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Yamakoshi T, Rolfe P, Yamakoshi KI. Peripheral arterial elasticity changes derived by volume-oscillometry in reaction to hyperemia as a possible assessment of flow-mediated vasodilatation. Sci Rep 2022; 12:19479. [PMID: 36376342 PMCID: PMC9663529 DOI: 10.1038/s41598-022-22050-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Accepted: 10/07/2022] [Indexed: 11/16/2022] Open
Abstract
The flow-mediated dilation (FMD) test is commonly utilized and is the only technique for the assessment of vascular endothelial cell function. With this test, the augmentation of a brachial artery diameter following reactive hyperemia is measured precisely using ultrasonography by a skilled operator. This is a hospital-only test, and would be more useful if conveniently performed at home. This paper describes a first approach for studying the impact of changes in peripheral arterial elasticity, with prospects towards possible assessment of functional reactivity. A recently developed smartphone-based instrument was used to measure elastic properties of finger and radial arteries, related to stiffness and vasodilatation, as a function of distending pressure derived by photo-plethysmographic volume-oscillometry. Elasticity changes in both arteries before and after a 5-min supra-systolic upper-arm cuff occlusion were successfully obtained in 15 normal volunteers. The index-values of stiffness and vasodilatation showed, respectively, a significant decrease and increase (p < 0.01), demonstrating clearly the expected elasticity changes with hyperemia, which could be consistent with the clinically-stated reaction in an FMD test. The results suggest that this method could easily provide important information of both elasticity and vasodilatation. It appears promising as a convenient assessment method to contribute to arteriosclerotic cardiovascular screening.
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Affiliation(s)
- Takehiro Yamakoshi
- grid.9707.90000 0001 2308 3329Institute of Liberal Arts and Science, Kanazawa University, Kakuma-machi, Kanazawa, Ishikawa 920-1192 Japan ,Department of Research and Development, Nonprofit Organization of Research Institute of Life Benefit, 6-11-7-1 Sumikawa, Minami-ku, Sapporo, Hokkaido 005-0006 Japan
| | - Peter Rolfe
- grid.19373.3f0000 0001 0193 3564Department of Automatic Measurement and Control, Harbin Institute of Technology, No. 92 West Dazhi Street, Nan Gang District, Harbin, 150001 Heilongjiang Province China ,Science and Technology, Oxford BioHorizons Ltd., 23 West Bar St., Banbury, OX16 9SA Oxfordshire UK
| | - Ken-ichi Yamakoshi
- grid.9707.90000 0001 2308 3329College of Science and Engineering, Kanazawa University, Kakuma-machi, Kanazawa, Ishikawa 920-1192 Japan ,grid.410714.70000 0000 8864 3422Department of Orthopaedic Surgery, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo, 142-8555 Japan ,Nonprofit Organization of Research Institute of Life Benefit, 6-11-7-1 Sumikawa, Minami-ku, Sapporo, Hokkaido 005-0006 Japan
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2
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Hidaka T, Sumimoto Y, Dohi Y, Morimoto H, Susawa H, Nitta K, Ishibashi K, Kurisu S, Fukuda Y, Hashimoto H, Matsui S, Kishimoto S, Kajikawa M, Maruhashi T, Ukawa T, Goto C, Nakashima A, Noma K, Tsuji T, Kihara Y, Higashi Y. Non-Invasive Central Venous Pressure Measurement Using Enclosed-Zone Central Venous Pressure (ezCVP TM). Circ J 2020; 84:1112-1117. [PMID: 32418957 DOI: 10.1253/circj.cj-20-0129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND Central venous pressure (CVP) is measured to assess intravascular fluid status. Although the clinical gold standard for evaluating CVP is invasive measurement using catheterization, the use of catheterization is limited in a clinical setting because of its invasiveness. We developed novel non-invasive technique, enclosed-zone (ezCVPTM) measurement for estimating CVP. The purpose of this study was to assess the feasibility of ezCVP and the relationship between ezCVP and CVP measured by a catheter.Methods and Results:We conducted 291 measurements in 97 patients. Linear regression analysis revealed that ezCVP was significantly correlated with CVP (r=0.65, P<0.0001). The Bland-Altman analysis showed that ezCVP had an underestimation bias of -2.5 mmHg with 95% limits of agreement of -14.1 mmHg and 9.6 mmHg for CVP (P<0.0001). The areas under the curves of receiver operating curve with ezCVP to detect the CVP ≥12 cmH2O (8.8 mmHg) and CVP >10 mmHg were 0.81 or 0.88, respectively. The sensitivity, specificity and positive likelihood ratio of ezCVP for the CVP ≥8.8 mmHg and CVP >10 mmHg were 0.59, 0.96 and 14.8 with a cut-off value of 11.9 and 0.79, 0.97 and 26.3 with a cut-off value of 12.7. CONCLUSIONS These findings suggest that ezCVP measurement is feasible and useful for assessing CVP.
