Vascular Medicine

Vascular Medicine

  • Jonathan Skillings added an answer:
    What is the impact of physical activity, screen time, diet drinks and weather on CV disease?
    Jonathan Skillings · University of New England (USA)

    Data from population studies dating back from the Framingham study/substudies among others demonstrated quite clearly that a sedate lifestyle and a diet high in calories were risk factors for the development of atherosclerosis. I am not aware of any studies looking specifically at "screen time" which I assume you mean computer screen time but any such activity, whether watching TV, playing video games or what have you that limit physical activity will have the same effect of classically measured low activity lifestyles. I am not aware of a US study on the effects of weather but the Scandinavians may have conducted a few.

  • Leong chen Onn added an answer:
    Do you know of any left ventricle or heart localization method for tagged MRI?

    I'm currently researching on left ventricle motion quantification. Can anyone suggest me any heart or left ventricle localization method in tagged cardiac MRI images? Appreciate if you can provide me references too. Thanks.

    Leong chen Onn · University of Malaya

    Thanks all. I'm looking for an automated method to define the ROI (left ventricle) for tagged MR images.

    To Aymeric Histace, I think the paper you recommended me is useful to me. I'm interested with the mean-std image method which I have personally tried to apply. But I ran into some problem. I've attached the image of the mean-std image below. The mean-std image i generated does not show a a significant contrast between the cavity and the left ventricle wall. I think I'm doing it wrong or missing some steps.

    Here are the steps I have taken using Matlab to process the image.
    1) compute local mean image using 'conv2' with kernel size N=11
    2) compute local std image using 'stdfilt' with kernel size N=11
    3) compute uendomap(i,j)=wm.mN(i,j) - wo.ON(i,j) with wm=1/3 and wo=2/3 where wm+wo=1 and wo/wo=2.

    Any help is appreciated as I might adopt this method to localize my tagged MR images for my coming paper. Thanks.

  • Hubert Dabire added an answer:
    At what percentage of relaxation of acetylcholine to norepinephrine the endothelium of a rat aorta may be considered intact in vitro?

    Recently, someone asked here how to remove the endothelium in a rat aorta. I do agree with all answers. My question now is how to check that the endothelium is correctly removed. In other words, at what percentage of relaxation to norepinephrine or other vasoconstrictors (what concentration?) induced by acetylcholine (also what concentration?) one can consider that the endothelium is correctly removed? Conversely, at what percentage of relaxation one can consider that the endothelium is present or intact?

    Hubert Dabire · French Institute of Health and Medical Research

    It will be a pleasure to meet you to discuss this subject. How can i contact you?

  • Vilemar Magalhaes added an answer:
    Do you agree that high carbohydrate diet may cause heart problem (cardiovascular disease) ?

    In most of the communities especially are owned by lower socioeconomic status.Diet contains more of carbohydrate than protein and fat. More carbohydrate after catabolism produce more saturated fatty acids. This may disturb the level of LDL( high ) lead to atherosclerosis.

    Vilemar Magalhaes · Easy Way Intercâmbios

    Dear Larry,

    Most of the specialists do not recommend carbs in the evening not because it van not be digested, but because it is digested too fast and so the person will be sleeping and may store that nutrient as fat. That absortion can be retarded by fat ingestion, then one may need water some time after and he will either have heartburn or will wake up during the night to urinate. There can be thousands of other motives and the ones given above not be true for some individuais. Or even worse it can be true for you today and not  tomorrow. Bit as a rule of thumb I would say no to carbs in the evening regardless if you feel bad after having it or not.

  • Reynold Agustinus added an answer:
    Can LMWH anticoagulation be used before ECV?

    What about LMWH anticoagulation (3-4 weeks) without TOE control before ECV? Because in guideline only VKA or NOAC has written, but nothing said about LMWH. What is you opinion?


