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1.
BMC Public Health ; 24(1): 2431, 2024 Sep 06.
Article in English | MEDLINE | ID: mdl-39243068

ABSTRACT

BACKGROUND: Atherogenic index of plasma (AIP) index is an important marker of insulin resistance and a significant risk factor for cardiovascular disease. Abdominal aortic calcification (AAC) is significantly associated with subclinical atherosclerotic disease. However, there are no studies that have examined the relationship between AIP index and AAC, so we investigated the potential association between them in the general population. METHODS: This was a cross-sectional study using data from the National Health and Nutrition Examination Survey (NHANES, 2013-2014). The association of AIP with AAC was estimated by multivariable regression analysis. RESULTS: After adjusting for confounders, the odds of extensive AAC doubled per unit increase in the AIP index (OR = 2.00, 95% CI: 1.05, 3.83; P = 0.035). The multivariable OR and 95% CI of the highest AIP index tertile compared with the lowest tertile was significantly different. (OR = 1.73, 95% CI: 1.05, 2.83; P = 0.031). The subgroup analyses indicated that the association was consistent irrespective of age, sex, hypertension, diabetes, smoking status, eGFR and hypercholesteremia. CONCLUSIONS: The AIP index was independently associated with the presence of extensive AAC in the study population. Further studies are required to confirm this relationship.


Subject(s)
Aorta, Abdominal , Atherosclerosis , Nutrition Surveys , Vascular Calcification , Humans , Cross-Sectional Studies , Male , Female , Middle Aged , Aorta, Abdominal/diagnostic imaging , Aorta, Abdominal/pathology , Vascular Calcification/epidemiology , Vascular Calcification/blood , Atherosclerosis/epidemiology , Atherosclerosis/blood , Adult , Risk Factors , Biomarkers/blood , Aortic Diseases/epidemiology , Aortic Diseases/blood , Aged
2.
Medicine (Baltimore) ; 103(24): e38608, 2024 Jun 14.
Article in English | MEDLINE | ID: mdl-38875360

ABSTRACT

Waist-to-height ratio (WtHR) is a validated biomarker of central obesity that appears to be preferable to other body composition measurements in the evaluation of cardiovascular disease. The goal of this research was to explore the connection between WtHR and abdominal aortic calcification (AAC) among adults. On the basis of data from the 2013 to 2014 National Health and Nutrition Examination Survey, multivariate logistic regression, sensitivity analysis, as well as smoothed curve fitting were used to evaluate the connection between WtHR and AAC. Subgroup analyses along with interaction tests were done to see if this link was consistent across populations. Among 3079 participants aged >40 years, there was a negative association between WtHR and ACC. Each 1-unit emergence of WtHR was related to a 2% reduction in the probability of severe AAC in the entirely adjusted model (odds ratio = 0.02, 95% confidence interval: [0.00-0.12]). Participants in the highest WtHR quartile were 39% less likely to acquire severe AAC compared with those in the lowest quartile. (odds ratio = 0.61, 95% confidence interval: [0.37-1.00]). This negative association was more pronounced in the diabetes subgroup. We discovered a reversed U-shaped association between WtHR as well as AAC score utilizing a 2-stage linear regression model, with an intersection point of 0.56. WtHR was negatively associated with AAC among US adults.


Subject(s)
Aorta, Abdominal , Nutrition Surveys , Vascular Calcification , Waist-Height Ratio , Humans , Cross-Sectional Studies , Male , Aorta, Abdominal/diagnostic imaging , Aorta, Abdominal/pathology , Middle Aged , Female , Vascular Calcification/epidemiology , Vascular Calcification/diagnostic imaging , Adult , Aortic Diseases/epidemiology , Aortic Diseases/diagnostic imaging , Aged , Risk Factors , Obesity, Abdominal/epidemiology
3.
Eur J Cardiothorac Surg ; 65(6)2024 Jun 03.
Article in English | MEDLINE | ID: mdl-38733570

ABSTRACT

OBJECTIVES: A focal intimal disruption (FID) is a risk factor for adverse aorta-related events in patients with acute type B intramural haematoma. This study evaluated the impact of FIDs on overall survival with a selective intervention strategy for large or growing FIDs. Additionally, this study evaluated the risk factors associated with the growth of FIDs. METHODS: This retrospective study included all consecutive patients admitted for acute type B intramural haematomas between November 2004 and April 2021. The primary outcome was overall survival. The secondary outcome was the cumulative incidence of composite aortic events and the growth of FIDs. The latter was calculated on centreline-reconstructed computed tomography images. RESULTS: A total of 105 patients were included. A total of 106 FIDs were identified in 73 patients (73/105, 69.5%). The 1- and 5-year cumulative incidence rates of composite aortic events were 36.2% and 39.2%, respectively. The 1- and 5-year overall survival was 93.3% and 81.5%, respectively. Initial maximal aortic diameter and large FIDs during acute phase were significant risk factors for composite aortic events, but not risk factors for overall survival. The early appearance interval of an FID was a significant risk factor for growth of an FID. CONCLUSIONS: With a selective intervention strategy for large or growing FIDs, the presence of large FIDs during the acute phase does not affect overall survival. The early appearance interval was associated with the growth of FIDs.


