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Microvascular disease

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https://www.readbyqxmd.com/read/28530383/diabetes-update-prevention-and-management-of-diabetes-complications
#1
Beth Choby
Macrovascular complications of diabetes include cardiovascular events, whereas common microvascular complications include neuropathy, retinopathy, and diabetic kidney disease. Control of hypertension and dyslipidemia is an important step in minimizing the risk of complications. Blood pressure (BP) levels should be maintained at less than 140 mm Hg systolic and less than 90 mm Hg diastolic. In older adults, medical therapy to reduce BP to less than 130/70 mm Hg is not recommended. In these patients, a systolic BP level less than 130 mm Hg has not been shown to improve atherosclerotic cardiovascular disease (ASCVD) outcomes, and a diastolic BP less than 70 mm Hg is associated with a higher mortality risk...
May 2017: FP Essentials
https://www.readbyqxmd.com/read/28529915/hemolytic-uremic-syndrome-in-adults-a-case-report
#2
Fabiel Gerardo Pérez-Cruz, Patricia Villa-Díaz, María Consuelo Pintado-Delgado, María Loreto Fernández Rodríguez, Ana Blasco-Martínez, María Pérez-Fernández
Thrombotic microangiopathies (TMA) are microvascular occlusive disorders characterized by platelet aggregation and mechanical damage to erythrocytes, clinically characterized by microangiopatic haemolytic anemia, thrombocytopenia and organ injury. We are reporting a case of a woman patient with severe hemolytic uremic syndrome associated to infectious diarrhoea caused by Shiga toxin-producing pathogen, who were admitted to our intensive care unit. The patient described developed as organ injury, neurological failure and acute renal failure, with need of haemodialysis technique...
May 4, 2017: World Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28529171/reproducibility-of-flow-mediated-skin-fluorescence-to-assess-microvascular-function
#3
Marcin Hellmann, Maria Tarnawska, Maria Dudziak, Karolina Dorniak, Matthieu Roustit, Jean-Luc Cracowski
OBJECTIVE: Recent technical developments enable skin fluorescence to be quantified in vivo in humans. The present study aimed at determining whether flow mediated skin fluorescence was reproducible, sensitive to changes within an individual, and if it could differ between patients with coronary artery disease and healthy volunteers. METHODS: First, forearm flow mediated skin fluorescence recorded during and after brachial artery occlusion was assessed following successive forearm occlusion periods (1, 2, 3 and 5min) and expressed as ischemic and hyperemic responses (as % of baseline)...
May 18, 2017: Microvascular Research
https://www.readbyqxmd.com/read/28528579/phosphodiesterase-type-5-inhibition-may-reduce-diastolic-function-in-women-with-ischemia-but-no-obstructive-coronary-artery-disease
#4
Michael D Nelson, Puja K Mehta, Janet Wei, Behzad Sharif, Louise E J Thomson, Daniel Berman, Debiao Li, C Noel Bairey Merz
BACKGROUND: Ischemia, in the absence of obstructive coronary artery disease, is prevalent in women, and associated with increased risk for major cardiovascular events. Coronary microvascular dysfunction is prevalent in these patients, and associated with impaired diastolic function. Despite our general understanding, however, optimal treatment of this cohort remains elusive. METHODS: To address this knowledge gap, we performed an open-label treatment trial to assess whether phosphodiesterase type 5 inhibition improves coronary microvascular perfusion and diastolic function in women with signs and symptoms of ischemia but no evidence of obstructive coronary artery disease...
May 22, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/28526710/gbt1118-a-potent-allosteric-modifier-of-hemoglobin-oxygen-affinity-increases-tolerance-to-severe-hypoxia-in-mice
#5
Kobina Dufu, Ozlem Yalcin, Eilleen Sy Ao-Ieong, Athiwat Hutchaleelala, Qing Xu, Zhe Li, Nicholas Vlahakis, Donna Oksenberg, Josh Lehrer-Graiwer, Pedro Cabrales
Adaptation to hypoxia requires compensatory mechanisms that affect oxygen (O2) transport and utilization. Decreased hemoglobin (Hb)-O2 affinity is considered part of the physiological adaptive process to chronic hypoxia. This manuscript explores the hypothesis that increased Hb-O2 affinity can complement acute physiological responses to hypoxia by increasing O2 uptake and delivery when compared to normal Hb-O2 affinity during acute severe hypoxia. To test this hypothesis, mice Hb-O2 affinity was increased via oral administration of 70 or 140 mg/kg GBT1118...
