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1.
Kardiologiia ; 61(1): 12-21, 2021 Feb 10.
Artigo em Russo, Inglês | MEDLINE | ID: mdl-33734051

RESUMO

Aim      To determine in a prospective study factors of progressive atherosclerotic lesion of blood vessels in patients with rheumatoid arthritis (RA).Material and methods  This prospective study included 124 patients with RA and suspected ischemic heart disease (IHD) and 30 patients with IHD (comparison group) aged 58 [52; 63] years. On enrollment to the study and at 3 years of follow-up, all patients underwent clinical and instrumental examination according to European and Russian guidelines for diagnosis and treatment of stable IHD (2013), including coronography as indicated. For all RA patients of the comparison group, risk factors (RF) were evaluated, including arterial hypertension, smoking, excessive body weight, family history of cardiovascular diseases (CVD), diabetes mellitus, and dyslipidemia. The following laboratory data were evaluated: blood count; biochemistry, including total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), triglycerides (TG), rheumatoid factor (RhF), cyclic citrullinated peptide antibodies, and high-sensitivity C-reactive protein (hsCRP). Proinflammatory cytokines, including interleukin (IL)-1ß, IL-6, and tumor necrosis factor-α (TNF- α), were measured in RA patients once, at 3 years of follow-up.Results Incidence of FRs for CVD was similar in RA patients and in the comparison group. Median RA duration before inclusion into the study was 11 years, and median DAS28 index score was 3.8. Incidence of dyslipidemia due to increased TC, LDL-C, and HDL-C was higher for RA patients at baseline. The LDL-C goal (<1.8 mmol/l) was achieved only in 3 (10 %) patients of the comparison group and 10 (8 %) RA patients. RA patients had higher levels of the inflammation indexes, hsCRP (0.75 mg/dl vs. 0.16 mg/dl; p<0.05) and erythrocyte sedimentation rate (ESR) (15 mm/h vs. 11.5 mm/h; p<0.05). In the RA group at baseline, atherosclerotic plaques with carotid artery (CTA) stenosis of 20% or more were found in 94 (77 %) patients; in 3 of them, CA stenosis was >50%. Patients with RA frequently had unchanged or slightly changed coronary arteries (CA) (47% of patients), and less frequently they had hemodynamically significant multi-arterial coronary atherosclerotic lesions (7 % vs. 57 % of patients in comparison group). At 37.5 months, 21 (23 %) of 94 RA patients had progressive atherosclerosis in CA and/or CTA; 12 (13 %) RA patients had only progressive CA atherosclerosis; 7 (8 %) had only progressive CTA atherosclerosis; and 2 (2 %) had simultaneous progression of CA and CTA atherosclerosis. Two groups of RA patients were formed, with the progression of atherosclerosis (n=21) and without the progression of atherosclerosis (n=69). RFs for the development/progression of atherosclerosis in RA patients included smoking, family history of CVD, and duration of the disease. Levels of lipids did not differ. Levels of proinflammatory cytokines (IL-1ß, IL-6, TNF-α) were higher in RA patients with progressive atherosclerosis. No effects of the anti-rheumatic therapy on the progression of atherosclerosis were observed.Conclusion      Progression of atherosclerosis in RA remains in disease with low and moderate activity during the anti-rheumatic and hypolipidemic treatment. The development of atherosclerosis in RA is determined by lipid, inflammatory, and immune disorders.


Assuntos
Artrite Reumatoide , Aterosclerose , Doenças das Artérias Carótidas , Artrite Reumatoide/complicações , Artrite Reumatoide/epidemiologia , Aterosclerose/epidemiologia , Aterosclerose/etiologia , Humanos , Pessoa de Meia-Idade , Estudos Prospectivos , Fatores de Risco , Federação Russa/epidemiologia
2.
Eur J Endocrinol ; 184(4): 587-596, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-33606661

RESUMO

Objective: To investigate the prevalence and risks factors associated with the presence of liver fibrosis in subjects with nonalcoholic fatty liver disease (NAFLD) with and without type 2 diabetes mellitus (T2D). Design and methods: This study was part of a population-based study conducted in the Barcelona metropolitan area among subjects aged 18-75 years old. Secondary causes of steatosis were excluded. Moderate-to-advanced liver fibrosis was defined as a liver stiffness measurement (LSM) ≥ 8.0 kPa assessed by transient elastography. Results: Among 930 subjects with NAFLD, the prevalence of moderate-to-advanced liver fibrosis was higher in subjects with T2D compared those without (30.8% vs 8.7%). By multivariable analysis, one of the main factors independently associated with increased LSM in subjects with NAFLD was atherogenic dyslipidemia but only in those with T2D. The percentage of subjects with LSM ≥ 8.0 kPa was higher in subjects with T2D and atherogenic dyslipidemia than in those with T2D without atherogenic dyslipidemia both for the cut-off point of LSM ≥8.0 kPa (45% vs 24% P = 0.002) and ≥13 kPa (13% vs 4% P = 0.020). No differences were observed in the prevalence of LSM ≥8.0 kPa regarding glycemic control among NAFLD-diabetic subjects. Conclusions: Factors associated with moderate-to-advanced liver fibrosis in NAFLD are different in subjects with and without T2D. Atherogenic dyslipidemia was associated with the presence of moderate-to-advanced liver fibrosis in T2D with NAFLD but not in non-diabetic subjects. These findings highlight the need for an active search for liver fibrosis in subjects with T2D NAFLD and atherogenic dyslipidemia.


