June 2011 A double-blind, crossover study of Effects of cranberry juice consumption Doxazosin and Enalapril on peripheral on vascular function in patients with vascular tone and nocturnal blood coronary artery disease. pressure in sleep apnea patients. Mustali M Dohadwala, Monika Holbrook, Naomi M Hamburg, Zou D, Grote L, Eder DN, Radlinski J, Hedner J. Sherene M Shenouda, William B Chung, Megan Titas, Matthew A Kluge, Na Wang, Joseph Palmisano, Paul E Milbury, Jeffrey B Blumberg, and Joseph A Vita.
Compared Doxazosin (DO - peripheral alpha-receptor inhibitor) and
Enalapril (EN, - ACE inhibitor), on PAT and nocturnal blood pressure(BP) in 16 hypertensive OSA patients. Full-night polysomnography,
Examined the effects of cranberry juice on vascular function in patients
PAT, beat-to-beat finger BP (Finapres), 24 H ambulatory BP, and
with coronary artery disease in an acute pilot study with no placebo
nighttime BP and PAT associated with apneas were tested at the end
(n=15), and in a chronic placebo-controlled crossover study (n=44),
before and after active and control beverages, and at ≥12h after the
Results: No differences between treatments in 24h BP profile and
OSA severity. Nighttime finger BP was significantly higher under DO. Results: Mean carotid-femoral pulse wave velocity decreased after
PAT ratio during apnea increased 5.3% under DO vs. EN (P<0.0001).
active juice vs. placebo (P = 0.003), but not Brachial FMD, EndoPAT
Apnea desaturation was associated with a 0.9% decrease in PAT
index, blood pressure, or carotid-radial pulse wave velocity. In the
ratio/-1% SaO2 (P<0.0001). REM sleep was associated with 2.2%
pilot study, brachial FMD improved (P=0.01), as did EndoPAT index
decrease of PAT ratio vs. NREM sleep (P=0.002). Conclusions: Digital vasoconstrictions associated with apneas are Conclusions: Chronic cranberry juice reduced carotid femoral pulse
alpha-receptor mediated. DO has a poorer effect on nocturnal BP
wave velocity. The uncontrolled pilot study suggested an acute but
not chronic benefit on endothelial function. http://www.ncbi.nlm.nih.gov/pubmed/20171140http://www.ncbi.nlm.nih.gov/pubmed/21411615Relation of brachial and digital measures Effect of periodontal treatment on of vascular function in the community: circulating CD34(+) cells and peripheral the Framingham heart study. vascular endothelial function: a randomized controlled trial. Hamburg NM, Palmisano J, Larson MG, Sullivan LM, Lehman BT, Vasan RS, Levy D, Mitchell GF, Vita JA, Benjamin EJ. Li X, Tse HF, Yiu KH, Li LS, Jin L. J Clin Periodontol. 2011 Feb;38(2):148-56
Noninvasively compared vasodilator function in the brachial artery
Investigated the effect of periodontal treatment on circulating
- (FMD, n=7031; age 48 ± 13, 54% women), and digital arteries
progenitor cell (CPC) count and vascular endothelial function in
using EndoPAT- (PAT ratio , n=4352; age 55 ± 16, 51% women), in
moderate-to-severe chronic Periodontitis in 25 patients assigned to
Framingham Offspring, Third Generation and Omni Cohorts.
