Cerebrovascular Atherosclerosis Research Articles

JAK2 V617F Mutation and Large Cerebral Artery Disease in Patients with Myeloproliferative Neoplasms.

The aim of the present study was to clarify the association between the Janus kinase 2 (JAK2) V617F mutation and large cerebral artery disease (LCAD) in patients with myeloproliferative neoplasms (MPNs). We retrospectively analysed patients diagnosed with MPNs between June 1992 and June 2022 who underwent brain magnetic resonance imaging. LCAD was defined as extracranial or intracranial large artery stenosis (≥ 50%) or occlusion on magnetic resonance angiography. A total of 86 patients (47 males; median age, 69 years old) were enrolled in this study. JAK2 V617F mutation was detected in 63 (73.3%) patients and LCAD in 35 (40.7%) patients. Univariate analysis showed that history of ischaemic stroke (LCAD, 62.9% vs. non-LCAD, 11.8%; P＜0.001), JAK2 V617F mutation (91.4% vs. 60.8%, P=0.002), and age ≥ 60 years (85.7% vs. 60.8%, P=0.016) were significantly associated with LCAD. Multiple logistic regression analysis showed that, in addition to ischaemic stroke, age ≥ 60 years and diabetes mellitus, JAK2 V617F mutation (odds ratio 29.2, 95% confidence interval 1.2-709.8, P=0.038) was independently associated with LCAD. LCAD was frequently observed in the intracranial carotid (14/35, 40.0%) and middle cerebral (13/35, 37.1%) arteries. This study revealed a significant association between the JAK2 V617F mutation and LCAD in patients with MPNs. This suggests that the JAK2 V617F mutation may promote cerebrovascular atherosclerosis and could be very important in determining therapeutic strategies for patients with not only JAK2 V617F-mutated MPNs but also LCAD-related stroke.

Cheese consumption on atherosclerosis, atherosclerotic cardiovascular diseases and its complications: A two-sample Mendelian randomization study

Background and aimEvidence from prospective cohort studies has revealed an inverse association between cheese consumption and the development of atherosclerosis (AS), atherosclerotic cardiovascular diseases (ASCVD), and their complications. However, it remains unclear whether this observed association is influenced by potential confounding factors that may arise during the long-term development process of AS, ASCVD, and its complications. Therefore, to further clarify the causal relationship between cheese consumption and AS, ASCVD, and its complications, we conducted a two-sample Mendelian randomization (MR) analysis to explore the causal association between cheese intake and the aforementioned health outcomes. Methods and resultsWe employed a two-sample MR analysis based on publicly available genome-wide association studies (GWAS) to infer the causal relationship, with no overlap between their participating populations. The effect estimates were calculated using the random-effects inverse-variance-weighted method. Sensitivity analyses were conducted using Cochran's Q statistic, funnel plot, leave-one-out analysis, and MR-Egger intercept tests. The genetically predicted cheese intake was found to be associated with lower risks of coronary AS (odds ratio [OR] = 0.72, 95 % confidence interval [CI] 0.59–0.88, P = 0.001), peripheral vascular AS (OR = 0.56, 95 % CI 0.37–0.84, P = 0.006), other vascular AS (OR = 0.66, 95 % CI 0.44–0.99, P = 0.043), coronary artery disease (OR = 0.64, 95 % CI 0.56–0.74, P = 1.57e-09), angina pectoris (OR = 0.70, 95 % CI 0.58–0.84, P = 4.92e-05), myocardial infarction (OR = 0.63, 95 % CI 0.52–0.77, P = 3.56e-06), heart failure (OR = 0.62, 0.49–0.79, P = 1.20e-04), total ischemic stroke (OR = 0.76, 95 % CI 0.63–0.91, P = 0.003), peripheral artery disease (OR = 0.64, 95 % CI 0.43–0.95, P = 0.028), and cognitive impairment (OR = 0.65, 95 % CI 0.56–0.74, P = 3.40e-10). However, no associations were observed for cerebrovascular AS, arrhythmia, cardiac death, ischemic stroke (large artery AS), ischemic stroke (small vessel), ischemic stroke (cardioembolic), and transient ischemic attack. ConclusionThis two-sample MR analysis reveals a causally inverse association between cheese intake and multi-vascular AS (including coronary AS, peripheral vascular AS, and other vascular AS), as well as multiple types of ASCVD and its complications (such as coronary artery disease, angina pectoris, myocardial infarction, heart failure, total ischemic stroke, and peripheral artery disease). The findings from this study may lay a stronger theoretical foundation and present new opportunities for the dietary management of future atherosclerotic cardiovascular diseases.

