Vascular Health and Risk Management最新文献

Background: Peripheral artery disease (PAD), a common manifestation of systemic atherosclerosis, is linked to high morbidity and mortality. Risk factors such as age, male gender, and hyperlipidemia significantly contribute to PAD. This study aims to estimate the Predictors and associations of peripheral artery diseases in the Abu Dhabi population.

Methods: Cross-sectional analysis of diabetic patients who had ankle brachial index tests in 2018-2019. Data collected from electronic medical records include demographics, treatment history, comorbidities (hypertension, smoking), lab results (HbA1c, renal function, lipid profile), and findings from sudoscan test used to assess the function of small nerve fibers and evaluate autonomic dysfunction. A cohort study from the Abu Dhabi Cardiovascular Risk Study (ADRS), to determine the predictors and relationships associated with peripheral artery disease in Abu Dhabi. Data were analyzed using Statistical Package for the Social Sciences (SPSS) version 26.

Results: Among the 359 patients from the cross-sectional study, 65.5% had normal ABI, 14.2% had low abnormal ABI, and 20.3% had high abnormal ABI. The average age was 65.3 years, with 66.3% females and 75.49% United Arab Emirates (UAE) nationals. Most patients (65.2%) were on non-insulin treatments, and 75.8% had hypertension. The mean HbA1c level was 7.3%. Regarding renal function, 51.5% had stage 1 estimated glomerular filtration rate (eGFR), and 9.2% had abnormal eye grading. Ulcers were present in 95.8%, and 9.7% had vascular referrals. Multivariate analysis showed no significant predictors of abnormal ABI (p > 0.05). In the cohort study of 8699 patients, PAD prevalence was highest among those aged 40-59, with significant associations with age, smoking, and diabetes.

Conclusion: Abnormal ABI was present in 34.5% of patients, with no significant association with various risk factors. However, the cohort study showed that age, smoking, and diabetes are significantly related to PAD development.

Purpose: Aquaporin 1 (AQP1), a transmembrane water channel protein, has been implicated in the regulation of necroptosis. However, its specific role in atherosclerotic plaque stability through the modulation of necroptosis remains unclear. Therefore, in this study, we aim to investigate whether AQP1 influences necroptosis in atherosclerosis by binding to receptor-interacting serine/threonine-protein kinase 1 (RIPK1) and decreasing the expression of receptor-interacting serine/threonine-protein kinase 3 (RIPK3) and mixed lineage kinase domain-like pseudokinase (MLKL).

Patients and methods: The gene expression of AQP1 and necroptosis-associated genes significantly differ between atherosclerosis and normal groups. Genes linked to necroptosis were screened to influence the AS identified by weighted gene coexpression network analysis (WGCNA). Then we collected femoral atherosclerosis and normal aortic samples, further conducted single-cell sequencing and spatial transcriptomic methods to confirm the potential function and pathway of AQP1 in endothelial cells. Meanwhile, we overexpressed AQP1 in ox-LDL-treated endothelial cells in vitro.

Results: Firstly, via single-sample Gene Set Enrichment Analysis (ssGSEA) scores, we found that necroptosis plays the most important role among all ways of programmed cell death in two kinds of atherosclerosis. AQP1, RIPK1, RIPK3 and MLKL express differently in normal and atherosclerosis tissue by differentially expressed gene (DEG) analysis and Western Blot (WB). WGCNA analysis indicates that AQP1, MLKL and RIPK3 were significantly related to the AS. The area under the curve of the above hub genes was greater than 0.8 (AQP1 0.946, RIPK1 0.908, RIPK3 0.988, MLKL 0.863). We found AQP1 highly enriched in endothelial cells (ECs) by single-cell analysis. We sequenced the samples by spatial transcriptome and found that AQP1 was also mainly enriched in ECs both in expression and spatial location. With AQP1 overexpression in ECs, it significantly inhibited the expression of MLKL and RIPK3 and stimulated EC proliferation.

Conclusion: Our study identified that AQP1 suppresses atherosclerotic necroptosis by inhibiting the expression of RIPK3 and MLKL in ECs which might indicates that AQP1 plays a role in atherosclerosis. This new mechanism contributes to improving the diagnostic, prognostic, and therapeutic outcomes of atherosclerosis.

Background: Aerobic training has been considered beneficial for determining the detrimental alterations in blood vessels caused by aging.

Objective: Evaluate the relationship between the preventive effects of aerobic exercise and time of practice on cardiovascular health, in aged Wistar rats.

Methods: Wistar rats (16 months) were divided into 3 groups: (1) sedentary (AGED); (2) long-term trained61 weeks (LTT); and (3) short-term trainedfinal 8 weeks of life (STT). Body weight, maximum physical capacity, systolic blood pressure (SBP), pulse wave velocity (PWV), plasma nitrite (NO), oxidative stress (TBARS), wall thickness, the wall-to-lumen ratio, and collagen of the thoracic aorta, carotid, and femoral arteries were measured.

