTS Men accounted for 61.3% of the participants, with a mean standard deviation age of 7.8 5.39 years. In subjects with CCHD, CIMT increased non-significantly and FMD decreased significantly, but systolic blood pressure was significantly higher in patients than in the healthy group. (P=0.003). CONCLUSION FMD was reduced in children with CCHD, but in controls, systolic blood pressure and CIMT were lower. The risk of developing atherosclerosis in CCHD patients may be increased by an increase in CIMT and systolic blood pressure.
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Affiliation(s)
- Mehdi Ghaderian
- Pediatric Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Alireza Ahmadi
- Pediatric Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Narges Navabfar
- Department of Pediatrics, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mohammad Reza Sabri
- Pediatric Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Bahar Dehghan
- Pediatric Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Chehreh Mahdavi
- Pediatric Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
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Ahmadi A, Ghaderian M, Nourmohammadi H, Sabri MR, Dehghan B, Mahdavi C. Comparison of CIMT and FMD in the Brachial Artery between Children with Acyanotic Congenital Heart Disease and Healthy Controls: A Case-Control Study. J Tehran Heart Cent 2023; 18:256-260. [PMID: 38680641 PMCID: PMC11053238 DOI: 10.18502/jthc.v18i4.14824] [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: 01/09/2023] [Accepted: 06/26/2023] [Indexed: 05/01/2024] Open
Abstract
Background Congenital heart disease (CHD), a developmental abnormality of the heart and vessels, is encountered in the pediatric age group frequently. Brachial artery flow-mediated dilation (FMD) and carotid intima-media thickness (CIMT) are indicators of subclinical cardiovascular disease and are used as surrogate measures of subclinical atherosclerosis. The present study aimed to compare CIMT and FMD between children with acyanotic congenital heart disease (ACHD) and healthy controls. Methods A case-control study on 50 children with ACHD and 43 healthy individuals was done in Isfahan, Iran, between 2021 and 2022. The case group was selected via non-random sampling, and healthy controls were recruited from the relatives of the patients. A checklist, including age, sex, body mass index, and blood pressure, was filled out for all the participants. Then, FMD and CIMT were measured with brachial and carotid artery ultrasonography. Results Fifty children with ACHD and 43 healthy individuals (controls) under 18 years old participated in this study. Of these, 44 (47.3%) were girls and 49 (52.7%) were boys. The mean FMD was significantly higher in the ACHD group than in the control group (0.084±0.027 vs 0.076±0.042; P=0.021; 95% CI, 007 to 0.122;). CIMT was significantly higher in the ACHD group than in the control group (0.39±0.12 vs 0.34±0.1; P=0.037; 95% CI, 0.009 to 0.102;). However, systolic and diastolic blood pressure did not show differences between the groups. Conclusion Based on our results, CIMT and FMD assessment may help detect early changes in peripheral vessels associated with atherosclerosis in the future in ACHD. Further studies are needed to confirm our findings.
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Affiliation(s)
- Alireza Ahmadi
- Pediatric Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mehdi Ghaderian
- Pediatric Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Hajar Nourmohammadi
- Department of Pediatrics, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mohammad Reza Sabri
- Pediatric Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Bahar Dehghan
- Pediatric Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Chehreh Mahdavi
- Pediatric Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
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Endothelial dysfunction in subfertile women with polycystic ovary syndrome. Reprod Biomed Online 2023; 46:391-398. [PMID: 36566144 DOI: 10.1016/j.rbmo.2022.11.013] [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: 09/06/2022] [Revised: 11/05/2022] [Accepted: 11/21/2022] [Indexed: 11/27/2022]
Abstract
RESEARCH QUESTION Is there an association between post-occlusive reactive hyperaemia (PORH) and ovarian stimulation in women with normoandrogenaemic polycystic ovary syndrome (PCOS)? DESIGN Women eligible for IVF at an academic fertility centre were invited to join this prospective study. Microvascular endothelial function was measured as PORH by laser Doppler flowmetry (LDF) before and after ovarian stimulation. Metabolic characteristics, hormone profiles and biochemical markers were analysed. RESULTS Thirty-four normoandrogenaemic women with PCOS and 36 normoandrogenaemic women without PCOS were included. The PCOS group displayed higher C-reactive protein levels and insulin resistance (P = 0.048 and P = 0.025, respectively). No significant difference was found in microcirculatory function between the groups at baseline. After ovarian stimulation, PORH was enhanced in the control group (slope 7.1 ± 3.3 versus 9.7 ± 4.5; P = 0.007; peak flow 30.7 ± 16.3 versus 43.5 ± 17.3, P = 0.008; however, the PCOS group experienced a blunting response to supraphysiological hormone status (slope 8.2 ± 5.1 versus 7.2 ± 4.3, P = 0.212; peak flow, 38.8 ± 19.4 versus 37.0 ± 21.8, P = 0.895). CONCLUSIONS Impaired microcirculatory function could be found using a non-invasive LDF technique in normoandrogenaemic women with PCOS undergoing IVF, indicating early changes in vascular endothelial dysfunction. Future observational studies should clarify whether PORH measurement might help predict IVF prognosis or obstetric complications.
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Patel S, Shokr H, Greenstein A, Gherghel D. Macro- and Microvascular Function in Middle-Aged Individuals with Low Cardiovascular Disease Risk. J Clin Med 2022; 11:jcm11236962. [PMID: 36498535 PMCID: PMC9740681 DOI: 10.3390/jcm11236962] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Revised: 11/23/2022] [Accepted: 11/24/2022] [Indexed: 11/29/2022] Open
Abstract
Aims: To investigate the microvascular function in apparently healthy individuals showing signs of early macrovascular endothelial dysfunction. Methods: Healthy participants aged between 30−55 years were recruited for the present study. Baseline measurements included body-mass index (BMI), waist-to-hip ratio (WHR), 24-h blood pressure, as well as fasted venous glucose, triglycerides (TG) and cholesterol (HDL, LDL and total). Brachial artery reactivity was measured using the flow-mediated dilation (FMD) technique and retinal vessel reactivity was assessed by using the Dynamic Retinal Vessel Analyser (DVA) in all individuals. The enrolled participants were separated in two groups, based on either a reduced (group 1: <5%—n = 53) or a normal FMD response (group 2: 7−10%—n = 47). Results: Individuals exhibiting reduced FMD responses showed a reduced baseline-corrected microvascular arterial dilation response to flickering light (p = 0.039). In addition, they also exhibited a reduced arteriolar maximum dilation (p = 0.034), as well as a longer dilation reaction time (p = 0.048) and a lower dilation amplitude (p = 0.042) when compared to those with normal FMD values. Conclusion: In otherwise healthy middle-aged individuals, early signs of vascular dysfunction are reflected simultaneously at both macro- and microvascular levels.
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Affiliation(s)
- Sunni Patel
- Vascular Research Laboratory, Ophthalmic Research Group, College Health and Life Sciences, Aston University, Birmingham B4 7ET, UK
| | - Hala Shokr
- Vascular Research Laboratory, Ophthalmic Research Group, College Health and Life Sciences, Aston University, Birmingham B4 7ET, UK
- Pharmacy Division, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester M13 9PL, UK
| | - Adam Greenstein
- Division of Cardiovascular Sciences, The University of Manchester, Manchester M13 9PL, UK
| | - Doina Gherghel
- Vascular Research Laboratory, Ophthalmic Research Group, College Health and Life Sciences, Aston University, Birmingham B4 7ET, UK
- Division of Cardiovascular Sciences, The University of Manchester, Manchester M13 9PL, UK
- Correspondence: ; Tel.: +44-0121-204-4120
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Sena CM, Gonçalves L, Seiça R. Methods to evaluate vascular function: a crucial approach towards predictive, preventive, and personalised medicine. EPMA J 2022; 13:209-235. [PMID: 35611340 PMCID: PMC9120812 DOI: 10.1007/s13167-022-00280-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Accepted: 05/02/2022] [Indexed: 11/06/2022]
Abstract
Endothelium, the gatekeeper of our blood vessels, is highly heterogeneous and a crucial physical barrier with the ability to produce vasoactive and protective mediators under physiological conditions. It regulates vascular tone, haemostasis, vascular inflammation, remodelling, and angiogenesis. Several cardio-, reno-, and cerebrovascular diseases begin with the dysfunction of endothelial cells, and more recently, COVID-19 was also associated with endothelial disease highlighting the need to monitor its function towards prevention and reduction of vascular dysfunction. Endothelial cells are an important therapeutic target in predictive, preventive, and personalised (3P) medicine with upmost importance in vascular diseases. The development of novel non-invasive techniques to access endothelial dysfunction for use in combination with existing clinical imaging modalities provides a feasible opportunity to reduce the burden of vascular disease. This review summarises recent advances in the principles of endothelial function measurements. This article presents an overview of invasive and non-invasive techniques to determine vascular function and their major advantages and disadvantages. In addition, the article describes mechanisms underlying the regulation of vascular function and dysfunction and potential new biomarkers of endothelial damage. Recognising these biomarkers is fundamental towards a shift from reactive to 3P medicine in the vascular field. Identifying vascular dysfunction earlier with non-invasive or minimally invasive techniques adds value to predictive diagnostics and targeted prevention (primary, secondary, tertiary care). In addition, vascular dysfunction is a potential target for treatments tailored to the person.
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Affiliation(s)
- Cristina M. Sena
- Institute of Physiology, Faculty of Medicine, University of Coimbra, Subunit 1, Polo 3, Azinhaga de Santa Comba, Celas, 3000-354 Coimbra, Portugal
- Institute for Clinical and Biomedical Research (iCBR), Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - Lino Gonçalves
- Institute for Clinical and Biomedical Research (iCBR), Faculty of Medicine, University of Coimbra, Coimbra, Portugal
- Department of Cardiology, Coimbra’s Hospital and University Centre (CHUC), Coimbra, Portugal
| | - Raquel Seiça
- Institute of Physiology, Faculty of Medicine, University of Coimbra, Subunit 1, Polo 3, Azinhaga de Santa Comba, Celas, 3000-354 Coimbra, Portugal
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Groot HJ, Broxterman RM, Gifford JR, Garten RS, Rossman MJ, Jarrett CL, Kwon OS, Hydren JR, Richardson RS. Reliability of the passive leg movement assessment of vascular function in men. Exp Physiol 2022; 107:541-552. [PMID: 35294784 PMCID: PMC9058221 DOI: 10.1113/ep090312] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Accepted: 03/14/2022] [Indexed: 11/08/2022]
Abstract
NEW FINDINGS What is the central question of this study? Use of the passive leg movement (PLM) test, a non-invasive assessment of microvascular function, is on the rise. However, PLM reliability in men has not been adequately investigated, nor has such reliability data, in men, been compared to the most commonly employed vascular function assessment, flow-mediated vasodilation (FMD). What is the main finding and its importance? PLM is a reliable method to assess vascular function in men, and is comparable to values previously reported for PLM in women, and for FMD. Given the importance of vascular function as a predictor of cardiovascular disease risk, these data support the utility of PLM as a clinically relevant measurement. ABSTRACT Although vascular function is an independent predictor of cardiovascular disease risk, and therefore has significant prognostic value, there is currently not a single clinically accepted method of assessment. The passive leg movement (PLM) assessment predominantly reflects microvascular endothelium-dependent vasodilation and can identify decrements in vascular function with advancing age and pathology. Reliability of the PLM model was only recently determined in women, and has not been adequately investigated in men. Twenty healthy men (age: 27 ± 2 year) were studied on three separate experimental days, resulting in three within-day and three between-day trials. The hyperemic response to PLM was assessed with Doppler ultrasound, and expressed as the absolute peak in leg blood flow (LBFpeak ), change from baseline to peak (ΔLBFpeak ), absolute area under the curve (LBFAUC ), and change in AUC from baseline (ΔLBFAUC ). PLM-induced hyperemia yielded within-day coefficients of variation (CV) from 10.9 to 22.9%, intraclass correlation coefficients (ICC) from 0.82 to 0.90, standard error of the measurement (SEM) from 8.3 to 17.2%, and Pearson's correlation coefficients (r) from 0.56 to 0.81. Between-day assessments of PLM hyperemia resulted in CV from 14.4 to 25%, ICC from 0.75 to 0.87, SEM from 9.8 to 19.8%, and r from 0.46 to 0.75. Similar to previous reports in women, the hyperemic responses to PLM in men display moderate-to-high reliability, and are comparable to reliability data for brachial artery flow mediated vasodilation. These positive reliability findings further support the utility of PLM as a clinical measurement of vascular function and cardiovascular disease risk.
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Affiliation(s)
- H. Jonathan Groot
- Department of Health & Kinesiology University of Utah, Salt Lake City, UT
| | - Ryan M. Broxterman
- Geriatric Research, Education, and Clinical Center, Salt Lake City VAMC, UT;,Department of Internal Medicine, University of Utah, Salt Lake City, UT
| | - Jayson R. Gifford
- Department of Exercise Sciences, Brigham Young University, Provo, UT
| | - Ryan S. Garten
- Department of Kinesiology and Health Sciences, Virginia Commonwealth University, Richmond, VA
| | - Matthew J. Rossman
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, CO
| | - Catherine L. Jarrett
- Geriatric Research, Education, and Clinical Center, Salt Lake City VAMC, UT;,Department of Internal Medicine, University of Utah, Salt Lake City, UT
| | - Oh Sung Kwon
- Department of Kinesiology, University of Connecticut, Storrs, CT
| | - Jay R. Hydren
- Geriatric Research, Education, and Clinical Center, Salt Lake City VAMC, UT;,Department of Nutrition and Integrative Physiology, University of Utah, Salt Lake City, UT
| | - Russell S. Richardson
- Geriatric Research, Education, and Clinical Center, Salt Lake City VAMC, UT;,Department of Internal Medicine, University of Utah, Salt Lake City, UT;,Department of Nutrition and Integrative Physiology, University of Utah, Salt Lake City, UT
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Quirós-Fernández R, López-Plaza B, Bermejo LM, Palma Milla S, Zangara A, Candela CG. Oral Supplement Containing Hydroxytyrosol and Punicalagin Improves Dyslipidemia in an Adult Population without Co-Adjuvant Treatment: A Randomized, Double-Blind, Controlled and Crossover Trial. Nutrients 2022; 14:nu14091879. [PMID: 35565844 PMCID: PMC9103949 DOI: 10.3390/nu14091879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Revised: 04/22/2022] [Accepted: 04/26/2022] [Indexed: 12/04/2022] Open
Abstract
Hydroxytyrosol (HT) and punicalagin (PC) exert cardioprotective and antiatherosclerotic effects. This study evaluated the effect of an oral supplement containing HT and PC (SAx) on dyslipidemia in an adult population. A randomized, double-blind, controlled, crossover trial was conducted over a 20-week period. SAx significantly reduced the plasma levels of triglycerides (TG) in subjects with hypertriglyceridemia (≥150 mg/dL) (from 200.67 ± 51.38 to 155.33 ± 42.44 mg/dL; p < 0.05), while no such effects were observed in these subjects after the placebo. SAx also significantly decreased the plasma levels of low-density lipoprotein cholesterol (LDL-C) in subjects with high plasma levels of LDL-C (≥160 mg/dL) (from 179.13 ± 16.18 to 162.93 ± 27.05 mg/dL; p < 0.01), while no such positive effect was observed with the placebo. In addition, the placebo significantly reduced the plasma levels of high-density lipoprotein cholesterol (HDL-C) in the total population (from 64.49 ± 12.65 to 62.55 ± 11.57 mg/dL; p < 0.05), while SAx significantly increased the plasma levels of HDL-C in subjects with low plasma levels of HDL-C (<50 mg/dL) (from 44.25 ± 3.99 to 48.00 ± 7.27 mg/dL; p < 0.05). In conclusion, the supplement containing HT and PC exerted antiatherosclerotic and cardio-protective effects by considerably improving dyslipidemia in an adult population, without co-adjuvant treatment or adverse effects.