N6-methyladenosine (m6A) reader YTHDF2 accelerates endothelial cells ferroptosis in cerebrovascular atherosclerosis.

Cerebrovascular diseases have extreme high mortality and disability rate worldwide, and endothelial cells injury-induced atherosclerosis acts as the main cause of cerebrovascular disease. Ferroptosis is a novel type of programmed cell death depending on iron-lipid peroxidation. Recent studies have revealed that ferroptosis might promote the progression of atherosclerosis (AS). Here, this research aimed to investigate the function and its profound mechanism on vascular endothelial cells in atherosclerosis. Research results revealed that YTHDF2 expression up-regulated in ox-LDL treated human umbilical vein endothelial cells (HUVECs). Gain/loss functional assays indicated that YTHDF2 overexpression inhibited HUVECs' proliferation and accelerated the ferroptosis in ox-LDL-administered HUVECs. Meanwhile, YTHDF2 silencing promoted cell proliferation and reduced the ferroptosis in ox-LDL-administered HUVECs. Mechanistically, in silico analysis suggested that there were potential m6A-modified sites on SLC7A11 mRNA, and YTHDF2 could bind with SLC7A11 mRNA via m6A-dependent manner. YTHDF2 promoted the degradation of SLC7A11 mRNA, thereby reducing its mRNA stability. Taken together, these findings suggest that YTHDF2 accelerates endothelial cells ferroptosis in cerebrovascular atherosclerosis, helping us enhance our comprehension on cerebrovascular disease pathological physiology.

Proniosomes Nanoparticle for the Treatment of Peripheral Arterial Disease.

The common symptom of systemic atherosclerosis is peripheral arterial disease(PAD), which occurs when the artery lumen in the lower extremities gradually becomes blocked by atherosclerotic plaque. The most frequent symptom of lower extremity PAD, called "vascular claudication," which is pain experienced when walking. Partial or total blockage of the peripheral arteries in the upper and lower limbs is called PAD. The danger of death from concurrent coronary artery and cerebrovascular atherosclerosis outweighs the risk of amputation. However, niosomes have issues with fusion, aggregation, leakage, vesicle sedimentation, and difficulty in sterilizing. A more recent strategy known as pro-vesicular carriers was used to solve these issues. The formulations in Proniosomes are dry and anhydrous, protected with a non-ionic surfactant that serves as a carrier when combined with water. Formulation prepared by organic solvent, surfactant, cholesterol, other components and hydration medium. Coacervation Phase separation Technique used for proniosome Nanoparticle. Box Bhenken Design is used for optimization batches. In this context, we shall discuss the development of Proniosome for the treatment of peripheral arterial diseases. From here, we know that proniosome nanoparticles is pro vesicular system good characteristics and effectiveness for treating peripheral arterial diseases. Proniosomes may be created using various techniques, which may impact how they develop along with the drug's characteristics. They increase the drug's stability while being delivered while being entrapped. They don't need particular conditions for handling, protection, storage, or industrial manufacturing.

One-step integrated coronary–carotid–cerebral computed tomography angiography to evaluate cardiovascular and cerebrovascular atherosclerosis

