Publications by authors named "Antonia Perez-Martin"

39 Publications

Effect of vitamin D supplementation on microvascular reactivity in obese adolescents: A randomized controlled trial.

Nutr Metab Cardiovasc Dis 2021 May 10. Epub 2021 May 10.

UMR MOISA, Univ Montpellier, CIRAD, CIHEAM-IAM, INRA, Montpellier SupAgro, Montpellier, France.

Background And Aim: Childhood obesity is associated with vitamin D (VD) deficiency and vascular dysfunction. Considering evidence indicates that VD may improve vascular function, this study, for the first time, assessed the effect of VD supplementation on microvascular reactivity in obese adolescents (OA).

Methods And Results: This randomized controlled trial included 26 OA, receiving fruit juice with (n = 13) or without VD (4000 IU/d; n = 13) over a 3-month lifestyle program, as well as 23 normal-weight adolescents (controls). The primary outcome was the pre-to-post-program change in microvascular reactivity determined by laser speckle contrast imaging with acetylcholine and sodium nitroprusside iontophoresis. Changes in 25 hydroxyvitamin D (25(OH)D), flow-mediated dilation (FMD), nitrate-mediated dilation (NMD), insulin resistance (HOMA-IR) and inflammatory markers (C-reactive protein [CRP]) were monitored. At inclusion, in comparison to controls, OA exhibited lower total and free 25(OH)D, impaired microvascular responses, and impaired FMD, but similar NMD. After the lifestyle program, total and free 25(OH)D increased in all OA, with a greater increase in those receiving VD supplements. HOMA-IR and CRP decreased in all OA. Neither FMD nor NMD were altered in either group. Endothelium-dependent microvascular reactivity only increased in the VD-supplemented group, reaching values comparable to that of controls. Similar results were found when analyzing only OA with a VD deficiency at baseline.

Conclusion: VD supplementation during a lifestyle program attenuated microvascular dysfunction in OA without altering macrovascular function.

Registration Number For Clinical Trial: NCT02400151.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.numecd.2021.04.025DOI Listing
May 2021

Early ADAMTS13 testing associates with pre-eclampsia occurrence in antiphospholipid syndrome.

Thromb Res 2021 Apr 27;203:101-109. Epub 2021 Apr 27.

Department of Gynaecology and Obstetrics, First Moscow State Medical University (Sechenov University), Russian Federation; Department of Haematology, CHU Nîmes, Univ Montpellier, Nîmes, France; Faculty of Pharmaceutical and Biological Sciences, Montpellier University, Montpellier, France; UA 011 INSERM- Université de Montpellier, Institut Desbrest d'Epidémiologie et de Santé Publique, Montpellier, France. Electronic address:

Introduction: Women with obstetric antiphospholipid syndrome (oAPS) still develop placental diseases, mainly pre-eclampsia (PEcl), which diagnosis is associated with reduced ADAMTS13 levels. Testing ADAMTS13 in newly pregnant oAPS may provide evidence for risk stratification.

Materials And Methods: We retrospectively investigated the prognostic value of ADAMTS13 activity, antigen and antibodies on stored plasma samples obtained prior to beginning low-molecular weight heparin-low dose aspirin treatment in 513 oAPS women.

Results: Some women had evidences of early positive ADAMTS13 antibodies and low ADAMTS13 activity:antigen ratio, suggestive of ADAMTS13 dysfunction. Women with a subsequent PEcl had higher ADAMTS13 antibodies (p < 0.0001), and lower ADAMTS13 activity and activity:antigen ratios (p < 0.0001). In multivariate analysis, these markers were significant risk factors for PEcl and for the most devastating PEcl subgroups (early-onset PEcl, severe PEcl, PEcl with no living child after 28 days). ADAMTS13-related markers showed acceptable discrimination power to predict clinical events, particularly for ADAMTS13 activity:antigen ratio in predicting PEcl cases with no living child after 28 days (AUC: 0.844 (0.712-0.974), p < 0.0001), with excellent negative predictive value (0.990).

Conclusions: The characterization of ADAMTS13 in newly pregnant women with oAPS depicts the risk of PEcl occurrence. ADAMTS13 might help identify pregnant women with oAPS not requiring escalating treatment strategies to prevent PEcl.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.thromres.2021.04.021DOI Listing
April 2021

Acute effects of graduated and progressive compression stockings on leg vein cross-sectional area and viscoelasticity in patients with chronic venous disease.

J Vasc Surg Venous Lymphat Disord 2021 May 5. Epub 2021 May 5.

Vascular Medicine, Montpellier University Hospital, France; EA2992, Montpellier University, France.

Objective: To determine the effects of graduated and progressive elastic compression stockings (ECS) on postural diameter changes and viscoelasticity of leg veins in healthy controls and in limbs with chronic venous disease (CVD).

Methods: In 57 patients whose legs presented with C, C, or C CEAP classes of CVD and treated primarily with compression, and 54 healthy controls matched for age and body mass index, we recorded interface pressures at 9 reference leg levels. Cross-sectional areas of the small saphenous vein (SSV) and a deep calf vein (DCV) were measured with B-mode ultrasound with subjects supine and standing, recording the force (PF) applied on the ultrasound probe to collapse each vein with progressive ECS, and with and without graduated 15‒20 mmHg and 20‒36 mmHg elastic stockings. We chose these veins because they were free of detectable lesion and could be investigated at the same level (mid-height of the calf), while their compression by the ultrasound probe was not hampered by bone structures.

Results: Interface pressures decreased from ankle to knee with graduated 15‒20 and 20‒36 mmHg, but increased with progressive ECS, and were 8.4‒13.8 mmHg lower for C than for control or C and C limbs. Without ECS, SSV median [lower‒upper quartile] cross-sectional area was 4.9[3.6‒7.1] and 7.1[3.0‒9.9]mm in C and C limbs vs. 2.9[1.8‒5.2] and 3.8[2.1‒5.4]mm in controls (p<.01), respectively while supine and standing. It remained greater in C and C than in C and control limbs wearing any ESC. Wearing compression, especially with progressive ECS, decreased SSV and DCV cross-sectional area only with subjects supine, thus lowering postural changes which remained highly diverse between individuals. The SSV cross-sectional area vs. PF function traced a hysteresis loop of which the area, related to viscosity, was greater in C and C limbs than controls, even with graduated 15‒20 or 20‒36 mmHg ECS. Progressive ECS lowered vein viscosity in the supine position whereas 20‒36 mm Hg and progressive ECS increased distensibility in the standing position.

