- Email: [email protected]
P1-17 LOW GRADE INFLAMMATION IN INDIVIDUALS WITH THE HYPERTRIGLYCERIDEMIC WAIST PHENOTYPE. ANOTHER FEATURE OF THIS ATHEROGENIC DYSMETABOLISM
66
Abstracts of the 16th Asian Pacific Congress of Cardiology, Taipei, Taiwan, 13-16 December, 2007
P1-16
P1-18
INFLAMMATION RELATED ERYTHROCYTE AGGREGATION AND OBESITY. POSSIBLE LINK TO CARDIOVASCULAR MORBIDITY
THE RELATIONSHIP AMONG PULMONARY FUNCTION, ARTERIAL WAVW REFLECTIONS, AND CENTRAL ARTERIAL PRESSURE
Itzhak Shapira, Ori Rogowski, Dorit Samocha-Bonet, Shlomo Berliner. Department of Medicine “D” and Institute for Special Medical Examinations (MALRAM), Tel Aviv Sourasky Medical Center, Tel Aviv, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
H. Tomiyama, M. Yoshida, J. Yamada, C. Matusmot, K. Shiina, K. Teraoka, Y. Sagawa, Y. Miyawaki, T. Shirota, A. Yamashina. Tokyo Medical University, OMRON HEALTHCARE Co., Ltd, Kyoto, Japan
Background: Preliminary data reveal a possible link between obesity, the presence of a microinflammatory response and enhanced red blood cell aggregation. The objective of the present study is to analyze the putative association in a relatively large cohort due to its possible relevance to the field of vascular biology. Methods: This is a cross sectional study in a relatively large cohort of apparently healthy individuals and those with atherothrombotic risk factors. A total of 4105 (2568 men and 1537 women) apparently healthy individuals and those with atherothrombotic risk factors who attended the Tel Aviv Sourasky Medical Center for a routine health examination. Inflammatory biomarkers including the white blood cell count (WBCC) and differential, the Westergren’s erythrocyte sedimentation rate (ESR), fibrinogen concentration, high sensitivity C-reactive protein (hs-CRP) as well as erythrocyte aggregation slide test. Results: A significant correlation was noted between the degree of erythrocyte aggregation in the peripheral blood and BMI in both men (r=0.11 p<0.005) and women (r=0.3 p<0.0005). In addition, the degree of erythrocyte aggregation correlated with markers of inflammation. For example it was r=0.280 p<0.0005 and r=0.409 p<0.0005 with high sensitivity C-reactive protein and r=0.372 p<0.0005 and r=0.482 p<0.0005 with fibrinogen for both men and women respectively. Conclusions: The increment in BMI is associated with a microinflammatory response and a enhanced red blood cell aggregation. This aggregation might have a detrimental hemorheological effect presenting a potential new pathological pathway between obesity, inflammation and the development of atherothrombotic diseases.
Objective: Pulmonary dysfunction is noted as a cardiovascular risk. On the other hand, augmented arterial wave reflections and/or increased central arterial pressure are thought to be a risk for cardiovascular disease. Then, we conducted to examine the relationship between pulmonary function, arterial wave reflections, and central arterial pressure in the general population. Design and Methods: A cross-sectional study was conducted in 1595 men (age: 51±10) and 1082 women (age: 49±12). Among them, forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1), and augmentation index (AI) in radial arteriary were measured. Estimated CAP (esCAP) was calculated from pressure wave analysis. Results: Linear regression analysis demonstrated that FVC, rather than FEV1, has a significant correlation with AI (men: r=−0.32, women: r=−0.31, <0.01) and esCAP (men: r=−0.32, women: r=−0.38, p<0.01). Multiple linear regression analysis demonstrated that these associations were significant in both genders even after the adjustment with age, smoking status, body mass index, blood pressure, and other conventional risk factors. While blood pressure levels obtained at upper arm were similar, according to decrease in tertile number of FVC, AI and esCAP were significantly increased according to incr in tertile number of FVC even after the same adjustment. Conclusions: The cardiovascular risk related to augmented arterial wave reflections seems to contribute to increased cardiovascular risk in subjects with reduced pulmonary function, at least in part.