PurposeThis study aims to develop a low-radiation dose, one-step integrated coronary–carotid–cerebral computed tomography angiography (ICCC-CTA) technique to analyze the relationship between cardiovascular and cerebrovascular atherosclerosis and evaluate the risk factors of plaque to provide an early-stage treatment to patients and reduce vascular events.MethodsA total of 300 consecutive asymptomatic patients with cardiovascular risk factors who underwent ICCC-CTA were enrolled in this prospective study. The association between coronary and carotid-cerebrovascular atherosclerosis was assessed. The primary cardiovascular risk factors for various plaque types in cardiovascular or cerebrovascular disease were evaluated using multivariate analysis.ResultsAmong 300 patients, 189 (63%) had plaques in their coronary and cerebral arteries. The presence of calcified and mixed plaques in the carotid-cerebral and coronary arteries was strongly correlated (χ2 = 20.71, P = 0.001; χ2 = 8.96, P = 0.003, respectively). Multivariate logistic regression analysis revealed that abnormal blood glucose [OR = 1.44, 95% CI 0.12–0.62, P = 0.01] and abnormal total cholesterol [OR = 1.28, 95% CI 0.07–0.46, P = 0.01] are risk factors in all the models in the coronary artery, non-calcified plaque group. Abnormal blood glucose [OR = 1.43, 95% CI 0.11–0.61, P = 0.01] and abnormal systolic blood pressure [OR = 1.02, 95% CI 0.01–0.04, P = 0.02] are risk factors in all the models in the coronary artery calcified plaque group. Abnormal blood glucose level [OR = 1.44, 95% CI = 0.12–0.62, P = 0.01] was only a risk factor in the non-calcified plaque carotid–cerebral artery group.ConclusionsWe confirm that elevated blood glucose and total cholesterol levels are associated with coronary and carotid-cerebrovascular plaques using the novel one-step low dose cerebral-carotid-cardiac CTA technique. These findings will provide insights for further studies focusing on developing low-radiation dose one-step ICCC-CTA to screen cardiovascular/cerebrovascular plaques in general population with cardiovascular risk factors.Advances in knowledgeWe developed a low–radiation dose, one-step ICCC-CTA technique to detect cardiovascular and cerebrovascular atherosclerosis. We evaluated the risk factors for plaque burden for the early treatment and reduction of vascular events. These findings supported the development of low–radiation dose one-step ICCC-CTA to screen for cardiovascular/cerebrovascular disease in general population with cardiovascular risk factors.

Protective effects of brain and muscle ARNT-like gene 1 on oxidized low-density lipoprotein-induced human brain microvascular endothelial cell injury by alleviating ferroptosis.

Ferroptosis plays an important role in atherosclerotic cerebrovascular diseases. The brain and muscle ARNT-like gene 1 (BMAL1) is an important mediator in the progression of cerebrovascular diseases. However, whether BMAL1 regulates ferroptosis in atherosclerotic cerebrovascular diseases remains obscure. Here, human brain microvascular endothelial cells (HBMECs) were exposed to oxidized low-density lipoprotein (ox-LDL) to imitate cerebrovascular atherosclerosis. It was found that ox-LDL treatment induced ferroptosis events and reduced BMAL1 expression in HBMECs, which could be reversed by ferroptosis inhibitor ferrostatin-1. Furthermore, BMAL1 overexpression markedly mitigated ox-LDL-induced ferroptosis events and cell damage. Moreover, BMAL1 overexpression significantly promoted nuclear factor erythroid 2-related factor 2 (Nrf2) expression in HBMECs under ox-LDL conditions. And, Nrf2 silencing attenuated the protective effects of BMAL1 on ox-LDL-stimulated HBMEC damage and ferroptosis. Altogether, our findings delineate the cerebrovascular protective role of BMAL1/Nrf2 by antagonizing ferroptosis in response to ox-LDL stimulation and provide novel perspectives for therapeutic strategies for atherosclerotic cerebrovascular diseases.

Large epidural hematoma in a child with progeria syndrome complicated by posterior cerebral artery stroke: A case report

Hutchinson-Gilford progeria Syndrome (HGPS) is a genetic disease in which patients manifest with a prematurely aged appearance and cardiovascular disease due to atherosclerosis. A 13-year-old male patient with HGPS was admitted with a history of trauma in the right temporoparietal region of the head, evolving with headache, worsening of previous left hemiparesis and right blepharoptosis. Head tomography showed a large epidural hematoma at the right parieto-occiptal convexity. A craniotomy was performed for drainage of the hematoma. After good evolution, the control tomography showed effective drainage of the hematoma with a new ischemia in the right posterior cerebral artery. In this case possibly the syndrome-related cerebrovascular atherosclerosis contributed to the formation of hematoma and postoperative ischemia.

Characteristics of Rheoencephalography and some Associated Factors on Menopausal Women.

