Arterial Cardiovascular Disease Research Articles

Combining Bibliometric Analysis to Uncover the Detrimental and Protective Roles of Various Dendritic Cell Types in Cardiovascular Arterial Diseases.

Immune cell dysregulation is increasingly recognized as a pivotal pathological factor in cardiovascular disease. Over the past decade, a surge of research has focused on the role of immune cells such as dendritic cells (DCs), T cells, macrophages, and neutrophils in cardiovascular diseases, findings that are frequently featured in leading cardiology journals. This review provides a comprehensive synthesis of the roles that DCs play in common and potentially fatal arterial diseases, including hypertension, coronary artery atherosclerosis, acute coronary syndrome, pulmonary arterial hypertension, aortic aneurysm, aortic dissection, and vasculitis. Combining with bibliometric analysis, this review delves into the critical mechanisms by which DCs contribute to these diseases and reveals the shared mechanisms across diverse diseases. This review also offers new advances in clinical treatment strategies involving DCs.

Association between changed self-rated health and the risk of venous thromboembolism in Malmö Preventive Program: a cohort study.

Poor self-rated health (SRH) is associated with incident arterial cardiovascular disease in both sexes. Studies on the association between SRH and incident venous thromboembolism (VTE) show divergent results in women and no association in men. This study focuses on the association between change in SRH and incident VTE in a cohort of 11,558 men and 6682 women who underwent a baseline examination and assessment of SRH between 1974 and 1992 and a re-examination in 2002-2006. To investigate if changes in SRH over time affect the risk of incident VTE in men and women. During a follow-up time from the re-examination of more than 16years, there was a lower risk for incident VTE among women if SRH changed from poor at baseline to very good/excellent (HR 0.46, 95% CI 0.28; 0.74) at the re-examination. Stable good SRH (good to very good/excellent at the re-examination, HR 0.60, 95% CI 0.42; 0.89), or change from good SRH at baseline into poor/fair at the re-examination (HR 0.68, 95% CI 0.51; 0.90) were all significantly associated with a reduced risk for VTE. All comparisons were done with the group with stable poor SRH. This pattern was not found among men. Regardless of a decreased or increased SRH during life, having an SRH of very good/excellent at any time point seems to be associated with a decreased risk of VTE among women.

High microRNA-145 plasma levels are associated with decreased risk of future incident venous thromboembolism: the HUNT study

AbstractMicroRNA-145 (miR-145) has been reported to downregulate the expression of tissue factor and factor XI in vitro and decrease venous thrombus formation in animal models. However, the association between miR-145 and risk of future venous thromboembolism (VTE) in the general population remains unknown. We investigated the association between plasma levels of miR-145 and risk of future VTE in a case-cohort study. Incident VTE cases (n = 510) and a subcohort (n = 1890) were derived from the third survey of the Trøndelag Health Study (HUNT3), a population-based cohort. The expression levels of miR-145 were measured in plasma samples obtained at baseline. The study population was divided into quartiles based on miR-145 levels in participants in the subcohort, and weighted Cox regression was used to estimate hazard ratios (HRs) with 95% confidence intervals (CIs). Plasma levels of miR-145 were inversely associated with VTE risk. Participants with miR-145 levels in the highest quartile had a 49% lower risk of VTE (HR, 0.51; 95% CI, 0.38-0.68) than those with miR-145 in the lowest quartile in age- and sex-adjusted analysis, and the inverse association was most pronounced for unprovoked VTE (HR, 0.39; 95% CI, 0.25-0.61). Risk estimates remained virtually the same after further adjustment for body mass index, and cancer and arterial cardiovascular disease at baseline. In conclusion, elevated expression levels of miR-145 in plasma were associated with decreased risk of future incident VTE. The protective role of miR-145 against VTE is consistent with previous experimental data and suggests that miR-145 has the potential to be a target for VTE prevention.

LDL Cholesterol Variability Impacts the Prognosis of Patients with Chronic Ischemic Heart Disease: A Real-World Italian Experience.

Epidemiologic, genetic, and clinical intervention studies have indisputably shown that low-density lipoprotein cholesterol (LDL-C) is causal in the development of atherosclerotic cardiovascular disease (ASCVD). However, LDL-C variability could be related to increased ASCVD risk in patients already treated with statins. The aim of the present retrospective real-life study was to assess the prognostic impact of LDL-C variability on all-cause mortality and cardiovascular hospitalizations in patients with stable cardiovascular artery disease. A total of 3398 patients were enrolled and followed up for a median of 56 months. Considering LDL-C < 70 mg/dL as the therapeutical target, during follow-up, the percentage of patients who achieved this goal raised from 20.7% to 31.9%. In total, 1988 events were recorded, of which 428 were all-cause deaths and 1560 were cardiovascular hospitalizations. At the last medical examination, each increase in LDL-C levels of 20 mg/dL corresponded to a 6% raise in the risk of any event (HR 1.06; 95%CI, 1.03 to 1.09). In conclusion, our real-world study supports the hypothesis that a continuous and progressive downward trend in LDL-C levels is needed to achieve and maintain a cardiovascular benefit, at least in secondary prevention.