Subject(s)
Hematoma , Humans , Male , Retrospective Studies , Female , Hematoma/epidemiology , Hematoma/etiology , Aged , Middle Aged , Risk Factors , Tunica Intima/pathology , Tunica Intima/diagnostic imaging , Acute Disease , Tomography, X-Ray Computed , Aged, 80 and over , Aortic Diseases/epidemiology
4.
JPEN J Parenter Enteral Nutr ; 48(5): 571-579, 2024 Jul.
Article in English | MEDLINE | ID: mdl-38734926

ABSTRACT

BACKGROUND: Oxidative stress has previously been shown to play a pivotal role in the pathogenesis of vascular calcification. In the present study, we aimed to investigate the association between the composite dietary antioxidant index (CDAI) and abdominal aortic calcification (AAC). METHODS: We conducted a cross-sectional study of United States adults using data from the 2013-2014 National Health and Nutrition Examination Survey. The CDAI was calculated from vitamins A, C, E, selenium, zinc, and caretenoid through two rounds of 24-h dietary recall interviews. AAC was assessed by a lateral dual-energy x-ray absorptiometry scan of the thoraco-lumbar spine. The association between CDAI and AAC was evaluated with weighted multivariable logistic regression. RESULTS: Overall, an unweighted 1081 participants were analyzed, including 110 with AAC and 971 without AAC. In the multivariable fully adjusted logistic regression model, CDAI was significantly associated with AAC (odds ratio = 0.89, 95% CI 0.81-0.98; P = 0.02). Compared with the lowest quartile, the highest quartile of CDAI was related to a 0.33-fold risk of AAC (95% CI 0.12-0.90; P = 0.03). Subgroup analysis showed that the significant association between CDAI and AAC was only observed in participants without hypertension (P for interaction = 0.002). CONCLUSION: A higher CDAI was associated with a lower prevalence of AAC among adults without hypertension in the US. Further large-scale prospective studies are required to analyze the protective role of the CDAI in AAC progression.


Subject(s)
Antioxidants , Aorta, Abdominal , Diet , Nutrition Surveys , Vascular Calcification , Humans , Cross-Sectional Studies , Male , Female , United States/epidemiology , Middle Aged , Antioxidants/analysis , Vascular Calcification/epidemiology , Diet/methods , Diet/statistics & numerical data , Adult , Aged , Risk Factors , Logistic Models , Absorptiometry, Photon , Aortic Diseases/epidemiology , Aortic Diseases/etiology , Oxidative Stress
5.
Int J Cardiol ; 407: 132000, 2024 Jul 15.
Article in English | MEDLINE | ID: mdl-38561108

ABSTRACT

AIM: To evaluate the association between raphe in bicuspid aortic valve (BAV) patients and valve dysfunction, aortopathy and aortic valve surgery in the REBECCA registry [REgistro della valvola aortica Bicuspide della Società Italiana di ECocardiografia e CArdiovascular Imaging (SIECVI)]. METHODS: Prevalence of aortic valve dysfunction and aortopathy was investigated in BAV patients with and without raphe. Aortic valve dysfunction (regurgitation or stenosis) was categorized as mild, moderate and severe. Aortopathy was defined as annulus ≥14 mm/m2; root ≥20 mm/m2; sinotubular junction ≥16 mm/m2; ascending aorta ≥17 mm/m2, and classified in Type A, isolated ascending aorta dilatation; Type B, aortic root and ascending aorta dilatation; and Type C, isolated aortic root dilatation. RESULTS: Overall, 695 patients with BAV were enrolled; 520 (74.8%) with raphe and 175 (25.2%) without raphe. BAV patients with raphe presented more frequently with moderate or severe aortic stenosis than BAV patients without raphe (183 [35.2%] vs 34 [19.4%], p < 0.001). A higher prevalence of aortopathy, particularly Type B, was observed in patients with vs without raphe. At multivariable analysis, raphe was a predictor of aortic valve surgery at three-year follow-up (odds ratio 2.19, 95% confidence interval 1.08-4.44, p < 0.001). CONCLUSIONS: Patients with BAV and raphe have a higher prevalence of significant aortic stenosis, aortopathy, especially Type B, and a higher risk of undergoing aortic valve surgery at three-year follow-up.


Subject(s)
Aortic Valve , Bicuspid Aortic Valve Disease , Heart Valve Diseases , Registries , Humans , Male , Female , Bicuspid Aortic Valve Disease/surgery , Bicuspid Aortic Valve Disease/diagnostic imaging , Bicuspid Aortic Valve Disease/complications , Middle Aged , Aortic Valve/abnormalities , Aortic Valve/surgery , Aortic Valve/diagnostic imaging , Aged , Heart Valve Diseases/surgery , Heart Valve Diseases/diagnostic imaging , Heart Valve Diseases/complications , Aortic Diseases/surgery , Aortic Diseases/diagnostic imaging , Aortic Diseases/epidemiology , Adult , Aortic Valve Stenosis/surgery , Aortic Valve Stenosis/diagnostic imaging , Follow-Up Studies , Italy/epidemiology
6.
Heart ; 110(14): 947-953, 2024 Jun 25.
Article in English | MEDLINE | ID: mdl-38627022