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Affiliation(s)
- Takayuki Hidaka
- Department of Cardiovascular Medicine, Hiroshima University Graduate School of Biomedical and Health Science
| | - Yoji Sumimoto
- Department of Cardiovascular Medicine, Hiroshima University Graduate School of Biomedical and Health Science
| | - Yoshihiro Dohi
- Department of Cardiovascular Medicine, Hiroshima University Graduate School of Biomedical and Health Science
| | | | - Hitoshi Susawa
- Department of Cardiovascular Medicine, Hiroshima University Graduate School of Biomedical and Health Science
| | - Kazuhiro Nitta
- Department of Cardiovascular Medicine, Hiroshima University Graduate School of Biomedical and Health Science
| | - Ken Ishibashi
- Department of Cardiovascular Medicine, Hiroshima University Graduate School of Biomedical and Health Science
| | - Satoru Kurisu
- Department of Cardiovascular Medicine, Hiroshima University Graduate School of Biomedical and Health Science
| | - Yukihiro Fukuda
- Department of Cardiovascular Medicine, Hiroshima University Graduate School of Biomedical and Health Science
| | - Haruki Hashimoto
- Department of Cardiovascular Medicine, Hiroshima University Graduate School of Biomedical and Health Science
| | - Shogo Matsui
- Department of Cardiovascular Medicine, Hiroshima University Graduate School of Biomedical and Health Science
| | - Shinji Kishimoto
- Department of Cardiovascular Medicine, Hiroshima University Graduate School of Biomedical and Health Science
| | - Masato Kajikawa
- Division of Regeneration and Medicine, Hiroshima University Hospital
| | - Tatsuya Maruhashi
- Department of Cardiovascular Medicine, Hiroshima University Graduate School of Biomedical and Health Science
| | | | | | - Ayumu Nakashima
- Department of Cardiovascular Regeneration and Medicine, Research Institute for Radiation Biology and Medicine, Hiroshima University
| | - Kensuke Noma
- Department of Cardiovascular Regeneration and Medicine, Research Institute for Radiation Biology and Medicine, Hiroshima University
| | - Toshio Tsuji
- Graduate School of Engineering, Hiroshima University
| | - Yasuki Kihara
- Department of Cardiovascular Medicine, Hiroshima University Graduate School of Biomedical and Health Science
| | - Yukihito Higashi
- Division of Regeneration and Medicine, Hiroshima University Hospital.,Department of Cardiovascular Regeneration and Medicine, Research Institute for Radiation Biology and Medicine, Hiroshima University
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3
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Tanaka H, Mito A, Hirano H, Soh Z, Nakamura R, Saeki N, Kawamoto M, Higashi Y, Yoshizumi M, Tsuji T. Estimation of Arterial Viscosity Based on an Oscillometric Method and Its Application in Evaluating the Vascular Endothelial Function. Sci Rep 2019; 9:2609. [PMID: 30796239 PMCID: PMC6384877 DOI: 10.1038/s41598-019-38776-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2018] [Accepted: 01/10/2019] [Indexed: 11/20/2022] Open
Abstract
This paper proposes an algorithm for estimating the arterial viscosity using cuff pressures and pulse waves measured by an automatic oscillometric sphygmomanometer. A change in the arterial viscosity during the enclosed-zone flow-mediated dilation test is calculated as an index for evaluating the vascular endothelial function %η. In all, 43 individuals participated in this study. After the index %η was calculated, the accuracy of the index %η in distinguishing healthy subjects and subjects at a high risk of arteriosclerosis was tested via a receiving operating characteristic (ROC) analysis. The calculated %η for the healthy participants and those at a high risk of arteriosclerosis was 13.4 ± 55.1% and -32.7 ± 34.0% (mean ± S.D.), respectively. The area under the ROC curve was 0.77. Thus, it was concluded that the proposed method can be used to evaluate the vascular endothelial function.
