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1.
Arterial tortuosity in pediatric Loeys-Dietz syndrome patients.
Brunet-Garcia, L, Prabaharan, P, Bruyndonckx, L, Field, E, D'Arco, F, Capelli, C, Cervi, E
American journal of medical genetics. Part A. 2024;(3):e63465
Abstract
Loeys-Dietz syndrome (LDS) is an autosomal connective tissue disorder commonly presenting with hypertelorism, bifid uvula, aortic aneurysms, and arterial tortuosity. The aim of the present study was to investigate differences in tortuosity index (TI) between genotypes of LDS, possible progression over time and its use as an adjunctive prognostic tool alongside aortic dimensions to aid timely surgical planning in pediatric patients. A retrospective observational study of pediatric LDS patients referred to our center (November 2012-February 2021) was conducted. Using magnetic resonance angiography (MRA) with 3D maximum intensity projection volume-rendered angiogram, arterial TI was measured. Twenty three patients had genetically confirmed LDS with at least one head and neck MRA and 19 had no less than one follow-up MRA available. All patients presented arterial tortuosity. Patients with TGFBR2 variants had greater values of TI compared to patients with TGFB2 variants (p = 0.041). For patients who did not undergo surgery (n = 18), z-scores at the level of the sinus of Valsalva showed a significant correlation with vertebral TI (rs = 0.547). There was one death during follow-up. This study demonstrates that patients with LDS and TGFBR2 variants have greater values of TI than patients with TGFB2 variants and that greatest values of TI are associated with increased aortic root z-scores. Furthermore, as TI decreases over time, less frequent neuroimaging follow-up can be considered. Nevertheless, additional studies are needed to better define more accurate risk stratification and long-term surveillance in these patients.
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Longitudinal association between leisure-time physical activity and vascular elasticity indices.
Szaló, G, Hellgren, M, Allison, M, Råstam, L, Lindblad, U, Daka, B
BMC cardiovascular disorders. 2021;(1):99
Abstract
AIM: We investigated the association between levels of leisure-time physical activity and vascular stiffness in a longitudinal observational study from a representative Swedish population. METHOD A total of 2816 randomly selected individuals were examined at visit 1 (2002-2005, Men = 1400). After a mean follow-up of 9.7 ± 1.4 years, a representative sample of 1327 of the original participants were re-examined at visit 2. After excluding subjects with hypertension at baseline, 761 participants were included in the longitudinal analyses. Leisure-time physical (LTPA) activity was self-reported and dichotomized as high or low (level 3, 4 and level 1, 2, respectively). Large Arterial Elasticity Index (LAEI) and Small Arterial Elasticity Index (SAEI) were measured using the HDI/Pulse Wave™ CR2000. Multivariable general linear models were used to investigate the differences in changes SAEI and LAEI based on LTPA levels. RESULTS At visit 1, and after adjustment for possible confounders, participants in the high LTPA group had better small artery elasticity (SAEI) (SAEI in low-level LTPA 7.89 ± 0.11, SAEI in high-level LTPA 8.32 ± 0.15, ΔSAEI: 0.42, CI: 0.07-0.78; p = 0.020). SAEI decreased between the two assessments (Visit 1: SAEI 8.01 ± 3.37 ml/mmHg; Δ SAEI 1.4, CI 1.2-1.6, p < 0.001). Participants with a higher LTPA at visit 1 had significantly better SAEI at visit 2 (ΔSAEI: 0.44, CI 0.03-0.85, p = 0.037). No significant associations were observed between LAEI and LTPA after adjustments. CONCLUSIONS High LTPA predicted higher small arterial compliance at visit 2 suggesting that positive effects of LTPA on arterial elasticity persists over time.
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Fat-Secreted Ceramides Regulate Vascular Redox State and Influence Outcomes in Patients With Cardiovascular Disease.