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Affiliation(s)
- Rebeca Quirós-Fernández
- Nutrition Research Group, Hospital La Paz Institute for Health Research (IdiPAZ), 28046 Madrid, Spain;
- Correspondence: (R.Q.-F.); (B.P.-L.)
| | - Bricia López-Plaza
- Nutrition Research Group, Hospital La Paz Institute for Health Research (IdiPAZ), 28046 Madrid, Spain;
- Correspondence: (R.Q.-F.); (B.P.-L.)
| | - Laura M. Bermejo
- Nutrition Research Group, Hospital La Paz Institute for Health Research (IdiPAZ), 28046 Madrid, Spain;
| | - Samara Palma Milla
- Nutrition Department, Hospital University La Paz, 28046 Madrid, Spain; (S.P.M.); (C.G.C.)
| | - Andrea Zangara
- Centre for Human Psychopharmacology, Swinburne University, Melbourne, VIC 3122, Australia;
- Euromed S.A., C/Rec de Dalt, 21-23, Pol. Ind. Can Magarola, 08100 Mollet del Valles, Spain
| | - Carmen Gómez Candela
- Nutrition Department, Hospital University La Paz, 28046 Madrid, Spain; (S.P.M.); (C.G.C.)
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Minhas AS, Goerlich E, Corretti MC, Arbab-Zadeh A, Kelle S, Leucker T, Lerman A, Hays AG. Imaging Assessment of Endothelial Function: An Index of Cardiovascular Health. Front Cardiovasc Med 2022; 9:778762. [PMID: 35498006 PMCID: PMC9051238 DOI: 10.3389/fcvm.2022.778762] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Accepted: 02/28/2022] [Indexed: 11/18/2022] Open
Abstract
Endothelial dysfunction is a key early mechanism in a variety of cardiovascular diseases and can be observed in larger conduit arteries as well as smaller resistance vessels (microvascular dysfunction). The presence of endothelial dysfunction is a strong prognosticator for cardiovascular events and mortality, and assessment of endothelial function can aid in selecting therapies and testing their response. While the gold standard method of measuring coronary endothelial function remains invasive angiography, several non-invasive imaging techniques have emerged for investigating both coronary and peripheral endothelial function. In this review, we will explore and summarize the current invasive and non-invasive modalities available for endothelial function assessment for clinical and research use, and discuss the strengths, limitations and future applications of each technique.
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Affiliation(s)
- Anum S. Minhas
- Division of Cardiology, Department of Medicine, The Johns Hopkins University School of Medicine, Baltimore, MD, United States
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | - Erin Goerlich
- Division of Cardiology, Department of Medicine, The Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Mary C. Corretti
- Division of Cardiology, Department of Medicine, The Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Armin Arbab-Zadeh
- Division of Cardiology, Department of Medicine, The Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Sebastian Kelle
- Department of Internal Medicine and Cardiology, German Heart Center Berlin, Berlin, Germany
| | - Thorsten Leucker
- Division of Cardiology, Department of Medicine, The Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Amir Lerman
- Division of Ischemic Heart Disease and Critical Care, Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, United States
| | - Allison G. Hays
- Division of Cardiology, Department of Medicine, The Johns Hopkins University School of Medicine, Baltimore, MD, United States
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Lew LA, Liu KR, Pyke KE. Reliability of the hyperaemic response to passive leg movement in young, healthy women. Exp Physiol 2021; 106:2013-2023. [PMID: 34216162 DOI: 10.1113/ep089629] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Accepted: 07/01/2021] [Indexed: 12/22/2022]
Abstract
NEW FINDINGS What is the central question of this study? This is the first study to assess the day-to-day reliability of passive leg movement-induced hyperaemia (PLM-H), an index of lower-limb microvascular function, in young, healthy women. What is the main finding and its importance? Passive leg movement-induced hyperaemia demonstrated good day-to-day reliability, comparable to other common indices of endothelial function, supporting the use of PLM-H to assess lower-limb microvascular function in women. ABSTRACT Passive leg movement-elicited hyperaemia (PLM-H) provides an index of lower-limb microvascular function. However, there is currently limited information regarding the reliability of PLM-H and no reliability information specific to women. The purpose of this study was to determine the reliability of PLM-H in women on two separate days. Seventeen young, healthy women [22 ± 3 years old (mean ± SD)] participated in two identical visits including three trials of PLM. Using duplex ultrasound, PLM-H was characterized by six indices: peak leg blood flow (LBF) and vascular conductance (LVC), peak change above baseline (Δpeak) for LBF and LVC, and area under the curve above baseline (AUC) during the first 60 s of PLM for LBF and LVC. The results demonstrated good day-to-day reliability of PLM-H characterized as peak LBF [r = 0.84, P < 0.001; intraclass correlation coefficient (ICC) = 0.84; coefficient of variation (CV) = 13.2%], peak LVC (r = 0.82, P < 0.001; ICC = 0.79; CV = 14.4%), Δpeak LBF (r = 0.83, P < 0.001; ICC = 0.82; CV = 17.8%) and Δpeak LVC (r = 0.83, P < 0.001; ICC = 0.80; CV = 16.5%). Characterization of PLM as AUC demonstrated moderate day-to-day reliability: AUC LBF (r = 0.71, P < 0.05; ICC = 0.70; CV = 31.2%) and AUC LVC (r = 0.78, P < 0.001; ICC = 0.74; CV = 27.1%). In conclusion, this study demonstrates that PLM-H has good reliability as an index of microvascular function; however, characterization of PLM-H as peak, Δpeak LBF and LVC is more reliable than AUC.
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Affiliation(s)
- Lindsay A Lew
- Cardiovascular Stress Response Laboratory, School of Kinesiology and Health Studies, Queen's University, Kingston, Ontario, Canada
| | - Kaitlyn R Liu
- Cardiovascular Stress Response Laboratory, School of Kinesiology and Health Studies, Queen's University, Kingston, Ontario, Canada
| | - Kyra E Pyke
- Cardiovascular Stress Response Laboratory, School of Kinesiology and Health Studies, Queen's University, Kingston, Ontario, Canada
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Tanghe A, Celie B, Shadid S, Rietzschel E, Op 't Roodt J, Reesink KD, Heyman E, Calders P. Acute Effects of Cocoa Flavanols on Blood Pressure and Peripheral Vascular Reactivity in Type 2 Diabetes Mellitus and Essential Hypertension: A Protocol for an Acute, Randomized, Double-Blinded, Placebo-Controlled Cross-Over Trial. Front Cardiovasc Med 2021; 8:602086. [PMID: 33791343 PMCID: PMC8005536 DOI: 10.3389/fcvm.2021.602086] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Accepted: 02/16/2021] [Indexed: 01/21/2023] Open
Abstract
Introduction: Patients with type 2 diabetes mellitus are at high risk to develop vascular complications resulting in high morbidity and mortality. Cocoa flavanols are promising nutraceuticals with possible beneficial vascular effects in humans. However, limited research is currently available on the vascular effects in a diabetic population with inconsistent results. Possible reasons for this inconsistency might be heterogeneity in the given intervention (dose per time and day, single dose vs. split-dose, placebo formula) and the studied population (blood pressure at baseline, duration of diabetes, use of vasoactive antihypertensive and antidiabetic drugs, sex). Therefore, we aimed to develop a randomized, double-blinded, placebo-controlled cross-over trial to investigate whether cocoa flavanols have an acute impact on blood pressure and vascular reactivity in patients with type 2 diabetes with and without arterial hypertension. Methods and Analysis: We will include participants in four groups: (i) patients with type 2 diabetes without arterial hypertension, (ii) patients with type 2 diabetes with arterial hypertension and 1 antihypertensive drug, (iii) non-diabetic participants with essential hypertension and 1 antihypertensive drug, and (iv) healthy controls. All participants will complete the same protocol on both testing days, consuming high-flavanol cocoa extract (790 mg flavanols) or placebo. Macrovascular endothelial function (flow-mediated dilation) and blood pressure will be measured before and after capsule ingestion. Forearm muscle vasoreactivity (near-infrared spectroscopy) and brachial artery blood flow (echo-doppler) will be assessed in response to a dynamic handgrip exercise test after capsule ingestion. Data will be analyzed with a random intercept model in mixed models. Clinical Trial Registration:www.Clinicaltrials.gov, identifier: NCT03722199.
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Affiliation(s)
- Anouk Tanghe
- Department of Rehabilitation Sciences, Ghent University, Ghent, Belgium.,Univ. Lille, Univ. Artois, Univ. Littoral Côte d'Opale, ULR 7369 - URePSSS - Unité de Recherche Pluridisciplinaire Sport Santé Société, Lille, France
| | - Bert Celie
- Department of Rehabilitation Sciences, Ghent University, Ghent, Belgium.,Faculty of Health Sciences, Sport, Exercise Medicine and Lifestyle Institute (SEMLI), University of Pretoria, Pretoria, South Africa
| | - Samyah Shadid
- Department of Endocrinology, Ghent University Hospital, Ghent, Belgium
| | - Ernst Rietzschel
- Department of Cardiology, Ghent University Hospital, Ghent, Belgium.,Department of Internal Medicine, Ghent University, Ghent, Belgium
| | - Jos Op 't Roodt
- School of Cardiovascular Diseases (CARIM), Maastricht University Medical Centre, Maastricht, Netherlands
| | - Koen D Reesink
- School of Cardiovascular Diseases (CARIM), Maastricht University Medical Centre, Maastricht, Netherlands
| | - Elsa Heyman
- Univ. Lille, Univ. Artois, Univ. Littoral Côte d'Opale, ULR 7369 - URePSSS - Unité de Recherche Pluridisciplinaire Sport Santé Société, Lille, France
| | - Patrick Calders
- Department of Rehabilitation Sciences, Ghent University, Ghent, Belgium
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12
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Grin L, Laish-Farkash A, Bruoha S, Rabinovich M, Harlev A, Anteby E, Yosefy C, Shenhav S. Effects of nifedipine on endothelial function, assessed by flow-mediated vasodilatation in pregnant patients. J Matern Fetal Neonatal Med 2021; 35:5498-5503. [PMID: 33627026 DOI: 10.1080/14767058.2021.1885645] [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: 10/22/2022]
Abstract
OBJECTIVES To evaluate the endothelial function, through flow-mediated vasodilation parameters from brachial artery test in women receiving nifedipine for acute tocolysis with threatened preterm delivery. METHODS In a prospective study in a university-affiliated hospital, each participant served as herself control. We evaluated various parameters of endothelial function in 22 patients between 27 and 33 weeks of gestation with a diagnosis of threatened preterm delivery (TPTD) before and after 48 h of nifedipine treatment. Each patient received 80 mg nifedipine per day. The assessment tool was Brachial artery reactivity test (BART). Primary outcome was flow mediated vasodilation (FMD). RESULTS The average participant's age was 27 ± 4.5 years, median gestational age of 28.5 weeks, BMI, kg/m2 (mean ± SD) 28.4 ± 3.3. Systolic blood pressure (mmHg) and diastolic blood pressure (mmHg) decreased from 108 ± 6 to 104 ± 5, p < .001 and from 66 ± 4 to 63 ± 4, p < .001, respectively. FMD (%) significantly decrease from 10.8 ± 6.1 to 7.2 ± 4.7, p = .03 prior to and after nifedipine treatment. The basal brachial artery diameter (mm) at rest was (3.19 ± 0.38 versus 3.39 ± 0.49, p = .28) before versus after nifedipine. The largest brachial artery diameter (mm) was (3.54 ± 0.35 versus 3.58 ± 0.44, p = .76) before versus after nifedipine. CONCLUSIONS Our results suggest unfavorable changes in FMD probably as a result of nifedipine used for acute tocolysis. Future prospective studies should try to evaluate the safety of acute and maintenance tocolytic therapy with nifedipine on endothelial function in pregnant women.