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Affiliation(s)
- Hiroshi Tanaka
- Department of System Cybernetics, Graduate School of Engineering, Hiroshima University, Higashi-Hiroshima, 739-8527, Japan
| | - Akihisa Mito
- Department of System Cybernetics, Graduate School of Engineering, Hiroshima University, Higashi-Hiroshima, 739-8527, Japan
| | - Harutoyo Hirano
- Academic Institute, College of Engineering, Shizuoka University, Hamamatsu, 432-8561, Japan
| | - Zu Soh
- Department of System Cybernetics, Faculty of Engineering, Hiroshima University, Higashi-Hiroshima, 739-8527, Japan
| | - Ryuji Nakamura
- Department of Anesthesiology and Critical Care, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, 734-8553, Japan
| | - Noboru Saeki
- Department of Anesthesiology and Critical Care, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, 734-8553, Japan
| | - Masashi Kawamoto
- Department of Anesthesiology and Critical Care, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, 734-8553, Japan
| | - Yukihito Higashi
- Department of Regeneration and Medicine, Research Center for Radiation Genome Medicine, Research Institute for Radiation Biology and Medicine, Hiroshima University, Hiroshima, 734-8553, Japan
- Division of Regeneration and Medicine, Hiroshima University Hospital, Hiroshima, 734-8551, Japan
| | - Masao Yoshizumi
- Department of Cardiovascular Physiology and Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, 734-8553, Japan
| | - Toshio Tsuji
- Department of System Cybernetics, Graduate School of Engineering, Hiroshima University, Higashi-Hiroshima, 739-8527, Japan.
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4
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Ma Y, Choi J, Hourlier-Fargette A, Xue Y, Chung HU, Lee JY, Wang X, Xie Z, Kang D, Wang H, Han S, Kang SK, Kang Y, Yu X, Slepian MJ, Raj MS, Model JB, Feng X, Ghaffari R, Rogers JA, Huang Y. Relation between blood pressure and pulse wave velocity for human arteries. Proc Natl Acad Sci U S A 2018; 115:11144-11149. [PMID: 30322935 PMCID: PMC6217416 DOI: 10.1073/pnas.1814392115] [Citation(s) in RCA: 110] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Continuous monitoring of blood pressure, an essential measure of health status, typically requires complex, costly, and invasive techniques that can expose patients to risks of complications. Continuous, cuffless, and noninvasive blood pressure monitoring methods that correlate measured pulse wave velocity (PWV) to the blood pressure via the Moens-Korteweg (MK) and Hughes Equations, offer promising alternatives. The MK Equation, however, involves two assumptions that do not hold for human arteries, and the Hughes Equation is empirical, without any theoretical basis. The results presented here establish a relation between the blood pressure P and PWV that does not rely on the Hughes Equation nor on the assumptions used in the MK Equation. This relation degenerates to the MK Equation under extremely low blood pressures, and it accurately captures the results of in vitro experiments using artificial blood vessels at comparatively high pressures. For human arteries, which are well characterized by the Fung hyperelastic model, a simple formula between P and PWV is established within the range of human blood pressures. This formula is validated by literature data as well as by experiments on human subjects, with applicability in the determination of blood pressure from PWV in continuous, cuffless, and noninvasive blood pressure monitoring systems.
