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Idiopathic deep venous thrombosis and arterial endothelial dysfunction in the elderly

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Abstract

Arterial and venous thrombosis have always been regarded as different pathologies and epidemiological studies have examined the association between venous thrombosis and indicators of atherosclerosis and/or arterial thromboembolic events. We measured the flow-mediated dilation (FMD), a well-known marker of arterial endothelial dysfunction, in young–middle-aged and old-aged patients with and without unprovoked deep venous thrombosis (DVT). The aim of this study was to investigate whether DVT was a significant predictor for impaired FMD, considering all the patients and young–middle-aged (age < 65 years) and old-aged (age ≥ 65 years) patients separately. FMD was measured in the brachial artery on a population of 120 subjects with the same atherosclerosis risk factors, 68 male and 52 female, 70 young–middle-aged subjects (mean age ± SD 49.5 ± 10.5 years) and 50 old-aged subjects (76.2 ± 7.7 years). Patients with DVT showed a significant decrease of FMD compared to patients without DVT (6.8 ± 5.5% vs. 10.9 ± 3.5%, p < 0.001). Moreover, old-aged patients showed a significant decrease of FMD compared to the young–middle-aged subjects (7.4 ± 4.1% vs. 9.8 ± 5.3%, p = 0.005). In the whole study population, DVT was strongly associated with FMD (risk factors adjusted β = −4.14, p < 0.001). A significant interaction between age and the presence of DVT on predicting FMD was found (p = 0.003) suggesting a differential behavior of DVT as predictor of FMD. In young–middle-aged group, multivariate model confirmed that DVT was the most significant predictor of continuous FMD (β = −6.06, p < 0.001). On the contrary, DVT was no more a predictor of FMD in the old age group (β = −0.73, p=0.556). Furthermore, old-aged patients without DVT showed a statistically significant decrease of FMD compared to the young–middle-aged subjects without DVT (8.2±2.1% vs. 12.6±2.7%, p<0.001) and old-aged patients with DVT showed a not statistically significant decrease of the FMD compared to the young–middle-aged patients with DVT (6.7±5.3% vs. 6.8±5.7%, p = 0.932). In conclusion, young–middle-aged patients with spontaneous DVT show an impaired FMD, whereas this impairment in old-aged subjects is evident independently from the presence or absence of DVT. Aging per se may be associated with physiologic abnormalities in the systemic arteries and with endothelial dysfunction.

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References

  • Ageno W, Becattini C, Selby R, Kamphuisen PW (2008) Cardiovascular risk factors and venous thromboembolism: a meta-analysis. Circulation 117(1):93–102

    Article  PubMed  Google Scholar 

  • Agouni A, Lagrue-Lak-Hal AH, Ducluzeau PH, Mostefai HA, Draunet-Busson C, Leftheriotis G, Heymes C, Martinez MC, Andriantsitohaina R (2008) Endothelial dysfunction caused by circulating microparticles from patients with metabolic syndrome. Am J Pathol 173(4):1210–1219

    Article  PubMed  CAS  Google Scholar 

  • Bots ML, Westerink J, Rabelink TJ, de Koning EJ (2005) Assessment of flow-mediated vasodilatation (FMD) of the brachial artery: effects of technical aspects of the FMD measurement on the FMD response. Eur Heart J 26(4):363–368

    Article  PubMed  Google Scholar 

  • Celermajer DS, Sorensen KE, Spiegelhalter DJ, Georgakopoulos D, Robinson J, Deanfield JE (1994) Aging is associated with endothelial dysfunction in healthy men years before the age-related decline in women. J Am Coll Cardiol 24(2):471–476

    Article  PubMed  CAS  Google Scholar 

  • Chung S, Yoon IY, Shin YK, Lee CH, Kim JW, Ahn HJ (2009) Endothelial dysfunction and inflammatory reactions of elderly and middle-aged men with obstructive sleep apnea sindrome. Sleep Breath 13:11–17

    Article  PubMed  Google Scholar 

  • Ciampi A, Negassa A, Lou Z (1995) Tree-structured prediction for censored survival data and the Cox model. J Clin Epidemiol 48:675–689

    Article  PubMed  CAS  Google Scholar 

  • Corretti MC, Anderson TJ, Benjamin EJ, Celermajer D, Charbonneau F, Creager MA, Deanfield J, Drexler H, Herman MG, Herrington D, Vallance P, Vita J, Vogel R (2002) Guidelines for the ultrasound assessment of endothelial-dependent flow-mediated vasodilation of the brachial artery. A report of the International Brachial Artery Reactivity Task Force. JACC 39(2):257–265

