Ankle-brachial index and brachial-ankle pulse wave velocity are risk factors for ischemic stroke in patients with type 2 diabetes

The incidence of ischemic stroke in patients with diabetes is increasing. While brachial-ankle pulse wave velocity （BaPWV） and ankle-bra- chial index （ABI） are known to be associated with ischemic cardiovascular and cerebrovascular diseases, whether these measures predict the risk of ischemic cerebrovascular disease in diabetic patients remains unclear. 117 patients with type 2 diabetes were enrolled in this study. According to the results of head magnetic resonance imaging, the patients were divided into a diabetes-only group （n = 55） and a diabetes and ischemic stroke group （n = 62）. We then performed ABI and BaPWV examinations for all patients. Compared with the diabe- tes-only group, we found decreased ABI and increased BaPWV in the diabetes and ischemic stroke group. Multivariate logistic regression analyses revealed that BaPWV and ABI were risk factors for ischemic stroke in patients with type 2 diabetes. Our findings indicate that decreased ABI and increased BaPWV are objective indicators of increased risk of ischemic stroke in patients with type 2 diabetes.

Serum Calcium Level is Associated with Brachial-ankle Pulse Wave Velocity in Middle-aged and Elderly Chinese

Objective To study the relation between serum calcium level and elevated BaPWV in Chinese subjects. Methods The relation between serum calcium level and elevated BaPWV was studied in 9 615 subjects. The mean value of left and right BaPWV was analyzed. BaPWV was defined as high when it was31 752.5 cm/s （the upper quartile） either side. Results The BaPWV and its elevated percentage progressively increased across the quartiles of the serum calcium level （P〈0.05）. The prevalence of elevated BaPWV was significantly higher in subjects of the second, third and highest quartiles than in those of the lowest quartile （26.9%, 28.4%, and 33.2%vs 23.7%, P=0.0116, P=0.0004, and P〈0.0001）. Logistic regression analysis revealed that the risk of elevated BaPWV was 1.32- fold higher in subjects of the highest quartile than in those of the lowest quartile （OR=1.32, 95%CI：1.08-1.60）. Conclusion The elevated serum calcium level is related to an elevated BaPWV and a higher risk of arterial stiffness, independent of conventional risk factors, in middle-aged and elderly Chinese subjects.

Relationship between the Plasma Fibulin-1 Levels,Pulse Wave Velocity,and Vascular Age in Asymptomatic Hyperuricemia

Fibulin-1(FBLN-1),an elastin-associated extracellular matrix protein,has been found in blood and may play a role in the pathophysiological processes leading to cardiovascular disease(CVD).We aimed to investigate the relationship between fibulin-1 levels and the risk of CVD by evaluating vascular age derived from the Framingham Heart Study and brachial-ankle Pulse Wave Velocity(baPWV)in patients with asymptomatic hyperuricemia(AHU).In total,66 patients with AHU and 66 gender-and age-matched healthy individuals were enrolled.The plasma fibulin-1 levels were measured by immunochemistry.Patients with AHU presented significantly higher vascular age[median(interquartile range):54(22)vs.48(14)years,P=0.01]and baPWV[mean±SD:1373±223 vs.1291±177 cm/s,P=0.02]than the healthy subjects;however,no significant difference was observed in the plasma fibulin-1 level between the patients with AHU and healthy subjects[median(interquartile range):4018(3838)vs.3099(3405)ng/mL,P=0.31].A correlation between fibulin-1 levels and baPWV was observed only in patients with AHU(r=0.29,P=0.02);and there was also a suggestively statistically significant correlation between fibulin-1 levels and vascular age(r=0.22,P=0.08).However,these associations were rendered insignificant after adjustments for potential confounders.In healthy subjects,no correlation was observed between fibulin-1 levels and CVD risk.This study reveals that plasma fibulin-1 levels may reflect the CVD risk in patients with AHU,but the relationship is not robust.

