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A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Vascular Medicine".

Deadline for manuscript submissions: closed (25 April 2022) | Viewed by 27831

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Special Issue Editors

Dr. Paolo Salvi

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Guest Editor

Department of Cardiology, Istituto Auxologico Italiano, IRCCS, Milan, Italy
Interests: arteriosclerosis; arterial stiffness; cardiovascular risk
Special Issues, Collections and Topics in MDPI journals

Dr. Andrea Grillo

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Guest Editor

Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy
Interests: vascular diseases; arterial stiffness; hypertension; blood pressure measurement
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

The area of vascular disease research is constantly evolving. New methods and devices are able to assess the dynamic properties of vessels in a way that was not possible a few years ago. The measurement of vascular stiffness is becoming increasingly important for evaluating blood pressure profiles at multiple sites of the arterial tree, in vascular ageing, and in patient care. Current research is addressing and debating some unresolved technical and methodological issues in evaluating the structural and functional properties of vessels. Future progress in this area of research, and the implementation of new indices and methodologies related to an increasingly reliable assessment of vascular stiffness will allow for an improvement in the early diagnosis of cardiovascular damage, and therefore in the clinical care of patients.

This Special Issue will focus on new methodological advances in vascular stiffness evaluation, as well as their applications in clinical or preclinical research. A privileged space will be reserved for new clinical acquisitions regarding the relationship between non-invasive hemodynamic assessment and early vascular damage in the various fields of cardiovascular research.

Prof. Dr. Paolo Salvi
Dr. Andrea Grillo
Guest Editors

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Keywords

Arterial stiffness
Cardiovascular risk
Early vascular damage
Cardiovascular prevention
Myocardial ischemia
Arteriosclerosis

Related Special Issue

Advances in Vascular Stiffness: Part II in Journal of Clinical Medicine (9 articles)

Published Papers (14 papers)

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Research

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11 pages, 1001 KiB

Open AccessArticle

Detectable Bias between Vascular Ultrasound Echo-Tracking Systems: Relevance Depends on Application

by Afrah E. F. Malik, Alessandro Giudici, Koen W. F. van der Laan, Jos Op ’t Roodt, Werner H. Mess, Tammo Delhaas, Bart Spronck and Koen D. Reesink

J. Clin. Med. 2023, 12(1), 69; https://doi.org/10.3390/jcm12010069 - 21 Dec 2022

Cited by 1 | Viewed by 1431

Abstract

The Esaote MyLab70 ultrasound system has been extensively used to evaluate arterial properties. Since it is reaching end-of-service-life, ongoing studies are forced to seek an alternative, with some opting for the Esaote MyLabOne. Biases might exist between the two systems, which, if uncorrected, could potentially lead to the misinterpretation of results. This study aims to evaluate a potential bias between the two devices. Moreover, by comparing two identical MyLabOne systems, this study also aims to investigate whether biases estimated between the MyLabOne and MyLab70 employed in this study could be generalized to any other pair of similar scanners. Using a phantom set-up, we performed n = 60 measurements to compare MyLab70 to MyLabOne and n = 40 measurements to compare the two MyLabOne systems. Comparisons were performed to measure diameter, wall thickness, and distension. Both comparisons led to significant biases for the diameter (relative bias: −0.27% and −0.30% for the inter- and intra-scanner model, respectively, p < 0.05) and wall thickness (relative bias: 0.38% and −1.23% for inter- and intra-scanner model, respectively p < 0.05), but not for distension (relative bias: 0.48% and −0.12% for inter- and intra-scanner model, respectively, p > 0.05). The biases estimated here cannot be generalized to any other pair of similar scanners. Therefore, longitudinal studies with large sample sizes switching between scanners should perform a preliminary comparison to evaluate potential biases between their devices. Furthermore, caution is warranted when using biases reported in similar comparative studies. Further work should evaluate the presence and relevance of similar biases in human data. Full article

(This article belongs to the Special Issue Frontiers in Vascular Stiffness)

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11 pages, 410 KiB

Open AccessArticle

The Correlation of Arterial Stiffness Parameters with Aging and Comorbidity Burden

by Francesco Fantin, Anna Giani, Monica Trentin, Andrea P. Rossi, Elena Zoico, Gloria Mazzali, Rocco Micciolo and Mauro Zamboni

