Pulse最新文献

{"title":"Association between Cardiovascular Health by Life's Essential 8 and Subsequent Coronary Artery Calcium Score: The Cardiovascular and Metabolic Diseases Etiology Research Center Cohort.","authors":"Hyoeun An, Jooeun Jeon, Hansol Choi, Yeeun Seo, Jaeyong Lee, Haewon Chung, Ji-Hye Kim, Jee-Seon Shim, Hokyou Lee, Hyeon Chang Kim","doi":"10.1159/000553596","DOIUrl":"https://doi.org/10.1159/000553596","url":null,"abstract":"<p><strong>Introduction: </strong>Although \"Life's Essential 8\" (LE8) is a key metric for cardiovascular health (CVH), its longitudinal association with subclinical atherosclerosis in Koreans remains unclear. We examined the association between baseline LE8 scores and the presence of coronary artery calcium (CAC).</p><p><strong>Methods: </strong>Data were obtained from the Cardiovascular and Metabolic Diseases Etiology Research Center cohort study, a prospective cohort (baseline: 2013-2018; follow-up: 2022-2024). Baseline CVH scores, comprising 8 metrics (diet, physical activity, nicotine exposure, sleep health, body mass index, blood lipids, blood glucose, and blood pressure), were categorized as low (0-<50), moderate (50-<80), and high (80-100). The main outcome was the presence of CAC at the follow-up. Multivariable logistic regression was used for statistical analysis.</p><p><strong>Results: </strong>During a mean follow-up of 7.3 years, among 1,746 participants (mean age: 52.3 years, 65.2% female), the overall prevalence of CAC was 41.4%, which decreased with increasing CVH scores (low: 64.6%, moderate: 41.5%, and high: 30.4%). Compared to the low CVH group, the fully adjusted odds ratios (95% confidence intervals) for the presence of CAC were 0.34 (0.23-0.51) in the moderate and 0.25 (0.15-0.39) in the high CVH group. Higher baseline CVH scores were log-linearly associated with lower odds of CAC presence, demonstrating a linear and dose-dependent relationship in the restricted cubic spline plot (<i>p</i> = 0.102). The association between CVH and CAC was consistently observed across subgroups and sensitivity analyses.</p><p><strong>Conclusion: </strong>Our study showed that higher baseline CVH scores were associated with a lower risk of subsequent CAC, highlighting the importance of promoting ideal CVH early to reduce the burden of cardiovascular disease.</p>","PeriodicalId":29774,"journal":{"name":"Pulse","volume":"14 1","pages":"169-180"},"PeriodicalIF":3.4,"publicationDate":"2026-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13657440/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149184745","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating Arterial Stiffness in Aortic Stenosis.","authors":"Ning Song, Mayooran Namasivayam, Christopher S Hayward, David W M Muller, Audrey Adji","doi":"10.1159/000553233","DOIUrl":"10.1159/000553233","url":null,"abstract":"<p><strong>Background: </strong>In an ageing population, degenerative aortic stenosis (AS) and elevated arterial stiffness frequently coexist, imposing a combined valvular and pulsatile arterial afterload on the left ventricle (LV). Since the significance of arterial stiffness in the setting of AS is becoming increasingly recognised, there is greater emphasis on accurately evaluating this pulsatile LV load in the presence of severe AS and predicting the arterial response post transcatheter aortic valve replacement (TAVR).</p><p><strong>Summary: </strong>Studies examining arterial stiffness in AS and after TAVR have yielded conflicting results. This review aims to comprehensively evaluate measures of arterial stiffness and pulsatile LV including pulse-wave velocity (PWV), augmentation index (AIx), arterial stiffness index (ASi), and aortic characteristic impedance (Zc); summarises current evidence on their interplay with AS and identifies key knowledge gaps, particularly the limited incorporation of simultaneous flow assessment.</p><p><strong>Key messages: </strong>PWV remains the most useful prognostic marker but appears pressure-dependent. AIx is confounded by multiple factors including ejection duration and contractility, especially post-TAVR. Zc best isolates proximal pulsatile load and may better reflect persistent afterload after AS correction. Future studies to validate a non-invasive index for pulsatile arterial load in AS may help guide pre-TAVR risk assessment.