Pub Date : 2017-01-01Epub Date: 2017-08-01DOI: 10.1155/2017/8515767
Jose Maria Pereira de Godoy, Henrique Jose Pereira de Godoy, Renata Lopes Pinto, Fernando Nestor Facio, Maria de Fatima Guerreiro Godoy
Objective: The aim of this study was to identify strategies to transfer responsibility of the maintenance of the results of lymphedema treatment to the patient.
Methods: Maintenance of the reduction of edema was evaluated in a prospective clinical trial in patients with Stage II leg lymphedema. Twenty-one lymphedematous lower limbs were evaluated in Clínica Godoy in 2014 and 2016. The evaluation was done by volumetry at baseline and weekly thereafter for volume control. Patients wore Venosan® cotton 20/30 and 30/40 mmHg elastic compression stockings followed by a custom-made inelastic stocking made of grosgrain fabric. The Friedman test for multiple comparisons and Conover post hoc test were used for statistical analysis with an alpha error of 5%.
Results: On comparing leg volume changes using the different types of stockings, the 20/30 mmHg elastic compression stockings failed in the first week to maintain the volume reductions but the 30/40 mmHg compression stockings did not allow significant increases in volume (p value > 0.05). During one week, the grosgrain stocking reduced leg volumes to baseline values (p value = 0.24).
Conclusion: Higher compression of elastic stockings is better than lower compression but the inelastic grosgrain stocking is even better than both to maintain the results.
{"title":"Maintenance of the Results of Stage II Lower Limb Lymphedema Treatment after Normalization of Leg Size.","authors":"Jose Maria Pereira de Godoy, Henrique Jose Pereira de Godoy, Renata Lopes Pinto, Fernando Nestor Facio, Maria de Fatima Guerreiro Godoy","doi":"10.1155/2017/8515767","DOIUrl":"https://doi.org/10.1155/2017/8515767","url":null,"abstract":"<p><strong>Objective: </strong>The aim of this study was to identify strategies to transfer responsibility of the maintenance of the results of lymphedema treatment to the patient.</p><p><strong>Methods: </strong>Maintenance of the reduction of edema was evaluated in a prospective clinical trial in patients with Stage II leg lymphedema. Twenty-one lymphedematous lower limbs were evaluated in Clínica Godoy in 2014 and 2016. The evaluation was done by volumetry at baseline and weekly thereafter for volume control. Patients wore Venosan® cotton 20/30 and 30/40 mmHg elastic compression stockings followed by a custom-made inelastic stocking made of grosgrain fabric. The Friedman test for multiple comparisons and Conover post hoc test were used for statistical analysis with an alpha error of 5%.</p><p><strong>Results: </strong>On comparing leg volume changes using the different types of stockings, the 20/30 mmHg elastic compression stockings failed in the first week to maintain the volume reductions but the 30/40 mmHg compression stockings did not allow significant increases in volume (<i>p</i> value > 0.05). During one week, the grosgrain stocking reduced leg volumes to baseline values (<i>p</i> value = 0.24).</p><p><strong>Conclusion: </strong>Higher compression of elastic stockings is better than lower compression but the inelastic grosgrain stocking is even better than both to maintain the results.</p>","PeriodicalId":14448,"journal":{"name":"International Journal of Vascular Medicine","volume":"2017 ","pages":"8515767"},"PeriodicalIF":1.3,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2017/8515767","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35442338","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-01-01Epub Date: 2017-08-30DOI: 10.1155/2017/1370751
Marika Vezzoli, Stefano Bonardelli, Michele Peroni, Marco Ravanelli, Emirena Garrafa
Objective: The pathogenesis of abdominal aortic aneurysm (AAA) is complex and different factors, including calcification, are linked to increased complications. This study was conducted in order to verify if classical risk factors for AAA and cell blood count parameter could help in the identification of calcification progression of the aneurysm.
