Arteriographic patterns of peripheral arterial disease in lower limbs in a Peruvian cohort of patients.

INTRODUCTION: There is currently no universal and uniform pattern of peripheral arterial disease (PAD) in the lower limbs; however, it is influenced by various cardiovascular factors of the individual. The objective of this study was to identify the arteriographic patterns of PAD in the lower limbs according to cardiovascular factors in a Peruvian cohort of patients. METHODS: This is an analytical, observational, and retrospective study. The arteriographic patterns of PAD in the aortoiliac segment were analyzed with the TransAtlantic InterSociety Consensus (TASC-II) score and the Global Anatomic Staging System (GLASS) for the femoropopliteal (FP), infraopopliteal (IP), and pedial (P) segments in a Peruvian cohort from January 2018 to May 2021. RESULTS: 595 patients (833 extremities) were analyzed with a mean age of 67.54 ± 16.39 years, and the main cardiovascular factor was diabetes (65.04%). The patients older than 65 years with GLASS FP 4 (p = 0.042), IP 0 (p = 0.004), and P2 (p = 0.047) presented significant findings: in men and women with GLASS IP 4 (p = 0.031) and P 2 (p = 0.045); diabetes with TASC-II A (p = 0.031), GLASS FP 4 (p = 0.038), IP 4 (p = 0.009), and P2 (p = 0.003); dyslipidemia with TASC-II D (p = 0.027), GLASS FP 4 (p = 0.038), IP 0 (p = 0.009), and P0 (p = 0.003); smoking with TASC-II D (p = 0.001), GLASS FP 4 (p = 0.049) and IP 0 (p = 0.008); chronic coronary disease with GLASS IP 4 (p = 0.049) and P2 (p = 0.037); chronic kidney disease with GLASS FP 4 (p=0.047), IP 4 (p = 0.004), and P2 (p = 0.016); and previous amputation history with GLASS IP 4 (p = 0.015) and P2 (p = 0.039). The most frequent arteriographic pattern of PAD in the lower limbs of our cohort was TASC-II A, GLASS FP 0 and 4, IP 0, and P2 (p = 0.047). CONCLUSION: Our work will allow the limb salvage teams to understand the behavior of PAD affectation in the population of our environment, allowing a timely control of cardiovascular risk factors, adequate revascularization planning, and a significant reduction in the risk of loss of limb.

Changes in cardiovascular risk factors in patients with acromegaly after trans-sphenoidal adenomectomy.

The surgical treatment of acromegaly reduces mortality, however its impact on cardiovascular risk factors is unclear. This study was carried out to determine the changes in cardiovascular risk factors in patients with acromegaly who received trans-sphenoidal surgery. We recruited 127 patients with acromegaly who received trans-sphenoidal adenomectomy between August 2003 and May 2014 and follow-up for 12 months. Fasting GH and IGF-1 levels were evaluated every 3 months, and cardiovascular risk factors were assessed before and 12 months after surgery. The main outcomes were changes in cardiovascular risk factors after surgery. One year after trans-sphenoidal adenomectomy, 68 patients (53.5%) had a fasting GH level <2.0 ng/mL, IGF-1 was normalized in 74 patients (58.3%), and both fasting GH and IGF-1 were under control in 51 patients (40.2%). Levels of glycated hemoglobin (HbA1c) (8.57 ± 3.19 vs. 6.66 ± 0.90%, p = 0.001) and triglycerides (130.6 ± 61.5 vs. 108.0 ± 47.5 mg/dL, p = 0.027) were significantly decreased and serum creatinine was significantly increased (0.665 ± 0.222 vs. 0.754 ± 0.223 mg/dL, p = 0.001) after trans-sphenoidal adenomectomy. However, there were no significant changes in body weight, systolic blood pressure, diastolic blood pressure, total cholesterol, high-density lipoprotein cholesterol and cardiovascular risk score after trans-sphenoidal adenomectomy. In the patient with high cardiovascular risk before surgery, systolic blood pressure, total cholesterol, fasting glucose, triglycerides and high-density lipoprotein cholesterol improved after trans-sphenoidal adenomectomy. In this study, HbA1c and triglycerides were significantly decreased after trans-sphenoidal adenomectomy in the patients with acromegaly irrespective of endocrinological outcomes. The other traditional cardiovascular factors might be improved after trans-sphenoidal adenomectomy in the patients with a high cardiovascular risk.

