scholarly journals The burden of subclinical cardiovascular disease in children and young adults with CKD and on dialysis

2021 ◽  
Author(s):  
Alexander D Lalayiannis ◽  
Charles J Ferro ◽  
David C Wheeler ◽  
Neill D Duncan ◽  
Colette Smith ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Young Adults ◽  
Intima Media Thickness ◽  
Carotid Intima Media Thickness ◽  
Left Ventricular ◽  
Structural Abnormality ◽  
Z Score ◽  
Functional Abnormality ◽  
Cross Sectional ◽  
Subclinical Cardiovascular Disease

Abstract Introduction Cardiovascular disease (CVD) is a common cause of morbidity and mortality even in young people with chronic kidney disease (CKD). We examined structural and functional cardiovascular changes in patients with CKD stages 4-5 and on dialysis under 30 years of age. Methods 79 children and 21 young adults underwent cardiac CT for coronary artery calcification (CAC), ultrasound for carotid intima media thickness (cIMT), carotid-femoral pulse wave velocity (cfPWV), and echocardiography. Differences in structural [CAC, cIMT z-score, left ventricular mass index] and functional [carotid distensibility z-score, cfPWV z-score] measures were examined between CKD stages 4-5 and dialysis patients. Results Overall the cIMT z-score was raised (median 2.17, IQR 1.14-2.86) and 10 (10%) had CAC. 16/23(69.5%) of CKD4-5 and 68/77(88.3%) on dialysis had at least one structural or functional CV abnormality. There was no difference in the prevalence of structural abnormalities in CKD or dialysis cohorts, but functional abnormalities were more prevalent in patients on dialysis (p < 0.05). The presence of > 1 structural abnormality was associated with a 4.5-fold increased odds of > 1 functional abnormality (95% CI 1.3 to 16.6, p < 0.05). Patients with structural and functional abnormalities (cIMT z-score >2SD or distensibility <-2SD) had less carotid dilatation (lumen/wall cross sectional areas ratio) compared to those with normal cIMT and distensibility. Conclusion There is a high burden of subclinical cardiovascular disease in young CKD patients, with a greater prevalence of functional abnormalities in dialysis compared to CKD patients. Longitudinal studies are required to test these hypothesis generating data and define the trajectory of CV changes in CKD.

Abstract P047: Association of 1,5-anhydroglucitol with Subclinical Cardiovascular Disease

Circulation ◽  
2016 ◽  
Vol 133 (suppl_1) ◽  
Author(s):  
Menglu Liang ◽  
John William (Bill) McEvoy ◽  
Yuan Chen ◽  
A. Richey Sharrett ◽  
Elizabeth Selvin
Keyword(s):  
Cardiovascular Disease ◽  
Regression Models ◽  
Troponin T ◽  
Subclinical Atherosclerosis ◽  
Myocardial Damage ◽  
Intima Media Thickness ◽  
Carotid Intima Media Thickness ◽  
Cardiac Damage ◽  
Cross Sectional ◽  
Subclinical Cardiovascular Disease