    Reynold Agustinus · Siloam Hospitals

    Greetings Norbi

    Mostly LMWHs trial would be related with deep vein thrombosis not with atrial fibrillation. At the moment, no evidence showed that LMWHs alone could reduce LA clot. In NOAC trials, they only compare with warfarin. 

    in practice, some physician would use LMWHs due to simple dosage and administration. Nevertheless LMWHs need no further laboratory evaluation for normal patients.

    Hope it helps

  • David Gross added an answer:
    What factors may be related to the adaptation of prosthesis in patients with major lower limb amputations?
    We observed that the prevalence of adaptation to lower limb prostheses was 38%. And patients with a low level of education were the least frequently adapted to the prosthesis.

    Thanks,  Dee for  a  very  thoughtful  and  enlightening  post.

  • Mohammad Faramarzi added an answer:
    What is the most common cause of Acroangiodermatitis of Mali?

    Acroangiodermatitis has been described in amputees (especially in those with poorly fitting suction-type devices), in patients with paralyzed legs, in patients undergoing hemodialysis (from arteriovenous shunts distally), and in association with hepatitis C. It has been documented in chronic venous insufficiency and in vascular malformations (eg, Klippel-Trenaunay syndrome, Stewart-Bluefarb syndrome, Prader-Labhart-Willi syndrome).

    Mohammad Faramarzi · Ahvaz Jondishapour University of Medical Sciences

    Severe chronic venous stasis and failure of the calf muscle pump could have resulted in the elevated capillary pressure causing reactive vascular proliferation and clinically presenting as lesions of acroangiodermatitis.

  • Marco Marano added an answer:
    Where can I find references on the alveolar-arterial gradient?

    The Alveolar–arterial gradient (A-aO2, or A–a gradient), is a measure of the difference between the alveolar concentration (A) and the arterial (a) partial pressure of oxygen. It seems an useful and interesting parameter in the topic of pulmonary imbibition, but I failed to find published research in last years.

    Can you help me?

    Marco Marano · Maria Rosaria Clinic Pompeii Italy

    Hi Robert,

    what a great paper ! what a shame it is historical one !!

    What I am looking for it is a blood gas analysis parameter linked to interdialytic weight gain in hemodialysis patients. In my experience, and "of course", in incoming pulmonary edema A-a O2 gradient rises up to 50 mmHg, but I am looking for early gas derangement. Can You suggest me what to look for ?


  • Markus M. Mueller added an answer:
    Is there any information about haemophilia and ageing?

    Congratulations, you discussed a very interesting issue. I agree with the individualized therapeutic approach, especially in the patients with mild haemophilia phenotype. I would like to discuss the management of elderly haemophilia patients with atherosclerosis, obesity, smokers who have undergone an episode of arterial thrombosis. What do you think about the combination of replacement and antiplatelet therapy? How many haemophilic patients with diabetes and other conditions such as cancer do you have? 

    Markus M. Mueller · Goethe-Universität Frankfurt am Main

    Dear Peter,

    an expert in your field of interest would be Dr. Wolfgang Miesbach, head of the hemophilia clinic at the university clinics of the Goethe University in Frankfurt/Main, Germany.

    If you can send an email directly to, I will send you his mail address.



  • Joseph J Carlson added an answer:
    What is preclinical carotid atherosclerosis, how is it defined and what is the marker for it?

    Hi, dear all, can you please help me with the follow questions: How to define preclinical carotid atherosclerosis? and what is the marker of it? If carotid intima-media thickness >1mm, may I say this patient already have carotid atherosclerosis, or I should say the patient is in the status of preclinical carotid atherosclerosis?

    Thank you all very much!

    Joseph J Carlson · Michigan State University

    Ditto, I also appreciate the references above.

  • Khaled Saad added an answer:
    What is the maximum dose of statins in children with hypercholesterolemia?

    Use of statins for treatment of familial homozygous hypercholesterolemia: What is the earliest age for initiating statin therapy and what is the maximum dose used in young children.

