Category: Cardiovascular

Researchers from the University of California, Irvine have just published a study that projects 93 million U.S. adults that are overweight and obese may be suitable for the 2.4 mg dosage of semaglutide, a weight loss medication known under the brand name Wegovy. They projected based on the known weight loss effects (15% average weight loss) of this therapy that its use could result in 43 million fewer people with obesity, and prevent up to 1.5 million heart attacks, strokes, and other adverse cardiovascular events over 10 years. The study, US Population Eligibility and Estimated Impact of Semaglutide Treatment on Obesity Prevalence and Cardiovascular Disease Events was published in the journal Cardiovascular Drugs and Therapy, and was led by Nathan D. Wong, PhD, professor and director of the Heart Disease Prevention Program in the Division of Cardiology at the UCI School of Medicine. Wong also recently presented his teams findings at the American College of Cardiology scientific sessions in March 2023. The analysis is based on results from the STEP 1 trial, published in 2021 in the New England Journal of Medicine, which showed the 2.4 mg dosage of semaglutide approved by the FDA for the treatment of obesity reduced body weight by an average of 14.9% along with reductions in several cardiovascular risk factors such as blood pressure and lipids. The study projected 93 million U.S. adults (based on National Health and Nutrition Examination Survey data) who are overweight or obese would fit STEP 1 eligibility criteria and that treatment with the drug would result in 43 million fewer persons with obesity. Wong and colleagues applied body mass index and other risk factor changes to cardiovascular disease risk scores among an estimated 83 million persons without pre-existing cardiovascular disease, estimating a reduction in 10-year cardiovascular disease risk of 1.8% from 10.15% to 8.34% (or a relative risk reduction of 18%), projecting up to 1.5 million cardiovascular events could be potentially prevented in 10 years. The analysis did not estimate the additional cardiovascular events that might be prevented from treatment among the approximately 10 million estimated eligible persons with cardiovascular disease. The projected 18% reduction in cardiovascular events in persons who are overweight or are obese but without cardiovascular disease compares favorably to the recently announced top line results of the SELECT trial which studied Wegovy in persons with cardiovascular disease and showed an actual 20% reduction in future cardiovascular events. “It is one of the biggest advances in the obesity and cardiovascular medicine world,” said Wong. We now have a weight control therapy that also significantly reduces cardiovascular events beyond the diabetes population where it was originally studied. It should be considered for patients who are obese or overweight with other risk factors where cardiovascular disease is their leading cause of disability and death.” Nathan D. Wong, PhD, professor and director of the Heart Disease Prevention Program in the Division of Cardiology at the UCI School of Medicine Related Stories Since drugs in this class have side effects, it is important that patients always discuss the risks and benefits of such therapies with their physician. Additionally, an appropriate dietary and physical activity regimen is always the foundation of weight management and cardiovascular risk reduction. Additionally, Wong noted that given the costs of these therapies, that better access is needed for our high risk underserved populations who may benefit from them. Wegovy is a glucagon-like peptide 1 receptor agonist (GLP1-RA) injectable therapy approved by the Federal Drug Administration (FDA) for chronic weight management in adults with who are obese or overweight with at least one weight-related condition, such as high blood pressure, type 2 diabetes, or high cholesterol. Wegovy is to be used in addition to a reduced calorie diet and increased physical activity. UCI School of Medicine Journal reference: Wong, N. D., et al. (2023) US Population Eligibility and Estimated Impact of Semaglutide Treatment on Obesity Prevalence and Cardiovascular Disease Events. Cardiovascular Drugs and Therapy. doi.org/10.1007/s10557-023-07488-3.

