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    Drug-Coated Balloon Treatment for Femoropopliteal Artery Disease: The IN.PACT Global Study De Novo In-Stent Restenosis Imaging Cohort.
    JACC Cardiovasc Interv 2017 Oct;10(20):2113-2123
    Universitäts-Herzzentrum Freiburg-Bad Krozingen, Bad Krozingen, Germany.
    Objectives: This study sought to evaluate the safety and effectiveness of a paclitaxel-coated drug-coated balloon (DCB) for the treatment of patients with de novo in-stent restenosis (ISR).

    Background: Treatment of patients with ISR remains a challenge. Current strategies are plagued by high rates of recurrent restenosis and need for reintervention. Read More

    Predicting long-term survival after coronary artery bypass graft surgery.
    Interact Cardiovasc Thorac Surg 2017 Oct 6. Epub 2017 Oct 6.
    School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia.
    Objectives: To develop a model for predicting long-term survival following coronary artery bypass graft surgery.

    Methods: This study included 46 573 patients from the Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZCTS) registry, who underwent isolated coronary artery bypass graft surgery between 2001 and 2014. Data were randomly split into development (23 282) and validation (23 291) samples. Read More

    Outcomes in Women and Minorities Compared With White Men 1 Year After Everolimus-Eluting Stent Implantation: Insights and Results From the PLATINUM Diversity and PROMUS Element Plus Post-Approval Study Pooled Analysis.
    JAMA Cardiol 2017 Oct 18. Epub 2017 Oct 18.
    Mount Sinai Medical Center, New York, New York.
    Importance: There exist limited outcomes data for women and minorities after contemporary percutaneous coronary intervention (PCI).

    Objective: To examine 1-year outcomes in women and minorities vs white men after PCI with everolimus-eluting stents.

    Design, Settings, And Participants: The PLATINUM Diversity study was a single-arm study enrolling women and minorities. Read More

    Long-term Outcomes of Multiple Arterial Coronary Artery Bypass Grafting: A Population-Based Study of Patients in British Columbia, Canada.
    JAMA Cardiol 2017 Oct 11. Epub 2017 Oct 11.
    University of British Columbia, Vancouver, British Columbia, Canada.
    Importance: Although the long-term survival advantage of multiple arterial grafting (MAG) vs the standard use of left internal thoracic artery (LITA) supplemented by saphenous vein grafts (LITA+SVG) has been demonstrated in several observational studies, to our knowledge its safety and other long-term clinical benefits in a large, population-based cohort are unknown.

    Objective: To compare the safety and long-term outcomes of MAG vs LITA+SVG among overall and selected subgroups of patients.

    Design, Setting, And Participants: In this population-based observational study, we included 20 076 adult patients with triple-vessel or left-main disease who underwent primary isolated coronary artery bypass grafting (MAG, n = 5580; LITA+SVG, n = 14 496) in the province of British Columbia, Canada, from January 2000 to December 2014, with follow-up to December 2015. Read More

    Effectiveness and patient safety of platelet aggregation inhibitors in the prevention of cardiovascular disease and ischemic stroke in older adults - a systematic review.
    BMC Geriatr 2017 Oct 16;17(Suppl 1):225. Epub 2017 Oct 16.
    Institute of General Practice and Family Medicine, Faculty of Health, University of Witten/Herdecke, Alfred-Herrhausen-Straße, Witten, Germany.
    Background: Platelet aggregation inhibitors (PAI) are among the most frequently prescribed drugs in older people, though evidence about risks and benefits of their use in older adults is scarce. The objectives of this systematic review are firstly to identify the risks and benefits of their use in the prevention and treatment of vascular events in older adults, and secondly to develop recommendations on discontinuing PAI in this population if risks outweigh benefits.

    Methods: Staged systematic review consisting of three searches. Read More

    Higher IGFB3 is associated with increased incidence of colorectal cancer in older men independently of IGF1.
    Clin Endocrinol (Oxf) 2017 Oct 16. Epub 2017 Oct 16.
    School of Medicine, University of Western Australia, Perth, Western Australia, Australia.
    Objective: Insulin-like growth factor 1 (IGF1) has anabolic and growth-promoting effects, raising concerns regarding its potential to promote tumour growth. Circulating IGF1 is bound to binding proteins, which modulate bioavailability of IGF1. This study assessed the associations of IGF1 and its binding proteins 1 (IGFBP1) and 3 (IGFBP3) with cancer risk. Read More

    Meta-analysis of the association between peripheral artery disease and growth of abdominal aortic aneurysms.
    Br J Surg 2017 Oct 17. Epub 2017 Oct 17.
    Queensland Research Centre for Peripheral Vascular Disease, College of Medicine and Dentistry, Townsville, Queensland, Australia.
    Background: The role of atherosclerosis in the pathogenesis of abdominal aortic aneurysm (AAA) is controversial. Atherosclerosis-associated peripheral artery disease (PAD) has been reported to be a risk factor for AAA in population screening studies; its relationship with AAA growth is controversial.

