scholarly journals Vascular ageing in elderly patients with metabolic syndrome

2020 ◽  
pp. 74-80
Author(s):  
S. V. Nedogoda ◽  
V. V. Tsoma ◽  
E. V. Chumachek ◽  
V. O. Smirnova ◽  
R. V. Palashkin
Keyword(s):  
Metabolic Syndrome ◽  
Arterial Wall ◽  
Pulse Wave ◽  
Propagation Rate ◽  
Convincing Evidence ◽  
Cumulative Exposure ◽  
Vascular Aging ◽  
Pulse Wave Propagation ◽  
Vascular Ageing ◽  
Vascular Age

Vascular aging is associated with increased arterial stiffness, vascular remodeling, and increased pulse wave propagation rate. This process can be accelerated by cumulative exposure to various factors that damage the arterial wall: arterial hypertension, hyperglycemia, dyslipidemia, smoking, etc. At present, there is no convincing evidence of the preferential effect of certain components of metabolic syndrome that have the greatest impact on the acceleration of vascular aging in older patients. In  this regard, a  non-interactive study was conducted to  calculate vascular age and compare it with passport age in patients over 65 years of age with metabolic syndrome (MS) and obesity, assessing the greatest contribution to vascular ageing in a given age group of different MS components. The study showed that at different age periods MS components have different specific weights in the formation of early vascular aging.

scholarly journals Early vascular aging in patients with metabolic syndrome: features of the course and diagnosis

2021 ◽  
Vol 2 (1) ◽  
pp. 50-62
Author(s):  
S. V. Nedogoda ◽  
A. S. Salasyuk ◽  
I. N. Barykina ◽  
V. O. Lutova ◽  
E. A. Popova
Keyword(s):  
Metabolic Syndrome ◽  
Pulse Wave Velocity ◽  
Wave Velocity ◽  
Pulse Wave ◽  
Clinical Score ◽  
Routine Care ◽  
Vascular Aging ◽  
Clinical Markers ◽  
Vascular Age

Purpose: identifying the causes of early vascular aging (EVA) in patients with metabolic syndrome (MetS), assessing the relationship between vascular age and various metabolic disorders, the severity of metabolic syndrome , tissue and circulating risk markers, the severity of non-infectious inflammation, and derive a new score for calculation vascular age and predicting early vascular aging in patients with metabolic syndrome.Materials and methods: а total of 750 patients aged 35 to 80 years with metabolic syndrome were examined. Early vascular aging syndrome was detected in 484 patients with metabolic syndrome and carotid-femoral pulse wave velocity (cfPWV) values exceeding expected for average age values by 2 or more SD.Results: Multiple logistic regression shown, that presence of type 2 diabetes and IR were associated with greater risk of early vascular aging, the risk of having early vascular aging increased by 76% with an increase in HOMA-IR by 1 unit, by 17% with an increase in carotid-femoral pulse wave velocity by 1 mg/l, by 4% with an increase in DBP by 1 mm Hg, and by 1% with each 1 pmol / L increase in the level of UA. For vascular age, calculated from carotid-femoral pulse wave velocity, SCORE scale, QRISK-3 scale and Framingham scale, respectively. Diabetes mellitus and clinical markers of IR (yes/no), HOMA-IR and UA level were used to develop a new VAmets score for EVA prediction providing a total accuracy of 0.830 (95% CI 0,799 to 0,860).Conclusion: parallel efforts for effective integration simple clinical score into clinical practice have been offered. Our score (VAmets) may accurately identify patients with metabolic syndrome and early vascular aging on the basis of widely available clinical variables and classic cardiovascular risk factors can prioritize using of vascular age in routine care.

scholarly journals Early vascular aging risk assessment in patients with metabolic syndrome

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
A Salasyuk ◽  
S Nedogoda ◽  
I Barykina ◽  
V Lutova ◽  
E Popova
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Type 2 Diabetes ◽  
Risk Assessment ◽  
Metabolic Syndrome ◽  
Vascular Aging ◽  
Clinical Markers ◽  
Cvd Risk ◽  
Vascular Age

