Artery Intima-media Thickness Research Articles

Non-linear association and benchmark dose of blood pressure on carotid artery intima-media thickening in a general population of southern China.

This study aimed to evaluate whether there is a J-curve association between blood pressure (BP) and carotid artery intima-media thickening (CAIT) and estimate the effect of the turning point of BP on CAIT. Data from 111,494 regular physical examinations conducted on workers and retirees (aged 18 years or older) between January 2011 and December 2016, exported from the hospital information system, were analyzed. Restricted cubic splines (RCS) logistic regression was employed to access the association of BP with CAIT, and Bayesian benchmark dose methods were used to estimate the benchmark dose as the departure point of BP measurements. All the pnon-linear values of BP measurements were less than 0.05 in the RCS logistic regression models. Both systolic blood pressure (SBP) and diastolic blood pressure (DBP) had J-curve associations with the risk of CAIT at a turning point around 120/70 mmHg in the RCS. The benchmark dose for a 1% change in CAIT risk was estimated to be 120.64 mmHg for SBP and 72.46 mmHg for DBP. The J-curve associations between SBP and DBP and the risk of CAIT were observed in the general population in southern China, and the turning point of blood pressure for significantly reducing the risk of CAIT was estimated to be 120.64/72.46 mmHg for SBP/DBP.

Frailty in relation to the risk of carotid atherosclerosis and cardiovascular events in Chinese community-dwelling older adults: A five-year prospective cohort study

ObjectiveTo investigate the frailty, as estimated by accumulated health deficits, in association with the symptomatic carotid atherosclerosis and in relation to five-year cardiovascular (CVD) outcomes. MethodsThis is a five-year prospective cohort study. Secondary analysis of data from the Beijing Longitudinal Study on Aging. Community-dwelling people aged 55+ years (n = 1257) have been followed between 2009 and 2014, and having carotid ultrasonography examinations with no CVD events at baseline. Frailty was quantified using the deficit accumulation-based frailty index (FI), constructed from 37 health deficits assessed at baseline. The association between the degree of frailty and carotid atherosclerosis was examined using odds ratios (OR) with multivariate logistic regression analyses. Effects of frailty on the probability of five-year cardiovascular events and mortality were evaluated using Cox proportional hazard ratios (HR). The analyses were adjusted for demographics, baseline carotid atherosclerosis status, and CVD risk factors. ResultsThe FI showed characteristic properties and was independently associated with the major carotid atherosclerosis symptoms, including carotid artery intima-media thickening (the most frail vs. the least frail: OR = 4.39: 1.98–7.82), carotid plaque (OR = 3.41: 1.28–6.54), and carotid plaque stability (OR = 1.19, 95 % CI: 1.01–3.59). Compared with the least frail, the most frail individuals were more likely to develop a cardiovascular event in five years, including myocardial infarction (HR = 3.38, 95 % CI = 1.84–6.19), stroke (HR = 1.26, 95 % CI = 1.00–5.87), CVD death (HR = 6.33, 95 % CI = 1.69–11.02), and all-cause death (HR = 5.95, 95 % CI = 2.74–8.95). ConclusionDeficit accumulation was closely associated with carotid atherosclerosis risks and strongly predicted five-year CVD events. The frailty index can be used to help identify older adults at high risks of CVD for improved preventive healthcare.

OA40 Predicting cardiovascular disease risk in children and adolescents with juvenile-onset systemic lupus erythematosus using the APPLE (Atherosclerosis Prevention in Paediatric Lupus Erythematosus) clinical trial cohort

Abstract Background/Aims The risk of developing cardiovascular disease (CVD) through atherosclerosis in juvenile-onset systemic lupus erythematosus (JSLE) patients is significantly increased. This study aimed to stratify and characterise JSLE patients at elevated CVD risk using patient/disease-related factors and metabolomic data from patients recruited to the APPLE (Atherosclerosis Prevention in Paediatric Lupus Erythematosus) clinical trial, designed to assess atherosclerosis development. Methods Unsupervised hierarchical clustering was performed to stratify patients by arterial intima-media thickness (IMT) measurements at baseline (N = 151) and carotid (c)IMT progression over 36 months (placebo arm only, N = 60). Baseline metabolomic profiles (∼250 serum metabolites) were compared between clusters using conventional statistics, univariate logistic regression, sparse Partial Least-Squares Discriminant Analysis (sPLS-DA) and random forest classifier. An independent cohort (UCL-JSLE cohort, N = 89) with matching metabolomics, immunophenotyping and proteomics, was used to validate the discovered CVD risk-related signatures from the APPLE cohort. Results Baseline IMT stratification identified 3 clusters with high, intermediate, and low baseline IMT measurements and progression trajectories over 36 months, each having distinct racial/BMI/household education/income characteristics. Analysis of cIMT progression over 36 months identified 2 patient groups with high and low IMT progression. Unique metabolomic profiles differentiated high and low cIMT progression groups, with a good discriminatory ability (0.81 AUC in ROC analysis) using the top 6 metabolites (total cholesterol esters, total cholesterol, phospholipids in small LDL particles, total cholesterol in small LDL particles, free cholesterol in medium LDL particles, and total lipids in small LDL particles) selected from the analysis. cIMT progression over 36 months in the placebo group correlated positively with baseline disease activity (SLEDAI), damage score (SLICC), white blood cell count, serum complement C3, blood pressure (both systolic and diastolic) and BMI. Metabolomics signatures discovered from the APPLE cohort were applied to stratify JSLE patients in the validation cohort (UCL-JSLE), where 3 groups were identified with distinct metabolomics profiles indicating JSLE patients with high risk (N = 20), intermediate risk (N = 43) and low risk (N = 26) CVD-risk. Significant differences were observed in the frequency of classical monocytes (p = 0.015) and nonclassical monocytes (p = 0.005) when comparing the high and low CVD risk groups in the UCL-JSLE cohort. Conclusion Complex analysis of IMT patterns and progression in the APPLE trial cohort identified novel key determinants that could guide further research for CVD-risk stratification in JSLE. Disclosure J. Peng: None. G.A. Robinson: None. S.P. Ardoin: None. L.E. Schanberg: None. O. Carra: None. E. Jury: None. C. Ciurtin: None.

