Media Thickness Research Articles

Contraceptive use, both oral and parenteral, is associated with increased arterial stiffness in young healthy women.

Previous studies on the impact on arterial health of contraceptive use, or across the menstrual phases, have yielded differing results. Furthermore, there is little research on the differences based on the delivery method of the contraceptive, oral vs parenteral contraceptives. In this study, we examined arterial health using three different physiological measures of arterial function and structure in contraceptive users and non-users. Young, healthy women, between 18.0-25.9 years of age were enrolled in the study (n = 577). Menstrual phase and contraceptive use and type were assessed by questionnaire. Arterial stiffness was measured using pulse-wave velocity (PWV) and augmentation index (AIx). Arterial thickness was measured using carotid-intima media thickness (cIMT). Blood samples were analysed for various biomarkers, which were used in multivariate regressions to adjust for the effects of contraceptive use on vascular status. Contraceptive users had a higher PWV than non-users. The menstrual phase did not impact PWV. In a smaller subgroup analysis, comparing the types of contraceptives, oral or parenteral, did not impact PWV. AIx and cIMT did not differ significantly between any studied groups. Systolic blood pressure, BMI, serum lipids, C-reactive protein, and sex hormone binding globulin concentrations were higher in the contraceptive using group, but in multivariable models, these biomarkers had only limited impact on the association between contraceptive use and PWV. In a population of young, healthy women, contraceptive users displayed higher PWV values. The effect could not be explained by the effect of contraceptives on androgenicity, blood pressure or lipids.

Oral microbiome diversity associates with carotid intima media thickness in middle-aged male subjects.

Although there have been significant advancements in reducing the burden of cardiovascular disease (CVD) by modifying traditional CVD risk factors, substantial risks persist, particularly among male subjects who exhibit heightened susceptibility to atherosclerosis. In this context, we aim to study the link between oral microbiome and carotid intima media thickness (cIMT). The Northern Finland Birth Cohort of 1966 (mean age 46 years, n = 869) underwent an extensive health examination, including the measurement of cIMT. The oral microbiome was also investigated using high-throughput 16S rRNA gene sequencing. Here we show that oral microbiome diversity links with atherosclerosis risk factors, namely smoking, glycemic balance, low-grade inflammation, and periodontitis. After excluding CVD-influencing factors (n = 339), oral microbiome genera (p = 0.030), Shannon index (p = 0.001), β-diversity Bray-Curtis (p < 0.001), and Jaccard (p < 0.001) are associated with cIMT in males, but not in the female sub-cohort. Furthermore, in the male sub-cohort (n = 131), the genera Prevotella, Megasphaera, and Veillonella associate positively with cIMT, while Absconditabacteria, Capnocytophaga, Gemella, Fusobacterium, Neisseria, Aggregatibacter, Tannerella, Treponema, Cardiobacterium, and Bacteroidales associate inversely with cIMT. We examine the involvement of serum total immunoglobulins and antibodies to phosphorylcholine (PCho) and malondialdehyde-acetaldehyde LDL (MAA-LDL) with cIMT. Subjects with high cIMT have lower levels of serum total IgA (p = 0.009), IgA to PCho (p = 0.017), and IgG to PCho (p = 0.008). The relative abundance of cIMT-associated genera correlates with serum IgA antibodies. This middle-aged birth cohort study shows that male oral microbiome diversity links to cIMT, suggesting a potential sex-specific interaction between the oral microbiome and atherosclerosis.

Daily fenugreek intake does not attenuate abdominal aortic aneurysm growth in rats.