Abstract Background Metabolic syndrome (MetS) and abdominal obesity are one of the most common CVD risk factors among young and mature patients. However, the currently used CVD risk assessment scales may underestimate the CV risk in people with obesity and MS. Early vascular aging rather than chronological aging can conceptually offer better risk prediction. MetS, as accumulation of classical risk factors, leads to acceleration of early vascular aging. Since an important feature of MetS is its reversibility, an adequate risk assessment and early start of therapy is important in relation to the possibilities of preventing related complications. Purpose To derive a new score for calculation vascular age and predicting EVA in patients with MetS. Methods Prospective open cohort study using routinely collected data from general practice. The derivation cohort consisted of 1000 patients, aged 35–80 years with MetS (IDF,2005 criteria). The validation cohort consisted of 484 patients with MetS and carotid-femoral pulse wave velocity (cfPWV) values exceeding expected for average age values by 2 or more SD (EVA syndrome). Results In univariate analysis, EVA was significantly correlated with the presence of type 2 diabetes and clinical markers of insulin resistance (IR), body mass index (BMI), metabolic syndrome severity score (MetS z-score), uric acid (UA) level, hsCRP, HOMA-IR, total cholesterol (TC), triglycerides (TG), heart rate (HR), central aortic blood pressure (CBP), diastolic blood pressure (DBP). Multiple logistic regression shown, that presence of type 2 diabetes and IR were associated with greater risk of EVA; the odds ratios were 2.75 (95% CI: 2.34, 3.35) and 1.57 (95% CI: 1.16, 2.00), respectively. In addition, the risk of having EVA increased by 76% with an increase in HOMA-IR by 1 unit, by 17% with an increase in hsCRP by 1 mg/l, by 4% with an increase in DBP by 1 mm Hg, and by 1% with each 1 μmol / L increase in the level of UA. The area under the curve for predicting EVA in patients with MetS was 0,949 (95% CI 0,936 to 0,963), 0,630 (95% CI 0,589 to 0,671), 0,697 (95% CI 0,659 to 0,736) and 0,686 (95% CI 0,647 to 0,726), for vascular age, calculated from cfPWV, SCORE scale, QRISK-3 scale and Framingham scale, respectively. Diabetes mellitus and clinical markers of IR (yes/no), HOMA-IR and UA level were used to develop a new VAmets score for EVA prediction providing a total accuracy of 0.830 (95% CI 0,799 to 0,860). Conclusion cfPWV at present the most widely studied index of arterial stiffness, fulfills most of the stringent criteria for a clinically useful biomarker of EVA in patients with MetS. Although, parallel efforts for effective integration simple clinical score into clinical practice have been offered. Our score (VAmets) may accurately identify patients with MetS and EVA on the basis of widely available clinical variables and classic cardiovascular risk factors can prioritize using of vascular age in routine care. ROC-curves for predicting EVA in MetS Funding Acknowledgement Type of funding source: None

scholarly journals Early and Supernormal Vascular Aging

Hypertension ◽  
2020 ◽  
Vol 76 (5) ◽  
pp. 1616-1624 ◽  
Author(s):  
Rosa Maria Bruno ◽  
Peter M. Nilsson ◽  
Gunnar Engström ◽  
Benjamin Nilsson Wadström ◽  
Jean-Philippe Empana ◽  
...  
Keyword(s):  
Pulse Wave Velocity ◽  
Wave Velocity ◽  
Cardiovascular Events ◽  
Pulse Wave ◽  
Hazard Ratio ◽  
Study Cohort ◽  
Vascular Aging ◽  
Cancer Study ◽  
Vascular Age ◽  
Diet And Cancer

Pulse wave velocity is an established marker of early vascular aging but may also help identifying individuals with supernormal vascular aging. We tested the hypothesis that individuals with the largest difference (Δ-age) between chronological and vascular age show the lowest rate of cardiovascular events and may thus be defined as supernormal vascular aging. Vascular age was defined as the predicted age in the best fitting multivariable regression model including classical risk factors and treatment and pulse wave velocity, in a subset of the Reference Values for Arterial Stiffness Collaboration Database (n=3347). Δ-age was then calculated as chronological age minus vascular age, and the 10th and 90th percentiles were used to define early (Δ-age<−5.7 years), normal (Δ-age −5.7 to 6.8 years) and supernormal vascular aging (Δ-age>6.8 years). The risk for fatal and nonfatal cardiovascular events associated with vascular aging categories was investigated in the Malmö Diet and Cancer Study cohort (n=2642). In the Malmö Diet and Cancer Study Cohort (6.6-year follow-up, 286 events), Δ-age was significantly ( P <0.01) and inversely associated with cardiovascular events. Compared with normal vascular aging, supernormal vascular aging had lower risk (hazard ratio, 0.59 [95% CI, 0.41–0.85]), whereas early vascular aging had higher risk (hazard ratio, 2.70 [95% CI, 1.55–4.70]) of cardiovascular events, in particular coronary events. There was no significant association with all-cause mortality. This study represents the first validation of the clinical significance of the supernormal vascular aging concept, based on prospective data. Its further characterization may help discovering novel protective molecular pathways and providing preventive strategies for successful vascular aging.