J. Clin. Med. 2022, 11(19), 5761; https://doi.org/10.3390/jcm11195761 - 28 Sep 2022

Cited by 2 | Viewed by 1118

Abstract

The aim of the study was to evaluate the relationships between carotid-femoral pulse wave velocity (PVW-cf), cardio-ankle vascular index (CAVI) and CAVI0 (which is a mathematical elaboration of CAVI, theoretically less dependent on blood pressure), age and comorbidity burden. Furthermore, 183 patients (119 female, mean age 67.5 ± 14.3 years) referred to the Geriatric Ward and Outpatient Clinic at Verona University Hospital were included; demographic, clinical and blood analysis data were collected. Charlson Comorbidity Index (CCI), PVW-cf, CAVI and CAVI 0 were obtained. Significant correlations were found between CAVI, CAVI0, PVW-cf and both age (r = 0.698, r = 0.717, r = 0.410, respectively p < 0.001 for all) and CCI, (r = 0.654; r = 0.658; r = 0.448 respectively and p < 0.001 for all), still significant after adjustment for several variables. In a stepwise multiple regression model, considering several variables, CCI was the only predictor of PWV-cf, whereas age and CCI were significant predictors of both CAVI and CAVI 0. In conclusion, all arterial stiffness indexes are associated with CCI and aging; the latter correlation is more evident for CAVI and CAVI 0 than for PVW-cf. Arterial stiffness parameters can complement the characterization of patients affected by a remarkable comorbidity burden across aging; arterial stiffening might mirror the complexity of these individuals. Full article

(This article belongs to the Special Issue Frontiers in Vascular Stiffness)

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9 pages, 265 KiB

Open AccessArticle

Comparison between Carotid Distensibility-Based Vascular Age and Risk-Based Vascular Age in Middle-Aged Population Free of Cardiovascular Disease

by Michaela Kozakova, Carmela Morizzo, Giuli Jamagidze, Dante Chiappino and Carlo Palombo

J. Clin. Med. 2022, 11(16), 4931; https://doi.org/10.3390/jcm11164931 - 22 Aug 2022

Cited by 1 | Viewed by 1239

Abstract

The concept of vascular age (VA) was proposed to provide patients with an understandable explanation of cardiovascular (CV) risk and to improve the performance of prediction models. The present study compared risk-based VA derived from Framingham Risk Score (FRS) and Systematic Coronary Risk Estimation (SCORE) models with value-based VA derived from the measurement of the common carotid artery (CCA) distensibility coefficient (DC), and it assessed the impact of DC-based VA on risk reclassification. In 528 middle-aged individuals apparently free of CV disease, DC was measured by radiofrequency-based arterial wall tracking that was previously utilised to establish sex- and age-specific reference values in a healthy population. DC-based VA represented the median value (50th percentile) for given sex in the reference population. FRS-based and SCORE-based VA was calculated as recommended. We observed a good agreement between DC-based and FRS-based VA, with a mean difference of 0.46 ± 12.2 years (p = 0.29), while the mean difference between DC-based and SCORE-based VA was higher (3.07 ± 12.7 years, p < 0.0001). When only nondiabetic individuals free of antihypertensive therapy were considered (n = 341), the mean difference dropped to 0.70 ± 12.8 years (p = 0.24). Substitution of chronological age with DC-based VA in FRS and SCORE models led to a reclassification of 28% and 49% of individuals, respectively, to the higher risk category. Our data suggest that the SCORE prediction model, in which diabetes and antihypertensive treatment are not considered, should be used as a screening tool only in healthy individuals. The use of VA derived from CCA distensibility measurements could improve the performance of risk prediction models, even that of the FRS model, as it might integrate risk prediction with additional risk factors participating in vascular ageing, unique to each individual. Prospective studies are needed to validate the role of DC-based VA in risk prediction. Full article

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12 pages, 1511 KiB

Open AccessArticle

Haemodynamic Adaptive Mechanisms at High Altitude: Comparison between European Lowlanders and Nepalese Highlanders

by Paolo Salvi, Andrea Grillo, Sylvie Gautier, Luca Montaguti, Fausto Brunacci, Francesca Severi, Lucia Salvi, Enzo Pretolani, Gianfranco Parati and Athanase Benetos

J. Clin. Med. 2022, 11(13), 3843; https://doi.org/10.3390/jcm11133843 - 2 Jul 2022

Cited by 2 | Viewed by 1348

Abstract

Background: Exposure to high altitudes determines several adaptive mechanisms affecting in a complex way the whole cardiovascular, respiratory, endocrine systems because of the hypobaric hypoxic condition. The aim of our study was to evaluate the circulatory adaptive mechanisms at high altitudes, during a scientific expedition in the Himalayas. Methods: Arterial distensibility was assessed measuring carotid-radial and carotid-femoral pulse wave velocity. Tests were carried out at several altitudes, from 1350 to 5050 m above sea level, on 8 lowlander European researchers and 11 highlander Nepalese porters. Results: In Europeans, systolic blood pressure and pulse pressure increased slightly but significantly with altitude (p < 0.05 and p < 0.001, respectively). Norepinephrine showed a significant increase after the lowlanders had spent some time at high altitude (p < 0.001). With increasing altitude, a progressive increase in carotid-radial and carotid-femoral pulse wave velocity values was observed in lowlanders, showing a particularly significant increase (p < 0.001) after staying at high altitude (carotid-radial pulse wave velocity, median value (interquartile range) from 9.2 (7.9–10.0) to 11.2 (10.9–11.8) m/s and carotid-femoral pulse wave velocity from 8.5 (7.9–9.0) to 11.3 (10.9–11.8) m/s). At high altitudes (3400 and 5050 m above sea level), no significant differences were observed between highlanders and lowlanders in hemodynamic parameters (blood pressure, carotid-radial and carotid-femoral pulse wave velocity). Conclusions: The progressive arterial stiffening with altitude observed in European lowlanders could explain the increase in systolic and pulse pressure values observed at high altitudes in this ethnic group. Further studies are needed to evaluate the role of aortic stiffening in the pathogenesis of acute mountain sickness. Full article

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10 pages, 1639 KiB

Open AccessArticle

The Impaired Elasticity of Large Arteries in Systemic Sclerosis Patients

by Michele Colaci, Luca Zanoli, Alberto Lo Gullo, Domenico Sambataro, Gianluca Sambataro, Maria Letizia Aprile, Pietro Castellino and Lorenzo Malatino

J. Clin. Med. 2022, 11(12), 3256; https://doi.org/10.3390/jcm11123256 - 7 Jun 2022

Cited by 5 | Viewed by 1409

Abstract

(1) Background: Systemic sclerosis (SSc) is an autoimmune disease characterized by endothelial dysfunction and fibrosis of skin and visceral organs. In the last decade, attention has been focused on the macrovascular involvement of the disease. In particular, the observation of increased arterial stiffness represented an interesting aspect of the disease, as predictor of cardiovascular risk. (2) Methods: We recruited 60 SSc patients (52 ± 12 years old, 90% females) and 150 age/sex-matched healthy controls in order to evaluate both intima-media thickness of the right common carotid artery and arterial stiffness using the B-mode echography and the SphygmoCor system^® tonometer. (3) Results: The carotid-femoral pulse wave velocity (PWV) was higher in SSc patients than in controls (8.6 ± 1.7 vs. 7.8 ± 1.5 m/s; p < 0.001), as was the carotid-radial PWV (7.8 ± 1.1 vs. 6.7 ± 1.4 m/s; p < 0.001). The intima-media thickness was higher in SSc than in controls (654 ± 108 vs. 602 ± 118 µm; p = 0.004). The other parameters measured at carotid (radial strain, Young’s modulus, compliance and distensibility) all indicated that arterial stiffness in tension was more pronounced in SSc. Of interest, the direct correlation between PWV and age corresponded closely in SSc. Moreover, a significant difference between SSc and controls as regards the carotid parameters was evident in younger subjects. (4) Conclusions: SSc patients showed an increased arterial stiffness compared to healthy controls. In particular, an SSc-related pathologic effect was suggested by the more pronounced increase in PWV with age and lower values of carotid elasticity in younger SSc patients than in age-matched controls. Full article

