Pub Date : 2024-06-01Epub Date: 2024-05-07DOI: 10.1177/1358863X241250325
Heather L Gornik
{"title":"Spotlight on the vascular zebras.","authors":"Heather L Gornik","doi":"10.1177/1358863X241250325","DOIUrl":"10.1177/1358863X241250325","url":null,"abstract":"","PeriodicalId":23604,"journal":{"name":"Vascular Medicine","volume":" ","pages":"243-244"},"PeriodicalIF":3.5,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140877486","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-06-01Epub Date: 2024-03-12DOI: 10.1177/1358863X241227476
Mohsen Sharifi, Robert Snyder, Iman Sharifi, Emily White
Background: External iliac artery endofibrosis (EIAE) is a rare vascular disease which has been traditionally seen in avid cyclists. The conventional approach has been surgery, although no high-quality evidence suggests superiority of surgery over percutaneous endovascular intervention. There are limited data on the efficacy of stenting in EIAE.
Methods: Over a 14-year period, we treated 10 patients (13 limbs) with EIAE with stents. These patients had declined surgery. The mean follow up was 8.4 ± 3.3 years. There were eight women. Five patients were competitive runners, three were cyclists, and two were triathletes. The mean age was 40.7 ± 2.9 years and body mass index was 19.46 ± 1.6. Intravascular ultrasound (IVUS) was used in eight limbs.
Results: Procedural success was achieved in all. The recurrence of symptoms occurred in three patients at a mean of 9.3 ± 2.1 months postindex intervention. The other seven patients remained symptom free. IVUS revealed a pathognomonic finding which we termed 'perfect circle appearance'. It results from symmetric or asymmetric hypertrophy of one or more layers of the arterial wall leading to negative remodeling, which creates a distinct echo dense structure contrasting itself from the luminal blood's echoluscent appearance. It is identical to IVUS images of diffuse venous stenosis with important implications in the treatment technique.
Conclusions: We conclude that stenting in EIAE is safe and effective with a good long-term outcome. It can be an alternative to surgery, particularly in those patients who refuse a surgical approach. The IVUS image is pathognomonic and 'sine qua non' of EIAE.
{"title":"Long-term outcome of percutaneous endovascular stenting in external iliac artery endofibrosis.","authors":"Mohsen Sharifi, Robert Snyder, Iman Sharifi, Emily White","doi":"10.1177/1358863X241227476","DOIUrl":"10.1177/1358863X241227476","url":null,"abstract":"<p><strong>Background: </strong>External iliac artery endofibrosis (EIAE) is a rare vascular disease which has been traditionally seen in avid cyclists. The conventional approach has been surgery, although no high-quality evidence suggests superiority of surgery over percutaneous endovascular intervention. There are limited data on the efficacy of stenting in EIAE.</p><p><strong>Methods: </strong>Over a 14-year period, we treated 10 patients (13 limbs) with EIAE with stents. These patients had declined surgery. The mean follow up was 8.4 ± 3.3 years. There were eight women. Five patients were competitive runners, three were cyclists, and two were triathletes. The mean age was 40.7 ± 2.9 years and body mass index was 19.46 ± 1.6. Intravascular ultrasound (IVUS) was used in eight limbs.</p><p><strong>Results: </strong>Procedural success was achieved in all. The recurrence of symptoms occurred in three patients at a mean of 9.3 ± 2.1 months postindex intervention. The other seven patients remained symptom free. IVUS revealed a pathognomonic finding which we termed 'perfect circle appearance'. It results from symmetric or asymmetric hypertrophy of one or more layers of the arterial wall leading to negative remodeling, which creates a distinct echo dense structure contrasting itself from the luminal blood's echoluscent appearance. It is identical to IVUS images of diffuse venous stenosis with important implications in the treatment technique.</p><p><strong>Conclusions: </strong>We conclude that stenting in EIAE is safe and effective with a good long-term outcome. It can be an alternative to surgery, particularly in those patients who refuse a surgical approach. The IVUS image is pathognomonic and 'sine qua non' of EIAE.</p>","PeriodicalId":23604,"journal":{"name":"Vascular Medicine","volume":" ","pages":"256-264"},"PeriodicalIF":3.5,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140102515","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-16DOI: 10.1177/1358863x241231942