3 month of treatment, and 25 untreated controls. CPCs and
Abnormality thresholds were defined respectively as the sex-specific
endothelial function using EndoPAT2000 were evaluated at baseline
fifth percentile in a reference group free of conventional cardiovascular
Results: Periodontal treatment exhibited neutral effects on endothelial Results: Abnormal FMD but not PAT ratio prevalence increased with
function while Circulating CD34(+) cells count significantly decreased
age and higher systolic blood pressure. Higher BMI was associated
with increased abnormality prevalence in both. Abnormal PAT ratio
Conclusions: Treatment of Periodontitis has neutral effects on
correlates included lower systolic blood pressure, increasing total/high-
peripheral endothelial function but significantly decreases circulating
density lipoprotein cholesterol ratio, diabetes, smoking, and lipid-
lowering medication. In 1,843 concurrent tests, PAT ratio and FMD were not significantly associated. Conclusions: FMD and PAT ratio might provide distinct information regarding vascular function in conduit versus smaller digital vessels. http://www.ncbi.nlm.nih.gov/pubmed/21133981http://www.ncbi.nlm.nih.gov/pubmed/21263120June 2011 Impaired vascular function in Modified-release sildenafil reduces asymptomatic young adult survivors of Raynaud's phenomenon attack Hodgkin Lymphoma following frequency in limited cutaneous systemic mediastinal radiation. sclerosis. Zelcer S, Chen B, Mangel J, Vujovic O, Thiessen-Philbrook HR, Herrick AL, van den Hoogen F, Gabrielli A, Tamimi N, Reid C, Reider M, Mahmud FH. O'Connell D, V·zquez-Abad MD, Denton CP. J Cancer Surviv. 2010 Sep; 4(3):218-24Arthritis Rheum. 2011 Mar;63(3):775-82
Evaluated endothelial function (EndoPAT2000), cardiovascular risk
Examined the effect of sildenafil in 57 patients with Raynaud's
factors, and activity level in 26 Hodgkin lymphoma survivors (HLS)
phenomenon (RP) secondary to limited cutaneous systemic sclerosis
aged 12-30, (>2 years from therapy) vs. 26 matched controls, and
(lcSSc), randomized to modified-release sildenafil 100 mg once daily
also determined the influence of mediastinal radiation.
for 3 days followed by modified-release sildenafil 200 mg once daily
Results: HLS were on average 6.7±4.6 yrs post treatment. No
for 25 days or placebo. Primary end point was percentage change
differences in endothelial function or cardiovascular risk factors were
in weekly RP attacks; secondary end points included Raynaud's
observed between HLS and control groups, but endothelial function
Condition Score, duration of attacks, RP pain score, endothelial
was impaired in those HLS who received mediastinal radiation (n=13),
dysfunction (EndoPAT2000), and serum biomarkers.
vs. controls (1.67±0.39 vs. 2.03±0.37, p<0.01). Results: Mean percentage reduction in attacks per week was greater Conclusions: Impaired endothelial function was preferentially
for modified-release sildenafil than for placebo (-44.0% vs. -18.1%,
observed in HLS who received mediastinal radiation, confirming that
P = 0.034); while secondary end points were similar between groups.
mediastinal radiation is an additional cardiovascular risk factor in this
Conclusions: Modified-release sildenafil reduced attack frequency in
patients with RP secondary to lcSSc and may thus be a treatmentoption. http://www.ncbi.nlm.nih.gov/pubmed/20652436http://www.ncbi.nlm.nih.gov/pubmed/21360507Increased arterial stiffness in patients Plasma leptin levels and digital pulse with psoriasis is associated with active volume in obese patients without systemic inflammation. metabolic syndrome - A pilot study. Yiu KH, Yeung CK, Chan HT, Wong RM, Tam S, Lam KF, Yan GH, Lin YH, Ho YL, Lee JK, Huang HL, Huang KC, Chen MF. Yue WS, Chan HH, Tse HF. Clin Chim Acta. 2011 Apr 11;412(9-10):730-4Br J Dermatol. 2011 Mar;164(3):514-20
Investigated the relationship between disease activity, systemic
Assessed the relationship among endothelial dysfunction
inflammation, macrovascular and microvascular function in 52 patients
(EndoPAT2000), anthropometric indices, adipokines and inflammatory
with psoriasis, vs. 50 matched controls. Baseline demographics, hs-
cytokines in 35 obese patients without metabolic syndrome, 11 of
CRP, Psoriasis Area and Severity Index (PASI), arterial stiffness and
whom had been diagnosed with endothelial dysfunction.
endothelial function were assessed using brachial - ankle pulse wave
Results: There was a significant difference of ln leptin (p=0.007), ln
[leptin/visceral fat thickness] (p=0.004) and ln [leptin/subcutaneous
Results: Patients with psoriasis had significantly higher hs-CRP (P<0.01)
fat thickness] (p<0.001) between patients with and without endothelial
and baPWV, (P< 0.01) but did not differ in their EndoPAT index vs.
dysfunction. ln [leptin/subcutaneous fat thickness] was significantly
controls. There was significant correlation of hs-CRP with baPWV
related to the ln (PAT ratio) (p=0.002). Using ln [leptin/subcutaneous
(r=0.51, P< 0.01) and with PASI (r=0.48, P< 0.01).