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11 pages, 288 KiB

Open AccessArticle

Increased Platelet Reactivity and Proinflammatory Profile Are Associated with Intima–Media Thickness and Arterial Stiffness in Prediabetes

by Maurizio Di Marco, Francesca Urbano, Agnese Filippello, Stefania Di Mauro, Alessandra Scamporrino, Nicoletta Miano, Giuseppe Coppolino, Giuseppe L’Episcopo, Stefano Leggio, Roberto Scicali, Salvatore Piro, Francesco Purrello and Antonino Di Pino

J. Clin. Med. 2022, 11(10), 2870; https://doi.org/10.3390/jcm11102870 - 19 May 2022

Cited by 3 | Viewed by 1526

Abstract

Alterations of glucose homeostasis are associated with subclinical vascular damage; however, the role of platelet reactivity in this process has not been fully investigated. In this cross-sectional study, we evaluated the correlation between markers of platelet reactivity and inflammation and markers of vascular disease in subjects with prediabetes. Markers of platelet reactivity such as 11-dehydro-thromboxane B2 urinary levels (11-dh-TXB2) and mean platelet volume (MPV) and inflammatory indexes such as platelet-to-lymphocyte ratio (PLR) were evaluated in subjects with prediabetes (n = 48), new-onset type 2 diabetes (NODM, n = 60) and controls (n = 62). Furthermore, we assessed the cardiovascular risk profile of the study population with arterial stiffness and quality intima–media thickness (qIMT). Subjects with prediabetes and NODM exhibited higher 11-dh-TXB2 urinary levels and MPV and a proinflammatory profile with an increased PLR, high-sensitivity C-reactive protein, ferritin and fibrinogen. Furthermore, after multiple regression analyses, we found that urinary 11-dh-TXB2 was one of the major determinants of IMT and arterial stiffness parameters. In conclusion, subjects with prediabetes exhibit increased platelet reactivity as well as a proinflammatory profile. Furthermore, this condition is associated with early markers of cardiovascular disease. Full article

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14 pages, 4098 KiB

Open AccessArticle

Non-Invasive Assessment of Arterial Stiffness: Pulse Wave Velocity, Pulse Wave Analysis and Carotid Cross-Sectional Distensibility: Comparison between Methods

by Paolo Salvi, Filippo Valbusa, Anna Kearney-Schwartz, Carlos Labat, Andrea Grillo, Gianfranco Parati and Athanase Benetos

J. Clin. Med. 2022, 11(8), 2225; https://doi.org/10.3390/jcm11082225 - 15 Apr 2022

Cited by 14 | Viewed by 2451

Abstract

Background: The stiffening of large elastic arteries is currently estimated in research and clinical practice by propagative and non-propagative models, as well as parameters derived from aortic pulse waveform analysis. Methods: Common carotid compliance and distensibility were measured by simultaneously recording the diameter and pressure changes during the cardiac cycle. The aortic and upper arm arterial distensibility was estimated by measuring carotid–femoral and carotid–radial pulse wave velocity (PWV), respectively. The augmentation index and blood pressure amplification were derived from the analysis of central pulse waveforms, recorded by applanation tonometry directly from the common carotid artery. Results: 75 volunteers were enrolled in this study (50 females, average age 53.5 years). A significant inverse correlation was found between carotid distensibility and carotid–femoral PWV (r = −0.75; p < 0.001), augmentation index (r = −0.63; p < 0.001) and central pulse pressure (r = −0.59; p < 0.001). A strong correlation was found also between the total slope of the diameter/pressure rate carotid curves and aortic distensibility, quantified from the inverse of the square of carotid–femoral PWV (r = 0.67). No correlation was found between carotid distensibility and carotid–radial PWV. Conclusions: This study showed a close correlation between carotid–femoral PWV, evaluating aortic stiffness by using the propagative method, and local carotid cross-sectional distensibility. Full article

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8 pages, 785 KiB

Open AccessArticle

Energy Drinks and Their Acute Effects on Arterial Stiffness in Healthy Children and Teenagers: A Randomized Trial

by Pengzhu Li, Guido Mandilaras, André Jakob, Robert Dalla-Pozza, Nikolaus Alexander Haas and Felix Sebastian Oberhoffer

J. Clin. Med. 2022, 11(8), 2087; https://doi.org/10.3390/jcm11082087 - 7 Apr 2022

Cited by 8 | Viewed by 2356

Abstract

Adolescents are the main consumer group of energy drinks (ED). Studies suggest that acute ED consumption is associated with increased peripheral blood pressure. Little is known of the ED-induced effects on arterial stiffness. Therefore, this study aimed to investigate the acute effects of ED consumption on arterial stiffness in healthy children and teenagers by conducting a prospective, randomized, single-blind, placebo-controlled, crossover clinical trial. Study participants (n = 27, mean age = 14.53 years) consumed a body-weight-adjusted amount of an ED or a placebo on two consecutive days. Arterial stiffness was evaluated sonographically by two-dimensional speckle tracking of the common carotid artery (CCA) at baseline and up to four hours after beverage consumption. The ED intake led to a significantly decreased peak circumferential strain of the CCA (11.78 ± 2.70% vs. 12.29 ± 2.68%, p = 0.043) compared with the placebo. The results of this study indicate that the acute ED consumption might be associated with increased arterial stiffness in healthy children and teenagers. Minors, particularly those with increased cardiovascular morbidity, should be discouraged from ED consumption. Full article

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10 pages, 1369 KiB

Open AccessArticle

Association of Increased Vascular Stiffness with Cardiovascular Death and Heart Failure Episodes Following Intervention on Symptomatic Degenerative Aortic Stenosis

by Jakub Baran, Anna Kablak-Ziembicka, Pawel Kleczynski, Ottavio Alfieri, Łukasz Niewiara, Rafał Badacz, Piotr Pieniazek, Jacek Legutko, Krzysztof Zmudka, Tadeusz Przewlocki and Jakub Podolec

J. Clin. Med. 2022, 11(8), 2078; https://doi.org/10.3390/jcm11082078 - 7 Apr 2022

Cited by 3 | Viewed by 1426

Abstract

Background. The resistive (RI) and pulsatile (PI) indices are markers of vascular stiffness (VS) which are associated with outcomes in patients with cardiovascular disease. We aimed to assess whether VS might predict incidence of cardiovascular death (CVD) and heart failure (HF) episodes following intervention on degenerative aortic valve stenosis (DAS). Methods. The distribution of increased VS (RI ≥ 0.7 and PI ≥ 1.3) from supra-aortic arteries was assessed in patients with symptomatic DAS who underwent aortic valve replacement (AVR, n = 127) or transcatheter aortic valve implantation (TAVI, n = 119). During a 3-year follow-up period (FU), incidences of composite endpoint (CVD and HF) were recorded. Results. Increased VS was found in 100% of TAVI patients with adverse event vs. 88.9% event-free TAVI patients (p = 0.116), and in 93.3% of AVR patients with event vs. 70.5% event-free (p = 0.061). Kaplan–Mayer free-survival curves at 1-year and 3-year FU were 90.5% vs. 97.1 % and 78% vs. 97.1% for patients with increased vs. lower VS. (p = 0.014). In univariate Cox analysis, elevated VS (HR 7.97, p = 0.04) and age (HR 1.05, p = 0.024) were associated with risk of adverse outcomes; however, both failed in Cox multivariable analysis. Conclusions. Vascular stiffness is associated with outcome after DAS intervention. However, it cannot be used as an independent outcome predictor. Full article

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9 pages, 256 KiB

Open AccessArticle

Association of IL-10 and CRP with Pulse Wave Velocity in Patients with Abdominal Aortic Aneurysm