Conclusion: Elastic compression stockings reduce cross-sectional area of superficial and deep calf veins with patients supine but not upright. C limbs show distinctive features, especially regarding interface pressures. Graduated 20‒36 mm Hg and progressive stockings lower viscosity and increase distensibility of the small saphenous vein.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.jvsv.2021.03.021DOI Listing
May 2021

Mechanisms of Venoarteriolar Reflex in Type 2 Diabetes with or without Peripheral Neuropathy.

Biology (Basel) 2021 Apr 15;10(4). Epub 2021 Apr 15.

STAPS Department, Avignon Université, LAPEC EA4278, 84000 Avignon, France.

The aim of this study is to investigate the underlying mechanisms of the venoarteriolar reflex (VAR) in type 2 diabetes mellitus (T2DM), with and without peripheral neuropathy. Laser Doppler flowmetry (LDF) recordings were performed on the medial malleus and dorsal foot skin, before and during leg dependency in healthy controls, in persons with obesity, in those with T2DM, in those with T2DM and subclinical neuropathy, and in those with T2DM and confirmed neuropathy. LDF recordings were analyzed with the wavelet transform to evaluate the mechanisms controlling the flowmotion (i.e., endothelial nitric oxide-independent and -dependent, neurogenic, myogenic, respiratory and cardiac mechanisms). Skin blood perfusion decreased throughout leg dependency at both sites. The decrease was blunted in persons with confirmed neuropathy compared to those with T2DM alone and the controls. During leg dependency, total spectral power increased in all groups compared to rest. The relative contribution of the endothelial bands increased and of the myogenic band decreased, without differences between groups. Neurogenic contribution decreased in controls, in persons with obesity and in those with T2DM, whereas it increased in subclinical- and confirmed neuropathy. In conclusion, this study provides evidence that confirmed diabetic neuropathy alters the VAR through the neurogenic response to leg dependency.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3390/biology10040333DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8071175PMC
April 2021

Changes in the profile of circulating HDL subfractions in severe obese adolescents following a weight reduction program.

Nutr Metab Cardiovasc Dis 2021 05 10;31(5):1586-1593. Epub 2021 Feb 10.

Institute of Bioengineering and Department of Applied Biology-Nutrition, University Miguel Hernandez, Alicante Institute for Health and Biomedical Research (ISABIAL), Alicante, Spain; CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain. Electronic address:

Background And Aims: Epidemiological studies show that obese adolescents are candidates to suffer cardiovascular pathologies in adulthood. In order to detect subfractions with a diagnostic value for future cardiovascular disorders, we analyzed the complete lipoprotein profile of severely obese adolescents.

Methods And Results: Twenty-eight obese adolescents free from comorbidities were admitted into a weight reduction program. Anthropometric parameters were monitored. The circulating lipoproteins and glycemia were measured at the beginning and at the end of the study by conventional blood analysis as well as by using lipoprotein electrophoresis. Twenty-one puberty-matched normal-weight adolescents were recruited as controls. After 4 months, participants improved anthropometric parameters. Blood analysis indicated that circulating lipoproteins were in the healthy range during intervention. Nevertheless, results obtained from lipoprotein electrophoresis showed a significant increase in the large high-density lipoprotein subfraction in the obese population at the end of intervention, but significantly lower than normal-weight counterparts. In addition, intermediate- and low-density lipoprotein subfractions were in the healthy range in controls and in obese adolescents during intervention.

Conclusions: Altogether, it seems that the obese adolescents with no comorbidities do not develop a clear dyslipidemia. However, low values of large high-density lipoprotein subfractions could be considered as candidate predictors to develop cardiovascular disease in the future. For this reason, diet and exercise are key tools to fight against this pathology.

Registration Number For Clinical Trials: ISRCTN99414527.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.numecd.2021.01.025DOI Listing
May 2021

Performance of the Wells score in predicting deep vein thrombosis in medical and surgical hospitalized patients with or without thromboprophylaxis: The R-WITT study.

Vasc Med 2021 Jun 22;26(3):288-296. Epub 2021 Mar 22.

Vascular Medicine Department, University Hospital Nîmes, Nîmes, Languedoc-Roussillon, France.

The Wells score had shown weak performance to determine pre-test probability of deep vein thrombosis (DVT) for inpatients. So, we evaluated the impact of thromboprophylaxis on the utility of the Wells score for risk stratification of inpatients with suspected DVT. This bicentric cross-sectional study from February 1, 2018 to January 31, 2019 included consecutive medical and surgical inpatients who underwent lower limb ultrasound study for suspected DVT. Wells score clinical predictors were assessed by both ordering and vascular physicians within 24 h after clinical suspicion of DVT. Primary outcome was the Wells score's accuracy for pre-test risk stratification of suspected DVT, accounting for anticoagulation (AC) treatment (thromboprophylaxis for ⩾ 72 hours or long-term anticoagulation). We compared prevalence of proximal DVT among the low, moderate and high pre-test probability groups. The discrimination accuracy was defined as area under the receiver operating characteristics (ROC) curve. Of the 415 included patients, 30 (7.2%) had proximal DVT. Prevalence of proximal DVT was lower than expected in all pre-test probability groups. The prevalence in low, moderate and high pre-test probability groups was 0.0%, 3.1% and 8.2% ( = 0.22) and 1.7%, 4.2% and 25.8% ( < 0.001) for inpatients with or without AC, respectively. Area under ROC curves for discriminatory accuracy of the Wells score, for risk of proximal DVT with or without AC, was 0.72 and 0.88, respectively. The Wells score performed poorly for discrimination of risk for proximal DVT in hospitalized patients with AC but performed reasonably well among patients without AC; and showed low inter-rater reliability between physicians.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1177/1358863X21994672DOI Listing
June 2021

Diabetes-associated dermatological manifestations in primary care and their association with vascular complications.

J Diabetes Metab Disord 2020 Dec 16;19(2):989-996. Epub 2020 Sep 16.

General Practice, 66650 Banuyls-sur-Mer, France.

Introduction: Although type 2 diabetes mellitus (DM) is a global public health problem, the diabetes-associated dermatological (non-infectious) manifestations (DADM) remain poorly understood and under-diagnosed. We aimed to evaluate the prevalence of 7 known DADM in a primary care setting, and their association macro/microvascular complications.

