scholarly journals The Evaluation of Flow Mediated Dilatation and Blood Parameters in Raynaud Phenomenon

2021 ◽  
Author(s):  
Suheyla UZUN ◽  
Ilker KAYA
Keyword(s):  
Endothelial Function ◽  
Underlying Disease ◽  
Blood Parameters ◽  
Smoking History ◽  
Raynaud Phenomenon ◽  
Albumin Ratio ◽  
Flow Mediated Dilatation ◽  
Endothelial Functions ◽  
And Control ◽  
D Dimer

Introduction: Raynaud phenomenon (RP) is a multifactorial disorder. If any underlying disease cannot be detected responsible for RP then it considered as primary RP (pRP). We aimed to investigate the differences between laboratory markers and impaired endothelial function in pRP. Material and Methods: Forty-two pRP patients included as study and control groups were created from 30 healthy individuals. The endothelial function was evaluated with flow-mediated dilatation (FMD) of the brachial artery. The blood samples were obtained both groups and white blood cell [WBC], hemoglobin, platelet, mean platelet volume [MPV], creatinine, alanine aminotransferase [ALT], aspartate aminotransferase[AST], D-dimer, fibrinogen, albumin, fibrinogen to albumin ratio [FAR], Neutrophil to Lymphocyte ratio [NLR], D-dimer to albumin ratio [DDAR] and monocyte chemo-attractant protein-1 [MCP-1]. Obtained blood parameters and FMD values were compared between groups. Results: The groups were found as similar in regards to age, gender, smoking history (p<0.05). There was no difference between the two groups in regards to hemoglobin, platelet, MPV, creatinine, ALT, D-dimer, albumin, FAR, NLR, DDAR levels (p<0.05). AST levels were slightly higher in pRP group (p=0.027). Markedly increased WBC, fibrinogen, MPV and MCP-1 values were detected in pRP group (p=0.000). Additionally, higher abnormal FMD responses were detected in pRP group (p=0.000). There was a direct correlation between abnormal FMD response and serum MCP-1 values in patients with pRP (R: 0.308, R2: 0.095, p: 0.044). Conclusion: It seems to be that MCP-1 levels are higher in patients with pRP and increased values of MCP-1 levels seem to be related to impaired endothelial functions

scholarly journals A Comparison of Measures of Endothelial Function in Patients with Peripheral Arterial Disease and Age and Gender Matched Controls

2016 ◽  
Vol 2016 ◽  
pp. 1-6 ◽  
Author(s):  
Richard B. Allan ◽  
Simon V. Vun ◽  
J. Ian Spark
Keyword(s):  
Endothelial Function ◽  
Reactive Hyperemia ◽  
Arterial Disease ◽  
Peripheral Artery ◽  
Flow Mediated Dilatation ◽  
Hyperaemic Response ◽  
Artery Disease ◽  
And Gender ◽  
Peripheral Arterial ◽  
And Control

This study compared flow-mediated dilatation (FMD), peripheral artery tonometry (PAT), and serum nitric oxide (NO) measures of endothelial function in patients with peripheral artery disease (PAD) against age/gender matched controls. 25 patients (mean age: 72.4 years, M : F 18 : 7) with established PAD and an age/gender matched group of 25 healthy controls (mean age: 72.4 years, M : F 18 : 7) were studied. Endothelial function was measured using the % FMD, reactive hyperemia index (RHI) using PAT and serum NO (μmol). Difference for each method between PAD and control patients and correlation between the methods were investigated. FMD and RHI were lower in patients with PAD (median FMD for PAD = 2.16% versus control = 3.77%,p=0.034and median RHI in PAD = 1.64 versus control = 1.92,p=0.005). NO levels were not significantly different between the groups (PAD median = 7.70 μmol, control median = 13.05 μmol,p=0.662). These results were obtained in elderly patients and cannot be extrapolated to younger individuals. FMD and PAT both demonstrated a lower hyperaemic response in patients with PAD; however, FMD results in PAD patients were unequivocally reduced whereas half the PAD patients had RHI values above the established threshold for endothelial dysfunction. This suggests that FMD is a more appropriate method for the measurement of NO-mediated endothelial function.

scholarly journals Transient Reduction of FMD-Response and L-Arginine Accompanied by Increased Levels of E-Selectin, VCAM, and ICAM after Prolonged Strenuous Exercise

