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Vascular Disease and Health

A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Health Behavior, Chronic Disease and Health Promotion".

Deadline for manuscript submissions: closed (30 June 2023) | Viewed by 57240

Special Issue Editors

Department and Clinic of Internal Medicine, Angiology, and Physical Medicine, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Batorego 15 St., 41-902 Bytom, Poland
Interests: physical medicine; thermal imaging; cryotherapy; cryogenic temperatures; vascular medicine; oxidative stress; rehabilitation; internal medicine
Special Issues, Collections and Topics in MDPI journals
Department and Division of Medical Rehabilitation, Wroclaw Medical University, Borowska 213, Wrocław, Poland
Interests: diabetes; diabetic foot syndrome; hypoglycaemia

Special Issue Information

Dear Colleagues,

Vascular diseases (VDs) are a major cause of morbidity and mortality in developed countries. Prevalent cases of total cardiovascular diseases (CVD) nearly doubled from 271 million in 1990 to 523 million in 2019, and the number of CVD deaths steadily increased from 12.1 million in 1990, reaching 18.6 million in 2019.  VDs also significantly impair the quality of life. They remain the leading cause of disease burden in the world.

VDs are common and can be serious. Some types include: aneurysm, atherosclerosis, venous thromboembolism, coronary artery disease, peripheral artery disease, stroke, vasculitis, Raynaud’s disease and syndrome as well as lymphedema and chronic venous disease.

The most important behavioural risk factors of VDs are unhealthy diet, physical inactivity, tobacco use and harmful use of alcohol. The effects of behavioural risk factors may show up in individuals as raised blood pressure, raised blood glucose, raised blood lipids, and overweight and obesity.

“Bench-to-bedside” process harnesses knowledge from basic scientific research into clinical research to create novel treatments and medical procedures, preventions, and diagnostics essentially forming a bridge between basic research and clinical research. This Special Issue will therefore contribute to our understanding the knowledge about physiology, pathophysiology of vascular system, novel treatments as well as preventions, but not limited only to these issues.

 In this Special Issue, manuscripts that focus on the topic “Vascular Diseases and Health” are welcome. This includes original in vitro, animal, and human research, cohort studies, systematic literature reviews, and meta-analyses.

Prof. Dr. Agata Stanek
Dr. Edyta Ewa Sutkowska
Guest Editors

Manuscript Submission Information

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Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Environmental Research and Public Health is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2500 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • Vascular diseases
  • Stroke
  • Peripheral arterial disease
  • Chronic venous disease
  • Microvascular disease
  • Health promotion

Published Papers (29 papers)

