Imaging Assessment of Endothelial Function: An Index of Cardiovascular Health

Minhas, Anum; Goerlich, Erin; Corretti, Mary C.; Arbab‐Zadeh, Armin; Kelle, Sebastian; Leucker, Thorsten M.; Lerman, Amir; Hays, Allison G.

doi:10.3389/fcvm.2022.778762

Cited by 13 publications

(9 citation statements)

References 100 publications

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“…Third, FMD is not a gold standard for endothelial functional assessment, which is invasive quantitative angiography 32 , potentially raising concerns about validation (e.g. learning curve) 33 .…”

Section: Discussionmentioning

confidence: 99%

The impact of chronic electronic cigarette use on endothelial dysfunction measured by flow-mediated vasodilation: A systematic review and meta-analysis

Lee,

Yao,

Boakye

et al. 2024

Tob. Induc. Dis.

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INTRODUCTION Despite electronic cigarettes (e-cigarettes) being marketed as a safer alternative to combustible cigarettes, the effects of chronic e-cigarette use on vascular health remain uncertain. Our meta-analysis aimed to assess the health implications of chronic exclusive e-cigarette use on endothelial dysfunction, as measured by flow-mediated vasodilation (FMD). METHODS PubMed, Embase and Scopus were searched for studies from 1 January 2004 to 31 March 2024. Four cross-sectional studies (n=769) were pooled using a random-effects model. The mean differences (MD) of FMD were reported by comparing exclusive e-cigarette use versus non-use; exclusive e-cigarette use versus combustible cigarette use; and combustible cigarette use versus non-use. RESULTS A non-significant reduction in FMD in exclusive e-cigarette use compared to non-use was reported (MD of FMD: -1.47%; 95% CI: -3.96 -1.02; I 2 = 84%). Similar MD of FMD in exclusive e-cigarette use and exclusive combustible cigarette use (vs non-use) suggested that both of these products might have comparable adverse influences on endothelial health. CONCLUSIONS The limited availability of studies assessing the chronic impact of e-cigarette use restricted our ability to provide definitive findings. We emphasize the importance of additional research that explores the long-term impact of e-cigarette use on endothelial dysfunction, and identify key areas and give suggestions for further study.

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Section: Discussionmentioning

confidence: 99%

The impact of chronic electronic cigarette use on endothelial dysfunction measured by flow-mediated vasodilation: A systematic review and meta-analysis

Lee,

Yao,

Boakye

et al. 2024

Tob. Induc. Dis.

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“…Many of these markers have been associated with all-cause mortality and some of these with CV mortality in PWH. 6,[20][21][22][23] Therefore, the chronic immune activation and inflammation present in PWH despite stable ART likely interacts with the immune and inflammatory processes of vascular repair and atherosclerosis. Of importance, our findings highlight that these processes are operative in the setting of coronary endothelial dysfunction (an early stage of coronary atherosclerosis), which has been investigated far less than systemic endothelial function using FMD among PWH.…”

Section: Discussionmentioning

confidence: 99%

The Relationship Between Impaired Coronary Endothelial Function and Systemic Markers of Inflammation in People Living With HIV

Bagchi

Kwapong

Schär

et al. 2023

JAIDS Journal of Acquired Immune Deficiency Syndromes

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Background: People with HIV (PWH) are at an increased risk of cardiovascular disease, partially believed to be related to chronically elevated systemic inflammation. Abnormal systemic endothelial function (SEF) and coronary endothelial function (CEF) develop early in atherogenesis and predict adverse events. It is unknown whether abnormal CEF is related to systemic inflammation in PWH. Methods:In this substudy of a prior randomized controlled trial in PWH without prior clinical coronary artery disease suppressed on antiretroviral therapy with CEF as a primary end point (N = 82), we investigated the associations between baseline serum markers of inflammation and adhesion and baseline CEF, assessed by noninvasive MRI measures of percentage changes in coronary blood flow and cross-sectional area during isometric handgrip exercise, and SEF using brachial ultrasound for flow-mediated dilation. We also evaluated whether baseline marker levels were associated with CEF after 8 weeks in the placebo group (N = 40).Results: CEF measures were abnormal at baseline, based on trial entry criteria. A higher value of CEF was directly associated with levels of interleukin 10, whereas CEF at baseline was inversely associated with E-selectin. Worse CEF at 8 weeks was directly associated with baseline tumor necrosis factor alpha, intercellular adhesion molecule 1, C-reactive protein, interferon gamma and sICAM-3. SEF at baseline or 8 weeks was not associated with any baseline markers. Conclusion:Coronary but not systemic endothelial dysfunction was significantly associated with select markers of inflammation and adhesion in PWH. Furthermore, CEF but not SEF at 8 weeks was associated with baseline levels of inflammation. Our findings suggest that abnormal CEF and systemic markers of inflammation are linked in PWH.

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“…Flow-mediated dilation (FMD) has frequently been used in research, though is considered an assessment of peripheral endothelial function, as opposed to coronary function [27]. Cardiac MRI and cardiac PET have also been used in the evaluation of coronary endothelial function (CEF) when combined with isometric handgrip exercise (IHE) or cold pressor challenge, respectively [28].…”

Section: Diagnostic Evaluation Of Coronary Microvascular Dysfunctionmentioning

confidence: 99%

Large lessons learned from small vessels: coronary microvascular dysfunction in HIV

Thomas,

Walpert,

Srinivasa

2023

Current Opinion in Infectious Diseases

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Purpose of review Large cohort studies have consistently shown the presence of heart failure is approximately doubled among persons with HIV (PWH). Early studies of cardiovascular disease (CVD) in HIV were primarily focused on atherosclerotic burden, and we now have a greater understanding of large vessel disease in HIV. More recent studies have begun to inform us about small vessel disease, or coronary microvascular dysfunction (CMD), in HIV. CMD is recognized to be an important risk factor for adverse events related to heart failure, associated with cardiovascular mortality, and often presents without overt atherosclerotic disease. Recent findings In this review, we highlight implications for CMD and relevant clinical studies in HIV. Inflammation and endothelial dysfunction, well known risk factors in HIV, may mediate the pathogenesis of CMD. Initial studies suggest that CMD worsens with ART initiation. Newer studies reveal CMD is present among well treated PWH without known CVD. In addition, myocardial flow reserve (MFR), a marker of CMD, is reduced in HIV similar to diabetes. There also appears to be sex differences, such that CMD is worse among women vs. men with HIV. Summary Alterations in the coronary microvasculature may be an important mediator of subclinical myocardial dysfunction that deserves further clinical attention among PWH without known CVD.

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Imaging Assessment of Endothelial Function: An Index of Cardiovascular Health

Cited by 13 publications

References 100 publications

The impact of chronic electronic cigarette use on endothelial dysfunction measured by flow-mediated vasodilation: A systematic review and meta-analysis

The impact of chronic electronic cigarette use on endothelial dysfunction measured by flow-mediated vasodilation: A systematic review and meta-analysis

The Relationship Between Impaired Coronary Endothelial Function and Systemic Markers of Inflammation in People Living With HIV

Large lessons learned from small vessels: coronary microvascular dysfunction in HIV

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