Prognosis Of Vascular Diseases Research Articles

Impact of frailty, early vascular decline and subclinical cognitive impairment in midlife adults: study protocol of the Toledo Study for Healthy Ageing in middle age.

Life expectancy has increased worldwide alongside a rise in disability prevalence during old age. The impact and interrelationship among the precursors of disability in midlife remain to be better understood. Furthermore, investigating whether lifestyle factors may potentially influence health outcomes and the prognosis of vascular disease could be especially relevant among the middle-aged population, which is a priority subpopulation when prevention is the goal. This is an observational, cross-sectional and population-based study. Participants, between 50 and 55 years old, are randomly selected from the municipality of Toledo (Spain). There are six non-consecutive days for the assessments, providing enough rest between evaluations. Participants perform the interview of the Toledo Study for Healthy Aging. Blood pressure monitoring and a resting electrocardiogram are also recorded. Then, resting peripheral and cerebral vascular measurements along with muscle size and architecture are assessed. Blood and urine samples, and body composition data are collected after an overnight fasting. On a different visit, physical performance and muscle function tests are performed. Additionally, brain magnetic resonance imaging is conducted. And finally, an accelerometer is given to the participants for a week. Frailty is evaluated by Frailty Trait Scale and Fried Frailty Phenotype. This project will shed light on the associations between frailty, early cognitive impairment, and vascular aging during midlife, and on the role that lifestyles play in their development. Lastly, this project will provide meaningful implications for public health strategies aimed at promoting healthy aging in later life.

Long non-coding RNAs: Modulators of phenotypic transformation in vascular smooth muscle cells.

Long non-coding RNA (lncRNAs) are longer than 200 nucleotides and cannot encode proteins but can regulate the expression of genes through epigenetic, transcriptional, and post-transcriptional modifications. The pathophysiology of smooth muscle cells can lead to many vascular diseases, and studies have shown that lncRNAs can regulate the phenotypic conversion of smooth muscle cells so that smooth muscle cells proliferate, migrate, and undergo apoptosis, thereby affecting the development and prognosis of vascular diseases. This review discusses the molecular mechanisms of lncRNA as a signal, bait, stent, guide, and other functions to regulate the phenotypic conversion of vascular smooth muscle cells, and summarizes the role of lncRNAs in regulating vascular smooth muscle cells in atherosclerosis, hypertension, aortic dissection, vascular restenosis, and aneurysms, providing new ideas for the diagnosis and treatment of vascular diseases.

High-resolution functional photoacoustic monitoring of vascular dynamics in human fingers

Functional imaging of microvascular dynamics in extremities delivers intuitive information for early detection, diagnosis, and prognosis of vascular diseases. High-resolution and high-speed photoacoustic microscopy (PAM) visualizes and measures multiparametric information of microvessel networks in vivo such as morphology, flow, oxygen saturation, and metabolic rate. Here, we demonstrate high-resolution photoacoustic monitoring of vascular dynamics in human fingers. We photoacoustically monitored the position displacement of blood vessels associated with arterial pulsation in human fingers. Then, during and after arterial occlusion, we photoacoustically quantified oxygen consumption and blood perfusion in the fingertips. The results demonstrate that high-resolution functional PAM could be a vital tool in peripheral vascular examination for measuring heart rate, oxygen consumption, and/or blood perfusion.

The role of high high-sensitivity C-reactive protein levels at admission on poor prognosis after acute ischemic stroke

