scholarly journals Retinal Vein Occlusion: A Form of Local Venous Thrombosis or a Result of Systemic Endothelial Dysfunction

Author(s):  
Erdinç Bozkurt ◽  
Turkhun Cetin ◽  
Ibrahim Rencuzogulları

Abstract Background: To determine the condition of systemic endothelial function and carotid intima media thickness (CIMT) in patients with retinal vein occlusion (RVO) and to identify the risk factors associated with the disease.Methods: Seventy-six patients who presented to the clinic with the diagnosis of RVO and 76 age- and gender-matched healthy individuals without a RVO history were included in the study. The patients' vision levels and central macular thickness were measures, and diabetes, hypertension, hyperlipidemia, carotid artery disease, body mass index and smoking histories were recorded. The endothelial function levels of the patients, pulse wave velocity (PWV), and CIMT were measured. Serum hematological parameters were evaluated.Results: The most important risk factor in patients with RVO was found to be hypertension (OR 1.455, 95% CI 1.981-9.272; p=0.001) compared to the control group, and diabetes (OR 0.460, 95% CI 1.981-9.272; p=0.001) and hyperlipidemia (OR 0.124, 95% CI 0.371-3.456; p=0.828) were significantly more common among the patients.There was a statistically significant difference between the RVO and control groups in terms of flow-mediated dilation (OR 0.050, 95% CI 0.020-0.080; p =0.001), PWV (OR 0.392, 95% CI 0.271-0.513; p<0.001), and the CIMT of both sides (OR 2.434, 95% CI 1.801-3.055 for the right CIMT and OR 2.284, 95% CI 1.646-2.922 for the left CIMT) (p<0.001 for all).Conclusion: Considering that RVO is associated with systemic endothelial dysfunction and may also be accompanied by carotid artery stenosis, we think that additional systemic diseases should be questioned in this patient group.

2021 ◽  
Author(s):  
Erdinc Bozkurt ◽  
Turkhun Cetin ◽  
Ibrahim Rencuzogulları

Abstract Purpose: To determine the condition of systemic endothelial function and carotid intima media thickness (CIMT) in patients with retinal vein occlusion (RVO) and to identify the risk factors associated with the disease.Material-Method: Seventy-six patients who presented to the clinic with the diagnosis of RVO and 76 age- and gender-matched healthy individuals without a RVO history were included in the study. The patients' vision levels and central macular thickness were measures, and diabetes, hypertension, hyperlipidemia, carotid artery disease, body mass index and smoking histories were recorded. The endothelial function levels of the patients, pulse wave velocity (PWV), and CIMT were measured. Serum hematological parameters were evaluated.Results: The most important risk factor in patients with RVO was found to be hypertension (OR 1.455, 95% CI 1.981-9.272; p=0.001) compared to the control group, and diabetes (OR 0.460, 95% CI 1.981-9.272; p=0.001) and hyperlipidemia (OR 0.124, 95% CI 0.371-3.456; p=0.828) were significantly more common among the patients.There was a statistically significant difference between the RVO and control groups in terms of flow-mediated dilation (OR 0.050, 95% CI 0.020-0.080; p =0.001), PWV (OR 0.392, 95% CI 0.271-0.513; p<0.001), and the CIMT of both sides (OR 2.434, 95% CI 1.801-3.055 for the right CIMT and OR 2.284, 95% CI 1.646-2.922 for the left CIMT) (p<0.001 for all).Conclusion: Considering that RVO is associated with systemic endothelial dysfunction and may also be accompanied by carotid artery stenosis, we think that additional systemic diseases should be questioned in this patient group.


2001 ◽  
Vol 101 (6) ◽  
pp. 707-713 ◽  
Author(s):  
Hiroki TERAGAWA ◽  
Masaya KATO ◽  
Junichi KUROKAWA ◽  
Togo YAMAGATA ◽  
Hideo MATSUURA ◽  
...  