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The following is a summary of “Association between hypertensive disorders of pregnancy and cardiovascular diseases within 24 months after delivery,” published in the JULY 2023 issue of Obstetrics and Gynecology by Ackerman-Banks, et al. For a longitudinal population-based study, researchers sought to assess the risk of specific cardiovascular diagnoses during the first 24 months after delivery in patients with hypertensive disorders of pregnancy compared to those without such disorders. The study included pregnant individuals with deliveries between 2007 and 2019, using data from the Maine Health Data Organization’s All Payer Claims Data. Patients with preexisting cardiovascular disease, multifetal pregnancies, or without continuous insurance during pregnancy were excluded. Hypertensive disorders of pregnancy and cardiovascular diseases were identified using diagnosis codes. Hazard ratios were estimated using Cox proportional hazards models, adjusting for potential confounding factors. Out of the 119,422 pregnancies analyzed, the risk of cardiovascular disease within 24 months after delivery differed significantly between patients with hypertensive disorders of pregnancy and those without such disorders. The cumulative risk of specific cardiovascular diseases for patients with hypertensive disorders of pregnancy compared to those without were as follows: heart failure (0.6% vs. 0.2%), ischemic heart disease (0.3% vs. 0.1%), arrhythmia or cardiac arrest (0.2% vs. 0.2%), cardiomyopathy (0.6% vs. 0.2%), cerebrovascular disease or stroke (0.8% vs. 0.4%), severe cardiac disease (1.6% vs. 0.7%), and new chronic hypertension (9.7% vs. 1.5%). After adjusting for potential confounding factors, patients with hypertensive disorders of pregnancy had a higher risk of heart failure (adjusted hazard ratio, 2.81; 95% CI, 1.90–4.15), cerebrovascular disease (adjusted hazard ratio, 1.43; 95% CI, 1.07–1.91), cardiomyopathy (adjusted hazard ratio, 2.90; 95% CI, 1.96–4.27), and severe cardiac disease (adjusted hazard ratio, 1.90; 95% CI, 1.54–2.30) within the first 24 months after delivery compared to those without hypertensive disorders of pregnancy. Additionally, patients with hypertensive disorders of pregnancy had an increased risk of new chronic hypertension diagnosed after 42 days following delivery (adjusted hazard ratio, 7.29; 95% CI, 6.57–8.09). However, there was no significant association between hypertensive disorders of pregnancy and ischemic heart disease (adjusted hazard ratio, 0.92; 95% CI, 0.55–1.54) or cardiac arrest or arrhythmia (adjusted hazard ratio, 0.90; 95% CI, 0.52–1.57). Notably, among pregnant women with hypertensive diseases, the first diagnoses of cardiomyopathy (44%), heart failure (39%), cerebrovascular disease or stroke (39%), and severe cardiac disease (41%) all occurred in the first month following delivery. Within 24 months of giving birth, patients with hypertensive disorders of pregnancy run a higher risk of acquiring new forms of chronic hypertension, heart failure, cerebrovascular illness, and cardiomyopathy. However, there was no significant association with ischemic heart disease, cardiac arrest, or arrhythmia. To enhance mother and newborn outcomes in subsequent pregnancies and protect long-term health, the findings emphasized the significance of focused early postpartum therapies and intensified surveillance in the first 24 months following delivery for individuals with hypertensive disorders of pregnancy. Source: ajog.org/article/S0002-9378(23)00236-3/fulltext

Skin-like microfiber Bragg grating (μFBG) patch. Credit: Compuscript Ltd Cardiovascular disease is the world’s leading cause of death. According to the World Health Organization, 17.9 million people die every year due to cardiovascular diseases. For the prewarning and accurate treatment of cardiovascular diseases, it is important to monitor hemodynamic parameters continuously, including blood pressure (BP), heart rate (HR), peripheral resistance (PR), and vascular elasticity. Soft wearable devices are well suited to monitoring physiological signals such as electrocardiogram (ECG) signals, phonocardiogram (PCG) signals, and pulse waves with the advantages of real-time operation capability, skin-like mechanical properties, and high-SNR sensing capability. However, the human cardiovascular system is complicated and distributed with network circulation. Monolithic hemodynamic parameters achieved by current wearable devices cannot adequately and precisely reflect the health status of regional vasculature. A spatiotemporal hemodynamic monitoring technique is urgently needed to satisfy the ever-growing demand for clinical treatment and daily health management of the cardiovascular system. The distributed optical fiber (DOF) sensing technique represented by the fiber Bragg grating (FBG) is ideally suited for spatiotemporal hemodynamic monitoring. Its spatially distributed multichannel sensing capability, excellent temporal synchronization and lack of electromagnetic interference lay a foundation for multiple high-SNR physiological signal monitoring. However, the traditional optical fiber has a large-distinct mechanical property