ABSTRACT

This study compared the prognostic value of quantified thoracic artery calcium (TAC) including aortic arch on chest CT and coronary artery calcium (CAC) score on ECG-gated cardiac CT. METHODS: A total of 2412 participants who underwent both chest CT and ECG-gated cardiac CT at the same period were included in the Multi-Ethnic Study of Atherosclerosis Exam 5. All participants were monitored for incident atherosclerotic cardiovascular disease (ASCVD) events. TAC is defined as calcification in the ascending aorta, aortic arch and descending aorta on chest CT. The quantification of TAC was measured using the Agatston method. Time-dependent receiver-operating characteristic (ROC) curves were used to compare the prognostic value of TAC and CAC scores. RESULTS: Participants were 69±9 years of age and 47% were male. The Spearman correlation between TAC and CAC scores was 0.46 (p<0.001). During the median follow-up period of 8.8 years, 234 participants (9.7%) experienced ASCVD events. In multivariable Cox regression analysis, TAC score was independently associated with increased risk of ASCVD events (HR 1.31, 95% CI 1.09 to 1.58) as well as CAC score (HR 1.82, 95% CI 1.53 to 2.17). However, the area under the time-dependent ROC curve for CAC score was greater than that for TAC score in all participants (0.698 and 0.641, p=0.031). This was particularly pronounced in participants with borderline/intermediate and high 10-year ASCVD risk scores. CONCLUSION: Our study demonstrated a significant association between TAC and CAC scores but a superior prognostic value of CAC score for ASCVD events. These findings suggest TAC on chest CT provides supplementary data to estimate ASCVD risk but does not replace CAC on ECG-gated cardiac CT.


Subject(s)
Coronary Artery Disease , Vascular Calcification , Humans , Male , Female , Aged , Vascular Calcification/diagnostic imaging , Vascular Calcification/epidemiology , Coronary Artery Disease/diagnostic imaging , Coronary Artery Disease/epidemiology , Coronary Artery Disease/diagnosis , Prognosis , Middle Aged , Risk Assessment/methods , Computed Tomography Angiography , Predictive Value of Tests , Aorta, Thoracic/diagnostic imaging , Risk Factors , Aortic Diseases/diagnostic imaging , Aortic Diseases/epidemiology , Aortic Diseases/diagnosis , ROC Curve , Coronary Vessels/diagnostic imaging , Cardiac-Gated Imaging Techniques , United States/epidemiology , Electrocardiography , Incidence , Coronary Angiography/methods , Tomography, X-Ray Computed , Atherosclerosis/epidemiology , Atherosclerosis/diagnosis
7.
Nutr Metab Cardiovasc Dis ; 34(6): 1488-1495, 2024 Jun.
Article in English | MEDLINE | ID: mdl-38494366

ABSTRACT

BACKGROUND AND AIMS: Vascular calcification has been linked to bone mineral density (BMD). This study aimed to investigate the association between BMD and abdominal aortic calcification (AAC). METHODS AND RESULTS: Data from the 2013-2014 National Health and Nutrition Examination Survey (NHANES) were utilized. Participants lacking BMD and AAC score data were excluded. BMD at the femoral neck was measured using dual-energy X-ray absorptiometry. AAC scores were assessed using the Kauppila scoring system, with AAC defined as a score greater than zero, and severe AAC defined as a score greater than six. Weighted multivariable regression analysis and subgroup analysis were conducted to examine the independent relationship between BMD and AAC score, AAC, and severe AAC. A total of 2965 participants were included. After adjusting for multiple covariates, BMD showed a negative association with higher AAC scores (ß = -0.17, 95% CI -0.29, -0.05, p = 0.0066). The odds of having AAC and severe AAC decreased by 9% and 16%, respectively, for every one-unit increase in BMD (AAC: odds ratio [OR] = 0.91, 95% CI 0.82, 1.00, p = 0.0431; severe AAC: OR = 0.84, 95% CI 0.71, 0.99, p = 0.0334). CONCLUSION: Low BMD is associated with higher AAC scores and an increased risk of AAC and severe AAC. Considering the detrimental impact of low BMD on cardiovascular health, individuals with AAC should be evaluated for osteopenia and osteoporosis in clinical settings.


Subject(s)
Absorptiometry, Photon , Aorta, Abdominal , Aortic Diseases , Bone Density , Nutrition Surveys , Vascular Calcification , Humans , Male , Female , Aorta, Abdominal/diagnostic imaging , Aorta, Abdominal/physiopathology , Middle Aged , Vascular Calcification/epidemiology , Vascular Calcification/diagnostic imaging , Vascular Calcification/physiopathology , Aortic Diseases/epidemiology , Aortic Diseases/diagnostic imaging , Aortic Diseases/physiopathology , Risk Factors , Aged , Cross-Sectional Studies , Risk Assessment , Adult , Severity of Illness Index , Femur Neck/diagnostic imaging , United States/epidemiology , Republic of Korea/epidemiology , Osteoporosis/epidemiology , Osteoporosis/diagnostic imaging , Osteoporosis/diagnosis
8.
Atherosclerosis ; 392: 117505, 2024 May.
Article in English | MEDLINE | ID: mdl-38527383