Mengwei Zhang, Saran Lotfollahzadeh, Nagla Elzinad, Xiaosheng Yang, Murad Elsadawi, Adam C Gower, Mostafa Belghasem, Tarek Shazly, Vijaya B Kolachalama, Vipul C Chitalia
Background:Paclitaxel (PTX) is touted as an essential medicine due to its extensive use as a chemotherapeutic agent for various cancers and an antiproliferative agent for endovascular applications. Emerging studies in cardio-oncology implicate various vascular complications of chemotherapeutic agents.Methods:We evaluated the inflammatory response induced by the systemic administration of PTX. The investigation included RNAseq analysis of primary human endothelial cells (ECs) treated with PTX to identify transcriptional changes in pro-inflammatory mediators. Additionally, we used dexamethasone (DEX), a well-known antiinflammatory compound, to assess its effectiveness in counteracting these PTX-induced changes. Further, we studied the effects of PTX on monocyte chemoattractant protein-1 (MCP-1) levels in the media of ECs. The study also extended to in vivo analysis, where a group of mice was injected with PTX and subsequently harvested at different times to assess the immediate and delayed effects of PTX on inflammatory mediators in blood and aortic ECs.Results:Our RNAseq analysis revealed that PTX treatment led to significant transcriptional perturbations in pro-inflammatory mediators such as MCP-1 and CD137 within primary human ECs. These changes were effectively abrogated when DEX was administered. In vitro experiments showed a marked increase in MCP-1 levels in EC media following PTX treatment, which returned to baseline upon treatment with DEX. In vivo, we observed a threefold increase in MCP-1 levels in blood and aortic ECs 12 h post-PTX administration. Similar trends were noted for CD137 and other downstream mediators like tissue factor, vascular cell adhesion molecule 1, and E-selectin in aortic ECs.Conclusion:Our findings illustrate that PTX exposure induces an upregulation of atherothrombotic mediators, which can be alleviated with concurrent administration of DEX. Considering these observations, further long-term investigations should focus on understanding the systemic implications associated with PTX-based therapies and explore the clinical relevance of DEX in mitigating such risks.
{"title":"Alleviating iatrogenic effects of paclitaxel via antiinflammatory treatment","authors":"Mengwei Zhang, Saran Lotfollahzadeh, Nagla Elzinad, Xiaosheng Yang, Murad Elsadawi, Adam C Gower, Mostafa Belghasem, Tarek Shazly, Vijaya B Kolachalama, Vipul C Chitalia","doi":"10.1177/1358863x241231942","DOIUrl":"https://doi.org/10.1177/1358863x241231942","url":null,"abstract":"Background:Paclitaxel (PTX) is touted as an essential medicine due to its extensive use as a chemotherapeutic agent for various cancers and an antiproliferative agent for endovascular applications. Emerging studies in cardio-oncology implicate various vascular complications of chemotherapeutic agents.Methods:We evaluated the inflammatory response induced by the systemic administration of PTX. The investigation included RNAseq analysis of primary human endothelial cells (ECs) treated with PTX to identify transcriptional changes in pro-inflammatory mediators. Additionally, we used dexamethasone (DEX), a well-known antiinflammatory compound, to assess its effectiveness in counteracting these PTX-induced changes. Further, we studied the effects of PTX on monocyte chemoattractant protein-1 (MCP-1) levels in the media of ECs. The study also extended to in vivo analysis, where a group of mice was injected with PTX and subsequently harvested at different times to assess the immediate and