Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 3.252
Filtrar
1.
J Thromb Thrombolysis ; 50(1): 229-232, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32306290

RESUMO

The outbreak of 2019 novel coronavirus disease (COVID-19) began since early December 2019, and has been declared as a public health emergency by the World Health Organization. Due to the hypercoagulable state, blood stasis and endothelial injury, severe patients with COVID-19 are at high risk for thrombosis. We report a case of very severe COVID-19 complicated with venous thrombosis and arteriosclerosis obliterans of lower extremities. Risk stratification for deep vein thrombosis and peripheral arterial disease are of vital importance for the prognosis of COVID-19.


Assuntos
Arteriosclerose Obliterante/virologia , Infecções por Coronavirus/complicações , Pneumonia Viral/complicações , Trombose Venosa/virologia , Idoso , Humanos , Masculino , Pandemias
2.
Kidney Blood Press Res ; 44(5): 1219-1232, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31614351

RESUMO

BACKGROUND: The molecular mechanisms underlying the contribution of human arterial smooth muscle cells (HASMCs), one of the most important components of the arterial wall, to the pathogenesis of arteriosclerosis obliterans (ASO) remain elusive. METHODS: The expression levels of miR-29a in arterial walls were analyzed via real-time-polymerase chain reaction. An ASO cell model was established to investigate the expression of miR-29a on HASMCs. The interaction between miR-29a and platelet-derived growth factor receptor B (PDGFRB) was detected by luciferase reporter assay, and the alteration of the expression of PDGFRB was determined in platelet-derived growth factor­BB (PDGF-BB)-stimulated HASMCs transfected with miR-NC, miR-29a mimics, and miR-29a inhibitors. Further, HASMCs cell proliferation was investigated by cell counting kit-8 and EdU assays, and cell migrations were evaluated by Transwell and wound closure assays. RESULTS: The expression of miR-29a was remarkably downregulated in the arterial walls of ASO patients compared with normal arterial walls. Furthermore, expression of miR-29a in HASMCs under PDGF-BB stimulation was lower than vehicle control. PDGFRB was identified as a target of miR-29a in HASMCs, and miR-29a inhibited the proliferation and migration in PDGF-BB-induced HASMCs, via regulating the expression of PDGFRB. CONCLUSION: This study showed that miR-29a is downregulated in the arterial wall of ASO patients, as well as in the PDGF-BB-stimulated HASMCs. This alteration of miR-29a could upregulate target genes PDGFRB and inhibits the proliferation and migration of HASMCs. These findings discovered new mechanisms of ASO pathogenesis, and the miR-29a/PDGFRB axis could serve as potential therapy target of ASO.


Assuntos
Arteriosclerose Obliterante/genética , MicroRNAs/metabolismo , Músculo Liso Vascular/metabolismo , Movimento Celular , Proliferação de Células , Humanos , Transfecção
3.
Artigo em Russo | MEDLINE | ID: mdl-31513163

RESUMO

BACKGROUND: Cardiovascular diseases occupy a leading place in the structure of morbidity in Russia and other developed countries of the world. AIM: To study the efficiency of using enhanced external counterpulsation in the comprehensive rehabilitation treatment of patients with stages I-IIB obliterating atherosclerosis of the lower extremities (OALE). SUBJECTS AND METHODS: A total of 68 patients aged 50 to 78 years with stages I-IIb oale in the presence of clinical symptomatology of arterial insufficiency were examined and treated. According to the method of treatment, the patients were divided into two groups: 1) 32 people received a standard drug therapy (a control group). 2) 36 patients had an enhanced external counterpulsation therapy cycle during the standard therapy (a study group). The frequency of characteristic complaints, pain-free walking distance, peripheral hemodynamics, and the ankle-brachial index (abi) were assessed. RESULTS: Posttreatment leg pain on walking persisted in 11 (30.6%) and 25 (78.1%) patients in the study group and in the control one, respectively; there were leg cramps in 9 (25.0%) and 14 (43.8%) people and cold feet in 5 (13.9%) and 25 (78.1%) patients, respectively (p<0.05). In the study group, the considerable increase in pain-free walking distance as compared to baseline values averaged 250±31.2 m (p<0.05), while that in the control group was only 64.5±25.1 m (p>0.05). The posttreatment increase in the leg and foot rheographic indices averaged 23.9 and 23.2%, respectively, in the study group and 11.9 and 12.3%, respectively, in the control group. The increases in abi in the anterior and posterior tibial arteries were 31.4 and 35.2%, respectively, in the study group (p<0.05), and 16.0 and 13.0%, respectively, in the control group (p>0.05). CONCLUSION: The findings suggest that the use of enhanced external counterpulsation in the combination therapy of patients with stages I-IIb oale is a clinically effective and safe treatment.


