Mean Diameter Of Artery Research Articles

Pulmonary Artery Size in Interstitial Lung Disease and Pulmonary Hypertension: Association with Interstitial Lung Disease Severity and Diagnostic Utility.

PurposeIt is postulated that ILD causes PA dilatation independent of the presence of pulmonary hypertension (PH), so the use of PA size to screen for PH is not recommended. The aims of this study were to investigate the association of PA size with the presence and severity of ILD and to assess the diagnostic accuracy of PA size for detecting PH.MethodsIncident patients referred to a tertiary PH centre underwent baseline thoracic CT, MRI and right heart catheterisation (RHC). Pulmonary artery diameter was measured on CT pulmonary angiography and pulmonary arterial areas on MRI. A thoracic radiologist scored the severity of ILD on CT from 0 to 4, 0 = absent, 1 = 1–25%, 2 = 26–50%, 3 = 51–75%, and 4 = 76–100% extent of involvement. Receiver operating characteristic analysis and linear regression were employed to assess diagnostic accuracy and independent associations of PA size.Results110 had suspected PH due to ILD (age 65 years (SD 13), M:F 37:73) and 379 had suspected PH without ILD (age 64 years (SD 13), M:F 161:218). CT derived main PA diameter was accurate for detection of PH in patients both with and without ILD - AUC 0.873, p =< 0.001, and AUC 0.835, p =< 0.001, respectively, as was MRI diastolic PA area, AUC 0.897, p =< 0.001, and AUC 0.857, p =< 0.001, respectively Significant correlations were identified between mean pulmonary arterial pressure (mPAP) and PA diameter in ILD (r = 0.608, p < 0.001), and non-ILD cohort (r = 0.426, p < 0.001). PA size was independently associated with mPAP (p < 0.001) and BSA (p = 0.001), but not with forced vital capacity % predicted (p = 0.597), Transfer factor of the lungs for carbon monoxide (TLCO) % predicted (p = 0.321) or the presence of ILD on CT (p = 0.905). The severity of ILD was not associated with pulmonary artery dilatation (r = 0.071, p = 0.459).ConclusionsPulmonary arterial pressure elevation leads to pulmonary arterial dilation, which is not independently influenced by the presence or severity of ILD measured by FVC, TLCO, or disease severity on CT. Pulmonary arterial diameter has diagnostic value in patients with or without ILD and suspected PH.

Renal artery anatomy assessed by quantitative analysis of selective renal angiography in 1,000 patients with hypertension.

With increasing attention to renovascular causes and targets for hypertension there arises a critical need for more detailed knowledge of renal arterial anatomy. However, a standardised nomenclature is lacking. The present study sought to develop a standardised nomenclature for renal anatomy considering the complexity and variation of the renal arterial tree and to assess the applicability of the nomenclature. One thousand hypertensive patients underwent invasive selective renal artery angiography in nine centres. Further, renovasography was performed in 249 healthy swine as a surrogate for normotensive anatomy. Anatomical parameters were assessed by quantitative vascular analysis. Patients' mean blood pressure was 168/90±26/17 mmHg. The right main renal artery was longer than the left (41±15 mm vs. 35±13 mm, p<0.001), but the left had a greater diameter (5.4±1.2 vs. 5.2±1.2 mm, p<0.001). Accessory renal arteries and renal artery disease were documented in 22% and 9% of the patients, respectively. Other than exhibiting a longer left main renal artery in uncontrolled hypertensives (+2.7 mm, p=0.034) there was no anatomical difference between patients with controlled and uncontrolled hypertension. Main renal artery mean diameter was smaller in patients with impaired kidney function (GFR <90 ml/min, left -0.5 mm, right -0.4 mm, both p<0.001). Renal arterial anatomy differs between sides but shows no difference between patients with and without blood pressure control. Impaired GFR was associated with small main renal artery diameter.

Capillaroscopic Findings in Primary Fibromyalgia.