fat thickness] to detect endothelial dysfunction provided area under
Conclusions: Young patients with psoriasis have increased arterial
stiffness but not microvascular dysfunction compared with healthy
Conclusions: Abnormal digital vascular function occurs in obese
patients without metabolic syndrome. Low plasma leptin/subcutaneousfat ratio is associated with endothelial dysfunction in this population. http://www.ncbi.nlm.nih.gov/pubmed/21039409http://www.ncbi.nlm.nih.gov/pubmed/21195702June 2011 AASM Recognizes Spotlight on WatchPAT™ Joseph A. Vita, M.D. for Diagnosis of Obstructive Sleep Apnea
Dr. Joseph A. Vita is a Professor of Medicine atBoston University School of Medicine and aSenior Cardiologist in the Section of
Cardiovascular Medicine. His research focuseson vascular biology and inflammation, andparticularly on endothelial dysfunction in
13th World Congress on Menopause
atherosclerosis and associated risk factors,
diabetes mellitus and obesity, and the effectsof drug, lifestyle, and dietary interventions on
American Academy of Dental Sleep Medicine
Dr. Vita's research is supported by several grants from the NIH and by
industry,and he is the principal investigator of an NIH Vascular SCCOR
grant, and is the director of an NIH K12 Vascular Medicine training program.
Dr. Vita currently serves as the Deputy Editor of Circulation.
Dr. Vita has been involved in several groundbreaking studies which have
significantly advanced the scientific base and clinical acceptance of
June 13th – 15th, 2011Minneapolis, MN, USA
Effects of cranberry juice consumption on vascular function in patients with coronary artery disease. Mustali M Dohadwala, Monika Holbrook, Naomi M Hamburg, Sherene M Shenouda, William B Chung, Megan Titas, NYC College of Dentistry Matthew A Kluge, Na Wang, Joseph Palmisano, Paul E Milbury, Jeffrey BBlumberg, and Joseph A Vita. Am J Clin Nutr. 2011 May;93(5):934-40. Vascular Function to Cardiovascular Risk Factors in the Framingham Heart Study.Naomi M. Hamburg, Michelle J. Keyes, Martin G. Larson, Ramachandran S. Vasan, Renate Schnabel, Moria M. Pryde, Gary F. Mitchell, Jacob Sheffy, Joseph A. Vita, Emelia J. Benjamin Cross-Sectional Relations
of Digital Circulation 2008; 117(19): 2467-2474. Dental Writer Cardiovascular risk factors in the community: The Framingham Heart Study. N. Hamburg, M.J. Keyes, M.G. Larson, R.S. Vasan, R. Schnabel, M.M. Pryde, J.A. Vita, E.J. Benjamin. Digital microvascular function is related to Circulation 2007; 116: II_846. AACP Annual Symposium July 29 – 30 Relation of Cardiovascular Risk Factors with Abnormal Brachial and Digital Vascular Function in the Community: The Framingham Heart IN Annual Sleep Meeting Study.NM Hamburg, J Palmisano, L M Sullivan, M G Larson, M J Keyes, G F Mitchell, R S Vasan, J A Vita, E J Benjamin. Circulation 9002; 021 Chronic Study of the Effect of Grape Seed Extract plus Ascorbic Acid European Society of Cardiovascular on Endothelial Function in Patients with Coronary Artery Disease.NM Hamburg, M Holbrook, W Chung, T Caiano, MA Duess, M Kluge, V Chernyshev,C Tabit, T McKinnon, T Wood, J Cuomo, B Dixon, N Eich, JA Vita. AHA EPINPAM
www.itamar-medical.com [email protected] 1 - 8 8 8 - 7 - I T A M A R + 9 7 2 - 4 - 6 1 7 - 7 0 0 0
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ANAESTHESIA AND ANALGESIA: CONTRIBUTION TO SURGERY,Department of Anaesthesia, Christchurch School of Medicine, University of Otago, Christchurch, New ZealandAnaesthetists provide comprehensive perioperative medical care to patients undergoing surgical and diagnostic procedures, includingpostoperative intensive care when needed. They are involved in the management of perioperative acute pain as w