Pulmonary hypertension rapidly leading to mortality in a patient with interstitial pneumonia with autoimmune features

Interstitial Pneumonia with Autoimmune Features (IPAF) is a newly defined connective tissue disease (CTD) related pulmonary involvement in 2015 by the European Respiratory Society and American Thoracic Society. It is used to define the subgroup of patients with no known CTD history. In this case report, we present a patient with IPAF diagnosis, who had rapid clinical deterioration after a COVID-19 infection, which was attributed to a newly diagnosed pulmonary hypertension. A 69-year-old male patient with chronic obstructive pulmonary disease (COPD) diagnosis was on the routine follow-up for a duration of five years. He had been diagnosed with type 2 diabetes mellitus and gout, with under constant follow-up for a known cardiovascular arterial disease history. During a routine pulmonary evaluation, the patient had stated a worsening exercise capacity and an increase in coughing. The requested high-resolution computed tomography showed emphysema at the upper lobes and a reticular pattern at the lower lobes, with honeycombing, traction bronchiectasis, and ground-glass findings. After a rheumatology consultation, which excluded the presence of an underlying rheumatological disease, the patient was diagnosed with IPAF. Under immunosuppressive treatment, the patient complained of increased dyspnea at a routine follow-up after a COVID infection in 2021, and antifibrotic treatment was initiated due to the progression of pulmonary fibrosis. During routine follow-up, further limitation in exercise capacity was evident, for which extra-pulmonary involvement was investigated. Pulmonary hypertension (PH) diagnosis was confirmed with vasoreactivity positivity; however, due to both progression in IPAF and concurrent PH, the patient was lost during the follow-up. As seen in this case, despite being stable for years, the addition of another comorbidity may rapidly worsen a patient’s otherwise stable clinical condition. While antifibrotic regimens may be used on a case-by-case basis, their effect on disease progression may not be sufficient to control an already present comorbidity, such as pulmonary hypertension.