</p>","PeriodicalId":29774,"journal":{"name":"Pulse","volume":"14 1","pages":"128-136"},"PeriodicalIF":3.4,"publicationDate":"2026-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13592797/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149018117","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between Brachial-Ankle Pulse Wave Velocity and Large-Nerve Fiber Function in Chinese Adults Aged 18-65 Years with Type 2 Diabetes.","authors":"Yan Xuan, Dou Tang, Xi Gu, Fanfan Zhu, Sujie Wang, Xun Wang, Ying Shen, Lu Leiqun","doi":"10.1159/000552508","DOIUrl":"https://doi.org/10.1159/000552508","url":null,"abstract":"<p><strong>Introduction: </strong>Arterial stiffness, measured by brachial-ankle pulse wave velocity (baPWV), has been linked to diabetic peripheral neuropathy (DPN). However, the evidence regarding its association with large-nerve fiber dysfunction, specifically assessed by vibration perception threshold (VPT), in Chinese patients aged 18-65 years with type 2 diabetes mellitus (T2DM) is scarce. This study aimed to investigate the relationship between baPWV and VPT in this specific population.</p><p><strong>Methods: </strong>This cross-sectional study enrolled 600 inpatients with T2DM aged 18-65 years. baPWV was measured using an automated waveform analyzer. DPN was defined as a VPT ≥15 volts in at least one foot. Multivariable logistic regression models were used to assess independent association, expressed as odds ratios (ORs) and 95% confidence intervals (CIs). Restricted cubic spline and subgroup analyses were performed to evaluate the dose-response relationship and consistency of the association.</p><p><strong>Results: </strong>Among the participants, 165 (27.5%) were classified into the abnormal VPT group. After full adjustment for confounders including age, gender, diabetes duration, glycated hemoglobin, and lifestyle factors, each 100 cm/s increase in baPWV was significantly associated with increased odds of DPN (OR = 1.07, 95% CI: 1.01-1.14). When analyzed by quartiles, participants in the highest baPWV quartile (≥1,660 cm/s) had 1.29-fold higher odds of abnormal VPT (OR = 1.29, 95% CI: 1.03-3.01) compared to those in the lowest quartile (<1,380 cm/s), with a significant trend across quartiles (<i>p</i> for trend = 0.005). A linear dose-response relationship was confirmed without evidence of a threshold effect. Subgroup analyses showed the association was consistent across different patient characteristics.</p><p><strong>Conclusion: </strong>Elevated baPWV is independently associated with higher odds of DPN measured by VPT in Chinese patients aged 18-65 years with type 2 diabetes. This linear relationship not only underscores the pivotal role of arterial stiffness in the pathogenesis of DPN but also positions baPWV as a valuable tool for early risk stratification in clinical practice.</p>","PeriodicalId":29774,"journal":{"name":"Pulse","volume":"14 1","pages":"119-127"},"PeriodicalIF":3.4,"publicationDate":"2026-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13480979/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148798726","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Para-Coumaric Acid Suppresses Vascular Endothelial Growth Factor-Induced DLL4-NOTCH1 Signaling, Tumor Angiogenesis, and Tumor Growth.","authors":"Seunghwan Ha, Jihye You, So Hee Bae, Hyoung-Geun Kim, Nam-In Baek, Ji-Hak Jeong, Jeong Ah Kim, You Mie Lee","doi":"10.1159/000553024","DOIUrl":"10.1159/000553024","url":null,"abstract":"<p><strong>Introduction: </strong>DLL4-NOTCH1 signaling mediates juxtacrine communication between tip- and stalk-like endothelial cells during vascular sprouting, contributing to complementary aspects of endothelial function. Thus, simultaneous modulation of DLL4 and NOTCH1 may provide a strategy to broadly interfere with the endothelial functions involved in tumor angiogenesis. Accordingly, this study aimed to identify a novel natural compound capable of modulating DLL4-NOTCH1-mediated endothelial communication and to investigate how such modulation influences tumor angiogenesis and growth.</p><p><strong>Methods: </strong>We screened 66 natural compounds to identify those that suppress DLL4 and NOTCH1 signaling in endothelial cells. Using a dual-reporter system that combines a DLL4 promoter-driven reporter and a CSL luciferase reporter, we simultaneously assessed ligand-associated activity and downstream transcriptional output of the DLL4-NOTCH1 axis. We confirmed VEGF-induced target gene expression via Western blotting and quantitative real-time polymerase chain reaction. We further performed in vitro angiogenesis assays and in vivo Lewis lung carcinoma (LLC) allograft tumor experiments.