Effect size for the main cognitive function determinants in a large cross-sectional study.

BACKGROUND AND PURPOSE: The aim of our study was to examine the effect sizes of different cognitive function determinants in middle and early old age. METHODS: Cognitive functions were assessed in 11 711 volunteers (45 to 75 years old), included in the French CONSTANCES cohort between January 2012 and May 2014, using the free and cued selective reminding test (FCSRT), verbal fluency tasks, digit-symbol substitution test (DSST) and trail making test (TMT), parts A and B. The effect sizes of socio-demographic (age, sex, education), lifestyle (alcohol, tobacco, physical activity), cardiovascular (diabetes, blood pressure) and psychological (depressive symptomatology) variables were computed as omega-squared coefficients (ω2 ; part of the variation of a neuropsychological score that is independently explained by a given variable). RESULTS: These sets of variables explained from R2 = 10% (semantic fluency) to R2 = 26% (DSST) of the total variance. In all tests, socio-demographic variables accounted for the greatest part of the explained variance. Age explained from ω2 = 0.5% (semantic fluency) to ω2 = 7.5% (DSST) of the total score variance, gender from ω2 = 5.2% (FCSRT) to a negligible part (semantic fluency or TMT) and education from ω2 = 7.2% (DSST) to ω2 = 1.4% (TMT-A). Behavioral, cardiovascular and psychological variables only slightly influenced the cognitive test results (all ω2 < 0.8%, most ω2 < 0.1%). CONCLUSION: Socio-demographic variables (age, gender and education) are the main variables associated with cognitive performance variations between 45 and 75 years of age in the general population.

Exploring the Insomnia-Ischemic Stroke Nexus: A Comprehensive Review.

Background: This study investigates the relationship between sleep patterns and ischemic stroke beyond the predominant focus on obstructive sleep apnea. Through a systematic review of the existing literature, we aim to elucidate the connections between insomnia, sleep duration, cardiovascular factors, and ischemic stroke onset. Methods: We searched databases, including MEDLINE, SciELO, Scopus, and Science Direct, using an adapted PICO framework. Using a search strategy with MeSH words, keywords, and expressions related to insomnia and stroke, we included clinical trials and analytical observational epidemiological studies, comprising cohort, case-control, and cross-sectional studies. Results: Following the initial search, we identified 984 records, with 779 titles and abstracts screened for eligibility after removing duplicates. From these, 63 full-text articles, including 5 in the data synthesis, were reviewed. Our findings highlight a significant correlation between poor sleep quality, extreme sleep durations, and a heightened risk of ischemic stroke, along with established cardiovascular risk factors, such as hypertension, hyperlipidemia, obesity, and diabetes. Conclusions: This systematic review offers a comprehensive analysis of ischemic stroke prevalence and its association with cardiovascular factors, such as hypertension, hyperlipidemia, obesity, and diabetes. It suggests that poor sleep quality and extreme sleep durations, particularly long ones, are linked to a heightened risk of ischemic stroke.

Atrial Fibrillation and Other Cardiovascular Factors and the Risk of Dementia: An Italian Case-Control Study.

Dementia is a major neurologic syndrome characterized by severe cognitive decline, and it has a detrimental impact on overall physical health, leading to conditions such as frailty, changes in gait, and fall risk. Depending on whether symptoms occur before or after the age of 65, it can be classified as early-onset (EOD) or late-onset (LOD) dementia. The present study is aimed at investigating the role of cardiovascular factors on EOD and LOD risk in an Italian population. Using a case-control study design, EOD and LOD cases were recruited at the Modena Cognitive Neurology Centers in 2016-2019. Controls were recruited among caregivers of all the dementia cases. Information about their demographics, lifestyles, and medical history were collected through a tailored questionnaire. We used the odds ratio (OR) and 95% confidence interval (CI) to estimate the EOD and LOD risk associated with the investigated factors after adjusting for potential confounders. Of the final 146 participants, 58 were diagnosed with EOD, 34 with LOD, and 54 were controls. According to their medical history, atrial fibrillation was associated with increased disease risk (ORs 1.90; 95% CI 0.32-11.28, and 3.64; 95% CI 0.32-41.39 for EOD and LOD, respectively). Dyslipidemia and diabetes showed a positive association with EOD, while the association was negative for LOD. We could not evaluate the association between myocardial infarction and EOD, while increased risk was observed for LOD. No clear association emerged for carotid artery stenosis or valvular heart disease. In this study, despite the limited number of exposed subjects and the high imprecision of the estimates, we found positive associations between cardiovascular disease, particularly dyslipidemia, diabetes, and atrial fibrillation, and EOD.