Objective: Abdominal aortic aneurysm (AAA) is a permanent local dilation of the abdominal aorta developed by chronic local inflammation and elastin degradation. Trigonella foenum-graecum (fenugreek) has been reported to have anti-inflammatory properties. We hypothesized that fenugreek supplementation can inhibit AAA growth. Materials and methods: AAA was induced in male Sprague-Dawley rats by intraluminal porcine pancreatic elastase infusion. The treatment by oral gavage was initiated post-operatively on day 1 and was administered daily (750mg/kg/daily or 1500mg/kg/daily or distilled water) for 27 days. AAA expansion was monitored weekly by ultrasound measurements in a blinded-to-treatment fashion; rats were euthanized 28 days after surgery. AAA cross-sections were examined histologically, where treatment allocation were blinded. Results: AAA developed in all three groups, yet there was no measured difference (p=0.104) in the maximal inner anterior-posterior abdominal aortic diameter on day 28 post-surgery between the control group (110% ± 70%, n=11), the low-dose fenugreek treatment group (LDF, 105% ± 68%, n=11), and the high-dose fenugreek treatment group (HDF, 153% ± 96%, n=13). Additionally, assessments of elastin structure in the AAA wall using Miller's stain revealed disorganized and ruptured fibers, but no significant differences in the severity of damage or elastin content among the groups were noted. No significant differences were observed in the presence of infiltrating neutrophils (as indicated by myeloperoxidase-positive cells), macrophage infiltration (% CD68-positive area), or area of vascular smooth muscle cells (a-SMA stained cells), or media thickness across control low-dose, and high-dose treatment groups. Conclusions: Daily fenugreek administrations did not halt AAA progression in either low-dose (750 mg/kg/daily) or high-dose (1500 mg/kg/daily) groups when compared to controls. These results did not show any beneficial effects of fenugreek supplementation in the aneurysm wall, and therefore, we can not recommend fenugreek supplementation as a treatment for patients with growing AAAs.

Non-Invasive Assessment of Vascular Damage Through Pulse Wave Velocity and Superb Microvascular Imaging in Pre-Dialysis Patients

Background/Objectives: Cardiovascular disease is the main cause of morbidity and mortality in Chronic Kidney Disease (CKD), so it is of great importance to find simple and non-invasive tools to detect vascular damage in pre-dialysis CKD patients. This study aimed to assess the applicability of non-invasive techniques to evaluate vascular damage in stages CKD-2 to CKD-5 and its progression after an 18-month follow-up using (A) carotid–femoral pulse wave velocity (PWV) to assess aortic stiffness and (B) Superb Microvascular Imaging (SMI) ultrasound to assess adventitial neovascularization compared with other traditional techniques to evaluate vascular damage, such as carotid intima–media thickness and Kauppila index. Methods: The study involved 43 CKD patients in stages CKD-2 to CKD-5 and a group of 38 sex- and age-matched controls, studied at baseline and at an 18-month follow-up. Age, sex, body mass index, arterial pressure, pharmacological treatments, and blood and urinary parameters were collected. Aortic stiffness was determined by carotid–femoral PWV and abdominal aortic calcification was assessed in lateral lumbar X-rays and quantified by the Kauppila index. Carotid intima–media thickness (cIMT), the number of carotid plaques, and adventitial neovascularization were evaluated by SMI. Results: Vascular impairment was mostly detected in CKD-4 and CKD-5 stages, with increased aortic stiffness measured by PWV and increased carotid plaques and adventitial neovascularization measured by SMI ultrasound. Furthermore, CKD-5 patients showed greater abdominal aortic calcification. Interestingly, CKD patients displayed a negative correlation between serum soluble Klotho (sKlotho) and cIMT. Finally, CKD patients showed no progression of vascular impairment after the 18-month follow-up, with the exception of carotid plaques. Conclusions: Performing non-invasive PWV and SMI ultrasound might be useful to evaluate vascular damage in CKD before entering dialysis, possibly helping to prevent cardiovascular events, although future studies should clarify the use of these techniques in clinical practice.

Application of TyG index and carotid ultrasound parameters in the prediction of ischemic stroke.

