Anand Brahmandam MD , Rafael Alves BM , Hao Liu (刘灏) MD , Luis Gonzalez PhD , Yukihiko Aoyagi (青栁 幸彦) MD , Yuichi Ohashi (大橋 雄一) MD , John T. Langford MD , Carly Thaxton MD , Ryosuke Taniguchi (谷口 良輔) MD, PhD , Weichang Zhang (张惟常) MD, PhD , Hualong Bai (白华龙) MD, PhD , Bogdan Yatsula PhD , Alan Dardik MD, PhD
{"title":"A central arteriovenous fistula reduces systemic hypertension in a mouse model","authors":"Anand Brahmandam MD , Rafael Alves BM , Hao Liu (刘灏) MD , Luis Gonzalez PhD , Yukihiko Aoyagi (青栁 幸彦) MD , Yuichi Ohashi (大橋 雄一) MD , John T. Langford MD , Carly Thaxton MD , Ryosuke Taniguchi (谷口 良輔) MD, PhD , Weichang Zhang (张惟常) MD, PhD , Hualong Bai (白华龙) MD, PhD , Bogdan Yatsula PhD , Alan Dardik MD, PhD","doi":"10.1016/j.jvssci.2024.100191","DOIUrl":"10.1016/j.jvssci.2024.100191","url":null,"abstract":"<div><h3>Objective</h3><p>A central arteriovenous fistula (AVF) has been proposed as a potential novel solution to treat patients with refractory hypertension. We hypothesized that venous remodeling after AVF creation in the hypertensive environment reduces systemic blood pressure but results in increased AVF wall thickness compared with remodeling in the normotensive environment.</p></div><div><h3>Methods</h3><p>A central AVF was performed in C57BL6/J mice previously made hypertensive with angiotensin II (Ang II); mice were sacrificed on postoperative day 7 or 21.</p></div><div><h3>Results</h3><p>In mice treated with Ang II alone, the mean systolic blood pressure increased from 90 ± 5 mmHg to 160 ± 5 mmHg at day 21; however, in mice treated with both Ang II and an AVF, the blood pressure decreased with creation of an AVF. There were significantly more PCNA-positive cells, SM22α/PCNA-positive cells, collagen I deposition, and increased Krüppel-like Factor 2 immunoreactivity in hypertensive mice with an AVF compared with normotensive mice with an AVF.</p></div><div><h3>Conclusions</h3><p>These data show that a central AVF decreases systemic hypertension as well as induces local alterations in venous remodeling.</p></div>","PeriodicalId":74035,"journal":{"name":"JVS-vascular science","volume":"5 ","pages":"Article 100191"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666350324000026/pdfft?md5=60786e70b011585e96e3a0ee22d68666&pid=1-s2.0-S2666350324000026-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139832835","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}
Marianna Pavlyha MD , Madeleine Hunter MD , Roman Nowygrod MD , Virenda Patel MD, MPH , Nicholas Morrissey MD , Danielle Bajakian MD , Yihao Li MS , Gissette Reyes-Soffer MD
{"title":"Small apolipoprotein(a) isoforms may predict primary patency following peripheral arterial revascularization","authors":"Marianna Pavlyha MD , Madeleine Hunter MD , Roman Nowygrod MD , Virenda Patel MD, MPH , Nicholas Morrissey MD , Danielle Bajakian MD , Yihao Li MS , Gissette Reyes-Soffer MD","doi":"10.1016/j.jvssci.2024.100211","DOIUrl":"https://doi.org/10.1016/j.jvssci.2024.100211","url":null,"abstract":"<div><h3>Background</h3><p>High lipoprotein (a) [Lp(a)] is associated with adverse limb events in patients undergoing lower extremity revascularization. Lp(a) levels are genetically pre-determined, with <em>LPA</em> gene encoding for two apolipoprotein (a) [apo(a)] isoforms. Isoform size variations are driven by the number of kringle IV type 2 (KIV-2) repeats. Lp(a) levels are inversely correlated with isoform size. In this study, we examined the role of Lp(a) levels, apo(a) size, and inflammatory markers with lower extremity revascularization outcomes.