scholarly journals Assessment of Post-Occlusive Reactive Hyperaemia in the Evaluation of Endothelial Function in Patients with Lower Extremity Artery Disease

2017 ◽  
Vol 63 (3) ◽  
pp. 129-132 ◽  
Author(s):  
Cosmin Carasca ◽  
Annamaria Magdas ◽  
Ioan Tilea ◽  
Alexandru Incze
Keyword(s):  
Endothelial Function ◽  
Challenge Test ◽  
Ankle Brachial Index ◽  
Arterial Occlusion ◽  
Control Group ◽  
Reactive Hyperaemia ◽  
Peripheral Perfusion ◽  
Surgical Revascularisation ◽  
Healthy Control ◽  
Artery Disease

Abstract Background: The aim was to assess endothelial function with photoplethysmography (PPG), by post-occlusive reactive hyperaemia (PORH) combined with alprostadil challenge test in patients with peripheral artery disease (PAD). Methods: Forty-nine PAD patients stage II-III Fontaine (39 male, 10 female, mean age 68.45±5.86 years) and a control group of 49 healthy individuals (24 male, 25 female; mean age 25.1±3.8 for a young subgroup; 71.0±0.16 years for an elderly subgroup) were included. Ankle-brachial index (ABI) was assessed at baseline, peripheral perfusion (PP) and PORH were assessed at baseline and after the 30 minutes administration of parenteral alprostadil. Results: After 3 minutes of arterial occlusion, peripheral perfusion increased from 0.69±0.94 mV/V to 2.27±2.42 mV/V (p<0.0001). After alprostadil challenge, peripheral perfusion increased from 0.84±1.24 mV/V to 4.52±3.52 mV/V (p<0.0001). In controls PP was 2.4±1.7 mV/V versus 3.8±1.5 mV/V, p<0.0001. Conclusion: In patients with PAD, an increase in PORH after alprostadil challenge due to the release of nitric oxide (NO), provides information on the endothelial function and could reflect the presence of collaterals. In the healthy control group, the increase in PORH could reflect the integrity of main arterial branch. In PAD patients with an increase in PORH, conservative therapy should be preferred over surgical revascularisation.

Endothelial Function in Patients with Severe and Moderate Haemophilia A and B

2018 ◽  
Vol 39 (02) ◽  
pp. 195-202
Author(s):  
Stephanie Böhmert ◽  
Ralf Schubert ◽  
Stephan Fichtlscherer ◽  
Sonja Alesci ◽  
Wolfgang Miesbach
Keyword(s):  
Endothelial Function ◽  
Adhesion Molecule ◽  
Reactive Hyperemia ◽  
Intercellular Adhesion Molecule ◽  
Control Group ◽  
Low Grade ◽  
Haemophilia A ◽  
Intercellular Adhesion Molecule 1 ◽  
Age Related ◽  
Artery Disease

AbstractThe life expectancy of patients with haemophilia has increased and therefore the interest in age-related comorbidities has grown. The aim of this study was to determine whether haemophilia patients have a different endothelial function compared with the general population. A total of 26 patients with severe or moderate haemophilia A or B, 14 controls and 36 patients with coronary artery disease (CAD) were included in this study. Five markers of endothelial dysfunction (MOEDs) were determined. Moreover, the endothelial function was examined using the Itamar Endo-PAT, and the reactive hyperemia index (RHI) was calculated from the results. The MOEDs soluble intercellular adhesion molecule-1 (p = 0.0095) and interleukin-6 (p = 0.010) were significantly higher for patients with haemophilia compared with the control group. The presence of increased adhesion molecule levels and low-grade inflammation is suggestive of a decreased endothelial function. RHI is impaired in CAD patients (1.862), whereas haemophilia patients have an RHI of 1.958 in comparison with 2.112 in controls (p = 0.127). Therefore, laboratory and functional measurements imply a possible higher risk for CAD in haemophilia patients.