Assuntos
Arteriosclerose Obliterante/terapia , Contrapulsação/métodos , Idoso , Humanos , Extremidade Inferior , Pessoa de Meia-Idade , Federação Russa , Resultado do Tratamento
4.
Zhongguo Yi Xue Ke Xue Yuan Xue Bao ; 41(2): 256-260, 2019 Apr 28.
Artigo em Chinês | MEDLINE | ID: mdl-31060683

RESUMO

Atherosclerosis-related diseases have increasingly become health concerns with the increased living conditions and aging.Globally,about 200 million people have suffered from arteriosclerosis obliterans(ASO),which can even be life-threatening in some cases.The past seven decades have witnessed the rapid advances in the treatment of ASO,which has developed from surgery to endovascular interventions including plain balloon angioplasty,bare metal stent placement,drug-coated balloon,and drug-eluting stent.However,the roles of these new techniques for femoral-popliteal lesions,especially their real-world clinical outcomes and indications,remain unclear.This article reviews the latest evidences on the use of drug-eluting devices in treating femoral-popliteal arteriosclerosis obliterans.


Assuntos
Arteriosclerose Obliterante/terapia , Stents Farmacológicos/tendências , Angioplastia com Balão , Humanos , Artéria Poplítea/patologia , Stents , Resultado do Tratamento
5.
J Atheroscler Thromb ; 26(7): 616-623, 2019 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-30487347

RESUMO

AIMS: This study elucidates the association of macroangiopathy development in type 2 diabetes patients with various arteriosclerosis risk factors (ARFs) and results of cardio-ankle vascular index (CAVI) and ankle-brachial pressure index (ABI). METHODS: The correlation between current and past macroangiopathy development, with ARFs or CAVI/ABI data, was retrospectively analyzed using multivariate logistic regression in 816 patients with type 2 diabetes at a single center. C-statistics combining some independent variables selected using the stepwise method were evaluated. RESULTS: CAVI was significantly correlated with macroangiopathies, including coronary artery disease (CAD), arteriosclerosis obliterans (ASO), and stroke with odds ratios (OR) of 1.20, 1.22, and 1.19, respectively. ABI significantly correlated with ASO and stroke with respective OR of 13.6 and 2.47, but not with CAD. Areas under the receiver operating characteristic curves (ROCs) revealed the accuracy of detecting ASO and stroke was increased by the combination of CAVI+ABI (0.94 and 0.74, respectively). However, areas under the ROC for the presence of CAD can be increased by the combination of CAVI and ARFs especially including dyslipidemia. CONCLUSION: CAVI/ABI and some ARFs are useful tools in daily clinical care units to identify the current and past existence of macroangiopathy in patients with type 2 diabetes, but the prediction weights using these factors were different among CAD, ASO, and stroke.


Assuntos
Índice Tornozelo-Braço , Tornozelo/irrigação sanguínea , Diabetes Mellitus Tipo 2/complicações , Angiopatias Diabéticas/diagnóstico , Rigidez Vascular/fisiologia , Idoso , Arteriosclerose Obliterante/diagnóstico , Arteriosclerose Obliterante/etiologia , Doença da Artéria Coronariana/diagnóstico , Doença da Artéria Coronariana/etiologia , Diabetes Mellitus Tipo 2/etiologia , Angiopatias Diabéticas/etiologia , Angiopatias Diabéticas/metabolismo , Feminino , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Fatores de Risco , Acidente Vascular Cerebral/diagnóstico , Acidente Vascular Cerebral/etiologia
7.
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi ; 32(12): 1576-1580, 2018 12 15.
Artigo em Chinês | MEDLINE | ID: mdl-30569686

RESUMO

Objective: To discuss the effectiveness of femoral-femoral artery bypass grafting combined with transverse tibial bone transporting in treatment of lower extremity arteriosclerosis obliterans (ASO) or combined with diabetic foot. Methods: Between March 2014 and June 2016, 9 patients with lower extremity ASO or combined with diabetic feet were treated with femoral-femoral artery bypass grafting and transverse tibial bone transporting. All patients were male, aged from 63 to 82 years with an average of 74.2 years. The disease duration of ASO was 1.5-22.0 months (mean, 10.5 months). All cases were severe unilateral iliac arterial occlusion, including 5 cases of the left side and 4 cases of the right side. There were 7 cases with superficial femoral and/or infrapopliteal artery disease. There were 7 cases of ASO and 2 cases of ASO combined with diabetic foot (Wagner grade 4); all the ASO were grade Ⅳ according to Fontaine criteria. All patients had rest pain before operation, and the ankle brachial index was 0.24±0.12. In femoral-femoral artery bypass grafting operations, artificial blood vessels were used in 7 cases and autologous saphenous vein were used in the other 2 cases. The tibial bone transverse transporting began on the 8th day after operation by 1 mm per day and once per 6 hours; after transported for 2-3 weeks, it was moved back. The whole course of treatment was 10-14 weeks. Results: The incision of tibial bone transverse transporting was necrotic in 1 case, and healed after dressing change. There was no obvious complication at the orifice of the needle. The other patients had no incision complication. The granulation tissue of foot wound was growing quickly after tibial bone transverse transporting, and the wound was reduced after 2-3 weeks. All the 9 patients were followed up 12-32 months (mean, 19 months). The ankle brachial index was 0.67±0.09 at 2 months postoperatively, which was significantly higher than that before operation ( t=17.510, P=0.032). All the feet ulcer wounds healed and the healing time was 6.7-9.4 weeks (mean, 7.7 weeks). During follow-up, color Doppler ultrasound or CT examination revealed grafted blood vessel patency. The external fixator was removed at 12-14 weeks after operation. One case died of sudden myocardial infarction at 14 months after operation, and there was no lymphatic leakage. The patency rate of femoral-femoral bypass was 100% at 1 year after operation. The tibial transverse bone grafting healed with tibia at 4-6 months after operation. At last follow-up, the effective rate was 100%. Conclusion: Femoral-femoral artery bypass grafting combined with transverse tibial bone transporting is an effective method in the treatment of lower extremity ASO or combined with diabetic foot.