Design: Risk factors were collected and cell blood count was performed in patients with AAA and patients were analyzed for the presence of aorta calcification using CT angiography.
Results: We found no association of calcification grade with risk factors for AAA but we found a strong association between MCV, MCH, and calcification grade. Instead, no association was found with the other parameter that we analyzed.
Conclusions: In this study, we demonstrate that biomarkers such as MCV and MCH could have potential important information about AAA calcification progression and could be useful to discriminate between those patients that should undergo a rapid imaging, thus allowing prompt initiation of treatment of suspicious patients that do not need imaging repetition.
{"title":"A Simple Blood Test, Such as Complete Blood Count, Can Predict Calcification Grade of Abdominal Aortic Aneurysm.","authors":"Marika Vezzoli, Stefano Bonardelli, Michele Peroni, Marco Ravanelli, Emirena Garrafa","doi":"10.1155/2017/1370751","DOIUrl":"https://doi.org/10.1155/2017/1370751","url":null,"abstract":"<p><strong>Objective: </strong>The pathogenesis of abdominal aortic aneurysm (AAA) is complex and different factors, including calcification, are linked to increased complications. This study was conducted in order to verify if classical risk factors for AAA and cell blood count parameter could help in the identification of calcification progression of the aneurysm.</p><p><strong>Design: </strong>Risk factors were collected and cell blood count was performed in patients with AAA and patients were analyzed for the presence of aorta calcification using CT angiography.</p><p><strong>Results: </strong>We found no association of calcification grade with risk factors for AAA but we found a strong association between MCV, MCH, and calcification grade. Instead, no association was found with the other parameter that we analyzed.</p><p><strong>Conclusions: </strong>In this study, we demonstrate that biomarkers such as MCV and MCH could have potential important information about AAA calcification progression and could be useful to discriminate between those patients that should undergo a rapid imaging, thus allowing prompt initiation of treatment of suspicious patients that do not need imaging repetition.</p>","PeriodicalId":14448,"journal":{"name":"International Journal of Vascular Medicine","volume":"2017 ","pages":"1370751"},"PeriodicalIF":1.3,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2017/1370751","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35387978","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-01-01Epub Date: 2017-10-01DOI: 10.1155/2017/7532702
Younsun Son, Kyungun Kim, Soeun Jeon, Minsoo Kang, Sukho Lee, Yoonjung Park
The objective of this meta-analysis is to summarize the effect of exercise intervention on flow-mediated dilatation (FMD) in overweight and obese adults. We searched four electronic databases (PubMed/Medline, Scopus, and CINAHL) through June 2016 for relevant studies pertaining to the effectiveness of exercise intervention on FMD. Seventeen of the 91 studies identified met the inclusion criteria. Comprehensive Meta-Analysis software (version 3) was used to compute the standardized mean difference effect size (ES) and 95% CI using a random effects model. We calculated 34 ESs. We found that exercise intervention had medium and positive effects on FMD, with an overall ES of 0.522 (95% CI = 0.257, 0.786). Heterogeneity of ESs was observed (Qb = 239, p ≤ 0.001, I2 = 86.19), and the effect was moderated by comorbidity (Qb = 6.39, df = 1, p = 0.011). A large ES for the combination exercise, low intensity exercise, and comorbidity subgroups (ES = 0.82~1.24) was found. We conclude that while exercise intervention significantly improves FMD in overweight and obese adults, the effect may depend on the different characteristics of exercise intervention and on participants' demographics.
