H19 Induces AAA Development and Progression

Abstract

A total of 200 patients with peripheral arterial disease (PAD) were randomized to home-based exercise consisting of on-site sessions for the first month, active exercise, and coaching (99 patients) vs usual care (101 patients) for 9 months. The mean change in walking distance was better in the usual care group than in the exercise group. Conclusion: A home-based exercise program consisting of a wearable activity monitor and telephone coaching did not improve walking performance at 9-month follow-up. These results do not support home-based exercise program of wearable devices and telephone counseling without periodic on-site medical center visits to improve walking performance in patients with PAD. Commentary: Clinical practice guidelines recommend either supervised treadmill exercise (class IA recommendation) or home-based walking exercise (class IIA recommendation) as first-line therapy to improve walking in patients with lower extremity PAD. But importantly, both programs required frequent visits to the medical center. But, how often should these visits be required? In this randomized study, the exercise group received four weekly medical center visits during the first month, followed by 8 months of a wearable activity monitor and telephone coaching. The authors suggest increased frequency of periodic on-site visits might have yielded improvedresults. I assume that they mean that if the subjects had visited the medical center three or four times a week instead of once a week, or if they continued to visit the medical center for the full 9-month trial, the exercise program would have resulted in improved walking distances. The study emphasizes that simply telling patients to walk more or involving them in a less than strenuous walking program to improve claudication will not do much good. The problem is that not many vascular surgeons have access to rigorous exercise programs to treat claudication. Until that happens, and until reimbursements for such exercise programs become widespread, the only realistic noninterventional options to treat disabling claudication due to PAD are cilostazol and smoking cessation programs.

The role of long non-coding RNA in abdominal aortic aneurysm

“…Li et al identified mouse lncRNA H19 by RNA sequencing AngII and PPE-induced AAAs in mice. Inhibition of H19 inhibits aneurysm formation in AngII-and PPE-AAA mouse models, lowldlr Yucatan mini pigs, samples from AAAs patients, and low-ldlr Yucatan mini pigs (Li et al, 2018). H19 is markedly elevated in advanced AAAs.…”

“…Few studies have examined the function of lncRNAs in the onset and progression of vascular disease. Currently, H19 is the only lncRNA associated with AAA (Li et al, 2018). Numerous studies have discovered that lncRNAs play a crucial role in the processes required to grow and spread AAA.…”