delayed effects of PTX on inflammatory mediators in blood and aortic ECs.Results:Our RNAseq analysis revealed that PTX treatment led to significant transcriptional perturbations in pro-inflammatory mediators such as MCP-1 and CD137 within primary human ECs. These changes were effectively abrogated when DEX was administered. In vitro experiments showed a marked increase in MCP-1 levels in EC media following PTX treatment, which returned to baseline upon treatment with DEX. In vivo, we observed a threefold increase in MCP-1 levels in blood and aortic ECs 12 h post-PTX administration. Similar trends were noted for CD137 and other downstream mediators like tissue factor, vascular cell adhesion molecule 1, and E-selectin in aortic ECs.Conclusion:Our findings illustrate that PTX exposure induces an upregulation of atherothrombotic mediators, which can be alleviated with concurrent administration of DEX. Considering these observations, further long-term investigations should focus on understanding the systemic implications associated with PTX-based therapies and explore the clinical relevance of DEX in mitigating such risks.","PeriodicalId":23604,"journal":{"name":"Vascular Medicine","volume":"16 1","pages":""},"PeriodicalIF":3.5,"publicationDate":"2024-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140615557","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-12DOI: 10.1177/1358863x241240442
Ying Huang, Hailong Luo, Xin Liu, Yanlin Li, Jing Gong
Background:The placement of inferior vena cava (IVC) filters often emerges as an alternative preventative measure against pulmonary embolism in patients with upper gastrointestinal (GI) bleeding and isolated distal deep vein thrombosis (DVT). We aimed to investigate the association of IVC filter placement and the incidence of venous thromboembolism (VTE) recurrence in this patient population.Methods:We performed a retrospective cohort study including 450 patients with upper GI bleeding and isolated distal DVT. Propensity score matching using logistic regression was conducted to mitigate potential selection bias. Logistic regression models and additional sensitivity analyses were conducted to estimate the association between IVC filter implantation and VTE recurrence. Interaction and stratified analyses were also performed according to the background covariates.Results:Patients who underwent IVC filter placement were significantly younger than patients in the surveillance group (55.8 ± 9.0 vs 58.4 ± 11.2 years, p = 0.034). Patients in the IVC filter group demonstrated a higher distal thrombus burden. The VTE recurrence composite was significantly higher in patients who underwent IVC filter placement (44.1% [45/102] vs 25% [87/348], p < 0.001). Unmatched crude logistic regression analysis identified a significant association between IVC filter placement and VTE recurrence composite (OR = 2.37; 95% CI, 1.50–3.75). Sensitivity analyses yielded congruent outcomes.Conclusion:This study revealed an increased risk of VTE recurrence among patients receiving IVC filter placement, suggesting that IVC filter placement may not be suitable as a primary treatment for patients with upper GI bleeding and isolated distal DVT.
{"title":"Independent association between IVC filter placement and VTE risk in patients with upper gastrointestinal bleeding and isolated distal DVT: A retrospective cohort study","authors":"Ying Huang, Hailong Luo, Xin Liu, Yanlin Li, Jing Gong","doi":"10.1177/1358863x241240442","DOIUrl":"https://doi.org/10.1177/1358863x241240442","url":null,"abstract":"Background:The placement of inferior vena cava (IVC) filters often emerges as an alternative preventative measure against pulmonary embolism in patients with upper gastrointestinal (GI) bleeding and isolated distal deep vein thrombosis (DVT). We aimed to investigate the association of IVC filter placement and the incidence of venous thromboembolism (VTE) recurrence in this patient population.Methods:We performed a retrospective cohort study including 450 patients with upper GI bleeding and isolated distal DVT. Propensity score