Potassium (K) measures are associated with cardiovascular disease (CVD) risk factors, particularly blood pressure (BP). Arterial stiffness is a pre-clinical marker of CVD risk. We sought to study associations of K measures with arterial stiffness and CVD risk in a population at high-risk of CVD.

We studied participants from the Jackson Heart Study (JHS), a longitudinal cohort of adults racially minoritized as Black, who were without CVD at Visit 1 (2000-2004). We compared characteristics between participants with low-normal (lowK) (≤4.0 mmol/L) vs. high-normal (highK) (>4.0 mmol/L) serum K. We used multivariable regression to examine associations of serum and dietary K at Visit 1 with arterial stiffness [brachial artery pulse pressure (PP) and carotid-femoral pulse wave velocity (CFPWV)], measured between 2012 and 2017, incident CVD overall over up to 15 years of follow-up, and individual CVD outcomes.

We included 4035 JHS participants in our analyses; mean age was 54 years, 64 % were female. Participants with highK as compared to lowK had lower mean baseline BP and had reduced arterial stiffness. In adjusted models, higher serum K (per standard deviation increase) was associated with lower CFPWV [estimate (95 % CI) -1.66 (-2.88, -0.44)]. There was a significant difference in cumulative incidence of CVD, with the highK group having lower risk (P = 0.047); however, we did not observe statistically significant associations between serum K and any CVD outcomes after multivariable adjustment. We found no significant associations between dietary K and arterial stiffness or incident CVD.

In this cohort of Black adults, higher serum K was significantly associated with lower arterial stiffness. Further study is needed to assess the relationship between K's association with arterial stiffness and future CVD risk.

Sodium glucose cotransporter 2 inhibitors lower blood pressure. The underlying mechanisms are multifactorial and include effects on vascular function. We examined the systemic hemodynamic effects of empagliflozin in patients with type 2 diabetes mellitus (DM2) with and without chronic kidney disease (CKD) and in patients with nondiabetic CKD.

Three double-blinded, randomized, placebo-controlled cross-over trials, including patients with DM2 and preserved renal function ( n  = 16), DM2 and CKD ( n  = 17) and nondiabetic CKD ( n  = 16). Participants were randomized to 4 weeks of empagliflozin 10 mg or placebo and crossed over after a 2-week washout. We measured brachial and central 24-h ambulatory blood pressure (ABP), pulse wave velocity (PWV), augmentation index (AIx@75), markers of nitric oxide and erythrocyte sodium sensitivity (ESS), a marker of endothelial glycocalyx function.

Empagliflozin reduced PWV [-0.16 m/s, 95% confidence interval (95% CI): -0.26; -0.06, P  = 0.002], AIx@75 (-2.17%, 95% CI: -3.31; -1.02, P  < 0.001) and brachial and central ABP in the combined study population ( n  = 49). Changes in PWV and AIx@75 correlated to changes in systolic brachial ABP. Markers of nitric oxide did not increase, but empagliflozin decreased ESS, which was correlated to an increase in haematocrit.

Empagliflozin decreased arterial stiffness, mediated partly by a decrease in brachial ABP. We found no increase in nitric oxide activity, but ESS decreased. While this may be explained partly by a change in haematocrit, it could indicate an improvement in endothelial glycocalyx function.

EU Clinical Trials Register 2019-004303-12, 2019-004447-80 and 2019-004467-50.

Menopause is a significant physiological transition characterized by hormonal changes that can influence cardiovascular health. One key concern is increased arterial stiffness, a predictor of cardiovascular disease and adverse cardiovascular events. However, the independent association between menopause and arterial stiffness, beyond traditional cardiovascular risk factors, remains unclear. This study investigates the relationship between menopause and arterial stiffness index in the women's UK Biobank cohort.

This cross-sectional study included 52,891 women from the UK Biobank with measurements of arterial stiffness index. Arterial stiffness index was assessed using a non-invasive photoplethysmographic method. Multiple linear and logistic regression models were used to examine the association between menopause status and arterial stiffness index (continuous and cutoff>10 m/s), adjusting for age, body mass index, antihypertensive medication use, income, education, dyslipidemia, alcohol consumption, chronic kidney disease, smoking, diabetes, heart rate, mean blood pressure, hormone therapy, and previous cardiovascular disease.

Postmenopausal women had significantly higher values of arterial stiffness index (9.10 ± 4.61 m/s) than premenopausal women (7.76 ± 2.72 m/s, p < 0.001). Menopause was independently associated with increased arterial stiffness index (B = 0.22, 95 % CI [0.16-0.28], p < 0.001) and a higher odds ratio for arterial stiffness index >10 m/s (OR = 1.41, 95 % CI [1.31-1.51], p < 0.001), after adjusting for confounders.

Menopause is significantly associated with increased arterial stiffness, independent of traditional cardiovascular risk factors. These findings highlight menopause as a critical period for cardiovascular health assessment and prevention strategies.

People living with type 2 diabetes (T2D) are at a two- to four-fold higher risk of developing cardiovascular disease (CVD) compared with those without T2D, making early assessment of their CV risk essential. European Society of Cardiology (ESC) has developed a new model to estimate 10-year CV risk in people with T2D aged ≥ 40 years: SCORE2-Diabetes. Despite its advantages, several aspects remain to be clarified. This study evaluated the association between CV risk stratified by SCORE2-Diabetes and early CV damage assessed through arterial stiffness, intima-media thickness (IMT), and carotid atherosclerosis. Additionally, it examined the agreement between risk stratification by SCORE2 and SCORE2-Diabetes and their concordance with vascular damage.

Pulse wave velocity (PWV), IMT, and carotid atherosclerosis were assessed in 179 individuals with T2D aged 40-69 years, categorized into SCORE2-Diabetes risk groups: Low (n = 20), Moderate (n = 29), High (n = 44), and very high (n = 37). Patients with a history of atherosclerotic cardiovascular disease (ASCVD) or severe target organ damage (TOD) constituted another group (ASCVD/TOD, n = 49).

PWV was significantly increased from Low to very high and ASCVD/TOD groups (7.2 ± 1.1, 8.7 ± 1.9, 9.8 ± 2.3, 12.8 ± 5.1 and 11.5 ± 3.8 m/s, respectively). Similarly, IMT showed a stepwise increase with risk class (0.68 ± 0.11, 0.78 ± 0.13, 0.83 ± 0.12, 0.86 ± 0.19 and 0.87 ± 0.15 mm, respectively). Patients in very high or ASCVD/TOD group showed a higher prevalence of carotid atherosclerosis than other groups (0%, 17.24%, 11.40%, 37.83% and 40.81%, respectively). No significant differences were found between the very high and ASCVD/TOD groups in any parameter. The correlation between PWV values and increasing CV risk was stronger for SCORE2-Diabetes than for SCORE2. ROC curve analysis showed SCORE2-Diabetes had superior predictive performance for carotid atherosclerosis and high PWV compared to SCORE2 (p = 0.048).