Carotid Intima-media Thickness is a Sequel of Elevated FGF-23 Levels in CKD!

International Journal of Medicine and Public Health,2022,12,4,165-168.DOI:10.5530/ijmedph.2022.4.30Published:January 2023Type:Original ArticleCarotid Intima-media Thickness is a Sequel of Elevated FGF-23 Levels in CKD!Upma Narain, Arvind Gupta, and Seema Pandey Upma Narain1,*, Arvind Gupta2, Seema Pandey3 1Microbiologist and Immunologist, Tejas Microdiagnostics, Prayagraj, Uttar Pradesh, INDIA. 2Department of Nephrology, MLN Medical College, Prayagraj, Uttar Pradesh, INDIA. 3Department of Radio Diagnosis, MLN Medical College, Prayagraj, Uttar Pradesh, INDIA. Abstract:Background: FGF-23 regulates phosphate homeostasis and has a correlation with morbidity and mortality due to cardiovascular episodes and chronic renal conditions. The risk of subclinical atherosclerosis can be predicted by measurements of the intima-media thickness of the carotid artery. The objective of this studyisto study therelation between serum FGF-23 levels and Carotid intima-media thickness in the early stages of CKD. Materials and Methods: This study was conducted at MLN Medical College, SRN Hospital, Prayagraj and Tejas Microdiagnostics. The study design adopted was prospective and observational. A total of 270 newly diagnosed CKD patients were enrolled as cases while 90 patients without CKD were taken as control. Highresolution ultrasonography was utilised to measure Carotid artery intima-media thickening. Serum FGF-23 levels were performed at the beginning of study, along with other baseline investigations and were repeated on 6th and 9th months respectively. Results: Among the case group of CKD, the mean age was 54.8+2.1 years with male to female proportions representing 62% and 38%, respectively of the control group consisted mean age distribution of 51.0 + 2.1 years a and male-female proportion of 58% and 42%, respectively. It was observed that FGF-23 levels and Carotid intima-media thickness measurements were high in patients than in controls. A statistically significant correlation at 0.01 levels was observed between FGF-23 and the Carotid intima-media thickness. Conclusion: Our study clearly establishes a strong correlation between FGF-23 and CIMT indicating that FGF-23 plays an important role in the development of vascular calcifications in early stages of CKD. Subclinical atherosclerosis in CKD patients can be predicted by monitoring of their FGF-23 and CIMT level. Keywords:Association, Carotid intima-media thickness, CKD, FGF-23View:PDF (347.97 KB)

FDADE: Flow direction algorithm with differential evolution for measurement of intima-media thickness of the carotid artery in ultrasound images

The third leading cause of death globally is cardiovascular disease. Atherosclerosis, the build-up of plaque on the arterial wall, is the earliest sign of cardiovascular disease. The common carotid artery's Intima-Media Thickness (IMT) is primarily used as an early indicator of cardiovascular disease. This paper proposes a new method called FDADE by integrating the Flow Direction Algorithm (FDA) with Differential Evolution (DE) to segment images using multilevel thresholding. Otsu's interclass variance function is used in FDADE to establish optimal threshold values for measuring IMT in Carotid Artery Ultrasound Images. Carotid ultrasound images are subjected to a quantitative evaluation, and the results are compared to those obtained using other, more recent techniques. This method is reliable in measuring the IMT in carotid ultrasound pictures by the experimental investigation. Also, the proposed FDADE's performance is tested using a variety of benchmark issues of varying levels of complexity. Various tests are undertaken, such as the Wilcoxon rank-sum test for statistical implication, convergence curvatures, and the detachment amid the resolution earlier and later applying alteration approaches. The data are then compared and analyzed to demonstrate the superiority of the proposed FDADE over alternative algorithms.

