scholarly journals Age- and sex-dependent changes of resting amygdalar activity in individuals free of clinical cardiovascular disease

2021 ◽  
Author(s):  
Ahmed Haider ◽  
Susan Bengs ◽  
Flavia Diggelmann ◽  
Gioia Epprecht ◽  
Dominik Etter ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Metabolic Activity ◽  
Stress Responses ◽  
Multimodality Imaging ◽  
Linear Regression Analysis ◽  
Final Population ◽  
Positron Emission ◽  
Cardiovascular Pathologies ◽  
Neuronal Stress ◽  
Age And Sex

Abstract Purpose Amygdalar metabolic activity was shown to independently predict cardiovascular outcomes. However, little is known about age- and sex-dependent variability in neuronal stress responses among individuals free of cardiac disease. This study sought to assess age- and sex-specific differences of resting amygdalar metabolic activity in the absence of clinical cardiovascular disease. Methods Amygdalar metabolic activity was assessed in 563 patients who underwent multimodality imaging by 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography/computed tomography and echocardiography for the evaluation of cardiac function. Results After exclusion of 294 patients with structural or functional cardiovascular pathologies, 269 patients (128 women) remained in the final population. 18F-FDG amygdalar activity significantly decreased with age in men (r = − 0.278, P = 0.001), but not in women (r = 0.002, P = 0.983). Similarly, dichotomous analysis confirmed a lower amygdalar activity in men ≥ 50 years as compared to those < 50 years of age (0.79 ± 0.1 vs. 0.84 ± 0.1, P = 0.007), which was not observed in women (0.81 ± 0.1 vs. 0.82 ± 0.1, P = 0.549). Accordingly, a fully adjusted linear regression analysis identified age as an independent predictor of amygdalar activity only in men (B-coefficient − 0.278, P = 0.001). Conclusion Amygdalar activity decreases with age in men, but not in women. The use of amygdalar activity for cardiovascular risk stratification merits consideration of inherent age- and sex-dependent variability.

scholarly journals Potential Impact of Statins on Neuronal Stress Responses in Patients at Risk for Cardiovascular Disease

2021 ◽  
Vol 11 (4) ◽  
pp. 261
Author(s):  
Flavia Diggelmann ◽  
Susan Bengs ◽  
Ahmed Haider ◽  
Gioia Epprecht ◽  
Anna Luisa Beeler ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
At Risk ◽  
Bone Marrow ◽  
Metabolic Activity ◽  
Stress Responses ◽  
Cardiovascular Outcomes ◽  
Inflammatory Activity ◽  
18F Fdg ◽  
Anti Inflammatory ◽  
Neuronal Stress

Background: Recent studies indicate that enhanced neuronal stress responses are associated with adverse cardiovascular outcomes. A chronic inflammatory state seems to mediate this detrimental neuro-cardiac communication. Statins are among the most widely prescribed medications in primary and secondary cardiovascular disease (CVD) prevention and not only lower lipid levels but also exhibit strong anti-inflammatory and neuroprotective effects. We therefore sought to investigate the influence of statins on neuronal stress responses in a patient cohort at risk for CVD. Methods: 563 patients (61.5 ± 14.0 years) who underwent echocardiography and 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography (PET) were retrospectively identified. Metabolic activity of the amygdala, a part of the brain’s salience network, was quantified by 18F-FDG uptake, while normal cardiac morphology and function were assured by echocardiography. Vertebral bone marrow metabolism, a marker of inflammatory activity, was measured by 18F-FDG PET. Results: Increased neuronal stress responses were associated with an increased inflammatory activity in the bone marrow (r = 0.152, p = 0.015) as well as with a subclinical reduction in left ventricular ejection fraction (LVEF, r = −0.138, p = 0.025). In a fully-adjusted linear regression model, statin treatment was identified as an independent, negative predictor of amygdalar metabolic activity (B-coefficient −0.171, p = 0.043). Conclusions: Our hypothesis-generating investigation suggests a potential link between the anti-inflammatory actions of statins and reduced neuronal stress responses which could lead to improved cardiovascular outcomes. The latter warrants further studies in a larger and prospective population.

scholarly journals A neurobiological mechanism linking transportation noise to cardiovascular disease in humans

