Risk Of Vascular Disease Research Articles

HIGHER FLOW VELOCITIES AT BOTH CAROTID AND CEREBRAL ARTERIES WERE ASSOCIATED WITH HIGHER COGNITIVE PERFORMANCE IN THE MIDDLE-AGE INDIVIDUALS

Objective: Lower carotid flow velocities were associated with cognitive function in elderly populations, however, this association in middle-aged adults remains unclear. This study aimed to investigate the association between the flow velocity at carotid and cerebral arteries and cognitive function among middle-aged adults. Design and method: A total of 137 adults aged between 30 and 60 years old completed the physical examinations and cognition function evaluation and the measurements of flow velocities at the carotid and middle cerebral arteries (n = 47) in an ongoing study (Cardio Vascular Disease risk FACtors Two-township Study[CVDFACTS]). We used the Montreal Cognitive Assessment [MOCA] to evaluate the cognitive function. The carotid flow velocities at common and internal carotid arteries were measured by Carotid Doppler and the flow velocity at intracranial arteries (middle cerebral vessels) were measured by Trans-Cranial Doppler. Crude and partial correlation were used to evaluate the association between flow velocities and cognitive function. Results: Peak-systolic velocity (r = 0.184, p-value[p] = 0.045), diastolic velocity(r = 0.185, p = 0.044) and mean flow velocity(r = 0.207, p = 0.024) at internal carotid artery (ICA) were significantly associated with MOCA in the multivariable model with adjusting age, sex, education, systolic blood pressure, glucose and lipids. The correlation coefficients (n = 47) between mean flow velocity at the internal carotid artery and at intracranial arteries (middle cerebral vessels) were 0.93 (p-value <. 0001). In addition, higher internal cerebral mean flow was associated with higher cognitive preference (MOCA) (r = 0.41, p = 0.0093) in the model with adjusted for age, sex and education. Conclusions: Flow velocities at the internal carotid artery and at cerebral artery were highly correlated, and those were associated with lower cognitive function in the middle-age population. Carotid flow velocity may be involved the pathogenesis of early cognitive function decline in middle-age.

Disturbed Cardiorespiratory Adaptation in Preeclampsia: Return to Normal Stress Regulation Shortly after Delivery?

Women with pregnancies complicated by preeclampsia appear to be at increased risk of metabolic and vascular diseases in later life. Previous research has also indicated disturbed cardiorespiratory adaptation during pregnancy. The aim of this study was to follow up on the physiological stress response in preeclampsia several weeks postpartum. A standardized laboratory test was used to illustrate potential deviations in the physiological stress responding to mildly stressful events of the kind and intensity in which they regularly occur in further everyday life after pregnancy. Fifteen to seventeen weeks postpartum, 35 women previously affected by preeclampsia (19 mild, 16 severe preeclampsia), 38 women after uncomplicated pregnancies, and 51 age-matched healthy controls were exposed to a self-relevant stressor in a standardized stress-reactivity protocol. Reactivity of blood pressure, heart rate, stroke index, and systemic vascular resistance index as well as baroreceptor sensitivity were analyzed. In addition, the mutual adjustment of blood pressure, heart rate, and respiration, partitioned for influences of the sympathetic and the parasympathetic branches of the autonomic nervous system, were quantified by determining their phase synchronization. Findings indicated moderately elevated blood pressure levels in the nonpathological range, reduced stroke volume, and elevated systemic vascular resistance in women previously affected by preeclampsia. Despite these moderate abnormalities, at the time of testing, women with previous preeclampsia did not differ from the other groups in their physiological response patterns to acute stress. Furthermore, no differences between early, preterm, and term preeclampsia or mild and severe preeclampsia were observed at the time of testing. The findings suggest that the overall cardiovascular responses to moderate stressors return to normal in women who experience a pregnancy with preeclampsia a few weeks after delivery, while the operating point of the arterial baroreflex is readjusted to a higher pressure. Yet, their regulation mechanisms may remain different.

