Structural Vascular Changes Research Articles

MD-Net: A multi-scale dense network for retinal vessel segmentation

Accurate retinal fundus vessel segmentation can contribute to precisely diagnosing diseases that cause retinal vascular structural changes. At present, retinal vessels are usually segmented manually in most hospitals. However, manual segmentation is time consuming and labor intensive. Moreover, due to the complex morphology of blood vessels, it is still a challenging task for computer automatic segmentation methods to achieve accurate segmentation. To address these problems, a multi-scale dense network (MD-Net) that can make full use of multi-scale information and encoder features is proposed in this paper. In this work, residual atrous spatial pyramid pooling (Res-ASPP) modules are embedded in the encoder to extract multi-scale information of blood vessels with improved information flow. Furthermore, a dense multi-level fusion mechanism is proposed to densely merge the multi-level features in the encoder and the decoder so that the feature losses are minimized. In addition, squeeze-and-excitation (SE) blocks are applied in the concatenation layers to emphasize effective feature channels. The network is evaluated on the DRIVE, STARE and CHASE_DB1 databases. The accuracy, dice similarity coefficient (DSC), sensitivity and specificity of MD-Net on these three databases are 0.9676/0.8099/0.8065/0.9826, 0.9732/0.8411/0.8290/0.9866 and 0.9731/0.7877/0.7504/0.9889, respectively. In addition, the overall performance of MD-Net outperforms other current state-of-the-art vessel segmentation methods, which indicates that the proposed network is more suitable for retinal blood vessel segmentation, and is of great clinical significance.

Effects of exercise training with blood flow restriction on vascular function in adults: a systematic review and meta-analysis.

BackgroundBlood flow restricted exercise (BFRE) improves physical fitness, with theorized positive effects on vascular function. This systematic review and meta-analysis aimed to report (1) the effects of BFRE on vascular function in adults with or without chronic health conditions, and (2) adverse events and adherence reported for BFRE.MethodologyFive electronic databases were searched by two researchers independently to identify studies reporting vascular outcomes following BFRE in adults with and without chronic conditions. When sufficient data were provided, meta-analysis and exploratory meta-regression were performed.ResultsTwenty-six studies were included in the review (total participants n = 472; n = 41 older adults with chronic conditions). Meta-analysis (k = 9 studies) indicated that compared to exercise without blood flow restriction, resistance training with blood flow restriction resulted in significantly greater effects on endothelial function (SMD 0.76; 95% CI [0.36–1.14]). No significant differences were estimated for changes in vascular structure (SMD −0.24; 95% CI [−1.08 to 0.59]). In exploratory meta-regression analyses, several experimental protocol factors (design, exercise modality, exercised limbs, intervention length and number of sets per exercise) were significantly associated with the effect size for endothelial function outcomes. Adverse events in BFRE studies were rarely reported.ConclusionThere is limited evidence, predominantly available in healthy young adults, on the effect of BFRE on vascular function. Signals pointing to effect of specific dynamic resistance exercise protocols with blood flow restriction (≥4 weeks with exercises for the upper and lower limbs) on endothelial function warrant further investigation.

Visit-to-visit office blood pressure variability revisited in SPRINT.

Visit-to-visit office blood pressure variability revisited in SPRINT.

Retinal Microvascular Vessel Density Differences between Adult Athletes and Nonathletes.

