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Review of Blood Pressure Control in Vulnerable Older Adults: The Role of Frailty and Sarcopenia. 易感老年人血压控制综述:虚弱和肌肉减少症的作用。
Pub Date : 2025-06-01 Epub Date: 2025-05-14 DOI: 10.3390/jvd4020018
Kunaal S Sarnaik, Saeid Mirzai

The aging of the global population over recent decades has resulted in an increased prevalence of hypertension in older adults. Hypertension develops with increasing age primarily due to a disastrous feedback loop of increased arterial stiffness and maladaptive hemodynamics; this is compounded by age-related changes in physiology. The risk of adverse hypertension-related outcomes concurrently increases with age, and optimal blood pressure (BP) control in older adults thus becomes increasingly important each year. The results of several randomized clinical trials (RCTs) evaluating antihypertension strategies in older adults have concluded that the potential benefits of intensive BP management outweigh the risks of harm. However, the exclusion of frail, multimorbid, and institutionalized individuals limits the generalizability of such findings to the broader population of older patients with hypertension. Secondary analyses and external studies have continued to support intensive BP control strategies in older adults with frailty or sarcopenia. Therefore, based on available evidence, clinicians should continue practicing intensive BP control strategies in the older population, yet careful consideration of functional status, life expectancy, medication side effects, polypharmacy, and multimorbidity must take place to avoid unnecessary harm. Strategies must then be tailored to accommodate modifiers such as frailty and sarcopenia in older adults with hypertension. Knowledge gaps underscore the need for future studies evaluating BP management in older adults that incorporate greater proportions of multimorbid and institutionalized individuals with frailty, assess personalization of treatment, and identify subgroups in which optimal BP levels exist or the permissibility of higher BP levels is safer than BP reduction.

近几十年来,全球人口老龄化导致老年人高血压患病率增加。随着年龄的增长,高血压的发展主要是由于动脉僵硬度增加和血流动力学不适应的灾难性反馈循环;这与年龄相关的生理变化相结合。高血压相关不良后果的风险随着年龄的增长而增加,因此老年人的最佳血压(BP)控制每年变得越来越重要。几项评估老年人降压策略的随机临床试验(RCTs)的结果表明,强化血压管理的潜在益处大于危害风险。然而,排除体弱多病和住院的个体限制了这些发现在更广泛的老年高血压患者群体中的推广。二次分析和外部研究继续支持强化血压控制策略,用于虚弱或肌肉减少的老年人。因此,根据现有证据,临床医生应继续在老年人群中实施强化的血压控制策略,但必须仔细考虑功能状态、预期寿命、药物副作用、多种药物和多种疾病,以避免不必要的伤害。因此,必须调整策略,以适应老年人高血压患者的虚弱和肌肉减少症等改变因素。知识缺口强调了未来研究评估老年人血压管理的必要性,包括更大比例的多病和体弱多病个体,评估个性化治疗,并确定存在最佳血压水平或允许较高血压水平比降低血压更安全的亚组。
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引用次数: 0
Macrovascular Function in People with HIV After Recent SARS-CoV-2 Infection. 近期SARS-CoV-2感染后HIV感染者的大血管功能
Pub Date : 2025-03-01 Epub Date: 2025-01-26 DOI: 10.3390/jvd4010004
Ana S Salazar, Louis Vincent, Bertrand Ebner, Nicholas Fonseca Nogueira, Leah Krauss, Madison S Meyer, Jelani Grant, Natalie Aguilar, Mollie S Pester, Meela Parker, Alex Gonzalez, Armando Mendez, Adam Carrico, Barry E Hurwitz, Maria L Alcaide, Claudia Martinez

Background: People with HIV (PWH) are at increased risk of vascular dysfunction and cardiovascular disease (CVD). SARS-CoV-2 infection has been associated with acute CVD complications. The aim of the study was to as-sess macrovascular function as an early indicator of CVD risk in PWH after mild SARS-CoV-2 infection.

Methods: PWH aged 20-60 years, with undetectable viral load (RNA < 20 copies/mL), on stable antiretroviral therapy (≥6 months) and history of mild COVID-19 (≥30 days) without any CVD manifestations prior to enrollment were recruited. Participants were excluded if they had history of diabetes mellitus, end-stage renal disease, heart or respiratory disease. Participants were matched 1:1 to pre-pandemic PWH. A health survey, surrogate measures of CVD risk, and macrovascular function (brachial artery flow-mediated vasodilation and arterial stiffness assessments via applanation tonometry) were compared between group.