Sports ◽  
2021 ◽  
Vol 9 (6) ◽  
pp. 86
Author(s):  
Christoffer Nyborg ◽  
Helene Støle Melsom ◽  
Martin Bonnevie-Svendsen ◽  
Jørgen Melau ◽  
Ingebjørg Seljeflot ◽  
...  
Keyword(s):  
Endothelial Function ◽  
Strenuous Exercise ◽  
Finish Line ◽  
Endothelial Inflammation ◽  
Flow Mediated Dilatation ◽  
Line P ◽  
Ironman Distance

We assessed endothelial function by flow-mediated dilatation (FMD), levels of the NO-precursor L-arginine, and markers of endothelial inflammation before, at the finish line, and one week after the Norseman Xtreme triathlon. The race is an Ironman distance triathlon with a total elevation of 5200 m. Nine male participants were included. They completed the race in 14.5 (13.4–15.3) h. FMD was significantly reduced to 3.1 (2.1–5.0)% dilatation compared to 8.7 (8.2–9.3)% dilatation before the race (p < 0.05) and was normalized one week after the race. L-arginine showed significantly reduced levels at the finish line (p < 0.05) but was normalized one week after the race. Markers of endothelial inflammation E-Selectin, VCAM-1, and ICAM-1 all showed a pattern with increased values at the finish line compared to before the race (all p < 0.05), with normalization one week after the race. In conclusion, we found acutely reduced FMD with reduced L-arginine levels and increased E-Selectin, VCAM-1, and ICAM-1 immediately after the Norseman Xtreme triathlon. Our findings indicate a transient reduced endothelial function, measured by the FMD-response, after prolonged strenuous exercise that could be explained by reduced NO-precursor L-arginine levels and increased endothelial inflammation.

457 The Impact of PAP Therapy on Hematocrit in OSA and Polycythemia: A Pilot Study

SLEEP ◽  
2021 ◽  
Vol 44 (Supplement_2) ◽  
pp. A180-A181
Author(s):  
Mustafa Jafri ◽  
Gabrielle Rosa-Acosta ◽  
Jose Flores Martinez ◽  
Elizabeth Schofield ◽  
Cy Wilkins ◽  
...  
Keyword(s):  
Intervention Group ◽  
Smoking History ◽  
Event Analysis ◽  
Control Groups ◽  
Testosterone Therapy ◽  
Obstructive Sleep ◽  
Significant Difference ◽  
Testosterone Administration ◽  
And Control ◽  
The Impact

Abstract Introduction Untreated polycythemia leads to complications including thrombosis. Obstructive sleep apnea (OSA) is commonly associated with secondary erythrocytosis, which testosterone therapy can perpetuate. Effects of positive airway pressure (PAP) on elevated hematocrit (HCT) is unknown. We hypothesize PAP adherence can reduce HCT in men with OSA and polycythemia. Methods Retrospective chart review of male outpatients with newly diagnosed OSA and HCT≥45% at or 3 months before polysomnography (PSG) was conducted. Intervention group consisted of patients initiating PAP for OSA. HCT within 6 months of PAP initiation and PSG were recorded for intervention and control groups, respectively. Primary endpoint was time-to-HCT reduction of HCT&lt;50% plus 3% decrease. Cox proportional-hazards analysis was used to assess time-to-HCT response. Demographics, smoking history, testosterone administration, STOP-Bang score, AHI, and PAP compliance data were obtained. Patients excluded if PAP not indicated, or if PSG, PAP compliance, or repeat HCT were unavailable. Results 41 men with OSA had HCT≥45%, of which 16 had HCT≥50%. Median age was 60 years and median BMI was 32 kg/m2. 28 started PAP. 21 met definition for PAP compliance within 6 months. Median AHI of intervention and control groups were 23 and 19 events/hr, respectively. Mean baseline HCT of both groups were 49 and 50, respectively. No significant difference in age, BMI, smoking history, testosterone therapy, and baseline HCT between both groups noted. 39% of intervention group exhibited HCT response at 1 or more longitudinal assessments, versus 38% of control. Intervention group had higher mean STOP-Bang than control (mean 5.9 vs. 4.6, p=0.01) and trended towards higher mean baseline AHI (27.4 vs. 19.0, p= 0.06). Time-to-event analysis controlling for STOP-Bang and AHI demonstrated PAP was not associated with time-to-HCT response (HR = 1.3, 95% CI = 0.4–4.4). In moderate-severe OSA patients, 40% of intervention group had HCT response compared to 14% of control, though difference was not significant (HR = 2.5, 95% CI = 0.3–20.0). Conclusion Moderate-severe OSA patients trended towards reduction in HCT with PAP, although not statistically significant. Testosterone administration did not affect HCT response to PAP in this cohort. Larger studies are required to determine HCT response to PAP in these patients. Support (if any):