Objective: Plasma high hypersensitive C-reactive protein (hs-CRP) levels are associated with risk and prognosis of vascular diseases. The clinical implications of markedly elevated hs-CRP levels are more discovered in the onset and development of stroke. The aim of this study is to determine the association of plasma hs-CRP levels on the prognosis in patients with acute ischemic stroke.Methods: Retrospective analysis of a single-center database of consecutive cases for acute cerebral infarction (ACI) from January 1 2012 to December 30 2016 was performed. Significant predictors of the dependent variable variance were identified by standard linear, univariate and multivariate, or binary logistic regression modeling. Multivariate regression analysis was introduced to investigate the relationship between plasma hs-CRP levels at admission and change in National Institutes of Health Stroke Scale (NIHSS) score at discharge.Results: The percentages of hypertension, diabetes mellitus, hyperlipidemia, atrial fibrillation, body mass index (BMI) and chronic kidney disease were raised with the increase of hs-CRP plasma concentration at admission among all patients (p < 0.05). ACI patients with large-artery atherosclerosis had an increasing percentage with the increase of hs-CRP mean value (p < 0.05). The initial NIHSS scores, the acute infection rate and age advance also increased with the increase of hs-CRP plasma concentration at admission (p < 0.05). The ratio of neurological improvement increased with the decrease of plasma hs-CRP concentration (p < 0.05). The neurological deterioration and poor prognosis increased with the increase of plasma hs-CRP concentration (p < 0.05).Conclusion: High plasma hs-CRP levels are associated with worse outcomes in the ACI patients. Monitoring plasma hs-CRP levels and cutting down the elevated plasma hs-CRP levels will be beneficial in screening and treatment decisions for the prognosis of acute ischemic stroke.

Dopplerfluxometria da artéria femoral de cães adultos hígidos (Canis lupus familiaris)

Background: In Veterinary Medicine, there are several methods for early and accurate assessment of blood flow dynamics. The Dopplerfluxometry can access the peak systolic velocity, mean velocity and end diastolic velocity, including Resistive Index and Pulsatility Index. Normal values of Dopplerfluxometry in healthy dogs allow the identification of vascular abnormalities and authors’ knowledge there are no reference regarding the values of Dopplerfluxometry of the femoral artery in healthy dogs. The aim of the study was to assess the femoral Dopplerfluxometry of adult healthy dogs by Resistive Index, Pulsatility Index, systolic and diastolic velocities, and femoral artery diameter.Materials, Methods &amp; Results: Eighteen healthy intact beagle dogs, male and female, aging from 2 to 4 years old (mean ± SD: mean 3 ± 0.8 years), weighing from 10.1-17.9 kg [22.3-39.5 lb] [mean ± SD: 14.3 ± 2.7 kg (31.5 ± 5.96 lb)] were used. The dogs underwent to physical examination, complete blood cell count, serum biochemistry examination urinalysis, and radiographs examination, muscular and cardiac evaluation. Females had to be in anestrous. All dogs were submitted to right femoral artery Dopplerfluxometry. The dogs were positioned in dorsal recumbency by one person without any chemical restraint. A high definition ultrasound device equipped with a 3 - 13 MHz multi-frequency linear transducer was used. The right femoral artery was identified with the transducer positioned transversely on the right triangle femoral area. Peak systolic velocity, end-diastolic velocity was measured. The Resistivity Index and Pulsatility Index were calculated automatically by the ultrasound machine software. Three measurements were obtained with the Doppler spectrum. The values of peak systolic velocity, end-diastolic velocity, Resistivity Index, Pulsatility Index and femoral artery diameter were expressed as Mean ± Standard Deviation (SD).Discussion: No studies regarding to femoral artery Dopplerfluxometry in healthy dogs were found in the literature. These results can be used as normal reference values of Dopplerfluxometric parameters for adult dogs. The literature cited only Dopplerfluxometric values of renal arteries, abdominal aorta and of the internal thoracic artery. The normal values of arterial Dopplerfluxometry is necessary to identify the spectral quantitative characteristics of the blood flow for diagnosis and prognosis of vascular diseases. Authors referred to changes in blood perfusion by Dopplerfluxometry examination, but no changes in B-mode ultrasonography. The femoral Resistivity Index values can be used to correlate the postoperative evolution in dogs submitted to femoral bone, hip and knee surgeries, since Dopplerfluxometry allows blood flow assessment in the femoral region muscles. Changes in the heart rate, blood pressure, stress, exercise, and diseases as hypotension, renal lesion, hepatic diseases, diabetes, hyperadrenocorticism can change the Dopplerfluxometric parameters. All dogs which used in this study were clinically healthy, and were used beagle dogs due to lowest variations within breed. Sedation was avoid due to possible changes in Dopplerfluxometric parameters since the use of sedation or tranquilization in animals is strongly discussed due to possible hemodynamic changes that may occur during the examination. In conclusion, the mean values of the right femoral artery Dopplerfluxometry in male and female adult healthy dogs is Resistivity Index (0.887); Pulsatility Index (1.599); peak systolic velocity (124.41 cm/s), end-diastolic velocity (14.12 cm/s), femoral artery diameter (3.9 mm).