Results: A total of 17 PWH and history of COVID-19 (PWH/COV+) were matched with 17 PWH without COVID-19 (PWH/COV-) pre-pandemic. Mean age (45.5 years), sex (76.5% male), body mass index (27.3), and duration of HIV infection (12.2 years) were not different between groups. Both groups had comparable CVD risk factors (total cholesterol, LDL, HDL, systolic and diastolic blood pressure). There were no differences in measures of flow mediated arterial dilatation or arterial stiffness after 30 days of SARS-CoV-2 infection.

Conclusions: After recent SARS-CoV-2 infection, PWH did not demonstrate evidence of macrovascular dysfunction and increased CVD risk. Results suggest that CVD risk may not be increased in people with well-controlled HIV who did not manifest CVD complications SARS-CoV-2 infection.

背景:HIV感染者(PWH)发生血管功能障碍和心血管疾病(CVD)的风险增加。SARS-CoV-2感染与急性心血管疾病并发症有关。该研究的目的是评估大血管功能作为轻度SARS-CoV-2感染后PWH患者心血管疾病风险的早期指标。方法:招募年龄在20-60岁、病毒载量检测不到(RNA < 20拷贝/mL)、接受稳定抗逆转录病毒治疗(≥6个月)、轻度COVID-19病史(≥30天)、入组前无任何CVD表现的PWH。如果参与者有糖尿病、终末期肾病、心脏或呼吸系统疾病病史,则被排除在外。参与者与大流行前的PWH按1:1匹配。比较两组患者的健康调查、心血管疾病风险替代指标和大血管功能(肱动脉血流介导的血管舒张和动脉僵硬度评估)。结果:有COVID-19病史(PWH/COV+)的17例PWH与大流行前无COVID-19病史(PWH/COV-)的17例PWH匹配。平均年龄(45.5岁)、性别(76.5%为男性)、体重指数(27.3)和HIV感染持续时间(12.2年)组间无差异。两组的心血管疾病危险因素(总胆固醇、低密度脂蛋白、高密度脂蛋白、收缩压和舒张压)相似。在SARS-CoV-2感染30天后,血流介导的动脉扩张或动脉硬度的测量没有差异。结论:最近感染SARS-CoV-2后,PWH未显示大血管功能障碍和CVD风险增加的证据。结果表明,在没有出现CVD并发症的SARS-CoV-2感染的HIV控制良好的人群中,CVD风险可能不会增加。
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引用次数: 0
The Evaluation Value of Non-Invasive Indices of Arterial Stiffness in the Early Stage of Coronary Artery Disease: Preliminary Results from an Exploratory Study 冠状动脉疾病早期非侵入性动脉僵硬度指标的评估价值:一项探索性研究的初步结果
Pub Date : 2024-08-08 DOI: 10.3390/jvd3030022
Fei Wang, Hui Zhang, Kotaro Uchida, Takuya Sugawara, Shintaro Minegishi, Hiroshi Doi, Rie Nakashima-Sasaki, Lin Chen, T. Ishigami
Background: Recently, the arterial velocity pulse index (AVI) and arterial pressure volume index (API) have been used to evaluate arterial stiffness and endothelial function. As arterial stiffness and endothelial injury are risk factors for coronary artery disease (CAD), these two indexes are therefore expected to predict and evaluate the future risk of CAD and cardiovascular events before clinical manifestations. Methods: A total of 90 consecutive patients with coronary angiography (CAG) were enrolled. After excluding normal patients and acute coronary syndrome patients, forty-seven patients with CAD and thirty-two patients with coronary atherosclerosis, and baseline characteristics data were collected. A multifunctional blood pressure monitoring device, AVE-1500 (Shisei Datum, Tokyo, Japan), was used to measure the AVI and API before CAG, and immediately and 2 h, 24 h, and 48 h after CAG and (or) PCI in all the selected participants. Results: After adjusting for various variables using stepwise multiple linear regression analyses, we found that the AVI in the CAD subjects was significantly higher than that in the coronary atherosclerosis subjects before CAG (p = 0.02), immediately after CAG/PCI (p = 0.01), and 48 h after CAG/PCI (p = 0.01), whereas the AVI decreased 24–48 h rather than immediately after CAG/PCI in the CAD group. Moreover, we also found that the API clearly changed in both groups during the periprocedural period of CAG (p = 0.01). Conclusions: In accordance with the results, we propose that the API and AVI may be useful for predicting the early stage of CAD and may be promising as indicators to assess the effect of early revascularization.
