Abstract P200: Elevated Triacylglycerols and Diacylglycerols Had Association With Increased Carotid Arterial Stiffness, Independent of Cvd Risk Factors, in Women With or at High Risk of HIV Infection

Circulation ◽  
2018 ◽  
Vol 137 (suppl_1) ◽  
Author(s):  
Renato Quispe ◽  
Simin Hua ◽  
Clary Clish ◽  
Justin Scott ◽  
Amy Deik ◽  
...  

Background: Metabolomics has provided new insights into mechanistic knowledge of CVD. However, this approach has limited use for studying arterial disease in high-risk women with and without HIV infection. Methods: Using liquid chromatography-tandem mass spectrometry, we profiled plasma levels of 114 cationic polar and 211 nonpolar lipid metabolites among 411 women (72% HIV+; 60% Black and 31% Hispanic) aged 35-50 from the Women’s Interagency HIV Study. Carotid arterial distensibility, a direct measure of carotid stiffness, was calculated from ultrasound measurements of the right common carotid artery diameter at systole and diastole and brachial artery pulse pressure measured. We performed partial least squares discriminant analysis (PLS-DA) to identify metabolite clusters associated with carotid stiffness (lowest vs. the other 3 quartiles of distensibility index). We used multivariate linear regression models to examine associations of individual metabolites with the distensibility index. Results: PLS-DA identified two major metabolite clusters associated with carotid stiffness. In the lipid metabolite cluster, triacylglycerols (TAGs 52:3, 52:4, 54:4), diacylglycerols (DAGs 36:2, 36:3) and sphingomyelins (16:1, 18:1, 18:2) were associated with decreased distensibility, while lysophosphatidylcholines (18:2, 20:5) were associated with increased distensibility. In the cationic polar metabolite cluster, urate, C4-OH carnitine, C5-DC carnitine, pseudouridine and 1-methyladenosine were associated with decreased distensibility. The associations of TAGs 52:3, 52:4, 54:4 and DAG 36:3 with carotid stiffness remained significant after further adjustment for conventional CVD risk factors ( Table ). No interaction by HIV infection was found. Conclusions: Among women with or at risk of HIV infection from predominantly race-ethnic minority groups, plasma TAGs and DAG of higher carbon number and double bond content are associated with carotid stiffness independent of conventional CVD risk factors.

2020 ◽  
Author(s):  
Pedro Martínez-Ayala ◽  
Guillermo Adrian Alanis-Sánchez ◽  
Luz Alicia Gonzalez-Hernández ◽  
Monserrat Álvarez-Zavala ◽  
Rodolfo Ismael Cabrera-Silva ◽  
...  

Abstract Background: Human immunodeficiency virus (HIV) infection is associated with a greater risk of cardiovascular disease (CVD). HIV infection causes a chronic inflammatory state and increases oxidative stress which can cause endothelial dysfunction and arterial stiffness. Aortic stiffness measured by carotid femoral-pulse wave velocity (cfPWV) and central hemodynamics are independent cardiovascular risk factors and have the prognostic ability for CVD. We assessed cfPWV and central hemodynamics in young individuals with recent HIV infection diagnosis and without antiretroviral therapy. We hypothesized that individuals living with HIV would present greater cfPWV and central hemodynamics (central systolic blood pressure and pulse pressure) compared to uninfected controls. Methods. We recruited 51 treatment-naïve individuals living with HIV (HIV(+)) without previous CVD and 51 age- and sex-matched controls (HIV(-)). We evaluated traditional CVD risk factors including metabolic profile, blood pressure (BP), smoking, HIV viral load, and CD4 T-cell count. Arterial stiffness and central hemodynamics were evaluated by cfPWV, central systolic BP, and central pulse pressure (cPP) via applanation tonometry. Results. HIV(+) individuals presented a greater prevalence of smoking, reduced high-density lipoprotein cholesterol, and body mass index. 65.9% of HIV(+) individuals exhibited lymphocyte T CD4+ count cell/mm3. <500 cell/µL. There was no difference in brachial or central BP between groups; however, HIV(+) individuals showed significantly lower cPP. We observed a greater cfPWV (mean difference= 0.5 m/s; p<0.01) in HIV(+) compared to controls, even after adjusting for heart rate, mean arterial pressure and smoking. Conclusion: In the early stages of infection, non-treated HIV individuals present a greater prevalence of traditional CVD risk factors, arterial stiffness, and normal or decreased central hemodynamics.


