Browsing by Author "D'Agata, Michele N."

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    Associations between noninvasive upper- and lower-limb vascular function assessments: extending the evidence to young women
    (Journal of Applied Physiology, 2022-10-01) D'Agata, Michele N.; Hoopes, Elissa K.; Witman, Melissa A.
    Brachial artery (BA) flow-mediated dilation (FMD) is a well-established measure of peripheral vascular function prognostic of future cardiovascular events. The vasodilatory response to FMD (FMD%) reflects upper-limb conduit artery function, whereas reactive hyperemia (RH) following cuff-occlusion release reflects upper-limb resistance artery function. Comparatively, passive leg movement (PLM) is a newer, increasingly utilized assessment of lower-limb resistance artery function. To increase its clinical utility, PLM-induced leg blood flow (LBF) responses have been compared with hemodynamic responses to FMD, but only in men. Therefore, the purpose of this study was to retrospectively compare LBF responses to FMD% and RH responses in women. We hypothesized that LBF responses would be positively associated with both FMD% and RH, but to a greater extent with RH. FMD and PLM were performed on 72 women (23 ± 4 yr). Arterial diameter and blood velocity were assessed using Doppler ultrasound. Pearson correlation coefficients were used to evaluate associations. Measures of resistance artery function were weakly positively associated: change in BA blood flow ΔBABF and ΔLBF (r = 0.33, P < 0.01), BABF area under the curve (BABF AUC) and LBF AUC (r = 0.33, P < 0.01), and BABFpeak and LBFpeak (r = 0.37, P < 0.01). However, FMD% was not associated with any index of PLM (all P > 0.30). In women, indices of resistance artery function in the upper- and lower limbs were positively associated. However, contrary to the previous work in men, upper-limb conduit artery function was not associated with lower-limb resistance artery function suggesting these assessments capture different aspects of vascular function and should not be used interchangeably in women. NEW & NOTEWORTHY: Upper- and lower-limb indices of resistance artery function are positively associated in young women when assessed by reactive hyperemia following brachial artery flow-mediated dilation (FMD) cuff-occlusion release and leg blood flow responses to passive leg movement (PLM), respectively. However, despite previous data demonstrating a positive association between upper-limb conduit artery function assessed by FMD and lower-limb resistance artery function assessed by PLM in young men, these measures do not appear to be related in young women.
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    Racial disparity in peripheral microvascular function assessed throughout the menstrual cycle
    (University of Delaware, 2020) D'Agata, Michele N.
    Vascular function is a non-traditional risk factor for cardiovascular disease (CVD) and is known to be attenuated in African Americans compared to Caucasian Americans. However, the vascular profile in young premenopausal African American women (AAW) has not been well elucidated. In premenopausal women, estrogen is cardioprotective and positively influences vascular function. Unfortunately, studies in AAW have either been restricted to the low estrogen phase of the menstrual cycle, or the menstrual cycle has not been controlled for altogether. Therefore, we evaluated peripheral microvascular function in healthy, premenopausal Caucasian women (CW) and AAW using passive leg movement (PLM) across three phases of the menstrual cycle; early follicular (EF), ovulation (OV), and mid-luteal (ML). We hypothesized that in both groups microvascular function would be augmented during the OV and ML phases compared to the EF phase, but would be attenuated in AAW compared to CW at all three menstrual phases. PLM was performed on 26 female participants not using hormonal contraceptives; 15 CW (23±1 years) and 11 AAW (24±2 years). In both groups, the overall change in leg blood flow (∆LBF) during PLM and the total hyperemic response to PLM, calculated as LBF area under the curve (AUC), were unchanged across the menstrual cycle phase (P=0.53 and P=0.46 respectively). There was a significant effect of race for ∆LBF (ANOVA P=0.03), as AAW were attenuated compared to CW during the EF and OV phases; EF (CW: 405±63, AAW: 218±40 ml/min) and OV (CW: 480±85, AAW: 223±55 ml/min). AAW also had significantly lower LBF AUC (ANOVA P=0.05) during the OV phase (CW: 138±32, AAW: 60±25 ml). These data imply that within CW and AAW, peripheral microvascular function is unchanged across the menstrual cycle, however a racial disparity is apparent during both the EF and OV phases. ☐ Key words: racial disparity, premenopausal women, menstrual cycle, estrogen, peripheral microvascular function, passive leg movement
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    Sleep Variability, Eating Timing Variability, and Carotid Intima‐Media Thickness in Early Adulthood
    (Journal of the American Heart Association Cardiovascular and Cerebrovascular Disease, 2023-10-03) Hoopes, Elissa K.; Witman, Melissa A.; D'Agata, Michele N.; Brewer, Benjamin; Edwards, David G.; Robson, Shannon M.; Malone, Susan K.; Keiser, Thomas; Patterson, Freda
    Background Day‐to‐day variability in sleep patterns and eating timing may disrupt circadian rhythms and has been linked with various adverse cardiometabolic outcomes. However, the extent to which variability in sleep patterns and eating timing relate to atherosclerotic development in subclinical stages remains unclear. Methods and Results Generally healthy adults (N=62, 29.3±7.3 years, 66% female) completed 14 days of sleep and dietary assessments via wrist accelerometry and photo‐assisted diet records, respectively. Variability in sleep duration, sleep onset, eating onset (time of first caloric consumption), eating offset (time of last caloric consumption), and caloric midpoint (time at which 50% of total daily calories are consumed) were operationalized as the SD across 14 days for each variable. Separate regression models evaluated the cross‐sectional associations between sleep and eating variability metrics with end‐diastolic carotid intima‐media thickness (CIMT) measured via ultrasonography. Models adjusted for age, sex, systolic blood pressure, sleep duration, and total energy intake. Each 60‐minute increase in sleep duration SD and sleep onset SD were associated with a 0.049±0.016 mm (P=0.003) and 0.048±0.017 mm (P=0.007) greater CIMT, respectively. Variability in eating onset and offset were not associated with CIMT; however, each 60‐minute increase in caloric midpoint SD was associated with a 0.033±0.015 mm greater CIMT (P=0.029). Exploratory post hoc analyses suggested that sleep duration SD and sleep onset SD were stronger correlates of CIMT than caloric midpoint SD. Conclusions Variability in sleep patterns and eating timing are positively associated with clinically relevant increases in CIMT, a biomarker of subclinical atherosclerosis, in early adulthood.