Effects of 3-week repeated cold water immersion on leukocyte counts and cardiovascular factors: an exploratory study.

Aim: This exploratory study aimed to investigate the effects of a 3-week repeated cold water immersion (CWI) intervention on leukocyte counts and cardiovascular factors (mean arterial pressure [MAP], heart rate [HR]) in healthy men. Methods: A total of n = 12, non-cold-adapted men (age: 25.2 ± 4.0 years; height: 177.8 ± 5.6 cm; weight: 73.8 ± 6.5 kg) were randomly allocated to the CWI or control (CON) group. The CWI group underwent a 3-week repeated CWI intervention (12min at 7°C, 4x/week). The CON group did not receive any cold exposure or therapy. Total leukocyte numbers and proportions (neutrophils, basophils, eosinophils, monocytes, lymphocytes) and cardiovascular factors (MAP, HR) were assessed at baseline and after the 3-week intervention period. Results: Total leukocyte count decreased in CWI (p = 0.027, 95% CI -2.35 to -0.20 × 103/µL) and CON (p = 0.043, 95% CI -2.75 to -0.50 × 103/µL). CWI showed a decrease in neutrophil number (p = 0.028, 95% CI -1.55 to -0.25 × 103/µL) and proportion (p = 0.046, 95% CI -6.42 to 0.56%). In contrast, CON showed no significant change (p > 0.05). No differences were found for other leukocyte subtypes in CWI or CON (all p > 0.05). MAP (p = 0.028, 95% CI -17 to -8 mmHg) and HR (p = 0.027, 95% CI -7 to -2 bpm) were reduced in CWI, whereas CON showed no change (p > 0.05). Conclusion: The results suggest no relevant effects of 3-week repeated CWI on leukocyte counts in healthy men. Due to methodological limitations, the effects on the investigated cardiovascular factors remain unclear. Further studies with larger sample sizes are needed to examine the effects on immune function and cardiovascular health.

Combined retinal vascular occlusion: Demography, clinical features, visual outcome, systemic co-morbidities, and literature review.

PURPOSE: To document the clinical features, systemic association, and treatment outcome of patients with a combined retinal vein and artery occlusion (CRVAO) and review of literature. METHODS: A retrospective chart review of patients diagnosed with CRVAO at a tertiary eye care center. Patient's demographic details and associated ocular and systemic factors were recorded. Treatment included laser photocoagulation, anti-vascular endothelial growth factor (VEGF) intravitreal injection or transscleral cyclophotocoagulation (TSCPC), alone or in combination. At last, follow- up treatment response was measured in visual acuity status, regression of neovascularization, and control of intraocular pressure (IOP). All cases reported in the current decade were analyzed and compared with this study. RESULTS: Seventeen eyes with CRVAO accounted for 0.3% of total vascular occlusion (total 5151 patients were seen in this period). The mean age was 48.12 ± 17.5 years (range: 12-87 years) and there were 9 females. Nine eyes had CRVO + CRAO; 6 eyes had BRVO + BRAO, and one patient each had CRVO + BRAO and CRAO + BRVO. Fluorescein angiography (FA) showed delayed 'arm to retina' time (>20 seconds) in all 10 eyes and delayed arteriovenous transit time in 9 out of 10 eyes. Optical coherence tomography (OCT) showed hypereflective inner retinal layers (16 eyes) and neurosensory detachment (7 eyes). The most common systemic associations were hypertension and dyslipidemia (n = 7 people; 41.18%) each. Four patients (23.5%) had a plaque in carotid arteries with normal 2D echocardiography. Ten (59%) eyes were treated with intravitreal bevacizumab + laser; four (23.5%) eyes were treated with laser only, and three (17.6%) eyes were treated with laser + anti-VEGF + TSCPC. At last follow up, vision improved in 9 (52.9%) eyes; stable in 3 (17.7%) eyes, and reduced to perception of light in 5 (29.4%) eyes. CONCLUSION: Combined CRVAO is a rare emergency leading to acute vision loss. Early diagnosis and treatment for ocular complications and systemic evaluation for cardiovascular risk factors are needed.

Dietary Intake of Free Sugars is Associated with Disease Activity and Dyslipidemia in Systemic Lupus Erythematosus Patients.

Diet has been closely associated with inflammatory autoimmune diseases, including systemic lupus erythematosus (SLE). Importantly, the consumption of dietary sugars has been positively linked to elevated levels of some inflammation markers, but the potential role of their consumption on the prognosis of autoimmune diseases has not yet been examined. The aim of this study was to evaluate the association between the dietary intake of free sugars and clinical parameters and cardiovascular (CVD) risk markers in patients with SLE. A cross-sectional study including a total of 193 patients with SLE (aged 48.25 ± 12.54 years) was conducted. The SLE Disease Activity Index (SLEDAI-2K) and the SDI Damage Index were used to asses disease activity and disease-related damage, respectively. Levels of C-reactive protein (CRP; mg/dL), homocysteine (Hcy; µmol/L), anti-double stranded DNA antibodies (anti-dsDNA) (IU/mL), complement C3 (mg/dL), and complement C4 (mg/dL), among other biochemical markers, were measured. The main factors we considered as risk factors for CVD were obesity, diabetes mellitus, hypertension, and blood lipids. The dietary-intrinsic sugar and added-sugar content participants consumed were obtained via a 24-h patient diary. Significant differences were observed in dietary sugar intake between patients with active and inactive SLE (in grams: 28.31 ± 24.43 vs. 38.71 ± 28.87; p = 0.035) and free sugar intake (as a percentage: 6.36 ± 4.82 vs. 8.60 ± 5.51; p = 0.020). Linear regression analysis revealed a significant association between free sugars intake (by gram or percentage) and the number of complications (ß (95% CI) = 0.009 (0.001, 0.0018), p = 0.033)); (ß (95% CI) = 0.046 (0.008, 0.084), p = 0.018)), and SLEDAI (ß (95% CI) = 0.017 (0.001, 0.034), p = 0.043)); (ß (95% CI) = 0.086 (0.011, 0.161), p = 0.024)) after adjusting for covariates. Free sugars (g and %) were also associated with the presence of dyslipidaemia (ß (95% CI) = -0.003 (-0.005, 0.000), p = 0.024)) and (ß (95% CI) = -0.015 (-0.028, -0.002), p = 0.021)). Our findings suggest that a higher consumption of free sugars might negatively impact the activity and complications of SLE. However, future longitudinal research on SLE patients, including dietary intervention trials, are necessary to corroborate these preliminary data.

Impact of Cardiovascular Factors on Pulse Wave Velocity and T otal Vascular Resistance in Different Age Group Patients with Cardiovascular Disorders.

BACKGROUND: Pulse Wave Velocity (PWV) is the propagation speed of the wave-induced along the aorta and arterial tree, each time the heart beats. PWV increases with increased arterial stiffness, thus establishing it as a reliable prognostic marker for cardiovascular morbidity and mortality. On the other hand, Total Vascular Resistance (TVR) is the overall resistance offered by systemic circulation and pulmonary circulation. This resistance needs to be overcome in order to create the flow of blood through the circulatory system. The goal of this study was to investigate the influence of different cardiovascular factors on arterial stiffness and vascular resistance in CVD patient from eastern India population. METHODS: Total of 782 patients with Cardiovascular Disease (CVD) like hypertension, Ischemic heart disease, Congestive cardiac failure and peripheral arterial disease were included to evaluate the cardiovascular hemodynamic and non-hemodynamic parameter by oscillometric method and investigated those factors on PWV and TVR in subjects of both sexes aged between 15 to 87 years. RESULTS: The old age (> 55 years) was found to have greatest impact on PWV as compared with younger age group. Systolic Blood Pressure (SBP), Heart Rate (HR), augmentation pressure and Body Surface Area (BSA) had a positive association with the PWV. Augmentation Index and Body Mass Index (BMI) had a negative impact on the PWV. CONCLUSION: Despite the limitations, like unequal number of male and female participants, wide variation of the age of the subjects and analyzing association of many factors at a time, our large and community-based study show individual blood pressure and pulse pressure depending on complex interaction between large arteries and arterioles. This study sheds light on the relationship between proximal and distal part (PWV and TVR) of the arterial tree as well as their association with different hemodynamic and non-hemodynamic parameters.

