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Tsotsios M, Katsargyris A, Moulakakis KG, Oikonomou E, Tsigkou V, Hasemaki N, Siasos G, Klonaris C. An Updated Review on Arterial Stiffness Measurement Techniques and Arterial Stiffness Alterations After Aortic Aneurysm Repair. Ann Vasc Surg 2025; 111:299-309. [PMID: 39622337 DOI: 10.1016/j.avsg.2024.11.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2024] [Revised: 10/27/2024] [Accepted: 11/11/2024] [Indexed: 12/21/2024]
Abstract
BACKGROUND Studies over the last years have revealed the possible impact of endovascular repair of abdominal or thoracic aortic aneurysms on the arterial stiffness and secondary on the cardiac function and the central hemodynamics. METHODS A literature search was conducted to collect data on current methods of arterial stiffness assessment and the induced changes in arterial stiffness after endovascular or open surgical repair of abdominal or thoracic aortic aneurysms. RESULTS Seventeen studies were analyzed. In most of these studies, arterial stiffness, either assessed by pulse wave velocity or augmentation index, was found to be increased after aortic aneurysm repair. Factors that increase arterial stiffness seem to be endovascular repair of the aneurysm and the proximity of the stent graft to the heart. The clinical implications of increased arterial stiffness are left ventricular hypertrophy, coronary arteries malperfusion and potential end-organ damage. CONCLUSIONS Both endovascular and open aortic aneurysm repair can alter arterial stiffness, with endovascular repair having a greater effect. Future research is essential, particularly in exploring the impact of aortic aneurysm repair methods on vital organs and cardiac function. Extended follow-up studies are proposed to gain a better understanding of the long-term cardiovascular consequences of both endovascular and open surgical repair outcomes.
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Affiliation(s)
- Michail Tsotsios
- 2nd Department of Vascular Surgery, Laiko General Hospital of Athens, National and Kapodistrian University of Athens Medical School, Athens, Greece
| | - Athanasios Katsargyris
- 2nd Department of Vascular Surgery, Laiko General Hospital of Athens, National and Kapodistrian University of Athens Medical School, Athens, Greece.
| | - Konstantinos G Moulakakis
- 1st Department of Vascular Surgery, Attikon University Hospital, National and Kapodistrian University of Athens Medical School, Athens, Greece
| | - Evangelos Oikonomou
- 3rd Department of Cardiology, Sotiria Chest Disease Hospital, National and Kapodistrian University of Athens Medical School, Athens, Greece
| | - Vasiliki Tsigkou
- 3rd Department of Cardiology, Sotiria Chest Disease Hospital, National and Kapodistrian University of Athens Medical School, Athens, Greece
| | - Natasha Hasemaki
- 2nd Department of Vascular Surgery, Laiko General Hospital of Athens, National and Kapodistrian University of Athens Medical School, Athens, Greece
| | - Gerasimos Siasos
- 3rd Department of Cardiology, Sotiria Chest Disease Hospital, National and Kapodistrian University of Athens Medical School, Athens, Greece
| | - Chris Klonaris
- 2nd Department of Vascular Surgery, Laiko General Hospital of Athens, National and Kapodistrian University of Athens Medical School, Athens, Greece
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Alsomali A, Lip GYH, Akhtar R, Field M, Grillo A, Tidbury N, Leo D, Proietti R. Associations between central and brachial blood pressure in patients with hypertension and aortovascular disease: Implications for clinical practice. Curr Probl Cardiol 2025; 50:102874. [PMID: 39369773 DOI: 10.1016/j.cpcardiol.2024.102874] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2024] [Accepted: 10/03/2024] [Indexed: 10/08/2024]
Abstract
Central blood pressure (CBP) measurements, compared to brachial blood pressure (bBP), offer a superior predictive accuracy for aortovascular disease outcomes. This emphasises the distinctiveness of central hemodynamic metrics such as CBP, measuring the pressure directly exerted from the cardiac muscle to the major arteries, and provides a more direct assessment of cardiovascular workload than bBP, which measures the pressure against peripheral artery walls. This review synthesises findings evaluating the correlation between CBP and key aortovascular disease markers. Thoracic aortic aneurysm (TAA) growth is a crucial aspect of aortovascular assessment. CBP more accurately correlates with arterial stiffness (AS), the growth of TAA, and cardiovascular diseases, offering a more dependable prediction of aortovascular diseases, adverse cardiovascular events (CVE) and organ damage compared to bBP. The incorporation of CBP into routine clinical practice could enhance aortovascular assessments and therapeutic strategies when compared to bBP, particularly through a deeper understanding of aortic wave dynamics, which could fundamentally alter aortovascular diagnostics and treatment. In conclusion, integrating CBP into aortovascular and cardiovascular risk management is encouraged. Further research is necessary to substantiate these aspects and explore the operative implications of CBP in clinical settings.
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Affiliation(s)
- Abdulghafoor Alsomali
- Department of Cardiovascular and Metabolic Medicine, Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, UK; Liverpool Centre for Cardiovascular Science at the University of Liverpool, Liverpool John Moores University and Liverpool Heart & Chest Hospital, Liverpool, UK; Department of Emergency Medical Services, Applied Medical Sciences College, Najran University, Saudi Arabia
| | - Gregory Y H Lip
- Department of Cardiovascular and Metabolic Medicine, Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, UK; Liverpool Centre for Cardiovascular Science at the University of Liverpool, Liverpool John Moores University and Liverpool Heart & Chest Hospital, Liverpool, UK; Danish Centre for Health Services Research, Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Riaz Akhtar
- Liverpool Centre for Cardiovascular Science at the University of Liverpool, Liverpool John Moores University and Liverpool Heart & Chest Hospital, Liverpool, UK; Material design and manufacturing engineering, School of Engineering, University of Liverpool, UK
| | - Mark Field
- Liverpool Centre for Cardiovascular Science at the University of Liverpool, Liverpool John Moores University and Liverpool Heart & Chest Hospital, Liverpool, UK
| | - Andrea Grillo
- Department of Medicine, Surgery and Health Sciences, University of Trieste, Trieste, Italy
| | - Nicola Tidbury
- Department of Cardiovascular and Metabolic Medicine, Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, UK; Liverpool Centre for Cardiovascular Science at the University of Liverpool, Liverpool John Moores University and Liverpool Heart & Chest Hospital, Liverpool, UK
| | - Donato Leo
- Department of Cardiovascular and Metabolic Medicine, Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, UK; Liverpool Centre for Cardiovascular Science at the University of Liverpool, Liverpool John Moores University and Liverpool Heart & Chest Hospital, Liverpool, UK
| | - Riccardo Proietti
- Department of Cardiovascular and Metabolic Medicine, Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, UK; Liverpool Centre for Cardiovascular Science at the University of Liverpool, Liverpool John Moores University and Liverpool Heart & Chest Hospital, Liverpool, UK.
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Yilmaz G, Ong JL, Ling LH, Chee MWL. Insights into vascular physiology from sleep photoplethysmography. Sleep 2023; 46:zsad172. [PMID: 37379483 PMCID: PMC10566244 DOI: 10.1093/sleep/zsad172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Revised: 05/19/2023] [Indexed: 06/30/2023] Open
Abstract
STUDY OBJECTIVES Photoplethysmography (PPG) in consumer sleep trackers is now widely available and used to assess heart rate variability (HRV) for sleep staging. However, PPG waveform changes during sleep can also inform about vascular elasticity in healthy persons who constitute a majority of users. To assess its potential value, we traced the evolution of PPG pulse waveform during sleep alongside measurements of HRV and blood pressure (BP). METHODS Seventy-eight healthy adults (50% male, median [IQR range] age: 29.5 [23.0, 43.8]) underwent overnight polysomnography (PSG) with fingertip PPG, ambulatory blood pressure monitoring, and electrocardiography (ECG). Selected PPG features that reflect arterial stiffness: systolic to diastolic distance (∆T_norm), normalized rising slope (Rslope) and normalized reflection index (RI) were derived using a custom-built algorithm. Pulse arrival time (PAT) was calculated using ECG and PPG signals. The effect of sleep stage on these measures of arterial elasticity and how this pattern of sleep stage evolution differed with participant age were investigated. RESULTS BP, heart rate (HR) and PAT were reduced with deeper non-REM sleep but these changes were unaffected by the age range tested. After adjusting for lowered HR, ∆T_norm, Rslope, and RI showed significant effects of sleep stage, whereby deeper sleep was associated with lower arterial stiffness. Age was significantly correlated with the amount of sleep-related change in ∆T_norm, Rslope, and RI, and remained a significant predictor of RI after adjustment for sex, body mass index, office BP, and sleep efficiency. CONCLUSIONS The current findings indicate that the magnitude of sleep-related change in PPG waveform can provide useful information about vascular elasticity and age effects on this in healthy adults.
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Affiliation(s)
- Gizem Yilmaz
- Centre for Sleep and Cognition, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Ju Lynn Ong
- Centre for Sleep and Cognition, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Lieng-Hsi Ling
- Department of Cardiology, National University Heart Centre, National University Health System, Singapore and
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Michael W L Chee
- Centre for Sleep and Cognition, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
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Jin L, Chen J, Zhang M, Sha L, Cao M, Tong L, Chen Q, Shen C, Du L, Li Z, Liu L. Relationship of Arterial Stiffness and Central Hemodynamics With Cardiovascular Risk In Hypertension. Am J Hypertens 2023; 36:201-208. [PMID: 36645322 DOI: 10.1093/ajh/hpad005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 01/03/2023] [Accepted: 01/14/2023] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND Hypertension is becoming a serious public health problem and noninvasive estimation of central hemodynamics and artery stiffness have been identified as important predictors of cardiovascular disease. METHODS The study included 4,311 participants, both sex and aged between 20 and 79 years. Arterial velocity pulse index, arterial pressure-volume index (AVI, API, and the index of artery stiffness), central systolic blood pressure, central artery pulse pressure (CSBP, CAPP, and estimated via oscillometric blood pressure monitor), and 10-year risk score of cardiovascular disease in China (China-PAR) and Framingham cardiovascular risk score (FCVRS) were assessed at baseline. Regression model was performed to identify factors associated with high cardiovascular disease risk stratification. The relationships between CSBP, CAPP and China-PAR, and FCVRS were analyzed by restrictive cubic spline functions. RESULTS The uncontrolled hypertension group showed the highest values of AVI, API, CSBP, and CAPP. In the regression analysis, CAPP and hypertension subtypes were identified as significant predictors of high cardiovascular risk stratification, and CAPP was strongly correlated with API in this cohort. Finally, CSBP and CAPP showed significant J-shaped relationships with China-PAR and FCVRS. CONCLUSIONS Subjects with uncontrolled hypertension present with elevated values of CAPP, CSBP, API, AVI, China-PAR, and FCVRS scores. CAPP was independently associated with high cardiovascular risk stratification, and there was a significant J-shaped relationship with China-PAR and FCVRS that may identify people with higher cardiovascular risk.