2019 ◽  
Vol 41 (6) ◽  
pp. 772-782 ◽  
Author(s):  
Michael T Osborne ◽  
Azar Radfar ◽  
Malek Z O Hassan ◽  
Shady Abohashem ◽  
Blake Oberfeld ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Metabolic Activity ◽  
Noise Exposure ◽  
Underlying Mechanism ◽  
Cvd Risk ◽  
Stress Perception ◽  
Transportation Noise ◽  
Positron Emission ◽  
Arterial Inflammation

Abstract Aims Chronic noise exposure associates with increased cardiovascular disease (CVD) risk; however, the role of confounders and the underlying mechanism remain incompletely defined. The amygdala, a limbic centre involved in stress perception, participates in the response to noise. Higher amygdalar metabolic activity (AmygA) associates with increased CVD risk through a mechanism involving heightened arterial inflammation (ArtI). Accordingly, in this retrospective study, we tested whether greater noise exposure associates with higher: (i) AmygA, (ii) ArtI, and (iii) risk for major adverse cardiovascular disease events (MACE). Methods and results Adults (N = 498) without CVD or active cancer underwent clinical 18F-fluorodeoxyglucose positron emission tomography/computed tomography imaging. Amygdalar metabolic activity and ArtI were measured, and MACE within 5 years was adjudicated. Average 24-h transportation noise and potential confounders were estimated at each individual’s home address. Over a median 4.06 years, 40 individuals experienced MACE. Higher noise exposure (per 5 dBA increase) predicted MACE [hazard ratio (95% confidence interval, CI) 1.341 (1.147–1.567), P &lt; 0.001] and remained robust to multivariable adjustments. Higher noise exposure associated with increased AmygA [standardized β (95% CI) 0.112 (0.051–0.174), P &lt; 0.001] and ArtI [0.045 (0.001–0.090), P = 0.047]. Mediation analysis suggested that higher noise exposure associates with MACE via a serial mechanism involving heightened AmygA and ArtI that accounts for 12–26% of this relationship. Conclusion Our findings suggest that noise exposure associates with MACE via a mechanism that begins with increased stress-associated limbic (amygdalar) activity and includes heightened arterial inflammation. This potential neurobiological mechanism linking noise to CVD merits further evaluation in a prospective population.

scholarly journals Multimodality imaging review of focal renal lesions

2021 ◽  
Vol 52 (1) ◽  
Author(s):  
Jonathan Lyske ◽  
Rishi Philip Mathew ◽  
Christopher Hutchinson ◽  
Vimal Patel ◽  
Gavin Low
Keyword(s):  
Malignant Tumors ◽  
Multimodality Imaging ◽  
Lymphoproliferative Disease ◽  
Benign Tumors ◽  
Main Body ◽  
Imaging Features ◽  
Focal Lesions ◽  
Renal Lesions ◽  
Positron Emission ◽  
Neoplastic Lesions

Abstract Background Focal lesions of the kidney comprise a spectrum of entities that can be broadly classified as malignant tumors, benign tumors, and non-neoplastic lesions. Malignant tumors include renal cell carcinoma subtypes, urothelial carcinoma, lymphoma, post-transplant lymphoproliferative disease, metastases to the kidney, and rare malignant lesions. Benign tumors include angiomyolipoma (fat-rich and fat-poor) and oncocytoma. Non-neoplastic lesions include infective, inflammatory, and vascular entities. Anatomical variants can also mimic focal masses. Main body of the abstract A range of imaging modalities are available to facilitate characterization; ultrasound (US), contrast-enhanced ultrasound (CEUS), computed tomography (CT), magnetic resonance (MR) imaging, and positron emission tomography (PET), each with their own strengths and limitations. Renal lesions are being detected with increasing frequency due to escalating imaging volumes. Accurate diagnosis is central to guiding clinical management and determining prognosis. Certain lesions require intervention, whereas others may be managed conservatively or deemed clinically insignificant. Challenging cases often benefit from a multimodality imaging approach combining the morphology, enhancement and metabolic features. Short conclusion Knowledge of the relevant clinical details and key imaging features is crucial for accurate characterization and differentiation of renal lesions.

scholarly journals Persistent metabolic syndrome and risk of cardiovascular disease in children and adolescents