P1-19 FACTORS CONTRIBUTE TO CONCOMITANT CORONARY ARTERY DISEASE AND CERVICAL ARTERY DISEASE
P1-17 LOW GRADE INFLAMMATION IN INDIVIDUALS WITH THE HYPERTRIGLYCERIDEMIC WAIST PHENOTYPE. ANOTHER FEATURE OF THIS ATHEROGENIC DYSMETABOLISM
Itzhak Shapira, Ori Rogowski, Sharon Toker, Samuel Melamed, Arie Shirom, Shlomo Berliner. Department of Medicine “D” and Institute for Special Medical Examinations (MALRAM), Tel Aviv Sourasky Medical Center, Tel Aviv, Sackler Faculty of Medicine, Tel Aviv University, Faculty of Management, Tel Aviv University, National Institute of Occupational & Environmental Health, Raanana, Israel, Sackler Faculty Medicine, Tel-Aviv University, Tel-Aviv, Israel Backgrounds. We explored the possibility that the recently described "hypertriglyceridemic waist" (HTGW) phenotype, a risk for future coronary artery disease (CAD), is associated with the presence of low grade inflammation. Methods. A cross sectional study in a cohort of apparently healthy non-diabetic employed individuals in whom the presence of low grade inflammation was determined by using the high sensitivity C-reactive protein (hs-CRP) assay. Results. We have presently analyzed the results obtained in 7,186 apparently healthy individuals, at a mean±SD age of 44±11 years. We identified 406 individuals (90.6% men) with the HTGW phenotype according to the cut-off points of waist girth of ≥90 cm for men and ≥85 cm for women and triglycerides levels of ≥177 mg/dl. In addition, we identified 473 individuals (64.3% men) with the metabolic syndrome (MetS) according to the updated ATP III criteria. The mean±SD of hs-CRP was 1.3±2.9 mg/l for the 5,879 individuals who had neither the HTGW phenotype nor the MetS, 2.0±2.5 mg/l for those who had the HTGW phenotype and no MetS, 2.7±2.6 for 473 individuals with the MetS and no HTGW phenotype while those who had both atherogenic disorders presented a hsCRP concentration of 2.8±2.3 mg/l. Conclusion. In this cohort of apparently healthy non-diabetic employed individuals, the HTGW phenotype had a similar prevalence as the MetS and was associated with the presence of low grade inflammation. The inflammatory machinery could be a pathophysiologic link between this dysmetabolism and atherothrombosis. In addition, it looks as if the HTGW phenotype is relatively prevalent and could be a simple and inexpensive way to single out individuals at risk for future CAD.
Yuan-Teng Tseng, Shih-Chung Chen, Hung-Yu Yang, Pai-Feng Kao, Yi-Jen Chen. Division of cardiology, Department of Internal Medicine, Taipei Medical University – WanFang Hospital,Taiwan Objective And Background: Patients with extracranial carotid and vertebral artery disease (ECVAD) frequently have concomitant coronary arteries disease (CAD). ECVAD has similar atherosclerotic risk factors as CAD. However, different impact on CAD and ECVAD of these risk factors are unclear, and predictive risk factors for concomitant CAD/ECVAD are lack. This study sought to evaluate different impact of traditional major and minor risk factors on coronary and carotid arteries. Methods: A total of 45 consecutive patients underwent cervical angiography (mainly for dizziness) and concurrent coronary angiography. The angiographic results, demographic characters (age, gender, body mass index, symptoms and prior stroke/hemiparesis), conventional atherosclerotic risk factors (cigarette smoking, family CAD history, diabetes mellitus, hypertension, serum lipid profile), biochemical data (CRP, uric acid, hemoglobin level), pulse pressure, and echocardiogram findings were compared among the patients with CAD alone, ECVAD alone, and concomitant CAD/ECVAD. Results: Among 45 patients (73.5±8.7 years old), 9 patients had CAD alone, and 13 patients had ECVAD alone, whereas 23 had concomitant CAD/ECVAD. Sixty-four percent (23 in 36) of patient with ECVAD had coincident CAD. Male gender and diabetes were significantly associated with concomitant CAD/ECVAD (P=0.039 and 0.046 respectively). High pulse pressure and higher serum uric acid level were stronger associated with CAD than ECVAD (p=0.012 and 0.003 respectively). BMI, prior stroke, smoking history, hypertension, serum LDL, HDL, and CRP level didn’t differ significantly among three groups. Conclusion: Patients with ECVAD have high prevalence of coincident CAD. Male gender and diabetes mellitus are associated with concomitant CAD/ECVAD. High pulse pressure and higher uric acid level are stronger associated with CAD than ECVAD.