ABSTRACT

BACKGROUND AND AIMS: Matrix Gla protein (MGP) is an inhibitor of calcification that requires carboxylation by vitamin K for activity. The inactive form of MGP, dephosphorylated-uncarboxylated matrix Gla protein (dp-ucMGP), has been associated with increased calcification. However, it is not known whether there is a longitudinal relationship between dephosphorylated-uncarboxylated matrix Gla protein levels and coronary and aortic calcification in large population cohorts. METHODS: The Multi-Ethnic Study of Atherosclerosis (MESA) followed participants with serial cardiac computed tomography (CT) measures of vascular calcification. Dp-ucMGP was measured at baseline in a subset of participants who completed baseline and follow-up CTs approximately 10 years later and had available plasma specimens (n = 2663). Linear mixed effects models (LMMs) were used to determine the association of dp-ucMGP with the simultaneous incidence and progression of coronary artery, ascending thoracic aortic, or descending thoracic aortic calcification (CAC, ATAC, DTAC)]. RESULTS: For every one standard deviation (SD, 178 pmol/L) increment in dp-ucMGP, CAC increased by 3.44 ([95% CI = 1.68, 5.21], p < 0.001) Agatston units/year (AU/year), ATAC increased by 0.63 ([95% CI = 0.27, 0.98], p = 0.001) AU/year, and DTAC increased by 8.61 ([95% CI = 4.55, 12.67], p < 0.001) AU/year. The association was stronger for DTAC in those ≥65 years and with diabetes. CONCLUSIONS: We found a positive association of the inactive form of matrix Gla protein, dp-ucMGP, and long-term incidence/progression of CAC, ATAC, and DTAC. Future studies should investigate dp-ucMGP as a calcification regulator and MGP as a possible therapeutic target to slow progression of calcification in the vasculature.


Subject(s)
Aortic Diseases , Calcium-Binding Proteins , Coronary Artery Disease , Disease Progression , Extracellular Matrix Proteins , Matrix Gla Protein , Vascular Calcification , Humans , Extracellular Matrix Proteins/blood , Calcium-Binding Proteins/blood , Male , Female , Vascular Calcification/diagnostic imaging , Vascular Calcification/ethnology , Vascular Calcification/blood , Vascular Calcification/epidemiology , Incidence , Aged , Middle Aged , Coronary Artery Disease/blood , Coronary Artery Disease/ethnology , Coronary Artery Disease/epidemiology , Coronary Artery Disease/diagnostic imaging , Aortic Diseases/ethnology , Aortic Diseases/blood , Aortic Diseases/diagnostic imaging , Aortic Diseases/epidemiology , United States/epidemiology , Aged, 80 and over , Aorta, Thoracic/diagnostic imaging , Aorta, Thoracic/pathology , Time Factors , Biomarkers/blood , Atherosclerosis/blood , Atherosclerosis/ethnology , Risk Factors , Prospective Studies , Phosphorylation , Computed Tomography Angiography
9.
Am J Med Sci ; 368(3): 203-213, 2024 Sep.
Article in English | MEDLINE | ID: mdl-38368945

ABSTRACT

BACKGROUND: Coronary and thoracic aortic calcification was associated with stroke, coronary heart, and peripheral vascular disease. Hepatitis C virus (HCV) infection is significantly associated with insulin resistance, diabetes mellitus and hepatic steatosis. We aimed to investigate the relationship between HCV infection and coronary, thoracic aortic atherosclerosis. MATERIALS AND METHODS: Calcification was detected by chest computed tomography and defined as any Agatston score greater than zero. Metabolic syndrome was based on the modified Adult Treatment Panel III criteria. Fibrosis-4 (FIB-4) and AST-to-platelet ratio (APRI) was calculated. The anti-HCV signal-to-cutoff (S/CO) ratio was determined by the third generation ELISA kit. Atherosclerosis risk was estimated by using multiple logistic regression modeling. RESULTS: Being positive for both metabolic syndrome and HCV infection (OR = 2.65, 95% CI: 1.26-5.59, p = 0.007), negative for metabolic syndrome and positive for HCV infection (OR = 2.75, 95% CI: 1.48-5.30, p = 0.001), and positive for metabolic syndrome and negative for HCV infection (OR = 2.42, 95% CI: 1.92-3.07, p < 0.001) were associated with atherosclerosis compared with being negative for both metabolic syndrome and HCV infection (Ptrend< 0.001). HCV infection with liver fibrosis (HCVFIB4>1.4; OR = 2.16, 95% CI: 1.22-3.82, p = 0.008), or (HCVAPRI>0.5; OR = 3.40, 95% CI: 1.28-9.06, p = 0.014) and elevated anti-HCV S/CO ratio (anti-HCVS/CO>10.0; OR = 1.72, 95% CI: 1.01-2.93, p = 0.045) was associated with atherosclerosis. CONCLUSIONS: HCV infection with metabolic syndrome, liver fibrosis and elevated anti-HCV S/CO ratio was associated with atherosclerosis.