Methods: Cross-sectionnal study included patients consulting in general practice for DM-follow up, from November 2016 to January 2017. Patients aged <18 years old or consulting for other reason than DM follow up were excluded. Each patient were screened for diabetic dermopathy (DD), Huntley's papules (HP), necrobiosis lipoidica diabeticorum (NL), acanthosis nigricans (AN), cheiroarthropathy (CA, or stiff hand syndrom), scleredema adultorum of Buschke (SB) and bullosis diabeticorum (BD).

Results: 213 diabetic patients were included over a period of 3 months. We found a prevalence of 17.8% (38 patients) for DD, 8.5% (18) for HP, 2.8% (6) for NL, 2.3% (5) for AN, 1.9% (4) for CA, 1.4% (3) for SB and 1.4% (3) for BD. DADM seems to be a risk factor for vascular complications (OR 1.97,  ≤ 0.001). Association with vascular involvement was stronger with DD and macroangiopathy (OR 1.86,  ≤ 0.001), and with NL and microangiopathy (OR 9.7, p ≤ 0.001).

Conclusion: In primary care, DM-associated dermatological manifestations present similar prevalence rates to a tertiary care setting, based on litterature. Complete dermatological examination of diabetic patients is essential and could lead to a better overall management of the pathology, as diabetic cutaneous manifestations appear as a sign of vascular involvement.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1007/s40200-020-00594-1DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7843712PMC
December 2020

Disparities Between International Guidelines (AHA/ESC/ESVS/ESVM/SVS) Concerning Lower Extremity Arterial Disease: Consensus of the French Society of Vascular Medicine (SFMV) and the French Society for Vascular and Endovascular Surgery (SCVE).

Ann Vasc Surg 2021 Apr 24;72:1-56. Epub 2020 Dec 24.

Cardiology Department, Sart Tilman University Hospital Centre, Liège, Belgium.

Several international guidelines concerning lower extremity arterial disease (LEAD) have been published recently, in particular, by the American Heart Association the European Society of Cardiology/European Society for Vascular Surgery, the European Society for Vascular Medicine and the Society for Vascular Surgery. These guidelines differ in some respects and certain issues are not addressed. The objective of this consensus driven by the French Societies of vascular Medicine and surgery was to analyze the disparities between the different guidelines, as well as certain issues not covered, and develop proposals with regard to these points. The following fields of LEAD have been explored: 1) classifications, 2) clinical evaluation, 3) diagnostic criteria, 4) quantification of arterial stenosis using duplex ultrasound, 5) detection of asymptomatic multisite lesions, 6) screening for LEAD in the context of cardiac disease, 7) medical treatment, 8) supervised exercise therapy, 9) revascularization and revascularization of the internal artery stenosis, 10) management of chronic limb ischemia, 11) longitudinal follow-up, and 12) diet.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.avsg.2020.11.011DOI Listing
April 2021

Noninvasive measurement of venous wall deformation induced by changes in transmural pressure shows altered viscoelasticity in patients with chronic venous disease.

J Vasc Surg Venous Lymphat Disord 2020 Nov 21. Epub 2020 Nov 21.

Department of Vascular Medicine, Montpellier University Hospital, Montpellier, France; University Research Unit # EA2992 (Female Characteristics of Dysfunctions of Cardiovascular Interfaces), Montpellier University, Montpellier, France.

Objective: The noninvasive measurement of venous wall deformation induced by changes in transmural pressure could allow for the assessment of viscoelasticity and differentiating normal from diseased veins.

Methods: In 57 patients with limbs in the C1s (telangiectasia or reticular veins and symptoms), C3 (edema), or C5 (healed venous ulcer) CEAP (clinical, etiologic, anatomic, pathophysiologic) category of chronic venous disease and 54 matched healthy controls, we measured the changes in the cross-sectional area of the small saphenous vein and a deep calf vein in the supine and standing positions and under compression with an ultrasound probe using ultrasonography.

Results: The small saphenous vein, but not the deep calf vein, cross-sectional area was smaller in the limbs of the controls than in the limbs with C3 or C5 disease but was not different from that in C1s limbs. When changing from the supine to the standing position, a greater force was required to collapse the leg veins. Their cross-sectional area increased in most subjects but decreased in 31.5% of them as for the small saphenous veins and 40.5% for the deep calf vein. The small saphenous vein area vs compression force function followed a hysteresis loop, demonstrating viscoelastic features. Its area, which represents the viscosity component, was greater (P < .001) in the pooled C3 and C5 limbs (median, 2.40 N⋅mm; lower quartile [Q1] to upper quartile [Q3], 1.65-3.88 N⋅mm) than in the controls (median, 1.24 N⋅mm; Q1-Q3, 0.64-2.14 N⋅mm) and C1s limbs (median, 1.15 N⋅mm; Q1-Q3, 0.71-2.97 N⋅mm). The area increased (P < .0001) in the standing position in all groups.

Conclusions: Postural changes in the cross-sectional area of the leg veins were highly diverse among patients with chronic venous disease and among healthy subjects and appear unsuitable for pathophysiologic characterization. In contrast, small saphenous vein viscoelasticity increased consistently in the standing position and the viscosity was greater in limbs with C3 and C5 CEAP disease than in controls.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.jvsv.2020.11.010DOI Listing
November 2020

COPD is deleterious for pericytes: implications during training-induced angiogenesis in skeletal muscle.

Am J Physiol Heart Circ Physiol 2020 11 28;319(5):H1142-H1151. Epub 2020 Sep 28.

PhyMedExp, INSERM-CNRS-Montpellier University, CHU Montpellier, Montpellier, France.