背景:最近,动脉速度脉搏指数(AVI)和动脉压力容积指数(API)被用于评估动脉僵化和内皮功能。由于动脉僵化和内皮损伤是冠状动脉疾病(CAD)的危险因素,因此这两个指数有望在临床表现之前预测和评估未来发生 CAD 和心血管事件的风险。研究方法共纳入 90 名连续接受冠状动脉造影术(CAG)的患者。在排除正常患者和急性冠脉综合征患者后,收集了 47 名 CAD 患者和 32 名冠状动脉粥样硬化患者的基线特征数据。使用 AVE-1500 多功能血压监测仪(Shisei Datum,日本东京)测量所有入选者在 CAG 之前、CAG 和(或)PCI 之后立即、2 小时、24 小时和 48 小时的 AVI 和 API。结果:使用逐步多元线性回归分析调整各种变量后,我们发现 CAD 受试者在 CAG 前(p = 0.02)、CAG/PCI 后立即(p = 0.01)和 CAG/PCI 后 48 小时(p = 0.01)的 AVI 显著高于冠状动脉粥样硬化受试者,而 CAD 组的 AVI 在 CAG/PCI 后 24-48 小时下降,而不是立即下降。此外,我们还发现,在 CAG 的围手术期,两组的 API 都发生了明显变化(p = 0.01)。结论:根据研究结果,我们认为 API 和 AVI 可用于预测 CAD 的早期阶段,并有望成为评估早期血管重建效果的指标。
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引用次数: 0
Systemic Arterial Function after Multisystem Inflammatory Syndrome in Children Associated with COVID-19 与 COVID-19 有关的儿童多系统炎症综合征后的全身动脉功能
Pub Date : 2024-07-26 DOI: 10.3390/jvd3030021
Ketaki Mukhopadhyay, Marla S. Johnston, James S. Krulisky, Shengping Yang, Thomas R. Kimball
Introduction: Multisystem inflammatory syndrome in children (MIS-C) is a new disease entity occurring in the pediatric population two to six weeks after coronavirus exposure due to a systemic arteritis. We investigated post-hospital-discharge arterial function at short- and mid-term intervals using pulse wave velocity. We assessed associations between arterial function, left ventricular diastolic and systolic function and left ventricular mass. Materials and methods: Retrospective data collection was carried out on 28 patients with MIS-C with at least two outpatient pediatric cardiology clinic visits post hospital admission. The patients underwent assessment of systemic arterial function and cardiac function. Data included pulse wave velocity between carotid and femoral arteries and echocardiographic assessment of left ventricular systolic function (shortening and ejection fraction, longitudinal strain), diastolic function and left ventricular mass. Results: Pulse wave velocity significantly decreased from visit 1 to visit 2 (5.29 ± 1.34 m/s vs. 4.51 ± 0.91 m/s, p = 0.009). Left ventricular mass significantly decreased from visit 1 to visit 2 (42 ± 9 g/m2.7 vs. 38 ± 7 g/m2.7, p = 0.02). There was a significant negative correlation between the pulse wave velocity and E/A mitral inflow (−0.41, p < 0.05). Conclusions: Children have elevated pulse wave velocity and left ventricular mass in the short-term relative to mid-term values after hospital discharge. These results suggest that MIS-C is associated with transient systemic arterial dysfunction, which, in turn, may play a role in cardiac changes.