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Affiliation(s)
- Lin Jin
- Department of Ultrasound, First Hospital of Shanxi Medical University, Taiyuan 030001, China
| | - Jianxiong Chen
- Department of Ultrasound, Mindong Hospital Affiliated to Fujian Medical University, Ningde 355000, China
| | - Mengjiao Zhang
- Department of Medical Imaging, Weifang Medical University, Weifang 261053, China
| | - Lei Sha
- Department of Ultrasound, Jiading Branch of Shanghai General Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 201812, China
| | - Mengmeng Cao
- Department of Ultrasound, Jiading Branch of Shanghai General Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 201812, China
| | - Lanyue Tong
- Department of Ultrasound, Jiading Branch of Shanghai General Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 201812, China
| | - Qingqing Chen
- Department of Ultrasound, Jiading Branch of Shanghai General Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 201812, China
| | - Cuiqin Shen
- Department of Ultrasound, Jiading Branch of Shanghai General Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 201812, China
| | - Lianfang Du
- Department of Ultrasound, Shanghai General Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200080, China
| | - Zhaojun Li
- Department of Ultrasound, Jiading Branch of Shanghai General Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 201812, China.,Department of Ultrasound, Shanghai General Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200080, China
| | - Liping Liu
- Department of Ultrasound, First Hospital of Shanxi Medical University, Taiyuan 030001, China
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Helleputte S, Spronck B, Sharman JE, Van Bortel L, Segers P, Calders P, Lapauw B, De Backer T. Central blood pressure estimation in type 1 diabetes: impact and implications of peripheral calibration method. J Hypertens 2023; 41:115-121. [PMID: 36214535 DOI: 10.1097/hjh.0000000000003308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
OBJECTIVE Peripheral blood pressure (BP) waveforms are used for noninvasive central BP estimation. Central BP could assist in cardiovascular risk assessment in patients with type 1 diabetes mellitus (T1DM). However, correct calibration of peripheral BP waveforms is important to accurately estimate central BP. We examined differences in central BP estimated by radial artery tonometry depending on which brachial BP (SBP/DBP vs. MAP/DBP) is used for calibration of the radial waveforms, for the first time in T1DM. METHODS A cross-sectional study in T1DM patients without known cardiovascular disease. Radial artery BP waveforms were acquired using applanation tonometry ( SphygmoCor ) for the estimation of central SBP, central pulse pressure (PP) and central augmentation pressure, using either brachial SBP/DBP or MAP/DBP for the calibration of the radial pressure waveforms. RESULTS Fifty-four patients (age: 46 ± 9.5 years; T1DM duration: 27 ± 8.8 years) were evaluated. Central BP parameters were significantly higher when brachial MAP/DBP-calibration was used compared with brachial SBP/DBP-calibration (7.5 ± 5.04, 7.5 ± 5.04 and 1.5 ± 1.36 mmHg higher central SBP, central PP and central augmentation pressure, respectively, P < 0.001). CONCLUSION In patients with T1DM, there are significant differences in central BP values estimated with radial artery tonometry, depending on the method used for calibration of the radial waveforms. Brachial MAP/DBP-calibration resulted in consistently higher central BP as compared to using brachial SBP/DBP, leading to patient re-stratification. Hence, the accuracy of noninvasive estimation of central BP by radial tonometry is dependent on calibration approach, and this problem must be resolved in validation studies using an invasive reference standard to determine which method best estimates true central BP.
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Affiliation(s)
- Simon Helleputte
- Faculty of Medicine and Health Sciences, Ghent University, Ghent
- Fonds Wetenschappelijk Onderzoek (FWO) Vlaanderen, Brussels, Belgium
| | - Bart Spronck
- Department of Biomedical Engineering, CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, The Netherlands
| | - James E Sharman
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - Luc Van Bortel
- Unit of Clinical Pharmacology, Department of Basic and Applied Medical Sciences
| | | | - Patrick Calders
- Faculty of Medicine and Health Sciences, Ghent University, Ghent
| | - Bruno Lapauw
- Faculty of Medicine and Health Sciences, Ghent University, Ghent
- Department of Endocrinology
| | - Tine De Backer
- Faculty of Medicine and Health Sciences, Ghent University, Ghent
- Unit of Clinical Pharmacology, Department of Basic and Applied Medical Sciences
- Department of Cardiology, Ghent University Hospital, Ghent, Belgium
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Dimitroulas T, Anyfanti P, Bekiari E, Angeloudi E, Pagkopoulou E, Kitas G. Arterial stiffness in rheumatoid arthritis: Current knowledge and future perspectivess. INDIAN JOURNAL OF RHEUMATOLOGY 2022. [DOI: 10.4103/injr.injr_254_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Koskela JK, Vääräniemi K, Tahvanainen AMH, Mustonen J, Mäkelä S, Tikkakoski AJ, Pörsti I. Disparate Information Provided by Pulse Wave Velocity versus Other Measures of Aortic Compliance in End-Stage Renal Disease. Nephron Clin Pract 2021; 146:11-21. [PMID: 34515178 DOI: 10.1159/000518174] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Accepted: 06/15/2021] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Unfavorable changes in cardiac and arterial function are related to poor prognosis in chronic kidney disease (CKD). We compared hemodynamic profiles between subjects with end-stage renal disease and 2 control groups with corresponding pulse wave velocities (PWVs). METHODS Noninvasive hemodynamics were recorded during passive head-up tilt in CKD stage 5 patients (n = 35), patients with primary hypertension (n = 35, n = 30 with antihypertensive medications), and subjects without cardiovascular or renal diseases and cardiovascular medications (n = 70). The groups were selected to have corresponding age, sex, body mass index, and PWV. Hemodynamic data were captured using whole-body impedance cardiography and radial tonometric pulse wave analysis. RESULTS Supine blood pressure did not differ between the groups, but upright diastolic blood pressure was lower in CKD patients than in the 2 control groups (p ≤ 0.001 for both, RANOVA). Despite similar PWV, supine aortic pulse pressure was higher in CKD patients versus nonmedicated subjects (p = 0.029). Two additional measures indicated reduced aortic compliance in CKD patients versus both control groups: lower ratio of stroke index to aortic pulse pressure (p ≤ 0.023) and higher aortic characteristic impedance (p ≤ 0.003). The subendocardial viability ratio was lower in the CKD group than in both control groups (p ≤ 0.039). CONCLUSION In the absence of differences in PWV, higher aortic pulse pressure and characteristic impedance, and lower ratio of stroke index to aortic pulse pressure, suggest reduced aortic compliance and impaired left ventricular function in CKD patients. A lower subendocardial viability ratio predisposes the CKD patients to impaired cardiac oxygen supply versus hypertensive patients and nonmedicated controls.
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Affiliation(s)
- Jenni Kaarina Koskela
- Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland.,Department of Internal Medicine, Tampere University Hospital, Tampere, Finland
| | - Kati Vääräniemi
- Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland.,Department of Internal Medicine, Central Hospital of Central Finland, Jyväskylä, Finland
| | - Anna Mari Helena Tahvanainen
- Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland.,Heart Hospital, Tampere University Hospital, Tampere, Finland
| | - Jukka Mustonen
- Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland.,Department of Internal Medicine, Tampere University Hospital, Tampere, Finland
| | - Satu Mäkelä
- Department of Internal Medicine, Tampere University Hospital, Tampere, Finland
| | - Antti Johannes Tikkakoski
- Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland.,Department of Clinical Physiology and Nuclear Medicine, Tampere University Hospital, Tampere, Finland
| | - Ilkka Pörsti
- Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland.,Department of Internal Medicine, Tampere University Hospital, Tampere, Finland
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Terentes-Printzios D, Gardikioti V, Vlachopoulos C. Central Over Peripheral Blood Pressure: An Emerging Issue in Hypertension Research. Heart Lung Circ 2021; 30:1667-1674. [PMID: 34426073 DOI: 10.1016/j.hlc.2021.07.019] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Revised: 06/13/2021] [Accepted: 07/13/2021] [Indexed: 01/09/2023]
Abstract
Measurement of blood pressure is one of the most important and powerful clinical tools in clinical practice. Physicians use the classical method that was introduced more than 100 years ago with the emergence of the brachial cuff sphygmomanometer. The use of this method, despite its initial setbacks, spread like fire throughout the medical community with the boost by the early adoption by insurance companies to assess risk as well as the ease of use, the availability with the wide variety of devices, the good reproducibility and its predictive role. However, a long-forgotten dispute between measurements of peripheral (brachial) and central (aortic, carotid) blood pressure has resurfaced after the introduction of techniques and devices that can easily and accurately estimate non-invasively the central pressure waveform. Clinicians, until recently, focussed only on the pressure waveform trough (diastole) and peak (systole), ignoring the possible information provided by the rest of the arterial pressure waveform. Several restrictions exist with peripheral blood pressures measured with either an oscillometric or a sphygmomanometer device that blur the existing image of the ideal biomarker to describe the haemodynamic characteristics of the cardiovascular system. On the other hand, central pressures seem to be more pathophysiologically relevant to end-organ damage of the brain, heart and kidneys and on future events. Furthermore, measurement of the central waveform can provide clinically useful information, like the quantification of wave reflections with augmentation index, beyond blood pressure measured in the brachial artery. This article will explain the pathophysiological mechanisms linking central pressures to cardiovascular outcomes, review the evidence for the use of central blood pressure over peripheral pressures, elaborate on the prognostic role of central blood pressures and finally review the latest developments on the pharmacological modulation of central blood pressures.
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Affiliation(s)
- Dimitrios Terentes-Printzios
- First Department of Cardiology, Hippokration Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece.
| | - Vasiliki Gardikioti
- First Department of Cardiology, Hippokration Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Charalambos Vlachopoulos
- First Department of Cardiology, Hippokration Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
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Cindro PV, Krnić M, Modun D, Smajić B, Vuković J. The differences between insulin glargine U300 and insulin degludec U100 in impact on the glycaemic variability, arterial stiffness and the lipid profiles in insulin naïve patients suffering from type two diabetes mellitus - outcomes from cross-over open-label randomized trial. BMC Endocr Disord 2021; 21:86. [PMID: 33926446 PMCID: PMC8082786 DOI: 10.1186/s12902-021-00746-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Accepted: 04/12/2021] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND AND AIMS Diabetes mellitus type two is one of the major cardiovascular risk factors. Treatment of diabetes can reduce this risk, but the treatment options differ a lot in their risk-reducing capabilities. We compared the impact of insulin degludec (IDeg-100) and insulin glargine U300 (IGlar-300) on cardiovascular risk parameters - glycaemic variability (GV), arterial stiffness and lipid parameters - in insulin naive patients with DMT2. METHODS To 23 individuals who previously had uncontrolled DMT2 on two or more oral antidiabetic drugs, IGlar-300 and IDeg-100 were applied for 12 weeks and then switched in a cross over design manner. Prior and after of each insulin phase, we analysed biochemical parameters,7-point SMBG profile over three days and arterial stiffness which was assessed indirectly by measuring the augmentation index (AIx) on the principles of applanation tonometry. RESULTS There were no significant differences between IGlar-300 and IDeg-100 regarding reduction of mean glucose values and coefficient of variation (CV). Both insulins insignificantly reduced AIx for standardised pulse of 75 beats/min and without differences between them. IGlar-300 and IDeg-100 reduced triglycerides and increased HDL with no significant difference between the two insulins. IGlar-300 increased the total cholesterol level and IDeg-100 decreased total cholesterol, but without statistically significant difference. IGlar-300 increased LDL level by 0.508 mmol/L and IDeg-100 decreased LDL by 0.217 mmol/L, with statistically significant difference (p = 0.0215). CONCLUSIONS This study did not show significant difference between IGlar-300 and IDeg-100 regarding glycaemic parameters and augmentation index using the same dose of 0.2 IU/kg for both insulins, but it has revealed possible differences in impact on lipid profile. TRIAL REGISTRATION Clinicaltrials.gov, NCT04692415 . Retrospectively registered on December 31th 2020.
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Affiliation(s)
- Pavle Vrebalov Cindro
- Department of Gastroenterology, University Hospital Split, Spinčićeva 1, 21000, Split, Croatia
| | - Mladen Krnić
- Department of Endocrinology, University Hospital Split, Šoltanska 1, 21000, Split, Croatia.
- Department of Pathophysiology, University of Split School of Medicine, Šoltanska 2, 21000, Split, Croatia.
| | - Darko Modun
- Department of Pharmacy, University of Split School of Medicine, Šoltanska 2, 21000, Split, Croatia
| | - Božo Smajić
- Medical Student, University of Split School of Medicine, Šoltanska 2, 21000, Split, Croatia
| | - Jonatan Vuković
- Department of Gastroenterology, University Hospital Split, Spinčićeva 1, 21000, Split, Croatia
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Characterization of Rat Cardiovascular System by Anacrotic/Dicrotic Notches in the Condition of Increase/Decrease of NO Bioavailability. Int J Mol Sci 2020; 21:ijms21186685. [PMID: 32932738 PMCID: PMC7555952 DOI: 10.3390/ijms21186685] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Revised: 09/08/2020] [Accepted: 09/10/2020] [Indexed: 02/07/2023] Open
Abstract
We characterized modes of action of NO-donor S-nitrosoglutathione (GSNO) and NO-synthase inhibitor l-NAME derived from dicrotic (DiN) and anacrotic (AnN) notches of rat arterial pulse waveform (APW) in the condition of increased/decreased NO bioavailability. The cross-relationship patterns of DiN and AnN with 34 hemodynamic parameters (HPs) induced by GSNO and l-NAME are presented. After GSNO bolus administration, approximate non-hysteresis relationships were observed in the difference between DiN-AnN (mmHg) blood pressure (BP) and other 19 HPs, suggesting that these HPs, i.e., their signaling pathways, responding to NO concentration, are directly connected. Hysteresis relationships were observed between DiN-AnN (mmHg) and other 14 HPs, suggesting that signaling pathways of these HPs are indirectly connected. The hysteresis relationships were only observed between the time interval DiN-AnN (ms) and other 34 HPs, indicating no direct connection of signaling pathways. The cross-relationship patterns of DiN-AnN (mmHg), but not DiN-AnN (ms), induced by l-NAME were in accordance to the increased NO bioavailability induced by GSNO. In conclusion, we found the non-hysteresis/hysteresis cross-relationship "patterns" of DiN-AnN intervals to other HPs in the presence of GSNO that revealed their direct or indirect signaling pathways connections. This may contribute to our understanding of biological effects of natural substances that modulate NO production and/or NO signaling pathways.