Improvements in skeletal muscle endurance and oxygen uptake are blunted in patients with chronic obstructive pulmonary disease (COPD), possibly because of a limitation in the muscle capillary oxygen supply. Pericytes are critical for capillary blood flow adaptation during angiogenesis but may be impaired by COPD systemic effects, which are mediated by circulating factors. This study compared the pericyte coverage of muscle capillaries in response to 10 wk of exercise training in patients with COPD and sedentary healthy subjects (SHS). Fourteen patients with COPD were compared with seven matched SHS. SHS trained at moderate intensity corresponding to an individualized moderate-intensity patient with COPD trained at the same relative (%V̇o: COPD-RI) or absolute (mL·min·kg: COPD-AI) intensity as SHS. Capillary-to-fiber ratio (C/F) and NG2 pericyte coverage were assessed from muscle biopsies, before and after 5 and 10 wk of training. We also tested in vitro the effect of COPD and SHS serum on pericyte morphology and mesenchymal stem cell (MSC) differentiation into pericytes. SHS showed greater improvement in aerobic capacity (V̇o) than both patients with COPD-RI and patients with COPD-AI (Group × Time: = 0.004). Despite a preserved increase in the C/F ratio, NG2 pericyte coverage did not increase in patients with COPD in response to training, contrary to SHS (Group × Time: = 0.011). Conversely to SHS serum, COPD serum altered pericyte morphology ( < 0.001) and drastically reduced MSC differentiation into pericytes ( < 0.001). Both functional capacities and pericyte coverage responses to exercise training are blunted in patients with COPD. We also provide direct evidence of the deleterious effect of COPD circulating factors on pericyte morphology and differentiation. This work confirms the previously reported impairment in the functional response to exercise training of patients with COPD compared with SHS. Moreover, it shows for the first time that pericyte coverage of the skeletal capillaries is drastically reduced in patients with COPD compared with SHS during training-induced angiogenesis. Finally, it provides experimental evidence that circulating factors are involved in the impaired pericyte coverage of patients with COPD.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1152/ajpheart.00306.2020DOI Listing
November 2020

COVID-19 associated coagulopathy: The crowning glory of thrombo-inflammation concept.

Anaesth Crit Care Pain Med 2020 06 4;39(3):381-382. Epub 2020 May 4.

Department of infectious and tropical diseases, university Montpellier, CHU Nîmes, Nîmes, France.

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.accpm.2020.04.013DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7196534PMC
June 2020

Atypical transient perivascular inflammation of the carotid artery (TIPIC) in a previously diagnosed VWD type 2 M.

Haemophilia 2020 Jul 29;26(4):e221-e222. Epub 2020 Apr 29.

UPRES EA2992 "Caractéristiques Féminines des Dysfonctions des Interfaces Vasculaires", University of Montpellier, Montpellier, France.

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1111/hae.14021DOI Listing
July 2020

Uncertainties on the prognostic value of D-dimers in COVID-19 patients.

J Thromb Haemost 2020 08 28;18(8):2066-2067. Epub 2020 May 28.

Department of Infectious and Tropical Diseases, Nîmes University Hospital, Nîmes, France.

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1111/jth.14876DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7267237PMC
August 2020

Normative and pathological values of hemodynamic and Doppler ultrasound arterial findings in children.

Vasa 2020 Jun 23;49(4):264-274. Epub 2020 Apr 23.

University Hospital Center Côte de Nacre, UniCaen University, Caen, France.

Doppler ultrasound is an effective, useful and remarkably powerful tool in pediatric imaging. If possible, its use is always favored to avoid exposure to radiation or sedatives. By waveform spectrum analysis, Doppler ultrasound reveals information on blood flow and details on normal physiology and pathological processes undiscernible from gray-scale imaging alone. However, Doppler ultrasound remains underused, largely due to the difficult interpretation of changes in Doppler waveforms during childhood. This article provides a narrative review of the literature regarding the normative values and the physiological arterial changes through childhood according to age, weight or height, as well as frequent pathological arterial findings in children, classified by arterial territory.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1024/0301-1526/a000860DOI Listing
June 2020

Impaired training-induced angiogenesis process with loss of pericyte-endothelium interactions is associated with an abnormal capillary remodelling in the skeletal muscle of COPD patients.

Respir Res 2019 Dec 5;20(1):278. Epub 2019 Dec 5.

PhyMedExp, INSERM - CNRS, Montpellier University, CHU Montpellier, Montpellier, France.

Chronic obstructive pulmonary disease (COPD) is associated with exercise intolerance and limits the functional gains in response to exercise training in patients compared to sedentary healthy subjects (SHS). The blunted skeletal muscle angiogenesis previously observed in COPD patients has been linked to these limited functional improvements, but its underlying mechanisms, as well as the potential role of oxidative stress, remain poorly understood. Therefore, we compared ultrastructural indexes of angiogenic process and capillary remodelling by transmission electron microscopy in 9 COPD patients and 7 SHS after 6 weeks of individualized moderate-intensity endurance training. We also assessed oxidative stress by plasma-free and esterified isoprostane (F-IsoP) levels in both groups. We observed a capillary basement membrane thickening in COPD patients only (p = 0.008) and abnormal variations of endothelial nucleus density in response to exercise training in these patients when compared to SHS (p = 0.042). COPD patients had significantly fewer occurrences of pericyte/endothelium interdigitations, a morphologic marker of capillary maturation, than SHS (p = 0.014), and significantly higher levels of F-IsoP (p = 0.048). Last, the changes in pericyte/endothelium interdigitations and F-IsoP levels in response to exercise training were negatively correlated (r = - 0.62, p = 0.025). This study is the first to show abnormal capillary remodelling and to reveal impairments during the whole process of angiogenesis (capillary creation and maturation) in COPD patients. TRIAL REGISTRATION: NCT01183039 & NCT01183052, both registered 7 August 2010 (retrospectively registered).
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1186/s12931-019-1240-6DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6896673PMC
December 2019

The role of haemostasis in placenta-mediated complications.

Thromb Res 2019 Sep;181 Suppl 1:S10-S14

University of Montpellier, France; Department of Vascular Imaging and Vascular Medicine, Nîmes University Hospital, France.

Normal pregnancy is associated with an increasing state of activation of the haemostatic system. This activation state is excessive in women with placenta-mediated pregnancy complications (PMPCs), including preeclampsia (PE). Platelet activation plays a crucial pathophysiological role in PE. The very early activation of coagulation in the intervillous space is mandatory for placental growth and morphogenesis but its excesses and/or inadequate control may participate to the emergence of the trophoblastic phenotype of PE. Extracellular vesicles, of endothelial but also of trophoblastic origin, can favour key cellular reactions of preeclampsia, acting as proactive cofactors. The understanding of this intricate relationship between haemostasis activation and PMPCs may provide interesting keys for new pathophysiological therapeutic developments.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/S0049-3848(19)30359-7DOI Listing
September 2019

Glutathione-dependent enzyme activities of peripheral blood mononuclear cells decrease during the winter season compared with the summer in normal-weight and severely obese adolescents.

J Physiol Biochem 2019 Aug 9;75(3):321-327. Epub 2019 Jul 9.

CIBERobn (Fisiopatología de la Obesidad y la Nutrición CB12/03/30038), Instituto de Salud Carlos III, Madrid, Spain.