导言:儿童多系统炎症综合征(MIS-C)是一种新的疾病,发生在因全身性动脉炎而接触冠状病毒两到六周后的儿童群体中。我们利用脉搏波速度对出院后短期和中期的动脉功能进行了调查。我们评估了动脉功能、左心室舒张和收缩功能以及左心室质量之间的关联。材料和方法我们对入院后至少在儿科心脏病学门诊就诊过两次的 28 名 MIS-C 患者进行了回顾性数据收集。患者接受了全身动脉功能和心脏功能评估。数据包括颈动脉和股动脉之间的脉搏波速度,以及左心室收缩功能(缩短率和射血分数、纵向应变)、舒张功能和左心室质量的超声心动图评估。结果脉搏波速度从第一次检查到第二次检查明显下降(5.29 ± 1.34 m/s vs. 4.51 ± 0.91 m/s,p = 0.009)。左心室质量从就诊 1 到就诊 2 显著下降(42 ± 9 g/m2.7 vs. 38 ± 7 g/m2.7,p = 0.02)。脉搏波速度与 E/A 二尖瓣流入量之间存在明显的负相关(-0.41,p < 0.05)。结论相对于出院后的中期值,儿童的脉搏波速度和左心室质量在短期内升高。这些结果表明,MIS-C 与一过性全身动脉功能障碍有关,而这反过来又可能在心脏变化中发挥作用。
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引用次数: 0
Biochemical Insights and Clinical Applications of Ischemia-Modified Albumin in Ischemic Conditions 缺血修饰白蛋白在缺血性疾病中的生化应用和临床应用
Pub Date : 2024-07-08 DOI: 10.3390/jvd3030020
Nimesha N. Senadeera, C. Ranaweera, Inoka C. Perera, D. U. Kottahachchi
Atherosclerotic coronary artery disease is a significant global health threat, impacting millions annually. Over time, plaque buildup narrows the coronary arteries, reducing blood flow to the heart muscle and resulting in myocardial ischemia. Timely diagnosis and intervention are crucial for restoring the blood flow to the heart muscle and preventing myocardial infarction. Given the limited availability of screening and diagnostic tests, the early diagnosis of myocardial ischemia remains challenging. While cardiac troponin is considered the gold standard for detecting myocardial injury, its effectiveness in identifying myocardial ischemia is limited. Ischemia-modified albumin (IMA) is a modified albumin variant that serves as a sensitive and early marker for ischemia. Despite extensive research on diagnostic applications of IMA as a biomarker for ischemia, significant gaps remain in understanding its formation, sensitive and specific detection, and precise clinical utility. This review aims to address these gaps by compiling literature on IMA discussing the latest findings on structure and formation, and detection methods. Further research is required to enhance understanding of the structure and formation of IMA, aiming to develop novel detection techniques or improve existing ones. However, currently, available sophisticated methods are associated with higher expenses and require specialized equipment and qualified personnel.
动脉粥样硬化性冠状动脉疾病是对全球健康的重大威胁,每年影响数百万人。随着时间的推移,斑块堆积会使冠状动脉变窄,减少流向心肌的血液,导致心肌缺血。及时诊断和干预是恢复心肌血流和预防心肌梗死的关键。由于筛查和诊断测试手段有限,心肌缺血的早期诊断仍具有挑战性。虽然心肌肌钙蛋白被认为是检测心肌损伤的金标准,但它在识别心肌缺血方面的效果有限。缺血修饰白蛋白(IMA)是一种修饰白蛋白变体,可作为缺血的早期敏感标记物。尽管对 IMA 作为缺血生物标志物的诊断应用进行了广泛的研究,但在了解其形成、灵敏和特异性检测以及精确的临床实用性方面仍存在很大的差距。本综述旨在通过汇编有关 IMA 的文献,讨论有关其结构、形成和检测方法的最新发现,弥补这些不足。需要进一步开展研究,加深对 IMA 结构和形成的了解,以开发新型检测技术或改进现有技术。然而,目前可用的复杂方法费用较高,需要专业设备和合格人员。
{"title":"Biochemical Insights and Clinical Applications of Ischemia-Modified Albumin in Ischemic Conditions","authors":"Nimesha N. Senadeera, C. Ranaweera, Inoka C. Perera, D. U. Kottahachchi","doi":"10.3390/jvd3030020","DOIUrl":"https://doi.org/10.3390/jvd3030020","url":null,"abstract":"Atherosclerotic coronary artery disease is a significant global health threat, impacting millions annually. Over time, plaque buildup narrows the coronary arteries, reducing blood flow to the heart muscle and resulting in myocardial ischemia. Timely diagnosis and intervention are crucial for restoring the blood flow to the heart muscle and preventing myocardial infarction. Given the limited availability of screening and diagnostic tests, the early diagnosis of myocardial ischemia remains challenging. While cardiac troponin is considered the gold standard for detecting myocardial injury, its effectiveness in identifying myocardial ischemia is limited. Ischemia-modified albumin (IMA) is a modified albumin variant that serves as a sensitive and early marker for ischemia. Despite extensive research on diagnostic applications of IMA as a biomarker for ischemia, significant gaps remain in understanding its formation, sensitive and specific detection, and precise clinical utility. This review aims to address these gaps by compiling literature on IMA discussing the latest findings on structure and formation, and detection methods. Further research is required to enhance understanding of the structure and formation of IMA, aiming to develop novel detection techniques or improve existing ones. However, currently, available sophisticated methods are associated with higher expenses and require specialized equipment and qualified personnel.","PeriodicalId":74009,"journal":{"name":"Journal of vascular diseases","volume":" 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141668639","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}