In order to evaluate peripheral endothelial function in patients with vasospastic angina (VSA), we measured flow-mediated dilation (FMD) of the brachial artery in patients with VSA and compared it with FMD in patients without VSA. Endothelial dysfunction is considered one of the mechanisms underlying VSA. However, its exact role remains to be clarified. The study included 30 patients with positive spasm-provocational test results without evidence of significant coronary stenosis (VSA group) and 30 patients with negative spasm-provocational test results without evidence of significant coronary stenosis (control group). In each patient, brachial artery diameter responses to hyperemic flow and glyceryl trinitrate spray were measured using high-resolution ultrasound. The carotid intima-media thickness was also measured as a marker of systemic atherosclerosis. FMD was lower in the VSA group (4.8±0.5%) compared with the control group (9.4±0.7%, P < 0.0001). In the VSA group, FMD was not affected by coronary risk factors or the presence of atherosclerotic changes on coronary angiography. Glyceryl trinitrate-induced dilation did not differ between the two groups. The intima-media thickness was comparable between the VSA (0.85±0.04mm) and control groups (0.81±0.05mm). These findings indicated that peripheral endothelial function is impaired only in the VSA group, whereas the atherosclerotic changes were similar in the two groups. We conclude that endothelial dysfunction may be an independent factor responsible for the development of VSA.


2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
A.A Khan ◽  
G.N Thomas ◽  
G.Y.H Lip

Abstract Background Atrial fibrillation (AF) and hypertension commonly co-exist and both are associated with endothelial dysfunction. A key consequence of normal endothelial function in vivo is the ability to release NO in response to physiological stimuli, such as increased flow, reflecting flow-dependent endothelium-mediated dilation (FMD). FMD measurement using a high-resolution ultrasound has become a reliable and reproducible technique for assessment of endothelial dysfunction. Purpose To investigate whether endothelium-dependent FMD is more abnormal in patients with AF and hypertension when compared to hypertension alone. Design In a cross-sectional comparison, we studied two patient groups: AF and hypertension (n=61) and hypertension control group (n=33). High-resolution ultrasound was used to measure brachial artery diameter at rest and during reactive hyperaemia (endothelium-dependent FMD). Data was analysed using SPSS software. Results Participants were matched for age, sex and BMI. There was no significant difference in FMD between permanent AF and hypertension group and hypertension control group (4.6%, 95% CI [2.6–5.9] vs 2.6%, 95% CI [1.9–5.3]; p=0.25). No variables were identified on univariate analysis and only heart rate was identified on multivariate analysis as an independent predictor of FMD (p=0.04). Conclusion First study investigating FMD in patients with permanent AF and hypertension together to assess whether presence of AF worsens the endothelial dysfunction seen in patients with hypertension. Endothelium-dependent FMD is impaired in patients with AF and hypertension. The presence of AF does not incrementally worsen endothelial dysfunction, nor was AF an independent predictor of endothelial dysfunction on multivariate analysis. Funding Acknowledgement Type of funding source: None


2012 ◽  
Vol 11 (6) ◽  
pp. 29-32
Author(s):  
S. M. Noskov ◽  
A. A. Zavodchikov ◽  
A. V. Evgenyeva ◽  
A. A. Lavrukhina ◽  
A. N. Chamorovskyi ◽  
...  