Regular physical activity may affect the neurovascular structures. Many studies have shown the positive effects of physical activity on ocular disorders such as glaucoma, retinopathy, and macular degeneration. Athletes were expected to have a better retinal vascular structure compared with the nonathletes. This study aimed to evaluate the effects of regular physical activity on the retinal microvascular structure. This observational and cross-sectional study was conducted between January and July 2020 with participants aged 20 to 35 years who had a visual acuity of ≥20/20, axial length of 22 to 24 mm, refractive defect spherical equivalent of ≤±1 D, and IOP of ≤21 mmHg. Updated AngioScan software (Navis version 1.8.0) of Nidek's RS-3000 Advance system was used to analyze the spectral-domain optical coherence tomography and optical coherence tomography angiography images. A total of 60 right eyes of 60 individuals were included in the study. Thirty subjects were in the athlete group, and 30 patients were in the nonathlete group. Sixteen of the individuals in the athlete group and 15 in the nonathlete group were women (P > .05). Retinal nerve fiber layer and ganglion cell complex thicknesses in all quadrants were thinner in nonathletes (P < .05). All of the Early Treatment Diabetic Retinopathy Study regions except central foveal subfield thickness were significantly higher in the athlete group (P < .05). In the nonathlete group, significantly reduced vessel densities of the superficial and deep capillary plexus and radial peripapillary capillary plexus, and the foveal avascular zone circularity index along with an increased foveal avascular zone perimeter and area were also detected (P < .05). Our study revealed that optical coherence tomography angiography measurements may be used in the determination of the effects of physical activity on retinal vascular structure changes.

This issue of ACTA

This issue of ACTA

MO728OPTICAL COHERENCE TOMOGRAPHY ANGIOGRAPHY (OCT-A) METRICS PREDICT INTRADIALYTIC HYPOTENSION EPISODES IN CHRONIC HEMODIALYSIS PATIENTS: A PILOT, PROSPECTIVE STUDY

Abstract Background and Aims In chronic hemodialysis (HD) patients, intradialytic hypotension (IDH) is a complication that increases mortality risk. The pathogenesis of this condition remains partly unexplained although dysfunctions of the nervous autonomous system and various factors related to the hemodialytic procedure like rapid or excessive ultrafiltration, excessive reduction in osmolality and reaction to the dialyzer membrane or machine tubing, seem to play a key role. The observation of ocular microcirculation gives us an exceptional chance to directly evaluate in vivo the reactions of human circulation to stress stimuli. Indeed, the ocular microcirculation is involved in systemic disease and early changes in vascular structures may predict the development of systemic vascular disorders. We run a pilot study to analyzing possible relationships between optical coherence tomography angiography (OCT-A) metrics and IDH and to evaluate whether OCT-A could represent a useful tool to stratify the hypotensive risk in dialysis patients. Method a total of 35 eyes (35 patients) being correctly analyzed. OCT-A was performed before and after a single dialysis session. Patients were then followed up to 30 days (10 HD sessions) and a total of 73 IDHs were recorded with 12 patients (60%) experiencing at least one IDH. Results Central choroid thickness (CCT), 6x6 mm whole vessel density (VD) of superficial capillary plexus (SPC) and 6x6 mm foveal VD of deep capillary plexus (DCP) were reduced after dialysis (Figure 1). At logistic regression analysis, IDH was positively associated with baseline foveal VD of SCP and DCP, while an inverse association was found with the choroid (Figure 2). In Kaplan-Meier analyses of patients categorized according to the ROC-derived optimal thresholds, CCT, the 3x3 foveal VD of SCP, the 3x3 mm and 6x6 mm foveal VD of DCP and the 6x6 mm foveal VD of SCP were strongly associated with a higher risk of IDH over the 30-days follow-up. Conclusion In our study, we demonstrated that HD patients experiencing frequent IDH episodes showed a different ocular pattern with respect to those not facing with this complication. Furthermore, a simple measurement of retinal and choroid parameters by OCT-A before a single dialysis session may help predicting the risk of following IDH in the short-term. In HD patients, a single OCT-A measurement may represent a non-invasive, rapid tool to evaluate the compliance of vascular bed to HD stress and to stratify the risk of IDH in the short term.

Childhood vascular phenotypes have differing associations with prenatal and postnatal growth.