CORRELATION OF LIPOPROTEIN(a) AND CORONARY ARTERY DISEASES

&lt;div&gt;&lt;p&gt;&lt;strong&gt;INTRODUCTION:&lt;/strong&gt; Cardiovascular diseases (CVD) continue to be one of the leading causes of mortality worldwide. While factors such as diabetes, sedentariness, psychostress, genetic predisposition, hypertension, smoking, and hyperlipidemia are well-known in the etiology of atherosclerosis (Ath) of coronary arteries. Recent studies have also identified high concentrations of lipoproteins (a) [Lp(a)] as a risk factor. In fact, high concentrations of Lp(a) above 30mg/dl (reference value-30mg/dl) have been found to be a risk factor for Ath, leading experts to develop medications aimed at reducing Lp(a) concentrations and preventing atherosclerotic manifestations. &lt;a href="https://eas-society.org/"&gt;&lt;em&gt;The European Atherosclerosis Society&lt;/em&gt;&lt;/a&gt; has also released clinical guidelines for testing and treating high concentrations of Lp(a) as part of the global assessment of cardiovascular risk.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;THE GOAL OF THE STUDY:&lt;/strong&gt; The goal of this study is to investigate the concentration of Lp(a) in patients with coronary disease and its connection to the presentation of atherosclerosis of the coronary arteries in patients with CVD compared to a control group of healthy individuals. Through this study, we hope to gain a better understanding of the role of Lp(a) in CVD and its potential as a target for prevention and treatment. By identifying and addressing risk factors like high Lp(a) concentrations, we can work towards reducing the global burden of CVD and improving health outcomes for individuals around the world.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;THE AIM OF THE STUDY:&lt;/strong&gt; The aim of this study is to determine the concentration of lipoprotein(a) in patients with coronary disease, its connectivity and role in the presentation of atherosclerosis of the coronary arteries in patients with CVD compared to the control group of healthy individuals.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;MATERIAL AND METHODS:&lt;/strong&gt; As working material, the blood taken from the vein of patients with coronary disease was used - N0=80, (with an identical average age of 55.70±6.00 years old, of which 35 were female while 45 were male. In the study, there was also a control group: N0=80 healthy volunteers (45 were male and 35 female) with the same age as the patients. Blood for analysis was taken at 8 o'clock in the morning, at room temperature of 19-24°C, every three months in a period of 12 months.&lt;/p&gt;&lt;p&gt;Echocardiography and EKG were also performed on all the patients with Toshiba SSH-140A machine, color Doppler probe 3.7Hz, sectorial type, taking into account as key parameters the thickness of the back wall of the left ventricle and the thickness of-Left ventricular internal diameter end diastole (LVPVd) and interventricular septal end diastole (IVSd&amp;gt;12 mm). Together with the examination of Lp(a) concentrations, the lipid profile was also analyzed. The analyzes were done at the Clinical Laboratory Institute at the University Clinical Center of the Faculty of Medicine – Skopje, North Macedonia.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;STATISTICAL PROCESSING OF THE MATERIAL:&lt;/strong&gt; From the statistical methods, arithmetic mean value, standard deviation X±SD were used. The comparative statistics of the lipid parameters between the analyzed groups were analyzed with students ‘t’ dependent and independent samples according to the Mann-Whitney U-test and Wilcoxon - test. The results of the lipid fractions will be shown tabularly (see table 3) with the statistical program SPSS V26.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;RESULTS:&lt;/strong&gt; The obtained values of lipids (Col.Total, TG, HDL-ch, LDL-ch) and lipoprotein (a) in both groups are presented with mean values and standard deviation X-SD. Due to the fact that in the obtained results of Lp(a) in both sexes, in patients with coronary disease, we did not notice any significant difference, we will present them as common for both groups, with CVD with maximum values of 78.00-16,00 mg/dl while in the control group =15.20-4.30 mg/dl, with a statistically significant difference with p&amp;lt;0.000. The same difference was found from the obtained results of lipid concentrations between the two groups with p &amp;lt;0.0001 (as presented in the tables below).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;CONCLUSION:&lt;/strong&gt; The results obtained in the paper proved that high concentrations of Lp(a) &amp;gt; 30 mg/dl are risk factors for the occurrence of Ath of the coronary arteries and that these patients are at a 5-8 times higher risk for the development of Ath of coronary arteries, compared to individuals with normal Lp(a) values, therefore the treatment of high concentrations of Lp(a) should be started at the beginning of their appearance. In conclusion, we can suggest that the adequate treatment of high Lp(a) concentrations and the balancing of the lipid profile can apparently affect the prevention of atherosclerotic processes of the coronary arteries, therefore we prefer that in individuals with a history of CAD and those with coronary disease, the examination of Lp(a) and lipid profile should be one of the initial examinations during the management of patients with CAD.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Keywords: &lt;/strong&gt;Lipoprotein (a), atherosclerosis, Cardiovascular Arterial Diseases (CAD), lipid profile.&lt;/p&gt;&lt;/div&gt;

Abstract P3-03-10: The Impact of Type 2 Diabetes on Complications after Primary Breast Cancer Surgery: a Danish population-based cohort study

Abstract Introduction Type 2 diabetes (T2D) is associated with obesity and other comorbidities involving multiple organ systems, which may increase the risk of postsurgical complications. Knowledge is sparse on the impact of T2D on the postsurgical outcome after breast cancer (BC) surgery in primary BC. Objectives To investigate the association of T2D and risk of complications after primary BC surgery, and according to neoadjuvant chemotherapy. Methods Our cohort included all Danish women diagnosed with early-stage operable BC during 1996-2018 registered in the Danish Breast Cancer Group clinical database. All patients had primary surgical treatment—mastectomy or breast conserving surgery. Information on prevalent T2D was collected from Danish medical and prescription registries, defining T2D via diagnostic codes or redemption of ≥2 prescriptions for glucose-lowering drugs. We defined postoperative complications as hospital admissions for medical or surgical complications (re-operations (excluding seromas), bleeding, infection, thrombosis, kidney or arterial cardiovascular disease) up to 30 days after primary BC surgery. We calculated the 30-day cumulative incidence function (CIF) of postoperative complications and used Cox regression to estimate hazard ratios (HR) and associated 95% confidence intervals (95% CI) overall, and stratified by the receipt of neoadjuvant chemotherapy, adjusting for potential confounders. Results Among 84,491 women with operable BC, 4,669 (5.5%) had prevalent T2D at time of BC surgery. Overall, 800 (17.1%) and 8,621 (10.8%) of BC patients with and without T2D developed postoperative complications corresponding to CIFs of 17% (95%CI: 16% - 18%) and 11% (95%CI: 10% - 11%), respectively, and a HR of 1.44 (95%CI: 1.34-1.56). 173 (3.7%) BC patients with T2D and 2,805 (3.5%) without T2D received neoadjuvant chemotherapy. Among those who did not receive neoadjuvant chemotherapy, the CIFs of postoperative complications was 17% (95% CI: 16% - 18%) and 11% (95% CI: 10% - 11%) for women with and without T2D, respectively, with a corresponding HR of 1.42 (95% CI: 1.31-1.53). For those with and without T2D who received neoadjuvant chemotherapy, the CIFs were 24% (95% CI: 18% - 30%) and 10% (95% CI: 9% - 11%), respectively, and with a corresponding HR of 2.08 (95% CI: 1.49-2.91). Conclusion Among women with BC, prevalent T2D at the time of primary BC surgery increases the risk of postoperative complications. This excess risk is particularly pronounced among patients who undergo neoadjuvant chemotherapy. Citation Format: Kasper Kjærgaard, Jannik Wheler, Looket Dihge, Peer Christiansen, Signe Borgquist, Deirdre Cronin-Fenton. The Impact of Type 2 Diabetes on Complications after Primary Breast Cancer Surgery: a Danish population-based cohort study [abstract]. In: Proceedings of the 2022 San Antonio Breast Cancer Symposium; 2022 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2023;83(5 Suppl):Abstract nr P3-03-10.