Novel Approach for 99mTc-Labeling of Red Blood Cells: Evaluation of 99mTc-4SAboroxime as a Blood Pool Imaging Agent.

Angiography with radiolabeled red blood cells (RBCs) plays an important role in diagnosis and prognosis in vascular diseases. Both in vitro and in vivo methods have been developed for 99mTc-labeling of RBCs. However, these methods are complicated and lack reproducibility. Therefore, it is highly desirable to develop an alternative method for routine 99mTc-labeling of RBCs. In this report, we present a novel approach for 99mTc-labeling of RBCs. We prepared a new 99mTc(III) radiotracer [99mTcCl(CDO)(CDOH)2B-4AS] (99mTc-4ASboroxime: 4AS-B(OH)2 = 4-aminosulfonylphenyl)boronic acid, and CDOH2 = cyclohexanedione dioxime) in >95% radiochemical purity. Imaging and biodistribution studies were performed in Sprague-Dawley (SD) rats. It was found that the blood radioactivity was ∼6.0%ID/g (∼90% injected dose for 200-225 g SD rats) for 99mTc-4ASboroxime with low uptake in the myocardium, kidneys, liver, lungs, and muscle, most likely due to lack of leakage of 99mTc-labeled RBCs from the intravascular space. The blood radioactivity was almost unchanged over the 2 h period, suggesting that the binding of 99mTc-4ASboroxime to blood components (cells, proteins, and plasma) is stable. The results from γ-counting of the isolated blood components showed that 99mTc-4ASboroxime had >95% of blood radioactivity binding to RBCs, ∼1% to albumin, and ∼3% remaining free in blood plasma, demonstrating its RBC-specificity. The results from imaging studies in SD rats indicated that 99mTc-4ASboroxime is predominantly distributed in the blood pool. Main blood vessels were well delineated in the head/neck and abdominal regions. This statement was further substantiated by the results from imaging studies in pigs. 99mTc-4ASboroxime is an excellent blood pool agent with the potential for diagnosis and prognosis of vascular diseases.

Microvesicles Derived from Indoxyl Sulfate Treated Endothelial Cells Induce Endothelial Progenitor Cells Dysfunction.

Cardiovascular disease is a major cause of mortality in chronic kidney disease patients. Indoxyl sulfate (IS) is a typical protein-bound uremic toxin that cannot be effectively cleared by conventional dialysis. Increased IS is associated with the progression of chronic kidney disease and development of cardiovascular disease. After endothelial activation by IS, cells release endothelial microvesicles (EMV) that can induce endothelial dysfunction. We developed an in vitro model of endothelial damage mediated by IS to evaluate the functional effect of EMV on the endothelial repair process developed by endothelial progenitor cells (EPCs). EMV derived from IS-treated endothelial cells were isolated by ultracentrifugation and characterized for miRNAs content. The effects of EMV on healthy EPCs in culture were studied. We observed that IS activates endothelial cells and the generated microvesicles (IsEMV) can modulate the classic endothelial roles of progenitor cells as colony forming units and form new vessels in vitro. Moreover, 23 miRNAs were contained in IsEMV including four (miR-181a-5p, miR-4454, miR-150-5p, and hsa-let-7i-5p) that were upregulated in IsEMV compared with control endothelial microvesicles. Other authors have found that miR-181a-5p, miR-4454, and miR-150-5p are involved in promoting inflammation, apoptosis, and cellular senescence. Interestingly, we observed an increase in NFκB and p53, and a decrease in IκBα in EPCs treated with IsEMV. Our data suggest that IS is capable of inducing endothelial vesiculation with different membrane characteristics, miRNAs and other molecules, which makes maintaining of vascular homeostasis of EPCs not fully functional. These specific characteristics of EMV could be used as novel biomarkers for diagnosis and prognosis of vascular disease.