Objective:In children aged 8--9 years, we examined the associations of linear and abdominal circumference growth during critical stages of prenatal and postnatal development with six vascular measurements commonly used as early markers of atherosclerosis and later cardiovascular disease (CVD) risk.Methods:In 724 children from the UK Southampton Women's Survey mother--offspring cohort, offspring length/height and abdominal circumference measurements were collected at 10 ages between 11 weeks’ gestation and age 8--9 years. Using residual growth modelling and linear regression, we examined the independent associations between growth and detailed vascular measures made at 8--9 years.Results:Postnatal linear and abdominal circumference growth were associated with higher childhood SBP and carotid--femoral pulse wave velocity, whereas prenatal growth was not. For example, 1SD faster abdominal circumference gain between ages 3 and 6 years was associated with 2.27 [95% confidence interval (CI): 1.56--2.98] mmHg higher SBP. In contrast, faster abdominal circumference gain before 19 weeks’ gestation was associated with greater carotid intima--media thickness [0.009 mm (0.004--0.015) per 1SD larger 19-week abdominal circumference), whereas later growth was not. We found no strong associations between prenatal or postnatal growth and DBP or measures of endothelial function.Conclusion:Higher postnatal linear growth and adiposity gain are related to higher SBP and carotid--femoral pulse wave velocity in childhood. In contrast, faster growth in early gestation is associated with greater childhood carotid intima--media thickness, perhaps resulting from subtle changes in vascular structure that reflect physiological adaptations rather than subclinical atherosclerosis.

Ultrasound evaluation of cardiovascular function in male and female APOE3 and APOE4 mice

Introduction Alzheimer's disease (AD) is the most common form of dementia and is the 6th leading cause of death in the US. Growing evidence supports a link between AD and cardiovascular disease (CVD). Variant isoforms of apolipoprotein E (APOE) are risk factors for both AD and CVD. The most common APOE isoform, APOE3, has neutral risk for developing AD, whereas APOE4 increases AD risk. Pathogenic alterations in cardiac (C), aortic (TA) and carotid artery (CA) function are known to contribute to neurodegenerative diseases including AD. Previous studies in our lab have demonstrated cerebral arteries from APOE3 mice exhibit “normal” aging characteristics, whereas cerebral arteries from APOE4 mice exhibited a delay in age-related changes in vascular structure and function. Because of this observation, we investigated whether age-related changes in cardiac structure/function (in vivo) mirrored in vitro experiments of isolated cerebral arteries. Here, we evaluated age-related changes in cardiac structure/function, in mice expressing human-ApoE targeted replacement of APOE3 (B6.129P2-Apoetm2(APOE*3)Mae N8) or APOE4 (B6.129P2-Apoetm3(APOE*4)Mae N8)(Taconic Labs). We hypothesized that mice expressing APOE4 would have delayed age-related changes in cardiac structure/function compared to age matched APOE3 mice. Methods In vivo high-resolution ultrasound (U/S) imaging was performed to evaluate the structure and function of cardiac, thoracic aorta (TA), carotid artery (CA), and cerebral blood flow in young (3-4 months), adult (12-14 months) and aged (18-20 months), APOE3 and APOE4 mice. Male and female mice were used. Blood pressure (BP) was determined using the tail-cuff method. All U/S and BP values were collected under isoflurane anesthesia. Results were considered significant at p<0.05. Results Both hAPOE3 and hAPOE4 mice exhibited age-related increase in body weight. The peak velocity measurements of the posterior cerebral artery showed no statistical difference between the groups. CA structure and function was assessed by wall thickness (WT) and pulse wave velocity (PWV) respectively. Our data showed an age-related increase in CA PWV and WT in hAPOE3 and hAPOE4 mice. TA PWV also showed an age-related increase in both hAPOE3 and hAPOE4 mice (P<0.05). The indices of cardiac function, cardiac output (CO), ejection fraction (EF), stroke volume (SV) showed no significant difference between the groups. The left ventricle mass increased with age in both hAPOE3 and hAPOE4 mice. And finally, the systolic and diastolic BP values showed no significance difference between groups. Conclusion These data suggest that hAPOE3 and hAPOE4 mice show similar age-related cardiac and vascular changes. Future studies have been designed to assess whether psycho-social stress and/or diet are involved in APOE4 allele related development of CVD and AD/dementia.