scholarly journals Hubungan ear lobe crease dengan penyakit jantung koroner

e-CliniC ◽  
2016 ◽  
Vol 4 (1) ◽  
Author(s):  
Jacqueline A. Fuzairi ◽  
Dewi U. Djafar ◽  
Agnes L. Panda
Keyword(s):  
Cardiovascular Disease ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Ankle Brachial Index ◽  
Intima Media Thickness ◽  
Carotid Intima Media Thickness ◽  
Case Control ◽  
Control Group ◽  
Media Thickness ◽  
Artery Disease

Abstract: Cardiovascular disease is a huge burden in terms of mortality, disability, and morbidity in this day. Prevention of cardiovascular disease is based on the physical signs. Waist circumference, Ankle Brachial Index (ABI) and Carotid Intima Media Thickness (CIMT) are useful to recognize occult atherosclerosis, so as ear lobe crease. However, medics have less attention about examination of ear lobe crease for detection of coronary artery disease. This study aimed to determine the relation of ear lobe crease and coronary artery disease. This was an analytical observational study with a case control design. The results showed that there were 45 samples for control group and 45 samples for case group. The statistical analysis showed the X2 = 21.78 with a p value <0,001 which indicated that there was a significant correlation between Ear Lobe Crease and Coronary Artery Disease. The OR = 8.9% (95% CI 3.4 -23.3) meant that if a person had ear lobe crease, the possibility of coronary artery disease was 8.9 times higher than a person without ELC. Conclusion: There was a significant correlation between Ear Lobe Crease and Coronary Artery Disease.Keywords: ear lobe crease, coronary artery diseaseAbstrak: Penyakit Kardiovaskular merupakan penyebab utama kematian, kecacatan dan kesakitan saat ini. Deteksi penyakit kardiovaskular sebagai tindakan pencegahan dapat dilihat melalui pemeriksaan fisik. Pengukuran lingkar pinggang, Ankle Brachial Index (ABI), dan Carotid Intima Media Thickness (CIMT) sangat berguna untuk penanda aterosklerosis subklinis, begitu pula dengan Ear Lobe Crease. Namun sampai saat ini, pemeriksaan Ear Lobe Crease untuk menilai penyakit jantung koroner kurang mendapat perhatian petugas medis. Tujuan penelitian ini adalah untuk mengetahui apakah terdapat hubungan antara Ear Lobe Crease (ELC) dengan Penyakit Jantung Koroner. Metode: Penelitian ini dilakukan menggunakan metode penelitian analitik observasional dengan case control. Hasil penelitian: Sampel penelitian terdiri dari 45 orang untuk kelompok kontrol dan 45 orang untuk kelompok kasus. Berdasarkan uji X2 diperoleh X2 = 21,78 dengan p < 0,001. Hasil ini menunjukkan bahwa adanya hubungan yang sangat bermakna antara Ear Lobe Crease (ELC) dengan Penyakit Jantung Koroner (p < 0,001). Dalam uji ini, juga diperoleh OR = 8,9 (95% CI: 3,4 – 23,3). Odd Ratio (OR) ini menyatakan bahwa bila seseorang ditemukan adanya ELC, maka orang tersebut berisiko 8,9 kali mendapat Penyakit Jantung Koroner dibanding dengan orang tanpa ELC. Simpulan: Terdapat hubungan yang sangat bermakna antara Ear Lobe Crease (ELC) dengan Penyakit Jantung Koroner.Kata kunci: ear lobe crease, penyakit jantung koroner.

scholarly journals Dietary flavanol intervention lowers the levels of endothelial microparticles in coronary artery disease patients

2013 ◽  
Vol 111 (7) ◽  
pp. 1245-1252 ◽  
Author(s):  
Patrick Horn ◽  
Nicolas Amabile ◽  
Franca S. Angeli ◽  
Roberto Sansone ◽  
Berthold Stegemann ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Endothelial Function ◽  
Current Evidence ◽  
Repair Capacity ◽  
Endothelial Microparticles ◽  
Control Subjects ◽  
Healthy Control ◽  
Artery Disease ◽  
Endothelial Integrity

