Cardiovascular disease is the leading cause of death worldwide, accounting for 48.0% of all deaths in Europe and 34.3% in the United States. Studies have shown that arterial stiffness takes precedence over vascular structural changes and is therefore considered to be an independent predictor of many cardiovascular diseases. At the same time, the characteristics of Korotkoff signal is related to vascular compliance. The purpose of this study is to explore the feasibility of detecting vascular stiffness based on the characteristics of Korotkoff signal. First, the Korotkoff signals of normal and stiff vessels were collected and preprocessed. Then the scattering features of Korotkoff signal were extracted by wavelet scattering network. Next, the long short-term memory (LSTM) network was established as a classification model to classify the normal and stiff vessels according to the scattering features. Finally, the performance of the classification model was evaluated by some parameters, such as accuracy, sensitivity, and specificity. In this study, 97 cases of Korotkoff signal were collected, including 47 cases from normal vessels and 50 cases from stiff vessels, which were divided into training set and test set according to the ratio of 8 : 2. The accuracy, sensitivity and specificity of the final classification model was 86.4%, 92.3% and 77.8%, respectively. At present, non-invasive screening method for vascular stiffness is very limited. The results of this study show that the characteristics of Korotkoff signal are affected by vascular compliance, and it is feasible to use the characteristics of Korotkoff signal to detect vascular stiffness. This study might be providing a new idea for non-invasive detection of vascular stiffness.
Humans ; Vascular Stiffness ; Neural Networks, Computer ; Cardiovascular Diseases/diagnosis* ; Sensitivity and Specificity

Cardiovascular disease is a major threat to human health and has become the leading cause of death worldwide; therefore, early diagnosis and treatment are of great value. Due to its miniaturization, integration, and ease of operation, microfluidic technology enables the rapid, multi-target detection of cardiovascular disease markers and significantly facilitates the early and rapid diagnosis of cardiovascular disease. This article reviews the research progress of microfluidics in cardiovascular disease detection, analyzes its advantages and weaknesses in the rapid detection of protein, lipid, and nucleic acid biomarkers, hopes to provide a reference to promote the quick detection technology of cardiovascular disease, and thus proposes new considerations for the early management of cardiovascular disease.
Humans ; Microfluidics ; Cardiovascular Diseases/diagnosis* ; Biomarkers ; Early Diagnosis

Humans ; Child ; Cardiovascular Diseases/diagnosis* ; Exercise Test ; Oxygen Consumption

BACKGROUND: The hemoglobin glycation index (HGI) was developed to quantify glucose metabolism and individual differences and proved to be a robust measure of individual glycosylated hemoglobin (HbA1c) bias. Here, we aimed to explore the relationship between different HGIs and the risk of 5-year major adverse cardiovascular events (MACEs) by performing a large multicenter cohort study in China. METHODS: A total of 9791 subjects from the Risk Evaluation of Cancers in Chinese Diabetic Individuals: a Longitudinal Study (the REACTION study) were divided into five subgroups (Q1-Q5) with the HGI quantiles (≤5th, >5th and ≤33.3th, >33.3th and ≤66.7th, >66.7th and ≤95th, and >95th percentile). A multivariate logistic regression model constructed by the restricted cubic spline method was used to evaluate the relationship between the HGI and the 5-year MACE risk. Subgroup analysis between the HGI and covariates were explored to detect differences among the five subgroups. RESULTS: The total 5-year MACE rate in the nationwide cohort was 6.87% (673/9791). Restricted cubic spline analysis suggested a U-shaped correlation between the HGI values and MACE risk after adjustment for cardiovascular risk factors ( χ2 = 29.5, P <0.001). After adjustment for potential confounders, subjects with HGIs ≤-0.75 or >0.82 showed odds ratios (ORs) for MACE of 1.471 (95% confidence interval [CI], 1.027-2.069) and 2.222 (95% CI, 1.641-3.026) compared to subjects with HGIs of >-0.75 and ≤-0.20. In the subgroup with non-coronary heart disease, the risk of MACE was significantly higher in subjects with HGIs ≤-0.75 (OR, 1.540 [1.039-2.234]; P = 0.027) and >0.82 (OR, 2.022 [1.392-2.890]; P <0.001) compared to those with HGIs of ≤-0.75 or >0.82 after adjustment for potential confounders. CONCLUSIONS We found a U-shaped correlation between the HGI values and the risk of 5-year MACE. Both low and high HGIs were associated with an increased risk of MACE. Therefore, the HGI may predict the 5-year MACE risk.
Humans ; Cohort Studies ; Longitudinal Studies ; Diabetes Mellitus, Type 2/diagnosis* ; Maillard Reaction ; Glycated Hemoglobin ; Cardiovascular Diseases