by Ida Åström Malm, Rachel De Basso, Peter Blomstrand and Dick Wågsäter

J. Clin. Med. 2022, 11(5), 1182; https://doi.org/10.3390/jcm11051182 - 23 Feb 2022

Cited by 2 | Viewed by 1659

Abstract

Background: Markers of inflammation and arterial stiffness are predictors of cardiovascular morbidity and events, but their roles in the mechanisms and progression of abdominal aortic aneurysm (AAA) in males have not been fully investigated. This study explored possible associations between inflammatory marker levels and arterial stiffness in males with AAA. Methods: A total of 270 males (191 AAA and 79 controls) were included in the study. Arterial stiffness was assessed using non-invasive applanation tonometry to measure the regional pulse wave velocity between the carotid and femoral arteries and the carotid and radial arteries. Blood samples were obtained, and interleukin-10 (IL-10) and CRP levels were analysed. Results: Subjects with an AAA had higher levels of IL-10 (21.5 ± 14.0 ng/mL versus 16.6 ± 9.3 ng/mL) compared to controls (p = 0.007). In the AAA cohort, subjects with T2DM showed higher levels of IL-10 (26.4 ± 17.3 versus 20.4 ± 13.0, p = 0.036). We observed a positive correlation between PWVcf and CRP in the control group (r = 0.332) but not the AAA group. PWVcf and CRP were negatively correlated (r = 0.571) in the T2DM subjects treated with metformin in the AAA group. Conclusion: Arterial stiffness is related to the degree of inflammation reflected by CRP and IL-10 levels in males with an AAA. IL-10 is negatively correlated with arterial stiffness in these subjects. This finding suggests that IL-10 may decrease arterial stiffness in males with AAA. The negative correlation between CRP and PWVcf in males with T2DM treated with metformin may indicate that metformin influences the arterial wall to decrease stiffness in subjects with AAA. Full article

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14 pages, 1249 KiB

Open AccessArticle

Arterial Stiffness Assessment Using the Arteriograph in Patients with Moderate–Severe OSA and Metabolic Syndrome—A Pilot Study

by Ioana Mădălina Zota, Cristian Stătescu, Radu Andy Sascău, Mihai Roca, Larisa Anghel, Ovidiu Mitu, Cristina Mihaela Ghiciuc, Daniela Boisteanu, Razvan Anghel, Sebastian Romica Cozma, Lucia Corina Dima-Cozma and Florin Mitu

J. Clin. Med. 2021, 10(18), 4238; https://doi.org/10.3390/jcm10184238 - 18 Sep 2021

Cited by 10 | Viewed by 2545

Abstract

Background: Both obstructive sleep apnea (OSA) and metabolic syndrome (MS) promote arterial stiffening. As a basis for this study, we presumed that arterial stiffness could be assessed using the Arteriograph (TensioMed, Budapest, Hungary) to detect early modifications induced by continuous positive airway therapy (CPAP) in reversing this detrimental vascular remodeling. Arterial stiffness is increasingly acknowledged as a major cardiovascular risk factor and a marker of subclinical hypertension-mediated organ damage. The aim of this pilot study was to evaluate the arterial stiffness changes in patients with moderate–severe OSA and MS after short-term CPAP use. Methods: We performed a prospective study that included patients with moderate–severe OSA and MS who had not undergone previous CPAP therapy. All subjects underwent clinical examination and arterial stiffness assessment using the oscillometric technique with Arteriograph (TensioMed, Budapest, Hungary) detection before and after 8-week CPAP therapy. Results: 39 patients with moderate–severe OSA were included. Eight weeks of CPAP therapy significantly improved central systolic blood pressure (Δ = −11.4 mmHg, p = 0.009), aortic pulse wave velocity (aoPWV: Δ = −0.66 m/s, p = 0.03), and aortic augmentation index (aoAix: Δ = −8.25%, p = 0.01) only in patients who used the device for a minimum of 4 h/night (n = 20). Conclusions: Arterial stiffness was improved only among CPAP adherent patients and could be detected using the Arteriograph (TensioMed, Budapest, Hungary), which involves a noninvasive procedure that is easy to implement for the clinical evaluation of arterial stiffness. Full article

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Review

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22 pages, 1116 KiB

Open AccessReview

The Gut Microbiota and Vascular Aging: A State-of-the-Art and Systematic Review of the Literature