Higher PWV, IMT, and carotid atherosclerosis prevalence were associated with increasing CV risk stratified by SCORE2-Diabetes, with no significant differences between the very high and ASCVD/TOD groups. SCORE2-Diabetes demonstrated a better identification of preclinical vascular damage compared to SCORE2, supporting its use as a reliable tool for identifying vascular damage in T2D patients without ASCVD or TOD.

This study aims to examine whether long working hours, repeatedly assessed at midlife, is associated with higher arterial stiffness at older age in a 24-year prospective study of white-collar workers in Quebec City, Canada.

This study relied on a prospective cohort, initiated in 1991-1993 (T1) with two follow-ups after 8 years (T2, 1999-2001) and 24 years (T3, 2015-2018). Participants (N = 1,629, 51.3% women, mean age 37 ± 6.4 at T1) were randomly selected for arterial stiffness measurement at T3 using carotid-femoral pulse wave velocity (PWV). Long working hours (> 40 h/week) were assessed at T1 and T2. Mean differences in PWV were estimated using generalized linear models, accounting for sociodemographic factors, lifestyle-related risk factors, clinical factors and psychosocial stressors at work.

Among participants who remained actively employed over the study period (age range: 21-59 at T1), long working hours at T1 were associated with a + 0.54 m/s (95% CI: 0.05; 1.02) increase in PWV, while repeated exposure at T1 and T2 was associated with a + 1.50 m/s (95% CI: 0.78; 2.21) increase. No association was observed among participants who retired between T2 and T3.

The present study suggests that exposure to long working hours during midlife is associated with higher arterial stiffness, among aging workers. Workplace preventive strategies reducing long working hours may be effective to mitigate long-term arterial stiffening.

Aortic pulse wave velocity (PWV) is an indicator of vascular aging and has proven to be effective in adult cardiovascular risk assessment. To use it in young people to identify those who may be at increased cardiovascular disease risk, reference values need to be determined. The Youth Vascular Consortium is a large, international database which was established to investigate vascular aging in youth. Using data from the Youth Vascular Consortium, this study aimed to develop reference values for aortic PWV in healthy young people.

This is a retrospective, multicenter study. Data on demographics, anthropometric, biochemical, and vascular aging measures from participants aged 1 year to 40 years were harmonized. Generalized additive models were used to derive percentile curves for PWV and predicted percentiles at years of age were reported by sex, continent, and device.

Data from 19 930 participants (mean age=17 years, 51% female, 71% European), classified as healthy based on blood pressure, body mass index, serum glucose, and cholesterol levels, were included to construct the reference values. Six devices were used to assess aortic PWV (29% SphygmoCor). Device-specific percentile curves for aortic PWV were constructed, and an increasing trend was identified for both sexes with age.

This study provided reference values for aortic PWV assessed with 6 devices for healthy young people by age and sex. These percentiles may be applied clinically to identify youth with impaired vascular aging and, thus, those who may be at risk of developing overt cardiovascular disease in the future.

Arterial stiffness (AS) is regarded as an independent predictor of cardiovascular events and all-cause mortality, and it is significantly associated with global mortality rates. Physical activity (PA) plays a positive role in reducing AS and improving cardiovascular health. The aim of this study is to compare the differences between high-intensity interval training (HIIT) and moderate-intensity continuous training (MICT) in their effects on reducing AS.

We conducted a comprehensive search of the PubMed, Cochrane, Embase, Web of Science, and EBSCO electronic databases, covering the period from their inception to January 10, 2025. We used a fixed-effect model to compare the changes in pulse wave velocity (PWV) before and after intervention between the HIIT group and the MICT group. Data were reported using the weighted mean difference (WMD) and 95 % confidence interval (95 % CI).

This study included 619 participants from 22 studies. Compared to MICT, HIIT demonstrated a more significant reduction in PWV (-0.10 m/s [95 % CI:0.16 to -0.03], P = 0.005). Additionally, we found that HIIT was superior in reducing CF-PWV (-0.10 m/s [95 % CI:0.17 to -0.02], P = 0.01).

HIIT is more effective than MICT in improving PWV and promoting arterial health in adults.

Arterial stiffness is associated with pathological changes underlying Alzheimer disease and related dementias. Total pulse wave velocity can be subdivided into 2 main mechanisms: structural arterial stiffness (S-PWV) due to intrinsic remodeling of the artery wall and load-dependent arterial stiffness due to increased blood pressure.

In this prospective cohort study, MESA (Multi-Ethnic Study of Atherosclerosis) participants completed B-mode carotid ultrasounds from which carotid total pulse wave velocity was calculated. S-PWV was calculated by adjusting pulse wave velocity to 120/80 mmHg using a nonlinear pressure-diameter relationship, and load-dependent arterial stiffness was derived by subtracting S-PWV from total pulse wave velocity. Participants had repeated cognitive assessments with the Cognitive Abilities Screening Instrument, Digit Symbol Coding, and Digit Span combined into a global cognitive composite (N=2489). Brain magnetic resonance imaging was used to generate total gray matter volume (N=906), white matter hyperintensity volume (N=896), and total white matter fractional anisotropy (N=810). Multivariable linear fixed and mixed effects regression models related standardized pulse wave velocity components to neuroimaging and cognitive decline parameters, respectively. Greater S-PWV was associated with greater longitudinal cognitive decline in global cognitive composite score (β=-0.05, P=0.002) and subtests, whereas greater load-dependent arterial stiffness was not associated with longitudinal cognitive decline. Greater S-PWV was associated with lower gray matter volume (β=-3183.4, P=0.013) and higher log white matter hyperintensity volume (β=0.20, P<0.001), whereas load-dependent arterial stiffness was associated with lower total white matter fractional anisotropy (β=-0.004, P≤0.001).

Higher structural stiffness of the carotid artery is associated with cognitive decline, whereas both structural and load-dependent stiffness are associated with brain structural abnormalities common in Alzheimer disease-related dementias.

Since the conceptualization of early vascular aging (EVA) in 2008, significant efforts have been made to develop and improve its assessment. Initially lead by the investigation of arterial stiffness through pulse wave velocity (PWV), several additional vascular aging biomarkers have gained prominence in recent years. Despite expanding literature addressing methodological concerns associated with these biomarkers in youth, a standardized approach for clinical evaluation of EVA remains elusive, leaving pertinent gaps in understanding the optimal methodology. This article, resulting from international consensus efforts from the Youth Vascular Consortium, aims to provide an updated overview of methods available to measure EVA in youth and to discuss challenges in translating these methods into clinical practice.

Recent evidence suggests that sex-related differences in cardiovascular health extend beyond traditional risk factors, affecting vascular structure and function. This study aimed to examine sex differences in vascular parameters, including central and peripheral blood pressure, pulse wave velocity (PWv), augmentation index at 75 bpm (AIx75), cardiac output, stroke volume, and peripheral vascular resistance, using harmonized data from three population-based cohorts (EVasCu, VascuNET, and ExIC-FEp) as part of the MUJER-EVA project. A total of 669 adult participants were included in this pooled cross-sectional analysis. Sex-stratified comparisons were conducted using multiple linear regression models adjusted for anthropometric, sociodemographic, and clinical covariates. The results showed that men had significantly higher values for central and peripheral blood pressure (p < 0.001), PWv (p = 0.003), cardiac output (p < 0.001), and stroke volume (p < 0.001), whereas women presented higher values of AIx75 (p < 0.001) and peripheral vascular resistance (p = 0.002). These differences remained statistically significant after full adjustment for potential confounders. These findings highlight the need to consider sex as a key biological variable in cardiovascular research and clinical decision-making. Incorporating sex-specific reference values and personalized treatment strategies could improve vascular health assessment and the effectiveness of cardiovascular disease prevention.