{"title":"Effect of Exercise Intervention on Flow-Mediated Dilation in Overweight and Obese Adults: Meta-Analysis.","authors":"Younsun Son, Kyungun Kim, Soeun Jeon, Minsoo Kang, Sukho Lee, Yoonjung Park","doi":"10.1155/2017/7532702","DOIUrl":"https://doi.org/10.1155/2017/7532702","url":null,"abstract":"<p><p>The objective of this meta-analysis is to summarize the effect of exercise intervention on flow-mediated dilatation (FMD) in overweight and obese adults. We searched four electronic databases (PubMed/Medline, Scopus, and CINAHL) through June 2016 for relevant studies pertaining to the effectiveness of exercise intervention on FMD. Seventeen of the 91 studies identified met the inclusion criteria. Comprehensive Meta-Analysis software (version 3) was used to compute the standardized mean difference effect size (ES) and 95% CI using a random effects model. We calculated 34 ESs. We found that exercise intervention had medium and positive effects on FMD, with an overall ES of 0.522 (95% CI = 0.257, 0.786). Heterogeneity of ESs was observed (<i>Q</i><sub><i>b</i></sub> = 239, <i>p</i> ≤ 0.001, <i>I</i><sup>2</sup> = 86.19), and the effect was moderated by comorbidity (<i>Q</i><sub><i>b</i></sub> = 6.39, df = 1, <i>p</i> = 0.011). A large ES for the combination exercise, low intensity exercise, and comorbidity subgroups (ES = 0.82~1.24) was found. We conclude that while exercise intervention significantly improves FMD in overweight and obese adults, the effect may depend on the different characteristics of exercise intervention and on participants' demographics.</p>","PeriodicalId":14448,"journal":{"name":"International Journal of Vascular Medicine","volume":"2017 ","pages":"7532702"},"PeriodicalIF":1.3,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2017/7532702","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35219648","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-01-01Epub Date: 2017-11-09DOI: 10.1155/2017/9763075
G Kalender, Milan Lisy, U A Stock, A Endisch, A Kornberger
Patients who undergo endovascular repair of aortic aneurysms (EVAR) require life-long surveillance because complications including, in particular, endoleaks, aneurysm rupture, and graft dislocation are diagnosed in a certain share of the patient population and may occur at any time after the original procedure. Radiation exposure in patients undergoing EVAR and post-EVAR surveillance has been investigated by previous authors. Arriving at realistic exposure data is essential because radiation doses resulting from CT were shown to be not irrelevant. Efforts directed at identification of factors impacting the level of radiation exposure in both the course of the EVAR procedure and post-EVAR endovascular interventions and CTAs are warranted as potentially modifiable factors may offer opportunities to reduce the radiation. In the light of the risks found to be associated with radiation exposure and considering the findings above, those involved in EVAR and post-EVAR surveillance should aim at optimal dose management.
{"title":"Identification of Factors Influencing Cumulative Long-Term Radiation Exposure in Patients Undergoing EVAR.","authors":"G Kalender, Milan Lisy, U A Stock, A Endisch, A Kornberger","doi":"10.1155/2017/9763075","DOIUrl":"https://doi.org/10.1155/2017/9763075","url":null,"abstract":"<p><p>Patients who undergo endovascular repair of aortic aneurysms (EVAR) require life-long surveillance because complications including, in particular, endoleaks, aneurysm rupture, and graft dislocation are diagnosed in a certain share of the patient population and may occur at any time after the original procedure. Radiation exposure in patients undergoing EVAR and post-EVAR surveillance has been investigated by previous authors. Arriving at realistic exposure data is essential because radiation doses resulting from CT were shown to be not irrelevant. Efforts directed at identification of factors impacting the level of radiation exposure in both the course of the EVAR procedure and post-EVAR endovascular interventions and CTAs are warranted as potentially modifiable factors may offer opportunities to reduce the radiation. In the light of the risks found to be associated with radiation exposure and considering the findings above, those involved in EVAR and post-EVAR surveillance should aim at optimal dose management.</p>","PeriodicalId":14448,"journal":{"name":"International Journal of Vascular Medicine","volume":"2017 ","pages":"9763075"},"PeriodicalIF":1.3,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2017/9763075","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35664808","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
We compared the changes in ambulatory outcomes between men and women with symptomatic peripheral arterial disease (PAD) following completion of a supervised, on-site, treadmill exercise program, and we determined whether exercise training variables and baseline clinical characteristics were predictive of changes in ambulatory outcomes in men and women. Twenty-three men and 25 women completed the supervised exercise program, consisting of intermittent walking to mild-to-moderate claudication pain for three months. Men and women significantly increased claudication onset time (COT) (p < 0.001 and p < 0.01, resp.) and peak walking time (PWT) (p < 0.001 for each group). However, change in PWT was less in women (54%) than in men (77%) (p < 0.05). Neither group significantly changed 6-minute walk distance (6MWD). In women, baseline COT was the only predictor for the change in COT (p = 0.007) and the change in PWT (p = 0.094). In men, baseline COT (p < 0.01) and obesity (p < 0.10) were predictors for the change in COT, and obesity was the only predictor for the change in PWT (p = 0.002). Following a supervised, on-site, treadmill exercise program, women had less improvement in PWT than men, and neither men nor women improved submaximal, overground 6MWD. Furthermore, obese men and patients with lower baseline COT were least responsive to supervised exercise. This trial is registered with ClinicalTrial.gov, unique identifier: NCT00618670.