The triglyceride - glucose (TyG) index has been confirmed as an independent risk factor for ischemic stroke (IS) in numerous studies. In terms of the role of carotid ultrasound in the risk assessment of IS, the focus has shifted from merely concentrating on the degree of stenosis to paying more attention to the status of carotid plaques. However, there are limited studies on combining clinical indicators such as the TyG index with carotid ultrasound parameters to assess the risk of IS. Through a retrospective study, we aim to explore the role of combining these two types of indicators in the risk assessment of IS. This study included 145 patients with IS and 99 no ischemic stroke (NIS) patients diagnosed by magnetic resonance imaging (MRI) from January 2020 to June 2024. The TyG index was calculated as ln [fasting triglyceride (mg/dL) × fasting blood glucose (mg/dL)/2]. The carotid ultrasound parameters integrated were as follows: the presence or absence of carotid plaques, the location of the largest carotid plaque, carotid intima - media thickness (CIMT), the lengthness and thickness diameters of the largest carotid plaque, and the degree of carotid stenosis. Univariate (multivariate) logistic regression analysis, ROC curve analysis, etc. were conducted on the data using SPSS 26 and MATLAB Online. These were aimed at assessing the effectiveness of integrating clinical indicators with carotid ultrasound parameters in predicting the risk of IS. The univariate logistic regression analysis (ULR) demonstrated that age, gender, TyG index, history of diabetes, history of hypertension, fasting blood glucose (FBG), systolic blood pressure(SBP), diastolic blood pressure(DBP), low-density lipoprotein cholesterol(LDL-C), cystatin C(Cys C), the presence or absence of carotid plaques, plaque location, carotid intima-media thickness(CIMT), the length and thickness of the largest plaque were significantly associated with IS (P < 0.05), while the P-values of triglycerides(TG), total cholesterol(TC), uric acid(UA) and carotid stenosis rate were greater than 0.05. The area under the ROC curve (AUC) of the TyG index for predicting IS was 0.645 (P < 0.001), indicating a certain predictive ability but relatively limited. The optimal cut-off value was 8.28, with a sensitivity of 0.83 and a specificity of 0.63 at this cut-off value. The stratified analysis based on quartiles of the TyG index revealed that as the TyG index increased, the prevalence of hypertension and diabetes, as well as multiple lipid and metabolic indicators, increased, and the characteristics of carotid plaques also changed. Multiple risk prediction models were constructed and analyzed by ROC curves. Model 1, which integrated traditional clinical indicators, TyG index and carotid ultrasound parameters, performed best (AUC = 0.932) (P < 0.001), while Model 16, which only included some carotid ultrasound indicators, had relatively low predictive efficacy (AUC = 0.750) (P < 0.001). This study confirms that the combination of TyG index and carotid ultrasound parameters is of great significance in predicting the risk of IS. The predictive ability of TyG index alone is limited, and Model 1 integrating multiple indicators has the best predictive effect and can provide a reference for clinical practice. However, due to the retrospective nature of this study and the limitations such as selection bias, small sample size and single-center, there are some discrepancies between some results and those of previous studies. Future studies need to conduct multi-center, large-sample studies and incorporate more factors to improve the model.

Investigating the presence and detectability of structural peripheral arterial changes in children with well-regulated type1 diabetes versus healthy controls using ultra-high frequency ultrasound: a single-centre cross-sectional and case-control study.

Investigating the presence and detectability of structural peripheral arterial changes in children with well-regulated type1 diabetes versus healthy controls using ultra-high frequency ultrasound: a single-centre cross-sectional and case-control study.

Age Related Histomorphological Changes in Aorta of Pig (Sus scrofa)

The present study was conducted during 2022 for a period of ten months ( January to October) in the Department of Veterinary Anatomy, in collaboration with ICAR-AICRP on pigs, C.V.Sc Tirupati, Andhra Pradesh, India on aorta of pigs (Sus scrofa). A total of 18 samples of thoracic and abdominal aorta were collected irrespective of sex of the animal. The samples were divided into three groups based on their age i.e., Group I (up to six months), Group II (seven months to one year) and Group III (above one year) and in each group six animals were studied for recording age-related histomorphological changes. In histomorphological study it was observed that the walls of both thoracic and abdominal aorta were made up of three layers viz., tunica intima, tunica media and tunica adventitia. The tunica intima was made up of endothelium, subendothelial tissue and internal elastic membrane. The thickness of tunica intima increased with advancement of age in both thoracic and abdominal aorta due to increase in the number of musculo-elastic layers. The thickness of tunica media increased with advancement of age of the pigs i.e., from group-I to group-II and decreased in group-III pigs in both thoracic and abdominal aorta. The thickness of tunica adventitia of thoracic aorta was less, when compared to tunica adventitia of abdominal aorta. The separate external elastic membrane was not identified in the aorta since it was merged with the adjacent elastic fibres. In the tunica adventitia numerous small blood vessels and few nerve fibres were observed.

Association between running biomechanics and lower limb musculotendinous changes over an adolescent marathon training program.

Association between running biomechanics and lower limb musculotendinous changes over an adolescent marathon training program.

Differential Impact of Metabolic Factors and Comorbidities on Peripheral Neuropathy.

