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Circulation Research Sep 2022Microvascular damage from large artery stiffness (LAS) in pancreatic, hepatic, and skeletal muscles may affect glucose homeostasis. Our goal was to evaluate the...
BACKGROUND
Microvascular damage from large artery stiffness (LAS) in pancreatic, hepatic, and skeletal muscles may affect glucose homeostasis. Our goal was to evaluate the association between LAS and the risk of type 2 diabetes using prospectively collected, carefully phenotyped measurements of LAS as well as Mendelian randomization analyses.
METHODS
Carotid-femoral pulse wave velocity (CF-PWV) and brachial and central pulse pressure were measured in 5676 participants of the FHS (Framingham Heart Study) without diabetes. We used Cox proportional hazards regression to evaluate the association of CF-PWV and pulse pressure with incident diabetes. We subsequently performed 2-sample Mendelian randomization analyses evaluating the associations of genetically predicted brachial pulse pressure with type 2 diabetes in the UKBB (United Kingdom Biobank).
RESULTS
In FHS, individuals with higher CF-PWV were older, more often male, and had higher body mass index and mean arterial pressure compared to those with lower CF-PWV. After a median follow-up of 7 years, CF-PWV and central pulse pressure were associated with an increased risk of new-onset diabetes (per SD increase, multivariable-adjusted CF-PWV hazard ratio, 1.36 [95% CI, 1.03-1.76]; =0.030; central pulse pressure multivariable-adjusted CF-PWV hazard ratio, 1.26 [95% CI, 1.08-1.48]; =0.004). In United Kingdom Biobank, genetically predicted brachial pulse pressure was associated with type 2 diabetes, independent of mean arterial pressure (adjusted odds ratio, 1.16 [95% CI, 1.00-1.35]; =0.049).
CONCLUSIONS
Using prospective cohort data coupled with Mendelian randomization analyses, we found evidence supporting that greater LAS is associated with increased risk of developing diabetes. LAS may play an important role in glucose homeostasis and may serve as a useful marker of future diabetes risk.
Topics: Biological Specimen Banks; Brachial Artery; Diabetes Mellitus, Type 2; Glucose; Humans; Longitudinal Studies; Male; Prospective Studies; Pulse Wave Analysis; Vascular Stiffness
PubMed: 35946401
DOI: 10.1161/CIRCRESAHA.122.320796 -
American Journal of Physiology. Heart... Sep 2020Tobacco cigarette (TC) smoking has never been lower in the United States, but electronic cigarette (EC) vaping has reached epidemic proportions among our youth.... (Comparative Study)
Comparative Study
Tobacco cigarette (TC) smoking has never been lower in the United States, but electronic cigarette (EC) vaping has reached epidemic proportions among our youth. Endothelial dysfunction, as measured by flow-mediated vasodilation (FMD) is a predictor of future atherosclerosis and adverse cardiovascular events and is impaired in young TC smokers, but whether FMD is also reduced in young EC vapers is uncertain. The aim of this study in otherwise healthy young people was to compare the effects of acute and chronic tobacco cigarette (TC) smoking and electronic cigarette (EC) vaping on FMD. FMD was compared in 47 nonsmokers (NS), 49 chronic EC vapers, and 40 chronic TC smokers at baseline and then after EC vapers ( = 31) and nonsmokers ( = 47) acutely used an EC with nicotine (ECN), EC without nicotine (EC0), and nicotine inhaler (NI) at ~4-wk intervals and after TC smokers ( = 33) acutely smoked a TC, compared with sham control. Mean age (NS, 26.3 ± 5.2 vs. EC, 27.4 ± 5.45 vs. TC, 27.1 ± 5.51 yr, = 0.53) was similar among the groups, but there were more female nonsmokers. Baseline FMD was not different among the groups (NS, 7.7 ± 4.5 vs. EC:6.6 ± 3.6 vs. TC, 7.9 ± 3.7%∆, = 0.35), even when compared by group and sex. Acute TC smoking versus control impaired FMD (FMD pre-/postsmoking, -2.52 ± 0.92 vs. 0.65 ± 0.93%∆, = 0.02). Although