{"title":"Predictors of Improved Walking after a Supervised Walking Exercise Program in Men and Women with Peripheral Artery Disease","authors":"A. Gardner, D. E. Parker, P. Montgomery","doi":"10.1155/2016/2191350","DOIUrl":"https://doi.org/10.1155/2016/2191350","url":null,"abstract":"We compared the changes in ambulatory outcomes between men and women with symptomatic peripheral arterial disease (PAD) following completion of a supervised, on-site, treadmill exercise program, and we determined whether exercise training variables and baseline clinical characteristics were predictive of changes in ambulatory outcomes in men and women. Twenty-three men and 25 women completed the supervised exercise program, consisting of intermittent walking to mild-to-moderate claudication pain for three months. Men and women significantly increased claudication onset time (COT) (p < 0.001 and p < 0.01, resp.) and peak walking time (PWT) (p < 0.001 for each group). However, change in PWT was less in women (54%) than in men (77%) (p < 0.05). Neither group significantly changed 6-minute walk distance (6MWD). In women, baseline COT was the only predictor for the change in COT (p = 0.007) and the change in PWT (p = 0.094). In men, baseline COT (p < 0.01) and obesity (p < 0.10) were predictors for the change in COT, and obesity was the only predictor for the change in PWT (p = 0.002). Following a supervised, on-site, treadmill exercise program, women had less improvement in PWT than men, and neither men nor women improved submaximal, overground 6MWD. Furthermore, obese men and patients with lower baseline COT were least responsive to supervised exercise. This trial is registered with ClinicalTrial.gov, unique identifier: NCT00618670.","PeriodicalId":14448,"journal":{"name":"International Journal of Vascular Medicine","volume":"2016 1","pages":""},"PeriodicalIF":1.3,"publicationDate":"2016-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2016/2191350","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"64265687","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Corey M. Bascone, Mazen Iqbal, P. Narh-Martey, M. Szuchmacher, M. Cicchillo, K. Krishnasastry
Purpose. To review and identify the most accurate ways of diagnosing and treating adventitial cystic disease (ACD) of the venous system. Methods. Cases of ACD were collected through three popular medical databases, including PubMed, Cochrane, OVID, and MEDLINE. After reviewing the literature, the sites of occurrence of 323 cases of adventitial cystic disease were documented, and all cases of arterial ACD were excluded. The clinical features, treatment, and subsequent course of 45 cases of venous ACD are included in this paper. Results. After reviewing all 45 cases of venous ACD , we have confirmed that the most common vessel affected is the common femoral vein, which reproduces the most common symptom of venous ACD: asymmetric lower extremity swelling worsening over time. Conclusion. Venous ACD most commonly affects the common femoral vein. When unilateral leg swelling occurs with or without a noticeable mass, ACD should be considered. It is best confirmed with CT venography and the treatment of choice is transluminal cyst evacuation and excision.