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14 pages, 2510 KiB  
Article
Reaching the Frail Elderly for the Diagnosis and Management of Atrial Fibrillation—REAFEL
by Carsten Bamberg, Caroline Thorup Ladegaard, Mathias Aalling, Dorthea Marie Jensen, Christoffer Læssøe Madsen, Sadaf Kamil, Henrik Gudbergsen, Thomas Saxild, Michaela Louise Schiøtz, Julie Grew, Luana Sandoval Castillo, Iben Tousgaard, Rie Laurine Rosenthal Johansen, Jakob Eyvind Bardram, Anne Frølich and Helena Domínguez
Int. J. Environ. Res. Public Health 2023, 20(18), 6783; https://doi.org/10.3390/ijerph20186783 - 19 Sep 2023
Viewed by 1070
Abstract
BACKGROUND: Frail elderly patients are exposed to suffering strokes if they do not receive timely anticoagulation to prevent stroke associated to atrial fibrillation (AF). Evaluation in the cardiological ambulatory can be cumbersome as it often requires repeated visits. AIM: To develop and implement [...] Read more.
BACKGROUND: Frail elderly patients are exposed to suffering strokes if they do not receive timely anticoagulation to prevent stroke associated to atrial fibrillation (AF). Evaluation in the cardiological ambulatory can be cumbersome as it often requires repeated visits. AIM: To develop and implement CardioShare, a shared-care model where primary care leads patient management, using a compact Holter monitor device with asynchronous remote support from cardiologists. METHODS: CardioShare was developed in a feasibility phase, tested in a pragmatic cluster randomization trial (primary care clinics as clusters), and its implementation potential was evaluated with an escalation test. Mixed methods were used to evaluate the impact of this complex intervention, comprising quantitative observations, semi-structured interviews, and workshops. RESULTS: Between February 2020 and December 2021, 314 patients (30% frail) were included, of whom 75% had AF diagnosed/not found within 13 days; 80% in both groups avoided referral to cardiologists. Patients felt safe and primary care clinicians satisfied. In an escalation test, 58 primary-care doctors evaluated 93 patients over three months, with remote support from four hospitals in the Capital Region of Denmark. CONCLUSIONS: CardioShare was successfully implemented for AF evaluation in primary care. Full article
(This article belongs to the Special Issue Vascular Disease and Health)
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13 pages, 2503 KiB  
Article
Radiofrequency Thermal Ablation for the Treatment of Chronic Insufficiency of the Saphenous Vein—A Comparative Retrospective Study
by Octavian Andercou, Bogdan Stancu, Horațiu Flaviu Coman, Beatrix Cucuruz, Thomas Noppeney and Dorin Marian
Int. J. Environ. Res. Public Health 2023, 20(4), 3308; https://doi.org/10.3390/ijerph20043308 - 14 Feb 2023
Cited by 1 | Viewed by 1248
Abstract
Objectives: The broad spectrum of chronic venous disease encompasses varicose veins, edema, hyperpigmentation and venous ulcers. Radiofrequency thermal ablation is indicated for the treatment of superficial venous reflux of the lower limb. Our research is a comparative clinical study that aims to identify [...] Read more.
Objectives: The broad spectrum of chronic venous disease encompasses varicose veins, edema, hyperpigmentation and venous ulcers. Radiofrequency thermal ablation is indicated for the treatment of superficial venous reflux of the lower limb. Our research is a comparative clinical study that aims to identify the most effective and safest therapeutic method in the management of chronic venous insufficiency of the lower limbs. Materials and methods: Patients admitted to the Department of Surgery of the University of Medicine and Pharmacy in Cluj-Napoca, Romania, with the clinical diagnosis of varicose veins of the lower limbs, treated by thermal ablation with radiofrequency or by open surgical techniques during the year 2022, were included. Results: A percentage of 50.9% of the patients were treated by the radiofrequency thermal ablation procedure and 49.1% by surgical treatment. More than half of them were hospitalized for 2 days. The duration of hospitalization was significantly longer in patients who had postoperative complications (p < 0.001). The chance of being treated by open surgical treatment for a small saphenous vein is 10.11 times higher than by radiofrequency thermal ablation. Conclusion: According to the applied tests, there is no statistical difference between the group treated by radiofrequency thermal ablation and the one surgically treated in terms of sex, age, origin, CEAP clinical stage at hospitalization, clinical diagnosis at hospitalization and affected lower limb. Full article
(This article belongs to the Special Issue Vascular Disease and Health)
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13 pages, 585 KiB  
Article
Polytetrafluorethylene (PTFE) vs. Polyester (Dacron®) Grafts in Critical Limb Ischemia Salvage
by Eliza Russu, Adrian Vasile Mureșan, Adrian Dumitru Ivănescu, Réka Kaller, Daniela Elena Nedelea, Raluca Niculescu, Bogdan Andrei Cordoș, Ovidiu Aurelian Budișcă, Eliza Mihaela Arbănași and Emil Marian Arbănași
Int. J. Environ. Res. Public Health 2023, 20(2), 1235; https://doi.org/10.3390/ijerph20021235 - 10 Jan 2023
Cited by 1 | Viewed by 1625
Abstract
Background: Critical ischemia of the lower limbs refers to the last stages of peripheral arterial disease. It is characterized by resting discomfort or trophic disorders such as ulceration, skin necrosis, or gangrene in the lower limbs. Critical ischemia corresponds to Leriche–Fontaine (LF) stages [...] Read more.
Background: Critical ischemia of the lower limbs refers to the last stages of peripheral arterial disease. It is characterized by resting discomfort or trophic disorders such as ulceration, skin necrosis, or gangrene in the lower limbs. Critical ischemia corresponds to Leriche–Fontaine (LF) stages III-IV and Rutherford stages 4–6. The purpose of this study was to observe the patency and postoperative complications of patients who have had infra-inguinal surgical revascularization and compare the results based on the kind of graft utilized. Methods: The present study was designed as an observational retrospective cohort study, including all patients from 2018 to 2019 diagnosed with severe ischemia of the lower limbs who were hospitalized at the Vascular Surgery Clinic of the County Emergency Clinical Hospital of Targu Mures. Results: Patients with a polytetrafluoroethylene (PTFE) graft had a higher incidence of chronic obstructive pulmonary disease (p = 0.01), stage III LF (70.41% vs. 55.29%), p = 0.03), and a lower incidence of stage IV LF (29.95% vs. 44.71%, p = 0.03). As for complications, the PTFE group showed a lower incidence of bypass thrombosis (29.59% vs. 44.71%; p = 0.03) and graft infection (9.18% vs. 21.18%; p = 0.02), but no statistical significance in the event of bleeding (p = 0.40). Regarding the outcomes, no statistical significance was seen for below-the-knee amputations or death. However, the PTFE group had a lower incidence of above-the-knee amputations (11.22% vs. 24.71%; p = 0.01). At multivariate analysis, the PTFE graft is an independent predictor of primary patency at 6, 12, and 24 months (OR: 2.15, p = 0.02; OR: 1.84, p = 0.04; and OR: 1.89, p = 0.03), as well as a protective factor against bypass thrombosis (OR: 0.52; p = 0.03), graft infection (OR: 0.37; p = 0.02), and above-the-knee amputation (OR: 0.38; p = 0.01).; Conclusions: According to this study’s findings, there were minor differences regarding the long-term patency, bypass thrombosis, graft infections, and above-the-knee amputations. In addition, the PTFE graft group had a higher incidence of primary patency at 6, 12, and 24 months, as well as a lower incidence of bypass thrombosis, graft infection, and above-the-knee amputations. Full article
(This article belongs to the Special Issue Vascular Disease and Health)
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13 pages, 5628 KiB  
Article
Computed Tomography Angiography Markers and Intraluminal Thrombus Morphology as Predictors of Abdominal Aortic Aneurysm Rupture
by Emil Marian Arbănași, Adrian Vasile Mureșan, Cătălin Mircea Coșarcă, Eliza Mihaela Arbănași, Raluca Niculescu, Septimiu Toader Voidăzan, Adrian Dumitru Ivănescu, Ioana Hălmaciu, Rareș Cristian Filep, Lucian Mărginean, Shuko Suzuki, Traian V. Chirilă, Réka Kaller and Eliza Russu
Int. J. Environ. Res. Public Health 2022, 19(23), 15961; https://doi.org/10.3390/ijerph192315961 - 30 Nov 2022
Cited by 5 | Viewed by 1499
Abstract
Background: Abdominal aortic aneurysm (AAA) is a complex vascular disease characterized by progressive and irreversible local dilatation of the aortic wall. Currently, the indication for repair is linked to the transverse diameter of the abdominal aorta, using computed tomography angiography imagery, which is [...] Read more.