the increase in plasma nicotine was similar after EC vapers used the ECN versus TC smokers smoked the TC (5.75 ± 0.74 vs. 5.88 ± 0.69 ng/mL, = 0.47), acute EC vaping did not impair FMD. In otherwise healthy young people who regularly smoke TCs or ECs, impaired FMD compared with that in nonsmokers was not present at baseline. However, FMD was significantly impaired after smoking one TC, but not after vaping an equivalent "dose" (estimated by change in plasma nicotine) of an EC, consistent with the notion that non-nicotine constituents in TC smoke mediate the impairment. Although it is reassuring that acute EC vaping did not acutely impair FMD, it would be dangerous and premature to conclude that ECs do not lead to atherosclerosis. In our study of otherwise healthy young people, baseline flow-mediated dilation (FMD), a predictor of atherosclerosis and increased cardiovascular risk, was not different among tobacco cigarette (TC) smokers or electronic cigarette (EC) vapers who had refrained from smoking, compared with nonsmokers. However, acutely smoking one TC impaired FMD in smokers, whereas vaping a similar EC "dose" (as estimated by change in plasma nicotine levels) did not. Finally, although it is reassuring that acute EC vaping did not acutely impair FMD, it would be premature and dangerous to conclude that ECs do not lead to atherosclerosis or increase cardiovascular risk.
Topics: Adult; Atherosclerosis; Brachial Artery; Cigarette Smoking; Consumer Product Safety; Cross-Over Studies; E-Cigarette Vapor; Electronic Nicotine Delivery Systems; Endothelium, Vascular; Female; Healthy Volunteers; Humans; Male; Middle Aged; Random Allocation; Risk Assessment; Risk Factors; Vaping; Vasodilation; Young Adult
PubMed: 32734819
DOI: 10.1152/ajpheart.00307.2020 -
Annals of Vascular Surgery Apr 2022Endovascular access is usually achieved through the common femoral artery due to its large size and accessibility. Access through the upper extremity can however be...
BACKGROUND
Endovascular access is usually achieved through the common femoral artery due to its large size and accessibility. Access through the upper extremity can however be necessary due to anatomic reasons, obesity, or peripheral arterial disease. The 2 main methods of access are surgical cutdown and percutaneous puncture. In this single-centre retrospective cohort study we compared complication risks for both surgical cutdown and percutaneous puncture of an upper arm approach.
MATERIALS AND METHODS
Data was obtained from patients receiving endovascular access through the brachial or axillary artery between 2005 and 2018. A total of 109 patients were included. Patient demographics including age, sex, medical history, smoking status, and actual medication were registered, as well as postoperative complications including hematoma, thrombosis, dissection, infection, pseudoaneurysm, nerve injury, reoperation, and readmission.
RESULTS
Access was achieved through surgical cutdown in 53% (n = 58) and through percutaneous puncture in 47% (n = 51) of patients. Fifty-eight percent (n = 63) received access via the brachial artery (BA) and 42% (n = 46) via the axillary artery. Complication rate was 25.0% (3 of 12) for surgical cutdown via the BA, 29.4% (15 of 51) for percutaneous puncture via the BA, and 10.9% (5 of 46) for surgical cutdown via the axillary artery. Major complication rate was 8.3% (1 of 12) for surgical cutdown via the BA, 13.7% (7 of 51) for percutaneous puncture via the BA, and 4.3% (2 of 46) for surgical cutdown via the axillary artery. There was no association between baseline patient characteristics and complication rate.
CONCLUSIONS
In this nonrandomized retrospective study, surgical cutdown via the axillary artery was the safest option with fewest complications, but selection of patients may have blurred the results. Surgical cutdown and percutaneous puncture seem equally safe in terms of complication rate in the BA.