Procoagulant factors and future risk of arterial cardiovascular disease in patients with prior venous thrombosis: A cohort study.

Patients with venous thrombosis (VT) are at increased risk of future arterial cardiovascular disease (CVD) (i.e., myocardial infarction, ischemic stroke or peripheral artery disease). We investigated whether shared risk factors for VT and CVD are associated with the levels of procoagulant factors (fibrinogen, factor VIII, and von Willebrand factor), and whether the relationship between these risk factors and subsequent CVD was mediated through these procoagulant factors in patients with VT. In a follow-up study consisting of 4956 patients with VT, 2176 patients (44%) provided blood samples and were linked to the Dutch Hospital registry of Statistics Netherlands to identify hospital admissions or procedures for subsequent CVD. In total, 52 CVD events occurred over a follow-up of 11,124 years, with an incidence rate of 4.7 per 1000 patient years (95% confidence intervals 3.5-6.1). Increasing age, male sex, smoking history, major illnesses, dyslipidemia, and impaired fasting glucose levels were associated with increased CVD risk. Procoagulant factor levels were also associated with CVD risk. When adjusted for these procoagulant factors, the association between the risk factors and CVD attenuated partially. This study provides evidence that procoagulant factors can partially explain the association between increased risks of subsequent CVD in patients with previous VT.

Quantitative Prediction of SYNTAX Score for Cardiovascular Artery Disease Patients via the Inverse Problem Algorithm Technique as Artificial Intelligence Assessment in Diagnostics.

The quantitative prediction of the SYNTAX score for cardiovascular artery disease patients using the inverse problem algorithm (IPA) technique in artificial intelligence was explored in this study. A 29-term semi-empirical formula was defined according to seven risk factors: (1) age, (2) mean arterial pressure, (3) body surface area, (4) pre-prandial blood glucose, (5) low-density-lipoprotein cholesterol, (6) Troponin I, and (7) C-reactive protein. Then, the formula was computed via the STATISTICA 7.0 program to obtain a compromised solution for a 405-patient dataset with a specific loss function [actual-predicted]2 as low as 3.177, whereas 0.0 implies a 100% match between the prediction and observation via "the lower, the better" principle. The IPA technique first created a data matrix [405 × 29] from the included patients' data and then attempted to derive a compromised solution of the column matrix of 29-term coefficients [29 × 1]. The correlation coefficient, r2, of the regression line for the actual versus predicted SYNTAX score was 0.8958, showing a high coincidence among the dataset. The follow-up verification based on another 105 patients' data from the same group also had a high correlation coefficient of r2 = 0.8304. Nevertheless, the verified group's low derived average AT (agreement) (ATavg = 0.308 ± 0.193) also revealed a slight deviation between the theoretical prediction from the STATISTICA 7.0 program and the grades assigned by clinical cardiologists or interventionists. The predicted SYNTAX scores were compared with earlier reported findings based on a single-factor statistical analysis or scanned images obtained by sonography or cardiac catheterization. Cardiologists can obtain the SYNTAX score from the semi-empirical formula for an instant referral before performing a cardiac examination.

Anti-embolism devices therapy to improve the ICU mortality rate of patients with acute myocardial infarction and type II diabetes mellitus.