Akawi, N, Checa, A, Antonopoulos, AS, Akoumianakis, I, Daskalaki, E, Kotanidis, CP, Kondo, H, Lee, K, Yesilyurt, D, Badi, I, et al
Journal of the American College of Cardiology. 2021;(20):2494-2513
Abstract
BACKGROUND Obesity is associated with increased cardiovascular risk; however, the potential role of dysregulations in the adipose tissue (AT) metabolome is unknown. OBJECTIVES The aim of this study was to explore the role of dysregulation in the AT metabolome on vascular redox signaling and cardiovascular outcomes. METHODS A screen was conducted for metabolites differentially secreted by thoracic AT (ThAT) and subcutaneous AT in obese patients with atherosclerosis (n = 48), and these metabolites were then linked with dysregulated vascular redox signaling in 633 patients undergoing coronary bypass surgery. The underlying mechanisms were explored in human aortic endothelial cells, and their clinical value was tested against hard clinical endpoints. RESULTS Because ThAT volume was associated significantly with arterial oxidative stress, there were significant differences in sphingolipid secretion between ThAT and subcutaneous AT, with C16:0-ceramide and derivatives being the most abundant species released within adipocyte-derived extracellular vesicles. High ThAT sphingolipid secretion was significantly associated with reduced endothelial nitric oxide bioavailability and increased superoxide generated in human vessels. Circulating C16:0-ceramide correlated positively with ThAT ceramides, dysregulated vascular redox signaling, and increased systemic inflammation in 633 patients with atherosclerosis. Exogenous C16:0-ceramide directly increased superoxide via tetrahydrobiopterin-mediated endothelial nitric oxide synthase uncoupling and dysregulated protein phosphatase 2 in human aortic endothelial cells. High plasma C16:0-ceramide and its glycosylated derivative were independently related with increased risk for cardiac mortality (adjusted hazard ratios: 1.394; 95% confidence interval: 1.030 to 1.886; p = 0.031 for C16:0-ceramide and 1.595; 95% confidence interval: 1.042 to 2.442; p = 0.032 for C16:0-glycosylceramide per 1 SD). In a randomized controlled clinical trial, 1-year treatment of obese patients with the glucagon-like peptide-1 analog liraglutide suppressed plasma C16:0-ceramide and C16:0-glycosylceramide changes compared with control subjects. CONCLUSIONS These results demonstrate for the first time in humans that AT-derived ceramides are modifiable regulators of vascular redox state in obesity, with a direct impact on cardiac mortality in advanced atherosclerosis. (The Interaction Between Appetite Hormones; NCT02094183).
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Nutrition, atherosclerosis, arterial imaging, cardiovascular risk stratification, and manifestations in COVID-19 framework: a narrative review.
Munjral, S, Ahluwalia, P, Jamthikar, AD, Puvvula, A, Saba, L, Faa, G, Singh, IM, Chadha, PS, Turk, M, Johri, AM, et al
Frontiers in bioscience (Landmark edition). 2021;(11):1312-1339
Abstract
Background: Atherosclerosis is the primary cause of the cardiovascular disease (CVD). Several risk factors lead to atherosclerosis, and altered nutrition is one among those. Nutrition has been ignored quite often in the process of CVD risk assessment. Altered nutrition along with carotid ultrasound imaging-driven atherosclerotic plaque features can help in understanding and banishing the problems associated with the late diagnosis of CVD. Artificial intelligence (AI) is another promisingly adopted technology for CVD risk assessment and management. Therefore, we hypothesize that the risk of atherosclerotic CVD can be accurately monitored using carotid ultrasound imaging, predicted using AI-based algorithms, and reduced with the help of proper nutrition. Layout: The review presents a pathophysiological link between nutrition and atherosclerosis by gaining a deep insight into the processes involved at each stage of plaque development. After targeting the causes and finding out results by low-cost, user-friendly, ultrasound-based arterial imaging, it is important to (i) stratify the risks and (ii) monitor them by measuring plaque burden and computing risk score as part of the preventive framework. Artificial intelligence (AI)-based strategies are used to provide efficient CVD risk assessments. Finally, the review presents the role of AI for CVD risk assessment during COVID-19. Conclusions: By studying the mechanism of low-density lipoprotein formation, saturated and trans fat, and other dietary components that lead to plaque formation, we demonstrate the use of CVD risk assessment due to nutrition and atherosclerosis disease formation during normal and COVID times. Further, nutrition if included, as a part of the associated risk factors can benefit from atherosclerotic disease progression and its management using AI-based CVD risk assessment.