引用次数: 0
Effect of Microencapsulated Cocoa Polyphenols on Macro- and Microvascular Function after Eccentric Exercise 微胶囊可可多酚对偏心运动后大血管和微血管功能的影响
Pub Date : 2024-07-03 DOI: 10.3390/jvd3030019
Gustavo Vieira de Oliveira, Leonardo Victor Miranda de Souza, Olavo João Frederico Ramos Junior, Mônica Volino-Souza, T. Alvares
Background: Evidence has demonstrated that non-habitual exercise, such as eccentric exercise, can increase reactive oxygen species and induce endothelial dysfunction, which plays a central role in the development of cardiovascular disease. Polyphenol-rich foods, such as cocoa, have been widely investigated in vascular function due to their antioxidant effect. Aims: The goal of this study was to evaluate the impact of microencapsulated cocoa (MC) polyphenols in the flow-mediated dilation (FMD) response and forearm muscle oxygenation (StO2) parameters after an eccentric exercise. Methods: Thirteen physically active adults were enrolled in a randomized, double-blind, and crossover study. FMD and StO2 were evaluated before and after 24 h, 48 h, and 72 h of eccentric exercise and MC or placebo supplementation. Results: No significant difference in FMD response and StO2 parameters was observed after MC and placebo (p > 0.05). Conclusions: A single dose of MC did not change FMD and muscle StO2 parameters after eccentric exercise in healthy individuals.
背景:有证据表明,非惯性运动(如偏心运动)会增加活性氧,诱发内皮功能障碍,而内皮功能障碍在心血管疾病的发展中起着核心作用。可可等富含多酚的食物因其抗氧化作用而被广泛研究其对血管功能的影响。目的:本研究旨在评估微胶囊可可(MC)多酚对偏心运动后血流介导的扩张(FMD)反应和前臂肌肉氧合(StO2)参数的影响。研究方法13 名身体活跃的成年人参加了一项随机、双盲和交叉研究。在进行偏心运动和补充 MC 或安慰剂 24 小时、48 小时和 72 小时前后,对 FMD 和 StO2 进行了评估。结果显示服用 MC 和安慰剂后,FMD 反应和 StO2 参数无明显差异(P > 0.05)。结论单剂量 MC 不会改变健康人偏心运动后的 FMD 和肌肉 StO2 参数。
{"title":"Effect of Microencapsulated Cocoa Polyphenols on Macro- and Microvascular Function after Eccentric Exercise","authors":"Gustavo Vieira de Oliveira, Leonardo Victor Miranda de Souza, Olavo João Frederico Ramos Junior, Mônica Volino-Souza, T. Alvares","doi":"10.3390/jvd3030019","DOIUrl":"https://doi.org/10.3390/jvd3030019","url":null,"abstract":"Background: Evidence has demonstrated that non-habitual exercise, such as eccentric exercise, can increase reactive oxygen species and induce endothelial dysfunction, which plays a central role in the development of cardiovascular disease. Polyphenol-rich foods, such as cocoa, have been widely investigated in vascular function due to their antioxidant effect. Aims: The goal of this study was to evaluate the impact of microencapsulated cocoa (MC) polyphenols in the flow-mediated dilation (FMD) response and forearm muscle oxygenation (StO2) parameters after an eccentric exercise. Methods: Thirteen physically active adults were enrolled in a randomized, double-blind, and crossover study. FMD and StO2 were evaluated before and after 24 h, 48 h, and 72 h of eccentric exercise and MC or placebo supplementation. Results: No significant difference in FMD response and StO2 parameters was observed after MC and placebo (p > 0.05). Conclusions: A single dose of MC did not change FMD and muscle StO2 parameters after eccentric exercise in healthy individuals.","PeriodicalId":74009,"journal":{"name":"Journal of vascular diseases","volume":" 17","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141681109","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}
引用次数: 0
Perivascular Adipose Tissue Density and Stenosis Plaque Degree in Lower Limb Peripheral Arteries in CT CT 中下肢外周动脉血管周围脂肪组织密度和狭窄斑块程度
Pub Date : 2024-06-11 DOI: 10.3390/jvd3020018
Alice Fortunati, Chiara Perazzo, Maria chiara Basile, Maurizio Cè, A. Malavazos, Sergio Papa, Deborah Fazzini, Francesco Secchi, Marco Alì