    Methods: A systematic search of MEDLINE, Scopus, CINAHL and the Cochrane Central Register of Controlled Trials was conducted in April 2016 and repeated in January 2017. Read More

    Diabetes in Iran: Prospective Analysis from First Nationwide Diabetes Report of National Program for Prevention and Control of Diabetes (NPPCD-2016).
    Sci Rep 2017 Oct 18;7(1):13461. Epub 2017 Oct 18.
    Department of Medicine, Biochemistry, Physiology and Biophysics, Division of Clinical and Molecular Endocrinology, Case Western Reserve University, Cleveland, Ohio, United States.
    We estimated proportions of different types of diabetes, comorbidities, treatment (the use of oral glucose-lowering agents and insulin), control (hyperglycemia, dyslipidemia and hypertension) and chronic microvascular and macrovascular complications among people with diabetes presenting to the tertiary-care academic diabetes outpatient clinics in Iran. This study is the prospective analysis of data (n = 30,202) from the registry of university-affiliated adult outpatient diabetes clinics in the country during 2015-2016. The proportions of type 1 diabetes, types 2 diabetes, and other types of diabetes were 11. Read More

    Nonfunctioning adrenal incidentaloma affecting central blood pressure and arterial stiffness parameters.
    Endocrine 2017 Oct 17. Epub 2017 Oct 17.
    Department of Internal Medicine, Sağlık Bilimleri Üniversitesi (University of Health Sciences) Keçiören SUAM, Ankara, Turkey.
    Purpose: Recently, cardiovascular risk is thought to be increased in patients with nonfunctioning adrenal incidentaloma (NFAI). There are no sufficient studies in the literature to evaluate this situation in NFAI patients without cardiovascular risk. The objective of this study is to compare peripheral and central blood pressure and arterial stiffness between patients with NFAI and healthy volunteers (of a similar age, gender and body mass index as the NFAI group) who have no traditional cardiovascular risk factors and autonomous cortisol secretion, with pulse wave analysis (PWA). Read More

    Peripheral Artery Disease and Transcatheter Aortic Valve Replacement Outcomes: A Report From the Society of Thoracic Surgeons/American College of Cardiology Transcatheter Therapy Registry.
    Circ Cardiovasc Interv 2017 Oct;10(10)
    From the Duke Clinical Research Institute, Durham, NC (A.C.F., P.M., M.W.S., W.S.J., S.V.); Division of Cardiology (A.C.F., J.K.H., W.S.J., S.V.) and Division of Cardiovascular and Thoracic Surgery (G.C.H.), Duke University, Durham, NC; Division of Cardiology, Mayo Clinic, Rochester, MN (D.R.H.); Saint Luke's Mid America Heart Institute, University of Missouri-Kansas City (D.J.C.); Division of Cardiothoracic Surgery, Emory University, Atlanta, GA (V.H.T.); The Heart Hospital Baylor Plano, TX (M.J.M.); and Inova Heart and Vascular Institute, Falls Church, VA (M.W.S.).
    Background: Peripheral artery disease (PAD) is associated with increased cardiovascular mortality, and PAD risk factors overlap with those for aortic stenosis. The prevalence and outcomes associated with PAD in a population undergoing transcatheter aortic valve replacement (TAVR) are unknown.

    Methods And Results: Using the Society of Thoracic Surgeons/Transcatheter Valve Therapy Registry linked to Medicare claims data, we identified patients ≥65 years old undergoing TAVR from 2011 to 2015. Read More

    Calcitriol promotes proangiogenic molecules in keratinocytes in a diabetic foot ulcer model.
    J Steroid Biochem Mol Biol 2017 Oct 14. Epub 2017 Oct 14.
    Unidad de Investigación Biomédica-Zacatecas, IMSS, Mexico. Electronic address:
    Foot ulceration is one of the most common and complex sequelae of diabetes mellitus, generally posing a therapeutic challenge due to poor healing responses and high rates of complications, including peripheral vascular disease, ischemia and infections. Calcitriol, the most active vitamin D metabolite, induces antimicrobial peptides production in keratinocytes from diabetic foot ulcers (DFU); however, little is known about its effects on angiogenic factors in this pathology. Herein we aimed at studying whether calcitriol induces angiogenic molecules in keratinocytes under normoxic and hypoxic conditions, and if these molecules are able to improve cell migration in vitro. Read More

    [Functional State of Vascular Endothelium in Patients With Pulmonary Arterial Hypertension Associated With Congenital Heart Diseases].
    Kardiologiia 2017 Aug;57(8):40-46
    Krasnoyarsk State Medical University named after Prof. V. F. Vojno-Yasenetsky.
    In this article, we present results of the study of blebbing activity of membranes of peripheral blood lymphocytes, concentrations of soluble platelet/endothelial cell adhesion molecule 1, and vascular endothelial growth factor (VEGF) in patients with pulmonary arterial hypertension associated with congenital heart diseases. The research has shown that hypoxia and hemodynamic factors are the initiators of blebbing of membrane of peripheral blood lymphocytes. The activity of blebbing increases in parallel with the severity of the disease. Read More