Correlation between HbA1c and carotid artery intima-media thickening(cIMT) in diabetic patients

Introduction: Correlation between carotid artery intima-media thickening and HbA1c levels in diabetic patients as a non invasive marker of progressive atherosclerosis. Objectives: The aim of this study is to study the role of two non invasive markers, carotid intima media thickening and HbA1c in diabetic patients and establish the usefulness of both the parameters in evaluating early risk factor assessment. Material and methods: 100 patients meeting the required criteria were taken coming to OPD/IPD bases to Dhiraj hospital in the age group of 35-70 years.HbA1c levels were used according to American diabetes association. Carotid intima media thickening was measures on B mode ultrasonography in radiology department. Results: among the 100 patients, 68 patients were female and 32 patients were male. The mean of HbA1c values were 8.0 ± 2.2%. The mean cIMT values were 0.78 ± 0.3 cm. Conclusion: HbA1c and carotid artery intimal thickness is useful as a diagnostic marker and early risk factor analysis for atherosclerotic changes in diabetic patients.

Tanshinone IIA alleviates monocrotaline-induced pulmonary hypertension in rats through the PI3K/Akt-eNOS signaling pathway

To explore the therapeutic mechanism of tanshinone IIA in the treatment of pulmonary arterial hypertension (PAH) in rats. A total of 100 male SD rats were randomized into 5 groups (n=20), and except for those in the control group with saline injection, all the rats were injected with monocrotaline (MCT) on the back of the neck to establish models of pulmonary hypertension. Two weeks after the injection, the rat models received intraperitoneal injections of tanshinone IIA (10 mg/kg), phosphatidylinositol 3 kinase (PI3K) inhibitor (1 mg/kg), both tanshinone IIA and PI3K inhibitor, or saline (model group) on a daily basis. After 2 weeks of treatment, HE staining and α-SMA immunofluorescence staining were used to evaluate the morphology of the pulmonary vessels of the rats. The phosphorylation levels of PI3K, protein kinase B (PKB/Akt) and endothelial nitric oxide synthase (eNOS) in the lung tissue were determined with Western blotting; the levels of eNOS and NO were measured using enzyme-linked immunosorbent assay (ELISA). The results of HE staining and α-SMA immunofluorescence staining showed that tanshinone IIA effectively inhibited MCT-induced pulmonary artery intimamedia thickening and muscularization of the pulmonary arterioles (P < 0.01). The results of Western blotting showed that treatment with tanshinone IIA significantly increased the phosphorylation levels of PI3K, Akt and eNOS proteins in the lung tissue of PAH rats; ELISA results showed that the levels of eNOS and NO were significantly decreased in the rat models after tanshinone IIA treatment (P < 0.01). Treatment with tanshinone IIA can improve MCT-induced pulmonary hypertension in rats through the PI3K/Akt-eNOS signaling pathway.

Development and validation of dietary atherogenic index using common carotid artery-intima-media thickness: A food frequency questionnaire-based longitudinal study in Korean adults

Dietary patterns based on pathways of diseases such as subclinical atherosclerosis can predict diet-disease associations better than dietary quality indices or data-driven indices. We aimed to develop and validate a novel dietary atherogenic index (DAI) in adults using the common carotid artery-intima media thickness (c-IMT) in Korean adults. Participants aged ≥40 years from the Yangpyeong cohort were enrolled in the development set (n = 1373). Two DAIs were developed using 38 predefined food groups as predictors and c-IMT as response variable, using stepwise linear regression (SLR) and reduced rank regression (RRR) models. Based on the associations between DAI and c-IMT, DAIs were then validated in the total, men, and women, internally in 1000 bootstrap sets, and externally in a set combined with 2 other populations (n = 2476). The DAI-S by SLR and the DAI-R by RRR included 7 anti- and 10 pro-inflammatory food groups and 2 anti- and 6 pro-inflammatory food groups, respectively. Total rice and white root kimchi were pro-inflammatory, and mushrooms, other beverages (mostly traditional beverages), poultry, processed seafood, and pizza/hamburger were anti-inflammatory in both the DAI-S and DAI-R. They were internally valid in the multivariable-adjusted models, showing a significant linear trend in all 3 sets; they were also valid in the bootstrap at 95% confidence interval. In the external validation, only the DAI-S was significantly associated with the c-IMT (P trend = .0004, .0133, and .0212 in total, men, and women, respectively). This study indicated that DAIs, particularly DAI-S, may be useful for assessing the atherogenic potential of food-based total diets.