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Affiliation(s)
- Yinji Ma
- Department of Engineering Mechanics, Tsinghua University, 100084 Beijing, China
- Center for Flexible Electronics Technology, Tsinghua University, 100084 Beijing, China
| | - Jungil Choi
- Department of Materials Science and Engineering, Northwestern University, Evanston, IL 60208
- Center for Bio-Integrated Electronics, Northwestern University, Evanston, IL 60208
- Simpson Querrey Institute for Bio-Nanotechnology, Northwestern University, Evanston, IL 60208
| | - Aurélie Hourlier-Fargette
- Department of Materials Science and Engineering, Northwestern University, Evanston, IL 60208
- Center for Bio-Integrated Electronics, Northwestern University, Evanston, IL 60208
- Simpson Querrey Institute for Bio-Nanotechnology, Northwestern University, Evanston, IL 60208
| | - Yeguang Xue
- Department of Materials Science and Engineering, Northwestern University, Evanston, IL 60208
- Center for Bio-Integrated Electronics, Northwestern University, Evanston, IL 60208
- Department of Civil and Environmental Engineering, Northwestern University, Evanston, IL 60208
- Department of Mechanical Engineering, Northwestern University, Evanston, IL 60208
| | - Ha Uk Chung
- Center for Bio-Integrated Electronics, Northwestern University, Evanston, IL 60208
- Simpson Querrey Institute for Bio-Nanotechnology, Northwestern University, Evanston, IL 60208
| | - Jong Yoon Lee
- Center for Bio-Integrated Electronics, Northwestern University, Evanston, IL 60208
- Simpson Querrey Institute for Bio-Nanotechnology, Northwestern University, Evanston, IL 60208
| | - Xiufeng Wang
- School of Materials Science and Engineering, Xiangtan University, 411105 Hunan, China
| | - Zhaoqian Xie
- Department of Materials Science and Engineering, Northwestern University, Evanston, IL 60208
- Center for Bio-Integrated Electronics, Northwestern University, Evanston, IL 60208
- Department of Civil and Environmental Engineering, Northwestern University, Evanston, IL 60208
- Department of Mechanical Engineering, Northwestern University, Evanston, IL 60208
| | - Daeshik Kang
- Department of Mechanical Engineering, Ajou University, 16499 Suwon-si, Republic of Korea
| | - Heling Wang
- Department of Materials Science and Engineering, Northwestern University, Evanston, IL 60208
- Center for Bio-Integrated Electronics, Northwestern University, Evanston, IL 60208
- Department of Civil and Environmental Engineering, Northwestern University, Evanston, IL 60208
- Department of Mechanical Engineering, Northwestern University, Evanston, IL 60208
| | - Seungyong Han
- Department of Mechanical Engineering, Ajou University, 16499 Suwon-si, Republic of Korea
| | - Seung-Kyun Kang
- Department of Bio and Brain Engineering, Korea Advanced Institute of Science and Technology, 34141 Daejeon, Republic of Korea
| | - Yisak Kang
- Department of Electrical and Computer Engineering, University of Illinois at Urbana-Champaign, Urbana, IL 61801
| | - Xinge Yu
- Department of Biomedical Engineering, City University of Hong Kong, 999077 Hong Kong, China
| | - Marvin J Slepian
- Department of Medicine and Biomedical Engineering, Sarver Heart Center, University of Arizona, Tucson, AZ 85724
| | - Milan S Raj
- Center for Bio-Integrated Electronics, Northwestern University, Evanston, IL 60208
| | - Jeffrey B Model
- Center for Bio-Integrated Electronics, Northwestern University, Evanston, IL 60208
| | - Xue Feng
- Department of Engineering Mechanics, Tsinghua University, 100084 Beijing, China
- Center for Flexible Electronics Technology, Tsinghua University, 100084 Beijing, China
| | - Roozbeh Ghaffari
- Center for Bio-Integrated Electronics, Northwestern University, Evanston, IL 60208