Results: Both trained groups showed an increase in physical capacity when compared to the AGED group (p=<0.001 for LTT and p=0.011 for STT), and the LTT group demonstrated higher values when compared to the STT group (p= 0.004). The LTT group presented attenuation of PWV (p= 0.002) and a reduction in the wall thickness and wall-to-lumen ratio of the thoracic aorta (p=0.032 and 0.008, respectively) and carotid arteries (p=0.019 and 0.012, respectively) when compared to the AGED group. The STT group presented a reduction in TBARS compared to the AGED group (p=0.046). Additionally, both trained groups (LTT and STT) presented a reduction in the percentage of arterial collagen compared to the AGED group in the thoracic aorta (p=<0.001 and p=0.001 respectively) and carotid arteries (p= <0.008 and p= 0.041 respectively).

Conclusion: This study demonstrated that long-term training decreased the level of collagen, PWV values, wall thickness, and the wall-to-lumen ratio of the aorta and carotid arteries compared to the AGED group. Moreover, short-term training reduced TBARS and collagen percentage in the aorta and carotid arteries compared to the AGED group.

Background: Hypertension (HT) is a major risk factor for adult morbidity and mortality in low- and middle-income countries and little is known regarding the distribution of HT risk and treatment access within urban areas.

Patients and methods: We used data from the Vientiane Multi-Generational Birth Cohort in urban Lao PDR to assess the prevalence of loss and retention across five stages of HT care for 40+ year old adults: i) prevalence of hypertension, ii) hypertensives who ever had their BP measured by a health care professional, iii) hypertensives ever diagnosed with HT by a professional, iv) patients currently treated with HT medication, and v) patients with currently controlled BP. We estimated associations between sociodemographic and lifestyle predictors and the proportion of participants who reached each care cascade step using mutually adjusted Poisson regression modeling.

Results: Among the 3196 participants aged 40 to 99 years, the overall prevalence of HT was 16.3%, with higher rates for women, people over 60 years, peripheral district residents, low educated, widowed, and obese. Among people with HT, 90.2% ever had their BP measured by a health care professional, 69.3% ever received a HT diagnosis, 60.9% HT were currently on (drug) treatment, and 39.5% had currently controlled BP. The largest cascade of care losses occurred at the diagnosis and control stages with better outcomes for women. While central districts showed higher rates of diagnosis, control levels were lower than in peripheral districts, but there these differences appeared to be explained by adjusting for sociodemographic and lifestyle factors.

Conclusion: While HT prevalence in Lao PDR is lower than reported for other LMICs, more than 16% over the age of 40 years suffer from HT, and 60% of these cases are currently not controlled. Major policy efforts are needed to support this population and to prevent HT-driven excess mortality.

Background: Kawasaki disease (KD), also known as mucocutaneous lymph node syndrome, is a systemic immune vasculitis with an unclear etiology. It is often complicated by coronary artery disease. This study uses bidirectional Mendelian randomization (MR) to investigate the interaction between KD and circulating inflammatory factors, providing insights into their causal relationships.

Methods: We conducted a two-way pooled MR analysis to examine the causal links between 41 circulating inflammatory regulators and the risk of KD. Genetic data related to inflammation were sourced from three genome-wide association studies (GWASs) involving CRP, PCT, and cytokines, while KD data were derived from other studies. Inverse-variance weighting (IVW) was the primary MR method, with sensitivity analyses performed using MR‒Egger, weighted median, weighted mode, and MR-PRESSO to ensure robustness.

Results: Forward MR analyses showed no significant relationship between inflammatory factors and KD outcomes. In contrast, reverse MR, with KD as the exposure factor, revealed that interleukin-2 (IL-2) and interleukin-8 (IL-8) were significantly associated with KD (IL-2: OR=1.0085, P=0.037; IL-8: OR=1.0099, P=0.014). Borderline significant associations were observed for factors such as B_NGF, EOTAXIN, HGF, and IL_12_P70 in MR‒Egger and weighted median analyses.

Conclusion: This bidirectional MR study highlights the role of circulating inflammatory modulators in KD risk, offering insights into KD pathogenesis and potential therapeutic targets.

Introduction: The association between depressive symptoms and cardiovascular disease (CVD) is widely acknowledged. However, there is a lack of relevant evidence among the middle-aged population in developing countries where depressive symptoms often go undetected and untreated. The objectives of this study were to assess the association between depressive symptoms and CVD in Indonesia and to compare the association between the middle-aged and elderly population.

Methods: This national cross-sectional population-based survey used secondary data from the publicly available Indonesian Family Life Survey (IFLS-5). Depressive symptoms were assessed using a modified Center for Epidemiologic Studies Depression (CESD-R-10) scale, and data on CVD and sociodemographic variables were self-reported. Binary logistic regression was performed to determine the association between depressive symptom and self-reported CVD after adjusting for confounding factors, with an adjusted odds ratio (AOR) and 95% confidence interval (CI) reported. Subgroup analysis was performed based on the age group.

