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advice, we encourage you to consult a physician or other medical
professional. The views expressed in these Commentaries are those
of the authors and are not necessarily those of IAS.
Brachial
Flow-Mediated Dilation and Cardiovascular disease: Associations,
Diagnostic and Prognostic Accuracies in the Elderly
Authors: Joseph Yeboah and John R Crouse III
The vascular endothelium plays a major role in
the control of vascular tone, platelet aggregation, and inflammation
via an extensive paracrine system. Among the mediators of vascular
tone produced by the endothelium are nitric oxide, prostaglandins,
endothelin-1, and endothelial-derived releasing factor.
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Impact
of Nonalcoholic Fatty Liver Disease on Accelerated Metabolic
Complications
Author: Jian-Gao Fan, MD, PhD
Nonalcoholic fatty liver disease (NAFLD) is currently
the most common cause of chronic liver disease in clinical practice.
Insulin resistance (IR) and oxidative stress play an important
role in the development and progression of NAFLD [1-4]. Mortality
in patients with NAFLD is significantly higher than in the age-
and gender-matched general population, with malignancy, cardiovascular
disease (CVD), and liver-related complications being the most
common causes of death [1,3,5].
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Diagnosis of Intracranial
Atherosclerosis
Authors: Edward Feldmann, MD and Aevan Mclaughlin, BS
Intracranial atherosclerosis is a major cause of ischemic stroke in the United
States, estimated to be responsible for over 70,000 strokes each year [1,2],
and is considered a major cause of stroke worldwide. Patients with intracranial
atherosclerosis have a high risk of recurrent stroke. Despite antithrombotic
therapy, symptomatic patients with > 50% stenosis have an 11% risk of having
a recurrent stroke in the territory of the stenotic artery at one year, and
patients with = 70% stenosis have a risk as high as 23% for stroke at one year
[3].
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Sleep-disordered Breathing:
a Risk Factor of the Metabolic Syndrome in Obese Children
and Adolescents?
Authors: Stijn Verhulst, MD, MSc, Luc Van Gaal, MD, PhD, Wilfried De Backer,
MD, PhD, and Kristine Desager, MD, PhD
The metabolic syndrome is comprised of the clustering
of the following cardiovascular risk factors: (central) obesity,
insulin resistance, dyslipidemia, and hypertension. Most definitions
in pediatric literature are derived of three definitions used
in adults: WHO criteria, National Cholesterol Education Program’s
Adult Treatment Panel III criteria, and International Diabetes
Federation definition. These definitions are then modified to
be used in children and adolescents, i.e. with age- and gender-specific
criteria. The metabolic syndrome is also frequently accompanied
by certain conditions which are not incorporated into the definition,
i.e. hypercoagulability, fatty liver disease, and micro-albuminuria
[1].
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Metabolic Syndrome
and Atherosclerosis: What about Femoral Involvement?
Author: Gaetano Vaudo, MD
Metabolic syndrome as defined by the presence of
at least three of the following factors: high triglyceride levels,
low high density lipoproteins (HDL), high fasting glycemia, hypertension,
and abdominal obesity, represents a cardiovascular risk condition
and is associated with increased coronary atherosclerosis [1-3].
Evidence has revealed the relationship between the early stages
of atherosclerosis and the components of metabolic syndrome [4,5].
It is well established that metabolic syndrome has a predictive
power on the development of carotid atherosclerosis [6,7], but
less is known about femoral involvement.
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The Role of Immunity
in Atherogenesis - Implications for Vaccine Development with
Reference to Oxidized LDL
Authors: Nandini Venkatesan, PhD and Vijay R. Prabhakar, MD
There is increasing evidence that both inflammation
and immunology regulate atherosclerogenesis and that anti-inflammatory
processes (via cells and molecules) play a role in the development
of atherosclerosis. Development of atherosclerosis is influenced
by innate and adaptive immune responses. Thus, research has focused
attention on the immune system as a possible novel target in
prevention and treatment of cardiovascular disease.
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Uric Acid and Cardiovascular
Disease: Risk Factor or Risk Marker?
Authors: Thais Coutinho, MD and Iftikhar Kullo, MD
Whether serum uric acid (UA) has an etiologic role
in cardiovascular disease continues to be a matter of debate.
Whereas several investigators have suggested that UA contributes
to the pathogenesis of atherosclerosis [1,2], hypertension [2],
and inflammation [3-5], others have hypothesized that elevation
of serum UA is a consequence, not a cause, of vascular disease
since UA is a free radical scavenger, and therefore its elevation
could represent a physiologic response to increased vascular
oxidative stress [6].
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Accelerated Atherosclerosis
in Diabetic Mice Mediated by High Glucose Levels and Anti-Atherosclerotic
Effects of Insulin
Authors: Tony Hayek and Marielle Kaplan
Diabetes mellitus (DM) is associated with premature
and accelerated atherosclerosis, and patients with diabetes are
at 2-4 times increased risk for coronary artery diseases, which
accounts for the major cause of death in these patients [1,2].
The precise mechanisms underlying the acceleration of atherosclerosis
in DM is poorly understood, but it was suggested that hyperglycemia
accelerates atherosclerosis by induction of vascular dysfunction,
increased inflammatory burden, increased lipid peroxidation of
lipoproteins, and arterial cells which lead to enhanced macrophage
foam cell formation, the hallmark of early atherosclerosis [3,4].
Moreover, the role of insulin in atherosclerosis progression
is uncertain. Hyperinsulinemia is considered to be an independent
risk factor for atherosclerosis development, but there are some
lines of evidence suggesting a protective role for insulin [5-7].
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