The significant drop in estrogen levels during menopause increases the cardiovascular risks, one of which is cerebrovascular atherosclerosis. Research on rheoencephalography (REG) parameters for the early diagnosis of cerebrovascular atherosclerotic lesions is of great interest to scientists because of its ease of implementation, low cost, and non-invasiveness. The objectives of study are to evaluate the vascular tone, cerebral circulation flow in each hemisphere of the brain of menopausal women, and some associated factors through waveform characteristics and parameters in REG. A controlled cross-sectional descriptive study was conducted on a group of patients including 80 menopausal women and a control group of 46 menstruating women. All patients were measured REG in the frontal-occipital leads by VasoScreen 5000 impedance REG meter. In menopausal women, the percentage of sharp waves, the percentage of clear side waves, and the average REG were all lower than in the control group (p<0.01). The mean conduction time and mean slope ratio was lower than the control group (p<0.001). The mean peak time was higher than the control group (p<0.01). The mean elasticity index (alpha/T) was higher than the control group (p<0.001). Menopausal women have increased vascular tone, the highest in the group of women 50-60 years old, menopause <5 years, having a habit of eating red meat; and decreased blood flow intensity, the highest in the group of women <50 years old. However, the difference was statistically significant only in the left hemisphere (p<0.05). Vascular hypertonia in menopausal women with central obesity was higher than in the non-obese group in both hemispheres (p<0.05). In conclusion, menopausal women had atherosclerosis in both hemispheres of the brain, which was clearly shown in the rate of increased vascular tone. Central obesity may increase the risk of vascular hypertonia 3.75 times in the right and 5.44 times in the left hemisphere.

Monitoring antiplatelet therapy: where are we now?

Single antiplatelet therapy represents the cornerstone of thrombosis prevention in atherosclerotic cardiovascular disease. Dual antiplatelet therapy (DAPT), consisting of aspirin plus a P2Y 12 inhibitor, is the standard of care for patients with acute coronary syndrome or undergoing both coronary and peripheral percutaneous interventions. Recent data suggest the efficacy of DAPT also after minor stroke. In this setting, a large body of evidence has documented that genetic and acquired patients' characteristics may affect the magnitude of platelet inhibition induced by antiplatelet agents. The implementation of tools allowing the identification and prediction of platelet inhibition has recently been shown to improve outcomes, leading to an optimal balance between antithrombotic efficacy and bleeding risk. We are therefore clearly moving towards tailored antiplatelet therapy. The aim of this paper is to summarize the available evidence on the evaluation of platelet inhibition in patients with coronary, peripheral, or cerebrovascular atherosclerosis. We will here focus on antiplatelet therapy based on both aspirin and P2Y 12 inhibitors. In addition, we provide practical insights into the clinical settings in which it appears reasonable to implement antiplatelet therapy monitoring.

Novel predictors and a predictive model of cerebrovascular atherosclerotic ischemic stroke based on clinical databases

ABSTRACT Background and Purpose Early identification of cerebrovascular atherosclerotic ischemic stroke is necessary for accurate treatment and clinical research. Aims To identify novel predictors and build a predictive model of ischemic strokes due to cerebrovascular atherosclerosis. Method MIMIC-IV database was used to search for clinical data of patients with ischemic stroke. Included patients were divided into two groups according to their etiologies. Univariate and multivariate logistic regressions were used to build the predictive model, and the model reliability parameters were calculated. The cut-off value for the model was selected according to the Youden index. Clinical data from the Neurovascular Center of Changhai Hospital were used to verify the predictive model. Results Logistical regressions showed a positive correlation between advanced age, peripheral atherosclerosis, history of transient ischemia, and the diagnosis of ischemic strokes due to cerebrovascular atherosclerosis. The history of atrial fibrillation, levels of the National Institutes of Health Stroke Scale, serum potassium, and activated partial thromboplastin time were negatively correlated to the diagnosis of cerebrovascular atherosclerotic ischemic stroke. The predictive model was constructed from logistic regression results, and the area under the curve was 0.764. The cut-off value for the model was set at 0.089 to achieve the highest Youden index, with sensitivity and specificity of 75.9% and 64.1%. Clinical verification of the model revealed that the sensitivity and specificity of the model were 52.5% and 93.0% respectively. Conclusion The efficacy of the predictive model was acceptable as an aid in predicting cerebrovascular atherosclerotic ischemic stroke.

Middle meningeal artery embolization for treatment of chronic subdural hematoma.

