scholarly journals To study the endothelial dysfunction by brachial artery flow mediated dilatation in coronary artery disease patients

2017 ◽  
Vol 4 (4) ◽  
pp. 1158
Author(s):  
Mahendra Chouhan ◽  
Sohan Singh Mandloi ◽  
Archana Kansal ◽  
O. P. Jatav
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Brachial Artery ◽  
Disease Risk ◽  
Cardiovascular Disease Risk ◽  
Flow Mediated Dilatation ◽  
Artery Disease ◽  
Artery Flow

Background: Brachial artery flow mediated dilatation (BAFMD), assessed by high resolution ultrasonography, reflects endothelium dependent vasodilator function. BAFMD is diminished in patients with atherosclerosis and with coronary risk factors and improves with risk reduction therapy.Methods: Study was conducted on 50 patients of coronary artery disease from In-patients who were admitted in the Department of Medicine and 25 healthy control without cardiovascular disease risk factors. All patients having established CAD i.e. Acute coronary syndrome and past history of CABG/angioplasty were included in study. Those morbidly ill and patients with evidence of chronic inflammatory or malignant disease were excluded. Doppler ultrasound of brachial artery was performed in all of them to assess baseline lumen diameter and flow mediated dilatation (i.e. percent change in brachial artery diameter after occlusion cuff release). Patients were divided into two groups; first group was classified as those having BAFMD less than 7.5% and the second group consisted patients having BAFMD less than 10%.Results: Flow mediated dilatation in cases was 6.87±5.48% as compared to the control group in which it was 13.08±3.40% and was statistically significant (P value 0.000002). Brachial artery flow mediated dilatation was abnormal in 80% cases at a cut off value <10% significant abnormalities; i.e. BAFMD <7.5% was found in 66% patients.Conclusions: Endothelial function as assessed by FMD is significantly impaired in patient of coronary artery disease. Hence it may be used as an important screening tool in people having cardiovascular disease risk factors and may play as a crucial role in preventive cardiology.  

scholarly journals Obesity and Cardiovascular Disease: A Scientific Statement From the American Heart Association

Circulation ◽  
2021 ◽  
Author(s):  
Tiffany M. Powell-Wiley ◽  
Paul Poirier ◽  
Lora E. Burke ◽  
Jean-Pierre Després ◽  
Penny Gordon-Larsen ◽  
...  
Keyword(s):  
Risk Factors ◽  
Heart Failure ◽  
Atrial Fibrillation ◽  
Cardiovascular Disease ◽  
Coronary Artery Disease ◽  
Weight Loss ◽  
Coronary Artery ◽  
Disease Risk ◽  
Artery Disease ◽  
The Impact

The global obesity epidemic is well established, with increases in obesity prevalence for most countries since the 1980s. Obesity contributes directly to incident cardiovascular risk factors, including dyslipidemia, type 2 diabetes, hypertension, and sleep disorders. Obesity also leads to the development of cardiovascular disease and cardiovascular disease mortality independently of other cardiovascular risk factors. More recent data highlight abdominal obesity, as determined by waist circumference, as a cardiovascular disease risk marker that is independent of body mass index. There have also been significant advances in imaging modalities for characterizing body composition, including visceral adiposity. Studies that quantify fat depots, including ectopic fat, support excess visceral adiposity as an independent indicator of poor cardiovascular outcomes. Lifestyle modification and subsequent weight loss improve both metabolic syndrome and associated systemic inflammation and endothelial dysfunction. However, clinical trials of medical weight loss have not demonstrated a reduction in coronary artery disease rates. In contrast, prospective studies comparing patients undergoing bariatric surgery with nonsurgical patients with obesity have shown reduced coronary artery disease risk with surgery. In this statement, we summarize the impact of obesity on the diagnosis, clinical management, and outcomes of atherosclerotic cardiovascular disease, heart failure, and arrhythmias, especially sudden cardiac death and atrial fibrillation. In particular, we examine the influence of obesity on noninvasive and invasive diagnostic procedures for coronary artery disease. Moreover, we review the impact of obesity on cardiac function and outcomes related to heart failure with reduced and preserved ejection fraction. Finally, we describe the effects of lifestyle and surgical weight loss interventions on outcomes related to coronary artery disease, heart failure, and atrial fibrillation.

scholarly journals Polygenic Scores to Assess Atherosclerotic Cardiovascular Disease Risk

2020 ◽  
Vol 126 (9) ◽  
pp. 1159-1177 ◽  
Author(s):  
Krishna G. Aragam ◽  
Pradeep Natarajan
Keyword(s):  
Cardiovascular Disease ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Clinical Utility ◽  
Disease Risk ◽  
Cardiovascular Disease Risk ◽  
Risk Scores ◽  
Atherosclerotic Cardiovascular Disease ◽  
Artery Disease ◽  
Atherosclerotic Cardiovascular Disease Risk