Oxidative stress-related inflammation is known to play a vital role in obesity-associated cardiovascular disease, contributing to the early stages of the pathology as well as during its development. Therefore, it is of great interest to understand how obesity-induced stress modulates antioxidant enzyme activity during puberty. To this end, 27 severely obese adolescents (body mass index > 30, z-score > 3.7) were recruited from a paediatric weight management centre. Eighteen were recruited during the summer and nine in the winter. All underwent a 4-month weight loss programme consisting in diet and physical activity. Twenty normal-weight age-matched adolescents were recruited from the same geographical area to serve as controls. Blood samples were extracted, and antioxidant enzyme activities were determined in peripheral blood mononuclear cells (PBMCs) and erythrocytes. The enzymes studied included catalase, superoxide dismutase, glutathione peroxidase and glutathione reductase. Severely obese adolescents presented lower PBMC-glutathione reductase activity than their corresponding normal-weight counterparts. In addition, glutathione-dependent activities tended to be lower in both groups during the winter compared with summer. These changes coincided with differences in circulating vitamin D levels. Results may suggest that season-dependent factors such as vitamin D could affect glutathione-dependent activities in severely obese as well as in normal-weight adolescents.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1007/s13105-019-00693-5DOI Listing
August 2019

Increased incidence of cancer in the follow-up of obstetric antiphospholipid syndrome within the NOH-APS cohort.

Haematologica 2020 31;105(2):490-497. Epub 2020 Jan 31.

UPRES EA2992 "Caractéristiques Féminines des Dysfonctions des Interfaces Vasculaires", University of Montpellier, Montpellier, France.

Malignancies can be associated with positive antiphospholipid antibodies but the incidence of cancer among women with the purely obstetric form of antiphospholipid syndrome (APS) is currently unknown. Our aim was to investigate the comparative incidence of cancers in women with a history of obstetric APS within a referral university hospital-based cohort (NOH-APS cohort). We performed a 17-year observational study of 1,592 non-thrombotic women with three consecutive spontaneous abortions before the 10 week of gestation or one fetal death at or beyond the 10 week of gestation. We compared the incidence of cancer diagnosis during follow-up among the cohort of women positive for antiphospholipid antibodies (n=517), the cohort of women carrying the rs6025 or rs1799963 polymorphism (n=279) and a cohort of women with negative thrombophilia screening results (n=796). The annualized rate of cancer was 0.300% (0.20%-0.44%) for women with obstetric APS and their cancer risk was substantially higher than that of women with negative thrombophilia screening [adjusted hazard ratio (aHR) 2.483; 95% confidence interval (CI) 1.27-4.85]. The computed standardized incidence ratio for women with obstetric APS was 2.89; 95% CI: 1.89-4.23. Among antiphospholipid antibodies, lupus anticoagulant was associated with incident cancers (aHR 2.608; 95% CI: 1.091-6.236). Our cohort study shows that the risk of cancer is substantially higher in women with a history of obstetric APS than in the general population, and in women with a similar initial clinical history but negative for antiphospholipid antibodies.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3324/haematol.2018.213991DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7012495PMC
April 2021

A New Echocardiographic Tool for Cardiac Output Evaluation: An Experimental Study.

Shock 2019 10;52(4):449-455

Caractéristiques Féminines des Dysfonctions des Interfaces Vasculaires, Univ Montpellier, Department of Emergency Medicine, Timone University Hospital, Marseille, France.

Background: The correlation between cardiac output (CO) evaluated by echocardiography and CO measured by thermodilution (COth) varies according to different studies. A new transthoracic echocardiography (TTE) tool allows automatic calculation of the subaortic velocity time index (VTIauto) and CO (COauto). The main objective was to evaluate the correlation between COth and COauto in an anesthetized, ventilated piglet hemorrhagic shock (HS) model. The secondary objectives were to evaluate the correlation between COth and CO evaluated by manual measurements of VTI, and the preload-dependency of VTIvaresp.

Methods: Eighteen piglets were bled until mean arterial pressure reached 40 mm Hg. Controlled hemorrhage was maintained for 30 min before a resuscitation phase. CO was measured by Pulse index Contour Cardiac Output thermodilution methods. At each time of the experiment, three VTI values were measured (min, med, max) and the average value was calculated. COs were calculated by TTE (COmax, COmed, COmin, COave).

Results: For the 204 measures attempted, the success rate was 197 (97%) manually and 122 (60%) automatically (P < 0.01). The correlation coefficients (r) between COth and, respectively, COauto, COave, COmax, COmed, and COmin were: 0.83 (95% CI [0.76; 0.88]; P < 0.01), 0.54 (95% CI [0.43; 0.63]; P < 0.01), 0.43 (95% CI [0.31; 0.54]; P < 0.01), 0.58 (95% CI [0.48; 0.67]; P < 0.01), and 0.52 (95% CI [0.41; 0.62]; P < 0.01).

Conclusion: In an experimental model of HS, a new ultrasound tool, COauto, seems better correlated with COth than manual echocardiographic measurements.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1097/SHK.0000000000001273DOI Listing
October 2019

Compression with a pocket-sized ultrasound device to diagnose proximal deep vein thrombosis.

Am J Emerg Med 2018 Jul 3;36(7):1262-1264. Epub 2018 Apr 3.

Department of Anesthesiology, Emergency and Critical Care Medicine, Intensive Care Unit, Nîmes University Hospital, place du Pr Debré, 30029 Nîmes, France; Emergency Department, Timone 2 Hospital, Aix-Marseille University, Marseille, France. Electronic address:

Introduction: Compression ultrasonography (CUS) is a validated technique for the diagnosis of deep venous thrombosis (DVT), but has never been studied with pocket-sized ultrasound device (PUD). The main objective of this study was to assess the diagnostic performance of CUS made by emergency physicians (EPs) using a PUD.

Materials: This was a prospective, diagnostic test assessment, single-center study. Patients underwent VCU performed by a trained EP with PUD (CUS-PUD) for searching proximal DVT (PDVT) and were then seen by an expert vascular physician who blindly performed a duplex venous ultrasound, which was the criterion standard. CUS-PUD's diagnostic performance was evaluated by sensitivity (Se), specificity (Sp), and positive and negative predictive values (PPV and NPV).