Fenotipo de la haptoglobina y presencia de enfermedad vascular subclínica: estudio poblacional

Introduction and objectivesHaptoglobin is a protein involved in the protection against oxidative damage caused by iron in haemoglobin. This protein is polymorphic, with 3 isomorphs prevalent in the population. The carriers of the Hp2-2 isoform have a lower antioxidant capacity and, in the population with diabetes, an increased risk of subclinical vascular disease and cardiovascular complications. The objective of this study was to evaluate whether this isomorphy is associated with an increased risk of carotid arteriosclerosis in subjects with and without diabetes, and free of cardiovascular disease. Patients and methodsA study was conducted in a population between 45 and 74years of age, randomly selected from the northwest area of Madrid. The participants were characterised in terms of their glycaemic status by oral glucose overload and the determination of the concentration of Hb1Ac. The haptoglobin phenotypes in all of them were determined by means of an immunoenzymatic assay, and the presence of carotid arteriosclerosis by ultrasound. ResultsOf the 1,256 participants included in the present analysis (mean age 61.6±6years, 41.8% males), the distribution of the isoforms of haptoglobin was as follows: Hp1-1: 13.3%, Hp1-2: 48.5%, and Hp2-2: 38.2%. In comparison with subjects Hp1-1 and Hp1-2, those with the Hp2-2 phenotype had a higher prevalence of dyslipidaemia (53.3% vs 43%; P<.0001) and arterial hypertension (39.2% vs. 32.2%, P=.012), and they more frequently received treatment with statins (31.5% vs 21.6%, P<.0001), and with antihypertensive agents (38.4% vs 30.8%, P=.006). The carriers of the Hp2-2 isoform had a higher prevalence of carotid plaques (OR: 1.35, 95%CI: 1.07-1.69, P=.011), with no differences in that prevalence as regards the glycaemic status. There were no differences in the intima-media thickness between the different phenotypes. The relationship of the Hp2-2 phenotype with the presence of plaques in the carotid was independent of age, gender, presence of risk factors (dyslipidaemia, hypertension and diabetes), the concentration of LDL-cholesterol, C-reactive protein and uric acid, blood pressure, and treatment with statins, and hypertensive drugs (OR: 1.31, 95%CI 1.01-1.70, P=.044). ConclusionSubjects with the Hp2-2 phenotype of haptoglobin have a higher prevalence of carotid arteriosclerosis, which is independent of the presence of other cardiovascular risk factors and their glycaemic status.

Variações anatômicas dos ramos do arco aórtico: relato de caso

Nos humanos, o arranjo considerado normal e mais frequente das artérias que se originam do arco aórtico é subclávia esquerda, carótida comum esquerda e tronco braquiocefálico. No entanto, são observadas e documentadas com frequência na literatura variações anatômicas na origem e na trajetória dos vasos sanguíneos do arco aórtico. Dessa forma, o objetivo do estudo foi relatar dois casos de variação anatômica observados nos ramos do arco aórtico em cadáveres formolizados. Durante a preparação das peças anatômicas para as aulas práticas no Laboratório de Anatomia Humana do Centro Universitário de Rio Preto (UNIRP), foram encontrados dois casos de variação anatômica dos ramos do arco aórtico. Observou-se a presença da artéria vertebral esquerda se originando a partir do arco aórtico, e a artéria carótida comum esquerda surgindo junto à origem do tronco braquiocefálico. Essas variações anatômicas encontradas no arco aórtico são importantes para diagnósticos clínicos e tratamentos cirúrgicos, pois diminuem os riscos de doenças e lesões vasculares.

Association of COX2 -765G>C promoter polymorphism and coronary artery disease in Korean population.