Abstracts of the 16th Asian Pacific Congress of Cardiology, Taipei, Taiwan, 13-16 December, 2007
P1-16
P1-18
INFLAMMATION RELATED ERYTHROCYTE AGGREGATION AND OBESITY. POSSIBLE LINK TO CARDIOVASCULAR MORBIDITY
THE RELATIONSHIP AMONG PULMONARY FUNCTION, ARTERIAL WAVW REFLECTIONS, AND CENTRAL ARTERIAL PRESSURE
Itzhak Shapira, Ori Rogowski, Dorit Samocha-Bonet, Shlomo Berliner. Department of Medicine “D” and Institute for Special Medical Examinations (MALRAM), Tel Aviv Sourasky Medical Center, Tel Aviv, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
H. Tomiyama, M. Yoshida, J. Yamada, C. Matusmot, K. Shiina, K. Teraoka, Y. Sagawa, Y. Miyawaki, T. Shirota, A. Yamashina. Tokyo Medical University, OMRON HEALTHCARE Co., Ltd, Kyoto, Japan
Background: Preliminary data reveal a possible link between obesity, the presence of a microinflammatory response and enhanced red blood cell aggregation. The objective of the present study is to analyze the putative association in a relatively large cohort due to its possible relevance to the field of vascular biology. Methods: This is a cross sectional study in a relatively large cohort of apparently healthy individuals and those with atherothrombotic risk factors. A total of 4105 (2568 men and 1537 women) apparently healthy individuals and those with atherothrombotic risk factors who attended the Tel Aviv Sourasky Medical Center for a routine health examination. Inflammatory biomarkers including the white blood cell count (WBCC) and differential, the Westergren’s erythrocyte sedimentation rate (ESR), fibrinogen concentration, high sensitivity C-reactive protein (hs-CRP) as well as erythrocyte aggregation slide test. Results: A significant correlation was noted between the degree of erythrocyte aggregation in the peripheral blood and BMI in both men (r=0.11 p<0.005) and women (r=0.3 p<0.0005). In addition, the degree of erythrocyte aggregation correlated with markers of inflammation. For example it was r=0.280 p<0.0005 and r=0.409 p<0.0005 with high sensitivity C-reactive protein and r=0.372 p<0.0005 and r=0.482 p<0.0005 with fibrinogen for both men and women respectively. Conclusions: The increment in BMI is associated with a microinflammatory response and a enhanced red blood cell aggregation. This aggregation might have a detrimental hemorheological effect presenting a potential new pathological pathway between obesity, inflammation and the development of atherothrombotic diseases.
Objective: Pulmonary dysfunction is noted as a cardiovascular risk. On the other hand, augmented arterial wave reflections and/or increased central arterial pressure are thought to be a risk for cardiovascular disease. Then, we conducted to examine the relationship between pulmonary function, arterial wave reflections, and central arterial pressure in the general population. Design and Methods: A cross-sectional study was conducted in 1595 men (age: 51±10) and 1082 women (age: 49±12). Among them, forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1), and augmentation index (AI) in radial arteriary were measured. Estimated CAP (esCAP) was calculated from pressure wave analysis. Results: Linear regression analysis demonstrated that FVC, rather than FEV1, has a significant correlation with AI (men: r=−0.32, women: r=−0.31, <0.01) and esCAP (men: r=−0.32, women: r=−0.38, p<0.01). Multiple linear regression analysis demonstrated that these associations were significant in both genders even after the adjustment with age, smoking status, body mass index, blood pressure, and other conventional risk factors. While blood pressure levels obtained at upper arm were similar, according to decrease in tertile number of FVC, AI and esCAP were significantly increased according to incr in tertile number of FVC even after the same adjustment. Conclusions: The cardiovascular risk related to augmented arterial wave reflections seems to contribute to increased cardiovascular risk in subjects with reduced pulmonary function, at least in part.