2017 ◽  
Vol 34 (3) ◽  
pp. 161-168 ◽  
Author(s):  
Carol Mitchell ◽  
Megan E. Piper ◽  
Claudia E. Korcarz ◽  
Kristin Hansen ◽  
JoAnne Weber ◽  
...  

This pilot study evaluated associations between carotid wall echogenicity, cardiovascular disease (CVD) risk factors, and three markers of smoking heaviness in a cohort of active smokers. Common carotid artery (CCA) gray-scale median (GSM) values were measured from sonographic images. Univariable correlations and exploratory multivariable models were used to determine associations between CCA GSM, CVD risk factors, and measures of smoking heaviness. CCA GSM was measured in 162 smokers and was correlated inversely with cigarettes smoked/d (r = −0.16, P = .048); pack-years (r = −0.204, P = .009); CVD risk factors such as age, male sex, waist circumference, and low-density lipoprotein cholesterol (all P ≤ .03); and positively with high-density lipoprotein cholesterol ( P < .001). Associations between CCA GSM and smoking heaviness markers were not statistically significant after adjustment for traditional risk factors. The results from this pilot study demonstrate the feasibility of measuring the GSM value of the CCA far wall and its association with measures of smoking heaviness and traditional CVD risk factors among current smokers.


Circulation ◽  
2007 ◽  
Vol 116 (suppl_16) ◽  
Author(s):  
Nauder Faraday ◽  
Lisa R Yanek ◽  
Taryn F Moy ◽  
Dhananjay Vaidya ◽  
J. E Herrera-Galeano ◽  
...  

Background: Platelet hyper-responsiveness to activating stimuli during aspirin (ASA) therapy may discriminate between high risk subjects who have developed acute thrombotic cardiovascular disease (CVD) events (coronary disease and stroke) and those who are at increased risk but are disease free. We hypothesized that subjects with documented CVD would have greater platelet reactivity on ASA therapy compared to matched high risk non-CVD subjects. Methods: Subjects (N=228; 61 +/− 8 yrs, 69% male, 60% white) were selected from families with known CVD; 114 had prevalent CVD and were matched on age, sex, and race to 114 apparently healthy controls with risk factors but without clinical CVD. CVD risk factors were measured and therapy adherence was determined by questionnaires. Platelet reactivity on 81 mg ASA/day was determined by whole blood (WB) aggregometry, platelet function analyzer (PFA) closure time, thromboxane B2 (TxB2) release ex vivo , and urinary excretion of 11-dehyrothromboxane B2 (Tx-M) in vivo . Results. CVD cases had greater platelet reactivity by all measures, both unadjusted, and adjusted for age, sex, race and adherence (Table ). Multivariable adjustment for cardiac risk factors and statin therapy eliminated case-control differences for Tx-M, but not for the ex vivo measures of platelet activation. ASA therapy duration in CVD subjects (8.8 +/− 6.2 yrs) was not related to platelet function. Conclusions: Greater residual platelet reactivity exists during ASA therapy in CVD subjects compared to matched high risk controls, even controlling for CVD risk factors and adherence to therapy. The data suggest that platelet hyper-responsiveness during ASA chemoprophylaxis may differentiate patients with CVD from those who are at risk for CVD, but have not developed it. Platelet hyper-responsiveness may be an intrinsic property of CVD, related to as yet unidentified environmental or genetic factors.


2020 ◽  
Author(s):  
Xintong Jiang ◽  
Xun Wang ◽  
Mengxi Yang ◽  
Li Sun ◽  
Jiangli Jin ◽  
...  