BackgroundAnti-Embolism (AE) devices therapy is an additional antithrombotic treatment that is effective in many venous diseases, but the correlations between this medical compression therapy and cardiovascular arterial disease or comorbid diabetes mellitus (DM) are still controversial. In this study we investigated the association between compression therapy and intensive care unit (ICU) mortality in patients with a first acute myocardial infarction (AMI) diagnosis complicated with type II DM.MethodsThis retrospective cohort study analyzed all patients with AMI and type II DM in the Medical Information Mart for Intensive Care-IV database. We extracted the demographics, vital signs, laboratory test results, comorbidities, and scoring system results of patients from the first 24 h after ICU admission. The outcomes of this study were 28-day mortality and ICU mortality. Analyses included Kaplan–Meier survival analysis, Cox proportional-hazards regression, and subgroup analysis.ResultsThe study included 985 eligible patients with AMI and type II DM, of who 293 and 692 were enrolled into the no-AE device therapy and AE device therapy groups, respectively. In the multivariate analysis, compared with no-AE device therapy, AE device therapy was a significant predictor of 28-day mortality (OR = 0.48, 95% CI = 0.24–0.96, P = 0.039) and ICU mortality (OR = 0.50, 95% CI = 0.27–0.90, P = 0.021). In addition to age, gender and coronary artery bypass grafting surgery, there were no significant interactions of AE device therapy and other related risk factors with ICU mortality and 28-day mortality in the subgroup analysis.ConclusionsSimple-AE-device therapy was associated with reduced risks of ICU mortality and 28-day mortality, as well as an improvement in the benefit on in-hospital survival in patients with AMI complicated with type II DM.

5 Early diagnosis of coronary artery disease in postmenopausal women by arterial stiffness assessment

Abstract Aims Arterial stiffness is a marker of cardiovascular disease useful to identify, at an early stage, subjects with increased risk of cardiovascular artery diseases (CADs). Nevertheless, studies on gender-specific interactions of PWV and CAD are lacking. Therefore, the aim of this study is to investigate, in a population of postmenopausal women, the role of PWV in relation to CAD. The goal of our study was to assess the prevalence of CAD, among postmenopausal women affected by increased arterial stiffness, assessed by global pulse wave velocity (gPWV), and with diabetes and/or hypertension on target, distinguishing the different phenotypes. Methods and results We enrolled 632 consecutive women with an increased gPWV, 300 consecutive postmenopausal women with normal gPWV were included as control group (CG). We assessed arterial stiffness by gPWV, performed by pulsed Doppler (3.5 MHz probe) using two-dimensional guidance and ECG trigger. Philips Epiq 7 was used which is an echo-Doppler system equipped with a multifrequency transducer. The gPWV was assessed as normal for a velocity equal or lower than 7.1 m/s. CAD diagnosis was accepted when confirmed by exercise or nuclear stress test, cardiac catheterization, and angiogram or cardiac CT scan. All women were on therapy, with blood pressure &amp;lt; 130/80 mmHg and HbA1c &amp;lt; 7%. 55 (8.8%) women were affected by CAD among 632 with increased gPMW, and 15 (5%) among 300 women of CG, P &amp;lt; 0.04. There was no difference for mean age between the two groups: 58 ± 11 and 56 ± 8, respectively, P = 0.2. 29 (4.5%) women were affected by CAD and hypertensive cardiomyopathy among 632 with increased gPMW, and 6 (2%) among 300 women of CG, P &amp;lt; 0.05. 16 (2.6%) women were affected by CAD and metabolic cardiomyopathy among 632 with increased gPMW, and 2 (0.7%) among 300 women of CG, P &amp;lt; 0.05. Seventeen (2.7%) women were affected by CAD alone among 632 with increased gPMW, and 2 (0.7%) among 300 women of CG, P &amp;lt; 0.04. Conclusions We found a higher prevalence of CAD among postmenopausal women with increased gPWV when affected by hypertension and/or diabetes, also if on target therapy; the statistically significant correlation is confirmed also when women are affected by hypertensive or metabolic cardiomyopathy. We conclude that early detection increased gPWV may identify women with higher risk to develop CAD also before they become symptomatic.

Consumption of coffee and tea and risk of developing stroke, dementia, and poststroke dementia: A cohort study in the UK Biobank.