</p></div><div><h3>Methods</h3><p>Twenty-five subjects with chronic peripheral arterial disease (PAD) underwent open or endovascular lower extremity revascularization (mean age, 66.7 ± 9.7 years; Female = 12; Male = 13; Black = 8; Hispanic = 5; and White = 12). Pre- and postoperative medical history, self-reported symptoms, ankle-brachial indices (ABIs), and lower extremity duplex ultrasounds were obtained. Plasma Lp(a), apoB100, lipid panel, and pro-inflammatory markers (IL-6, IL-18, hs-CRP, TNFα) were assayed preoperatively. Isoform size was estimated using gel electrophoresis and weighted isoform size (<em>wIS</em>) calculated based on % isoform expression. Firth logistic regression was used to examine the relationship between Lp(a) levels and <em>wIS</em> with procedural outcomes: symptoms (better/worse), early primary patency at 2 to 4 weeks, ABIs, and reintervention within 3 to 6 months. We controlled for age, sex, history of diabetes, smoking, statin, antiplatelet, and anticoagulation use.</p></div><div><h3>Results</h3><p>Median plasma Lp(a) level was 108 (interrquartile range, 44-301) nmol/L. The mean apoB100 level was 168.0 ± 65.8 mg/dL. These values were not statistically different among races. We found no association between Lp(a) levels and w<em>IS</em> with measured plasma pro-inflammatory markers. However, smaller apo(a) <em>wIS</em> was associated with occlusion of the treated lesion(s) in the postoperative period (odds ratio, 1.97; 95% confidence interval, 1.01-3.86; <em>P</em> < .05). The relationship of smaller apo(a) <em>wIS</em> with reintervention was not as strong (odds ratio, 1.57; 95% confidence interval, 0.96-2.56; <em>P</em> = .07). We observed no association between <em>wIS</em> with patient reported symptoms or change in ABIs.</p></div><div><h3>Conclusions</h3><p>In this small study, subjects with smaller apo(a) isoform size undergoing peripheral arterial revascularization were more likely to experience occlusion in the postoperative period and/or require reintervention. Larger cohort studies identifying the mechanism and validating these preliminary data are needed to improve understanding of long-term peripheral vascular outcomes.</p></div>","PeriodicalId":74035,"journal":{"name":"JVS-vascular science","volume":"5 ","pages":"Article 100211"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666350324000221/pdfft?md5=51b8275b14785503ef1bd582d15e92f7&pid=1-s2.0-S2666350324000221-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141582807","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}
Cassius Iyad Ochoa Chaar MD, MS , Tanner Kim MD , Dana Alameddine MD , Andrew DeWan PhD , Raul Guzman MD , Alan Dardik MD, PhD , Holly K. Grossetta Nardini MLS , Joshua D. Wallach PhD , Iftikhar Kullo MD , Michael Murray MD
{"title":"Systematic review and meta-analysis of the genetics of peripheral arterial disease","authors":"Cassius Iyad Ochoa Chaar MD, MS , Tanner Kim MD , Dana Alameddine MD , Andrew DeWan PhD , Raul Guzman MD , Alan Dardik MD, PhD , Holly K. Grossetta Nardini MLS , Joshua D. Wallach PhD , Iftikhar Kullo MD , Michael Murray MD","doi":"10.1016/j.jvssci.2023.100133","DOIUrl":"10.1016/j.jvssci.2023.100133","url":null,"abstract":"<div><h3>Background</h3><p>Peripheral artery disease (PAD) impacts more than 200 million people worldwide. The understanding of the genetics of the disease and its clinical implications continue to evolve. This systematic review provides a comprehensive summary of all DNA variants that have been studied in association with the diagnosis and progression of PAD, with a meta-analysis of the ones replicated in the literature.</p></div><div><h3>Methods</h3><p>A systematic review of all studies examining DNA variants associated with the diagnosis and progression of PAD was performed. Candidate gene and genome-wide association studies (GWAS) were included. A meta-analysis of 13 variants derived from earlier smaller candidate gene studies of the diagnosis of PAD was performed. The literature on the progression of PAD was limited, and a meta-analysis was not feasible because of the heterogeneity in the criteria used to characterize it.