Effect of Acupuncture on Artery Elasticity for Atherosclerosis: A Randomized Controlled Trial

Background Atherosclerosis (AS) is a chronic arterial disease. Atherosclerosis related diseases, like myocardial infarctions (MI) and strokes have the highest mortality and disability rate. However, limited evidence verified the effects of acupuncture on arterial stiffness for subclinical atherosclerosis. We hypothesized that acupuncture could improve arterial stiffness in subclinical atherosclerosis and resist plaque progression. The aim of this study is to assess the effect of acupuncture on arterial elasticity via ultrafast pulse wave velocity (ufPWV) and explore the effect of acupuncture on lipid level and platelet function for subclinical atherosclerosis patients.MethodsThis was a randomized parallel controlled trial included 44 patients. Patients were assigned in a 1:1 ratio to acupuncture group and sham acupuncture group. Patients completed 24 treatments in total within 12 weeks of intervention. The primary outcome was ultrafast pulse wave velocity (ufPWV) assessed after every 4-weeks treatment; the secondary outcomes were carotid intima-media thickness (cIMT), blood lipid levels, fibrinogen (FIB) and blood platelet. Intention-to-treat (ITT) principle was applied and data sets were analyzed using SPSS 20.0 software.ResultsAmong the 44 randomly assigned patients, changes of right-side BS value in TA group (0.841) at week 12 were greater than SA group (-0.189), with a mean difference of 1.030 (95% CI, 0.320, 1.739; P=0.006). Similar results were observed in right-side ES, left-side BS, left-side ES at week 12. As to secondary outcomes, compared with SA group(1.08mm), the TA group(0.98mm) showed a significant decline in mean of left-side IMT at week 12. (Z= -2.118; P=0.034). There were no serious adverse events.ConclusionsAmong patients with Carotid intima-media thickening, both-side carotids arterial elasticity is significantly improved after 12-week acupuncture compared with sham acupuncture. The effects of acupuncture are more noticeable at week 12 during end-systole.Trial registrationThe trial was registered at http://www.chictr.org.cn (NO. ChiCTR1900025551, 31/08/2019)

Thoracic Aorta Diameter Calculation by Artificial Intelligence Can Predict the Degree of Arterial Stiffness

Background: Arterial aging is characterized by decreased vascular function, caused by arterial stiffness (AS), and vascular morphological changes, caused by arterial dilatation. We analyzed the relationship of pre-AS and AS, as assessed by cardio ankle vascular index (CAVI), with arterial diameters (AD) at nine levels, from the aortic sinus to the abdominal aorta, as measured by artificial intelligence (AI) on non-enhanced chest computed tomography (CT) images.Methods: Overall, 801 patients who underwent both chest CT scan and arterial elasticity test were enrolled. Nine horizontal diameters of the thoracic aorta (from the aortic sinuses of Valsalva to the abdominal aorta at the celiac axis origin) were measured by AI using CT. Patients were divided into non-AS (mean value of the left and right CAVIs [M.CAVI] < 8), pre-AS (8 ≤ M.CAVI < 9), and AS (M.CAVI ≥ 9) groups. We compared AD differences among groups, analyzed the correlation of age, ADs, and M.CAVI or the mean pressure-independent CAVI (M.CAVI0), Furthermore, we evaluated the risk predictors and the diagnostic value of the nine ADs for pre-AS and AS.Results: The AD at mid descending aorta (MD) correlated strongest with CAVI (r = 0.46, p < 0.001) or M.CAVI0 (r = 0.42, p < 0.001). M.CAVI was most affected by the MD AD and by age. An increase in the MD AD independently predicted the occurrence of pre-AS or AS. For MD AD, every 4.37 mm increase caused a 14% increase in the pre-AS and AS risk and a 13% increase in the AS risk. With a cut-off value of 26.95 mm for the MD AD, the area under the curve (AUC) for identifying the risk of AS was 0.743. With a cut-off value of 25.15 mm, the AUC for identifying the risk of the stage after the prophase of AS is 0.739.Conclusions: Aging is associated with an increase in AD and a decrease in arterial elasticity. An increase in AD, particularly at the MD level is an independent predictor of AS development.

1244Associations of endothelial function, arterial elasticity, and arterial stiffness with adiponectin and skeletal muscle mass

Background A temporal association where better arterial function and structure predicts adiponectin level and skeletal muscle mass during childhood remains uninvestigated. Methods We studied 5566 children and adolescents (51% girls) aged 9-11 years from the Avon Longitudinal Study of Parents and Children (ALSPAC) birth cohort, Bristol, UK. Brachial artery endothelial function was determined using flow-mediated dilation (FMD), expressed as the percentage change in diameter from baseline after reactive hyperemia; arterial elasticity as distensibility coefficient (DC) expressed in mean percentage change in cross-sectional area relative to blood pressure (BP); and arterial stiffness by carotid to radial pulse wave velocity (crPWV). Skeletal muscle mass and total fat mass were assessed by dual-energy Xray absorptiometry. We conducted multivariable linear regressions with Sidak correction and adjusted for age, sex, total fat mass, cardiorespiratory fitness, pubertal status, brachial artery diameter, systolic BP, low-density lipoprotein cholesterol, mother’s social-economic class, and time (years) between the measurement of predictors and outcomes. Results FMD (β [95% CI]) = (0.027 [0.007 to 0.047]; P = 0.009) and DC (0.229 [0.088 to 0.369]; P = 0.001) were directly associated with skeletal muscle mass. FMD had a borderline inverse association with adiponectin (-0.004 [-0.008 to < 0.0001]; P = 0.056). crPWV was unrelated to adiponectin and skeletal muscle mass, while DC was not associated with adiponectin. Conclusions Better endothelial function and arterial elasticity were associated with higher skeletal muscle mass while arterial stiffness was unrelated to adiponectin and lean mass. Key message Healthy arterial function and structure may enhance muscle growth in children.

Beneficial Effect of Statin Therapy on Arterial Stiffness

Arterial stiffness describes the increased rigidity of the arterial wall that occurs as a consequence of biological aging and several diseases. Numerous studies have demonstrated that parameters to assess arterial stiffness, especially pulse-wave velocity, are predictive of those individuals that will suffer cardiovascular morbidity and mortality. Statin therapy may be a pharmacological strategy to improve arterial elasticity. It has been shown that the positive benefits of statin therapy on cardiovascular disease is attributable not only to their lipid-lowering capacity but also to various pleiotropic effects, such as their anti-inflammatory, antiproliferative, antioxidant, and antithrombotic properties. Additionally, statins reduce endothelial dysfunction, improve vascular and myocardial remodeling, and stabilize atherosclerotic plaque. The aim of the present review was to summarize the evidence from human studies showing the effects of statins on arterial stiffness.