    Khaled Saad · Assiut University

    Lea S. Eiland, and Paige K. Luttrell,  Use of Statins for Dyslipidemia in the Pediatric Population.J Pediatr Pharmacol Ther. 2010 Jul-Sep; 15(3): 160–172.
    PMCID: PMC3018249

  • Christos P Loizou added an answer:
    Can anyone help me to find the Database of CCA Ultrasound Video and its ground Truth?

    for Atherosclerotic Plaque Segmentation

    Christos P Loizou · Intercollege

    Dear Emimal, We have a database such the one you are describing, but it is not yet available to download. We have however some other image databases with ultrasound images of the CCA with their Ground Truth available. Have a look at See under downloads.

  • Liqun Zeng added an answer:
    How to determine if an ischmeia heart disease patient is with irreversible ischemia or reversible ischemia?

    My understanding is, when the myocadium cells lack of blood supply, the cell will be damaged but to some degree, it's still reversible. When the blood flow recovered, the cell can become alive again. When the ischemia is serious to a certain stage, the cell will die completely. Thus even the blood flow recover, the cell cannot gain live again, call irresversible. (if these are not true, please kindly correct me)

    And my question is, for a specific patient, how to judge if his ischemia is reversible, irreversible? E.g. by using some imaging machines??

    Liqun Zeng · Stanford University

    Thanks for sharing, Dr. Delgado.

  • Ugo Limbruno added an answer:
    Is there any role for triple therapy after ACS especially with the increased used NOAC?

    Optimal management of patients on NOACs after ACS and PCI with DES. 

    Ugo Limbruno · Azienda Unità Sanitaria Locale 9 Grosseto

    Latest european guidelines suggest  6 month of triple therapy (no matter if vit K antagonist or NOAC & no matter if DES or BMS) for ACS with HASBLED<3 (IIa indication). Three month triple therapy for all other cases (IIa indication). A WOEST-like strategy of simply dual therapy (OAC/NOAC + clopidogrel) is only a IIb indication despite in this study there was a strong signal towards a mortality benefit. with dual therapy with respect to triple one. 

    In my opinion, the use of NOAC instead of vit K anagonists might shift net clinical balance towards triple therapy (when compared with a WOEST-like dual therapy) due to the more favourable safety profile of these new drugs.   

  • Parth Shah added an answer:
    What kind of useful information can be extracted from Wrist-Type PPG signals?

    Wrist-Type PPG is very popular right now, but I would like to ask what kind of useful information can be extracted from it (except the head rate)?

    Parth Shah · VIT University

    Welcome. Feel free to ask any other related doubts.


  • Liqun Zeng added an answer:
    How long will the anticoagulation therapy last after the PTFE-covered stent implant in vein?

    I found the the anticoagulation therapy strategy varies with ePTFE material implants in human vessels, such as artificial vascular graft, stent, etc. What are the factors that influence the anticoagulation therapy?

    Liqun Zeng · Stanford University

    Dear Dr. James Spain, thank you for your comment.

    But just out of curious, there is a clinical presenation - deep vein thrombosis. Isn't the thombsis generated from the vein? And for impants in the vein, such as the lead of pacemaker, into the coronary sinus, anticoagulation for a short term, e.g. 3 months at least, is normal in practice. It seems in contradiction with your saying, never used anticoagulation?

  • Olivier Pétrault added an answer:
    When we add a drug in an isolated 10 ml organ bath must the dilution be not more than 1:20?

    We have Isolated tissue bath, we work on it, herbal, drug blocker....etc

    If our krebs solution in organ is 10 ml, I read paper it said you can not adding more than 0.5 ml , is eqaul to 10.5 ml

    If more than 0.5 all results become ERROR

    Can any one help me ?

    Olivier Pétrault · University of Lille Nord de France

    I'm agree with the last comment. Osmolarity is a crutial parameter ! Don't forget that ionic channels can be activated with osmolarity changes in particular with salt-based compounds ! In addition, very high concentrations ask us questions of the specificity of your molecule...

  • Perbinder Grewal added an answer:
    Any advice on the management of the asymptomatic aorta valve stenosis (Accent on the preoperative time)?

