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1.
Hypertension ; 79(1): 150-158, 2022 01.
Artigo em Inglês | MEDLINE | ID: mdl-34775788

RESUMO

Elastic arteries stiffen via 2 main mechanisms: (1) load-dependent stiffening from higher blood pressure and (2) structural stiffening due to changes in the vessel wall. Differentiating these closely coupled mechanisms is important to understanding vascular aging. MESA (Multi-Ethnic Study of Atherosclerosis) participants with B-mode carotid ultrasound and brachial blood pressure at exam 1 and exam 5 (year 10) were included in this study (n=2604). Peterson and Young elastic moduli were calculated to represent total stiffness. Structural stiffness was calculated by adjusting Peterson and Young elastic moduli to a standard blood pressure of 120/80 mm Hg with participant-specific models. Load-dependent stiffness was the difference between total and structural stiffness. Changes in carotid artery stiffness mechanisms over 10 years were compared by age groups with ANCOVA models adjusted for baseline cardiovascular disease risk factors. The 75- to 84-year age group had the greatest change in total, structural, and load-dependent stiffening compared with younger groups (P<0.05). Only age and cessation of antihypertensive medication were predictive of structural stiffening, whereas age, race/ethnicity, education, blood pressure, cholesterol, and antihypertensive medication were predictive of increased load-dependent stiffening. On average, structural stiffening accounted for the vast majority of total stiffening, but 37% of participants had more load-dependent than structural stiffening. Rates of structural and load-dependent carotid artery stiffening increased with age. Structural stiffening was consistently observed, and load-dependent stiffening was highly variable. Heterogeneity in arterial stiffening mechanisms with aging may influence cardiovascular disease development.


Assuntos
Envelhecimento/fisiologia , Aterosclerose/fisiopatologia , Doenças Cardiovasculares/fisiopatologia , Artérias Carótidas/fisiopatologia , Rigidez Vascular/fisiologia , Idoso , Idoso de 80 Anos ou mais , Pressão Sanguínea/fisiologia , Progressão da Doença , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Ultrassonografia
2.
Hypertension ; 79(1): 159-169, 2022 01.
Artigo em Inglês | MEDLINE | ID: mdl-34784721

RESUMO

We examined the temporal longitudinal associations of carotid-femoral pulse wave velocity (cfPWV), a measure of arterial stiffness, and carotid intima-media thickness (cIMT) with the risk of overweight/obesity and elevated blood pressure (BP)/hypertension. We studied 3862 adolescents aged 17.7 years from the Avon Longitudinal Study of Parents and Children, followed-up for 7 years. cfPWV and cIMT were measured by ultrasound. Total and trunk fat mass and lean mass were assessed by dual-energy X-ray absorptiometry. Body mass index and BP were measured. Data were analyzed using logistic regression, linear mixed-effect, and cross-lagged structural equation models, with covariate adjustments. Among 1719 male and 2143 female participants, higher cfPWV at 17.7 years was associated with the risk of elevated systolic BP/hypertension (odds ratio, 1.20 [1.02-1.41]; P=0.026), elevated diastolic BP/hypertension (1.77 [1.32-2.38]; P<0.0001), body mass index-overweight/obesity (1.19 [1.01-1.41]; P=0.041), and trunk fat mass overweight/obesity (1.24 [1.03-1.49]; P=0.023) at 24.5 years. Higher cIMT at 17.7 years had no associations with obesity and elevated BP at follow-up. cfPWV progression was directly associated with 7-year increase in systolic BP (effect estimate 16 mm Hg [9-24]; P<0.0001) and diastolic BP (28 mm Hg [23-34]; P<0.0001). cIMT progression was directly associated with the 7-year increase of all adiposity measures and diastolic BP. In the temporal analysis, baseline cfPWV was directly associated with follow-up systolic and diastolic BP, however, baseline BP was unassociated with follow-up cfPWV. cfPWV but not cIMT was bidirectionally associated with adiposity. Obesity and hypertension prevention from adolescence may require developing novel approaches to mitigate arterial stiffness.


Assuntos
Pressão Sanguínea/fisiologia , Hipertensão/fisiopatologia , Obesidade/fisiopatologia , Sobrepeso/fisiopatologia , Rigidez Vascular/fisiologia , Adiposidade/fisiologia , Adolescente , Índice de Massa Corporal , Espessura Intima-Media Carotídea , Criança , Progressão da Doença , Feminino , Humanos , Hipertensão/diagnóstico por imagem , Masculino , Obesidade/diagnóstico por imagem , Sobrepeso/diagnóstico por imagem , Fatores de Risco , Inquéritos e Questionários , Ultrassonografia , Adulto Jovem
3.
Nutrients ; 13(10)2021 Oct 03.
Artigo em Inglês | MEDLINE | ID: mdl-34684499

RESUMO

The frequency of aerobic exercise training in reducing the increase in arterial stiffness during acute hyperglycemia, a risk factor for cardiovascular disease, is unknown. The aim of the study was to determine the aerobic exercise training frequency on arterial stiffness in a hyperglycemic state in middle-aged and elderly females. Twenty healthy elderly people were randomly assigned to a two-times-a-week (T2, n = 10) and four-times-a-week (T4, n = 10) exercise group. All participants exercised for 35 min per session, which consisted of jogging exercises with a heart rate intensity of 65%. Brachial-ankle (ba), and heart-brachial (hb) pulse wave velocity (PWV) were measured before, 4 and 8 weeks after intervention; before the oral ingestion of 75-g of glucose; and 30, 60, and 90 min after ingestion. The baPWV before and 4 weeks after the intervention increased in both groups (p < 0.05), but only increased 8 weeks after intervention in the T2 group. hbPWV was unchanged before, 4 and 8 weeks after intervention in both groups. These findings show that frequent aerobic exercise suppresses the increase in arterial stiffness following glucose intake. The results of this study can be used to support the implementation of exercise programs for middle-aged and elderly patients.