Assuntos
Arteriosclerose Obliterante , Pé Diabético , Artéria Femoral , Tíbia , Idoso , Idoso de 80 Anos ou mais , Arteriosclerose Obliterante/cirurgia , Pé Diabético/cirurgia , Artéria Femoral/cirurgia , Humanos , Extremidade Inferior , Masculino , Pessoa de Meia-Idade , Tíbia/cirurgia , Resultado do Tratamento
8.
Vasc Health Risk Manag ; 14: 225-232, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30271161

RESUMO

Background: The aim was to evaluate the significance of arteriosclerosis obliterans-related biomarkers in patients with type 2 diabetes mellitus (T2DM), and to compare the effects of sarpogrelate, eicosapentaenoic acid (EPA) and pitavastatin on these markers. Patients and methods: Seventy-two arteriosclerosis obliterans patients with T2DM were classified into two groups, pitavastatin with either sarpogrelate (PS) or EPA (PE). We observed no differences in all biomarkers between the PS and PE groups before treatments. Results: The levels of body mass index, hemoglobin A1c, soluble E-selectin, soluble vascular cell adhesion molecule 1, plasminogen activator inhibitor-1 and platelet-derived microparticle in the PE group decreased significantly after treatment. The ankle branchial pressure index and adiponectin levels significantly increased in the PE group after treatment compared with the PS group. Conclusion: These results suggest that combination therapy using pitavastatin and EPA possesses an antiatherosclerotic effect and may be beneficial for prevention of vascular complications in patients with T2DM.


Assuntos
Arteriosclerose Obliterante/prevenção & controle , Diabetes Mellitus Tipo 2/tratamento farmacológico , Angiopatias Diabéticas/prevenção & controle , Ácido Eicosapentaenoico/uso terapêutico , Inibidores de Hidroximetilglutaril-CoA Redutases/uso terapêutico , Inibidores da Agregação de Plaquetas/uso terapêutico , Quinolinas/uso terapêutico , Succinatos/uso terapêutico , Adiponectina/sangue , Idoso , Idoso de 80 Anos ou mais , Índice Tornozelo-Braço , Arteriosclerose Obliterante/sangue , Arteriosclerose Obliterante/diagnóstico , Biomarcadores/sangue , Diabetes Mellitus Tipo 2/sangue , Diabetes Mellitus Tipo 2/diagnóstico , Angiopatias Diabéticas/sangue , Angiopatias Diabéticas/diagnóstico , Quimioterapia Combinada , Ácido Eicosapentaenoico/efeitos adversos , Feminino , Humanos , Inibidores de Hidroximetilglutaril-CoA Redutases/efeitos adversos , Japão , Modelos Lineares , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Inibidores da Agregação de Plaquetas/efeitos adversos , Quinolinas/efeitos adversos , Fatores de Risco , Succinatos/efeitos adversos , Fatores de Tempo , Resultado do Tratamento
9.
Int Heart J ; 59(5): 1041-1046, 2018 Sep 26.
Artigo em Inglês | MEDLINE | ID: mdl-30101855

RESUMO

The prevalence of arteriosclerosis obliterans (ASO) and critical limb ischemia (CLI) is currently increasing, and arterial reconstruction is often attempted to salvage the limb. Some patients cannot undergo attempted revascularization because of contraindications, and they only receive conservative treatment. In this study, we investigate the comorbidities and survival rates of patients with CLI who receive conservative treatment. Thirty-five patients with CLI due to ASO, who had not undergone revascularization surgery (C group), were enrolled. As controls, 136 patients with CLI due to ASO who did undergo revascularization (R group), mainly via bypass surgery, were enrolled. Coronary artery disease, heart failure, and respiratory dysfunction were factors indicating conservative treatment. Limb salvage rates and survival rates were not significantly different between the two groups. Patients who had survived for less than two years after surgery had a higher prevalence of chronic heart failure, cardiovascular disease, and end-stage renal disease compared to patients who had survived for more than two years. The use of statins, dual antiplatelets, aspirin, or warfarin did not influence whether a patient survived for longer than two years. 77% of patients survived for more than two years after receiving only conservative therapies. Surgical revascularization did not improve the prognosis of patients with CLI as compared with the conservative therapy. Clinicians might start with conservative treatment while considering other treatment options for patients with CLI.