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Kurakova L, Misak A, Tomasova L, Cacanyiova S, Berenyiova A, Ondriasova E, Balis P, Grman M, Ondrias K. Mathematical relationships of patterns of 35 rat haemodynamic parameters for conditions of hypertension resulting from decreased nitric oxide bioavailability. Exp Physiol 2020; 105:312-334. [PMID: 31769908 DOI: 10.1113/ep088148] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
NEW FINDINGS What is the central question of this study? Can the cross-relationship between 35 rat arterial pulse waveform (APW) parameters be described by known mathematical functions and can mathematical parameters be obtained for conditions in a model of hypertension resulting from decreased NO bioavailability? What is the main finding and its importance? Mathematical functions and their parameters were obtained that approximate the cross-relationships of 35 APW parameters to systolic blood pressure and to the augmentation index in conditions of decreased NO bioavailability. The results enable APW parameters to be assigned to decreased NO bioavailability, which may have predictive or diagnostic value. ABSTRACT Information obtained from the arterial pulse waveform (APW) using haemodynamic parameters (HPs) is useful for characterization of the cardiovascular system in particular (patho)physiological conditions. Our goal was to find out whether the relationships between rat HPs could be described by simple mathematical functions and to find mathematical parameters for conditions of high blood pressure (BP) resulting from decreased NO bioavailability. The right jugular vein of anaesthetized Wistar rats was cannulated for i.v. administration of Nω -nitro-l-arginine methyl ester (l-NAME). The left common carotid artery was cannulated to detect the APW. From 10 points on the rat APW we defined 35 HPs (some were known already) and found 595 cross-relationships between HPs showing unique patterns for particular cardiovascular conditions. Here we show parallel time-dependent changes of 35 HPs and some of their cross-relationships in condition of high BP induced by l-NAME. We found that most of the time-dependent changes of 35 HPs and their relationships were very well fitted by simple mathematical functions, e.g. a linear function, exponential growth, exponential decay or exponential rise to maximum. The results may enable the mathematical functions to be assigned for decreased NO bioavailability, which may have predictive or diagnostic value for conditions of high BP. Using this approach, it may be possible to find unique cross-relationship patterns of HPs and mathematical functions between HPs for different cardiovascular (patho)physiological or drug-modulating conditions. This knowledge can be used in studying the molecular mechanisms of particular (patho)physiological conditions or drug actions and may have predictive or diagnostic value.
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Affiliation(s)
- Lucia Kurakova
- Faculty of Pharmacy, Comenius University, Bratislava, Slovak Republic.,Institute of Clinical and Translational Research, Biomedical Research Center, Slovak Academy of Sciences, Bratislava, Slovak Republic
| | - Anton Misak
- Institute of Clinical and Translational Research, Biomedical Research Center, Slovak Academy of Sciences, Bratislava, Slovak Republic
| | - Lenka Tomasova
- Institute of Clinical and Translational Research, Biomedical Research Center, Slovak Academy of Sciences, Bratislava, Slovak Republic
| | - Sona Cacanyiova
- Institute of Normal and Pathological Physiology, Centre of Experimental Medicine, Slovak Academy of Sciences, Bratislava, Slovak Republic
| | - Andrea Berenyiova
- Institute of Normal and Pathological Physiology, Centre of Experimental Medicine, Slovak Academy of Sciences, Bratislava, Slovak Republic
| | - Elena Ondriasova
- Faculty of Pharmacy, Comenius University, Bratislava, Slovak Republic
| | - Peter Balis
- Institute of Normal and Pathological Physiology, Centre of Experimental Medicine, Slovak Academy of Sciences, Bratislava, Slovak Republic
| | - Marian Grman
- Institute of Clinical and Translational Research, Biomedical Research Center, Slovak Academy of Sciences, Bratislava, Slovak Republic
| | - Karol Ondrias
- Institute of Clinical and Translational Research, Biomedical Research Center, Slovak Academy of Sciences, Bratislava, Slovak Republic
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12
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Papaioannou TG, Thymis J, Benas D, Triantafyllidi H, Kostelli G, Pavlidis G, Kousathana F, Katogiannis K, Vlastos D, Lambadiari V, Papadavid E, Parissis J, Tousoulis D, Ikonomidis I. Measurement of central augmentation index by three different methods and techniques: Agreement among Arteriograph, Complior, and Mobil‐O‐Graph devices. J Clin Hypertens (Greenwich) 2019; 21:1386-1392. [PMID: 31465154 DOI: 10.1111/jch.13654] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2019] [Revised: 07/10/2019] [Accepted: 07/17/2019] [Indexed: 12/01/2022]
Affiliation(s)
- Theodore G. Papaioannou
- Medical School, 1st and 2nd Department of Cardiology, 2nd Department of Internal Medicine National and Kapodistrian University of Athens Athens Greece
| | - John Thymis
- Medical School, 1st and 2nd Department of Cardiology, 2nd Department of Internal Medicine National and Kapodistrian University of Athens Athens Greece
| | - Dimitrios Benas
- Medical School, 1st and 2nd Department of Cardiology, 2nd Department of Internal Medicine National and Kapodistrian University of Athens Athens Greece
| | - Helen Triantafyllidi
- Medical School, 1st and 2nd Department of Cardiology, 2nd Department of Internal Medicine National and Kapodistrian University of Athens Athens Greece
| | - Gavriela Kostelli
- Medical School, 1st and 2nd Department of Cardiology, 2nd Department of Internal Medicine National and Kapodistrian University of Athens Athens Greece
| | - George Pavlidis
- Medical School, 1st and 2nd Department of Cardiology, 2nd Department of Internal Medicine National and Kapodistrian University of Athens Athens Greece
| | - Fotini Kousathana
- Medical School, 1st and 2nd Department of Cardiology, 2nd Department of Internal Medicine National and Kapodistrian University of Athens Athens Greece
| | - Kostantinos Katogiannis
- Medical School, 1st and 2nd Department of Cardiology, 2nd Department of Internal Medicine National and Kapodistrian University of Athens Athens Greece
| | - Dimitrios Vlastos
- Medical School, 1st and 2nd Department of Cardiology, 2nd Department of Internal Medicine National and Kapodistrian University of Athens Athens Greece
| | - Vaia Lambadiari
- Medical School, 1st and 2nd Department of Cardiology, 2nd Department of Internal Medicine National and Kapodistrian University of Athens Athens Greece
| | - Evangelia Papadavid
- Medical School, 1st and 2nd Department of Cardiology, 2nd Department of Internal Medicine National and Kapodistrian University of Athens Athens Greece
| | - John Parissis
- Medical School, 1st and 2nd Department of Cardiology, 2nd Department of Internal Medicine National and Kapodistrian University of Athens Athens Greece
| | - Dimitrios Tousoulis
- Medical School, 1st and 2nd Department of Cardiology, 2nd Department of Internal Medicine National and Kapodistrian University of Athens Athens Greece
| | - Ignatios Ikonomidis
- Medical School, 1st and 2nd Department of Cardiology, 2nd Department of Internal Medicine National and Kapodistrian University of Athens Athens Greece
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13
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Zhou S, Ogihara A, Nishimura S, Jin Q. Analysis of health changes and the association of health indicators in the elderly using TCM pulse diagnosis assisted with ICT devices: A time series study. Eur J Integr Med 2019. [DOI: 10.1016/j.eujim.2019.02.010] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
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14
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Jensen MT. Resting heart rate and relation to disease and longevity: past, present and future. Scandinavian Journal of Clinical and Laboratory Investigation 2019; 79:108-116. [PMID: 30761923 DOI: 10.1080/00365513.2019.1566567] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Assessment of heart rate has been used for millennia as a marker of health. Several studies have indicated that low resting heart rate (RHR) is associated with health and longevity, and conversely, a high resting heart to be associated with disease and adverse events. Longitudinal studies have shown a clear association between increase in heart rate over time and adverse events. RHR is a fundamental clinical characteristic and several trials have assessed the effectiveness of heart rate lowering medication, for instance beta-blockers and selective sinus node inhibition. Advances in technology have provided new insights into genetic factors related to RHR as well as insights into whether elevated RHR is a risk factor or risk marker. Recent animal research has suggested that heart rate lowering with sinus node inhibition is associated with increased lifespan. Furthermore, genome-wide association studies in the general population using Mendelian randomization have demonstrated a causal link between heart rate at rest and longevity. Furthermore, the development in personal digital devices such as mobile phones, fitness trackers and eHealth applications has made heart rate information and knowledge in this field as important as ever for the public as well as the clinicians. It should therefore be expected that clinicians and health care providers will be met by relevant questions and need of advice regarding heart rate information from patients and the public. The present review provides an overview of the current knowledge in the field of heart rate and health.
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Affiliation(s)
- Magnus T Jensen
- a Department of Cardiology , Rigshospitalet , Copenhagen, Denmark.,b Department of Cardiology , Herlev-Gentofte Hospital , Hellerup , Denmark
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15
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Szucs B, Petrekanits M, Varga J. Effectiveness of a 4-week rehabilitation program on endothelial function, blood vessel elasticity in patients with chronic obstructive pulmonary disease. J Thorac Dis 2018; 10:6482-6490. [PMID: 30746192 DOI: 10.21037/jtd.2018.10.104] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Background Chronic obstructive pulmonary disease (COPD) may have considerable cardiovascular risk. Physical activity has a paramount role in COPD treatment. Our aim was to evaluate the applicability of arteriograph in COPD and measure the effectiveness of pulmonary rehabilitation on endothelial function. Methods A total of 40 patients with COPD (FEV1: 45.43±20.20%pred, BMI: 27.99±6.98 kg/m2, male: female was 21:19, age: 65.47±7.39 years) participated in a 4-week rehabilitation program. We used a patented, invasively validated Arteriograph. Blood pressure, pulse, augmentation index (AIX), pulse wave velocity (PWV), diastolic area index (DAI) were registered with functional measurements in pulmonary rehabilitation. Results Pulmonary rehabilitation was effective in 6 minutes walking distance (6MWD: 335.32±110.43 vs. 398.32±126.21 m), maximal inspiratory pressure (MIP: 57.72±22.69 vs. 63.63±18.01 cmH2O), chest wall expansion (CWE: 2.84±1.26 vs. 4.00±1.76 cm), breath holding time (BHT: 25.77±10.63 to 29.21±11.60 sec) and grip strength (GS: 24.87±11.88 vs. 27.03±11.43 kg) (P<0.05). Improvement in quality of life was monitored by COPD assessment test marker (CAT: 17.00±8.49 vs. 11.89±7.31, P<0.05). Systolic (133.38±22.15 vs. 126.48±20.22 mmHg) and diastolic blood pressure (76.95±14.37 vs. 75.4±12.7 mmHg) showed a reduction tendency. Pulse also decreased (76.95±14.37 vs. 72.53±13.65 bpm). AIX levels showed slight improvement (3.54±35.59% vs. 2.93±30.79%); 23 patients peripheral circulation progressed. The PWV data showed abnormal elasticity with minimal change (11.74±2.13 vs. 11.4±2.73 m/s); although 20 patients showed improvement. DAI detected slightly diminished coronary circulation with moderate improvement (43.32±6.81 vs. 47.1±7.01 m/s). Conclusions Elevated arterial stiffness, high PWV turned the COPD patients to the high/very high-risk cluster. Rehabilitation resulted significant improvement in MIP, CWE, BHT, 6MWD, CAT with mild, but favorable changes in blood pressure, pulse, AIX, PWV. As a consequence of the four weeks rehabilitation period overall quality of life improved and cardiovascular risk showed a reduction tendency in COPD.
