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1.
Role of dual energy CT to improve diagnosis of non-traumatic abdominal vascular emergencies.
Shaqdan, KW, Parakh, A, Kambadakone, AR, Sahani, DV
Abdominal radiology (New York). 2019;(2):406-421
Abstract
Computed tomography angiography (CTA) is the modality of choice to evaluate abdominal vascular emergencies (AVE). CTA protocols are often complex and require acquisition of multiple phases to enable a variety of diagnosis such as acute bleeding, pseudoaneurysms, bowel ischemia, and dissection. With single energy CT (SECT), differentiating between calcium, coagulated blood, and contrast agents can be challenging based on their attenuation, especially when in small quantity or present as a mixture. With dual-energy CT (DECT), virtual monoenergetic (VM) and material decomposition (MD) image reconstructions enable more robust tissue characterization, improve contrast-enhancement, and reduce beam hardening artifacts. This article will demonstrate how radiologists can utilize DECT for various clinical scenarios in assessment of non-traumatic AVE.
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2.
Preventing spasm of the radial artery conduit during coronary artery bypass grafting: Nicardipine versus verapamil.
Özdemir, HI, van Dijk, CHB, Özdemir, AB, van Straten, BHM, Haanschoten, M, Soliman-Hamad, MA
Journal of cardiac surgery. 2019;(12):1505-1510
Abstract
BACKGROUND AND AIM OF THE STUDY In vitro studies have shown a reduction in radial artery spasm with the use of calcium antagonists. The purpose of this study was to evaluate the efficacy of topical treatment of the radial artery conduit using either verapamil or nicardipine before the anastomoses. METHODS This prospective randomized study included 131 patients, who underwent coronary artery bypass grafting surgery with the use of the radial artery as a conduit. In 65 patients, the harvested radial artery was topically treated with verapamil and in 66 patients with nicardipine. After harvesting the radial artery, the direct flow through the conduit was measured in vitro before 5-minute incubation in nicardipine or verapamil and measured again after incubation. The flow before and after incubation was compared. Postincubation flow was also compared in the two groups. After performing the anastomosis, the flow through the radial artery was measured in vivo. RESULTS The mean flow after NaCl incubation was 19.93 ± 12.66 mL/min and after incubation in the Ca+ channel blocker 47.16 ± 14.58 mL/min (P < .001). No significant difference in postincubation free flow was found between verapamil (46.29 ± 15.43 mL/min) and nicardipine (48.01 ± 13.77 mL/min; P = .503). CONCLUSION Topical treatment with Ca+ channel blockers reduces radial artery spasm and significantly increases the free flow through the radial artery conduit. Nicardipine is a safe and effective alternative of verapamil in preventing spasm of radial artery conduit.
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3.
Curcumin and arterial function in health and disease: impact on oxidative stress and inflammation.
Fleenor, BS, Carlini, NA, Campbell, MS
Current opinion in clinical nutrition and metabolic care. 2019;(6):459-464
Abstract
PURPOSE OF REVIEW The purpose of this review is to provide a concise overview of the polyphenol curcumin for improving arterial health, specifically endothelial function and arterial stiffness, to reduce cardiovascular disease (CVD) risk and to highlight potential mechanisms of action by which curcumin may improve artery function. RECENT FINDINGS The primary findings of this review support the notion for curcumin to improve arterial health both with aging and obesity. There are few clinical trials on curcumin, and those that currently exist are small in scale but provide evidence for curcumin to improve endothelial function in older adults and reduce arterial stiffness in young, obese men. The antioxidant and anti-inflammatory properties of curcumin appear to be important targets of curcumin that are related to improved arterial health. Mechanistic studies have revealed superoxide dismutase, heme oxygenase-1 and nuclear factor erythroid 2-related factor 2 as emerging targets for the beneficial effects of curcumin on the vasculature. SUMMARY In summary, the efficacy of curcumin for improving arterial function is promising in the limited number of clinical studies performed to date. Still, much investigation is needed to elucidate the effectiveness of curcumin for improving arterial health to lower CVD risk.
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4.
Soluble Receptor for Advanced Glycation End Products and Its Correlation with Vascular Damage in Adolescents with Obesity.