This study aimed to assess the impact of metabolic factors and comorbidities on peripheral neuropathy. Qatari nationals and long-term residents from the Qatar Biobank underwent clinical/metabolic assessments, including iDXA to measure visceral adipose tissue (VAT) and subcutaneous (SAT) volumes, inflammation, thyroid function, carotid intima media thickness (CIMT), corneal confocal microscopy (CCM), vibration perception threshold (VPT), and DN4 questionnaire. In 332 adults aged 43.4 ± 12.7 years, the prevalence of neuropathy was 3.9%. The prevalence of T2D was 16.6%, and the prevalence of neuropathy was significantly higher in T2D (14.5% vs. 1.8%, p < 0.0001). A higher HbA1c (p = 0.05) and lower eGFR (p < 0.01) were associated with reduced inferior whorl length (IWL) and lower FT3 was associated with reduced corneal nerve fiber length (CNFL) (p < 0.01). Triglycerides were associated with increased neuropathic symptoms (p = 0.05). All the risk factors in this study contributed to 39% of neuropathy in T2D but had a minimal impact in those without T2D. This study highlights the importance of additional risk factors beyond traditional risk factors associated with peripheral neuropathy in T2D.

Vascular strain of the aorta and peripheral arteries in patients with type 1 diabetes mellitus in comparison with healthy controls.

Vascular strain of the aorta and peripheral arteries in patients with type 1 diabetes mellitus in comparison with healthy controls.

Efficacy of somapacitan in treatment-fatigue adult patients with growth hormone deficiency previously treated with once-daily growth hormone injections: a 24-week randomized active-controlled trial.

Efficacy of somapacitan in treatment-fatigue adult patients with growth hormone deficiency previously treated with once-daily growth hormone injections: a 24-week randomized active-controlled trial.

Effects of Moringa Oliefera on Thickness of Tunica Intima and Tunica Media In Aorta of Diabetic Rat

Effects of Moringa Oliefera on Thickness of Tunica Intima and Tunica Media In Aorta of Diabetic Rat

Evolution of cardiovascular risk factors and the risk for cardiovascular events in a Caucasian population with polycystic ovary syndrome.

To estimate the risk of cardiovascular (CV) events (primary aim) and to evaluate the long-term variation in CV risk factors in a Caucasian population of women with polycystic ovary syndrome (PCOS). Matched cohort prospective study based on 10 years of follow-up. One hundred twenty Caucasian women with PCOS diagnosed by the National Institutes of Health criteria in reproductive age were assessed at baseline (2009) and at the end of follow-up (2020) for major and minor CV events and CV risk factors. Five controls were exactly matched by age and the presence/absence of type 2 diabetes with each participant at baseline (total number = 600) and followed up to evaluate the relative risk of PCOS for CV events. Change in epicardial fat thickness (EFT) was also analysed. The mean age of patients with PCOS at follow-up was 51.9 ± 7.7 years. No major CV events were detected in PCOS patients (0% vs. 2% among controls), and the incidence of any minor CV events was 4.2% vs. 2.3% among controls (P = .340). The percentage of most CV risk factors (obesity, type 2 diabetes, hypertension, dyslipidaemia, and carotid intima media thickness ≥1 mm with or without plaques with non-critical stenosis) increased. By contrast, both short- and long-axis EFTs and smoking decreased markedly. Caucasian patients with PCOS do not have an increased risk for CV events during the late reproductive or early post-menopausal period, despite the increase in most CV risk factors, except for EFT that markedly decreases. Further studies are needed to determine the role of EFT on CV risk in PCOS.

Benefits of Dietary Supplementation with Specific Silicon-Enriched Spirulina on Arterial Function in Healthy Elderly Individuals: A Randomized, Placebo-Controlled Trial