Peripheral artery disease (PAD) in the lower extremity arteries leads to significant morbidity and mortality. Arterial calcification contributes to poor clinical outcomes and greatly increases the risk of amputation. Current treatments for calcific lesions are limited and yield suboptimal results. A large animal model that closely mimics calcific PAD and accommodates human-sized devices could enhance the development of safer and more effective therapies. Our objective was to create a swine model of late-stage arterial calcification to test the efficacy and side effects of surgical interventions. To induce lesions, swine received injections of CaCl2 directly into the media and periadventitial spaces of the iliac, femoral, and popliteal arteries using a micro-needle catheter. The injection sites were varied to create eccentric and concentric lesions of differing lengths and patterns. Adjacent non-calcified arterial segments served as intersubject controls. The lesions were allowed to mature, and Computed Tomography Angiography and Intravascular Ultrasound imaging demonstrated ring-like calcification patterns and no pulsatility as early as 4 weeks after induction. Mechanical testing of excised arteries mirrored the mechanical properties of calcified human vessels, including characteristic stiffening. Histological analysis further confirmed that the calcified arteries in this model closely resembled human calcified femoropopliteal vessels, displaying inflammation, accumulation of collagen and glycosaminoglycans, elastin degradation, and smooth muscle cell loss within a degenerated tunica media. This porcine model replicates key pathological features of human calcific disease and provides a robust platform to evaluate the impacts and mechanisms of calcium-modifying treatments. STATEMENT OF SIGNIFICANCE: Arterial calcification is a key contributor to poor outcomes in peripheral artery disease (PAD). Our study presents a swine model of controlled peripheral artery calcification produced using targeted calcium chloride injections delivered endovascularly via a microneedle catheter. This approach creates arterial calcific lesions that closely replicate the mechanical, structural, and histological features of human calcified arteries. Additionally, the model accommodates human-sized devices, providing a robust platform for testing advanced biomaterials, devices, and therapies designed to modify or reverse calcification. By addressing a significant gap in preclinical research, our work aims to enhance treatment strategies for PAD, with the potential to reduce amputation rates and improve patient outcomes.

Carotid-femoral pulse wave velocity (cfPWV) is widely used to measure arterial stiffness. The type of legwear worn by participants during the measurement may introduce variabilities because different fabric materials and thicknesses may disturb arterial waveforms. Therefore, we investigated the impact of common legwear on cfPWV measured using tonometry and oscillometry. We studied 50 adults (36 women) varying widely in age (19-78 years). We evaluated cfPWV using two commonly used devices that detect femoral pulses using tonometric and cuff-based oscillometric sensors. The participants wore thin medical shorts as the reference condition, khaki pants, sweatpants, and athletic shorts, with an optional bare skin condition (optimum control) with 10 min of rest between measurements. Both devices produced similar cfPWV among different legwear with no significant systematic differences. The range of cfPWV was 647-649 cm/s for the tonometric device and 482-500 cm/s for the oscillometric device across different types of legwear. Mean values of cfPWV measured with a bare skin condition did not differ significantly from other legwear. No data output rates were 13% for khaki, 6% for sweatpants, 3% for medical shorts, athletic shorts, and bare skin using the tonometry while the oscillometric device had a 0% no data output rate among all conditions. We concluded that relatively thin legwear did not appear to affect arterial stiffness as assessed by cfPWV. However, stiffer legwear, such as khaki pants, presents a challenge to detect femoral pulses when using a tonometric sensor.

Diabetic retinopathy (DR) is a common microvascular complication of diabetes mellitus (DM). A number of studies have investigated if patients with diabetic retinopathy present altered arterial stiffness compared to diabetic individuals without retinopathy.

To compare arterial stiffness parameters in participants with diabetic retinopathy (DR) compared to participants with diabetes without retinopathy.

Medline and Scopus were searched for published articles comparing indices of arterial stiffness in participants with DR and in diabetic participants without retinopathy. Standardized Mean Difference (SMD) with 95% confidence interval (CI) was calculated for the comparisons. The study protocol was registered with PROSPERO with registration ID: CRD42023482577.

The meta-analysis analyzed 3 arterial stiffness parameters brachial ankle PWV, carotid-femoral PWV and augmentation index (AI). 8 studies were included in the analysis of brachial ankle PWV, 4 in the analysis of carotid-femoral PWV and 4 in the analysis of the augmentation index. Brachial ankle PWV, carotid-femoral PWV and augmentation index were found to be increased in participants with DR compared to diabetic participants without DR (SMD = 0.59, 95 %CI = 0.40-0.79, P < 0.00001, I2 = 89 %, SMD = 0.86, 95 %CI = 0.55-1.18P < 0.00001, I2 = 91 % and SMD = 0.23, 95 %CI = 0.13-0.32, P < 0.00001, I2 = 0 %, respectively).

Diabetic participants with DR exhibit increased arterial stiffness compared to diabetic participants without DR.

Vascular function is a critical determinant of cardiovascular health and all-cause mortality. Recent studies have suggested that intermittent fasting, a popular dietary strategy, elicits beneficial effects on vascular function. These studies also suggest that fasting-mediated improvements in vascular function coincide with reductions in systemic inflammation. However, the mechanisms that connect fasting, the immune system, and vascular function remain largely underexplored. The current review summarizes the effects of different intermittent fasting modalities on vascular health, focusing on endothelial dysfunction and arterial stiffness, 2 critical indices of vascular function. Improvements in vascular function are associated with reduced inflammation and are mechanistically linked to decreased circulating immune cells and their accumulation within the vascular wall and perivascular tissue. Recent data show that fasting redistributes circulating and tissue-resident immune cells to the bone marrow, affecting their inflammatory actions. However, there is no direct evidence relating immune cell redistribution to cardiovascular health. By relating fasting-induced immune cell redistribution to reduced inflammation and improved vascular function, we propose an exciting avenue of further exploration is determining whether fasting-induced immune cell redistribution impacts cardiovascular health.