</p></div><div><h3>Results</h3><p>A total of 231 DNA variants in 112 papers were studied for the association with the diagnosis of PAD. There were significant variations in the definition of PAD and the selection of controls in the various studies. GWAS have established 19 variants associated with the diagnosis of PAD that were replicated in several large patient cohorts. Only variants in intercellular adhesion molecule-1 (rs5498), IL-6 (rs1800795), and hepatic lipase (rs2070895) showed significant association with the diagnosis of PAD. However, these variants were not noted in the published GWAS.</p></div><div><h3>Conclusions</h3><p>Genetic research in the diagnosis of PAD has significant heterogeneity, but recent GWAS have demonstrated variants consistently associated with the disease. More research focusing on the progression of PAD is needed to identify patients at risk of adverse events and develop strategies that would improve their outcomes.</p></div>","PeriodicalId":74035,"journal":{"name":"JVS-vascular science","volume":"5 ","pages":"Article 100133"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666350323000378/pdfft?md5=97acbf5f67b9b955600edb1326df5a52&pid=1-s2.0-S2666350323000378-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135763503","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}
Wojciech Derwich MD, MHBA , Manuel Schönborn MEng , Christopher Blase RNDr , Andreas Wittek Dr-Ing , Kyriakos Oikonomou MD, PhD , Dittmar Böckler MD, PhD, MHBA , Philipp Erhart MD, PhD, MHBA
{"title":"Correlation of four-dimensional ultrasound strain analysis with computed tomography angiography wall stress simulations in abdominal aortic aneurysms","authors":"Wojciech Derwich MD, MHBA , Manuel Schönborn MEng , Christopher Blase RNDr , Andreas Wittek Dr-Ing , Kyriakos Oikonomou MD, PhD , Dittmar Böckler MD, PhD, MHBA , Philipp Erhart MD, PhD, MHBA","doi":"10.1016/j.jvssci.2024.100199","DOIUrl":"10.1016/j.jvssci.2024.100199","url":null,"abstract":"<div><h3>Objective</h3><p>Biomechanical modeling of infrarenal aortic aneurysms seeks to predict ruptures in advance, thereby reducing aneurysm-related deaths. As individual methods focusing on strain and stress analysis lack adequate discretization power, this study aims to explore multifactorial characterization for progressive aneurysmal degeneration. The study’s objective is to compare stress- and strain-related parameters in infrarenal aortic aneurysms.</p></div><div><h3>Methods</h3><p>Twenty-two patients with abdominal aortic aneurysms (AAAs) (mean maximum diameter, 53.2 ± 7.2 mm) were included in the exploratory study, examined by computed tomography angiography (CTA) and three-dimensional real-time speckle tracking ultrasound (4D-US). The conformity of aneurysm anatomy in 4D-US and CTA was determined with the mean point-to-point distance (MPPD). CTA was employed for each AAA to characterize stress-related indices using the semi-automated A4-clinics RE software. Five segmentations from one 4D-US examination were fused into one averaged model for strain analysis using MATLAB and the Abaqus solver.</p></div><div><h3>Results</h3><p>The mean MPPD between the adjacent points of the 4D-US and CTA-derived geometry was 1.8 ± 0.4 mm. The interclass correlation coefficients for all raters and all measurements for the maximum AAA diameter in 2D, 4D ultrasound, and CTA indicate moderate to good reliability (interclass correlation coefficient<sub>1</sub> 0.69 with 95% confidence interval [CI], 0.49-0.84; <em>P</em> < .001). The peak wall stress (PWS) correlates fairly with the maximum AAA diameter in 2D-US (r = 0.54; <em>P</em> < .01) and 4D-US (r = 0.53; <em>P</em> < .05) and moderately strongly with the maximum exterior AAA diameter (r = 0.63; <em>P</em> < .01). The peak wall rupture risk index shows a strong correlation with the PWS (ρ > 0.9; <em>P</em> < .001) and is influenced by anatomical parameters with equal strength. Isolated observation of the intraluminal thrombus does not provide significant information in the determination of PWS. The maximum AAA diameter in 2D-US shows a fair negative correlation with the mean circumferential, longitudinal and in-plane shear strain (ρ = −0.46; r = −0.45; ρ = −0.47; <em>P</em> < .05 for all). The circumferential strain ratio as an indicator of wall motion heterogeneity increases with the aneurysm diameter (r = 0.47; <em>P</em> < .05). The direct comparison of wall strain and wall stress indices shows no quantitative correlation.