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Affiliation(s)
- Leonti Grin
- Department of Obstetrics and Gynecology, Barzilai University Medical Center, Ashkelon, Israel.,Faculty of Health Sciences, Ben-Gurion University of the Negev, Negev, Israel
| | - Avishag Laish-Farkash
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Negev, Israel.,Department of Cardiology, Assuta University Medical Center, Ashdod, Israel
| | - Sharon Bruoha
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Negev, Israel.,Department of Cardiology, Barzilai University Medical Center, Ashkelon, Israel
| | - Mark Rabinovich
- Department of Obstetrics and Gynecology, Barzilai University Medical Center, Ashkelon, Israel.,Faculty of Health Sciences, Ben-Gurion University of the Negev, Negev, Israel
| | - Avi Harlev
- Department of Obstetrics and Gynecology, Barzilai University Medical Center, Ashkelon, Israel.,Faculty of Health Sciences, Ben-Gurion University of the Negev, Negev, Israel
| | - Eyal Anteby
- Department of Obstetrics and Gynecology, Barzilai University Medical Center, Ashkelon, Israel.,Faculty of Health Sciences, Ben-Gurion University of the Negev, Negev, Israel
| | - Chaim Yosefy
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Negev, Israel.,Department of Cardiology, Barzilai University Medical Center, Ashkelon, Israel
| | - Simon Shenhav
- Department of Obstetrics and Gynecology, Barzilai University Medical Center, Ashkelon, Israel.,Faculty of Health Sciences, Ben-Gurion University of the Negev, Negev, Israel
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13
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Langham MC, Caporale AS, Wehrli FW, Parry S, Schwartz N. Evaluation of Vascular Reactivity of Maternal Vascular Adaptations of Pregnancy With Quantitative MRI: Pilot Study. J Magn Reson Imaging 2020; 53:447-455. [PMID: 32841482 DOI: 10.1002/jmri.27342] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Revised: 08/06/2020] [Accepted: 08/07/2020] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Abnormal maternal vascular function during pregnancy stemming from systemic endothelial dysfunction (EDF) has a central role in the pathophysiology of preeclampsia (PE). PURPOSE To utilize quantitative MRI to investigate changes in physiological measures of vascular reactivity during normal pregnancy, and to explore EDF associated with preeclampsia. STUDY TYPE Prospective. POPULATION Healthy pregnant (HP) (n = 14, mean GA = 26 ± 7 weeks) and nonpregnant women (NP; n = 14); newly postpartum (PP <48 hours) women with severe PE (PP-PE; n = 4) and normotensive pregnancy (PP-HP; n = 5). FIELD STRENGTH/SEQUENCE 1.5T/3T. RF spoiled multiecho gradient-recalled echo, 1D phase-contrast MRI, time-of-flight. ASSESSMENT The micro- and macrovascular function (vasodilatory capacity of arterioles and conduit arteries, respectively) of the femoral vascular bed was evaluated with MRI-based venous oximetry, arterial velocimetry, and luminal flow-mediated dilation quantification, during cuff-induced reactive hyperemia. Aortic arch pulse-wave velocity (aPWV) was quantified to assess arterial stiffness using an ungated 1D technique. STATISTICAL TESTS Two-tailed unpaired t-tests were performed to address our two, primary a priori comparisons, HP vs. NP, and PP-PE vs. PP-HP. Given the pilot nature of this study, adjustments for multiple comparisons were not performed. RESULTS In HP, microvascular function was attenuated compared to NP by a significant increase in the washout time (10 ± 2 vs. 8 ± 2 sec; P < 0.05) and reduced upslope (2.1 ± 0.5 vs. 3.2 ± 0.8%HbO2 /s; P < 0.05), time of forward flow (28 ± 5 vs. 33 ± 6 sec, P < 0.05), and hyperemic index (11 ± 3 vs. 16 ± 4 cm/s2 ; P < 0.05), but luminal flow-mediated dilatation (FMDL )was comparable between HP and NP. PP-PE exhibited significant vascular dysfunction compared to PP-HP, as evidenced by differences in upslope (2.2 ± 0.6 vs. 1.3 ± 0.2%HbO2 /s, P < 0.05), overshoot (16 ± 5 vs. 7 ± 3%HbO2 , P < 0.05), time of forward flow (28 ± 6 vs. 15 ± 7 s, P < 0.05), and aPWV (7 ± 1 vs. 8 ± 1 m/s, P < 0.05). DATA CONCLUSION Attenuated vascular reactivity during pregnancy suggests that the systemic vasodilatory state partially depletes nitric oxide bioavailability. Preliminary data support the potential for MRI to identify vascular dysfunction in vivo that underlies PE. Level of Evidence 2 Technical Efficacy Stage 1 J. MAGN. RESON. IMAGING 2021;53:447-455.
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Affiliation(s)
- Michael C Langham
- Department of Radiology, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, USA
| | - Alessandra S Caporale
- Department of Radiology, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, USA
| | - Felix W Wehrli
- Department of Radiology, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, USA
| | - Samuel Parry
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, USA
| | - Nadav Schwartz
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, USA
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14
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Effect of direct renin inhibition on vascular function after long-term treatment with aliskiren in hypertensive and diabetic patients. J Hypertens 2020; 39:169-180. [PMID: 32740409 DOI: 10.1097/hjh.0000000000002595] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE We tested the hypothesis that chronic treatment with the direct renin inhibitor aliskiren improves vascular function in resistance and conduit arteries of type two diabetic and hypertensive patients. METHOD Sixteen patients with mild essential hypertension and with a previous diagnosis of noninsulin-dependent diabetes mellitus were included in the study. Patients were then randomized to aliskiren (150 mg once daily, n = 9), or ramipril (5 mg once daily, n = 7). Each patient underwent a biopsy of the subcutaneous tissue and small arteries were dissected and mounted on a pressurized micromyograph to evaluate endothelium dependent vasorelaxation in response to acetylcholine ± N omega-nitro-L-arginine methyl ester hydrochloride in vessels precontracted with norepinephrine. Endothelial function has been quantified also in large conduit arteries by flow-mediated dilation. RESULTS A similar office blood pressure-lowering effect was observed with the two drugs, although changes in DBP were not statistically significant in the ramipril group. Aliskiren significantly improved endothelium-dependent relaxation in subcutaneous resistance arteries, as well as increased flow-mediated dilation in conduit arteries, whereas the effects induced by ramipril did not reach statistical significance. Only aliskiren significantly increased the expression of p1177-endothelial nitric oxide synthase in the endothelium. Both aliskiren and ramipril had a negligible effect on markers of oxidative stress. CONCLUSION Aliskiren restored endothelial function and induced a more prompt peripheral vasodilation in hypertensive and diabetic patients possibly through the increased production of nitric oxide via the enhanced expression and function of the active phosphorylated form of endothelial nitric oxide synthase.
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15
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Al Jasmi F, Al Zaabi N, Al-Thihli K, Al Teneiji AM, Hertecant J, El-Hattab AW. Endothelial Dysfunction and the Effect of Arginine and Citrulline Supplementation in Children and Adolescents With Mitochondrial Diseases. J Cent Nerv Syst Dis 2020; 12:1179573520909377. [PMID: 32165851 PMCID: PMC7050027 DOI: 10.1177/1179573520909377] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2019] [Accepted: 02/01/2020] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND In addition to the reduced energy production, characteristic of mitochondrial disorders, nitric oxide (NO) deficiency can occur as well. The NO produced by vascular endothelial cells relaxes vascular smooth muscles, resulting in vasodilation that maintains the patency of small blood vessels and promotes blood flow through microvasculature. Endothelial dysfunction due to inability of vascular endothelium to generate enough NO to maintain adequate vasodilation can result in decreased perfusion in the microvasculature of various tissues, contributing to many complications seen in individuals with mitochondrial diseases. The amino acids arginine and citrulline are NO precursors: increasing their concentrations could potentially restore NO production. METHODS In this study, we assessed endothelial dysfunction in children and adolescents with mitochondrial diseases. We also investigated the effect of arginine and citrulline supplementation on endothelial dysfunction in these individuals. We used peripheral arterial tonometry to measure the reactive hyperemic index (RHI), which is low when there is endothelial dysfunction. RESULTS The results demonstrated low RHI in individuals with mitochondrial diseases, indicating endothelial dysfunction. RHI increased with arginine or citrulline supplementation suggesting that supplementation with NO precursors can improve endothelial dysfunction by enhancing NO production. CONCLUSIONS This study is the first one to use peripheral arterial tonometry methodology in mitochondrial diseases. The results of this study provide evidence for endothelial dysfunction in mitochondrial diseases and demonstrate that arginine or citrulline supplementation can alleviate the endothelial dysfunction, providing more evidence for the potential therapeutic utility of these amino acids in mitochondrial diseases.
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Affiliation(s)
- Fatma Al Jasmi
- Division of Clinical Genetic and Metabolic Disorders, Tawam Hospital, Al-Ain, United Arab Emirates
- Department of Pediatrics, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Nuha Al Zaabi
- Division of Clinical Genetic and Metabolic Disorders, Tawam Hospital, Al-Ain, United Arab Emirates
- Department of Pediatrics, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Khalid Al-Thihli
- Genetic and Developmental Medicine Clinic, Sultan Qaboos University Hospital, Muscat, Oman
| | - Amal M Al Teneiji
- Genetic and Metabolic Division, Pediatrics Department, Sheikh Khalifa Medical City, Abu Dhabi, United Arab Emirates
| | - Jozef Hertecant
- Division of Clinical Genetic and Metabolic Disorders, Tawam Hospital, Al-Ain, United Arab Emirates
| | - Ayman W El-Hattab
- Department of Clinical Sciences, College of Medicine, University of Sharjah, Sharjah, United Arab Emirates
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16
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Englund EK, Langham MC. Quantitative and Dynamic MRI Measures of Peripheral Vascular Function. Front Physiol 2020; 11:120. [PMID: 32184733 PMCID: PMC7058683 DOI: 10.3389/fphys.2020.00120] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2019] [Accepted: 02/03/2020] [Indexed: 12/31/2022] Open
Abstract
The endothelium regulates and mediates vascular homeostasis, allowing for dynamic changes of blood flow in response to mechanical and chemical stimuli. Endothelial dysfunction underlies many diseases and is purported to be the earliest pathologic change in the progression of atherosclerotic disease. Peripheral vascular function can be interrogated by measuring the response kinetics following induced ischemia or exercise. In the presence of endothelial dysfunction, there is a blunting and delay of the hyperemic response, which can be measured non-invasively using a variety of quantitative magnetic resonance imaging (MRI) methods. In this review, we summarize recent developments in non-contrast, proton MRI for dynamic quantification of blood flow and oxygenation. Methodologic description is provided for: blood oxygenation-level dependent (BOLD) signal that reflect combined effect of blood flow and capillary bed oxygen content; arterial spin labeling (ASL) for quantification of regional perfusion; phase contrast (PC) to quantify arterial flow waveforms and macrovascular blood flow velocity and rate; high-resolution MRI for luminal flow-mediated dilation; and dynamic MR oximetry to quantify oxygen saturation. Overall, results suggest that these dynamic and quantitative MRI methods can detect endothelial dysfunction both in the presence of overt cardiovascular disease (such as in patients with peripheral artery disease), as well as in sub-clinical settings (i.e., in chronic smokers, non-smokers exposed to e-cigarette aerosol, and as a function of age). Thus far, these tools have been relegated to the realm of research, used as biomarkers of disease progression and therapeutic response. With proper validation, MRI-measures of vascular function may ultimately be used to complement the standard clinical workup, providing additional insight into the optimal treatment strategy and evaluation of treatment efficacy.
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Affiliation(s)
- Erin K Englund
- Department of Orthopaedic Surgery, University of California, San Diego, La Jolla, CA, United States
| | - Michael C Langham
- Department of Radiology, University of Pennsylvania, Philadelphia, PA, United States
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17
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Whisner CM, Angadi SS, Weltman NY, Weltman A, Rodriguez J, Patrie JT, Gaesser GA. Effects of Low-Fat and High-Fat Meals, with and without Dietary Fiber, on Postprandial Endothelial Function, Triglyceridemia, and Glycemia in Adolescents. Nutrients 2019; 11:nu11112626. [PMID: 31684015 PMCID: PMC6893531 DOI: 10.3390/nu11112626] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2019] [Revised: 10/09/2019] [Accepted: 10/17/2019] [Indexed: 01/05/2023] Open
Abstract
The consumption of fiber-rich foods may negate the deleterious effects of high-fat meals on postprandial triglyceridemia and endothelial function. Despite supportive data in adults, little is known about the effects of high-fat and high-fiber foods on cardiovascular health parameters in pediatric populations. In this crossover trial, male and female adolescents (n = 10; 14.1 + 2.6 years; range 10–17 years) consumed (1) low-fat, low-fiber, (2) low-fat, high-fiber, (3) high-fat, low-fiber, and (4) high-fat, high-fiber breakfast meals in randomized order, each following an overnight fast. Baseline and 4 h post-meal blood was obtained for determination of glucose, insulin and triglyceride concentrations. Endothelial function was assessed via brachial artery flow-mediated dilation (FMD). Postprandial FMD was not significantly changed after any meal. However, regression analyses revealed a significant inverse relationship between the change in 4 h triglyceride concentration and change in 4 h FMD for the high-fat, low-fiber meal (β = −0.087; 95% CI = −0.138 to −0.037; p = 0.001) that was no longer significant in the high-fat, high-fiber meal (β = −0.044; 95% CI = −0.117 to 0.029; p = 0.227). Interpretation of these analyses must be qualified by acknowledging that between-meal comparison revealed that the two regression lines were not statistically different (p = 0.226). Addition of high-fiber cereal to the high-fat meal also reduced 4 h postprandial triglyceride increases by ~50% (p = 0.056). A high-fiber breakfast cereal did not attenuate postprandial glucose and insulin responses after consumption of a low-fat meal. While further work is needed to confirm these results in larger cohorts, our findings indicate the potential importance of cereal fiber in blunting the inverse relationship between postprandial hypertriglyceridemia and FMD after consumption of a high-fat meal in adolescents.
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Affiliation(s)
- Corrie M Whisner
- College of Health Solutions, Arizona State University, 550 N Third St., Phoenix, AZ 85004, USA.
| | - Siddhartha S Angadi
- College of Health Solutions, Arizona State University, 550 N Third St., Phoenix, AZ 85004, USA.
| | - Nathan Y Weltman
- Department of Anesthesiology, Perioperative and Pain Management, Brigham and Women's Hospital, Boston, MA 02115, USA.
| | - Arthur Weltman
- Department of Kinesiology, University of Virginia, Charlottesville, VA 22903, USA.
| | | | - James T Patrie
- Department of Public Health, University of Virginia, Charlottesville, VA 22903, USA.
| | - Glenn A Gaesser
- College of Health Solutions, Arizona State University, 550 N Third St., Phoenix, AZ 85004, USA.