Repeated exposures to acute psychological stress may be associated with cardiovascular disease (CVD) risk, but the mechanisms underlying this relationship are not fully understood. The objective of this meta-analysis was to determine the effect of acute psychological stress on central pulse wave velocity (PWV) compared to pre-stress (baseline) levels in adults free of overt CVD. Electronic databases (PubMed, SPORTDiscus, and Google Scholar) were queried from inception to July 2024. Reference lists of eligible studies and previous relevant reviews were also screened. Studies were included if: (i) a noninvasive measure of PWV was used that included a central (aortic) arterial segment; (ii) participants were adults (≥ 18 years) free of overt CVD; and (iii) the acute stressor was purely psychological in nature. Appraisal and Synthesis Methods: Effect sizes were calculated as standardized mean differences (SMD) and pooled using a random-effects model. The magnitude of effect was adjudicated as trivial (< 0.2), small (0.2), moderate (0.5), or large (0.8). A total of 11,689 studies were identified, from which 7 studies (11 effects, N = 162 participants) were eligible for inclusion. Moderate Acute psychological stress induced a moderate (SMD: 0.51, p < 0.0001; 95% CI: 0.34, 0.68) increase (detrimental) in central PWV, and there was insubstantial heterogeneity between studies (Cochran's Q (10) = 2.62 (p = 0.99)). The small overall number of studies as well as key differences in study methodologies limit the ability to elucidate the magnitude and consistency of stress-induced increases in PWV. Nonetheless, the present findings suggest that acute psychological stress induces significant increases in central PWV among adults free of overt CVD. The acute PWV response to psychological stress likely contributes to elevated CVD risk over time.

To evaluate the combination of novel colour Doppler US (CDUS), greyscale US (GSUS), and oscillometric indices of macroangiopathy in patients with idiopathic inflammatory myopathies (IIM). Second, to explore the associations between these imaging markers and both patient-related and disease-related characteristics, as well as traditional cardiovascular (CV) risk factors.

We conducted CDUS to evaluate arterial compliance markers, specifically the resistance (RI) and pulsatility (PI) indices, both in the common (CCA) and internal carotid arteries (ICA) of patients with IIM and healthy controls. Additionally, we performed GSUS examinations to measure carotid intima-media thickness (cIMT), identify plaques, and quantify cumulative carotid calcification surface. Oscillometric assessments determined aortic stiffness using carotid-femoral pulse wave velocity (cfPWV).

We recruited 82 IIM patients and 88 healthy controls. Patients showed significantly higher cIMT (Padj = 0.032), CCA-RI (Padj = 0.015), CCA-PI (Padj = 0.013), ICA-RI (Padj = 0.012), and ICA-PI (Padj = 0.039), compared with controls. RI and PI of CCA and ICA were higher in patients with lower lung function vital capacity, respectively (all Ps < 0.05). cfPWV correlated positively with traditional CV risk factors including age (ρ = 0.546, P < 0.001), mean arterial pressure (ρ = 0.331, P = 0.003), diabetes (P = 0.007), and hyperlipidaemia (P = 0.032), and associated negatively with lung carbon monoxide (CO) diffusion (ρ = -0.329, P = 0.031).

In one of the largest CV surrogate marker studies in IIM, patients exhibited increased carotid pulsatility, resistance, and atherosclerosis compared with controls. Lower lung function parameters predicted aortic stiffness and Doppler indices, suggesting a possible link between lung involvement and increased CV risk. Angiopathy markers may reveal significant vascular abnormalities in IIM patients, enhancing CV screening and risk classification.

Removing uremic toxins from the body is one of the most critical points in the maintenance hemodialysis (MHD) population. This study aimed to evaluate the effects of medium cutoff (MCO) membranes on pulse wave velocity (PWV) and augmentation index (AIx), early markers of arterial stiffness, in MHD patients over both short- and long-term periods.

Twenty MHD patients were included in this study. Patients were switched from low-flux to MCO membranes. Hemodynamic parameters and laboratory results were recorded in the low-flux membrane as baseline and the second week and the sixth month after switching to the MCO membranes. PWV and AIx were measured using the IME Mobil-O-Graph.

The median was 69.5 years old, with 60% female predominance. 35% of the patients were diabetic, 70% had hypertension, and 21.1% were smokers. The median systolic, diastolic blood pressure, mean arterial pressure, and pulse were similar at all study time points. The pulse pressure tended to decrease with a significant reduction in the sixth month (p = 0.73 and p = 0.03). We did not observe any significant differences regarding the PWV measurements (p = 0.71 and p = 0.62) and total vascular resistance (p = 0.23 and p = 0.79). The median AIx decreased during the study time points, with a significant difference between the second-week MCO and the sixth-month MCO measurements (p = 0.04).

Our findings underscore the potential benefits of MCO membranes to provide a favorable cardiovascular profile in conventional HD setting.

The effect of type 2 diabetes (T2D) on indices of cardiovascular function during exposure to cold or hot environmental temperatures is not well known. Therefore, the aim of our study was to assess the effect of short-term whole-body cold and heat exposure on the cardiovascular responses in individuals with T2D.

10 participants with T2D and hypertension (mean age 64 ± 4 years) and 10 controls (mean age 63 ± 5 years) underwent 90 min of whole-body exposure to cold (10°C; 10% relative humidity) and heat (40°C; 50% relative humidity) in a randomized sequence on differing days. Central and brachial blood pressure (BP), heart rate (HR), and skin blood flow were measured before, during, and after the exposure.

During cold exposure, subjects with T2D exhibited a smaller increase in central (14 (CI 95%:3, 23) vs. 43 (CI 95%:32, 53) mmHg, p < 0.05) and brachial systolic BP (12 (CI 95%:1, 22)) vs. 40 (CI 95%:30, 51) mmHg, p < 0.05) compared to controls. The corresponding reduction in HR in the cold was also less in T2D compared to controls (5 (CI 95%: 10, 0.02) vs. 9 (CI 95%: 14, -4) bpm, p < 0.05). Heat exposure reduced central and brachial BP similarly in both groups. However, the heat-related increase in HR was less pronounced in T2D subjects compared to controls (7 (CI 95%:1, 13) vs. 14 (CI 95%: 9, 19) bpm, p < 0.05). Finally, the magnitude of the increase in skin blood flow was less in the heat in T2D subjects (+210 (CI 95%: 41, 461) vs. +605 (CI 95%: 353, 855) PU, p < 0.05).

T2D attenuated cardiovascular responses, such as BP and HR during short-term exposure to cold, and HR and skin blood flow during short-term exposure to heat. These observations suggest impaired capacity to respond to environmental temperature extremes in individuals with T2D.

Background and Objectives: Cardiovascular diseases are prevalent entities, especially in emergency patients. Arterial stiffness is a known predictor of cardiovascular risk and mortality and is quantified by carotid-femoral pulse wave velocity (cfPWV). It is caused in part by vascular calcification, but exact details of the underlying mechanisms are yet to be elucidated, and current data suggest endocrine influences. This study thus aimed to assess the associations of endocrine parameters, particularly thyroid and parathyroid hormones, calcium, inorganic phosphate, and vitamin D, with cfPWV as a surrogate for arterial stiffness. Materials and Methods: Adults presenting to a single tertiary care emergency department in Vienna between 2018 and 2023 were prospectively enrolled. CfPWV was measured non-invasively, and levels of thyroid and parathyroid hormones and 25-hydroxyvitamin D, calcium, and inorganic phosphate were assessed. Results: In total, data from 827 patients, predominantly male (57%) and around 60 (47-72) years of age, were assessed. We observed a significant worsening of cfPWV with increasing parathyroid hormone levels (p < 0.001) and TSH levels (p = 0.03). No significant influences of calcium, inorganic phosphate, or 25-hydroxyvitamin D were observed. Conclusions: Thyroid and parathyroid hormone levels are associated with arterial stiffness in emergency department patients, suggesting a need for a comprehensive workup in patients at risk because of comorbidities and age. Additional prospective studies are needed to further elucidate the role of endocrinology in arterial stiffness and the subsequent relevance in emergency medicine.