Adverse Vascular Functional and Structural Changes Secondary to Breast Cancer and its Treatments with Adjuvant Therapy: a Systematic Review

Adverse Vascular Functional and Structural Changes Secondary to Breast Cancer and its Treatments with Adjuvant Therapy: a Systematic Review

VEGFA165 gene therapy ameliorates blood-labyrinth barrier breakdown and hearing loss.

Millions of people are affected by hearing loss. Hearing loss is frequently caused by noise or aging and often associated with loss of pericytes. Pericytes populate the small vessels in the adult cochlea. However, their role in different types of hearing loss is largely unknown. Using an inducible and conditional pericyte depletion mouse model and noise-exposed mouse model, we show that loss of pericytes leads to marked changes in vascular structure, in turn leading to vascular degeneration and hearing loss. In vitro, using advanced tissue explants from pericyte fluorescence reporter models combined with exogenous donor pericytes, we show that pericytes, signaled by VEGF isoform A165 (VEGFA165), vigorously drive new vessel growth in both adult and neonatal mouse inner ear tissue. In vivo, the delivery of an adeno-associated virus serotype 1–mediated (AAV1–mediated) VEGFA165 viral vector to pericyte-depleted or noise-exposed animals prevented and regenerated lost pericytes, improved blood supply, and attenuated hearing loss. These studies provide the first clear-cut evidence that pericytes are critical for vascular regeneration, vascular stability, and hearing in adults. The restoration of vascular function in the damaged cochlea, including in noise-exposed animals, suggests that VEGFA165 gene therapy could be a new strategy for ameliorating vascular associated hearing disorders.

Local vibration induced vascular pathological structural changes and abnormal levels of vascular damage indicators

BackgroundThe vascular component of the hand-arm-vibration syndrome (HAVS) is often characterized by vibration-induced white fingers (VWF). Active substances secreted by the vascular endothelial cells (VEC) maintain a dynamic balance but damage to the blood vessels may occur when the equilibrium is altered, thus forming an important pathological basis for VWF. This study was aimed at investigating vascular damage indicators as a basis for an early detection of disorders caused by vibration, using the rat tail model. Methods and resultsExperiments were conducted using a control group of rats not exposed to vibration while two exposed groups having different exposure durations of 7 and 14 days were randomly formed. Following exposure, the structural changes of tail tissue samples in anesthetized rats were observed. Enzyme-linked immunosorbent assay (ELISA) was used for analyzing four vascular damage indicators myosin regulatory light chain (MLC2), endothelin-1 (ET-1), vinculin (VCL) and 5-hydroxytryptamine (5-HT) in tail blood samples. We found that both vascular smooth muscle and endothelial cells displayed changes in morphology characterized by vacuolization and swelling in the vibration-exposed group. The levels of vascular damage indicators were altered under the vibration. ConclusionThe degree of vascular pathology increased with the longer duration exposure. Furthermore, the levels of MLC2, ET-1 and 5-HT in rat plasma were associated with vascular injury caused by local vibration.

ASSOCIATIONS OF SODIUM INTAKE WITH CENTRAL HEMODYNAMICS AND CHANGES IN VASCULAR STRUCTURE AND FUNCTION AT HIGH ALTITUDE LOCALITIES