with the skin and a low response on physiological signals considering its rigid and brittle silica material and thick diameter of 125 μm, making it difficult to be worn on the body stably and comfortably. Flexible packaging technology has been used to address the mechanical mismatch. Nevertheless, excessive thick encapsulation and the low sensitivity of commercial FBG devices pose an obstacle in detecting subtle physiological signals, thereby limiting their potential applications in wearable devices. Optical microfibers have been proven to have excellent flexibility, configurability, and large evanescent fields for high sensitivity sensing. However, the existing devices based on optical microfiber have difficulty achieving spatially distributed, time-synchronized, and multi-parameter sensing capabilities without a wavelength encoding strategy. The authors of an article, published in Opto-Electronic Advances, propose a spatiotemporal hemodynamic monitoring technique based on a skin-like microfiber grating group. The technique employs microfiber and ultra-thin flexible packaging technology to prepare skin-like microfiber patches. By effectively reducing the equivalent modulus of the device and the cross-sectional area of the microfiber, the stress response of the patch is improved by two orders of magnitude (the sensitivity is 5.26 nm/N under a stress within 50 mN). It also shows great repeatability and stability under 10,000 stress circles. In addition, the technique employs femtosecond laser direct writing technology to non-invasively inscribe Bragg gratings into the interior of the microfiber, providing different wavelength encodings for multiple microfiber patches, enabling the synchronous multi-channel sensing capabilities. By connecting microfiber grating (μFBG) patches in series, multiple physiological signals at different nodes of the human body can be detected simultaneously and distinguished by different working wavelengths. Since the light-based physiological signals propagate at close to the speed of light in the μFBG group, the time synchronization is only limited by the FBG interrogator. By detecting the proximal ballistocardiograph (BCG) signal and the distal pulse wave at each superficial artery in the human cardiovascular system, and then calculating the pulse wave transmit time (PTT), the spatiotemporal hemodynamics monitoring technology is established. Configurable spatiotemporal hemodynamic monitoring technique. Credit: Compuscript Ltd By detecting mechanical signals at the proximal and distal ends of the cardiovascular system instead of electrophysiological activity signals, the monitoring technique can present the real dynamics of the systemic cardiovascular system, such as heartbeat, angiectasis, and pulse wave propagation. Three hemodynamic monitoring modes are presented in this study. First, pulse waves of different superficial arteries in the human body, such as carotid artery, radial artery and pedal artery, were collected, and PTTs were analyzed using the BCG signal. Different PTTs arise from the differences in the length, diameter, and elastic modulus of blood vessels. This mode could enable the health assessment of local arterial branches in the cardiovascular system. Second, the μFBG group dynamically recorded the subjects’ dual-channel physiological signals during the process of exercise and rest. The heart rate was calculated by the cardiac cycle, and the pulse wave propagation velocity changed along with the blood pressure. In addition, the μFBG group dynamically recorded the dual-channel physiological signals when the external pressure imposed, and the changes of PTT could sensitively reflect the different degrees of peripheral arterial resistance. This real-time local peripheral vascular resistance monitoring technique was proposed for the first time. This study develops the synchronous multi-channel sensing technology based on the skin-like μFBG group, which has significant advantages such as temporal dynamic, spatial distribution, easy networking and configurability, high sensitivity and high flexibility. The proposed spatiotemporal hemodynamic monitoring technology has the working capability of real-time and dynamic evaluation of local blood vessel health status in the whole cardiovascular system, demonstrating the great potential in the diagnosis of cardiovascular diseases such as arrhythmia, angiosclerosis, hypertension, and thrombosis and facilitating precise clinical diagnosis, the fast screening of lesions, and daily health management. More information: Hengtian Zhu et al, Spatiotemporal hemodynamic monitoring via configurable skin-like microfiber Bragg grating group, Opto-Electronic Advances (2023). DOI: 10.29026/oea.2023.230018 Provided by Compuscript Ltd Citation: Research proposes photonic skin sensing network for cardiovascular health monitoring (2023, August 16) retrieved 16 August 2023 from https://medicalxpress.com/news/2023-08-photonic-skin-network-cardiovascular-health.html This document is subject to copyright. Apart from any fair dealing for the purpose of private study or research, no part may be reproduced without the written permission. The content is provided for information purposes only.