Results: The sample included 57 patients of whom 56 were analyzed. Eleven (20%) PDVT were diagnosed with CUS-PUD: 7 (64%) femoral and 4 (36%) popliteal. The CUS-PUD's Se was 100% [72%; 100%], Sp 100% [92%; 100%]. The PPV was 100% [74%; 100%], and the NPV was 100% [90%; 100%].

Conclusion: CUS-PUD performed with a pocket-sized ultrasound appears to be feasible in emergency practice for the diagnosis of proximal DVT. A study with a larger sample size will have to describe the accuracy.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.ajem.2018.03.076DOI Listing
July 2018

Obstetric antiphospholipid syndrome: early variations of angiogenic factors are associated with adverse outcomes.

Haematologica 2017 05 25;102(5):835-842. Epub 2017 Jan 25.

Department of Hematology, University Hospital, Nîmes, France

The prognostic value of angiogenic factors in newly pregnant women with obstetric antiphospholipid syndrome (oAPS) has not been documented. We observed 513 oAPS who experienced three consecutive spontaneous abortions before the 10 week of gestation or one fetal loss at or beyond the 10 week. We assessed the plasma concentrations of the proangiogenic factor placenta growth factor (PIGF) and of the antiangiogenic factor soluble fms-like tyrosine kinase-1 on the eve and on the 4 day of the low-molecular weight heparin-low-dose aspirin treatment. Placenta growth factor and fms-like tyrosine kinase-1 plasma concentrations showed marked increases. Treatment-associated variations of PIGF and of soluble fms-like tyrosine kinase-1 were antagonist risk factors for placenta-mediated complications (PMC) and for severe PMC, for fetal death, stillbirth and neonatal death. The ratio between PIGF increase and soluble fms-like tyrosine kinase-1 was a summary variable whose best cut-off values (1.944.10) had high negative predictive values for PMC (0.918) and may be used to help rule out the development of PMC in evolutive pregnancies after 19 completed weeks. The early variations of PIGF and soluble fms-like tyrosine kinase-1 concentrations in newly pregnant oAPS may help to detect patients at low risk of PMC. ().
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3324/haematol.2016.155184DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5477602PMC
May 2017

Systolic peak foot-to-apex time interval, a novel oscillometric technique for systolic blood pressure measurement.

J Hypertens 2017 05;35(5):1002-1010

aVascular Medicine and Laboratory, Nîmes University Hospital, Nîmes, France bBiomedical Engineering Laboratory, Faculty of Technology, Aboubekr Belkaid University, Tlemcen, Algeria cResearch Unit (Female characteristics of dysfunctions of vascular interfaces), Montpellier University, Montpellier, France.

Background: Noninvasive blood pressure (BP) measurement is essential for the study of human physiology but automatic oscillometric devices only estimate SBP and DBP using various, undisclosed algorithms, precluding standardization and interchangeability. We propose a novel approach by tracking, during pneumatic cuff deflation, the time interval from the foot to the apex of the systolic peak of the oscillometric signal, which reaches a maximum concomitant with the first Korotkoff sound.

Method: In 145 study participants and patients (group 1), we measured the systolic brachial artery blood pressure by Korotkoff sound recording, conventional oscillometry, and our fully automated systolic peak foot-to-apex time interval (SFATI) technique. In 35 other patients (group 2), we compared SFATI with intra-arterial measurement.

Results: In group 1, the concordance correlation coefficient was 0.989 and 0.984 between SFATI and Korotkoff sounds, 0.884 and 0.917 between oscillometry and Korotkoff sounds, and 0.882 and 0.919 between SFATI and oscillometry, respectively, on the left and right arm. In group 2, it was 0.72 between SFATI and intra-arterial measurement, 0.67 between oscillometry and intra-arterial measurement, and 0.92 between SFATI and Korotkoff sounds. In 40 study participants, the reproducibility study yielded a concordance coefficient of 0.95 for SFATI and 0.94 for Korotkoff sounds.

Conclusion: SFATI BP measurement shows an excellent concordance with the auscultatory technique, offering a major improvement over current oscillometric techniques and allowing standardization.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1097/HJH.0000000000001252DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5378056PMC
May 2017

An ultrasound look at Korotkoff sounds: the role of pulse wave velocity and flow turbulence.

Blood Press Monit 2017 Apr;22(2):86-94

aVascular Medicine and Laboratory, Nimes University Hospital, and EA2992 Research Unit, Montpellier University, Nimes bLaboratoire d'Informatique, de Robotique et de Microélectronique de Montpellier, CNRS-Montpellier University UMR 5506, Montpellier, France cBiomedical Engineering Laboratory, Faculty of Technology, Aboubekr Belkaid University, Tlemcen, Algeria.

Aims: The aim of this study was to analyze the temporal relationships between pressure, flow, and Korotkoff sounds, providing clues for their comprehensive interpretation.

Materials And Methods: When measuring blood pressure in a group of 23 volunteers, we used duplex Doppler ultrasonography to assess, under the arm-cuff, the brachial artery flow, diameter changes, and local pulse wave velocity (PWV), while recording Korotkoff sounds 10 cm downstream together with cuff pressure and ECG.

Results: The systolic (SBP) and diastolic (DBP) blood pressures were 118.8±17.7 and 65.4±10.4 mmHg, respectively (n=23). The brachial artery lumen started opening when cuff pressure decreased below the SBP and opened for an increasing length of time until cuff pressure reached the DBP, and then remained open but pulsatile. A high-energy low-frequency Doppler signal, starting a few milliseconds before flow, appeared and disappeared together with Korotkoff sounds at the SBP and DBP, respectively. Its median duration was 42.7 versus 41.1 ms for Korotkoff sounds (P=0.54; n=17). There was a 2.20±1.54 ms/mmHg decrement in the time delay between the ECG R-wave and the Korotkoff sounds during cuff deflation (n=18). The PWV was 10±4.48 m/s at null cuff pressure and showed a 0.62% decrement per mmHg when cuff pressure increased (n=13).

Conclusion: Korotkoff sounds are associated with a high-energy low-frequency Doppler signal of identical duration, typically resulting from wall vibrations, followed by flow turbulence. Local arterial PWV decreases when cuff pressure increases. Exploiting these changes may help improve SBP assessment, which remains a challenge for oscillometric techniques.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1097/MBP.0000000000000231DOI Listing
April 2017

Impaired training-induced adaptation of blood pressure in COPD patients: implication of the muscle capillary bed.

Int J Chron Obstruct Pulmon Dis 2016 22;11:2349-2357. Epub 2016 Sep 22.