</p><p><strong>Results: </strong>Among the 66 screened natural compounds, <i>para</i>-coumaric acid (<i>p</i>-CA) dose-dependently suppressed DLL4 transcription and NOTCH1 signaling activity in endothelial cells, with IC₅₀ values of 4.57 and 8.34 µm, respectively. Furthermore, <i>p</i>-CA significantly suppressed VEGF-induced endothelial cell proliferation, migration, and tube formation. In the LLC allograft model, <i>p</i>-CA treatment suppressed tumor growth and vascular density, increased pericyte coverage, reduced tumor hypoxia, and enhanced CD3⁺ T-cell infiltration and tumor cell apoptosis.</p><p><strong>Conclusion: </strong>In summary, <i>p</i>-CA is a natural compound that functionally suppresses VEGF-driven DLL4-NOTCH1 signaling in endothelial cells, exhibiting strong anti-angiogenic effects and promoting functional vascular normalization, resulting in marked tumor suppression and enhanced antitumor immunity in vivo. These findings suggest that <i>p</i>-CA warrants further investigation as an anti-angiogenic compound for cancer therapy.</p>","PeriodicalId":29774,"journal":{"name":"Pulse","volume":"14 1","pages":"105-118"},"PeriodicalIF":3.4,"publicationDate":"2026-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13441282/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148679354","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Differences in Segmental β Response between Elastic and Muscular Arteries: A Comparison between Young and Adults.","authors":"Yuko Horikoshi, Rie Sakuraba-Hirata, Toa Kotani, Takumu Watanabe, Shin-Ichiro Katsuda, Yasuchika Takeishi, Akiomi Yoshihisa","doi":"10.1159/000551759","DOIUrl":"https://doi.org/10.1159/000551759","url":null,"abstract":"<p><strong>Introduction: </strong>The cardio-ankle vascular index (CAVI) is a noninvasive indicator used to assess arterial stiffness and predict atherosclerotic cardiovascular disease (ASCVD). CAVI represents a scale-converted form of the stiffness parameter β. Both CAVI and β reflect overall arterial stiffness from the heart to the ankle. However, there are distinct mechanistic pathways underlying the heterogeneous progression of ASCVD across the arterial tree (e.g., elastic and muscular arteries). Thus, the present study aimed to (1) examine differences in segmental β between elastic and muscular arteries at rest; (2) compare these differences between young and older adults at rest; and (3) further compare them with the segmental β responses observed after exercise.</p><p><strong>Methods: </strong>Eighty-three healthy individuals aged 18-52 years were recruited and divided into two groups: the young group (18-23 years, <i>n</i> = 57) and the adult group (31-52 years, <i>n</i> = 26). Cuffs were applied to both upper arms, the left thigh, and the right ankle. Segmental β was measured at rest as well as immediately after exercise using the Master's two-step exercise test.</p><p><strong>Results: </strong>At rest, muscular arterial stiffness (thigh-ankle β [taβ]) was 4.7 times higher in the young group and 2.8 times higher in the adult group, compared to that of the elastic arteries (heart-thigh β [htβ]). htβ and heart-ankle β (haβ) were higher in the adult group than in the young group (<i>p</i> < 0.05), whereas taβ was lower in the adult group (<i>p</i> < 0.05). After exercise, taβ, htβ, and haβ decreased in both groups. In the young group, exercise-induced β reduction was greatest in taβ, compared with htβ and haβ. This reduction was significantly greater in the young group than in the adult group (e.g., reduction in taβ was 4.9 times greater in the young group).</p><p><strong>Conclusion: </strong>This study demonstrated distinct segmental β values between elastic and muscular arteries, suggesting that the inherent stiffness of the arterial beds should ideally be assessed separately.</p>","PeriodicalId":29774,"journal":{"name":"Pulse","volume":"14 1","pages":"53-61"},"PeriodicalIF":7.3,"publicationDate":"2026-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13245958/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148212887","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Indices of Arterial Stiffness and the Alzheimer's Disease Biomarker, p-tau217, in Non-Demented Midlife Women.","authors":"Benecia Wan Qing Thia, Darren Yuen Zhang Tan, Beverly Wen Xin Wong, Liang Shen, Lingli Gong, Lieng-Hsi Ling, Christopher Li-Hsian Chen, Eu-Leong Yong","doi":"10.1159/000552328","DOIUrl":"https://doi.org/10.1159/000552328","url":null,"abstract":"<p><strong>Introduction: </strong>The association between indices of arterial stiffness and/or pressure wave reflection with Alzheimer disease amyloid-β accumulation and tau pathology in the brain is unclear. Deficiency of estrogen post-menopause may be an important contributor to changes in these indices to affect Alzheimer's disease progression. We aimed to assess the associations between indices of arterial stiffness and/or pressure wave reflection and the Alzheimer's disease blood biomarker, p-tau217, in midlife women without dementia.