- Simpson Querrey Institute for Bio-Nanotechnology, Northwestern University, Evanston, IL 60208
- Department of Chemistry and Biomedical Engineering, Northwestern University, Evanston, IL 60208
| | - John A Rogers
- Department of Materials Science and Engineering, Northwestern University, Evanston, IL 60208;
- Center for Bio-Integrated Electronics, Northwestern University, Evanston, IL 60208
- Simpson Querrey Institute for Bio-Nanotechnology, Northwestern University, Evanston, IL 60208
- Department of Mechanical Engineering, Northwestern University, Evanston, IL 60208
- Department of Chemistry and Biomedical Engineering, Northwestern University, Evanston, IL 60208
- Department of Dermatology, Northwestern University, Evanston, IL 60208
- Feinberg School of Medicine Center for Bio-Integrated Electronics, Northwestern University, Evanston, IL 60208
- Department of Electrical Engineering and Computer Science, Northwestern University, Evanston, IL 60208
- Department of Neurological Surgery, Northwestern University, Evanston, IL 60208
- Department of Chemistry, Northwestern University, Evanston, IL 60208
- Department of Materials Science and Engineering, University of Illinois at Urbana-Champaign, Urbana, IL 61801
- Frederick Seitz Materials Research Laboratory, University of Illinois at Urbana-Champaign, Urbana, IL 61801
| | - Yonggang Huang
- Department of Materials Science and Engineering, Northwestern University, Evanston, IL 60208;
- Center for Bio-Integrated Electronics, Northwestern University, Evanston, IL 60208
- Department of Civil and Environmental Engineering, Northwestern University, Evanston, IL 60208
- Department of Mechanical Engineering, Northwestern University, Evanston, IL 60208
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5
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Hirano H, Takama R, Matsumoto R, Tanaka H, Hirano H, Soh Z, Ukawa T, Takayanagi T, Morimoto H, Nakamura R, Saeki N, Hashimoto H, Matsui S, Kishimoto S, Oda N, Kajikawa M, Maruhashi T, Kawamoto M, Yoshizumi M, Higashi Y, Tsuji T. Assessment of Lower-limb Vascular Endothelial Function Based on Enclosed Zone Flow-mediated Dilation. Sci Rep 2018; 8:9263. [PMID: 29915185 PMCID: PMC6006353 DOI: 10.1038/s41598-018-27392-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2018] [Accepted: 06/01/2018] [Indexed: 01/22/2023] Open
Abstract
This paper proposes a novel non-invasive method for assessing the vascular endothelial function of lower-limb arteries based on the dilation rate of air-cuff plethysmograms measured using the oscillometric approach. The principle of evaluating vascular endothelial function involves flow-mediated dilation. In the study conducted, blood flow in the dorsal pedis artery was first monitored while lower-limb cuff pressure was applied using the proposed system. The results showed blood flow was interrupted when the level of pressure was at least 50 mmHg higher than the subject’s lower-limb systolic arterial pressure and that blood flow velocity increased after cuff release. Next, values of the proposed index, %ezFMDL, for assessing the vascular endothelial function of lower-limb arteries were determined from 327 adult subjects: 87 healthy subjects, 150 subjects at high risk of arteriosclerosis and 90 patients with cardiovascular disease (CAD). The mean values and standard deviations calculated using %ezFMDL were 30.5 ± 12.0% for the healthy subjects, 23.6 ± 12.7% for subjects at high risk of arteriosclerosis and 14.5 ± 15.4% for patients with CAD. The %ezFMDL values for the subjects at high risk of arteriosclerosis and the patients with CAD were significantly lower than those for the healthy subjects (p < 0.01). The proposed method may have potential for clinical application.