Objective: To investigate the associations of sodium intake with central hemodynamics and changes in vascular structure and function at high altitude localities. Design and method: From December 2018 to January 2019, a total of 383 monks who participated in cardiovascular risk factors screening were enrolled in four temples around Luhuo County, Ganzi Tibetan Autonomous Prefecture with an average elevation of 3,800 meters. Questionnaire, physical examination, blood and urine examination, electrocardiogram, echocardiography, intima-media thickness (IMT), Brachial ankle pulse wave velocity (BaPWV), Ankle brachial index (ABI), Central systolic blood pressure (CSBP), Central diastolic blood pressure (CDBP), Central pulse pressure (CPP), Central mean arterial pressure (CMAP), Augmentation pressure (AP), Augmentation index (AI) and other tests were performed on all participants. Estimated 24-hour urinary sodium excretion was measured by the Kawasaki formula using the urinary sodium/urinary creatinine ratio of the second morning fasting urine. Pearson correlation and multiple linear regression were used to analyze the associations between 24 h urinary sodium and central arterial hemodynamic parameters and BaPWV and IMT. Results: 1. The estimated 24 h urinary sodium excretion in the temple was (5.26 ± 1.61)g, and the estimated salt intake was (13.36 ± 4.09)g. There was no significant correlation between 24 h urinary sodium and CDBP, AP and IMT (P &gt; 0.05). After gender, age, CSBP, body Mass Index (BMI), fasting blood glucose (FBG), estimated glomerular filtration rate (eGFR), triglycerides (TG), high density lipoprotein (HDL) and low density lipoprotein (LDL) were adjusted, 24 h urine sodium was positively correlated with CSBP (P = 0.018) and CPP (P &lt; 0.001). After adjusting for gender, age, CSBP, BMI, eGFR, FBG, TG, HDL, LDL, 24 h urinary sodium was significantly negatively correlated with AIX75 and BaPWV (P = 0.028,P &lt; 0.001, respectively). The line graph of means across the 24 h urinary sodium quartiles and the cubic fitting curve showed that the associations between 24 h urinary sodium excretion with AIX75 and BaPWV presented an approximate ’J’ shape. Conclusions: 24 h urinary sodium was positively correlated with CSBP and CPP in the monks in this region. The associations between 24 h urinary sodium with AIX75 and BaPWV resembled a ’J’ shape.

The value of ultrasonography combined with clinical features for predicting carotid imaging progression of Takayasu's arteritis: a prospective cohort study.

To identify valuable ultrasonography findings combined with clinical markers for predicting carotid progression of Takayasu's arteritis (TAK) on imaging during a 1-year follow-up period. From May 2016 to June 2019, 77 Chinese TAK patients with carotid artery involvement were enrolled in the present study. The patients' clinical characteristics and serological test and carotid ultrasonography results were recorded at baseline and each visit. Carotid progression was evaluated by ultrasonography every 3 months during the 1-year follow-up. Baseline clinical characteristics and ultrasonography results for predicting progression on imaging were identified. Sixteen (20.8%) patients presented with carotid progression on imaging during the 1-year follow-up period. The patients in the progressive group were younger (23.4±3.7 vs. 32.3±9.8 years, p<0.01) than those in the non-progressive group. At baseline, the vessel wall was thicker in the progressive group than in the non-progressive group (2.4±0.8 vs. 1.9±0.5 mm, p=0.041). Furthermore, the proportion of patients with refractory disease (87.5% vs. 16.4%, p<0.01) was higher in the progressive group than in the non-progressive group. Patients with a thickened carotid wall (≥1.9 mm), refractory disease, and younger age (≤30 years) might be at a high risk of carotid progression on imaging (75%, AUC: 0.93, sensitivity: 75%, specificity: 93.4%). Younger patients with early vascular structural changes at baseline as well as refractory disease seemed more likely to show carotid progression on imaging.

