Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “VASCULAR DISEASES”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 397 records · Page 22Linked to original sources
PubMed2004

Maternal plasma from pregnant women with umbilical placental vascular disease does not affect endothelial cell mRNA expression of nitric oxide synthase.

OBJECTIVE: In placental vascular disease identified by umbilical artery Doppler study we have shown the existence of a factor in fetal plasma that causes activation of endothelial cells in culture with expression of cell adhesion molecules and nitric oxide synthase, apoptosis, and proinflammatory cytokine production. The present work was carried out to investigate a maternal origin for this factor active in the fetal circulation. METHODS: We collected maternal plasma from pregnant women with Doppler-defined umbilical placental vascular disease and examined its effect on endothelial cells in culture. Aliquots from a common culture of human umbilical vein endothelial cells (HUVEC) were incubated with maternal plasma from women with normal pregnancy (n = 23), umbilical placental vascular disease defined by abnormal umbilical artery Doppler (n = 30, with or without preeclampsia), and preeclampsia with normal umbilical artery Doppler (n = 14). The expression of mRNA for inducible and endothelial constitutive nitric oxide synthase (iNOS and ecNOS, respectively) was assessed by reverse transcriptase polymerase chain reaction. RESULTS: There was no significant increase in either the iNOS or the ecNOS mRNA expression by HUVEC cultured with maternal plasma from pregnancies with umbilical placental vascular disease compared with normal pregnancy (iNOS 1.49 +/- 0.35 versus 1.38 +/- 0.25; ecNOS 1.51 +/- 0.35 versus 1.25 +/- 0.27; P >.05). In the placental vascular disease group the results were similar for the presence or absence of maternal preeclampsia. In the samples from women with preeclampsia with normal umbilical Doppler, both iNOS and ecNOS mRNA expression (iNOS 1.42 +/- 0.53; ecNOS 1.46 +/- 0.39; P >.05) did not differ from normal. CONCLUSION: Maternal plasma from pregnancies with umbilical placental vascular disease did not affect endothelial cell expression of nitric oxide synthase. This finding does not support a maternal origin for the factor demonstrated in fetal plasma. These results suggest separate pathogenic pathways for the endothelial cell activation seen in preeclampsia and fetal growth restriction associated with abnormal umbilical artery Doppler flow velocity waveforms. These findings are also consistent with the concept that the vascular pathology in the fetal placenta may be primary and that the uteroplacental circulation is reduced in response rather than acts as a constraint.

Adult↗
PubMed2000

Coronary angiography in the presence of peripheral vascular disease: femoral or brachial/radial approach?

Peripheral vascular disease is considered a relative contraindication to the femoral approach for coronary angiography, but no data exist comparing the femoral and brachial/radial routes under these circumstances. We examined the influence of vascular approach on outcome. Two hundred and ninety-seven patients, mean age 67.1 +/- 8.4 years, with clinical or radiographic evidence of aortofemoral peripheral arterial disease underwent diagnostic coronary angiography during a 3-year period at this cardiothoracic center. The approach was successful in 121 of 154 femoral cases (79%) compared with 130 of 143 brachial/radial cases (91%; P < 0.01). Of the 33 failed femoral cases, 15 were then approached from the other femoral artery, with success in 6 (40%), while 18 were approached from the arm, with success in all (100%; P < 0.01). Brachial/radial cases took significantly longer than femoral cases (51 +/- 19 vs. 42 +/- 22 mins; P < 0.01). In cases where the femoral pulse was considered normal, the femoral approach nonetheless failed in 19 of 95 (20%). Major vascular complications (e.g., pulseless limb, arterial dissection, hemorrhage, or false aneurysm) occurred in nine femoral cases vs. zero brachial/radial cases (P < 0.01). Patients with peripheral vascular disease who undergo coronary angiography from the femoral artery have a 1-in-5 risk of procedural failure, necessitating use of an alternative vascular approach, and a 1-in-20 risk of a major vascular complication. Normality of femoral arterial pulsation is not a good predictor of femoral success. Brachial/radial approaches take longer, but succeed more frequently and have a negligible major vascular complication rate. We believe that patients with peripheral vascular disease should undergo coronary angiography via brachial or radial approach. Cathet. Cardiovasc. Intervent. 49:32-37, 2000.