    Postoperative complications after lower extremity arterial bypass increase the risk of new deep venous thrombosis.
    Phlebology 2017 Jan 1:268355517737455. Epub 2017 Jan 1.
    4 Vascular Surgery, 92661 Jobst Vascular Institute , Toledo, OH, USA.
    Background Deep venous thrombosis after any surgical operations is considered a preventable complication. Lower extremity bypass surgery is a commonly performed operation to improve blood flow to lower extremities in patients with severe peripheral arterial disease. Despite advances in endovascular surgery, lower extremity arterial bypass remains the gold standard treatment for severe, symptomatic peripheral arterial disease. Read More

    Pro-angiogenic effect of RANTES-loaded polysaccharide-based microparticles for a mouse ischemia therapy.
    Sci Rep 2017 Oct 16;7(1):13294. Epub 2017 Oct 16.
    INSERM, U1148, Laboratory for Vascular Translational Science, UFR SMBH, Université Paris 13, Sorbonne Paris Cité, Bobigny, France.
    Peripheral arterial disease results from the chronic obstruction of arteries leading to critical hindlimb ischemia. The aim was to develop a new therapeutic strategy of revascularization by using biodegradable and biocompatible polysaccharides-based microparticles (MP) to treat the mouse hindlimb ischemia. For this purpose, we deliver the pro-angiogenic chemokine Regulated upon Activation, Normal T-cell Expressed and Secreted (RANTES)/CCL5 in the mouse ischemic hindlimb, in solution or incorporated into polysaccharide-based microparticles. Read More

    Arterial stiffness and cardiometabolic phenotype of Cameroonian Pygmies and Bantus.
    J Hypertens 2017 Oct 13. Epub 2017 Oct 13.
    aHypertension Clinic, Department of Cardiology, Erasme University Hospital bCardiac Surgery Department, St Pierre University Hospital cDepartment of Emergency Medicine, Erasme University Hospital dDepartment of Cardiology, Ixelles Hospital eDepartment of Vascular Pathology, Erasme University Hospital, Université Libre de Bruxelles fDepartment of Diabetology, Saint Luc University Hospital, Université Catholique de Louvain, Brussels gHeymans Institute of Pharmacology, Ghent University, Ghent, Belgium.
    Background: Pygmies living in the Central African rainforest with a traditional hunter-gatherer lifestyle have a low incidence of cardiovascular diseases. Because of progressive loss of traditional habitat and ancestral lands, some Pygmies have migrated to urban areas and adopt specific Bantu lifestyles such as increased salt consumption and a sedentary way of life. We tested the hypothesis that migrant Pygmies could present with hemodynamic and metabolic characteristics different from those of traditional in-situ Pygmies and possibly closer to those of Bantu farmers. Read More

    Persistent Sciatic Artery Aneurysm with Limb Ischemia: A Report of Two Cases.
    Ann Vasc Dis 2017 Mar 31;10(1):44-47. Epub 2017 Mar 31.
    Department of Vascular Surgery, Kokura Memorial Hospital, Kitakyushu, Fukuoka, Japan.
    We report two cases of persistent sciatic artery (PSA) aneurysm with limb ischemia. Physicians who treat peripheral artery disease should be aware that PSA is a very rare congenital malformation of the lower extremities that is potentially hazardous, and that revascularization should be performed when a PSA aneurysm is treated. Read More

    Delivery of Antioxidant and Anti-inflammatory Agents for Tissue Engineered Vascular Grafts.
    Front Pharmacol 2017 21;8:659. Epub 2017 Sep 21.
    Department of Biomedical Engineering, Florida Institute of Technology, MelbourneFL, United States.
    The treatment of patients with severe coronary and peripheral artery disease represents a significant clinical need, especially for those patients that require a bypass graft and do not have viable veins for autologous grafting. Tissue engineering is being investigated to generate an alternative graft. While tissue engineering requires surgical intervention, the release of pharmacological agents is also an important part of many tissue engineering strategies. Read More

    Stable ischemic heart disease in women: current perspectives.
    Int J Womens Health 2017 27;9:701-709. Epub 2017 Sep 27.
    Division of Cardiology, Department of Medicine, Duke University Medical Center, Durham, NC, USA.
    Cardiovascular disease is the leading cause of death in women accounting for 1 in every 4 female deaths. Pathophysiology of ischemic heart disease in women includes epicardial coronary artery, endothelial dysfunction, coronary vasospasm, plaque erosion and spontaneous coronary artery dissection. Angina is the most common presentation of stable ischemic heart disease (SIHD) in women. Read More

    Outcomes of patients at estimated low surgical risk undergoing transcatheter aortic valve implantation with balloon-expandable prostheses.
    Cardiovasc Revasc Med 2017 Aug 30. Epub 2017 Aug 30.
    Cardiology, Hospital Universitario Madrid Montepríncipe.
    Introduction And Objectives: Transcatheter aortic-valve implantation (TAVI) is an accepted treatment for patients with severe aortic stenosis and high surgical risk. However, there is lack in data about TAVI in low-risk patients that are already being treated with this therapy in some clinical contexts.