Assuntos
Exercício Físico/fisiologia , Hiperglicemia/terapia , Doença Arterial Periférica/prevenção & controle , Fatores de Tempo , Rigidez Vascular/fisiologia , Idoso , Idoso de 80 Anos ou mais , Índice Tornozelo-Braço , Glicemia/análise , Feminino , Teste de Tolerância a Glucose , Frequência Cardíaca/fisiologia , Humanos , Hiperglicemia/complicações , Hiperglicemia/fisiopatologia , Pessoa de Meia-Idade , Doença Arterial Periférica/etiologia , Análise de Onda de Pulso
4.
Am J Nurs ; 121(11): 69, 2021 11 01.
Artigo em Inglês | MEDLINE | ID: mdl-34673700

RESUMO

According to this study: In obese older adults, combining aerobic exercise with moderate caloric restriction leads to greater improvement in proximal aortic stiffness than exercise alone.


Assuntos
Aorta , Restrição Calórica , Exercício Físico/fisiologia , Obesidade , Rigidez Vascular/fisiologia , Perda de Peso/fisiologia , Idoso , Índice de Massa Corporal , Feminino , Humanos , Masculino
5.
Sci Rep ; 11(1): 17827, 2021 09 08.
Artigo em Inglês | MEDLINE | ID: mdl-34497312

RESUMO

Because of their long lifespan, matrix proteins of the vascular wall, such as elastin, are subjected to molecular aging characterized by non-enzymatic post-translational modifications, like carbamylation which results from the binding of cyanate (mainly derived from the dissociation of urea) to protein amino groups. While several studies have demonstrated a relationship between increased plasma concentrations of carbamylated proteins and the development of cardiovascular diseases, molecular mechanisms explaining the involvement of protein carbamylation in these pathological contexts remain to be fully elucidated. The aim of this work was to determine whether vascular elastic fibers could be carbamylated, and if so, what impact this phenomenon would have on the mechanical properties of the vascular wall. Our experiments showed that vascular elastin was carbamylated in vivo. Fiber morphology was unchanged after in vitro carbamylation, as well as its sensitivity to elastase degradation. In mice fed with cyanate-supplemented water in order to increase protein carbamylation within the aortic wall, an increased stiffness in elastic fibers was evidenced by atomic force microscopy, whereas no fragmentation of elastic fiber was observed. In addition, this increased stiffness was also associated with an increase in aortic pulse wave velocity in ApoE-/- mice. These results provide evidence for the carbamylation of elastic fibers which results in an increase in their stiffness at the molecular level. These alterations of vessel wall mechanical properties may contribute to aortic stiffness, suggesting a new role for carbamylation in cardiovascular diseases.


Assuntos
Aorta/fisiologia , Tecido Elástico/metabolismo , Elastina/metabolismo , Rigidez Vascular/fisiologia , Animais , Aorta/efeitos dos fármacos , Bovinos , Cianatos/farmacologia , Tecido Elástico/efeitos dos fármacos , Camundongos , Carbamilação de Proteínas/efeitos dos fármacos , Rigidez Vascular/efeitos dos fármacos
6.
Sci Rep ; 11(1): 16501, 2021 08 13.
Artigo em Inglês | MEDLINE | ID: mdl-34389755

RESUMO

There is an established link between cardiometabolic abnormality, central arterial stiffness, and preserved ejection fraction heart failure (HFpEF). Adipocyte free fatty acid binding protein (a-FABP) has been shown to signal endothelial dysfunction through fatty acid toxicity, though its role in mediating ventricular-arterial dysfunction remains unclear. We prospectively examined the associations of a-FABP with central arterial pressure using non-invasive applanation tonometry (SphygmoCor) and cardiac structure/function (i.e., tissue Doppler imaging [TDI] and global longitudinal myocardial strain [GLS]) in patients with cardiometabolic (CM) risk (n = 150) and HFpEF (n = 50), with healthy volunteers (n = 49) serving as a control. We observed a graded increase of a-FABP across the healthy controls, CM individuals, and HFpEF groups (all paired p < 0.05). Higher a-FABP was independently associated with higher central systolic and diastolic blood pressures (CSP/CPP), increased arterial augmentation index (Aix), lower early myocardial relaxation velocity (TDI-e'), higher left ventricle (LV) filling (E/TDI-e') and worsened GLS (all p < 0.05). During a median of 3.85 years (interquartile range: 3.68-4.62 years) follow-up, higher a-FABP (cutoff: 24 ng/mL, adjusted hazard ratio: 1.01, 95% confidence interval: 1.001-1.02, p = 0.04) but not brain natriuretic peptide, and higher central hemodynamic indices were related to the incidence of heart failure (HF) in fully adjusted Cox models. Furthermore, a-FABP improved the HF risk classification over central hemodynamic information. We found a mechanistic pathophysiological link between a-FABP, central arterial stiffness, and myocardial dysfunction. In a population with a high metabolic risk, higher a-FABP accompanied by worsened ventricular-arterial coupling may confer more unfavorable outcomes in HFpEF.