Sonographic Intima-Media Thickness Evaluation of Common Carotid and Internal Carotid Arteries in Type-2 Diabetes Mellitus

Background: Intima-media thickness (IMT) is a useful marker in early detection of atherosclerotic lesions in carotid arteries in Type-2 Diabetes Mellitus (T2DM) patients. The study was conducted to determine the association of IMT with various physical and biochemical parameters in the Indian population. Objective: To compare IMT of common and internal carotid arteries in T2DM patients and healthy individuals and study the correlation of IMT with physical and biochemical parameters. Methods: Case group with T2DM (n=27) were matched with Control group consisting of healthy individuals (n=27) of similar age and sex were included. Physical parameters and routine biochemical data were collected and compared. Ultrasonographical imaging of the common and internal carotid arteries of both sides were performed presence of plaque was observed. Data was analyzed by software IBM® SPSS Statistics V20.0. For all analyses, P&lt;0.05 was considered as statistically significant. Results: Mean IMT value obtained in case and control group are 0.711±0.14 mm and 0.601±0.16 mm respectively (P=0.005). Presence of plaque was noticed in 37.03% subjects in case group and in 14.81% subjects in control group. Mean IMT was significantly higher for smoker than non-smokers (P=0.004). Fasting blood sugar, postprandial blood sugar, Postprandial triglycerides and total cholesterol were significantly higher in case group (P&lt;0.05). There was a strong family history of T2DM in case group (51.85%) compared to control group (14.81%) with a statistical significance between them (P=0.009). Conclusion: IMT of common and internal carotid arteries have a significant association in T2DM patients compared to healthy subjects and IMT is significantly associated with physical and biochemical parameters.

Association of HbA1c with carotid artery plaques in patients with coronary heart disease: a retrospective clinical study

Background and aims Haemoglobin A1c (HbA1c) levels have been shown to be related to carotid artery plaques. However, studies on the relationship between HbA1c levels and carotid artery plaques in patients with coronary heart disease (CHD) are limited and inconsistent. Our objective was to examine the correlation between HbA1c levels and carotid artery plaques in patients with CHD. Methods The study comprised 9275 Chinese adults with CHD from January 1, 2014, to September 30, 2020. HbA1c levels were assessed, and colour Doppler ultrasound was used to evaluate the carotid artery, including plaque presence, intima-media thickness, and plaque echo properties, to investigate the association between HbA1c and carotid plaque. A logistic regression model was used to assess the association between carotid artery plaques, carotid plaque echogenicity, and HbA1c. Results The HbA1c level of the plaque-present group was higher than that of the plaque-absent group [6.1 (5.6–7.2) vs. 5.8 (5.5–6.5), p < 0.001]. In multiple linear regression analysis, intima-media thickness was associated with HbA1c (p < 0.001). Logistic regression showed that a higher HbA1c level was associated with plaque incidence as well as hyperechoic and heterogeneous plaques (p < 0.001). These associations persist after adjusting for age, sex, blood pressure, lipid profiles, alcohol consumption, and tobacco exposure. Conclusion HbA1c levels are notably associated with carotid artery plaque incidence, intima-media thickness, and plaque echogenicity in patients with CHD. These findings show that different levels of HbA1c may be an indicator for carotid artery plaques and thus, should be observed in patients with CHD.

Abstract 11483: A 7-Year Arterial Stiffness and Carotid Intima-Media Thickness Progression Predict Obesity, High Lean Mass, and Incident Hypertension from Age 17.7 to 24.5 Years: the ALSPAC Study

Introduction: An American Heart Association’s statement recommended investigating the natural history of arterial stiffness and blood pressure (BP) vis-à-vis the rate at which arterial stiffness and BP increase with age. Hypothesis: To test whether carotid-femoral pulse wave velocity (cfPWV), a measure of arterial stiffness, and carotid intima-media thickness (cIMT) progression independently predict increased fat mass and BP. Methods: We studied 3862 participants from the Avon Longitudinal Study of Parents and Children birth cohort. cfPWV and cIMT were measured by ultrasound scan, total and trunk fat mass, and lean mass by dual-energy Xray absorptiometry scan, body mass index (BMI), BP, heart rate, fasting insulin, glucose, high sensitivity C-reactive protein, and lipid profile were measured at ages 17.7 and 24.5 years. Participants at &gt;75th percentile of total and trunk fat mass or having &gt;24.9 kg/m 2 BMI were classified as overweight and obese, &gt;75th percentile as high lean mass, and &gt;120/80 mm Hg as elevated BP and hypertension. Data were analysed with logistic regression and linear mixed models, adjusting for cardiometabolic and lifestyle factors. Results: Among 1719 [44.5%] male and 2143 [55.5%] female participants, cfPWV at 17.7 years independently predicted systolic hypertension [Odds ratio (OR) 1.19 (1.01 - 1.40); p=0.043], diastolic hypertension [OR 1.77 (1.32 - 2.38); p&lt;0.0001], BMI-obesity [OR 1.19 (1.01 - 1.41); p=0.041], and trunk fat mass-obesity [OR 1.24 (1.03 - 1.49); p=0.023] at age 24.5 years. cIMT at 17.7 years predicted high lean mass [OR 54.29 (0.73 - 4053.52); p=0.069] at 24.5 years with borderline significance. A 7-year increase in cfPWV was directly associated with the 7-year increase in lean mass [Effect estimate 0.09 kg (0.05 - 0.13); p&lt;0.0001], systolic BP [21.58 mmHg (14.32 - 28.84); p&lt;0.0001] and diastolic BP [31.74 mmHg (24.90 - 38.57); p&lt;0.0001], but inversely associated with BMI [-0.03 kg/m 2 (-0.06 - -0.01); p=0.039]. cIMT progression from age 17.7 - 24.5 years was directly associated with the 7-year increase in total fat mass, trunk fat mass, lean mass, BMI, and diastolic BP. Conclusions: Arterial stiffness and cIMT progression independently predicted obesity, high lean mass, and incident hypertension among young adults.