Chronic subdural hematoma (cSDH) is caused by rupture of bridging intracranial veins located in the subdural space. Predominantly, cSDH is adisease of older adults and other predisposing risk factors include minor head trauma, cerebral atrophy, antiplatelet and anticoagulation therapies, arterial hypertension, cerebrovascular atherosclerosis, diabetes mellitus, cerebrospinal fluid loss, and excessive alcohol consumption. The incidence of cSDH is rising worldwide due to an aging population and the increased use of anticoagulant or antiplatelet medications. Clinical manifestations are varied, with altered mental status and focal neurologic deficits among the most common. Treatment strategies depend on the symptomatology and extent of hematoma. In general, conservative treatment is sought for patients who are asymptomatic or have only mild symptoms, whereas symptomatic patients are often treated surgically. However, the recurrence rate of cSDH may be as high as 30%. In recent years, middle meningeal artery embolization has emerged as acomplementary option to surgery aimed at decreasing the recurrence rate after excision as well as an alternative therapeutic approach to surgical therapy in certain circumstances. Embolization of the middle meningeal artery appears to be a promising treatment for patients with cSDH, both before and after surgical excision.

Transcranial Doppler ultrasound: Clinical applications from neurological to cardiological setting.

Transcranial Doppler (TCD) ultrasonography is a rapid, noninvasive, real-time, and low-cost imaging technique. It is performed with a low-frequency (2 MHz) probe in order to evaluate the cerebral blood flow (CBF) and its pathological alterations, through specific acoustic windows. In the recent years, TCD use has been expanded across many clinical settings. Actually, the most widespread indication for TCD exam is represented by the diagnosis of paradoxical embolism, due to patent foramen ovale, in young patients with cryptogenic stroke. In addition, TCD has also found useful applications in neurological care setting, including the following: cerebral vasospasm following acute subarachnoid hemorrhage, brain trauma, cerebrovascular atherosclerosis, and evaluation of CBF and cerebral autoregulation after an ischemic stroke event. The present review aimed to describe the most recent evidences of TCD utilization from neurological to cardiological setting.

MicroRNA as significant biomarkers of cerebrovascular atherosclerosis

Introduction. Carotid atherosclerosis (CA) is one of the main causes of ischaemic stroke. MicroRNA is a relatively new group of biomarkers, some of which are associated with atherogenesis.&#x0D; The aim of the study was to evaluate the expression of several microRNAs in patients with cerebrovascular disease, depending on the severity of CA.&#x0D; Materials and methods. The study included 50 people (median age 66 [61; 71] years, 58% men) with cerebrovascular disease secondary to CA. The patients were divided into two groups: 16 patients (32%) had 70% internal carotid artery (ICA) stenosis (main group), while the remaining 34 patients had 70% stenosis and formed the comparison group. Expression of the following microRNAs was measured: miR-126-5p, miR-126-3p, miR-29-5p, miR-29-3p, miR-33a-5p, miR-33a-3p, miR-21-5p and miR-21-3p.&#x0D; Results. Compared to the comparison group, patients with a high degree of CA had reduced expression of miR-126-5p/-3p (4.8 and 5.9 vs. 8.5 and 7.6, respectively; p 0.001) and miR-29-3p (7.6 vs. 10.3; p 0.001), while miR-33a-5p expression was elevated (46.3 vs. 40.0; p 0.05). Cluster analysis confirmed typical expression patterns of these microRNAs in patients with varying degrees of ICA stenosis. Significant negative correlations were also found between the degree of stenosis and expression of miR-126-5p ( = 0.83; р 0.05), miR-126-3p ( = 0.64; р 0.05) and miR-29-3p ( = 0.62; р 0.05).&#x0D; Conclusion. Based on an analysis of patients with cerebral atherosclerosis, the studied microRNAs can be divided into proatherogenic (miR-33a-5p/-3p) and atheroprotective (miR-126-5p/-3p, miR-29-3p, and mir-21-5p/-3p). These biomarkers can be diagnostically useful in predicting the risk of both CA progression and acute cerebrovascular accidents, yet prospective studies are required.

Intracranial Hemorrhage in the TST Trial.