    Methods: A retrospective analysis of patients treated with transfemoral TAVI using Edwards Sapien prosthesis in one center was performed, classifying the patients into three groups according to the surgical risk (high/intermediate/low risk for STS score>8/4-8/<4). Read More

    Effect of long-term hydroxychloroquine on vascular events in patients with systemic lupus erythematosus: a database prospective cohort study.
    Rheumatology (Oxford) 2017 Sep 27. Epub 2017 Sep 27.
    Division of Cardiology, Department of Internal Medicine, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Keelung, Taiwan.
    Objectives: The incidence of thromboembolism in patients with SLE is higher than that in the general population. HCQ, widely used to treat lupus, may have vascular protective effects. The aim of this study was to determine whether long-term HCQ exposure is associated with decreased thromboembolism risk in SLE. Read More

    Salmonella Typhimurium gastroenteritis leading to chronic prosthetic vascular graft infection.
    JMM Case Rep 2017 Aug 8;4(8):e005104. Epub 2017 Aug 8.
    Freeman Hospital, Freeman Road, Newcastle Upon Tyne NE7 7DN, UK.
    Introduction. It is estimated up to 6 % of prosthetic vascular grafts become infected. Staphylococcus aureus is predominant in early infection and coagulase-negative staphylococci are predominant in late infections. Read More

    Environmental tobacco smoke and peripheral arterial disease: A review.
    Atherosclerosis 2017 Sep 22;266:113-120. Epub 2017 Sep 22.
    Centre for Clinical Epidemiology & Biostatistics, School of Medicine & Public Health, University of Newcastle, New South Wales, Australia.
    Background And Aims: Despite worldwide reductions in active smoking, non-smokers continue to be exposed to environmental tobacco smoke, especially at home or workplace. There is a well-recognised association between active smoking and peripheral arterial disease, however, a relationship to environmental tobacco smoke exposure is less substantiated. The aims of this paper are to review the literature regarding the association between environmental tobacco smoke and peripheral arterial disease and identify the public health implications of the findings. Read More

    Why do SGLT2 inhibitors reduce heart failure hospitalization? A differential volume regulation hypothesis.
    Diabetes Obes Metab 2017 Oct 12. Epub 2017 Oct 12.
    Quantitative Clinical Pharmacology, Early Clinical Development, Innovative Medicines, AstraZeneca, Gaithersburg, MD, USA.
    The effect of a sodium glucose cotransporter 2 inhibitor (SGLT2i) in reducing heart failure hospitalization in the EMPA-REG OUTCOMES trial has raised the possibility of using these agents to treat established heart failure. We hypothesize that osmotic diuresis induced by SGLT2 inhibition, a distinctly different diuretic mechanism than other diuretic classes, results in greater electrolyte-free water clearance, and ultimately in greater fluid clearance from the interstitial fluid (IF) space than from the circulation, potentially resulting in congestion relief with minimal impact on blood volume, arterial filling, and organ perfusion. We utilize a mathematical model to illustrate that electrolyte-free water clearance results in a greater reduction in IF volume compared to blood volume, and that this difference may be mediated by peripheral sequestration of osmotically inactive sodium. Read More

    Autologous cell therapy for vascular regeneration: the role of proangiogenic cells.
    Curr Med Chem 2017 Oct 12. Epub 2017 Oct 12.
    Unit of Internal Medicine, Department of Medicine, University of Perugia. Italy.
    Autologous cell therapy represents a novel treatment option for vascular regeneration in different disease conditions. Both experimental and clinical studies indicate a therapeutic potential for different proangiogenic cells (PCs), including endothelial progenitor cells (EPCs) in the treatment of peripheral artery disease. A significant improvement of ischemic symptoms has been reported in different trials evaluating PCs for the treatment of critical limb ischemia. Read More

    Blood pressure targets for the treatment of people with hypertension and cardiovascular disease.
    Cochrane Database Syst Rev 2017 Oct 11;10:CD010315. Epub 2017 Oct 11.
    Drug Prescribing Service, Navarre Health Service, Plaza de la Paz, s/n, 7th floor, Pamplona, Navarre, Spain, 31002.
    Background: Hypertension is a prominent preventable cause of premature morbidity and mortality. People with hypertension and established cardiovascular disease are at particularly high risk, so reducing blood pressure below standard targets may be beneficial. This strategy could reduce cardiovascular mortality and morbidity but could also increase adverse events. Read More