Although Raynaud's Phenomenon (RP) is observed in a significant proportion of patients with primary fibromyalgia, the available data on capillaroscopic findings in primary fibromyalgia are scarce. The purpose of the study was to assess the capillaroscopic pattern in patients with primary fibromyalgia. 26 patients with primary fibromyalgia (25 women and 1 man) were included in the study. Mean age was 55±10 years. As control groups were examined 31 patients with primary RP and 35 healthy volunteers. Capillaroscopic examination was performed with a videocapillaroscope Videocap 3.0 (DS Medica), magnification 200x with analysis of the main capillaroscopic parameters as follows: capillary distribution, shape, mean capillary diameters and length, mean capillary density, visibility of the subpapillary plexus; presence of avascular areas, microhaemorrhages and neoangiogenic capillaries. Symptoms of RP were observed in 65% (17/26) of the cases with primary fibromyalgia. At capillaroscopic examination, the most frequent finding in patients with primary fibromyalgia was the presence of capillary dilation in 85% (22/26) of the patients - both in cases with and without RP. However, the mean arterial and venous capillary diameters were significantly higher in the subgroup of fibromyalgia patients with clinical symptoms of RP. Of note, microvascular abnormalities characteristic of connective tissue diseases could not be observed in primary fibromyalgia patients. Analogous changes - presence of dilated capillaries - were found in 96.6% (29/30) of patients with primary RP. In our study, the most frequent capillaroscopic finding in patients with primary fibromyalgia was the presence of dilated capillary loops analogous to primary RP. Capillaroscopic signs suggestive of connective tissue disease could not be found in primary fibromyalgia patients.

Blood Pressure and Vascular Function in Hypertensive Individuals: Partitioning cause and effect

IntroductionVascular dysfunction is a hallmark of hypertension and contributes to an increased risk of cardiovascular disease. Pharmacological interventions to treat hypertension generally result in improved blood pressure status and concomitant improvements in vascular function. However, recent findings have challenged this notion as vascular dysfunction appears to persist despite blood pressure control with antihypertensive medications. Importantly, medications differ in their vasoactive properties and may have direct effects on the vasculature independent of their impact on blood pressure. Therefore, it is difficult to discern if the potential improvements in vascular function are associated with lower blood pressure or a direct effect on vascular function. Utilizing the dietary approach of salt restriction this study examined the impact of reducing blood pressure on vascular function and peripheral hemodynamics in individuals with essential hypertension.MethodsHypertensive adults (male n=14, female n=8, 50±10 yr) completed two dietary phases: liberal sodium (LS) (200 mmol/d) followed by restricted sodium (RS) (10 mmol/day) diet for five days, respectively. Antihypertensive medications were withdrawn 2 weeks before the first intervention. Following each dietary phase, measurements of systolic (SBP), diastolic (DBP), and mean arterial blood pressure (MAP), arterial diameter and blood velocity (Doppler ultrasound) were assessed at rest, during brachial artery (BA) flow mediated dilation (FMD), and during progressive handgrip (HG) exercise performed at 15, 30 and 45% of maximal voluntary contraction (MVC).ResultsRS significantly lowered SBP (LS: 140±3, RS: 123±3 mmHg), DBP (LS: 85±2, RS: 79±2 mmHg) and MAP (LS: 103±2, RS: 94±2 mmHg) (all p&lt;0.05). Despite improvements in blood pressure, conduit artery function, as measured by FMD, was similar between conditions (LS: 4.6±0.4%; RS: 5.1±0.5%). Similarly, the hyperemic response during FMD, an assessment of microvascular function, was not different between conditions (LS: 548±43; RS: 615±44 ml). During HG exercise, MAP was lower at all exercise intensities during RS compared to LS (15% MVC; LS: 109±2 vs. RS: 102±2 mmHg; 30% MVC; LS: 113±2 vs. RS: 105±2 mmHg; 45% MVC; LS: 122±3 vs. RS: 112±3 mmHg) while vascular conductance and BA vasodilation were not different between LS and RS (p&gt;0.05).ConclusionDespite improvements in blood pressure at rest and during exercise, both conduit artery and microvascular function measured during FMD and HG exercise‐induced vasodilation were not improved. These findings support recent evidence that vascular dysfunction persists in individuals with hypertension independent of blood pressure status.This abstract is from the Experimental Biology 2018 Meeting. There is no full text article associated with this abstract published in The FASEB Journal.

A non-living, effective model for microvascular training.

To introduce a nonliving microvascular training model based on vessels diameter and feasibility. We dissected ten oxen tongues, and divided the pedicles into three-thirds: proximal, middle and distal. We measured the external vessels diameter in all regions. We performed a descriptive statistical analysis. Three students (two beginner level and one intermediate level) performed this training. We evaluated the confidence, according Likert scale. We dissected all oxen tongues, each tongue showed two parallel pedicles. Each pedicle was located at 1.5 - 2.0 cm from the midline. Proximal median artery and vein diameter were 3.9 ± 0.7, and 5.04 ± 1.44mm, respectively. In the middle third, the mean artery diameter was 3.3 ± 0.4mm, and the vein diameter was 3.5 ± 0.9mm. The distal third showed a mean artery diameter of 2.0 ± 0.42mm, and a vein diameter of 2.4 ± 0.82mm. The students performed ten anastomoses. This study showed a higher confidence level (CL) (p=0.03) than the pre training CL assessment. This study suggested a feasible non-animal model for microsurgical training process for beginners and intermediate trainees.