Background: Abdominal aortic aneurysm (AAA) is a complex vascular disease characterized by progressive and irreversible local dilatation of the aortic wall. Currently, the indication for repair is linked to the transverse diameter of the abdominal aorta, using computed tomography angiography imagery, which is one of the most used markers for aneurysmal growth. This study aims to verify the predictive role of imaging markers and underlying risk factors in AAA rupture. Methods: The present study was designed as an observational, analytical, retrospective cohort study and included 220 patients over 18 years of age with a diagnosis of AAA, confirmed by computed tomography angiography (CTA), admitted to Vascular Surgery Clinic of Mures County Emergency Hospital in Targu Mures, Romania, between January 2018 and September 2022. Results: Patients with a ruptured AAA had higher incidences of AH (p = 0.006), IHD (p = 0.001), AF (p < 0.0001), and MI (p < 0.0001), and higher incidences of all risk factors (tobacco (p = 0.001), obesity (p = 0.02), and dyslipidemia (p < 0.0001)). Multivariate analysis showed that a high baseline value of all imaging ratios markers was a strong independent predictor of AAA rupture (for all p < 0.0001). Moreover, a higher baseline value of DAmax (OR:3.91; p = 0.001), SAmax (OR:7.21; p < 0.001), and SLumenmax (OR:34.61; p < 0.001), as well as lower baseline values of DArenal (OR:7.09; p < 0.001), DACT (OR:12.71; p < 0.001), DAfemoral (OR:2.56; p = 0.005), SArenal (OR:4.56; p < 0.001), SACT (OR:3.81; p < 0.001), and SThrombusmax (OR:5.27; p < 0.001) were independent predictors of AAA rupture. In addition, AH (OR:3.33; p = 0.02), MI (OR:3.06; p = 0.002), and PAD (OR:2.71; p = 0.004) were all independent predictors of AAA rupture. In contrast, higher baseline values of SAmax/Lumenmax (OR:0.13; p < 0.001) and ezetimibe (OR:0.45; p = 0.03) were protective factors against AAA rupture. Conclusions: According to our findings, a higher baseline value of all imaging markers ratios at CTA strongly predicts AAA rupture and AH, MI, and PAD highly predicted the risk of rupture in AAA patients. Furthermore, the diameter of the abdominal aorta at different levels has better accuracy and a higher predictive role of rupture than the maximal diameter of AAA. Full article
(This article belongs to the Special Issue Vascular Disease and Health)
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10 pages, 4440 KiB  
Article
Stimulation of the Vascular Endothelium and Angiogenesis by Blood-Flow-Restricted Exercise
by Mikołaj Maga, Martyna Schönborn, Agnieszka Wachsmann-Maga, Agnieszka Śliwka, Jakub Krężel, Aleksandra Włodarczyk, Marta Olszewska and Roman Nowobilski
Int. J. Environ. Res. Public Health 2022, 19(23), 15859; https://doi.org/10.3390/ijerph192315859 - 29 Nov 2022
Cited by 4 | Viewed by 1627
Abstract
Blood-flow-restricted exercise (BFRE) has been gaining constantly increasing interest in rehabilitation, but its influence on endothelial functions has not been well studied yet. Our aim is to examine the influence of low-resistance BFRE on endothelial functions and angiogenesis. This prospective cross-over study involved [...] Read more.
Blood-flow-restricted exercise (BFRE) has been gaining constantly increasing interest in rehabilitation, but its influence on endothelial functions has not been well studied yet. Our aim is to examine the influence of low-resistance BFRE on endothelial functions and angiogenesis. This prospective cross-over study involved 35 young healthy adults. They conducted a 21-min low-resistant exercise with blood flow restricted by pressure cuffs placed on arms and tights. They also did the same training but without blood flow restriction. Endothelial parameters and angiogenesis biomarkers were evaluated before and up to 20 min after exercise. Both types of exercise increased Flow-Mediated Dilatation (FMD) but elevation after BFRE was more significant compared to the controls. The stiffness index decreased only after BFRE, while the reflection index decreased significantly after both types of exercise but was higher after BFRE. Platelet endothelial cell adhesion molecule (PECAM-1) and vascular endothelial growth factor receptor 2 (VEGFR-2) concentrations were increased by both exercise types but elevations were higher after BFRE compared to the controls. Only BFRE elevated the mean serum CD34 protein concentration. Based on these results, we can assume that low-resistance BFR exercise stimulates angiogenesis and improves endothelial functions more significantly compared to the same training performed without blood flow restriction. Full article
(This article belongs to the Special Issue Vascular Disease and Health)
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14 pages, 2421 KiB  
Article
Effect of Obstructive Sleep Apnea and CPAP Treatment on the Bioavailability of Erythrocyte and Plasma Nitric Oxide
by Jakub Mochol, Jakub Gawryś, Ewa Szahidewicz-Krupska, Jerzy Wiśniewski, Paulina Fortuna, Piotr Rola, Helena Martynowicz and Adrian Doroszko
Int. J. Environ. Res. Public Health 2022, 19(22), 14719; https://doi.org/10.3390/ijerph192214719 - 09 Nov 2022
Cited by 1 | Viewed by 1692
Abstract
Introduction: Endothelial dysfunction resulting from decreased nitric oxide (NO) bioavailability is an important mechanism that increases cardiovascular risk in subjects with obstructive sleep apnea (OSA). NO is produced by nitric oxide synthase (NOS) in a reaction that converts L-arginine to L-citrulline. Asymmetric-dimethylarginine (ADMA) [...] Read more.
Introduction: Endothelial dysfunction resulting from decreased nitric oxide (NO) bioavailability is an important mechanism that increases cardiovascular risk in subjects with obstructive sleep apnea (OSA). NO is produced by nitric oxide synthase (NOS) in a reaction that converts L-arginine to L-citrulline. Asymmetric-dimethylarginine (ADMA) is created by L-arginine and is a naturally occurring competitive inhibitor of nitric oxide synthase (NOS). The aim of our study was to verify if erythrocytes could play a role in the storage and accumulation of ADMA in OSA patients. The crosstalk between erythrocyte-ADMA, SDMA, L-arginine, and L-citrulline levels and endothelial function was investigated in OSA subjects both at baseline and prospectively following 1-year CPAP (continuous positive airway pressure) treatment. Material and Methods: A total of 46 subjects with OSA were enrolled in this study and divided into two groups: those with moderate-to-severe OSA and those with mild or no OSA. A physical examination was followed by blood collection for the assessment of biochemical cardiovascular risk factors and the nitric oxide bioavailability parameters both in plasma and erythrocytes. Vasodilative endothelial function was assessed using Laser Doppler Flowmetry (LDF). Results: No significant changes regarding the NO pathway metabolites were noted apart from the plasma L-citrulline concentration, which was decreased in patients with OSA (26.9 ± 7.4 vs. 33.1 ± 9.4 μM, p < 0.05). The erythrocyte ADMA concentration was lower than in plasma irrespective of the presence of OSA (0.33 ± 0.12 vs. 0.45 ± 0.08 μM in OSA, p < 0.05 and 0.33 ± 0.1 vs. 0.45 ± 0.07 μM in the control, p < 0.05). No significant changes regarding the LDF were found. CPAP treatment did not change the levels of NO metabolites in the erythrocytes. Conclusions: The erythrocyte pool of the NO metabolic pathway intermediates does not depend on OSA and its treatment, whereas the erythrocytes could constitute a high-volume buffer in their storage Hence, the results from this prospective study are a step forward in understanding the role of the erythrocyte compartment and the intra-erythrocyte pathways regulating NO bioavailability and paracrine endothelial function in the hypoxia-reoxygenation setting, such as obstructive sleep apnea. Full article
(This article belongs to the Special Issue Vascular Disease and Health)
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14 pages, 1051 KiB  
Article
Carotid Plaque Features and Inflammatory Biomarkers as Predictors of Restenosis and Mortality Following Carotid Endarterectomy
by Raluca Niculescu, Eliza Russu, Emil Marian Arbănași, Réka Kaller, Eliza Mihaela Arbănași, Răzvan Marian Melinte, Cătălin Mircea Coșarcă, Iuliu Gabriel Cocuz, Adrian Horațiu Sabău, Andreea Cătălina Tinca, Adina Stoian, Vlad Vunvulea, Adrian Vasile Mureșan and Ovidiu Simion Cotoi
Int. J. Environ. Res. Public Health 2022, 19(21), 13934; https://doi.org/10.3390/ijerph192113934 - 26 Oct 2022
Cited by 22 | Viewed by 1894
Abstract
Background: Carotid endarterectomy (CEA) is the first-line surgical intervention for cases of severe carotid stenoses. Unfortunately, the restenosis rate is high after CEA. This study aims to demonstrate the predictive role of carotid plaque features and inflammatory biomarkers (monocyte-to-lymphocyte ratio (MLR), neutrophil-to-lymphocyte ratio [...] Read more.