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18
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Assessment of endothelial function is reproducible in patients with cystic fibrosis. J Cyst Fibros 2019; 18:772-777. [DOI: 10.1016/j.jcf.2019.03.011] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2019] [Revised: 03/14/2019] [Accepted: 03/26/2019] [Indexed: 12/31/2022]
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19
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Bucci T, Parente R, De Feo G, Cardamone C, Triggiani M. Flow-mediated dilation shows impaired endothelial function in patients with mastocytosis. J Allergy Clin Immunol 2019; 144:1106-1111. [PMID: 31211959 DOI: 10.1016/j.jaci.2019.05.037] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2018] [Revised: 03/25/2019] [Accepted: 05/29/2019] [Indexed: 02/06/2023]
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20
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The Role of Inflammation in the Endothelial Dysfunction in a Cohort of Pediatric Patients With Inflammatory Bowel Disease. J Pediatr Gastroenterol Nutr 2019; 69:330-335. [PMID: 31169657 DOI: 10.1097/mpg.0000000000002374] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
OBJECTIVES Chronic inflammation plays a central role in the etiology of endothelial damage. Endothelial dysfunction (ED) is the inability of the artery to dilate in response to an endothelial stimulus. We assessed the ED by measuring the reactive hyperaemia index (RHI) and the flow-mediated dilation (FMD) in a cohort of pediatric patients affected by inflammatory bowel disease (IBD) and comparing these parameters to a group of healthy controls (HC). METHODS Forty-one patients were consecutive enrolled. ED was evaluated by both the plethysmographic RHI method and the measurement of the FMD of brachial artery after occlusion of the blood flow. Differences between patients and controls were assessed by the Mann-Whitney test. In each patient with IBD, the main inflammation markers were detected and correlated to RHI and FMD by a linear regression test. RESULTS We enrolled 26 (59%) patients with IBD and 18 (41%) HC. When comparing FMD value at diagnosis it was significantly lower in IBD patients than in HC (P = 0.04). This result was confirmed at follow-up, when this difference became even more significant (P = 0.004). A significant indirect correlation was found between FMD and fecal calprotectin (r: 0.17; P = 0.04). No differences were found when comparing RHI. CONCLUSIONS Our results suggest that inflammation could lead to ED assessed by ultrasound FMD. These data were not confirmed by RHI; however, this could be due to the lack of a standardized pediatric cut-off. More studies are necessary to confirm our data.
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Quirós-Fernández R, López-Plaza B, Bermejo LM, Palma-Milla S, Gómez-Candela C. Supplementation with Hydroxytyrosol and Punicalagin Improves Early Atherosclerosis Markers Involved in the Asymptomatic Phase of Atherosclerosis in the Adult Population: A Randomized, Placebo-Controlled, Crossover Trial. Nutrients 2019; 11:nu11030640. [PMID: 30884808 PMCID: PMC6470561 DOI: 10.3390/nu11030640] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2019] [Revised: 03/09/2019] [Accepted: 03/12/2019] [Indexed: 01/05/2023] Open
Abstract
Hydroxytyrosol (HT) and Punicalagin (PC) exert cardioprotective and anti-atherosclerotic effects. This study evaluates the effect of oral supplementation with HT and PC (SAx) on early atherosclerosis markers in middle-aged, seemingly healthy adults. A randomized, double-blinded, placebo-controlled, crossover trial was performed for 20 weeks. There were two treatment sequences (Placebo/SAx, n = 41; SAx/Placebo, n = 43) for which the intervention periods (Placebo and SAx) were 8 weeks long, followed by a 4-week wash out period. The supplement was composed of 9.9 mg of HT and 195 mg of PC, and the placebo was composed of maltodextrin. SAx increased endothelial function (Flow-mediated dilatation [FMD]: 2.36%; p < 0.001) in the endothelial dysfunction subgroup compared to the placebo (2.36 ± 3.9 vs. 0.76 ± 3.5%, p < 0.05). SAx also reduced oxLDL by -28.74 ng/mL (p < 0.05) in subjects with higher levels of oxLDL, which was an improvement compared with the placebo (-28.74 ± 40.2 vs. 25.64 ± 93.8 ng/mL, p < 0.001). The prehypertension and hypertension subgroups exhibited decreased systolic (-15.75 ± 9.9 mmHg; p < 0.001) and diastolic (-6.36 ± 8.7 mmHg; p < 0.001) blood pressure after SAx consumption. Moreover, the systolic prehypertension and hypertension subgroups presented significant differences in systolic blood pressure compared to the placebo (-15.75 ± 9.9 vs. -2.67 ± 12.0 mmHg, p < 0.05). In conclusion, the supplement exerted anti-atherosclerotic effects by improving endothelial function, blood pressure, and levels of circulating oxLDL, especially for persons in whom these parameters were altered.
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Affiliation(s)
- Rebeca Quirós-Fernández
- Nutrition Research Group, Hospital La Paz Institute for Health Research (IdiPAZ), 28046 Madrid, Spain.
| | - Bricia López-Plaza
- Nutrition Research Group, Hospital La Paz Institute for Health Research (IdiPAZ), 28046 Madrid, Spain.
| | - Laura M Bermejo
- Nutrition Research Group, Hospital La Paz Institute for Health Research (IdiPAZ), 28046 Madrid, Spain.
| | - Samara Palma-Milla
- Nutrition Department, La Paz University Hospital, Hospital La Paz Institute for Health Research (IdiPAZ), Autonomous University of Madrid, 28046 Madrid, Spain.
| | - Carmen Gómez-Candela
- Nutrition Department, La Paz University Hospital, Hospital La Paz Institute for Health Research (IdiPAZ), Autonomous University of Madrid, 28046 Madrid, Spain.
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Kranen SH, Bond B, Williams CA, Barker AR. Reliability of low-flow vasoreactivity in the brachial artery of adolescents. JOURNAL OF CLINICAL ULTRASOUND : JCU 2019; 47:133-138. [PMID: 30474121 DOI: 10.1002/jcu.22664] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/14/2018] [Revised: 08/01/2018] [Accepted: 10/09/2018] [Indexed: 06/09/2023]
Abstract
PURPOSE Macrovascular endothelial function is commonly assessed using flow-mediated dilation (FMD) and is nitric oxide (NO) dependent. However, the vasoreactivity to low flow during the FMD protocol may complement FMD interpretation. This study aimed to investigate in adolescents: (1) the day-to-day reliability of low-flow-mediated constriction (L-FMC) and composite vessel reactivity (CVR); and (2) the relationship between L-FMC and FMD. METHODS A retrospective analysis of data on 27 adolescents (14.3 ± 0.6 year, 12 males) was performed. Participants had two repeat measures, on separate days, of macrovascular function using high-resolution ultrasound for assessment of L-FMC, FMD, and CVR. RESULTS On average, the L-FMC response was vasoconstriction on both days (-0.59 ± 2.22% and -0.16 ± 1.50%, respectively). In contrast, an inconsistent response to low flow (vasoconstriction, dilation, or no change) was observed on an individual level. Cohen's Kappa revealed poor agreement for classifying the L-FMC measurement between visits (k = 0.04, P > .05). Assessment of the actual vessel diameter was robust with a coefficient of variation of 1.7% (baseline and peak) and 2.7% (low-flow). The between-day correlation coefficient between measures was r = .18, r = .96 and r = .52 for L-FMC, FMD, and CVR, respectively. No significant correlation between FMD and L-FMC was observed for either visit (r = -.06 and r = -.07, respectively; P > .05). CONCLUSION In adolescents, the low-flow vasoreactivity is inconsistent between days. Whereas the actual vessel diameter is reproducible, the measurement of L-FMC and CVR has poor between-day reliability compared to FMD. Finally, L-FMC, and FMD are not significantly correlated.
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Affiliation(s)
- Sascha H Kranen
- Children's Health and Exercise Research Centre, Sport and Health Sciences, College of Life and Environmental Sciences, University of Exeter, Exeter, United Kingdom
| | - Bert Bond
- Children's Health and Exercise Research Centre, Sport and Health Sciences, College of Life and Environmental Sciences, University of Exeter, Exeter, United Kingdom
| | - Craig A Williams
- Children's Health and Exercise Research Centre, Sport and Health Sciences, College of Life and Environmental Sciences, University of Exeter, Exeter, United Kingdom
| | - Alan R Barker
- Children's Health and Exercise Research Centre, Sport and Health Sciences, College of Life and Environmental Sciences, University of Exeter, Exeter, United Kingdom
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Maranna S, Hill A, Fairlie-Jones L, Osborne B, Davison K. Reliability of sonographic measurements of endothelial function: Flow-mediated dilation, blood flow velocity, resistive and pulsatility indices. SONOGRAPHY 2018. [DOI: 10.1002/sono.12138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Sandhya Maranna
- School of Health Sciences; University of South Australia; South Australia Australia
| | - Alison Hill
- School of Pharmacy and Medical Sciences; University of South Australia; South Australia Australia
| | - Lucy Fairlie-Jones
- School of Pharmacy and Medical Sciences; University of South Australia; South Australia Australia
| | - Brooke Osborne
- School of Health Sciences; University of South Australia; South Australia Australia
| | - Kade Davison
- School of Health Sciences; University of South Australia; South Australia Australia
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Bøtker HE, Hausenloy D, Andreadou I, Antonucci S, Boengler K, Davidson SM, Deshwal S, Devaux Y, Di Lisa F, Di Sante M, Efentakis P, Femminò S, García-Dorado D, Giricz Z, Ibanez B, Iliodromitis E, Kaludercic N, Kleinbongard P, Neuhäuser M, Ovize M, Pagliaro P, Rahbek-Schmidt M, Ruiz-Meana M, Schlüter KD, Schulz R, Skyschally A, Wilder C, Yellon DM, Ferdinandy P, Heusch G. Practical guidelines for rigor and reproducibility in preclinical and clinical studies on cardioprotection. Basic Res Cardiol 2018; 113:39. [PMID: 30120595 PMCID: PMC6105267 DOI: 10.1007/s00395-018-0696-8] [Citation(s) in RCA: 346] [Impact Index Per Article: 49.4] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2018] [Revised: 07/18/2018] [Accepted: 08/03/2018] [Indexed: 02/07/2023]
Affiliation(s)
- Hans Erik Bøtker
- Department of Cardiology, Aarhus University Hospital, Palle-Juul Jensens Boulevard 99, 8200, Aarhus N, Denmark.
| | - Derek Hausenloy
- The Hatter Cardiovascular Institute, University College London, 67 Chenies Mews, London, WC1E 6HX, UK
- The National Institute of Health Research, University College London Hospitals Biomedial Research Centre, Research and Development, London, UK
- National Heart Research Institute Singapore, National Heart Centre, Singapore, Singapore
- Yon Loo Lin School of Medicine, National University Singapore, Singapore, Singapore
- Cardiovascular and Metabolic Disorders Program, Duke-National University of Singapore, 8 College Road, Singapore, 169857, Singapore
| | - Ioanna Andreadou
- Laboratory of Pharmacology, Faculty of Pharmacy, National and Kapodistrian University of Athens, Athens, Greece
| | - Salvatore Antonucci
- Department of Biomedical Sciences, CNR Institute of Neuroscience, University of Padova, Via Ugo Bassi 58/B, 35121, Padua, Italy
| | - Kerstin Boengler
- Institute for Physiology, Justus-Liebig University Giessen, Giessen, Germany
| | - Sean M Davidson
- The Hatter Cardiovascular Institute, University College London, 67 Chenies Mews, London, WC1E 6HX, UK
| | - Soni Deshwal
- Department of Biomedical Sciences, CNR Institute of Neuroscience, University of Padova, Via Ugo Bassi 58/B, 35121, Padua, Italy
| | - Yvan Devaux
- Cardiovascular Research Unit, Luxembourg Institute of Health, Strassen, Luxembourg
| | - Fabio Di Lisa
- Department of Biomedical Sciences, CNR Institute of Neuroscience, University of Padova, Via Ugo Bassi 58/B, 35121, Padua, Italy
| | - Moises Di Sante
- Department of Biomedical Sciences, CNR Institute of Neuroscience, University of Padova, Via Ugo Bassi 58/B, 35121, Padua, Italy
| | - Panagiotis Efentakis
- Laboratory of Pharmacology, Faculty of Pharmacy, National and Kapodistrian University of Athens, Athens, Greece
| | - Saveria Femminò
- Department of Clinical and Biological Sciences, University of Torino, Turin, Italy
| | - David García-Dorado
- Experimental Cardiology, Vall d'Hebron Institut de Recerca (VHIR), Hospital Universitari Vall d'Hebron, Pg. Vall d'Hebron 119-129, 08035, Barcelona, Spain
| | - Zoltán Giricz
- Department of Pharmacology and Pharmacotherapy, Semmelweis University, Budapest, Hungary
- Pharmahungary Group, Szeged, Hungary
| | - Borja Ibanez
- Centro Nacional de Investigaciones Cardiovasculares Carlos III (CNIC), IIS-Fundación Jiménez Díaz, CIBERCV, Madrid, Spain
| | - Efstathios Iliodromitis
- Second Department of Cardiology, Faculty of Medicine, Attikon University Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Nina Kaludercic
- Department of Biomedical Sciences, CNR Institute of Neuroscience, University of Padova, Via Ugo Bassi 58/B, 35121, Padua, Italy
| | - Petra Kleinbongard
- Institute for Pathophysiology, West German Heart and Vascular Center, University of Essen Medical School, Essen, Germany
| | - Markus Neuhäuser
- Department of Mathematics and Technology, Koblenz University of Applied Science, Remagen, Germany
- Institute for Medical Informatics, Biometry, and Epidemiology, University Hospital Essen, Essen, Germany
| | - Michel Ovize
- Explorations Fonctionnelles Cardiovasculaires, Hôpital Louis Pradel, Lyon, France
- UMR, 1060 (CarMeN), Université Claude Bernard, Lyon1, Villeurbanne, France
| | - Pasquale Pagliaro
- Department of Clinical and Biological Sciences, University of Torino, Turin, Italy
| | - Michael Rahbek-Schmidt
- Department of Cardiology, Aarhus University Hospital, Palle-Juul Jensens Boulevard 99, 8200, Aarhus N, Denmark
| | - Marisol Ruiz-Meana
- Experimental Cardiology, Vall d'Hebron Institut de Recerca (VHIR), Hospital Universitari Vall d'Hebron, Pg. Vall d'Hebron 119-129, 08035, Barcelona, Spain
| | | | - Rainer Schulz
- Institute for Physiology, Justus-Liebig University Giessen, Giessen, Germany
| | - Andreas Skyschally
- Institute for Pathophysiology, West German Heart and Vascular Center, University of Essen Medical School, Essen, Germany
| | - Catherine Wilder
- The Hatter Cardiovascular Institute, University College London, 67 Chenies Mews, London, WC1E 6HX, UK
| | - Derek M Yellon
- The Hatter Cardiovascular Institute, University College London, 67 Chenies Mews, London, WC1E 6HX, UK
| | - Peter Ferdinandy
- Department of Pharmacology and Pharmacotherapy, Semmelweis University, Budapest, Hungary
- Pharmahungary Group, Szeged, Hungary
| | - Gerd Heusch
- Institute for Pathophysiology, West German Heart and Vascular Center, University of Essen Medical School, Essen, Germany.