Relationship between brachial-ankle pulse wave velocity and metabolic syndrome components in a Chinese population

The purpose of this study was to assess the relationship between arterial stiffness, as measured by brachial-ankle pulse wave velocity （baPWV）, and the presence of the metabolic syndrome （MS） in a Chinese population. A total of 4,445 subjects were enrolled. The prevalence of MS in for the general population, males and females, respectively. our study population was 21.7%, 17.2% and 25.6% With adjustments for age, gender, cigarette smoking, heart rate, total cholesterol, low-density lipoprotein （LDL） cholesterol, and the use of anti-hypertensive drug, the stepwise regression analysis showed that baPWV had a significant relationship with components of MS, including systolic blood pressure （P 〈 0.001）, diastolic blood pressure （P 〈 0.001）, glucose （P 〈 0.001）, highdensity lipoprotein （HDL） cholesterol （P = 0.04）, and triglycerides （P 〈 0.001）, but no relationship with waist circumference （P = 0.25）. With an increase in the number of the MS components, baPWV increased significantly both in women and men. This study indicated that the MS is indeed a risk factor for arterial stiffness. Monitoring of baPWV in patients with MS may help in identifying persons at high risk for cardiovascular disease.

Association of Estimated Pulse Wave Velocity and the Dynamic Changes in Estimated Pulse Wave Velocity with All-Cause Mortality among Middle-Aged and Elderly Chinese

Objective We aimed to clarify the association between estimated pulse wave velocity(ePWV)and the changes in ePWV with all-cause mortality among middle-aged and elderly Chinese.Methods Data were obtained from the China Health and Retirement Longitudinal Study(CHARLS)from 2011-2018.The ePWV was calculated using an equation that included age and mean blood pressure(MBP).The ΔePWV was assessed as the difference in ePWV between the first two waves.Cox proportional hazard models were used to determine the association between ePWV and ΔePWV with all-cause mortality after adjustment for potential confounders.Results Of 13,116 participants during a median follow-up of 7.0 years,1,356 deaths occurred.An increased ePWV was independently associated with all-cause mortality.The hazard ratio[95% confidence interval(CI)]for participants from the 1^(st)-4^(th) quartile groups was 1.00,1.69(1.31-2.18),3.09(2.44-3.91),and 8.54(6.78-10.75),respectively.Each standard deviation(SD)increment of ePWV increased the risk of all-cause mortality by 132%.Furthermore,theΔePWV was significantly associated with a 1.28-fold(95%CI,1.18-1.38)risk of all-cause mortality per SD increment.Conclusion This cohort study provided novel evidence from a Chinese population that an increased ePWV or progression of the ePWV was independently associated with all-cause mortality,which highlighted the importance of mitigating ePWV progression in clinical practice.

Local Pulse Wave Velocity Estimation in the Carotids Using Dynamic MR Sequences

The current study presents a new protocol for local pulse wave velocity (PWV) measurement using dynamic MR sequences, which have a high temporal resolution (TR < 6 ms). MR images were obtained at two positions along the common carotid artery, separated by a distance of 5 cm. In each phase of a MR series, carotid region was automatically extracted and then its area distension waveform could be obtained. Sixteen volunteers with no symptoms of cardiovascular diseases were studied. For local PWV estimation, three delay estimation principles were tested and produced the following values: intersecting tangents method (M1): 4.72 ± 1.40 m/s, second derivative method (M2): 4.94 ± 1.68 m/s and cross-correlation method (M3): 5.03 ± 1.17 m/s. The cross-correlation method showed a relative high reliability as its least standard deviation.

Increased brachial-ankle pulse wave velocity is associated with impaired endothelial function in patients with coronary artery disease

Background Pulse wave velocity and flow-mediated vasodilation （FMD） are widely used as noninvasive modalities for evaluating atherosclerosis. However, it is not known whether pulse wave velocity is related to FMD in patients with coronary artery disease （CAD）. Therefore, the present study was designed to investigate the alteration in brachial-ankle pulse wave velocity （baPWV） and endothelial function in CAD patients. Methods Thirty-three patients with CAD and thirty control subjects were recruited for this study, baPWV was measured non-invasively using a VP 1000 automated PWV/ABI analyzer （PWV/ABI, Colin Co. Ltd., Komaki, Japan）. Endothelial function as reflected by FMD in the brachial artery was assessed with a high-resolution ultrasound device. Results baPWV was increased in CAD patients compared with control subjects [（1756.1±253.1） cm/s vs （1495.3±202.3） cm/s, P〈0.01]. FMD was significantly reduced in CAD patients compared with control subjects [（5.2±2.1） % vs （11.1±4.4） %, P〈0.01]. baPWV correlated with FMD （r =-0.68, P〈0.001）. The endothelium-independent vasodilation induced by sublingual nitroglycerin in the brachial artery was similar in the CAD group compared with the control group.Conclusions CAD is associated with increased baPWV and endothelial dysfunction. Increased baPWV parallels diminished endothelial function. Our data therefore suggest that baPWV can be used as a noninvasive surrogate index in clinical evaluation of endothelial function.