Cyclooxygenase-2 (COX2) plays a role in the formation of prostaglandins, which contribute to the inflammation involved in atherosclerosis. However, the role of the COX2 -765G>C polymorphism in susceptibility to coronary artery disease (CAD) is controversial. To identify the association between COX2 -765G>C polymorphism with CAD risk in Korean patients. We recruited 622 patients who were diagnosed to have coronary artery disease and 202 controls who did not have history and vascular disease risk factors. Using polymerase chain reaction-restriction fragment length polymorphism, the COX2 -765G>C polymorphism was analyzed in 622 Korean patients who received percutaneous coronary intervention and in 202 healthy control subjects. The GC+CC genotype frequencies of the -765G>C polymorphism were significantly different between the CAD and control groups. The COX2 -765G>C polymorphism showed peculiar associations with CAD according to the presence of hyperlipidemia and plasma folate levels. However, there were no associations between the -765G>C polymorphism and the rates of hypertension, diabetes mellitus, or homocysteine levels. This study suggests that the COX2 -765G>C polymorphism is a possible genetic determinant for the risk of CAD, and an individual risk factor in Koreans. Thus, further association studies between the COX2 polymorphism and atherosclerotic-related diseases such as cerebrovascular or cardiovascular diseases in other races or ethnicities will be needed.

257-OR: High Glucose Levels and Risk of Vascular Diseases—Observational Studies and Mendelian Randomization Studies of the General Population

Aim: To investigate the observational and causal associations between glucose levels in the nondiabetic range and risk of vascular diseases in the general population. Methods: We included 112,457 nondiabetic individuals from the Copenhagen City Heart Study and the Copenhagen General Population Study and assessed their prospective risk of retinopathy, neuropathy, diabetic nephropathy, peripheral arterial disease (PAD), and myocardial infarction (MI) as a function of increasing glucose levels. We used Mendelian randomization (MR) to assess a potential causal effect of high glucose levels on the vascular endpoints using genetic variants known to be associated with elevated glucose levels. We replicated our analyses in a 2-sample MR design using glucose data from the MAGIC consortium and vascular endpoint data from the UK Biobank. Results: Observationally, glucose levels in the nondiabetic range and higher were associated with increased risks of retinopathy, neuropathy, diabetic nephropathy, PAD, and MI (p trend for all &amp;lt;0.001). In genetic, causal analyses risk ratios for a 1 mmol/L higher glucose were 2.01 (95% confidence interval: 1.18-3.41) for retinopathy, 2.15 (1.38-3.35) for neuropathy, 1.58 (1.04-2.40) for diabetic nephropathy, 1.19 (0.90-1.58) for PAD, and 1.49 (1.02-2.17) for MI. Summary level data from the MAGIC consortium and the UK Biobank gave similar results. Conclusion: In this general population, glucose levels in the nondiabetic range and higher were prospectively associated with a high risk of retinopathy, neuropathy, diabetic nephropathy, PAD, and MI. These associations were causal for retinopathy, neuropathy, diabetic nephropathy, and MI, but causality could not be confirmed for PAD. These findings suggest that elevated glucose levels in the nondiabetic range is an important risk factor for microvascular diseases. Disclosure F. Emanuelsson: None. S. Marott: None. A. Tybjaerg-Hansen: None. B.G. Nordestgaard: None. M. Benn: None. Funding Danish Council for Independent Research

Epigenetic Regulation of Vascular Diseases.

Epigenetic regulatory mechanisms, encompassing diverse molecular processes including DNA methylation, histone post-translational modifications, and noncoding RNAs, are essential to numerous processes such as cell differentiation, growth and development, environmental adaptation, aging, and disease states. In many cases, epigenetic changes occur in response to environmental cues and lifestyle factors, resulting in persistent changes in gene expression that affect vascular disease risk during the lifetime of the individual. Biological aging-a powerful cardiovascular risk factor-is partly genetically determined yet strongly influenced by traditional risk factors, reflecting epigenetic modulation. Quantification of specific DNA methylation patterns may serve as an accurate predictor of biological age-a concept known as the epigenetic clock, which could help to refine cardiovascular risk assessment. Epigenetic reprogramming of monocytes rewires cellular immune signaling and induces a metabolic shift toward aerobic glycolysis, thereby increasing innate immune responses. This form of trained epigenetic memory can be maladaptive, thus augmenting vascular inflammation. Somatic mutations in epigenetic regulatory enzymes lead to clonal hematopoiesis of indeterminate potential, a precursor of hematologic malignancies and a recently recognized cardiovascular risk factor; moreover, epigenetic regulators are increasingly being targeted in cancer therapeutics. Thus, understanding epigenetic regulatory mechanisms lies at the intersection between cancer and cardiovascular disease and is of paramount importance to the burgeoning field of cardio-oncology (Graphic Abstract).