Subject(s)
Aorta, Thoracic , Atherosclerosis , Metabolic Syndrome , Humans , Male , Middle Aged , Female , Aorta, Thoracic/diagnostic imaging , Metabolic Syndrome/complications , Metabolic Syndrome/epidemiology , Atherosclerosis/epidemiology , Hepatitis C/complications , Coronary Artery Disease/epidemiology , Coronary Artery Disease/diagnostic imaging , Aortic Diseases/diagnostic imaging , Aortic Diseases/epidemiology , Aortic Diseases/etiology , Aged , Adult , Hepacivirus , Risk Factors
10.
BMC Cardiovasc Disord ; 24(1): 26, 2024 01 03.
Article in English | MEDLINE | ID: mdl-38172671

ABSTRACT

BACKGROUND: Hemoglobin A1c (HbA1c), a "gold standard" for the assessment of glycemic control, was associated with an increased risk of cardiovascular disease and coronary artery calcification. However, its effects on abdominal aortic calcification (AAC) are uncertain. The present study comprehensively investigated the association between HbA1c and AAC in the 2013-2014 National Health and Nutrition Examinations Surveys. METHODS: Among 1,799 participants ≥ 40 years, dual-energy X-ray absorptiometry-derived AAC was quantified using the Kauppila score (AAC-24). Severe AAC was defined as a total AAC-24 > 6. Weighted linear regression models and logistic regression models were used to determine the effects of HbA1c on AAC. The restricted cubic spline model was used for the dose-response analysis. RESULTS: The mean AAC-24 of participants was 1.3, and 6.7% of them suffered from severe AAC. Both AAC-24 and the prevalence of severe AAC increased with the higher tertile of HbA1c (P < 0.001). Elevated HbA1c levels would increase the AAC-24 (ß = 0.73, 95% CI: 0.30-1.16) and the risk of severe AAC (OR = 1.63, 95% CI: 1.29-2.06), resulting in nearly linear dose-response relationships in all participants. However, this positive correlation were not statistically significant when participants with diabetes were excluded. Furthermore, subgroup analysis showed significant interactions effect between HbA1c and hypertension on severe AAC with the OR (95% CI) of 2.35 (1.62-3.40) for normotensives and 1.39 (1.09-1.79) for hypertensives (P for interaction = 0.022). CONCLUSION: Controlling HbA1c could reduce AAC scores and the risk of severe AAC. Glycemic management might be a component of strategies for preventing AAC among all participants, especially normotensives.


Subject(s)
Aortic Diseases , Vascular Calcification , Humans , Glycated Hemoglobin , Nutrition Surveys , Risk Factors , Vascular Calcification/diagnostic imaging , Vascular Calcification/epidemiology , Vascular Calcification/etiology , Aorta, Abdominal/diagnostic imaging , Aortic Diseases/diagnostic imaging , Aortic Diseases/epidemiology , Aortic Diseases/etiology
11.
Clin Endocrinol (Oxf) ; 100(3): 269-276, 2024 03.
Article in English | MEDLINE | ID: mdl-38214123

ABSTRACT

OBJECTIVE: The risk of aortic dissection (AoD) is increased in Turner syndrome (TS) but predicting those at risk is difficult. Based on scarce evidence, preventive aortic surgery is recommended when aortic diameter increases >5 mm/year. To investigate the aortic growth rate in TS and TS-related conditions associated with aortic growth. We also reported our experience of women who suffered aortic dissection (AoD), and who had preventive aortic replacement. METHODS: 151 adult TS were retrospectively identified. Women who had more than one transthoracic echocardiogram (TTE) after age 16 years were included in the aortic growth study. Aortic diameters at sinuses of Valsalva (SoV) and ascending aorta (AA) were analysed by two experts. RESULTS: 70/151 women had more than one TTE (interscan interval 4.7 years). Mean aortic growth was 0.13 ± 0.59 mm/year at SoV and 0.23 ± 0.82 mm/year at AA. Known risk factors for aortic dilatation and TS-related conditions were not associated with aortic growth. 4/151 women experienced AoD (age 25±8 years): two had paired scans for aortic growth, which was 0.67 mm/year at both SoV and AA in the first woman, and 11 mm/year (SoV) and 4 mm/year (AA) in the second. Only 1/4 of women with AoD survived; she used a TS cardiac-alert card to inform emergency personnel about her risk of AoD. 5/151 had a preventive aortic replacement, but one died post-operatively. CONCLUSIONS: Mean aortic growth in our TS population was increased compared to non-TS women and was not associated with currently known risk factors for AoD, suggesting that aortic growth rate itself could be a useful variable to stratify who is at risk for AoD.


Subject(s)
Aortic Diseases , Aortic Dissection , Turner Syndrome , Adult , Female , Humans , Adolescent , Young Adult , Turner Syndrome/complications , Turner Syndrome/epidemiology , Retrospective Studies , Aortic Diseases/complications , Aortic Diseases/epidemiology , Risk Assessment
12.
Ann Vasc Surg ; 98: 164-172, 2024 Jan.
Article in English | MEDLINE | ID: mdl-37516427

ABSTRACT

BACKGROUND: Acute aortic occlusion (AAO) is a morbid diagnosis in which mortality correlates with severity of ischemia on presentation. Visceral ischemia (VI) is challenging to diagnose and its presentation as a consequence of AAO is not well-studied. We aim to identify characteristics associated with VI in AAO to facilitate diagnosis. METHODS: Patients diagnosed with AAO who underwent revascularization were identified retrospectively from institutional records (2006-2020). The primary outcome was the development of VI (intra-abdominal ischemia). Univariate analysis was used to compare demographic, exam, imaging, and intraoperative variables between patients with and without VI in the setting of AAO. RESULTS: Ninety-one patients were included. The prevalence of VI was 20.9%. Preoperative comorbidities, time to revascularization, and operative approach did not differ between patients with and without VI. Patients with VI more frequently were transferred from outside institutions (100% vs. 53%, P = 0.02), presented with advanced acute limb ischemia (Rutherford III 36.9% vs. 7.5%, P < 0.01), and had elevated preoperative serum lactate (4.31 vs. 2.41 mmol/L, P < 0.01). VI patients had an increased occurrence of bilateral internal iliac artery (IIA) occlusion (47.4% vs. 18.1%, P = 0.01). Unilateral IIA occlusion, level of aortic occlusion, and patency of inferior mesenteric arteries were not associated with VI. Patients with VI had worse postoperative outcomes. In particular, VI conferred significant risk of mortality (odds ratio 5.45, P < 0.01). CONCLUSIONS: Visceral ischemia is a common consequence of AAO. Elevated lactate, bilateral IIA occlusion, and advanced acute limb ischemia (ALI) should increase clinical suspicion for concomitant VI with AAO and may facilitate earlier diagnosis to improve outcomes.


Subject(s)
Aortic Diseases , Arterial Occlusive Diseases , Humans , Incidence , Retrospective Studies , Risk Factors , Treatment Outcome , Arterial Occlusive Diseases/diagnostic imaging , Arterial Occlusive Diseases/epidemiology , Arterial Occlusive Diseases/surgery , Aortic Diseases/diagnostic imaging , Aortic Diseases/epidemiology , Aortic Diseases/surgery , Ischemia/diagnostic imaging , Ischemia/epidemiology , Ischemia/surgery , Lactates
14.
Nutr Metab Cardiovasc Dis ; 33(10): 1960-1968, 2023 10.
Article in English | MEDLINE | ID: mdl-37544869

ABSTRACT

BACKGROUND AND AIMS: This study was performed to investigate the effect of coffee consumption on abdominal aortic calcification (AAC) among adults with and without hypertension, diabetes, and cardiovascular diseases (CVD). METHODS AND RESULTS: A total of 2548 participants from the National Health and Nutrition Examination Survey (NHANES) 2013-2014 were included. Coffee consumption was obtained from 24-h dietary recalls. Dual-energy X-ray absorptiometry (DXA) was used to measure the severity of AAC. In the fully adjusted model, compared with non-drinkers, high coffee consumption (≥390 g/d) was associated with higher AAC scores among participants with hypertension (ß = 0.72, 95% CI: 0.21-1.22), diabetes (ß = 1.20, 95% CI: 0.35-2.05), and CVD (ß = 2.03, 95% CI: 0.71-3.36). We did not observe such an association among participants without hypertension, diabetes, and CVD. Furthermore, decaffeinated coffee was not associated with AAC. CONCLUSION: In conclusion, patients with hypertension, diabetes, and CVD should focus on coffee consumption, especially caffeinated coffee, to reduce the burden of AAC.


Subject(s)
Aortic Diseases , Cardiovascular Diseases , Diabetes Mellitus , Hypertension , Vascular Calcification , Humans , Adult , Cardiovascular Diseases/diagnosis , Cardiovascular Diseases/epidemiology , Cardiovascular Diseases/prevention & control , Nutrition Surveys , Hypertension/diagnosis , Hypertension/epidemiology , Hypertension/complications , Diabetes Mellitus/diagnosis , Diabetes Mellitus/epidemiology , Diet , Aorta, Abdominal/diagnostic imaging , Aortic Diseases/diagnostic imaging , Aortic Diseases/epidemiology , Vascular Calcification/diagnostic imaging , Vascular Calcification/epidemiology , Risk Factors
15.
Nutr Metab Cardiovasc Dis ; 33(10): 1941-1950, 2023 10.
Article in English | MEDLINE | ID: mdl-37500348

ABSTRACT

BACKGROUND AND AIMS: Copper is an essential dietary element with a crucial role in physiological regulation. However, the relationship between dietary copper intake and abdominal aortic calcification (AAC) remains uncertain. METHODS AND RESULTS: This study encompassed a cohort of 2535 adults aged over 40 years, derived from the National Health and Nutrition Examination Survey 2013-2014. Dietary copper intake from both food sources and supplements was assessed through two 24-h dietary recall interviews. AAC was measured by dual-energy X-ray absorptiometry and classified into 3 groups using the Kauppila score system. Multivariable logistic regression models were constructed to evaluate the association between dietary copper intake and AAC. Among the participants, a total of 771 individuals (30.4%) were diagnosed with AAC, of which 239 (9.4%) exhibited severe AAC. Higher dietary copper intake was significantly associated with a lower incidence of severe AAC. Specifically, for each 1 mg/day increase in dietary copper intake, the incidence of severe AAC decreased by 38% (odds ratios [OR] 0.62, 95% confidence intervals [CI] 0.39-0.98) after adjustment for relevant covariates. Moreover, individuals in the third tertile of copper intake had a 37% lower incidence of AAC compared to those in the first tertile [OR 0.63, 95% CI (0.43-0.95)]. However, no significant associations were found between supplemental copper intake or serum copper levels and AAC. CONCLUSIONS: This study demonstrates that lower dietary copper intake, rather than serum copper levels or supplement copper intake, is significantly associated with a higher prevalence of AAC in adults ≥40 years old in the United States.


Subject(s)
Aortic Diseases , Vascular Calcification , Humans , Adult , United States/epidemiology , Middle Aged , Nutrition Surveys , Cross-Sectional Studies , Copper/adverse effects , Vascular Calcification/diagnostic imaging , Vascular Calcification/epidemiology , Nutritional Status , Aorta, Abdominal/diagnostic imaging , Aortic Diseases/diagnostic imaging , Aortic Diseases/epidemiology , Risk Factors
16.
J Investig Med ; 71(8): 845-853, 2023 12.
Article in English | MEDLINE | ID: mdl-37485956

ABSTRACT

This study investigated the risk factors of abdominal aortic calcification (AAC) in patients with stage 5 chronic kidney disease (CKD) and the effects of AAC and different dialysis methods on the 3-year survival rate of patients with stage 5 CKD. A retrospective cohort study was conducted on stage 5 CKD patients who received dialysis treatment. The general data were collected, and all fasting venous blood samples were harvested before the first dialysis to detect biochemical markers. The AAC was evaluated by lateral abdominal X-ray. The patients were followed up with a cut-off date of March 31, 2022, with all-cause mortality as the endpoint event. A total of 205 patients were included. multivariable Cox regression analysis confirmed that AAC (hazard ratio (HR) = 2.173, 95% CI 1.029-4.588, p = 0.042), advanced age (HR = 1.061, 95% CI 1.031-1.093, p < 0.001), duration of dialysis (HR = 1.015, 95% CI 1.007-1.032, p < 0.001), diabetes (HR = 3.966, 95% CI 2.164-7.269, p < 0.001), and hypertension (HR = 1.897, 95% CI 1.089-3.303, p = 0.024) were independent risk factors for 3-year mortality. However, peritoneal dialysis (HR = 0.366, 95% CI 0.165-0.812, p = 0.013), high albumin (HR = 0.882, 95% CI 0.819-0.950, p = 0.001), and high hemoglobin (HR = 0.969, 95% CI 0.942-0.997, p = 0.031) were protective factors for 3-year mortality in stage 5 CKD patients. Increased age, long-term dialysis, high level of intact parathyroid hormone, diabetes, and hypertension are closely related to the occurrence of AAC in patients with stage 5 CKD. In addition, AAC is an independent risk factor for all-cause mortality in patients with stage 5 CKD.


Subject(s)
Aortic Diseases , Diabetes Mellitus , Hypertension , Kidney Failure, Chronic , Vascular Calcification , Humans , Renal Dialysis/adverse effects , Renal Dialysis/methods , Vascular Calcification/complications , Vascular Calcification/diagnosis , Retrospective Studies , Kidney Failure, Chronic/complications , Risk Factors , Hypertension/complications , Aortic Diseases/epidemiology , Aortic Diseases/etiology
17.
J Cardiovasc Transl Res ; 16(6): 1425-1438, 2023 Dec.
Article in English | MEDLINE | ID: mdl-37468727

ABSTRACT

The aim of our study was to assess the effect of blood cadmium levels (B-Cd) on abdominal aortic calcification (AAC). We used the data from the 2013-2014 NHANES database. A total of 1530 participants were included in our study, with a mean AAC score of 1.40 ± 0.10, and a prevalence of severe AAC of 7.98%. Participants with higher B-Cd quartiles showed a higher prevalence of severe AAC. B-Cd was positively associated with higher AAC scores and increased risk of severe AAC. In the obese population, blood cadmium levels showed a positive association with the risk of severe AAC. There may be a positive correlation between B-Cd levels and AAC scores and risk of severe AAC, and this correlation is more pronounced in the obese population. Therefore, the cadmium load in AAC patients in the obese population should be considered in clinical work.


Subject(s)
Aortic Diseases , Vascular Calcification , Humans , Cadmium/adverse effects , Nutrition Surveys , Vascular Calcification/diagnostic imaging , Vascular Calcification/epidemiology , Obesity/diagnosis , Obesity/epidemiology , Obesity/complications , Aorta, Abdominal/diagnostic imaging , Aortic Diseases/diagnostic imaging , Aortic Diseases/epidemiology , Risk Factors
18.
BMC Cardiovasc Disord ; 23(1): 363, 2023 07 19.
Article in English | MEDLINE | ID: mdl-37468858

ABSTRACT

INTRODUCTION: Bicuspid aortic valve (BAV) patients have an increased risk to develop thoracic aortic complications. Little is known about the prevalence and severity of atherosclerosis in the BAV ascending aortic wall. This study evaluates and compares the prevalence of thoracic aortic atherosclerosis in BAV and tricuspid aortic valve (TAV) patients. METHODS: Atherosclerosis was objectified using three diagnostic modalities in two separate BAV patient cohorts (with and without an aortic dilatation). Within the first group, atherosclerosis was graded histopathologically according to the modified AHA classification scheme proposed by Virmani et al. In the second group, the calcific load of the ascending aorta and coronary arteries, coronary angiographies and cardiovascular risk factors were studied. Patients were selected from a surgical database (treated between 2006-2020), resulting in a total of 128 inclusions. RESULTS: Histopathology showed atherosclerotic lesions to be more prevalent and severe in all TAV as compared to all BAV patients (OR 1.49 (95%CI 1.14 - 1.94); p = 0.003). Computed tomography showed no significant differences in ascending aortic wall calcification between all BAV and all TAV patients, although a tendency of lower calcific load in favor of BAV was seen. Coronary calcification was higher in all TAV as compared to all BAV (OR 1.30 (95%CI 1.06 - 1.61); p = 0.014). CONCLUSION: Ascending aortic atherosclerotic plaques were histologically more pronounced in TAV as compared to the BAV patients, while CT scans revealed equal amounts of calcific depositions within the ascending aortic wall. This study confirms less atherosclerosis in the ascending aortic wall and coronary arteries of BAV patients as compared to TAV patients. These results were not affected by the presence of a thoracic aortic aneurysm.


Subject(s)
Aortic Diseases , Atherosclerosis , Bicuspid Aortic Valve Disease , Heart Valve Diseases , Humans , Bicuspid Aortic Valve Disease/complications , Heart Valve Diseases/diagnostic imaging , Heart Valve Diseases/epidemiology , Heart Valve Diseases/complications , Case-Control Studies , Aortic Valve/surgery , Aortic Diseases/diagnostic imaging , Aortic Diseases/epidemiology , Aortic Diseases/complications , Atherosclerosis/diagnostic imaging , Atherosclerosis/epidemiology
19.
Ann Med ; 55(1): 2195205, 2023 12.
Article in English | MEDLINE | ID: mdl-37014261

ABSTRACT

BACKGROUND: Vascular calcification (VC) is one of the complications of chronic kidney disease (CKD) patients. Previous studies have confirmed that oxidative stress (OS) plays an important role in developing VC and that antioxidants have anti-VC effects. OBJECTIVES: Our study aimed to determine the relationship between the intake of antioxidants from dietary sources and the prevalence of VC, especially in the CKD population. METHODS: This cross-sectional study analyzed population-based data from the National Health and Nutrition Examination Survey (NHANES; 2013-2014). Participants were noninstitutionalized adults >40 years of age. Diet-derived antioxidants were obtained from the first 24-h dietary recall interviews. The abdominal aortic calcification (AAC) score was measured by a DXA scan. We divided the AAC scores into three groups: no calcification (AAC =0), mild to moderate calcification (0< AAC ≤6), and severe calcification (AAC >6). RESULTS: A total of 2897 participants were included in the main analysis. Our results showed that vitamin B6, α-tocopherol, and lycopene were associated with severe AAC in unadjusted models (odds ratio (OR): 0.81, 95% confidence interval (CI): 0.72-0.91, p = 0.001; OR: 0.97, 95% CI: 0.95-0.99, p = 0.008; OR: 0.98, 95% CI: 0.96-0.99, p = 0.01, respectively). However, only dietary lycopene was associated with severe AAC after adjusting covariates based on clinical and statistical significance. Per 1 mg higher intake of diet-derived lycopene per day, the odds of having severe AAC were 2% lower in the fully adjusted model (OR: 0.98, 95% CI: 0.95-0.999, p = 0.04). Moreover, in subgroup analysis, diet-derived antioxidant was not associated with AAC in patients with CKD.Our findings indicate that a higher intake of diet-derived lycopene was independently associated with lower odds of having severe AAC in humans. Therefore, a high intake of diet-derived lycopene may help prevent severe AAC.


Dietary lycopene was inversely associated with vascular calcification (VC) in adults.Patients with chronic kidney disease (CKD) have a higher chance of having severe VC.Dietary antioxidants were not significantly associated with VC in patients with CKD.


Subject(s)
Aortic Diseases , Renal Insufficiency, Chronic , Vascular Calcification , Humans , Adult , Nutrition Surveys , Cross-Sectional Studies , Lycopene , Diet , Vascular Calcification/diagnostic imaging , Vascular Calcification/epidemiology , Vascular Calcification/etiology , Renal Insufficiency, Chronic/epidemiology , Renal Insufficiency, Chronic/complications , Aortic Diseases/diagnostic imaging , Aortic Diseases/epidemiology , Aortic Diseases/etiology , Risk Factors
20.
Ther Apher Dial ; 27(4): 742-751, 2023 Aug.
Article in English | MEDLINE | ID: mdl-36855773

ABSTRACT

INTRODUCTION: We aimed to investigate the relationship between monocyte/lymphocyte ratio (MLR) and monocyte/high-density lipoprotein ratio (MHR) with abdominal aortic calcification (AAC) in patients on peritoneal dialysis (PD). METHODS: The time-averaged (TA) of relevant indexes and AAC scores (AACs) of 160 eligible patients were measured. RESULTS: Patients divided into the new AAC (n = 57) and the other without (n = 82). High TA-MLR (OR = 110.537, p = 0.018) and long duration of dialysis (OR = 1.045, p < 0.001) were independent risk factors of the new AAC. Patients divided into the no AAC (n = 82), the moderate-to-severe AAC (n = 26), and the mild AAC (n = 52). High TA-MLR (OR = 42.649, p = 0.032), high age at starting PD (OR = 1.055, p < 0.001), and long duration of PD (OR = 1.036, p < 0.001) were independent risk factors of AAC severity. CONCLUSIONS: MLR is an independent risk factor for the occurrence and severity of AAC and its value for the assessment of AAC is better than MHR.


Subject(s)
Aortic Diseases , Peritoneal Dialysis , Vascular Calcification , Humans , Vascular Calcification/etiology , Vascular Calcification/epidemiology , Aorta, Abdominal , Monocytes , Peritoneal Dialysis/adverse effects , Renal Dialysis/adverse effects , Risk Factors , Aortic Diseases/epidemiology
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