    How manage preoperative time of  the patients with asymptomatic significant aorta stenosis? Should patient wait for the surgery at home or at the hospital? What criteria for select (home, hospital)? The risk stratification of the sudden cardiac death of the asymptomatic AS patient? And what is your own opinion, practice of the management of the preoperative time?

    Thank you!

    Perbinder Grewal · Portsmouth Hospitals NHS Trust

    Hi Peter - I think he means aortic valve stenosis - funny thing is I thought the same as you unitl I was writing out a reply similar to yours - funny how we get clouded by our specialties!

  • M. Ricky Ramadhian added an answer:
    How to confirm vascular smooth muscle cell (VSMC) hypertrophy?
    Recently, we found a decrease in nuclei number and no change in smooth muscle alpha-actin protein expression in aorta of our experiment group. We think this may indicate VSMC hypertrophy. I want to ask whether there is a specific protein or signaling pathways that can verify VSMC hypertrophy in our samples ? I would appreciate any suggestions.
    M. Ricky Ramadhian · Lampung University

    maybe you can have cross section aorta with same level cutting  ex: abdominal aorta, you stain with Masson or HE or others satining protocol, and you measure ratio of thickness of tunica media and intima with lumen diameter

  • Mark Cobain added an answer:
    Is anyone aware of a paper describing a population wide estimation of CVD risk using risk scores?

    Estimation of CVD risk using a risk score such as Framingham, SCORE, ASSING, JBS is usually done for an individual. But has this ever been done on a population wide basis, i.e. average risk for CVD is x% in US using the Framingham Risk Score?

    Mark Cobain · Heart Age

    If you search for papers by Earl Ford you will find that analyses using NHANES to calculate CVD risk using FRS scores have been published for the US population. 

  • Tausif Alam added an answer:
    What is the underlying mechanism of low immunity in diabetics?

    Mechanism of reduced immunity in Diabetes Mellitus.

    Tausif Alam · University of Wisconsin–Madison

    You may want to elaborate on your query...

    There are several types of diabetes with distinct differences and "low immunity" in what context?

  • Paulo Eduardo Ocke Reis added an answer:
    Can anyone help me find information/guidelines for segmental pressure testing s/p bypass graft and stenting?

    Good day, I am reaching out to the research community in an effort to find information/guidelines for segmental pressure testing s/p bypass graft and stenting. If there are articles that you may know of on this subject I would appreciate your help.

    Jay Shafer

    Paulo Eduardo Ocke Reis · Universidade Federal Fluminense

    Dear James Shafer ,

    I hope this attached can help you!

    Best Regards,


  • Josef Veselka added an answer:
    What is the best imaging modality to detect and measure atherosclerotic plaque regression and stabilization?
    Noinvasive (US, CT, MRI) or Invasive (Angio, IVUS, OCT, Lipiscan, etc.)
    Josef Veselka · University Hospital Motol, 2nd Medical School, Charles University, Czech Republic

    Try to use NIRS-IVUS catheters. Near infrared spectroscopy is able to determine the amount of lipids in the plaque and brings another piece of information than more traditional metohods - OCT and plain IVUS.

  • Paulo Eduardo Ocke Reis added an answer:
    Can anyone help with a vascular closure system for a Dacron graft after thrombolytic therapy?
    I am planning a thrombolytic therapy for graft thrombosis of Aorto left femoral bypass (symptoms present for10 days). Do you have any experience with any of the vascular closure systems I can use for a previously placed Dacron graft?
    Paulo Eduardo Ocke Reis · Universidade Federal Fluminense

    Dear All,

    Do you have experience with Exoseal?

  • Panayot Tanchev added an answer:
    How frequently do you use novel anticoagulants in the treatment of venous thromboembolism?
    I am interested in your experience regarding VTE.
    Panayot Tanchev · Medical University of Sofia

    Dear Rivaroxaban fans, I can not imagine how patients with severe VTE, and especiially those with severe PE accompanied by hemodynamic failure and pulmonary hypertension would be treated with oral anticoagulants. Those patients need IC, intravenous (easily controlable) anticoagulants  or fibrinolysis. In elective cases with massive PE there are indications for pulmonary embolectomy in the conditions of cardio-pulmonary bypass. 