PS946 BLINATUMOMAB + PONATINIB FOR RELAPSED PH1‐POSITIVE ACUTE LYMPHOBLASTIC LEUKEMIA: THE FRENCH EXPERIENCE

Background:Despite the progress achieved with the combination of BCR‐ABL1 tyrosine kinase inhibitors (TKI) and chemotherapy, the prognosis of patients with a refractory/relapsed Philadelphia chromosome‐positive acute lymphoblastic leukemia (Ph1+ ALL) is still very dismal. However, new drugs have recently improved outcomes of these patients: ponatinib has shown some efficacy in this context and a recent study has reported very encouraging results of the anti‐CD3/CD19 monoclonal antibody blinatumomab as single‐agent. Data regarding the efficacy and tolerance of a combination of blinatumomab+ponatinib (blina/pona) are still scarce.Aims:Methods:This was a retrospective study in 12 French centers: 23 patients with a relapsed/refractory Ph1+ ALL have concomitantly received blinatumomab (28 mg/day by continuous infusion for 28 days every 6 weeks) and daily orally ponatinib.Results:There were 13 males and 10 females, with a median age of 58 years (range:17–72). All patients, but 3 with blast crisis of chronic myeloid leukemia, had de novo Ph1+ ALL. Seven cases (30.4%) had BCR‐ABL1 T315I mutation. Patients received the blina/pona combination, either after a first (n = 10) or a second or more (n = 11) cytologic relapse. There was one refractory patient. One patient received blina/pona in consolidation, after serious side effects from front‐line chemotherapy. Previous allograft and autograft has been performed in 9 and 4 patients, respectively. The majority of patients (n = 15) had previously received 3 2 or more lines of TKI. The median number of blinatumomab cycle administered per patient was 3 (range: 1–5) while ponatinib was administered continuously at an initial dose of 45 mg once daily in 17 pts (74%) and 30 mg in 6 pts (26%) during a median time of 5 months (range: 1–41) from first blinatumomab cycle. The toxicity profile was safe: blinatumomab was stopped in 48% of cases because of neurologic events in 4, infections in 4 and cytokine release syndrome in 3 patients; ponatinib was stopped in 22% of cases because of neurologic events in 3, hepatobiliary disorder in 1 and severe arteriopathy in 1 patient who had others vascular disease risk factors. All neurologic events resolved after stopping involved drug. All but one patient (95.6%) obtained a cytologic complete remission (CR), of whom 19/22 (86%) achieved a complete molecular response (CMR). However, 2 patients were documented with CNS relapse, treated with intrathecal infusion of chemotherapy. Then, 7 patients underwent allogeneic transplant (including 3 patients already allotransplanted before blina/pona). With a median follow‐up of 29 months (range: 17.5–66.7) for the alive patients (74%), median overall survival from first cycle of blina/pona was not reached and leukemia‐free survival was 18.2 months (range: 1.3–41). At last follow‐up (February 2019), 7 relapses had occurred at a median of 7 months (range: 1.3–41) from first blina/pona cycle and 1 patient had refractory disease. 6 patients (26%) had died of 2 bacterial infections, 2 fungal infections, 1 secondary cancer and 1 progressive refractory ALL. Among the 17 patients alive, one had relapsed and 16 are still in CMR, but 2 with CNS relapse. Twelve patients are still under ponatinib medication.Summary/Conclusion:The combination of blinatumomab+ponatinib appears effective and tolerable in relapsed Ph1+ALL patients. It could replace chemotherapy salvage regimens and allow a brigde to allogeneic transplantation, or may be tested in first‐line therapy in the future. Our results have to be confirmed prospectively on a larger cohort of patients.