Previous studies have revealed the involvement of coffee and tea in the development of stroke and dementia. However, little is known about the association between the combination of coffee and tea and the risk of stroke, dementia, and poststroke dementia. Therefore, we aimed to investigate the associations of coffee and tea separately and in combination with the risk of developing stroke and dementia. This prospective cohort study included 365,682 participants (50 to 74 years old) from the UK Biobank. Participants joined the study from 2006 to 2010 and were followed up until 2020. We used Cox proportional hazards models to estimate the associations between coffee/tea consumption and incident stroke and dementia, adjusting for sex, age, ethnicity, qualification, income, body mass index (BMI), physical activity, alcohol status, smoking status, diet pattern, consumption of sugar-sweetened beverages, high-density lipoprotein (HDL), low-density lipoprotein (LDL), history of cancer, history of diabetes, history of cardiovascular arterial disease (CAD), and hypertension. Coffee and tea consumption was assessed at baseline. During a median follow-up of 11.4 years for new onset disease, 5,079 participants developed dementia, and 10,053 participants developed stroke. The associations of coffee and tea with stroke and dementia were nonlinear (P for nonlinear <0.01), and coffee intake of 2 to 3 cups/d or tea intake of 3 to 5 cups/d or their combination intake of 4 to 6 cups/d were linked with the lowest hazard ratio (HR) of incident stroke and dementia. Compared with those who did not drink tea and coffee, drinking 2 to 3 cups of coffee and 2 to 3 cups of tea per day was associated with a 32% (HR 0.68, 95% CI, 0.59 to 0.79; P < 0.001) lower risk of stroke and a 28% (HR, 0.72, 95% CI, 0.59 to 0.89; P = 0.002) lower risk of dementia. Moreover, the combination of coffee and tea consumption was associated with lower risk of ischemic stroke and vascular dementia. Additionally, the combination of tea and coffee was associated with a lower risk of poststroke dementia, with the lowest risk of incident poststroke dementia at a daily consumption level of 3 to 6 cups of coffee and tea (HR, 0.52, 95% CI, 0.32 to 0.83; P = 0.007). The main limitations were that coffee and tea intake was self-reported at baseline and may not reflect long-term consumption patterns, unmeasured confounders in observational studies may result in biased effect estimates, and UK Biobank participants are not representative of the whole United Kingdom population. We found that drinking coffee and tea separately or in combination were associated with lower risk of stroke and dementia. Intake of coffee alone or in combination with tea was associated with lower risk of poststroke dementia.

Когнитивные нарушения и деменция у больных артериальной гипертензией. Часть І. Классификация, распространенность, механизмы развития нарушений когнитивных функций и рекомендации по обследованию пациентов

Одним из наиболее частых и ранних поражений головного мозга при артериальной гипертензии являются нарушения когнитивных функций, которые со временем у большинства больных закономерно трансформируются в деменцию — тяжелую, инвалидизирующую и неизлечимую патологию. В статье приведены данные о классификации и распространенности когнитивных нарушений, сведения о механизмах их развития при артериальной гипертензии и ассоциированных с ней сердечно-сосудистых заболеваниях, методы обследования больных и методы диагностики когнитивных нарушений (специальные нейропсихиатрические тесты), современная стратегия лечения больных артериальной гипертензией с нарушениями когнитивных функций и подходы к профилактике развития данного поражения головного мозга.

MO143UTILITY OF SIFT-MS TO EVALUATE VOLATILE ORGANIC COMPOUNDS IN NEPHROPATHIC PATIENTS' BREATH

Abstract Background and Aims Breath analysis techniques allow detection and quantification of multiple analytes present in breath to the low parts per billion volume (ppbv) level. One such technique is selected ion flow tube–mass spectrometry (SIFT-MS), which can measure numerous volatile organic compounds (VOCs) in breath on-line and in real-time. This technique has already been used in an innovative manner to monitor infectious, inflammatory status and metabolic conditions. However, there is no evidence on its use in ambulatory patients with chronic kidney disease (CKD). End-stage-renal-disease patients are characterized by "uremic halitosis" caused by the accumulation of uremic toxins that are detectable in breath such as ammonia and amines. The aims of this study are identifying a possible correlation between the detected VOCs and the presence of CKD, moreover, exploring the range of VOCs levels in patients with different CKD stage. Method In the present study, a mobile Voice200ultra® SIFT-MS instrument was made available by the Agilent SRA Division. The SIFT-MS allowed to quantify the VOCs in CKD patients. The SIFT-MS uses a precise and controlled application of “soft” chemical ionization. We enrolled 50 CKD patients, divided into two subgroups according to the estimated glomerular filtration rate (eGFR): eGFR ≥30 mL/min/1.73m2 (A) and eGFR &amp;lt;30 mL/min/1.73m2 (B) compared to 18 healthy subjects (C). The anamnestic data and information about any comorbidities such as arterial hypertension, cardiovascular and metabolic diseases, were collected for each patient. In order to reduce the possible interferences in the exhaled composition induced by different lifestyles, all participants were instructed to perform hygienic procedures before the test execution. The exhaled was sampled through the use of a standard spirometry mouthpiece for single use, directly connected with the input probe to the MS detector of the instrument that was able to detect more than 30 VOCs. The processing of the sample was made through the direct use of an internal comparison library (Syft library). The SIFT-MS software instantly calculates the absolute concentration of the target compounds by interpolating mass-to-charge ratios, reaction rate coefficients and branching ratios. Results Among all the VOCs analyzed, the most significant results are observed for ammonia and isoprene. In particular, the ROC curve of ammonia highlighted statistically significant differences between the three subgroups respectively A vs C AUC=0,756 p=0,001; B vs C AUC=0,942 p&amp;lt;0,001; A vs B AUC=0,797 p&amp;lt;0,001 (Figure 1). Youden index J between subgroups B and C defines the best cut-off =0,8704 associated with the criterion ammonia concentration ≤4700 ppbv with sensitivity =94,44% and specificity = 92,59%. The ROC curve of isoprene showed statistically significant differences between the three subgroups respectively B vs C AUC=0,669 p=0,050; A vs B AUC=0,691 p=0,014 (Figure 2). These data allow us to define this a highly accurate test. The same significant results were observed also with Anova one-way test that highlighted an inversely correlation between the ammonia breath concentration and eGFR, and a direct correlation between isoprene and eGFR. Conclusion This preliminary data confirms the potential utility of SIFT-MS for the CKD diagnosis and the possible relation between the VOCs concentration and CKD stage. This exam could be a new, non-invasive, fast-performing diagnostic technique with real-time results useful for clinical management of CKD. The study was inserted in the projects: “MioMenù: nuova filiera dell’agro-industria e una cucina tracciata natura/benessere- Lazio Region” and “BioSynOL- Oil and Legumes: biodynamic and synergistic crops for naturally fortified foods and innovative products for health and sport – G.O.Tuscany Region”.