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Jung KY, Kim KM, Han SK, Yun HM, Oh TJ, Choi SH, Park KS, Jang HC, Lim S. Effect of Rosuvastatin on Cholesterol Efflux Capacity and Endothelial Function in Type 2 Diabetes Mellitus and Dyslipidemia. Circ J 2018; 82:1387-1395. [PMID: 28943594 DOI: 10.1253/circj.cj-17-0411] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND Quality and quantity of high-density lipoprotein cholesterol (HDL-C) may be associated with cardiovascular risk. We investigated the effect of rosuvastatin on cholesterol efflux (CE) for HDL function and vascular health. METHODS AND RESULTS We enrolled 30 dyslipidemic patients with type 2 diabetes mellitus and 20 healthy subjects as controls. Vascular health was assessed on flow-medicated dilation (FMD), nitroglycerin-induced dilatation of the brachial artery and carotid artery intima-media thickness (cIMT). These parameters were compared between patients and controls, and between baseline and at 12 weeks of treatment with rosuvastatin 20 mg. Age and body mass index were 49.8±11.3 years and 25.8±3.7 kg/m2in the patients, and 28.8±3.2 years and 22.4±2.4 kg/m2in the controls, respectively. The biomarkers related to lipid and glucose metabolism and lipoprotein (a), high-sensitivity C-reactive protein, and cIMT were significantly higher, and CE and FMD were significantly lower in the patients than in the controls. In the patients, rosuvastatin 20 mg decreased low-density lipoprotein cholesterol by 54.1% and increased HDL-C by 4.8%. The CE increased significantly after rosuvastatin treatment (12.26±2.72% vs. 14.05±4.14%). FMD also increased, and lipoprotein (a) and cIMT decreased significantly and were associated with changes of CE. CONCLUSIONS Rosuvastatin-induced changes in HDL function are significantly associated with cardiovascular benefit.
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Affiliation(s)
- Kyong Yeun Jung
- Department of Internal Medicine, Eulji General Hospital
- Department of Internal Medicine, Seoul National University Bundang Hospital
| | - Kyoung Min Kim
- Department of Internal Medicine, Seoul National University Bundang Hospital
- Department of Internal Medicine, Seoul National University College of Medicine
| | - Sun Kyoung Han
- Department of Internal Medicine, Seoul National University College of Medicine
| | - Han Mi Yun
- Physiologic Diagnostic Laboratory, Vascular Laboratory, Seoul National University Bundang Hospital
| | - Tae Jung Oh
- Department of Internal Medicine, Seoul National University Bundang Hospital
- Department of Internal Medicine, Seoul National University College of Medicine
| | - Sung Hee Choi
- Department of Internal Medicine, Seoul National University Bundang Hospital
- Department of Internal Medicine, Seoul National University College of Medicine
| | - Kyong Soo Park
- Department of Internal Medicine, Seoul National University College of Medicine
| | - Hak Chul Jang
- Department of Internal Medicine, Seoul National University Bundang Hospital
- Department of Internal Medicine, Seoul National University College of Medicine
| | - Soo Lim
- Department of Internal Medicine, Seoul National University Bundang Hospital
- Department of Internal Medicine, Seoul National University College of Medicine
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Harbin MM, Zavala H, Ryder JR, Steinberger J, Sinaiko AR, Jacobs DR, Dengel DR. Associations of sex, age and adiposity in endothelium-independent dilation in children. Physiol Meas 2018; 39:045002. [PMID: 29513264 PMCID: PMC5975258 DOI: 10.1088/1361-6579/aab4cf] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE To examine the association of age, sex, and obesity status on endothelial-independent dilation (EID) among children and adolescents. STUDY DESIGN This study examined 264 children (143 males) between 8 to 18 years old (mean ± SD: age = 14.3 ± 2.7 years). Endothelial-independent dilation was assessed via ultrasound imaging of the brachial artery following administration of 0.3 milligrams of sublingual nitroglycerin. A one-way analysis of variance with Bonferroni post hoc comparisons assessed sex-differences in percent peak EID dilation (EID%-peak) and EID area under the curve (EID%-AUC), while analysis of covariance (ANCOVA) adjusted for race, age, body mass index percentile (BMI-percentile), and brachial artery diameter. Multiple linear regression evaluated the association of sex, age, BMI-percentile, percent body fat (%BF), and brachial artery diameter on EID. RESULTS Prior to adjustment, EID%-peak was significantly higher among females than males (mean ± SE: 26.9 ± 0.5% versus 22.9 ± 0.6%, p < 0.001, respectively); similar findings for EID%-AUC (4214% ± 105%·s versus 3398% ± 97%·s, p < 0.001) were observed. After adjusting for covariates, EID%-AUC remained consistent (p = 0.03) while EID%-peak was not significantly different between sexes (p = 0.21). EID%-peak was significantly higher among normal weight compared to obese participants (p = 0.04), while no differences were observed between obesity status after adjustment for brachial artery diameter (p = 0.64). Both unadjusted (p = 0.16) and adjusted EID%-AUC (p = 0.24) was not significantly different between obesity status. BMI-percentile was not associated with EID%-peak (p = 0.76) or EID%-AUC (p = 0.30). Additionally, %BF was not associated with EID%-peak (p = 0.56) or EID%-AUC (p = 0.15). After adjusting for brachial artery diameter, BMI-percentile, and age, males had lower EID%-AUC (p = 0.03) and lower but not significant EID%-peak (p = 0.21). SIGNIFICANCE Vascular smooth muscle function was significantly lower among male children and adolescents, which is suggestive that impaired EID and increased cardiovascular disease risk among males may begin in childhood. Interestingly, obesity status and BMI-percentile was not associated with EID in children and adolescents after adjusting for brachial artery diameter.
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Affiliation(s)
- Michelle M. Harbin
- Laboratory of Integrative Human Physiology, School of Kinesiology, University of Minnesota, Minneapolis, Minnesota, 55455
| | - Hanan Zavala
- Laboratory of Integrative Human Physiology, School of Kinesiology, University of Minnesota, Minneapolis, Minnesota, 55455
| | - Justin R. Ryder
- Department of Pediatrics, University of Minnesota Medical School, 2450 Riverside Avenue, Minneapolis, MN 55455, USA
| | - Julia Steinberger
- Department of Pediatrics, University of Minnesota Medical School, 2450 Riverside Avenue, Minneapolis, MN 55455, USA
| | - Alan R. Sinaiko
- Department of Pediatrics, University of Minnesota Medical School, 2450 Riverside Avenue, Minneapolis, MN 55455, USA
| | - David R. Jacobs
- Division of Epidemiology & Community Health, University of Minnesota School of Public Health, 1300 South Second St, Minneapolis, MN 55454, USA
| | - Donald R. Dengel
- Laboratory of Integrative Human Physiology, School of Kinesiology, University of Minnesota, Minneapolis, Minnesota, 55455
- Department of Pediatrics, University of Minnesota Medical School, 2450 Riverside Avenue, Minneapolis, MN 55455, USA
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Costa KCM, Ciampo LAD, Silva PS, Lima JC, Martins WDP, Nogueira de Almeida CA. ULTRASONOGRAPHIC MARKERS OF CARDIOVASCULAR DISEASE RISK IN OBESE CHILDREN. ACTA ACUST UNITED AC 2018; 36:171-175. [PMID: 29617475 PMCID: PMC6038792 DOI: 10.1590/1984-0462/;2018;36;2;00016] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2017] [Accepted: 07/28/2017] [Indexed: 01/08/2023]
Abstract
Objective: To evaluate whether the obesity alters ultrasonographical markers of
metabolic and cardiovascular disease risk in children. Methods: A cross-sectional study evaluated 80 children aged between 6 and 10 years,
comparing 40 obese with 40 normal children. The following parameters were
assessed: weight; height; body mass index; arterial blood pressure; body
fat; basal metabolic rate; HDL-cholesterol, LDL-cholesterol and total
cholesterol; fasting insulin and glucose; quantitative insulin sensitivity
check index (QUICKI); homeostasis model of assessment - insulin resistance
(HOMA-IR); basal diameter of the brachial artery; brachial artery flow
mediated dilation (FMD) and of pulsatility index change (PI-C). Results: Significant differences were observed between obese vs. non-obese children:
systolic blood pressure (97.7±8.4 vs. 89.0±5.8 mmHg; p<0.01), diastolic
blood pressure (64.3±7.9 vs. 52.9±5.1 mmHg; p<0.01), proportion of body
fat (45.1±5.9 vs. 21.3±6.0%; p<0.01), basal metabolic rate (1216.1±102.1
vs. 1072.9±66.4 Kcal; p<0.01), total cholesterol (164.7±25.2 vs.
153.4±15.8 mg/dL; p=0.03), fasting insulin (7.1±5.2 vs. 2.8±1.8 pIU/mL;
p<0.01), HOMA-IR (1.5±1.1 vs. 0.6±0.4; p<0.01), basal diameter of the
brachial artery (2.5±0.3 vs. 2.1±0.3 mm; p<0.01); PI-C (-15.5±27.2 vs.
-31.9±15.5%; p<0.01), decreased QUICKI (0.4±0.05 vs. 0.4±0.03;
p<0.01), and FMD (6.6±3.2 vs. 15.6±7.3%; p<0.01). Conclusions: Obesity worsens ultrasonographical and laboratorial markers of metabolic and
cardiovascular disease risk in children.
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Affiliation(s)
| | | | | | - Jailson Costa Lima
- Departamento de Medicina, Universidade Federal de São Carlos, São Carlos, SP, Brazil
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Impaired arterial responsiveness in untreated gout patients compared with healthy non-gout controls: association with serum urate and C-reactive protein. Clin Rheumatol 2018; 37:1903-1911. [PMID: 29450849 DOI: 10.1007/s10067-018-4029-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2018] [Revised: 02/01/2018] [Accepted: 02/06/2018] [Indexed: 12/13/2022]
Abstract
To determine whether arterial responsiveness is impaired among patients with gout, and whether arterial responsiveness inversely correlates with serum urate and inflammatory measures. This is a cross-sectional study of untreated gout subjects (n = 34) and non-gout healthy controls (n = 64). High-resolution dynamic ultrasound-measured flow-mediated dilation (FMD) and nitroglycerin-mediated dilation (NMD) assessed endothelium-dependent and endothelium-independent arterial responsiveness respectively. Serum urate (sUA) and high-sensitivity C-reactive protein (hsCRP) were measured in the gout group, and correlated with FMD and NMD responses. Both FMD (2.20 ± 0.53 vs 3.56 ± 0.31, p = 0.021) and NMD (16.69 ± 1.54 vs 24.51 ± 0.90, p = 0.00002) were impaired in the gout versus control group. Stratification for individual comorbidities suggested that no single risk factor accounted for impaired FMD/NMD in the gout subjects. However, the degree of association between gout and FMD, but not NMD impairment, was dampened after multivariable adjustment (FMD unadjusted beta = - 1.36 (SE 0.58), p = 0.02; adjusted beta = - 1.16 (SE 0.78), p = 0.14 and NMD unadjusted beta = - 7.68 (SE 1.78), p < 0.0001; adjusted beta = - 5.33 (SE 2.46), p = 0.03). Within the gout group, there was an inverse correlation between FMD and sUA (R = - 0.5, p = 0.003), and between FMD and hsCRP (R = - 0.42, p = 0.017), but not between NMD and sUA or hsCRP. Compared with healthy controls, subjects with gout have reduced arterial function. Individual comorbidities are insufficient to account for differences between gout and control groups, but multiple comorbidities may collectively contribute to impairment in endothelium-dependent arterial responsiveness. Endothelial impairment is also related to sUA and hsCRP, markers of gout severity and inflammation respectively. Studies to determine whether gout therapy may improve arterial responsiveness are warranted.
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Correlation of endothelial dysfunction measured by flow-mediated vasodilatation to severity of coronary artery disease. Indian Heart J 2018; 70:622-626. [PMID: 30392498 PMCID: PMC6205249 DOI: 10.1016/j.ihj.2018.01.008] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2017] [Revised: 11/09/2017] [Accepted: 01/08/2018] [Indexed: 01/22/2023] Open
Abstract
OBJECTIVES Brachial artery ultrasound imaging during reactive hyperemia is widely used tool for quantifying endothelium dependent vasomotion. Angiodefender device is used for non invasive determination of percentage flow mediated vasodilation (FMD). An attempt is made to study whether endothelial dysfunction determined by FMD of brachial artery predicts the presence or absence of coronary artery disease and its correlation with the severity of coronary artery disease. METHODS One hundred six patients admitted between May 2014 and April 2015 who were posted for coronary angiography diagnosed to have chronic stable angina on clinical basis and/or by exercise stress test, for evaluation of coronary artery disease were submitted to standard clinical evaluation, calculation of percentage FMD by Angiodefender device. Statistical significance of difference of categorical variables was tested using Fisher's exact test. Sensitivity, specificity, positive predictive value and negative predictive value of FMD were studied. RESULTS There was no correlation between number of risk factors and percentage of FMD. Significantly higher proportion of cases with less FMD had higher prevalence of coronary artery disease and vice-versa. Significantly higher proportion of cases with positive stress test had less percentage of FMD and vice-versa. Significantly higher proportion of cases with less percentage of FMD and positive stress test had higher prevalence of obstructive coronary artery disease and vice-versa. Specificity was 100% when percentage of FMD was ≤10. CONCLUSIONS FMD an inexpensive and non-invasive test provides information regarding extent and severity of coronary artery disease.