Longitudinal micro-ultrasound assessment of the ob/ob mouse model: evaluation of cardiovascular, renal and hepatic parameters.

Obesity is reaching epidemic proportions and is associated with increased risk factors for cardiovascular disease. Leptin-deficient mice (ob/ob) are widely employed to investigate obesity. Aim of this study was to provide a micro-ultrasound (μUS) longitudinal evaluation of the ob/ob mouse model in terms of cardiovascular effects, consequences for renal microcirculation and liver fat accumulation. Sixteen wild-type (wt) and eleven ob/ob male mice were studied at 8 (T0) and 25 (T1) weeks of age with a μUS system (Vevo2100) and B-mode and Doppler images were acquired. Cardiac output (CO), ejection fraction (EF), stroke volume (SV), fractional shortening (FS) and E/A ratio were measured from cardiac images. Mean diameter (Dmabd, Dmcar), relative distension (relDabd and relDcar) and pulse wave velocity (PWVabd and PWVcar) were obtained for both abdominal aorta and common carotid. As regards renal microcirculation, renal resistivity and pulsatility index (RI and PI) were assessed. The ratio between grey levels related to liver and kidney (Steato-Score) was used as index of hepatic steatosis. At T0, ob/ob mice showed reduced SV, EF, CO and relDabd values and increased LVmass, PWVabd, RI, PI and Steato-score measurements. The same comparison repeated at T1 highlighted similar results for SV, EF, CO, RI, PI and Steato-Score; furthermore, obese mice showed reduced Dmabd and Dmcar measurements in comparison with lean controls. The longitudinal analysis showed an increase in LVmass and Dmabd and a reduction of FS, EF, CO, relDabd and relDcar for wt animals, while no differences were found for the ob/ob group. ob/ob mice presented a premature cardiac dysfunction without a further age-related deterioration and a reduction in the abdominal aorta and carotid artery mean diameter in adult age. The proposed analysis can represent a valid approach for longitudinal studies aimed at testing new therapeutic strategies or for characterizing other mouse models.

Study of Enhanced Depth Imaging Optical Coherence Tomography in Cerebral Autosomal Dominant Arteriopathy with Subcortical Infarcts and Leukoencephalopathy.

Background:Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) is a hereditary small artery disease caused by NOTCH3 gene mutation. We performed enhanced depth imaging optical coherence tomography (EDI-OCT) to evaluate the retinal vessel changes in CADASIL patients and assessed their consonance with brain magnetic resonance imaging (MRI) findings.Methods:Of 27 genetically confirmed patients and an equal number of controls were recruited at the Peking University First Hospital from January 2015 to August 2016. All patients underwent 7T-MRI of the brain. Fazekas score, number of small infarcts and microbleeds were evaluated. All patients and controls underwent EDI-OCT to measure subfoveal choroidal thickness (SFCT), inner and outer diameters as well as arterial and venous wall thickness, and arterial venous ratio of the inner (AVRin) and outer diameters (AVRout). The relation between retinal vessel changes and Fazekas scores, numbers of small infarcts, or microbleeds was analyzed. Paired t-test was used to compare the SFCT and retinal vessel measurement data between patients and controls. Spearman's correlation was used to investigate the correlation between retinal vessel changes and MRI lesions.Results:In CADASIL patients, mean SFCT (268.37 ± 46.50 μm) and mean arterial inner diameter (93.46 ± 9.70 μm) were significantly lower than that in controls (P < 0.001, P = 0.048, respectively). Mean arterial outer diameter (131.74 ± 10.87 μm), venous inner (128.99 ± 13.62 μm) and outer diameter (164.82 ± 14.77 μm), and mean arterial (19.13 ± 1.85 μm) and venous (17.91 ± 2.76 μm) wall thickness were significantly higher than that in controls (P = 0.023, P = 0.004, P < 0.001, P < 0.001, respectively). Arterial inner diameter (rs= −0.39, P = 0.044), AVRin (rs= −0.65, P < 0.001), and AVRout (rs= −0.56, P = 0.002) showed a negative correlation with the number of small infarcts. Venous inner diameter (rs = 0.46, P = 0.016) showed a positive correlation with the number of small infarcts. Venous inner diameter (rs = 0.59, P = 0.002), outer diameter (rs = 0.47, P = 0.017), showed a positive correlation with the number of cerebral microbleeds (CMBs). AVRin (rs= −0.52, P = 0.007) and AVRout (rs= −0.40, P = 0.048) showed a negative correlation with the number of CMBs.Conclusions:Measurement of retinal vessels using EDI-OCT correlates moderately well with MRI parameters. EDI-OCT might be a useful evaluation tool for CADASIL patients.