Although statins are effective in secondary prevention of ischemic stroke, they are also associated with an increase risk of intracranial hemorrhage (ICH) in certain conditions. In the TST trial (Treat Stroke to Target), we prespecified an exploration of the predictors of incident ICH. Patients with ischemic stroke in the previous 3 months or transient ischemic attack within the previous 15 days and evidence of cerebrovascular or coronary artery atherosclerosis were randomly assigned in a 1:1 ratio to a target LDL (low-density lipoprotein) cholesterol of <70 mg/dL or 100±10 mg/dL, using statin or ezetimibe. Among 2860 patients enrolled, 31 incident ICH occurred over a median follow-up of 3 years (18 and 13 in the lower and higher target group, 3.21/1000 patient-years [95% CI, 2.38-4.04] and 2.32/1000 patient-years [95% CI, 1.61-3.03], respectively). While there were no baseline predictors of ICH, uncontrolled hypertension (HR, 2.51 [95% CI, 1.01-6.31], P=0.041) and being on anticoagulant (HR, 2.36 [95% CI, 1.00-5.62], P=0.047)] during the trial were significant predictors. On-treatment low LDL cholesterol was not a predictor of ICH. Targeting an LDL cholesterol of <70 mg/dL compared with 100±10 mg/dL in patients with atherosclerotic ischemic stroke nonsignificantly increased the risk of ICH. Incident ICHs were not associated with low LDL cholesterol. Uncontrolled hypertension and anticoagulant therapy were associated with ICH which has important clinical implications. Registration: URL: https://www.clinicaltrials.gov; Unique identifier: NCT01252875; EUDRACT identifier: 2009-A01280-57.

Factors associated with the elasticity of asymptomatic carotid plaques in hypertension Tibetan population.

Hypertension is a major risk factor for coronary, cerebrovascular, and the greatest cause of stroke. Half of stroke events are the result of cerebrovascular atherosclerosis, including carotid plaques. It is of major importance to detect which plaques are vulnerable, even though not yet ruptured. Due to the particularity of the Tibetan population, this study evaluated the elasticity of asymptomatic carotid plaques in Tibetan hypertension patients using shear wave elastography (SWE) and explored associated risk factors. A total of 91 Tibetan patients were divided into normotension, grade 1-2, and grade 3 hypertension groups based on the level of blood pressure. All subjects underwent common duplex ultrasonic examination and SWE evaluation for carotid plaques. Elasticity of carotid plaque was assessed by Young's modulus. The final analysis included 126 plaques as representative plaques according to Total Plaque Risk Score. The mean and maximum Young's modulus in the grade 3 hypertension group were smaller, and more plaques with irregularity surface compared with the other two groups (p < 0.05). Multivariate regression analysis showed drinking butter tea (β = -0.220, p = 0.009; β = -0.240, p = 0.004, respectively) was the independent factor associated with mean and maximum Young's modulus. SWE is feasible for measurement of Young's modulus of carotid plaques. Plaques in the grade 3 hypertension group were more likely to become vulnerable ones. In hypertension Tibetan patients, drinking butter tea was an independent factor associated with mean and maximum Young's modulus of asymptomatic carotid plaque.

Arterial Elasticity: Linking of Cardiovascular Risks, Pulse Pressure, Dementia, Aging, and Drug Targeting

Cerebrovascular atherosclerosis, and several other cardiovascular (or "inflamm-aging" type) diseases, are more frequent and advanced in subjects with Alzheimer's disease compared with normal aging. In addition, the observed pathogenic link to dementia (and its associated cerebral microvascular damage) is readily explained by alterations of arterial elasticity. A therapeutic strategy to delay dementia could be based upon localized drug delivery, using lipid nanocarriers (i.e., biobased nanoemulsion technology), targeted toward a major serum amyloid A (SAA) receptor involved in certain proinflammatory, SAA-mediated, cell signaling events. Moreover, by incorporating drug molecules into such lipid nanocarriers, one can obtain a "combination therapeutic" capable of targeting simultaneously (via cell-surface scavenger receptors) a variety of cell types, each potentially implicated in Alzheimer's disease and/or dementia, for focused drug delivery in vivo.

Common Polymorphisms in the RGMa Promoter Are Associated With Cerebrovascular Atherosclerosis Burden in Chinese Han Patients With Acute Ischemic Cerebrovascular Accident.