    Association between mitochondrial DNA copy number and sudden cardiac death: findings from the Atherosclerosis Risk in Communities study (ARIC).
    Eur Heart J 2017 Jun 30. Epub 2017 Jun 30.
    McKusick-Nathans Institute of Genetic Medicine, Johns Hopkins University School of Medicine, 733 N. Broadway, Miller Research Building, Room 459, Baltimore, MD 21205, USA.
    Aims: Sudden cardiac death (SCD) is a major public health burden. Mitochondrial dysfunction has been implicated in a wide range of cardiovascular diseases including cardiomyopathy, heart failure, and arrhythmias, but it is unknown if it also contributes to SCD risk. We sought to examine the prospective association between mtDNA copy number (mtDNA-CN), a surrogate marker of mitochondrial function, and SCD risk. Read More

    Rapid volumetric photoacoustic tomographic imaging with a Fabry-Perot ultrasound sensor depicts peripheral arteries and microvascular vasomotor responses to thermal stimuli.
    Eur Radiol 2017 Oct 10. Epub 2017 Oct 10.
    Photoacoustic Imaging Group, Department of Medical Physics and Biomedical Engineering, University College London, London, UK.
    Purpose: To determine if a new photoacoustic imaging (PAI) system successfully depicts (1) peripheral arteries and (2) microvascular circulatory changes in response to thermal stimuli.

    Methods: Following ethical permission, 8 consenting subjects underwent PAI of the dorsalis pedis (DP) artery, and 13 completed PAI of the index fingertip. Finger images were obtained after immersion in warm (30-35 °C) or cold (10-15 °C) water to promote vasodilation or vasoconstriction. Read More

    Elevated serum osteoprotegerin may predict peripheral arterial disease after kidney transplantation: a single-center prospective cross-sectional study in Taiwan.
    PeerJ 2017 2;5:e3847. Epub 2017 Oct 2.
    Department of Surgery, Buddhist Tzu Chi General Hospital, Hualien, Taiwan.
    Background: Osteoprotegerin (OPG) is a potential biomarker for severity and complications of cardiovascular diseases. Peripheral arterial disease (PAD) is associated with an increased risk of death in kidney transplantation (KT) patients. This prospective cross-sectional study evaluated the relationship between serum OPG and PAD in KT patients. Read More

    The ultrastructure of spinal cord perivascular spaces: Implications for the circulation of cerebrospinal fluid.
    Sci Rep 2017 Oct 10;7(1):12924. Epub 2017 Oct 10.
    Faculty of Medicine and Health Sciences, Macquarie University, New South Wales, NSW 2109, Australia.
    Perivascular spaces play a pivotal role in the exchange between cerebrospinal and interstitial fluids, and in the clearance of waste in the CNS, yet their precise anatomical components are not well described. The aim of this study was to characterise the ultrastructure of perivascular spaces and their role in the transport of fluid, in the spinal cord of healthy rats, using transmission electron microscopy. The distribution of cerebrospinal fluid tracers injected into the subarachnoid space was studied using light, confocal and electron microscopy. Read More

    Unplanned 30-day readmission in patients with diabetic foot wounds treated in a multidisciplinary setting.
    J Vasc Surg 2017 Oct 7. Epub 2017 Oct 7.
    Diabetic Foot and Wound Service, The Johns Hopkins Hospital, Baltimore, Md; Division of Vascular Surgery and Endovascular Therapy, The Johns Hopkins Hospital, Baltimore, Md; Johns Hopkins Surgery Center for Outcomes Research, The Johns Hopkins Hospital, Baltimore, Md. Electronic address:
    Objective: Readmission rates are known to be high for vascular surgery patients in general, but there are limited data describing the risk of surgical and nonsurgical readmission among patients with diabetic foot ulcers (DFUs). Our aim was to identify factors associated with unplanned readmission in DFU patients treated in a multidisciplinary setting.

    Methods: We studied a single-center cohort of patients enrolled in a multidisciplinary diabetic foot service (July 2012-June 2017). Read More

    Atherosclerotic plaque characteristics are not associated with future cardiovascular events in patients undergoing iliofemoral endarterectomy.
    J Vasc Surg 2017 Oct 7. Epub 2017 Oct 7.
    Department of Vascular Surgery, University Medical Center Utrecht, Utrecht, The Netherlands. Electronic address:
    Background: Plaque characteristics such as intraplaque hemorrhage (IPH) have been associated with secondary cardiovascular events (CVE) in patients undergoing carotid endarterectomy. In addition, carotid plaques containing macrophage infiltration or a large lipid core size were associated with less restenosis. It is currently unknown whether iliofemoral plaque histopathologic characteristics are predictive for secondary CVE in patients with peripheral arterial disease undergoing iliofemoral endarterectomy. Read More