matching using logistic regression was conducted to mitigate potential selection bias. Logistic regression models and additional sensitivity analyses were conducted to estimate the association between IVC filter implantation and VTE recurrence. Interaction and stratified analyses were also performed according to the background covariates.Results:Patients who underwent IVC filter placement were significantly younger than patients in the surveillance group (55.8 ± 9.0 vs 58.4 ± 11.2 years, p = 0.034). Patients in the IVC filter group demonstrated a higher distal thrombus burden. The VTE recurrence composite was significantly higher in patients who underwent IVC filter placement (44.1% [45/102] vs 25% [87/348], p < 0.001). Unmatched crude logistic regression analysis identified a significant association between IVC filter placement and VTE recurrence composite (OR = 2.37; 95% CI, 1.50–3.75). Sensitivity analyses yielded congruent outcomes.Conclusion:This study revealed an increased risk of VTE recurrence among patients receiving IVC filter placement, suggesting that IVC filter placement may not be suitable as a primary treatment for patients with upper GI bleeding and isolated distal DVT.","PeriodicalId":23604,"journal":{"name":"Vascular Medicine","volume":"26 1","pages":""},"PeriodicalIF":3.5,"publicationDate":"2024-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140566342","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-12DOI: 10.1177/1358863x241237776
Stanislav Henkin, Stephen A Kearing, Pablo Martinez-Camblor, Nikolaos Zacharias, Mark A Creager, Michael N Young, Philip P Goodney, Jesse A Columbo
Background: In 2014, the Affordable Care Act Medicaid Expansion (ME) increased Medicaid eligibility for adults with an income level up to 138% of the federal poverty level. In this study, we examined the impact of ME on mortality and amputation in patients with peripheral artery disease (PAD). Methods: The 100% MedPAR and Part-B Carrier files from 2011 to 2018 were queried to identify all fee-for-service Medicare beneficiaries with PAD using International Classification of Diseases codes. Our primary exposure was whether a state had adopted the ME on January 1, 2014. Our primary outcomes were the change in all-cause 1-year mortality and leg amputation. We used a state-level difference-in-differences (DID) analysis to compare the rates of the primary outcomes among patients who were in states (including the District of Columbia) who adopted ME ( n = 25) versus those who were in states that did not ( n = 26). We performed a subanalysis stratifying by sex, race, region, and dual-eligibility status. Results: Over the 8-year period, we studied 37,743,929 patients. The average unadjusted 1-year mortality decreased from 2011 to 2018 in both non-ME (9.5% to 8.7%, p < 0.001) and ME (9.1% to 8.3%, p < 0.001) states. The average unadjusted 1-year amputation rate did not improve in either the non-ME (0.86% to 0.87%, p = 0.17) or ME (0.69% to 0.69%, p = 0.65) states. Across the entire cohort, the DID model revealed that ME did not lead to a significant change in mortality ( p = 0.15) or amputation ( p = 0.34). Conclusion: Medicaid Expansion was not associated with reduced mortality or leg amputation in Medicare beneficiaries with PAD.
背景：2014 年，《平价医疗法案》的医疗补助扩展（Medicaid Expansion，ME）提高了收入水平不超过联邦贫困线 138% 的成年人的医疗补助资格。在本研究中，我们考察了 ME 对外周动脉疾病 (PAD) 患者死亡率和截肢率的影响。方法：查询了 2011 年至 2018 年的 100% MedPAR 和 Part-B Carrier 文件，以使用国际疾病分类代码识别所有患有 PAD 的付费服务医疗保险受益人。我们的主要接触点是一个州是否在 2014 年 1 月 1 日采用了 ME。我们的主要结果是全因 1 年死亡率和腿部截肢率的变化。我们采用州级差异（DID）分析方法，比较了采用ME的州（包括哥伦比亚特区）（n = 25）与未采用ME的州（n = 26）患者的主要结果发生率。我们根据性别、种族、地区和双重资格状况进行了分层子分析。结果：在 8 年的时间里，我们研究了 37,743,929 名患者。从 2011 年到 2018 年，非 ME 州（9.5% 降至 8.7%，p <0.001）和 ME 州（9.1% 降至 8.3%，p <0.001）的平均未经调整的 1 年死亡率均有所下降。在非 ME 州（从 0.86% 到 0.87%，p = 0.17）和 ME 州（从 0.69% 到 0.69%，p = 0.65），平均未经调整的 1 年截肢率没有提高。在整个队列中，DID 模型显示 ME 并未导致死亡率（p = 0.15）或截肢率（p = 0.34）的显著变化。结论：医疗补助计划的扩大与患有 PAD 的医疗保险受益人死亡率或截肢率的降低无关。