Reference values of brachial-ankle pulse wave velocity for Northern Chinese

Background Brachial-ankle pulse wave velocity （baPWV） is a reliable method for measuring arterial elasticity, but the absence of reference value for baPWV has limited its wide use. We conducted an epidemical study in north China to investigate the reference value of baPWV for Chinese people and its influential factors. Methods A total of 974 identified healthy subjects were recruited in this study. The values of baPWV were evaluated noninvasively with an automatic device. Results For healthy population, the mean value of baPWV was higher for male （P 〈0.001）. Multiple regression analysis demonstrated that both age and systolic blood pressure were positively associated with baPWV for male and female （P 〈0.001）. BaPWV value was higher in male than in female in younger group （〈50 years） but not in older group （P〈-0.001）. The upper limits of baPWV were 1394/1264 cm/s, 1435/1361 cm/s, 1552/1433 cm/s, 1597/1609 cm/s and 1798/1915 cm/s for healthy male/female at 10 years interval （age range 20-70 years）. Conclusions Aging is the most important reason of arterial stiffness, but the effect of age on baPWV augmentation is greater for healthy female than their male counterpart. The reference values of baPWV by sex and age are very useful for clinical and preventive medicine.

Can we early diagnose metabolic syndrome using brachial-ankle pulse wave velocity in community population？

Background The prevalence of metabolic syndrome （MetS） increased recently and there was still not a screening index to predict MetS.The aim of this study was to estimate whether brachial-ankle pulse wave velocity （baPVVV）,a novel marker for systemic arterial stiffness,could predict MetS in Chinese community population.Methods A total of 2 191 participants were recruited and underwent medical examination including 1 455 men and 756 women from June 2011 to January 2012.MetS was diagnosed according to the criteria of the International Diabetes Federation （IDF）.Multiple Logistic regressions were conducted to explore the risk factors of MetS.Receiver operating characteristic （ROC） curve was performed to estimate the ideal diagnostic cutoff point of baPWV to predict MetS.Results The mean age was （45.35±8.27） years old.In multiple Logistic regression analysis,the gender,baPWV and smoking status were risk factors to MetS after adjusting age,gender,baPWV,walk time and sleeping time.The prevalence of MetS was 17.48% in 30-year age population in Shanghai.There were significant differences （Х^2=96.46,P 〈0.05） between male and female participants on MetS prevalence.According to the ROC analyses,the ideal cutoff point of baPWV was 1 358.50 cm/s （AUC=60.20%） to predict MetS among male group and 1 350.00 cm/s （AUC=70.90%） among female group.Conclusion BaPWV may be considered as a screening marker to predict MetS in community Chinese population and the diagnostic value of 1 350.00 cm/s was more significant for the female group.

Relationship between Neutrophil-to-Lymphocyte Ratio and Pulse Wave Velocity in Young Patients with Systemic Lupus Erythematosus