P1-19 FACTORS CONTRIBUTE TO CONCOMITANT CORONARY ARTERY DISEASE AND CERVICAL ARTERY DISEASE
P1-17 LOW GRADE INFLAMMATION IN INDIVIDUALS WITH THE HYPERTRIGLYCERIDEMIC WAIST PHENOTYPE. ANOTHER FEATURE OF THIS ATHEROGENIC DYSMETABOLISM
Itzhak Shapira, Ori Rogowski, Sharon Toker, Samuel Melamed, Arie Shirom, Shlomo Berliner. Department of Medicine “D” and Institute for Special Medical Examinations (MALRAM), Tel Aviv Sourasky Medical Center, Tel Aviv, Sackler Faculty of Medicine, Tel Aviv University, Faculty of Management, Tel Aviv University, National Institute of Occupational & Environmental Health, Raanana, Israel, Sackler Faculty Medicine, Tel-Aviv University, Tel-Aviv, Israel Backgrounds. We explored the possibility that the recently described "hypertriglyceridemic waist" (HTGW) phenotype, a risk for future coronary artery disease (CAD), is associated with the presence of low grade inflammation. Methods. A cross sectional study in a cohort of apparently healthy non-diabetic employed individuals in whom the presence of low grade inflammation was determined by using the high sensitivity C-reactive protein (hs-CRP) assay. Results. We have presently analyzed the results obtained in 7,186 apparently healthy individuals, at a mean±SD age of 44±11 years. We identified 406 individuals (90.6% men) with the HTGW phenotype according to the cut-off points of waist girth of ≥90 cm for men and ≥85 cm for women and triglycerides levels of ≥177 mg/dl. In addition, we identified 473 individuals (64.3% men) with the metabolic syndrome (MetS) according to the updated ATP III criteria. The mean±SD of hs-CRP was 1.3±2.9 mg/l for the 5,879 individuals who had neither the HTGW phenotype nor the MetS, 2.0±2.5 mg/l for those who had the HTGW phenotype and no MetS, 2.7±2.6 for 473 individuals with the MetS and no HTGW phenotype while those who had both atherogenic disorders presented a hsCRP concentration of 2.8±2.3 mg/l. Conclusion. In this cohort of apparently healthy non-diabetic employed individuals, the HTGW phenotype had a similar prevalence as the MetS and was associated with the presence of low grade inflammation. The inflammatory machinery could be a pathophysiologic link between this dysmetabolism and atherothrombosis. In addition, it looks as if the HTGW phenotype is relatively prevalent and could be a simple and inexpensive way to single out individuals at risk for future CAD.
Yuan-Teng Tseng, Shih-Chung Chen, Hung-Yu Yang, Pai-Feng Kao, Yi-Jen Chen. Division of cardiology, Department of Internal Medicine, Taipei Medical University – WanFang Hospital,Taiwan Objective And Background: Patients with extracranial carotid and vertebral artery disease (ECVAD) frequently have concomitant coronary arteries disease (CAD). ECVAD has similar atherosclerotic risk factors as CAD. However, different impact on CAD and ECVAD of these risk factors are unclear, and predictive risk factors for concomitant CAD/ECVAD are lack. This study sought to evaluate different impact of traditional major and minor risk factors on coronary and carotid arteries. Methods: A total of 45 consecutive patients underwent cervical angiography (mainly for dizziness) and concurrent coronary angiography. The angiographic results, demographic characters (age, gender, body mass index, symptoms and prior stroke/hemiparesis), conventional atherosclerotic risk factors (cigarette smoking, family CAD history, diabetes mellitus, hypertension, serum lipid profile), biochemical data (CRP, uric acid, hemoglobin level), pulse pressure, and echocardiogram findings were compared among the patients with CAD alone, ECVAD alone, and concomitant CAD/ECVAD. Results: Among 45 patients (73.5±8.7 years old), 9 patients had CAD alone, and 13 patients had ECVAD alone, whereas 23 had concomitant CAD/ECVAD. Sixty-four percent (23 in 36) of patient with ECVAD had coincident CAD. Male gender and diabetes were significantly associated with concomitant CAD/ECVAD (P=0.039 and 0.046 respectively). High pulse pressure and higher serum uric acid level were stronger associated with CAD than ECVAD (p=0.012 and 0.003 respectively). BMI, prior stroke, smoking history, hypertension, serum LDL, HDL, and CRP level didn’t differ significantly among three groups. Conclusion: Patients with ECVAD have high prevalence of coincident CAD. Male gender and diabetes mellitus are associated with concomitant CAD/ECVAD. High pulse pressure and higher uric acid level are stronger associated with CAD than ECVAD.