FLOW MEDIATED DILATATION, CAROTID INTIMA MEDIA THICKNESS, ANKLE BRACHIAL PRESSURE INDEX AND PULSE PRESSURE IN YOUNG MALE POST MYOCARDIAL INFARCTION PATIENTS

Introduction:Due to increase in Coronary Artery Disease (CAD) at a younger age, we should try to diagnose atherosclerotic process and population at risk, at the earliest. Flow Mediated Dilatation (FMD), Carotid Intima-Media Thickness (CIMT) and Ankle-Brachial Pressure Index (ABI) are probable markers for early atherosclerosis and may be useful in coronary risk stratification Objectives: To compare and correlate the FMD, CIMT, ABI and Pulse Pressure (PP) in young male patients of Myocardial Infarction (MI) with age and sex matched healthy controls Method50 patients of MI aged ≤45 years, who presented to iccu of Department of Medicine Indira Gandhi medical college Nagpur India, were recruited consecutively for this case control study and same number of age and sex matched healthy controls were also analyzed. 3 days after Myocardial infarction FMD of the brachial artery, intima media thickness of carotid artery, ABPI and PP were measured in the cases and compared with healthy control Results: The FMD was lower among young patients of MI than controls . CIMT was higher among cases than controls . ABI was lower among cases than controls . Compared to controls, PP was higher among cases . In all subjects, a negative correlation between FMD and CIMT and a positive correlation between FMD and ABPI was found. A statistically significant negative correlation was found between endothelial dependent FMD and PP among cases and control groups Conclusion: Biophysical parameters were deranged in young post MI patients. Majority of our young male patients fell in low risk Framingham risk score but still they manifested with CAD. Despite 3 days of treatment among young male patients of MI, various biophysical parameters were stillderanged.

Metabolic syndrome is related to vascular structural alterations but not to functional one both in hypertensives and healthy subjects

Abstract Background Metabolic Syndrome (MS) has been related to an impairment in arterial structural and functional properties with heterogeneous results. Purpose In this study we focused on the effects of MS on arterial carotid-femoral Pulse Wave Velocity (PWV) and common carotid Intima Media Thickness (IMT) in two different populations, one of hypertensive patients and one of healthy controls. Methods We enrolled 816 consecutive hypertensive (HT) and 536 healthy controls. Vascular structural (IMT) and functional (PWV) properties were evaluated. NCEP-ATP-III criteria were used for diagnosis of MS. Results MS was diagnosed in 26.9% and 6.9% in hypertensive and control subjects, respectively. PWV was similar in controls with and without MS (7.7±1.9 vs 7.6±1.1 m/s, p=0.69), while IMT was higher in controls with than those without MS (0.64±0.18 vs 0.57±0.13 mm, p=0.02). Hypertensives with MS were older (57.9±12.2 vs 52.7±14.1 years, p&amp;lt;0.001) and showed higher PWV (9.0±2.3 vs 8.4±2.1 m/s, p=0.001) and IMT (0.72±0.22 vs 0.65±0.17 mm, p&amp;lt;0.001) than those without MS, however at the age-adjusted analysis only the difference in IMT was confirmed (p=0.007). Regression models showed that MS was an independent determinant of IMT in both controls (β=0.08, p=0.03) and hypertensives (β=0.08, p=0.01), but not of PWV either in controls (β=0.006, p=0.886 and β=0.04, p=0.19, respectively). Conclusions The main finding of our work is that MS is a significant determinant of IMT while this is not the case for PWV. This result has been confirmed both in hypertensive subjects and in healthy controls. Funding Acknowledgement Type of funding sources: Public hospital(s). Main funding source(s): ASST Grande Ospedale Metropolitano Niguarda

Impact of Interleukin-17 Inhibitor Therapy on Arterial Intima-media Thickness among Severe Psoriatic Patients.