Abstract Background A comprehensive assessment of cardiovascular disease (CVD) risk factors is the foundation of CVD prevention and treatment. This study assessed the awareness of CVD risk factors and treatment among Chinese medical students. Methods This cross-sectional study enrolled 48 3 rd year medical students who had finished preclinical course of medicine and 61 4 th year medical students who had finished their rotation in Internal Medicine’s Ambulatory Medicine clerkship from Peking University. The knowledge of CVD risk factors and therapeutic strategy was assessed by a self-administered questionnaire. Results Only about 50% of the 4 th year students knew the target value of low-density lipoprotein cholesterol for diabetic patients and blood pressure for high-risk patients, while the proportions in 3 rd year students were 20.8% and 29.2%, respectively. Although more than 90% students would prescribe cholesterol-lowering therapy to high-risk patients, few students knew the therapy of hypertriglyceridemia (2.1% and 27.9% of 3 rd and 4 th year students, respectively, p =0.001) or combined dyslipidemia. The awareness of their own lipid profile or blood glucose level was not as good as their blood pressure. Conclusions There is an urgent need to improve the knowledge of CVD risk factors and the details of therapeutic strategies among Chinese medical students.


2020 ◽  
Author(s):  
Pedro Martínez-Ayala ◽  
Guillermo Adrian Alanis-Sánchez ◽  
Luz Alicia Gonzalez-Hernández ◽  
Monserrat Álvarez-Zavala ◽  
Rodolfo Ismael Cabrera-Silva ◽  
...  

Abstract Background: Human immunodeficiency virus (HIV) infection is associated with a greater risk of cardiovascular disease (CVD). HIV infection causes a chronic inflammatory state and increases oxidative stress which can cause endothelial dysfunction and arterial stiffness. Aortic stiffness measured by carotid femoral-pulse wave velocity (cfPWV) and central hemodynamics are independent cardiovascular risk factors and have the prognostic ability for CVD. We assessed cfPWV and central hemodynamics in young individuals with recent HIV infection diagnosis not receiving antiretroviral therapy. We hypothesized that HIV individuals would present greater cfPWV and central hemodynamics (central systolic blood pressure and pulse pressure) compared to uninfected controls. Methods. We recruited 51 treatment naïve HIV individuals (HIV(+)) without previous CVD and 51 age- and sex-matched controls (HIV(-)). We evaluated traditional CVD risk factors including metabolic profile, blood pressure (BP), smoking, and immune state. Arterial stiffness and central hemodynamics were evaluated by cfPWV, central systolic BP and central pulse pressure (cPP) via applanation tonometry. Results. HIV(+) individuals presented a greater prevalence of smoking, reduced high density lipoprotein cholesterol, and body mass index. 65.9% of HIV(+) individuals exhibited lymphocytes <500 cell/µL. There was no difference in brachial or central BP between groups; however, HIV(+) individuals showed significantly lower cPP. We observed a greater cfPWV (mean difference= 0.5 m/s; p<0.01) in HIV(+) compared to controls, even after adjusting for heart rate, mean arterial pressure and smoking. Conclusion: In the early stages of infection, non-treated HIV individuals present a greater prevalence of traditional CVD risk factors, arterial stiffness, and normal or decreased central hemodynamics.


2020 ◽  
Vol 9 (7) ◽  
pp. 2208
Author(s):  
Johnny K. M. Sundholm ◽  
Anu Suominen ◽  
Taisto Sarkola ◽  
Kirsi Jahnukainen