</p></div><div><h3>Conclusions</h3><p>The strain and stress analyses provide independent biomechanical information of AAAs. At the current stage of development, the two methods are considered complementary and may optimize a more patient-specific rupture risk prediction in the future.</p></div>","PeriodicalId":74035,"journal":{"name":"JVS-vascular science","volume":"5 ","pages":"Article 100199"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666350324000105/pdfft?md5=42932adee70e336a4d63c951df71ba17&pid=1-s2.0-S2666350324000105-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140273013","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":"A new large animal model in venous thromboembolism","authors":"Marianna Pavlyha MD , Alan Dardik MD, PhD","doi":"10.1016/j.jvssci.2024.100201","DOIUrl":"10.1016/j.jvssci.2024.100201","url":null,"abstract":"","PeriodicalId":74035,"journal":{"name":"JVS-vascular science","volume":"5 ","pages":"Article 100201"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666350324000129/pdfft?md5=e6ebf231f7fca24919583ae2373db5c7&pid=1-s2.0-S2666350324000129-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140276996","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}
Peter James Bruhn MD , Majken Lyhne Jessen MD , Jonas Eiberg MD, PhD , Qasam Ghulam MD, PhD
{"title":"Hypoxia inducible factor 1-alpha in the pathogenesis of abdominal aortic aneurysms in vivo: A narrative review","authors":"Peter James Bruhn MD , Majken Lyhne Jessen MD , Jonas Eiberg MD, PhD , Qasam Ghulam MD, PhD","doi":"10.1016/j.jvssci.2023.100189","DOIUrl":"10.1016/j.jvssci.2023.100189","url":null,"abstract":"<div><p>Abdominal aortic aneurysms (AAAs) are relatively common, primarily among older men, and, in the case of rupture, are associated with high mortality. Although procedure-related morbidity and mortality have improved with the advent of endovascular repair, noninvasive treatment and improved assessment of AAA rupture risk should still be sought. Several cellular pathways seem contributory to the histopathologic changes that drive AAA growth and rupture. Hypoxia inducible factor 1-alpha (HIF-1α) is an oxygen-sensitive protein that accumulates in the cytoplasm under hypoxic conditions and regulates a wide array of downstream effectors to hypoxia. Examining the potential role of HIF-1α in the pathogenesis of AAAs is alluring, because local hypoxia is known to be present in the AAA vessel wall. A systematic scoping review was performed to review the current evidence regarding the role of HIF-1α in AAA disease in vivo. After screening, 17 studies were included in the analysis. Experimental animal studies and human studies show increased HIF-1α activity in AAA tissue compared with healthy aorta and a correlation of HIF-1α activity with key histopathologic features of AAA disease. In vivo HIF-1α inhibition in animals protects against AAA development and growth. One study reveals a positive correlation between HIF-1α–activating genetic polymorphisms and the risk of AAA disease in humans. The main findings suggest a causal role of HIF-1α in the pathogenesis of AAAs in vivo. Further research into the HIF-1α pathway in AAA disease might reveal clinically applicable pharmacologic targets or biomarkers relevant in the treatment and monitoring of AAA disease.