Subclinical atherosclerosis is a "silent" cardiovascular disease that can be devastating when combined with other illnesses. Its presence may affect therapy responses but can potentially worsen hematological malignancies due to most chemotherapy regimens' cardiovascular adverse effects. Thus, cardiovascular risk factor (CVRF) assessment is required before chemotherapy. Unfortunately, this rarely happens.

we aim to examine the impact of CVRFs on hemodynamic parameters of acute leukemia (AL) patients before chemotherapy.

Overall, 45 AL patients and 26 controls were included. Intima-media thickness (IMT), ankle brachial index (ABI), pulse wave velocity (PWV), and functional cardiac parameters were used. CVRFs were found in 26 AL patients (36.6%), while 19 AL (26.8%) patients lacked CVRFs. CVRFs were also found in 26 controls (36.6%).

Left ventricular ejection fraction (LVEF) significantly decreased for patients with CVRFs (59.26 ± 5.62) compared to those without CVRFs (64.05 ± 7.43, p < 0.05). Hypertensive and diabetic patients had a significantly higher left IMT (mm) of 0.92 ± 0.01 compared to those without them (0.76 ± 0.03, p < 0.05). Patients with acute myeloid leukemia (AML) with CVRFs had a significantly higher PWV (m/s) of 8.4 ± 0.12 compared to those without CVRFs (6.87 ± 0.66) (p < 0.05).

AL and cardiovascular risk factors interacted before chemotherapy. To decrease cardiotoxicity, AL patients need cardiovascular risk assessment. Subclinical atherosclerosis and echocardiography help chemotherapy patients to choose a treatment regimen, predict long-term outcomes, and predict cardiovascular issues.

Objective. Large artery stiffening leads to an increase in cardiovascular risk and organ damage of the kidneys, brain or the heart. Biomarkers that allow for early detection of this phenomenon are a point of interest in research, with pulse-wave velocity (PWV) having been proven useful in predicting and monitoring arterial stiffness. We previously introduced a laser Doppler vibrometry (LDV) prototype which can measure carotid-femoral PWV (cfPWV). In this work, we assess the feasibility of using the same device to infer heart-carotid pulse-transit time (hcPTT) as a first step towards measuring heart-carotid PWV (hcPWV). The advantage of hcPWV over cfPWV is that the ascending aorta, which is the most distensible segment of the aorta contributing most to total arterial compliance, is included in the arterial pathway.Approach. Signals were simultaneously acquired from a location on the chest (near either the base or the apex of the heart) and the right carotid artery for 100 patients (45% female). Fiducial points on the heart waveforms are associated with opening and closure (second heart sound; S2) of the aortic valve, which can be combined with, respectively, the foot and dicrotic notch (DN) of the carotid waveform to retrieve hcPTT. Considering two distinct heart-signal measurement sites, four hcPTT estimations are evaluated in about 94% of all measurements.Main results. Correlations between these and known predictors of arterial stiffness i.e. age, blood pressure and carotid-femoral PTT via applanation tonometry indicated that combining S2 from a heart-measurement site located at the base of the heart, with the carotid DN yields hcPTT providing convincing correlations with known determinants of arterial stiffness (ρ = 0.377 with age).Significance.We conclude that LDV may provide a corollary biomarker of arterial stiffness, encompassing the ascending aorta.

Aortic dissection continues to be responsible for significant morbidity and mortality, although recent advances in medical data assimilation and in experimental and in silico models have improved our understanding of the initiation and progression of the accumulation of blood within the aortic wall. Hence, there remains a pressing necessity for innovative and enhanced models to more accurately characterize the associated pathological changes. Early on, experimental models were employed to uncover mechanisms in aortic dissection, such as hemodynamic changes and alterations in wall microstructure, and to assess the efficacy of medical implants. While experimental models were once the only option available, more recently they are also being used to validate in silico models. Based on an improved understanding of the deteriorated microstructure of the aortic wall, numerous multiscale material models have been proposed in recent decades to study the state of stress in dissected aortas, including the changes associated with damage and failure. Furthermore, when integrated with accessible patient-derived medical data, in silico models prove to be an invaluable tool for identifying correlations between hemodynamics, wall stresses, or thrombus formation in the deteriorated aortic wall. They are also advantageous for model-guided design of medical implants with the aim of evaluating the deployment and migration of implants in patients. Nonetheless, the utility of in silico models depends largely on patient-derived medical data, such as chosen boundary conditions or tissue properties. In this review article, our objective is to provide a thorough summary of medical data elucidating the pathological alterations associated with this disease. Concurrently, we aim to assess experimental models, as well as multiscale material and patient data-informed in silico models, that investigate various aspects of aortic dissection. In conclusion, we present a discourse on future perspectives, encompassing aspects of disease modeling, numerical challenges, and clinical applications, with a particular focus on aortic dissection. The aspiration is to inspire future studies, deepen our comprehension of the disease, and ultimately shape clinical care and treatment decisions.

Normotensive African Americans (AAs) show attenuated vascular responses and reduced nitric oxide (NO) bioavailability compared to European Americans (EAs). Few studies have used diverse measures to examine differences in macrovascular function and structure in individuals with a family history of CV disease (CVD). We assessed 150 AAs (Mage, 23.57 ± 2.73 yr) and 104 EAs (Mage, 22.70 ± 2.86) with a confirmed family history of CVD. Age, sex, body mass index, and father's education were used as covariates, hemodynamic measures (heart-rate [HR], stroke volume [SV], cardiac output [CO], total peripheral resistance [TPR], mean arterial pressure [MAP], systolic and diastolic blood pressure [SBP/DBP], and pulse pressure [PP]), high-frequency heart-rate variability [HF-HRV], and endothelial-dependent arterial dilation [EDAD] were the dependent variables. AA's had lower EDAD (11.64 vs. 13.20%) and higher HF-HRV (7.31 vs. 7.11 ms2), TPR (17.60 vs. 15.93 mmHg/L/min), TPI (33.72 vs. 30.09 mmHg/L/min/m2), MAP (83.60 vs. 78.36 mmHg), SBP (115.44 vs. 110.23 mmHg), and DBP (65.35 vs. 60.57 mmHg). Lower EDAD alongside no ethnic differences in PP, HR, or SV suggests early onset endothelial dysfunction (lower NO availability) rather than inherited pathophysiological structural characteristics (arterial stiffness) in AAs. Future prospective studies are needed and should consider measures of sympathetic activity and potential moderators, including discrimination.