Background/Objectives: Vascular aging is associated with increased arterial stiffness and changes in the wall structure, leading to a loss of elasticity. Silicon is abundant in arteries and plays a key role in the synthesis and stabilization of elastin fibers. In animal models of accelerated cardiovascular aging, a specific nutritional supplement based on silicon-enriched spirulina (SpSi) has been shown to have beneficial effects on vascular function. The present study, designed as a randomized, double-blind, placebo-controlled trial, aimed to evaluate the effectiveness of this SpSi supplement on aging-related changes in vascular function among healthy older adults. Methods: Here, 120 healthy volunteers aged 60–75 years were enrolled and randomly assigned to either the SpSi group (n = 60) or placebo group (n = 60). Over 6 months, the participants received either 3.5 g of specific 1% silicon-enriched spirulina (SpSi group) or placebo tablets daily. The primary outcome was the assessment of arterial wall pressure waveforms, which included blood pressure (BP) readings and the determination of the aortic pulse wave velocity (aPWV). Secondary outcomes included the vasomotor endothelial function through post-ischemic vasorelaxation, measured using the reactive hyperemia index (RHI), and carotid intima–media thickness. Results: When considering the entire sample, none of the studied parameters differed between the placebo and SpSi groups. However, when focusing on individuals with high–normal blood pressure (i.e., systolic BP between 130 and 150 mmHg) and aPWV levels above cutoff values (&gt;10 m/s), the BP decreased by 8% (p &lt; 0.001) and aPWV decreased by 13.5% (p &lt; 0.0001) in subjects receiving SpSi. In individuals with BP and aPWV levels below the cutoff values, no effect was observed. Conclusions: In healthy elderly individuals, SpSi supplementation improved high–normal blood pressure and aortic pulse wave velocity, suggesting an enhanced vascular function.

Deciphering the role of Wnt/β-catenin and miR-214 in knee osteoarthritis: molecular and clinical insights.

Understanding the molecular mechanism underlying the pathogenesis of knee osteoarthritis (KOA) may be beneficial in fetching new therapeutics. Our study aims to investigate the implication of Wnt/ β-catenin pathway in development of KOA by detection of the downstream target genes and their crosstalk with miR-214 in patients with KOA and to correlate that with the clinical findings. Sixty participants were involved in the study. The levels of miR-214, β-catenin, Wnt4, matrix metalloproteinase 3 (MMP3), Bax, caspase 3, and phosphorylated glycogen synthase kinase-3 beta (pGSK3β) were determined. All participants were assessed clinically and radiologically regarding knee joint pain, stiffness, range of motion, and knee medial cartilage thickness. Besides, a correlation between Western Ontario and McMaster Universities (WOMAC) score, clinical, and radiological data, and the measured parameters was conducted. Patients with KOA showed downregulated miR-214 with upregulated β-catenin, Wnt4, MMP3, Bax, caspase 3, and pGSK3β compared to healthy individuals. Statistically significant positive correlation between WOMAC score, knee joint pain regarding Visual Analogue Scale (VAS) with β-catenin, pGSK3β, Wnt4, MMP3, Bax, and caspase 3, and significant negative relationship between them and knee joint medial cartilage thickness; while there was a statistically significant negative correlation between WOMAC, and clinical findings of osteoarthritis and miR-214 and significant positive relationship between it and knee joint medial cartilage thickness. This study provides valuable insights into involvement of the Wnt/β-catenin and miR-214 in KOA pathogenesis. By targeting these molecular components, future therapeutics may modulate their activity and mitigate chondrocyte apoptosis and matrix degradation, potentially halting KOA progression.

Treatment with PCSK9 inhibitors influences microRNAs expression and changes of arterial wall properties: a randomized controlled trial

BackgroundMicroRNAs (miRNAs) are involved in the synthesis of proprotein convertase subtilisin–kexin type 9 (PCSK9), one of the regulators of low-density lipoprotein cholesterol (LDL-C) metabolism, and are directly involved in the atherosclerotic process. The aim of this study was to verify whether treatment with PCSK9 inhibitors (PCSK9i) and changes in the expression of miRNAs involved in PCSK9 metabolism are associated with arterial wall properties in stable post-myocardial infarction (MI) patients with insufficiently regulated LDL-C levels and significantly increased Lp(a) levels.MethodsNinety-five patients after MI were enrolled and randomized to a placebo (N = 31) or PCSK9i group (N = 64). The treatment group received subcutaneous alirocumab 150 mg or evolocumab 140 mg, every 2 weeks. Blood for biochemical and epigenetic analysis was taken and ultrasound measurements of flow-mediated dilation of brachial artery (FMD), carotid intima–media thickness (c-IMT) and pulse wave velocity (PWV) were performed initially and after 6 months of treatment. The expression of the selected 5 miRNAs (miR-191-5p, miR-224-5p, miR-337-3p, miR-483-5p, and miR-552-3p) was quantified using quantitative polymerase chain reaction.ResultsA decrease in c-IMT was associated with a decrease in the expression of miR-337-3p (ρ = 0.329; p = 0.010) and miR-483-5p (ρ = 0.324; p = 0.012). We did not detect any associations between miRNA changes and FMD or PWV.ConclusionsOur results suggest that changes in the selected miRNAs are associated with changes in the morphological properties of the arterial wall. We have shown that the decrease in miR-483-5p expression present a good indicator of the regression of morphological atherosclerotic change.The trial registration: The study is registered with CinicalTrials under the number NCT04613167, date of registration November 2nd, 2020. Approval for this study was obtained from the National Medical Ethics Committee of the Republic of Slovenia (reference number: KME 0120-357/2018/8).