Pulmonary Artery Dimensions as a Prognosticator of Transplant-Free Survival in Scleroderma Interstitial Lung Disease.

Systemic sclerosis is a chronic debilitating autoimmune disease characterized by endothelial dysfunction and multi-organ fibrosis. Interstitial lung disease, a common manifestation of SSc, is termed scleroderma-related interstitial lung disease (SSc-ILD) and along with pulmonary hypertension contributes to a majority of deaths in SSc. SSc-ILD patients frequently develop pulmonary hypertension, which prognosticates a poorer outcome. We investigated pulmonary artery dimensions as an outcome predictor in patients with SSc-ILD. A retrospective chart review abstracting data from SSc-ILD patients evaluated at a large tertiary care center was performed. HRCT imaging was reviewed and pulmonary artery (PA) and ascending aorta (Ao) diameters were measured for calculation of the PA:Ao ratio. Additionally, demographics, vital signs, spirometric parameters, comorbidities, and mean pulmonary artery pressures were collected when available. Outcome analysis with lung transplant or death events within 4years based on pulmonary artery size as well as PA:Ao ratio was performed. 70 SSc-ILD patients were identified. Mean pulmonary artery diameter and PA:Ao ratio was 31.17 and 1.07mm, respectively. Patients with a pulmonary artery diameter≥32mm had higher risk of lung transplantation or death (p<0.001) within 4years. Patients with a PA:Ao ratio≥1.1 also had higher risk of lung transplantation or death (p<0.001) within 4years. Unadjusted outcomes analyses also identified PA:Ao ratio≥1.1 as an independent outcome predictor (hazard ratio 3.30, p<0.001). In SSc-ILD patients, a PA:Ao ratio≥1.1 is associated with higher risk of lung transplant or death. These data suggest that PA:Ao dimension may be used for prognostication in SSc-ILD.

Pharmacological or Genetic Interruption of Focal Adhesion Kinase Improves Endothelial Barrier Dysfunction Resulting from Ischemia/Reperfusion Injury

Ischemia reperfusion (I/R) injury results from reoxygenation following an initial ischemic insult. Although oxygen levels are restored during reperfusion, the abrupt increase in blood supply results in high levels of reactive oxygen species that leads to endothelial barrier dysfunction and exacerbates the tissue injury originally elicited by the ischemic event. One therapeutic strategy used to enhance the endothelial barrier and prevent further tissue damage is to treat the exacerbated tissue damage caused by reperfusion. Our lab and others have shown that focal adhesion kinase (FAK) is a key player that participates in the signaling events required for endothelial barrier dysfunction. Therefore, we hypothesized that targeting FAK pharmacologically would improve I/R injury in vitro and in vivo. Using murine intestinal endothelial cells, we performed electric cell‐substrate impedance sensing (ECIS) assays with and without FAK inhibitor (PF573228, 1μM) in the presence of H2O2 (250μM). Results showed that FAK inhibition significantly attenuated barrier dysfunction induced by H2O2. Similarly, we also utilized FITC‐albumin flux assays to determine whether targeting FAK improved barrier function resulting from H2O2. These experiments showed that the increase of endothelial albumin flux due to treatment with H2O2 was reduced by approximately 50% when cells were pretreated with FAK inhibitor. Western blots of endothelial cell lysates treated with H2O2 indicated that FAK is activated in as little as 10 minutes and remains elevated for 60 minutes of treatment. Other experiments showed that the use of PF573228 dramatically reduced detection of active FAK (pY397 FAK) as well as total tyrosine phosphorylated proteins despite the presence of inflammatory signals. Using an in vivo model of I/R injury and endothelial specific, tamoxifen inducible, FAK knockout transgenic animals, as well as wild type animals given PF573228, we showed that interruption of FAK activity or expression reduced albumin leakage induced by I/R injury by over two‐fold, while neither mean arterial blood pressure nor diameter was altered by the drug or genetic manipulation. Taken together, these results suggest that targeting FAK may be a novel strategy to improve endothelial barrier dysfunction that occurs as a consequence of I/R injury.Support or Funding InformationNIH HL‐120954

Morphometric analysis of rat femoral vessels under a video magnification system.