by Davide Agnoletti, Federica Piani, Arrigo F. G. Cicero and Claudio Borghi

J. Clin. Med. 2022, 11(12), 3557; https://doi.org/10.3390/jcm11123557 - 20 Jun 2022

Cited by 12 | Viewed by 3409

Abstract

The gut microbiota is a critical regulator of human physiology, deleterious changes to its composition and function (dysbiosis) have been linked to the development and progression of cardiovascular diseases. Vascular ageing (VA) is a process of progressive stiffening of the arterial tree associated with arterial wall remodeling, which can precede hypertension and organ damage, and is associated with cardiovascular risk. Arterial stiffness has become the preferred marker of VA. In our systematic review, we found an association between gut microbiota composition and arterial stiffness, with two patterns, in most animal and human studies: a direct correlation between arterial stiffness and abundances of bacteria associated with altered gut permeability and inflammation; an inverse relationship between arterial stiffness, microbiota diversity, and abundances of bacteria associated with most fit microbiota composition. Interventional studies were able to show a stable link between microbiota modification and arterial stiffness only in animals. None of the human interventional trials was able to demonstrate this relationship, and very few adjusted the analyses for determinants of arterial stiffness. We observed a lack of large randomized interventional trials in humans that test the role of gut microbiota modifications on arterial stiffness, and take into account BP and hemodynamic alterations. Full article

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24 pages, 604 KiB

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Arterial Stiffness in Thyroid and Parathyroid Disease: A Review of Clinical Studies

by Andrea Grillo, Vincenzo Barbato, Roberta Maria Antonello, Marco Fabio Cola, Gianfranco Parati, Paolo Salvi, Bruno Fabris and Stella Bernardi

J. Clin. Med. 2022, 11(11), 3146; https://doi.org/10.3390/jcm11113146 - 1 Jun 2022

Cited by 1 | Viewed by 2053

Abstract

Growing evidence shows that arterial stiffness measurement provides important prognostic information and improves clinical stratification of cardiovascular risk. Thyroid and parathyroid diseases are endocrine diseases with a relevant cardiovascular burden. The objective of this review was to consider the relationship between arterial stiffness and thyroid and parathyroid diseases in human clinical studies. We performed a systematic literature review of articles published in PubMed/MEDLINE from inception to December 2021, restricted to English languages and to human adults. We selected relevant articles about the relationship between arterial stiffness and thyroid and parathyroid diseases. For each selected article, data on arterial stiffness were extracted and factors that may have an impact on arterial stiffness were identified. We considered 24 papers concerning hypothyroidism, 9 hyperthyroidism and 16 primary hyperparathyroidism and hypoparathyroidism. Most studies evidenced an increase in arterial stiffness biomarkers in hypothyroidism, hyperthyroidism and primary hyperparathyroidism, even in subclinical and mild forms, although heterogeneity of measurement methods and of study designs prevented a definitive conclusion, suggesting that the assessment of arterial stiffness may be considered in the clinical evaluation of cardiovascular risk in these diseases. Full article

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14 pages, 612 KiB

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The Importance of Arterial Stiffness Assessment in Patients with Familial Hypercholesterolemia

by Beáta Kovács, Orsolya Cseprekál, Ágnes Diószegi, Szabolcs Lengyel, László Maroda, György Paragh, Mariann Harangi and Dénes Páll

J. Clin. Med. 2022, 11(10), 2872; https://doi.org/10.3390/jcm11102872 - 19 May 2022

Cited by 3 | Viewed by 2442

Abstract

Cardiovascular diseases are still the leading cause of mortality due to increased atherosclerosis worldwide. In the background of accelerated atherosclerosis, the most important risk factors include hypertension, age, male gender, hereditary predisposition, diabetes, obesity, smoking and lipid metabolism disorder. Arterial stiffness is a firmly established, independent predictor of cardiovascular risk. Patients with familial hypercholesterolemia are at very high cardiovascular risk. Non-invasive measurement of arterial stiffness is suitable for screening vascular dysfunction at subclinical stage in this severe inherited disorder. Some former studies found stiffer arteries in patients with familial hypercholesterolemia compared to healthy controls, while statin treatment has a beneficial effect on it. If conventional drug therapy fails in patients with severe familial hypercholesterolemia, PCSK9 inhibitor therapy should be administered; if these agents are not available, performing selective LDL apheresis could be considered. The impact of recent therapeutic approaches on vascular stiffness is not widely studied yet, even though the degree of accelerated athero and arteriosclerosis correlates with cardiovascular risk. The authors provide an overview of the diagnosis of familial hypercholesterolemia and the findings of studies on arterial dysfunction in patients with familial hypercholesterolemia, in addition to presenting the latest therapeutic options and their effects on arterial elasticity parameters. Full article

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