Assuntos
Arteriosclerose Obliterante/epidemiologia , Tratamento Conservador/métodos , Salvamento de Membro/métodos , Extremidade Inferior/patologia , Doença Arterial Periférica/patologia , Idoso , Idoso de 80 Anos ou mais , Arteriosclerose Obliterante/complicações , Doenças Cardiovasculares/epidemiologia , Comorbidade , Tratamento Conservador/estatística & dados numéricos , Feminino , Insuficiência Cardíaca/epidemiologia , Humanos , Isquemia/patologia , Falência Renal Crônica/epidemiologia , Extremidade Inferior/irrigação sanguínea , Masculino , Pessoa de Meia-Idade , Doença Arterial Periférica/tratamento farmacológico , Doença Arterial Periférica/cirurgia , Prevalência , Resultado do Tratamento
10.
Zhongguo Zhen Jiu ; 38(8): 809-13, 2018 Aug 12.
Artigo em Chinês | MEDLINE | ID: mdl-30141289

RESUMO

OBJECTIVE: To observe the effect difference of warming needling combined with Zhuyu Tongluo Xuebi decoction and ciloprost for arteriosclerosis obliterans (ASO) with stasis. METHODS: A total of 96 ASO patients with stasis were randomly assigned into a combination group and a western medication group, 48 cases in each group. Anti-hypertension, glucose-lowering and lipid lowering therapies were applied in the two groups. Ciloprost was prescribed orally in the western medication group, twice a day, 100 mg a time. The main acupoints in the combination group were Sanyinjiao (SP 6), Yinlingquan (SP 9), Zusanli (ST 36), Guanyuan (CV 4), and Xuehai (SP 10), matched with Yanglingquan (GB 34) and Weizhong (BL 40). Warming needling was used at Sanyinjiao (SP 6), Zusanli (ST 36), Xuehai (SP 10) and Guanyuan (CV 4), 5 times a week, once a day, 20 min a time. At the same time, self-made Zhuyu Tongluo Xuebi decoction was applied in the combination group, 1 dose a day, twice a day. All the treatment was given for continuous 3 courses, 1 month as a course. The indexes were the symptom scores for cool limb skin, sour swelling, numbness, pain, abnormal complexion, ankle brachial index (ABI) and blood biochemical indexes, including fasting blood-glucose (FPG), triacylglycerol (TG), cholesterol total (TC), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), glutamic-pyruvic transaminase (ALT), glutamic-oxalacetic transaminase (AST), serum creatinine (Scr) and blood urea nitrogen (BUN). The adverse reactions were recorded. The clinical effect was evaluated. Two-month follow-up was carried out. RESULTS: After treatment, the symptom scores for cool limb skin, sour swelling, numbness, pain, abnormal complexion and total score decreased in the two groups (all P<0.05), with better results in the combination group (all P<0.05). The bilateral ABI were higher than those before treatment in the two groups (all P<0.05), with better results in the combination group (both P<0.05). The FPG, TG, TC, HDL-C, LDL-C, ALT, AST, Scr, BUN before and after treatment had no statistical significance in the two groups (all P>0.05). There was no adverse reaction on acupuncture and moxibustion. The total effective rate of the combination group was 95.8% (46/48), which was better than 91.7% (44/48) of the western medication group (P<0.05). The recurrence and aggravation rate in the combination group was 8.7% (4/46), which was lower than 18.2% (8/44) in the western medication group (P<0.05). CONCLUSION: Warming needling combined with Zhuyu Tongluo Xuebi decoction for ASO are better than simple oral ciloprost, with safety.


Assuntos
Terapia por Acupuntura , Arteriosclerose Obliterante , Moxibustão , Pontos de Acupuntura , Medicamentos de Ervas Chinesas , Humanos
11.
Circ J ; 82(8): 2165-2174, 2018 07 25.
Artigo em Inglês | MEDLINE | ID: mdl-29877199

RESUMO

BACKGROUND: The clinical usefulness of peripheral blood (PB) mononuclear cell (MNC) transplantation in patients with peripheral arterial disease (PAD), especially in those with mild-to-moderate severity, has not been fully clarified.Methods and Results:A randomized clinical trial was conducted to evaluate the efficacy and safety of granulocyte colony-stimulating factor (G-CSF)-mobilized PBMNC transplantation in patients with PAD (Fontaine stage II-IV and Rutherford category 1-5) caused by arteriosclerosis obliterans or Buerger's disease. The primary endpoint was progression-free survival (PFS). In total, 107 subjects were enrolled. At baseline, Fontaine stage was II/III in 82 patients and IV in 21, and 54 patients were on hemodialysis. A total of 50 patients had intramuscular transplantation of PBMNC combined with standard of care (SOC) (cell therapy group), and 53 received SOC only (control group). PFS tended to be improved in the cell therapy group than in the control group (P=0.07). PFS in Fontaine stage II/III subgroup was significantly better in the cell therapy group than in the control group. Cell therapy-related adverse events were transient and not serious. CONCLUSIONS: In this first randomized, large-scale clinical trial of G-CSF-mobilized PBMNC transplantation, the cell therapy was tolerated by a variety of PAD patients. The PBMNC therapy was significantly effective for inhibiting disease progression in mild-to-moderate PAD.