{"title":"Venous Adventitial Cystic Disease: A Review of 45 Cases Treated Since 1963","authors":"Corey M. Bascone, Mazen Iqbal, P. Narh-Martey, M. Szuchmacher, M. Cicchillo, K. Krishnasastry","doi":"10.1155/2016/5287697","DOIUrl":"https://doi.org/10.1155/2016/5287697","url":null,"abstract":"Purpose. To review and identify the most accurate ways of diagnosing and treating adventitial cystic disease (ACD) of the venous system. Methods. Cases of ACD were collected through three popular medical databases, including PubMed, Cochrane, OVID, and MEDLINE. After reviewing the literature, the sites of occurrence of 323 cases of adventitial cystic disease were documented, and all cases of arterial ACD were excluded. The clinical features, treatment, and subsequent course of 45 cases of venous ACD are included in this paper. Results. After reviewing all 45 cases of venous ACD , we have confirmed that the most common vessel affected is the common femoral vein, which reproduces the most common symptom of venous ACD: asymmetric lower extremity swelling worsening over time. Conclusion. Venous ACD most commonly affects the common femoral vein. When unilateral leg swelling occurs with or without a noticeable mass, ACD should be considered. It is best confirmed with CT venography and the treatment of choice is transluminal cyst evacuation and excision.","PeriodicalId":14448,"journal":{"name":"International Journal of Vascular Medicine","volume":"2016 1","pages":""},"PeriodicalIF":1.3,"publicationDate":"2016-11-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2016/5287697","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"64420569","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
M. Naghavi, A. Yen, A. Lin, Hirofumi Tanaka, S. Kleis
Background. Endothelial function is viewed as a barometer of cardiovascular health and plays a central role in vascular reactivity. Several studies showed digital thermal monitoring (DTM) as a simple noninvasive method to measure vascular reactivity that is correlated with atherosclerosis risk factors and coronary artery disease. Objectives. To further evaluate the relations between patient characteristics and DTM indices in a large patient registry. Methods. DTM measures were correlated with age, sex, heart rate, and systolic and diastolic blood pressure in 6084 patients from 18 clinics. Results. DTM vascular reactivity index (VRI) was normally distributed and inversely correlated with age (r = −0.21, p < 0.0001). Thirteen percent of VRI tests were categorized as poor vascular reactivity (VRI < 1.0), 70 percent as intermediate (1.0 ≤ VRI < 2.0), and 17 percent as good (VRI ≥ 2.0). Poor VRI (<1.0) was noted in 6% of <50 y, 10% of 50–70 y, and 18% of ≥70 y. In multiple linear regression analyses, age, sex, and diastolic blood pressure were significant but weak predictors of VRI. Conclusions. As the largest database of finger-based vascular reactivity measurement, this report adds to prior findings that VRI is a meaningful physiological marker and reflects a high level of residual risk found in patients currently under care.