Retinal vessel density in primary open-angle glaucoma with a hemifield defect

Objective: To evaluate the retinal vessel density in eyes with primary open-angle glaucoma (POAG) with single-hemifield visual field (VF) defects and its relationship to retinal nerve fiber layer (RNFL) thickness and visual field indices. Methods: Cross-sectional study. Twenty-eight POAG patients with single-hemifield VF defects and 31 normal controls were recruited from October 2015 to October 2018 in the Eye, Ear, Nose and Throat Hospital of Fudan University. All subjects underwent complete ophthalmological examinations, including RNFL, retinal ganglion cell complex (GCC) thickness and visual field tests, and the general information was collected. The peripapillary radial peripapillary capillaries (RPC) and macular superifical retinal capillary plexus (SCP) were derived from optical coherence tomography angiography. The retinal vessel density, structural values, and VF values were compared among the corresponding hemifields of POAG and healthy eyes using the Rank Sum test. Results: There were 16 males and 12 females in POAG patients, with the age of (47±12) years; there were no significant differences in gender distribution, age, intraocular pressure, central corneal thickness, axial length and intraocular perfusion pressure between POAG patients and the normal controls (all P>0.05). Among POAG patients, there were 19 cases with upper and 9 cases with lower visual field defect. In the POAG eyes, the vascular density of peripapillary RPC and macular SCP were 45.86% (34.92%-52.78%) and 39.31% (32.55%-46.79%), respectively. In the normal eyes, the vascular density of peripapillary RPC and macular SCP were 56.90% (51.69%-60.84%) and 47.48% (37.95%-52.25%), respectively. The difference was statistically significant (Z=-6.56, -5.86; both P<0.01). The RNFL and GCC thicknesses in the POAG group were 84.4 (62.1-97.1), 76.4 (60.3-92.5) μ m, respectively, which were smaller than those in normal controls [110.6 (95.7-131.6), 98.1 (84.0-109.2) μm; Z=-6.57, -6.36; both P<0.01]. In the POAG eyes, the peripapillary RPC [44.12% (34.73%-53.20%) vs. 51.85% (38.64%-61.02%); Z=-4.62; P<0.01] and macular SCP [36.81% (29.73%-47.82%) vs. 41.78% (33.93%-49.22%); Z=-4.12; P<0.01] vessel densities were reduced in the abnormal hemisphere compared with the opposite hemisphere. Compared with the normal eyes, the normal hemisphere of the POAG eyes had lower peripapillary RPC and macular SCP vessel densities (Z=-5.08, -4.95; both P<0.01), a thinner RNFL and a thinner retinal GCC [93.0 (61.9-116.5) μm vs. 110.6 (95.7-131.6) μm, Z=-5.15; 86.3 (67.2-98.2) μm vs. 98.1 (84.0-109.2) μm, Z=-5.35; both P<0.01]. But the mean deviation and pattern standard deviation values of the VF were not significantly different between them (both P>0.05). Conclusions: The retinal vessel density reduce in eyes with POAG with single-hemifield VF defects. The normal hemisphere of POAG eyes have a reduced retinal microcirculation along with the thinning of the RNFL and GCC, suggesting that vascular dysfunction and structural changes preceded VF loss in POAG. (Chin J Ophthalmol, 2021, 57: 201-206).

Ultrasound techniques in the diagnosis of vascular structural changes and blood flow velocity in patients with obstructive sleep apnea

Obstructive sleep apnea (OSA) is a common sleep-related breathing disorder that increases the risk of cardiovascular disease. Currently, there is a sufficient amount of evidence that OSA increases the risk of cardiovascular diseases, but the mechanisms underlying the formation of these changes remain unclear. The use of Doppler ultrasound and functional stress tests in patients with OSA will make it possible to assess the state of the vascular wall and its changes during treatment. This method can be included in the examination program for patients with sleep-related breathing disorders.

MicroRNA‑1929‑3p participates in murine cytomegalovirus‑induced hypertensive vascular remodeling through Ednra/NLRP3 inflammasome activation.