Background: Carotid endarterectomy (CEA) is the first-line surgical intervention for cases of severe carotid stenoses. Unfortunately, the restenosis rate is high after CEA. This study aims to demonstrate the predictive role of carotid plaque features and inflammatory biomarkers (monocyte-to-lymphocyte ratio (MLR), neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), systemic inflammatory index (SII), Systemic Inflammation Response Index (SIRI), and Aggregate Index of Systemic Inflammation (AISI)) in carotid restenosis and mortality at 12 months following CEA. Methods: The present study was designed as an observational, analytical, retrospective cohort study and included all patients over 18 years of age with a minimum of 70% carotid stenosis and surgical indications for CEA admitted to the Vascular Surgery Clinic, Emergency County Hospital of Targu Mures, Romania between 2018 and 2021. Results: According to our results, the high pre-operative values of inflammatory biomarkers—MLR (OR: 10.37 and OR: 6.11; p < 0.001), NLR (OR: 34.22 and OR: 37.62; p < 0.001), PLR (OR: 12.02 and OR: 16.06; p < 0.001), SII (OR: 18.11 and OR: 31.70; p < 0.001), SIRI (OR: 16.64 and OR: 9.89; p < 0.001), and AISI (OR: 16.80 and OR: 8.24; p < 0.001)—are strong independent factors predicting the risk of 12-month restenosis and mortality following CEA. Moreover, unstable plaque (OR: 2.83, p < 0.001 and OR: 2.40, p = 0.04) and MI (OR: 3.16, p < 0.001 and OR: 2.83, p = 0.005) were independent predictors of all outcomes. Furthermore, AH (OR: 2.30; p = 0.006), AF (OR: 1.74; p = 0.02), tobacco (OR: 2.25; p < 0.001), obesity (OR: 1.90; p = 0.02), and thrombotic plaques (OR: 2.77; p < 0.001) were all independent predictors of restenosis, but not for mortality in all patients. In contrast, antiplatelet (OR: 0.46; p = 0.004), statin (OR: 0.59; p = 0.04), and ezetimibe (OR:0.45; p = 0.03) therapy were protective factors against restenosis, but not for mortality. Conclusions: Our data revealed that higher preoperative inflammatory biomarker values highly predict 12-month restenosis and mortality following CEA. Furthermore, age above 70, unstable plaque, cardiovascular disease, and dyslipidemia were risk factors for all outcomes. Additionally, AH, AF, smoking, and obesity were all independent predictors of restenosis but not of mortality in all patients. Antiplatelet and statin medication, on the other hand, were protective against restenosis but not against mortality. Full article
(This article belongs to the Special Issue Vascular Disease and Health)
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9 pages, 1348 KiB  
Article
Two-Stage Gene Therapy (VEGF, HGF and ANG1 Plasmids) as Adjunctive Therapy in the Treatment of Critical Lower Limb Ischemia in Diabetic Foot Syndrome
by Piotr Barć, Maciej Antkiewicz, Katarzyna Frączkowska-Sioma, Diana Kupczyńska, Paweł Lubieniecki, Wojciech Witkiewicz, Małgorzata Małodobra-Mazur, Dagmara Baczyńska, Dariusz Janczak and Jan Paweł Skóra
Int. J. Environ. Res. Public Health 2022, 19(19), 12818; https://doi.org/10.3390/ijerph191912818 - 06 Oct 2022
Cited by 3 | Viewed by 1888
Abstract
One of the most serious problems in people with diabetes is diabetic foot syndrome. Due to the peripheral location of atherosclerotic lesions in the arterial system of the lower extremities, endovascular treatment plays a dominant role. However, carrying out these procedures is not [...] Read more.
One of the most serious problems in people with diabetes is diabetic foot syndrome. Due to the peripheral location of atherosclerotic lesions in the arterial system of the lower extremities, endovascular treatment plays a dominant role. However, carrying out these procedures is not always possible and does not always bring the expected results. Gene therapy, which stimulates angiogenesis, improves not only the inflow from the proximal limb but also the blood redistribution in individual angiosomes. Due to the encouraging results of sequential treatment consisting of intramuscular injections of VEGF/HGF bicistronic plasmids followed by a month of ANG1 plasmids, we decided to use the described method for the treatment of critical ischemia of the lower limbs in the course of diabetes and, more specifically, in diabetic foot syndrome. Twenty-four patients meeting the inclusion criteria were enrolled in the study. They were randomly divided into two equal groups. The first group of patients was subjected to gene therapy, where the patients received intramuscular injections of pIRES/VEGF165/HGF plasmids and 1 month of ANG-1 plasmids. The remaining patients constituted the control group. Gene therapy was well tolerated by most patients. The wounds healed significantly better in Group 1. The minimal value of ABI increased significantly in Group 1 from 0.44 ± 0.14 (± standard deviation) to 0.47 ± 0.12 (with p = 0.028) at the end of the study. There were no significant differences in the control group. In the gene treatment group, PtcO2 increased significantly (from 28.71 ± 10.89 mmHg to 33.9 ± 6.33 mmHg with p = 0.001), while in Group 2, no statistically significant changes were found. The observed resting pain decreased significantly in both groups (Group 1 decreased from 6.80 ± 1.48 to 2.10 ± 1.10; p < 0.001; the control group decreased from 7.44 ± 1.42 to 3.78 ± 1.64 with p < 0.001). In our study, we evaluated the effectiveness of gene therapy with the growth factors described above in patients with CLI in the course of complicated DM. The therapy was shown to be effective with minimal side effects. No serious complications were observed. Full article
(This article belongs to the Special Issue Vascular Disease and Health)
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14 pages, 782 KiB  
Article
The Use of the ICF Classification Sheet to Assess Cognitive-Behavioral Disorders and Verbal Communication in Patients after Ischemic and Hemorrhagic Stroke during Rehabilitation
by Ewa Lucka, Mateusz Lucki, Marcin Cybulski, Przemysław Daroszewski and Przemysław Lisiński
Int. J. Environ. Res. Public Health 2022, 19(19), 12127; https://doi.org/10.3390/ijerph191912127 - 25 Sep 2022
Cited by 1 | Viewed by 2100
Abstract
Background: In patients after experiencing stroke, the cognitive-behavioral deficits and disorders of verbal communication limit the effectiveness of rehabilitation. The key is to diagnose them at an early stage of rehabilitation and to implement appropriate psychological and speech therapy. Objective: Identify differences in [...] Read more.
Background: In patients after experiencing stroke, the cognitive-behavioral deficits and disorders of verbal communication limit the effectiveness of rehabilitation. The key is to diagnose them at an early stage of rehabilitation and to implement appropriate psychological and speech therapy. Objective: Identify differences in the frequency and effectiveness of cognitive-behavioral disorder therapy depending on the clinical type of stroke, assessed before and after rehabilitation treatment, and their presentation using the ICF (International Classification of Functioning, Disability, and Health) classification. Materials and Methods: The study was prospective and included the analysis of cognitive-behavioral and verbal communication disorders. The study consisted of 47 patients after intracerebral hemorrhage (ICH) and 47 patients after an ischemic stroke (IS) before the implementation of rehabilitation and after completing a 4-week rehabilitation. Results: In the group after ICH, psychological therapy significantly reduced the disturbances of consciousness and orientation (p < 0.001) and improved the speed of performing tasks in tests (p < 0.001). In patients after IS and ICH, memory and attention function improved significantly (p < 0.001). Moreover, in patients after ICH, language function deficits decreased significantly (p = 0.018). Mood disturbances were maintained in 17% of patients after ICH and 40% of patients after IS (p = 0.007). Speech therapy reduced speech articulation disorders and aphasia in 85% of patients after ICH (p = 0.001) and in 68% of patients after IS (p = 0.033). Conclusions: The frequency and type of cognitive-behavioral and verbal communication disorders vary depending on the history of ICH or IS. The ICF classification may be useful in assessing and analyzing cognitive-behavioral and verbal communication disorders, which may lead to the implementation of appropriate psychological and speech therapy at an early stage of rehabilitation and increase the effectiveness of the therapy. Full article
(This article belongs to the Special Issue Vascular Disease and Health)
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16 pages, 1287 KiB  
Article
Discrete Event Simulation Model for Cost-Effectiveness Evaluation of Screening for Asymptomatic Patients with Lower Extremity Arterial Disease
by Vojtěch Kamenský, Vladimír Rogalewicz, Ondřej Gajdoš and Gleb Donin
Int. J. Environ. Res. Public Health 2022, 19(18), 11792; https://doi.org/10.3390/ijerph191811792 - 19 Sep 2022
Viewed by 1501
Abstract
Lower limb ischemic disease (LEAD) affects a significant portion of the population, with most patients being asymptomatic. Patient screening is necessary because LEAD patients have an increased risk of occurrence of other cardiovascular events and manifestations of disease, in terms of leg symptoms [...] Read more.