    The Role of the Mineralocorticoid Receptor in Inflammation: Focus on Kidney and Vasculature.
    Am J Nephrol 2017 Oct 10;46(4):298-314. Epub 2017 Oct 10.
    Case Cardiovascular Research Institute, Case Western Reserve University, Cleveland, OH, USA.
    Background: The remarkable success of clinical trials in mineralocorticoid receptor (MR) inhibition in heart failure has driven research on the physiological and pathological role(s) of nonepithelial MR expression. MR is widely expressed in the cardiovascular system and is a major determinant of endothelial function, smooth muscle tone, vascular remodeling, fibrosis, and blood pressure. An important new dimension is the appreciation of the role MR plays in immune cells and target organ damage in the heart, kidney and vasculature, and in the development of insulin resistance. Read More

    Early recognition vital in acute coronary syndrome.
    Practitioner 2016 10;260(1797):19-23
    Acute coronary syndrome (ACS) includes both ST (STEMI) and non ST elevation (NSTEMI) MI, and unstable angina. The common pathological process underlying MI involves thrombus formation on top of a complex atheromatous plaque, resulting in partial or complete occlusion of the coronary artery and myocyte necrosis. Unstable angina is defined as ischaemia at rest or on minimal exertion in the absence of myocyte necrosis. Read More

    Painful and Prolonged Muscle Cramps following Insulin Injections in a Patient with Type 2 Diabetes Mellitus: Revisiting the 1992 Duke Case.
    Front Endocrinol (Lausanne) 2017 25;8:243. Epub 2017 Sep 25.
    Calcium Metabolism and Osteoporosis Program, Department of Internal Medicine, Division of Endocrinology, American University of Beirut Medical Center, Beirut, Lebanon.
    A 56-year-old middle-eastern male with a long-standing history of poorly controlled type 2 diabetes mellitus presented to us complaining of severely painful bilateral upper and lower extremity cramps occurring shortly after his rapid-acting insulin analog injection(s). The cramps had started 6 months ago and have been occurring intermittently in non-predictable episodes since then. He had otherwise never experienced any insulin-related adverse reaction(s) before. Read More

    Age Drives Distortion of Brain Metabolic, Vascular and Cognitive Functions, and the Gut Microbiome.
    Front Aging Neurosci 2017 25;9:298. Epub 2017 Sep 25.
    Sanders-Brown Center on Aging, University of KentuckyLexington, KY, United States.
    Advancing age is the top risk factor for the development of neurodegenerative disorders, including Alzheimer's disease (AD). However, the contribution of aging processes to AD etiology remains unclear. Emerging evidence shows that reduced brain metabolic and vascular functions occur decades before the onset of cognitive impairments, and these reductions are highly associated with low-grade, chronic inflammation developed in the brain over time. Read More

    Wrist mass in a 93-year-old woman.
    Heart 2017 Oct 9. Epub 2017 Oct 9.
    Department of Cardiology, King's College Hospital, London, UK.
    Clinical Introduction: A 93-year-old woman presented electively for transaortic valve implantation (TAVI), for severe aortic stenosis. She had a history of hypertension and hypothyroidism, and she was taking clopidogrel, antihypertensives and levothyroxine. In preparation for her TAVI procedure she underwent coronary angiography 4 months previously. Read More

    Peripheral Artery Disease: What the Orthopaedic Physical Therapist Needs to Know.
    J Orthop Sports Phys Ther 2017 Oct 9:1-26. Epub 2017 Oct 9.
    Chief of Vascular Surgery, Greater Los Angeles Veterans Affairs Medical Center; Associate Professor, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA.
    Synopsis Claudication from peripheral artery disease (PAD) may mimic or coexist with musculoskeletal conditions and represents an important diagnostic consideration in patients over 50. Physical therapists are optimally positioned to recognize this condition by incorporating a vascular history and physical examination in appropriately selected patients. Recognition of PAD is important both from the standpoint of addressing the ischemic risk to the limb and because PAD associated with high cerebrovascular and cardiovascular risk. Read More

    Points to consider-Raynaud's phenomenon in systemic sclerosis.
    Rheumatology (Oxford) 2017 Sep;56(suppl_5):v45-v48
    The University of Manchester, Salford Royal NHS Foundation Trust, Manchester and NIHR Manchester Musculoskeletal Biomedical Research Unit, Central Manchester NHS Foundation Trust, Manchester Academic Health Science Centre, UK.
    RP is an exaggerated vasospastic response to cold or emotion. Randomized, double-blind, placebo-controlled trials with either parallel group or cross-over trials should be mainly considered. Cross-over design, which is good for early phase trials of immediate or very short-term outcomes, is important in a condition as heterogeneous as RP: a wash-out period between treatment arms should always be included to minimize the possibility of a period (carry-over) effect. Read More