Aim. To study the prevalence of selected parameters of subclinical atherosclerosis and their association with muscle function and muscle volume in patients with different levels of cardiovascular risk (CVR). Material and methods. The study included 20 patients (11 men and 9 women; mean age 54,5±8,5 years) with chronic coronary heart disease (CCHD; mean duration 6,4±2,3 years) in the main group (MG), as well as 20 CCHD-free people in the control group (CG). Arterial stiffness was assessed by pulse wave velocity (PWV) and calculated carotid-femoral index (CFI). Endothelial function was assessed by endothelium-dependent vasodilatation (EDVD) in the reactive hyperemia (RH) test. Common carotid artery (CCA) ultrasound was performed in order to assess intima-media thickness (IMT) of carotid arteries. All participants underwent veloergometry (VEM); exercise capacity (EC) was measured by calculated metabolic equivalents (MET). Muscle tissue volume was assessed using a bioelectrical impedance analyser. The percentage of active muscle mass (%AMM) and fat-free muscle mass (%FFM), out of the total body mass, was calculated. Results. Increased CFI values >12 m/s, as a marker of adverse prognosis, were observed in 20% CCHD patients and in 10% of controls (z=0,17; p=0,87). Vasomotor endothelial dysfunction (EDVD <10%) was registered in 65% and 50%, respectively (z=0,74; p=0,46), while increased IMT values >0,9 mm were observed in 55% and 15%, respectively (z=2,3; p=0,02). Most patients with pathologically increased arterial stiffness and vasomotor endothelial dysfunction had low EC. In CCHD patients with low EC, CFI significantly correlated with %AMM and %FFM (r=-0,32; p<0,05; and r=-0,36; p<0,05, respectively). EDVD significantly correlated with both %AMM and %FFM (r=0,47; p<0,05; and r=0,5; p<0,05, respectively). There was a significant correlation between CFI and EDVD (r=-0,3; p<0,05). In CG participants with low EC, EDVD correlated with %AMM and %FFM (r=0723; p<0,05 and r=0,7; p<0,05, respectively). In both groups, %AMM and %FFM correlated with MET (r=0,49; p<0,05 and r=0,55; p<0,05, respectively; r=0,34; p<0,05 and r=0,31; p<0,05, respectively). Conclusion. EDVD and PWV reflect the lower PA levels and functional disadaptation of CCHD patients, which can result in a faster progression of atherosclerosis.


2019 ◽  
Vol 29 (2) ◽  
pp. 190-194
Author(s):  
Mehmet Akif Dündar ◽  
Yasemin Altuner Torun ◽  
Serkan Fazlı Çelik ◽  
Emine Kaygı Tartıcı ◽  
Çiğdem Karakükçü

AbstractObjectiveVitamin B12 deficiency induces hyper-hyperhomocysteinemia by inhibiting intracellular methionine re-methylation. Hyper-hyperhomocysteinemia increases the risk of atherosclerosis. Asymmetric dimethylarginine is an endogenous inhibitor of nitric oxide synthase and its level elevates in cardiovascular diseases. In this study, we aimed to examine the relationship between asymmetric dimethylarginine and arterial stiffness and atherosclerosis in adolescents with vitamin B12 deficiency.MethodsA total of 88 adolescents with age ranging between 11 and 17 years of age were enrolled for this study. Among them, 50 patients had vitamin B12 deficiency <130 pg/ml and 38 healthy controls had B12 >200 pg/ml. In all cases, the levels of asymmetric dimethylarginine were measured with high performance liquid chromatography method. The carotid artery intima media thickness and left ventricular mass index were measured using echocardiography. All these measurements of the study groups were compared.ResultsBoth plasma levels of asymmetric dimethylarginine and carotid artery intima media thickness were significantly higher in the vitamin B12 deficiency group than in the control group. Correlation analysis showed significant negative correlation of vitamin B12 with homocysteine, asymmetric dimethylarginine, and carotid artery intima media thickness (p<0.05).ConclusionOur results suggest that endothelial dysfunction starts in the early stage of adolescent vitamin B12 deficiency, and vitamin B12-deficient adolescents have increased circulating asymmetric dimethylarginine, showing that endothelial dysfunction and increased carotid artery intima media thickness be related to atherosclerosis.


2013 ◽  
Vol 2013 ◽  
pp. 1-4 ◽  
Author(s):  
Alparslan Şahin ◽  
Muhammed Şahin ◽  
Harun Yüksel ◽  
Fatih Mehmet Türkcü ◽  
Yasin Çınar ◽  
...  