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Affiliation(s)
- Botond Szucs
- PharmaFlight Research and Training Center, Debrecen, Hungary.,Institute of Exercise Physiology and Sport Medicine, University of Physical Education, Budapest, Hungary
| | - Mate Petrekanits
- PharmaFlight Research and Training Center, Debrecen, Hungary.,Institute of Exercise Physiology and Sport Medicine, University of Physical Education, Budapest, Hungary
| | - Janos Varga
- Department of Pulmonary Rehabilitation, National Koranyi Institute for Pulmonology, Budapest, Hungary
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16
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Li K, Zhang S, Yang L, Jiang H, Chi Z, Wang A, Yang Y, Li X, Hao D, Zhang L, Zheng D. Changes of Arterial Pulse Waveform Characteristics with Gestational Age during Normal Pregnancy. Sci Rep 2018; 8:15571. [PMID: 30349022 PMCID: PMC6197191 DOI: 10.1038/s41598-018-33890-1] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2018] [Accepted: 10/01/2018] [Indexed: 11/11/2022] Open
Abstract
Arterial pulse waveform analysis has been widely used to reflect physiological changes in the cardiovascular system. This study aimed to comprehensively investigate the changes of waveform characteristics of both photoplethysmographic (PPG) and radial pulses with gestational age during normal pregnancy. PPG and radial pulses were simultaneously recorded from 130 healthy pregnant women at seven gestational time points. After normalizing the arterial pulse waveforms, the abscissa of notch point, the total pulse area and the reflection index were extracted and compared between different measurement points and between the PPG and radial pulses using post-hoc multiple comparisons with Bonferrioni correction. The results showed that the effect of gestational age on all the three waveform characteristics was significant (all p < 0.001) after adjusting for maternal age, heart rate and blood pressures. All the three waveform characteristics demonstrated similar changing trends with gestational age, and they were all significantly different between the measurements from gestational week 12–15 and the others (all p < 0.05, except for the PPG total pulse area between the first and second measurement points). In conclusion, this study has comprehensively quantified similar changes of both PPG and radial pulse waveform characteristics with gestational age.
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Affiliation(s)
- Kunyan Li
- College of Life Science and Bioengineering, Beijing University of Technology, Beijing, 100124, China.,Department of Medical Science and Public Health, Faculty of Medical Science, Anglia Ruskin University, Chelmsford, CM1 1SQ, UK
| | - Song Zhang
- College of Life Science and Bioengineering, Beijing University of Technology, Beijing, 100124, China
| | - Lin Yang
- College of Life Science and Bioengineering, Beijing University of Technology, Beijing, 100124, China.
| | - Hongqing Jiang
- Haidian Maternal & Child Health Hospital, Beijing, 100026, China
| | - Zhenyu Chi
- College of Life Science and Bioengineering, Beijing University of Technology, Beijing, 100124, China
| | - Anran Wang
- College of Life Science and Bioengineering, Beijing University of Technology, Beijing, 100124, China
| | - Yimin Yang
- College of Life Science and Bioengineering, Beijing University of Technology, Beijing, 100124, China
| | - Xuwen Li
- College of Life Science and Bioengineering, Beijing University of Technology, Beijing, 100124, China
| | - Dongmei Hao
- College of Life Science and Bioengineering, Beijing University of Technology, Beijing, 100124, China
| | - Lei Zhang
- College of Life Science and Bioengineering, Beijing University of Technology, Beijing, 100124, China
| | - Dingchang Zheng
- Department of Medical Science and Public Health, Faculty of Medical Science, Anglia Ruskin University, Chelmsford, CM1 1SQ, UK.
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17
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Rezk-Hanna M, Doering L, Robbins W, Sarna L, Elashoff RM, Victor RG. Acute Effect of Hookah Smoking on Arterial Stiffness and Wave Reflections in Adults Aged 18 to 34 Years of Age. Am J Cardiol 2018; 122:905-909. [PMID: 30057235 DOI: 10.1016/j.amjcard.2018.05.033] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2018] [Revised: 05/10/2018] [Accepted: 05/10/2018] [Indexed: 11/19/2022]
Abstract
Hookah (waterpipe) smoking is rapidly increasing in popularity worldwide. Despite being heavily advertised in the media as a healthier alternative to cigarettes, the toxicology of hookah smoke suggest otherwise. Cigarette smoking unequivocally causes an acute increase in arterial stiffness, but whether hookah does the same is unknown. In 48 young healthy habitual hookah but not cigarette smokers, we measured heart rate, peripheral and central blood pressure, carotid-femoral pulse wave velocity (measure of arterial stiffness), aortic augmentation index (measure of wave reflection), plasma nicotine, and exhaled carbon monoxide before and after ad lib hookah smoking. Hookah smoking increased heart rate by +16 ± 1 beats/min and mean brachial arterial pressure by +6 ± 1 mm Hg (both p <0.05, mean ± SE). Most importantly, it increased carotid-femoral pulse wave velocity and aortic augmentation index by +0.66 ± 0.09 m/s-1 and +8.76 ± 3.99%, respectively (p <0.05, mean ± SE), denoting increased acute arterial stiffness. These vascular effects were accompanied by increases in plasma nicotine concentration (+5.8 ± 1.2 ng/ml, p <0.05) and expired carbon monoxide (+25.44 ± 1.68 ppm, p <0.05). All these parameters were unchanged during time-control studies (n = 14). Thus, in contrast to effective media marketing of hookah as a safer alternative to cigarettes, the present study shows for the first time that in young adult hookah smokers, a single hookah smoking session causes an acute increase in arterial stiffness of comparable magnitude to what has been previously reported for cigarettes. Further research is warranted to determine whether habitual hookah smoking accelerates the age-dependent development of hypertension and its cardiovascular complications.
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Affiliation(s)
- Mary Rezk-Hanna
- Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California; School of Nursing, University of California, Los Angeles, Los Angeles, California.
| | - Lynn Doering
- School of Nursing, University of California, Los Angeles, Los Angeles, California
| | - Wendie Robbins
- School of Nursing, University of California, Los Angeles, Los Angeles, California
| | - Linda Sarna
- School of Nursing, University of California, Los Angeles, Los Angeles, California
| | - Robert M Elashoff
- Department of Biomathematics, The David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California
| | - Ronald G Victor
- Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California.
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18
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Misak A, Kristek F, Tomasova L, Grman M, Ondriasova E, Krizanova O, Ondrias K. Mathematical relationships and their consequences between rat pulse waveform parameters and blood pressure during decreasing NO bioavailability. Exp Physiol 2017; 102:164-179. [PMID: 27862525 DOI: 10.1113/ep085958] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2016] [Accepted: 11/08/2016] [Indexed: 01/19/2023]
Abstract
NEW FINDINGS What is the central question of this study? We wanted to find out whether the relationship between rat arterial pulse waveform (APW) parameters and blood pressure could be described by known mathematical functions and find mathematical parameters for conditions of hypertension resulting from decreased NO bioavailability. What is the main finding and its importance? We found mathematical functions and their parameters that approximate the relationships of 12 APW parameters to systolic and diastolic blood pressure in conditions of decreased NO bioavailability. The results may assign APW parameters to decreased NO bioavailability, which may have predictive or diagnostic value. Information obtained from the arterial pulse waveform (APW) is useful for characterization of the cardiovascular system in particular (patho)physiological conditions. Our goal was to find out whether the relationships between rat APW parameters could be described by simple mathematical functions and to find mathematical parameters for conditions of hypertension resulting from decreased NO bioavailability. Therefore, we explored details of 14 left carotid APW parameters of anaesthetized male Wistar rats and mathematically characterized their relationship to systolic and diastolic blood pressure (BP) in conditions of a gradual reduction in NO bioavailability after administration of l-NAME. The right jugular vein of anaesthetized Wistar rats was cannulated for l-NAME administration. The left carotid artery was cannulated to detect the APW at high resolution. Here, we show the time-dependent parallel changes of 14 APW parameters before and after i.v. administration of l-NAME and present mathematical functions that approximate the relationships of 12 APW parameters to systolic and diastolic BP. Some APW parameters had minor (e.g. heart rate) or biphasic dependence on BP (e.g. relative level of the maximum rate of ventricular pressure decrease (dP/dtmin )), but all relationships, within a particular range of BP, could be approximated by known regression functions, as a linear function (e.g. pulse BP), exponential decay (e.g. relative level of the maximum rate of ventricular pressure increase (dP/dtmax )), exponential growth (systolic area), exponential rise to a maximum (relative augmentation index) or sigmoid function (e.g. increase of relative level of dP/dtmin ). The mathematical functions may assign APW parameters to decreased NO bioavailability. This may have predictive or diagnostic value.
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Affiliation(s)
- Anton Misak
- Institute of Clinical and Translational Research, Biomedical Research Center, Slovak Academy of Sciences, Bratislava, Slovak Republic
| | - Frantisek Kristek
- Institute of Normal and Pathological Physiology, Slovak Academy of Sciences, Bratislava, Slovak Republic
| | - Lenka Tomasova
- Institute of Clinical and Translational Research, Biomedical Research Center, Slovak Academy of Sciences, Bratislava, Slovak Republic
| | - Marian Grman
- Institute of Clinical and Translational Research, Biomedical Research Center, Slovak Academy of Sciences, Bratislava, Slovak Republic
| | - Elena Ondriasova
- Department of Pharmacology and Toxicology, Faculty of Pharmacy, Comenius University, Bratislava, Slovak Republic
| | - Olga Krizanova
- Institute of Clinical and Translational Research, Biomedical Research Center, Slovak Academy of Sciences, Bratislava, Slovak Republic
| | - Karol Ondrias
- Institute of Clinical and Translational Research, Biomedical Research Center, Slovak Academy of Sciences, Bratislava, Slovak Republic
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19
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20
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Vlachopoulos C, Tsekoura D, Tsiamis E, Panagiotakos D, Stefanadis C. Effect of alcohol on endothelial function in healthy subjects. Vasc Med 2016; 8:263-5. [PMID: 15125487 DOI: 10.1191/1358863x03vm505oa] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
While studies have shown that red wine improves endothelial function, the effect of pure alcohol, the common denominator of all alcoholic beverages, on endothelial function has not been defined. The effect of oral intake of alcohol (one ounce - a dose corresponding to two drink equivalents) on flow-mediated dilatation of the brachial artery was studied in 12 healthy subjects using high-resolution ultrasonography according to a randomized, sham procedure-controlled, single-blind protocol. Alcohol produced a significant vasodilatation of the brachial artery at resting conditions. Furthermore, it led to a significant increase of the brachial artery diameter at reactive hyperemia; however, the percentage flow-mediated dilatation did not change. This study shows, for the first time, that acute moderate intake of alcohol has a potent dilating effect on large arteries both at resting and at reactive hyperemic conditions, without affecting flow-mediated dilatation as a percentage. This may be useful for explaining the divergent effect of different alcoholic beverages on endothelial function and provides valuable insight into the mechanisms involved in the vascular effects of alcohol.
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21
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Yeung KR, Chiu CL, Pears S, Heffernan SJ, Makris A, Hennessy A, Lind JM. A Cross-Sectional Study of Ageing and Cardiovascular Function over the Baboon Lifespan. PLoS One 2016; 11:e0159576. [PMID: 27427971 PMCID: PMC4948874 DOI: 10.1371/journal.pone.0159576] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2016] [Accepted: 07/04/2016] [Indexed: 12/20/2022] Open
Abstract
Background Ageing is associated with changes at the molecular and cellular level that can alter cardiovascular function and ultimately lead to disease. The baboon is an ideal model for studying ageing due to the similarities in genetic, anatomical, physiological and biochemical characteristics with humans. The aim of this cross-sectional study was to investigate the changes in cardiovascular profile of baboons over the course of their lifespan. Methods Data were collected from 109 healthy baboons (Papio hamadryas) at the Australian National Baboon Colony. A linear regression model, adjusting for sex, was used to analyse the association between age and markers of ageing with P < 0.01 considered significant. Results Male (n = 49, 1.5–28.5 years) and female (n = 60, 1.8–24.6 years) baboons were included in the study. Age was significantly correlated with systolic (R2 = 0.23, P < 0.001) and diastolic blood pressure (R2 = 0.44, P < 0.001), with blood pressure increasing with age. Age was also highly correlated with core augmentation index (R2 = 0.17, P < 0.001) and core pulse pressure (R2 = 0.30, P < 0.001). Creatinine and urea were significantly higher in older animals compared to young animals (P < 0.001 for both). Older animals (>12 years) had significantly shorter telomeres when compared to younger (<3 years) baboons (P = 0.001). Conclusion This study is the first to demonstrate that cardiovascular function alters with age in the baboon. This research identifies similarities within cardiovascular parameters between humans and baboon even though the length of life differs between the two species.