    Fighting type-2 diabetes: present and future perspectives.
    Curr Med Chem 2017 Oct 9. Epub 2017 Oct 9.
    Beijing Key Laboratory of Diabetic Prevention and Research, Department of Endocrinology, Lu He hospital, Capital Medical University, Beijing 100149. China.
    Background: Type-2 diabetes mellitus accounts for 80-90% of diabetic patients. So far, the treatment of diabetes mainly aims at elevating insulin level and lowering glucose level in the peripheral blood and mitigating insulin resistance. Physiologically, insulin secretion from pancreatic β cells is delicately regulated. Read More

    Blood pressure gradients in cerebral arteries: a clue to pathogenesis of cerebral small vessel disease.
    Stroke Vasc Neurol 2017 Sep 8;2(3):108-117. Epub 2017 Jun 8.
    Stroke Prevention & Atherosclerosis Research Centre, Robarts Research Institute, Western University, London, Canada.
    Rationale: The role of hypertension in cerebral small vessel disease is poorly understood. At the base of the brain (the 'vascular centrencephalon'), short straight arteries transmit blood pressure directly to small resistance vessels; the cerebral convexity is supplied by long arteries with many branches, resulting in a drop in blood pressure. Hypertensive small vessel disease (lipohyalinosis) causes the classically described lacunar infarctions at the base of the brain; however, periventricular white matter intensities (WMIs) seen on MRI and WMI in subcortical areas over the convexity, which are often also called 'lacunes', probably have different aetiologies. Read More

    Acute Limb Ischemia: An Emergency Medicine Approach.
    Emerg Med Clin North Am 2017 Nov 23;35(4):889-909. Epub 2017 Aug 23.
    Department of Emergency Medicine, University of Wisconsin School of Medicine and Public Health, 600 Highland Avenue, Madison, WI 53792, USA; Emergency Department, Beloit Memorial Hospital, 1969 W Hart Road, Beloit, WI 53511, USA. Electronic address:
    Acute limb ischemia is a medical emergency with significant morbidity and mortality. Rapid diagnosis is required because it is a time-sensitive condition. Timely treatment is necessary to restore blood flow to the extremity and prevent complications. Read More

    Bypass for symptomatic in-stent carotid restenosis.
    Int J Cardiol 2017 Sep 20. Epub 2017 Sep 20.
    Vascular and Endovascular Surgery Division, Department of Surgery "Paride Stefanini", Policlinico Umberto I, "Sapienza" University of Rome, Italy.
    Background: To evaluate early and long-term outcomes of symptomatic patients treated for in-stent carotid restenosis (ISR) with carotid bypass (CB).

    Methods: Data were retrospectively collected from a prospectively compiled database on patients treated with CB in two high-volume Italian centers between 2008 and 2016, for symptomatic high-grade ISR after CAS. After carotid endarterectomy and stent removal, a greater saphenous vein (GSV) was preferentially employed as the graft; when the GSV was not accessible, a 6mm polytetrafluoroethylene (PTFE) graft was implanted. Read More

    Predictors of successful chronic total occlusion percutaneous coronary interventions: a systematic review and meta-analysis.
    Heart 2017 Oct 6. Epub 2017 Oct 6.
    University of Sydney, Sydney, New South Wales, Australia.
    Objective: The aim of this study was to identify positive and negative predictors of technical and clinical success for percutaneous coronary intervention (PCI) of chronic total occlusions (CTO).

    Methods: We conducted a systematic review and meta-analysis of studies published between 2000 and 2016 analysing rates of CTO PCI success with respect to demographic and angiographic characteristics. Crude ORs and 95% CIs for each predictor were calculated using a random effects model. Read More

    Inverse relations of serum phosphatidylcholines and lysophosphatidylcholines with vascular damage and heart rate in patients with atherosclerosis.
    Nutr Metab Cardiovasc Dis 2017 Aug 2. Epub 2017 Aug 2.
    Institute of Biomedicine and Translational Medicine, Department of Biochemistry, Centre of Excellence for Genomics and Translational Medicine, University of Tartu, 19 Ravila Street, Tartu 50411, Estonia; Endothelial Centre, University of Tartu, 8 Puusepa Street, Tartu 51014, Estonia.
    Background And Aims: The rapidly growing discipline of lipidomics allows the study of a wide spectrum of lipid species in body fluids and provides new insights into the pathogenesis of cardiovascular disease. We investigated serum phosphatidylcholine (PC) and lysophosphatidylcholine (lysoPC) species in relation to arterial stiffness, hemodynamics, and endothelial dysfunction in symptomatic patients with atherosclerosis and in healthy controls.