</p><p><strong>Methods: </strong>This cross-sectional analysis of participants from the Integrated Women's Health Program (IWHP) enrolled community-dwelling midlife women without dementia attending routine health screening at the National University Hospital in Singapore. Fasted blood p-tau217 was measured using the Simoa® ALZpath p-tau217 Advantage PLUS (Quanterix, MA, USA). Aortic augmentation index (AIx) and reflection index (RI) were obtained from peripheral arterial pressure waveforms and cardio-ankle vascular index (CAVI) measured using pressure cuffs on the extremities and a phonocardiogram. Multivariable linear regression was used to examine the independent associations between indices of arterial stiffness and serum levels of p-tau217.</p><p><strong>Results: </strong>Among 871 participants (mean age: 62.80 ± 6.02 years), every SD increase in AIx and RI scores was both associated with 0.010 pg/mL (95% CI: 0.003-0.017, <i>p</i> = 0.004) higher blood p-tau217 levels after adjustment for age, employment status, BMI, mild cognitive impairment, hypertension, cholesterol-HDL ratio, renal function, and ApoE4 carrier status. With natural logarithmic transformed p-tau217, RI remained significantly associated with ln(p-tau217), β = 0.026 (0.007, 0.045), <i>p</i> = 0.007, after covariate adjustment. For AIx, the association was attenuated but remained directionally consistent. Trends for the association between CAVI and blood p-tau217 level were not statistically significant after adjustment for covariates.</p><p><strong>Conclusion: </strong>Increases in indices of arterial stiffness and pressure wave reflection were associated with higher blood p-tau217 levels in community-dwelling midlife women without dementia. These indices may be markers of risk for tau-related pathologies in the brain.</p>","PeriodicalId":29774,"journal":{"name":"Pulse","volume":"14 1","pages":"78-92"},"PeriodicalIF":3.4,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13282107/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148296393","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Systolic Blood Pressure Burden: A Novel Metric for Predicting Cardiovascular Outcomes in High Cardiovascular Risk Patients - Insights from the SPRINT Study.","authors":"Moran Li, Jieying Shi, Minghui Chen, Qiaorui He, Bo Wang, Song Zhao, Yan Li, Yifan Zhao, Yi Zhang","doi":"10.1159/000551995","DOIUrl":"https://doi.org/10.1159/000551995","url":null,"abstract":"<p><strong>Introduction: </strong>Conventional systolic blood pressure (SBP) indices, such as mean SBP or variability indices, fail to capture control consistency. SBP time in target range (TTR) improves risk prediction by measuring SBP control duration. However, it neglects the magnitude of SBP elevation, treating minor and severe elevations equally. We developed and validated the SBP burden, a novel metric integrating both the duration and magnitude of SBP elevation, to enhance cardiovascular risk prediction.</p><p><strong>Methods: </strong>This post hoc analysis of the SPRINT included 9,017 high-risk, nondiabetic participants (age, 67.0 [61.0-76.0] years; 64.7% men). SBP burden was calculated as the proportion of the over-target time multiplied by the over-target part proportion of SBP area under the curve [AUC] during that time, using SBP records in months 0-6 (target: 130 mm Hg). Its prediction performance was compared with mean SBP, SBP standard deviation (SD), SBP average real variability (ARV), SBP TTR, and SBP AUC. The primary outcome was the first occurrence of major adverse cardiovascular events (MACEs), including cardiovascular death (CVD death), myocardial infarction, stroke, and heart failure (HF) hospitalization.</p><p><strong>Results: </strong>Over a median follow-up of 3.89 years, 568 MACEs occurred. After adjusting for traditional risk co-variables, the SBP burden showed an independent linear association with MACEs (hazard ratio [HR], 95% confidence interval [CI]: 1.17, 1.09-1.26; <i>p</i> < 0.01) and this association remained even after further adjustment for SBP SD and ARV. Mean SBP (HR, 95% CI: 1.13, 1.03-1.23; <i>p</i> < 0.01), SBP SD (HR, 95% CI: 1.10, 1.01-1.19; <i>p</i> = 0.03), SBP ARV (HR, 95% CI: 1.10, 1.01-1.18; <i>p</i> = 0.02), SBP AUC (HR, 95% CI: 1.15, 1.05-1.26; <i>p</i> < 0.01), and SBP TTR (HR, 95% CI: 0.88, 0.80-0.97; <i>p</i> = 0.01) were also independent risk predictors. Further, we confirmed SBP burden acheived the greatest improvement in discrimination and reclassification (Net reclassification improvement as 0.12 [0.03-0.22]; integrated discrimination improvement as 0.0032 [0.0006-0.0076]), and feature importance (relative informativeness and LASSO ranking as top 1) among tested SBP indices.