{"title":"The impact of the Affordable Care Act Medicaid Expansion in Medicare beneficiaries with peripheral artery disease","authors":"Stanislav Henkin, Stephen A Kearing, Pablo Martinez-Camblor, Nikolaos Zacharias, Mark A Creager, Michael N Young, Philip P Goodney, Jesse A Columbo","doi":"10.1177/1358863x241237776","DOIUrl":"https://doi.org/10.1177/1358863x241237776","url":null,"abstract":"Background: In 2014, the Affordable Care Act Medicaid Expansion (ME) increased Medicaid eligibility for adults with an income level up to 138% of the federal poverty level. In this study, we examined the impact of ME on mortality and amputation in patients with peripheral artery disease (PAD). Methods: The 100% MedPAR and Part-B Carrier files from 2011 to 2018 were queried to identify all fee-for-service Medicare beneficiaries with PAD using International Classification of Diseases codes. Our primary exposure was whether a state had adopted the ME on January 1, 2014. Our primary outcomes were the change in all-cause 1-year mortality and leg amputation. We used a state-level difference-in-differences (DID) analysis to compare the rates of the primary outcomes among patients who were in states (including the District of Columbia) who adopted ME ( n = 25) versus those who were in states that did not ( n = 26). We performed a subanalysis stratifying by sex, race, region, and dual-eligibility status. Results: Over the 8-year period, we studied 37,743,929 patients. The average unadjusted 1-year mortality decreased from 2011 to 2018 in both non-ME (9.5% to 8.7%, p < 0.001) and ME (9.1% to 8.3%, p < 0.001) states. The average unadjusted 1-year amputation rate did not improve in either the non-ME (0.86% to 0.87%, p = 0.17) or ME (0.69% to 0.69%, p = 0.65) states. Across the entire cohort, the DID model revealed that ME did not lead to a significant change in mortality ( p = 0.15) or amputation ( p = 0.34). Conclusion: Medicaid Expansion was not associated with reduced mortality or leg amputation in Medicare beneficiaries with PAD.","PeriodicalId":23604,"journal":{"name":"Vascular Medicine","volume":"91 1","pages":""},"PeriodicalIF":3.5,"publicationDate":"2024-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140566247","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-12DOI: 10.1177/1358863x241240428
Bernhard Zierfuss, Anna Karlinger, Marija Bojic, Renate Koppensteiner, Gerit-Holger Schernthaner, Clemens Höbaus
Background:Chronic kidney disease is associated with increased rates of incidence, morbidity, and mortality in lower-extremity peripheral artery disease (PAD). No specific marker for a functional risk assessment of kidney disease in PAD is known, especially at the early stages. Thus, we speculated that urinary vanin-1 (uVNN1), a marker of oxidative stress even in early kidney injury, could further stratify outcome assessment in patients with PAD.Methods:Patients with stable PAD ( n = 304) of the Vienna medical cohort were followed up for up to 10 years and the outcome was assessed by central death database queries. uVNN1 was measured by enzyme-linked immunosorbent assay (ELISA) at study inclusion and normalized to urinary creatinine (uVNN1/Cr). During the observation time (9.3, 7.0–9.8 years), 104 patients died, 54.8% of which were due to cardiovascular causes.Results:uVNN1/Cr was associated with a urine albumin–creatinine ratio (UACR) ( R = 0.166, p = 0.004) but not with an estimated glomerular filtration rate ( R = 0.102, p = 0.077). Levels of uVNN1/Cr did not differ between asymptomatic and symptomatic PAD ( p = 0.406). Kaplan–Meier curves showed a clear-cut association with higher all-cause (log-rank p = 0.034) and cardiovascular mortality (log-rank p = 0.032) with higher uVNN1/Cr levels. Similarly, significant associations for all-cause (hazard ratio [HR] 1.34, 95% CI [1.08–1.67], p = 0.009) and cardiovascular mortality (HR 1.45, 95% CI [1.06–1.99], p = 0.020) could be seen in multivariable Cox regression models.Conclusions:uVNN1/Cr showed an independent association with both all-cause and cardiovascular mortality in patients with PAD and was associated with early kidney disease. Thus, uVNN1 could be a useful marker for risk stratification of kidney disease in PAD.