Current evidence suggests that regenerative v. degenerative endothelial responses can be integrated in a clinical endothelial phenotype, reflecting the net result between damage from risk factors and endogenous repair capacity. We have previously shown that a cocoa flavanol (CF) intervention can improve endothelial function and increase the regenerative capacity of the endothelium by mobilising circulating angiogenic cells in patients with coronary artery disease (CAD). The aim of the present study was to investigate whether CF can lower the levels of circulating endothelial microparticles (EMP), markers of endothelial integrity, along with improvements in endothelial function. The levels of EMP in the frozen plasma samples of CAD patients were measured along with endothelial function (flow-mediated vasodilation, FMD); n 16, FMD data published previously), and these data were compared with those of young (n 12) and age-matched (n 12) healthy control subjects. The CAD patients exhibited significantly increased levels of EMP along with impaired FMD when compared with the healthy control subjects. The levels of CD144+ and CD31+/41− EMP were inversely correlated with FMD (r − 0·67, P= 0·01 and r − 0·59, P= 0·01, respectively). In these CAD patients, the levels of EMP were measured after they had consumed a drink containing 375 mg of CF (high-CF intervention, HiFI) or 9 mg of CF (macro- and micronutrient-matched low-CF control, LoFl) twice daily over a 30-d period in a randomised, double-blind, cross-over study. After 1 month of HiFI, the levels of CD31+/41− and CD144+ EMP decreased ( − 25 and − 23 %, respectively), but not after LoFl. Our data show that flavanols lower the levels of EMP along with higher endothelial function, lending evidence to the novel concept that flavanols may improve endothelial integrity.

scholarly journals Analysis of Gut Microbiota in Patients with Coronary Artery Disease and Hypertension

2021 ◽  
Vol 2021 ◽  
pp. 1-9
Author(s):  
Chuanqi Wan ◽  
Chen Zhu ◽  
Gulei Jin ◽  
Min Zhu ◽  
Junyi Hua ◽  
...  
Keyword(s):  
Gut Microbiota ◽  
High Sensitivity ◽  
Cerebrovascular Diseases ◽  
Control Group ◽  
Clinical Indicator ◽  
Significant Difference ◽  
Healthy Control ◽  
Artery Disease ◽  
Dominant Bacteria ◽  
Microbiota Diversity

Cardiovascular and cerebrovascular diseases are characterized by high rates of morbidity and mortality. Microbiota is closely associated with cardiovascular disease. We aimed to comprehensively analyze the microbiotas of 300 healthy controls, 300 patients with high blood pressure (HBP), and 300 patients with coronary heart disease (CHD). The results indicated no significant difference in microbiota diversity among the three groups ( P > 0.05 ). However, differences in microbiota richness among the three groups were significant ( P < 0.05 ). Bacteroidetes and Bacteroidia were the dominant bacteria in the CHD group, Enterobacteriales and Escherichia-shigella in the HBP group, and Acidaminococcaceae and Phascolarctobacterium in the healthy control group. The prediction results of the random forest model indicated that the population with CHD displayed prominent features with high sensitivity, indicating that microbiota detection might become a novel clinical indicator to predict and monitor the risk of cardiovascular events. The prediction of microbiota function suggested differences in oxygen supply and chronic inflammation between populations with HBP/CHD and healthy populations. Although there is no difference in gut microbiota diversity among the three groups, each group has its dominant microbiota in terms of richness.

Adaptation of external counterpulsation based on individual shear rate therapy improves endothelial function and claudication distance in peripheral artery disease

VASA ◽  
2016 ◽  
Vol 45 (4) ◽  
pp. 317-324 ◽  
Author(s):  
Eva-Elina Buschmann* ◽  
Michele Brix* ◽  
Lulu Li ◽  
Janke Doreen ◽  
Andreas Zietzer ◽  
...  
Keyword(s):  
Shear Rate ◽  
Endothelial Function ◽  
Walking Distance ◽  
Peripheral Perfusion ◽  
Peripheral Artery ◽  
Doppler Flow ◽  
External Counterpulsation ◽  
Non Invasive ◽  
Artery Disease