Introduction: Serum 1,5-anhydroglucitol (1,5-AG) concentrations decrease in the setting of acute hyperglycemia, making 1,5-AG a useful biomarker of glucose peaks. In recent studies, 1,5-AG has been associated with clinical cardiovascular disease events. However, the association between 1,5-AG and subclinical vascular disease is unknown. Hypothesis: 1,5-AG will be associated with subclinical myocardial damage (assessed by cardiac troponin T measured using a novel highly sensitive assay (hs-cTnT)) and subclinical atherosclerosis (assessed by ultrasound-detected carotid intima-media thickness (cIMT)), particularly in persons with diabetes. Methods: We measured 1,5-AG in 10,753 participants in the ARIC Study at visit 2 (1990[[Unable to Display Character: &#8211;]]1992) and conducted a cross-sectional analysis to characterize the associations of 1,5-AG with elevated hs-cTnT (≥ 14 ng/L) or thick cIMT (top quartile, ≥0.79 mm) using logistic regression models. We also evaluated the prospective association between baseline 1,5-AG and incident elevated hs-cTnT at 6-years using Poisson regression models. Results: Among diabetics, those with 1,5-AG <6 ug/mL were 5 times more likely to have prevalent elevated hs-TnT at baseline compared to non-diabetics with 1,5-AG >10 ug/mL (adjusted OR 4.67, 95%CI, 3.27[[Unable to Display Character: &#8211;]]6.68) and almost 2 times more likely to be in the top quartile of the cIMT (adjusted OR 1.75, 95%CI 1.39-2.19). 1,5-AG <6 ug/mL in persons with diabetes was also significantly associated with 6-year incident elevated hs-TnT: RR 2.26 (95%CI, 1.50[[Unable to Display Character: &#8211;]]3.39). The associations of 1,5-AG with elevated hs-TnT and thick cIMT were non-linear and mostly driven by persons with diabetes (Figure). Conclusions: 1,5-AG was associated with prevalent and incident subclinical cardiovascular disease in persons with diabetes in the community. Our results suggest that glucose peaks may be relevant for the development of subclinical cardiac damage and atherosclerosis in persons with diabetes.

scholarly journals The Association of Self-Reported Muscle-Strengthening Activities With Carotid Intima–Media Thickness in Older Adults: Cooper Center Longitudinal Study

2020 ◽  
Vol 28 (4) ◽  
pp. 534-539
Author(s):  
Joowon Lee ◽  
Baojiang Chen ◽  
Harold W. Kohl ◽  
Carolyn E. Barlow ◽  
Chong Do Lee ◽  
...  
Keyword(s):  
Physical Activity ◽  
Cardiovascular Disease ◽  
Older Adults ◽  
Disease Risk ◽  
Cardiovascular Disease Risk ◽  
Intima Media Thickness ◽  
Carotid Intima Media Thickness ◽  
Cross Sectional ◽  
Muscle Strengthening ◽  
Media Thickness

The purpose of the current investigation was to examine the cross-sectional associations of participation in muscle-strengthening activities (MSAs) with carotid intima–media thickness (CIMT) among older adults. The data are from 2,557 older adult participants enrolled in an observational cohort who reported no history of cardiovascular disease. MSA was determined using a questionnaire. Carotid ultrasound was performed to measure the CIMT of the common carotid artery bilaterally. Logistic regression models were constructed to estimate the association of MSA with CIMT after adjustment for potential confounders. The participants were aged 68.6 ± 7.0 years, and the majority were male (71.7%) and White (96.5%); 18% had abnormal CIMT. Meeting the physical activity guidelines for MSA was inversely associated with abnormal CIMT after adjustment for age and sex. However, this observed inverse relation became statistically null after further adjustment for cardiovascular disease risk factors, including aerobic physical activity.

Abstract 17808: Fasting Levels of High-sensitive Growth Hormone in Males are Associated to Carotid Intima Media Thickness and are Reduced by Treatment With Fluvastatin

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Erik Hallengren ◽  
Peter Almgren ◽  
Maria Rosvall ◽  
Gerd Östling ◽  
Margaretha Persson ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Growth Hormone ◽  
Controlled Trial ◽  
Intima Media Thickness ◽  
Carotid Intima Media Thickness ◽  
Statin Treatment ◽  
Linear Regression Models ◽  
Double Blind ◽  
Cross Sectional ◽  
Media Thickness