Decreased Flow-Mediated Dilatation in Children With Type 1 Diabetes: A Systematic Review and Meta-Analysis

Angiology ◽  
2021 ◽  
pp. 000331972110100
Author(s):  
Lei Cao ◽  
Miao Hou ◽  
Wanping Zhou ◽  
Ling Sun ◽  
Jie Shen ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Type 1 Diabetes ◽  
Endothelial Function ◽  
Meta Analysis ◽  
Quality Data ◽  
Cochrane Library ◽  
Healthy Children ◽  
Healthy Controls ◽  
Flow Mediated Dilatation

Type 1 diabetes (T1DM) is a strong risk factor for the development of cardiovascular disease. Flow-mediated dilatation (FMD) is an early noninvasive marker of endothelial function and it predicts future cardiovascular disease. However, the changes in FMD among T1DM children are still controversial. The present meta-analysis aimed to investigate whether FMD is impaired in children with T1DM. PubMed, EMBASE, Cochrane library, and Web of Science were searched for studies comparing FMD in children with T1DM and healthy controls. The Newcastle-Ottawa quality assessment scale for case–control studies was used to assess study quality. Data were pooled using a random effects models to obtain the weighted mean differences (WMD) in FMD and 95% CIs. Overall, 19 studies with 1245 patients and 872 healthy controls were included in this meta-analysis. Children with T1DM had significantly lower FMDs compared with healthy controls (WMD: −2.58; 95% CI: −3.36 to −1.81; P < .001). Meta-regression analysis revealed that low-density lipoprotein cholesterol levels impacted the observed difference in FMD between T1DM and healthy children. This meta-analysis showed that T1DM children have impaired endothelial function, which indicates they are at higher risk of developing cardiovascular disease in later life.

Flow-mediated dilatation following wrist and upper arm occlusion in humans: the contribution of nitric oxide

2001 ◽  
Vol 101 (6) ◽  
pp. 629-635 ◽  
Author(s):  
Sagar N. DOSHI ◽  
Katerina K. NAKA ◽  
Nicola PAYNE ◽  
Christopher J.H. JONES ◽  
Moira ASHTON ◽  
...  
Keyword(s):  
Nitric Oxide ◽  
Endothelial Function ◽  
Brachial Artery ◽  
Peak Flow ◽  
Ultrasound Probe ◽  
Upper Arm ◽  
Flow Mediated Dilatation ◽  
Synthase Inhibitor ◽  
Increased Blood Flow ◽  
Similar Peak

Flow-mediated dilatation (FMD) of the brachial artery assessed by high-resolution ultrasound is widely used to measure endothelial function. However, the technique is not standardized, with different groups using occlusion of either the wrist or the upper arm to induce increased blood flow. The validity of the test as a marker of endothelial function rests on the assumption that the dilatation observed is endothelium-dependent and mediated by nitric oxide (NO). We sought to compare the NO component of brachial artery dilatation observed following wrist or upper arm occlusion. Dilatation was assessed before and during intra-arterial infusion of the NO synthase inhibitor NG-monomethyl-l-arginine (l-NMMA) following occlusion of (i) the wrist (distal to ultrasound probe) and (ii) the upper arm (proximal to ultrasound probe) for 5min in ten healthy males. Dilatation was significantly greater after upper arm occlusion (upper arm, 11.62±3.17%; wrist, 7.25±2.49%; P = 0.003). During l-NMMA infusion, dilatation after wrist occlusion was abolished (from 7.25±2.49% to 0.16±2.24%; P < 0.001), whereas dilatation after upper arm occlusion was only partially attenuated (from 11.62±3.17% to 7.51±2.34%; P = 0.006). The peak flow stimulus was similar after wrist and upper arm occlusion. We conclude that dilatation following upper arm occlusion is greater than that observed after wrist occlusion, despite a similar peak flow stimulus. l-NMMA infusion revealed that FMD following wrist occlusion is mediated exclusively by NO, while dilatation following upper arm occlusion comprises a substantial component not mediated by NO, most probably related to tissue ischaemia around the brachial artery. FMD following wrist occlusion may be a more valid marker of endothelial function than dilatation following upper arm occlusion.