Assuntos
Aterosclerose/epidemiologia , Diabetes Mellitus Tipo 2/epidemiologia , Dislipidemias/epidemiologia , Hiperglicemia/epidemiologia , Cirrose Hepática/epidemiologia , Hepatopatia Gordurosa não Alcoólica/epidemiologia , Adolescente , Adulto , Idoso , Aterosclerose/etiologia , Comorbidade , Diabetes Mellitus Tipo 2/complicações , Dislipidemias/complicações , Técnicas de Imagem por Elasticidade , Feminino , Humanos , Hiperglicemia/complicações , Cirrose Hepática/diagnóstico , Cirrose Hepática/etiologia , Cirrose Hepática/patologia , Masculino , Pessoa de Meia-Idade , Hepatopatia Gordurosa não Alcoólica/complicações , Prevalência , Fatores de Risco , Índice de Gravidade de Doença , Espanha/epidemiologia , Adulto Jovem
3.
Medicine (Baltimore) ; 100(6): e24549, 2021 Feb 12.
Artigo em Inglês | MEDLINE | ID: mdl-33578549

RESUMO

BACKGROUND: Psoriasis (PSO) is a systemic inflammatory disorder that presents with erythematous scaling of the skin and is associated with autoimmune dysfunction. Atherosclerosis is one of the major comorbidities of PSO. PSO-associated inflammatory factor IL-17 could lead to vascular endothelial cell injury and atherosclerosis. While some research results show that IL-17 helps stabilize plaque formation. Efficacy and safety on PSO and psoriatic arthritis (PSA) of existing IL-17/IL-17R biologics (secukinumab, ixekizumab, brodalumab, and bimekizumab) have been clinically validated, but whether they can improve atherosclerotic outcomes in psoriatic patients remains controversial. METHODS: Seven electronic search engines will be searched from inception to December 1, 2020, including PubMed, Embase, Scopus, PsycINFO, Global Health, Web of Science and the Cochrane Library. Clinical trial registries, potential grey literature, relevant conference abstracts, and reference lists of identified studies will also be searched. Literature selection, data extraction, and quality assessment will be done by 2 independent authors. Based on the heterogeneity test, the fixed effect or random effect model will be used for data synthesis. Changes in lung function will be evaluated as the primary outcome. Assessment of symptoms, quality of life, medication use, exacerbations and adverse events will be assessed as secondary outcomes. RevMan V. 5.3.5 (The Nordic Cochrane Centre, Copenhagen, Denmark) will be used for meta-analysis. RESULTS: This study will provide a synthesis of current evidence of IL-17/IL-17R inhibitors on atherosclerosis in PSO and PSA. CONCLUSION: The conclusion of our study will provide updated evidence to judge whether IL-17/IL-17R inhibitors is an effective solution to atherosclerosis as comorbidity of PSO and PSA. PROSPERP REGISTRATION NUMBER: CRD42020209897.


Assuntos
Anticorpos Monoclonais Humanizados/uso terapêutico , Artrite Psoriásica/complicações , Aterosclerose/tratamento farmacológico , Interleucina-17/antagonistas & inibidores , Receptores de Interleucina-17/antagonistas & inibidores , Anticorpos Monoclonais Humanizados/farmacologia , Aterosclerose/etiologia , Humanos , Metanálise como Assunto , Revisões Sistemáticas como Assunto
4.
Angiology ; 72(4): 303-314, 2021 04.
Artigo em Inglês | MEDLINE | ID: mdl-33601945

RESUMO

Atherosclerosis and inflammatory bowel disease (IBD) are often regarded as 2 distinct entities. The commonest manifestation of atherosclerosis is ischemic heart disease (IHD), and an association between IHD and IBD has been reported. Atherosclerosis and IBD share common pathophysiological mechanisms in terms of their genetics, immunology, and contributing environmental factors. Factors associated with atherosclerosis are implicated in the development of IBD and vice versa. Therefore, treatments targeting the common pathophysiology pathways may be effective in both conditions. The current review considers the pathophysiological pathways that are shared between the 2 conditions and discusses the implications for treatment and research.


Assuntos
Imunidade Adaptativa , Aterosclerose/etiologia , Imunidade Inata , Doenças Inflamatórias Intestinais/etiologia , Estilo de Vida , Polimorfismo de Nucleotídeo Único , Animais , Aterosclerose/genética , Aterosclerose/imunologia , Aterosclerose/terapia , Microbioma Gastrointestinal , Predisposição Genética para Doença , Humanos , Doenças Inflamatórias Intestinais/genética , Doenças Inflamatórias Intestinais/imunologia , Doenças Inflamatórias Intestinais/terapia , Fenótipo , Polimorfismo Genético , Medição de Risco , Fatores de Risco , Vitamina D/imunologia
5.
Environ Health Prev Med ; 26(1): 19, 2021 Feb 06.
Artigo em Inglês | MEDLINE | ID: mdl-33549053

RESUMO

Recent studies have revealed an inverse association between height and cardiovascular disease. However, the background mechanism of this association has not yet been clarified. Height has also been reported to be positively associated with cancer. Therefore, well-known cardiovascular risk factors, such as increased oxidative stress and chronic inflammation, are not the best explanations for this inverse association because these risk factors are also related to cancer. However, impaired blood flow is the main pathological problem in cardiovascular disease, while glowing feeding vessels (angiogenesis) are the main characteristic of cancer pathologies. Therefore, endothelial maintenance activity, especially for the productivity of hematopoietic stem cells such as CD34-positive cells, could be associated with the height of an individual because this cell contributes not only to the progression of atherosclerosis but also to the development of angiogenesis. In addition, recent studies have also revealed a close connection between bone marrow activity and endothelial maintenance; bone marrow-derived hematopoietic stem cells contribute towards endothelial maintenance. Since the absolute volume of bone marrow is positively associated with height, height could influence endothelial maintenance activity. Based on these hypotheses, we performed several studies. The aim of this review is not only to discuss the association between height and bone marrow activity, but also to describe the potential mechanism underlying endothelial maintenance. In addition, this review also aims to explain some of the reasons that implicate hypertension as a major risk factor for stroke among the Japanese population. The review also aims to clarify the anthropological reasons behind the high risk of atherosclerosis progression in Japanese individuals with acquired genetic characteristics.