Background: Perivascular adipose tissue (PVAT) attenuation has emerged as a novel biomarker for identifying high-risk arterial plaques due to its association with inflammation. Recognizing the systemic nature of atherosclerosis and its link with major cardiovascular events in coronary disease, this study evaluated PVAT attenuation in the peripheral arteries using CT imaging to expand the understanding of its diagnostic and prognostic potential. Methods: a retrospective analysis of 53 consecutive patients who underwent CT angiography, examining PVAT density across five primary peripheral arterial segments. A 5 mm region of interest adjacent to the vascular wall was analyzed by two blinded readers, with reproducibility coefficients calculated to determine the reliability of the measurements. For the statistical analyses, mean values were derived from these measurements. The patients were stratified into four groups based on the degree of arterial stenosis: <25%, 25–50%, 50–70%, and >70%. PVAT density comparisons between these groups were performed using the Kruskal–Wallis test and the pairwise Mann–Whitney U test with Holm–Bonferroni correction for multiple comparisons. Results: the Kruskal–Wallis test revealed statistically significant disparities in PVAT density across the categorically differentiated stenosis groups (p < 0.001), indicating an association between PVAT density and arterial stenosis severity. This association was especially pronounced in the external iliac, common femoral, superficial femoral, and popliteal arteries, where the p-values were consistently below 0.05. Subsequent pairwise analyses utilizing the Mann–Whitney U test with Holm–Bonferroni correction affirmed these findings, in particular for the external iliac, common femoral, superficial femoral and popliteal arteries (p < 0.05). Conclusions: our findings reinforce the correlation between increased PVAT density and the degree of arterial stenosis, supporting the clinical value of PVAT as a non-invasive biomarker for cardiovascular risk stratification and potentially guiding therapeutic interventions.
背景:血管周围脂肪组织(PVAT)衰减与炎症有关,因此已成为识别高风险动脉斑块的新型生物标志物。考虑到动脉粥样硬化的系统性及其与冠心病主要心血管事件的联系,本研究使用 CT 成像评估了外周动脉的 PVAT 衰减,以扩大对其诊断和预后潜力的认识。方法:对 53 名连续接受 CT 血管造影术的患者进行回顾性分析,检查五个主要外周动脉节段的 PVAT 密度。由两名盲人阅片员对血管壁附近 5 毫米的感兴趣区进行分析,并计算重现性系数,以确定测量结果的可靠性。在进行统计分析时,根据这些测量结果得出平均值。根据动脉狭窄程度(70%)将患者分为四组。使用 Kruskal-Wallis 检验和成对 Mann-Whitney U 检验对这些组间的 PVAT 密度进行比较,并对多重比较进行 Holm-Bonferroni 校正。结果:Kruskal-Wallis 检验显示,在分类区分的狭窄组别中,PVAT 密度存在显著的统计学差异(P < 0.001),表明 PVAT 密度与动脉狭窄严重程度之间存在关联。这种关联在髂外动脉、股总动脉、股浅动脉和腘动脉中尤为明显,P 值始终低于 0.05。随后利用 Mann-Whitney U 检验和 Holm-Bonferroni 校正进行的配对分析证实了这些发现,尤其是髂外动脉、股总动脉、股浅动脉和腘动脉(p < 0.05)。结论:我们的研究结果加强了 PVAT 密度增加与动脉狭窄程度之间的相关性,支持 PVAT 作为心血管风险分层的非侵入性生物标志物的临床价值,并有可能指导治疗干预。
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引用次数: 0
Retrospective Correlation of the Circulation Time of Test Bolus Injections in MR Angiography and Cardiac Function 核磁共振血管造影中试验性注射剂的循环时间与心功能的回顾性相关性
Pub Date : 2024-06-10 DOI: 10.3390/jvd3020017
David F. Möller, Borut Mohorko, Theresia E. Aschauer, Tobias Schwager, Manuela A. Aschauer
This retrospective study examines 248 test bolus examinations preceding contrast-enhanced magnetic resonance angiography (CE-MRA) to extract clinically relevant data for critical limb ischemia (CLI) management. The method involved a retrospective review of test bolus exams, analysing 60 graphs for time to peak (TTP), full-width half-maximum (FWHM) time, and time to continual rise in signal intensity. These values were correlated with heart function parameters (ejection fraction, ASA classification, Lee index, and MET score). The results indicate a mean TTP of 31.2 ± 7.3 s, showing a correlation between the ejection fraction and ASA classification. Patients with atrial fibrillation exhibited prolonged TTP compared to those without. Despite population heterogeneity, these findings facilitate risk stratification for limb-saving interventions in CLI. TTP emerges as a potential clinical cardiovascular parameter and a risk factor for vascular interventions. Given the variation in injection protocols across centres, this study underscores the importance of precise bolus arrival time documentation for future multicentre studies.