[The sleep apnoea syndrome: Clinical characteristics of affected patients in the hospital population of Château-Thierry]. / Syndrome d'apnées du sommeil : caractéristiques cliniques des patients atteints dans la population hospitalière de Château-Thierry.

INTRODUCTION: The sleep apnoea syndrome (SAS) is a public health problem particularly due to its involvement in cardiovascular and metabolic disorders. The aim of this study was to investigate the epidemiological characteristics of the affected population in order to facilitate screening for SAS. MATERIALS AND METHODS: The study was retrospective, monocentric and observational. It was undertaken at the Château-Thierry hospital from 01/01/2010 to 31/12/2014. Several epidemiological parameters were collected. Two groups were created according to the apnoea/hypopnoea index (AHI) and compared with the R software. RESULTS: In all, 629 patients were included and separated into two groups with a division at an AHI limit of 15/h: 425 sick patients (AHI>15/h) and 204 healthy (AHI<15/h). Differences in sex were observed (more sick men, P<0.05), of age (sick patients were older P<0.001), obesity (sick patients were on average 5kg heavier, P<0.05) and of cardiovascular history (hypertension P<0.05, coronary disease P<0.05 and arhythmic heart disease P<0.05). We found no difference using the Epworth scale, nor in benzodiazepine consumption or the presence of dementia. CONCLUSION: This study highlights several risk factors for sleep apnoea in this population but also shows that the Epworth scale is not a good screening tool.

Effect of Caffeine on the Repeated Modified Agility Test from Some Cardiovascular Factors, Blood Glucose and Rating of Perceived Exertion in Young People.

BACKGROUND: The aim of this study was to compare the effects of the ingestion of either the caffeine (CAF) or the placebo (PLA) on performance of repeated modified agility test (RMAT), some cardiovascular factors, metabolic and notes of perceived exertion (RPE) in young males and females. METHODS: In a randomized double-blind study, we enrolled 18 active students (10 males and 8 females) in Sport Sciences pursuing degrees in Exercise Science and Physical Education at the University of Sports of Kef (Tunisia), during the academic year 2013-2014. All participants were ingested CAF (5 mg.kg-1) or PLA 60 min before performing an RMAT. Total times (TT), peak time (PT) and fatigue index (FI) were identified as the RMAT indices. Heart rate (HR), arterial pressures (PA), blood glucose (BG) and RPE were assessed before, during and after the RMAT. RESULTS: Taking caffeine had been improved the performance by the significant decreased of TT on male gender better than female gender and the entire group. In addition, there was a significant improvement on HR during and after RMAT in both genders and the whole group, except after RMAT among male gender. However, the repeated measurement results had demonstrated no effect of caffeine on PA, BG and RPE. CONCLUSION: Caffeine supplement had a beneficial effect on agility performance and HR in male better than in female, although, there was no improvement in PA, BG and RPE.

Comparison of scores for the classification of cardiometabolic risk in adult patients enrolled in a Venezuelan program for chronic non-communicable diseases: a cross-sectional study

ABSTRACT BACKGROUND: Several continuous measurements of cardiometabolic risk (CMR) have emerged as indexes or scores. To our knowledge, there are no published data on its application and validation in Latin America. OBJECTIVE: To evaluate four continuous measurements of metabolic status and CMR. We established its predictive capacity for four conditions associated with CMR. DESIGN AND SETTING: Cross-sectional study conducted at a healthcare center in the state of Carabobo, Venezuela. METHODS: The sample comprised 176 Venezuelan adults enrolled in a chronic disease care program. Four CMR scores were calculated: metabolic syndrome (MetS) Z-score; cardiometabolic index (ICMet); simple method for quantifying MetS (siMS) score; and siMS risk score. CMR biomarkers, proinflammatory status and glomerular function were assessed. MetS was established in accordance with a harmonized definition. RESULTS: Patients with MetS showed higher levels of all scores. All scores increased as the number of MetS components rose. The scores showed significant correlations with most CMR biomarkers, inflammation and glomerular function after adjusting for age and sex. In the entire sample, MetS Z-score, siMS score and siMS risk score showed the ability to detect MetS, reduced glycemic control, proinflammatory status and decreased estimated glomerular filtration rate. ICMet only discriminated MetS and proinflammatory state. There were some differences in the predictive capacity of the scores according to sex. CONCLUSIONS: The findings support the use of the scores assessed here. Follow-up studies should evaluate the predictive capacity of scores for cardiovascular events and diabetes in the Venezuelan population.