Aim: The aim of this study was to clarify the relationship between CAVI and serum cystatin C levels to understand the role of arterial stiffness in the presence of renal insufficiency. Methods: We ...enrolled 206 consecutive patients with cardiovascular risk factors and/or coronary artery disease (CAD) in the study. Serum cystatin C, estimated glomerular filtration rate (eGFR), and plasma levels of von Willebrand factor (vWF) and plasminogen activator inhibitor (PAI-1) were measured. CAVI was determined as an index of arterial stiffness. Results: For all patients, the mean serum cystatin C level was 0.81±0.21 mg/L and mean eGFR was 65.8±15.5 mL/min per 1.73 m2. In univariate analysis, CAVI levels significantly correlated with cystatin C levels (r=0.414, p<0.001), eGFR (r=-0.315, p<0.01), PAI-1 (r=0.269, p<0.01), and vWF (r=0.207, p<0.01). Multiple regression analysis showed that age, cystatin C, PAI-1, and a history of CAD were independent variables of CAVI. Age-adjusted CAVI was highest in the presence of both CAD and renal impairment. Conclusion: CAVI was closely associated with cystatin C levels. These results suggest a significant role of arterial stiffness in renal insufficiency.
Arterial stiffness has been known to be a surrogate marker of arteriosclerosis, and also of vascular function. Pulse wave velocity (PWV) had been the most popular index and was known to be a ...predictor of cardiovascular events. But, it depends on blood pressure at measuring time. To overcome this problem, cardio-ankle vascular index (CAVI) is developed. CAVI is derived from stiffness parameter β by Hayashi, and the equation of Bramwell-Hill, and is independent from blood pressure at a measuring time. Then, CAVI might reflect the proper change of arterial wall by antihypertensive agents. CAVI shows high value with aging and in many arteriosclerotic diseases and is also high in persons with main coronary risk factors. Furthermore, CAVI is decreased by an administration of α1 blocker, doxazosin for 2-4 hours, Those results suggested that CAVI reflected the arterial stiffness composed of organic components and of smooth muscle cell contracture. Angiotensin II receptor blocker, olmesartan decreased CAVI much more than that of calcium channel antagonist, amlodipine, even though the rates of decreased blood pressure were almost same. CAVI might differentiate the blood pressure-lowering agents from the point of the effects on proper arterial stiffness. This paper reviewed the principle and rationale of CAVI, and the possibilities of clinical applications, especially in the studies of hypertension.
Aim: To clarify whether the cardio-ankle vascular index (CAVI) independently contributes to the development of exudative age-related macular degeneration (AMD) compared with carotid arteriosclerosis ...parameters and other risk factors. Methods: Eighty-eight consecutive patients with exudative AMD were enrolled. A control group (40 age-matched men, 65 years of age or older) was also evaluated, and the parameters were compared between the two groups. A logistic regression analysis was used to determine independent factors for the diagnosis of AMD. In addition, simple linear and multiple regression analyses were used to determine the relationships between the CAVI and other parameters. Results: The carotid intima-media thickness and plaque scores in the AMD group did not differ significantly from those observed in the control group. The CAVI in the AMD group was significantly (p=0.01) higher than that observed in the control group. A logistic regression analysis showed that the CAVI (odds ratio OR, 1.91; 95% confidence interval CI, 1.26-7.20; p=0.007) and the use of lipid-lowering drugs (OR, 0.29; 95% CI, 0.10-0.86; p=0.03) independently contributed to the diagnosis of AMD. Age, the high-sensitivity C-reactive protein level and the incidence of exudative AMD each independently contributed to the CAVI. Conclusions: The CAVI is more significantly associated with exudative AMD than carotid atherosclerosis parameters. The overall arterial stiffness is correlated with the pathogenesis of exudative AMD. The CAVI is a useful marker of exudative AMD in elderly patients with arteriosclerosis risk factors.
Background
To evaluate the vitreous fluid levels of soluble LR11 (sLR11), a novel circulating marker for proliferative diabetic retinopathy (PDR), in patients with PDR and non-PDR (NPDR) in ...comparison to those in patients with non-diabetic ocular diseases.
Method
Twenty NPDR and 60 PDR cases were included. Twenty-four subjects with a macular hole were served as a control group. The sLR11 levels of vitreous fluid and serum were determined by sandwich enzyme-linked immunosorbent assay.
Results
The serum sLR11 levels in the PDR and NPDR groups were 12.3 ± 5.0 ng/ml and 10.0 ± 2.7 ng/ml, respectively. The sLR11 levels in the vitreous fluid in the PDR (17.8 ± 6.2 ng/ml) and NPDR (17.4 ± 7.1 ng/ml) groups were significantly higher than those in the control subjects (12.3 ± 4.5 ng /ml) (
P
= 0.0003 and
P
= 0.006, respectively). The vitreous fluid levels of sLR11 were not significantly different between the PDR and NPDR groups, and the levels were not significantly correlated with the serum levels of sLR11 in the patients with PDR or NPDR.
Conclusion
Vitreous fluid sLR11 level may be a novel risk factor for the early development of PDR prior to the increase in circulating levels in diabetic patients.
