scholarly journals Gut Metabolite Trimethylamine-N-Oxide in Atherosclerosis: From Mechanism to Therapy

2021 ◽  
Vol 8 ◽  
Author(s):  
BingYu Wang ◽  
Jun Qiu ◽  
JiangFang Lian ◽  
Xi Yang ◽  
JianQing Zhou
Keyword(s):  
Coronary Atherosclerosis ◽  
Vascular Inflammation ◽  
Clinical Manifestations ◽  
Food Studies ◽  
Short Chain Fatty Acids ◽  
Arterial Disease ◽  
Health Concern ◽  
Gut Flora ◽  
Inflammatory State ◽  
Peripheral Arterial

Atherosclerosis is associated with various pathological manifestations, such as ischemic heart disease, ischemic stroke, and peripheral arterial disease, and remains a leading cause of public health concern. Atherosclerosis is an inflammatory disease characterized by endothelial dysfunction; vascular inflammation; and the deposition of lipids, cholesterol, calcium, and cellular debris within the vessel wall intima. In-depth studies of gut flora in recent years have shown that bacterial translocation and the existence of bacterial active products in blood circulation can affect the inflammatory state of the whole blood vessel. The gut flora is considered to be a large “secretory organ,” which produces trimethylamine-N-oxide (TMAO), short-chain fatty acids and secondary bile acids by breaking down the ingested food. Studies have shown that TMAO is an independent risk factor for the occurrence of malignant adverse cardiovascular events, but whether it is harmful or beneficial to patients with cardiovascular diseases with mild or no clinical manifestations remains controversial. We review the relationship between TMAO and its precursor (L-carnitine) and coronary atherosclerosis and summarize the potential molecular mechanism and therapeutic measures of TMAO on coronary atherosclerosis.

Relationship between Peripheral Arterial Disease and Metabolic Syndrome

Angiology ◽  
2009 ◽  
Vol 60 (5) ◽  
pp. 546-553 ◽  
Author(s):  
Milos Maksimovic ◽  
Hristina Vlajinac ◽  
Djordje Radak ◽  
Jelena Marinkovic ◽  
Jagoda Jorga
Keyword(s):  
Metabolic Syndrome ◽  
Peripheral Arterial Disease ◽  
Clinical Manifestations ◽  
Density Lipoprotein ◽  
High Sensitivity ◽  
Arterial Disease ◽  
Lipoprotein Cholesterol ◽  
Reactive Protein ◽  
Peripheral Arterial ◽  
Metabolic Syndrome Score

The aim of the study was to estimate the prevalence of metabolic syndrome among 388 patients with peripheral arterial disease, to determine the relationship between the number of metabolic syndrome components (metabolic syndrome score) and the degree of established and some of the emerging vascular risk factors, and to estimate whether there was any relationship of metabolic syndrome score and other vascular risk factors with the severity of peripheral arterial disease clinical manifestations. Metabolic syndrome was present in 59.8% of the patients with peripheral arterial disease. All metabolic syndrome components were significantly related to metabolic syndrome score. The same was true for the body weight, body mass index, percentage of body fat, total cholesterol/high-density lipoprotein cholesterol ratio, uric acid, and percentage of patients with high-sensitivity C-reactive protein. The metabolic syndrome score was also significantly, but inversely, related to high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, and smoking. The degree of peripheral arterial disease clinical manifestations was not related to metabolic syndrome score, but gangrene was significantly positively associated with increased fasting glucose, high-sensitivity C-reactive protein, and lower education.

scholarly journals Peripheral Arterial Disease and Progression of Coronary Atherosclerosis

2011 ◽  
Vol 57 (10) ◽  
pp. 1220-1225 ◽  
Author(s):  
Ayman A. Hussein ◽  
Kiyoko Uno ◽  
Kathy Wolski ◽  
Samir Kapadia ◽  
Paul Schoenhagen ◽  
...  
Keyword(s):  
Peripheral Arterial Disease ◽  
Coronary Atherosclerosis ◽  
Arterial Disease ◽  
Peripheral Arterial

scholarly journals Pharmacological therapy in critically ill patients with peripheral and concomitant arteriopathy

ABOUTOPEN ◽  
2018 ◽  
Vol 4 (1) ◽  
pp. 166-173
Author(s):  
Nicola Troisi ◽  
Antonio Trani ◽  
Pierluigi Antonino Cappiello
Keyword(s):  
Peripheral Arterial Disease ◽  
Clinical Manifestations ◽  
Arterial Disease ◽  
Risk Profile ◽  
Pharmacological Therapy ◽  
Lower Limbs ◽  
Limb Amputation ◽  
Critical Ischemia ◽  
Good Safety Profile ◽  
Peripheral Arterial