Assuntos
Leucócitos Mononucleares/transplante , Doença Arterial Periférica/terapia , Transplante de Células-Tronco de Sangue Periférico/métodos , Idoso , Arteriosclerose Obliterante/complicações , Progressão da Doença , Feminino , Fator Estimulador de Colônias de Granulócitos/uso terapêutico , Mobilização de Células-Tronco Hematopoéticas/métodos , Humanos , Masculino , Pessoa de Meia-Idade , Doença Arterial Periférica/etiologia , Intervalo Livre de Progressão , Tromboangiite Obliterante/complicações , Transplante Autólogo
12.
Zhongguo Zhong Yao Za Zhi ; 43(8): 1701-1707, 2018 Apr.
Artigo em Chinês | MEDLINE | ID: mdl-29751719

RESUMO

To evaluate the clinical efficacy of Panax notoginseng extract combined with alprostadil in the treatment of arteriosclerosis occlusion and investigate its effects on the degree of atherosclerosis. CNKI, Wanfang, VIP journal database, Chinese biomedical literature database(CBM), PubMed, the Cochrane Library and Science Citation Index(SCI) database were searched between inception to December 2017 for relevant studies. Two researchers independently screened and extracted the literature in strict accordance with the inclusion criteria and exclusion criteria. The bias risk assessment method recommended by Cochrane was used to evaluate the bias risk and extract data, and then Review Manager 5.3 was used for Meta analysis. 10 RCTs involving a total of 1 032 cases were included in the study. Analysis results showed that the P. notoginseng extract combined with alprostadil had higher clinical efficacy than alprostadil alone in the treatment of arteriosclerosis occlusion disorder, with statistically significant difference(OR=6.39, 95%CI[3.97, 10.30], P<0.000 01); the atherosclerosis was obviously improved, including ankle brachial index(ABI) (MD=0.08, 95%CI[0.04, 0.13], P=0.000 3), toe brachial index(TBI) (MD=0.09, 95%CI[0.05, 0.12], P<0.000 01), and maximum walking distance(WD) (MD=471.62, 95%CI[383.54, 559.70], P<0.000 01). Studies have shown that P. notoginseng extract combined with the conventional treatment had significantly improved clinical efficacy in the treatment of arteriosclerosis occlusion, and could improve the atherosclerosis degree of lower extremities. However, the quality of the included literature was not high, in addition, due to the small number of included literature as well as bias and low-quality bias in some of the literature, more high quality RCTs are still needed to further verify the clinical effect of P. notoginseng extract in the treatment of arteriosclerosis occlusion.


Assuntos
Arteriosclerose Obliterante , Medicamentos de Ervas Chinesas , Alprostadil , Humanos
13.
Biosci Rep ; 38(5)2018 10 31.
Artigo em Inglês | MEDLINE | ID: mdl-29752344

RESUMO

Aberrant vascular smooth muscle cell (VSMC) migration has been implicated in a variety of vascular disorders, while the signal pathways governing this process remain unclear. Here, we investigated whether miRNAs, which are strong post-transcriptional regulators of gene expression, could alter VSMC migration. We detected the expression of miR-4463 in the plasma of patients with atherosclerosis and in human aortic smooth muscle cells under hypoxia-ischemia condition, and investigated the migration effect and its downstream pathways. The results have shown that whether in clinical AS patients or hypoxic cells, the expression of miR-4463 was lower than that of normal group, then the number of migrating cells in the miR-4463 mimic intervention group was significantly decreased compared with the normal group and miR-4463 inhibitor instead. Furthermore, the expression of angiomotin (AMOT) in gastrocnemius muscle and femoral artery of patients was significantly higher than that of the control group. The protein level of AMOT in miR-4463 mimic intervention group was significantly decreased, and its level was reversed by inhibiting miR-4463. In summary, these results indicate that miR-4463 is a novel modulator of VSMC migration by targetting AMOT expression. Regulating miR-4463 or its specific downstream target genes in VSMCs may represent an attractive approach for the treatment of vascular diseases.


Assuntos
Aorta/patologia , Arteriosclerose Obliterante/patologia , Peptídeos e Proteínas de Sinalização Intercelular/genética , Proteínas de Membrana/genética , MicroRNAs/metabolismo , Miócitos de Músculo Liso/citologia , Idoso , Idoso de 80 Anos ou mais , Antígenos CD/genética , Antígenos CD/metabolismo , Aorta/citologia , Arteriosclerose Obliterante/genética , Caderinas/genética , Caderinas/metabolismo , Estudos de Casos e Controles , Hipóxia Celular/genética , Movimento Celular/genética , Células Cultivadas , Feminino , Regulação da Expressão Gênica , Humanos , Peptídeos e Proteínas de Sinalização Intercelular/metabolismo , Masculino , Proteínas de Membrana/metabolismo , MicroRNAs/antagonistas & inibidores , MicroRNAs/genética , Pessoa de Meia-Idade , Músculo Liso Vascular/citologia , Miócitos de Músculo Liso/fisiologia , Regulação para Cima
14.
Diagn Interv Imaging ; 99(9): 561-568, 2018 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-29753661

RESUMO

PURPOSE: To evaluate the use of 80 kVp and iterative model reconstruction (IMR) in lower extremity computed tomography angiography (CTA). MATERIALS AND METHODS: Sixty patients were randomly assigned to Group A or Group B (both n=30) to further undergo CTA. Group A received Protocol 1 (P1) with 120 kVp, 180mAs, and 100mL of contrast agent with filtered back-projection (FBP). Group B received Protocol 2 (P2) and Protocol 3 (P3) with 80 kVp, 140mAs and 75mL of contrast agent with hybrid iterative reconstruction (P2) and IMR (P3). Mean intravascular attenuation (MIA), image noise, contrast-to-noise ratio (CNR), and signal-to-noise ratio (SNR) were compared. Radiologists assessed image quality on a 5-point scale, and radiation was compared between both groups. RESULTS: Group A had 9 men and 21 women (mean age, 68.2±9.3 years [range: 53-85 years]), and Group B had 20 men and 10 women (mean age, 64.8±10.4 years [range: 37-81 years]). The MIA of P2 and P3 were significantly larger than that of P1 (P<0.01). The CNR and SNR of P3 were significantly higher than those of P1 and P2 (P<0.01). The interobserver agreement had Kappa values of 0.78, 0.77, and 0.81 for P1, P2, P3, respectively. The mean CT volume dose index and dose-length product of Group B were lower than those of Group A (P<0.01). CONCLUSION: Lower extremity CTA using 80 kVp and IMR is useful for lower radiation and contrast agent dose while preserving image quality. IMR can also provide better image quality for small-caliber vessels below the knee than HIR.


