Endothelial Dysfunction Is Associated with Cognitive Impairment of Elderly Cardiovascular Disease Patients

Fujiyoshi, Kazuhiro; Yamaoka‐Tojo, Minako; Minami, Yoshiyasu; Kutsuna, Toshiki; Obara, Shinichi; Kakizaki, Ryota; Nemoto, Teruyoshi; Hashimoto, Takuya; Namba, Sayaka; Shimohama, Takao; Tojo, Taiki; Ako, Junya

doi:10.1536/ihj.17-610

Cited by 22 publications

(13 citation statements)

References 39 publications

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“…As a common feature of various diseases, cognitive impairment impacts the health of elderly patients (52). Previous studies showed that BBB permeability has an essential effect on cognitive impairment-related diseases (53), but the function and mechanism of BBB permeability in cognitive impairment caused by sleep deprivation is unclear.…”

Section: Discussionmentioning

confidence: 99%

Sleep Deprivation Induces Cognitive Impairment by Increasing Blood-Brain Barrier Permeability via CD44

Sun

Hua

et al. 2020

Front. Neurol.

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Sleep deprivation occurs frequently in older adults, which can result in delirium and cognitive impairment. CD44 is a key molecular in blood-brain barrier (BBB) regulation. However, whether CD44 participates in the role of sleep deprivation in cognitive impairment remains unclear. In this study, the effect of sleep deprivation on cognitive ability, tissue inflammation, BBB permeability, and astrocyte activity were evaluated in vivo. The differentially expressed genes (DEGs) were identified by RNA sequencing. A CD44 overexpression in the BBB model was performed in vitro to assess the effect and mechanisms of CD44. Sleep deprivation impaired the learning and memory ability and increased the levels of inflammatory cytokines, along with increased BBB permeability and activated astrocytes in hippocampus tissue. RNA sequencing of the hippocampus tissue revealed that 329 genes were upregulated in sleep deprivation-induced mice compared to control mice, and 147 genes were downregulated. GO and pathways showed that DEGs were mainly involved in BBB permeability and astrocyte activation, including nervous system development, neuron development, and brain development, and neuroactive ligand-receptor interaction. Moreover, the PCR analysis revealed that CD44 was dramatically increased in mice with sleep deprivation induction. The overexpression of CD44 in astrocytes promoted BBB permeability in vitro and induced the expression of the downstream gene NANOG. Our results indicate that sleep deprivation upregulated CD44 expression in hippocampus tissue, and increased BBB permeability, resulting in cognitive impairment.

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Section: Discussionmentioning

confidence: 99%

Sleep Deprivation Induces Cognitive Impairment by Increasing Blood-Brain Barrier Permeability via CD44

Sun

Hua

et al. 2020

Front. Neurol.

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“…The strong relationship between proBNPage and cardiovascular pathologies leads to the conclusion that the presence of these pathologies may also have a strong influence on the self-rating of health status. With the intermediation of endothelial dysfunction, hypertension is a relevant cause of cardiovascular damage, and both hypertension and endothelial dysfunction have been found to be associated with cognitive impairment [56,57]. The impact on cognitive aging of even subtle alterations of cardiovascular hemodynamics, including both cardiac output and arterial stiffening, has recently been reviewed [58].…”

Section: Psychological or Mental Complaintsmentioning

confidence: 99%

The association of proBNPage with manifestations of age-related cardiovascular, physical, and psychological impairment in community-dwelling older adults