Arterial stiffness is a cardiovascular risk factor that increases with age. Kyolic aged garlic extract has been shown to reduce arterial stiffness, while normalizing blood pressure, cholesterol and blood thickness. The present study hypothesized that increased flexibility of arteries could lead to slower blood flow and increased oxygen uptake and overall aerobic fitness. The present 12 week trial aimed to assess the effect of Kyolic aged garlic extract (AGE) on arterial stiffness, aerobic fitness, lactate threshold, recovery from muscle soreness and cardiovascular proteomic biomarkers in middle-aged (40-65 years) endurance athletes with elevated arterial stiffness. A total of 75 middle-aged recreational endurance athletes completed the trial, after being randomly allocated for 12 weeks to either the placebo or Kyolic aged garlic extract groups: low-dose cohort 1 (n=37), 2 capsules/day containing 1.2 g AGE powder and 1.2 mg S-allylcysteine (SAC); and the high-dose cohort 2 (n=38), 4 capsules/day of 2.4 g AGE powder and 2.4 mg SAC. Arterial stiffness was assessed through pulse wave velocity measurements and aerobic fitness was measured by volume-maximal-oxygen-consumption (VO2max) and lactate thresholds during high-intensity exercise using a cycle-ergometer-test-station, as well as measuring the levels of muscle fatigue and recovery time at 12 weeks compared with the baseline results. Urinary proteomic analysis was performed in a subgroup of participants and measured the levels of certain relevant proteins used as biomarkers for risk of cardiovascular events, at 12 weeks compared with baseline results. The Kyolic aged garlic extract group significantly improved their aerobic fitness, as was evidenced by increased VO2max, increased aerobic power, higher lactate threshold-to-oxygen uptake, higher lactate threshold-to-power output and quicker recovery times compared with the placebo group. Pulse wave velocity, a measure for arterial flexibility, was improved in the Kyolic aged garlic extract group compared with the placebo. The proteomics analysis demonstrated that a subset of polypeptides associated with cardiovascular risk, such as heart attacks and stroke, decreased in the Kyolic aged garlic extract group at 12 weeks compared with the baseline, which was contrary to the effects observed in the placebo group. Therefore, the results of the present study suggested that Kyolic aged garlic extract significantly improved aerobic fitness, lactate threshold, recovery and cardiovascular proteomic biomarkers in middle-aged endurance athletes within 12 weeks. The present clinical trial was registered on 11/03/2020 at the Australian New Zealand Clinical Trial Registry (trial registration no. ACTRN12620000340932).

We examined the association between clusters of vascular aging manifestations and ultrasensitivity cardiac troponin I in individuals without cardiovascular disease.

A cross-sectional analysis was conducted using baseline data from PPS-3 (Paris Prospective Study III), a French cohort of 10 157 participants. Cardiac troponin I was measured with an ultrasensitive immunoassay with a limit of detection of 0.013 pg/mL. Vascular aging manifestations were assessed via echotracking of the right common carotid artery to measure structural and functional parameters. Hierarchical clustering was used to identify clusters of vascular aging. Multinomial regression assessed the association between vascular aging clusters and cardiac troponin I quintiles. The study included 8722 cardiovascular disease-free participants (mean±SD age, 59.5±6.3 years; 39% women). Three vascular aging clusters were identified. Cluster 1 (n=4158; 47.4%) was characterized as healthy vascular aging with the lowest arteriosclerosis and atherosclerosis indices; cluster 2 (n=2237; 25.5%) was characterized by the highest arteriosclerosis indices, including increased pulse wave velocity, β index, and Young elastic modulus and lowest distensibility coefficient; and cluster 3 (n=2377; 27.0%) was characterized by the highest atherosclerosis indices, including more frequent plaque prevalence and greater intima-media thickness. Compared with healthy vascular aging, arteriosclerosis and atherosclerosis clusters showed a graded positive association with cardiac troponin I quintiles, independent of traditional risk factors. The adjusted odds ratio for belonging to the highest quintile (quintile 5 versus quintile 1) was 1.55 (95% CI, 1.31-1.92) for arteriosclerosis and 2.66 (95% CI, 2.18-3.23) for atherosclerosis clusters.

Vascular aging manifestations of arteriosclerosis and atherosclerosis may partly explain the release of troponin I into the bloodstream in adults without clinical cardiovascular disease.

URL: https://clinicaltrials.gov; Unique identifier: NCT00741728.

Heart failure with preserved ejection fraction (HFpEF) is a high prevalence condition, with high rates of hospitalization and mortality. Arterial hypertension is the main risk factor for HFpEF. Among hypertensive patients, alterations in cardiac and vascular morphology identify hypertension-mediated organ damage (HMOD). Cardiac HMOD in terms of ventricular hypertrophy and diastolic dysfunction is a continuum between the preclinical condition (arterial hypertension) and HFpEF. In hypertensive patients, it is currently unknown what is the prevalence of individuals classifiable as being at high risk of developing HFpEF and whether aortic morphofunctional vascular changes are present.

This study seeks to retrospectively assess the prevalence of echocardiographic alterations consistent with the diagnosis of HFpEF in a cohort of patients with essential arterial hypertension, and the prevalence of vascular HMOD (V-HMOD) in different risk categories of patients.

Hypertensive outpatients referred at the Hypertension Center of Turin from 2003 to 2021 were retrospectively evaluated. Patients with a previous diagnosis of heart failure and known cardiovascular events were excluded. A predictive model associated with the risk of HFpEF development was calculated using echocardiographic variables. V-HMOD morphological and functional parameters were assessed by ascending aorta diameter and arterial stiffness (carotid-femoral pulse wave velocity, cfPWV).

Eight hundred and four patients (34.8% women) were analyzed, age 53.1 ± 14 years; left ventricular mass index (LVMi) and E / e' ratio were impaired in 15.9 and 29.1% of cases, respectively. Dividing them into tertiles according to score: score 1 or less (30.2%); score 2-3 (47.4%); score at least 3 (22.7%). Patients identified at high risk of HFpEF (score ≥3) had higher age, BMI and blood pressure than the other two groups ( P  < 0.05); they showed a significantly higher prevalence of female patients (42.3%), treatment with at least two antihypertensive drugs (40.1%), diabetes (7.1%), and dyslipidemia (28%; P  < 0.05), with a larger ascending aorta diameter (35.5 ± 5.5 mm, P  < 0.05) and higher cfPWV (8.8 ± 2.4 m/s, P  < 0.05).

At least one in five hypertensive patients, referred to an outpatient echocardiographic examination, has C-HMOD compatible with a high-risk category of HFpEF and have a significant increase in V-HMOD. This reinforces the notion that arterial hypertension and HFpEF are not two distinctly separate conditions but a continuum of pathophysiologic alterations.

To assess the relationship between arterial stiffness, an early marker of macrovascular cardiovascular disease, and microvascular complications in adolescents and young adults with youth-onset diabetes.

This study included 1,226 individuals (median age at initial visit 18 years; 58% female; 53% non-Hispanic White, 22% non-Hispanic Black, and 20% Hispanic) with youth-onset type 1 or type 2 diabetes from the SEARCH for Diabetes in Youth Study. Arterial stiffness measures included pulse wave velocity for carotid femoral, carotid radial, femoral foot, and augmentation index (AIx). Microvascular complications included microalbuminuria, peripheral neuropathy, and retinopathy. Participants were followed up once at ∼5 years.