The long-term vascular effects following childhood hematopoietic stem cell transplantation (HSCT) are not well characterized. We compared arterial wall morphology and function using very-high resolution ultrasound (25–55 MHz) in 62 patients following autologous (n = 19) or allogenic (n = 43) HSCT for childhood malignancies and hematological disease (median age 25.9 years, IQR 21.1–30.1; median follow-up time 17.5 years IQR 14.1–23.0) with an age matched healthy control group (n = 44). Intima-media thickness of carotid (CIMT 0.49 ± 0.11 vs. 0.42 ± 0.06 mm, p < 0.001), brachial, femoral, radial arteries, and local carotid stiffness, but not adventitial thickness, were increased (p < 0.001). Diffuse intimal thickening (>0.06 mm) of femoral or radial arteries (n = 17) and subclinical carotid or femoral plaques (n = 18) were more common (p < 0.001). Radiation predicted plaques (p < 0.001) and local carotid stiffness (p < 0.001), but not intimal thickening. CIMT was predicted by age, BMI >30 kg/m2, hsCRP >2.5 mg/L, hypertension, HbA1c > 42 mmol/L, and cumulative anthracycline >150 mg/m2. Cumulative metabolic syndrome criteria and cardiovascular disease (CVD) risk factors were more common among HSCT and related with CIMT (p < 0.001), but CIMT was similar among controls and HSCT without CVD risk factors. Long-term childhood HSCT survivors show early arterial aging related with radiation, metabolic, and CVD risk factors. Prevention of risk factors could potentially decelerate early arterial wall thickening.


Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Issada Trakarnwijitr ◽  
Bobby V Li ◽  
Heath Adams ◽  
Jamie Layland ◽  
John Garlick ◽  
...  

Introduction: Inflammation has an important role in initiation and progression of coronary artery disease (CAD). Different white cell count (WCC) subtypes may reflect different mechanisms of this complex disease, and may be valuable clinically in risk stratification and detection of patients with CAD. Studies on the correlation between WCC subtypes and CAD have yielded conflicting results. Hypothesis: We hypothesized that WCC subtypes are associated with the presence of CAD in high-risk patients over 55 years old. Methods: We analyzed 622 patients over the age of 55 from the BRAVEHEART and MINACS cohort who were referred for coronary angiogram at our institution. Univariate and multivariate logistic regression models were used to compare different WCC subtypes as predictors of presence of CAD, defined as ≥50% stenosis of 1 or more coronary arteries. We adjusted for age, sex and conventional cardiac risk factors. Results: On univariate analysis, patients with CAD had significantly more CVD risk factors compared to control patients. Markers associated with CAD were lower lymphocytes (tertile 2 OR 0.61, 95% CI 0.39-0.98, p=0.040, tertile 3 OR 0.70, 95% CI 0.44-1.12, p=0.139), and higher monocytes (tertile 3 OR 2.51, 95% CI 1.45-4.34, p=0.001), neutrophil-lymphocyte ratio (NLR) (OR 1.70, 95% CI 1.07-2.68, p=0.024), and monocyte-lymphocyte ratio (MLR) (tertile 3 OR 2.62, 95% CI 1.61-4.26, p<0.001). After adjustment for CVD risk factors, lower lymphocytes (tertile 2 OR 0.40, 95% CI 0.22-0.73, p=0.003, tertile 3 OR 0.50, 95% CI 0.27-0.93, p=0.028), and higher monocytes (tertile 3 OR 2.38, 95% CI 1.23-4.61, p=0.010), NLR (tertile 3 OR 1.91, 95% CI 1.08-3.38, p=0.025), and MLR (tertile 3 OR 2.26, 95% CI 1.23-4.14, p=0.009) were associated with CAD. Conclusions: In high-risk patients over 55 years old, lower lymphocytes, and higher monocytes, NLR and MLR were associated with angiographically determined CAD independent of other risk factors. Monocytes and MLR were the strongest correlates of CAD in high-risk patients over 55. Whether these can be used as biomarkers of CAD in high risk patients warrants further study.


2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Pedro Martínez-Ayala ◽  
Guillermo Adrián Alanis-Sánchez ◽  
Luz Alicia González-Hernández ◽  
Monserrat Álvarez-Zavala ◽  
Rodolfo Ismael Cabrera-Silva ◽  
...  