May 19, 2017: American Journal of Physiology. Heart and Circulatory Physiology
https://www.readbyqxmd.com/read/28526473/coronary-flow-reserve-is-reduced-in-sarcoidosis
#6
Seref Kul, Gonul Aciksari Kutlu, Tolga Sinan Guvenc, Murat Kavas, Kenan Demircioglu, Yusuf Yilmaz, Halil Ibrahim Yakar, Asiye Kanbay, Sibel Boga, Mustafa Caliskan
BACKGROUND AND AIMS: Sarcoidosis is a multisystem disease with frequent cardiac involvement, albeit manifest cardiac disease is rare. Though epicardial coronary arteries are not frequently involved, microvascular disease is rather common in both symptomatic and asymptomatic patients. The mechanism of microvascular involvement has not been elaborated yet. The aim of this study is to investigate coronary flow velocity reserve (CFVR) using transthoracic echocardiography in patients with sarcoidosis but without known atherosclerotic coronary artery disease or risk factors for atherosclerosis...
May 4, 2017: Atherosclerosis
https://www.readbyqxmd.com/read/28526185/empa-reg-outcome-the-endocrinologist-s-point-of-view
#7
Leigh Perreault
For many years, it was widely accepted that control of plasma lipids and blood pressure could lower macrovascular risk in patients with type 2 diabetes mellitus (T2DM), whereas the benefits of lowering plasma glucose were largely limited to improvements in microvascular complications. The Empagliflozin Cardiovascular Outcome Event Trial in Type 2 Diabetes Mellitus Patients-Removing Excess Glucose (EMPA-REG OUTCOME) study demonstrated for the first time that a glucose-lowering agent, the sodium glucose cotransporter 2 (SGLT2) inhibitor empagliflozin, could reduce major adverse cardiovascular events, cardiovascular mortality, hospitalization for heart failure, and overall mortality when given in addition to standard care in patients with T2DM at high cardiovascular risk...
May 12, 2017: American Journal of Medicine
https://www.readbyqxmd.com/read/28526034/differential-darc-ackr1-expression-distinguishes-venular-from-non-venular-endothelial-cells-in-murine-tissues
#8
Aude Thiriot, Carolina Perdomo, Guiying Cheng, Igor Novitzky-Basso, Sara McArdle, Jamie K Kishimoto, Olga Barreiro, Irina Mazo, Robinson Triboulet, Klaus Ley, Antal Rot, Ulrich H von Andrian
BACKGROUND: Intravascular leukocyte recruitment in most vertebrate tissues is restricted to postcapillary and collecting venules, whereas capillaries and arterioles usually support little or no leukocyte adhesion. This segmental restriction is thought to be mediated by endothelial, rather than hemodynamic, differences. The underlying mechanisms are largely unknown, in part because effective tools to distinguish, isolate, and analyze venular endothelial cells (V-ECs) and non-venular endothelial cells (NV-ECs) have been unavailable...
May 19, 2017: BMC Biology
https://www.readbyqxmd.com/read/28521931/hemodynamic-measurements-for%C3%A2-the%C3%A2-selection-of-patients-with-renal%C3%A2-artery%C3%A2-stenosis-a-systematic-review
#9
REVIEW
Peter M van Brussel, Tim P van de Hoef, Robbert J de Winter, Liffert Vogt, Bert-Jan van den Born
Interventions targeting renal artery stenoses have been shown to lower blood pressure and preserve renal function. In recent studies, the efficacy of catheter-based percutaneous transluminal renal angioplasty with stent placement has been called into question. In the identification of functional coronary lesions, hyperemic measurements have earned a place in daily practice for clinical decision making, allowing discrimination between solitary coronary lesions and diffuse microvascular disease. Next to differences in clinical characteristics, the selection of renal arteries suitable for intervention is currently on the basis of anatomic grading of the stenosis by angiography rather than functional assessment under hyperemia...
May 22, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28520942/emerging-roles-for-micrornas-in-diabetic-microvascular-disease-novel-targets-for-therapy
#10
Yu Zhang, Xinghui Sun, Basak Icli, Mark W Feinberg
Chronic, low-grade systemic inflammation and impaired microvascular function are critical hallmarks in the development of insulin resistance. Accordingly, insulin resistance is a major risk factor for type 2 diabetes and cardiovascular disease. Accumulating studies demonstrate that restoration of impaired function of the diabetic macro- and microvasculature may ameliorate a range of cardiovascular disease states and diabetes-associated complications. In this review, we focus on the emerging role of microRNAs (miRNAs), noncoding RNAs that fine-tune target gene expression and signaling pathways, in insulin-responsive tissues and cell types important for maintaining optimal vascular homeostasis and preventing the sequelae of diabetes-induced end organ injury...