Phenomics of Vascular Disease: The Systematic Approach to the Combination Therapy.

Vascular diseases are usually caused by multifactorial pathogeneses involving genetic and environmental factors. Our current understanding of vascular disease is, however, based on the focused genotype/phenotype studies driven by the “one-gene/one-phenotype” hypothesis. Drugs with “pure target” at individual molecules involved in the pathophysiological pathways are the mainstream of current clinical treatments and the basis of combination therapy of vascular diseases. Recently, the combination of genomics, proteomics, and metabolomics has unraveled the etiology and pathophysiology of vascular disease in a big-data fashion and also revealed unmatched relationships between the omic variability and the much narrower definition of various clinical phenotypes of vascular disease in individual patients. Here, we introduce the phenomics strategy that will change the conventional focused phenotype/genotype/genome study to a new systematic phenome/genome/proteome approach to the understanding of pathophysiology and combination therapy of vascular disease. A phenome is the sum total of an organism’s phenotypic traits that signify the expression of genome and specific environmental influence. Phenomics is the study of phenome to quantitatively correlate complex traits to variability not only in genome, but also in transcriptome, proteome, metabolome, interactome, and environmental factors by exploring the systems biology that links the genomic and phenomic spaces. The application of phenomics and the phenome-wide associated study (PheWAS) will not only identify a systemically-integrated set of biomarkers for diagnosis and prognosis of vascular disease but also provide novel treatment targets for combination therapy and thus make a revolutionary paradigm shift in the clinical treatment of these devastating diseases.

Roles of miR-15b in endothelial cell function and their relevance to vascular diseases

MicroRNAs (miRNAs) are noncoding RNAs with a short length of about 22 nucleotides. As major modulators participating in RNA interference, they affect cellular behaviors by regulating the expression of diverse genes at post-transcriptional levels. miR-15b is a member of the miR-15/16 family, which is broadly expressed in major tissues and specially enriched in the endovascular system of human beings. miR-15/16 affects cellular proliferation, apoptosis, invasion and angiogenesis. In this review, we summarize the role and the underlying mechanism of miR-15b as well as other miR-15/16 family members in different cells, especially in endothelial cells. We focus on the diverse roles of miR-15b in the occurrence, progression and prognosis of vascular diseases, with particular emphasis on preeclampsia, a hypertensive disorder related to endovascular dysfunction in the placenta.

Interventional neuroradiology in children.

Conclusions about pediatric interventional neuroradiology • It deals with rare diseases that are mostly not treatable by a direct surgical approach. Results have been published that cannot be ignored today. • The traditionally poor prognosis of vascular disease in young children cannot justify isolated heroic procedures, just because the tools are easy to use and to purchase. • The low costs, clinical efficiency and low mortality-morbidity in cerebral intervention require a critical mass of patients per year. • In a given place standards of quality should be guaranted before settling on pediatric interventional neuroradiology and not after ward. • Although an interventional neuroradiologist is required for 5 million patients in the adult population, the vascular disease spread in pediatrics probably justifies European network coverage by a few centers to offer satisfactory training and the creation of new converging centers.

Peripheral Vascular Disease

This article, in three parts, is about peripheral vascular disease. The topic has appeared on medicine and surgery examination papers regularly over the last few years. Examiners have become increasingly concerned about the content of many answers, the number of similar inaccuracies that have appeared and, in particular, the confusion between arterial disease and venous disorders, their treatment and management. Concern was also expressed at the disturbing tendency for amputation to be quoted as the only form of treatment available. The Education and Research Board takes the view that it is essential that therapists have a thorough, up-to-date understanding of the symptoms, management and prognosis of vascular disease, particularly since these conditions are often present in patients whose primary referral may have been for other reasons. In this article the topic of amputation is not considered in depth since this is considered to be only one option — a last resort in the range of treatments available. It is hoped that this article will assist students and occupational therapists alike to ensure that their knowledge and approach to this topic is up to date. — L S Phillips, Chairman, Examinations Standing Group (England, Ireland &amp; Wales).