Assuntos
Aterosclerose/epidemiologia , Estatura/fisiologia , Medula Óssea/fisiologia , Endotélio/fisiologia , Hipertensão/epidemiologia , Acidente Vascular Cerebral/epidemiologia , Idoso , Aterosclerose/etiologia , Aterosclerose/fisiopatologia , Progressão da Doença , Humanos , Hipertensão/etiologia , Hipertensão/fisiopatologia , Japão/epidemiologia , Masculino , Pessoa de Meia-Idade , Fatores de Risco , Acidente Vascular Cerebral/etiologia , Acidente Vascular Cerebral/fisiopatologia
6.
Arterioscler Thromb Vasc Biol ; 41(3): 1076-1091, 2021 03.
Artigo em Inglês | MEDLINE | ID: mdl-33504177

RESUMO

OBJECTIVE: Chondroitin sulfate proteoglycans are the primary constituents of the macrophage glycosaminoglycan and extracellular microenvironment. To examine their potential role in atherogenesis, we investigated the biological importance of one of the chondroitin sulfate glycosaminoglycan biosynthesis gene, ChGn-2 (chondroitin sulfate N-acetylgalactosaminyltransferase-2), in macrophage foam cell formation. Approach and Results: ChGn-2-deficient mice showed decreased and shortened glycosaminoglycans. ChGn-2-/-/LDLr-/- (low-density lipoprotein receptor) mice generated less atherosclerotic plaque after being fed with Western diet despite exhibiting a metabolic phenotype similar to that of the ChGn-2+/+/LDLr-/- littermates. We demonstrated that in macrophages, ChGn-2 expression was upregulated in the presence of oxLDL (oxidized LDL), and glycosaminoglycan was substantially increased. Foam cell formation was significantly altered by ChGn-2 in both mouse peritoneal macrophages and the RAW264.7 macrophage cell line. Mechanistically, ChGn-2 enhanced oxLDL binding on the cell surface, and as a consequence, CD36-an important macrophage membrane scavenger receptor-was differentially regulated. CONCLUSIONS: ChGn-2 alteration on macrophages conceivably influences LDL accumulation and subsequently accelerates plaque formation. These results collectively suggest that ChGn-2 is a novel therapeutic target amenable to clinical translation in the future. Graphic Abstract: A graphic abstract is available for this article.


Assuntos
Aterosclerose/metabolismo , Células Espumosas/metabolismo , Glicosaminoglicanos/metabolismo , N-Acetilgalactosaminiltransferases/metabolismo , Animais , Aterosclerose/etiologia , Aterosclerose/patologia , Modelos Animais de Doenças , Feminino , Células Espumosas/patologia , Glicosaminoglicanos/química , Lipoproteínas LDL/metabolismo , Macrófagos Peritoneais/metabolismo , Masculino , Camundongos , Camundongos Endogâmicos C57BL , Camundongos Knockout , N-Acetilgalactosaminiltransferases/deficiência , N-Acetilgalactosaminiltransferases/genética , Placa Aterosclerótica/etiologia , Placa Aterosclerótica/metabolismo , Placa Aterosclerótica/patologia , Células RAW 264.7 , Regulação para Cima
7.
Vasc Health Risk Manag ; 17: 13-21, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33488084

RESUMO

Purpose: Abdominal arteries differ from the arteries located at the extremities in histological composition and clinical features. This study investigated the distributional pattern of atherosclerosis in arteries of the abdomen and lower extremities and its association with clinical and hematologic factors. Patients and Methods: This retrospective study included 227 patients with atherosclerosis who underwent computed tomography angiography (CTA) of the abdomen and lower extremities. The distributional pattern of atherosclerosis was categorized into type 1 (suprainguinal elastic), type 2 (infrainguinal muscular), and type 3 (both arterial involvement). Chi-square tests, Mann-Whitney U-tests, and logistic regression analysis were used to investigate the data. Results: Of the 227 patients, 132 (58%) had type 1 and 95 (42%) had type 3 atherosclerosis. None had type 2. Older age, heavier smoking, and higher levels of HbA1c and homocysteine were the significant risk factors for type 3 atherosclerosis (odds ratio: 1.076, 1.023, 1.426, and 1.130, respectively). Patients with type 3 showed significantly lower right and left ankle and toe brachial indices compared to type 1 (P: 0.029, 0.023, 0.003, and <0.001, respectively). Conclusion: In arteries of the abdomen and lower extremities, atherosclerosis may occur initially at suprainguinal elastic arteries. In addition, the significant risk factors for type 3 atherosclerosis may contribute to the development of atherosclerosis at infrainguinal muscular arteries and deteriorate the peripheral arterial circulation. Therefore, if atherosclerotic lesions are found at the suprainguinal elastic arteries on CTA, to prevent atherosclerosis at infrainguinal muscular arteries and subsequent peripheral arterial ischemic disease, cessation of smoking and control of blood glucose and homocysteine may be recommended, especially in elderly patients.


Assuntos
Abdome/irrigação sanguínea , Artérias/diagnóstico por imagem , Aterosclerose/diagnóstico por imagem , Angiografia por Tomografia Computadorizada , Extremidade Inferior/irrigação sanguínea , Placa Aterosclerótica , Idoso , Idoso de 80 Anos ou mais , Aterosclerose/sangue , Aterosclerose/etiologia , Biomarcadores/sangue , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Estudos Retrospectivos , Fatores de Risco
8.
Nutr Metab Cardiovasc Dis ; 31(1): 344-353, 2021 01 04.
Artigo em Inglês | MEDLINE | ID: mdl-33500110

RESUMO

BACKGROUND AND AIMS: Cardiovascular disease is the main cause of death worldwide, but the collective efforts to prevent this pathological condition are directed exclusively to individuals at higher risk due to hypercholesterolemia, hypertension, obesity, diabetes. Recently, vitamin D deficiency was identified as a risk factor for cardiovascular disease in healthy people, as it predisposes to different vascular dysfunctions that can result in plaque development and fragility. In this scenario, the fundamental aim of the study was to reproduce a disease model inducing vitamin D deficiency and atheromatosis in ApoE-/- mice and then to evaluate the impact of this vitamin D status on the onset/progression of atheromatosis, focusing on plaque formation and instability. METHODS AND RESULTS: In our murine disease model, vitamin D deficiency was achieved by 3 weeks of vitamin D deficient diet along with intraperitoneal paricalcitol injections, while atheromatosis by western-type diet administration. Under these experimental conditions, vitamin D deficient mice developed more unstable atheromatous plaques with reduced or absent fibrotic cap. Since calcium and phosphorus metabolism and also cholesterol and triglycerides systemic concentration were not affected by vitamin D level, our results highlighted the role of vitamin D deficiency in the formation/instability of atheromatous plaque and, although further studies are needed, suggested a possible intervention with vitamin D to prevent or delay the atheromatous disease. CONCLUSIONS: The data obtained open the question about the potential role of the vitamins in the pharmacological treatments of cardiovascular disorders as coadjutant of the primary drugs used for these pathologies.


Assuntos
Doenças da Aorta/etiologia , Aterosclerose/etiologia , Deficiência de Vitamina D/complicações , Vitamina D/análogos & derivados , Animais , Aorta/metabolismo , Aorta/patologia , Doenças da Aorta/sangue , Doenças da Aorta/patologia , Aterosclerose/sangue , Aterosclerose/patologia , Biomarcadores/sangue , Dieta Hiperlipídica , Modelos Animais de Doenças , Fibrose , Lipídeos/sangue , Camundongos Knockout para ApoE , Placa Aterosclerótica , Ruptura Espontânea , Vitamina D/sangue , Deficiência de Vitamina D/sangue
9.
Metabolism ; 116: 154706, 2021 03.
Artigo em Inglês | MEDLINE | ID: mdl-33421505

RESUMO

BACKGROUND: Elevated plasma lipoprotein (a) [Lp(a)] and coronary artery calcification (CAC) are established cardiovascular risk factors that correlate with each other. We hypothesized that other cardiovascular risk factors could affect their relationship. METHODS: We tested for interactions of 24 study variables related to dyslipidemia, diabetes, insulin resistance, hypertension, inflammation and coagulation with baseline Lp(a) on change in CAC volume and density over 9.5 years in 5975 Multi-Ethnic Study of Atherosclerosis (MESA) participants, free of apparent cardiovascular disease at baseline. RESULTS: Elevated Lp(a) was associated with larger absolute increase in CAC volume (3.21 and 4.45 mm3/year higher for Lp(a) ≥30 versus <30 mg/dL, and Lp(a) ≥50 versus <50 mg/dL, respectively), but not relative change in CAC volume. No association was found with change in CAC density when assessing continuous ln-transformed Lp(a). The association between elevated Lp(a) (≥30 mg/dL) and absolute change in CAC volume was greater in participants with higher circulating levels of interleukin-2 soluble receptor α, soluble tumor necrosis factor alpha receptor 1 and fibrinogen (15.33, 11.81 and 7.02 mm3/year in quartile 4, compared to -3.44, -0.59 and 1.91 mm3/year in quartile 1, respectively). No significant interaction was found for other study variables. Similar interactions were seen when assessing Lp(a) levels ≥50 mg/dL. CONCLUSIONS: Elevated Lp(a) was associated with an absolute increase in CAC volume, especially in participants with higher levels of selected markers of inflammation and coagulation. These results suggest Lp(a) as a potential biomarker for CAC volume progression.


Assuntos
Doença da Artéria Coronariana/sangue , Lipoproteína(a)/sangue , Calcificação Vascular/sangue , Idoso , Idoso de 80 Anos ou mais , Aterosclerose/sangue , Aterosclerose/epidemiologia , Aterosclerose/etiologia , Biomarcadores/sangue , Estudos de Casos e Controles , Doença da Artéria Coronariana/epidemiologia , Doença da Artéria Coronariana/etiologia , Vasos Coronários/patologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Fatores de Risco , Estados Unidos/epidemiologia , Calcificação Vascular/epidemiologia , Calcificação Vascular/etiologia
10.
Arterioscler Thromb Vasc Biol ; 41(3): 1191-1204, 2021 03.
Artigo em Inglês | MEDLINE | ID: mdl-33406853

RESUMO

OBJECTIVE: Noncoding RNAs are emerging as important players in gene regulation and cardiovascular diseases. Their roles in the pathogenesis of atherosclerosis are not fully understood. The purpose of this study was to determine the role played by a previously uncharacterized long noncoding RNA, RP11-728F11.4, in the development of atherosclerosis and the mechanisms by which it acts. Approach and Results: Expression microarray analysis revealed that atherosclerotic plaques had increased expression of RP11-728F11.4 as well as the cognate gene FXYD6 (FXYD domain containing ion transport regulator 6), which encodes a modulator of Na+/K+-ATPase. In vitro experiments showed that RP11-728F11.4 interacted with the RNA-binding protein EWSR1 (Ewings sarcoma RNA binding protein-1) and upregulated FXYD6 expression. Lentivirus-induced overexpression of RP11-728F11.4 in cultured monocytes-derived macrophages resulted in higher Na+/K+-ATPase activity, intracellular cholesterol accumulation, and increased proinflammatory cytokine production. The effects of RP11-728F11.4 were enhanced by siRNA-mediated knockdown of EWSR1 and reduced by downregulation of FXYD domain containing ion transport regulator 6. In vivo experiments in apoE knockout mice fed a Western diet demonstrated that RP11-728F11.4 increased proinflammatory cytokine production and augmented atherosclerotic lesions. CONCLUSIONS: RP11-728F11.4 promotes atherosclerosis, with an influence on cholesterol homeostasis and proinflammatory molecule production, thus representing a potential therapeutic target. Graphic Abstract: A graphic abstract is available for this article.


Assuntos
Aterosclerose/genética , RNA Longo não Codificante/genética , Animais , Aterosclerose/etiologia , Aterosclerose/metabolismo , Células Cultivadas , Colesterol/metabolismo , Citocinas/metabolismo , Modelos Animais de Doenças , Células Endoteliais/metabolismo , Feminino , Técnicas de Silenciamento de Genes , Humanos , Canais Iônicos/genética , Canais Iônicos/metabolismo , Metabolismo dos Lipídeos , Masculino , Camundongos , Camundongos Endogâmicos C57BL , Camundongos Knockout para ApoE , Pessoa de Meia-Idade , Placa Aterosclerótica/etiologia , Placa Aterosclerótica/genética , Placa Aterosclerótica/patologia , RNA Longo não Codificante/metabolismo , Proteína EWS de Ligação a RNA/antagonistas & inibidores , Proteína EWS de Ligação a RNA/genética , Proteína EWS de Ligação a RNA/metabolismo , ATPase Trocadora de Sódio-Potássio/metabolismo , Regulação para Cima
11.
J Surg Res ; 257: 189-194, 2021 01.
Artigo em Inglês | MEDLINE | ID: mdl-32835952

RESUMO

BACKGROUND: Carotid artery stenosis (CAS) is the most frequently detected treatable cause of ischemic stroke. However, there are no recommendations to screen asymptomatic patients. The atherosclerotic cardiovascular disease (ASCVD) risk score estimates individuals' 10-year risk for developing cardiovascular disease. The objective of this study is to identify a relationship between the ASCVD risk score and moderate/severe CAS based on ultrasound findings. MATERIALS AND METHODS: We performed a single-institution retrospective review of patients who underwent a surveillance ultrasound for CAS between 2015 and 2018. We used Strandness velocity criteria to separate patients into two cohorts: none to mild CAS (<50%) and moderate/severe CAS (≥50%). We performed Student's t-test, multivariate analysis, and receiver operator characteristic (ROC) curve analysis to determine a relationship between the ASCVD risk score and degree of CAS. We evaluated a new risk score model based on stepwise logistic regression of significant variables on univariate analysis. RESULTS: Two thousand eight hundred and fifty-six patients with carotid ultrasounds (1623 with none to mild, 1161 with moderate, and 72 with severe disease) were included in the study. The ASCVD risk score significantly predicted moderate/severe CAS in an adjusted multivariate analysis. Each 10% increase in the ASCVD risk score corresponded to an additional 11% likelihood of moderate/severe stenosis (OR: 1.11 [1.04-1.20], P = 0.004). The ROC area under the curve for predicting moderate/severe CAS based on the ASCVD risk score was 0.59 (Youden index (J) = 0.14); the optimized ASCVD cutoff point was 28.4%. Our new atherosclerotic disease model demonstrated increased odds of moderate/severe CAS with scores greater than zero (ROC area under the curve = 0.57). CONCLUSIONS: This is the first study to demonstrate an association between atherosclerotic disease risk factors as measured by the ASCVD risk score and moderate/severe CAS. However, this tool is not sensitive or specific for using the ASCVD risk score as a screening mechanism for moderate/severe CAS.


Assuntos
Aterosclerose/epidemiologia , Estenose das Carótidas/epidemiologia , Idoso , Idoso de 80 Anos ou mais , Aterosclerose/etiologia , Artérias Carótidas/diagnóstico por imagem , Estenose das Carótidas/complicações , Estenose das Carótidas/diagnóstico , Feminino , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Curva ROC , Estudos Retrospectivos , Medição de Risco/métodos , Fatores de Risco , Índice de Gravidade de Doença , Ultrassonografia
12.
Food Chem ; 345: 128868, 2021 May 30.
Artigo em Inglês | MEDLINE | ID: mdl-33352404

RESUMO

Dietary fats may affect blood lipid levels and the development of cardiovascular diseases. Offal, may contribute to food security in marginalised communities and information on the contribution to dietary fat intake is needed to inform dietary guidelines and recommendations and consumers. This study aimed to describe the fatty acid profile, cholesterol content and indexes of lipid quality. The fatty acid profile and cholesterol were determined by gas chromatography coupled with flame ionisation detection (GC-FID). To evaluate lipid quality the indices of atherogenicity (IA) and thrombogenicity (IT) were calculated. Offal products can contribute beneficial fatty acids to the diet, not only in terms of essential fatty acids such as linoleic (C18:2n-6) and alpha linolenic (C18:3n-3) acids, but also the polyunsaturated fatty acids, arachidonic (C20:4n-6) and eicosapentaenoic (C20:5n3) acids. The offal studied in the present work showed a P/S ratio of 0.04-0.12 and the n-6/n-3 ratio varied between 3.9 and 12.5.


Assuntos
Aterosclerose/etiologia , Colesterol/análise , Gorduras na Dieta/análise , Carne Vermelha/efeitos adversos , Carne Vermelha/análise , Ovinos , Trombose/etiologia , Animais , Cromatografia Gasosa , Humanos
13.
Chin J Physiol ; 63(6): 256-262, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33380610

RESUMO

Atherosclerosis and associated pathologies, such as coronary artery disease, peripheral vascular disease, and stroke, are still the leading cause of death in Western society. The impact of female sex hormones on cardiovascular diseases has been studied intensively with conflicting findings. The controversy is mainly due to the differences in groups sampling, animal models used, hormonal treatment regimens, and the data analyzed. In the present article, the results of in vitro and in vivo studies and clinical trials are under review.


Assuntos
Aterosclerose , Animais , Aterosclerose/etiologia , Doença da Artéria Coronariana , Feminino , Hormônios Esteroides Gonadais
14.
PLoS One ; 15(12): e0242543, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33326419

RESUMO

Clinical studies using a range of omega-3 supplements have yielded conflicting results on their efficacy to control inflammation. Omega-3 fatty acids are substrate for the formation of potent immune-protective mediators, termed as specialized pro-resolving mediators (SPM). Herein, we investigated whether observed differences in the potencies of distinct omega-3 supplements were linked with their ability to upregulate SPM formation. Using lipid mediator profiling we found that four commercially available supplements conferred a unique SPM signature profile to human macrophages, with the overall increases in SPM concentrations being different between the four supplements. These increases in SPM concentrations were linked with an upregulation of macrophage phagocytosis and a decreased uptake of oxidized low-density lipoproteins. Pharmacological inhibition of two key SPM biosynthetic enzymes 5-Lipoxygenase or 15-Lipoxygenase reversed the macrophage-directed actions of each of the omega-3 supplements. Furthermore, administration of the two supplements that most potently upregulated macrophage SPM formation and reprogrammed their responses in vitro, to APOE-/- mice fed a western diet, increased plasma SPM concentrations and reduced vascular inflammation. Together these findings support the utility of SPM as potential prognostic markers in determining the utility of a given supplement to regulate macrophage responses and inflammation.


Assuntos
Aterosclerose/prevenção & controle , Suplementos Nutricionais , Ácidos Graxos Ômega-3/administração & dosagem , Leucotrienos/biossíntese , Lipoxinas/biossíntese , Macrófagos/efeitos dos fármacos , Prostaglandinas/biossíntese , Animais , Apolipoproteínas E/deficiência , Apolipoproteínas E/genética , Apolipoproteínas E/imunologia , Araquidonato 15-Lipoxigenase/genética , Araquidonato 15-Lipoxigenase/imunologia , Araquidonato 5-Lipoxigenase/genética , Araquidonato 5-Lipoxigenase/imunologia , Aterosclerose/etiologia , Aterosclerose/imunologia , Aterosclerose/metabolismo , Dieta Ocidental/efeitos adversos , Ácidos Graxos Ômega-3/metabolismo , Feminino , Expressão Gênica , Humanos , Leucotrienos/imunologia , Lipoproteínas LDL/antagonistas & inibidores , Lipoproteínas LDL/farmacologia , Lipoxinas/imunologia , Inibidores de Lipoxigenase/farmacologia , Macrófagos/citologia , Macrófagos/imunologia , Masculino , Camundongos , Camundongos Knockout para ApoE , Fagocitose/efeitos dos fármacos , Cultura Primária de Células , Análise de Componente Principal , Prostaglandinas/imunologia
15.
PLoS One ; 15(12): e0243232, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33326424

RESUMO

AIM: This study explores the association between Coronary Artery Calcium (CAC) scores and dental pathology such as missing teeth, the (peri-apical) health status and restoration grade of the teeth, and the grade of alveolar bone loss seen on a dental panoramic radiograph (Orthopantomograph-OPG). MATERIALS AND METHODS: In this retrospective cross-sectional study, data was collected from three hospitals spread in the Netherlands. Patients were included when a CAC score and an OPG were available, both recorded within a maximum period of 365 days from 2009-2017. The CAC score was measured on a CT scan, using the Agatston method. To assess dental pathology, the number of missing teeth, the number of dental implants, alveolar bone loss, caries, endodontic treatments, peri-apical radiolucencies, bone loss at implants, impacted teeth and dental cysts, were determined on the OPG. All observers were calibrated. The electronic health records provided information about: gender, age, smoking, Diabetes Mellitus, hypercholesterolemia, hypertension and Body Mass Index (BMI). RESULTS: 212 patients were included. We found a statistically significant association between the number of missing teeth and the CAC score. When modeling age, sex, and other well-known risk factors for cardiovascular disease, the significant correlation was no longer present after multivariate correction. Furthermore, the results showed a trend for more teeth with peri-apical lesions and a higher percentage of mean alveolar bone loss in the group with the highest CAC scores. CONCLUSION: This study showed that being edentulous or missing teeth is correlated to higher CAC scores however failed to be an independent predictor of atherosclerotic cardiovascular diseases. The number of (missing) teeth is an easily accessible marker and could be used as a marker for atherosclerotic cardiovascular disease (ACVD) risk by almost any healthcare worker. The current study needs to be considered as an explorative pilot study and could contribute to the design of further (prospective) studies on the relationship between dental pathology and coronary artery calcification by adding clinical information and extra cardiovascular biomarkers.