NEW YORK – GeninCode announced Wednesday that it filed a 510(k) submission for its CARDIO inCode-Score (CIC-SCORE) in vitro polygenic risk score (PRS) test for cardiovascular disease with the US Food and Drug Administration. The filing is part of the UK-based company’s effort to expand the US commercial distribution of CIC-SCORE. GeninCode currently offers the CIC-SCORE through the company’s CLIA-certified and College of American Pathologists-accredited lab in Irvine, California via an early access program. The firm partnered with Milwaukee-based Eversana in 2021 to commercialize GeninCode’s products within the US and last year filed its pre-submission for CIC-SCORE with the FDA. The CIC-SCORE recently received a CPT PLA code (0401U) and the firm expects a payment rate for the test to be set by the US Centers for Medicare and Medicaid Services in October. “Approval of the 510(k) kit/medical device filing will complement our US laboratory testing enabling GENinCode to accelerate commercial growth of CIC-SCORE in the US market,” Matthew Walls, CEO of GeninCode, said in a statement. “Our early access program is seeing strong demand for use of our CIC-SCORE CLIA lab test to identify patients at high genetic risk, personalise treatment and prevent [CVD].”

NEW YORK – GenInCode announced Wednesday that it filed a 510(k) submission for its CARDIO inCode-Score (CIC-Score) in vitro polygenic risk score (PRS) test for cardiovascular disease with the US Food and Drug Administration. The filing is part of the UK-based company’s effort to expand the US commercial distribution of CIC-Score. GenInCode currently offers the CIC-Score through the company’s CLIA-certified and College of American Pathologists-accredited lab in Irvine, California, via an early access program. The firm partnered with Milwaukee-based Eversana in 2021 to commercialize GenInCode’s products within the US and last year filed its pre-submission for CIC-Score with the FDA. The CIC-Score recently received a CPT PLA code (0401U) and the firm expects a payment rate for the test to be set by the US Centers for Medicare and Medicaid Services in October. “Approval of the 510(k) kit/medical device filing will complement our US laboratory testing enabling GenInCode to accelerate commercial growth of CIC-Score in the US market,” Matthew Walls, CEO of GenInCode, said in a statement. “Our early access program is seeing strong demand for use of our CIC-Score CLIA lab test to identify patients at high genetic risk, personalize treatment, and prevent [CVD].”