这项回顾性研究对造影剂增强磁共振血管造影(CE-MRA)前的 248 次试验性注射检查进行了研究,以提取与危重肢体缺血(CLI)管理相关的临床数据。该方法包括对试验性注射检查进行回顾性审查,分析 60 张图表的峰值时间 (TTP)、全宽半最大值 (FWHM) 时间和信号强度持续上升时间。这些值与心脏功能参数(射血分数、ASA 分级、李氏指数和 MET 评分)相关联。结果显示,平均 TTP 为 31.2 ± 7.3 秒,射血分数与 ASA 分级之间存在相关性。与无心房颤动的患者相比,有心房颤动的患者TTP时间更长。尽管人群存在异质性,但这些发现有助于对CLI患者进行救肢干预的风险分层。TTP是一个潜在的临床心血管参数,也是血管介入治疗的风险因素。鉴于各中心注射方案的差异,本研究强调了精确记录栓剂到达时间对未来多中心研究的重要性。
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引用次数: 0
The Role of Amino Acid Glycine on Cardiovascular Health and Its Beneficial Effects: A Narrative Review 氨基酸甘氨酸对心血管健康的作用及其益处:叙述性综述
Pub Date : 2024-06-06 DOI: 10.3390/jvd3020016
Gabriela Elizabeth Quintanilla-Villanueva, M. Rodríguez-Delgado, J. Villarreal-Chiu, Edgar Allan Blanco-Gámez, Donato Luna-Moreno
Glycine, a simple amino acid, is not only essential due to its potential insufficiency in vivo, but also has significant metabolic functions. It serves as a crucial building block for proteins. At the same time, as a bioactive molecule, it regulates gene expression for cytoprotection, protein configuration and activity, and other critical biological processes, including glutathione synthesis. The intriguing, beneficial effects of glycine in medical applications have piqued the research community’s interest in recent decades. This work delves into the compelling discoveries about the pivotal role of glycine in cardiovascular health and its intricate mechanisms of action for alleviating several medical conditions. Glycine’s broad spectrum of impact spans numerous diseases, encompassing not only acute myocardial infarction, aortic dissection, and cardiac hypertrophy, but also transplant rejections of aortic allografts, insulin resistance, and endothelial dysfunction, thereby providing a comprehensive understanding of its medical applications.
甘氨酸是一种简单的氨基酸,不仅因其在体内可能不足而成为必需氨基酸,而且还具有重要的新陈代谢功能。它是构成蛋白质的重要成分。与此同时,作为一种生物活性分子,它还能调节基因表达以实现细胞保护、蛋白质构型和活性,以及包括谷胱甘肽合成在内的其他关键生物过程。近几十年来,甘氨酸在医学应用中令人感兴趣的有益作用引起了研究界的兴趣。本著作深入探讨了甘氨酸在心血管健康中的关键作用及其缓解多种病症的复杂作用机制,这些发现令人信服。甘氨酸的影响范围广泛,涉及多种疾病,不仅包括急性心肌梗塞、主动脉夹层和心肌肥厚,还包括主动脉异体移植排斥反应、胰岛素抵抗和内皮功能障碍,从而使人们对甘氨酸的医学应用有了全面的了解。
{"title":"The Role of Amino Acid Glycine on Cardiovascular Health and Its Beneficial Effects: A Narrative Review","authors":"Gabriela Elizabeth Quintanilla-Villanueva, M. Rodríguez-Delgado, J. Villarreal-Chiu, Edgar Allan Blanco-Gámez, Donato Luna-Moreno","doi":"10.3390/jvd3020016","DOIUrl":"https://doi.org/10.3390/jvd3020016","url":null,"abstract":"Glycine, a simple amino acid, is not only essential due to its potential insufficiency in vivo, but also has significant metabolic functions. It serves as a crucial building block for proteins. At the same time, as a bioactive molecule, it regulates gene expression for cytoprotection, protein configuration and activity, and other critical biological processes, including glutathione synthesis. The intriguing, beneficial effects of glycine in medical applications have piqued the research community’s interest in recent decades. This work delves into the compelling discoveries about the pivotal role of glycine in cardiovascular health and its intricate mechanisms of action for alleviating several medical conditions. Glycine’s broad spectrum of impact spans numerous diseases, encompassing not only acute myocardial infarction, aortic dissection, and cardiac hypertrophy, but also transplant rejections of aortic allografts, insulin resistance, and endothelial dysfunction, thereby providing a comprehensive understanding of its medical applications.","PeriodicalId":74009,"journal":{"name":"Journal of vascular diseases","volume":"75 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141377448","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}