</p><p><strong>Conclusion: </strong>In high-risk, nondiabetic patients, SBP burden is an independent predictor of cardiovascular outcomes. It overcomes the limitations of SBP TTR, outperforming other SBP indices in predictive performance and feature importance for cardiovascular outcomes.</p>","PeriodicalId":29774,"journal":{"name":"Pulse","volume":"14 1","pages":"93-104"},"PeriodicalIF":3.4,"publicationDate":"2026-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13286498/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148309691","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Plasma Metabolomic Signature Predicting Deviation from Healthy Vascular Aging in Two European Cohorts.","authors":"Dong-Yan Zhang, Dries S Martens, De-Wei An, Vannina González-Marrachelli, Yu-Ling Yu, Katarzyna Stolarz-Skrzypek, Marek Rajzer, Yan Li, Peter Verhamme, Tim S Nawrot, Daniel Monleon, Josep Redón, Jan A Staessen","doi":"10.1159/000551883","DOIUrl":"https://doi.org/10.1159/000551883","url":null,"abstract":"<p><strong>Introduction: </strong>Biological rather than chronological age (C-age) drives deviation from healthy aging. This study aimed to identify a plasma metabolomic signature indicative of age-related cardiovascular risk (pMTB-age) predicting vascular morbidity and mortality.</p><p><strong>Methods: </strong>Nuclear magnetic resonance identified 38 plasma metabolites in two population cohorts: the Flemish cohort examined as discovery (<i>N</i> = 719 [2005-2010]) and internal replication cohort (<i>N</i> = 580/719 [2009-2013]) and the external replication Spanish Hortega cohort (<i>N</i> = 811 [2001]).</p><p><strong>Results: </strong>The trained model (pMTB-age), relating C-age to the plasma metabolome derived by elastic net regression, included 18 metabolites (six amino acids) and explained from 28.6% to 22.9% of C-age in the discovery and replication data. Feature importance of the retained metabolites derived by SHapley Additive exPlanation showed large interindividual variability in the relation between C-age and pMTB-age. In Flemish and Spanish, cardiovascular risk factors were significantly associated with C-age, pMTB-age, and pMTB-age uncorrelated from C-age (pMTB-age-R). In Flemish (median follow-up 12.3 years) and Spanish (18.8 years), mortality and cardiovascular complications correlated with C-age and pMTB-age. In Flemish, cardiac endpoints (hazard ratio [95% CI] 1.28 [1.00-1.63]) and its components kept significance in relation to pMTB-age-R. The pathway analysis revealed overrepresentation of glycine, serine, and threonine.</p><p><strong>Conclusions: </strong>pMTB-age is a multidimensional biomarker, which identifies individuals with accelerated vascular aging with high precision and combined with the pathway analysis highlights the role of amino acids in vascular disease. Therefore, pMTB-age can guide risk stratification and the personalized and timely prevention and treatment tailored to an individual's unique pMTB-age profile.</p>","PeriodicalId":29774,"journal":{"name":"Pulse","volume":"14 1","pages":"62-77"},"PeriodicalIF":3.4,"publicationDate":"2026-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13278728/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148296431","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Association between Serum Endostatin, Kidney Disease Progression, and Mortality in Patients with Chronic Kidney Disease in the Salford Kidney Study.","authors":"Johanna Helmersson-Karlqvist, Rajkumar Chinnadurai, Per Wändell, Axel Carl Carlsson, Philip A Kalra, Anders Olof Larsson, Tobias Feldreich, Johan Ärnlöv, Toralph Ruge","doi":"10.1159/000551072","DOIUrl":"https://doi.org/10.1159/000551072","url":null,"abstract":"<p><strong>Introduction: </strong>Patients with chronic kidney disease (CKD) have an increased risk of cardiovascular morbidity. Circulating endostatin is associated with both cardiovascular morbidity and impaired kidney function in the general population, but the utility of endostatin as a prognostic marker for CKD progression and mortality in patients with CKD is not well studied. The aim was to study association between serum endostatin and mortality, and also kidney function decline in a cohort of CKD patients (Salford Kidney Study [SKS]).