  • Pao Yen added an answer:
    Is it possible to decrease the heart rate by 20 bpm in 6 months?
    Starting from a 80 bpm, is it possible to decrease it to 60 in 6 months by performing both aerobic and anaerobic training?
    How long -if possible- would a person need to decrease it by 20 by performing only aerobic training?
    Pao Yen · University of California, Berkeley
    6 months is really too short even to change all the bad habits of a person since birth. Perhaps, you can explore one very risky thing - to modify the brain by powerful meditation. When I studied the effect of taichi on microcirculations in internal organs, I found that taichi healing (improvement of microcirculations) can happen simply by slowing down the movements until my brain thinks that I am not moving. There was no involvement of meditation and Qi or Ying/Yang kind of stuff. So, why many taichi masters followed Taoist teachings and learned the meditation type of Qigong (different from Qigong stretching exercises)? After much reading and logic deductions, I’ve concluded that this type of Qigong is to modify one’s brain cells to possess supernatural powers, e.g. raising body temperature, generating static charge or some other wave forms that they call it Qi (similar to electric eels), turning the brain into a large reception dish to see or hear things from other brains, or having illusions & vivid dreams (like seeing ghosts or out-of-body experience), etc. It is likely that they modify the brain by moving a microwave hot spot and do some soldering by trial and error, without any circuit diagram. After each attempt, a permanent damage will be made and cannot be undone. After many attempts, a brain tumor or many tumors may be found. If you are successful...and still sane, some of these supernatural powers have healing functions because they can raise heart rates (see attachment below). As I said, this is risky, and possibly deadly. I don’t know if you can find some brain surgeons to attest to it.
  • Asif Ahmed added an answer:
    What is the relationship between hydrogen sulfide and endothelial dysfunction?
    Or, how and by which mechanism can hydrogen sulfide modulate endothelial dysfunction?
    Asif Ahmed · Aston University
    Loss of eNOS activity is an established contributor to endothelial dysfunction. There is a dynamic competition between superoxide and lipid radicals for reaction with NO. NO only stimulates superoxide-dependent lipid oxidation when the production rate of NO is less than superoxide. H2S application augments NO bioavailability and signaling. A recent study showed that in eNOS phosphomutant mice H2S failed to rescue H2S-mediated cytoprotection.

    Endothelial dysfunction is a hallmark also of preeclampsia. Recently, it was shown that plasma H2S in preeclamptic women is reduced and in a pregnant mouse model loss of H2S leads to preeclampsia like condition.

    Thus the relationship between endothelial dysfunction and hydrogen sulfide exists and is also interdependent of eNOS.
  • Ismail Hassan Ibrahim added an answer:
    What is the risk of having hypertension(160/90) + gout(9)?
    What is the risk of having hypertension(160/90) + gout(9)?
    Ismail Hassan Ibrahim · King Fahd Military Medical Complex
    Uric acid is a known herald of hypertension...Treatment is indicated once being symptomatic/ problematic and/ or exceeding cut-off of 10mg/dl...Needless to reemphasize that both hyperuricemia and hypertension are independent cardiovascular risk factors and need to be rigorously attended to forestall adverse outcomes at an era of comorbidities and polypharmacy; a lot of confounders are difficult to pinpoint in the arena!!! Again, pros and cons of medications as well as personalization of overall management should be poised by the end of the day...
  • David Bunton added an answer:
    Does anyone know which research lab can perform the antidiabetic and vasodilation activity?
    Vasodilation activity is important for my synthesized heterocycles.
    David Bunton · Biopta Ltd.
    In our lab we can run this type of in vitro experiment in human blood vessels from both healthy patients and those with type 2 diabetes. Kind regards, David Bunton

About Vascular Medicine

Vascular medicine (angiology) is the medical specialty which studies the diseases of circulatory system and of the lymphatic system, i.e., arteries, veins and lymphatic vases, and its diseases.

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