2018 ◽  
Vol 71 (3) ◽  
pp. 1013-1021 ◽  
Author(s):  
Camilla Ribeiro Lima de Farias ◽  
Carla Campos Muniz Medeiros ◽  
Diogo Rodrigues Souza ◽  
Ivelise Fhrideraid Alves Furtado da Costa ◽  
Mônica Oliveira da Silva Simões ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Metabolic Syndrome ◽  
Children And Adolescents ◽  
Demographic Characteristics ◽  
Multiple Logistic Regression ◽  
Overweight Children ◽  
Low Hdl ◽  
Score Method ◽  
Blood Variables ◽  
Age And Sex

ABSTRACT Objective: to verify persistence of metabolic syndrome (MetS) and components in overweight children and adolescents, as well as its relation to socioeconomic and demographic characteristics and to the Pathobiological Determinants of Atherosclerosis in Youth (PDAY) score. Method: a two-point longitudinal study: at enrollment and after a 24-month interval, with 133 individuals ages from two to 18 years. The demographic anthropomorphic and blood variables were evaluated. Analysis was carried out by simple and paired association tests, as well as multiple logistic regression. Results: persistent MetS was observed in 38.3% of the sample, associated cardiovascular risk (ACR) in 79.7%, reduction in arterial pressure and do HDL-c. After adjusting for age and sex, excess weight (ExpB: 0.182; CI: 0.059-0.561), low HDL-c (ExpB: 9.247; CI: 1.157-73.930) and high LDL-c (ExpB:1.915; CI: 0.921-3.979) were associated with persistent MetS. Conclusion: persistent MetS was associated with obesity, HDL-c and LDL-c, but not with the PDAY score.

Thirty-year cardiovascular risk score in patients with newly diagnosed bipolar disorder and their unaffected first-degree relatives

2018 ◽  
Vol 53 (7) ◽  
pp. 651-662 ◽  
Author(s):  
Klara Coello ◽  
Hanne L Kjærstad ◽  
Sharleny Stanislaus ◽  
Sigurd Melbye ◽  
Maria Faurholt-Jepsen ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Bipolar Disorder ◽  
Cardiovascular Risk ◽  
Risk Score ◽  
Disease Risk ◽  
Cardiovascular Disease Risk ◽  
Newly Diagnosed ◽  
Healthy Individuals ◽  
First Degree Relatives ◽  
Age And Sex

Objectives: Bipolar disorder is associated with a decreased life expectancy of 8–12 years. Cardiovascular disease is the leading cause of excess mortality. For the first time, we investigated the Framingham 30-year risk score of cardiovascular disease in patients with newly diagnosed/first-episode bipolar disorder, their unaffected first-degree relatives and healthy individuals. Methods: In a cross-sectional study, we compared the Framingham 30-year risk score of cardiovascular disease in 221 patients with newly diagnosed/first-episode bipolar disorder, 50 of their unaffected first-degree relatives and 119 healthy age- and sex-matched individuals with no personal or first-degree family history of affective disorder. Among patients with bipolar disorder, we further investigated medication- and illness-related variables associated with cardiovascular risk. Results: The 30-year risk of cardiovascular disease was 98.5% higher in patients with bipolar disorder ( p = 0.017) and 85.4% higher in unaffected first-degree relatives ( p = 0.042) compared with healthy individuals in models adjusted for age and sex. When categorizing participants in low cardiovascular risk without considering age and sex distribution among participants, 81% of patients were at low risk, versus 92% of unaffected relatives and 89% of healthy individuals. Of the patients 209 (94.6%) were diagnosed within the preceding 2 years. Smoking was more prevalent among patients with bipolar disorder (45.2%) and their unaffected first-degree relatives (20.4%) compared with healthy individuals (12.8%). Similarly, dyslipidemia was more common among patients with bipolar disorder compared with healthy individuals. Treatment with psychotropic medication with metabolic adverse effects was associated with higher 30-year cardiovascular disease risk score, whereas we did not find illness-related variables associated with cardiovascular risk among patients with bipolar disorder. Conclusion: We found an enhanced cardiovascular disease risk score in patients with newly diagnosed bipolar disorder and their unaffected first-degree relatives, which points to a need for specific primary preventive interventions against smoking and dyslipidemia in these populations.

scholarly journals Reference Values and Related Factors for Peak Expiratory Flow in Middle-aged and Elderly Chinese

2020 ◽  
Author(s):  
Chao Ji ◽  
Huixu Dai ◽  
Zhiying Zhao ◽  
Tiancong Liu ◽  
Shuhui Tong ◽  
...  
Keyword(s):  
Peak Expiratory Flow ◽  
Reference Values ◽  
Chinese Population ◽  
Linear Regression Analysis ◽  
Middle Aged ◽  
Value Analysis ◽  
Men And Women ◽  
Expiratory Flow ◽  
Older Chinese ◽  
Age And Sex