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Konstantinopoulos A, Giannitsas K, Raptis S, Perimenis P. Endothelial Dysfunction, Erectile Dysfunction and Phosphodiesterase 5 Inhibitors. An Update of the Current Data and Future Perspectives. Drug Target Insights 2017. [DOI: 10.1177/117739280700200012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Affiliation(s)
| | | | - Spiros Raptis
- Department of Urology, University Hospital of Patras, Greece
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Karney A, Brągoszewska H, Soluch L, Ołtarzewski M. [Risk factors for atherosclerosis in obese children aged 6-12 years]. DEVELOPMENTAL PERIOD MEDICINE 2017. [PMID: 29077565 PMCID: PMC8522952 DOI: 10.34763/devperiodmed.20172103.259265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Obesity in children causes metabolic and structural changes in blood vessels which lead to the development of cardiovascular diseases and type 2 diabetes. AIM The aim of the study was to assess the risk factors for atherosclerosis in obese children studied in the One-Day Hospitalization Department of the Institute of Mother and Child. MATERIAL AND METHODS The study included 75 children aged 6-12 years (36 boys, 39 girls) with aBMI>97th percentile. The control group consisted of 36 children aged 5-10 years (18 boys, 18 girls) with a BMI of 75-90. Analysis was conducted of family history regarding obesity, CVD, dyslipidemia. The children's examination consisted of: BMI, waist circumference, cholesterol, LDL, HDL, triglycerides, and insulin. Both groups had their IMT (left and right) examined with ultrasound. RESULTS In the study group 82.6% of the obese children had a positive family history of obesity and 72% of CVD and dyslipidemia. Regarding the children from the control group, 34.2% had a family history of obesity and 36.8 of CVD and dyslipidemia. The mean waist circumference in the obese children was 72.7 cm, while in the control group it was 59.9 (<0.001). The mean levels of lipids were higher in obese children (<0.001). The insulin level was almost twice as high as in the control group (±8.47 SD; <0.003). The mean IMT in obese patients was 0.36 mm; ±0.059 SD (right side) and 0.37 mm; ±0.033 SD (left side), while in the control group it was 0.32 mm; ±0.087 SD (right side) and 0.32 mm, ±0.082 SD (left side). The differences between the two groups were statistically significant. A positive correlation between waist circumference and insulin level was found (<0.003). CONCLUSIONS Obesity and dyslipidemia are more common among children with familial obesity and CVD. Dyslipidemia is statistically more widespread among obese children. IMT is significantly higher in obese children compared with the control group, suggesting that changes in the structure of carotid atherosclerosis may occur in obese children in early childhood. This can be diagnosed using the noninvasive IMT method measured with ultrasound. Children with obesity, especially visceral, have higher levels of insulin, which may contribute to insulin resistance. Parents lack sufficient knowledge about the effects of childhood obesity and its effects on atherosclerosis and cardiovascular diseases. RESULTS In the study group 82.6% of the obese children had a positive family history of obesity and 72% of CVD and dyslipidemia. Regarding the children from the control group, 34.2% had a family history of obesity and 36.8 of CVD and dyslipidemia. The mean waist circumference in the obese children was 72.7 cm, while in the control group it was 59.9 (<0.001). The mean levels of lipids were higher in obese children (<0.003). CONCLUSIONS Obesity and dyslipidemia are more common among children with familial obesity and CVD. Dyslipidemia is statistically more widespread among obese children. IMT is significantly higher in obese children compared with the control group, suggesting that changes in the structure of carotid atherosclerosis may occur in obese children in early childhood. This can be diagnosed using the noninvasive IMT method measured with ultrasound. Children with obesity, especially visceral, have higher levels of insulin, which may contribute to insulin resistance. Parents lack sufficient knowledge about the effects of childhood obesity and its effects on atherosclerosis and cardiovascular diseases.
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Affiliation(s)
- Alicja Karney
- Oddział Hospitalizacji Jednego Dnia, Instytut Matki i Dziecka, Warszawa, Polska,Alicja Karney Oddział Hospitalizacji Jednego Dnia, Instytut Matki i Dziecka ul. Kasprzaka 17a, 01-211 Warszawa, Polska tel. (+48-22) 32-77-104
| | - Hanna Brągoszewska
- Zakład Diagnostyki Obrazowej, Instytut Matki i Dziecka, Warszawa, Polska
| | - Leszek Soluch
- Centralne Laboratorium, Instytut Matki i Dziecka, Warszawa, Polska
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32
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Gifford JR, Richardson RS. CORP: Ultrasound assessment of vascular function with the passive leg movement technique. J Appl Physiol (1985) 2017; 123:1708-1720. [PMID: 28883048 DOI: 10.1152/japplphysiol.00557.2017] [Citation(s) in RCA: 65] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
As dysfunction of the vascular system is an early, modifiable step in the progression of many cardiovascular diseases, there is demand for methods to monitor the health of the vascular system noninvasively in clinical and research settings. Validated by very good agreement with more technical assessments of vascular function, like intra-arterial drug infusions and flow-mediated dilation, the passive leg movement (PLM) technique has emerged as a powerful, yet relatively simple, test of peripheral vascular function. In the PLM technique, the change in leg blood flow elicited by the passive movement of the leg through a 90° range of motion is quantified with Doppler ultrasound. This relatively easy-to-learn test has proven to be ≤80% dependent on nitric oxide bioavailability and is especially adept at determining peripheral vascular function across the spectrum of cardiovascular health. Indeed, multiple reports have documented that individuals with decreased cardiovascular health such as the elderly and those with heart failure tend to exhibit a substantially blunted PLM-induced hyperemic response (~50 and ~85% reduction, respectively) compared with populations with good cardiovascular health such as young individuals. As specific guidelines have not yet been put forth, the purpose of this Cores of Reproducibility in Physiology (CORP) article is to provide a comprehensive reference for the assessment and interpretation of vascular function with PLM with the aim to increase reproducibility and consistency among studies and facilitate the use of PLM as a research tool with clinical relevance.
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Affiliation(s)
- Jayson R Gifford
- Department of Exercise Sciences, Brigham Young University , Provo, Utah.,Geriatric Research, Education, and Clinical Center, Veterans Affairs Medical Center, Salt Lake City, Utah.,Department of Internal Medicine, University of Utah , Salt Lake City, Utah
| | - Russell S Richardson
- Geriatric Research, Education, and Clinical Center, Veterans Affairs Medical Center, Salt Lake City, Utah.,Department of Internal Medicine, University of Utah , Salt Lake City, Utah.,Department of Nutrition and Integrative Physiology, University of Utah , Salt Lake City, Utah
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Abstract
PURPOSE OF REVIEW The complexity of gout continues to unravel with each new investigation. Gout sits at the intersection of multiple intrinsically complex processes, and its prevalence, impact on healthcare costs, and association with important co-morbidities make it increasingly relevant. The association between gout and type 2 diabetes, hypertension, hyperlipidemia, cardiovascular disease, renal disease, and obesity suggest that either gout, or its necessary precursor hyperuricemia, may play an important role in the manifestations of the metabolic syndrome. In this review, we analyze the complex interconnections between gout and metabolic syndrome, by reviewing gout's physiologic and epidemiologic relationships with its major co-morbidities. RECENT FINDINGS Increasing evidence supports gout's association with metabolic syndrome. More specifically, both human studies and animal models suggest that hyperuricemia may play a role in promoting inflammation, hypertension and cardiovascular disease, adipogenesis and lipogenesis, insulin and glucose dysregulation, and liver disease. Fructose ingestion is associated with increased rates of hypertension, weight gain, impaired glucose tolerance, and dyslipidemia and is a key driver of urate biosynthesis. AMP kinase (AMPK) is a central regulator of processes that tend to mitigate against the metabolic syndrome. Within hepatocytes, leukocytes, and other cells, a fructose/urate metabolic loop drives key inhibitors of AMPK, including AMP deaminase and fructokinase, that may tilt the balance toward metabolic syndrome progression. Preliminary evidence suggests that agents that block the intracellular synthesis of urate may restore AMPK activity and help maintain metabolic homeostasis. Gout is both an inflammatory and a metabolic disease. With further investigation of urate's role, the possibility of proper gout management additionally mitigating metabolic syndrome is an evolving and important question.
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Affiliation(s)
- Gabrielle E Thottam
- Department of Medicine, Roger Williams Medical Center, Providence, RI, USA.,Crystal Diseases Study Group, Division of Rheumatology, Department of Medicine, New York University School of Medicine, 301 East 17th Street, Suite 1410, New York, NY, 10003, USA
| | - Svetlana Krasnokutsky
- Crystal Diseases Study Group, Division of Rheumatology, Department of Medicine, New York University School of Medicine, 301 East 17th Street, Suite 1410, New York, NY, 10003, USA.,Rheumatology Section, Department of Medicine, VA New Harbor Health Care System, New York Campus, New York, NY, USA
| | - Michael H Pillinger
- Crystal Diseases Study Group, Division of Rheumatology, Department of Medicine, New York University School of Medicine, 301 East 17th Street, Suite 1410, New York, NY, 10003, USA. .,Rheumatology Section, Department of Medicine, VA New Harbor Health Care System, New York Campus, New York, NY, USA.
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Gupta RM, Hadaya J, Trehan A, Zekavat SM, Roselli C, Klarin D, Emdin CA, Hilvering CRE, Bianchi V, Mueller C, Khera AV, Ryan RJH, Engreitz JM, Issner R, Shoresh N, Epstein CB, de Laat W, Brown JD, Schnabel RB, Bernstein BE, Kathiresan S. A Genetic Variant Associated with Five Vascular Diseases Is a Distal Regulator of Endothelin-1 Gene Expression. Cell 2017; 170:522-533.e15. [PMID: 28753427 PMCID: PMC5785707 DOI: 10.1016/j.cell.2017.06.049] [Citation(s) in RCA: 322] [Impact Index Per Article: 40.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2016] [Revised: 04/13/2017] [Accepted: 06/29/2017] [Indexed: 01/20/2023]
Abstract
Genome-wide association studies (GWASs) implicate the PHACTR1 locus (6p24) in risk for five vascular diseases, including coronary artery disease, migraine headache, cervical artery dissection, fibromuscular dysplasia, and hypertension. Through genetic fine mapping, we prioritized rs9349379, a common SNP in the third intron of the PHACTR1 gene, as the putative causal variant. Epigenomic data from human tissue revealed an enhancer signature at rs9349379 exclusively in aorta, suggesting a regulatory function for this SNP in the vasculature. CRISPR-edited stem cell-derived endothelial cells demonstrate rs9349379 regulates expression of endothelin 1 (EDN1), a gene located 600 kb upstream of PHACTR1. The known physiologic effects of EDN1 on the vasculature may explain the pattern of risk for the five associated diseases. Overall, these data illustrate the integration of genetic, phenotypic, and epigenetic analysis to identify the biologic mechanism by which a common, non-coding variant can distally regulate a gene and contribute to the pathogenesis of multiple vascular diseases.
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Affiliation(s)
- Rajat M Gupta
- Broad Institute of MIT and Harvard University, Cambridge, MA, USA; Cardiology Division, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA USA; Center for Genomic Medicine, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.
| | - Joseph Hadaya
- Broad Institute of MIT and Harvard University, Cambridge, MA, USA
| | - Aditi Trehan
- Broad Institute of MIT and Harvard University, Cambridge, MA, USA
| | | | - Carolina Roselli
- Broad Institute of MIT and Harvard University, Cambridge, MA, USA
| | - Derek Klarin
- Broad Institute of MIT and Harvard University, Cambridge, MA, USA
| | - Connor A Emdin
- Broad Institute of MIT and Harvard University, Cambridge, MA, USA
| | | | - Valerio Bianchi
- Hubrecht Institute, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Christian Mueller
- Department of General and Interventional Cardiology, University Heart Center Hamburg-Eppendorf, Hamburg, Germany
| | - Amit V Khera
- Broad Institute of MIT and Harvard University, Cambridge, MA, USA; Cardiology Division, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA USA; Center for Genomic Medicine, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Russell J H Ryan
- Broad Institute of MIT and Harvard University, Cambridge, MA, USA; Department of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Jesse M Engreitz
- Broad Institute of MIT and Harvard University, Cambridge, MA, USA
| | - Robbyn Issner
- Broad Institute of MIT and Harvard University, Cambridge, MA, USA
| | - Noam Shoresh
- Broad Institute of MIT and Harvard University, Cambridge, MA, USA
| | | | - Wouter de Laat
- Hubrecht Institute, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Jonathan D Brown
- Division of Cardiovascular Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Renate B Schnabel
- Department of General and Interventional Cardiology, University Heart Center Hamburg-Eppendorf, Hamburg, Germany
| | - Bradley E Bernstein
- Broad Institute of MIT and Harvard University, Cambridge, MA, USA; Department of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Sekar Kathiresan
- Broad Institute of MIT and Harvard University, Cambridge, MA, USA; Cardiology Division, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA USA; Center for Genomic Medicine, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.
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Adamo M, Labate AM, Ferrulli A, Macrì C, Terruzzi I, Luzi L. Effects of hazelnuts and cocoa on vascular reactivity in healthy subjects: a randomised study. Int J Food Sci Nutr 2017; 69:223-234. [DOI: 10.1080/09637486.2017.1348492] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Affiliation(s)
- Michela Adamo
- Department of Biomedical Sciences for Health, Università degli Studi di Milano, Milan, Italy
- Endocrinology and Metabolic Diseases Unit, San Donato Hospital, Milan, Italy
| | | | - Anna Ferrulli
- Endocrinology and Metabolic Diseases Unit, San Donato Hospital, Milan, Italy
| | - Concetta Macrì
- Endocrinology and Metabolic Diseases Unit, San Donato Hospital, Milan, Italy
| | - Ileana Terruzzi
- Division of Metabolic and Cardiovascular Science, Metabolism, Nutrigenomics and Cellular Differentiation Unit, San Raffaele Scientific Institute, Milan, Italy
| | - Livio Luzi
- Department of Biomedical Sciences for Health, Università degli Studi di Milano, Milan, Italy
- Endocrinology and Metabolic Diseases Unit, San Donato Hospital, Milan, Italy
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Depleted nitric oxide and prostaglandin E 2 levels are correlated with endothelial dysfunction in β-thalassemia/HbE patients. Int J Hematol 2017; 106:366-374. [PMID: 28474291 DOI: 10.1007/s12185-017-2247-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2017] [Revised: 05/01/2017] [Accepted: 05/01/2017] [Indexed: 01/22/2023]
Abstract
Mechanisms of vascular disorders in β-thalassemia/HbE patients remain poorly understood. In the present study, we aimed to determine the presence of endothelial dysfunction and its association with altered vascular mediators in this population. Forty-three β-thalassemia/HbE patients without clinically documented vascular symptoms and 43 age-sex-matched healthy controls were enrolled. Endothelial function was assessed using flow-mediated dilatation (FMD) before and after administration of nitroglycerine (NTG). β-Thalassemia/HbE patients showed a significant endothelial dysfunction using FMD. The percentage change in the brachial artery diameter before NTG was significantly lower in the thalassemia group compared to the control (5.0 ± 5.9 vs. 9.0 ± 4.0%, p < 0.01) while no significant differences after NTG (18.4 ± 8.3 vs. 17.8 ± 6.3%, p = 0.71). Plasma nitric oxide metabolites (NO x ) and prostaglandin E2 (PGE2) levels were significantly decreased in β-thalassemia/HbE (117.2 ± 27.3 vs. 135.8 ± 11.3 µmol/L, p < 0.01) and (701.9 ± 676.0 vs. 1374.7 ± 716.5 pg/mL, p < 0.01), respectively, while a significant elevation in soluble thrombomodulin levels in β-thalassemia/HbE (3587.7 ± 1310.0 vs. 3093.9 ± 583.8 pg/mL, p = 0.028). NO x and PGE2 levels were significantly correlated with FMD (r = 0.27, p = 0.025) and (r = 0.35, p = 0.003), respectively. These findings suggest roles for endothelial mediators and a new mechanism underlying endothelial dysfunction in β-thalassemia/HbE patients.