The patterns suggest vaping is being used as a smoking cessation tool—whether that’s a bad or good thing isn’t fully clear. Use of e-cigarettes by people with cardiovascular disease had been on the decline for a few years but then rebounded in 2020 with the emergence of the COVID-19 pandemic, topping out at a prevalence of around 5%, according to an analysis of US survey data. The findings were published online Tuesday as a research letter in JAMA Network Open. “E-cigarettes have been considered a safe means of smoking cessation for combustible cigarettes. However, the evidence of cardiovascular harm of e-cigarettes has been accumulating in recent years, so it is necessary to understand the proportion and trend of e-cigarette use in people with CVD,” said Shanjie Wang, MD, PhD (Second Affiliated Hospital of Harbin Medical University, China), who shares senior authorship on the paper with Yiying Zhang, MD, PhD (Jiamusi University, China). What they found, Wang told TCTMD in an email, is that adults below the age of 60, women, and former smokers are all more likely to use e-cigarettes. The data also show that people who currently smoke conventional cigarettes and those who’ve quit have a higher prevalence of vaping than those who’ve never smoked to begin with, “suggesting that the idea of replacing traditional cigarettes with e-cigarettes cannot be ignored,” he said. Clinicians [should] pay more attention to the cardiovascular health of current tobacco users and former cigarette users who use e-cigarettes when asking about e-cigarette use. Shanjie Wang Wang noted that e-cigarette use is more prevalent in CVD patients than in the general population. “Clinicians [should] pay more attention to the cardiovascular health of current tobacco users and former cigarette users who use e-cigarettes when asking about e-cigarette use. However, there is still no definitive conclusion on whether e-cigarettes can replace traditional cigarettes and relatively improve the cardiovascular health of patients,” he explained. Holly R. Middlekauff, MD (UCLA Health, Los Angeles, CA), commenting on the results for TCTMD, said that the new data interestingly show that while e-cigarette use among people with CVD went up in the last year or so of the study period, the use of traditional cigarettes was on the decline. Moreover, only a tiny slice of the e-cigarette users classified themselves as “never smokers.” This points to the existence of a group—current smokers who wish to quit or cut back—“that would really benefit from doing almost anything besides smoking a tobacco cigarette. It’s that whole harm reduction idea,” she said. “Dual use is not so beneficial from the heart standpoint,” but it seems likely that completely eliminating smoked tobacco by switching to e-cigarettes would be a good move, Middlekauff noted. “We do know that if somebody smokes just one to two tobacco cigarettes a day, they have a similar cardiovascular risk as somebody who smokes one to two packs a day. It’s kind of an on/off thing. . . . The cancer risk is more related to duration of smoking and burden, but the cardiovascular risk is really related to whether you smoke at all. So if you’ve cut out 95% of your tobacco cigarettes, that’s good, but it’s not going to give you nearly the benefit as completely stopping smoking.” There probably is going to be some cardiovascular harm from using electronic cigarettes, but it’s probably orders of magnitude less than tobacco cigarettes. Holly R. Middlekauff The long-term cardiovascular effects of vaping are still unknown, said Middlekauff. Her own research, along with other studies, has shown that e-cigarettes can cause physiologic changes that might up the risk of a person developing cardiovascular disease. Still, if e-cigarettes can indeed help people quit smoking—as has been suggested by earlier research, including the randomized E3 trial—then the risks might be outweighed by the health gains, she suggested. “There probably is going to be some cardiovascular harm from using electronic cigarettes, but it’s probably orders of magnitude less than tobacco cigarettes. We know that those are bad for you, those kill you—they kill half the people that use them, yet people still use them because it’s such a powerful addiction,” Middlekauff said. From Tobacco to E-Cigarettes Led by Xin Wen, MD (Jiamusi University), the researchers analyzed data on 30,465 adults with CVD who responded to the National Health Interview Survey between 2014 and 2020. The mean age was 65 years, and 47.8% were women. Most of the participants (84.7%) self-identified as white, while 4.9% self-identified as Black, 4.9% as Hispanic, and 1.6% as Asian. Among these patients with a history of cardiovascular disease, current use of e-cigarettes decreased initially, with the weighted prevalence dropping from 5.2% in 2014 to 3.1% in 2019. However, it then rebounded back to 5.2% in 2020. E-cigarette use decreased over the years for those ages 60 or older (dropping from 2.9% in 2014 to 0.9% in 2020) but held steady for those younger than 60 (at 6.2% in 2014 and 7.2% in 2020). Before 2018, men were more apt to use e-cigarettes than were women, though this was no longer the case in 2019 and 2020, by which time 2.9% of men and 8.3% of women reported vaping. People with CVD who had quit smoking conventional cigarettes were, over the years, increasingly more likely to use e-cigarettes (rising from 3.2% in 2015 to 10.1% in 2020). Adjusted for age, sex, region, race/ethnicity, education, and household income, several factors predicted higher or lower odds of e-cigarette use. Predictors of E-Cigarette Use in Patients With CVD Adjusted OR (95% CI) Age (vs ≥ 60 Years) 18-39 Years 40-59 Years 5.2 (4.0-6.7) 3.2 (2.6-4.1) Race/Ethnicity (vs White) Asian Black 0.3 (0.2-0.4) 0.3 (0.3-0.5) Education Level (vs ≥ College) < High School 1.6 (1.2-2.1) Household Income (vs High) Middle Low 1.7 (1.4-2.5) 2.2 (1.6-2.8) Smoking Status (vs Current) Former, Quit ≤ 1 Year Former, Quit > 4 Years Never 1.8 (1.2-2.7) 0.2 (0.2-0.3) 0.1 (0.1-0.2) Failed Attempt to Quit ≤ 1 Year 2.0 (1.5-2.6) “More attention should be paid to young people, women, and