Peripheral arterial disease is one of the most frequent clinical manifestations of atherosclerotic disease. The clinical picture of critical ischemia of the lower limbs is often burdened by high mortality and the risk of limb amputation. The direct and indirect prostanoids, and in particular iloprost and cilostazol, are effective in the medical treatment of peripheral arterial disease. We describe here five clinical cases in which iloprost and cilostazol have been successfully administered in arterial patients with various concomitant cardiovascular diseases, highlighting a good safety profile in relation to the cardiocascular risk profile (Cardiology).

Revisiting the frequency of peripheral arterial disease in patients with coronary artery disease: is there a difference between diabetic and non-diabetic patients?

VASA ◽  
2006 ◽  
Vol 35 (4) ◽  
pp. 227-231 ◽  
Author(s):  
Papanas ◽  
Tziakas ◽  
Hatzinikolaou ◽  
Chalikias ◽  
Maltezos ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Peripheral Arterial Disease ◽  
Coronary Atherosclerosis ◽  
Arterial Disease ◽  
Control Group ◽  
Diabetic Patients ◽  
Group I ◽  
Artery Disease ◽  
Peripheral Arterial

Background: The aim of this study was to investigate whether frequency of concomitant peripheral arterial disease (PAD) is associated with angiographic severity of coronary artery disease (CAD), as well as to ascertain if diabetic patients differ from those without diabetes in the association between these two manifestations of atherosclerosis. Patients and methods: This study included 302 patients (229 men, mean age 62.2 ± 11.5 years) with documented CAD, divided into groups I–III, according to the angiographic severity of coronary atherosclerosis. Group I comprised 140 patients (104 men) with severe CAD, group II comprised 63 patients (48 men) with moderate CAD and group III comprised 99 patients (77 men) with mild CAD. Each of the groups I-III was further divided into the subgroups of diabetic and non-diabetic patients. Included were also 88 patients (42 men, mean age 61.7 ± 9.5 years) without CAD and a control group of 60 healthy volunteers (30 men), aged 18–40 years. PAD was diagnosed by means of a Doppler apparatus. Results: Frequency of PAD was associated with angiographic severity of CAD (p = 0.0001). This association was shown both in diabetic (p = 0.012) and in non-diabetic patients (p = 0.0041). Significantly (p ≤ 0.01) higher frequency of PAD among diabetic patients was found in each of the groups I–III. Conclusions: Among patients with CAD, frequency of concomitant PAD is associated with angiographic severity of coronary atherosclerosis. This association is demonstrated both in diabetic and in non-diabetic patients. Finally, PAD is significantly more frequent in diabetic patients, irrespective of the angiographic severity of CAD.

scholarly journals A diabeteses láb ischaemiás eredete. Epidemiológia, a diagnózis nehézségei, prevenciós és revascularisatiós lehetőségek

2017 ◽  
Vol 158 (6) ◽  
pp. 203-211 ◽  
Author(s):  
Endre Kolossváry ◽  
Zoltán Bánsághi ◽  
Gábor Viktor Szabó ◽  
Zoltán Járai ◽  
Katalin Farkas
Keyword(s):  
Peripheral Arterial Disease ◽  
Diabetic Foot ◽  
Clinical Manifestations ◽  
Limb Ischemia ◽  
Arterial Disease ◽  
Diagnostic Tools ◽  
Public Health Issue ◽  
Effective Prevention ◽  
Increased Risk ◽  
Peripheral Arterial

Abstract: “Diabetic foot” as definition covers a multifactorial clinical condition. According to the recent epidemiological data, the role of lower limb ischemia is getting more influential over other pathological causes, like neuropathy, infections and bone or soft tissue deformity. In diabetes, vascular disease leads to increased risk for leg ulcers and minor or major amputations. The traditional diagnostic tools for recognition of peripheral arterial disease have limited value because of diabetes specific clinical manifestations. Available vascular centers with special expertise and diagnostic tools are the prerequisite for efficient diagnosis supporting timely recognition of peripheral arterial disease. In course of treatment of diabetic foot with ischemic origin, beyond effective medical treatment revascularization (open vascular surgery or endovascular procedures) has paramount importance for prevention of limb loss. Vascular teams of vascular specialists, vascular surgeons and interventional radiologist in dedicated centers in multidisciplinary cooperation with other professions represent public health issue in effective prevention. Orv. Hetil., 2017, 158(6), 203–211.