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Moroni L, Selmi C, Angelini C, Meroni PL. Evaluation of Endothelial Function by Flow-Mediated Dilation: a Comprehensive Review in Rheumatic Disease. Arch Immunol Ther Exp (Warsz) 2017; 65:463-475. [DOI: 10.1007/s00005-017-0465-7] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2016] [Accepted: 03/03/2017] [Indexed: 12/18/2022]
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Scalzo RL, Moreau KL, Ozemek C, Herlache L, McMillin S, Gilligan S, Huebschmann AG, Bauer TA, Dorosz J, Reusch JEB, Regensteiner JG. Exenatide improves diastolic function and attenuates arterial stiffness but does not alter exercise capacity in individuals with type 2 diabetes. J Diabetes Complications 2017; 31:449-455. [PMID: 27884660 PMCID: PMC5787373 DOI: 10.1016/j.jdiacomp.2016.10.003] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2016] [Revised: 09/19/2016] [Accepted: 10/03/2016] [Indexed: 02/07/2023]
Abstract
BACKGROUND Exercise is recommended as a cornerstone of treatment for type 2 diabetes mellitus (T2DM), however, it is often poorly adopted by patients. Even in the absence of apparent cardiovascular disease, persons with T2DM have an impaired ability to carry out maximal and submaximal exercise and these impairments are correlated with cardiac and endothelial dysfunction. Glucagon-like pepetide-1 (GLP-1) augments endothelial and cardiac function in T2DM. We hypothesized that administration of a GLP-1 agonist (exenatide) would improve exercise capacity in T2DM. METHODS AND RESULTS Twenty-three participants (64±4years; mean±SE) with uncomplicated T2DM were randomized in a double-blinded manner to receive either 10μg BID of exenatide or matching placebo after baseline measurements. Treatment with exenatide did not improve VO2peak (P=0.1464) or VO2 kinetics (P=0.2775). Diastolic function, assessed via resting lateral E:E', was improved with administration of exenatide compared with placebo (Placebo Pre: 7.6±1.0 vs. Post: 8.4±1.2 vs. Exenatide Pre: 8.1±0.7 vs. Post: 6.7±0.6; P=0.0127). Additionally, arterial stiffness measured by pulse wave velocity, was reduced with exenatide treatment compared with placebo (Placebo Pre: 10.5±0.8 vs. Post: 11.5±1.1s vs. Exenatide Pre: 11.4±1.8 vs. Post: 10.2±1.4s; P=0.0373). Exenatide treatment did not improve endothelial function (P=0.1793). CONCLUSIONS Administration of exenatide improved cardiac function and reduced arterial stiffness, however, these changes were not accompanied by improved functional exercise capacity. In order to realize the benefits of this drug on exercise capacity, combining exenatide with aerobic exercise training in participants with T2DM may be warranted.
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Affiliation(s)
- Rebecca L Scalzo
- Division of Endocrinology, Department of Medicine, University of Colorado School of Medicine (UCSOM), Denver, Colorado 80215
| | - Kerrie L Moreau
- Division of Geriatrics, Department of Medicine, University of Colorado School of Medicine (UCSOM), Denver, Colorado 80215; Center for Women's Health Research, Department of Medicine, University of Colorado School of Medicine (UCSOM), Denver, Colorado 80215; VAMC-Geriatric Research Education and Clinical Center (GRECC), Denver, Colorado 80215
| | - Cemal Ozemek
- Division of Geriatrics, Department of Medicine, University of Colorado School of Medicine (UCSOM), Denver, Colorado 80215
| | - Leah Herlache
- Division of General Internal Medicine, Department of Medicine, University of Colorado School of Medicine (UCSOM), Denver, Colorado 80215
| | - Shawna McMillin
- Division of General Internal Medicine, Department of Medicine, University of Colorado School of Medicine (UCSOM), Denver, Colorado 80215
| | - Sarah Gilligan
- Division of General Internal Medicine, Department of Medicine, University of Colorado School of Medicine (UCSOM), Denver, Colorado 80215
| | - Amy G Huebschmann
- Center for Women's Health Research, Department of Medicine, University of Colorado School of Medicine (UCSOM), Denver, Colorado 80215; Division of General Internal Medicine, Department of Medicine, University of Colorado School of Medicine (UCSOM), Denver, Colorado 80215
| | - Tim A Bauer
- Division of General Internal Medicine, Department of Medicine, University of Colorado School of Medicine (UCSOM), Denver, Colorado 80215
| | - Jennifer Dorosz
- Division of Cardiology, Department of Medicine, University of Colorado School of Medicine (UCSOM), Denver, Colorado 80215
| | - Jane E B Reusch
- Division of Endocrinology, Department of Medicine, University of Colorado School of Medicine (UCSOM), Denver, Colorado 80215; Center for Women's Health Research, Department of Medicine, University of Colorado School of Medicine (UCSOM), Denver, Colorado 80215; Veterans Administration Medical Center (VAMC), Denver, Colorado 80215
| | - Judith G Regensteiner
- Center for Women's Health Research, Department of Medicine, University of Colorado School of Medicine (UCSOM), Denver, Colorado 80215; Division of General Internal Medicine, Department of Medicine, University of Colorado School of Medicine (UCSOM), Denver, Colorado 80215.
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Ostrem JD, Evanoff NG, Ryder JR, Dengel DR. Intra- and interday reproducibility of high-flow-mediated constriction response in young adults. Clin Physiol Funct Imaging 2016; 38:200-205. [PMID: 28025878 DOI: 10.1111/cpf.12399] [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: 06/30/2016] [Accepted: 09/30/2016] [Indexed: 11/29/2022]
Abstract
BACKGROUND Previously, we have demonstrated that high-flow-mediated constriction (H-FMC) of the brachial artery has been shown to negatively affect flow-mediated dilation (FMD). However, the reproducibility of an H-FMC response is unknown. OBJECTIVE The aim of this study was to determine the intra- and interday reproducibility of H-FMC in young adults. METHODS Thirty young adults (15 male, 15 female; 24 ± 3 years) were assessed for H-FMC reproducibility via high-resolution ultrasound imaging of the brachial artery during and after forearm occlusion of a normal FMD procedure. Two vascular assessments were conducted for all participants during two separate visits with a minimum of 7 days in between. H-FMC was characterized as the greatest 10-s average constriction occurring after 3-s postocclusion compared to baseline brachial artery diameter and considered present if the percent change was <-0·1%. RESULTS Of the 120 total vascular assessments performed in this study, 98 of the assessments (80·3%) displayed an H-FMC. H-FMC diameter was not statistically different for intraday comparisons for visit 1 (P = 0·39) or visit 2 (P = 0·55) or interday comparisons between the first (P = 0·61) or second (P = 0·10) assessments. H-FMC percentage was also not statistically different for intra-day comparison for visit 1 (P = 0·94) or visit 2 (P = 0·15) or interday comparisons between the first (P = 0·63) or second (P = 0·16) assessments. CONCLUSION These data are supportive of H-FMC being reproducible in young adults and included in future FMD studies. The impact of H-FMC on future CVD risk and development warrants evaluation.
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Affiliation(s)
- Joseph D Ostrem
- Laboratory of Integrative Human Physiology, School of Kinesiology, University of Minnesota, Minneapolis, MN, USA.,Kinesiology and Health Sciences, College of Education and Science, Concordia University - St. Paul, St. Paul, MN, USA
| | - Nicholas G Evanoff
- Laboratory of Integrative Human Physiology, School of Kinesiology, University of Minnesota, Minneapolis, MN, USA
| | - Justin R Ryder
- Department of Pediatrics, University of Minnesota Medical School, Minneapolis, MN, USA
| | - Donald R Dengel
- Laboratory of Integrative Human Physiology, School of Kinesiology, University of Minnesota, Minneapolis, MN, USA.,Department of Pediatrics, University of Minnesota Medical School, Minneapolis, MN, USA
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Long term evolution of endothelial function during kidney transplantation. BMC Nephrol 2016; 17:160. [PMID: 27770793 PMCID: PMC5075412 DOI: 10.1186/s12882-016-0369-5] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2016] [Accepted: 10/11/2016] [Indexed: 01/22/2023] Open
Abstract
Background Endothelial dysfunction is an important precursor to the development of atherosclerosis, and has been suggested to play a role in the increased cardiovascular risk in patients with end stage renal disease. Endothelial function improves rapidly following post kidney transplantation, but the long term change remains unclear. Hypothesizing that endothelial function would remain improved long term post kidney transplantation, we evaluated the longitudinal change of endothelial function, measured by flow-mediated dilation (FMD) of the brachial artery, from months 1 to 24 post transplantation. Given the previously reported association of fibroblast growth factor 23 (FGF-23) with endothelial dysfunction, we also examined changes in the association between FGF-23 levels and the change in FMD following kidney transplantation. Methods We performed a prospective cohort study of 149 kidney transplant recipients, measuring endothelial function by FMD at months 1, 12, and 24 post-transplant. FGF-23 levels were measured at months 1 and 24 post-transplant. Linear mixed effects models were used to assess both the unadjusted and adjusted outcomes. Results The cohort (mean age 49 ± 13 years) was 74 % male and 75 % white. The median FMD was 6.3 % (IQR: 3.4, 10.2), 5.4 % (IQR: 3.1, 8.5), and 5.6 % (IQR: 3.5, 9.1) at 1, 12, and 24 months, respectively. After adjustment for covariates, compared to month 1, no change occurred in FMD at 12 months (−0.66 %; 95 % CI: −1.81 %, 0.49 %; P = 0.262) or 24 months (−0.25 %; 95%CI: −1.76 %, 1.26 %; P = 0.746). FGF-23 decreased significantly over time (P = 0.024), but there was no significant association between FGF-23 and FMD (P = 0.799). Conclusion Endothelial function remained stable at 12 and 24 months from 1 month post-kidney transplant, indicating that the improved endothelial function seen with transplant is maintained up to 2 years post transplantation. There was also no significant association between FGF-23 and endothelial function following kidney transplantation.
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Arifoglu HB, Karatepe Hashas AS, Atas M, Sarli B, Ozkose A, Demircan S. Systemic endothelial function in cases with wet-type age-related macular degeneration. Aging Clin Exp Res 2016; 28:853-6. [PMID: 26003670 DOI: 10.1007/s40520-015-0377-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2014] [Accepted: 05/11/2015] [Indexed: 11/24/2022]
Abstract
BACKGROUND Choroidal endothelial dysfunction plays key role in wet-type age-related macular degeneration (AMD). Peripheral vascular endothelial function is not known in wet AMD. OBJECTIVE We aimed to analyze peripheral vascular endothelial function in cases with wet-type age-related macular degeneration by measuring flow-mediated dilatation (FMD). MATERIALS AND METHODS The study included 20 cases with wet AMD (Group 1, mean age 65.9 ± 7.2 years) and 24 healthy individuals (Group 2, mean age 62.0 ± 11.9 years). In all cases, a cardiologist assessed the responses of endothelial function by measuring the FMD following brachial artery occlusion. RESULTS Mean FMD, an indicator of endothelial function was found to be 6.4 ± 2.7 % in Group 1 and 15.6 ± 7.3 % in Group 2 (p < 0.001). There was no significant difference between patient and control groups regarding age, sex, total cholesterol, LDL cholesterol, HDL cholesterol, triglyceride, ESR and CRP. CONCLUSION Reduced FMD is present in patients with wet AMD, suggesting that impaired peripheral endothelial function may be involved in its pathogenesis.
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Affiliation(s)
- Hasan Basri Arifoglu
- Ophthalmology Department, S.B. Kayseri Research and Education Hospital, Sanayi Mah. Atatürk Boulevard Hastane Street No:78, Kayseri, 38010, Turkey.
| | - Arzu Seyhan Karatepe Hashas
- Ophthalmology Department, S.B. Kayseri Research and Education Hospital, Sanayi Mah. Atatürk Boulevard Hastane Street No:78, Kayseri, 38010, Turkey
| | - Mustafa Atas
- Ophthalmology Department, S.B. Kayseri Research and Education Hospital, Sanayi Mah. Atatürk Boulevard Hastane Street No:78, Kayseri, 38010, Turkey
| | - Bahadır Sarli
- Cardiology Department, S.B. Kayseri Research and Education Hospital, Sanayi Mah. Atatürk Boulevard Hastane Street No:78, Kayseri, 38010, Turkey
| | - Ayse Ozkose
- Ophthalmology Department, S.B. Kayseri Research and Education Hospital, Sanayi Mah. Atatürk Boulevard Hastane Street No:78, Kayseri, 38010, Turkey
| | - Suleyman Demircan
- Ophthalmology Department, S.B. Kayseri Research and Education Hospital, Sanayi Mah. Atatürk Boulevard Hastane Street No:78, Kayseri, 38010, Turkey
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Mitchell AJ, Mills NL, Newby DE, Cruden NLM. Radial artery vasomotor function following transradial cardiac catheterisation. Open Heart 2016; 3:e000443. [PMID: 27752330 PMCID: PMC5051497 DOI: 10.1136/openhrt-2016-000443] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2016] [Revised: 07/22/2016] [Accepted: 08/09/2016] [Indexed: 12/11/2022] Open
Abstract
Aims To determine the reproducibility of flow-mediated dilation (FMD) and nitrate-mediated dilation (NMD) in the assessment of radial artery vasomotor function, and to examine the effect of transradial catheterisation on radial artery injury and recovery. Methods Radial artery FMD and NMD were examined in 20 volunteers and 20 patients on four occasions (two visits at least 24 hours apart, with two assessments at each visit). In a further 10 patients, radial artery FMD was assessed in the catheterised arm prior to, at 24 hours and 3 months following cardiac catheterisation. Results There were no differences in baseline radial artery diameter (2.7±0.4 mm vs 2.7±0.4 mm), FMD (13.4±6.4 vs 12.89±5.5%) or NMD (13.6±3.8% vs 10.1±4.3%) between healthy volunteers and patients (p>0.05 for all comparisons). Mean differences for within and between day FMD were 2.53% (95% CIs −15.5% to 20.5%) and −4.3% (−18.3% to 9.7%) in patients. Compared to baseline, radial artery FMD was impaired at 24 hours (8.7±4.1% vs 3.9±2.9%, p=0.015) but not 3 months (8.7±4.1% vs 6.2±4.4, p=0.34) following transradial catheterisation. Conclusions Radial FMD is impaired early after transradial catheterisation but appears to recover by 3 months. While test–retest variability was demonstrated, our findings suggest that transradial access for cardiac catheterisation may afford a potential model of vascular injury and repair in vivo in man.