Abstract Background: Peak expiratory flow (PEF), as an essential index used for screening and monitoring asthma, chronic obstructive pulmonary disease, and respiratory mortality especially in elderly, is recommended especially for low resource settings in low- and middle-income countries. However, few reports have focused on the reference of PEF in China, especially in the middle-aged and elderly. Thus, the aim of this study was to determine age- and sex-specific reference values of PEF in the middle-aged and older Chinese population.Methods: There were 11,717 participants included for reference value analysis and 11,340 participants were included for risk factor analysis. The PEF was measured using a peak flow meter in L/min. The distribution of PEF terciles stratified by sex and age were reported. Multiple linear regression analysis was used to determine the associations between risk factors and PEF.Results: The PEF was higher in men than women across all age subgroups. The value of PEF decreased with age in both men and women. Height, weight, handgrip strength, and household air pollution were positively associated with PEF, and age, waist circumference smoking status were negatively associated with PEF significantly in both men and women (all P <0.05). The mean values were 9.38 L/min and 64.12 L/min for men and women. Meanwhile, the prevalence of low PEF was 1.62% and 2.16% for men and women, respectively.Conclusions: Age- and sex-specific centiles of PEF for the middle-aged and older Chinese population were estimated. The reference values for low PEF were provided for epidemiological studies and clinical practice in the future. Interventions on lung function or respiratory disease should be pay more attention on factors associated with PEF.

scholarly journals Regional Gas Exchange and Cellular Metabolic Activity in Ventilator-induced Lung Injury

2007 ◽  
Vol 106 (4) ◽  
pp. 723-735 ◽  
Author(s):  
Guido Musch ◽  
Jose G. Venegas ◽  
Giacomo Bellani ◽  
Tilo Winkler ◽  
Tobias Schroeder ◽  
...  
Keyword(s):  
Gas Exchange ◽  
Lung Injury ◽  
Metabolic Activity ◽  
Cell Activation ◽  
Test Lung ◽  
Ventilator Induced Lung Injury ◽  
Positron Emission ◽  
Cellular Metabolic Activity ◽  
The Right ◽  
Tissue Fraction

Background Alveolar overdistension and repetitive derecruitment-recruitment contribute to ventilator-induced lung injury (VILI). The authors investigated (1) whether inflammatory cell activation due to VILI was assessable by positron emission tomography and (2) whether cell activation due to dynamic overdistension alone was detectable when other manifestations of VILI were not yet evident. Methods The authors assessed cellular metabolic activity with [(18)F]fluorodeoxyglucose and regional gas exchange with [(13)N]nitrogen. In 12 sheep, the left ("test") lung was overdistended with end-inspiratory pressure of 50 cm H(2)O for 90 min, while end-expiratory derecruitment of this lung was either promoted with end-expiratory pressure of -10 cm H(2)O in 6 of these sheep (negative end-expiratory pressure [NEEP] group) or prevented with +10 cm H(2)O in the other 6 (positive end-expiratory pressure [PEEP] group) to isolate the effect of overdistension. The right ("control") lung was protected from VILI. Results Aeration decreased and shunt fraction increased in the test lung of the NEEP group. [(18)F]fluorodeoxyglucose uptake of this lung was higher than that of the control lung and of the test lung of the PEEP group, and correlated with neutrophil count. When normalized by tissue fraction to account for increased aeration of the test lung in the PEEP group, [(18)F]fluorodeoxyglucose uptake was elevated also in this group, despite the fact that gas exchange had not yet deteriorated after 90 min of overdistension alone. Conclusion The authors could detect regional neutrophil activation in VILI even when end-expiratory derecruitment was prevented and impairment of gas exchange was not evident. Concomitant end-expiratory derecruitment converted this activation into profound inflammation with decreased aeration and regional shunting.

scholarly journals Association between socioeconomic position and cystatin C in the Heinz Nixdorf Recall Study

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Tanja Zamrik ◽  
Mirjam Frank ◽  
Carina Emmel ◽  
Lars Christian Rump ◽  
Raimund Erbel ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
Cardiovascular Risk ◽  
Cardiovascular Risk Factors ◽  
Cystatin C ◽  
Socioeconomic Position ◽  
Social Inequalities ◽  
Men And Women ◽  
Income Quartile ◽  
Age And Sex