MicroRNAs (miRNAs) play an important role in the development of vascular remodeling in essential hypertension (EH) by mediating the effects of human cytomegalovirus (HCMV) on the vascular system. Therefore, the aim of the present study was to investigate the effects of murine cytomegalovirus (MCMV) infection on blood pressure and vascular function in mice, in order to elucidate the role of miR-1929-3p in this process. For model development, 7-month-old C57BL/6J mice were infected with the Smith strain of MCMV, and MCMV DNA, IgG and IgM were detected. Subsequently, blood pressure was measured via the carotid artery, and the morphological changes of the aorta were evaluated by hematoxylin and eosin and Masson's trichrome staining. miR-1929-3p transfection was performed using an adeno-associated virus packaged vector and the changes in vascular structure were then observed. The levels of nitric oxide (NO) and endothelial NO synthase were also assessed with colorimetry. Vascular remodeling and expression of NLRP3 inflammasome pathway-related proteins were detected by immunohistochemistry and western blotting. Endothelin-1 (ET-1), interleukin (IL)-1β and IL-18 were assayed by ELISA. The results revealed that MCMV infection increased the blood pressure, promoted vascular remodeling, caused endothelial cell injury, and downregulated miR-1929-3p. However, these effects were alleviated by miR-1929-3p overexpression, which downregulated endothelin A receptor (Ednra) and NLRP3 inflammasome, as well as endothelial injury- and vascular remodeling-related genes. Taken together, the findings of the present study indicated that overexpression of miR-1929-3p may improve MCMV-induced vascular remodeling, possibly via the deactivation of the NLRP3 inflammasome by ET-1/Ednra.

Cardiovascular Changes Among Healthy Elderly

World Health Organization (WHO) defines health as a complete physical, mental, and social well-being and not merely the absence of disease or infirmity. Health is one of the important and valuable values among the elderly. Aging is a progress of life in each individual. Unlike pathological conditions, the aging process will occurs in each individual. Elderly tend to experience physical, mental, and spiritual deterioration. The health status of each individual can have an impact on changes in cardiovascular function in the elderly. After each individual reaches the age of 30, heart-lung fitness decreases by 1% for each age, which increases by one year. At the age of 60, heart-lung fitness will decrease until 35%. The aim of conducting this literature review is to provide an understanding of the cardiovascular changes among healthy elderly. The main effects aging on the cardiovascular system are a changes in vascular structure, a decrease in vascular function, myocytes and atrial pacemaker cells, an increase in cardiac fibrous tissue, a decrease in the function of the ventricular, myocardial contraction, and cardiac output which results in impaired cardiovascular fitness among elderly.

Influences of Hypomagnesemia on Optic Nerve and Retinal Vascular Structure Determined Using Optical Coherence Tomography (OCT) Angiography.

ABSTRACT Purpose: To evaluate the effects of low blood magnesium levels on the optic nerve, retina, and retinal vascular structure. Methods: This observational and cross-sectional study was conducted between June 2019 and May 2020 with participants aged 20–39 years, who had a visual acuity of ≥20/20, the axial length of 22–24.5 mm, refractive defect spherical equivalent of ≤±3D, and intraocular pressure of ≤21 mm Hg. All participants had a complaint of twitching in their eyes. The participants with normal serum magnesium levels constituted the control group, and patients with hypomagnesemia constituted the patient group. Updated AngioScan software (Navis ver. 1.8.0.) of Nidek’s RS-3000 Advance system was used to analyze the spectral domain-optical coherence tomography (SD-OCT) and optical coherence tomography-angiography (OCT-A) images. Results: A total of 100 right eyes of 100 individuals was included in the study. The mean retinal nerve fiber layer (RNFL) thickness was 108.52 ± 12.46 μm in the control group, and 97.3 ± 9.7 μm in the hypomagnesemia group (P < .001). In the control group, the global superficial capillary plexus (SCP) and deep capillary plexus (DCP) vessel densities (VDs) were 41.92 ± 2.29, and 37.54 ± 3.83, respectively. In the patient group, the global SCP and DCP VDs were 37.66 ± 3.14, and 32.95 ± 5.57, respectively. The SCP and DCP VD percentages were significantly lower in the patient group. The mean foveal avascular zone (FAZ) area, perimeter and circularity index (CI) were 0.32 ± 0.13 mm2, 2.89 ± 0.59 mm, and 0.52 ± 0.09, respectively, for the control group and 0.38 ± 0.11 mm2, 2.99 ± 0.64 mm, and 0.38 ± 0.1, respectively, for the patient group. The FAZ area and perimeter were significantly higher (P = .013 and P = .001) and FAZ CI was significantly lower (P < .001) in the patients with hypomagnesemia. Conclusion: Our study revealed that OCT and OCT-A measurements may be used in the determination of the optic nerve and retinal vascular structure changes in hypomagnesemia.