Background. The aim of this study was to investigate the mean platelet volume (MPV) of patients with retinal vein occlusion (RVO).Methods. Hundred and ninty-three patients with the diagnosis of RVO and 83 healthy control subjects were included in this retrospective study. Retinal vein occlusion was diagnosed based on clinical examination. All patients and control subjects underwent complete ocular examination. MPV, hematocrit, hemoglobin, and platelet count of the participants were recorded. The data of patients with RVO was compared with the control subjects.Results. Patients with RVO had significantly higher MPV values ( fL) compared with the control subjects ( fL) (). No significant difference was found in platelet counts between RVO group and the control group ( 109/L and  109/L, resp., ), Mean platelet volume was an independent predictor of RVO (odds ratio (OR) = 1.43; 95% confidence interval (CI) = 1.09–1.89; ).Conclusion. Our results demonstrated that the MPV values were significantly higher in patients with RVO, suggesting that larger platelets may contribute to the pathogenesis of the RVOs.


2020 ◽  
Vol 25 (4) ◽  
pp. 302-308
Author(s):  
Nikolaos Gouliopoulos ◽  
Gerasimos Siasos ◽  
Marilita M Moschos ◽  
Evangelos Oikonomou ◽  
Alexandros Rouvas ◽  
...  

Retinal vein occlusion (RVO) is a common retinal vascular lesion, and a leading cause of visual impairment. Patients with RVO have an increased risk for cardiovascular disease and share multiple common risk factors. In this study, we investigated the endothelial function and arterial stiffness of patients with RVO compared to healthy-control (CL) subjects. We enrolled 40 consecutive patients with RVO and 40 CL subjects. RVO was diagnosed by an ophthalmologist, endothelial function was evaluated by flow mediated dilation (FMD) in the brachial artery, and carotid-femoral pulse wave velocity (PWV) and augmentation index (AIx) of the radial artery were measured to evaluate arterial stiffness and reflected waves, respectively. No significant differences were detected between the studied groups in sex, age, presence of hypertension or dyslipidemia, body mass index, systolic and diastolic blood pressure levels, total cholesterol levels, and smoking habits ( p > 0.05 for all). However, patients with RVO had impaired FMD ( p = 0.002) and increased PWV ( p = 0.004), even after adjustment for several confounders. Both FMD and PWV were also significantly and independently associated with the development of RVO. Furthermore, a significant and positive correlation between PWV and systolic blood pressure existed only in the CL group. Therefore, we have shown that RVO is associated with significant endothelial dysfunction and increased arterial stiffness. Our results strengthen the vascular theory, according to which, systemic endothelial dysfunction and arteriosclerosis play a significant role in the pathogenesis of RVO.


2020 ◽  
Vol 2 ◽  
pp. 32-39
Author(s):  
Olga Venediktova

Acute inflammation and endothelial dysfunction (EDF) are typical pathological processes, which determine the development of retinal vein occlusion (RVO) during cardio-surgery with the use of cardiopulmonary bypass (CB), but the connection of seromarkers according to the terms of occlusion appearance remains undefined. The aim – to determine the influence of the acute inflammation and EDF for RVO formation after cardio-surgical interferences with the use of CB according to the terms of occlusion appearance. Material and methods. There were selected for the research the data of 137 eyes (126 patients, the main group) with RVO after the surgery with CB. The comparison group contains the data about examination of 86 eyes (43 patients), who had not any occlusion during all term of examination. The control group consisted of 10 eyes (5 patients) without occlusion, which were examined before surgery. An ophthalmologist 2, 7, 30, 60, 90 and 180 days after cardio-surgical interference, examined patients. The content of IL-6, IL-8 and VE-cadherin in blood serum was determined by immunoenzyme technique (Bender Medsystems, Austria). Statistical data processing was performed with the use of Statistica 10 program (StatSoft, Inc., USA), regression analysis – with the use of the program package GLZ. Results. The conduction of cardio-surgeries with the use of CB caused an increase of the interleukins content in the early period (IL-6 on the 2nd and 7th days, and IL-8 up to 30 days), while the content of VE-cadherin (VE-C) was slightly increased during almost all period of monitoring. With the availability of RVO, the content of IL-6 during all terms of occlusion appearance was significantly higher, the content of IL-6 was up to 30 days, and the content of VE-C in a greater degree was after the 7th day. The regression analysis showed that after 1-2 days RVO appearance was directly related with the content of IL-6 and IL-8 in the blood, on the 3rd and 7th days – only with the content of IL-8, on the 8th and 30th days – with the content of all markers, and then with the content of IL-6 and VE-C. The accuracy of the prediction of the presence or absence of RVO at the appropriate period according to the calculated regression model is at least 78 % (p <0.001), what proves the influence of markers on the development of RVO. Conclusions. The undertaken study shows the meaning of the acute inflammation and EDF by appearance of RVO with the use of CB, what justifies the application of the preventive measures - at the early stages the restriction of activity of the inflammatory process, at the later stages – prevention of EDF development.