Thermoacoustic assessment of hematocrit changes in human forearms* *Project supported by the National Natural Science Foundation of China (Grant Nos. 61701076, 82071940, and 62001075).

Abnormal hematocrit (Hct) is associated with an increased risk of pre-hypertension and all-cause death in general population, and people with a high Hct value are susceptible to arterial cardiovascular disease and venous thromboembolism. In this study, we report for the first time on the ability of thermoacoustic imaging (TAI) for in vivo evaluating Hct changes in human forearms. In vitro blood samples with different Hct values from healthy volunteers (n = 3) were prepared after centrifugation. TAI was performed using these samples in comparison with the direct measurements of conductivity. In vivo TAI was conducted in the forearm of healthy volunteers (n = 7) where Hct changes were produced through a vascular occlusion stimulation over a period of time. The results of in vitro blood samples obtained from the 3 healthy subjects show that the thermoacoustic (TA) signals changes due to the variation of blood conductivity are closely related to the changes in Hct. In addition, the in vivo TA signals obtained from the 7 healthy subjects consistently increase in the artery/muscle and decrease in the vein during venous or arterial occlusion because of the changed Hct value in their forearms. These findings suggest that TAI has the potential to become a new tool for monitoring Hct changes for a variety of pre-clinical and clinical applications.

Mitochondria-DNA copy-number and incident venous thromboembolism among middle-aged women: a population-based cohort study

Venous thromboembolism (VTE) is the third most common cardiovascular disease. Low amount of mitochondrial DNA copy number (mtDNA-CN) has been associated with arterial cardiovascular disease (CVD) and reflects mitochondrial dysfunctions. However, whether mtDNA-CN is associated with VTE has not been determined. To examine the association between mtDNA-CN and incident VTE among middle-aged women. 6917 women aged 50–64 years, followed for 20 years in the Women’s Health In the Lund Area (WHILA) study. DNA samples for mtDNA quantification were available from 2521 women. Quantification of mtDNA-CN was performed using a well-optimized droplet digital PCR method. After exclusions of women with anticoagulant treatment, women living in nursing homes, and women who were diagnosed with cancer, stroke, VTE, or coronary heart disease at baseline, a cohort of 2117 women remained for analysis. Cox regression was used to analyze the relationship between mtDNA-CN and time to VTE (hazard ratio = HR). In total, 87 women were diagnosed with VTE during follow-up, corresponding to an incidence rate of 2.8 per 1000 person-years. Neither crude nor adjusted HR for mtDNA-CN were significantly associated with incident VTE. A sensitivity analysis with inclusion of excluded women did not change the results. MtDNA-CN was not significantly associated with VTE. The present study suggests that mtDNA-CN, reflecting mitochondrial dysfunction, should not be considered a biomarker that plays a major role for developing VTE. However, due to limited study size we may not exclude minor associations.

Crosstalk between cyclophilins and T lymphocytes in coronary artery disease

Cardiovascular diseases and atherosclerosis are currently some of the most widespread diseases of our time. Within cardiovascular disease, coronary artery disease and underlying atherosclerosis were recently linked with systemic and local inflammation. Cyclophilins participate in the initiation and progression of these inflammatory-related diseases. Cyclophilins are released into the extracellular space upon inflammatory stimuli and participate in the pathology of cardiovascular diseases. The cell surface receptor for extracellular cyclophilins, the CD147 receptor, also contributes to coronary artery disease pathogenesis. Nevertheless, the physiological relevance of cyclophilin's family and their receptor in cardiovascular diseases remains unclear. The present study aimed to better understand the role of cyclophilins in cardiovascular artery disease and their relationship with inflammation. Hence, cyclophilins and pro-inflammatory interleukins were measured in the serum of 30 subjects (divided into three groups according to coronary artery disease status: 10 patients with acute coronary syndrome, 10 patients with chronic coronary artery disease, and 10 control volunteers). In addition, cyclophilin levels and CD147 receptor expression were measured in T lymphocytes purified from these subjects. Cyclophilin A, B, and C, pro-inflammatory interleukins, and CD147 membrane expression were significantly elevated in patients with coronary artery disease.