Prenatal hypoxia predisposes vascular functional and structural changes associated with oxidative stress damage and depressive behavior in adult offspring male rats

Intrauterine hypoxia-ischemia (HI) provides a strong stimulus for a developmental origin of both the central nervous system and cardiovascular diseases. This study aimed to investigate vascular functional and structural changes, oxidative stress damage, and behavioral alterations in adult male offspring submitted to HI during pregnancy. The pregnant Wistar rats had a uterine artery clamped for 45 min on the 18th gestational day, submitting the offspring to hypoxic-ischemic conditions. The Sham group passed to the same surgical procedure as the HI rats, without occlusion of the maternal uterine artery, and the controls consisted of non-manipulated healthy animals. After weaning, the male pups were divided into three groups: control, sham, and HI, according to the maternal procedure. At postnatal day 90 (P90), the adult male offspring performed the open field and forced swim tests. In P119, the rats had their blood pressure checked and were euthanized. Prenatal HI induced a depressive behavior in adult male offspring associated with a reduced vasodilator response to acetylcholine in perfused mesenteric arterial bed, and reduced superoxide dismutase and glutathione peroxidase activities in the aorta compared to control and sham groups. Prenatal HI also increased the vasoconstrictor response to norepinephrine, the media thickness, collagen deposition, and the oxidative damage in the aorta from adult male offspring compared to control and sham groups. Our results suggest an association among prenatal HI and adult vascular structural and functional changes, oxidative stress damage, and depressive behavior.

Endostar Rebuilding Vascular Homeostasis and Enhancing Chemotherapy Efficacy in Cervical Cancer Treatment.

BackgroundThe incidence rate of cervical cancer is the highest in the reproductive tract and is not sensitive to chemotherapy. An appropriate amount of anti-angiogenic agents can reconstruct tumor blood vessels in a short period of time and form vascular homeostasis, increase the function of blood vessel perfusion and reverse the multidrug resistance of chemotherapy, which is also called “vascular normalization.” Endostar (a recombinant human endostatin) was developed by China and as a multi-target anti-angiogenesis agent. Many reports about endostar involved the treatment of non-small cell lung cancer, fewer reports are on cervical cancer.PurposeTo determine whether endostar can rebuild tumor vascular homeostasis and enhance chemotherapy effects for patients with cervical cancer.MethodsIn this study, the patients with cervical cancer within stage IIB2 were selected, endostar combined with cisplatin+paclitaxel neoadjuvant chemotherapy (NACT) before radical surgical operation was adopted, patients outcome and adverse reaction were followed up. The changes of tumor vascular structure and perfusion function before and after endostar given were evaluated by histopathology and dynamic contrast-enhanced magnetic resonance imaging (DEC-MRI). VEGF-Notch signal pathway was detected for the regulating mechanism of vascular proliferation in different groups. GraphPad Prism 6 software was used for statistical analysis of the study results.ResultsEndostar enhanced the short-term (2 year) overall survival (OS), progression-free survival (PFS) rates for cervical cancer patients. All the same, endostar increased long-term (5 year) OS for cervical cancer patients. Endostar therapy exhibited with mild adverse reaction. MRI showed endostar+NACT further reduce tumor volume than NACT alone. The parameters of Ktrans, Ve for DEC-MRI in endostar group exhibited obviously increase than NACT group. Tumor vascular maturation index α-SMA/CD31 in endostar group increased obviously than NACT group, correspondingly Ki67 staining for tumor proliferative rates, lymphovascular space invasion in endostar group further declined than NACT group. The genes and proteins expression of VEGFR2, Notch1, Notch4, Dll4, Jag1 were obviously downregulated in endostar group comparing to NACT group.ConclusionEndostar restored vascular homeostasis in cervical cancer temporarily, enhanced chemotherapeutic agents effects in cervical cancer, increased patient OS ratio. Endostar+NACT treatment may provide a new target therapy for cervical cancer.