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EMUNI, FIS, FZAB, GEOZS, GIS, IJS, IMTLJ, KILJ, KISLJ, MFDPS, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, SBMB, SBNM, UKNU, UL, UM, UPUK, VKSCE, ZAGLJ
Aim: Recent clinical studies have reported that low lipoprotein lipase mass in preheparin serum (s-LpL) and hypoadiponectinemia are important risk factors for acute myocardial infarction (AMI). The ...aim of this study was to elucidate the relationship between low s-LpL and hypoadiponectinemia, both of which are risk factors for AMI. Methods: One hundred and thirty-seven male patients with AMI and fifty-three males with normal coronary arteries (NCA) were enrolled in the study. Coronary risk factors, including s-LpL and serum total adiponectin concentrations (t-adiponectin), were compared. Results: Both s-LpL and t-adiponectin were significantly lower in patients with AMI than in subjects with NCA (s-LpL, NCA: 48.1±11.0 ng/mL, AMI: 38.9±11.1 ng/mL, p< 0.01; t-adiponectin, NCA: 7.7±2.9 μg/mL, AMI: 6.1±3.3 μg/mL, p< 0.01). In AMI patients, there was a significant positive correlation between s-LpL and t-adiponectin (r=0.46, p< 0.01). Furthermore, multivariate analysis indicated that both s-LpL and t-adiponectin were independent variables for AMI (s-LpL: p< 0.05, t-adiponectin: p< 0.05). Conclusion: These results indicate that although low s-LpL and hypoadiponectinemia are associated with each other, they are independent risk factors for AMI.
We report on a patient with ischemic colitis and another with paralytic ileus, both of whom experienced an acute abdomen after intravitreal injection of bevacizumab (IVB). Case 1 was a 78-year-old ...woman. Her medical history included surgery for colon carcinoma 10 years earlier. The patient developed acute severe abdominal pain and nausea the day after IVB for retinal vein occlusion with macular edema, and massive lower gastrointestinal bleeding occurred. Ischemic colitis was diagnosed. Case 2 was a 64-year-old man who presented with neovascular glaucoma with proliferative diabetic retinopathy. We performed vitreous surgery on the 9th day after IVB, and we reperformed IVB at the end of the vitreous surgery. On the first postoperative day, severe abdominal distension, vomiting and abdominal pain were observed, and paralytic ileus was diagnosed. It is possible that gastrointestinal disorders are induced after IVB, depending on the patient's background, including for example severe diabetes or a history of surgery for gastrointestinal cancer. Thus, ophthalmologists should apply alternative therapies instead of IVB to patients with severe diabetes mellitus or a history of gastrointestinal cancer.
Aim: Recent clinical studies using intra-vascular ultrasound have clarified that coronary artery plaque already exists in subjects with normal coronary artery which is diagnosed by coronary ...angiography; furthermore, culprit lesion on acute coronary syndrome often occurs in mild to moderate angiographical stenotic lesion. The aim of this study is to clarify relationship between metabolic syndrome and early stage coronary atherosclerosis using a 3-dimensional intra-vascular ultrasound. Methods: 70 subjects with normal coronary artery diagnosed by coronary angiography were enrolled. Proxymal range of left anterior descending coronary artery was observed by intra-vascular ultrasound using autopullback methods. Results: Subjects with metabolic syndrome had significantly high percent plaque volume (31 ± 8% vs 21 ± 8%, p < 0.0001) and frequently detected abnormal plaque quality such as eccentricity, calcification and lipid pool into plaque than those without metabolic syndrome. Multivariate analysis showed that serum adiponectin concentration was the most strongest variable for percent plaque volume (t value= − 3.0, p < 0.01). On the other hand, subjects with hypoadiponectinemia were detected high incidence of mild calcification into plaque. Conclusion: Metabolic syndrome needs to be detected and treated as early as possible. Furthermore, measurement of serum adiponectin concentration and appropriate treatment would prevent acute coronary syndrome.
Purpose
To clarify the relationship between sleep-disordered breathing (SDB) and background factors in patients with proliferative diabetic retinopathy (PDR).
Participants and methods
One hundred ...fifty-one consecutive PDR patients were included in this study. These patients’ SDB parameters, including the mean and lowest SpO
2
, sleeping 4% oxygen desaturation index (ODI), and cumulative percentage of time spent at SpO
2
< 90% (CT90%), were measured. Simple linear regression analyses were conducted to investigate whether the SDB parameters correlated with systemic factors for PDR, including age, duration of diabetes, HbA1c value, incidence of hypertension, estimated glomerular filtration rate (eGFR), body mass index (BMI), and insulin therapy. Logistic regression analysis was also conducted to investigate whether the SDB evaluation items were factors independently associated with the incidence of hypertension.
Results
Hypertension and BMI were statistically correlated with all of the parameters. The eGFR was statistically correlated with 4% ODI and insulin therapy with the lowest SpO
2
. Logistic regression analysis revealed 4% ODI and eGFR as factors independently contributing to the incidence of hypertension.
Conclusion
The results of our study confirmed the relationship between SDB and background factors reported to be risk factors for diabetic retinopathy progression in patients with PDR.
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EMUNI, FIS, FZAB, GEOZS, GIS, IJS, IMTLJ, KILJ, KISLJ, MFDPS, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, SBMB, SBNM, UKNU, UL, UM, UPUK, VKSCE, ZAGLJ
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