AbstractSocial inequalities in health and disease are well studied. Less information is available on inequalities in biomarker levels indicating subclinical stages of disease such as cystatin C, an early diagnostic marker of renal dysfunction and predictor for cardiovascular disease. We evaluated the relationship between cystatin C, socioeconomic position (SEP) and established cardiovascular risk factors in a population-based study. In 4475 men and women aged 45–75 years participating in the baseline examination of the Heinz Nixdorf Recall Study cystatin C was measured from serum samples with a nephelometric assay. SEP was assessed by education and household income. Linear regression models were used to analyse the association between SEP and cystatin C as well as the impact of cardiovascular risk factors (i.e., body mass index, blood pressure, blood glucose, diabetes mellitus, blood lipids, C-reactive protein, smoking) on this association. After adjustment for age and sex cystatin C decreased by 0.019 mg/l (95% confidence interval (CI) − 0.030 to − 0.008) per five years of education. While using a categorical education variable cystatin C presented 0.039 mg/l (95% CI 0.017–0.061) higher in men and women in the lowest educational category (≤ 10 years of education) compared to the highest category (≥ 18 years). Concerning income, cystatin C decreased by 0.014 mg/l (95% CI − 0.021 to − 0.006) per 1000 € after adjustment for age and sex. For men and women in the lowest income quartile cystatin C was 0.024 mg/l (95% CI 0.009–0.038) higher compared to the highest income quartile. After adjusting for established cardiovascular risk factors the observed associations were substantially diminished. Social inequalities seem to play a role in subclinical stages of renal dysfunction, which are also related to development of cardiovascular disease. Adjustment for traditional cardiovascular risk factors showed that these risk factors largely explain the association between SEP and cystatin C.

The Association of Atherosclerotic Cardiovascular Disease and Statin Use With Inflammation and Treatment Outcomes in Tuberculosis

2021 ◽  
Author(s):  
Vignesh Chidambaram ◽  
Jennie Ruelas Castillo ◽  
Amudha Kumar ◽  
Justin Wei ◽  
Siqing Wang ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Linear Regression Analysis ◽  
Elevated Serum ◽  
University Hospital ◽  
Sputum Smear ◽  
Atherosclerotic Cardiovascular Disease ◽  
All Cause Mortality ◽  
Multivariable Linear Regression Analysis ◽  
Related Mortality ◽  
Statin Use

Abstract Objective: Tuberculosis (TB) and atherosclerotic cardiovascular disease (ASCVD) have a close epidemiological and pathogenetic overlap. Thus, it becomes essential to understand the relationship between ASCVD and TB outcomes.Methods:From our retrospective cohort on drug-susceptible TB patients at the National Taiwan University Hospital, we assessed the association of pre-existing ASCVD (coronary artery disease (CAD) and atherothrombotic stroke (ATS)) with 9-month all-cause and infection-related mortality and the extent of mediation by systemic inflammatory markers. We determined the effect of pre-existing ASCVD on 2-month sputum microbiological status. Among ASCVD patients, we assessed the association of statin use on mortality.Results:Nine-month all-cause mortality was higher in CAD patients with prior acute myocardial infarction (CAD+AMI+) (adjusted HR 2.01, 95%CI 1.38-3.00) and ATS patients (aHR 2.79, 95%CI 1.92-4.07) and similarly, for infection-related mortality was higher in CAD+AMI+ (aHR 1.95, 95%CI 1.17-3.24) and ATS (aHR 2.04, 95%CI 1.19-3.46) after adjusting for confounding factors. Pre-existing CAD (AMI- or AMI+) or ATS did not change sputum culture conversion or sputum smear AFB positivity at 2 months. The CAD+AMI+ group had significantly higher levels of CRP at TB diagnosis in the multivariable linear regression analysis (Adjusted B(SE) 1.24(0.62)). CRP mediated 66% (p=0.048) and 25% (p=0.033) of the association all-cause mortality with CAD+AMI- and CAD+AMI+, respectively. ConclusionsIn summary, patients with ASCVD have higher hazards of 9-month all-cause and infection-related mortality, with elevated serum inflammation mediating one to three-quarters of this association when adjusted for confounders. Statin use was associated with lower all-cause mortality among patients with ASCVD.

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