Topics: Axillary Artery; Brachial Artery; Catheterization, Peripheral; Endovascular Procedures; Femoral Artery; Humans; Retrospective Studies; Treatment Outcome
PubMed: 34775017
DOI: 10.1016/j.avsg.2021.09.052 -
Indian Journal of Critical Care... Feb 2022Selvam V, Srinivasan S. Doppler-estimated Carotid and Brachial Artery Flow as Surrogate for Cardiac Output: Needs Further Validation. Indian J Crit Care Med...
Selvam V, Srinivasan S. Doppler-estimated Carotid and Brachial Artery Flow as Surrogate for Cardiac Output: Needs Further Validation. Indian J Crit Care Med 2022;26(2):159-160.
PubMed: 35712735
DOI: 10.5005/jp-journals-10071-24108 -
Cureus Feb 2020The brachial artery is the main artery of the arm and constitutes the continuation of the axillary artery. It gives off two terminal branches, the radial and ulnar... (Review)
Review
The brachial artery is the main artery of the arm and constitutes the continuation of the axillary artery. It gives off two terminal branches, the radial and ulnar arteries. According to the literature, the brachial artery might present a deviation from the normal pattern in 20% of the cases. High bifurcation of the artery seems to be the most common variation and may result in a series of complications during surgery and interventional radiology. An embryological overview is necessary for a better understanding of this variant. The brachial artery is being developed during embryonic life by the main trunk of the axis artery. The superficial brachial artery is also an important stable fetal vessel for normal arterial morphogenesis of the upper limb.
PubMed: 32231893
DOI: 10.7759/cureus.7097 -
American Journal of Physiology.... Dec 2021This study sought to compare the brachial and carotid hemodynamic response to hot water immersion (HWI) between healthy young men and women. Ten women (W) and 11 men (M)... (Comparative Study)
Comparative Study
This study sought to compare the brachial and carotid hemodynamic response to hot water immersion (HWI) between healthy young men and women. Ten women (W) and 11 men (M) (24 ± 4 yr) completed a 60-min HWI session immersed to the level of the sternum in 40°C water. Brachial and carotid artery hemodynamics (Doppler ultrasound) were measured at baseline (seated rest) and every 15 min throughout HWI. Within the brachial artery, total shear rate was elevated to a greater extent in women [+479 (+364, +594) s] than in men [+292 (+222, +361) s] during HWI ( = 0.005). As shear rate is inversely proportional to blood vessel diameter and directly proportional to blood flow velocity, the sex difference in brachial shear response to HWI was the result of a smaller brachial diameter among women at baseline ( < 0.0001) and throughout HWI (main effect of sex, < 0.0001) and a greater increase in brachial velocity seen in women [+48 (+36, +61) cm/s] compared with men [+35 (+27, +43) cm/s] with HWI ( = 0.047) which allowed for a similar increase in brachial blood flow between sexes [M: +369 (+287, +451) mL/min, W: +364 (+243, +486) mL/min, = 0.943]. In contrast, no differences were seen between sexes in carotid total shear rate, flow, velocity, or diameter at baseline or throughout HWI. These data indicate the presence of an artery-specific sex difference in the hemodynamic response to a single bout of HWI.
Topics: Adult; Blood Flow Velocity; Brachial Artery; Carotid Artery, Common; Female; Hemodynamics; Hot Temperature; Humans; Hyperthermia, Induced; Immersion; Male; Regional Blood Flow; Sex Factors; Time Factors; Ultrasonography, Doppler; Young Adult
PubMed: 34643115
DOI: 10.1152/ajpregu.00110.2021 -
European Journal of Vascular and... Jan 2021
Topics: Aged; Arm Injuries; Brachial Artery; COVID-19; Humans; Male; Quarantine; SARS-CoV-2; Suicide, Attempted; Tomography, X-Ray Computed; Treatment Outcome; Wounds, Gunshot
PubMed: 32900584
DOI: 10.1016/j.ejvs.2020.08.017 -
European Journal of Applied Physiology Jul 2021Measures of arterial stiffness (AS) and central blood pressure (BP) are indicators for cardiovascular health and possess a high prognostic value in the prediction of...