AI automation will save significant amounts of exam and post-processing time for sonographers and the cardiologists. If the tedious and time-consuming work of drawing lines and making measurements can be removed, he said the humans can spend more time interacting with their patients rather than with the machine. Most of the FDA-cleared AI algorithms in echo are for the automation of measurements. Many of these are already available on current ultrasound systems to help automate ejection fractions, assessing all the measurements needed for structural heart assessments, strain, and others. Other deep learning algorithms can help act as a second set of eyes to help diagnose patients with specific conditions, including aortic stenosis, heart failure and amyloidosis. “These applications are very useful in echocardiography to automate the process and create more time for us to do more higher-caliber activity,” he said. By training AI to always take measurements from ideal planes and anatomic landmarks, it can make measurements much more reproducible and help eliminate variability between sonographers. GPT AI may significantly change cardiac imaging “The second inflection point that I am really excited about is the development of GPT,” Sangupta said. He explained these algorithms basically connect the language in the body of the reports and in the electronic medical records for new ways of communication between physicians. GPT in the future might also begin connecting the physicians and the patients to the images. Sangupta said the new frontier is going to be the ability to train GPT models to create effortless reports and communicate clinical information to referring physicians. GPT is also being developed to look at clinical reports and other patient information to instantly create a layman’s language version of exam reports that are more patient friendly and easier to understand. “It will give them the ability to understand what is in their reports and their records. There is no doubt that communication piece is lacking right now. This will give them the ability to digest and understand the report so they can have a decision-making capability,” Sangupta explained. GPT AI also might be able to provide additional relief for clinicians who are feeling burned out with the amount of work that is required. Sangupta said it is still in the early days of GPT development, so the technology is not ready yet for regular use in patient care. There are also many questions about where the algorithms are pulling their data and how they reach conclusions. “There is a great deal of uncertainty, but there is also a great deal of opportunity,” he explained. “But we need to embrace this because this change is imminent.” This change is also necessary to enable moving patient care forward and to address burnout. “I believe a lot of physicians experience burnout because of the additional work they have to do with the electronic medical record, which is not really rewarding. So the whole idea of being able to create more free time so doctors can do what they like and do best, which is talk to the patients. Everything else can be put into the EMR using ChatGPT, and that is absolutely needed,” he said. Why human clinicians will not be replaced by AI or GPT technology Sangupta is certain there is no way a clinician can be replaced by GPT technology anytime soon because the technology is just not as capable as human brain or understanding context in the human world. “The human level competency of GPT is still very underdeveloped. Even if these models are able to become more generalizable and precise, they lack the human element of intelligence, which has several layers. There is contextual information that is clearer and easier for the human mind to digest, versus a ChatGPT,” Sangupta explained. Often the diagnosis or treatment of a patient is based on a doctor’s intuition and clinical judgement. And this is hard for programs to replicate and that is where clinical expertise, for now, is still a human trait required for patient care. “It also comes down to empathy and why we took the Hippocratic Oath, to make patients feel better. ChatGPT does not have feelings, so it does not have these sets of information to drive what is good for patient care, and that is where human doctors need to focus on,” Sangupta said. What he said will happen is that clinicians will have new tools for exploring the unknown components of the images with the ability to see far better than the human eye. He also said this new AI will be able to parse out large amounts of data and distill it for easier human consumption.