Sex and gender-specific aspects in prediabetes and diabetes mellitus-clinical recommendations (Update 2019)

Metabolic diseases dramatically affect the life of men and women from infancy up to old age in different and manifold ways and are amajor challenge for the healthcare system. The treating physicians are confronted with the different needs of women and men in the clinical routine. Gender-specific differences affect screening, diagnostic and treatment strategies as well as the development of complications and mortality rates. Impairments in glucose and lipid metabolism, regulation of energy balance and body fat distribution and therefore the associated cardiovascular diseases, are greatly influenced by steroidal and sex hormones. Furthermore, education, income and psychosocial factors play an important role in the development of obesity and diabetes differently in men and women. Males appear to be at greater risk of diabetes at a younger age and at a lower body mass index (BMI) compared to women but women feature adramatic increase in the risk of diabetes-associated cardiovascular diseases after the menopause. The estimated future years of life lost owing to diabetes is somewhat higher in women than men, with a higher increase in vascular complications in women but a higher increase of cancer deaths in men. In women prediabetes or diabetes are more distinctly associated with ahigher number of vascular risk factors, such as inflammatory parameters, unfavorable changes in coagulation and higher blood pressure. Women with prediabetes and diabetes have a much higher relative risk for vascular diseases. Women are more often morbidly obese and less physically active but may have an even greater benefit in health and life expectation from increased physical activity than men. In weight loss studies men often showed a higher weight loss than women; however, diabetes prevention is similarly effective in men and women with prediabetes with arisk reduction of nearly 40%. Nevertheless, along-term reduction in all cause and cardiovascular mortality was so far only observed in women. Men predominantly feature increased fasting blood glucose levels, women often show impaired glucose tolerance. Ahistory of gestational diabetes or polycystic ovary syndrome (PCOS) as well as increased androgen levels in women and the presence of erectile dysfunction or decreased testosterone levels in men are important sex-specific risk factors for the development of diabetes. Many studies showed that women with diabetes reach their target values for HbA1c, blood pressure and low-density lipoprotein (LDL)-cholesterol less often than their male counterparts, although the reasons are unclear. Furthermore, sex differences in the effects, pharmacokinetics and side effects of pharmacological treatment should be taken more into consideration.

Complexity in the muscular blood vessel model with variable fractional derivative and external disturbances

In this paper, a variable fractional-order muscular blood vessel system under the influence of different external disturbances is proposed. Specifically, those external disturbances includes periodic forces, stochastic signal and time delay force. Its dynamical analysis is then carried out by employing the bifurcation diagram and phase portraits. Meanwhile, multiscale C0 complexity measure and multiscale 0–1 test are applied to analyze complexity and to detect chaos. It shows that the multiscale coarse graining process deduces better analysis results. Rich dynamics and high complexity are found in the system. Specifically, the noise and non-constant derivative order functions make the system more complex such that the risk of vascular disease is increased. It provides a reference for understanding the vascular disease with complex external disturbances.

Total Adiponectin and Risk of Symptomatic Lower Extremity Peripheral Vascular Disease in Type 2 Diabetes Mellitus

Total Adiponectin and Risk of Symptomatic Lower Extremity Peripheral Vascular Disease in Type 2 Diabetes Mellitus

Vascular Disease Risk Factors (VDRF) in MS is Associated with Brain ATP Abnormalities: Dysmetabolism May Drive MS Disease Progression. (S55.001)

Vascular Disease Risk Factors (VDRF) in MS is Associated with Brain ATP Abnormalities: Dysmetabolism May Drive MS Disease Progression. (S55.001)

Risk of vascular disease and cognitive function in very old adults.

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Cardio-Oncology: Vascular and Metabolic Perspectives: A Scientific Statement From the American Heart Association.