scholarly journals Assessing hemodynamics from the photoplethysmogram to gain insights into vascular age: A review from VascAgeNet

2021 ◽  
Author(s):  
Peter H. Charlton ◽  
Birutė Paliakaitė‬‬‬ ◽  
Kristjan Pilt ◽  
Martin Bachler ◽  
Serena Zanelli ◽  
...  
Keyword(s):  
Pulse Wave ◽  
Pulse Transit Time ◽  
Time Measurement ◽  
Future Research ◽  
Full Potential ◽  
Vascular Ageing ◽  
Vascular Age ◽  
Repeatability And Reproducibility ◽  
Consumer Devices ◽  
Pulse Arrival

The photoplethysmogram (PPG) signal is widely measured by clinical and consumer devices, and it is emerging as a potential tool for assessing vascular age. The shape and timing of the PPG pulse wave are both influenced by normal vascular ageing, changes in arterial stiffness and blood pressure, and atherosclerosis. This review summarises research into assessing vascular age from the PPG. Three categories of approaches are described: (i) those which use a single PPG signal (based on pulse wave analysis); (ii) those which use multiple PPG signals (such as pulse transit time measurement); and (iii) those which use PPG and other signals (such as pulse arrival time measurement). Evidence is then presented on the performance, repeatability and reproducibility, and clinical utility of PPG-derived parameters of vascular age. Finally, the review outlines key directions for future research to realise the full potential of photoplethysmography for assessing vascular age.

scholarly journals Modeling Pulse Wave Propagation Through a Stenotic Artery With Fluid Structure Interaction: A Validation Study Using Ultrasound Pulse Wave Imaging

2020 ◽  
Vol 143 (3) ◽  
Author(s):  
Vittorio Gatti ◽  
Pierre Nauleau ◽  
Grigorios M. Karageorgos ◽  
Jay J. Shim ◽  
Gerard A. Ateshian ◽  
...  
Keyword(s):  
Mechanical Properties ◽  
Wave Propagation ◽  
Arterial Wall ◽  
Pulse Wave ◽  
Fluid Structure Interaction ◽  
Clinical Findings ◽  
Pulse Wave Propagation ◽  
Fluid Structure ◽  
Structure Interaction ◽  
Wave Imaging

Abstract Pulse wave imaging (PWI) is an ultrasound-based method that allows spatiotemporal mapping of the arterial pulse wave propagation, from which the local pulse wave velocity (PWV) can be derived. Recent reports indicate that PWI can help the assessment of atherosclerotic plaque composition and mechanical properties. However, the effect of the atherosclerotic plaque's geometry and mechanics on the arterial wall distension and local PWV remains unclear. In this study, we investigated the accuracy of a finite element (FE) fluid–structure interaction (FSI) approach to predict the velocity of a pulse wave propagating through a stenotic artery with an asymmetrical plaque, as quantified with PWI method. Experiments were designed to compare FE-FSI modeling of the pulse wave propagation through a stenotic artery against PWI obtained with manufactured phantom arteries made of polyvinyl alcohol (PVA) material. FSI-generated spatiotemporal maps were used to estimate PWV at the plaque region and compared it to the experimental results. Velocity of the pulse wave propagation and magnitude of the wall distension were correctly predicted with the FE analysis. In addition, findings indicate that a plaque with a high degree of stenosis (&gt;70%) attenuates the propagation of the pulse pressure wave. Results of this study support the validity of the FE-FSI methods to investigate the effect of arterial wall structural and mechanical properties on the pulse wave propagation. This modeling method can help to guide the optimization of PWI to characterize plaque properties and substantiate clinical findings.

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