Exposure to environmental chemicals, including those in common plastic products, has been linked with an increased risk of cardiovascular disease, or CVD, the leading cause of death worldwide. According to the World Health Organization, 17.9 million people died from CVDs in 2019. Changcheng Zhou, a professor of biomedical sciences in the School of Medicine at the University of California, Riverside, has received an eight-year award of nearly $6.8 million from the Revolutionizing Innovative, Visionary Environmental Health Research (RIVER) program of the National Institute of Environmental Health Sciences, or NIEHS, to investigate how interactions between genes and endocrine disrupting chemicals, or EDCs, may increase CVD risk. Only five scientists, including Zhou, received RIVER grants this year. The grant “rewards outstanding environmental health sciences researchers who demonstrate a broad vision and potential for continuing their impactful research with increased scientific flexibility, stability in funding, and administrative efficiency.” EDCs mimic, block, or interfere with the body’s hormones. They can affect reproduction and the functioning of the immune and nervous systems. They are also known to increase cancer risk. Examples are human-made chemicals used as industrial solvents/lubricants and their byproducts, as well as some plastics, pesticides, fungicides, and pharmaceutical agents. Other examples are some natural chemicals, such as phytoestrogens (estrogen-like compounds derived from plants), found in human and animal food. How exposure to EDCs and other environmental chemicals influences CVD risk is not well understood. Recent large-scale studies found a link between exposure to EDCs and atherosclerosis, the gradual buildup of plaque — fats, cholesterol, and other substances — in and on the artery walls, resulting in the hardening and narrowing of the arteries. Treatment for atherosclerosis typically includes lifestyle changes, medicine, and surgery. “I am humbled and honored to receive the NIEHS RIVER grant, which provides the flexible and long-term support my research program needs to conduct innovative and impactful research in an area of crucial importance to the NIEHS mission,” Zhou said. “We expect the research this grant supports will contribute to the understanding of gene-EDC interactions in predisposing individuals and their children to CVD. We will explore how chemicals in common plastics and household products can act as EDCs, singly and in mixtures, and whether microplastics can act as Trojan horses, ferrying EDCs into the body to develop atherosclerosis.” Zhou’s prior work showed many EDCs activate a sensor in cells, called the pregnane X receptor, or PXR, which detects foreign chemicals and substances and helps regulate atherosclerosis development. The new funding will allow Zhou to study the mechanisms that allow EDCs to affect PXR in cells, leading to atherosclerosis. “Using a mouse model, we will look particularly at circulating cholesterol and ceramide lipids and how PXR regulates them to affect atherosclerosis development,” Zhou said. “We will also explore whether male mice’s exposure to EDCs can cause PXR to alter their sperm in a way that increases CVD risk in their offspring. We hope this research will help establish a novel therapeutic target for chemical-induced CVD.” Zhou’s lab was the first to reveal the novel function of PXR in the regulation of atherosclerosis development and showed in mouse models that widely used EDCs increase atherosclerosis through PXR signaling. Zhou’s scientific training in molecular biology, toxicology, pharmacology, and cardiovascular research uniquely positions him to investigate how gene-EDC interactions affect atherosclerosis development. “Influences of the chemical environment on human health have become the subject of intense interest but very few studies in the EDC research field have focused on atherosclerosis development,” Zhou said. “Besides establishing a novel therapeutic target for chemical-induced cardiovascular disease, our findings from this research have the potential to revolutionize our understanding of the etiology of many chronic human diseases originating from chemical-elicited intergenerational effects.”