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Mitochondrial Dysfunction in Vascular Wall Cells and Its Role in Atherosclerosis.
Salnikova, D, Orekhova, V, Grechko, A, Starodubova, A, Bezsonov, E, Popkova, T, Orekhov, A
International journal of molecular sciences. 2021;(16)
Abstract
Altered mitochondrial function is currently recognized as an important factor in atherosclerosis initiation and progression. Mitochondrial dysfunction can be caused by mitochondrial DNA (mtDNA) mutations, which can be inherited or spontaneously acquired in various organs and tissues, having more or less profound effects depending on the tissue energy status. Arterial wall cells are among the most vulnerable to mitochondrial dysfunction due to their barrier and metabolic functions. In atherosclerosis, mitochondria cause alteration of cellular metabolism and respiration and are known to produce excessive amounts of reactive oxygen species (ROS) resulting in oxidative stress. These processes are involved in vascular disease and chronic inflammation associated with atherosclerosis. Currently, the list of known mtDNA mutations associated with human pathologies is growing, and many of the identified mtDNA variants are being tested as disease markers. Alleviation of oxidative stress and inflammation appears to be promising for atherosclerosis treatment. In this review, we discuss the role of mitochondrial dysfunction in atherosclerosis development, focusing on the key cell types of the arterial wall involved in the pathological processes. Accumulation of mtDNA mutations in isolated arterial wall cells, such as endothelial cells, may contribute to the development of local inflammatory process that helps explaining the focal distribution of atherosclerotic plaques on the arterial wall surface. We also discuss antioxidant and anti-inflammatory approaches that can potentially reduce the impact of mitochondrial dysfunction.
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Advantages and disadvantages of single-source dual-energy whole-body CT angiography with 50% reduced iodine dose at 40 keV reconstruction.
Noda, Y, Nakamura, F, Yasuda, N, Miyoshi, T, Kawai, N, Kawada, H, Hyodo, F, Matsuo, M
The British journal of radiology. 2021;(1121):20201276
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Abstract
OBJECTIVES To assess the feasibility of whole-body dual-energy computed tomographic angiography (DECTA) at 40 keV with 50% reduced iodine dose protocol. METHODS Whole-body CTA was performed in 65 patients; 31 of these patients underwent 120 kVp single-energy computed tomographic angiography (SECTA) with standard iodine dose (600 mgI/kg) and 34 with 40 keV DECTA with 50% reduced iodine dose (300 mgI/kg). SECTA data were reconstructed with adaptive statistical iterative reconstruction of 40% (SECTA group), and DECTA data were reconstructed with adaptive statistical iterative reconstruction of 40% (DECTA-40% group) and 80% (DECTA-80% group). CT numbers of the thoracic and abdominal aorta, iliac artery, background noise, signal-to-noise ratio (SNR), and arterial depiction were compared among the three groups. The CT dose index volumes (CTDIvol) for the thorax, abdomen, and pelvis were compared between SECTA and DECTA protocols. RESULTS The vascular CT numbers and background noise were found to be significantly higher in DECTA groups than in the SECTA group (p < 0.001). SNR was significantly higher in the order corresponding to DECTA-80%, SECTA, and DECTA-40% (p < 0.001). The arterial depiction was comparable in almost all arteries; however, intrapelvic arterial depiction was significantly worse in DECTA groups than in the SECTA group (p < 0.0001-0.017). Unlike the pelvic region (p = 0.055), CTDIvol for the thorax (p < 0.0001) and abdomen (p = 0.0031) were significantly higher in the DECTA protocol than in the SECTA protocol. CONCLUSION DECTA at 40 keV with 50% reduced iodine dose provided higher vascular CT numbers and SNR than SECTA, and almost comparable arterial depiction, but had a degraded intrapelvic arterial depiction and required a larger radiation dose. ADVANCES IN KNOWLEDGE DECTA enables 50% reduction of iodine dose while maintaining image quality, arterial depiction in almost all arteries, vascular CT numbers, and SNR; however, it does not allow clear visualization of intrapelvic arteries, requiring a slightly larger radiation dose compared with SECTA with standard iodine dose.