    PubMed  Google Scholar 

  • De Berardis G, Pellegrini F, Franciosi M et al (2007) Clinical and psychological predictors of incidence of self-reported erectile dysfunction in patients with type 2 diabetes. J Urol 177:252–257

    Article  PubMed  Google Scholar 

  • Drexler H, Herman MG, Herrington D, Vallance P, Vita J, Vogel R (2002) Guidelines for the ultrasound assessment of endothelial-dependent flow-mediated vasodilation of the brachial artery. A report of the International Brachial Artery Reactivity Task Force. JACC 39(2):257–265

    PubMed  Google Scholar 

  • Gresele P, Momi S, Migliacci R (2010) Endothelium, venous thromboembolism and ischaemic cardiovascular events. Thromb Haemost 103(1):56–61

    Article  PubMed  CAS  Google Scholar 

  • Heit JA (2008) The epidemiology of venous thromboembolism in the community. Arterioscler Thromb Vasc Biol 28(3):370–372

    Article  PubMed  CAS  Google Scholar 

  • Holst AG, Jensen G, Prescott E (2010) Risk factors for venous thromboembolism results from the Copenhagen City Heart Study. Circulation 121:1896–1903

    Article  PubMed  Google Scholar 

  • Isma N, Svensson PJ, Gottsäter A, Lindblad B (2009) Prospective analysis of risk factors and distribution of venous thromboembolism in the population-based Malmö Thrombophilia Study (MATS). Thromb Res 124(6):663–666

    Article  PubMed  CAS  Google Scholar 

  • Jerjes-Sanchez C (2005) Venous and arterial thrombosis: a continuous spectrum of the same disease? Eur Heart J 26(1):3–4

    Article  PubMed  Google Scholar 

  • Jezovnik MK, Poredos P, Lusa L (2010a) Idiopathic venous thrombosis is associated with preclinical atherosclerosis. J Atheroscler Thromb 17:304–311

    Article  PubMed  Google Scholar 

  • Jezovnik MK, Poredos P, Stalc M (2010b) Impairment of the vasodilatation capability of the brachial artery in patients with idiopathic venous thrombosis. J Atheroscler Thromb 17:1190–1198

    Article  PubMed  Google Scholar 

  • Kimura Y, Matsumoto M, Deng YB, Iwai K, Munehira J, Hattori H, Hoshino T, Yamada K, Kawanishi K, Tsuchiya H (1999) Impaired endothelial function in hypertensive elderly patients evaluated by high resolution ultrasonography. Can J Cardiol 15:563–568

    PubMed  CAS  Google Scholar 

  • Migliacci R, Becattini C, Pesavento R, Davi G, Vedovati MC, Guglielmini G, Falcinelli E, Ciabattoni G, Dalla Valle F, Prandoni P, Agnelli G, Gresele P (2007) Endothelial dysfunction in patients with spontaneous venous thromboembolism. Haematologica 92(6):812–818

    Article  PubMed  CAS  Google Scholar 

  • Matsuo S, Matsumoto T, Takashima H, Ohira N, Yamane T, Yasuda Y, Tarutani Y, Horie M (2004) The relationship between flow-mediated brachial artery vasodilation and coronary vasomotor responses to bradykinin: comparison with those to acetylcholine. J Cardiovasc Pharmacol 44(2):164–170

    Article  PubMed  CAS  Google Scholar 

  • Peretz A, Leotta DF, Sullivan JH, Trenga CA, Sands FN, Aulet MR, Paun M, Gill EA, Kaufman JD (2007) Flow mediated dilation of the brachial artery: an investigation of methods requiring further standardization. BMC Cardiovasc Disord 7:11–19

    Article  PubMed  Google Scholar 

  • Prandoni P (2007) Venous thromboembolism and atherosclerosis: is there a link? J Thromb Haemost 5(1):270–275

    Article  PubMed  CAS  Google Scholar 

  • Prandoni P, Bilora F, Marchiori A, Bernardi E, Petrobelli F, Lensing A, Prins MH, Girolami A (2003) An association between atherosclerosis and venous thrombosis. N Engl J Med 349(4):1435–1441

    Article  Google Scholar 

  • Prandoni P, Ghirarduzzi A, Prins MH, Pengo V, Davidson BL, Soresen H, Pesavento R, Iotti M, Casiglia E, Iliceto S, Pagnan A, Lensing AW (2006) Venous thromboembolism and the risk of subsequent symptomatic atherosclerosis. J Thromb Haemost 4(9):1891–1896