Background: Psoriasis is frequently accompanied by cardiovascular diseases based on the shared immunopathogenic pathway. Authors determined the effect of interleukin (IL)-17 inhibitor therapy on arterial intima-media thickness (IMT) among severe psoriatic patients. Methods: Thirty-one severe psoriatic patients were enrolled. Twenty received secukinumab and 11 received ixekizumab. Before treatment initiation and after 6 months, the carotid-brachial-femoral IMT, the Psoriasis Area Severity Index (PASI), the Dermatology Life Quality of Index (DLQI) and the EuroQol Visual Analogue Scale (EQ VAS) were evaluated. Results: After 6 months, significant ameliorations were observed in PASI (p < 0.001) from 18 to 0, in DLQI (p < 0.001) from 17 to 0, in EQ VAS (p < 0.001) from 60 to 90, in right carotid IMT (p < 0.001) from 1.1 mm to 0.8 mm, in left carotid IMT (p < 0.001) from 1.1 mm to 0.7 mm, in right brachial IMT (p < 0.001) from 0.75 mm to 0.6 mm, in left brachial IMT (p < 0.001) from 0.8 mm to 0.5 mm, in right femoral IMT (p < 0.001) from 0.9 mm to 0.7 mm and in left femoral IMT (p < 0.001) from 0.8 mm to 0.7 mm. Conclusions: By reducing the inflammation of the vascular wall, anti-IL-17 therapy may have a beneficial long-term effect on cardiovascular complications of systemic inflammation.

Abstract P435: Probiotic Supplements Could Prevent Diet-induced Mitochondrial Dysfunction In The Liver Hepatocytes Of Apolipoprotein-e Knockout Mice

A poor diet can modify the intestinal microbiota, known as gut dysbiosis, which causes hepatocyte mitochondrial dysfunction through the release of endotoxins in the portal vein. Mitochondrial dysfunction in the liver leads to non-alcoholic fatty liver disease (NAFLD). Epidemiological evidence shows that most deaths from NAFLD are related to cardiovascular diseases (CVD) demonstrated by impaired vasodilatation as well as increased arterial stiffness, calcification, inflammation, and intimal-medial thickness. Therefore, the objective of our study was to investigate the potential of probiotic supplements to prevent a diet-induced mitochondrial dysfunction in hepatocytes. Apolipoprotein-E knockout mice—genetically modified animals that develop dyslipidemia—were placed in 3 diet groups including a control, western style (high in fats and carbohydrates), as well as a low-carbohydrate high-protein diet. Each group was then further divided in 3 subgroups based on the dose of probiotics administered, including a control, low (0.5 B/dose) and high (5 B/dose) dose of probiotics, for a total of 9 groups (n= 8-12 animals/group). The probiotic supplements contained a 1:1 ratio of Lactobacillus Helveticus and Bifidobacterium Bifidum . The bodyweight and water intake were monitored weekly. After 6 weeks, the liver mitochondria were analyzed by high resolution respirometry using a sequential substrate addition protocol (malate, octanoylcarnitine, ADP, glutamate, pyruvate, cytochrome C, succinate and FCCP) to investigate mitochondrial maximal respiration, leak, membrane damage and uncoupling. Our preliminary results show that the groups that received a high dose of probiotics gained less weight, had a higher respiration following the addition of ADP (a biomarker of complex V efficiency) and a lower respiration following FCCP (a biomarker of mitochondrial uncoupling), as compared to control. Supplements of probiotics could promote weight loss and prevent a diet-induced mitochondrial dysfunction in liver hepatocytes, an important risk factor for NAFLD and therefore, CVD. This project could translate into future research directions in preventative medicine, for example by investigating the potential of probiotics in the prevention of mitochondrial dysfunction in other organs, including the heart and the vascular system.

Поєднане атеросклеротичне ураження у хворих на цукровий діабет 2-го типу

Актуальність. Значна поширеність атеросклерозу та його ускладнень у хворих на цукровий діабет (ЦД) 2-го типу визначає необхідність в подальших дослідженнях існуючих факторів ризику. Мета дослідження. Визначити вплив різних факторів ризику на розвиток атеросклеротичного ураження у хворих на ЦД 2-го типу. Матеріали й методи. Проаналізовані в динаміці впродовж 5 років середні показники систолічного артеріального тиску (САТ), HbA1c, високочутливого С-реактивного білка (вчСРБ), сечової кислоти (СК), холестерину ліпопротеїнів низької щільності (ХС ЛПНЩ) у сироватці крові та бали за шкалою тривоги та депресії HADRS у зіставленні з оцінкою ультразвукових даних щодо атеросклеротичного ураження сонних артерій (товщина комплексу інтима-медіа ≥ 0,9 мм чи наявність атеросклеротичних бляшок) та артерій нижніх кінцівок (кісточково-плечовий індекс ≤ 0,9) у 122 хворих на ЦД 2-го типу (66 жінок, 56 чоловіків; середній вік — 55,0 (49,8–62,0) року). Статистичний аналіз проведений за допомогою IBM SPSS Statistics 20. Результати. У ході дослідження хворі були поділені на 3 групи: I група — 48 осіб із атеросклеротичним ураженням сонних артерій та нижніх кінцівок, II група — 47 осіб із атеросклерозом сонних артерій, III група — 27 осіб без ознак атеросклеротичного ураження. Виявлено, що у хворих I групи середні рівні САТ (141,7 (132,1–152,9) мм рт.ст.), HbA1c (9,2 (8,2–9,9) %), вчСРБ (5,8 (4,2–6,9) мг/л) та СК (358,1 (302,4–396,1) мкмоль/л), ХС ЛПНЩ (4,1 (3,6–5,2) ммоль/л), балів за шкалою HADRS (16,0 (9,0–18,8) бала) були вірогідно вищими порівняно з показниками III групи (САТ — 136,7 (128,3–143,3) мм рт.ст., HbA1c — 7,7 (7,0–8,4)%, вчСРБ — 2,7 (1,1–3,3) мг/л, СК — 276,8 (227,0–316,0) мкмоль/л, ХС ЛПНЩ — 3,3 (3,0–4,0) ммоль/л, за шкалою HADRS — 8,0 (7,0–10,0) бала) (р &lt; 0,05). Середні рівні HbA1c та вчСРБ хворих I групи були вірогідно вищіми порівняно з показниками II групи (HbA1c — 8,7 (7,6–9,3) %, вчСРБ — 4,2 (3,0–5,3) мг/л) (р &lt; 0,05). Висновок. У хворих на ЦД 2-го типу з вищими середніми рівнями САТ, вчСРБ, HbA1c, СК, ХС ЛПНЩ та тривожно-депресивними порушеннями захворювання супроводжується більш частим виникненням атеросклеротичного ураження, у тому числі поєднаного ураження артерій різних басейнів.

