Invasive Physiological Assessment of Lower Limb Peripheral Arterial Disease: A Narrative Review

Journal of Cardiovascular Development and Disease, Journal Year: 2025, Volume and Issue: 12(2), P. 77 - 77

Published: Feb. 18, 2025

Peripheral arterial disease (PAD) affects over 236 million people globally, with endovascular treatment as the predominant mode of revascularization. While pre-procedural lesion assessment typically relies on non-invasive Doppler measurement, invasive physiological offers a promising approach to guide selection and provide real-time evaluation angioplasty success. This review explores current methods, challenges, future directions in PAD. Sensor-tipped wires, particularly pressure sensor-tipped wires (pressure-wires), enable precise stenoses through indices such peripheral fractional flow reserve (pFFR) measured during hyperaemia. pFFR can identify significant flow-limiting lesions, assess efficacy, predict tissue healing. Additional indices, including Doppler-wire derived reserves resistance measurements, further enhance understanding physiology. Early data support utility these techniques for guiding decisions, although variability methodologies highlights need standardization outcome-driven cut-off values. uniquely consolidates evidence PAD, addressing critical gaps providing framework research. By advancing lesion-specific procedural optimization, this work underscores transformative potential improving patient outcomes redefining PAD management.

Language: Английский

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GLP-1 receptor agonism in cardiovascular disease prevention

Asia-Pacific Journal of Pharmacotherapy & Toxicology, Journal Year: 2025, Volume and Issue: unknown

Published: Jan. 1, 2025

Cardiovascular diseases (CVDs) are leading cause of mortality worldwide, closely linked to risk factors such as type 2 diabetes mellitus (T2DM) and obesity. Recent advances in therapeutic strategies have identified glucagon-like peptide-1 receptor agonists (GLP-1RAs) promising agents that extend beyond glycemic control offer significant cardiovascular benefits. This review examines the evolving role GLP-1RAs CVD prevention, focusing on their mechanisms action clinical implications. act by mimicking endogenous GLP-1 enhance insulin secretion, reduce glucagon levels, regulate blood glucose. Their impact extends improving vascular health, reducing atherosclerotic progression, mitigating inflammation, countering diabetic hyperglycemia dyslipidemia. also contribute weight reduction, a key factor alleviating risk. Results from trials real-world evidences consistently support GLP-1RA treatment lowers incidence major adverse events (MACEs), including myocardial infarction stroke, diverse patient populations. Despite potential, barriers limited awareness among healthcare professionals unequal access hinder broader adoption into clinics. Ongoing studies continue explore integration with other approaches, sodium-glucose cotransporter-2 (SGLT2) inhibitors lipid-lowering agents, optimize outcomes. underscores importance leveraging multifaceted tool global burden while addressing challenges ensure equitable long-term

Language: Английский

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Optimization of Cardiovascular Care: Beyond the Guidelines

Journal of Clinical Medicine, Journal Year: 2025, Volume and Issue: 14(7), P. 2406 - 2406

Published: April 1, 2025

Scientific cardiac and vascular societies provide essential guidelines tailored to broad patient populations [...].

Language: Английский

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Can the Atherogenic Index of Plasma (AIP) Be a Prognostic Marker for Good Clinical Outcome After Mechanical Thrombectomy for Acute Ischemic Stroke?

Diagnostics, Journal Year: 2025, Volume and Issue: 15(8), P. 947 - 947

Published: April 8, 2025

Background: Stroke remains a leading cause of morbidity and mortality worldwide, with dyslipidemia playing crucial role in atherosclerosis stroke development. The Atherogenic Index Plasma (AIP), calculated as log(triglyceride/HDL), has emerged biomarker for cardiovascular risk. However, its relationship prognosis unclear. This study aimed to investigate the association between AIP favorable clinical outcomes at three months acute ischemic patients undergoing mechanical thrombectomy. Methods: We conducted retrospective analysis 222 who underwent thrombectomy December 2019 April 2023. demographic variables, etiology, successful recanalization, intracerebral hemorrhage, three-month mRS was evaluated. values were compared good (mRS 0–2) poor 3–6) outcomes. Results: most common comorbidity hypertension (72.1%), followed by AF (50%). etiologies included large artery (16.2%), cardioembolism (57.2%), undetermined causes (26.6%). significantly lower functional Additionally, inversely associated but positively correlated DM previous history. No significant observed recanalization or hemorrhage. Conclusions: is first demonstrate that elevated after Given strong correlation prognosis, may serve valuable identifying high-risk patients. Future prospective studies are needed further validate these findings explore potential management.