Evaluation of Coronary Artery Luminal Diameters in Patients with Pulmonary Arterial Hypertension

Background and Objectives: Recent studies have demonstrated that pulmonary arterial hypertension (PAH) is a vascular disease that extends beyond the pulmonary vasculature. PAH has been associated with increased intramural coronary arteriolar medial thickness and decreased coronary arteriolar luminal area in both human and experimental models of the disease. The objective of this study was to assess the luminal diameter of epicardial coronary arteries in patients with PAH. Materials and Methods: Fifty patients with PAH who underwent cardiac computed tomography (CT) angiography at our center were included in this retrospective study. Fifty patients without pulmonary hypertension matched for age, sex, and coronary dominance were also included. Coronary artery luminal diameters measured by cardiac CT angiography were compared between the groups, in addition to baseline characteristics and standard cardiac measurements. Correlation analysis was also performed. Results: The diameters of the left main coronary artery, left anterior descending artery, and left circumflex artery were comparable between the groups. However, the right coronary artery (RCA) diameter was found to be greater in the PAH group (3.51 ± 0.66 mm vs. 3.02 ± 0.49 mm, p &lt; 0.001). The RCA diameter exhibited a positive moderate correlation with the main pulmonary artery diameter (R = 0.517, p &lt; 0.001), right atrial area (R = 0.515, p &lt; 0.001), and right ventricular diastolic diameter (R = 0.506, p &lt; 0.001). Conclusion: PAH may be associated with an increase in the RCA diameter.

Cardio-metabolic effects of apremilast in patients with psoriatic arthritis: a prospective cohort study.

Psoriatic arthritis (PsA) is associated with metabolic and cardiovascular disease. Studies have suggested that treatment with apremilast is associated with weight loss and other cardio-metabolic benefits. This study aimed to examine the effects of apremilast on body weight, body composition and cardiovascular risk factors in PsA patients. This longitudinal, non-randomized, multicenter trial included adults with active PsA initiating apremilast (30 mg twice daily after a step-up regime). Patients were followed for 12 months, measurements were done at baseline and repeated at 26 and 52 weeks. Body composition, the primary outcome, was assessed using Dual Energy X-ray Absorptiometry (DEXA). Secondary outcomes included disease activity (DAS28-CRP), blood pressure, lipids, intima media thickness and glucose. Statistical analysis involved mixed models adjusted for relevant covariates. 44 patients were included, with mean age 56 years (±SD, 11 years) and median BMI of 28 kg/m2 [range 24-33]. 17 patients completed the study, while 27 discontinued due to ineffectiveness or side effects.After one year of apremilast significant reductions were observed in multiple body mass parameters, including total fat (-7.4 kg; p=0.005) and android fat (1.1 kg; p=0.002). Lean mass remained stable.Blood pressure showed minor reduction, while lipids, intima media thickness, and glucose levels did not change. Disease activity improved, with a significant decrease in DAS28-CRP (-0.6; p=0.02). Android fat correlated most strongly with disease activity reduction (r=0.312; p=0.004) CONCLUSION: This study demonstrates that apremilast reduces fat mass in PsA patients and suggests beneficial cardiovascular and metabolic effects, potentially reducing the risk for cardiovascular events.

Ultrasound Evaluation of the Short-Term Impact of Sleeve Gastrectomy on Common Carotid Artery Structure and Lower Limb Arterial Hemodynamics in Patients with Metabolic Syndrome: A Prospective Pilot Study.