Assuntos
Cardiomiopatias/sangue , Proteínas de Ligação a Ácido Graxo/sangue , Insuficiência Cardíaca/sangue , Rigidez Vascular , Idoso , Pressão Sanguínea , Cardiomiopatias/diagnóstico por imagem , Estudos de Casos e Controles , Ecocardiografia , Feminino , Insuficiência Cardíaca/diagnóstico por imagem , Hemodinâmica , Humanos , Masculino , Manometria , Pessoa de Meia-Idade , Estudos Prospectivos , Volume Sistólico , Rigidez Vascular/fisiologia
7.
Medicine (Baltimore) ; 100(32): e26931, 2021 Aug 13.
Artigo em Inglês | MEDLINE | ID: mdl-34397939

RESUMO

ABSTRACT: Peripheral arterial disease (PAD) is one of major vascular diseases which frequently coexists with coronary arterial disease and cerebrovascular disease. The patients with PAD have a poor prognosis when it progresses. A new blood pressure testing device enables to simultaneously measure brachial blood pressure (BP), central BP, and several vascular parameters, with easy and non-invasive, in a short time. Here, we aimed to evaluate these arterial stiffness parameters in patients with PAD.In this study, 243 consecutive patients who were suspected of having PAD and referred to our hospital from September 2016 to June 2019, were registered. Several parameters, such as brachial BP, central BP, aortic pulse wave velocity (aPWV), total vascular resistance (TVR), augmentation index (AI) and augmentation pressure (AP), were determined by Mobil-O-Graph. Ankle-brachial pressure index (ABI) was used to define PAD (ABI ≤ 0.9 as PAD). The relationship between PAD and central BP, aPWV, TVR, AI, or AP were investigated.One hundred sixty-two patients (67%) were categorized as the PAD group and 81 patients (33%) as the non-PAD group. In the PAD group, the systolic brachial BP and central systolic BP were significantly higher than those in the non-PAD group (138 ±â€Š24 mmHg vs 131 ±â€Š19 mmHg, P < .05, 125 ±â€Š22 mmHg vs 119 ±â€Š18 mmHg, P < .05, respectively). TVR, AI, and AP were significantly higher in the PAD group (1785 ±â€Š379 dyn s/cm5 vs 1661 ±â€Š317 dyn s/cm5, P < .05, 26.2 ±â€Š13.0% vs 22.2 ±â€Š13.3%, P < .05, 13.5 ±â€Š9.4 mmHg vs 10.7 ±â€Š7.2 mmHg, P < .05, respectively). No significant differences in diastolic BP, central diastolic BP, and aPWV were found between the groups. Multivariate logistic regression analysis revealed that PAD was significantly associated with TVR, AI, and AP (P < .05, respectively).TVR/AP/AI were significantly higher in the PAD group than in the non-PAD group.


Assuntos
Velocidade do Fluxo Sanguíneo/fisiologia , Pressão Sanguínea/fisiologia , Doença Arterial Periférica/fisiopatologia , Resistência Vascular/fisiologia , Rigidez Vascular/fisiologia , Idoso , Índice Tornozelo-Braço , Estudos Transversais , Feminino , Humanos , Masculino , Análise de Onda de Pulso , Estudos Retrospectivos
8.
Sci Rep ; 11(1): 14143, 2021 07 08.
Artigo em Inglês | MEDLINE | ID: mdl-34239018

RESUMO

This study aimed to explore the associations between renal-related and arterial stiffness biomarkers with all-cause and expanded cardiovascular disease (CVD) mortality in a general Taiwanese population. This prospective community-based cohort study included 4883 subjects aged ≥ 20 years who were followed up until December 31, 2016. Renal-related biomarkers consisted of blood urea nitrogen (BUN), estimated glomerular filtration rate (eGFR), and urine albumin-to-creatinine ratio (UACR). Arterial stiffness biomarker consisted of brachial-ankle pulse wave velocity (baPWV). The death status of the subjects was ascertained by matching information from death records with the identification number and date of birth of the subjects. Cox proportional hazard models with restricted cubic splines estimated the hazard ratios and 95% confidence intervals for all-cause mortality and expanded CVD mortality. During a mean 8.3 years of follow up, 456 deaths were recorded, 146 of which were due to expanded CVD mortality. The multivariable-adjusted hazard ratios of all-cause mortality was 1.53 (95% CI 1.21-1.94) for BUN (≥ 20 mg/dL vs. < 20 mg/dL), 1.57 (1.15-2.14) for eGFR (< 90 mL/min/1.73 m2 vs. ≥ 90 mL/min/1.73 m2), 1.55 (1.25-1.92) for UACR (≥ 30 mg/g vs. < 30 mg/g), and 1.75 (1.14-2.67) for baPWV (≥ 1400 cm/s vs. < 1400 cm/s). The expanded CVD mortality was 1.89 (95% CI 1.30-2.73) for BUN (≥ 20 mg/dL vs. < 20 mg/dL), 2.28 (1.13-4.57) for eGFR (< 90 mL/min/1.73 m2 vs. ≥ 90 mL/min/1.73 m2), 2.13 (1.52-2.99) for UACR (≥ 25 mg/g vs. < 25 mg/g), and 15.73 (2.14-115.61) for baPWV (≥ 1400 cm/s vs. < 1400 cm/s). High levels of BUN, UACR, and baPWV and low levels of eGFR showed high risks with all-cause and expanded CVD mortality. Our study provides insights into screening tests to target populations at high risk of premature death due to CVD.