scholarly journals Genetics of Vascular Inflammation in Lower Limb Ischemia: The TNF-α Hypothesis in Peripheral Arterial Disease

2021 ◽  
Author(s):  
Diego Caicedo ◽  
Clara V. Álvarez ◽  
Sihara Pérez ◽  
Jesús Devesa
Keyword(s):  
Peripheral Arterial Disease ◽  
Mrna Expression ◽  
Lower Limb ◽  
Vascular Inflammation ◽  
Limb Ischemia ◽  
Arterial Disease ◽  
Diabetic Patients ◽  
Lower Limb Ischemia ◽  
Hs Crp ◽  
Peripheral Arterial

Background: Vascular inflammation plays a crucial role in peripheral arterial disease (PAD), although the role of the mediators involved has not yet been properly defined. The aim of this work is to investigate gene expression and plasma biomarkers in chronic limb-threating ischemia (CLTI). Methods: Using patients from the GHAS trial, both blood and ischemic muscle samples were obtained to analyze plasma markers and mRNA expression, respectively. Statistical analy-sis was performed by using univariate (Spearman, t-Student, X2) and multivariate (multiple lo-gistic regression) tests. Results: 35 patients were available at baseline (29 for mRNA expression). Baseline characteristics (mean): Age:71.4±12.4 (79.4% male); TNF-α:10.7±4.9; hs-CRP:1.6±2.2; Neutrophil-to-lymphocyte ratio (NLR):3.5±2.8. Plasma TNF-α was found elevated (≥8.1) in 68.6% of patients, while high hs-CRP (≥0.5) in 60.5%. Diabetic patients with high level of inflammation showed significantly higher levels of NOX4 expression at baseline (p=0.0346). Plasma TNF-α had a negative correlation with eNOS expression (-0.5, p=0.015) and hs-CRP with VEGF-A (-0.63, p=0.005). The expression of NOX4 was parallel to that of plasma TNF-α (0.305, p=0.037), especial-ly in DM. Cumulative mortality at 12-month was related to NLR ≥3 (p=0.019) and TNF-α ≥8.1 (p=0.048). The best cut-off point for NLR to predict mortality was 3.4. Conclusions: NOX4 and TNF-α are crucial for the development and complications of lower limb ischemia, especially in DM. hs-CRP could have a negative influence on angiogenesis too. NLR and TNF-α represent suita-ble markers of mortality in CLTI. These results are novel because they connect muscle gene expres-sion and plasma information in patients with advanced PAD, deepening the search of new and ac-curate targets for this condition.

Study the Relation between Peripheral Arterial Disease and vitamin D Level among Maintenance Hemodialysis Patients

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Walid Ahmed Bichari ◽  
Ashraf Hassan Abdelmobdy ◽  
Amr Abd Elshafy Aboud
Keyword(s):  
Vitamin D ◽  
Renal Failure ◽  
Peripheral Arterial Disease ◽  
Arterial Disease ◽  
Health Concern ◽  
Dialysis Patients ◽  
Increased Risk ◽  
Significant Difference ◽  
25 Oh Vitamin D ◽  
Peripheral Arterial

Abstract Background Chronic kidney disease (CKD) represents a global health concern. The Global Burden of Disease study stated that, worldwide mortality attributed to renal failure showed a tremendous rise with around 1.2 million deaths from renal failure in 2015. Hemodialysis (HD) patients are at increased risk for atherosclerotic disorders including peripheral arterial disease (PAD). Among dialysis patients, many of the risk factors for PAD are the same as for the general population, but there are associations that seem to be unique to dialysis patients. Objective To study the relation between PAD assessed by ankle brachial index (ABI) and serum level of 25(OH) vitamin D among Maintenance HD Patients. Patients and Methods The present study included 90 subjects, 45 end stage renal disease patients patients(ESRD) on maintenance HD with PAD assessed by ABI (value less than 0.9) and 45 ESRD patients on maintenance HD without PAD assessed by ABI (value more than or equal 0.9). Results There was a statistically significant difference between the two studied groups as regard serum 25(OH) vitamin D level (P = 0.000). We also found a statistically significant positive correlation between ABI and serum vitamin D level in both patients and control groups (P = 0.000). Conclusion Vitamin D deficiency is associated with PAD among maintenance HD patients.

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