    Methods And Results: Thirty-two patients with peripheral arterial disease (age 61. Read More

    Simultaneous pain intensity rating and quantification of ischemia throughout exercise and recovery in proximal versus distal arterial claudication.
    Vasc Med 2017 Oct 1:1358863X17734304. Epub 2017 Oct 1.
    1 Vascular and Exercise Investigations, University Hospital of Angers, Angers, France.
    Data on simultaneous hemodynamic changes and pain rating estimation in arterial claudication while walking are lacking. This study was conducted to determine if a difference in transcutaneous oxygen pressure (tc pO2) exists between proximal and distal localization at pain appearance (PAINapp), maximal pain (PAINmax) and pain relief (PAINrel) in proximal or distal claudication and if a relationship exists between tc pO2 changes and pain intensity. We analyzed the pain rating (Visual Analog Scale (VAS)) to lower limb ischemia, measured with the decrease from rest of oxygen pressure (DROP) tc pO2 index during constant-load treadmill tests in patients with calf ( n = 41) or buttock ( n = 19) claudication. Read More

    Sickle cell disease and the eye.
    Curr Opin Ophthalmol 2017 Nov;28(6):623-628
    aUSC Roski Eye Institute, Keck School of Medicine bUSC Institute for Biomedical Therapeutics, University of Southern California, Los Angeles, California, USA.
    Purpose Of Review: To review recent literature pertaining to sickle cell retinopathy (SCR) and, in particular, sickle cell maculopathy.

    Recent Findings: Several recent studies suggest that macular perfusion abnormalities seen in patients with sickle cell disease of various genotypes may affect both the superficial and deep capillary plexi, with a predilection for the deep capillary plexus. Further, these changes may be associated with areas of macular thinning, as well as with peripheral retinal ischemia, even in individuals without visual symptoms, contrary to what has previously been described in both diabetic retinopathy and retinal vein occlusion. Read More

    Phenotypic Consequences of a Genetic Predisposition to Enhanced Nitric Oxide Signaling.
    Circulation 2017 Oct 5. Epub 2017 Oct 5.
    Center for Genomic Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA; Cardiology Division Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA; Program in Medical and Population Genetics, Broad Institute, Cambridge, MA
    Background -Nitric oxide signaling plays a key role in regulation of vascular tone and platelet activation. Here, we seek to understand the impact of a genetic predisposition to enhanced nitric oxide signaling on risk for cardiovascular diseases, thus informing the potential utility of pharmacologic stimulation of the nitric oxide pathway as a therapeutic strategy. Methods -We analyzed the association of common and rare genetic variants in two genes that mediate nitric oxide signaling [Nitric Oxide Synthase 3 (NOS3) and Guanylate Cyclase 1, Soluble, Alpha 3 (GUCY1A3)] with a range of human phenotypes. Read More

    Muscle-derived extracellular superoxide dismutase inhibits endothelial activation and protects against multiple organ dysfunction syndrome in mice.
    Free Radic Biol Med 2017 Oct 2;113:212-223. Epub 2017 Oct 2.
    Center for Skeletal Muscle Research at Robert Berne Cardiovascular Research Center, University of Virginia, Charlottesville, VA 22908, USA; Departments of Medicine, University of Virginia, Charlottesville, VA 22908, USA; Departments of Pharmacology, University of Virginia, Charlottesville, VA 22908, USA; Departments of Molecular Physiology & Biological Physics, University of Virginia, Charlottesville, VA 22908, USA. Electronic address:
    Multiple organ dysfunction syndrome (MODS) is a detrimental clinical complication in critically ill patients with high mortality. Emerging evidence suggests that oxidative stress and endothelial activation (induced expression of adhesion molecules) of vital organ vasculatures are key, early steps in the pathogenesis. We aimed to ascertain the role and mechanism(s) of enhanced extracellular superoxide dismutase (EcSOD) expression in skeletal muscle in protection against MODS induced by endotoxemia. Read More

    Acute oral tetrahydrobiopterin administration ameliorates endothelial dysfunction in systemic sclerosis.
    Clin Exp Rheumatol 2017 Sep-Oct;35 Suppl 106(4):167-172. Epub 2017 Sep 14.
    Department of Internal Medicine, University of Utah, Salt Lake City, UT, USA.
    Objectives: Systemic sclerosis (SSc) is a rare, autoimmune disease characterised by endothelial dysfunction, which is associated with peripheral vasculopathy, such as digital ulcers (DU). We sought to determine if acute oral administration of tetrahydrobiopterin (BH4), an essential cofactor for endothelial nitric oxide synthase, would augment endothelial function in patients with SSc.

    Methods: Twelve SSc patients, of whom a majority had a history of DU, were studied 5 hours after oral BH4 administration (10 mg/kg body mass) or placebo on separate days using controlled, counterbalanced, double-blind, crossover experimental design. Read More

    The association of race with quality of health in peripheral artery disease following peripheral vascular intervention: The Q-PAD Study.
    Vasc Med 2017 Oct 1:1358863X17733065. Epub 2017 Oct 1.
    1 Division of Cardiology, St John Hospital and Medical Center, Detroit, MI, USA.
    Black patients have a higher prevalence of peripheral artery disease (PAD) than white patients, and also tend to have a greater extent and severity of disease, and poorer outcomes. The association of race with quality of health (QOH) after peripheral vascular intervention (PVI), however, is less well-known. In our study, we hypothesized that after PVI, black patients experience worse QOH than white patients. Read More

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