Aged↗
PubMed1991

Hyperhomocysteinemia: an independent risk factor for vascular disease.

BACKGROUND: Hyperhomocysteinemia arising from impaired methionine metabolism, probably usually due to a deficiency of cystathionine beta-synthase, is associated with premature cerebral, peripheral, and possibly coronary vascular disease. Both the strength of this association and its independence of other risk factors for cardiovascular disease are uncertain. We studied the extent to which the association could be explained by heterozygous cystathionine beta-synthase deficiency. METHODS: We first established a diagnostic criterion for hyperhomocysteinemia by comparing peak serum levels of homocysteine after a standard methionine-loading test in 25 obligate heterozygotes with respect to cystathionine beta-synthase deficiency (whose children were known to be homozygous for homocystinuria due to this enzyme defect) with the levels in 27 unrelated age- and sex-matched normal subjects. A level of 24.0 mumol per liter or more was 92 percent sensitive and 100 percent specific in distinguishing the two groups. The peak serum homocysteine levels in these normal subjects were then compared with those in 123 patients whose vascular disease had been diagnosed before they were 55 years of age. RESULTS: Hyperhomocysteinemia was detected in 16 of 38 patients with cerebrovascular disease (42 percent), 7 of 25 with peripheral vascular disease (28 percent), and 18 of 60 with coronary vascular disease (30 percent), but in none of the 27 normal subjects. After adjustment for the effects of conventional risk factors, the lower 95 percent confidence limit for the odds ratio for vascular disease among the patients with hyperhomocysteinemia, as compared with the normal subjects, was 3.2. The geometric-mean peak serum homocysteine level was 1.33 times higher in the patients with vascular disease than in the normal subjects (P = 0.002). The presence of cystathionine beta-synthase deficiency was confirmed in 18 of 23 patients with vascular disease who had hyperhomocysteinemia. CONCLUSIONS: Hyperhomocysteinemia is an independent risk factor for vascular disease, including coronary disease, and in most instances is probably due to cystathionine beta-synthase deficiency.

Cerebrovascular Disorders↗
PubMed2006

Arterial blood flow to the brain in patients with vascular disease: the SMART Study.

PURPOSE: To retrospectively investigate which characteristics are related to total arterial blood flow to the brain in patients with symptomatic vascular disease. MATERIALS AND METHODS: The study was approved by the ethics committee of the authors' institution, and written informed consent was obtained. The total volume flow rate (tVFR) values in the internal carotid arteries and the basilar artery in 636 patients (536 men, 100 women; mean age, 58 years) with symptomatic vascular disease were measured with two-dimensional phase-contrast magnetic resonance (MR) angiography. Reference tVFR values in the general population were obtained from previous research involving 158 subjects (73 men, 85 women; mean age, 60 years). RESULTS: A higher tVFR was found in patients with symptomatic vascular disease, but this association was statistically significant in only those patients in the 7th decade of life. The mean tVFR decreased with increasing age (-3.4 mL/min per year; 95% confidence interval [CI]: -4.3, -2.5). Diabetes (-27.6 mL/min; 95% CI: -52.6, -2.6) and increasing body mass index (BMI) (-2.8 mL/min per BMI unit; 95% CI: -5.3, -0.2) were associated with lower tVFR. Patients with vascular disease in a cerebral location had lower tVFR values (-39.7 mL/min; 95% CI: -65.1, -14.3) than did patients with symptomatic vascular disease elsewhere in the vascular tree. CONCLUSION: Patients with symptomatic vascular disease had slightly higher arterial blood flow to the brain compared with the general population. The tVFR decreased with increasing age and increasing BMI, and patients with diabetes had lower tVFR values than did those without diabetes. Patients with vascular disease in a cerebral location had lower tVFR values than did those with symptomatic vascular disease at other arterial sites.

Age Factors↗