Assuntos
Biomarcadores , Doenças Cardiovasculares/mortalidade , Rim/metabolismo , Insuficiência Renal Crônica/mortalidade , Idoso , Albuminúria/urina , Biomarcadores/sangue , Biomarcadores/urina , Nitrogênio da Ureia Sanguínea , Doenças Cardiovasculares/sangue , Doenças Cardiovasculares/patologia , Doenças Cardiovasculares/urina , Creatinina/urina , Feminino , Taxa de Filtração Glomerular/fisiologia , Fatores de Risco de Doenças Cardíacas , Humanos , Rim/patologia , Testes de Função Renal , Masculino , Pessoa de Meia-Idade , Insuficiência Renal Crônica/sangue , Insuficiência Renal Crônica/patologia , Insuficiência Renal Crônica/urina , Rigidez Vascular/fisiologia
9.
J Am Heart Assoc ; 10(14): e021261, 2021 07 20.
Artigo em Inglês | MEDLINE | ID: mdl-34240614

RESUMO

Background Most of the circulating sphingosine-1-phosphate (S1P) is bound to ApoM (apolipoprotein M) of high-density lipoprotein (HDL) and mediates many beneficial effects of HDL on the vasculature via G protein-coupled S1P receptors. HDL-bound S1P is decreased in atherosclerosis, myocardial infarction, and diabetes mellitus. In addition to being the target, the endothelium is a source of S1P, which is transported outside of the cells by Spinster-2, contributing to circulating S1P as well as to local signaling. Mice lacking endothelial S1P receptor 1 are hypertensive, suggesting a vasculoprotective role of S1P signaling. This study investigates the role of endothelial-derived S1P and ApoM-bound S1P in regulating vascular tone and blood pressure. Methods and Results ApoM knockout (ApoM KO) mice and mice lacking endothelial Spinster-2 (ECKO-Spns2) were infused with angiotensin II for 28 days. Blood pressure, measured by telemetry and tail-cuff, was significantly increased in both ECKO-Spns2 and ApoM KO versus control mice, at baseline and following angiotensin II. Notably, ECKO-Spns2 presented an impaired vasodilation to flow and blood pressure dipping, which is clinically associated with increased risk for cardiovascular events. In hypertension, both groups presented reduced flow-mediated vasodilation and some degree of impairment in endothelial NO production, which was more evident in ECKO-Spns2. Increased hypertension in ECKO-Spns2 and ApoM KO mice correlated with worsened cardiac hypertrophy versus controls. Conclusions Our study identifies an important role for Spinster-2 and ApoM-HDL in blood pressure homeostasis via S1P-NO signaling and dissects the pathophysiological impact of endothelial-derived S1P and ApoM of HDL-bound S1P in hypertension and cardiac hypertrophy.


Assuntos
Proteínas de Transporte de Ânions/genética , Apolipoproteínas M/genética , Endotélio Vascular/fisiopatologia , Regulação da Expressão Gênica , Hipertensão/genética , Lisofosfolipídeos/genética , Esfingosina/análogos & derivados , Rigidez Vascular/fisiologia , Animais , Proteínas de Transporte de Ânions/biossíntese , Apolipoproteínas M/biossíntese , Modelos Animais de Doenças , Endotélio Vascular/metabolismo , Hipertensão/metabolismo , Hipertensão/fisiopatologia , Lisofosfolipídeos/biossíntese , Masculino , Camundongos , Camundongos Knockout , RNA/genética , Esfingosina/biossíntese , Esfingosina/genética
10.
Am J Physiol Heart Circ Physiol ; 321(2): H424-H434, 2021 08 01.
Artigo em Inglês | MEDLINE | ID: mdl-34213389

RESUMO

In a progressively aging population, it is of utmost importance to develop reliable, noninvasive, and cost-effective tools to estimate biomarkers that can be indicative of cardiovascular risk. Various pathophysiological conditions are associated to changes in the total arterial compliance (CT), and thus, its estimation via an accurate and simple method is valuable. Direct noninvasive measurement of CT is not feasible in the clinical practice. Previous methods exist for indirect estimation of CT, which, however, require noninvasive, yet complex and expensive, recordings of the central pressure and flow. Here, we introduce a novel, noninvasive method for estimating CT from a single carotid waveform measurement using regression analysis. Features were extracted from the carotid wave and were combined with demographic data. A prediction pipeline was adopted for estimating CT using, first, a feature-based regression analysis and, second, the raw carotid pulse wave. The proposed methodology was appraised using the large human cohort (N = 2,256) of the Asklepios study. Accurate estimates of CT were yielded for both prediction schemes, namely, r = 0.83 and normalized root mean square error (nRMSE) = 9.58% for the feature-based model, and r = 0.83 and nRSME = 9.67% for the model that used the raw signal. The major advantage of this method pertains to the simplification of the technique offering easily applicable and convenient CT monitoring. Such an approach could offer promising applications, ranging from fast and cost-efficient hemodynamical monitoring by the physician to integration in wearable technologies.NEW & NOTEWORTHY This article introduces a novel artificial intelligence method to estimate total arterial compliance (CT) via exploiting the information provided by an uncalibrated carotid blood pressure waveform as well as typical clinical variables. The major finding of this study is that CT, which is usually acquired using both pressure and flow waveforms, can be accurately derived by the use of the pressure wave alone. This method could potentially facilitate easily applicable and convenient monitoring of CT.