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Affiliation(s)
- Harutoyo Hirano
- Academic Institute, College of Engineering, Shizuoka University, Hamamatsu, 739-8527, Japan.
| | - Renjo Takama
- Graduate School of Engineering, Hiroshima University, Higashi-Hiroshima, 739-8527, Japan
| | - Ryo Matsumoto
- Graduate School of Engineering, Hiroshima University, Higashi-Hiroshima, 739-8527, Japan
| | - Hiroshi Tanaka
- Graduate School of Engineering, Hiroshima University, Higashi-Hiroshima, 739-8527, Japan
| | - Hiroki Hirano
- Graduate School of Engineering, Hiroshima University, Higashi-Hiroshima, 739-8527, Japan
| | - Zu Soh
- Department of System Cybernetics, Faculty of Engineering, Hiroshima University, Higashi-Hiroshima, 739-8527, Japan
| | - Teiji Ukawa
- Nihon Kohden corporation, Tokorozawa, 359-8580, Japan
| | | | | | - Ryuji Nakamura
- Department of Anesthesiology and Critical Care, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, 734-8553, Japan
| | - Noboru Saeki
- Department of Anesthesiology and Critical Care, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, 734-8553, Japan
| | - Haruki Hashimoto
- Department of Cardiovascular Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, 734-8553, Japan
| | - Shogo Matsui
- Department of Cardiovascular Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, 734-8553, Japan
| | - Shinji Kishimoto
- Department of Cardiovascular Regeneration and Medicine, Research Institute for Radiation Biology and Medicine, Hiroshima University, Hiroshima, 734-8553, Japan
| | - Nozomu Oda
- Department of Cardiovascular Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, 734-8553, Japan
| | - Masato Kajikawa
- Department of Cardiovascular Regeneration and Medicine, Research Institute for Radiation Biology and Medicine, Hiroshima University, Hiroshima, 734-8553, Japan
| | - Tatsuya Maruhashi
- Department of Cardiovascular Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, 734-8553, Japan
| | - Masashi Kawamoto
- Department of Anesthesiology and Critical Care, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, 734-8553, Japan
| | - Masao Yoshizumi
- Department of Cardiovascular Physiology and Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, 734-8553, Japan
| | - Yukihito Higashi
- Department of Cardiovascular Regeneration and Medicine, Research Institute for Radiation Biology and Medicine, Hiroshima University, Hiroshima, 734-8553, Japan. .,Division of Regeneration and Medicine, Medical Center for Translational and Clinical Research, Hiroshima University Hospital, Hiroshima, 734-8551, Japan.
| | - Toshio Tsuji
- Department of System Cybernetics, Faculty of Engineering, Hiroshima University, Higashi-Hiroshima, 739-8527, Japan.