</p></div>","PeriodicalId":74035,"journal":{"name":"JVS-vascular science","volume":"5 ","pages":"Article 100189"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666350323000937/pdfft?md5=e74bfdf09e3161db2aaec1f065cf1e87&pid=1-s2.0-S2666350323000937-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139194076","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":"A new rat model of aortic sympathetic denervation","authors":"Marianna Pavlyha MD , Alan Dardik MD, PhD","doi":"10.1016/j.jvssci.2024.100205","DOIUrl":"10.1016/j.jvssci.2024.100205","url":null,"abstract":"","PeriodicalId":74035,"journal":{"name":"JVS-vascular science","volume":"5 ","pages":"Article 100205"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666350324000166/pdfft?md5=557a5ee8bf03c9370cb9fb68eab23552&pid=1-s2.0-S2666350324000166-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141049571","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":"Toll-like receptor 4, a potential therapeutic target of lower limb ischemic myopathy that raises further questions","authors":"Ali H. Hakim MD , Ulf Hedin MD, PhD","doi":"10.1016/j.jvssci.2024.100195","DOIUrl":"10.1016/j.jvssci.2024.100195","url":null,"abstract":"","PeriodicalId":74035,"journal":{"name":"JVS-vascular science","volume":"5 ","pages":"Article 100195"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666350324000063/pdfft?md5=f8e84094eb706ee57b0a7c200c648cbb&pid=1-s2.0-S2666350324000063-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139884775","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}
David P. Stonko MD, MS , Mathieu C. Rousseau MD , Colin Price BS , Amy Benike MS , Rebecca N. Treffalls BS , Nichole E. Brunton DO , Dorian Rosen PhD , Jonathan J. Morrison MBChB, PhD
{"title":"Technical and analytical approach to biventricular pressure-volume loops in swine including a completely endovascular, percutaneous closed-chest large animal model","authors":"David P. Stonko MD, MS , Mathieu C. Rousseau MD , Colin Price BS , Amy Benike MS , Rebecca N. Treffalls BS , Nichole E. Brunton DO , Dorian Rosen PhD , Jonathan J. Morrison MBChB, PhD","doi":"10.1016/j.jvssci.2024.100190","DOIUrl":"10.1016/j.jvssci.2024.100190","url":null,"abstract":"<div><p>Pressure-volume (PV) loop analysis is a sophisticated invasive approach to quantifying load-dependent and independent measures of cardiac function. Biventricular (BV) PV loops allow left and right ventricular function to be quantified simultaneously and independently, which is important for conditions and certain physiologic states, such as ventricular decoupling or acute physiologic changes. BV PV loops can be performed in an entirely endovascular, percutaneous, and closed-chest setting. This technique is helpful in a survival animal model, as a percutaneous monitoring system during endovascular device experiments, or in cases where chest wall compliance is being tested or may be a confounder. In this article, we describe the end-to-end implementation of a completely endovascular, totally percutaneous, and closed-chest large animal model to obtain contemporaneous BV PV loops in 40 to 70 kg swine. We describe the associated surgical and technical challenges and our solutions to obtaining endovascular BV PV loops, closed-chest cardiac output, and stroke volume (including validation of the correction factor necessary for thermodilution), as well as how to perform endovascular inferior vena cava occlusion in this swine model. We also include techniques for data acquisition and analysis that are required for this method.</p></div>","PeriodicalId":74035,"journal":{"name":"JVS-vascular science","volume":"5 ","pages":"Article 100190"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666350324000014/pdfft?md5=e902bcba624ca754a31ab13d638a2cee&pid=1-s2.0-S2666350324000014-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139639781","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}