PhyMedExp, INSERM U1046, CNRS UMR 9214, University of Montpellier; Department of Clinical Physiology, Montpellier University Hospital, Montpellier.

Background And Aims: Targeting the early mechanisms in exercise-induced arterial hypertension (which precedes resting arterial hypertension in its natural history) may improve cardiovascular morbidity and mortality in COPD patients. Capillary rarefaction, an early event in COPD before vascular remodeling, is a potential mechanism of exercise-induced and resting arterial hypertension. Impaired training-induced capillarization was observed earlier in COPD patients; thus, this study compares the changes in blood pressure (BP) during exercise in COPD patients and matches control subjects (CSs) after a similar exercise training program, in relationship with muscle capillarization.

Methods: Resting and maximal exercise diastolic pressure (DP) and systolic pressure (SP) were recorded during a standardized cardiopulmonary exercise test, and a quadriceps muscle biopsy was performed before and after training.

Results: A total of 35 CSs and 49 COPD patients (forced expiratory volume in 1 second =54%±22% predicted) completed a 6-week rehabilitation program and improved their symptom-limited maximal oxygen uptake (VO: 25.8±6.1 mL/kg per minute vs 27.9 mL/kg per minute and 17.0±4.7 mL/kg per minute vs 18.3 mL/kg per minute; both <0.001). The improvement in muscle capillary-to-fiber (C/F) ratio was significantly greater in CSs vs COPD patients (+11%±9% vs +23%±21%; <0.05). Although maximal exercise BP was reduced in CSs (DP: 89±10 mmHg vs 85±9 mmHg; <0.001/SP: 204±25 mmHg vs 196±27 mmHg; <0.05), it did not change in COPD patients (DP: 94±14 mmHg vs 97±16 mmHg; =0.46/SP: 202±27 mmHg vs 208±24 mmHg; =0.13). The change in muscle C/F ratio was negatively correlated with maximal exercise SP in CSs and COPD patients (=-0.41; =0.02).

Conclusion: COPD patients showed impaired training-induced BP adaptation related to a change in muscle capillarization, suggesting the possibility of blunted angiogenesis.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.2147/COPD.S113657DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5038574PMC
August 2017

Does the infusion rate of fluid affect rapidity of mean arterial pressure restoration during controlled hemorrhage.

Am J Emerg Med 2016 Sep 13;34(9):1743-9. Epub 2016 May 13.

Department of Anesthesiology, Emergency and Critical Care Medicine, Nimes University Hospital, 30029 Nîmes, France; Physiology Department, EA 2992, Faculté de Médecine de Nîmes, Université Montpellier 1, 30029 Nîmes, France.

Objective: This study aimed to compare 2 fluid infusion rates of lactated Ringer (LR) and hydroxyethyl starch (HES) 130/0.4 on hemodynamic restoration at the early phase of controlled hemorrhagic shock.

Methods: Fifty-six anesthetized and ventilated piglets were bled until mean arterial pressure (MAP) reached 40 mm Hg. Controlled hemorrhage was maintained for 30 minutes. After this period, 4 resuscitation groups were studied (n=14 for each group): HES infused at 1 or 4mL/kg per minute or LR1 infused at 1 or 4mL/kg per minute until baseline MAP was restored. Hemodynamic assessment using PiCCO monitoring and biological data were collected.

Results: Time to restore baseline MAP ±10% was significantly lower in LR4 group (11±11 minutes) compared to LR1 group (41±25 minutes) (P=.0004). Time to restore baseline MAP ±10% was significantly lower in HES4 group (4±3 minutes) compared to HES1 (11±4 minutes) (P=.0003). Time to restore baseline MAP ±10% was significantly lower with HES vs LR whatever the infusion rate. No statistically significant difference was observed in cardiac output, central venous saturation, extravascular lung water, and arterial lactate between 4 and 1 mL/kg per minute groups.

Conclusions: In this controlled hemorrhagic shock model, a faster infusion rate (4 vs 1mL/kg per minute) significantly decreased the time for restoring baseline MAP, regardless of the type of infused fluid. The time for MAP restoration was significantly shorter for HES as compared to LR whatever the fluid infusion rate.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.ajem.2016.05.019DOI Listing
September 2016

Evaluation of lower limb vein biomechanical properties and the effects of compression stockings, with an instrumented ultrasound probe.

Annu Int Conf IEEE Eng Med Biol Soc 2014 ;2014:74-7

We present a new approach for the evaluation of the biomechanical properties of lower limb veins based on the simultaneous measurements of the vein cross-sectional area with B-mode ultrasound imaging and of the force exerted on the skin by the ultrasound probe. Ongoing clinical trials allowed us to identify a behavioral model of lower limb veins without and with compression stockings.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1109/EMBC.2014.6943532DOI Listing
October 2015

Effects of a lifestyle program on vascular reactivity in macro- and microcirculation in severely obese adolescents.

J Clin Endocrinol Metab 2014 Mar 1;99(3):1019-26. Epub 2014 Jan 1.

Avignon University (D.M., G.W., S.G., A.V.), LAPEC EA4278, F-84000 Avignon, France; Vascular Medicine Unit (A.P.-M.), Nimes University Hospital, 30021 Nimes, France; Applied Biology Department (D.M., N.V.-S., E.R.), Nutrition/Institute of Bioengineering, University Miguel Hernandez, 03202 Elche, Alicante, Spain; AJO les Oiseaux (C.S.M.), 83110 Sanary sur Mer, France; CIBERobn (Fisiopatología de la Obesidad y la Nutrición CB12/03/30038) (E.R.), Instituto de Salud Carlos III, ES-28029 Madrid, Spain; and Unit of Immunology (J.M.S., P.M.-P.), Depàrtment of Biotechnology, University of Alicante, 03690 San Vicente del Raspeig, Spain.

Context And Objective: This study aimed to comprehensively assess the macro- and microcirculation of severely obese adolescents (SOA) and normal-weight counterparts and to determine the longitudinal effects of weight loss on vascular function in SOA. DESIGN, SETTING, PARTICIPANTS, AND OUTCOME MEASURES: Seventeen SOA (body mass index z-score = 4.22 ± 0.73) and 19 puberty-matched normal-weight counterparts (body mass index z-score = -0.02 ± 1.04) were included. The SOA participated in a 4 month weight loss program. Brachial artery flow-mediated dilation and response to sublingual nitrate (nitrate-mediated dilation [NMD]) were assessed by high-resolution ultrasound. Microvascular reactivity was evaluated by laser Doppler flowmetry in response to NMD, iontophoresis of acetylcholine and sodium nitroprusside, and local hyperthermia. Plasma insulin, leptin, resistin, C-reactive protein, myeloperoxidase, and tissue plasminogen activator were measured.