Background： The incidence of atherosclerosis-related myocardial infarction can be as much as 50-fold greater in young patients with systemic lupus e~,thematosus （SLE） than in age-matched controls. There are several explanations for this phenomenon, all of which result in a chronic state of low-grade inflammation. Recently, the neutrophil-to-lynlphocyte ratio （NLR） has been proposed as a useliil biomarker of inflammation. Pulse wave velocity （PWV） is a reliable indicator of vascular damage and atherosclerosis. There is a paucity of data concerning the relationship between NLR and atherosclerosis as measured by PWV in patients with SLE. This study aimed to verify whether there is a positive correlation between NLR and PWV and to explore factors that influence PWV in young SLE patients. Methods： A total of 90 female patients with SLE were enrolled in this cross-sectional investigation. Traditional and nontraditional cardiovascular risk factors were assessed on the same day that brachial-ankle PWV （baPWV） was examined. The patients were divided into three groups according to their mean baPWV values： patients whose mean baPWV value was lower than the first tertile were placed in Group 1 ： patients whose mean baPWV value was between the first tertile and the second tertile were placed in Group 2： and patients whose mean baPWV value was higher than the second tertile were placed in Group 3. SPSS 20.0 was used to perform all statistical analyses in this study. Both univariate linear regression and multivariate regression models were utilized to analyze the association between NLR and arterial stiffness. Results： Systolic blood pressure, diastolic blood presstire （DBP）. and triglycerides were all significantly different among Groups 1,2, and 3 （ 111.90 ± 12.85 mmHg vs. 114.60 ± 12.88 mmHg vs. 129.43 ±16.21 mmHg, P 〈 0.001 ： 68.77 ± 8.63 mmHg vs. 71.87 ± 9.77 mmHg vs. 82.57 ± 14.89 mmHg, P 〈 0.001 ; and 1.44 [0.91-2.47] mmol/L vs. 0.98 [0.78-1.26] mmol/L vs. 2.20 [0.94-3.66] mmol/L P = 0.030： respectively）, as were creatinine （57.50 [52.00-69.00] mmol/L vs. 55.50 [49.00-64.00] mmol/L vs. 64.00 [56.00-86.00] mmol/L P = 0.045） and blood urea nitrogen （4.27 [3.79-6.22] mmol/L vs. 4.16 [3.47-4.84] mmol/L vs. 5.88 [4.04-8.19] mmol/L, P = 0.011 ）. NLRs were significantly different among Groups 1, 2, and 3 （2.16 [1.56-3.42] vs. 3.12 [1.91-4.19] vs. 5.29 [2.63-7.25], P = 0.001）. N LR, together with DBP and the SLE disease activity index, independently predicts PWV. Conclusions： This study demonstrated that there was a positive correlation between NLR and PWV. Moreover, we found that disease activity and DBP were also positively correlated with PWV.

New definition of metabolic dysfunction-associated fatty liver disease with elevated brachial-ankle pulse wave velocity and albuminuria: a prospective cohort study

A new definition of metabolic dysfunction-associated fatty liver disease(MAFLD)has recently been proposed.We aim to examine the associations of MAFLD,particularly its discordance from non-alcoholic fatty liver disease(NAFLD),with the progression of elevated brachial-ankle pulse wave velocity(baPWV)and albuminuria in a community-based study sample in Shanghai,China.After 4.3 years of follow-up,778 participants developed elevated baPWV and 499 developed albuminuria.In comparison with the non-MAFLD group,the multivariable adjusted odds ratio(OR)of MAFLD group for new-onset elevated baPWV was 1.25(95%confidence interval(CI)1.01–1.55)and 1.35(95%CI 1.07–1.70)for albuminuria.Participants without NAFLD but diagnosed according to MAFLD definition were associated with higher risk of incident albuminuria(OR 1.77;95%CI 1.07–2.94).Patients with MAFLD with high value of hepamet fibrosis score or poor-controlled diabetes had higher risk of elevated baPWV or albuminuria.In conclusion,MAFLD was associated with new-onset elevated baPWV and albuminuria independently of body mass index,waist circumference,and hip circumference.Individuals without NAFLD but diagnosed as MAFLD had high risk of albuminuria,supporting that MAFLD criteria would be practical for the evaluation of long-term risk of subclinical atherosclerosis among fatty liver patients.

Altered heart rate variability and pulse-wave velocity after spinal cord injury

BACKGROUND Heart rate variability(HRV) and pulse-wave velocity(PWV),indicators of cardiac function,are altered in patients with spinal cord injury(SCI),suggesting that autonomic cardiac function and arterial stiffness may underlie the high risk of cardiovascular complications in these patients.No study has simultaneously investigated HRV and PWV in the same patients.AIM To evaluate cardiovascular complications in SCI patients by comparing HRV and PWV between patients with and without SCI.METHODS In this cross-sectional pilot study,patients with(n = 60) and without SCI(n = 60) were recruited from December 7,2019 to January 21,2020.Each participant received a five-minute assessment of HRV and the cardiovascular system using the Medicore HRV Analyzer SA-3000 P.Differences in HRV and PWV parameters between participants with and without SCI were statistically examined.RESULTS We observed a significant difference between participants with and without SCI with respect to the standard deviation of all normal-to-normal intervals,square root of the mean sum of squared successive risk ratio interval differences,physical stress index,total power,very-low frequency,low frequency,high frequency,and arterial elasticity.CONCLUSION Patients with SCI have weaker sympathetic and parasympathetic activity as well as lower arterial elasticity compared to those without,suggesting that SCI may increase cardiac function loading.