Cross-sectionally, in type 1 diabetes, AIx was associated with higher odds of having any one microvascular complication (odds ratio [OR] 1.35; 95% CI 1.04-1.76), microalbuminuria (OR 2.76; 95% CI 1.78-4.39), neuropathy (OR 1.63; 95% CI 1.07-2.50), and retinopathy (OR 1.37; 95% CI 1.06-1.79). In type 2 diabetes, AIx was associated with higher odds of microalbuminuria (OR 2.05; 95% CI 1.04-4.33; all P < 0.05). In longitudinal analysis, in type 1 diabetes, a change in AIx was associated with the development of any one microvascular complication (OR 1.45; 95% CI 1.15-1.82), microalbuminuria (OR 5.42; 95% CI 1.98-14.80), neuropathy (OR 2.03; 95% CI 1.22-3.40), and retinopathy (OR 1.48; 95% CI 1.15-1.90). In type 2 diabetes, a change in AIx was associated with the development of microalbuminuria (OR 21.98; 95% CI 1.30-372.88; all P < 0.05).

Arterial stiffness is related to and predicts microvascular complications in youth-onset type 1 and type 2 diabetes.

There is a strong association between hypertension and cerebrovascular disease, mainly with stroke and cognitive impairment. However, but the mechanistic of this relationship are not completely understood.

To analyze the relationship of central, peripheral blood pressure (BP) and arterial stiffness, with intracranial pressure (ICP) in long-term chronic hypertensive patients.

Adult individuals were consecutively included in the study from November 2022 to August 2023. The cut-off point identified to define intracranial hypertension (ICHT) by the wave peak (P2/P1) ratio was > 1.2, and the cut-off for time to peak (TTP) was > 0.25. The level of significance adopted in the statistical analysis was 5%.

A total of 145 patients (32 male, 113 female) with long-term hypertension (average of time since diagnoses 20 ± 12 years) were evaluated over a period of 10 months. The median age was 69.0 (61.8 - 75.7) years and median body mass index 29.0 (25.4 - 33.1) kg/m2. Median value of P2/P1 ratio for all cohort was 1.4 (1.2 - 1.5) and TTP 0.24 (0.21 - 0.29). The analysis was performed considering presence or not of ICHT, and parameters of central BP and pulse wave velocity. There was higher central systolic (SBP), diastolic blood pressure (DBP), and peripheral DBP among patients with ICHT based on the P2/P1 ratio.

Central SBP levels are more linked to ICHT than office peripheral SBP measurements, while DBP measurements are similar, raising questions about the most suitable BP assessment method for hypertensive patients with cerebrovascular damage.

To assess the available evidence on whether nonsurgical periodontal treatment (NSPT) improves arterial stiffness outcomes in patients with periodontitis (PD).

Following the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines and population, intervention, comparison, outcomes, and study design (PICOS) question, electronic databases were screened for clinical interventional studies addressing the impact of NSPT on pulse wave velocity (PWV), carotid intima-media thickness (CIMT), and flow-mediated dilatation (FMD) outcomes in PD patients. Furthermore, the research strategy was implemented using a hand search. Studies were selected, and data were extracted by two independent reviewers. Random effects models were applied to perform a meta-analysis, and methodological index for nonrandomized studies (MINORS) and Cochrane Rob2 tools were used to assess the risk of bias.

Fifteen articles were finally included for qualitative synthesis. Among them, eight single-arm cohort studies met the final inclusion criteria for meta-analysis. The Rob2 analysis evidenced that one randomized clinical trial (RCT) had a low risk, three RCTs raised some concerns, and three RCTs had a high risk of bias, while the MINORS scores ranged from 9 to 14. The meta-analysis showed that NSPT significantly impacted FMD (p < 0.001) and CIMT (p = 0.004), while changes in PWV were not statistically significant. However, there was high heterogeneity among studies (I2 = 78% for FMD and I2 = 62% for CIMT).

Despite some beneficial effects on FMD and CIMT, due to study limitations, high heterogeneity, and risk of bias, it cannot be concluded that NSPT is effective in improving arterial stiffness. Therefore, further studies are necessary to achieve high-quality evidence on the effect of NSPT on arterial stiffness outcomes in PD patients.

PROSPERO ID CRD42024501399.

Periodontitis (PD) has been associated with alterations in arterial stiffness outcomes related to early endothelial dysfunction. Based on noninterventional studies, this meta-analysis indicates that nonsurgical periodontal treatment (NSPT) may reduce cardiovascular disease risk in patients with PD. The moderate evidence derived from the studies that were finally included showed that NSPT had beneficial effects on flow-mediated dilatation and carotid intima-media thickness, while this trend was not observed for pulse wave velocity. Moreover, the findings of the present meta-analysis were characterized by high heterogeneity and risk of bias and were derived from uncontrolled clinical trials or randomized clinical trials with limitations. Therefore, more studies with standardized protocols and homogeneous arterial stiffness outcomes are needed to elevate the quality of the present evidence.

This study aims to describe the prevalence of discordant mild/moderate aortic stenosis (AS) in a population-based study and to identify the mechanisms that lead to reduced stroke volume (SV) and discordant moderate AS.

Discordant high-gradient (HG)-mild AS, defined as AVA > 1.5 cm2 and mean pressure gradient (MG) of 20-40 mmHg, and discordant low-gradient (LG) moderate AS, defined as AVA 1.0-1.5 cm2 and MG < 20 mmHg, were assessed in 883 individuals from the DANCAVAS screening study with aortic valve calcification and 257 individuals form the PROGRESSA study excluding those with left ventricular (LV) ejection fraction < 50%. In the DANCAVAS cohort, 150 men had mild/moderate AS of which 34% had discordance between MG and AVA, representing 66% with moderate AS. Among 262 patients in the combined cohort, 39% had discordant LG-moderate AS and 6% discordant HG-mild AS. Compared with concordant mild and moderate AS, individuals with discordant LG-moderate AS were more likely to present with LV concentric remodelling geometry (26 vs. 33 vs. 45%, P < 0.001), increased valvulo-arterial impedance (3.3 ± 0.7 vs. 3.6 ± 0.5 vs. 4.1 ± 0.7 mmHg/mL/m2, P < 0.001), and reduced systemic arterial compliance (SAC) (0.74 ± 0.22 vs. 0.81 ± 0.22 vs. 0.64 ± 0.18 mL/m2/mmHg, P < 0.001). Factors associated with SV index were relative wall thickness, LV end-diastolic diameter index, SAC, and LV remodelling pattern.

Discordant moderate AS is common, accounting for two-thirds of patients with moderate AS in the general male population. Patients with discordant LG-moderate AS have predominantly a concentric remodelling pattern with reduced SV. Reduced SV index was associated with signs of reduced vascular compliance, suggesting that altered vascular properties drive differences in remodelling patterns and discordant moderate AS.

Hypertension and vascular dysfunction are major health concerns, and studies have suggested different interventions, including dietary nitrate (NO3), to improve it. We sought to elucidate the effects of dietary NO3 on plasma NO3 and nitrite (NO2) levels and to determine the shape of the effect of dietary NO3 on blood pressure (BP) and vascular health biomarkers.