The right femoral vessels of 80 rats were identified and dissected. External lengths and diameters of femoral arteries and femoral veins were measured using either a microscope or a video magnification system. Findings were correlated to animals’ weights. Mean length was 14.33 mm for both femoral arteries and femoral veins, mean diameter of arteries was 0.65 mm and diameter of veins was 0.81 mm. In our sample, rats’ body weights were only correlated with the diameter of their femoral veins.

Basilar Artery Changes in Fabry Disease.

Dolichoectasia of the basilar artery is a characteristic finding of Fabry disease. However, its prevalence, severity, and course have been poorly studied. This study quantitatively evaluated, by MRA, a panel of basilar artery parameters in a large cohort of patients with Fabry disease. Basilar artery mean diameter, curved length, "origin-to-end" linear distance (linear length), and tortuosity index ([curved length ÷ linear length] - 1) were retrospectively measured on 1.5T MRA studies of 110 patients with Fabry disease (mean age, 39.4 ± 18.6 years; 40 males) and 108 control patients (mean age, 42.0 ± 18.2 years; 40 males). Patients with Fabry disease had increased basilar artery mean diameter (P < .001) and basilar artery linear length (P = .02) compared with control patients. Basilar artery curved length and tortuosity index correlated with age in both groups (P < .001), whereas basilar artery linear length correlated with age only in patients with Fabry disease (P = .002). Patients with Fabry disease showed a basilar artery curved length mean increase of 4.2% (9.7% in male patients with Fabry disease versus male control patients), whereas the basilar artery mean diameter had a mean increase of 12.4% (14.3% in male patients with Fabry disease versus male control patients). Male patients with Fabry disease had increased basilar artery mean diameter, curved length, and tortuosity index compared with female patients with Fabry disease (P = .04, P = .02, and P < .001, respectively) and male control patients (P < .001, P = .01, and P = .006, respectively). Female patients with Fabry disease demonstrated an age-dependent increase of basilar artery mean diameter that became significant (P < .001) compared with female control patients above the age of 45 years. The basilar artery of patients with FD is subjected to major remodeling that differs according to age and sex, thus providing interesting clues about the pathophysiology of cerebral vessels in Fabry disease.

Analysis of renal artery morphometery in adults: A study conducted by using Multidetector computed Tomography Angiography.

Objective:To determine a reference range of renal artery measurements by using Multidetector Computed Tomography (MDCT) angiography and to find association of renal artery measurements with side of artery, gender and age.Method:Two hundred and fifty study participants without renal artery disease who werepresented to Radiology Department, Ziauddin Hospital, Karachi, from November, 2016 to April, 2017 were included in this study. Main renal artery measurements were taken on Multidetector computed angiography and variation with side, gender and age were analyzed. Statistical analysis was done on Statistical Package for Social Sciences (SPSS) version 20. Independent sample T test, one way ANOVA and Pearson’s correlation analysis were applied. P-value of < 0.05 was considered significant.Results:A significance difference (p=0.001) was seen between mean right renal artery (diameter 6.66 ± 0.39 mm; length 44.69 ± 2.48 mm) and left renal artery (diameter 6.79 ± 0.36; length 35.10 ± 2.86 mm). Females found to have smaller mean diameter and length of renal arteries than males. However, a weak negative correlation was seen between mean renal artery diameter and age (right r= -0.158, p=0.0121; left r= -0.017, p= 0.708).Conclusion:The mean diameter and mean length were found to be significantly different between right and left main renal artery and between males and females. A significant weak negative correlation was observed between renal artery diameter and age.

Racial and Gender Differences in Arterial Anatomy of the Arm

Prior studies have shown racial and gender differences with respect to maturation of arteriovenous fistulas. Women and minorities have lower maturation rates for unclear reasons. Small arterial diameter and high brachial artery bifurcation (HBB) are also implicated in reduced maturation rates. We sought to correlate differences in upper extremity arterial anatomy to race and gender. All upper extremity vascular mapping ultrasounds from 2013 to 2014 were retrospectively reviewed. A total of 509 arms in 284 patients were evaluated. Men had significantly higher mean arterial diameters than women at the elbow brachial (4.7 vs 3.9 mm, P < 0.01) and wrist radial arteries (2.1 vs 1.9 mm, P = 0.03). There were 20 (7%) patients with HBB of at least one arm, and 7 (2.5%) patients with bilateral HBB. African-American patients had significantly higher rates of both unilateral HBB (15.9% vs 5.4%, P = 0.02) and bilateral HBBs (9.1% vs 1.3%, P = 0.01). In conclusion, men had significantly larger arteries than women, and African-Americans had a higher rate of HBB than non-African-Americans. Consideration should be given for routine preoperative ultrasound to assess arterial anatomy before arteriovenous fistulas creation, particularly in women and in African-Americans.

Pulmonary artery size as a predictor of outcomes in idiopathic pulmonary fibrosis.

IPF patients have heightened propensity for pulmonary hypertension, which portends a worse outcome. Presence of pulmonary hypertension may be reflected in an enlarged pulmonary artery. We investigated pulmonary artery size measured on high-resolution computed tomography (HRCT) as an outcome predictor in IPF.We retrospectively reviewed all IPF patients evaluated at a tertiary-care centre between 2008 and 2013. Pulmonary artery and ascending aorta diameters were measured from chest HRCT with pulmonary artery:ascending aorta diameter (PA:A) ratio calculations. Outcome analysis defined by either death or lung transplant based on pulmonary artery size and PA:A ratio over 60 months was performed. Independent effects of different variables on overall outcomes were evaluated using the Cox proportional hazards model.98 IPF patients with available HRCT scans had a mean pulmonary artery diameter and PA:A ratio of 32.8 mm and 0.94, respectively. Patients with a PA:A ratio >1 had higher risk of death or transplant compared with a PA:A ratio ≤1 (p<0.001). A PA:A ratio >1 was also an independent predictor of outcomes in unadjusted and adjusted outcomes analyses (hazard ratio 3.99, p<0.001 and hazard ratio 3.35, p=0.002, respectively).A PA:A ratio >1 is associated with worse outcomes in patients with IPF. A ratio measurement may assist in risk stratification and prognostication of IPF patients.

Carotid 2D Strain Imaging Reveals Enhanced Rate Of Arterial Wall Deformation Following Exercise In High-fit Young Males

PURPOSE: The purpose of this study was to compare common carotid artery (CCA) stiffness at rest and immediately following brief aerobic exercise between young males of moderate and high cardiorespiratory fitness (CRF). METHODS: Accordingly, heart rate (HR), blood pressure (BP), arterial diameter, conventional parameters of arterial stiffness (Petersons’ elastic modulus [Ep], β1 stiffness index) and novel two-dimensional (2D) strain imaging indices (global circumferential strain, strain rate and β2 stiffness index) were assessed in the CCA pre and immediately post 5-min of aerobic exercise (40% peak exercise capacity) in twenty-two young healthy males (age: 21 ± 2 years). Moderate and high CRF groups demonstrated mean V†o2 peak data of 49 ± 8 and 66 ± 6 mL kg-1min-1, respectively (P <.001). RESULTS: Heart rate, systolic BP, pulse pressure, mean arterial pressure, arterial diameter, Ep, β1 and β2 stiffness indices were not different between fitness groups at rest or immediately following exercise (all P > .05). However, whilst there was a similar increase in CCA wall deformation as indicated by global circumferential strain following exercise (pre vs. post, moderate: 9.12 ± 2.6% vs. 9.36 ± 2.4%; high: 10.19 ± 2.9% vs. 11.34 ± 2.9%, both P > .05), CCA wall deformation was significantly faster in the high-fit group only, as reflected by increased systolic circumferential strain rate (moderate: 1.09 ± 0.3 vs. 1.17 ± 0.2 1/s, P > .05; high: 1.14 ± 0.2 vs. 1.35 ± 0.3 1/s, P = .049). CONCLUSION: Using novel 2D strain imaging, this study shows that young high-fit individuals may exhibit different arterial wall dynamics compared to their lower-fit counterparts following a short bout of aerobic exercise. The increase in global circumferential strain rate following exercise in high-fit individuals may reflect a greater ability to buffer the significant rise in pulse-pressure and blood flow that occurs in response to exercise.