Language: Английский

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Screening for Subclinical Atherosclerosis in Patients with Familial Hypercholesterolemia: Insights and Implications

Journal of Clinical Medicine, Journal Year: 2025, Volume and Issue: 14(2), P. 656 - 656

Published: Jan. 20, 2025

Background/Objectives: Familial hypercholesterolemia (FH) is a monogenic dyslipidemia that leads to early cardiovascular events. Subclinical atherosclerosis refers the formation of atheromatous plaques in arterial beds before any clinical In our study, we investigated presence, extent, and independent predictors subclinical among patients diagnosed with FH. Methods: This was single-center, prospective, cross-sectional study. original study included 215 FH from cohort 1145 individuals assessed according Dutch Lipid Clinical Network (DLCN) criteria. Carotid femoral ultrasonography were performed, coronary artery calcium score measured screen for atherosclerosis. Apolipoprotein A-I, apolipoprotein B, lipoprotein (a) analyzed using nephelometric method. Results: The comprised 136 females (63%) mean age 54 (43–62) years. stigmata rate 18%. statin use during screening 32% only eight (4%) attained LDL-C values < 70 mg/dL. observed 148 (69%), rates 48%, 47.5%, 40.5% arteries, carotid bifurcation, respectively. Advanced age, male sex, high pretreatment low-density lipoprotein-cholesterol (LDL-C) level, diabetes, low Apo A-I/Apo B ratio identified as Lp(a) levels ≥ 30 mg/dL predicted atherosclerosis, while diabetes ratios smoking Conclusions: prevalent, medication adherence remains suboptimal patients. Screening may impact treatment strategies, via an increase physician commitment protocols improving patient compliance.

Language: Английский

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Cardiac CT in Large Vessel Occlusion Stroke for the Evaluation of Non-Thrombotic and Non-Atrial-Fibrillation-Related Embolic Causes

Neurology International, Journal Year: 2025, Volume and Issue: 17(2), P. 25 - 25

Published: Feb. 7, 2025

Background: The purpose of this study is the evaluation imaging findings acute-phase cardiac CT (cCT) in stroke patients with large vessel occlusion (LVO) to identify potential cardioembolic sources (CES) without intracardiac thrombi and atrial fibrillation (AF). Material Methods: This retrospective included 315 LVO who underwent cCT acute setting. images were analysed for 15 following established minor major risk factors. final aetiology was determined using TOAST classification through interdisciplinary consensus a thorough clinical evaluation. Multivariate regression analysis performed associated CES. Results: A identified on 211 cases (70%). After adjustment AF thrombi, multivariate revealed significant associations left ventricular dilation (adjusted odds-ratio (AOR) 32.4; 95% CI 3.0–349; p = 0.004), visible interatrial right-to-left shunt (AOR 30.8; 2.7–341.3; 0.006), valve implants 24.5; 2.2–270.9; 0.009), aortic arch atheroma grade > II 6.9; 1.5–32.8; 0.015) post-ischaemic myocardial scars 6.3, 1.2–34.1; 0.032) as independent factors aetiology. combined model achieved an area under ROC curve 0.83. Conclusions: In cause, presence dilatation, shunts, implants, scarring advanced (grade 2) particular significantly cause should be add-on evaluated cCT. Further investigations are warranted confirm these associations.