Lower limb ischemic disease (LEAD) affects a significant portion of the population, with most patients being asymptomatic. Patient screening is necessary because LEAD patients have an increased risk of occurrence of other cardiovascular events and manifestations of disease, in terms of leg symptoms such as intermittent claudication, critical limb ischemia, or amputation. The aim of this work was to evaluate the cost-effectiveness of screening using ABI diagnostics in asymptomatic patients and its impact on limb symptoms associated with LEAD. A discrete event simulation model was created to capture lifetime costs and effects. Costs were calculated from the perspective of the health care payer, and the effects were calculated as QALYs. A cost-effectiveness analysis was performed to compare ABI screening examination and the situation without such screening. A probabilistic sensitivity analysis and scenario analysis were carried out to evaluate the robustness of the results. In the basic setting, the screening intervention was a more expensive intervention, at a cost of CZK 174,010, compared to CZK 70,177 for the strategy without screening. The benefits of screening were estimated at 14.73 QALYs, with 14.46 QALYs without screening. The final ICER value of CZK 389,738 per QALY is below the willingness to pay threshold. Likewise, the results of the probabilistic sensitivity analysis and of the scenario analysis were below the threshold of willingness to pay, thus confirming the robustness of the results. In conclusion, ABI screening appears to be a cost-effective strategy for asymptomatic patients aged 50 years when compared to the no-screening option. Full article
(This article belongs to the Special Issue Vascular Disease and Health)
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12 pages, 1267 KiB  
Article
The Association between Osteoporosis and Peripheral Artery Disease: A Population-Based Longitudinal Follow-Up Study in Taiwan
by De-Kai Syu, Shu-Hua Hsu, Ping-Chun Yeh, Tsung-Lin Lee, Yu-Feng Kuo, Yen-Chun Huang, Ching-Chuan Jiang and Mingchih Chen
Int. J. Environ. Res. Public Health 2022, 19(18), 11327; https://doi.org/10.3390/ijerph191811327 - 09 Sep 2022
Viewed by 1648
Abstract
Background: There are several possible links that have been used to claim that osteoporosis and peripheral artery disease (PAD) are associated; however, the solid evidence is not sufficient. This study aimed to use the Taiwan National Health Insurance Research Database (NHIRD) to determine [...] Read more.
Background: There are several possible links that have been used to claim that osteoporosis and peripheral artery disease (PAD) are associated; however, the solid evidence is not sufficient. This study aimed to use the Taiwan National Health Insurance Research Database (NHIRD) to determine if osteoporosis is associated with peripheral artery disease (PAD). Method: NHIRD records from 23 million patients were collected to recruit two matched cohort groups: 64,562 patients with and 64,562 patients without osteoporosis. To compare the crude hazard ratio (HR) and the incidence rate ratio between the two cohort groups for PAD, the Cox model was used. Result: With an adjusted HR of 1.18 (95% CI, 1.08–1.29), the osteoporosis cohort group had a significantly greater risk for PAD than the group without osteoporosis. The cumulative incidence of PAD in the cohort group was also statistically higher than it was in the group without osteoporosis (1.71% and 1.39%; p ≤ 0.0001, log-rank) over the 10-year follow-up period. In addition, the osteoporotic patients with ischemic stroke, chronic obstructive pulmonary disease (COPD), and congestive heart failure (CHF) had a significantly increased risk of PAD based on subgroup analysis. Conclusions: There was a positive association between osteoporosis and the development of PAD, as patients with osteoporosis had an increased incidence of PAD over time. Full article
(This article belongs to the Special Issue Vascular Disease and Health)
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12 pages, 3740 KiB  
Article
Arterial Stiffness and HbA1c: Association Mediated by Insulin Resistance in Hispanic Adults
by Alexandro J. Martagón, Carlos A. Fermín-Martínez, Neftali Eduardo Antonio-Villa, Roopa Mehta, Paloma Almeda-Valdés, Arsenio Vargas-Vázquez, Liliana Muñoz-Hernández, Donají V. Gómez-Velasco, Daniel Elías-López, Gabriela A. Galán-Ramírez, Fabiola Mabel del Razo-Olvera, Ivette Cruz-Bautista, Rogelio González-Arellanes and Carlos A. Aguilar-Salinas
Int. J. Environ. Res. Public Health 2022, 19(17), 11017; https://doi.org/10.3390/ijerph191711017 - 03 Sep 2022
Cited by 2 | Viewed by 1551
Abstract
Arterial stiffness may be associated with glucose metabolism parameters, such as HbA1c, mainly via insulin resistance. We aimed to investigate the association between arterial stiffness and HbA1c and explore the mediator effect of insulin resistance. In this cross-sectional study, arterial stiffness (pulse-wave velocity; [...] Read more.
Arterial stiffness may be associated with glucose metabolism parameters, such as HbA1c, mainly via insulin resistance. We aimed to investigate the association between arterial stiffness and HbA1c and explore the mediator effect of insulin resistance. In this cross-sectional study, arterial stiffness (pulse-wave velocity; PWV), HbA1c, and insulin resistance (METS-IR) were determined in Hispanic adults. In addition to sex and age, various biochemical measurements (glucose, lipid profile, etc.) and adipose tissue (fat mass and visceral fat mass) were considered as potential confounding variables. A multivariate regression analysis shows that HbA1c is associated with PWV, even after adjusting for several confounding variables. Importantly, the results show that insulin resistance mediated 17.9% of the effect of HbA1c over PWV. In conclusion, HbA1c may be a potential resource for predicting arterial stiffness due to the influence of insulin resistance in Hispanic subjects. Full article
(This article belongs to the Special Issue Vascular Disease and Health)
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10 pages, 455 KiB  
Article
Thromboelastometry as an Ancillary Tool for Evaluation of Coagulation Status after rFVIIa Therapy in a Pregnant Woman with Severe Hypoproconvertinemia—A Case Series and Review of the Literature
by Arkadiusz Krzyżanowski, Tomasz Gęca, Bożena Sokołowska, Maciej Kwiatek, Andrzej Miturski, Aleksandra Stupak, Piotr Terlecki, Piotr Paluszkiewicz and Anna Kwaśniewska
Int. J. Environ. Res. Public Health 2022, 19(17), 10918; https://doi.org/10.3390/ijerph191710918 - 01 Sep 2022
Cited by 1 | Viewed by 1366
Abstract
Introduction: Factor VII (FVII) deficiency is a rare hemorrhagic diathesis. In females, heavy menstrual and postpartum bleeding can appear as a consequence of its deficiency. Supplementation of the recombinant FVIIa is widely accepted. The supplementation effect in FVII-deficient subjects is difficult to predict, [...] Read more.
Introduction: Factor VII (FVII) deficiency is a rare hemorrhagic diathesis. In females, heavy menstrual and postpartum bleeding can appear as a consequence of its deficiency. Supplementation of the recombinant FVIIa is widely accepted. The supplementation effect in FVII-deficient subjects is difficult to predict, and severe hemorrhage has been described even when FVII levels after supplementation were within normal ranges. The aim of this report is to present the application of thromboelastometry to control the coagulation status in a patient with severe FVII deficiency during pregnancy and delivery, supplemented by rFVIIa per protocol complicated with life-threatening venous thromboembolism. Methods: Rotational thromboelastometry (ROTEM) was performed in 16 pregnant women: in one 28 year old primigravida at 35 weeks of pregnancy with congenital FVII deficiency after rFVIIa administration and 15 healthy women at 38 gestational weeks. The results were compared. Results: The thromboelastometry results showed significant shortening of the clotting time in the extrinsic and the intrinsic pathway in the hypoproconvertinemia patient after rFVIIa administration in relation to healthy pregnant women. A significant reduction in maximum lysis of the clot after FVII supplementation was observed. Conclusions: The thromboelastometry results showed a significant hypercoagulable state with hypoproconvertinemia. Thrombotic complications after delivery might be prevented by the reduction in rFVIIa guided by thromboelastometry. Thromboelastometry performed on a pregnant woman with factor VII deficiency during the supplementation of rFVIIa in peripartum time might be helpful in order to determine an individual, effective dosage regimen of rFVIIa to ensure full correction of clotting disorders without the tendency to develop thrombosis, but further studies are needed. Full article
(This article belongs to the Special Issue Vascular Disease and Health)
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18 pages, 4616 KiB  
Article
Spatiotemporal Correlation Analysis of Hydraulic Fracturing and Stroke in the United States
by Chuanbo Hu, Bin Liu, Shuo Wang, Zhenduo Zhu, Amelia Adcock, James Simpkins and Xin Li
Int. J. Environ. Res. Public Health 2022, 19(17), 10817; https://doi.org/10.3390/ijerph191710817 - 30 Aug 2022
Cited by 3 | Viewed by 2051
Abstract
Hydraulic fracturing or fracking has led to a rapid growth of oil and gas production in the United States, but the impact of fracking on public health is an important but underresearched topic. We designed a methodology to study spatiotemporal correlations between the [...] Read more.