Relationship of plasma level of Lp-PLA_2 and pulse wave velocity and carotid intima-media thickness

Background Increased plasma level of Lp-PLA2 is a potential risk factor for atherosclerosis. Nevertheless, whether Lp-PLA2 has effects on both vascular function and structure changes is still unclear. Method One hundred and eighty-six outpatient subjects without overt cardiovascular disease were enrolled and anthropomet- ric data, plasma level of Lp-PLA2 and other related laboratory parameters were collected. Measurements of pulse wave velocity （PWV） and carotid intima-media thickness （CIMT） were performed by an experienced investigator. According to plasma level of Lp-PLA2, all the subjects were divided into two groups as follows： 〈 200 ng/mL （n = 96） and ≥200 ng/mL （n = 90）. Result Body mass index, smoking, diabetic mellitus, systolic blood pressure, and LDL-C level were positive correlation with plasma level of Lp-PLA2, while use of statins was negatively correlative. Both PWV and CIMT positively correlated with smoking, systolic blood pressure, LDL-C level and plasma level of Lp-PLA2, while negatively correlated with HDL-C level and usage of statins. CIMT in the group with plasma level of Lp-PLA2 〈 200 ng/mL （0.9 ± 0.2 mm, n = 96） was sig- nificantly less than that with plasma level of Lp-PLA2≥200 ng/mL （1.2 ±0.4 mm, n = 90, P = 0.32）, and similar finding was also observed in PWV （9.1± 0.5 m/s vs 12.7 ± 0.4 m/s, P = 0.38）. Conclusion Our present study shows that in subjects without overt CVD, increased plasma level of Lp-PLA2 is associated with vascular function （PWV） and structure （CIMT） deterioration.

Correlations between ultrasonic pulse wave velocities and rock properties of quartz-mica schist

Physico-mechanical properties are critically important parameters for rocks. This study aims to examine some of the rock properties of quartz-mica schist（QMS） rocks in a cost-effective manner by establishing correlations between non-destructive and destructive tests. Using simple regression analysis, good correlations were obtained between the pulse wave velocities and the properties of QMS rocks. The results were further improved by using multiple regression analysis as compared to those obtained by the simple linear regression analysis. The results were also compared to the ones obtained by other empirical equations available. The general equations encompassing all types of rocks did not give reliable results of rock properties and showed large relative errors, ranging from 23% to 1146%. It is suggested that empirical correlations must be investigated separately for different types of rocks. The general empirical equations should not be used for the design and planning purposes before they are verified at least on one rock sample from the project site, as they may contain large unacceptable errors.

Association between Gene Polymorphisms and SNP-SNP Interactions of the Matrix Metalloproteinase 2 Signaling Pathway and the Risk of Vascular Senescence

Objective This study aimed to explore the association of single nucleotide polymorphisms(SNP)in the matrix metalloproteinase 2(MMP-2)signaling pathway and the risk of vascular senescence(VS).Methods In this cross-sectional study,between May and November 2022,peripheral venous blood of151 VS patients(case group)and 233 volunteers(control group)were collected.Fourteen SNPs were identified in five genes encoding the components of the MMP-2 signaling pathway,assessed through carotid-femoral pulse wave velocity(cf PWV),and analyzed using multivariate logistic regression.The multigene influence on the risk of VS was assessed using multifactor dimensionality reduction(MDR)and generalized multifactor dimensionality regression(GMDR)modeling.Results Within the multivariate logistic regression models,four SNPs were screened to have significant associations with VS:chemokine(C-C motif)ligand 2(CCL2)rs4586,MMP2 rs14070,MMP2rs7201,and MMP2 rs1053605.Carriers of the T/C genotype of MMP2 rs14070 had a 2.17-fold increased risk of developing VS compared with those of the C/C genotype,and those of the T/T genotype had a19.375-fold increased risk.CCL2 rs4586 and MMP-2 rs14070 exhibited the most significant interactions.Conclusion CCL2 rs4586,MMP-2 rs14070,MMP-2 rs7201,and MMP-2 rs1053605 polymorphisms were significantly associated with the risk of VS.