Assuntos
Arteriosclerose Obliterante/diagnóstico por imagem , Angiografia por Tomografia Computadorizada/métodos , Extremidade Inferior/irrigação sanguínea , Extremidade Inferior/diagnóstico por imagem , Adulto , Idoso , Idoso de 80 Anos ou mais , Meios de Contraste , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Doses de Radiação , Interpretação de Imagem Radiográfica Assistida por Computador , Razão Sinal-Ruído
15.
Cell Physiol Biochem ; 46(4): 1566-1580, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29689557

RESUMO

BACKGROUND/AIMS: Increasing evidence links microRNAs to the pathogenesis of peripheral vascular disease. We recently found microRNA-125b (miR-125b) to be one of the most significantly down­regulated microRNAs in human arteries with arteriosclerosis obliterans (ASO) of the lower extremities. However, its function in the process of ASO remains unclear. This study aimed to investigate the expression, regulatory mechanisms, and functions of miR-125b in the process of ASO. METHODS: Using the tissue explants adherent method, vascular smooth muscle cells (VSMCs) were prepared for this study. A rat carotid artery balloon injury model was constructed to simulate the development of vascular neointima, and a lentiviral transduction system was used to overexpress serum response factor (SRF) or miR-125b. Quantitative real­time PCR (qRT­PCR) was used to detect the expression levels of miR­125b and SRF mRNA. Western blotting was performed to determine the expression levels of SRF and Ki67. In situ hybridization analysis was used to analyze the location and expression levels of miR-125b. CCK-8 and EdU assays were used to assess cell proliferation, and transwell and wound closure assays were performed to measure cell migration. Flow cytometry was used to evaluate cell apoptosis, and a dual-luciferase reporter assay was conducted to examine the effects of miR­125b on SRF. Immunohistochemistry and immunofluorescence analyses were performed to analyze the location and expression levels of SRF and Ki67. RESULTS: miR-125b expression was decreased in ASO arteries and platelet-derived growth factor (PDGF)-BB-stimulated VSMCs. miR-125b suppressed VSMC proliferation and migration but promoted VSMC apoptosis. SRF was determined to be a direct target of miR-125b. Exogenous miR-125b expression modulated SRF expression and inhibited vascular neointimal formation in balloon-injured rat carotid arteries. CONCLUSIONS: These findings demonstrate a specific role of the miR-125b/SRF pathway in regulating VSMC function and suggest that modulating miR-125b levels might be a novel approach for treating ASO.


Assuntos
MicroRNAs/metabolismo , Fator de Resposta Sérica/metabolismo , Regiões 3' não Traduzidas , Adulto , Idoso , Animais , Antagomirs/metabolismo , Apoptose/efeitos dos fármacos , Arteriosclerose Obliterante/genética , Arteriosclerose Obliterante/metabolismo , Arteriosclerose Obliterante/patologia , Sequência de Bases , Becaplermina , Lesões das Artérias Carótidas/metabolismo , Lesões das Artérias Carótidas/patologia , Movimento Celular/efeitos dos fármacos , Proliferação de Células/efeitos dos fármacos , Células Cultivadas , Regulação para Baixo/efeitos dos fármacos , Feminino , Humanos , Hibridização in Situ Fluorescente , Masculino , MicroRNAs/antagonistas & inibidores , MicroRNAs/genética , Pessoa de Meia-Idade , Músculo Liso Vascular/citologia , Músculo Liso Vascular/metabolismo , Proteínas Proto-Oncogênicas c-sis/farmacologia , Ratos , Ratos Sprague-Dawley , Alinhamento de Sequência , Fator de Resposta Sérica/química , Fator de Resposta Sérica/genética
16.
Scand J Clin Lab Invest ; 78(4): 269-274, 2018 07.
Artigo em Inglês | MEDLINE | ID: mdl-29553861