{"title":"New Indices of Endothelial Function Measured by Digital Thermal Monitoring of Vascular Reactivity: Data from 6084 Patients Registry","authors":"M. Naghavi, A. Yen, A. Lin, Hirofumi Tanaka, S. Kleis","doi":"10.1155/2016/1348028","DOIUrl":"https://doi.org/10.1155/2016/1348028","url":null,"abstract":"Background. Endothelial function is viewed as a barometer of cardiovascular health and plays a central role in vascular reactivity. Several studies showed digital thermal monitoring (DTM) as a simple noninvasive method to measure vascular reactivity that is correlated with atherosclerosis risk factors and coronary artery disease. Objectives. To further evaluate the relations between patient characteristics and DTM indices in a large patient registry. Methods. DTM measures were correlated with age, sex, heart rate, and systolic and diastolic blood pressure in 6084 patients from 18 clinics. Results. DTM vascular reactivity index (VRI) was normally distributed and inversely correlated with age (r = −0.21, p < 0.0001). Thirteen percent of VRI tests were categorized as poor vascular reactivity (VRI < 1.0), 70 percent as intermediate (1.0 ≤ VRI < 2.0), and 17 percent as good (VRI ≥ 2.0). Poor VRI (<1.0) was noted in 6% of <50 y, 10% of 50–70 y, and 18% of ≥70 y. In multiple linear regression analyses, age, sex, and diastolic blood pressure were significant but weak predictors of VRI. Conclusions. As the largest database of finger-based vascular reactivity measurement, this report adds to prior findings that VRI is a meaningful physiological marker and reflects a high level of residual risk found in patients currently under care.","PeriodicalId":14448,"journal":{"name":"International Journal of Vascular Medicine","volume":"2016 1","pages":""},"PeriodicalIF":1.3,"publicationDate":"2016-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2016/1348028","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"64218383","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objective. Endothelial dysfunction plays a key role in atherosclerotic disease. Several methods have been reported to be useful for evaluating the endothelial dysfunction, and we investigated the endothelial dysfunction in patients with peripheral arterial disease (PAD) using peripheral arterial tonometry (PAT) test in this study. Furthermore, we examined the factors significantly correlated with PAT test. Methods. We performed PAT tests in 67 patients with PAD. In addition, we recorded the patients' demographics, including comorbidities, and hemodynamical status, such as ankle brachial pressure index (ABI). Results. In a univariate analysis, the ABI value (r = 0.271, P = 0.029) and a history of cerebrovascular disease (r = 0.208, P = 0.143) were found to significantly correlate with PAT test, which calculated the reactive hyperemia index (RHI). In a multivariate analysis, only the ABI value significantly and independently correlated with RHI (β = 0.254, P = 0.041). Conclusion. This study showed a significant correlation between RHI and ABI. The PAT test is a useful tool for evaluating not only endothelial dysfunction but also the hemodynamical state in patients with PAD.
目标。内皮功能障碍在动脉粥样硬化疾病中起关键作用。据报道，有几种方法可用于评估内皮功能障碍，我们在本研究中使用外周动脉血压计(PAT)试验研究了外周动脉疾病(PAD)患者的内皮功能障碍。进一步，我们检验了与PAT测试显著相关的因素。方法。我们对67例PAD患者进行了PAT试验。此外，我们还记录了患者的人口统计数据，包括合并症和血液动力学状态，如踝肱压力指数(ABI)。结果。在单因素分析中，ABI值(r = 0.271, P = 0.029)和脑血管病史(r = 0.208, P = 0.143)与PAT试验(计算反应性充血指数)显著相关。在多变量分析中，只有ABI值与RHI呈显著独立相关(β = 0.254, P = 0.041)。结论。本研究显示RHI与ABI之间存在显著相关性。PAT试验不仅是评估PAD患者内皮功能障碍和血流动力学状态的有用工具。