Objective: To explore associations between lipoprotein-associated phospholipase A2 (Lp-PLA2) and the risk of cardiovascular events in a Chinese population, with a long-term follow-up. Methods: A random sample of 2,031 participants (73.6% males, mean age = 60.4 years) was derived from the Asymptomatic Polyvascular Abnormalities Community study (APAC) from 2010 to 2011. Serum Lp-PLA2 levels were determined by enzyme-linked immunosorbent assay (ELISA). The composite endpoint was a combination of first-ever stroke, myocardial infarction (MI) or all-cause death. Lp-PLA2 associations with outcomes were assessed using Cox models. Results: The median Lp-PLA2 level was 141.0 ng/mL. Over a median follow-up of 9.1 years, we identified 389 events (19.2%), including 137 stroke incidents, 43 MIs, and 244 all-cause deaths. Using multivariate Cox regression, when compared with the lowest Lp-PLA2 quartile, the hazard ratios with 95% confidence intervals for developing composite endpoints, stroke, major adverse cardiovascular events, and all-cause death were 1.77 (1.24-2.54), 1.92 (1.03-3.60), 1.69 (1.003-2.84), and 1.94 (1.18-3.18) in the highest quartile, respectively. Composite endpoints in 145 (28.6%) patients occurred in the highest quartile where Lp-PLA2 (159.0 ng/mL) was much lower than the American Association of Clinical Endocrinologists recommended cut-off point, 200 ng/mL. Conclusion Higher Lp-PLA2 levels were associated with an increased risk of cardiovascular event/death in a middle-aged Chinese population. The Lp-PLA2 cut-off point may be lower in the Chinese population when predicting cardiovascular events.
1-Alkyl-2-acetylglycerophosphocholine Esterase/blood* ; Asians ; Cardiovascular Diseases/diagnosis* ; China/epidemiology* ; Female ; Humans ; Longitudinal Studies ; Male ; Middle Aged ; Mortality ; Myocardial Infarction/blood* ; Predictive Value of Tests ; Risk Factors ; Stroke/blood*

Cardiovascular homeostasis is regulated by both physical and chemical factors. Vascular stiffness, a physical property of vessel, is crucial in maintaining the physiological function of vasculature. Vascular stiffness has been indicated to be correlated with hypertension, heart failure and other cardiovascular diseases. It has been the most widely accepted clinical index for assessment of vascular function and dysfunction. This paper reviews the commonly used experimental and clinical techniques for evaluating vascular stiffness including direct detection of the Young's modulus and indirect detection method that is based on ultrasound technique and others. Principles of these methodologies, as well as their advantages and disadvantages, are also presented here. Researchers and clinical staff are encouraged to choose the most suitable methods for detecting vascular stiffness according to their purposes and objects, so as to effectively evaluate vascular function.
Humans ; Vascular Stiffness ; Elastic Modulus ; Hypertension/diagnosis* ; Cardiovascular Diseases/diagnosis* ; Heart Failure

BACKGROUND: Epidemiological evidence has shown that serum N-terminal pro-brain natriuretic peptide (NT-proBNP) concentrations, a diagnostic biomarker for heart failure, are positively associated with cardiovascular risk. Since NT-proBNP in serum is excreted in urine, it is hypothesized that urinary NT-proBNP concentrations are correlated with serum concentrations and linked with cardiovascular risk in the general population. METHODS: A total of 3060 community-dwelling residents aged ≥ 40 years without history of cardiovascular disease (CVD) were followed up for a median of 8.3 years (2007-2015). Serum and urinary concentrations of NT-proBNP at baseline were compared. The hazard ratios (HRs) and their 95% confidence intervals (CIs) for the association between NT-proBNP concentrations and the risk of developing CVD were computed using the Cox proportional hazards model. RESULTS: The median values (interquartile ranges) of serum and urinary NT-proBNP concentrations at baseline were 56 (32-104) pg/mL and 20 (18-25) pg/mL, respectively. There was a strong quadratic correlation between the serum and urinary concentrations of NT-proBNP (coefficient of determination [R CONCLUSIONS The present study demonstrated that urinary NT-proBNP concentrations were well-correlated with serum concentrations and were positively associated with cardiovascular risk. Given that urine sampling is noninvasive and does not require specially trained personnel, urinary NT-proBNP concentrations have the potential to be an easy and useful biomarker for detecting people at higher cardiovascular risk.
Adult ; Aged ; Aged, 80 and over ; Biomarkers/urine* ; Cardiovascular Diseases/urine* ; Female ; Heart Failure/diagnosis* ; Humans ; Incidence ; Japan/epidemiology* ; Male ; Middle Aged ; Natriuretic Peptide, Brain/urine* ; Peptide Fragments/urine* ; Prospective Studies ; Risk Assessment