RESUMO

Animal studies have indicated that olfactomedin 2 (OLFM2) is involved in the process of vascular remolding. The aim of the present study was to investigate circulating OLFM2 levels in lower extremity arteriosclerosis obliterans (LEASO) patients and the association of OLFM2 with postoperative restenosis in patients. A total of 203 LEASO patients were enrolled in the present study. Plasma OLFM2 was measured before and 6 h after interventional therapy. After 6 months, patients were divided into a restenosis group and a non-restenosis group. Inter-group and intra-group differences in plasma OLFM2 were compared. The correlation between plasma OLFM2 and the severity of restenosis was analyzed by Spearman's correlation analysis. An receiver operating characteristic (ROC) curve was used to evaluate the predictive efficacy of plasma OLFM2 on restenosis. Logistic regression was used to determine the risk factors for restenosis. Postoperative OLFM2 in the restenosis group was significantly higher compared with the non-restenosis group (34.07 ± 5.76 ng/mL vs. 19.53 ± 2.99 ng/mL). No significant difference in preoperative plasma OLFM2 levels was identified between the two groups (10.92 ± 2.49 ng/mL vs. 11.54 ± 3.18 ng/mL). Postoperative OLFM2 levels were positively correlated with the severity of restenosis (r = 0.728, p < .001). The area under the ROC curve was 0.902 (95% confidence interval (CI): 0.874-0.965), with a cutoff value of 26.91 ng/mL (95% CI: 26.16-28.32). Plasma OLFM2 was an independent risk factor for restenosis. Our results suggest that plasma OLFM2 is a potential biomarker for restenosis and may be a novel target for the treatment of restenosis.


Assuntos
Arteriosclerose Obliterante/sangue , Arteriosclerose Obliterante/complicações , Reestenose Coronária/sangue , Reestenose Coronária/diagnóstico , Proteínas da Matriz Extracelular/sangue , Glicoproteínas/sangue , Extremidade Inferior/patologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Arteriosclerose Obliterante/cirurgia , Reestenose Coronária/etiologia , Feminino , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Curva ROC , Fatores de Risco , Índice de Gravidade de Doença
17.
Ann Vasc Surg ; 49: 30-38, 2018 May.
Artigo em Inglês | MEDLINE | ID: mdl-29455014

RESUMO

BACKGROUND: Few reports have described the effects of medication on the wound healing of ischemic ulcers after revascularization. This study was conducted to investigate the effects of cilostazol on wound healing in patients who underwent infrainguinal bypass for ischemic tissue loss. METHODS: Two hundred sixty-three limbs undergoing de novo infrainguinal bypass for tissue loss from January 2004 to December 2015 were divided into 2 groups based on whether or not cilostazol was administered after surgery. The end point was wound healing. The 1-year outcomes of the groups were analyzed using the Kaplan-Meier method, and a propensity score matching analysis was performed to examine the effects of cilostazol on wound healing. In addition, the significant predictors were determined using a Cox proportional hazards regression analysis. RESULTS: Sixty-one and 202 limbs were included in the cilostazol and non-cilostazol group, respectively. The cilostazol group showed superior wound healing to the non-cilostazol group (cilostazol versus non-cilostazol, 1-year wound healing rate: 92% vs. 81%; median wound healing time: 45 vs. 78 days, P = 0.002). The results of the cilostazol group remained superior after a propensity score matching (cilostazol versus non-cilostazol, 1-year wound healing rate: 95% vs. 83%; median wound healing time: 45.5 vs. 57 days, P = 0.048). A Cox proportional hazards regression analysis indicated that foot infection, Rutherford classification, diabetes mellitus, coronary artery disease, angiosome, the administration of cilostazol, and graft patency were significant factors that influenced wound healing. CONCLUSIONS: The postoperative use of cilostazol help to promote wound healing after open surgery.


Assuntos
Arteriosclerose Obliterante/cirurgia , Implante de Prótese Vascular , Isquemia/cirurgia , Inibidores da Fosfodiesterase 3/uso terapêutico , Tetrazóis/uso terapêutico , Veias/transplante , Cicatrização/efeitos dos fármacos , Adulto , Idoso , Idoso de 80 Anos ou mais , Arteriosclerose Obliterante/diagnóstico , Arteriosclerose Obliterante/fisiopatologia , Implante de Prótese Vascular/efeitos adversos , Cilostazol , Bases de Dados Factuais , Feminino , Humanos , Isquemia/diagnóstico , Isquemia/fisiopatologia , Estimativa de Kaplan-Meier , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Inibidores da Fosfodiesterase 3/efeitos adversos , Pontuação de Propensão , Modelos de Riscos Proporcionais , Estudos Retrospectivos , Fatores de Risco , Tetrazóis/efeitos adversos , Fatores de Tempo , Sobrevivência de Tecidos , Resultado do Tratamento , Grau de Desobstrução Vascular
18.
Presse Med ; 47(1): 62-65, 2018 Jan.
Artigo em Francês | MEDLINE | ID: mdl-29370994

RESUMO

Women have a risk of LEAD (lower-extremity artery disease)similar to men's risk. Symptoms are often absent, atypical or underestimated, leading to diagnosis in the most severe stages. Medical care is often less well adapted. In cases of revascularization, women have a higher morbidity rate than men, regardless of the severity grade and procedure chosen.