Assuntos
Calcinose/etiologia , Cálcio/análise , Vasos Coronários/patologia , Perda de Dente/complicações , Adulto , Idoso , Aterosclerose/etiologia , Aterosclerose/patologia , Calcinose/patologia , Doenças Cardiovasculares/etiologia , Doenças Cardiovasculares/patologia , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Projetos Piloto , Estudos Retrospectivos , Fatores de Risco , Perda de Dente/patologia
16.
PLoS One ; 15(12): e0241779, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33315867

RESUMO

Accurate quantification and characterization of atherosclerotic plaques with MRI requires high spatial resolution acquisitions with excellent image quality. The intrinsically better signal-to-noise ratio (SNR) at high-field clinical 7T compared to the widely employed lower field strengths of 1.5 and 3T may yield significant improvements to vascular MRI. However, 7T atherosclerosis imaging also presents specific challenges, related to local transmit coils and B1 field inhomogeneities, which may overshadow these theoretical gains. We present the development and evaluation of 3D, black-blood, ultra-high resolution vascular MRI on clinical high-field 7T in comparison lower-field 3T. These protocols were applied for in vivo imaging of atherosclerotic rabbits, which are often used for development, testing, and validation of translatable cardiovascular MR protocols. Eight atherosclerotic New Zealand White rabbits were imaged on clinical 7T and 3T MRI scanners using 3D, isotropic, high (0.63 mm3) and ultra-high (0.43 mm3) spatial resolution, black-blood MR sequences with extensive spatial coverage. Following imaging, rabbits were sacrificed for validation using fluorescence imaging and histology. Image quality parameters such as SNR and contrast-to-noise ratio (CNR), as well as morphological and functional plaque measurements (plaque area and permeability) were evaluated at both field strengths. Using the same or comparable imaging parameters, SNR and CNR were in general higher at 7T compared to 3T, with a median (interquartiles) SNR gain of +40.3 (35.3-80.1)%, and a median CNR gain of +68.1 (38.5-95.2)%. Morphological and functional parameters, such as vessel wall area and permeability, were reliably acquired at 7T and correlated significantly with corresponding, widely validated 3T vessel wall MRI measurements. In conclusion, we successfully developed 3D, black-blood, ultra-high spatial resolution vessel wall MRI protocols on a 7T clinical scanner. 7T imaging was in general superior to 3T with respect to image quality, and comparable in terms of plaque area and permeability measurements.


Assuntos
Aterosclerose/diagnóstico , Imageamento Tridimensional/métodos , Angiografia por Ressonância Magnética/métodos , Placa Aterosclerótica/diagnóstico por imagem , Animais , Aorta Abdominal/diagnóstico por imagem , Aorta Abdominal/lesões , Aorta Abdominal/patologia , Aterosclerose/etiologia , Aterosclerose/patologia , Dieta Hiperlipídica/efeitos adversos , Modelos Animais de Doenças , Estudos de Viabilidade , Humanos , Angiografia por Ressonância Magnética/instrumentação , Masculino , Placa Aterosclerótica/etiologia , Placa Aterosclerótica/patologia , Coelhos , Reprodutibilidade dos Testes , Razão Sinal-Ruído
17.
Ter Arkh ; 92(9): 94-101, 2020 Oct 14.
Artigo em Russo | MEDLINE | ID: mdl-33346437

RESUMO

The review presents an analysis of studies on the role of the intestinal microbiota and microbiome in lipid metabolism and the development of dyslipidemia, atherosclerosis and cardiovascular diseases. The role of the intestine as a metabolic organ with a multifactorial strain evolution, involved in lipid metabolism, cholesterol homeostasis and enterohepatic circulation is shown. The influence of microbial imbalance on the development of dyslipidemia and atherosclerosis is considered. Special attention is paid to preventive therapy with hypolipidemic probiotics. It is shown that the use of probiotics with hypolipidemic properties and consisting of a mixture of such strains asLactobacillus plantarumCECT7527, CET7528 and CECT7529, mixtures ofLactobacillus acidophilusLa-5,Bifidobacterium lactisBB-12,Bifidobacterium animalis lactisBB-12 contribute to reducing the level of LDL-C, CCS, TG, are safe and well tolerated, can be used as an adjuvant non-drug therapy in combination with hypolipidemic drugs for dyslipidemia, multifocal atherosclerosis.


Assuntos
Aterosclerose , Dislipidemias , Microbioma Gastrointestinal , Probióticos , Aterosclerose/etiologia , Aterosclerose/prevenção & controle , Dislipidemias/tratamento farmacológico , Dislipidemias/etiologia , Dislipidemias/prevenção & controle , Humanos , Fatores de Risco
19.
Rev. cuba. estomatol ; 57(3): e2976, jul.-set. 2020. tab, graf
Artigo em Espanhol | LILACS, CUMED | ID: biblio-1126523

RESUMO

RESUMEN Introducción: La periodontitis se caracteriza por ser una inflamación mediada por el huésped y asociada a microbios que producen la pérdida de la adherencia periodontal. Una infección focal localizada como la enfermedad periodontal podría conducir a una inflamación sistémica. La disfunción endotelial vascular se ha asociado con una variedad de enfermedades y factores de riesgo para la aterosclerosis, que incluyen la edad, hipertensión arterial, dislipidemias, diabetes, tabaquismo, enfermedades cardiovasculares específicas como arteriopatía coronaria, cerebral y procesos infecciosos e inflamatorios como enfermedad periodontal. Objetivo: Evaluar los efectos del tratamiento periodontal no quirúrgico sobre la función endotelial de los pacientes con periodontitis crónica mediante una revisión de ensayos clínicos aleatorizados. Métodos: Se utilizó una estrategia de búsqueda primaria en combinación de vocabulario controlado y términos de texto libre para la elaboración de una estrategia de búsqueda en MEDLINE a través de PubMed, mediante el PubMed Advanced Search Builder el 5 de julio de 2019. Análisis e integración de la información: Fueron seleccionados 29 artículos de 2214. Para la elección se tuvo en cuenta que fueran estudios en humanos donde estuvieran relacionadas las variables de estudio. Del 100 por ciento de los artículos seleccionados se encontró que el 37,9 por ciento pertenecían a estudios de casos y controles, el 31 por ciento pertenecían a estudios transversales, el 10,34 por ciento a estudios de cohorte y solo 20,6 por ciento fueros estudios de ensayos clínicos, de los cuales solo 3 artículos (10 por ciento) fueron seleccionados para esta revisión. Conclusiones: La terapia periodontal no presenta un efecto sobre la función endotelial en un periodo de 3 meses, sin embargo, a los 6 meses se reporta una mejoría en la función endotelial(AU)