An individual’s susceptibility to atherosclerotic cardiovascular disease is influenced by numerous clinical and lifestyle factors, motivating the multifaceted approaches currently endorsed for primary and secondary cardiovascular disease prevention. With growing knowledge of the genetic basis of atherosclerotic cardiovascular disease—in particular, coronary artery disease—and its contribution to disease pathogenesis, there is increased interest in understanding the potential clinical utility of a genetic predictor that might further refine the assessment and management of atherosclerotic cardiovascular disease risk. Rapid scientific and technological advances have enabled widespread genotyping efforts and dynamic research in the field of coronary artery disease genetic risk prediction. In this review, we describe how genomic analyses of coronary artery disease have been leveraged to create polygenic risk scores. We then discuss evaluations of the clinical utility of these scores, pertinent mechanistic insights gleaned, and practical considerations relevant to the implementation of polygenic risk scores in the health care setting.

scholarly journals Ceramide Scores Predict Cardiovascular Risk in the Community

2021 ◽  
Vol 41 (4) ◽  
pp. 1558-1569
Author(s):  
Vlad C. Vasile ◽  
Jeffrey W. Meeusen ◽  
Jose R. Medina Inojosa ◽  
Leslie J. Donato ◽  
Christopher G. Scott ◽  
...  
Keyword(s):  
Risk Factors ◽  
Myocardial Infarction ◽  
Cardiovascular Disease ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Dose Response ◽  
Disease Risk ◽  
Community Based ◽  
Artery Disease

Objective: Cardiovascular disease remains a leading cause of mortality worldwide. Ceramide scores have been associated with adverse outcomes in patients with established coronary artery disease. The prognostic value of ceramide score has not been assessed in the general population. We tested the hypothesis that ceramide scores are associated with major adverse cardiac events (MACE) in a community-based cohort with average coronary artery disease burden at enrollment. Approach and results: In a prospective community-based cohort, we performed passive follow-up using a record linkage system to ascertain the composite outcome of MACE, defined as acute myocardial infarction, coronary revascularization (bypass grafting or percutaneous intervention), stroke, or death. Ceramides were analyzed as log-transformed continuous variables, ratios or scores, and quartiles with adjustment for confounders. We analyzed 1131 subjects, 52% females, mean age±(SD) 64±9 years. After a median follow-up of 13.3 years (Q1, 12.7; Q3, 14.4), 486 patients experienced a MACE: myocardial infarction (80), coronary artery bypass surgery (34), percutaneous coronary intervention (62), stroke (94), and all-cause death (362). Ceramide ratios were significantly associated with MACE independently of LDL-c (low-density lipoprotein cholesterol) and conventional coronary artery disease risk factors. Those in the highest quartile of ceramide score had nearly 1.5-fold risk of MACE, hazard ratio, 1.47 (95% CI, 1.12–1.92). There was a dose-response association across quartiles of ceramide ratios and MACE. Conclusions: Elevated ceramide score is a robust predictor of cardiovascular disease and MACE in the community. The risk conferred by the ceramide score has a dose-response behavior and is independent of conventional risk factors.

Prevention of cardiovascular disease

2018 ◽  
Author(s):  
Amitava Banerjee ◽  
Kaleab Asrress
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Disease Risk ◽  
Sub Saharan Africa ◽  
Individual Risk ◽  
Mortality And Morbidity ◽  
Future Risk ◽  
Artery Disease

The global scale of the cardiovascular disease epidemic is unquestionable, with cardiovascular disease causing a greater burden of mortality and morbidity than any other disease, regardless of country or population. With demographic change and ageing populations, the prevalence of cardiovascular disease and its risk factors is set to increase. The commonest cardiovascular diseases are atherosclerotic, affecting all arterial territories. The ‘burden of disease’ approach has highlighted the fact that cardiovascular disease and non-communicable diseases are not simply diseases of affluence but affect people of all countries, with enormous costs in terms of public health, healthcare, and overall economies. Coronary artery disease is the leading cause of mortality in all regions of the world apart from sub-Saharan Africa, followed by cerebrovascular disease. It should be noted, however, that there has been a major decline in cardiovascular disease mortality in Western Europe, the US, and Japan over the past 40 years. There are multiple factors underlying these favourable trends but understanding the epidemiology and characterizing individual risk factors for cardiovascular disease has been central in formulating preventive and treatment strategies. The INTERHEART study showed that 90% of cardiovascular risk can be explained by nine easily identifiable risk factors; an awareness of these, and the discovery of novel factors, will continue to serve in the fight to reduce the burden of cardiovascular disease. Geoffrey Rose first championed population-wide approaches versus strategies which target only high-risk individuals. Prevention aims to ‘catch the disease’ upstream, therefore delaying, reducing, or eliminating the risk of coronary artery disease. Surrogate markers for coronary artery disease have emerged in efforts to detect disease at earlier stages, and in order to better understand the pathophysiology. For example, coronary artery calcium scoring is emerging as a marker of future risk of coronary artery disease. Risk stratification scores are increasingly used as tools to individualize a person’s future risk of coronary artery disease in order to better target treatment and prevention strategies.

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