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Affiliation(s)
- Kristen R. Yeung
- Western Sydney University, School of Medicine, Sydney, Australia
| | | | - Suzanne Pears
- Department of Renal Medicine, Royal Prince Alfred Hospital, Sydney, Australia
| | - Scott J. Heffernan
- Department of Renal Medicine, Royal Prince Alfred Hospital, Sydney, Australia
| | - Angela Makris
- Western Sydney University, School of Medicine, Sydney, Australia
- The Heart Research Institute, Sydney, Australia
- Nephrology Department, Liverpool Hospital, Sydney, Australia
| | - Annemarie Hennessy
- Western Sydney University, School of Medicine, Sydney, Australia
- The Heart Research Institute, Sydney, Australia
| | - Joanne M. Lind
- Western Sydney University, School of Medicine, Sydney, Australia
- * E-mail:
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22
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Tritakis V, Tzortzis S, Ikonomidis I, Dima K, Pavlidis G, Trivilou P, Paraskevaidis I, Katsimaglis G, Parissis J, Lekakis J. Association of arterial stiffness with coronary flow reserve in revascularized coronary artery disease patients. World J Cardiol 2016; 8:231-239. [PMID: 26981218 PMCID: PMC4766273 DOI: 10.4330/wjc.v8.i2.231] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2015] [Revised: 10/09/2015] [Accepted: 12/11/2015] [Indexed: 02/06/2023] Open
Abstract
AIM: To investigate the association of arterial wave reflection with coronary flow reserve (CFR) in coronary artery disease (CAD) patients after successful revascularization.
METHODS: We assessed 70 patients with angiographically documented CAD who had undergone recent successful revascularization. We measured (1) reactive hyperemia index (RHI) using fingertip peripheral arterial tonometry (RH-PAT Endo-PAT); (2) carotid to femoral pulse wave velocity (PWVc-Complior); (3) augmentation index (AIx), the diastolic area (DAI%) and diastolic reflection area (DRA) of the central aortic pulse wave (Arteriograph); (4) CFR using Doppler echocardiography; and (5) blood levels of lipoprotein-phospholipase A2 (Lp-PLA2).
RESULTS: After adjustment for age, sex, blood pressure parameter, lipidemic, diabetic and smoking status, we found that coronary flow reserve was independently related to AIx (b = -0.38, r = 0.009), DAI (b = 0.36, P = 0.014), DRA (b = 0.39, P = 0.005) and RT (b = -0.29, P = 0.026). Additionally, patients with CFR < 2.5 had higher PWVc (11.6 ± 2.3 vs 10.2 ± 1.4 m/s, P = 0.019), SBPc (139.1 ± 17.8 vs 125.2 ± 19.1 mmHg, P = 0.026), AIx (38.2% ± 14.8% vs 29.4% ± 15.1%, P = 0.011) and lower RHI (1.26 ± 0.28 vs 1.50 ± 0.46, P = 0.012), DAI (44.3% ± 7.9% vs 53.9% ± 6.7%, P = 0.008), DRA (42.2 ± 9.6 vs 51.6 ± 11.4, P = 0.012) and LpPLA2 (268.1 ± 91.9 vs 199.5 ± 78.4 ng/mL, P = 0.002) compared with those with CFR ≥ 2.5. Elevated LpPLA2 was related with reduced CFR (r = -0.33, P = 0.001), RHI (r = -0.37, P < 0.001) and DRA (r = -0.35, P = 0.001) as well as increased PWVc (r = 0.34, P = 0.012) and AIx (r = 0.34, P = 0.001).
CONCLUSION: Abnormal arterial wave reflections are related with impaired coronary flow reserve despite successful revascularization in CAD patients. There is a common inflammatory link between impaired aortic wall properties, endothelial dysfunction and coronary flow impairment in CAD.
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Tazawa Y, Mori N, Ogawa Y, Ito O, Kohzuki M. Arterial Stiffness Measured with the Cuff Oscillometric Method Is Predictive of Exercise Capacity in Patients with Cardiac Diseases. TOHOKU J EXP MED 2016; 239:127-34. [DOI: 10.1620/tjem.239.127] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Affiliation(s)
- Yasushi Tazawa
- Department of Internal Medicine and Rehabilitation Science, Tohoku University Graduate School of Medicine
| | - Nobuyoshi Mori
- Department of Internal Medicine and Rehabilitation Science, Tohoku University Graduate School of Medicine
| | - Yoshiko Ogawa
- Department of Internal Medicine and Rehabilitation Science, Tohoku University Graduate School of Medicine
| | - Osamu Ito
- Department of Internal Medicine and Rehabilitation Science, Tohoku University Graduate School of Medicine
| | - Masahiro Kohzuki
- Department of Internal Medicine and Rehabilitation Science, Tohoku University Graduate School of Medicine
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Zhang H, Fujiwara N, Kobayashi M, Yamada S, Liang F, Takagi S, Oshima M. Development of a Numerical Method for Patient-Specific Cerebral Circulation Using 1D-0D Simulation of the Entire Cardiovascular System with SPECT Data. Ann Biomed Eng 2015; 44:2351-2363. [PMID: 26721836 DOI: 10.1007/s10439-015-1544-8] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2015] [Accepted: 12/22/2015] [Indexed: 11/28/2022]
Abstract
The detailed flow information in the circle of Willis (CoW) can facilitate a better understanding of disease progression, and provide useful references for disease treatment. We have been developing a one-dimensional-zero-dimensional (1D-0D) simulation method for the entire cardiovascular system to obtain hemodynamics information in the CoW. This paper presents a new method for applying 1D-0D simulation to an individual patient using patient-specific data. The key issue is how to adjust the deviation of physiological parameters, such as peripheral resistance, from literature data when patient-specific geometry is used. In order to overcome this problem, we utilized flow information from single photon emission computed tomography (SPECT) data. A numerical method was developed to optimize physiological parameters by adjusting peripheral cerebral resistance to minimize the difference between the resulting flow rate and the SPECT data in the efferent arteries of the CoW. The method was applied to three cases using different sets of patient-specific data in order to investigate the hemodynamics of the CoW. The resulting flow rates in the afferent arteries were compared to those of the phase-contrast magnetic resonance angiography (PC-MRA) data. Utilization of the SPECT data combined with the PC-MRA data showed a good agreement in flow rates in the afferent arteries of the CoW with those of PC-MRA data for all three cases. The results also demonstrated that application of SPECT data alone could provide the information on the ratios of flow distributions among arteries in the CoW.
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Affiliation(s)
- Hao Zhang
- Department of Mechanical Engineering, The University of Tokyo, Tokyo, Japan.
| | - Naoya Fujiwara
- Center for Spatial Information Science, The University of Tokyo, Chiba, Japan
| | - Masaharu Kobayashi
- Interfaculty Initiative in Information Studies, The University of Tokyo, Tokyo, Japan
| | - Shigeki Yamada
- Department of Neurosurgey, Stroke Center, Rakuwakai Otowa Hospital, Kyoto, Japan
| | - Fuyou Liang
- Department of Naval Architecture and Ocean Engineering, Shanghai Jiao Tong University, Shanghai, China
| | - Shu Takagi
- Department of Mechanical Engineering, The University of Tokyo, Tokyo, Japan
| | - Marie Oshima
- Interfaculty Initiative in Information Studies, The University of Tokyo, Tokyo, Japan
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25
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Qureshi MU, Hill NA. A computational study of pressure wave reflections in the pulmonary arteries. J Math Biol 2015; 71:1525-49. [PMID: 25754476 DOI: 10.1007/s00285-015-0867-2] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2014] [Revised: 01/28/2015] [Indexed: 01/09/2023]
Abstract
Experiments using wave intensity analysis suggest that the pulmonary circulation in sheep and dogs is characterized by negative or open-end type wave reflections, that reduce the systolic pressure. Since the pulmonary physiology is similar in most mammals, including humans, we test and verify this hypothesis by using a subject specific one-dimensional model of the human pulmonary circulation and a conventional wave intensity analysis. Using the simulated pressure and velocity, we also analyse the performance of the P-U loop and sum of squares techniques for estimating the local pulse wave velocity in the pulmonary arteries, and then analyse the effects of these methods on linear wave separation in the main pulmonary artery. P-U loops are found to provide much better estimates than the sum of squares technique at proximal locations, but both techniques accumulate progressive error at distal locations away from heart, particularly near junctions. The pulse wave velocity estimated using the sum of squares method also gives rise to an artificial early systolic backward compression wave. Finally, we study the influence of three types of pulmonary hypertension viz. pulmonary arterial hypertension, chronic thromboembolic pulmonary hypertension and pulmonary hypertension associated with hypoxic lung disease. Simulating these conditions by changing the relevant parameters in the model and then applying the wave intensity analysis, we observe that for each group the early systolic backward decompression wave reflected from proximal junctions is maintained, whilst the initial forward compression and the late systolic backward compression waves amplify with increasing pathology and contribute significantly to increases in systolic pressure.
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Affiliation(s)
- M Umar Qureshi
- Department of Mathematics, International Islamic University, Sector H10, Islamabad, 44000, Pakistan. .,School of Mathematics and Statistics, University of Glasgow, Glasgow, G12 8QW, UK.
| | - N A Hill
- School of Mathematics and Statistics, University of Glasgow, Glasgow, G12 8QW, UK.
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26
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Stamatelopoulos K, Georgiou S, Kanakakis I, Papamichael C, Oikonomidis N, Mantzou A, Samouilidou E, Loizos S, Zakopoulos N, Sfikakis PP. Circulating levels of TNF-like cytokine 1A correlate with reflected waves and atherosclerosis extent and may predict cardiac death in patients with stable coronary artery disease. Cytokine 2015; 72:102-4. [PMID: 25563533 DOI: 10.1016/j.cyto.2014.12.016] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2014] [Revised: 11/05/2014] [Accepted: 12/10/2014] [Indexed: 10/24/2022]
Abstract
BACKGROUND TNF-like cytokine 1A (TL1A)-mediated interactions are involved in atheromatic plaque formation. In stable coronary artery disease (CAD) we examined whether circulating TL1A levels correlate with coronary and/or peripheral atherosclerosis extent and predict future cardiovascular events. METHODS In this cross-sectional study, peripheral vascular studies and TL1A serum measurements were performed in 122 consecutive patients with angiographically confirmed CAD who were followed for a median of 41.9 months. TL1A levels were compared against controls (n = 63) and 20 patients with acute coronary syndrome (ACS). RESULTS TL1A was higher in ACS than the 2 other groups (p < 0.001). In stable CAD, after adjustment for traditional risk factors independent positive correlations between TL1A serum levels and reflected waves (p = 0.049), and carotid atheromatic plaque score (p = 0.049) were evident. In stable patients with a history of ACS, TL1A levels correlated with worse endothelial function (p = 0.006), extent of CAD assessed by Gensini score (p = 0.042), and cardiac mortality (p = 0.051). CONCLUSIONS This pilot study suggests that serum TL1A measurements are of clinical value in CAD. Studies on the pathogenetic role of TL1A in atherosclerosis and its sequelae are warranted.
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Affiliation(s)
- Kimon Stamatelopoulos
- Vascular Laboratory, Department of Clinical Therapeutics, Alexandra Hospital, Greece.
| | - Stylianos Georgiou
- Vascular Laboratory, Department of Clinical Therapeutics, Alexandra Hospital, Greece
| | - Ioannis Kanakakis
- Vascular Laboratory, Department of Clinical Therapeutics, Alexandra Hospital, Greece
| | - Christos Papamichael
- Vascular Laboratory, Department of Clinical Therapeutics, Alexandra Hospital, Greece
| | - Nikolaos Oikonomidis
- Vascular Laboratory, Department of Clinical Therapeutics, Alexandra Hospital, Greece
| | - Aimilia Mantzou
- Vascular Laboratory, Department of Clinical Therapeutics, Alexandra Hospital, Greece
| | - Elizabeth Samouilidou
- Vascular Laboratory, Department of Clinical Therapeutics, Alexandra Hospital, Greece
| | - Savvas Loizos
- Vascular Laboratory, Department of Clinical Therapeutics, Alexandra Hospital, Greece
| | - Nikolaos Zakopoulos
- Vascular Laboratory, Department of Clinical Therapeutics, Alexandra Hospital, Greece
| | - Petros P Sfikakis
- First Department of Propaedeutic and Internal Medicine, Laikon Hospital, Athens University Medical School, Athens, Greece
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27
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Blanco PJ, Watanabe SM, Passos MARF, Lemos PA, Feijóo RA. An anatomically detailed arterial network model for one-dimensional computational hemodynamics. IEEE Trans Biomed Eng 2014; 62:736-53. [PMID: 25347874 DOI: 10.1109/tbme.2014.2364522] [Citation(s) in RCA: 78] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Simulation platforms are increasingly becoming complementary tools for cutting-edge cardiovascular research. The interplay among structural properties of the arterial wall, morphometry, anatomy, wave propagation phenomena, and ultimately, cardiovascular diseases continues to be poorly understood. Accurate models are powerful tools to shed light on these open problems. We developed an anatomically detailed computational model of the arterial vasculature to conduct 1-D blood flow simulations to serve as simulation infrastructure to aid cardiovascular research. An average arterial vasculature of a man was outlined in 3-D space to serve as geometrical substrate for the mathematical model. The architecture of this model comprises almost every arterial vessel acknowledged in the medical/anatomical literature, with a resolution down to the luminal area of perforator arteries. Over 2000 arterial vessels compose the model. Anatomical, physiological, and mechanical considerations were employed for the set up of model parameters and to determine criteria for blood flow distribution. Computational fluid dynamics was used to simulate blood flow and wave propagation phenomena in such arterial network. A sensitivity analysis was developed to unveil the contributions of model parameters to the conformation of the pressure waveforms. In addition, parameters were modified to target model to a patient-specific scenario. On the light of the knowledge domain, we conclude that the present model features excellent descriptive and predictive capabilities in both patient-generic and patient-specific cases, presenting a new step toward integrating an unprecedented anatomical description, morphometric, and simulations data to help in understanding complex arterial blood flow phenomena and related cardiovascular diseases.