Cardio-oncology has organically developed as a new discipline within cardiovascular medicine as a result of the cardiac and vascular adverse sequelae of the major advances in cancer treatment. Patients with cancer and cancer survivors are at increased risk of vascular disease for a number of reasons. First, many new cancer therapies, including several targeted therapies, are associated with vascular and metabolic complications. Second, cancer itself serves as a risk factor for vascular disease, especially by increasing the risk for thromboembolic events. Finally, recent data suggest that common modifiable and genetic risk factors predispose to both malignancies and cardiovascular disease. Vascular complications in patients with cancer represent a new challenge for the clinician and a new frontier for research and investigation. Indeed, vascular sequelae of novel targeted therapies may provide insights into vascular signaling in humans. Clinically, emerging challenges are best addressed by a multidisciplinary approach in which cardiovascular medicine specialists and vascular biologists work closely with oncologists in the care of patients with cancer and cancer survivors. This novel approach realizes the goal of providing superior care through the creation of cardio-oncology consultative services and the training of a new generation of cardiovascular specialists with a broad understanding of cancer treatments.

The Effects of Pilates and Aerobic Exercise on Blood Pressure, Heart Rates, and Blood Serum Lipids in Sedentary Females

The aim of this study was to determinate the effects of 12 weeks pilates and aerobic exercise on blood pressure, heart rates, and blood serum lipids in sedentary females. 18 sedentary women with an average age of 45.52 years, height of 161.14 cm and weight of 72.5 kg have been selected and put through a plates and aerobic exercise programmer one hour a day for three days a week. Exercises in each training session were arranged in such a way as to make each woman’s heart rate to reach a level of 130-140 a minute. The waist and hip circumferences were measured using a measuring tape. BMI and waist hip ratio were calculated by standard formulas. Triglyceride (TG), Total Cholesterol (TC), High density lipoprotein (HDL-C) and Low density lipoprotein (LDL-C) levels were determined by Hitachi 717 auto analyzer. Analysis was performed on SPSS 21 version. Paired-t tests were done statistical analysis. Body Weight found before 12 weeks plates and aerobic exercise 72.5 kg and after 63.8 kg. At the end of the 12 weeks exercise program, a decrease of %12.00 in body weight, %14.03 in systolic, %3.96 in diastolic, %13.85 in cholesterol, %25.30 in Triglyceride, and %22.33 in LDL-C have been registered. However, there were increases of %16.34 in HDL-C. The effects of aerobic exercise is on Triglyceride, HDL-C, LDL-C and total cholesterol since (p&lt;0.01). At the end of the 12 weeks exercise program, a decrease %13.34 hip circumference and %4.19 waist circumference. Waist to hip ratio found before 12 weeks plates and aerobic exercise 0.87 cm and after 0.78 cm. The effects of aerobic exercise is on Body weight, Systolic blood pressure, Heart rate, hip and waist circumference since (p&lt;0.05; p&lt;0.01). In this study, together Pilates and aerobic exercise was effective in sedentary women with initially high total cholesterol, triglyceride, and Low density lipoprotein levels. At end of the cycles of 12 weeks Pilates and aerobic exercises, has a positive effect of waist to hip ratio, blood pressure, and heart beats in sedentary females. Risk of heart and vascular disease is reduced. Pilates and aerobic exercises are recommended for decrease risk.

A cross sectional study on health status and prevalence of risk factors of non-communicable diseases among auto rickshaw drivers of Hyderabad, Telangana

Background: Auto rickshaws form 10-20% of daily motorized urban transport and ensure connectivity and easy access throughout congested Indian cities. Harmful lifestyles practiced by auto rickshaw drivers like irregularity of meals, bad posture while driving, sedentary lifestyle predisposes them to many gastrointestinal, respiratory, musculoskeletal, cardiovascular diseases. This study was taken to assess the risk factors of non-communicable diseases among of auto rickshaw drivers. Objectives of the study were to estimate the proportion of various non-communicable diseases among study population and to assess various risk factors for non- communicable diseases among study population.Methods: A cross sectional study was carried out among 100 auto rickshaw drivers, aged above 20 years commuting at bus terminus and railway station in Hyderabad, Telangana using a predesigned questionnaire from May to July 2018.Results: The mean age of the study population was found to be 41.58±10.9 years. Around 14% of study subjects had history of diabetes mellitus and 15% hypertension. About 69% were overweight or obese, 41% had refractive errors and majority had musculoskeletal problems. The mean duration of physical activity was found to be 35±7 minutes/day.Conclusions: The prevalence of cardio vascular disease risk factors i.e. tobacco smoking, sedentary lifestyle, obesity was found to be quite high among auto rickshaw drivers. Early precautionary measures, regular medical check-up and prompt interventions are necessary for managing risk factors.