et al. 2021

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NT-proB-type natriuretic peptide (NT-proBNP) serum concentration can be transformed by simple formulas into proBNPage, a surrogate of biological age strongly associated with chronological age, all-cause mortality, and disease count. This cross-sectional study aimed to assess whether proBNPage is also associated with other manifestations of the aging process in comparison with other variables. The study included 1117 noninstitutionalized older adults (73.1 ± 5.6 years, 537 men). Baseline measurements of serum NT-proBNP, erythrocyte sedimentation rate, hemoglobin, lymphocytes, and creatinine, which have previously been shown to be highly associated with both age and all-cause mortality, were performed. These variables were compared between subjects with and without manifestations of cardiovascular impairment (myocardial infarction (MI), stroke, peripheral artery disease (PAD), arterial revascularizations (AR)), physical impairment (long step test duration (LSTD), walking problems, falls, deficit in one or more activities of daily living), and psychological impairment (poor self-rating of health (PSRH), anxiety/depression, Mini Mental State Examination (MMSE) score < 24). ProBNPage (years) was independently associated (OR, 95% CI) with MI (1.08, 1.07–1.10), stroke (1.02, 1.00–1.05), PAD (1.04, 1.01–1.06), AR (1.06, 1.04–1.08), LSTD (1.03, 1.02–1.04), walking problems (1.02, 1.01–1.03), and PSRH (1.02, 1.01–1.02). For 5 of these 7 associations, the relationship was stronger than that of chronological age. In addition, proBNPage was univariately associated with MMSE score < 24, anxiety/depression, and falls. None of the other variables provided comparable performances. Thus, in addition to the known associations with mortality and disease count, proBNPage is also associated with cardiovascular manifestations as well as noncardiovascular manifestations of the aging process.

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“…Before the evaluation, the patients were asked to rest for 30 minutes in the supine position in a quiet, dark, air-conditioned room (22 -25 ). 12) The FMD procedure was performed in the morning or evening (between 6 and 8 am or between 5 and 6 pm). A forearm cuff was then inflated for 5 minutes at 50 mmHg above the systolic blood pressure just before the FMD measurement.…”

Section: Study Populationmentioning

confidence: 99%

Impaired Flow-Mediated Dilation and Severity and Vulnerability of Culprit Plaque in Patients with Coronary Artery Disease

et al. 2019

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The association between endothelial function, evaluated using flow-mediated dilatation (FMD), and the severity of coronary artery disease remains to be elucidated. A total of 245 consecutive patients with stable angina were prospectively enrolled. FMD was evaluated in the brachial artery before percutaneous coronary intervention. Patients were divided into 2 groups according to the FMD value (lower FMD group [FMD < 2.0], n = 82; higher FMD group [FMD !2.0], n = 163). The severity of coronary artery disease was evaluated using findings of angiography and optical coherence tomography, and compared between the 2 groups. The prevalence of left main (LM) disease was significantly higher in the lower FMD group than in the higher FMD group (8.5% versus 2.5%, P = 0.046), although the prevalence of multivessel disease was comparable between the groups. Lower FMD was independently associated with a higher prevalence of LM disease (odds ratio, 3.89; 95% confidence interval, 1.12-15.5; P = 0.033). A general linear model with multiple variables revealed that the minimal lumen area (MLA) in the culprit lesion was significantly smaller in patients with lower FMD than in those with higher FMD (regression coefficient b, −0.249 mm 2 ; 95% confidence interval, −0.479-−0.018 mm 2 ; P = 0.035). The prevalence ofvulnerable plaque characteristics was comparable between the 2 groups. Patients with lower FMD had a higher incidence of LM disease and a smaller MLA in the culprit lesion. FMD may be a useful, noninvasive indicator for identifying patients with severe coronary artery disease.

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Endothelial Dysfunction Is Associated with Cognitive Impairment of Elderly Cardiovascular Disease Patients

Cited by 22 publications

References 39 publications

Sleep Deprivation Induces Cognitive Impairment by Increasing Blood-Brain Barrier Permeability via CD44

Sleep Deprivation Induces Cognitive Impairment by Increasing Blood-Brain Barrier Permeability via CD44

The association of proBNPage with manifestations of age-related cardiovascular, physical, and psychological impairment in community-dwelling older adults

Impaired Flow-Mediated Dilation and Severity and Vulnerability of Culprit Plaque in Patients with Coronary Artery Disease

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