Determinants of short-term variation in arterial flow-mediated dilatation in healthy young men

2006 ◽  
Vol 110 (4) ◽  
pp. 475-482 ◽  
Author(s):  
Mikko J. Järvisalo ◽  
Laura Jartti ◽  
Jukka Marniemi ◽  
Tapani Rönnemaa ◽  
Jorma S. A. Viikari ◽  
...  
Keyword(s):  
Endothelial Function ◽  
Brachial Artery ◽  
Serum Insulin ◽  
Circadian Variation ◽  
Low Fat ◽  
Ultrasound Technique ◽  
Brachial Artery Diameter ◽  
Flow Mediated Dilatation ◽  
Hourly Variation ◽  
Fat Meal

Brachial artery FMD (flow-mediated dilatation) is widely used as a marker of systemic arterial endothelial function. FMD, however, shows considerable 25% day-to-day variation that hinders its clinical use. The reasons for this variability are poorly characterized. Therefore the present study was designed to clarify factors responsible for the hourly variation in endothelial function, including consuming a low-fat meal and circadian rhythms in endogenous hormonal levels. Brachial artery FMD, along with serum glucose, triacylglycerols (triglycerides) and levels of several hormones were measured six times per day on two separate days 1 week apart. On one day, the subjects (healthy males: n=12, mean age, 24 years) ate a light breakfast and a standardized lunch (23.5% fat, 48.7% carbohydrate and 27.8% protein). On the other day, they had a similar breakfast after which they fasted. Postprandial FMD values (both after breakfast and after lunch) were similar to baseline FMD. FMD showed a 28% hourly variation and 27% weekly variation. Variation in plasma levels of insulin (P=0.02) associated negatively and DHPG (3,4-dihydroxyphenylglycol) (P=0.001), a marker of sympathetic nervous activation, associated positively with variation in FMD. The effects of DHPG and insulin on FMD were independent of changes in baseline brachial artery diameter, although DHPG was also inversely associated with baseline diameter. Eating a regular low-fat meal does not have any measurable effects on brachial artery endothelial function. These data suggest that strict requirements for fasting conditions may be unnecessary when measuring peripheral endothelial function using the ultrasound technique. Circadian variation in serum insulin and sympathetic tone are physiological determinants of endothelial function.

scholarly journals Higher D-dimer level in the early third trimester predicts the occurrence of postpartum hemorrhage

2016 ◽  
Vol 44 (5) ◽  
Author(s):  
Naho Endo-Kawamura ◽  
Mana Obata-Yasuoka ◽  
Hiroya Yagi ◽  
Rena Ohara ◽  
Yuko Nagai ◽  
...  
Keyword(s):  
Risk Factors ◽  
Postpartum Hemorrhage ◽  
Blood Parameters ◽  
Demographic Characteristics ◽  
Activity Level ◽  
Late Gestation ◽  
Antithrombin Activity ◽  
Estimated Blood Loss ◽  
Independent Risk Factors ◽  
D Dimer

AbstractThis study aimed to determine effective predictive factors for primary postpartum hemorrhage (PPH) among clinical blood parameters associated with coagulation and fibrinolysis and demographic characteristics.We retrospectively studied 1032 women who underwent determinations of clinical blood parameters at gestational week (GW) 29–32 and GW 35–37 and gave birth to singleton infants at our hospital between January 2011 and December 2013. PPH was defined as estimated blood loss ≥700 mL. Multivariate logistic regression analyses were used to determine independent risk factors and odds ratios (OR) for PPH.PPH occurred in 104 of 1032 women (10%). Three blood variables, fibrinogen level <4.0 g/L (OR [95% CI], 1.96 [1.18–3.27]), antithrombin activity <85% of normal activity level (1.84 [1.05–3.21]), and D-dimer level >2.7 μg/mL (2.03 [1.29–3.19]) at GW 35–37, and three demographic characteristics, maternal age ≥35 years (1.75 [1.15–2.68]), BMI >28.2 kg/mAmong blood parameters, higher D-dimer levels and lower levels of antithrombin activity and fibrinogen in late gestation were independent risk factors for PPH.