背景：慢性肾脏病与下肢外周动脉疾病（PAD）的发病率、发病率和死亡率增加有关。目前还不知道对 PAD 肾脏疾病进行功能性风险评估的特异性标志物，尤其是在早期阶段。因此，我们推测尿液中的香草素-1（uVNN1）--即使在早期肾脏损伤时也是氧化应激的标志物--可进一步对 PAD 患者的预后评估进行分层。方法：我们对维也纳医疗队列中的稳定型 PAD 患者（n = 304）进行了长达 10 年的随访，并通过中央死亡数据库查询评估了患者的预后。结果：uVNN1/Cr 与尿白蛋白-肌酐比值（UACR）相关（R = 0.166，p = 0.004），但与估计肾小球滤过率无关（R = 0.102，p = 0.077）。无症状和有症状的 PAD 之间的 uVNN1/Cr 水平没有差异 ( p = 0.406)。卡普兰-梅耶曲线显示，uVNN1/Cr水平越高，全因死亡率（log-rank p = 0.034）和心血管死亡率（log-rank p = 0.032）越高，两者之间存在明显的相关性。同样，在多变量 Cox 回归模型中，全因死亡率（危险比 [HR] 1.34，95% CI [1.08-1.67]，p = 0.009）和心血管死亡率（HR 1.45，95% CI [1.06-1.99]，p = 0.020）也有明显相关性。因此，uVNN1可能是对PAD肾脏疾病进行风险分层的有用标志物。
{"title":"Urinary vanin-1 as a novel biomarker for survival in peripheral artery disease","authors":"Bernhard Zierfuss, Anna Karlinger, Marija Bojic, Renate Koppensteiner, Gerit-Holger Schernthaner, Clemens Höbaus","doi":"10.1177/1358863x241240428","DOIUrl":"https://doi.org/10.1177/1358863x241240428","url":null,"abstract":"Background:Chronic kidney disease is associated with increased rates of incidence, morbidity, and mortality in lower-extremity peripheral artery disease (PAD). No specific marker for a functional risk assessment of kidney disease in PAD is known, especially at the early stages. Thus, we speculated that urinary vanin-1 (uVNN1), a marker of oxidative stress even in early kidney injury, could further stratify outcome assessment in patients with PAD.Methods:Patients with stable PAD ( n = 304) of the Vienna medical cohort were followed up for up to 10 years and the outcome was assessed by central death database queries. uVNN1 was measured by enzyme-linked immunosorbent assay (ELISA) at study inclusion and normalized to urinary creatinine (uVNN1/Cr). During the observation time (9.3, 7.0–9.8 years), 104 patients died, 54.8% of which were due to cardiovascular causes.Results:uVNN1/Cr was associated with a urine albumin–creatinine ratio (UACR) ( R = 0.166, p = 0.004) but not with an estimated glomerular filtration rate ( R = 0.102, p = 0.077). Levels of uVNN1/Cr did not differ between asymptomatic and symptomatic PAD ( p = 0.406). Kaplan–Meier curves showed a clear-cut association with higher all-cause (log-rank p = 0.034) and cardiovascular mortality (log-rank p = 0.032) with higher uVNN1/Cr levels. Similarly, significant associations for all-cause (hazard ratio [HR] 1.34, 95% CI [1.08–1.67], p = 0.009) and cardiovascular mortality (HR 1.45, 95% CI [1.06–1.99], p = 0.020) could be seen in multivariable Cox regression models.Conclusions:uVNN1/Cr showed an independent association with both all-cause and cardiovascular mortality in patients with PAD and was associated with early kidney disease. Thus, uVNN1 could be a useful marker for risk stratification of kidney disease in PAD.","PeriodicalId":23604,"journal":{"name":"Vascular Medicine","volume":"49 1","pages":""},"PeriodicalIF":3.5,"publicationDate":"2024-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140566245","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-10DOI: 10.1177/1358863x241238702
Madeline E Shivgulam, Myles W O’Brien, Yanlin Wu, Haoxuan Liu, Jennifer L Petterson, Beverly D Schwartz, Derek S Kimmerly
Introduction:Single bouts of prolonged bent-legged sitting attenuate popliteal endothelial-dependent vasodilation (as assessed via flow-mediated dilation [FMD]), which is partially attributed to arterial ‘kinking’. However, the impact of knee-flexion angle on sitting-induced popliteal FMD is unknown. The objective of this study was to perform separate laboratory and free-living studies to test the hypotheses that: (1) popliteal FMD impairments would be graded between knee flexions at 90° (bent-legged sitting) > 45° > 0° (straight-legged sitting) following a 3-hour bout of sitting; and (2) more habitual time spent bent-legged sitting (< 45°) would be associated with lower FMD.Methods:The laboratory study included eight young, healthy adults (24 ± 2 years; four women) who underwent two sitting bouts over 2 days with one leg positioned at a knee-flexion angle of 0° or 90° and the opposite leg at 45° knee flexion. Popliteal FMD was assessed at pre- and postsitting timepoints.Results:Sitting-induced reductions in FMD were similar between all knee-flexion angles (all, p > 0.674). The free-living study included 35 young, healthy adults (23 ± 3 years; 16 women) who wore three activPAL monitors (torso, thigh, shin) to determine detailed sedentary postures. Time spent sedentary (624 ± 127 min/day), straight-legged sitting (112 ± 98 min/day), and bent-legged sitting (442 ± 106 min/day) were not related to relative FMD (5.3 ± 1.8%; all, p > 0.240).Conclusion:These findings suggest that knee-flexion angle-mediated arterial ‘kinking’ during sitting is not a major contributor toward sitting-induced popliteal endothelial-dependent vasodilatory dysfunction.