Results: At baseline, SOA had similar flow-mediated dilation and impaired NMD in the brachial artery compared to normal-weight adolescents. Similarly, peak responses to acetylcholine and sodium nitroprusside iontophoresis and to local hyperthermia were unaltered, whereas cutaneous blood flow after NMD was lower in the forearm microcirculation of SOA. All plasma measurements were significantly higher in SOA. After the 4-month program, SOA presented a weight reduction of 7.4 ± 3.1%, but neither brachial artery nor microvascular reactivity variables were improved. Significant decreases were detected in plasma leptin, myeloperoxidase, and tissue plasminogen activator.

Conclusions: Macro- and microvascular endothelial function are preserved in adolescents with severe obesity. Conversely, weight loss does not improve their impaired smooth muscle response to exogenous organic nitrate in both vascular beds, despite reducing plasma markers adversely related to vascular homeostasis.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1210/jc.2013-3394DOI Listing
March 2014

Validation of lower limb segmental volumetry with hand-held, self-positioning three-dimensional laser scanner against water displacement.

J Vasc Surg Venous Lymphat Disord 2014 Jan 5;2(1):39-45. Epub 2013 Nov 5.

Internal and Vascular Medicine Department, Montpellier University Hospital, Montpellier, France; Dysfunctions of Vascular Interfaces Laboratory EA2992, Montpellier 1, University, Montpellier and Nimes, France; Clinical Investigation Center, INSERM CIC 1001, Montpellier University Hospital, Montpellier, France.

Background: Measurement of limb volume is helpful for the evaluation and follow-up of edema, especially in patients with chronic venous insufficiency (CVI) or lymphedema. Water displacement (WD) is the reference method for limb volumetry but is not really suitable for clinical routine. Indirect volumetry based on circumference measurements as well as the more expansive but automatic optoelectronic techniques do not allow detailed measurement at the extremity of the limb.

Methods: We used a self-positioning laser scanner with dynamic referencing for acquisition and real-time three-dimensional (3D) reconstruction of the lower limb volume in 30 patients with CVI, 30 patients with lymphedema, and 30 healthy controls. Two independent observers performed either one or two laser scans, whose results were tested for intra- and interobserver reproducibility and compared with WD volumetry by Lin's concordance correlation coefficient and Bland and Altman graphic analysis.

Results: Automatic volume calculation from 3D laser scanning data failed in one patient with major lymphedema. Lin's concordance correlation coefficient was 0.99 and 0.98, respectively, for intraobserver no. 1 and no. 2, 0.98 for interobserver reproducibility, and 0.98 and 0.96, respectively, for observer no. 1 and observer no. 2 vs WD comparison. The 3D laser scanning yielded 1.99% precision. Accuracy was 3.12% for observer no. 1 and 2.71% for observer no. 2, laser scanning values being 90 mL higher than WD, which could be attributed to the different posture during measurement.

Conclusions: Three-dimensional laser scanning is accurate and reproducible, and appears suitable for the evaluation of limb volume in patients with CVI or lymphedema.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.jvsv.2013.08.002DOI Listing
January 2014

Decreased microvascular myogenic response to insulin in severely obese adolescents.

Clin Hemorheol Microcirc 2014 ;57(1):23-32

Avignon University, Avignon, France.

By means of flowmotion analysis, it is mainly accepted that, in normal conditions, insulin specifically increases the activity of microvascular smooth muscle. The objective of this study was to compare this effect in severely obese and normal-weight adolescents. Laser Doppler measurements were used to assess cutaneous blood flux (CBF) and flowmotion in response to transdermal iontophoresis of insulin in 20 severely obese adolescents (SOA) aged 12-17 years (BMI = 33.34 ± 1.07 kg/m2), and 16 normal-weight adolescents (BMI = 18.85 ± 0.50 kg/m2). Fasting insulin levels were higher in SOA than in normal-weight adolescents (6.25 ± 1.03 vs. 3.11 ± 0.28 μU/ml, P = 0.007). Net insulin-induced increase of CBF did not significantly differ between SOA and normal-weight adolescents (422.41 ± 146.09 vs. 232.36 ± 80.98 %, P = 0.265). A significant impairment of myogenic flowmotion was detected in SOA compared to normal-weight adolescents in response to insulin delivery (5.91 ± 0.35 vs. 8.12 ± 0.63 %, P = 0.003). Severely obese adolescents exhibit decreased myogenic activity in response to insulin, which may be an early step in the development of insulin resistance.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3233/CH-131769DOI Listing
February 2015

Effects of exercise training on arterial function in type 2 diabetes mellitus: a systematic review and meta-analysis.

Sports Med 2013 Nov;43(11):1191-9

Avignon University, LAPEC EA4278, 84000, Avignon, France,

Background And Objective: Controversy exists among trials assessing whether exercise can improve arterial function in type 2 diabetes mellitus (T2DM) subjects. Therefore the aim of this study was to systematically review and quantify the effects of exercise on arterial function in T2DM subjects.

Methods: MEDLINE, Cochrane, Scopus and Web of Science were searched up until January 2013 for randomized controlled trials evaluating the effects of exercise interventions lasting 4 weeks or more on arterial function in T2DM subjects. Flow-mediated dilation (FMD) and nitrate-mediated dilation (NMD) of the brachial conduit artery were considered for assessment of arterial endothelial function and smooth muscle function, respectively.

Results: Five randomized trials comparing exercise and control groups (overall n = 217) met the inclusion criteria. The mean exercise characteristics were as follows: 3.6 sessions per week, 67.5 min per session, intensity at 74.4 % of the maximum heart rate (HR(max)), for 14 weeks. The post-intervention mean difference in FMD favoured the exercise groups over the control groups (2.23 %; P < 0.0001). No significant post-intervention mean difference in NMD (1.22 %; P = 0.29) was found between the groups. Neither heterogeneity nor publication bias was detected among the trials.

Conclusion: Exercise training alone improved FMD, showing its capacity to restore arterial endothelial function in T2DM subjects. However, further research is needed to determine whether longer and/or more intense exercise interventions could enhance arterial smooth muscle function in this population.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1007/s40279-013-0085-2DOI Listing
November 2013