引用次数: 0
The Intersection of HIV and Pulmonary Vascular Health: From HIV Evolution to Vascular Cell Types to Disease Mechanisms 艾滋病毒与肺血管健康的交叉点:从艾滋病毒进化到血管细胞类型再到疾病机制
Pub Date : 2024-05-06 DOI: 10.3390/jvd3020015
Amanda K. Garcia, S. Almodovar
People living with HIV (PLWH) face a growing burden of chronic diseases, owing to the combinations of aging, environmental triggers, lifestyle choices, and virus-induced chronic inflammation. The rising incidence of pulmonary vascular diseases represents a major concern for PLWH. The study of HIV-associated pulmonary vascular complications ideally requires a strong understanding of pulmonary vascular cell biology and HIV pathogenesis at the molecular level for effective applications in infectious diseases and vascular medicine. Active HIV infection and/or HIV proteins disturb the delicate balance between vascular tone and constriction, which is pivotal for maintaining pulmonary vascular health. One of the defining features of HIV is its high genetic diversity owing to several factors including its high mutation rate, recombination between viral strains, immune selective pressures, or even geographical factors. The intrinsic HIV genetic diversity has several important implications for pathogenic outcomes of infection and the overall battle to combat HIV. Challenges in the field present themselves from two sides of the same coin: those imposed by the virus itself and those stemming from the host. The field may be advanced by further developing in vivo and in vitro models that are well described for both pulmonary vascular diseases and HIV for mechanistic studies. In essence, the study of HIV-associated pulmonary vascular complications requires a multidisciplinary approach, drawing upon insights from both infectious diseases and vascular medicine. In this review article, we discuss the fundamentals of HIV virology and their impact on pulmonary disease, aiming to enhance the understanding of either area or both simultaneously. Bridging the gap between preclinical research findings and clinical practice is essential for improving patient care. Addressing these knowledge gaps requires interdisciplinary collaborations, innovative research approaches, and dedicated efforts to prioritize HIV-related pulmonary complications on the global research agenda.
由于老龄化、环境诱因、生活方式选择和病毒引起的慢性炎症等综合因素,艾滋病病毒感染者(PLWH)面临着日益沉重的慢性疾病负担。肺血管疾病发病率的上升是艾滋病病毒感染者关注的主要问题。研究 HIV 相关肺血管并发症的理想方法是,从分子水平深入了解肺血管细胞生物学和 HIV 致病机理,以便在传染病和血管医学中有效应用。活跃的 HIV 感染和/或 HIV 蛋白会扰乱血管张力和收缩之间的微妙平衡,而这种平衡对于维持肺血管健康至关重要。艾滋病病毒的一个显著特点是其高度遗传多样性,这是由多种因素造成的,包括高突变率、病毒株之间的重组、免疫选择性压力,甚至是地理因素。艾滋病病毒固有的遗传多样性对感染的致病结果和抗击艾滋病病毒的整体斗争具有若干重要影响。该领域面临的挑战来自同一硬币的两面:病毒本身带来的挑战和宿主带来的挑战。通过进一步开发体内和体外模型,对肺血管疾病和艾滋病病毒进行充分描述,进行机理研究,可以推动这一领域的发展。从本质上讲,研究与 HIV 相关的肺血管并发症需要采用多学科方法,同时借鉴传染病学和血管医学的见解。在这篇综述文章中,我们讨论了艾滋病病毒学的基本原理及其对肺部疾病的影响,旨在加强对其中一个领域或同时对两个领域的理解。缩小临床前研究结果与临床实践之间的差距对于改善患者护理至关重要。要弥补这些知识差距,需要跨学科合作、创新的研究方法以及在全球研究议程中优先考虑艾滋病相关肺部并发症的不懈努力。
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Journal of vascular diseases
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