Hydraulic fracturing or fracking has led to a rapid growth of oil and gas production in the United States, but the impact of fracking on public health is an important but underresearched topic. We designed a methodology to study spatiotemporal correlations between the risk of fracking and stroke mortality. An annualized loss expectancy (ALE) model is applied to quantify the risk of fracking. The geographically and temporally weighted regression (GTWR) model is used to analyze spatiotemporal correlations of stroke mortality, fracking ALE, and nine other socioeconomic- and health-related factors. The analysis shows that fracking ALE is moderately correlated with stroke mortality at ages over 65 in most states of fracking, in addition to cardiovascular disease and drug overdose being positively correlated with stroke mortality. Furthermore, the correlations between fracking ALE and stroke mortality in men appear to be higher than in women near the Marcellus Shale, including Ohio, Pennsylvania, West Virginia, and Virginia, while stroke mortality among women is concentrated in the Great Plains, including Montana, Wyoming, New Mexico, and Oklahoma. Lastly, within two kilometers of the fracking mining activity, the level of benzene in the air was found to be significantly correlated with the fracking activity in Colorado. Full article
(This article belongs to the Special Issue Vascular Disease and Health)
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11 pages, 954 KiB  
Article
Effects of Continuous Positive Airway Pressure Therapy on Nocturnal Blood Pressure Fluctuation Patterns in Patients with Obstructive Sleep Apnea
by Hajime Kumagai, Hiroyuki Sawatari, Tetsuro Hoshino, Noriyuki Konishi, Yuka Kiyohara, Kengo Kawaguchi, Yoko Murase, Ayako Urabe, Aki Arita and Toshiaki Shiomi
Int. J. Environ. Res. Public Health 2022, 19(16), 9906; https://doi.org/10.3390/ijerph19169906 - 11 Aug 2022
Viewed by 1627
Abstract
This retrospective study was designed to evaluate the effects of continuous positive airway pressure (CPAP) therapy, a well-established treatment for obstructive sleep apnea (OSA), on nocturnal blood pressure fluctuations (NBPFs) during rapid eye movement (REM) and non-REM sleep, and to evaluate the NBPF [...] Read more.
This retrospective study was designed to evaluate the effects of continuous positive airway pressure (CPAP) therapy, a well-established treatment for obstructive sleep apnea (OSA), on nocturnal blood pressure fluctuations (NBPFs) during rapid eye movement (REM) and non-REM sleep, and to evaluate the NBPF patterns in patients with OSA. We included 34 patients with moderate-to-severe OSA who underwent polysomnography using pulse transit time before and at 3–6 months after CPAP therapy. Nocturnal BP and NBPF frequency in REM and non-REM sleep were investigated, as well as NBPF pattern changes after receiving CPAP therapy. CPAP therapy resulted in significant reductions in the apnea–hypopnea index (AHI), arousal index, nocturnal systolic and diastolic BP, and NBPF frequency in REM and non-REM sleep (all p < 0.01). A higher AHI before CPAP resulted in lower nocturnal systolic BP (r = 0.40, p = 0.019) and NBPFs (r = 0.51, p = 0.002) after CPAP. However, 58.8% of patients showed no change in NBPF patterns with CPAP therapy. CPAP therapy significantly improved almost all sleep-related parameters, nocturnal BP, and NBPF frequency in REM and non-REM sleep periods, but NBPF patterns showed various changes post-CPAP therapy. These results suggest that factors other than OSA influence changes in NBPF patterns. Full article
(This article belongs to the Special Issue Vascular Disease and Health)
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10 pages, 564 KiB  
Article
Serum Adipocyte Fatty-Acid Binding Protein as an Independent Marker of Peripheral Artery Disease in Patients with Type-2 Diabetes Mellitus
by Bang-Gee Hsu, Chin-Yee Mah, Du-An Wu and Ming-Chun Chen
Int. J. Environ. Res. Public Health 2022, 19(15), 9459; https://doi.org/10.3390/ijerph19159459 - 02 Aug 2022
Cited by 2 | Viewed by 1348
Abstract
The adipocyte fatty-acid binding protein (A-FABP) is predominantly expressed in macrophages and adipocytes and is an essential mediator of inflammation and atherosclerosis pathogenesis. Atherosclerosis is an aggravating factor for peripheral arterial disease (PAD). Our study intended to study the association between PAD and [...] Read more.
The adipocyte fatty-acid binding protein (A-FABP) is predominantly expressed in macrophages and adipocytes and is an essential mediator of inflammation and atherosclerosis pathogenesis. Atherosclerosis is an aggravating factor for peripheral arterial disease (PAD). Our study intended to study the association between PAD and serum A-FABP levels in type-2 diabetes mellitus (T2DM) patients. One hundred and twenty T2DM subjects were enrolled in the study. Fasting blood samples were collected to determine biochemical data and A-FABP levels. By the automatic oscillometric method, the ankle–brachial index (ABI) was measured. Low ABI was defined as any value < 0.9. Twenty participants with T2DM (16.7%) were included in the low ABI group. Low ABI T2DM participants had an increased mean body mass index, body fat mass, systolic blood pressure, C-reactive protein, urine albumin–creatinine ratio, and A-FABP levels compared to those in the normal ABI group. After variables significantly associated with PAD were adjusted by multivariate logistic regression analyses, circulating A-FABP levels (odds ratio [OR]: 1.138; 95 percent confidence interval [CI]: 1.023–1.266; p = 0.017) were identified as the independent marker of PAD. In conclusion, fasting serum A-FABP value has positive association with PAD in T2DM patients. Full article
(This article belongs to the Special Issue Vascular Disease and Health)
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12 pages, 1462 KiB  
Article
Intravascular Lithotripsy as a Novel Treatment Method for Calcified Unprotected Left Main Diseases—Comparison to Rotational Atherectomy—Short-Term Outcomes
by Piotr Rola, Jan Jakub Kulczycki, Adrian Włodarczak, Mateusz Barycki, Szymon Włodarczak, Marek Szudrowicz, Łukasz Furtan, Artur Jastrzębski, Maciej Pęcherzewski, Maciej Lesiak and Adrian Doroszko
Int. J. Environ. Res. Public Health 2022, 19(15), 9011; https://doi.org/10.3390/ijerph19159011 - 25 Jul 2022
Cited by 9 | Viewed by 2184
Abstract
Background: The unprotected calcified Left Main disease represents a high-risk subset for percutaneous coronary intervention (PCI), and it is associated with a higher number of periprocedural complications and an increased rate of in-stent thrombosis and restenosis. Adequate lesion preparation plays a crucial role [...] Read more.
Background: The unprotected calcified Left Main disease represents a high-risk subset for percutaneous coronary intervention (PCI), and it is associated with a higher number of periprocedural complications and an increased rate of in-stent thrombosis and restenosis. Adequate lesion preparation plays a crucial role in achieving a favorable PCI outcome. Rotational Atherectomy (RA) is a well-established plaque-modifying method; nevertheless, the data regarding the effectiveness of RA in LM diseases is scarce. Recently, the novel ShockWave-Intravascular-Lithotripsy(S-IVL) device has been introduced to the PCI armamentarium in order to modify the calcified plaque. Methods: We performed a retrospective evaluation of 44 consecutive subjects who underwent the LM-PCI, and who were supported by either the RA or S-IVL. Results: The Rota group consisted of 29 patients with a mean syntax score of 28.0 ± 7.5. The S-IVL group was composed of 15 subjects with a syntax score of 23.3 ± 13.0 There were no statistical differences regarding MACE between the RA and Shockwave arms of the in-hospital group (10.3% vs. 6.7%), or in the six month (17.2% vs. 13.3%) follow-up group. Conclusions: RA and S-IVL could be safe and effective therapeutic strategies for calcified LM disease. Further studies with a higher number of participants and longer follow-up times are warranted to establish the potential benefits of RA and S-IVL for the management of LM stenosis. Full article
(This article belongs to the Special Issue Vascular Disease and Health)
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12 pages, 1862 KiB  
Article
Effect of Low High-Density Lipoprotein Level on Endothelial Activation and Prothrombotic Processes in Coronary Artery Disease—A Pilot Study
by Magdalena Lampka, Dorota Olszewska-Słonina, Iga Hołyńska-Iwan, Zofia Grąbczewska, Karolina Obońska, Anna Cwynar, Justyna Stępowska and Karolina Szewczyk-Golec
Int. J. Environ. Res. Public Health 2022, 19(14), 8637; https://doi.org/10.3390/ijerph19148637 - 15 Jul 2022
Cited by 2 | Viewed by 1311
Abstract
High-density lipoproteins (HDL) play an important role in the prevention of atherosclerosis. The aim of the study was to assess the relationship between serum HDL-C concentration and proinflammatory/prothrombic activation in coronary artery disease (CAD) patients. The study group included 27 acute myocardial infarction [...] Read more.
High-density lipoproteins (HDL) play an important role in the prevention of atherosclerosis. The aim of the study was to assess the relationship between serum HDL-C concentration and proinflammatory/prothrombic activation in coronary artery disease (CAD) patients. The study group included 27 acute myocardial infarction (AMI) patients and 30 stable angina pectoris (SA) patients. The control group consisted of 23 people without cardiac symptoms. In the AMI and SA groups, a lower HDL-C and a higher LDL-C/HDL-C index were observed. The SA patients had lower total cholesterol, LDL-C, sE-selectin ligand, as well as higher triglycerides and CD40 concentration in comparison with both the control and AMI groups. A higher von Willebrand Factor and intercellular adhesion molecule-1 were found in both study groups. Low HDL-C concentration in the CAD patients may intensify pro-inflammatory endothelial activation and prothrombotic processes. A low concentration of HDL-C and a high value of the LDL-C/HDL-C index seem to be better indices of atherogenic processes than the LDL-C concentration alone. Full article