Abstract. Background: External counterpulsation therapy enhances blood flow and was shown to improve endothelial function and quality of life in coronary artery disease patients. However, high pressures of up to 300 mmHg may lead to malperfusion of the ischaemic limb. To improve the clinical outcome of patients with peripheral artery disease (PAD), we adjusted external counterpulsation and developed a novel non-invasive approach termed individual shear rate therapy (ISRT). Patients and methods: In the present study, 14 patients with a Fontaine stage IIb and femoral-popliteal PAD underwent 30 hours of ISRT over 5 weeks. For ISRT, individual treatment pressures that do not exceed 160 mmHg were assessed by Doppler flow parameters during counterpulsation (individual shear rate diagnosis) in order to enhance and maximise peripheral perfusion. The study aimed to enhance peripheral perfusion and evaluate the primary clinical endpoint endothelial function, as well as to perform preliminary analysis of the ankle brachial index (ABI) and walking distance. Results: Doppler flow measurements in the lower limb (ankle) validated that maximum blood flow velocity during systole and acceleration doubled during ISRT. Study results demonstrated that long-term ISRT significantly increased flow-mediated dilation (FMD) in the brachial artery (0.13+/- 0.09 mm to 0.38+/- 0.05 mm; p < 0.05), while nitromediated dilation (0.36+/- 0.10 mm to 0.45+/- 0.08 mm) remained and common femoral artery FMD did not reach statistical significance (0.38+/- 0.08 mm to 0.67+/- 0.19 mm; p<0.05). Initial claudication distance considerably improved for all patients after 30 hours of ISRT (92.6 +/- 8.2 metres to 280+/- 101.3 metres, p<0.05), just like the absolute claudication distance, which showed a more than 2.5-fold increase (167.8+/- 18.1 metres to 446.7+/- 133.3 metres; p<0.05). The ABI did not improve (0.58+/- 0.03 to 0.65+/- 0.04). Conclusions: Our data demonstrate that long-term ISRT is a potential novel non-invasive treatment to improve endothelial function and absolute pain-free walking distance for PAD patients.

scholarly journals Effectiveness of Home-Based Pain-Free Exercise versus Walking Advice in Patients with Peripheral Artery Disease: A Randomized Controlled Trial

2021 ◽  
Vol 4 (2) ◽  
pp. 29
Author(s):  
Fabio Manfredini ◽  
Nicola Lamberti ◽  
Luca Traina ◽  
Gladiol Zenunaj ◽  
Chiara Medini ◽  
...  
Keyword(s):  
Peripheral Artery Disease ◽  
Controlled Trial ◽  
Ankle Brachial Index ◽  
Exercise Program ◽  
Walking Distance ◽  
Control Group ◽  
Peripheral Artery ◽  
Free Exercise ◽  
Home Based ◽  
Artery Disease

Exercise therapy in the intermediate stages of peripheral artery disease (PAD) represents an effective solution to improve mobility and quality of life (QoL). Home-based programs, although less effective than supervised programs, have been found to be successful when conducted at high intensity by walking near maximal pain. In this randomized trial, we aim to compare a low-intensity, pain-free structured home-based exercise (SHB) program to an active control group that will be advised to walk according to guidelines. Sixty PAD patients aged > 60 years with claudication will be randomized with a 1:1 ratio to SHB or Control. Patients in the training group will be prescribed an interval walking program at controlled speed to be performed at home; the speed will be increased weekly. At baseline and after 6 months, the following outcomes will be collected: pain-free walking distance and 6-min walking distance (primary outcome), ankle-brachial index, QoL by the VascuQoL-6 questionnaire, foot temperature by thermal camera, 5-time sit-to-stand test, and long-term clinical outcomes including revascularization rate and mortality. The home-based pain-free exercise program may represent a sustainable and cost effective option for patients and health services. The trial has been approved by the CE-AVEC Ethics Committee (898/20). Registration details: Clinicaltrials.gov NCT04751890 [Registered: 12 February 2021].

scholarly journals The Association of Serum Levels of stromolysin-1 and connexin-37 with the severity of coronary artery disease