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28
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Papaioannou TG, Protogerou AD, Stergiopulos N, Vardoulis O, Stefanadis C, Safar M, Blacher J. Total arterial compliance estimated by a novel method and all-cause mortality in the elderly: the PROTEGER study. AGE (DORDRECHT, NETHERLANDS) 2014; 36:9661. [PMID: 24801452 PMCID: PMC4082579 DOI: 10.1007/s11357-014-9661-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/01/2013] [Accepted: 04/22/2014] [Indexed: 05/06/2023]
Abstract
Aortic stiffness, assessed by carotid-to-femoral pulse wave velocity (PWV), often fails to predict cardiovascular (CV) risk and mortality in the very elderly. This may be due to the non-linear association between PWV and compliance or to blood pressure decrease in the frailest subjects. Total arterial compliance (C T) is the most relevant arterial property regarding CV function, compared to local or regional arterial stiffness. A new method for C T estimation, based on PWV, was recently proposed. We aimed to investigate the value of C T to predict all-cause mortality at the elderly. PWV was estimated in 279 elderly subjects (85.5 ± 7.0 years) who were followed up for a mean period of 12.8 ± 6.3 months. C T was estimated by the formula C T = k × PWV(-2); coefficient k is body-size dependent based on previous in silico simulations. Herein, k was adjusted for body mass index (BMI) with a 10 % change in BMI corresponding to almost 11 % change in k. For a reference BMI = 26.2 kg/m(2), k = 37. Survivors (n = 185) and non-survivors (n = 94) had similar PWV (14.2 ± 3.6 versus 14.9 ± 3.8 m/s, respectively; p = 0.139). In contrast, non-survivors had significantly lower C T than survivors (0.198 ± 0.128 versus 0.221 ± 0.1 mL/mmHg; p = 0.018). C T was a significant predictor of mortality (p = 0.022, odds ratio = 0.326), while PWV was not (p = 0.202), even after adjustment for gender, mean pressure and heart rate. Age was an independent determinant of C T (p = 0.016), but not of PWV. C T, estimated by a novel method, can predict all-cause mortality in the elderly. C T may be more sensitive arterial biomarker than PWV regarding CV risk assessment.
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Affiliation(s)
- Theodore G Papaioannou
- Biomedical Engineering Unit, First Department of Cardiology, Hippokration Hospital, Medical School, National and Kapodistrian University of Athens, 114 Vas Sophias ave., Athens, 115 28, Greece,
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29
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Ferreira ADS, Moura NGRD. Asserted and neglected issues linking evidence-based and Chinese medicines for cardiac rehabilitation. World J Cardiol 2014; 6:295-303. [PMID: 24944759 PMCID: PMC4062128 DOI: 10.4330/wjc.v6.i5.295] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2013] [Revised: 03/28/2014] [Accepted: 04/29/2014] [Indexed: 02/06/2023] Open
Abstract
High blood pressure is among the most prevalent chronic disease in adults that impacts on the quality of life of patients, which are often subjected to physical rehabilitation. Chinese medicine intervention in patients with hypertension presents promising albeit inconclusive results, mostly due to methodological issues. This paper discusses asserted and neglected issues linking evidence-based and Chinese medicines as related to systemic arterial hypertension, as well as their impact on the physical rehabilitation of those patients. On the one hand, natural history of hypertension, pulse palpation, and herbal therapy are among the asserted issues because of the scientific evidence collected about them, either in favor or against its integration to the current medical practice. On the other hand, anatomical variations of vessels and comparative physiology are among the most commonly neglected issues because previous researches on integrative medicine ignored the possible effects of these issues as related to the study’s outcome. The asserted issues highlighted in this paper stimulate the increasing use of Chinese medicine for health care and the continuity of research on integrative medicine in the cardiovascular field for rehabilitation. The neglected issues poses additional challenges that must not be overlooked in future research on this topic so that the integration of both traditional and current knowledge may be of benefit to the population with cardiovascular disease.
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30
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Blood flow distribution in an anatomically detailed arterial network model: criteria and algorithms. Biomech Model Mechanobiol 2014; 13:1303-30. [DOI: 10.1007/s10237-014-0574-8] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2013] [Accepted: 03/14/2014] [Indexed: 12/11/2022]
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31
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Effect of Cardio-Metabolic Risk Factors Clustering with or without Arterial Hypertension on Arterial Stiffness: A Narrative Review. Diseases 2013. [DOI: 10.3390/diseases1010051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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32
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MA ZUCHANG, ZHANG YONGLIANG, NI CHAOMING, HE ZIJUN, CAO QINGQING, SUN YINING. A NEW METHOD FOR DETERMINING SUBENDOCARDIAL VIABILITY RATIO FROM RADIAL ARTERY PRESSURE WAVES. J MECH MED BIOL 2013. [DOI: 10.1142/s0219519413500607] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Aortic subendocardial viability ratio (SEVR), an index of myocardial oxygen demand relative to supply, has been used for the early detection of hemodynamic changes. We aimed to validate a new method for determining SEVR directly from radial pressures. Hemodynamic parameters were measured in 231 outpatients (108 males and 123 females) for physical examination, aged from 20–77 years (45.9 ± 17.3 years), including 210 healthy and 21 hypertensive subjects. Aortic SEVR was obtained using a validated device (SphygmoCor; AtCor Medical, Sydney, Australia), and radial SEVR was obtained using a portable vascular testing device (IIM-2010A; Institute and Intelligent of Machines, Hefei, China). Radial SEVR was strongly related to aortic SEVR (r = 0.824, p < 0.01), with approximately 15.7% lower value. Aortic and radial SEVR had similar independent predictors, including diastolic time fraction (DTF), systolic blood pressure, diastolic blood pressure, age, and height. DTF exerted the most influence on both of them. In healthy subjects, there were significant changes in aortic and radial SEVR between age groups in both males and females (p < 0.05 for both ). Changes in aortic and radial SEVR with aging were parallel though the differences between them increased. These results suggested that the simple and easily obtainable radial SEVR could provide equivalent information to aortic SEVR, and has potential for the primary prevention of cardiovascular disease in health screening.
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Affiliation(s)
- ZU-CHANG MA
- Jiangsu Institute of Sports Science, Nanjing 210033, Jiangsu, P. R. China
- Beijing Sport University, Beijing 100084, P. R. China
- Institute and Intelligent of Machines, Chinese Academy of Sciences, Hefei 230031, Anhui, P. R. China
| | - YONG-LIANG ZHANG
- Institute and Intelligent of Machines, Chinese Academy of Sciences, Hefei 230031, Anhui, P. R. China
- Department of Automation, University of Science and Technology of China, Hefei 230027, Anhui, P. R. China
| | - CHAO-MING NI
- Department of Rehabilitation Medicine, The Affiliated Provincial Hospital of Anhui Medical University, Hefei 230001 Anhui, P. R. China
| | - ZI-JUN HE
- Institute and Intelligent of Machines, Chinese Academy of Sciences, Hefei 230031, Anhui, P. R. China
- Department of Automation, University of Science and Technology of China, Hefei 230027, Anhui, P. R. China
| | - QING-QING CAO
- Institute and Intelligent of Machines, Chinese Academy of Sciences, Hefei 230031, Anhui, P. R. China
| | - YI-NING SUN
- Institute and Intelligent of Machines, Chinese Academy of Sciences, Hefei 230031, Anhui, P. R. China
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Stoner L, Young JM, Fryer S. Assessments of arterial stiffness and endothelial function using pulse wave analysis. Int J Vasc Med 2012; 2012:903107. [PMID: 22666595 PMCID: PMC3361177 DOI: 10.1155/2012/903107] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2011] [Revised: 02/16/2012] [Accepted: 03/02/2012] [Indexed: 02/02/2023] Open
Abstract
Conventionally, the assessments of endothelial function and arterial stiffness require different sets of equipment, making the inclusion of both tests impractical for clinical and epidemiological studies. Pulse wave analysis (PWA) provides useful information regarding the mechanical properties of the arterial tree and can also be used to assess endothelial function. PWA is a simple, valid, reliable, and inexpensive technique, offering great clinical and epidemiological potential. The current paper will outline how to measure arterial stiffness and endothelial function using this technique and include discussion of validity and reliability.
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Affiliation(s)
- Lee Stoner
- School of Sport and Exercise, Massey University, P.O. Box 756, Wellington 6140, New Zealand
| | - Joanna M. Young
- Lipid and Diabetes Research Group, Diabetes Research Institute, Christchurch Hospital, Christchurch 8011, New Zealand
- Department of Medicine, University of Otago, Christchurch 8140, New Zealand
| | - Simon Fryer
- School of Sciences and Physical Education, University of Canterbury, Christchurch 8140, New Zealand
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34
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Khoshdel AR, Carney SL, Gillies A. Circulatory syndrome: an evolution of the metabolic syndrome concept! Curr Cardiol Rev 2012; 8:68-76. [PMID: 22845817 PMCID: PMC3394110 DOI: 10.2174/157340312801215773] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2011] [Revised: 03/28/2012] [Accepted: 04/03/2012] [Indexed: 02/08/2023] Open
Abstract
The metabolic syndrome has been a useful, though controversial construct in clinical practice as well as a valuable model in order to understand the interactions of diverse cardiovascular risk factors. However the increasing importance of the circulatory system in particular the endothelium, in both connecting and controlling organ function has underlined the limitations of the metabolic syndrome definition. The proposed "Circulatory Syndrome" is an attempt to refine the metabolic syndrome concept by the addition of recently documented markers of cardiovascular disease including renal impairment, microalbuminuria, arterial stiffness, ventricular dysfunction and anaemia to more classic factors including hypertension, dyslipidemia and abnormal glucose metabolism; all of which easily measured in clinical practice. These markers interact with each other as well as with other factors such as aging, obesity, physical inactivity, diet and smoking. The final common pathways of inflammation, oxidative stress and hypercoagulability thereby lead to endothelial damage and eventually cardiovascular disease. Nevertheless, the Circulatory (MARC) Syndrome, like its predecessor the metabolic syndrome, is only a small step toward an understanding of these complex and as yet poorly understood markers of disease.
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Affiliation(s)
- Ali Reza Khoshdel
- Department of Epidemiology, Faculty of Medicine, AJA University of medical Sciences, Tehran, Iran.
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35
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Ghasemzadeh N, Zafari AM. A brief journey into the history of the arterial pulse. Cardiol Res Pract 2011; 2011:164832. [PMID: 21811677 PMCID: PMC3147130 DOI: 10.4061/2011/164832] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2010] [Revised: 04/26/2011] [Accepted: 05/20/2011] [Indexed: 11/20/2022] Open
Abstract
Objective. This paper illustrates the evolution of our knowledge of the arterial pulse from ancient times to the present. Several techniques for arterial pulse evaluation throughout history are discussed. Methods. Using databases including Worldcat, Pubmed, and Emory University Libraries' Catalogue, the significance of the arterial pulse is discussed in three historical eras of medicine: ancient, medieval, and modern. Summary. Techniques used over time to analyze arterial pulse and its characteristics have advanced from simple evaluation by touch to complex methodologies such as ultrasonography and plethysmography. Today's understanding of the various characteristics of the arterial pulse relies on our ancestors' observations and experiments. The pursuit of science continues to lead to major advancements in our knowledge of the arterial pulse and its application in diagnosis of atherosclerotic disease.