Effects of HIV-1 gp120 and TAT-derived microvesicles on endothelial cell function.

The aims of this study were twofold. The first was to determine if human immunodeficiency virus (HIV)-1 glycoprotein (gp) 120 and transactivator of transcription (Tat) stimulate the release of endothelial microvesicles (EMVs). The second was to determine whether viral protein-induced EMVs are deleterious to endothelial cell function (inducing endothelial cell inflammation, oxidative stress, senescence and increasing apoptotic susceptibility). Human aortic endothelial cells (HAECs) were treated with recombinant HIV-1 proteins Bal gp120 (R5), Lav gp120 (X4), or Tat. EMVs released in response to each viral protein were isolated and quantified. Fresh HAECs were treated with EMVs generated under control conditions and from each of the viral protein conditions for 24 h. EMV release was higher (P < 0.05) in HAECs treated with R5 (141 ± 21 MV/µl), X4 (132 ± 20 MV/µl), and Tat (130 ± 20 MV/µl) compared with control (61 ± 13 MV/µl). Viral protein EMVs induced significantly higher endothelial cell release of proinflammatory cytokines and expression of cell adhesion molecules than control. Reactive oxygen species production was more pronounced (P < 0.05) in the R5-, X4- and Tat-EMV-treated cells. In addition, viral protein-stimulated EMVs significantly augmented endothelial cell senescence and apoptotic susceptibility. Concomitant with these functional changes, viral protein-stimulated EMVs disrupted cell expression of micro-RNAs 34a, 126, 146a, 181b, 221, and miR-Let-7a (P < 0.05). These results demonstrate that HIV-1 gp120 and Tat stimulate microvesicle release from endothelial cells, and these microvesicles confer pathological effects on endothelial cells by inducing inflammation, oxidative stress, and senescence as well as enhancing susceptibility to apoptosis. Viral protein-generated EMVs may contribute to the increased risk of vascular disease in patients with HIV-1. NEW & NOTEWORTHY Human immunodeficiency virus (HIV)-1-related proteins glycoprotein (gp) 120 and transactivator of transcription (Tat)-mediated endothelial damage and dysfunction are poorly understood. Endothelial microvesicles (EMVs) serve as indicators and potent mediators of endothelial dysfunction. In the present study we determined if HIV-1 R5- and X4-tropic gp120 and Tat stimulate EMV release in vitro and if viral protein-induced EMVs are deleterious to endothelial cell function. gp120 and Tat induced a marked increase in EMV release. Viral protein-induced EMVs significantly increased endothelial cell inflammation, oxidative stress, senescence, and apoptotic susceptibility in vitro. gp120- and Tat-derived EMVs promote a proinflammatory, pro-oxidative, prosenescent, and proapoptotic endothelial phenotype and may contribute to the endothelial damage and dysfunction associated with gp120 and Tat.

A Wearable Sensor for Arterial Stiffness Monitoring Based on Machine Learning Algorithms

Arterial stiffness is strongly associated with cardiovascular events. Existing devices for evaluating arterial stiffness based on ultrasound or pulse wave velocity suffer a lot from complexity and inconvenience in home-care settings. This paper proposed a wearable sensor for arterial stiffness monitoring via machine learning techniques. The proposed sensor is comprised of one electrocardiogram (ECG) and one photoplethysmogram (PPG) module. The ECG and PPG signals were first simultaneously collected by the wearable sensor, and 21 features were extracted from two signals for arterial stiffness evaluation. A genetic algorithm-based feature selection method was then used to select the important indicators. Multivariate linear regression (MLR), decision tree, and back propagation (BP) neural network were employed to develop the model. Vascular age and 10-year cardiovascular disease risk from OMRON arteriosclerosis instrument were deemed as the gold standard to evaluate arterial stiffness. Experimental results based on 501 diverse subjects showed that the MLR approach exhibited the best accuracy in vascular age estimation (correlation coefficient, 0.89; mean of the residual, 0.2136; and standard deviation of the residual, 6.2432). While the BP neural networks-based approach was best in cardiovascular disease risk estimation (correlation coefficient, 0.9488; mean of the residual, - 0.3579%; and standard deviation of the residual, 3.7131%). The results indicate that the proposed learning-based sensor has great potential in arterial stiffness monitoring in home-care settings.