Assuntos
Arteriosclerose Obliterante , Perna (Membro)/irrigação sanguínea , Amputação/estatística & dados numéricos , Arteriosclerose Obliterante/diagnóstico , Arteriosclerose Obliterante/epidemiologia , Arteriosclerose Obliterante/prevenção & controle , Arteriosclerose Obliterante/cirurgia , Doenças Assintomáticas , Doenças Cardiovasculares/epidemiologia , Ensaios Clínicos como Assunto , Gerenciamento Clínico , Feminino , Humanos , Isquemia/etiologia , Isquemia/cirurgia , Masculino , Seleção de Pacientes , Prevalência , Fatores de Risco , Fatores Sexuais , Enxerto Vascular/métodos
19.
J Vasc Surg ; 67(3): 826-837, 2018 03.
Artigo em Inglês | MEDLINE | ID: mdl-28965798

RESUMO

OBJECTIVE: The aim of this study was to elucidate the efficacy of paramalleolar or inframalleolar bypass (PIMB) in hemodialysis-dependent (HD) patients with critical limb ischemia (CLI) and nonhemodialysis-dependent (NHD) patients in terms of clinical outcomes. METHODS: Between January 2000 and December 2013, there were 333 consecutive arteriosclerosis obliterans patients with CLI who underwent 401 PIMB procedures for limb salvage (LS). Of the 333 patients, 188 (56.5%) were HD patients. Vein grafts were exclusively used, and 172 paramalleolar and 229 inframalleolar bypasses were performed. Five-year primary and secondary cumulative graft patency, LS, and amputation-free survival (AFS) rates were compared between the two groups, and the independent determinants of these outcomes were identified in each group. RESULTS: The 5-year primary and secondary cumulative graft patency rates were 53% and 82% in HD patients and 69% and 92% in NHD patients (primary cumulative graft patency, P < .05; secondary cumulative graft patency, nonsignificant), respectively. The LS rates were 87% and 99% (P < .01) in HD patients and NHD patients, respectively. Overall, 48% and 70% of HD and NHD patients were ambulatory before PIMB (P < .01), and 73% and 85% of HD and NHD patients were ambulatory 12 months after PIMB (including 1-year survivors; nonsignificant), respectively, demonstrating drastic post-PIMB improvement in HD patients. The 5-year AFS rates in the HD and NHD groups were 27% and 69% (P < .01), respectively, demonstrating very poor AFS rates in HD patients. In HD patients, factors negatively associated with AFS were female gender (hazard ratio [HR], 2.102; 95% confidence interval [CI], 1.254-3.524), history of congestive heart failure (HR, 2.075; 95% CI, 1.395-3.085), and preoperative nonambulatory status (HR, 1.974; 95% CI, 1.305-2.986), whereas older age (HR, 2.601; 95% CI, 1.372-4.931) and history of congestive heart failure (HR, 2.928; 95% CI, 1.496-5.731) were identified as independent factors negatively associated with AFS in NHD patients. CONCLUSIONS: The use of PIMB for CLI was associated with excellent LS rates in both HD and NHD patients with low operative mortality and complications. However, the AFS rate observed in HD patients was significantly lower than that observed in NHD patients, indicating the necessity of a specific management program to improve AFS after LS in HD patients.


Assuntos
Braço/irrigação sanguínea , Arteriosclerose Obliterante/cirurgia , Isquemia/cirurgia , Diálise Renal , Insuficiência Renal Crônica/cirurgia , Veia Safena/transplante , Enxerto Vascular/métodos , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Amputação , Arteriosclerose Obliterante/diagnóstico , Arteriosclerose Obliterante/mortalidade , Arteriosclerose Obliterante/fisiopatologia , Comorbidade , Estado Terminal , Intervalo Livre de Doença , Feminino , Humanos , Isquemia/diagnóstico , Isquemia/mortalidade , Isquemia/fisiopatologia , Estimativa de Kaplan-Meier , Rim/fisiopatologia , Salvamento de Membro , Masculino , Pessoa de Meia-Idade , Modelos de Riscos Proporcionais , Diálise Renal/efeitos adversos , Diálise Renal/mortalidade , Insuficiência Renal Crônica/diagnóstico , Insuficiência Renal Crônica/mortalidade , Insuficiência Renal Crônica/fisiopatologia , Estudos Retrospectivos , Fatores de Risco , Veia Safena/fisiopatologia , Fatores Sexuais , Fatores de Tempo , Resultado do Tratamento , Enxerto Vascular/efeitos adversos , Enxerto Vascular/mortalidade , Grau de Desobstrução Vascular
20.
Presse Med ; 47(1): 56-61, 2018 Jan.
Artigo em Francês | MEDLINE | ID: mdl-29273182

RESUMO

Medical management of peripheral arterial disease (PAD) patients is aimed at limb symptom relief and reducing systemic major adverse events risk. For the first purpose: exercise therapy is recommended in case of claudication; multidisciplinary evaluation for surgical options is mandatory in case of critical limb ischaemia. Reducing cardiac and stroke risk can be achieved through: statin prescription in most of the cases; antiplatelet agents in symptomatic PAD patients; cardio-vascular risk factors control.


Assuntos
Perna (Membro)/irrigação sanguínea , Doença Arterial Periférica/tratamento farmacológico , Inibidores da Enzima Conversora de Angiotensina/uso terapêutico , Arteriosclerose Obliterante/tratamento farmacológico , Gerenciamento Clínico , Humanos , Inibidores de Hidroximetilglutaril-CoA Redutases/uso terapêutico , Claudicação Intermitente/tratamento farmacológico , Isquemia/tratamento farmacológico , Isquemia/cirurgia , Educação de Pacientes como Assunto , Doença Arterial Periférica/complicações , Doença Arterial Periférica/cirurgia , Inibidores da Agregação de Plaquetas/uso terapêutico , Fatores de Risco , Acidente Vascular Cerebral/prevenção & controle , Trombofilia/tratamento farmacológico , Trombofilia/etiologia , Enxerto Vascular/métodos
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA