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Autophagy Induced by Low Shear Stress Leads to Endothelial Glycocalyx Disruption. 低剪切应力诱导的自噬导致内皮细胞糖萼破坏
IF 1.7 4区 医学 Q3 PERIPHERAL VASCULAR DISEASE Pub Date : 2024-01-01 Epub Date: 2024-03-19 DOI: 10.1159/000537772
Lina Lin, Wei Gao, Linya Feng, Chundong Wang, Ruiqi Yang, Weijian Wang, Qiaolin Wu

Introduction: Previous studies have confirmed that low shear stress (LSS) induces glycocalyx disruption, leading to endothelial dysfunction. However, the role of autophagy in LSS-induced glycocalyx disruption and relevant mechanism are not clear. In this study, we hypothesized that LSS may promote autophagy, disrupting the endothelium glycocalyx.

Methods: Human umbilical vein endothelial cells were subjected to physiological shear stress and LSS treatments, followed by the application of autophagy inducers and inhibitors. Additionally, cells were treated with specific matrix metalloproteinase-2 (MMP-2) and matrix metalloproteinase-9 (MMP-9) inhibitor. The expression of autophagic markers, glycocalyx, MMP-2, and MMP-9 was measured.

Results: LSS impacted the expression of endothelium autophagy markers, increasing the expression of LC3II.LC3I-1 and Beclin-1, and decreasing the levels of p62, accompanied by glycocalyx disturbance. Moreover, LSS upregulated the expression of MMP-2 and MMP-9 and downregulated the levels of syndecan-1 and heparan sulfate (HS). Additionally, expression of MMP-2 and MMP-9 was increased by an autophagy promoter but was decreased by autophagy inhibitor treatment under LSS. Autophagy and MMP-2 and MMP-9 further caused glycocalyx disruption.

Conclusion: LSS promotes autophagy, leading to glycocalyx disruption. Autophagy increases the expression of MMP-2 and MMP-9, which are correlated with the glycocalyx destruction induced by LSS.

导言:以往的研究证实,低剪切应力(LSS)会诱导糖萼破坏,导致内皮功能障碍。然而,自噬在 LSS 诱导的糖萼破坏中的作用及相关机制尚不清楚。方法:对人脐静脉内皮细胞进行生理剪切应力和 LSS 处理,然后使用自噬诱导剂和抑制剂。此外,还用特异性基质金属蛋白酶-2(MMP-2)和基质金属蛋白酶-9(MMP-9)抑制剂处理细胞。测量了自噬标记物、糖萼、MMP-2 和 MMP-9 的表达:结果:LSS影响了内皮细胞自噬标记物的表达,增加了LC3II.LC3I-1和Beclin-1的表达,降低了p62的水平,并伴有糖萼紊乱。此外,LSS 上调了 MMP-2 和 MMP-9 的表达,下调了辛迪加-1 和硫酸肝素(HS)的水平。此外,自噬启动子会增加 MMP-2 和 MMP-9 的表达,但在 LSS 条件下,自噬抑制剂会降低其表达。自噬及MMP-2和MMP-9进一步导致了糖萼的破坏:结论:LSS 促进自噬,导致糖萼破坏。自噬增加了 MMP-2 和 MMP-9 的表达,这与 LSS 诱导的糖萼破坏有关。
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引用次数: 0
Preserving Endothelial Integrity in Human Saphenous Veins during Preparation for Coronary Bypass Surgery. 在准备冠状动脉搭桥手术期间保持人体无隐静脉内皮的完整性。
IF 1.7 4区 医学 Q3 PERIPHERAL VASCULAR DISEASE Pub Date : 2024-01-01 Epub Date: 2024-01-12 DOI: 10.1159/000535843
Meghan W Sedovy, Xinyan Leng, Farwah Iqbal, Mark C Renton, Melissa Leaf, Kailynn Roberts, Arya Malek, W Scott Arnold, David A Wyatt, Cynthia W Choate, Joseph F Rowe, Joseph W Baker, Scott R Johnstone, Mark Joseph

Introduction: While multiple factors influence coronary artery bypass graft (CABG) success rates, preserving saphenous vein endothelium during surgery may improve patency. Standard preparations include saphenous vein preparation in heparinized saline (saline) which can result in endothelial loss and damage. Here, we investigated the impact of preparing saphenous graft vessels in heparinized patient blood (blood) versus saline.

Methods: Saphenous vein tissues from a total of 23 patients undergoing CABG were split into 2 groups (1) saline and (2) heparinized patient blood. Excess tissue was fixed for analysis immediately following surgery. Level of endothelial coverage, oxidative stress marker 4-hydroxynonenal (4HNE), and oxidative stress protective marker nuclear factor erythroid 2-related factor 2 (NRF2) were evaluated.

Results: In saline patient veins, histological analysis revealed a limited luminal layer, suggesting a loss of endothelial cells (ECs). Immunofluorescent staining of EC markers vascular endothelial cadherin (VE-cadherin) and endothelial nitric oxide identified a significant improvement in EC coverage in the blood versus saline groups. Although both treatment groups expressed 4HNE to similar levels, EC blood samples expressed higher levels of NRF2.

Conclusion: Our data indicate that use of heparinized patient blood helps preserve the endothelium and promotes vein graft health. This has the potential to improve long-term outcomes in patients.

导言:影响冠状动脉旁路移植手术(CABG)成功率的因素很多,但在手术过程中保留隐静脉内皮可提高通畅率。标准制备方法包括在肝素化生理盐水(生理盐水)中制备隐静脉,这会导致内皮脱落和损伤。在此,我们研究了在肝素化患者血液(血液)和生理盐水中制备隐静脉移植血管的影响:方法:将接受 CABG 手术的 23 名患者的隐静脉组织分成两组(1)生理盐水组和(2)肝素化患者血液组。术后立即固定多余组织进行分析。对内皮覆盖水平、氧化应激标志物 4-羟基壬烯醛(4HNE)和氧化应激保护标志物核因子红细胞2相关因子2(NRF2)进行了评估:在生理盐水患者的静脉中,组织学分析显示管腔层有限,表明内皮细胞(EC)丢失。对血管内皮标记物血管内皮粘连蛋白(VE-cadherin)和血管内皮一氧化氮进行免疫荧光染色后发现,血液组与生理盐水组相比,血管内皮细胞的覆盖率显著提高。虽然两个治疗组的 4HNE 表达水平相似,但心肌血液样本中的 NRF2 表达水平更高:我们的数据表明,使用肝素化患者血液有助于保护血管内皮,促进静脉移植健康。这有可能改善患者的长期预后。
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引用次数: 0
Nitric Oxide/Glucose Transporter Type 4 Pathway Mediates Cardioprotection against Ischemia/Reperfusion Injury under Hyperglycemic and Diabetic Conditions in Rats. 一氧化氮/葡萄糖转运体 4 型通路介导大鼠在高血糖和糖尿病条件下对缺血/再灌注损伤的心脏保护作用
IF 1.8 4区 医学 Q3 PERIPHERAL VASCULAR DISEASE Pub Date : 2024-01-01 Epub Date: 2024-06-28 DOI: 10.1159/000539461
Aisha Al-Kouh, Fawzi Babiker

Introduction: The comorbidities of ischemic heart disease (IHD) and diabetes mellitus (DM) compromise the protection of the diabetic heart from ischemia/reperfusion (I/R) injury. We hypothesized that manipulation of reperfusion injury salvage kinase (RISK) and survivor activating factor enhancement (SAFE) pathways might protect the diabetic heart, and intervention of these pathways could be a new avenue for potentially protecting the diabetic heart.

Methods: All hearts were subjected to 30-min ischemia and 30-min reperfusion. During reperfusion, hearts were exposed to molecules proven to protect the heart from I/R injury. The hemodynamic data were collected using suitable software. The infarct size, troponin T levels, and protein levels in hearts were evaluated.

Results: Both cyclosporine-A and nitric oxide donor (SNAP) infusion at reperfusion protected 4-week diabetic hearts from I/R injury. However, 6-week diabetic hearts were protected only by SNAP, but not cyclosporin-A. These treatments significantly (p < 0.05) improved cardiac hemodynamics and decreased infarct size.

Conclusions: The administration of SNAP to diabetic hearts protected both 4- and 6-week diabetic hearts; however, cyclosporine-A protected only the 4-week diabetic hearts. The eNOS/GLUT-4 pathway executed the SNAP-mediated cardioprotection.

导言:缺血性心脏病(IHD)和糖尿病(DM)的合并症损害了糖尿病心脏对缺血/再灌注(I/R)损伤的保护。我们假设,操纵再灌注损伤挽救激酶(RISK)和幸存者激活因子增强(SAFE)通路可能会保护糖尿病心脏,对这些通路的干预可能是保护糖尿病心脏的新途径:方法:对所有心脏进行 30 分钟缺血和 30 分钟再灌注。方法:对所有心脏进行 30 分钟缺血和 30 分钟再灌注,在再灌注期间,心脏暴露于经证实能保护心脏免受 I/R 损伤的分子。使用合适的软件收集血液动力学数据。结果显示,环孢素-A和硝酸甘油都能保护心脏免受I/R损伤:结果:环孢素-A 和一氧化氮供体(SNAP)在再灌注时都能保护 4 周糖尿病患者的心脏免受 I/R 损伤。然而,6周糖尿病患者的心脏只受到SNAP的保护,而没有受到环孢素-A的保护。这些治疗方法能明显(p < 0.05)改善心脏血流动力学并缩小梗死面积:结论:对糖尿病心脏施用 SNAP 可保护 4 周和 6 周糖尿病心脏;但环孢素-A 只保护 4 周糖尿病心脏。eNOS/GLUT-4通路发挥了SNAP介导的心脏保护作用。
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引用次数: 0
Regulation of Skeletal Muscle Resistance Arteriolar Tone: Temporal Variability in Vascular Responses. 骨骼肌阻力动脉张力的调节:血管反应的时空变异性。
IF 1.8 4区 医学 Q3 PERIPHERAL VASCULAR DISEASE Pub Date : 2024-01-01 Epub Date: 2024-10-03 DOI: 10.1159/000541169
Brayden D Halvorson, Aaron D Ward, Donna Murrell, James C Lacefield, Robert W Wiseman, Daniel Goldman, Jefferson C Frisbee

Introduction: A full understanding of the integration of the mechanisms of vascular tone regulation requires an interrogation of the temporal behavior of arterioles across vasoactive challenges. Building on previous work, the purpose of the present study was to start to interrogate the temporal nature of arteriolar tone regulation with physiological stimuli.

Methods: We determined the response rate of ex vivo proximal and in situ distal resistance arterioles when challenged by one-, two-, and three-parameter combinations of five major physiological stimuli (norepinephrine, intravascular pressure, oxygen, adenosine [metabolism], and intralumenal flow). Predictive machine learning models determined which factors were most influential in controlling the rate of arteriolar responses.

Results: Results indicate that vascular response rate is dependent on the intensity of the stimulus used and can be severely hindered by altered environments, caused by application of secondary or tertiary stimuli. Advanced analytics suggest that adrenergic influences were dominant in predicting proximal arteriolar response rate compared to metabolic influences in distal arterioles.

Conclusion: These data suggest that the vascular response rate to physiologic stimuli can be strongly influenced by the local environment. Translating how these effects impact vascular networks is imperative for understanding how the microcirculation appropriately perfuses tissue across conditions.

简介要全面了解血管张力调节机制的整合,就必须对动脉血管在血管活性挑战下的时间行为进行研究。本研究的目的是在先前工作的基础上,开始探究生理刺激下动脉张力调节的时间性:我们测定了体内近端和原位远端阻力动脉在受到五种主要生理刺激(去甲肾上腺素、血管内压力、氧气、腺苷[代谢]和腔内流量)的单参数、双参数和三参数组合时的反应率。预测性机器学习模型确定了哪些因素对控制动脉反应速率最有影响:结果表明,血管反应速度取决于所使用刺激的强度,并且会受到因使用二级或三级刺激而导致的环境改变的严重阻碍。高级分析表明,与远端动脉血管的代谢影响相比,肾上腺素能影响在预测近端动脉血管反应速率方面占主导地位:这些数据表明,血管对生理刺激的反应速度会受到当地环境的强烈影响。要了解微循环如何在不同条件下对组织进行适当灌注,就必须了解这些影响是如何影响血管网络的。
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引用次数: 0
Cerebral Cortical Vasodilation via Nicotinic Receptors by Heated Tobacco Product Aerosol Extract in Rats. 加热烟草制品气溶胶提取物通过尼古丁受体对大鼠大脑皮层血管的扩张作用
IF 1.8 4区 医学 Q3 PERIPHERAL VASCULAR DISEASE Pub Date : 2024-01-01 Epub Date: 2024-11-05 DOI: 10.1159/000541726
Sae Uchida, Jura Moriya, Daichi Morihara, Mayura Shimura, Fusako Kagitani

Introduction: Smoking increases the risk of lung cancer due to a number of components of smoke. The use of novel heated tobacco products (HTPs), alternative to conventional combustion cigarettes, has increased in recent years. However, the in vivo biological effects of HTPs are poorly understood. This study aimed to clarify the acute effects of injecting aerosol extract prepared from an HTP on regional cerebral blood flow (rCBF) in rat cortex by comparing them to the effects of injecting smoke extract prepared from conventional combustible cigarettes.

Methods: In urethane anesthetized rats, rCBF was measured using laser speckle contrast imaging simultaneously with arterial pressure.

Results: Both cigarette smoke extract and HTP aerosol extract, at a dose equivalent to 30 μg nicotine/kg, injected intravenously, increased cortical rCBF without changing arterial pressure. The magnitude and time course of the increased rCBF response to both extracts were similar throughout the cortical area, and the rCBF increases were all abolished by dihydro-β-erythroidine, an α4β2-preferring nicotinic acetylcholine receptor (nAChR) antagonist.

Conclusion: In conclusion, our study demonstrated that the effect of injecting aerosol extract prepared from an HTP, an acute increase in cortical rCBF, is mediated via activation of α4β2-like neuronal nAChRs in the brain.

导 言吸烟会增加罹患肺癌的风险,因为烟雾中含有多种成分。近年来,使用新型加热烟草制品(HTPs)替代传统燃烧香烟的情况有所增加。然而,人们对加热烟草制品的体内生物效应知之甚少。本研究旨在通过与注射传统可燃卷烟烟雾提取物的影响进行比较,明确注射 HTP 提取物气溶胶对大鼠大脑皮层区域血流(rCBF)的急性影响:方法:在氨基甲酸乙酯麻醉的大鼠体内,使用激光斑点对比成像技术测量rCBF,同时测量动脉压:结果:香烟烟雾提取物和 HTP 气溶胶提取物的剂量相当于 30 μg 尼古丁/kg,静脉注射可增加大脑皮层的 rCBF,而动脉压不变。在整个大脑皮层区域,两种提取物增加的rCBF反应的幅度和时间过程相似,而且rCBF的增加均被α4β2-烟碱乙酰胆碱受体(nAChR)拮抗剂二氢-β-赤藓酮(dihydro-β-erythroidine)所抑制:总之,我们的研究表明,注射从 HTP 中提取的气溶胶萃取物对大脑皮层 rCBF 急性增加的影响是通过激活大脑中类似 α4β2 的神经元 nAChRs 介导的。
{"title":"Cerebral Cortical Vasodilation via Nicotinic Receptors by Heated Tobacco Product Aerosol Extract in Rats.","authors":"Sae Uchida, Jura Moriya, Daichi Morihara, Mayura Shimura, Fusako Kagitani","doi":"10.1159/000541726","DOIUrl":"10.1159/000541726","url":null,"abstract":"<p><strong>Introduction: </strong>Smoking increases the risk of lung cancer due to a number of components of smoke. The use of novel heated tobacco products (HTPs), alternative to conventional combustion cigarettes, has increased in recent years. However, the in vivo biological effects of HTPs are poorly understood. This study aimed to clarify the acute effects of injecting aerosol extract prepared from an HTP on regional cerebral blood flow (rCBF) in rat cortex by comparing them to the effects of injecting smoke extract prepared from conventional combustible cigarettes.</p><p><strong>Methods: </strong>In urethane anesthetized rats, rCBF was measured using laser speckle contrast imaging simultaneously with arterial pressure.</p><p><strong>Results: </strong>Both cigarette smoke extract and HTP aerosol extract, at a dose equivalent to 30 μg nicotine/kg, injected intravenously, increased cortical rCBF without changing arterial pressure. The magnitude and time course of the increased rCBF response to both extracts were similar throughout the cortical area, and the rCBF increases were all abolished by dihydro-β-erythroidine, an α4β2-preferring nicotinic acetylcholine receptor (nAChR) antagonist.</p><p><strong>Conclusion: </strong>In conclusion, our study demonstrated that the effect of injecting aerosol extract prepared from an HTP, an acute increase in cortical rCBF, is mediated via activation of α4β2-like neuronal nAChRs in the brain.</p>","PeriodicalId":17530,"journal":{"name":"Journal of Vascular Research","volume":" ","pages":"318-326"},"PeriodicalIF":1.8,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11651226/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142583763","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Scoping Review: Integration of the Major Mechanisms Underlying the Regulation of Arteriolar Tone. 范围审查:整合动脉调节的主要机制。
IF 1.8 4区 医学 Q3 PERIPHERAL VASCULAR DISEASE Pub Date : 2024-01-01 Epub Date: 2023-12-14 DOI: 10.1159/000535404
Brayden D Halvorson, Moeiz Ahmed, Sophie J Huang, Jefferson C Frisbee

Background: Cardiovascular diseases remain the leading cause of morbidity and mortality worldwide. Arteriolar tone regulation plays a critical role in maintaining appropriate organ blood flow and perfusion distribution, which is vital for both vascular and overall health.

Summary: This scoping review aimed to explore the interplay between five major regulators of arteriolar tone: metabolism (adenosine), adrenergic control (norepinephrine), myogenic activation (intravascular pressure), perivascular oxygen tension, and intraluminal flow rates. Specifically, the aim was to address how arteriolar reactivity changes in the presence of other vasoactive stimuli and by what mechanisms. The review focused on animal studies that investigated the impact of combining two or more of these stimuli on arteriolar diameter. Overall, 848 articles were identified through MEDLINE and EMBASE database searches, and 38 studies were included in the final review.

Key messages: The results indicate that arteriolar reactivity is influenced by multiple factors, including competitive processes, structural limitations, and indirect interactions among stimuli. Additionally, the review identified a lack of research involving female animal models and limited insight into the interaction of molecular signaling pathways, which represent gaps in the literature.

背景:心血管疾病仍然是全球发病率和死亡率的主要原因。动脉张力调节在维持适当的器官血流和灌注分布方面发挥着关键作用,这对血管和整体健康都至关重要。摘要:本范围综述旨在探讨动脉张力的五大调节因素之间的相互作用:新陈代谢(腺苷)、肾上腺素能控制(去甲肾上腺素)、肌源激活(血管内压)、血管周围氧张力和腔内流速。具体来说,目的是探讨在其他血管活性刺激物存在的情况下,动脉血管反应性如何变化,以及变化的机制是什么。综述的重点是调查两种或两种以上刺激对动脉直径影响的动物研究。通过 MEDLINE 和 EMBASE 数据库检索,共发现了 848 篇文章,其中 38 项研究被纳入最终综述:研究结果表明,动脉反应性受多种因素影响,包括竞争过程、结构限制以及刺激物之间的间接相互作用。此外,综述还发现缺乏涉及雌性动物模型的研究,对分子信号通路相互作用的了解也很有限,这些都是文献中的空白。
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引用次数: 0
Bone Morphogenetic Protein-4 Promotes Phenotypic Modulation via SMAD-4/MCT-4 Axis in Vascular Smooth Muscle Cells. 骨形态发生蛋白-4 通过 SMAD-4/MCT-4 轴促进血管平滑肌细胞的表型调节
IF 1.8 4区 医学 Q3 PERIPHERAL VASCULAR DISEASE Pub Date : 2024-01-01 Epub Date: 2023-12-27 DOI: 10.1159/000532029
Qi Li, Zhongsha Li, Jingyu Li, Xiaoling Qin, Fengjiao Wu, Chang Chen

Introduction: This study aimed to determine whether bone morphogenetic protein-4 (BMP-4), which increases in response to intimal hyperplasia, promotes phenotype transition in vascular smooth muscle cells (VSMCs).

Methods: Balloon injury was used to induce intimal hyperplasia in rats. Hematoxylin-eosin staining was used to detect the alteration of vascular structure. Serum levels of BMP-4 and lactate were detected by ELISA. Human aortic smooth muscle cells (HA-SMCs) were cultured. Protein and mRNA expression levels were detected through Western blot and real-time PCR. Cell migration was measured by transwell assay.

Results: Our data showed that serum concentration of BMP-4 was upregulated after balloon injury. Treatment with BMP-4 inhibitor DMH1 (4-(6-(4-isopropoxyphenyl)pyrazolo(1,5-a)pyrimidin-3-yl)quinoline) suppressed the abnormal expression of BMP-4 and inhibited the intimal hyperplasia induced by balloon injury. Compared to BMP-4-negative medium, BMP-4-positive medium was associated with higher synthetic VSMC marker expression levels and lower in contractile gene markers in cultured HA-SMCs. Transfection of monocarboxylic acid transporters-4 (MCT-4) siRNA inhibited the excretion of lactate induced by BMP-4.

Conclusion: Our analyses provided evidence that BMP-4 and its regulator Smad-4 are key regulators in MCT-4-mediated lactate excretion. This indicates that BMP-4 stimulates the phenotypic transition of VSMCs via SMAD-4/MCT-4 signaling pathway.

简介:本研究旨在确定骨形态发生蛋白-4(BMP-4)是否会促进血管平滑肌细胞(VSMCs)的表型转换:方法:用球囊损伤诱导大鼠血管内膜增生。方法:利用球囊损伤诱导大鼠血管内膜增生,采用苏木精-伊红染色法检测血管结构的改变。通过 ELISA 检测血清中 BMP-4 和乳酸的水平。培养人主动脉平滑肌细胞(HA-SMCs)。通过 Western 印迹和实时 PCR 检测蛋白质和 mRNA 表达水平。结果:结果:我们的数据显示,球囊损伤后血清中的 BMP-4 浓度上调。用 BMP-4 抑制剂 DMH1(4-(6-(4-异丙氧基苯基)吡唑并(1,5-a)嘧啶-3-基)喹啉)治疗可抑制 BMP-4 的异常表达,并抑制球囊损伤诱导的内膜增生。与 BMP-4 阴性培养基相比,BMP-4 阳性培养基与培养 HA-SMC 的合成 VSMC 标记表达水平较高和收缩基因标记表达水平较低有关。转染单羧酸转运体-4(MCT-4)siRNA 可抑制 BMP-4 诱导的乳酸排泄:我们的分析提供了证据,证明BMP-4及其调节因子Smad-4是MCT-4介导的乳酸排泄的关键调节因子。这表明 BMP-4 通过 SMAD-4/MCT-4 信号通路刺激 VSMC 的表型转换。
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引用次数: 0
Preoperative Congestive Heart Failure Is Associated with Higher 30-Day Myocardial Infarction and Pneumonia after Endovascular Repair of Abdominal Aortic Aneurysm. 腹主动脉瘤血管内修复术后 30 天心肌梗死和肺炎发生率较高与术前充血性心力衰竭有关。
IF 1.8 4区 医学 Q3 PERIPHERAL VASCULAR DISEASE Pub Date : 2024-01-01 Epub Date: 2024-09-19 DOI: 10.1159/000540918
Renxi Li, Anton Sidawy, Bao-Ngoc Nguyen

Introduction: Preoperative congestive heart failure (CHF) is associated with higher postoperative mortality and complications in noncardiac surgery. However, postoperative outcomes for patients with preoperative CHF undergoing endovascular aneurysm repair (EVAR) have not been thoroughly established. This study evaluated the effect of preoperative CHF on 30-day outcomes following nonemergent intact EVAR using a large-scale national registry.

Methods: Patients who had infrarenal EVAR were identified in the ACS-NSQIP database from 2012 to 2022. A 1:5 propensity-score matching was used to match demographics, baseline characteristics, aneurysm diameter, distant aneurysm extent, anesthesia, and concomitant procedures between patients with and without preoperative CHF. Thirty-day postoperative outcomes were examined.

Results: 467 (2.84%) CHF patients underwent intact EVAR. Meanwhile, 15,996 non-CHF patients underwent EVAR, where 2,248 of them were matched to all CHF patients. Patients with and without preoperative CHF had comparable 30-day mortality (3.02% vs. 2.62%, p = 0.64). However, CHF patients had higher myocardial infarction (3.02% vs. 1.47%, p = 0.03), pneumonia (3.23% vs. 1.73%, p = 0.04), 30-day readmission (p = 0.01), and longer length of stay (p < 0.01).

Conclusion: While patients with and without preoperative CHF had comparable 30-day mortality rates, those with CHF faced higher risks of cardiopulmonary complications. Effective management of preoperative CHF may help prevent postoperative complications in these patients.

导言:在非心脏手术中,术前充血性心力衰竭(CHF)与较高的术后死亡率和并发症有关。然而,对于术前患有充血性心力衰竭并接受血管内动脉瘤修补术(EVAR)的患者,其术后效果尚未完全确定。本研究通过大规模的全国登记,评估了术前CHF对非急诊完整EVAR术后30天预后的影响:方法:2012 年至 2022 年期间,在 ACS-NSQIP 数据库中识别了肾下 EVAR 患者。采用1:5倾向得分匹配法对术前有和没有CHF的患者进行人口统计学、基线特征、动脉瘤直径、远处动脉瘤范围、麻醉和伴随手术的匹配。对术后30天的结果进行了研究:467名(2.84%)CHF患者接受了完整的EVAR手术。同时,15996 名非慢性阻塞性肺病患者接受了 EVAR,其中 2248 人与所有慢性阻塞性肺病患者匹配。术前患有和不患有慢性阻塞性肺病的患者的 30 天死亡率相当(3.02% 对 2.62%,P = 0.64)。然而,CHF患者的心肌梗死(3.02% vs. 1.47%,p = 0.03)、肺炎(3.23% vs. 1.73%,p = 0.04)、30天再入院(p = 0.01)和住院时间(p < 0.01)均较高:结论:虽然术前患有和未患有心血管疾病的患者的 30 天死亡率相当,但患有心血管疾病的患者面临的心肺并发症风险更高。有效控制术前合并心房颤动有助于预防这些患者的术后并发症。
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引用次数: 0
Relationship of Warfarin and Apixaban with Vascular Function in Patients with Atrial Fibrillation. 华法林和阿哌沙班与心房颤动患者血管功能的关系
IF 1.7 4区 医学 Q3 PERIPHERAL VASCULAR DISEASE Pub Date : 2024-01-01 Epub Date: 2024-03-06 DOI: 10.1159/000535618
Rehan T Junejo, Dhiraj Gupta, Richard L Snowdon, Gregory Y H Lip, James P Fisher

Introduction: Atrial fibrillation (AF) is associated with endothelial damage/dysfunction. Herein, we tested the hypothesis that brachial artery flow-mediated dilation (FMD) is superior in AF patients taking apixaban compared to warfarin.

Methods: AF patients on apixaban (n = 46; 67 [7] years; mean [standard deviation]; 15 women) and warfarin (n = 27; 73 [9] years (p < 0.01); 11 women) were recruited. Duplex Doppler ultrasound imaging was undertaken during baseline (2 min), cuff inflation (5 min), and following cuff deflation (3 min). FMD was defined as peak increase in brachial artery diameter following cuff deflation and analysed as percentage change in diameter, as a ratio of FMD, shear rate area under the curve (SRAUC; FMD-to-SRAUC), and using SRAUC as a covariate (FMDSR).

Results: Baseline artery diameter (4.96 [1.14] vs. 4.89 [0.88] mm), peak diameter (5.12 [1.17] vs. 5.14 [0.93] mm), and FMDSR (3.89 [3.62] vs. 4.80 [3.60] %) were not different between warfarin and apixaban (p > 0.05; analysis of covariance with age, CHA2DS2-VASc, years since AF diagnosis, number of diabetics, alcohol drinkers, and units of alcohol consumed per week as covariates). Stepwise multiple regression identified independent association of fibrillation, hypertension, and increased age with FMD.

Conclusion: AF patients on warfarin and apixaban exhibit similar endothelium-dependent vasodilation. Increased blood pressure negatively impacts vasodilator capacity in AF patients.

导言:心房颤动(房颤)与内皮损伤/功能障碍有关。在此,我们测试了服用阿哌沙班的房颤患者肱动脉血流介导的扩张(FMD)优于华法林的假设:招募了服用阿哌沙班(n = 46;67 [7]岁;平均[标准差];15 名女性)和华法林(n = 27;73 [9]岁(p < 0.01);11 名女性)的房颤患者。在基线(2 分钟)、袖带充气(5 分钟)和袖带放气(3 分钟)期间进行了双相多普勒超声成像。FMD 被定义为袖带放气后肱动脉直径的峰值增加,并以直径变化的百分比、FMD 与剪切率曲线下面积(SRAUC;FMD-to-SRAUC)之比以及将 SRAUC 作为协变量(FMDSR)进行分析:结果:华法林和阿哌沙班的基线动脉直径(4.96 [1.14] vs. 4.89 [0.88] mm)、峰值直径(5.12 [1.17] vs. 5.14 [0.93] mm)和 FMDSR(3.89 [3.62] vs. 4.80 [3.60] %)没有差异(p > 0.05;以年龄、CHA2DS2-VASc、确诊房颤以来的年数、糖尿病患者人数、饮酒者和每周饮酒单位为协变量进行协方差分析)。逐步多元回归确定了心颤、高血压和年龄增加与 FMD 的独立关联:结论:服用华法林和阿哌沙班的房颤患者表现出相似的内皮依赖性血管扩张。血压升高会对房颤患者的血管舒张能力产生负面影响。
{"title":"Relationship of Warfarin and Apixaban with Vascular Function in Patients with Atrial Fibrillation.","authors":"Rehan T Junejo, Dhiraj Gupta, Richard L Snowdon, Gregory Y H Lip, James P Fisher","doi":"10.1159/000535618","DOIUrl":"10.1159/000535618","url":null,"abstract":"<p><strong>Introduction: </strong>Atrial fibrillation (AF) is associated with endothelial damage/dysfunction. Herein, we tested the hypothesis that brachial artery flow-mediated dilation (FMD) is superior in AF patients taking apixaban compared to warfarin.</p><p><strong>Methods: </strong>AF patients on apixaban (n = 46; 67 [7] years; mean [standard deviation]; 15 women) and warfarin (n = 27; 73 [9] years (p &lt; 0.01); 11 women) were recruited. Duplex Doppler ultrasound imaging was undertaken during baseline (2 min), cuff inflation (5 min), and following cuff deflation (3 min). FMD was defined as peak increase in brachial artery diameter following cuff deflation and analysed as percentage change in diameter, as a ratio of FMD, shear rate area under the curve (SRAUC; FMD-to-SRAUC), and using SRAUC as a covariate (FMDSR).</p><p><strong>Results: </strong>Baseline artery diameter (4.96 [1.14] vs. 4.89 [0.88] mm), peak diameter (5.12 [1.17] vs. 5.14 [0.93] mm), and FMDSR (3.89 [3.62] vs. 4.80 [3.60] %) were not different between warfarin and apixaban (p &gt; 0.05; analysis of covariance with age, CHA2DS2-VASc, years since AF diagnosis, number of diabetics, alcohol drinkers, and units of alcohol consumed per week as covariates). Stepwise multiple regression identified independent association of fibrillation, hypertension, and increased age with FMD.</p><p><strong>Conclusion: </strong>AF patients on warfarin and apixaban exhibit similar endothelium-dependent vasodilation. Increased blood pressure negatively impacts vasodilator capacity in AF patients.</p>","PeriodicalId":17530,"journal":{"name":"Journal of Vascular Research","volume":" ","pages":"59-67"},"PeriodicalIF":1.7,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10997243/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140049792","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Perivascular Adipose Tissue Remodels Only after Elevation of Blood Pressure in the Dahl SS Rat Fed a High-Fat Diet. 以高脂肪饮食喂养的 Dahl SS 大鼠只有在血压升高后血管周围脂肪组织才会发生重塑。
IF 1.7 4区 医学 Q3 PERIPHERAL VASCULAR DISEASE Pub Date : 2024-01-01 Epub Date: 2023-12-19 DOI: 10.1159/000535513
Caitlin Wilson, Janice M Thompson, Leah Terrian, Adam D Lauver, Emma D Flood, Gregory D Fink, Lisa Sather, Sudin Bhattacharya, G Andres Contreras, Stephanie W Watts

Introduction: Tunica media extracellular matrix (ECM) remodeling is well understood to occur in response to elevated blood pressure, unlike the remodeling of other tunicas. We hypothesize that perivascular adipose tissue (PVAT) is responsive to hypertension and remodels as a protective measure.