Repulsive guidance molecule a (RGMa) plays a vital role in the progression of numerous inflammatory diseases. However, whether it participates in atherosclerosis development is not known. Here, we explored the influence of RGMa in atherogenesis by investigating whether an association exists between functional polymorphisms in the RGMa promoter and cerebrovascular atherosclerosis burden (CAB) in Chinese Han patients diagnosed with acute ischemic cerebrovascular accident. To this end, we conducted a genetic association study on 201 patients with prior diagnoses of acute ischemic stroke or transient ischemic attack recruited from our hospital. After admission, we conducted three targeted single-nucleotide polymorphisms (SNPs) genotyping and evaluated CAB by computed tomography angiography. We used logistic regression modeling to analyze genetic associations. Functional polymorphism analysis indicated an independent association between the rs725458 T allele and increased CAB in patients with acute ischemic cerebrovascular accident [adjusted odds ratio (OR) = 1.66, 95% confidence interval (CI) = 1.01–2.74, P = 0.046]. In contrast, an association between the rs4778099 AA genotype and decreased CAB (adjusted OR = 0.10, 95% CI = 0.01–0.77, P = 0.027) was found. Our Gene Expression Omnibus analysis revealed lower RGMa levels in the atherosclerotic aortas and in the macrophages isolated from plaques than that in the normal aortas and macrophages from normal tissue, respectively. In conclusion, the relationship between RGMa and cerebrovascular atherosclerosis suggests that RGMa has a potential vasoprotective effect. The two identified functional SNPs (rs725458 and rs4778099) we identified in the RGMa promoter are associated with CAB in patients diagnosed with acute ischemic cerebrovascular accident. These findings offer a promising research direction for RGMa-related translational studies on atherosclerosis.

Changes in the phenotype of vascular wall cells in cerebrovascular atherosclerosis in patients with ischemic stroke

Changes in the phenotype of vascular wall cells in cerebrovascular atherosclerosis in patients with ischemic stroke

Sleep apnoea in the elderly: a great challenge for the future.

Due in part to overall improvements in health, the population of elderly individuals is increasing rapidly. Similarly, obstructive sleep apnoea (OSA) is both gaining increased recognition and also increasing due to the worldwide obesity epidemic. The overlap of OSA and ageing is large, but there is strong plausibility for causation in both directions: OSA is associated with pathological processes that may accelerate ageing and ageing-related processes; ageing may cause physical and neurological changes that predispose to obstructive (and central) apnoea. In addition, the common symptoms (e.g. excessive daytime sleepiness, and defects in memory and cognition), possible physiological consequences of OSA (e.g. accelerated cardiovascular and cerebrovascular atherosclerosis), and changes in metabolic and inflammatory markers overlap with the symptoms and associated conditions seen in ageing. There is also the possibility of synergy in the effects of these symptoms and conditions on quality of life, as well as a need to separate treatable consequences of OSA from age-related complaints. Taken together, the aforementioned considerations make it essential to review the interaction of OSA and ageing, both proven and suspected. The present review examines some aspects of what is known and points to the need for further investigation of the relationships, given the large number of potentially affected subjects.

Клинический портрет пациента с влажной формой возрастной макулярной дегенерации на этапе выявления заболевания

Purpose. To study the phenotypic features and systemic correlations at the stage of detection of wet age-related macular degeneration (AMD). Material and methods. A prospective comprehensive clinical study included 197 patients with newly diagnosed wet AMD (82 (41.6%) males and 115 (58.4%) females). All patients underwent standard ophthalmological examination and a survey based on a specially developed questionnaire. Results. The average age of wet AMD manifestation varied widely (from 42 to 95 years), averaging 69.9±7.1 years. There was no statistically significant difference in the timing of the onset of the disease in males and females (67.91±8.2 and 70.22±6.9 years, respectively, p&gt;0.05). Light colors of the iris (blue and gray) were found in 108 (54.8%) and 57 (28.9%) cases, respectively. In all cases, the development of wet AMD proceeded asymmetrically with the primary lesion of one of the eyes. The incidence of the disease in the right and left eyes was almost the same (49.7% and 50.3%, respectively). In all age groups, the body mass index exceeded normal values. Arterial hypertension was observed in most patients with wet AMD - in 91.9% of cases, coronary heart disease – in 10.2% of patients. The prevalence of diabetes mellitus (mainly type 2) in patients with wet AMD was 5.6%. Among the cerebrovascular disorders, cerebral atherosclerosis and dyscirculatory encephalopathy prevailed, accounting for 11.4%. Conclusion. The data obtained indicate a variety of phenotypic correlations of wet AMD and the need to study them to address the issues of early diagnosis and the formation of appropriate risk groups. Key words: age-related macular degeneration, cardiovascular pathology.