Rodríguez-Mortera, R, Luevano-Contreras, C, Solorio-Meza, S, Gómez-Ojeda, A, Caccavello, R, Bains, Y, Gugliucci, A, Garay-Sevilla, ME
Hormone research in paediatrics. 2019;(1):28-35
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Abstract
OBJECTIVE The aim of this study was to evaluate soluble receptor for advanced glycation end products (sRAGE) and advanced glycation end products (AGEs) in adolescents with and without obesity (OB) and their correlation with vascular damage. METHODS This is a cross-sectional study with 15-19 years old adolescents: 33 with OB and 33 with normal weight (NW), each group included 17 male and 16 female. Lipid profile, insulin, carboxymethylysine (CML), sRAGE, total AGEs, and dietary AGEs intake (dAGEs) were evaluated. Vascular damage was measured by flow-mediated vasodilation (FMD) and arterial stiffness index (Iβ). Homeostatic model assessment-insulin (HOMA-IR) and atherogenic index (AI) were calculated. RESULTS The group with OB had higher triglycerides (TG; p < 0.0001), AI (p < 0.001), HOMA-IR (p < 0.0001), dAGEs intake (p < 0.0001), lower CML (p = 0.05), total AGEs (p < 0.01), sRAGE (p < 0.001), and FMD (p < 0.002). In the total group, sRAGE correlated with AI (r = -0.26 p = 0.037); in the NW group, CML correlated with Iβ (r = -0.36; p = 0.037); and in the group of adolescents with OB, sRAGE correlated with FMD (r = -0.37; p = 0.037) and Iβ (r = 0.47; p = 0.006), while CML and total AGEs correlated with AI, p = 0.007 and p < 0.01, respectively). CONCLUSIONS The group of adolescents with OB showed higher cardiometabolic risk as shown by higher TG, AI, HOMA-IR, and lower sRAGE and FMD. sRAGE correlated negatively with FMD and positively with Iβ, so it could be suggested as a biochemical marker of impaired endothelial function.
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Chronic venous disease: from symptoms to microcirculation.
Senra Barros, B, Kakkos, SK, De Maeseneer, M, Nicolaides, AN
International angiology : a journal of the International Union of Angiology. 2019;(3):211-218
Abstract
The recently published European Venous Forum (EVF) Guidelines 2018 update on the management of chronic venous disorders of the lower limbs has focused on several new aspects: a new place for early symptoms, new data on microcirculation alterations, and a re-evaluation of veno-active drugs (VADs), based on new criteria. The symposium "Chronic Venous Disease (CVD): From Symptoms to Microcirculation", held at the annual meeting of the EVF on 28 June 2018 in Athens, Greece, highlighted this perspective by answering three questions: What do symptoms mean and how do they influence our choice of investigations? Is there a link between symptoms and microcirculation alterations? How to choose the right VAD for the right patient based on the updated EVF guidelines? The answers given led the speakers to three conclusions: early symptoms reveal the initial stage of CVD and patients with C0S disease should be properly diagnosed, investigated, and treated; damage to the microcirculation is likely to be the first evidence of the onset of venous disease; Ruscus+HMC+VitC has proven efficacy in randomized controlled trials, and has been given a strong recommendation (Grade 1A) by the 2018 EVF guidelines for treatment of pain, heaviness, feeling of swelling, paresthesia, and edema, and should be considered as one of the preferred treatments to relieve these symptoms in CVD patients.
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Internal coil packing method for the Amplatzer vascular plug 4.
Koganemaru, M, Tanoue, S, Kuhara, A, Kugiyama, T, Abe, T
Diagnostic and interventional radiology (Ankara, Turkey). 2019;(5):410-412
Abstract
The Amplatzer vascular plugs (AVPs), including AVP 4, have excellent occlusion; however, insufficient embolization or recanalization may occasionally occur. This study aimed to evaluate the feasibility and effectiveness of internal coil packing method to insert microcoils into the AVP 4 using an experimental vascular model. The insertion of a 1.7 F microcatheter through the nitinol mesh of the AVP 4 was not possible. Only 0.010-inch electrolytic detachable microcoils could be inserted through catheter tips in contact with nitinol mesh. The internal coil packing of the AVP 4 may be accomplished by inserting 0.010-inch microcoils into the AVP 4 in cases of continued perfusion or recanalization with required short-segment embolization.
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Intention of Older Women to Consume 100% Watermelon Juice for Vascular Health: An Application of Theory of Planned Behavior.