2021 ◽  
Author(s):  
Melika Naebian ◽  
Naser Aslanabadi ◽  
Alireza Nourazarian ◽  
Reza Rahbarghazi ◽  
behrouz shademan ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Serum Levels ◽  
Chronic Inflammatory Disease ◽  
Control Group ◽  
Vessel Disease ◽  
Significant Difference ◽  
Healthy Control ◽  
Connexin 37 ◽  
Artery Disease

Abstract Background Coronary Artery Disease (CAD) is a common form of heart disease that is considered a serious health problem in society. Atherosclerosis is widely recognized as a chronic inflammatory disease of the vessels and can lead to CAD and myocardial infarction. The aim of the present study was to investigate serum levels of connexin-37 and stromelysin-1 as significant biomarkers of CAD and their correlation with the extent of CAD. Methods and results Sixty CAD patients with one-vessel (1VD), two-vessel (2VD), and three-vessel (3VD) disease were enrolled in this study. For comparison with the results, 20 healthy control subjects were also included in this study. Serum concentrations of connexin-37 and stromelysin-1 were determined using commercial ELISA kits. Serum connexin-37 concentrations were not significantly different between the patient and control groups (p < 0.05). The analysis showed a statistically significant difference between subjects with one-vessel disease, subjects with two-vessel disease, and subjects with three-vessel disease. Serum Stromelysin-1 concentration was significantly higher in the patients than in the control group (p < 0.05). Conclusions The results of our study indicate that serum levels of stromelysin-1, but not connexin-37, may contribute to the prediction of the occurrence and progression of CAD.

scholarly journals Carotid Intima-Media Thickness and Ankle-Brachial Index and Their Correlation with Coronary Artery Dilatation in Children with Kawasaki Disease

2021 ◽  
Vol 2021 ◽  
pp. 1-7
Author(s):  
Yinna Yao ◽  
Gunan Yang ◽  
Yanling Chen
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Carotid Artery ◽  
Normal Control ◽  
Ankle Brachial Index ◽  
Normal Control Group ◽  
Control Group ◽  
Carotid Imt ◽  
Coronary Artery Diameter ◽  
Artery Disease

Objective. To investigate the correlation between carotid intima-media thickness (IMT), ankle-brachial index (ABI), and coronary artery dilatation (CAD) in children with Kawasaki disease (KD) and to evaluate the effectiveness of CAD. Methods. A total of 68 children diagnosed with KD from January 2019 to January 2021 in our hospital were included. According to the results of cardiac color Doppler ultrasound, the children with KD were divided into a noncoronary artery dilation group (NCAD), with 41 children with KD who did not have coronary artery lesions, and a coronary artery dilation group (CAD), with 27 children with KD who had coronary artery dilation. 27 healthy children undergoing physical examination in our hospital at the same time were selected as the normal control group. Laboratory index of all subjects was measured individually. The carotid IMT, ABI, and coronary artery diameter of all subjects were measured and compared. Pearson correlation was used to analyze the correlation between carotid IMT, ABI, and the severity of coronary artery disease. The ROC curve was used to evaluate the efficacy of carotid IMT and ABI in predicting coronary artery disease. Results. The ALB of children in the CAD group was lower than that in the NCAD group P < 0.05 . The IMT of carotid artery and the diameter of coronary artery in children of the CAD group and the NCAD group were higher than those of the normal control group, and the IMT of the CAD group was higher than that of the NCAD group. The ABI of children in the CAD group and the NCAD group was lower than that of the normal control group, and the ABI of children in the CAD group was lower than that of the NCAD group P < 0.05 . Correlation analysis showed that carotid artery IMT of children with KD was positively correlated with coronary artery diameter, while ABI was negatively correlated with coronary artery diameter. The AUC of carotid IMT for CAD in children with KD was 0.668 (95% CI: 0.538–0.797), that of ABI for CAD in children with KD was 0.646 (95% CI: 0.513–0.780), and that of the combination of carotid IMT and ABI for CAD was 0.874 (95% CI: 0.785–0.963). Conclusion. The changes of carotid artery IMT and ABI in children with KD have a certain correlation with CAD, and the joint detection of carotid artery IMT and ABI can provide clinical reference value for predicting the degree of coronary artery disease in children with KD.

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