cardiovascular disease in the cohort based from the entire Korean population.METHODS: Using the Korean National Health Insurance database, we conducted an observational study of 579,377 men who sought treatment for Pca between January 1, 2012 and December 31, 2016. After excluding patients with previously diagnosed cardiovascular disease or who had undergone chemotherapy, we extracted the data from 2,053 patients who started GnRHa (GnRHa users) and 2,654 men who were newly diagnosed with Pca (GnRHa nonusers) between July 1, 2012, and December 31, 2012, with follow-up through December 31, 2016. The primary outcomes were cerebrovascular attack (CVA) and ischemic heart disease (IHD).RESULTS: GnRHa users were older, were more likely to reside in rural areas, had lower socioeconomic status, and had more comorbidities than nonusers (all P < 0.050). Although GnRHa users had an increased incidence of CVA and IHD (P = 0.013 and 0.048, respectively) in univariate analysis, GnRHa use was not associated with the outcomes in multivariate analysis. Furthermore, the cumulative duration of ADT was not associated with the outcomes whereas the associations between age at diagnosis with all diseases were significant.CONCLUSION: Our complete enumeration of the Korean Pca population shows that ADT is not associated with increased risks of cardiovascular disease.]]>
Antineoplastic Agents ; Cardiovascular Diseases ; Cohort Studies ; Comorbidity ; Diagnosis ; Drug Therapy ; Follow-Up Studies ; Gonadotropin-Releasing Hormone ; Humans ; Incidence ; Male ; Morinda ; Multivariate Analysis ; Myocardial Ischemia ; National Health Programs ; Observational Study ; Passive Cutaneous Anaphylaxis ; Prostate ; Prostatic Neoplasms ; Social Class

BACKGROUND: This study evaluated factors independently associated with electrocardiographic left ventricular hypertrophy (ECG-LVH) in subjects who were normotensive on clinical measurement and had no prior history of hypertension. METHODS: This cross-sectional study analyzed cases and controls in the Comprehensive Medical Examination Center of Hallym University Sacred Heart Hospital. Eligible case participants presented ECG-LVH according to the Sokolow- Lyon or Cornell criteria, were normotensive on clinical measurement, and had never received a diagnosis of hypertension. The control group comprised subjects with normal sinus rhythm who were normotensive on clinical measurement with no history of hypertension. RESULTS: A multiple logistic regression model showed male sex, age and systolic blood pressure to be positively related to the presence of ECG-LVH. A positive relation of smoking and regular exercise; an inverse relation of pulse rate to the presence of ECG-LVH were found only in men. An inverse relation of uric acid level was found only in women. Detailed analyses of relatively healthy and young men according to whether or not to exercise regularly showed that positive relations of age and systolic blood pressure; an inverse relation of obesity to the presence of ECG-LVH were apparent in the non-regular exercise group but not in the regular exercise group. In the regular exercise group, only pulse rate showed significant (inverse) association with the presence of ECG-LVH. CONCLUSION: The varying risk factor profiles associated with ECG-LVH according to sex and the participation in regular exercise may help to elucidate the ECG-LVH in clinical normotensives with no prior history of hypertension.
Blood Pressure ; Cardiovascular Diseases ; Cross-Sectional Studies ; Diagnosis ; Electrocardiography ; Female ; Heart ; Heart Rate ; Humans ; Hypertension ; Hypertrophy, Left Ventricular ; Logistic Models ; Male ; Obesity ; Risk Factors ; Smoke ; Smoking ; Uric Acid

BACKGROUND: Hyperuricemia is associated with the development and progression of chronic kidney disease (CKD) as well as cardiovascular diseases. However, there is no consistent recommendation regarding the treatment of asymptomatic hyperuricemia (AHU) in CKD patients. Here, we surveyed Korean physicians’ perceptions regarding the diagnosis and management of AHU in CKD patients. METHODS: Questionnaires on the management of AHU in CKD patients were emailed to regular members registered with the Korean Society of Nephrology. RESULTS: A total of 158 members answered the questionnaire. Among the respondents, 49.4%/41.1% were considered hyperuricemic in male CKD patients whereas 36.7%/20.9% were considered hyperuricemic in female CKD patients when defined by serum uric acid level over 7.0/8.0 mg/dL, respectively. A total of 80.4% reported treating AHU in CKD patients. The most important reasons to treat AHU in CKD patients were renal function preservation followed by cerebro-cardiac protection. Majority of respondents (59.5%) thought that uric acid-lowering agents (ULAs) were the most effective method for controlling serum uric acid levels. Approximately 80% chose febuxostat as the preferred medication. A total of 32.3% and 31.0%, respectively, initiated ULA treatment if the serum uric acid level was more than 8.0 or 9.0 mg/dL, respectively. In addition, 39.2% and 30.4% answered that target serum uric acid levels of less than 6.0 or 7.0 mg/dL, respectively, were appropriate. The two major hurdles to prescribing ULAs were concerns of adverse reactions and the existing lack of evidence (i.e., the absence of Korean guidelines). CONCLUSION: Most Korean physicians treat AHU in CKD patients to prevent CKD progression and cerebro-cardiovascular complications.
Cardiovascular Diseases ; Diagnosis ; Electronic Mail ; Febuxostat ; Female ; Humans ; Hyperuricemia ; Male ; Methods ; Nephrology ; Renal Insufficiency, Chronic ; Surveys and Questionnaires ; Uric Acid