Jung, SE, Ellis, AC, Crowe-White, K
Journal of nutrition in gerontology and geriatrics. 2018;(2):130-143
Abstract
To strengthen randomized controlled trials (RCT) evaluating the efficacy of 100% watermelon juice on vascular function of older women, theory-driven behavioral analysis as well as comparative sensory analysis of the intervention and placebo were conducted. The Theory of Planned Behavior was adopted to assess psychosocial determinants of intention to consume watermelon juice. Sensory attributes were assessed utilizing hedonic scales. Analysis included Structural Equation Modeling with maximum likelihood. The measurement model provided a good fit (x2 = 70.22, df = 38; RMSEA = 0.07, CFI = 0.98; NFI = 0.95). Attitude (γ = 0.36), subjective norm (γ = 0.43), and perceived behavioral control (γ = 0.21,) were significant predictors (p < 0.001) of intention. Participants identified no significant differences in sensorial attributes between beverages, thereby minimizing sensory bias and discrimination. Similar approaches may help other RCT investigating novel foods and bioactive compounds bridge gaps between efficacy and effectiveness.
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Workplace Strategies to Prevent Sitting-induced Endothelial Dysfunction.
Kruse, NT, Hughes, WE, Benzo, RM, Carr, LJ, Casey, DP
Medicine and science in sports and exercise. 2018;(4):801-808
Abstract
UNLABELLED Prolonged sitting induces endothelial dysfunction in healthy young adults, which has been demonstrated to be offset by intermittent fidgeting and standing. No information exists on the effect of sitting and endothelial dysfunction in sedentary middle-age adults, and whether common workplace counterinterventions (i.e., desk standing/desk pedaling) mitigate sitting-induced endothelial dysfunction. PURPOSE The objective of this study was to examine whether breaking up prolonged sitting with intermittent standing or underdesk pedaling prevents sitting-induced popliteal artery endothelial dysfunction in middle-age sedentary, overweight/obese office workers. HYPOTHESIS We tested the hypothesis that sitting-induced leg endothelial dysfunction would be prevented by intermittent standing or desk pedaling. METHODS Thirteen middle-age, sedentary overweight/obese subjects (10 men, 3 women; age, 38 ± 3 yr; body mass index, 29.7 ± 2 kg·m) participated in three separate testing sessions in a randomized order: 1) 4 h of uninterrupted sitting, 2) 4 h of sitting interrupted with four 10-min bouts of standing, and 3) 4 h of sitting interrupted with four 10-min bouts of light-intensity desk pedaling. Doppler ultrasound-measured popliteal artery flow-mediated dilation and associated measures (e.g., shear rate, blood velocity) were measured immediately before and immediately after each intervention (sit, stand, and desk pedaling). RESULTS Four hours of uninterrupted sitting induced a significant impairment in popliteal artery flow-mediated dilation (baseline: 3.1% ± 0.3%, post: 1.6% ± 0.5%; P < 0.05). Interestingly, neither intermittent standing (baseline: 3.2% ± 0.4%, post: 1.9% ± 0.5%; P < 0.05) nor intermittent desk pedaling (baseline: 3.2% ± 0.4%, post: 1.9% ± 0.4%; P < 0.05) was effective at preventing excessive sitting-induced endothelial dysfunction. CONCLUSIONS Prolonged sitting-induced leg endothelial dysfunction cannot be prevented by brief intermittent bouts of standing or desk pedaling in middle-age sedentary overweight/obese adults.
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9.
Strategies for Achieving Healthy Vascular Aging.
Nowak, KL, Rossman, MJ, Chonchol, M, Seals, DR
Hypertension (Dallas, Tex. : 1979). 2018;(3):389-402
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10.
Prognostic and therapeutic implications of vascular disease in patients with atrial fibrillation.
Shahid, F, Pastori, D, Violi, F, Lip, GYH
Pharmacological research. 2018;:149-159
Abstract
Atrial fibrillation (AF) is associated with a 5-fold increase in the risk of ischemic stroke, and AF-related stroke patients have a higher mortality and greater morbidity than patients with non-AF related stroke. AF and vascular disease share a close relationship, with the concomitant presence of both disease states leading to a dramatic rise in future cardiovascular events. Indeed, the presence of peripheral artery disease independently predicts stroke in patients with AF. Myocardial infarction (MI) is another well-established risk factor for the development of AF; however, the role of pre-existing AF in MI is less well evidenced, with recent studies showing that this population more frequently develops coronary ischaemic events and has a higher risk of mortality than sinus rhythm patients. Finally, complex aortic plaque is associated with heightened thromboembolic risk in AF patients. Recent data from clinical trials with non-vitamin K antagonist oral anticoagulants (NOACs) provided new insights on the prognostic implications of vascular disease coexistence in AF patients, and randomised trials testing a combination of NOAC with antiplatelet agents are ongoing. This review article provides an overview of recent data linking adverse outcomes in concomitant AF and vascular disease and the clinical trial evidence for possible therapeutic targets.