{"title":"Endothelial Dysfunction of Patients with Peripheral Arterial Disease Measured by Peripheral Arterial Tonometry","authors":"K. Igari, T. Kudo, T. Toyofuku, Y. Inoue","doi":"10.1155/2016/3805380","DOIUrl":"https://doi.org/10.1155/2016/3805380","url":null,"abstract":"Objective. Endothelial dysfunction plays a key role in atherosclerotic disease. Several methods have been reported to be useful for evaluating the endothelial dysfunction, and we investigated the endothelial dysfunction in patients with peripheral arterial disease (PAD) using peripheral arterial tonometry (PAT) test in this study. Furthermore, we examined the factors significantly correlated with PAT test. Methods. We performed PAT tests in 67 patients with PAD. In addition, we recorded the patients' demographics, including comorbidities, and hemodynamical status, such as ankle brachial pressure index (ABI). Results. In a univariate analysis, the ABI value (r = 0.271, P = 0.029) and a history of cerebrovascular disease (r = 0.208, P = 0.143) were found to significantly correlate with PAT test, which calculated the reactive hyperemia index (RHI). In a multivariate analysis, only the ABI value significantly and independently correlated with RHI (β = 0.254, P = 0.041). Conclusion. This study showed a significant correlation between RHI and ABI. The PAT test is a useful tool for evaluating not only endothelial dysfunction but also the hemodynamical state in patients with PAD.","PeriodicalId":14448,"journal":{"name":"International Journal of Vascular Medicine","volume":"2016 1","pages":""},"PeriodicalIF":1.3,"publicationDate":"2016-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2016/3805380","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"64349787","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
K. Ballard, E. Mah, Yi Guo, R. Bruno, B. Taylor, J. Beam, D. Polk, P. Thompson
Objective. To investigate vascular endothelial function (VEF) responses to a single low-density lipoprotein (LDL) apheresis session in hypercholesterolemic patients undergoing chronic treatment. Methods. We measured brachial artery flow-mediated dilation (FMD), plasma lipids, vitamin E (α- and γ-tocopherol), markers of oxidative/nitrative stress (malondialdehyde (MDA) and nitro-γ-tocopherol (NGT)), and regulators of NO metabolism (arginine (ARG) and asymmetric dimethylarginine (ADMA)) prior to (Pre) and immediately following (Post) LDL apheresis and at 1, 3, 7, and 14 d Post in 5 hypercholesterolemic patients (52 ± 11 y). Results. Relative to Pre, total cholesterol (7.8 ± 1.5 mmol/L) and LDL-cholesterol (6.2 ± 1.2 mmol/L) were 61% and 70% lower (P < 0.01), respectively, at Post and returned to Pre levels at 14 d. Brachial FMD responses (6.9 ± 3.6%) and plasma MDA, ARG, and ADMA concentrations were unaffected by LDL apheresis. Plasma α-tocopherol, γ-tocopherol, and NGT concentrations were 52–69% lower at Post (P < 0.01), and α-tocopherol remained 36% lower at 1 d whereas NGT remained 41% lower at d 3. Conclusions. Acute cholesterol reduction by LDL apheresis does not alter VEF, oxidative stress, or NO homeostasis in patients treated chronically for hypercholesterolemia.
{"title":"Single Low-Density Lipoprotein Apheresis Does Not Improve Vascular Endothelial Function in Chronically Treated Hypercholesterolemic Patients","authors":"K. Ballard, E. Mah, Yi Guo, R. Bruno, B. Taylor, J. Beam, D. Polk, P. Thompson","doi":"10.1155/2016/4613202","DOIUrl":"https://doi.org/10.1155/2016/4613202","url":null,"abstract":"Objective. To investigate vascular endothelial function (VEF) responses to a single low-density lipoprotein (LDL) apheresis session in hypercholesterolemic patients undergoing chronic treatment. Methods. We measured brachial artery flow-mediated dilation (FMD), plasma lipids, vitamin E (α- and γ-tocopherol), markers of oxidative/nitrative stress (malondialdehyde (MDA) and nitro-γ-tocopherol (NGT)), and regulators of NO metabolism (arginine (ARG) and asymmetric dimethylarginine (ADMA)) prior to (Pre) and immediately following (Post) LDL apheresis and at 1, 3, 7, and 14 d Post in 5 hypercholesterolemic patients (52 ± 11 y). Results. Relative to Pre, total cholesterol (7.8 ± 1.5 mmol/L) and LDL-cholesterol (6.2 ± 1.2 mmol/L) were 61% and 70% lower (P < 0.01), respectively, at Post and returned to Pre levels at 14 d. Brachial FMD responses (6.9 ± 3.6%) and plasma MDA, ARG, and ADMA concentrations were unaffected by LDL apheresis. Plasma α-tocopherol, γ-tocopherol, and NGT concentrations were 52–69% lower at Post (P < 0.01), and α-tocopherol remained 36% lower at 1 d whereas NGT remained 41% lower at d 3. Conclusions. Acute cholesterol reduction by LDL apheresis does not alter VEF, oxidative stress, or NO homeostasis in patients treated chronically for hypercholesterolemia.","PeriodicalId":14448,"journal":{"name":"International Journal of Vascular Medicine","volume":"2016 1","pages":""},"PeriodicalIF":1.3,"publicationDate":"2016-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2016/4613202","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"64388556","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