Abstract Background Human immunodeficiency virus (HIV) infection is associated with a greater risk of cardiovascular disease (CVD). HIV infection causes a chronic inflammatory state and increases oxidative stress which can cause endothelial dysfunction and arterial stiffness. Aortic stiffness measured by carotid femoral-pulse wave velocity (cfPWV) and central hemodynamics are independent cardiovascular risk factors and have the prognostic ability for CVD. We assessed cfPWV and central hemodynamics in young individuals with recent HIV infection diagnosis and without antiretroviral therapy. We hypothesized that individuals living with HIV would present greater cfPWV and central hemodynamics (central systolic blood pressure and pulse pressure) compared to uninfected controls. Methods We recruited 51 treatment-naïve individuals living with HIV (HIV(+)) without previous CVD and 51 age- and sex-matched controls (HIV negative (−)). We evaluated traditional CVD risk factors including metabolic profile, blood pressure (BP), smoking, HIV viral load, and CD4+ T-cells count. Arterial stiffness and central hemodynamics were evaluated by cfPWV, central systolic BP, and central pulse pressure (cPP) via applanation tonometry. Results HIV(+) individuals presented a greater prevalence of smoking, reduced high-density lipoprotein cholesterol, and body mass index. 65.9% of HIV(+) individuals exhibited lymphocyte CD4+ T-cells count < 500 cells/μL. There was no difference in brachial or central BP between groups; however, HIV(+) individuals showed significantly lower cPP. We observed a greater cfPWV (mean difference = 0.5 m/s; p < 0.01) in HIV(+) compared to controls, even after adjusting for heart rate, mean arterial pressure and smoking. Conclusion In the early stages of infection, non-treated HIV individuals present a greater prevalence of traditional CVD risk factors, arterial stiffness, and normal or in some cases central hemodynamics.


Circulation ◽  
2001 ◽  
Vol 103 (suppl_1) ◽  
pp. 1356-1357
Author(s):  
Ronny A. Bell ◽  
Daniel J. Zaccaro ◽  
Lynne E. Wagenknecht ◽  
Elizabeth J. Mayer-Davis

P31 Ethnic disparities in cardiovascular disease (CVD) and end-stage renal disease exist in the US, with African Americans (AAs) and Hispanic Americans (HAs) being at greater risk compared to non-Hispanic whites (NHWs). This maybe related to variations in individual and/or clusters of CVD risk factors across ethnic groups. We have previously shown ethnic differences in cross-sectional analyses from the Insulin Resistance and Atherosclerosis Study (IRAS) data in the effect of CVD risk factor clustering, with AAs being more greatly affected for nephropathy risk, and NHWs being more affected for CVD. We examined the effect of CVD risk factor clustering on the 5-year progression of albuminuria, which itself is a known CVD risk factor. Data were analyzed from the IRAS study, a multi-center epidemiologic cohort study that included roughly similar numbers of persons with normal and impaired glucose tolerance and type 2 diabetes, at baseline and 5-year follow-up. Comparisons were made forAAs and NHWs (Oakland/LAclinics), and for HAs and NHWs (San Antonio/San Luis Valley clinics). Data were available on 1256 IRAS subjects on nephropathy progression status, of which about 10% progressed from normal, defined as albumin/creatinine ratio less than 30 mg/g, to microalbuminuria (ACR of ≥30 and < 300) or macroalbuminuria (ACR ≥300) or from microalbuminuria to macroalbuminuria. CVD risk factors (dyslipidemia, BMI, waist-hip ratio, PAI-1, hypertension, diabetes status) at baseline were dichotomized, and subjects were classified as having high (≥ risk factors) or low (< 3 risk factors) risk. Overall 30.9% of the sample were classified as high risk. After adjusting for age, gender, and baseline nephropathy status, risk factor clustering predicted nephropathy progression in both ethnic comparisons (OR 2.24, p< 0.001 in AAs/NHWs group; OR 2.81, p< 0.001 in the HAs/NHWs group). With risk status in the model, HAs were at no greater risk for progression compared to NHWs, but risk was about 80% greater for AAs compared to NHWs (p < 0.05). These data indicate a risk of nephropathy among AAs that extends beyond the traditional CVD risk factor clusters.


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