Credit: Unsplash/CC0 Public Domain What if we could identify the earliest warning signs of cardiovascular disease from a simple saliva sample? Scientists think they have found a way to do so. Gum inflammation leads to periodontitis, which is linked with cardiovascular disease. The team used a simple oral rinse to see if levels of white blood cells—an indicator of gum inflammation—in the saliva of healthy adults could be linked to warning signs for cardiovascular disease. they found that high levels correlated with compromised flow-mediated dilation, an early indicator of poor arterial health. “Even in young healthy adults, low levels of oral inflammatory load may have an impact on cardiovascular health—one of the leading causes of death in North America,” said Dr. Trevor King of Mount Royal University, corresponding author of the study published in Frontiers in Oral Health. Tooth care for heart health Periodontitis is a common infection of the gums which has previously been linked to the development of cardiovascular disease: scientists suspect that inflammatory factors may enter the bloodstream through the gums and damage the vascular system. King and his colleagues set out to study currently healthy young people without diagnosed periodontal issues to determine whether lower levels of oral inflammation can be clinically relevant to cardiovascular health. “We are starting to see more relationships between oral health and risk of cardiovascular disease,” said Ker-Yung Hong, first author of the study, now studying dentistry at the University of Western Ontario. “If we are seeing that oral health may have an impact on the risk of developing cardiovascular disease even in young healthy individuals, this holistic approach can be implemented earlier on.” The team chose pulse-wave velocity, which can measure the stiffness of arteries, and flow-mediated dilation, a measure of how well arteries can dilate to allow for higher blood flow, as key indicators of cardiovascular risk. These measure arterial health directly: stiff and poorly functioning arteries raise patients’ risk of cardiovascular disease. The scientists recruited 28 non-smokers between 18 and 30, with no comorbidities or medications that could affect cardiovascular risk and no reported history of periodontal disease. They were asked to fast for six hours, except for drinking water, prior to visiting the lab. At the lab, participants rinsed their mouths with water before rinsing their mouths with saline which was collected for analysis. Participants then laid down for 10 minutes for an electrocardiogram, and stayed lying down for another 10 minutes so that the scientists could take their blood pressure, flow-mediated dilation, and pulse-wave velocity. “The mouth rinse test could be used at your annual checkup at the family doctors or the dentist,” said Dr. Michael Glogauer of the University of Toronto, a co-author of the study. “It is easy to implement as an oral inflammation measuring tool in any clinic.” The heart of the matter The scientists found that high white blood cells in saliva had a significant relationship to poor flow-mediated dilation, suggesting these people may be at elevated risk of cardiovascular disease. However, there was no relationship between white blood cells and pulse wave velocity, so longer-term impacts on the health of the arteries had not yet taken place. The scientists hypothesized that inflammation from the mouth, leaking into the vascular system, impacts the ability of arteries to produce the nitric oxide that allows them to respond to changes in blood flow. Higher levels of white blood cells could have a greater impact on vascular dysfunction; the levels found in the participants are usually not considered clinically significant. “Optimal oral hygiene is always recommended in addition to regular visits to the dentist, especially in light of this evidence,” said King. “But this study was a pilot study. We are hoping to increase the study population and explore those results. We are also hoping to include more individuals with gingivitis and more advanced periodontitis to more deeply understand the impact of different levels of gingival inflammation on cardiovascular measures.” More information: Oral inflammatory load predicts vascular function in a young adult population: A pilot study, Frontiers in Oral Health (2023). DOI: 10.3389/froh.2023.1233881 Provided by Frontiers Citation: A simple mouth rinse could spot early heart disease risk (2023, August 18) retrieved 18 August 2023 from https://medicalxpress.com/news/2023-08-simple-mouth-early-heart-disease.html This document is subject to copyright. Apart from any fair dealing for the purpose of private study or research, no part may be reproduced without the written permission. The content is provided for information purposes only.