(This article belongs to the Special Issue Vascular Disease and Health)
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11 pages, 814 KiB  
Article
Association of Peripheral Arterial Occlusive Disease and Deep Venous Thrombosis with Risk of Consequent Sepsis Event: A Retrospective Population-Based Cohort Study
by Bo-Yuan Wang, Ying-Hsiang Chou, Chi-Tzu Chung, Shun-Fa Yang, Shu-Ling Tzeng, Yu-Hsun Wang, Ming-Chih Chou, Chao-Bin Yeh and Chi-Ho Chan
Int. J. Environ. Res. Public Health 2022, 19(11), 6710; https://doi.org/10.3390/ijerph19116710 - 31 May 2022
Cited by 1 | Viewed by 1619
Abstract
Peripheral artery occlusive disease (PAOD) and deep vein thrombosis (DVT) can cause a variety of acute and chronic vascular complications and put patients at risk of subsequent sepsis. This study aimed to determine whether DVT compared with PAOD patients would increase the risk [...] Read more.
Peripheral artery occlusive disease (PAOD) and deep vein thrombosis (DVT) can cause a variety of acute and chronic vascular complications and put patients at risk of subsequent sepsis. This study aimed to determine whether DVT compared with PAOD patients would increase the risk of sepsis. This study recruited 43,535 patients newly diagnosed as having PAOD and 6932 patients who were newly diagnosed as having DVT from a population of 2 million patients from the Longitudinal Health Insurance Database. Propensity score matching (PSM) between the PAOD and DVT groups was performed for age, sex, comorbidities, and prior antibiotic administration. A total of 4383 patients with PAOD and 4383 patients with DVT were analyzed for risk of sepsis. The incidence density of sepsis per 1000 person years for patients with PAOD was 25.75 (95% CI = 23.90 to 27.74) and 35.61 (95% CI = 33.29 to 38.09) for patients with DVT. After age, sex, associated comorbidities, and antibiotic administration were adjusted for, the risk of sepsis for the DVT group was 1.46-fold (95% CI = 1.32–1.62) higher than that for the PAOD group. In conclusion, patients with DVT were associated with a higher risk of subsequent sepsis than patients with PAOD. Aging was another risk factor. Full article
(This article belongs to the Special Issue Vascular Disease and Health)
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11 pages, 1100 KiB  
Article
Level of Serum Fetuin-A Correlates with Heart Rate in Obstructive Sleep Apnea Patients without Metabolic and Cardiovascular Comorbidities
by Elżbieta Reichert, Jerzy Mosiewicz, Wojciech Myśliński, Andrzej Jaroszyński, Agata Stanek, Klaudia Brożyna-Tkaczyk and Barbara Madejska-Mosiewicz
Int. J. Environ. Res. Public Health 2022, 19(11), 6422; https://doi.org/10.3390/ijerph19116422 - 25 May 2022
Cited by 1 | Viewed by 1622
Abstract
Obstructive sleep apnea (OSA) is the most common type of sleep-induced breathing disorder in the adult population and significantly affects the condition of the cardiovascular system. Fetuin-A (Fet-A) is a hepato- and adipokine, which prevents vessel calcification, and its level correlates with atherogenesis [...] Read more.
Obstructive sleep apnea (OSA) is the most common type of sleep-induced breathing disorder in the adult population and significantly affects the condition of the cardiovascular system. Fetuin-A (Fet-A) is a hepato- and adipokine, which prevents vessel calcification, and its level correlates with atherogenesis and metabolic disorders. The associations of cardiovascular diseases (CVD) both with OSA, which increases CVD risk, and Fet-A, which prevents CVD, justify the question of their mutual interactions in patients with OSA. Therefore, we sought to analyze Fet-A as an early biomarker of CVD risk in OSA patients without metabolic and cardiovascular comorbidities except for properly controlled arterial hypertension. We have found that in these patients, OSA does not appear to directly affect Fet-A levels. However, high Fet-A levels were more common in the group of patients with OSA, and the hypopnea index was significantly higher among subjects with the highest Fet-A levels. The level of Fet-A in OSA patients positively correlates with pulse rate, and it does not correlate with pulse pressure in this group unlike in the control group, where such a relationship exists. To our best knowledge, this is the first study to analyze this relationship in OSA patients without any significant cardiovascular comorbidities. Full article
(This article belongs to the Special Issue Vascular Disease and Health)
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14 pages, 2986 KiB  
Article
Effect of Reconstructive Procedures of the Extracranial Segment of the Carotid Arteries on Damage to the Blood–Brain Barrier
by Piotr Terlecki, Stanisław Przywara, Karol Terlecki, Dariusz Janczak, Maciej Antkiewicz and Tomasz Zubilewicz
Int. J. Environ. Res. Public Health 2022, 19(10), 6210; https://doi.org/10.3390/ijerph19106210 - 20 May 2022
Cited by 1 | Viewed by 1504
Abstract
Introduction: Endarterectomy and angioplasty of the internal carotid artery are surgical measures for the prevention of ischemic stroke. Perioperative complications are caused by concomitant embolism and reperfusion syndrome leading to damage of the blood–brain barrier. Methods: The study included 88 patients divided into [...] Read more.
Introduction: Endarterectomy and angioplasty of the internal carotid artery are surgical measures for the prevention of ischemic stroke. Perioperative complications are caused by concomitant embolism and reperfusion syndrome leading to damage of the blood–brain barrier. Methods: The study included 88 patients divided into two groups, depending on the surgical technique used: internal carotid artery endarterectomy (CEA), 66 patients, and percutaneous carotid angioplasty and stenting (CAS), 22 patients. Blood was drawn 24 h before surgery, as well as 8, 24, and 48 h post-surgery. The assessment of damage to the blood–brain barrier was based on the evaluation of the concentration of claudin-1 and occludin, aquaporin-4, the measurements of the activity of metalloproteinase-2 (MMP-2) and -9 (MMP-9), and the assessment of central nervous system damage, measured by changes in the blood S100β protein concentration. Results: A significant increase in the concentration of the blood–brain barrier damage markers and increased MMP-2 and MMP-9 activity were found in patient blood. The degree of damage to the blood–brain barrier was higher in the CEA group. Conclusions: The authors’ own research has indicated that revascularization of the internal carotid artery may lead to damage to the central nervous system secondary to damage to the blood–brain barrier. Full article
(This article belongs to the Special Issue Vascular Disease and Health)
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10 pages, 477 KiB  
Article
A Retrospective Cohort Study of the Association between Serum Osteopontin Levels and Aortic Stiffness in Hypertensive Patients
by Yuan-Chieh Chang, Jen-Pi Tsai, Ji-Hung Wang and Bang-Gee Hsu
Int. J. Environ. Res. Public Health 2022, 19(1), 477; https://doi.org/10.3390/ijerph19010477 - 02 Jan 2022
Cited by 1 | Viewed by 1387
Abstract
By suppressing mineralization and preventing ectopic calcium deposits, osteopontin (OPN) has an inhibitory effect on vascular calcification. Also, there is an association between OPN and aortic stiffness (AS). We aimed to investigate the association between serum OPN levels and AS measured by carotid–femoral [...] Read more.
By suppressing mineralization and preventing ectopic calcium deposits, osteopontin (OPN) has an inhibitory effect on vascular calcification. Also, there is an association between OPN and aortic stiffness (AS). We aimed to investigate the association between serum OPN levels and AS measured by carotid–femoral pulse wave velocity (cfPWV) in hypertensive patients. Baseline characteristics and fasting blood sampling of 120 participants with hypertension and 120 participants without hypertension were acquired. Serum OPN concentrations were determined by enzyme-linked immunosorbent assay. In total, 43 (35.9%) participants were assigned to the AS group with cfPWV of >10 m/s in hypertensive patients. There were more patients with diabetes mellitus, old age, high systolic blood pressure, high serum intact parathyroid hormone (iPTH), elevated C-reactive protein, and high OPN levels in the AS group compared with the control group in hypertensive participants. A multivariate logistic regression analysis discloses that age, SBP, serum OPN, and iPTH levels were independently associated with AS in hypertensive patients. Moreover, according to a multivariate forward stepwise linear regression analysis, OPN level is positively associated with cfPWV. In conclusion, serum OPN level is assumed to be a potential biomarker to predict AS and is positively associated with cfPWV in patients with hypertension. Full article
(This article belongs to the Special Issue Vascular Disease and Health)
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Review