Evaluating Arterial Stiffness in Type 2 Diabetes Patients Using Ultrasonic Radiofrequency

Differences in arterial stiffness between the two sides of the carotid arteries were investigated using ultrasonic radiofrequency in 88 patients with type 2 diabetes and 70 controls. The compliance coefficient（CC）, pulse wave velocity（PWV）, intima-media thickness（CIMT） and diameter（CCAD） of the common carotid arteries（CCAs） were measured. The ratio of the left to right CCAs was calculated to provide four indexes： CC ratio, PWV ratio, CIMT ratio and CCAD ratio. In the diabetes group, the PWV on the left side was significantly higher than that on the right side, while the CC on the left side was significantly lower than that on the right side. The bilateral CIMT was thicker and CCAD was wider, the left PWV traveled faster, and the right CC was higher in the diabetes group than in the control group. The PWV ratio between the two groups was significantly different and correlated positively with duration of diabetes and systolic blood pressure（SBP）. The differences between the two sides of CCAs in patients with diabetes suggested that disease duration and SBP were important risk factors for arterial stiffness. Identifying the difference could potentially lead to the much earlier diagnosis of arteriosclerosis.

Association between dairy intake,lipids and vascular structure and function in diabetes

AIM To determine lipid species that change in response to a change in dairy consumption. In addition, to investigate whether dairy associated lipid species are correlated with changes in measures of vascular structure and function.METHODS A 12-mo randomised controlled trial was conducted to determine the effect of increased consumption of fruit, vegetables and dairy, compared to usual diet, on measures of vascular structure and function in adults with type 1 and type 2 diabetes(n = 108). Thispaper comprises post-hoc analyses investigating the relationship between dairy intake, serum lipid species and vascular health. Central and peripheral blood pressure, carotid femoral pulse wave velocity, augmentation index, serum lipid species and dietary intake were measured at baseline and 3-mo. Common carotid artery intima media thickness was measured at baseline and 12-mo.RESULTS Serum lipid species [lysophosphatidylcholine(LPC) 14:0, LPC 15:0, LPC 16:1, phosphatidylcholine(PC) 29:0 PC 30:0, PC 31:0 and cholesterol ester(CE) 14:0] were associated with the change in full fat dairy consumption(rho 0.19-0.25; P < 0.05). The 3-mo change in some lipids was positively associated with the 3-mo change in central systolic [LPC 14:0(rho 0.30; P = 0.007), PC 30:0(rho 0.28; P = 0.010)] and diastolic blood pressure [LPC 14:0(rho 0.32; P = 0.004), LPC 15:0(rho 0.23; P = 0.04), LPC 16:1(rho 0.23; P = 0.035), PC 29:0(rho 0.28; P = 0.01), PC 30:0(rho 0.36; P = 0.001), PC 31:0(rho 0.30; P = 0.007)] and 12-mo change in common carotid artery intimal medial thickness [CE 14:0(rho 0.22; P = 0.02)]. Pulse wave velocity and augmentation index were unrelated to dairy and lipid species.CONCLUSION An increase in dairy associated lipids appears to be associated with an increase in blood pressure and common carotid intimal medial thickness.

Effects of Zhibitai capsules on blood lipids and arterial elasticity

Objective To evaluate the effects of Zhibitai(ZBT) on blood lipids and arterial elasticity in patients with high cardiovascular risk.Methods Eighty three subjects with high risk factors of cardiovascular diseases were enrolled into the study and randomized to two groups,i.e.,the ZBT group(n =44,treated with ZBT 0.48 g twice per day) and the atorvastatin(ATO) group(n =39,treated with ATO 10 mg per day).The levels of fasting serum lipids including total cholesterol(TC),triglyceride(TG),high and low density lipoprotein cholesterol(HDL-C and LDL-C) and pulse wave velocity(PWV) were investigated before and eight weeks after treatment.Results The serum levels of TG,TC,LDL-C,femoral-ankle PWV(FAPWV) and carotid-radial PWV(CRPWV) were markedly decreased after the therapy with ZBT or ATO for 8 weeks(P <0.05).There was no significant alteration in HDL-C and carotid-femoral PWV(CFPWV) levels in both ZBT and ATO groups(P >0.05) after eight-week's treatment.Conclusion ZBT could reduce the levels of FAPWV and CRPWV,thus improve the elasticity of medium-sized peripheral muscular arteries in addition to its lipids lowering effect.The efficacy of ZBT is similar to that of ATO.