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Affiliation(s)
- Nima Ghasemzadeh
- Atlanta Veterans Affairs Medical Center, Decatur, GA 30033-4004, USA
- Division of Cardiology, Emory University School of Medicine, 1639 Pierce Drive, 322 WMB, Atlanta, GA 30322, USA
| | - A. Maziar Zafari
- Atlanta Veterans Affairs Medical Center, Decatur, GA 30033-4004, USA
- Division of Cardiology, Emory University School of Medicine, 1639 Pierce Drive, 322 WMB, Atlanta, GA 30322, USA
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36
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Katsi V, Vlachopoulos C, Souretis G, Baou K, Dagalaki I, Alexopoulos N, Tousoulis D, Hatziyianni A, Stefanadis C, Kallikazaros I. Association between retinal microcirculation and aortic stiffness in hypertensive patients. Int J Cardiol 2011; 157:370-3. [PMID: 21256605 DOI: 10.1016/j.ijcard.2010.12.074] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2010] [Revised: 11/07/2010] [Accepted: 12/21/2010] [Indexed: 01/06/2023]
Abstract
BACKGROUND The fundoscopic examination of hypertensive patients, an established hypertension-related target organ damage, tends to be underutilized in clinical practice. We sought to investigate the relationship between retinal alterations and aortic stiffness, an independent predictor of cardiovascular morbidity and mortality. METHODS Our population consisted of 197 consecutive essential hypertensive patients (age 60 ± 13 years, 115 females) without overt cardiovascular disease. All subjects underwent fundoscopy examination and were distributed to four groups according to Scheie's grading system. Aortic stiffness was evaluated by carotid-femoral pulse wave velocity with a validated device (Complior). RESULTS The four groups (Scheie's grades 0-3: including 24, 75, 74, 24 patients respectively) did not differ with regard to age, gender and their metabolic profile. Patients with higher Scheie's category had higher values of pulse wave velocity (8.2 ± 1.5, 8.9 ± 1.7, 9.3 ± 1.8, 9.8 ± 2.1m/s respectively, p=0.001). Multivariable regression analysis showed that age, fundus classification and systolic arterial pressure were independent determinants of pulse wave velocity. CONCLUSION Hypertensive subjects exhibit a progressive stiffening of the aorta in parallel with the progression of retinal alterations according to Scheie's scale. Further studies are needed to clarify involved pathophysiological mechanisms and explore possible causal relationships.
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Affiliation(s)
- Vasiliki Katsi
- Cardiology Department, Hippokration Hospital, Athens, Greece.
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37
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Tsiachris D, Tsioufis C, Syrseloudis D, Roussos D, Tatsis I, Dimitriadis K, Toutouzas K, Tsiamis E, Stefanadis C. Subendocardial viability ratio as an index of impaired coronary flow reserve in hypertensives without significant coronary artery stenoses. J Hum Hypertens 2011; 26:64-70. [PMID: 21228823 DOI: 10.1038/jhh.2010.127] [Citation(s) in RCA: 97] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Subendocardial viability ratio (SEVR), calculated through pulse wave analysis, is an index of myocardial oxygen supply and demand. Our aim was to evaluate the relationship between coronary flow reserve (CFR) and SEVR in 36 consecutive untreated hypertensives (aged 57.9 years, 12 males, all Caucasian) with indications of myocardial ischaemia and normal coronary arteries in coronary angiography. CFR was calculated by a 0.014-inch Doppler guidewire (Flowire, Volcano, San Diego, CA, USA) in response to bolus intracoronary administration of adenosine (30-60 μg). SEVR was calculated by radial applanation tonometry, while diastolic function was evaluated by means of transmitral flow and tissue Doppler imaging. Hypertensive patients with low CFR (n=24) compared with those with normal CFR (n=12) exhibited significantly decreased SEVR by 24.5% (P=0.002). In hypertensives with low CFR, CFR was correlated with SEVR (r=0.651, P=0.001). After applying multivariate linear regression analysis, age, left ventricular mass index, Em/Am, 24-h diastolic blood pressure (BP) and SEVR turned out to be the only independent predictors of CFR (adjusted R(2)=0.718). Estimation of SEVR by using applanation tonometry may provide a reliable tool for the assessment of coronary microcirculation in essential hypertensives with indications of myocardial ischaemia and normal coronary arteries.
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Affiliation(s)
- D Tsiachris
- First Cardiology Clinic, University of Athens, Hippokration Hospital, Athens, Greece
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Parczyk M, Herold V, Klug G, Bauer WR, Rommel E, Jakob PM. Regional in vivo transit time measurements of aortic pulse wave velocity in mice with high-field CMR at 17.6 Tesla. J Cardiovasc Magn Reson 2010; 12:72. [PMID: 21134260 PMCID: PMC3014910 DOI: 10.1186/1532-429x-12-72] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2010] [Accepted: 12/06/2010] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Transgenic mouse models are increasingly used to study the pathophysiology of human cardiovascular diseases. The aortic pulse wave velocity (PWV) is an indirect measure for vascular stiffness and a marker for cardiovascular risk. RESULTS This study presents a cardiovascular magnetic resonance (CMR) transit time (TT) method that allows the determination of the PWV in the descending murine aorta by analyzing blood flow waveforms. Systolic flow pulses were recorded with a temporal resolution of 1 ms applying phase velocity encoding. In a first step, the CMR method was validated by pressure waveform measurements on a pulsatile elastic vessel phantom. In a second step, the CMR method was applied to measure PWVs in a group of five eight-month-old apolipoprotein E deficient (ApoE(-/-)) mice and an age matched group of four C57Bl/6J mice. The ApoE(-/-) group had a higher mean PWV (PWV = 3.0 ± 0.6 m/s) than the C57Bl/6J group (PWV = 2.4 ± 0.4 m/s). The difference was statistically significant (p = 0.014). CONCLUSIONS The findings of this study demonstrate that high field CMR is applicable to non-invasively determine and distinguish PWVs in the arterial system of healthy and diseased groups of mice.
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Affiliation(s)
- Marco Parczyk
- Julius-Maximilians-Universität Würzburg, Lehrstuhl für Experimentelle Physik 5, Am Hubland, 97074 Würzburg, Germany
| | - Volker Herold
- Julius-Maximilians-Universität Würzburg, Lehrstuhl für Experimentelle Physik 5, Am Hubland, 97074 Würzburg, Germany
| | - Gert Klug
- Julius-Maximilians-Universität Würzburg, Medizinische Klinik und Poliklinik I, Oberdürrbacher Straße 6, 97080 Würzburg, Germany
| | - Wolfgang R Bauer
- Julius-Maximilians-Universität Würzburg, Medizinische Klinik und Poliklinik I, Oberdürrbacher Straße 6, 97080 Würzburg, Germany
| | - Eberhard Rommel
- Julius-Maximilians-Universität Würzburg, Lehrstuhl für Experimentelle Physik 5, Am Hubland, 97074 Würzburg, Germany
| | - Peter M Jakob
- Julius-Maximilians-Universität Würzburg, Lehrstuhl für Experimentelle Physik 5, Am Hubland, 97074 Würzburg, Germany
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Increased arterial stiffness and impaired endothelial function in nonalcoholic Fatty liver disease: a pilot study. Am J Hypertens 2010; 23:1183-9. [PMID: 20634799 DOI: 10.1038/ajh.2010.144] [Citation(s) in RCA: 87] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Nonalcoholic fatty liver disease (NAFLD) is the most common liver disease both in the general and pediatric population and has been associated with increased cardiovascular risk. Arterial function and early atherosclerotic changes are markers of cardiovascular disease and independent predictors of the corresponding risk. Through a global approach, we investigated the relationships between NAFLD and functional arterial changes and early atherosclerosis. METHODS A total of 23 consecutive patients (mean age 55 ± 14 years, 11 males) with biopsy evidence of NAFLD and 28 control subjects matched for age, gender, body mass index, and other cardiovascular risk factors participated in the study. RESULTS Compared to controls, NAFLD subjects had significantly higher carotid-femoral pulse wave velocity (PWV; 8.2 ± 1.3 m/s vs. 6.9 ± 1.3 m/s, P = 0.001), higher carotid intima-media thickness (IMT; 0.79 ± 0.18 mm vs. 0.67 ± 0.13 mm, P = 0.01), and reduced flow-mediated dilatation (FMD; 1.92 ± 2.11% vs. 4.8 ± 2.43%, P < 0.001). In multivariable analysis, presence of NAFLD was an independent determinant of both PWV and FMD, whereas leptin was an independent determinant of PWV (B = 0.036, P < 0.05), and adiponectin was independently associated with FMD (B = 0.104, P < 0.05). In addition, histological activity of liver disease expressed by the global Brunt Grade was associated independently with FMD (B = -1.054, P < 0.05). CONCLUSIONS NAFLD is associated with arterial stiffness and endothelial dysfunction. Given the important independent prognostic role of these arterial indexes, these findings have important implications for increased cardiovascular risk in patients with NAFLD.
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Vyssoulis G, Karpanou E, Kyvelou SM, Vlachopoulos C, Tzamou V, Stefanadis C. Prostate-specific antigen levels are associated with arterial stiffness in essential hypertensive patients. J Sex Med 2010; 9:3205-10. [PMID: 20722777 DOI: 10.1111/j.1743-6109.2010.01979.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
INTRODUCTION Prostate-specific antigen (PSA) has been recently related to cardiovascular system in a multifactorial way. Arterial stiffness is a independent predictor of cardiovascular events and is involved in the pathogenesis of hypertension. The aim of the present study was to investigate whether PSA values, are associated with arterial stiffness indices in patients with essential arterial hypertension. METHODS The study comprised 150 consecutive male patients (mean age 60 years) with uncomplicated never-treated essential hypertension. All patients underwent a complete clinical and laboratory evaluation, including measurement of PSA levels. Aortic stiffness and arterial wave reflection assessment was made by using carotid-femoral (PWVc-f) pulse wave velocity and aortic augmentation index corrected for heart rate (AIx75). Patients with prostate cancer or benign prostate hyperplasia (PSA > 4 ng/mL) were excluded from the study. RESULTS PSA was positively associated with waist-to-hip ratio (r = 0.235, P = 0.04), PWVc-f (r = 0.426, P < 0.001), AIx75 (r = 0.264, P = 0.001), and high sensitivity C-reactive protein (hsCRP; r = 0.376, P < 0.001). In categorization to PSA quartiles, patients in the higher quartile presented with higher waist-to hip ratio (P = 0.009), PWVc-f (P < 0.00001), AIx75 (P < 0.001) and hsCRP (P < 0.001) values. In multivariate analysis after adjustment for various confounders PSA remained a significant determinant of PWVc-f values (beta [SE] = 0.477 [0.13], R(2) = 0.405, P < 0.001). CONCLUSION The present study points towards an association between PSA levels and aortic stiffness in untreated essential hypertensive males. Potential causal relationships between PSA and arterial stiffness remain to be further explored.
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Affiliation(s)
- Gregory Vyssoulis
- Hypertension Unit, 1st Cardiology Clinic Athens University, Hippokration Hospital, Athens, Greece
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Abstract
BACKGROUND Arterial stiffness and wave reflection alterations may be implicated in the association between cardiovascular mortality, meteorological variables and ambient particulate matter air pollution. The present study explored the cross-sectional relations between ambient environmental parameters, arterial stiffness, peripheral and central hemodynamics in a large-scale cohort of hypertensive patients and normotensive controls. METHODS The study comprised 1222 consecutive individuals who sought medical consultation in the hypertension outpatient clinics of the Hippokration' and 'Onassis' Hospitals (Athens, Greece) during a 3-year period (2004-2006). All individuals underwent a complete clinical and lipid-profile assessment at drug-free baseline. Carotid radial, carotid-femoral pulse wave velocity measurements and aortic pressure waveform analysis were performed noninvasively to all participants. Data from the National Technical University of Athens and the air quality department of the Hellenic Ministry for the Environment were used to estimate daily meteorological conditions and PM10 exposure. RESULTS In the total population, multiple-linear regression analysis revealed no significant associations between environmental variables and arterial stiffness. However, in men, the mean 5 day PM10 air concentration was independently associated with the augmentation pressure [2.0 mmHg (95% confidence interval (CI) 0.56-3.39) per 43.4 microg/m3] and the aortic-pulse pressure [2.78 mmHg (95% CI 3.91-5.12)] denoting a significant effect of particulate matter on the aortic-wave reflection magnitude and central hemodynamics. In addition, globally, the mean-daily temperature was related to the aortic-pulse pressure [-2.38 mmHg (95% CI -4.51 to -0.26) per 23.6 degrees C change] and the subendocardial viability ratio [5.85% (95% CI 1.1-10.6 per 23.6 degrees C)]. CONCLUSION The exposure to lower environmental temperatures is related to impaired hemodynamics not only to the periphery but also to the aorta. In men, PM10 air-pollution levels are associated with heightened amplitude of the reflection wave leading to significant alterations in central-pulse pressure.