Methods: The adventitia and PVAT of the thoracic aorta were used in measuring ECM genes from 5 pairs of Dahl SS male rats on 8 or 24 weeks of feeding from weaning on a control (10% Kcal fat) or high-fat (HF; 60%) diet. A PCR array of ECM genes was performed with cDNA from adventitia and PVAT after 8 and 24 weeks. A gene regulatory network of the differentially expressed genes (DEGs) (HF 2-fold > con) was created using Cytoscape.

Results: After 8 weeks, 29 adventitia but 0 PVAT DEGs were found. By contrast, at 24 weeks, PVAT possessed 47 DEGs while adventitia had 3. Top DEGs at 8 weeks in adventitia were thrombospondin 1 and collagen 8a1. At 24 weeks, thrombospondin 1 was also a top DEG in PVAT. The transcription factor Adarb1 was identified as a regulator of DEGs in 8-week adventitia and 24-week PVAT.

Conclusion: These data support that PVAT responds biologically once blood pressure is elevated.

简介中膜细胞外基质(ECM)重塑是对血压升高的反应,与其他中膜的重塑不同。我们假设血管周围脂肪组织(PVAT)对高血压有反应并重塑作为一种保护措施:方法:用 5 对 Dahl SS 雄性大鼠的胸主动脉临膜和 PVAT 测量 ECM 基因,这 5 对大鼠从断奶起以对照组(10% 千卡脂肪)或高脂肪(HF;60%)饮食喂养 8 或 24 周。在 8 周和 24 周后,用来自血管内膜和 PVAT 的 cDNA 对 ECM 基因进行了 PCR 阵列分析。使用 Cytoscape 创建了差异表达基因(DEGs)(HF 2 倍 > con)的基因调控网络:结果:8 周后,发现了 29 个临近组织 DEGs,但 PVAT DEGs 为 0。相比之下,在 24 周时,PVAT 有 47 个 DEGs,而血管壁有 3 个。8 周时,临近组织中最主要的 DEGs 是血栓软骨素 1 和胶原 8a1。在24周时,血栓软骨素1也是PVAT的最高DEG。转录因子 Adarb1 被确定为 8 周临近组织和 24 周 PVAT 中 DEGs 的调节因子:这些数据支持一旦血压升高,PVAT 就会做出生物反应。
{"title":"Perivascular Adipose Tissue Remodels Only after Elevation of Blood Pressure in the Dahl SS Rat Fed a High-Fat Diet.","authors":"Caitlin Wilson, Janice M Thompson, Leah Terrian, Adam D Lauver, Emma D Flood, Gregory D Fink, Lisa Sather, Sudin Bhattacharya, G Andres Contreras, Stephanie W Watts","doi":"10.1159/000535513","DOIUrl":"10.1159/000535513","url":null,"abstract":"<p><strong>Introduction: </strong>Tunica media extracellular matrix (ECM) remodeling is well understood to occur in response to elevated blood pressure, unlike the remodeling of other tunicas. We hypothesize that perivascular adipose tissue (PVAT) is responsive to hypertension and remodels as a protective measure.</p><p><strong>Methods: </strong>The adventitia and PVAT of the thoracic aorta were used in measuring ECM genes from 5 pairs of Dahl SS male rats on 8 or 24 weeks of feeding from weaning on a control (10% Kcal fat) or high-fat (HF; 60%) diet. A PCR array of ECM genes was performed with cDNA from adventitia and PVAT after 8 and 24 weeks. A gene regulatory network of the differentially expressed genes (DEGs) (HF 2-fold &gt; con) was created using Cytoscape.</p><p><strong>Results: </strong>After 8 weeks, 29 adventitia but 0 PVAT DEGs were found. By contrast, at 24 weeks, PVAT possessed 47 DEGs while adventitia had 3. Top DEGs at 8 weeks in adventitia were thrombospondin 1 and collagen 8a1. At 24 weeks, thrombospondin 1 was also a top DEG in PVAT. The transcription factor Adarb1 was identified as a regulator of DEGs in 8-week adventitia and 24-week PVAT.</p><p><strong>Conclusion: </strong>These data support that PVAT responds biologically once blood pressure is elevated.</p>","PeriodicalId":17530,"journal":{"name":"Journal of Vascular Research","volume":" ","pages":"26-37"},"PeriodicalIF":1.7,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10836923/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138805883","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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Journal of Vascular Research
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