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Anticancer Therapy-Related Increases in Arterial Stiffness: A Systematic Review and Meta-Analysis.
Parr, SK, Liang, J, Schadler, KL, Gilchrist, SC, Steele, CC, Ade, CJ
Journal of the American Heart Association. 2020;(14):e015598
Abstract
Background Cardio-oncology is a clinical discipline focused primarily on the early detection of anticancer therapy-related cardiomyopathy. However, there is growing evidence that the direct adverse consequences extend beyond the myocardium to affect the vasculature, but this evidence remains limited. In addition, there remains a paucity of clinically based strategies for monitoring vascular toxicity in these patients. Importantly, arterial stiffness is increasingly recognized as a surrogate end point for cardiovascular disease and may be an important vascular outcome to consider. Therefore, the aim of this systematic review and meta-analysis was to summarize evidence of increased arterial stiffening with anticancer therapy and evaluate the effect of treatment modifiers. Methods and Results A total of 19 longitudinal and cross-sectional studies that evaluated arterial stiffness both during and following anticancer therapy were identified using multiple databases. Two separate analyses were performed: baseline to follow-up (12 studies) and control versus patient groups (10 studies). Subgroup analysis evaluated whether stiffness differed as a function of treatment type and follow-up time. Standard mean differences and mean differences were calculated using random effect models. Significant increases in arterial stiffness were identified from baseline to follow-up (standard mean difference, 0.890; 95% CI, 0.448-1.332; P<0.0001; mean difference, 1.505; 95% CI, 0.789-2.221; P≤0.0001) and in patient versus control groups (standard mean difference, 0.860; 95% CI, 0.402-1.318; P=0.0002; mean difference, 1.437; 95% CI, 0.426-2.448; P=0.0052). Subgroup analysis indicated differences in arterial stiffness between anthracycline-based and non-anthracycline-based therapies (standard mean difference, 0.20; 95% CI, 0.001-0.41; P=0.048), but not follow-up time. Conclusions Significant arterial stiffening occurs following anticancer therapy. Our findings support the use of arterial stiffness as part of a targeted vascular imaging strategy for the identification of early cardiovascular injury during treatment and for the detection of long-term cardiovascular injury into survivorship.
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Utilization of Cu-nanoparticles as medication agent to reduce atherosclerotic lesions of a bifurcated artery having compliant walls.
Shahzadi, I, Suleman, S, Saleem, S, Nadeem, S
Computer methods and programs in biomedicine. 2020;:105123
Abstract
OBJECTIVE A theoretical analysis is presented to study the bio-nanofluid with copper as medication agent for atherosclerotic bifurcated artery with flexible walls. DESIGN/APPROACH The circulatory framework in human body is comprised of a system of veins that incorporate the bifurcation in this way the impact of copper nanoparticles on parent, at apex and on daughter artery regions (in the wake of being bifurcated) is watched. Streaming of blood along vessel segment is recognized to be newtonian. The consistent idea of the atherosclerotic arterial wall is additionally considered to make relationship with permeability aspects with arterial wall thickness. Copper nanoparticles are utilized to reduce the atherosclertic lesions for bifurcated stenotic artery. FINDINGS The designed equations along with the experimental values of copper nanoparticles and blood are utilized for theoretical investigation. Moreover, hemodynamics impacts are also figure out to examine the flow of blood for atherosclertic artery. Comparison between parent and daughter artery is plotted through velocity profile. To see the theoretical assistance of this copper mediated model in biomedical field, graphical illustration is presented. At the end, noticed that the inclusion of copper nanoparticles enhances the velocity significantly both for parent as well as daughter artery. CONCLUSIONS The circulation of blood is considered to be different from pressure between portions of atherosclerotic and non-atherosclerotic artery. Shear stress is reduces by changing the bifurcation angle for daughter artery while trend is reversed for parent artery. The size of inner circularting bolus decreases by changing compliant parameter for parent artery while shape is changed for daughter artery.