Endothelial function state following repair of cyanotic congenital heart diseases

2013 ◽  
Vol 25 (2) ◽  
pp. 222-227 ◽  
Author(s):  
Mohammad Reza Sabri ◽  
Hooman Daryoushi ◽  
Mojgan Gharipour
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Endothelial Function ◽  
Tetralogy Of Fallot ◽  
Congenital Heart ◽  
Cyanotic Congenital Heart Disease ◽  
Vascular Endothelial ◽  
Vascular Endothelial Function ◽  
Flow Mediated Dilatation ◽  
The Mean

AbstractBackgroundRepairing cyanotic congenital heart disease may be associated with preserving endothelial function. The present study aimed to evaluate vascular endothelial function in patients with repaired cyanotic congenital heart disease.MethodsIn a case–control study conducted in 2012 in Isfahan, Iran, 42 consecutive patients aged <35 years who had suffered from different types of cyanotic congenital heart disease and had undergone complete repair of their congenital heart defect were assessed in regard to their endothelial function state by measuring flow-mediated dilatation and other cardiac function indices. They were paired with 42 sex- and age-matched healthy controls.ResultsThe mean flow-mediated dilatation was lower in patients with repaired cyanotic congenital heart disease than in the controls [6.14±2.78 versus 8.16±1.49 respectively (p<0.001)]. Significant adverse correlations were found between flow-mediated dilatation, age, and body mass indexes, in those who underwent repair surgery. In addition, flow-mediated dilatation had a positive association with the shortening fraction, ejection fraction, and tricuspid annular plane systolic excursion value, and it was also inversely associated with carotid intima-media thickness and the myocardial performance index. The mean of the flow-mediated dilatation was significantly higher in the group with tetralogy of Fallot along with complete repair before the age of 2.5 years and also in those patients with total anomalous pulmonary venous connection or transposition of the great arteries repaired with an arterial switch operation before 6 months of age, compared with the other two subgroups. This includes patients with a tetralogy of Fallot defect repaired after 4 years of age and those with complex cyanotic congenital heart disease that was repaired after 2.5 years of age (mean age at repair 9±6.1 years).ConclusionEarly repair of a cyanotic defect can result in the protection of vascular endothelial function and prevent the occurrence of vascular accidents at an older age.

scholarly journals Hospital Readmission in Patients With COVID-19

2021 ◽  
Author(s):  
Neda Rahimian ◽  
Mahshid Heidari ◽  
Nahid Hashemi-Madani ◽  
Nader Tavakoli ◽  
Moammad E Khamseh
Keyword(s):  
Risk Factors ◽  
Hospital Readmission ◽  
Underlying Disease ◽  
Control Groups ◽  
Factors Associated ◽  
Infection Age ◽  
Discharge Plan ◽  
Matched Case ◽  
And Control ◽  
Control Study

Abstract Objective: During the COVID-19 pandemic, the demand for hospital beds has exceeded substantially. Thus, we aimed to conduct this study to identify factors associated with the risk of readmission in order to introduce the best discharge plan for patients with high risk of hospital readmission. Method: This is a multicenter, case-control study included 1357 patients hospitalized with COVID-19 infection. Age-sex-matched case and control groups were paired at 1:2 ratios. COVID-19 readmission rate was assessed. Moreover, Logistic regression analysis was applied to determine the factors associated with readmission. Results: Of the 1357 patients, 99 (7.29%) subjects were readmitted. The most common cause of readmission was respiratory distress. The median (IQR) of the interval between hospital discharge and the second admission was 5 (2-16) days. Upon adjusting with the main risk factors, having at least one underlying disease and being treated with the corticosteroid (GC) were significantly associated with a higher rate of readmission (OR: 2.76, 95% CI :1.30- 5.87) and (OR:8.24, 95% CI :3.72- 18.22), respectively.Conclusion: Identification of Risk factors of COVID 19 readmission will improve resource utilization and patient care.

scholarly journals FLOW-MEDIATED DILATATION IDENTIFIES IMPAIRED ENDOTHELIAL FUNCTION IN PATIENTS WITH SLEEP APNEA SYNDROME

2010 ◽  
Vol 56 (2) ◽  
pp. 115-120 ◽  
Author(s):  
AKIOMI YOSHIHISA ◽  
TAKASHI OWADA ◽  
YASUTO HOSHINO ◽  
MAKIKO MIYATA ◽  
TOMOFUMI MISAKA ◽  
...  
Keyword(s):  
Sleep Apnea ◽  
Endothelial Function ◽  
Sleep Apnea Syndrome ◽  
Flow Mediated Dilatation ◽  
Apnea Syndrome
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