Effects of Exercise Training on Endothelial Function,Arterial Structure,and Physical Conditioning in Patients with Systemic Autoimmune Myopathies:A Case Series Study

Introduction. Exercise training has been effective in improving endothelial function and decreasing arterial stiffness in several systemic autoimmune diseases. However, to date, no studies have assessed patients with systemic autoimmune myopathies (SAM). Methods. Five female patients with definite SAM (3 dermatomyositis and 2 polymyositis) who underwent a 12-week, twice-a-week, exercise training program were assessed prospectively. The following parameters were assessed: endothelial function measured by flow-mediated dilatation (FMD), carotid femoral by pulse wave velocity (PWV), disease status by International Myositis Assessment & Clinical Studies Group (IMACS) set score, the ventilatory anaerobic threefold (VAT), respiratory compensation point (RCP), maximum effort (ME), maximal oxygen uptake (VO2max) measured by ergospyrometer, and strength and muscle function. Results. Mean age of the patients and duration of disease were 43.9 and 10.5 years, respectively. The median FMD and PWV were 10.2% and 7.1 m/s. After exercise training, important FMD reduction was observed in 4 out of 5 patients, whereas the PWV parameters decreased in only 2 out of 5 patients. The exercise training was safe, without clinical intercurrences or disease relapses. Moreover, an increase in strength and functionality was observed. Concerning aerobic capacity, there was a decrease in the VAT and an increase in ME, without al-terations in the maximum oxygen consumption. Conclusions. In general, exercise training does not alter endothelial function and PWV values, but improves muscle strength and function and also, does not lead to disease reactivation (Clinical Trials (NCT03092167)).

Composition and Functional Capacity of Gut Microbes are Associated with Arterial Stiffness:A Prospective Study

Objective:Arterial stiffness is an important predictor of cardiovascular disease.Microbial diversity in the gut has been shown to be associated inversely with arterial stiffness in Caucasian populations.However,due to the different profiles of the gut microbiota among ethnicities,the relationship between gut-microbiota dysbiosis and the progression of arterial stiffness merits further investigation.This study aimed to investigate the association between the composition and functional capacity of the gut microbiota and the progression of arterial stiffness.Methods:“Shotgun”metagenomics sequencing were undertaken in 96 individuals from a hypertension-associated gut-microbiota study in the Kailuan cohort,who measured brachial-ankle pulse wave velocity(baPWV)and provided fecal samples between September 2014 and February 2015 at Kailuan General Hospital and 11 affiliated hospitals.The different composition and functional capacity of the gut microbiota were compared between individuals without arterial stiffness(normal arterial stiffness group,baPWV<1,400 cm/s,n=27)and participants with arterial stiffness(increased arterial stiffness group,baPWV≥1,400 cm/s,n=69)at baseline.These participants were followed up prospectively for a mean duration of 2.6 years,and 50 underwent a repeat baPWV measurement.Associations between the gut microbiota and severity and progression of arterial stiffness were assessed using MaAsLin2 software after adjustment for age,sex,and mean arterial blood pressure and correction for multiple testing.Gene“catalogs”were aligned to the Kyoto Encyclopedia of Genes and Genomes(KEGG)database to obtain information for potential functional capacities of the gut microbiota.Results:In this study,14 genera and 50 species of bacteria were identified to be abundant in participants with normal arterial stiffness compared with those with increased arterial stiffness.Of 14 genera,the prevalence of beneficial bacteria of the genera Leadbetterella and Cytophaga was correlated inversely with baPWV(P<0.05).Analyses of functional capacity revealed gut-microbial dysfunctions in the synthetic processes of“threonine dehydratase”“hypothetical protein”“mannosyl transferase”and“type-IV secretion-system proteins”in individuals suffering from arterial stiffness.During follow-up,bacteria of the proinflammatory genera Escherichia,Shigella,and Ruegeria were enriched in individuals with increased baPWV.Functional analyses showed that 26 KEGG orthologs of gut microbes were associated with an increase in baPWV and involved in“carbohydrate metabolism”“amino acid metabolism”and“protein families related to genetic information processing.”Conclusions:The composition and functional capacity of the microbial community in the gut of people suffering from arterial stiffness differed from those in individuals not suffering from arterial stiffness.Our data provide a new direction for the causality of the host-gut microbiota in arterial stiffness.