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Near-infrared diffuse correlation spectroscopy tracks changes in oxygen delivery and utilization during exercise with and without isolated arterial compression.
Tucker, WJ, Rosenberry, R, Trojacek, D, Sanchez, B, Bentley, RF, Haykowsky, MJ, Tian, F, Nelson, MD
American journal of physiology. Regulatory, integrative and comparative physiology. 2020;(1):R81-R88
Abstract
Near-infrared diffuse correlation spectroscopy (NIR-DCS) is an emerging technology for simultaneous measurement of skeletal muscle microvascular oxygen delivery and utilization during exercise. The extent to which NIR-DCS can track acute changes in oxygen delivery and utilization has not yet been fully established. To address this knowledge gap, 14 healthy men performed rhythmic handgrip exercise at 30% maximal voluntary contraction, with and without isolated brachial artery compression, designed to acutely reduce convective oxygen delivery to the exercising muscle. Radial artery blood flow (Duplex Ultrasound) and NIR-DCS derived variables [blood flow index (BFI), tissue oxygen saturation (StO2), and metabolic rate of oxygen (MRO2)] were simultaneously measured. During exercise, both radial artery blood flow (+51.6 ± 20.3 mL/min) and DCS-derived BFI (+155.0 ± 82.2%) increased significantly (P < 0.001), whereas StO2 decreased -7.9 ± 6.2% (P = 0.002) from rest. Brachial artery compression during exercise caused a significant reduction in both radial artery blood flow (-32.0 ± 19.5 mL/min, P = 0.001) and DCS-derived BFI (-57.3 ± 51.1%, P = 0.01) and a further reduction of StO2 (-5.6 ± 3.8%, P = 0.001) compared with exercise without compression. MRO2 was not significantly reduced during arterial compression (P = 0.83) due to compensatory reductions in StO2, driven by increases in deoxyhemoglobin/myoglobin (+7.1 ± 6.1 μM, P = 0.01; an index of oxygen extraction). Together, these proof-of-concept data help to further validate NIR-DCS as an effective tool to assess the determinants of skeletal muscle oxygen consumption at the level of the microvasculature during exercise.
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A significant role of permeability on blood flow for hybrid nanofluid through bifurcated stenosed artery: Drug delivery application.
Shahzadi, I, Bilal, S
Computer methods and programs in biomedicine. 2020;:105248
Abstract
OBJECTIVE The prime objective of concerned article is to discuss the permeability impacts on blood flow by considering hybrid nanofluid through bifurcated stenosed artery. DESIGN/APPROACH The human body circulatory framework involves the arrangement of veins that fuse the bifurcation on parent, at apex and on regions of daughter artery with nanoparticles is viewed. Blood streaming is recognized as Newtonian along vessel segment. The walls of the stenosed bifurcated artery is considered to be permeable as well as compliant. Copper and its oxide as used as drug to minimize the stress and the lesions of the atherosclerotic artery. FINDINGS The theoretical investigation is carried out by invoking the experimental values of hybrid nanoparticles into the structured equations. Moreover, impacts of hemodynamics are also make sense of to inspect the progression of blood for atherosclerotic vein. Daughter and parent artery comparison is described through parabolic graph of velocity. Graphical illustration is utilized to present the theoretical results of this drug delivery model. Metallic nanoparticles justify their use in drug delivery. CONCLUSIONS The flow of blood is viewed as not quite the same as pressure between segments of atherosclerotic and non-atherosclerotic course. Bifurcation angle minimize the stress for daughter artery whereas trend is opposite for parent daughter. The change in compliant wall parameter reduces the circulating bolus size for parent daughter whereas for daughter artery the change in bolus shape is observed.