E. Ulfhammer, P. Larsson, Mia Magnusson, L. Karlsson, N. Bergh, S. Jern
Objective. Endothelial tissue-type plasminogen activator (t-PA) release is a pivotal response to protect the circulation from occluding thrombosis. We have shown that the t-PA gene is epigenetically regulated and greatly induced by the histone deacetylase (HDAC) inhibitor valproic acid (VPA). We now investigated involvement of known t-PA promoter regulatory elements and evaluated dependence of potential interacting transcription factors/cofactors. Methods. A reporter vector with an insert, separately mutated at either the t-PA promoter CRE or GC box II or GC box III elements, was transfected into HT-1080 and HUVECs and challenged with VPA. HUVECs were targeted with siRNA against histone acetyl transferases (HAT) and selected transcription factors from the Sp/KLF family. Results. An intact VPA-response was observed with CRE mutated constructs, whereas mutation of GC boxes II and III reduced the magnitude of the induction by 54 and 79% in HT-1080 and 49 and 50% in HUVECs, respectively. An attenuated induction of t-PA mRNA was observed after Sp2, Sp4, and KLF5 depletion. KLF2 and p300 (HAT) were identified as positive regulators of basal t-PA expression and Sp4 and KLF9 as repressors. Conclusion. VPA-induced t-PA expression is dependent on the proximal GC boxes in the t-PA promoter and may involve interactions with Sp2, Sp4, and KLF5.
{"title":"Dependence of Proximal GC Boxes and Binding Transcription Factors in the Regulation of Basal and Valproic Acid-Induced Expression of t-PA","authors":"E. Ulfhammer, P. Larsson, Mia Magnusson, L. Karlsson, N. Bergh, S. Jern","doi":"10.1155/2016/7928681","DOIUrl":"https://doi.org/10.1155/2016/7928681","url":null,"abstract":"Objective. Endothelial tissue-type plasminogen activator (t-PA) release is a pivotal response to protect the circulation from occluding thrombosis. We have shown that the t-PA gene is epigenetically regulated and greatly induced by the histone deacetylase (HDAC) inhibitor valproic acid (VPA). We now investigated involvement of known t-PA promoter regulatory elements and evaluated dependence of potential interacting transcription factors/cofactors. Methods. A reporter vector with an insert, separately mutated at either the t-PA promoter CRE or GC box II or GC box III elements, was transfected into HT-1080 and HUVECs and challenged with VPA. HUVECs were targeted with siRNA against histone acetyl transferases (HAT) and selected transcription factors from the Sp/KLF family. Results. An intact VPA-response was observed with CRE mutated constructs, whereas mutation of GC boxes II and III reduced the magnitude of the induction by 54 and 79% in HT-1080 and 49 and 50% in HUVECs, respectively. An attenuated induction of t-PA mRNA was observed after Sp2, Sp4, and KLF5 depletion. KLF2 and p300 (HAT) were identified as positive regulators of basal t-PA expression and Sp4 and KLF9 as repressors. Conclusion. VPA-induced t-PA expression is dependent on the proximal GC boxes in the t-PA promoter and may involve interactions with Sp2, Sp4, and KLF5.","PeriodicalId":14448,"journal":{"name":"International Journal of Vascular Medicine","volume":"2016 1","pages":""},"PeriodicalIF":1.3,"publicationDate":"2016-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2016/7928681","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"64539817","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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