April 1, 2017: Endocrine Reviews
https://www.readbyqxmd.com/read/28514657/huntington-s-disease-ipsc-derived-brain-microvascular-endothelial-cells-reveal-wnt-mediated-angiogenic-and-blood-brain-barrier-deficits
#11
Ryan G Lim, Chris Quan, Andrea M Reyes-Ortiz, Sarah E Lutz, Amanda J Kedaigle, Theresa A Gipson, Jie Wu, Gad D Vatine, Jennifer Stocksdale, Malcolm S Casale, Clive N Svendsen, Ernest Fraenkel, David E Housman, Dritan Agalliu, Leslie M Thompson
Brain microvascular endothelial cells (BMECs) are an essential component of the blood-brain barrier (BBB) that shields the brain against toxins and immune cells. While BBB dysfunction exists in neurological disorders, including Huntington's disease (HD), it is not known if BMECs themselves are functionally compromised to promote BBB dysfunction. Further, the underlying mechanisms of BBB dysfunction remain elusive given limitations with mouse models and post-mortem tissue to identify primary deficits. We undertook a transcriptome and functional analysis of human induced pluripotent stem cell (iPSC)-derived BMECs (iBMEC) from HD patients or unaffected controls...
May 16, 2017: Cell Reports
https://www.readbyqxmd.com/read/28512159/employing-extracellular-volume-cardiovascular-magnetic-resonance-measures-of-myocardial-fibrosis-to-foster-novel-therapeutics
#12
Erik B Schelbert, Hani N Sabbah, Javed Butler, Mihai Gheorghiade
Quantifying myocardial fibrosis (MF) with myocardial extracellular volume measures acquired during cardiovascular magnetic resonance promises to transform clinical care by advancing pathophysiologic understanding and fostering novel therapeutics. Extracellular volume quantifies MF by measuring the extracellular compartment depicted by the myocardial uptake of contrast relative to plasma. MF is a key domain of dysfunctional but viable myocardium among others (eg, microvascular dysfunction and cardiomyocyte/mitochondrial dysfunction)...
June 2017: Circulation. Cardiovascular Imaging
https://www.readbyqxmd.com/read/28511878/epidemiological-multicentre-study-on-the-education-provided-to-patients-with-type-2-diabetes-mellitus-in-the-spanish-health-care-system-the-forma2-study
#13
J A García-Donaire, J Franch-Nadal, P Rodríguez-Fortúnez, E Labrador-Barba, M L Orera-Peña, M Rodríguez de Miguel
PURPOSE: The purpose of the present study was to characterize the education that patients with type 2 diabetes mellitus receive, and to identify differences as regards the presence of insulin therapy or not. METHODS: This crossover, multicentre and descriptive study involved 1066 Spanish physicians who completed a questionnaire on Internet. RESULTS: The physicians that responded had a mean of 26.0 years of experience in healthcare, and mainly worked in a walk-in clinic in an urban area...
May 13, 2017: Semergen
https://www.readbyqxmd.com/read/28511390/expression-of-angiogenic-factors-in-psoriasis-vulgaris
#14
Lakshna Sankar, Dhanalakshmi Arumugam, Sudha Boj, Priyanka Pradeep
INTRODUCTION: Psoriasis is a chronic inflammatory skin disease characterized by epidermal hyperproliferation, abnormal differentiation and inflammatory infiltration in the dermis. The dermal microvascular expansion associated with abnormal orientation and dilatation of capillaries in the biopsies of the psoriatic skin suggest that the disease is dependent on angiogenesis. AIM: To analyze and compare the immunohistochemical expression of angiogenic factors - Vascular Endothelial Growth Factor (VEGF), von Willebrand Factor (vWF) and CD 34 in skin biopsies of psoriasis cases with control skin samples; and to correlate the expression of angiogenic factors with Psoriasis Area and Severity Clinical Index (PASI SCORE)...
March 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28509723/determinants-of-retinal-microvascular-features-and-their-relationships-in-two-european-populations
#15
Mirna Kirin, Reka Nagy, Thomas J MacGillivray, Ozren Polašek, Caroline Hayward, Igor Rudan, Harry Campbell, Sarah Wild, Alan F Wright, James F Wilson, Veronique Vitart
OBJECTIVES: To examine factors influencing retinal vasculature in two environmentally contrasted, cross-sectional studies of adult participants of European descent and to estimate the extent and specificity of genetic contributions to each retinal vasculature feature. METHODS: Retinal images from 1088 participants in the Orkney Complex Disease Study and 387 in the CROATIA-Korčula study, taken using the same nonmydriatic camera system and graded by the same person, were evaluated...