PubMed, Scopus, and Web of Science were searched up to February 2024 for eligible randomized controlled trials (RCTs). The pooled results were reported as weighted mean differences (WMD) and 95% confidence intervals (CIs).

Our analysis of 75 RCTs involving 1823 participants revealed that per each millimole (mmol) increase in the administered NO3 dose, both acute (WMD: 32.7µmol/L; 95%CI: 26.1, 39.4) and chronic-term (WMD: 19.6µmol/L; 95%CI: 9.95, 29.3) plasma NO3 levels increased. Per each mmol increase in NO3 intake, a reduction in systolic BP levels was observed in the acute (WMD: -0.28mmHg; 95%CI: -0.40, -0.17), short-term (WMD: -0.24mmHg; 95%CI: -0.40, -0.07), and medium-term (WMD: -0.48mmHg; 95%CI: -0.71, -0.25) periods. Furthermore, a decrease in diastolic BP for each mmol increase in NO3 intake (WMD: -0.12 mmHg; 95% CI: -0.21, -0.03) was shown. Moreover, a linear dose-response relationship was indicated between each mmol of NO3 intake and medium-term pulse wave velocity (WMD: -0.07 m/s; 95%CI: -0.11, -0.03), medium-term flow-mediated dilation (WMD: 0.30%; 95%CI: 0.15, 0.46), and medium-term augmentation index (WMD: -0.57%; 95%CI: -0.98, -0.15).

We observed dose-dependent increases in plasma NO3 and NO2 levels, along with consequent reductions in BP and enhancements in vascular health following dietary NO3 supplementation. Future high-quality, population-specific studies with optimized dietary NO3 dosages are needed to strengthen the certainty of the evidence.

The protocol for this systematic review was registered in PROSPERO under the registration number CRD42024535335.

Hypercholesterolemia is associated with endothelial dysfunction. While good evidence exists for the beneficial endothelial effects of statins, less is known on the new class of proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors.

The goal of this study was to study the effects of PCSK9 inhibitors on markers of micro- and macrovascular endothelial function and arterial stiffness.

In this prospective observational study, cardiovascular high-risk patients were measured for retinal microvascular function, brachial artery flow-mediated dilatation (FMD), and arterial stiffness (pulse wave velocity [PWV]; augmentation index [AI]) at baseline and after 3 and 12 months of PCSK9 inhibitor therapy. The primary endpoint was the change in flicker-induced dilatation of retinal arterioles (FIDart) after 12 months compared to baseline.

The final study cohort included 42 patients (mean age 56 ± 12 years; 74% male; 76% coronary artery disease). Low-density lipoprotein (LDL) cholesterol was reduced from 3.8 ± 1.2 to 1.8 ± 0.9 mmol/L after 12 months. Retinal microvascular function (FIDart 2.6% ± 1.6% at baseline vs 3.4% ± 2.3% after 12 months, p = .01) and AI (24% ± 9% at baseline vs 21% ± 12% after 12 months, p = .03) improved significantly on PCSK9 inhibitor therapy. No significant changes were observed for FMD, PWV, and other retinal vascular measurements.

In cardiovascular high-risk patients, PCSK9 inhibition is associated with an improvement of retinal flicker-induced dilatation and AI, thereby linking LDL lowering with improvement of microvascular function.

Stroke volume (SV) is a major indicator of cardiovascular function, providing essential information about heart performance and blood flow adequacy. Accurate SV measurement is particularly important for assessing patients with heart failure, managing patients undergoing major surgeries, and delivering optimal care in critical settings. Traditional methods for estimating SV, such as thermodilution, are invasive and unsuitable for routine diagnostics. Non-invasive techniques, although safer and more accessible, often lack the precision and user-friendliness needed for continuous bedside monitoring. We developed a modified method for SV estimation that combines a validated 1-D model of the systemic circulation with machine learning. Our approach replaces the traditional optimization process developed in our previous work, with a regression method, utilizing an in silico-generated dataset of various hemodynamic profiles to create a gradient boosting regression-enabled SV estimator. This dataset accurately mimics the dynamic characteristics of the 1-D model, allowing for precise SV predictions without resource-intensive parameter adjustments. We evaluated our method against SV values derived from the gold standard thermodilution method in 24 patients. The results demonstrated that our approach provides a satisfactory agreement between the predicted and reference data, with a MAE of 16 mL, a normalized RMSE of 21%, a bias of -9.2 mL, and limits of agreement (LoA) of [-47, 28] mL. A correlation coefficient of r = 0.7 (p < 0.05) was reported, with the predicted SV slightly underestimated (68 ± 23 mL) in comparison to the reference SV (77 ± 26 mL). The significant reduction in computational time of our method for SV assessment should make it suitable for real-time clinical applications.

This case series describes five pediatric patients with acute myocarditis presenting holodiastolic flow reversal in the descending aorta despite the absence of aortic run-off lesions. This Doppler finding highlights the role of aortitis or Concomitant Acute Myocarditis and Aortitis (CAMA). Cardiac magnetic resonance imaging (MRI) with late gadolinium enhancement (LGE) confirmed myocarditis in three cases. Key findings included poor response to exogenous catecholamines, elevated troponin I, hyponatremia, low vitamin D, and frequent biventricular involvement. Outcomes included one successful cardiac transplantation, one requiring levosimendan, and three fatalities. Low diastolic blood pressure and flow reversal in the descending aorta are critical clues for diagnosing CAMA. Clinical implications, pathophysiology, and management are discussed.

This study explores the feasibility of continuous pulse wave velocity (PWV) monitoring during general anaesthesia (GA), particularly in response to blood pressure fluctuations. Our aim is to evaluate whether dynamic PWV can provide new insight to detect cardiovascular risks. From December 2022 to February 2023, continuous carotid and femoral Doppler monitoring was performed on patients scheduled for surgery with GA, to collect PWV data at awakening (PWVAW) and during GA (PWVGA). The study investigated PWV's response to MAP fluctuations using the α-angle, a dynamic stiffness parameter. We evaluated PWV and α-angle efficacy in discriminating between low (CVR-) and high (CVR+) cardiovascular risk patients. Among 43 patients, 41 (95%) had successful PWV measurements. PWVAW was significantly higher than PWVGA (8.1 vs. 7.4 m.s-1, p < 0.0001). This difference vanished after matching MAP levels. A strong correlation was found between PWVAW and PWVGA (r = 0.88, and r = 0.97 at the same MAP levels). PWVGA, α-angle and their product (α x PWVGA) were significantly higher in CVR + patients (8.1 vs. 6.9 m.s-1, p < 0.01; 2.6 vs. 1.3 degrees, p < 0.001; 21.8 vs. 8.1 degrees.m.s-1, p < 0.001, respectively), with AUC values indicating good predictive capabilities for cardiovascular risk (PWVGA: AUC [95%CI] = 0.80 [0.65-0.95]; α-angle: 0.83 [0.69-0.96]; product: 0.86 [0.74-0.97]). Measurement of PWV under GA using carotid and femoral Doppler is a feasible method to continuously assess arterial stiffness under general anaesthesia. Further studies are required to validate the α-angle parameter in different physiological conditions.