To investigate the application value of ultrasound in assessing the short-term impact of sleeve gastrectomy (SG) on common carotid artery (CCA) structure and lower limb arterial hemodynamics in patients with metabolic syndrome (MS). Twenty-one patients with MS undergoing SG at our hospital were enrolled as the experimental group, with 29 healthy volunteers as the control group. Ultrasound was employed to measure and compare the lumen diameter (D), adventitial thickness (AT), intima media thickness (IMT), peak systolic velocity (PSV), end-diastolic velocity (EDV), and resistance index (RI) of bilateral CCA as well as the PSV and early diastolic reverse flow velocity (R) of lower limb arteries including common femoral (CFA), proximal superficial femoral (SFA), middle superficial femoral and popliteal arteries (POA) at baseline and 1month after SG. The correlation between laboratory indicators and ultrasound parameters of CCA was analyzed. The MS group had higher D (P = 0.004 and 0.041, respectively), AT (both P = 0.00), and IMT (both P = 0.00) of right and left CCA, lower EDV of right and left CCA(P = 0.009 and 0.019, respectively), lower PSV of RCCA (P = 0.021) and ultrasound parameters of lower limb arteries at baseline, compared to the control group. One month after SG, the MS group exhibited lower AT (both P = 0.00), IMT (P = 0.001 and 0.00, respectively), PSV and EDV (P = 0.009 and 0.019; P = 0.018 and 0.008, respectively)of right and left CCA, lower D of right CCA (P = 0.030) and certain lower limb arteries compared to preoperative levels. Correlation analysis revealed a positive correlation between white blood cell count (WBC), red blood cell count (RBC), hematocrit (HCT), absolute neutrophil count (NC), monocyte percentage (MP), average glucose (eAG), glycosylated hemoglobin (HbA1c), total cholesterol (TC), very low-density lipoprotein cholesterol (VLDL-C), and ultrasound parameters of CCA (P < 0.05). Patients with MS exhibited significant improvements in partial ultrasound parameters of CCA and lower limb hemodynamic 1month after SG, with a significant correlation to laboratory indicators, suggesting that ultrasound can offer clinical application value in assessing postoperative changes following SG in patients with MS and validating the effectiveness of SG.

Vascular remodelling in a mouse model of heart failure with preserved ejection fraction.

Heart failure (HF) with preserved ejection fraction (HFpEF) is a complex syndrome characterized by symptoms of HF despite normal left ventricular function. It now accounts for >50% of all HF cases, with the only effective treatment (morbidity benefit) so far being sodium-glucose co-transporter-2 inhibitors, finerenone and tirzepatide. Recently, vascular dysfunction has been highlighted as one of the main pathophysiological mechanisms of HFpEF. Recently, a 'two-hit' experimental model of HFpEF was described in which mice fed a high-fat diet (HFD) and l-NAME developed a phenotype that mimics human HFpEF. We further characterize this model by assessing vascular remodelling in the aorta, carotid and femoral arteries. C57BL/6N mice aged 11-12 weeks were fed a HFD and water supplemented with l-NAME 1.5g/L for 15 weeks. These mice manifested increased body weight and blood pressure, glucose and exercise intolerance, and cardiac structural and functional alterations consistent with HFpEF. Morphometric analyses were performed in the aorta, carotid and femoral arteries, revealing increased media thickness and media-to-lumen ratios. Moreover, we detected evidence of fibrosis in the middle layer of the aorta. A correlation between increased aortic remodelling and fibrosis with diastolic dysfunction was observed. Vascular reactivity studies using wire myography uncovered impaired vasoconstriction and vasodilatation responses, suggesting aortic stiffness. We also detected the presence of a senescence-like phenotype in the aortic wall. Together, these data offer valuable contributions to understanding the vascular mechanisms underlying HFpEF. KEY POINTS: Heart failure with preserved ejection fraction (HFpEF) represents >50% of heart failure patients. Despite its growing prevalence, the aetiology of HFpEF continues to be incompletely understood, mainly due to the lack of reliable animal models. An HFpEF mouse model, obtained by feeding mice a high-fat diet and exposing them to l-NAME, reproduces the majority of the clinical features observed in HFpEF patients. Possible vascular alterations elicited by this model remain unknown. Here, we report that HFpEF mice manifest aortic, carotid and femoral artery remodelling. The aorta also harboured fibrosis plus impaired vasodilatation and vasoconstriction responses. Aortic remodelling and fibrosis correlated with diastolic dysfunction. The aorta from HFpEF mice harboured increased p53, IL-6 and VCAM-1 protein levels, suggesting a senescence-like phenotype. These data reveal that this HFpEF mouse model displays vascular alterations similar to those reported in HFpEF patients. These findings unveil novel insights into the vascular remodelling of HFpEF and, furthermore, validate a reliable animal model that can be used to study HFpEF aetiology and potentially develop future therapeutic approaches.