Jump to: Research, Other

18 pages, 416 KiB  
Review
Ischemic and Hemorrhagic Cerebrovascular Events Related to COVID-19 Coagulopathy and Hypoxemia
by Michał Sojka, Anna Drelich-Zbroja, Maryla Kuczyńska, Mateusz Cheda, Izabela Dąbrowska, Ewa Kopyto, Izabela Halczuk, Monika Zbroja, Weronika Cyranka and Tomasz Jargiełło
Int. J. Environ. Res. Public Health 2022, 19(18), 11823; https://doi.org/10.3390/ijerph191811823 - 19 Sep 2022
Cited by 6 | Viewed by 1762
Abstract
Since the very beginning of the COVID-19 pandemic, numerous researchers have made an effort to determine the molecular composition of the SARS-CoV-2 virus, and the exact pathomechanism through which the virus exerts such a devastating effect on the host/infected organism. Recent scientific evidence [...] Read more.
Since the very beginning of the COVID-19 pandemic, numerous researchers have made an effort to determine the molecular composition of the SARS-CoV-2 virus, and the exact pathomechanism through which the virus exerts such a devastating effect on the host/infected organism. Recent scientific evidence highlights the affinity of the virus towards ACE2 receptors, which are widespread in multiple human systems, including the central nervous system (CNS) and cerebral vessels. Such an affinity may explain endothelial dysfunction and damage that is observed in COVID-positive patients in histopathological studies, with subsequent dysregulation of the cerebral circulation leading to transient or acute cerebrovascular accidents. In this paper, we aimed to evaluate the effects of COVID-related hypoxemia and direct viral invasion on the cerebral circulation, with special respect to the postulated pathomechanism, vulnerable groups of patients, clinical course and outcomes, as well as diagnostic imaging findings. Full article
(This article belongs to the Special Issue Vascular Disease and Health)
16 pages, 906 KiB  
Review
Endothelial Function Assessment by Flow-Mediated Dilation Method: A Valuable Tool in the Evaluation of the Cardiovascular System
by Szymon Mućka, Martyna Miodońska, Grzegorz K. Jakubiak, Monika Starzak, Grzegorz Cieślar and Agata Stanek
Int. J. Environ. Res. Public Health 2022, 19(18), 11242; https://doi.org/10.3390/ijerph191811242 - 07 Sep 2022
Cited by 28 | Viewed by 3466
Abstract
Cardiovascular diseases (CVDs) in the course of atherosclerosis are one of the most critical public health problems in the world. Endothelial cells synthesize numerous biologically active substances involved in regulating the functions of the cardiovascular system. Endothelial dysfunction is an essential element in [...] Read more.
Cardiovascular diseases (CVDs) in the course of atherosclerosis are one of the most critical public health problems in the world. Endothelial cells synthesize numerous biologically active substances involved in regulating the functions of the cardiovascular system. Endothelial dysfunction is an essential element in the pathogenesis of atherosclerosis. Thus, the assessment of endothelial function in people without overt CVD allows for a more accurate estimate of the risk of developing CVD and cardiovascular events. The assessment of endothelial function is primarily used in scientific research, and to a lesser extent in clinical practice. Among the tools for assessing endothelial function, we can distinguish biochemical and physical methods, while physical methods can be divided into invasive and non-invasive methods. Flow-mediated dilation (FMD) is based on the ultrasound assessment of changes in the diameter of the brachial artery as a result of increased blood flow. FMD is a non-invasive, safe, and repeatable test, but it must be performed by qualified and experienced medical staff. The purpose of this paper is to present the literature review results on the assessment of endothelial function using the FMD method, including its methodology, applications in clinical practice and research, limitations, and future perspectives. Full article
(This article belongs to the Special Issue Vascular Disease and Health)
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14 pages, 407 KiB  
Review
Arterial Stiffness Assessment by Pulse Wave Velocity in Patients with Metabolic Syndrome and Its Components: Is It a Useful Tool in Clinical Practice?
by Monika Starzak, Agata Stanek, Grzegorz K. Jakubiak, Armand Cholewka and Grzegorz Cieślar
Int. J. Environ. Res. Public Health 2022, 19(16), 10368; https://doi.org/10.3390/ijerph191610368 - 19 Aug 2022
Cited by 24 | Viewed by 3358
Abstract
Metabolic syndrome (MS) is not a single disease but a cluster of metabolic disorders associated with increased risk for development of diabetes mellitus and its complications. Currently, the definition of MS published in 2009 is widely used, but there are more versions of [...] Read more.
Metabolic syndrome (MS) is not a single disease but a cluster of metabolic disorders associated with increased risk for development of diabetes mellitus and its complications. Currently, the definition of MS published in 2009 is widely used, but there are more versions of the diagnostic criteria, making it difficult to conduct scientific discourse in this area. Increased arterial stiffness (AS) can predict the development of cardiovascular disease both in the general population and in patients with MS. Pulse wave velocity (PWV), as a standard method to assess AS, may point out subclinical organ damage in patients with hypertension. The decrease in PWV level during antihypertensive therapy can identify a group of patients with better outcomes independently of their reduction in blood pressure. The adverse effect of metabolic disturbances on arterial function can be offset by an adequate program of exercises, which includes mainly aerobic physical training. Non-insulin-based insulin resistance index can predict AS due to a strong positive correlation with PWV. The purpose of this paper is to present the results of the review of the literature concerning the relationship between MS and its components, and AS assessed by PWV, including clinical usefulness of PWV measurement in patients with MS and its components. Full article
(This article belongs to the Special Issue Vascular Disease and Health)
11 pages, 1424 KiB  
Review
Approaches to Peripheral Artery Disease in Diabetes: Are There Any Differences?
by Alexandru Achim, Agata Stanek, Călin Homorodean, Mihail Spinu, Horea Laurenţiu Onea, Leontin Lazăr, Mădălin Marc, Zoltán Ruzsa and Dan Mircea Olinic
Int. J. Environ. Res. Public Health 2022, 19(16), 9801; https://doi.org/10.3390/ijerph19169801 - 09 Aug 2022
Cited by 25 | Viewed by 2700
Abstract
Peripheral artery disease (PAD) increases the risk of diabetes, while diabetes increases the risk of PAD, and certain symptoms in each disease increase the risk of contracting the other. This review aims to shed light on this harmful interplay between the two disorders, [...] Read more.
Peripheral artery disease (PAD) increases the risk of diabetes, while diabetes increases the risk of PAD, and certain symptoms in each disease increase the risk of contracting the other. This review aims to shed light on this harmful interplay between the two disorders, with an emphasis on the phenotype of a patient with both diabetes and PAD, and whether treatment should be individualized in this high-risk population. In addition, current guideline recommendations for the treatment of PAD were analyzed, in an attempt to establish the differences and evidence gaps across a population suffering from these two interconnected disorders. Full article
(This article belongs to the Special Issue Vascular Disease and Health)
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23 pages, 479 KiB  
Review
Pathogenesis and Clinical Significance of In-Stent Restenosis in Patients with Diabetes
by Grzegorz K. Jakubiak, Natalia Pawlas, Grzegorz Cieślar and Agata Stanek
Int. J. Environ. Res. Public Health 2021, 18(22), 11970; https://doi.org/10.3390/ijerph182211970 - 15 Nov 2021
Cited by 55 | Viewed by 5328
Abstract
Diabetes mellitus (DM) is a strong risk factor for the development of cardiovascular diseases such as coronary heart disease, cerebrovascular disease, and peripheral arterial disease (PAD). In the population of people living with DM, PAD is characterised by multi-level atherosclerotic lesions as well [...] Read more.
Diabetes mellitus (DM) is a strong risk factor for the development of cardiovascular diseases such as coronary heart disease, cerebrovascular disease, and peripheral arterial disease (PAD). In the population of people living with DM, PAD is characterised by multi-level atherosclerotic lesions as well as greater involvement of the arteries below the knee. DM is also a factor that significantly increases the risk of lower limb amputation. Percutaneous balloon angioplasty with or without stent implantation is an important method of the treatment for atherosclerotic cardiovascular diseases, but restenosis is a factor limiting its long-term effectiveness. The pathogenesis of atherosclerosis in the course of DM differs slightly from that in the general population. In the population of people living with DM, more attention is drawn to such factors as inflammation, endothelial dysfunction, platelet dysfunction, blood rheological properties, hypercoagulability, and additional factors stimulating vascular smooth muscle cell proliferation. DM is a risk factor for restenosis. The purpose of this paper is to provide a review of the literature and to present the most important information on the current state of knowledge on mechanisms and the clinical significance of restenosis and in-stent restenosis in patients with DM, especially in association with the endovascular treatment of PAD. The role of such processes as inflammation, neointimal hyperplasia and neoatherosclerosis, allergy, resistance to antimitotic drugs used for coating stents and balloons, genetic factors, and technical and mechanical factors are discussed. The information on restenosis collected in this publication may be helpful in planning further research in this field, which may contribute to the formulation of more and more precise recommendations for the clinical practice. Full article
(This article belongs to the Special Issue Vascular Disease and Health)

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9 pages, 2171 KiB  
Case Report
Diabetic Muscle Infarction—A Rare Diabetic Complication: Literature Review and Case Report
by Maciej Rabczyński, Monika Fenc, Edwin Kuźnik, Paweł Lubieniecki and Agnieszka Hałoń
Int. J. Environ. Res. Public Health 2023, 20(4), 3390; https://doi.org/10.3390/ijerph20043390 - 15 Feb 2023
Cited by 1 | Viewed by 1433
Abstract
We present a case of a 31-year-old patient with type 1 diabetes diagnosed at the age of 6. Diabetes is complicated with neuropathy, retinopathy, and nephropathy. He has been admitted to the diabetes ward due to inadequate diabetes control. Gastroscopy and abdominal CT [...] Read more.
We present a case of a 31-year-old patient with type 1 diabetes diagnosed at the age of 6. Diabetes is complicated with neuropathy, retinopathy, and nephropathy. He has been admitted to the diabetes ward due to inadequate diabetes control. Gastroscopy and abdominal CT were performed, and gastroparesis was confirmed as an explanation for postprandial hypoglycemia. During hospitalization, the patient reported sudden pain localized on the lateral, distal part of his right thigh. The pain occurred at rest and was aggravated by movement. Diabetic muscle infarction (DMI) is a rare complication of long-lasting, uncontrolled diabetes mellitus. It usually occurs spontaneously, without any previous infection or trauma, and is often misdiagnosed clinically as an abscess, neoplasm, or myositis. DMI patients suffer from pain and swelling of the affected muscles. Radiological examinations, including MRI, CT, and USG, are most important for the diagnosis, assessing the extent of involvement and differentiating DMI from other conditions. However, sometimes a biopsy and histopathological examination are necessary. The optimal treatment has still not been determined. There is also a potential risk of DMI recurrence. Full article
(This article belongs to the Special Issue Vascular Disease and Health)
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49 pages, 1755 KiB  
Systematic Review
A Systematic Review on Attenuation of PCSK9 in Relation to Atherogenesis Biomarkers Associated with Natural Products or Plant Bioactive Compounds in In Vitro Studies: A Critique on the Quality and Imprecision of Studies
by Rahayu Zulkapli, Mohd Yusmiaidil Putera Mohd Yusof, Suhaila Abd Muid, Seok Mui Wang, Al’Aina Yuhainis Firus Khan and Hapizah Nawawi
Int. J. Environ. Res. Public Health 2022, 19(19), 12878; https://doi.org/10.3390/ijerph191912878 - 08 Oct 2022
Cited by 2 | Viewed by 1818
Abstract
A systematic review was performed to identify all the related publications describing PCSK9 and atherogenesis biomarkers attenuation associated with a natural product and plant bioactive compounds in in vitro studies. This review emphasized the imprecision and quality of the included research rather than [...] Read more.
A systematic review was performed to identify all the related publications describing PCSK9 and atherogenesis biomarkers attenuation associated with a natural product and plant bioactive compounds in in vitro studies. This review emphasized the imprecision and quality of the included research rather than the detailed reporting of the results. Literature searches were conducted in Scopus, PubMed, and Science Direct from 2003 until 2021, following the Cochrane handbook. The screening of titles, abstracts, and full papers was performed by two independent reviewers, followed by data extraction and validity. Study quality and validity were assessed using the Imprecision Tool, Model, and Marker Validity Assessment that has been developed for basic science studies. A total of 403 articles were identified and 31 of those that met the inclusion criteria were selected. 13 different atherogenesis biomarkers in relation to PCSK9 were found, and the most studied biomarkers are LDLR, SREBP, and HNF1α. In terms of quality, our review suggests that the basic science study in investigating atherogenesis biomarkers is deficient in terms of imprecision and validity. Full article
(This article belongs to the Special Issue Vascular Disease and Health)
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