May 13, 2017: Journal of Hypertension
https://www.readbyqxmd.com/read/28508133/children-and-adolescents-macrovascular-reactivity-level-and-dynamics-but-not-the-microvascular-response-is-associated-with-body-mass-index-and-arterial-stiffness-levels
#16
Yanina Zócalo, Marco Marotta, Victoria García-Espinosa, Santiago Curcio, Pedro Chiesa, Gustavo Giachetto, Daniel Bia
INTRODUCTION: The existing evidence indicates that primary prevention of atherosclerotic disease should begin in childhood. Detection of children and adolescents at risk for atherosclerosis may allow early intervention to decrease the atherosclerotic process, thereby preventing or delaying cardiovascular disease. Vascular reactivity (VR) is altered even by early atherosclerosis. Obesity is a main cardiovascular risk factor (CVRF) observed in childhood. If childhood obesity associates impaired macro and/or micro VR is controversial...
May 15, 2017: High Blood Pressure & Cardiovascular Prevention: the Official Journal of the Italian Society of Hypertension
https://www.readbyqxmd.com/read/28507925/stratified-platelet-to-lymphocyte-ratio-a-novel-target-for-prognostic-prediction-of-hepatocellular-carcinoma-after-curative-liver-resection
#17
Gui-Qian Huang, Ji-Na Zheng, Tian-Tian Zou, Yi-Ran Chen, Ke-Qing Shi, Sven Van Poucke, Zhang Cheng, Lu-Yi Ruan, Ming-Hua Zheng
Background and Aims: Platelet-to-lymphocyte ratio (PLR) has been shown to predict prognosis of cancers. We aimed to evaluate the prognostic value of stratification of PLR in patients after curative liver resection (CLR) for hepatocellular carcinoma (HCC). Methods: A total of 1804 patients who underwent CLR for suspected HCC between January 2007 and January 2014 were screened for the study. All of the patients were categorized into equal tertiles according to the number of patients and the distribution of PLR...
March 28, 2017: Journal of Clinical and Translational Hepatology
https://www.readbyqxmd.com/read/28504673/a-fluoro-nissl-dye-identifies-pericytes-as-distinct-vascular-mural-cells-during-in-vivo-brain-imaging
#18
Eyiyemisi C Damisah, Robert A Hill, Lei Tong, Katie N Murray, Jaime Grutzendler
Pericytes and smooth muscle cells are integral components of the brain microvasculature. However, no techniques exist to unambiguously identify these cell types, greatly limiting their investigation in vivo. Here we show that the fluorescent Nissl dye NeuroTrace 500/525 labels brain pericytes with specificity, allowing high-resolution optical imaging in the live mouse. We demonstrate that capillary pericytes are a population of mural cells with distinct morphological, molecular and functional features that do not overlap with precapillary or arteriolar smooth muscle actin-expressing cells...
May 15, 2017: Nature Neuroscience
https://www.readbyqxmd.com/read/28502083/in-vivo-microvascular-imaging-of-cutaneous-actinic-keratosis-bowen-s-disease-and-squamous-cell-carcinoma-using-dynamic-optical-coherence-tomography
#19
L Themstrup, G Pellacani, J Welzel, J Holmes, G B E Jemec, M Ulrich
BACKGROUND: A clear distinction between actinic keratosis (AK), Bowen's disease (BD) and squamous cell carcinoma (SCC) cannot reliably be made by clinical and dermoscopic evaluation alone. Dynamic optical coherence tomography (D-OCT) is a novel angiographic variant of OCT that allows for non-invasive, in vivo evaluation of the cutaneous microvascular morphology. OBJECTIVE: To investigate the microvascular structures of AK, BD and invasive SCC using D-OCT in order to gain insights into the microvascular morphology of lesions in the spectrum of keratinocyte skin cancers...
May 14, 2017: Journal of the European Academy of Dermatology and Venereology: JEADV
https://www.readbyqxmd.com/read/28499961/towards-an-improved-global-understanding-of-treatment-and-outcomes-in-people-with-type-2-diabetes-rationale-and-methods-of-the-discover-observational-study-program
#20
Linong Ji, Fabrice Bonnet, Bernard Charbonnel, Marilia B Gomes, Mikhail Kosiborod, Kamlesh Khunti, Antonio Nicolucci, Stuart Pocock, Wolfgang Rathmann, Marina V Shestakova, Iichiro Shimomura, Hirotaka Watada, Peter Fenici, Niklas Hammar, Kiyoshi Hashigami, Greg Macaraeg, Filip Surmont, Jesús Medina
AIM: Contemporary global real-world data on the management of type 2 diabetes are scarce. The global DISCOVER study program aims to describe the disease management patterns and a broad range of associated outcomes in patients with type 2 diabetes initiating a second-line glucose-lowering therapy in routine clinical practice. METHODS: The DISCOVER program comprises two longitudinal observational studies involving more than 15,000 patients in 38 countries across six continents...
April 5, 2017: Journal of Diabetes and its Complications
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