Introduction: Growth hormone (GH) has been linked to cardiovascular disease and lipid metabolism but the exact mechanisms of this association are still unclear. Objectives: We here test if GH is cross-sectionally associated to carotid intima media thickness (IMT) and whether treatment with fluvastatin have any effects on the fasting level of GH in a randomized controlled trial of carotid IMT progression. Methods: We examined the association between GH and IMT in 4425 individuals (aged 46-68 years) included in the baseline examination (1991-1994) of the Malmö Diet and Cancer cardiovascular cohort (MDC-CC). From that cohort we then studied 472 individuals (aged 50-70 years) who also participated (1994-1999) in the β-Blocker Cholesterol-Lowering Asymptomatic Plaque Study (BCAPS), a randomized, double blind, placebo-controlled, single-center clinical trial. Using multivariate linear regression models we related the change in GH-levels at 12 months compared to baseline to treatment with fluvastatin. Results: In MDC-CC fasting values of GH exhibited a positive cross-sectional relation to the IMT at the carotid bifurcation after adjustment for traditional cardiovascular risk factors (p=0.002). In a gender-stratified analysis the association were positive and significant for males (p=0.005), but not for females (p=0.09). In males in BCAPS treated with fluvastatin there tended to be a greater reduction of GH after 12 months when compared to subjects not receiving fluvastatin (p=0.05) (Table). Fasting levels of GH did not interact with the different treatment regimes’ effect on the IMT. Conclusions: We here demonstrate that higher fasting levels of GH are associated to thicker IMT in the carotid bulb and that statin treatment may reduce fasting levels of GH in males. Our results are in line with previous results with GH being associated to cardiovascular disease. The effects of statin treatment on GH are small and need to be confirmed in a larger trial.

Association between Plasma Dehydroepiandrosterone Sulfate and Carotid Intima-Media Thickness among Male and Female Patients with End-Stage Renal Disease on Hemodialysis

2019 ◽  
Vol 10 (1) ◽  
pp. 61-68
Author(s):  
Rasha Samir Shemies ◽  
Tamer Zaki Gaber ◽  
Samar Tharwat Radwan ◽  
Mostafa Mansour ◽  
Mohamed Mofreh ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Intima Media Thickness ◽  
Carotid Intima Media Thickness ◽  
Dehydroepiandrosterone Sulfate ◽  
Cross Sectional ◽  
Female Patients ◽  
Male Group ◽  
Media Thickness ◽  
Group I ◽  
Significant Difference

Background and Aim: Serum dehydroepiandrosterone sulfate (DHEA-S) is known to be lower in chronic kidney disease (CKD) patients and in those with cardiac disease, and correlates with a poor cardiovascular outcome. This study aimed to assess the correlation between DHEA-S and carotid intima-media thickness (CIMT) as a predictor of cardiovascular disease in hemodialysis (HD) patients. Methods: A total of 88 HD patients were included in this cross-sectional study. They included 53 male (group I) and 35 female patients (group II). In addition to conventional history taking, clinical examination, and routine laboratory investigations, serum DHEA-S and CIMT were measured for all patients. CIMT was measured using B-mode ultrasonography, and the mean of maximum CIMT was recorded. The 2 patient groups were further classified according to the level of DHEA-S. The correlation between serum DHEA-S and CIMT was studied. Results: In male patients, CIMT and age were significantly higher in the group with low DHEA-S level (p = 0.003 and 0.001, respectively), while there was no significant difference in both parameters in females. A higher percentage of HCV-positive patients is present in the male group with low DHEA-S level (p = 0.009). Serum DHEA-S is significantly negatively correlated with CIMT in males (p = 0.003) but not in females, and has a significant negative correlation to age in both genders (p = 0.001 and 0.04, respectively). Conclusion: Endocrinal disturbance representing as lower serum DHEA-S is associated with increased CIMT, which is considered a predictor of cardiovascular disease in male HD patients, although it is largely explained by advancing age.

scholarly journals Depression in young adults is associated with increased carotid atherosclerotic burden: insights from the Corinthia study

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
P Theofilis ◽  
E Oikonomou ◽  
G Vogiatzi ◽  
G Lazaros ◽  
S Tsalamandris ◽  
...  
Keyword(s):  
Young Adults ◽  
Depressive Disorder ◽  
Emotional Health ◽  
Depression Scale ◽  
Severe Depression ◽  
Intima Media Thickness ◽  
Carotid Intima Media Thickness ◽  
The Elderly ◽  
Plaque Burden ◽  
Cross Sectional