Pulmonary artery size as a predictor of pulmonary hypertension and outcomes in patients with chronic obstructive pulmonary disease

The relationship between pulmonary artery size with underlying pulmonary hypertension and mortality remains to be determined in COPD. We sought to evaluate the relationships in a cohort of patients with advanced COPD. A retrospective study of advanced COPD patients evaluated between 1998 and 2012 was conducted at a tertiary care center. Patients with chest computed tomography images and right heart catheterizations formed the study cohort. The diameters of the pulmonary artery and ascending aorta were measured by independent observers and compared to pulmonary artery pressures. Intermediate-term mortality was evaluated for the 24-month period subsequent to the respective studies. Cox proportional hazards model was used to determine independent effects of variables on survival. There were 65 subjects identified, of whom 38 (58%) had pulmonary hypertension. Patients with and without pulmonary hypertension had mean pulmonary artery diameters of 34.4 mm and 29.1 mm, respectively (p = 0.0003). The mean PA:A ratio for those with and without pulmonary hypertension was 1.05 and 0.87, respectively (p = 0.0003). The PA:A ratio was an independent predictor of mortality with a reduced survival in those with a PA:A >1 (p = 0.008). The PA:A ratio is associated with underlying pulmonary hypertension in patients with COPD and is an independent predictor of mortality. This readily available measurement may be a valuable non-invasive screening tool for underlying pulmonary hypertension in COPD patients and appears to impart important independent prognostic information.

Use of angular vessels in head and neck free-tissue transfer: a comprehensive preclinical evaluation.

The angular artery, its perforating branches, and their zones of tissue perfusion have been described extensively for facial reconstruction. Various cutaneous and mucosal flaps with either anterograde or retrograde perfusion play an important role in facial and oral reconstruction. However, these flaps share the limitations of pedicled nature and donor-site intolerance. Free-tissue transfer (FTT) has transformed capabilities and outcomes in head and neck reconstruction. While less constrained by tissue volume and subtype, FTT has its own limitations, including pedicle reach for anastomosis to inflow and outflow vasculature in upper face reconstruction. The angular vessels, owing to their relatively high central location and accessibility via a camouflaged nasolabial fold incision, may have value in midface and nasal reconstruction. To detail a technique for consistently locating the angular vessels while preserving the integrity of adjacent neuromuscular structures and to evaluate the caliber and consistency of the angular artery and vein for their usability in microvascular anastomosis. We conducted a PubMed literature search for the terms angular artery, melolabial flap, nasolabial flap, retroangular flap, and any associations with FTT. We also performed 26 anatomic cadaveric dissections on 13 fresh cadavers to evaluate the angular arteries and veins. Vessel caliber, length, and variability were analyzed and utility for use in FTT was assessed. A total of 26 angular arteries and 26 angular veins were included in the analysis. Anatomic relationships were used to develop a surgical schema for dissection and isolation of the angular vessels specifically for FTT. The angular vessels have consistent anatomic relationships facilitating localization and have a consistent caliber amenable to use in microvascular FTT. The mean (SD) artery diameter was 2.34 (0.67) mm prior to dilation and 3.21 (0.87) mm after dilation. The diameters of the vein before and after dilation were 3.57 (0.53) mm and 6.40 (0.81) mm, respectively. There was no statistical difference between the vessels on the right and left sides. We describe for the first time the anatomic cadaveric dissection and analysis of the angular arteries and veins specifically to determine compatibility with regard to FTT. We found good FTT compatibility. NA.

DIAMETER OF RETINAL VESSELS IN PATIENTS WITH DIABETIC MACULAR EDEMA IS NOT ALTERED BY INTRAVITREAL RANIBIZUMAB (LUCENTIS)