2018 ◽  
Vol 69 (6) ◽  
pp. 1550-1553
Author(s):  
Rosana Manea ◽  
Bianca Elena Popovici ◽  
Carmen Daniela Neculoiu ◽  
Dan Minea ◽  
Alina Calin

Hypertension is a major risk factor for progression of the atherosclerotic process and for developing of degenerative cardiovascular diseases in adulthood. The aim of this study is to evaluate how the measurement of carotid intima - media thickness for prediction of essential hypertension in children can be used.The study group included 81 children and the control group 61 children, all aged between 5 - 17 years and 11 months old, and admitted in Children Hospital Brasov in the period of 2009 � 2014. The study protocol included: BMI, blood pressure and Doppler echography of the common carotid artery for each group. Mean age of the patients from the study group was 13.67 years, 43.20 % girls and 56.80 % boys, while in the control group, the mean age was 14.07 years, 54.10% girls and 45.90 % boys. 70.37% of the children from the study group presented obesity, while in the control group 40.98% were obese. The IMTC study group ranged from 0.52 - 0.69 mm and the limits of the normotensive subjects were 0.32 -0.54 mm. In both groups the obese patients were found to have increased carotid artery intima-media, which means that IMTC was positively correlated with BMI (p=0.000001).It is necessary to identify diagnostic methods easily applicable for children, allowing involvement of the characteristics of the arterial wall in the degenerative pathological processes. Increased intima-media ratio is positively correlated with high values of blood pressure.


2021 ◽  
Vol 12 ◽  
pp. 204062232110269
Author(s):  
Yipin Zhao ◽  
Huawei Wang ◽  
Dazhi Ke ◽  
Wei Deng ◽  
Yingying Ji ◽  
...  

Background and Aims: Studies have shown that dipeptidyl peptidase-4 (DDP-4) inhibitors have anti-atherosclerotic effects. However, in the PROLOGUE study, sitagliptin failed to slow the progression of carotid intima-media thickness (CIMT) relative to conventional therapy. We conducted a post hoc analysis of the PROLOGUE study and compared the effects of sitagliptin and conventional therapy on changes in CIMT in subgroups with or without hyperuricemia. Methods: The PROLOGUE study was a randomized controlled trial of 442 patients with type 2 diabetes mellitus (T2DM). Patients were randomized to receive sitagliptin added therapy or conventional therapy. Based on the serum uric acid levels of all study populations in the PROLOGUE study, we divided them into hyperuricemia subgroup ( n = 104) and non-hyperuricemia subgroup ( n = 331). The primary outcome was changed in carotid intima-media thickness (CIMT) parameters compared with baseline during the 24 months treatment period. Results: In the hyperuricemia subgroup, compared with the conventional therapy group, the changes in the mean internal carotid artery (ICA)-IMT and max ICA-IMT at 24 months were significantly lower in the sitagliptin group [−0.233 mm, 95% confidence interval (CI) (−0.419 to 0.046), p = 0.015 and −0.325 mm, 95% CI (−0.583 to −0.068), p = 0.014], although there was no significant difference in the common carotid artery CIMT. Conclusion: The results of our analysis indicated that sitagliptin attenuated the progression of CIMT than conventional therapy in T2DM and hyperuricemia patients.


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