</p><p><strong>Methods: </strong>Analyses were performed on baseline and annual follow-up samples from 970 adults in the SKS cohort with CKD stage 3-5. Association with mortality was studied using Cox proportional hazard models adjusted for age, gender, systolic and diastolic blood pressure, smoking status, diabetes mellitus, prior cardiovascular disease, creatinine-based estimated glomerular filtration rate (eGFR), and urine protein-to-creatinine ratio (uPCR). Associations between endostatin and eGFR decline were studied with linear regression analyses. eGFR decline was defined as the percentage difference between baseline eGFR and follow-up eGFR (median follow-up, 6.2 years).</p><p><strong>Results: </strong>Median age of the cohort was 66 years, with a median eGFR of 30 mL/min/1.73 m². Multivariate Cox regression models revealed an association between higher endostatin levels and mortality with adjustments for established cardiovascular risk factors (HR: 1.14; CI: 1.02-1.28; <i>p</i> = 0.02) but was attenuated and nonsignificant after adjustments for baseline eGFR and uPCR. Baseline levels of endostatin were associated with eGFR decline but were nonsignificant after adjustments for baseline eGFR and uPCR. Changes of endostatin concentrations during the study were significantly associated with eGFR decline in all models (regression coefficient 0.0023% decrease per month [95% confidence intervals 0.0012-0.0034, <i>p</i> < 0.001]).</p><p><strong>Conclusion: </strong>The clinical utility of plasma endostatin for risk prediction in CKD patients seems limited. Importantly, longitudinal changes of endostatin were significantly associated with eGFR decline. The clinical relevance of this warrants further studies.</p>","PeriodicalId":29774,"journal":{"name":"Pulse","volume":"14 1","pages":"31-42"},"PeriodicalIF":7.3,"publicationDate":"2026-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13155748/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147869681","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Aortic Calcification and Pulse Wave Velocity Remain Associated after Adjustment for Kidney Function and Covariates.","authors":"Jakob Nyvad, Kent Lodberg Christensen, Gratien Andersen, Mark Reinhard, Sebastian Nielsen, Martin Bjergskov Thomsen, Michael Maeng, Jesper Møller Jensen, Bjarne Linde Nørgaard, Niels Henrik Buus","doi":"10.1159/000551429","DOIUrl":"https://doi.org/10.1159/000551429","url":null,"abstract":"<p><strong>Introduction: </strong>Aortic wall calcification increases arterial stiffness which is often assessed by carotid-femoral pulse wave velocity (cfPWV). However, the impact of kidney function upon the association between calcification of the aortic wall and cfPWV remains unknown.</p><p><strong>Methods: </strong>To examine the association between aortic calcification and cfPWV, we prospectively recruited chronic kidney disease (CKD) patients (estimated glomerular filtration rate [eGFR] <60 mL/min/1.73 m²) and patients with normal renal function, planned for invasive coronary angiography. Participants underwent a non-contrast computed tomography scan of the entire aorta with subsequent Agatston scoring of the aortic wall in addition to a standardized cfPWV measurement and biochemical markers.</p><p><strong>Results: </strong>A total of 144 patients (67.1 ± 10.3 years, 24% female), of whom 110 had CKD (26 stage 3a, 33 stage 3b, 24 stage 4, and 27 stage 5), were included. Agatston score was associated with cfPWV in a univariate regression analysis (<i>p</i> < 0.001). So were age (<i>p</i> < 0.001) and diabetes (<i>p</i> = 0.001), but not gender, smoking status, eGFR, office systolic blood pressure, calcium-phosphate product, C-reactive protein nor vasodilator treatment. Multiple regression analysis including all these factors did not significantly change these associations and relative weight analysis revealed Agatston score to account for 30% of the variation in cfPWV in the model (total <i>r</i> ² = 0.31).</p><p><strong>Conclusion: </strong>In a cohort representing the entire spectrum of kidney function, aortic Agatston score, as well as age and diabetes, were associated with cfPWV after adjustment for other risk factors including eGFR. However, most of the variation in cfPWV remains unexplained by these factors.</p>","PeriodicalId":29774,"journal":{"name":"Pulse","volume":"14 1","pages":"43-52"},"PeriodicalIF":7.3,"publicationDate":"2026-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13193698/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148017752","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}