Assuntos
Aorta/fisiopatologia , Artérias Carótidas/fisiopatologia , Rigidez Vascular/fisiologia , Adulto , Aorta/fisiologia , Artérias Carótidas/fisiologia , Complacência (Medida de Distensibilidade) , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Análise de Onda de Pulso
11.
J Am Heart Assoc ; 10(14): e019724, 2021 07 20.
Artigo em Inglês | MEDLINE | ID: mdl-34227407

RESUMO

Background Arterial hypertension affects cardiovascular outcome in patients with peripheral artery disease (PAD). We hypothesized that angioplasty of peripheral arterial stenoses decreases aortic (aBP) and brachial blood pressure (bBP). Methods and Results In an index cohort (n=30), we simultaneously measured aBP, bBP, augmentation index (AIx), and aortic pulse wave velocity (PWV) before and after angioplasty of the iliac and femoropopliteal arteries; diagnostic angiography served as a control. In an all-comer registry cohort (n=381), we prospectively measured bBP in patients scheduled for angioplasty of the iliac, femoral, and crural arteries or diagnostic angiography. Systolic aBP decreased after iliac (Δ-25 mmHg; 95% CI, -30 to -20; P<0.0001) and femoropopliteal angioplasty (Δ-12 mmHg; 95% CI, -17 to -5; P<0.0001) as compared with diagnostic angiography. Diastolic aBP decreased after iliac (Δ-9 mmHg; 95% CI, -13 to -1; P=0.01) but not femoropopliteal angioplasty. In parallel, AIx significantly dropped, whereas PWV remained stable. In the registry cohort, systolic bBP decreased after angioplasty of the iliac (Δ-17 mmHg; 95% CI, -31 to -8; P=0.0005) and femoropopliteal arteries (Δ-10 mmHg; 95% CI, -23 to -1; P=0.04) but not the crural arteries, as compared with diagnostic angiography. Diastolic bBP decreased after iliac (Δ-10 mmHg; 95% CI, -17 to -2; P=0.01) and femoropopliteal angioplasty (Δ-9 mmHg; 95% CI, -15 to -1; P=0.04). Multivariate analysis identified baseline systolic bBP and site of lesion as determinants of systolic bBP drop after endovascular treatment. Conclusions Angioplasty of flow-limiting stenoses in patients with peripheral artery disease lowers aortic and brachial blood pressure with more pronounced effects at more proximal lesion sites and elevated baseline systolic blood pressure. These data indicate a role of endovascular treatment to acutely optimize blood pressure in patients with peripheral artery disease. Registration URL: https://www.clinicaltrials.gov; Unique identifier: NCT02728479.


Assuntos
Pressão Sanguínea/fisiologia , Hipertensão/fisiopatologia , Doença Arterial Periférica/fisiopatologia , Rigidez Vascular/fisiologia , Idoso , Idoso de 80 Anos ou mais , Angioplastia/métodos , Aorta/fisiopatologia , Artéria Braquial/fisiopatologia , Constrição Patológica/diagnóstico , Constrição Patológica/fisiopatologia , Feminino , Humanos , Hipertensão/diagnóstico , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Doença Arterial Periférica/diagnóstico , Estudos Prospectivos , Análise de Onda de Pulso
12.
Acta Med Indones ; 53(2): 177-183, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-34251346

RESUMO

BACKGROUND: arterial stiffness is a mortality predictor in hemodialysis patients, hemodialysis induces inflammation, marked by an intradialysis increase in the inflammatory marker pentraxin 3 (PTX3). Arterial stiffness in twice-weekly hemodialysis patients in Indonesia is lower than has been found in studies of thrice-weekly patients. This study therefore aims to determine the factors associated with arterial stiffness, focusing on the role of hemodialysis frequency and PTX3. METHODS: a cross-sectional study was conducted at Cipto Mangunkusumo Hospital, Fatmawati Hospital, and Medistra Hospital involving patients with twice- and thrice-weekly hemodialysis. Arterial stiffness was measured by carotid-femoral pulse wave velocity after hemodialysis, and blood samples for PTX3 testing were taken before hemodialysis. Bivariate and multivariate analyses were performed using chi-squared tests and logistic regression. RESULTS: out of 122 subjects, 82 underwent twice-weekly hemodialysis. There was no difference in arterial stiffness between patients with twice- and thrice-weekly hemodialysis. In bivariate analysis, PTX3, cardiovascular disease, dialysis vintage had p values of <0.05, while the subsequent multivariate analysis showed that PTX3>2.3 ng/ml was associated with arterial stiffness (adjusted OR 5.18; 95% CI 1.07-24.91), as well as cardiovascular disease (adjusted OR 3.67; 95% CI 1.40-10.55), LDL (adjusted OR 3.10; 95% CI 1.04-9.24), and dialysis vintage (adjusted OR 2.72; 95% CI 1.001-7.38). CONCLUSION: predialysis PTX3 levels above 2.3 ng/ml were associated with arterial stiffness. There was no difference in arterial stiffness between patients with twice- and thrice-weekly hemodialysis.


Assuntos
Velocidade do Fluxo Sanguíneo/fisiologia , Proteína C-Reativa/metabolismo , Falência Renal Crônica/sangue , Diálise Renal , Componente Amiloide P Sérico/metabolismo , Rigidez Vascular/fisiologia , Adulto , Idoso , Biomarcadores/sangue , Estudos Transversais , Feminino , Humanos , Indonésia , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Análise de Onda de Pulso
13.
Am J Physiol Heart Circ Physiol ; 321(1): H242-H252, 2021 07 01.
Artigo em Inglês | MEDLINE | ID: mdl-34085841