Language: Английский

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Association Between Lipoprotein(a) and Arterial Stiffness in Young Adults with Familial Hypercholesterolemia

Journal of Clinical Medicine, Journal Year: 2025, Volume and Issue: 14(5), P. 1611 - 1611

Published: Feb. 27, 2025

Background and Aims: Elevated lipoprotein(a) [Lp(a)] familial hypercholesterolemia (FH) are both inherited dyslipidemias that independently associated with cardiovascular disease. Surrogate markers to assess signs of atherosclerosis, such as arterial stiffness, might be useful evaluate the risk in young patients. The aim this study is contribution Lp(a) measured by carotid pulse wave velocity (cPWV) adults FH. Methods: For cross-sectional study, 214 children FH who participated a randomized controlled trial between 1997 1999 on efficacy safety pravastatin were eligible. After 20 years, these patients invited for hospital visit, including cPWV assessment (by 4D flow MRI) measurement. Linear mixed-effects models used association cPWV. Results: We included 143 (mean [standard deviation] age: 31.8 [3.2] years) from 108 families. Median (interquartile range) was 1.62 (1.31–2.06) m/s. Both unadjusted (ß = −0.0014 m/s per 1 mg/dL increase Lp(a), 95% CI: −0.0052 0.0023, p 0.455) adjusted model −0.0005 −0.0042 0.0032, 0.785) showed no significant Conclusions: Our findings indicate levels not stiffness Possibly, High cause atherosclerosis mechanisms beyond adults. Other surrogate early may more suitable Lp(a)-mediated

Language: Английский

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Prevalence of extracranial carotid artery disease in symptomatic peripheral artery disease and implications for long-term outcome

Annals of Medicine, Journal Year: 2025, Volume and Issue: 57(1)

Published: March 13, 2025

Background Patients with peripheral artery disease (PAD) still experience excessive rates of fatal cardiovascular events. In this context, the relevance co-existing extracranial carotid (ECAD) on outcome in patients PAD is unclear. Thus, study elucidates long-term effects presence both atherosclerotic entities for further risk stratification.

Language: Английский

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Relationship between Pulse Pressure and Handgrip Strength in the Korean Population: A Nationwide Cross-Sectional Study

Journal of Clinical Medicine, Journal Year: 2024, Volume and Issue: 13(5), P. 1515 - 1515

Published: March 6, 2024

Background: Sarcopenia is defined as the loss of muscle mass and strength low physical performance, it closely related to risk cardiovascular disease mortality. Pulse pressure (PP) a biomarker arterial stiffness compliance. Elevated PP levels increase diseases all-cause Nevertheless, association between sarcopenia has not yet been clearly established. Methods: Participant data were extracted from Korea National Health Nutrition Examination Survey conducted 2014 2020. The study population was classified into three groups (PP < 40 mmHg, mmHg ≤ 60 ≥ mmHg). calculated by deducting diastolic blood systolic pressure. For handgrip strength, maximum value measured with grip dynamometer adopted (weak strength: <28 kg for men, <18 woman; normal ≥28 ≥18 women). To determine relationship prevalence weak multiple logistic regression analysis performed after adjusting possible confounding factors. Results: higher group had age, body index; pressure, hypertension, diabetes, hyperlipidemia, metabolic syndrome, strength. In all models, significantly in compared control Conclusions: associated Thus, monitoring may be used identify individuals at helpful improving health outcomes.

Language: Английский

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Overweight, Obesity, and Age Are the Main Determinants of Cardiovascular Risk Aggregation in the Current Mexican Population: The FRIMEX III Study

Journal of Clinical Medicine, Journal Year: 2024, Volume and Issue: 13(8), P. 2248 - 2248

Published: April 12, 2024

Background: The Mexican population exhibits several cardiovascular risk factors (CVRF) including high blood pressure (HBP), dysglycemia, dyslipidemia, overweight, and obesity. This study is an extensive observation of the most important CVFRs in six populated cities Mexico. Methods: In a cohort 297,370 participants (54% female, mean age 43 ± 12.6 years), anthropometric (body mass index (BMI)), metabolic (glycemia total cholesterol (TC)), (BP) data were obtained. Results: From 40, 40% 30% cohort’s overweight or obese, respectively. HBP was found 27% participants. However, only 8% all hypertensive patients controlled. Fifty percent subjects 50 years older hypercholesterolemic. Glycemia had constant linear relation with age. BMI correlation SBP, glycemia, TC, elevated coefficients cases genders. β1 coefficient for more significant equations than other β, indicating that it greatly influences CVRFs. Conclusions: critical atherogenic factors, are directly related to BMI.

Language: Английский

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