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6
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Morimoto H, Kajikawa M, Oda N, Idei N, Hirano H, Hida E, Maruhashi T, Iwamoto Y, Kishimoto S, Matsui S, Aibara Y, Hidaka T, Kihara Y, Chayama K, Goto C, Noma K, Nakashima A, Ukawa T, Tsuji T, Higashi Y. Endothelial Function Assessed by Automatic Measurement of Enclosed Zone Flow-Mediated Vasodilation Using an Oscillometric Method Is an Independent Predictor of Cardiovascular Events. J Am Heart Assoc 2016; 5:JAHA.116.004385. [PMID: 28003249 PMCID: PMC5210444 DOI: 10.1161/jaha.116.004385] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
BACKGROUND A new device for automatic measurement of flow-mediated vasodilation (FMD) using an oscillometric method has been developed to solve technical problems of conventional FMD measurement. This device measures enclosed zone FMD (ezFMD). The purpose of this study was to evaluate the prognostic value of endothelial function assessed by ezFMD for future cardiovascular events. METHODS AND RESULTS We measured ezFMD in 272 participants who underwent health-screening examinations. First, we investigated cross-sectional associations between ezFMD and cardiovascular risk factors, and then we assessed the associations between ezFMD and first major cardiovascular events (death from cardiovascular causes, stroke, and coronary revascularization). Univariate regression analysis revealed that ezFMD was significantly correlated with age, triglycerides, glucose, smoking pack-years, estimated glomerular filtration rate, high-sensitivity C-reactive protein, and Framingham risk score. During a median follow-up period of 36.1 months (interquartile range 18.8-40.1 months), 12 participants died (6 from cardiovascular causes), 3 had stroke, 8 had coronary revascularization, and 10 were hospitalized for heart failure. There was no episode of acute coronary syndrome during the study period. Participants were divided into tertiles (low, intermediate, and high) based on ezFMD. Kaplan-Meier curves for first major cardiovascular events among the 3 groups were significantly different (P=0.004). After adjustment for cardiovascular risk factors, the low group was significantly associated with an increased risk of first major cardiovascular events compared with the high group (hazard ratio 6.47; 95% CI 1.09-125.55; P=0.038). CONCLUSIONS These findings suggest that endothelial function assessed by ezFMD may be useful as a surrogate marker of future cardiovascular events. CLINICAL TRIAL REGISTRATION URL: https://upload.umin.ac.jp. Unique identifier: UMIN000004902.
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Affiliation(s)
- Haruka Morimoto
- Department of Cardiovascular Regeneration and Medicine, Research Institute for Radiation Biology and Medicine, Hiroshima University, Hiroshima, Japan.,Nihon Kohden Co., Tokyo, Japan
| | - Masato Kajikawa
- Division of Regeneration and Medicine, Medical Center for Translational and Clinical Research, Hiroshima University Hospital, Hiroshima, Japan
| | - Nozomu Oda
- Department of Cardiovascular Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Naomi Idei
- Department of Cardiology, Hiroshima Red Cross Hospital, Hiroshima, Japan
| | - Harutoyo Hirano
- College of Engineering, Academic Institute, Shizuoka University, Hamamatsu, Japan
| | - Eisuke Hida
- Center for Integrated Medical Research, Hiroshima University Hospital, Hiroshima, Japan
| | - Tatsuya Maruhashi
- Department of Cardiovascular Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Yumiko Iwamoto
- Department of Cardiovascular Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Shinji Kishimoto
- Department of Cardiovascular Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Shogo Matsui
- Department of Cardiovascular Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Yoshiki Aibara
- Department of Cardiovascular Regeneration and Medicine, Research Institute for Radiation Biology and Medicine, Hiroshima University, Hiroshima, Japan
| | - Takayuki Hidaka
- Department of Cardiovascular Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Yasuki Kihara
- Department of Cardiovascular Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Kazuaki Chayama
- Department of Gastroenterology and Metabolism, Institute of Biomedical and Health Sciences, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Chikara Goto
- Hiroshima International University, Hiroshima, Japan
| | - Kensuke Noma
- Department of Cardiovascular Regeneration and Medicine, Research Institute for Radiation Biology and Medicine, Hiroshima University, Hiroshima, Japan.,Division of Regeneration and Medicine, Medical Center for Translational and Clinical Research, Hiroshima University Hospital, Hiroshima, Japan
| | - Ayumu Nakashima
- Department of Cardiovascular Regeneration and Medicine, Research Institute for Radiation Biology and Medicine, Hiroshima University, Hiroshima, Japan
| | | | - Toshio Tsuji
- Institute of Engineering, Hiroshima University, Higashi-Hiroshima, Japan
| | - Yukihito Higashi
- Department of Cardiovascular Regeneration and Medicine, Research Institute for Radiation Biology and Medicine, Hiroshima University, Hiroshima, Japan .,Division of Regeneration and Medicine, Medical Center for Translational and Clinical Research, Hiroshima University Hospital, Hiroshima, Japan
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