{"title":"Sitting knee-flexion angle does not influence endothelial-dependent vasodilation in laboratory or free-living conditions","authors":"Madeline E Shivgulam, Myles W O’Brien, Yanlin Wu, Haoxuan Liu, Jennifer L Petterson, Beverly D Schwartz, Derek S Kimmerly","doi":"10.1177/1358863x241238702","DOIUrl":"https://doi.org/10.1177/1358863x241238702","url":null,"abstract":"Introduction:Single bouts of prolonged bent-legged sitting attenuate popliteal endothelial-dependent vasodilation (as assessed via flow-mediated dilation [FMD]), which is partially attributed to arterial ‘kinking’. However, the impact of knee-flexion angle on sitting-induced popliteal FMD is unknown. The objective of this study was to perform separate laboratory and free-living studies to test the hypotheses that: (1) popliteal FMD impairments would be graded between knee flexions at 90° (bent-legged sitting) > 45° > 0° (straight-legged sitting) following a 3-hour bout of sitting; and (2) more habitual time spent bent-legged sitting (< 45°) would be associated with lower FMD.Methods:The laboratory study included eight young, healthy adults (24 ± 2 years; four women) who underwent two sitting bouts over 2 days with one leg positioned at a knee-flexion angle of 0° or 90° and the opposite leg at 45° knee flexion. Popliteal FMD was assessed at pre- and postsitting timepoints.Results:Sitting-induced reductions in FMD were similar between all knee-flexion angles (all, p > 0.674). The free-living study included 35 young, healthy adults (23 ± 3 years; 16 women) who wore three activPAL monitors (torso, thigh, shin) to determine detailed sedentary postures. Time spent sedentary (624 ± 127 min/day), straight-legged sitting (112 ± 98 min/day), and bent-legged sitting (442 ± 106 min/day) were not related to relative FMD (5.3 ± 1.8%; all, p > 0.240).Conclusion:These findings suggest that knee-flexion angle-mediated arterial ‘kinking’ during sitting is not a major contributor toward sitting-induced popliteal endothelial-dependent vasodilatory dysfunction.","PeriodicalId":23604,"journal":{"name":"Vascular Medicine","volume":"122 1","pages":""},"PeriodicalIF":3.5,"publicationDate":"2024-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140566127","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-04DOI: 10.1177/1358863x241241019
Andrea D Kim, Alexandra L Solomon, Elizabeth V Ratchford
{"title":"Vascular Medicine Patient Information Page: Popliteal artery aneurysm","authors":"Andrea D Kim, Alexandra L Solomon, Elizabeth V Ratchford","doi":"10.1177/1358863x241241019","DOIUrl":"https://doi.org/10.1177/1358863x241241019","url":null,"abstract":"","PeriodicalId":23604,"journal":{"name":"Vascular Medicine","volume":"13 1","pages":""},"PeriodicalIF":3.5,"publicationDate":"2024-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140566131","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-04DOI: 10.1177/1358863x241241022
Chinmay Mahatme, Virna M. Shah, Veerappan R. Saravanan
{"title":"Images in Vascular Medicine: Takayasu retinopathy as a primary presentation of active vasculitis","authors":"Chinmay Mahatme, Virna M. Shah, Veerappan R. Saravanan","doi":"10.1177/1358863x241241022","DOIUrl":"https://doi.org/10.1177/1358863x241241022","url":null,"abstract":"","PeriodicalId":23604,"journal":{"name":"Vascular Medicine","volume":"248 1","pages":""},"PeriodicalIF":3.5,"publicationDate":"2024-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140566329","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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