Results: The study included 9049 respondents, predominantly the middle-aged (71.1%), female (52.6%), elementary school graduates (50.7%), non-smokers (59.0%), non-obese (77.3%), without depressive symptoms (82.2%), and without self-reported CVD (96.7%). Respondents with depressive symptoms were more likely to experience self-reported CVD (AOR = 1.56; 95% CI = 1.18-2.05; p-value = 0.002), after adjusting for potential confounders. A significant association was observed between depressive symptoms and self-reported CVD in elderly respondents (AOR = 1.89; 95% CI = 1.22-2.94; p-value = 0.005), whereas no significant association was observed in the middle-aged group (AOR = 1.39; 95% CI = 0.98-1.98; p-value = 0.063) after adjusting for confounders.

Conclusion: Respondents with depressive symptoms were associated with an increased risk of self-reported CVD, highlighting the urgent need for targeted prevention strategies, especially for those struggling with depressive symptoms.

Background: Scientific societies universally recommend evaluating the accuracy of electronic devices designed for blood pressure (BP) measurement using established validation protocols.

Objective: This study aimed to assess the accuracy of the Combei BP880W wrist device for BP measurement in the general population, according to the ISO 81060-2:2018/AMD 1:2020 Universal Standard.

Methods: The Combei BP880W is an oscillometric device designed to measure BP at the wrist. This study adhered to the ISO 81060-2:2018/AMD 1:2020 protocol and employed the same-arm sequential BP measurement method. A total of 85 participants, meeting protocol-specified age, gender, BP, and cuff distribution criteria, were included. The accuracy analysis utilized Criterion 1 (differences and standard deviations between reference and test device measurements) and Criterion 2 (intra-individual standard deviation of BP differences).

Results: Eighty-five participants were included. Mean BP differences between the simultaneous observer measurements were -0.2 ± 1.9 mmHg for systolic BP (SBP) and 0.1 ± 1.9 mmHg for diastolic BP (DBP). For Criterion 1, the mean difference ± standard deviation (SD) between the reference and test device measurements were -2.7 ± 5.9 mmHg (SBP) and -2.0 ± 3.9 mmHg (DBP), meeting the required threshold (≤ 5 ± 8 mmHg). For Criterion 2, intra-individual SDs were 4.6 mmHg (SBP) and 3.4 mmHg (DBP), both below the respective limits (≤ 6.39 mmHg for SBP and ≤ 6.65 mmHg for DBP).

Conclusion: The Combei BP880W wrist device meets the accuracy requirements of the ISO 81060-2:2018/AMD 1:2020 protocol, supporting its use for home BP monitoring in the general population.

Introduction: Previous studies with visible light spectroscopy (VLS) and laser Doppler flowmetry (LDF) have shown reduced mucosal circulation of the stomach and duodenal wall in patients with median arcuate ligament syndrome (MALS) and chronic mesenteric ischemia (CMI). However, transserosal microcirculatory assessment during the operative treatment of patients with these conditions has not yet been performed. We aimed to investigate if laparoscopic decompression for MALS and aortomesenteric bypass in CMI can result in immediate measurable increase in the microcirculation in stomach and duodenum.

Patients and methods: In a single center, prospective comparative cohort study, twenty-eight patients suspected of MALS, and eleven with CMI underwent assessment of transserosal microcirculation of stomach and duodenum with Visible Light Spectroscopy (VLS) and Laser Doppler flowmetry (LDF), during surgery. Patients with computed tomography angiography (CTA) verified stenosis grade ≥50% in MALS and ≥70% in CMI were included in the study. Duplex ultrasound (DUS) was performed before and after the surgical treatment. The changes in the pre- and postoperative microcirculation were calculated with paired sample t-test.

Results: VLS showed significant increase in the transserosal relative hemoglobin concentration (rHb) after laparoscopic decompression in patients with MALS (Stomach, before: 58AU±13, after: 62AU±14, p = 0.017) and (Duodenum, before: 62AU±15, after:70AU±15, p = 0.004). Furthermore, a significantly increased blood flow was found in duodenum (Before: 276AU±89, After: 315AU±93, p = 0.015). However, the SaO2 was decreased significantly in the stomach (Before: 86AU±10, After: 82AU±14, p = 0.015), but remained unchanged in the duodenal serosa.The study did not find any increase in the microcirculation of the CMI patients after revascularization. The baseline transserosal microcirculation was indifferent between the groups.

Conclusion: Laparoscopic decompression leads to enhanced transserosal microcirculation in stomach and duodenum in the patients with MALS. The baseline transserosal microcirculation in stomach and duodenum is indifferent in the MALS and CMI.