Anemia in Patients with Axial Spondyloarthritis is Not Associated with an Increase of Arterial Stiffness and Intima-Media Thickness (Results of a Single-Center Cross-Sectional Study)

Aim: to study parameters of arterial stiffness and subclinical atherosclerosis in patients with axial spondyloarthritis (axSpA) without clinically manifest cardiovascular pathology depending on the presence of anemia.Material and methods. 102 patients with axSpA (mean age – 37.7±9.8 years, axSpA duration – 13.5±8.7 years, 66 (64.7%) men) were included. The BASDAI index and C-reactive protein (CRP)-based ASDAS score were measured, the hemogram, the erythrocyte sedimentation rate (ESR), and the level of CRP were studied. Parameters of arterial stiffness were studied by oscillography and photoplethysmography, intima-media thickness (IMT) was evaluated by B-mode ultrasound according to standard protocols.Results. During analysis of pulse wave properties, no statistically significant differences in parameters of vascular wall stiffness were found in axSpA patients with and without anemia. Aortic pulse wave velocity (PWVao) in patients with anemia was 7.4±1.5 m/sec, aortic augmentation index (Aix-ao) was 19.1±13.7%, stiffness index (SI) was 8.2±1.7 m/sec; in patients without anemia – 7.4±1.4 m/sec, 17.3±10.6% and 8.8±2.0 m/sec, respectively (p &gt;0.05 for all). IMT in patients with anemia was 0.70±0.13 cm, in patients without anemia – 0.73±0.16 cm (p &gt;0.05). Correlation analysis was performed and significant correlations were noted between Aix-ao, PWVao, SI, IMT and age (r=0.488, r=0.516, r=0.289, r=0.461, respectively, p &lt;0.05); Aix-ao, PWVao and the BASDAI index (r=0.243, r=0.253, respectively, p &lt;0.05). Significant correlations between PWVao and Aix-ao (r=0.442, p &lt;0.001), SI (r=0.273, p=0.011) and IMT (r=0.236, p=0.034) were found.Conclusion. The present study did not confirm the negative effect of anemia on vascular wall stiffness parameters and IMT in patients with axSpA. We consider that potential protective effect of anemia, due to well-known pathophysiological patterns — a decrease in blood viscosity and the induction of nitric oxide synthesis, plays an important role. Further studies are required to assess relationship between hemoglobin levels and markers of endothelial dysfunction in patients with axSpA.

Effect of Chronic Khat Chewing on Intima-Media Thickness of Common Carotid Arteries in Yemeni volunteers