Abstract Introduction Depression appears to have a detrimental effect not only on mental health but also in the progression of various diseases. Purpose The examination of a potential association between depression and atherosclerosis progression in a rural population. Methods In the context of the cross-sectional Corinthia study, volunteers fulfilled a questionnaire concerning emotional health. The Geriatric Depression Scale was used for individuals aged 60 or more while the Zung self-rating depression score was preferred in younger adults. Carotid ultrasonography examination was performed to evaluate the mean carotid intima-media thickness (cIMT). Thickness of cIMT&gt;1.5 mm or protrusion &gt;50% compared to adjacent segments was considered as atherosclerotic plaque. Results Young adults with significant depression were usually female and did not differ significantly on other risk factors of atherosclerosis compared to those with mild or no depressive disorder. Importantly, those with moderate-severe depression appeared to have increased mean cIMT (Mild-No depression: 0.85±0.30mm, Moderate-severe depression: 0.91±0.42mm, p=0.04) and a higher carotid plaque burden (Mild-No depression: 12.8%, Moderate-severe depression: 20.3%, p=0.04). With regards to the elderly, those with moderate-severe depression were usually smokers (Mild-No depression: 13.9%, Moderate-severe depression: 24.2%, p=0.01). However, mean cIMT (Mild-No depression: 1.11±0.47mm, Moderate-severe depression: 1.09±0.39mm, p=0.69) and carotid plaques (Mild-No depression: 31.1%, Moderate-severe depression: 36.1%, p=0.36) did not differ according to depression status in this subgroup. Conclusion Significant depressive disorder is associated with accelerated carotid atherosclerosis in young individuals. Funding Acknowledgement Type of funding source: None

scholarly journals Association of Ideal Cardiovascular Health with Carotid Intima-Media thickness (cIMT) in a Young Adult Population: Tehran Lipid and Glucose Study (TLGS)

2021 ◽  
Author(s):  
Vajihe Chavoshi ◽  
Maryam Barzin ◽  
Amir Ebadinejad ◽  
Pooneh Dehghan ◽  
Amin Momeni Moghaddam ◽  
...  
Keyword(s):  
Young Adults ◽  
Cardiovascular Health ◽  
Subclinical Atherosclerosis ◽  
Adult Population ◽  
Intima Media Thickness ◽  
Carotid Intima Media Thickness ◽  
Inverse Association ◽  
Cross Sectional ◽  
Ideal Cardiovascular Health ◽  
Media Thickness

Abstract Ideal cardiovascular health (CVH) is associated with a lower risk of developing cardiovascular diseases. This study aims to investigate the association of CVH metrics with carotid intima-media thickness (cIMT) as a marker of subclinical atherosclerosis in young adults. A cross-sectional study was performed on 1295 adults, average age of 29.7 ± 4.0 years, selected among the participants of the Tehran Lipid and Glucose Study (TLGS). The participants were divided into two CVH groups: Ideal CVH and poor/intermediate CVH. Multivariate-adjusted linear regression was used to determine the association of ideal CVH score with cIMT. Multivariate-adjusted odd ratios (ORs) were calculated for high cIMT (≥95%percentile). Also, the independent effects of each ideal CVH metric on cIMT were analyzed. The prevalence of ideal CVH was 9.3% in the studied population, and the mean of cIMT was 0.55±0.09 mm. A 1-point increase in CVH score was associated with a decrease of 0.128 mm (Beta [SE] = -0.128 [0. 002], p<0.001) in cIMT and rendered an odd ratio of 0.68 (OR = 0.68 [95% CI: 0.56-0.82], p<0.001) for having a high CIMT (≥95%percentile). Each ideal glucose, ideal blood pressure and ideal body mass index (BMI) had a significant inverse association with cIMT. There was a graded inverse association between ideal CVH score and cIMT among young adults, indicating that ideal CVH metrics are associated with better vascular health in this population. The low prevalence of ideal CVH highlighted the importance of implementing health promotion strategies.

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