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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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Measurement of arterial stiffness and vascular aging in community pharmacies-The ASINPHAR@2action project.
Pereira, T, Paulino, E, Maximiano, S, Rosa, M, Pinto, AL, Mendes, MJ, Brito, J, Soares, P, Risse, J, Gose, S
Journal of clinical hypertension (Greenwich, Conn.). 2019;(6):813-821
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Abstract
The ASINPHAR@2action project aims at raising awareness to arterial stiffness (AS) and early vascular aging (EVA) through a community pharmacy-based intervention. This preliminary analysis is focused on the analysis of the proportion of participants with increased AS and the identification of its main determinants. We performed an observational cross-sectional study of participants enrolled in 11 community pharmacies in Portugal, between April and November 2017. Blood pressure (BP) and arterial function parameters were measured with a validated device. Clinical and demographic information was gathered, as well as the estimation of global cardiovascular risk, health-related quality of life, and dietary profile. Cholesterol and glycaemia were taken from a recent laboratory bulletin. The cohort includes 658 participants with a mean age of 57.3 ± 16.3 years, 66% women. Brachial BP was 126.6 ± 16.4 mm Hg and 79.9 ± 11.5 mm Hg, and central BP was 115.8 ± 15.4 mm Hg and 81.2 ± 11.6 mm Hg, respectively, for systolic and diastolic BP. Mean pulse wave velocity (PWV) was 8.5 ± 2.3 m/s, and the augmentation index was 23.6 ± 15.6%. The proportion of participants with increased AS was 19.8%. The overall best-fitting model for AS included age, gender, aortic PP, visceral fat, HDL cholesterol, AIx@75, total vascular resistance, hypertension, and diabetes, corresponding to an AUC of 0.910 (CI: 0.883, 0.937; P < 0.001) in the ROC curve analysis. The preliminary results of this pioneering large-scale study measuring arterial function in community pharmacies provide the grounds for the operationalization of subclinical target organ damage screening in pharmacies, as a strategy to improve cardiovascular risk monitoring and to promote adherence to treatment.
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Study on the Prevalence of Vascular Calcification in Different Types of Arteries and Influencing Factors in Maintenance Peritoneal Dialysis Patients.
Niu, Q, Zhao, H, Wu, B, Tsai, S, Wu, J, Zhang, M, Lu, L, Qiao, J, Men, C, Zuo, L, et al
Blood purification. 2019;(Suppl 1):8-16
Abstract
OBJECTIVE To investigate the occurrence of vascular calcification (VC) in different types of arteries in patients with maintenance peritoneal dialysis (PD) patients and its influencing factors. METHODS This study enrolled PD patients with stable status who has received PD treatment for more than 6 months in Peking University People's Hospital. We used plain X-ray films of abdomen, pelvis, and hands to quantitatively evaluate VC of large artery (abdominal aorta, iliac artery), medium artery (femoral artery, radial artery), and small artery (finger arteries). Two radiologists read and scored radiographs blindly. Demographic data, clinical characteristics, Charlson comorbidity index (CCI), baseline and time-average laboratory indices including parameters of calcium phosphorus metabolism, serum albumin, PD adequacy were collected. A logistic regression model was used to estimate the influencing factors of different sites of VC. RESULTS (1) 154 PD patients were enrolled in this study: seventy-eight males, mean age was 60.4 ± 13.9 years, and median PD duration was 24 (16.39) months. The major primary disease was diabetic nephropathy (39%). (2) Among the 154 PD patients, the proportion of calcification of large artery was the highest (found in 100 patients, accounting for 64.9%); then the medium artery (66, 42.9%); and 15 of small artery, accounting for 9.7%. (3) Logistic regression showed that older age, longer dialysis duration, lower baseline serum intact parathyroid hormone (iPTH), and higher CCI scores were independent risk factors of large artery calcification (p < 0.05), and higher CCI scores, higher baseline serum triglycerides (TG), lower baseline serum iPTH, and time-average iPTH were independent risk factors of medium and small arteries. CONCLUSIONS In PD patients, the occurrence of large artery calcification was higher than others. Among different sites of VC, the abdominal aortic calcification was most likely to occur, and the proportion of small artery calcification was low. Calcification of medium and small arteries can exist alone without calcification of large artery. Large artery calcification was more likely to occur in patients with older age, longer dialysis duration, lower baseline serum iPTH levels and higher CCI scores. Patients with higher CCI scores, higher baseline TG and lower baseline iPTH, and time-average iPTH were more likely to develop small and medium artery calcification.