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Affiliation(s)
- A J Mitchell
- Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, UK; Edinburgh Heart Centre, NHS Lothian, Edinburgh, UK
| | - N L Mills
- Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, UK; Edinburgh Heart Centre, NHS Lothian, Edinburgh, UK
| | - D E Newby
- Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, UK; Edinburgh Heart Centre, NHS Lothian, Edinburgh, UK
| | - N L M Cruden
- Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, UK; Edinburgh Heart Centre, NHS Lothian, Edinburgh, UK
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Sezgin AT, Barutcu I, Sezgin N, Gullu H, Esen AM, Acikgoz N, Topal E, Ozdemir R. Contribution of Plasma Lipid Disturbances to Vascular Endothelial Function in Patients With Slow Coronary Flow. Angiology 2016; 57:694-701. [PMID: 17235109 DOI: 10.1177/0003319706295472] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Previous studies have suggested that microcirculatory abnormalities cause slow coronary flow (SCF). However, the underlying mechanism of this phenomenon has not yet been well documented. Therefore, the aim of this study was to determine the role of plasma lipid disturbances in pathogenesis of slow coronary flow (SCF). Forty patients with SCF (group I) and 37 subjects with normal coronary arteries (group II) were included in the study. In each subject plasma lipid concentrations (total cholesterol [TC], low-density lipoprotein cholesterol [LDL-C], high-density lipoprotein cholesterol [HDL-C], and triglyceride [TG]) and brachial artery flow-mediated dilatation (FMD) and nitroglycerin (NTG)-induced dilatation were measured. Total cholesterol level was found to be similar in the 2 groups. In group I, HDL-C level was lower than in group II (34 ±3 vs 40 ±4 mg/dL, p=0.0001). In group I, TG level was higher than in group II (213 ±29 vs 198 ±24 mg/dL p=0.002). In group I, FMD was smaller than that of group II (3.48 ±3.1% vs 10.4 ±5.6%, p=0.0001). The percent NTG-induced dilatation was not different between the groups (15.5 ±5.3% vs 17.3 ±6.9%, p=0.27). On regression analysis; there was a significant relationship between percent of FMD and HDL-C ( r =0.65, p=0.0001). When the 2 groups were analyzed separately, HDL-C was still related to percent of FMD in both groups ( r =0.47 p=0.002 and r =0.45 p=0.005, respectively). Multivariate regression analysis showed that only plasma HDL-C was independently related to FMD (F=7.5 p=0.0001). In patients with SCF, reduced flow-mediated dilatation was detected and was found to be associated with plasma lipid disturbances, principally low HDL and high TG levels.
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Affiliation(s)
- Alpay Turan Sezgin
- Department of Cardiology, Baskent University, Practice and Research Hospital, Adana, Turkey
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Title LM, Ur E, Giddens K, McQueen MJ, Nassar BA. Folic acid improves endothelial dysfunction in type 2 diabetes - an effect independent of homocysteine-lowering. Vasc Med 2016; 11:101-9. [PMID: 16886840 DOI: 10.1191/1358863x06vm664oa] [Citation(s) in RCA: 84] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Diabetes is associated with endothelial dysfunction, which in part may be related to uncoupling of the endothelial nitric oxide (NO) synthase enzyme, thus reducing the availability of NO. As folates may potentially reverse the uncoupling of NO synthase, we wanted to determine whether folic acid supplementation could modulate endothelial function and markers of inflammation in patients with type 2 diabetes without vascular disease. Nineteen patients with type 2 diabetes were treated with folic acid (10 mg/day for 2 weeks) versus placebo in a randomized, placebo-controlled, cross-over study with an 8-week washout period between treatments. Fasting endothelium-dependent flow-mediated dilatation (FMD) of the brachial artery, endothelium-independent nitroglycerin-mediated dilatation (NMD), plasma homocysteine, serum lipids, folate, and inflammatory markers (high-sensitivity C-reactive protein, soluble intercellular adhesion molecule-1 and vascular cell adhesion molecule-1, interleukin-18, tumor necrosis factor-alpha) were assessed after each 2-week treatment period. Folic acid supplementation significantly increased folate levels and lowered plasma homocysteine levels. Folic acid significantly improved FMD compared to placebo (5.8 4.8% vs 3.2 2.7%, p 0.02). There were no significant effects of folic acid supplementation on lipids, NMD, or the inflammatory markers. There was no relationship between the change in homocysteine and the improvement in FMD. Thus, 2 weeks of folic acid supplementation can improve endothelial dysfunction in type 2 diabetics independent of homocysteine-lowering, but does not modulate markers of inflammation.
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Affiliation(s)
- Lawrence M Title
- Queen Elizabeth II Health Sciences Centre, Division of Cardiology, 6896-1796 Summer St, Halifax, NS, Canada.
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Impact of volunteer-related and methodology-related factors on the reproducibility of brachial artery flow-mediated vasodilation. J Hypertens 2016; 34:1738-45. [DOI: 10.1097/hjh.0000000000001012] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
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Swampillai J, Doshi S, Fraser AG, Goodfellow J, Jones CJ. Review: Clinical assessment of endothelial function — an update. ACTA ACUST UNITED AC 2016. [DOI: 10.1177/14746514050050020401] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Endothelial dysfunction precedes clinically detectable vascular disease, suggesting its early detection may allow the targeting of treatment to improve endothelial function and thus inhibit progression of disease.1,2 Although the evidence for a preventive strategy remains circumstantial, there is worldwide interest in the measurement of endothelial function in relation to risk factors and treatment of atherosclerotic vascular disease. Unfortunately, a widely applicable clinical measurement of endothelial function does not yet exist; those that are available remain tools for research. The ideal clinical test of endothelial function should be specific, sensitive and reproducible, as well as simple to perform, painless, and inexpensive. In this review we outline the relative merits and disadvantages of the techniques that are available.
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Affiliation(s)
- Janice Swampillai
- Wales Heart Research Institute, University of Wales College of Medicine, Heath Park, Cardiff, CF14 4XN, UK,
| | - Sagar Doshi
- Wales Heart Research Institute, University of Wales College of Medicine, Heath Park, Cardiff, CF14 4XN, UK
| | - Alan G Fraser
- Wales Heart Research Institute, University of Wales College of Medicine, Heath Park, Cardiff, CF14 4XN, UK
| | - Jonathan Goodfellow
- Wales Heart Research Institute, University of Wales College of Medicine, Heath Park, Cardiff, CF14 4XN, UK
| | - Christopher Jh Jones
- Wales Heart Research Institute, University of Wales College of Medicine, Heath Park, Cardiff, CF14 4XN, UK
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Yu CCW, McManus AM, So HK, Chook P, Au CT, Li AM, Kam JTC, So RCH, Lam CWK, Chan IHS, Sung RYT. Effects of resistance training on cardiovascular health in non-obese active adolescents. World J Clin Pediatr 2016; 5:293-300. [PMID: 27610345 PMCID: PMC4978622 DOI: 10.5409/wjcp.v5.i3.293] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2016] [Revised: 07/01/2016] [Accepted: 07/22/2016] [Indexed: 02/06/2023] Open
Abstract
AIM: To determine the benefits of a 10-wk resistance training programme on cardiovascular health in non-obese and active adolescents.
METHODS: This is a pragmatic randomised controlled intervention. The study was carried out in a Hong Kong Government secondary school. Thirty-eight lean and active boys and girls were randomised to either the resistance training group or the control group. Students in the resistance training group received in-school 10-wk supervised resistance training twice per week, with each session lasting 70 min. Main outcome measures taken before and after training included brachial endothelial dependent flow-mediated dilation, body composition, fasting serum lipids, fasting glucose and insulin, high sensitive C-reactive protein, 24-h ambulatory blood pressure and aerobic fitness.
RESULTS: The only training related change was in endothelial dependent flow-mediated dilation which increased from 8.5% to 9.8%. A main effect of time and an interaction (P < 0.005) indicated that this improvement was a result of the 10-wk resistance training. Main effects for time (P < 0.05) in a number of anthropometric, metabolic and vascular variables were noted; however, there were no significant interactions indicating the change was more likely an outcome of normal growth and development as opposed to a training effect.
CONCLUSION: Ten weeks of resistance training in school appears to have some vascular benefit in active, lean children.
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Quaranta N, De Ceglie V, D'Elia A. Endothelial Dysfunction in Idiopathic Sudden Sensorineural Hearing Loss: A Review. Audiol Res 2016; 6:151. [PMID: 27588164 PMCID: PMC4988098 DOI: 10.4081/audiores.2016.151] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2016] [Revised: 05/24/2016] [Accepted: 05/24/2016] [Indexed: 12/22/2022] Open
Abstract
An endothelial dysfunction has been described in idiopathic sudden sensorineural hearing loss (ISSHL) patients. The purpose of our review was to: i) identify, evaluate and review recent research about cardiovascular risk factors involvement and signs of endothelial dysfunction in ISSHL; ii) implication of these discovering in clinical practice and future research. A Medline literature search was conducted to identify any study on the involvement of endothelial dysfunction in ISSHL, published in the English language in the last decade. The following MEDLINE search terms were used: sudden sensorineural hearing loss (SSHL) and endothelial dysfunction (text words). Additional studies were identified by hand searching the references of original articles and review articles. Studies were not excluded on the basis of the qualitative or quantitative definitions of SSHL, treatment regimens, or outcome measures. Data were extracted from included papers by a reviewer. Information on the patients, investigations, methods, interventions, and outcomes were systematically analyzed. Characteristics and results of all included studies were reviewed systematically. High levels of adhesion molecules, hyperhomocysteinemia and lower folate levels, unbalanced oxidative status, a lower value of flow-mediated dilatation of brachial artery and a reduced percentage of circulating endothelial progenitor cells in patients affected by ISSHL support the hypothesis that this syndrome should be considered as a microcirculation disorder based on endothelial dysfunction and drive clinicians to implement all the traditional strategies used for preventing cardiovascular events, to also reduce the likelihood of ISSHL occurrence.
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Affiliation(s)
- Nicola Quaranta
- Otolaryngology Unit, Department of Basic Medical Science, Neuroscience and Sensory Organs, University of Bari , Italy
| | - Vincenzo De Ceglie
- Otolaryngology Unit, Department of Basic Medical Science, Neuroscience and Sensory Organs, University of Bari , Italy
| | - Alessandra D'Elia
- Otolaryngology Unit, Department of Basic Medical Science, Neuroscience and Sensory Organs, University of Bari , Italy
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Der H, Kerekes G, Veres K, Szodoray P, Toth J, Lakos G, Szegedi G, Soltesz P. Impaired endothelial function and increased carotid intima-media thickness in association with elevated von Willebrand antigen level in primary antiphospholipid syndrome. Lupus 2016; 16:497-503. [PMID: 17670848 DOI: 10.1177/0961203307080224] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Primary antiphospholipid syndrome (APS) is characterized by venous or arterial thrombotic events and/or recurrent abortions, fetal death, preeclasmpsia, eclampsia in the presence of anticardiolipin antibodies or lupus anticoagulant, in the absence of accompanying diseases. Antiphospholipid antibodies can activate endothelial cells, and were recently implicated in atherosclerosis. To assess potential endothelial impairment and early signs of atherosclerosis, flow-mediated (endothelium-dependent) and nitrate-mediated (endothelium independent) vasodilation, as well as von Willebrand factor antigen level and carotid artery intima-media thickness (IMT) were measured in patients with primary antiphospholipid syndrome and in healthy controls. Flow-mediated vasodilation in patients with primary APS was significantly lower than that of controls (3.43 ± 2.86% versus 7.96 ± 3.57%; P < 0.0001). We also found significantly higher von Willebrand antigen levels in patients with primary APS than in the control group (157.91 ± 52.45% versus 125.87 ± 32.8%; P = 0.012). Moreover, carotid artery IMT was significantly larger in the primary APS group compared to controls (0.714 ± 0.2 mm versus 0.58 ± 0.085 mm; P = 0.0037). Our results reflect ongoing endothelial damage and accelerated atherosclerosis in patients with primary APS, and suggest that vasoprotective therapy may be beneficial in the treatment of these patients. Lupus (2007) 16, 497—503.
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Affiliation(s)
- H Der
- 3rd Department of Medicine, Institute for Internal Medicine, University of Debrecen, Medical and Health Science Center, Debrecen, Hungary
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Roman MJ, Naqvi TZ, Gardin JM, Gerhard-Herman M, Jaff M, Mohler E. American Society of Echocardiography Report. Vasc Med 2016; 11:201-11. [PMID: 17288128 DOI: 10.1177/1358863x06070511] [Citation(s) in RCA: 101] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Noninvasive measures of atherosclerosis have emerged as adjuncts to standard cardiovascular disease (CVD) risk factors in an attempt to refine risk stratification and the need for more aggressive preventive strategies. Two such approaches, carotid artery imaging and brachial artery reactivity testing (BART), are ultrasound based. Numerous carotid artery imaging protocols have been used, and methodologic aspects are described in detail in this review. The panel recommends that protocols: (1) use end-diastolic (minimum dimension) images for intimal-medial thickness (IMT) measurements; (2) provide separate categorization of plaque presence and IMT; (3) avoid use of a single upper limit of normal for IMT because the measure varies with age, sex, and race; and (4) incorporate lumen measurement, particularly when serial measurements are performed to account for changes in distending pressure. Protocols may vary in the number of segments wherein IMT is measured, whether near wall is measured in addition to far wall, and whether IMT measurements are derived from B-mode or M-mode images, depending on the application. BART is a technique that requires meticulous attention to patient preparation and methodologic detail. Its application is substantially more challenging than is carotid imaging and remains largely a research technique that is not readily translated into routine clinical practice.
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Affiliation(s)
- Mary J Roman
- Weill Medical College of Cornell University, New York, NY, USA.
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