RESUMO

Disturbed balance between matrix metalloproteinases (MMPs) and their respective tissue inhibitors (TIMPs) is a well-recognized pathophysiological component of pulmonary arterial hypertension (PAH). Both classes of proteinases have been associated with clinical outcomes as well as with specific pathological features of ventricular dysfunction and pulmonary arterial remodeling. The purpose of this study was to evaluate the circulating levels of MMPs and TIMPs in children with PAH undergoing the same-day cardiac magnetic resonance imaging (MRI) and right heart catheterization. Children with PAH (n = 21) underwent a same-day catheterization, comprehensive cardiac MRI evaluation, and blood sample collection for proteomic analysis. Correlative analysis was performed between protein levels and 1) standard PAH indices from catheterization, 2) cardiac MRI hemodynamics, and 3) pulmonary arterial stiffness. MMP-8 was significantly associated with the right ventricular end-diastolic volume (R = 0.45, P = 0.04). MMP-9 levels were significantly associated with stroke volume (R = -0.49, P = 0.03) and pulmonary vascular resistance (R = 0.49, P = 0.03). MMP-9 was further associated with main pulmonary arterial stiffness evaluated by relative area change (R = -0.79, P < 0.01).TIMP-2 and TIMP-4 levels were further associated with the right pulmonary artery pulse wave velocity (R = 0.51, P = 0.03) and backward compression wave (R = 0.52, P = 0.02), respectively. MMPs and TIMPs warrant further clinically prognostic evaluation in conjunction with the conventional cardiac MRI hemodynamic indices.NEW & NOTEWORTHY Metalloproteinases have been associated with clinical outcomes in pulmonary hypertension and with specific pathological features of ventricular dysfunction and pulmonary arterial remodeling. In this study, we demonstrated that plasma circulating levels of metalloproteinases and their inhibitors are associated with standard cardiac MRI hemodynamic indices and with the markers of proximal pulmonary arterial stiffness. Particularly, MMP-9 and TIMP-2 were associated with several different markers of pulmonary arterial stiffness. These findings suggest the interplay between the extracellular matrix (ECM) remodeling and overall hemodynamic status in children with PAH might be assessed using the peripheral circulating MMP and TIMP levels.


Assuntos
Hipertensão Pulmonar/fisiopatologia , Metaloproteinases da Matriz/sangue , Inibidores Teciduais de Metaloproteinases/sangue , Rigidez Vascular/fisiologia , Função Ventricular/fisiologia , Adolescente , Pressão Arterial/fisiologia , Criança , Feminino , Hemodinâmica/fisiologia , Humanos , Hipertensão Pulmonar/sangue , Masculino , Artéria Pulmonar/fisiopatologia
14.
Aging (Albany NY) ; 13(11): 15114-15125, 2021 06 03.
Artigo em Inglês | MEDLINE | ID: mdl-34081619

RESUMO

We aim to investigate the risk of incident arterial stiffness according to metabolically healthy obese (MHO) phenotype in Chinese population. 37,180 participants with at least one-time measurement of branchial-ankle pulse wave velocity (baPWV) were included in the cross-sectional analysis, and 16,236 participants with repeated measurement of baPWV during the follow-ups were included in the longitudinal study. Cross-classification of body mass index (BMI) categories and metabolic health status created six groups. Linear and logistic regression analyses were used. The results of cross-sectional and longitudinal investigation were essentially the same, as the abnormality of baPWV increased with BMI categories in metabolically healthy participants, while the increasing tendency disappeared in metabolically unhealthy participants. A 1.4-fold, 2.2-fold increased risk for the new occurrence of arterial stiffness were documented in MHO and metabolically unhealthy obese participants compared to metabolically healthy normal-weight controls in the fully adjusted model. Further stratified analysis showed that metabolic health status was an interaction factor between BMI and arterial stiffness in all study populations (P=0.0001 for cross-sectional study and P=0.0238 for longitudinal study). In conclusion, metabolic health status and BMI categories contribute to the progression of arterial stiffness, while BMI is positively associated with arterial stiffness only in metabolically healthy participants.


Assuntos
Obesidade/epidemiologia , Obesidade/fisiopatologia , Rigidez Vascular/fisiologia , Índice Tornozelo-Braço , Índice de Massa Corporal , Intervalos de Confiança , Estudos Transversais , Feminino , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Razão de Chances , Fenótipo , Análise de Onda de Pulso , Fatores de Risco
15.
PLoS One ; 16(6): e0245026, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34181640

RESUMO

One of the European gold standard measurement of vascular ageing, a risk factor for cardiovascular disease, is the carotid-femoral pulse wave velocity (cfPWV), which requires an experienced operator to measure pulse waves at two sites. In this work, two machine learning pipelines were proposed to estimate cfPWV from the peripheral pulse wave measured at a single site, the radial pressure wave measured by applanation tonometry. The study populations were the Twins UK cohort containing 3,082 subjects aged from 18 to 110 years, and a database containing 4,374 virtual subjects aged from 25 to 75 years. The first pipeline uses Gaussian process regression to estimate cfPWV from features extracted from the radial pressure wave using pulse wave analysis. The mean difference and upper and lower limits of agreement (LOA) of the estimation on the 924 hold-out test subjects from the Twins UK cohort were 0.2 m/s, and 3.75 m/s & -3.34 m/s, respectively. The second pipeline uses a recurrent neural network (RNN) to estimate cfPWV from the entire radial pressure wave. The mean difference and upper and lower LOA of the estimation on the 924 hold-out test subjects from the Twins UK cohort were 0.05 m/s, and 3.21 m/s & -3.11m/s, respectively. The percentage error of the RNN estimates on the virtual subjects increased by less than 2% when adding 20% of random noise to the pressure waveform. These results show the possibility of assessing the vascular ageing using a single peripheral pulse wave (e.g. the radial pressure wave), instead of cfPWV. The proposed code for the machine learning pipelines is available from the following online depository (https://github.com/WeiweiJin/Estimate-Cardiovascular-Risk-from-Pulse-Wave-Signal).