Objective: To assess the changes occurring in both common carotid arteries (CCAs) intima-media thickness (IMT) in Yemeni chronic khat chewers using B-mode ultrasonography.&#x0D; Methods: This cross-sectional study was conducted among 195 participants (103 regular khat chewers and 92 non-khat chewers) conveniently selected at the Radiology Department of the University of Science and Technology Hospital (USTH) in Sana’a from August 2017 to August 2018. Data about gender, age, BMI, chewing khat and the period of chewing were collected from participants using a structured questionnaire. B-mode ultrasonography of bilateral CCAs was then performed to measure the IMT. Data were analyzed using suitable statistical tests, and P-values &lt;0.05 were considered statistically significant.&#x0D; Results: The majority of participants with CCA-IMT were males (91.8%) and aged 27 years or younger (59.0%), with a mean age of 27.9 ± 6.8 years. Khat chewers constituted more than half of patients with CCA-IMT. There was no statistically significant difference in the mean values of RT CCA-IMT and LT CCA-IMT between khat chewers and non-khat chewers. The CCA-MIT was significantly higher among male khat chewers compared to male non-chewers (P = 0.004). However, there was no statistically significant difference between khat chewers and non-chewers with respect to the age of 20 years or older (P = 0.301) and BMI of 18.5 kg/m2 or higher (P = 0.888). Age showed a significant positive correlation with RT CCA-IMT (r = 0.380; P &lt; 0.001) and LT CCA-IMT (r = 0.458; P &lt; 0.001) in Khat chewers. In contrast, age showed a significant positive correlation with LT CCA-IMT only in non-khat chewers (r = 0.236; P = 0.024). On the other hand, BMI showed a significant positive correlation with LT CCA-IMT (r = 0.254; P = 0.010) among khat chewers, but no significant correlation was found in CCA-IMT of both sides among non-khat chewers. Among khat chewers, there was a significant positive correlation with RT CCA-IMT (r = 0.273; P = 0.005) and LT CCA-IMT(r = 0.194; P = 0.049).&#x0D; Conclusion: Khat chewing does not lead to a significant difference in CCA-IMT among Yemeni chewers compared to non-chewers. However, the period of chewing may slightly affect the CCA-IMT among khat chewers. Age has a significant positive correlation with CCA-IMT in khat chewers and LT CCA-MIT in non-khat chewers, which could help to determine the contribution of different predisposing factors to atherosclerosis. A significant positive correlation can be found between BMI and LT CCA-MIT among khat chewers.&#x0D; Keywords: Khat Chewing, Intima media thickness, Carotid, Yemen

Elastic tissue disruption is a major pathogenic factor to human vascular disease.

Elastic fibers are essential components of the arterial extracellular matrix. They consist of the protein elastin and an array of microfibrils that support the protein and connect it to the surrounding matrix. The elastin gene encodes tropoelastin, a protein that requires extensive cross-linking to become elastin. Tropoelastin is expressed throughout human life, but its expression levels decrease with age, suggesting that the potential to synthesize elastin persists during lifetime although declines with aging. The initial abnormality documented in human atherosclerosis is fragmentation and loss of the elastic network in the medial layer of the arterial wall, suggesting an imbalance between elastic fiber injury and restoration. Damaged elastic structures are not adequately repaired by synthesis of new elastic elements. Progressive collagen accumulation follows medial elastic fiber disruption and fibrous plaques are formed, but advanced atherosclerosis lesions do not develop in the absence of prior elastic injury. Aging is associated with arterial extracellular matrix anomalies that evoke those present in early atherosclerosis. The reduction of elastic fibers with subsequent collagen accumulation leads to arterial stiffening and intima-media thickening, which are independent predictors of incident hypertension in prospective community-based studies. Arterial stiffening precedes the development of hypertension. The fundamental role of the vascular elastic network to arterial structure and function is emphasized by congenital disorders caused by mutations that disrupt normal elastic fiber production. Molecular changes in the genes coding tropoelastin, lysyl oxidase (tropoelastin cross-linking), and elastin-associated microfibrils, including fibrillin-1, fibulin-4, and fibulin-5 produce severe vascular injury due to absence of functional elastin.

Associations between SNP83 of phosphodiesterase 4D gene and carotid atherosclerosis in a southern Chinese Han population: a case-control study.

Atherosclerosis was an important pathophysiological basis of atherothrombotic stroke, and phosphodiesterase 4D (PDE4D) polymorphism (SNP83/rs966221) was reported to be associated with the susceptibility to atherothrombotic stroke. Aim of the present study was to explore the potential association between SNP83 and carotid atherosclerosis (CAS). 204 southern Chinese Han participants were divided into two groups according to the carotid intima-media thickness (IMT) of the carotid artery: CAS group (carotid IMT ≥ 1.0mm) and non-CAS group (carotid IMT < 1.0mm). Carotid IMT was measured by color Doppler ultrasound. The PDE4D SNP83 polymorphism was determined by SNaPshot technique. Our study found that SNP83 was associated significantly with CAS susceptibility under the dominant, overdominant and codominant models. After adjusting for age, gender, low-density lipoprotein cholesterol, Hemoglobin A1c, cigarette smoking, hypertension history, and diabetes mellitus history, the association still remained significant (dominant model: crude OR = 2.373, 95% CI: 1.268-4.442, P = 0.007; adjusted OR = 3.129, 95% CI: 1.104-8.866, P = 0.032; overdominant model: crude OR = 1.968, 95% CI: 1.043-3.714, P = 0.037; adjusted OR = 2.854, 95% CI: 1.005-8.108, P = 0.049; codominant: crude OR = 2.102, 95% CI: 1.110-3.979, P = 0.023; adjusted OR = 2.984, 95% CI: 1.047-8.502, P = 0.041). Carotid IMT of carriers with CT + CC genotypes was higher than carriers with TT genotype (P = 0.016). Our results indicated that the SNP83/rs966221 located on PDE4D gene was significantly associated between CAS susceptibility and carotid IMT independently of conventional risk factors in a southern Chinese Han population.