ABSTRACT Introduction: Periodontitis is characterized by being an inflammation mediated by the host and associated with microbes that produce, the loss of periodontal adhesion. A localized focal infection such as periodontal disease could lead to systemic inflammation. Vascular endothelial dysfunction has been associated with a variety of pathologies and risk factors for atherosclerosis, including age, hypertension, dyslipidemias, diabetes, smoking, specific cardiovascular pathologies such as coronary artery disease, cerebral, inflammatory, and infectious processes such as periodontal disease. Objective: Assess the effects of non-surgical periodontal treatment on the endothelial function of patients with chronic periodontitis through a review of randomized clinical trials. Methods: We used a primary search strategy using a combination of controlled vocabulary and free text terms based on the MEDLINE search strategy through PubMed using the PubMed Advanced Search Builder on July 05, 2019. Analysis and integration of the information: 29 articles of 2214 were selected because they are human studies where the study variables are related. 100 percent of the selected articles found that 37.9 percent belonged to case-control studies, 31 percent belonged to cross-sectional studies, 10.34 percent to cohort studies and only 20.6 percent were clinical trial studies, of which only 3 articles (10 percent) were selected for this review. Conclusions: Periodontal therapy does not have an effect on endothelial function in a period of 3 months, however at 6 months an improvement in endothelial function was reported(AU)


Assuntos
Humanos , Periodontite/fisiopatologia , Literatura de Revisão como Assunto , Doenças Cardiovasculares/etiologia , Fatores de Risco , Aterosclerose/etiologia , Estudos de Casos e Controles , Estudos Transversais , Estudos de Coortes , Bases de Dados Bibliográficas
20.
Am J Physiol Heart Circ Physiol ; 319(3): H547-H556, 2020 09 01.
Artigo em Inglês | MEDLINE | ID: mdl-32734819

RESUMO

Tobacco cigarette (TC) smoking has never been lower in the United States, but electronic cigarette (EC) vaping has reached epidemic proportions among our youth. Endothelial dysfunction, as measured by flow-mediated vasodilation (FMD) is a predictor of future atherosclerosis and adverse cardiovascular events and is impaired in young TC smokers, but whether FMD is also reduced in young EC vapers is uncertain. The aim of this study in otherwise healthy young people was to compare the effects of acute and chronic tobacco cigarette (TC) smoking and electronic cigarette (EC) vaping on FMD. FMD was compared in 47 nonsmokers (NS), 49 chronic EC vapers, and 40 chronic TC smokers at baseline and then after EC vapers (n = 31) and nonsmokers (n = 47) acutely used an EC with nicotine (ECN), EC without nicotine (EC0), and nicotine inhaler (NI) at ~4-wk intervals and after TC smokers (n = 33) acutely smoked a TC, compared with sham control. Mean age (NS, 26.3 ± 5.2 vs. EC, 27.4 ± 5.45 vs. TC, 27.1 ± 5.51 yr, P = 0.53) was similar among the groups, but there were more female nonsmokers. Baseline FMD was not different among the groups (NS, 7.7 ± 4.5 vs. EC:6.6 ± 3.6 vs. TC, 7.9 ± 3.7%∆, P = 0.35), even when compared by group and sex. Acute TC smoking versus control impaired FMD (FMD pre-/postsmoking, -2.52 ± 0.92 vs. 0.65 ± 0.93%∆, P = 0.02). Although the increase in plasma nicotine was similar after EC vapers used the ECN versus TC smokers smoked the TC (5.75 ± 0.74 vs. 5.88 ± 0.69 ng/mL, P = 0.47), acute EC vaping did not impair FMD. In otherwise healthy young people who regularly smoke TCs or ECs, impaired FMD compared with that in nonsmokers was not present at baseline. However, FMD was significantly impaired after smoking one TC, but not after vaping an equivalent "dose" (estimated by change in plasma nicotine) of an EC, consistent with the notion that non-nicotine constituents in TC smoke mediate the impairment. Although it is reassuring that acute EC vaping did not acutely impair FMD, it would be dangerous and premature to conclude that ECs do not lead to atherosclerosis.NEW & NOTEWORTHY In our study of otherwise healthy young people, baseline flow-mediated dilation (FMD), a predictor of atherosclerosis and increased cardiovascular risk, was not different among tobacco cigarette (TC) smokers or electronic cigarette (EC) vapers who had refrained from smoking, compared with nonsmokers. However, acutely smoking one TC impaired FMD in smokers, whereas vaping a similar EC "dose" (as estimated by change in plasma nicotine levels) did not. Finally, although it is reassuring that acute EC vaping did not acutely impair FMD, it would be premature and dangerous to conclude that ECs do not lead to atherosclerosis or increase cardiovascular risk.


Assuntos
Artéria Braquial/fisiopatologia , Fumar Cigarros/efeitos adversos , Vapor do Cigarro Eletrônico/efeitos adversos , Sistemas Eletrônicos de Liberação de Nicotina , Endotélio Vascular/fisiopatologia , Vaping/efeitos adversos , Vasodilatação , Adulto , Aterosclerose/etiologia , Aterosclerose/fisiopatologia , Fumar Cigarros/fisiopatologia , Qualidade de Produtos para o Consumidor , Estudos Cross-Over , Feminino , Voluntários Saudáveis , Humanos , Masculino , Pessoa de Meia-Idade , Distribuição Aleatória , Medição de Risco , Fatores de Risco , Adulto Jovem
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