Assuntos
Velocidade da Onda de Pulso Carótido-Femoral/métodos , Análise de Onda de Pulso/métodos , Rigidez Vascular/fisiologia , Adulto , Idoso , Algoritmos , Pressão Sanguínea , Doenças Cardiovasculares/diagnóstico por imagem , Doenças Cardiovasculares/prevenção & controle , Artérias Carótidas/diagnóstico por imagem , Artérias Carótidas/fisiologia , Feminino , Artéria Femoral/diagnóstico por imagem , Artéria Femoral/fisiologia , Frequência Cardíaca , Humanos , Aprendizado de Máquina , Masculino , Pessoa de Meia-Idade , Artéria Radial/diagnóstico por imagem , Artéria Radial/fisiologia , Fatores de Risco
16.
Heart Surg Forum ; 24(3): E512-E516, 2021 Jun 11.
Artigo em Inglês | MEDLINE | ID: mdl-34173743

RESUMO

BACKGROUND: This study aimed to examine the long-term functional results of patients with isolated discrete subaortic stenosis who underwent subaortic membrane resection and myectomy, using transthoracic M-mode echocardiography and 2D speckle-tracking echocardiography. METHODS: Twenty patients operated for isolated discrete subaortic stenosis and 31 controls were included in the study. Patients underwent subaortic membrane resection and myectomy. During the long-term follow up, patients were evaluated with transthoracic M-mode echocardiography and 2D speckle-tracking echocardiography for functional assessment. RESULTS: The mean age at operation and mean duration of follow up was 8.1±5.6 years and 7.2±3.3 years, respectively. Interventricular septal thickness at diastole (0.9±0.1 vs. 0.8±0.1 cm, P = 0.001), ejection time (285.7±26.2 vs. 261.2±24.3 msec, P = 0.001), and aortic strain (15.6±3.7 vs. 10.5±4.0, P < 0.001) were significantly higher in patients. On the other hand, ejection fraction (64.9±6.1 vs. 75.1±5.4 %, P < 0.001), fractional shortening (35.0±5.1 vs. 43.7±5.1, P < 0.001), and corrected velocity circumferential fiber shortening (0.12±0.02 vs. 0.17±0.03, P < 0.001) were significantly lower, when compared with the controls. Longitudinal strain value significantly differed among the groups, with patients having significantly lower strain (18.8±1.8 vs. 20.1±2.1, P = 0.021). CONCLUSION: In patients operated for isolated discrete subaortic stenosis, aortic gradient seems to continue in the long-term, with the persistence of low longitudinal strain.


Assuntos
Estenose Subaórtica Fixa/fisiopatologia , Ecocardiografia/métodos , Volume Sistólico/fisiologia , Rigidez Vascular/fisiologia , Procedimentos Cirúrgicos Vasculares/métodos , Adolescente , Criança , Estenose Subaórtica Fixa/diagnóstico , Estenose Subaórtica Fixa/cirurgia , Feminino , Seguimentos , Humanos , Masculino , Recidiva , Reoperação , Estudos Retrospectivos , Fatores de Tempo , Resultado do Tratamento
17.
Neurology ; 97(4): e329-e340, 2021 07 27.
Artigo em Inglês | MEDLINE | ID: mdl-34031194

RESUMO

OBJECTIVES: To test the hypothesis that increased aortic stiffening is associated with greater CSF evidence of core Alzheimer disease pathology (ß-amyloid [Aß], phosphorylated tau [p-tau]), neurodegeneration (total tau [t-tau]), synaptic dysfunction (neurogranin), neuroaxonal injury (neurofilament light [NFL]), and neuroinflammation (YKL-40, soluble triggering receptor expressed on myeloid cells 2 [sTREM2]), we analyzed pulse wave velocity (PWV) data and CSF data among older adults. METHODS: Participants free of stroke and dementia from the Vanderbilt Memory and Aging Project, an observational community-based study, underwent cardiac magnetic resonance to assess aortic PWV (meters per second) and lumbar puncture to obtain CSF. Linear regressions related aortic PWV to CSF Aß, p-tau, t-tau, neurogranin, NFL, YKL-40, and sTREM2 concentrations after adjustment for age, race/ethnicity, education, apolipoprotein (APOE) ε4 status, Framingham Stroke Risk Profile, and cognitive diagnosis. Models were repeated testing PWV interactions with age, diagnosis, APOE ε4, and hypertension on each biomarker. RESULTS: One hundred forty-six participants were examined (age 72 ± 6 years). Aortic PWV interacted with age on p-tau (ß = 0.31, p = 0.04), t-tau, (ß = 2.67, p = 0.05), neurogranin (ß = 0.94, p = 0.04), and sTREM2 (ß = 20.4, p = 0.05). Among participants >73 years of age, higher aortic PWV related to higher p-tau (ß = 2.4, p = 0.03), t-tau (ß = 19.3, p = 0.05), neurogranin (ß = 8.4, p = 0.01), and YKL-40 concentrations (ß = 7,880, p = 0.005). Aortic PWV had modest interactions with diagnosis on neurogranin (ß = -10.76, p = 0.03) and hypertension status on YKL-40 (ß = 18,020, p < 0.001). CONCLUSIONS: Among our oldest participants, ≥74 years of age, greater aortic stiffening is associated with in vivo biomarker evidence of neuroinflammation, tau phosphorylation, synaptic dysfunction, and neurodegeneration, but not amyloidosis. Central arterial stiffening may lead to cumulative cerebral microcirculatory damage and reduced blood flow delivery to tissue, resulting in neuroinflammation and neurodegeneration in more advanced age.