PURPOSE
Measures of arterial stiffness (AS) and central blood pressure (BP) are indicators for cardiovascular health and possess a high prognostic value in the prediction of cardiovascular events. The effects of physical training are widely unexplored in the context of competitive, high-performance sports. Therefore, we aimed to present possible reference values of brachial and central BP and of AS of adult elite athletes compared to a control group.
METHODS
A total of 189 subjects participated in this cross-sectional study. Of these were 139 adult elite athletes (70 male, 69 female) performing on top-national and international level, and 50 control subjects (26 male, 24 female). Resting brachial and central BP and aortic pulse wave velocity (PWV) were measured and were compared in terms of sex, sport category, and age of the athletes.
RESULTS
Results show no difference between athletes and controls in any parameter. Women exhibit lower brachial and central BP and AS values compared to men. PWV is positively correlated with age. Evaluation of the parameters according to the different sport categories showed that endurance athletes exhibit lower BP and PWV compared to other athletes.
CONCLUSIONS
This study presents brachial and central BP and PWV values of athletes, suggesting that high-performance sport does not negatively impact AS. The proposed reference values might support a more detailed evaluation of elite athlete's cardiovascular and hemodynamic system and a better assignment to possible risk groups.
Topics: Adolescent; Adult; Athletes; Blood Pressure; Brachial Artery; Cross-Sectional Studies; Female; Humans; Male; Physical Conditioning, Human; Risk Factors; Vascular Stiffness
PubMed: 33713201
DOI: 10.1007/s00421-021-04662-z -
Advances in Clinical and Experimental... Mar 2022Blood flow-mediated dilation (FMD) is a noninvasive assessment of vascular endothelial function in humans. The study of the FMD in hypertensive (HT) patients is an...
BACKGROUND
Blood flow-mediated dilation (FMD) is a noninvasive assessment of vascular endothelial function in humans. The study of the FMD in hypertensive (HT) patients is an important factor supporting the recognition of the early mechanisms of cardiovascular pathologies, and also of the pathogenesis related to hypertension.
OBJECTIVES
To investigate whether FMD measured on the radial artery (FMD-RA) using high-frequency ultrasounds can be used as an alternative to FMD assessed with the lower frequency system on the brachial artery in patients with HT.
MATERIAL AND METHODS
The simultaneous measurements of FMD-RA and FMD measurements in the brachial artery (FMD-BA) were performed on 76 HT patients using 20 MHz and 7-12 MHz linear array probes, and were compared to the FMD measured in healthy groups. All quantitative data are presented as mean ± standard deviation (SD); the p-values of the normality and tests for variables comparisons are listed. The agreement of the FMD-RA and FMD-BA in HT patients was assessed with the Bland-Altman method, and using the intraclass correlation coefficient (ICC). In some statistical calculations, the FMD-RA values were rescaled by dividing them by a factor of 2.
RESULTS
The mean FMD-RA and FMD-BA in HT patients were 5.16 ±2.18% (95% confidence interval (95% CI): [4.50%, 5.82%]) and 2.13 ±1.12% (95% CI: [1.76%, 2.49%]), respectively. The FMD-RA and FMD-BA values of HT patients were significantly different than those in respective control groups. The p-values of Mann-Whitney-Wilcoxon tests were less than 0.05. The Bland-Altman coefficient for both measurement methods, FMD-RA and FMD-BA, was 3%, and the ICC was 0.69.
CONCLUSIONS
Our findings show that FMD-RA, supplementary to FMD-BA measurements, can be used to assess endothelial dysfunction in the group of HT patients. In addition, the FMD-RA measurements met the criteria of high concordance with the FMD-BA measurements.
Topics: Brachial Artery; Dilatation; Endothelium, Vascular; Humans; Hypertension; Radial Artery; Regional Blood Flow; Ultrasonography; Vasodilation
PubMed: 35040291
DOI: 10.17219/acem/144040