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Determining That Aortic Valve Stenosis Is Severe: Back-to-the-Future. JACC Cardiovasc Imaging 2010; 3:563-6. [DOI: 10.1016/j.jcmg.2010.02.006] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2010] [Revised: 02/10/2010] [Accepted: 02/18/2010] [Indexed: 11/19/2022]
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Rogers DT, Colon M, Gambala C, Wilkins I, Hibbard JU. Effects of magnesium on central arterial compliance in preeclampsia. Am J Obstet Gynecol 2010; 202:448.e1-8. [PMID: 20452485 DOI: 10.1016/j.ajog.2010.03.049] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
OBJECTIVE The objective of the study was to investigate the effect of MgSO4 infusion on central arterial compliance, using radial artery applanation tonometry in women with preeclampsia. STUDY DESIGN Seventy women with preeclampsia were prospectively recruited. Radial pulse waveforms were obtained and the aortic waveforms constructed. The arterial compliance surrogates, augmentation pressure (AP) and augmentation index (AIx-75), were derived from the aortic waveform and then compared: prior to MgSO4 (t1), 1 hour after MgSO4 bolus (t2), 4 hours after MgSO4 infusion (t3), and 24 hours after MgSO4 cessation (t4). Statistical analysis was performed using differences of least squared means with Tukey Kramer adjustments. RESULTS The AP and AIx-75 at t2-t4 were significantly lower compared with t1, with the greatest decrease in arterial stiffness at t3 (P<.05). CONCLUSION In preeclampsia, MgSO4 improved central arterial compliance. This effect was most exaggerated after 4 hours of infusion and remained 24 hours following MgSO4 completion, suggesting either a sustained arterial compliance effect or resolution of the vasoconstrictive effect of preeclampsia.
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Affiliation(s)
- Dennie T Rogers
- Maternal-Fetal Medicine Division, Department of Obstetrics and Gynecology, University of Illinois Hospital at Chicago, Chicago, IL, USA
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Festa P, Ait-Ali L, Minichilli F, Kristo I, Deiana M, Picano E. A New Simple Method to Estimate Pulmonary Regurgitation by Echocardiography in Operated Fallot: Comparison With Magnetic Resonance Imaging and Performance Test Evaluation. J Am Soc Echocardiogr 2010; 23:496-503. [DOI: 10.1016/j.echo.2010.01.004] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2009] [Indexed: 11/25/2022]
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Papaioannou TG, Stamatelopoulos KS, Georgiopoulos G, Vlachopoulos C, Georgiou S, Lykka M, Lambrinoudaki I, Papamichael CM, Stefanadis CI. Arterial Wave Reflections During the Menstrual Cycle of Healthy Women. Hypertension 2009; 54:1021-7. [DOI: 10.1161/hypertensionaha.109.137703] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Increased wave reflection is an independent factor associated with cardiovascular diseases, risk, and mortality. The influence of the menstrual cycle on wave reflections and particularly on the reproducibility of their measurement has never been examined. The aim of the present study was to examine the reproducibility and variability of wave reflection indices in premenopausal healthy women during their menstrual cycle. Thirty-two women were examined at 3 phases of their menstrual cycle: days 1 to 2 (menstrual phase), days 6 to 14 (late follicular), and days 4 to 7 after ovulation (early luteal phase). Applanation tonometry of the radial artery and aortic pulse wave analysis were performed for the calculation of augmentation pressure, augmentation index, and timing of reflected waves. Reproducibility of these measures was evaluated by intraclass correlation coefficient and Bland-Altman analysis, whereas ANOVA was performed to assess their variability during the menstrual cycle. The SD of augmentation index differences between repeated measurements within the menstrual cycle ranged from 7.6% to 9.9%. Bland-Altman analysis indicated no evidence of systemic bias and no trend for the reproducibility of measurements to vary with their underlying mean value. Intraclass correlation coefficient indicated a moderate reproducibility of augmentation index and augmentation pressure (>0.80) and a rather low reproducibility for timing of reflected waves (0.43). Mean augmentation pressure, augmentation index, and timing of reflected waves did not vary significantly during the menstrual cycle (ANOVA). Measurement of wave reflections at the same phase of the menstrual cycle or statistical adjustment could be suggested for optimal study design and data interpretation.
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Affiliation(s)
- Theodore G. Papaioannou
- From the Biomedical Engineering Unit, 1st Department of Cardiology, Hippokration Hospital (T.G.P., C.V., C.I.S.), and Vascular Laboratory, Department of Clinical Therapeutics, Alexandra Hospital (K.S.S., G.G., S.G., M.L., I.L., C.M.P.), Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Kimon S. Stamatelopoulos
- From the Biomedical Engineering Unit, 1st Department of Cardiology, Hippokration Hospital (T.G.P., C.V., C.I.S.), and Vascular Laboratory, Department of Clinical Therapeutics, Alexandra Hospital (K.S.S., G.G., S.G., M.L., I.L., C.M.P.), Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - George Georgiopoulos
- From the Biomedical Engineering Unit, 1st Department of Cardiology, Hippokration Hospital (T.G.P., C.V., C.I.S.), and Vascular Laboratory, Department of Clinical Therapeutics, Alexandra Hospital (K.S.S., G.G., S.G., M.L., I.L., C.M.P.), Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Charalambos Vlachopoulos
- From the Biomedical Engineering Unit, 1st Department of Cardiology, Hippokration Hospital (T.G.P., C.V., C.I.S.), and Vascular Laboratory, Department of Clinical Therapeutics, Alexandra Hospital (K.S.S., G.G., S.G., M.L., I.L., C.M.P.), Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Stellios Georgiou
- From the Biomedical Engineering Unit, 1st Department of Cardiology, Hippokration Hospital (T.G.P., C.V., C.I.S.), and Vascular Laboratory, Department of Clinical Therapeutics, Alexandra Hospital (K.S.S., G.G., S.G., M.L., I.L., C.M.P.), Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Marita Lykka
- From the Biomedical Engineering Unit, 1st Department of Cardiology, Hippokration Hospital (T.G.P., C.V., C.I.S.), and Vascular Laboratory, Department of Clinical Therapeutics, Alexandra Hospital (K.S.S., G.G., S.G., M.L., I.L., C.M.P.), Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Irene Lambrinoudaki
- From the Biomedical Engineering Unit, 1st Department of Cardiology, Hippokration Hospital (T.G.P., C.V., C.I.S.), and Vascular Laboratory, Department of Clinical Therapeutics, Alexandra Hospital (K.S.S., G.G., S.G., M.L., I.L., C.M.P.), Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Christos M. Papamichael
- From the Biomedical Engineering Unit, 1st Department of Cardiology, Hippokration Hospital (T.G.P., C.V., C.I.S.), and Vascular Laboratory, Department of Clinical Therapeutics, Alexandra Hospital (K.S.S., G.G., S.G., M.L., I.L., C.M.P.), Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Christodoulos I. Stefanadis
- From the Biomedical Engineering Unit, 1st Department of Cardiology, Hippokration Hospital (T.G.P., C.V., C.I.S.), and Vascular Laboratory, Department of Clinical Therapeutics, Alexandra Hospital (K.S.S., G.G., S.G., M.L., I.L., C.M.P.), Medical School, National and Kapodistrian University of Athens, Athens, Greece
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Vukovic J, Modun D, Budimir D, Sutlovic D, Salamunic I, Zaja I, Boban M. Acute, food-induced moderate elevation of plasma uric acid protects against hyperoxia-induced oxidative stress and increase in arterial stiffness in healthy humans. Atherosclerosis 2009; 207:255-60. [DOI: 10.1016/j.atherosclerosis.2009.04.012] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2008] [Revised: 04/02/2009] [Accepted: 04/07/2009] [Indexed: 02/04/2023]
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Frimodt-Møller M, Nielsen AH, Kamper AL, Strandgaard S. Pulse‐wave morphology and pulse‐wave velocity in healthy human volunteers: Examination conditions. Scandinavian Journal of Clinical and Laboratory Investigation 2009; 66:385-94. [PMID: 16901849 DOI: 10.1080/00365510600731332] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
OBJECTIVE Applanation tonometry for pulse-wave analysis (PWA) and determination of pulse-wave velocity (PWV) is a non-invasive method for assessment of the central aortic pressure waveform and indices of arterial stiffness. The objective of this study was to examine the influence of eating and smoking on PWA and PWV measurements in order to establish standard examination conditions. Furthermore, intra- and interobserver reproducibility and the effects of varying the site of measurements were observed. MATERIAL AND METHODS Duplicate measurements of the radial pressure waveform and of the brachial and aortic PWV on the right and left side of the body were recorded in 23 healthy subjects by two trained observers. Measurements were performed in the fasting state and 3 h after a high-calorie meal, and before and 1 h after smoking a cigarette. RESULTS Intake of a high-calorie meal as well as smoking caused significant changes in both PWA and PWV parameters and an inter-arm difference was observed. Intra- and interobserver reproducibility was good. CONCLUSIONS Pulse-wave measurements by applanation tonometry should be undertaken in the same arm during fasting and smoking abstinence.
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Affiliation(s)
- M Frimodt-Møller
- Department of Nephrology, Herlev University Hospital, Herlev, Denmark.
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Arterial Compliance in the Elderly: Its Effect on Blood Pressure Measurement and Cardiovascular Outcomes. Clin Geriatr Med 2009; 25:191-205. [DOI: 10.1016/j.cger.2009.01.001] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Adamopoulos D, Argacha JF, Gujic M, Preumont N, Degaute JP, van de Borne P. Acute effects of nicotine on arterial stiffness and wave reflection in healthy young non-smokers. Clin Exp Pharmacol Physiol 2009; 36:784-9. [PMID: 19207722 DOI: 10.1111/j.1440-1681.2009.05141.x] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
1. Recently, we have demonstrated that cigarette smoke exposure proportionally increases plasma nicotine levels and arterial wave reflection to the aorta. However, the exact contribution of nicotine to the smoke-induced enhancement of wave reflection and the potential underlying mechanisms have not been fully investigated. 2. The present study was a prospective study in 15 healthy male non-smokers. All received a placebo and a 2 mg nicotine tablet, according to a randomized double-blind cross-over study design. Each subject underwent repeated measurements at baseline and for 1 h after nicotine or placebo intake, using carotid-femoral pulse wave velocity (PWV) to assess arterial compliance. Concurrently, aortic pressures and the augmentation index were evaluated using applanation tonometry. 3. Plasma nicotine concentrations achieved 1 h after intake of the nicotine tablet reached comparable levels to those achieved after 1 h exposure to passive smoke (3.6 +/- 0.4 vs 3.2 +/- 0.4 ng/mL, respectively; P = 0.4). 4. Nicotine enhanced arterial wave reflection to the aorta, as assessed by the augmentation index corrected for heart rate (4.2 +/- 1.3 vs-0.7 +/- 0.8% with placebo; P = 0.001). In addition, a progressive increase in carotid-femoral PWV was noted after nicotine administration (0.3 +/- 0.1 vs-0.02 +/- 0.1 m/s with placebo; P = 0.04). This remained significant even after adjustment for changes in mean blood pressure and heart rate (P = 0.01). 5. Plasma nicotine concentrations comparable to those achieved after exposure to passive smoke enhance arterial wave reflection to the aorta. This is accompanied by an increase in carotid-femoral PWV, denoting a deterioration of arterial compliance by nicotine.
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Heimann K, Steffen M, Bernstein N, Heerich N, Stanzel S, Cordes A, Leonhardt S, Wenzl TG, Orlikowsky T. Kontaktlose Überwachung von Atemtätigkeit und Herzaktion mittels magnetischer Bioimpedanzmessung in einem neonatalen Tiermodell / Non-contact monitoring of heart and lung activity using magnetic induction measurement in a neonatal animal model. ACTA ACUST UNITED AC 2009; 54:337-45. [DOI: 10.1515/bmt.2009.044] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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