To investigate the effect(s) of intravitreally injected ranibizumab on retinal vessel diameter in patients with diabetic macular edema. Participants of this prospective study were 14 men and 16 women (30 eyes) aged 60 ± 11 years (mean ± standard deviation), all with clinically significant diabetic macular edema. Treatment comprised 3 intravitreal injections of ranibizumab given at 4-week intervals. Examinations were conducted before the first (baseline), before the second (Month 1), before the third (Month 2) injections, and 3 months after baseline (Month 3). Measured parameters included systemic blood pressure, static retinal vessel analysis (central retinal artery equivalent and central retinal vein equivalent), and dynamic retinal vessel analysis, as measured by the change in vessel diameter in response to flicker stimulation during three measurement cycles. Flicker stimulation was accomplished using a 50-second baseline recording, followed by an online measurement during 20-second flicker stimulation and 80-second online measurements in both arteriolar and venular vessel segments. Static retinal vessel analysis showed a reduction of central retinal artery equivalent from 186.25 ± 51.40 μm (baseline) to 173.20 ± 22.2 μm (Month 1), to 174.30 ± 27.30 μm (Month 2), and to 170.56 ± 22.89 μm (Month 3), none of which was statistically significant (P = 0.23, 0.12, and 0.14, respectively). Central retinal vein equivalent was reduced from 216.21 ± 25.0 μm (baseline) to 214.48 ± 25.4 μm (Month 1), to 214.80 ± 24.30 μm (Month 2), and to 211.41 ± 24.30 μm (Month 3), revealing no statistically significant differences between examination time points (P = 0.54, 0.06, and 0.24, respectively). Dynamic vessel analysis yielded a mean retinal arterial diameter change of +1.47% ± 2.3 (baseline), +1.91% ± 2.5 (Month 1), +1.76% ± 2.2 (Month 2), and +1.66% ± 2.1 (Month 3), none of which showed statistically significant differences (P = 0.32, 0.49, and 0.70, respectively). Mean retinal venous diameter changes were +3.15% ± 1.7 (baseline), +3.7% ± 2.3 (Month 1), +4.0% ± 2.0 (Month 2), and +4.95% ± 1.9 (Month 3), none of which showed statistically significant differences (P = 0.12, 0.17, and 0.14, respectively). Central retinal thickness, as measured by spectral domain optical coherence tomography, decreased significantly from 435.2 ± 131.8 μm (baseline) to 372.3 ± 142.8 μm (Month 3), P = 0.01. Regression analysis of arteriolar and venular diameters indicated that there was no significant correlation between these 2 parameters (r = 0.053; P = 0.835 and r = 0.06; P = 0.817, respectively). Also, no significant correlation was observed between the difference in the central retinal thickness and change in arteriolar or venular dilatation (r = 0.291, P = 0.241 and r = 0.06, P = 0.435, respectively). Intravitreally applied ranibizumab did not significantly affect retinal vessel diameter in patients with diabetic macular edema. Decline in the central foveal thickness after ranibizumab therapy, as measured by spectral domain optical coherence tomography, was not linked to any change in retinal vessel diameter or dilatatory response, neither for arterioles nor venules.

AB0569 Markers of Subclinical Cardiovascular Disease in Behcet's Disease: Correlations with Demographic and Clinical Profile

BackgroundGrowing interest exists on the role of markers of subclinical cardiovascular disease as independent predictors of cardiovascular events. Among these, great emphasis has been placed on the role of vascular...

Hypertensive Rat Lungs Retain Hallmarks of Vascular Disease upon Decellularization but Support the Growth of Mesenchymal Stem Cells

There are an insufficient number of donor organs available to meet the demand for lung transplantation. This issue could be addressed by regenerating functional tissue from diseased or damaged lungs that would otherwise be deemed unsuitable for transplant. Detergent-mediated whole-lung decellularization produces a three-dimensional natural scaffold that can be repopulated with various cell types. In this study, we investigated the decellularization and initial recellularization of diseased lungs using a rat model of monocrotaline-induced pulmonary hypertension (MCT-PHT). Decellularization of control and MCT-PHT Sprague-Dawley rat lungs was accomplished by treating the lungs with a combination of Triton X-100, sodium deoxycholate, NaCl, and DNase. The resulting acellular matrices were characterized by DNA quantification, Western blotting, immunohistochemistry, and proteomic analyses revealing that decellularization was able to remove cells while leaving the extracellular matrix (ECM) components and lung ultrastructure intact. Decellularization significantly reduced DNA content (∼30-fold in MCT-PHT lungs and ∼50-fold in the control lungs) and enriched ECM components (>60-fold in both the control and MCT-PHT lungs) while depleting cellular proteins. MicroCT visualization of MCT-PHT rat lungs indicated that the vasculature was narrowed as a result of MCT treatment, and this characteristic was unchanged by decellularization. Mean arterial vessel diameter of representative decellularized MCT-PHT and control scaffolds was estimated to be 0.152±0.134 mm and 0.247±0.160 mm, respectively. Decellularized MCT-PHT lung scaffolds supported attachment and survival of rat adipose-derived stem cells (rASCs), seeded into the airspace or the vasculature, for at least 2 weeks. The cells seeded in MCT-PHT lung scaffolds proliferated and underwent apoptosis similar to control scaffolds; however, the initial percentage of apoptotic cells was slightly higher in MCT-PHT lungs (2.79±2.03% vs. 1.05±1.02% of airway-seeded rASCs, and 4.47±1.21% vs. 2.66±0.10% of vascular seeded rASCs). The ECM of cell-seeded scaffolds showed no signs of degradation by the cells after 14 days in culture. These data suggest that diseased hypertensive lungs can be efficiently decellularized similar to control lungs and have the potential to be recellularized with mesenchymal stem cells with the ultimate goal of generating healthy, functional pulmonary tissue.