Cardiac and Vascular Events in Patients with History of Hematopoietic STEM CELL Transplant (HSCT) Are NOT Associated with Poor Outcomes: Analysis of National Inpatient Sample 2010-2014

Background Studies have suggested an increased risk of cardiovascular, cerebrovascular and peripheral vascular disease in patients with history of hematopoietic stem cell transplant (HSCT). (Tichelli et al, Blood 2007). This is attributed cumulative exposure to anthracyclines, total body or chest irradiation during treatment of the primary malignancy as well as the high prevalence of metabolic syndrome reported among HSCT survivors. Data on impact of HSCT on cardiovascular mortality are limited to single center studies. Our study aims to assess impact of HSCT on mortality associated with cardiovascular and cerebrovascular disease in a large national database. Methods We extracted data for all the adult admissions with cardiovascular or cerebrovascular events (myocardial infarction, angina, stroke and transient ischemic attack) from National Inpatient Sample (NIS) database from 2010-2014 and stratified it into two groups based on the status of HSCT; using ICD-9 CM diagnostic codes. The baseline characteristics, total charges per admission, length of stay and mortality were compared. Results A total of 6808386 admissions with primary diagnosis of either a cardiovascular or cerebrovascular event were identified, and amongst those 1254 admissions had underlying history of HSCT. Average age of patients was lower in patients with concomitant HSCT (59.57 yrs vs 69.01 yrs; p=0.00), with higher percentage of male patients (62.34% vs 53.8%, p=0.007). In-hospital mortality was noted in 44 (3.54%) patients in HSCT group, but it was not a clinically significant, when compared to the group without HSCT (in-hospital mortality in 3.84% patients). No significant difference was found in length of stay or average costs per admissions for patients with HSCT. Conclusion Annual cardiovascular risk factor evaluation for all HSCT recipients, with more frequent evaluations for high risk patients. Our study suggests that HSCT does not impact the mortality associated with cardiovascular events. These results support and validates strong efforts to promote healthy lifestyle behaviors and to treat cardiovascular risk factors aggressively in HCT survivors. Educating and reinforcing this published screening and preventive practice recommendations for Metabolic syndrome and cardiovascular disease amongst stakeholders like primary care physicians, oncologists, advanced practice providers may reduce future ischemic heart disease in this high-risk population.

Raised Serum Homocysteine Level is Associated with Hypertension

An elevated serum homocysteine concentration is associated with an increased risk of coronary, cerebral, and peripheral vascular disease. The objective of the study was to evaluate the association of serum homocysteine level with hypertension (HTN). This cross sectional analytical study was conducted at Sir Salimullah Medical College &amp; Mitford Hospital and National Health Care Network Dhaka, Bangladesh over a duration of 21 months from July 2012 to May 2014. Fifty HTN patients were included as study subjects and age and sex matched fifty non-HTN healtlhy controls were included. All the clinical measurements were taken and serum Hcy was measured for all study subjects. In this study, females were predominant in both groups, mean age of the HTN patients was 41.0±5.6 years and non-HTN healthy subjects was 38.2±5.2 years. BMI and FBG were found higher in HTN group than that of non-HTN group but the differences were not statistically significant. Systolic and diastolic BP were found significantly higher in HTN group than that of non-HTN group. Serum Hcy level was significantly higher in HTN group (19.93±4.12 μmol/L) than that of non-HTN group (13.20±1.88 μmol/L). This study depicted that serum Hcy had significant correlation with SBP and DBP in HTN. In conclusion, it was seen that elevated serum Hcy level is associated with hytpertension.&#x0D; Bangladesh J Med Biochem 2018; 11(1): 22-25