    Article  PubMed  CAS  Google Scholar 

  • Reich LM, Folsom AR, Key NS, Boland LL, Heckbert SR, Rosamond WD, Cushman MJ (2006) Prospective study of subclinical atherosclerosis as a risk factor for venous thromboembolism. J Thromb Haemost 4(9):1886–1890

    Article  Google Scholar 

  • Roman MJ, Naqvi TZ, Gardin JM, Gerhard-Herman M, Jaff M, Mohler E (2006) Clinical application of noninvasive vascular ultrasound in cardiovascular risk stratification: a report from the American Society of Echocardiography and the Society of Vascular Medicine and Biology. J Am Soc Echocardiogr 19(8):943–954

    Article  PubMed  Google Scholar 

  • Sørensen HT, Horvath-Puho E, Pedersen L, Baron JA, Prandoni P (2007) Venous thromboembolism and subsequent hospitalisation due to acute arterial cardiovascular events: a 20- year cohort study. Lancet 370(9601):1773–1779

    Article  PubMed  Google Scholar 

  • Stehouwer CD, Henry RM, Dekker JM, Nijpels G, Heine RJ, Bouter LM (2004) Microalbuminuria is associated with impaired brachial artery, flow-mediated vasodilation in elderly individuals without and with diabetes: further evidence for a link between microalbuminuria and endothelial dysfunction—the Hoorn Study. Kidney Int Suppl 92:S42–S44, Review

    Article  PubMed  Google Scholar 

  • Takase B, Uehata A, Akima T, Nagai T, Nishioka T, Hamabe A, Satomura K, Ohsuzu F, Kurita A (1998) Endothelium-dependent flow mediated vasodilation in coronary and brachial arteries in suspected coronary artery disease. Am J Cardiol 82(12):1535–1539

    Article  PubMed  CAS  Google Scholar 

  • Thanyasiri P, Celermajer DS, Adams MR (2005) Endothelial dysfunction occurs in peripheral circulation patients with acute and stable coronary artery disease. Am J Physiol Heart Circ Physiol 289(2):H513–H517

    Article  PubMed  CAS  Google Scholar 

  • Tsai AW, Cushman M, Rosamond WD, Heckbert SR, Polak JF, Folsom AR (2002) Cardiovascular risk factors and venous thromboembolism incidence: the longitudinal investigation of thromboembolism etiology. Arch Intern Med 162(10):1182–1189

    Article  PubMed  Google Scholar 

  • Van der Hagen PB, Folsom AR, Jenny NS, Heckbert SR, O’Meara ES, Reich LM, Rosendaal FR, Cyshman M (2006) Subclinical atherosclerosis and the risk of future venous thrombosis in the cardiovascular health study. J Thromb Haemost 4(9):1903–1908

    Article  PubMed  Google Scholar 

  • Yavuz BB, Yavuz B, Sener DD, Cankurtaran M, Halil M, Ulger Z, Nazli N, Kabakci G, Aytemir K, Tokgozoglu L, Oto A, Ariogul S (2008) Advanced Age Is Associated with Endothelial Dysfunction in Healthy Elderly Subjects. Gerontology 54:153–156

    Article  PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. Unit of Internal Medicine, Department of Medical Sciences, Scientific Institute and Regional General Hospital “Casa Sollievo della Sofferenza”, San Giovanni Rotondo, Italy

    Gianluigi Mazzoccoli, Massimo Grilli, Mariangela Pia Dagostino & Gianluigi Vendemiale

  2. Unit of Biostatistics, Scientific Institute and Regional General Hospital “Casa Sollievo della Sofferenza”, S.Giovanni Rotondo, Italy

    Andrea Fontana, Massimiliano Copetti & Fabio Pellegrini

  3. Department of Clinical Pharmacology and Epidemiology, Consorzio Mario Negri Sud, Chieti, Italy

    Fabio Pellegrini

  4. Unit of Geriatrics, Department of Medical Sciences, University of Foggia, Foggia, Italy

    Gianluigi Vendemiale

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  1. Gianluigi Mazzoccoli
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  2. Andrea Fontana
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  3. Massimo Grilli
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  4. Mariangela Pia Dagostino
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  5. Massimiliano Copetti
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  6. Fabio Pellegrini
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  7. Gianluigi Vendemiale
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Correspondence to Gianluigi Mazzoccoli.

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Mazzoccoli, G., Fontana, A., Grilli, M. et al. Idiopathic deep venous thrombosis and arterial endothelial dysfunction in the elderly. AGE 34, 751–760 (2012). https://doi.org/10.1007/s11357-011-9265-x

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  • DOI: https://doi.org/10.1007/s11357-011-9265-x

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