Assuntos
Envelhecimento/fisiologia , Coração/diagnóstico por imagem , Inflamação/diagnóstico por imagem , Doenças Neurodegenerativas/diagnóstico por imagem , Rigidez Vascular/fisiologia , Idoso , Idoso de 80 Anos ou mais , Envelhecimento/líquido cefalorraquidiano , Peptídeos beta-Amiloides/líquido cefalorraquidiano , Biomarcadores/líquido cefalorraquidiano , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Doenças Neurodegenerativas/líquido cefalorraquidiano , Fosforilação , Análise de Onda de Pulso , Proteínas tau/líquido cefalorraquidiano
18.
J Am Heart Assoc ; 10(10): e020641, 2021 05 18.
Artigo em Inglês | MEDLINE | ID: mdl-33938228

RESUMO

Background Adropin is a peptide hormone that promotes nitric oxide (NO) production via activation of endothelial NO synthase (eNOS) in endothelial cells. Its circulating levels are reduced with aging and increased with aerobic exercise training (AT). Using a mouse model, we hypothesized that AT restores aging-associated reductions in arterial and circulating adropin and improves adropin-induced NO-dependent vasorelaxation. Further, we hypothesized these findings would be consistent with data obtained in elderly humans. Methods and Results In the animal study, 50-week-old SAMP1 male mice that underwent 12 weeks of voluntary wheel running, or kept sedentary, were studied. A separate cohort of 25-week-old SAMP1 male mice were used as a mature adult sedentary group. In the human study, 14 healthy elderly subjects completed an 8-week AT program consisting of 45 minutes of cycling 3 days/week. In mice, we show that advanced age is associated with a decline in arterial and circulating levels of adropin along with deterioration of endothelial function, arterial NO production, and adropin-induced vasodilation. All these defects were restored by AT. Moreover, AT-induced increases in arterial adropin were correlated with increases in arterial eNOS phosphorylation and NO production. Consistently with these findings in mice, AT in elderly subjects enhanced circulating adropin levels and these effects were correlated with increases in circulating nitrite/nitrate (NOx) and endothelial function. Conclusions Changes in arterial adropin that occur with age or AT relate to alterations in endothelial function and NO production, supporting the notion that adropin should be considered a therapeutic target for vascular aging. Registration URL: https://www.umin.ac.jp; Unique identifier: UMIN000035520.


Assuntos
Envelhecimento/genética , Aorta Torácica/metabolismo , Células Endoteliais/metabolismo , Peptídeos e Proteínas de Sinalização Intercelular/genética , Óxido Nítrico/farmacologia , Resistência Física/fisiologia , Vasodilatação/efeitos dos fármacos , Envelhecimento/metabolismo , Animais , Aorta Torácica/citologia , Aorta Torácica/efeitos dos fármacos , Células Endoteliais/citologia , Células Endoteliais/efeitos dos fármacos , Regulação da Expressão Gênica , Peptídeos e Proteínas de Sinalização Intercelular/biossíntese , Masculino , Camundongos , Condicionamento Físico Animal/métodos , RNA/genética , Rigidez Vascular/fisiologia
20.
Metabolism ; 120: 154794, 2021 07.
Artigo em Inglês | MEDLINE | ID: mdl-33971204

RESUMO

PURPOSE: Preeclampsia (PrE) is a leading complication of pregnancy characterized by vascular dysfunction. Characterizing the longitudinal changes in vascular function prior to PrE onset is critical to the identification of optimal timepoints for vascular assessment and the development of effective early screening strategies. METHODS: In this prospective longitudinal study of women with singleton high-risk pregnancies, arterial stiffness and wave reflection parameters were assessed using applanation tonometry at 10-13 weeks' gestation and repeated every 4 weeks throughout pregnancy. Changepoints in carotid-femoral pulse wave velocity (cfPWV), carotid-radial PWV (crPWV), augmentation index (AIx), time to wave reflection (T1R), pulse pressure amplification (PPA), and subendocardial viability ratio (SEVR) were compared between women who did and did not subsequently develop PrE. RESULTS: A changepoint in cfPWV and crPWV was detected at 14-17 weeks' gestation. cfPWV then increased in women who went on to develop PrE but decreased in women who did not; a 1.2 m/s difference in cfPWV between the groups was observed at 22-25 weeks' gestation. Conversely, crPWV converged in the two groups from a baseline difference of 1.05 m/s (95% credible interval: 0.37, 1.72). Women who subsequently developed PrE demonstrated an increase in AIx at 18-21 weeks' gestation that was not seen in women who did not develop PrE until 30-33 weeks. No differences in T1R, PPA, or SEVR were observed between the groups. CONCLUSIONS: Altered vascular adaptations were detected using measures of arterial stiffness and wave reflection in the early second trimester of pregnant women who developed PrE compared to those who did not. These findings demonstrate the potential clinical utility of arterial stiffness and wave reflection parameters as an early screening tool for PrE, which can be used to inform clinical management of high-risk pregnancies.


Assuntos
Pré-Eclâmpsia/diagnóstico , Análise de Onda de Pulso , Rigidez Vascular/fisiologia , Adulto , Teorema de Bayes , Biomarcadores/análise , Diagnóstico Precoce , Feminino , Idade Gestacional , Humanos , Estudos Longitudinais , Pré-Eclâmpsia/fisiopatologia , Gravidez , Primeiro Trimestre da Gravidez/fisiologia , Gravidez de Alto Risco , Estudos Prospectivos , Quebeque
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