Browsing by Subject "Cardiovascular risk"

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The intersection of pain, fatigue, and cardiovascular risk in teens with juvenile arthritis : a biobehavioral case-control pilot study
(2021-04-06) Lewis, Kimberly Anette; Osier, Nico; Garcia, Alexandra; Tiziani, Stefano; Acton, Gayle
Teens with juvenile idiopathic arthritis (JIA) live with chronic pain and fatigue. They are at higher risk of cardiovascular morbidity and mortality than the general population. Yet there is little evidence about the metabolic processes underlying the symptoms and comorbidity. The purpose of this biobehavioral, cross-sectional pilot study is to describe the characteristics of, differences between, and relationships among groups of teens with JIA and healthy controls. The study design is guided by a synthesized model of: metabolomics theory, the Revised Child- and Family Self-Management Framework, and the Symptom Science Model. A group of n=20 controls and n=20 teens with JIA were recruited from a clinic in Austin, TX between August 2018-January 2019. Participants and their parent proxy completed a study visit with a morning, fasting blood sample collection, biometrics, and surveys. Measures include complex symptoms (pain, pain interference, fatigue), phenotypic characterization (individual characteristics, facilitators and barriers, and behaviors), and biomarkers (metabolomics signature and cardiovascular risk factors). Data were analyzed using descriptive statistics, t-tests, chi square, and Pearson’s correlations. Blood samples were processed using mass spectroscopy. Best practices for recruitment strategies for this population and study design were identified. Results indicate that the groups were equivalent in characteristics, yet they share similarities and exhibit important differences between groups. A pattern of metabolites was identified. Additional differences were found between teens with JIA in active versus inactive disease at the time of the study visit. Sixty-five metabolites were identified, 55 of which were common to both groups. Alpha-D-glucose, alpha-ketoglutaric acid, citrate, citrulline, lactate, L-histidine, L-phenylalanine, L-proline, L-serine, L-tyrosine, malate, myristic acid, N-acetyl-D-L-serine, N-acetyl-L-aspartic acid, and uracil were significantly lower in the JIA group relative to controls; Glycine and L-cysteine were significantly higher. Findings from this biobehavioral pilot study indicate 17 metabolites that were significantly different in teens with JIA relative to controls. The pathways in which these metabolites are implicated may be a source of new treatment and prevention options. Results provide initial evidence of symptom clusters or potential biomarkers. Further research is warranted to confirm these findings in a larger sample.
Validity of digital thermal monitoring techniques to assess vascular reactivity following finger and brachial occlusion
(2020-06-23) Heath, Melanie Ann; Tanaka, Hirofumi, Ph. D.
Digital thermal monitoring (DTM) using the VENDYS-II device is an alternative, fully automated and noninvasive methodology to evaluate endothelial function using temperature change on finger as a surrogate measure of the magnitude of vascular reactivity index (VRI). Due to the simplicity, it could provide a more feasible technique to assess vascular endothelial function in the clinical setting. A most recent modification to the technique includes the application of occlusion cuff at the base of a finger. Therefore, the purpose of this study is to assess the validity of the VENDYS-II device compared with the standard flow-mediated dilation (FMD) protocol. Thirty-eight (22 males; 38±15 years) participants varying widely in age, health status, ethnicity, and socioeconomic status were studied. Occlusion cuff was placed over the right antecubital fossa or at the base of the right index finger. Temperature monitors were placed on bilateral index fingers to assess change in temperature throughout 5-minute occlusion and recovery phases. FMD was obtained simultaneously using high-resolution ultrasound. Shear rate total area under the curve (SR [subscript AUC]) was calculated for 180 cardiac cycles following cuff release. Mean brachial artery FMD was 7.5±2.2% and mean SR [subscript AUC] was 43,924±10,256. SR [subscript AUC] was significantly correlated with VRI obtained from brachial occlusion (r=0.34; p<0.05), but more strongly correlated with finger occlusion VRI (r=0.43; p<0.05) (Figure 1). Inversely, brachial FMD was more strongly correlated with brachial occlusion VRI (r=0.69; p<0.05), than finger occlusion VRI (r=0.53; p<0.05). VRI values obtained with the finger occlusion (1.58±0.29 AU) were not significantly different from VRI measured with the brachial artery occlusion (1.55±0.26 AU) (p=0.47), and both VRI values were moderately correlated with each other (r=0.25; p=0.47) Therefore, finger-based VRI may be a valid and novel alternative measure of endothelial function that is more suitable than the standard FMD or hyperemic shear rate for the assessment of endothelial function in the routine clinical setting.