A Short Note on Arterial cardiovascular disease

Arterial high vital sign (AH) is taken into consideration as a public condition owing to its high prevalence and difficult management and it’s in addition depicted joined of the foremost very important risk factors for vas diseases. Thisstudy aimed to figure out the prevalence of AH, nevertheless as characteristics related to the presence of its hereditary facet among individuals aging between twenty four and seventy years from the urban region of town city in Democratic and well-liked Republic of African nation. Pulmonary high vital sign could also be a heavy condition that gets worse over time, but treatments can facilitate your symptoms so you will be able to live higher with the ill health. It ought to take some coming up with, but immeasurable people that have it notice ways that during which to undertake to all or any the things they love, as they did before they were diagnosed. Having internal organ vessel high vital sign (PAH) means that you have high level inside the arteries that go from your heart to your lungs. It’s very completely different from having regular high level. With PAH, the little arteriesin your lungs become slim or blocked. It's a lot ofsturdy for blood to flow through them that raises the pressure in your lungs. Your heart ought to work a lot of sturdy to pump blood through those arteries, and once a brief whereas the center muscle gets weak. Eventually, it'll lead to cardiovascular disease. Transversal study from January 2010 to January 2011, population- primarily based study, of 620 participants with sampling. For classification of AH, criteria enclosed vitalsign (BP) ≥ 140/90 mmHg or current use of medication medicine. People were interviewed with standardized questionnaires antecedently tested.

Visualization of platelet recruitment to tumor lesions using highly sensitive and stable radioiodine studded gold nanoprobes.

In vivo imaging of platelets will provide a better understanding of their critical roles in arterial cardiovascular disease, hemostasis, inflammation, and cancer. Here, we demonstrate the feasibility of using radioiodine studded gold nanoprobes (RIS-GNPs) as a platelet tracker for nuclear medicine imaging in tumor-bearing mice using positron emission tomography and computed tomography (PET/CT). Platelet labeling with RIS-GNPs did not alter the platelet functions, such as cellular proliferation and aggregation. PET/CT imaging clearly revealed the migration of platelets into tumor sites at 1 to 5 h post-transfer of RIS-GNP-labeled platelets, which was consistent with the biodistribution data. Our findings suggest that the imaging approach using RIS-GNPs makes it feasible to visualize the biological behavior of platelets in living organisms with cancer.

Impact of arterial stiffness on diastolic function and outcomes of heart failure in patients presenting with acute myocardial infarction

Abstract Background Relation of arterial stiffness and cardiovascular disease is well-known. However, there is no data on association between diastolic function and brachial-ankle pulse wave velocity (baPWV) and influence on heart failure outcomes in patients with acute myocardial infarction (AMI). Methods Among patients presenting with AMI, all subjects underwent baPWV and echocardiography were recruited. Diastolic function was categorized by 2016 guideline of ASE/EACVI left ventricular diastolic function. Heart failure outcomes were defined 1) hospitalization for heart failure, 2) cardiac death and 3) sudden cardiac arrest. Results Totally 1,016 subjects were enrolled (FU duration; 3.5±2.0 years, mean age 65±13, predominant male 71.3% and STEMI 40.8%) from 2012 to 2015 in the our University Hospital. Elderly, female, low BMI, higher PWV, HTN, DM and stroke were associated with higher baPWV. Increased arterial stiffness (defined as baPWV ≥1700) had higher prevalence of diastolic dysfunction compared with baPWV &amp;lt;1700 (98.3% vs 86.2%). HF outcomes of 69 events were identified (HF; n=48, cardiac death; n=16, sudden cardiac arrest; n=2, death d/t HF; n=3). In the multivariate analysis, baPWV ≥1700, HTN and low BMI (23 kg/m2) were independent predictors for HF outcomes after adjustment with age, LVEF, DM and stroke (Table 1). Furthermore, KM curve showed that increased arterial stiffness was associated with higher prevalence of diastolic dysfunction and poor outcomes of heart failure (Figure 1). Conclusions In patients with AMI, arterial stiffness was associated with higher prevalence of diastolic dysfunction an independent predictor for heart failure hospitalization and cardiac death. Figure 1. Diastolic dysfunction and HF in AMI Funding Acknowledgement Type of funding source: None