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Chen J, Jin L, Wu L, Zhang M, Wu X, Hong Y, Luo X, Li Z. Gender and age disparities in small-to-medium arterial stiffness among the Chinese population. Nutr Metab Cardiovasc Dis 2023; 33:2355-2362. [PMID: 37788957 DOI: 10.1016/j.numecd.2023.08.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 08/02/2023] [Accepted: 08/09/2023] [Indexed: 10/05/2023]
Abstract
BACKGROUND AND AIMS Arterial pressure-volume index (API) is a non-invasive tool for assessing small-to-medium-sized arterial stiffness. This study aimed to investigate the potential age- and sex-related differences in the API and explore the practical implications of such differences. METHODS AND RESULTS The study analysed 7620 subjects for whom API measurements were available. Linear regression and restrictive cubic spline models were used to investigate the associations between potential risk conditions and the API. Additionally, this study employed a backward stepwise regression method to identify the independent factors associated with a high API. Middle-aged to older women had higher API values and a higher prevalence of high API than men in the same age group. However, the opposite was observed among younger individuals, with women having lower API values than men. This study also identified a J-shaped relationship between API and age, where API values began to increase at a certain age and rapidly increased after that. In women, the API started to increase at 31 years of age and rapidly increased after 54 years of age. In men, the API started to increase at 38 years of age, followed by a rapid increase after 53 years of age. CONCLUSION This study's observation of a significant age-sex interaction in small-to-medium-sized arterial stiffening offers a valuable explanation for cardiovascular disease risk and provides important parameters for using API measurements to evaluate such risk.
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Affiliation(s)
- Jianxiong Chen
- Department of Ultrasound, Mindong Hospital Affiliated to Fujian Medical University, Ningde, China
| | - Lin Jin
- Department of Ultrasound, Guanghua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Lingheng Wu
- Department of Ultrasound, Mindong Hospital Affiliated to Fujian Medical University, Ningde, China
| | - Mengjiao Zhang
- Department of Medical Imaging, Weifang Medical University, Weifang 261053, Shandong, China; Department of Ultrasound, Shanghai General Hospital Jiading Branch, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Xiuqin Wu
- Department of Ultrasound, Mindong Hospital Affiliated to Fujian Medical University, Ningde, China
| | - Yongqiang Hong
- Department of Ultrasound, Mindong Hospital Affiliated to Fujian Medical University, Ningde, China
| | - Xianghong Luo
- Department of Echocardiography, Shanghai General Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Zhaojun Li
- Department of Ultrasound, Shanghai General Hospital Jiading Branch, Shanghai Jiaotong University School of Medicine, Shanghai, China; Department of Ultrasound, Shanghai General Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.
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Jin L, Wu L, Chen J, Zhang M, Sun J, Shen C, Du L, She X, Li Z. Uncoupling of the center-to-periphery arterial stiffness gradient and pulse pressure amplification in viral pneumonia infection. BMC Infect Dis 2023; 23:657. [PMID: 37798630 PMCID: PMC10552441 DOI: 10.1186/s12879-023-08650-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Accepted: 09/26/2023] [Indexed: 10/07/2023] Open
Abstract
OBJECTIVES Arterial stiffness is a common manifestation of viral pneumonia infections, including COVID-19. Nevertheless, the relationship between the center-to-periphery arterial stiffness gradient and pulse pressure amplification (PPA) in infectious diseases remains unclear. This study aimed to investigate this relationship utilizing arterial pressure volume index (API) and arterial velocity pulse index (AVI) ratio. METHODS API/AVI and PPA were measured in 219 participants with COVID-19 and 374 normal participants. Multiple linear regression was used to assess the association of API/AVI and PPA, and restricted cubic spline was used to investigate the non-linear relationship between API/AVI and PPA. Receiver operating characteristic curve (ROC) analysis was used to evaluate the effects of API/AVI in identifying COVID-19 infection and severe stage. RESULTS There was a significant J-shaped relationship between API/AVI and PPA in COVID-19 group, while a M-shaped relationship was observed in normal group. API/AVI decreased rapidly as PPA decreased until API/AVI decreased slowly at PPA of 1.07, and then API/AVI decreased slowly again at PPA of 0.78. ROC results showed that API/AVI demonstrated excellent accuracy in identifying COVID-19 infection (AUC = 0.781) and a high specificity (84.88%) in identifying severe stage. CONCLUSIONS There was a J-shaped association between the API/AVI and PPA in viral infected patients, while a M-shaped relationship in the normal participants. API/AVI is better for identifying infected and uninfected patients, with a high specificity in identifying those in severe stages of the disease. The attenuation or reversal of API/AVI may be associated with the loss of PPA coupling.
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Affiliation(s)
- Lin Jin
- Department of Ultrasound, Guanghua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, 200052, China
- Department of Ultrasound, Jiading Branch of Shanghai General Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, 201812, China
| | - Lingheng Wu
- Department of Ultrasound, Jiading Branch of Shanghai General Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, 201812, China
- Department of Ultrasound, Shanghai General Hospital of Nanjing Medical University, Shanghai, 200080, China
| | - Jianxiong Chen
- Department of Ultrasound, Jiading Branch of Shanghai General Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, 201812, China
- Department of Ultrasound, Shanghai General Hospital of Nanjing Medical University, Shanghai, 200080, China
| | - Mengjiao Zhang
- Department of Ultrasound, Jiading Branch of Shanghai General Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, 201812, China
| | - Jiali Sun
- Department of Ultrasound, Jiading Branch of Shanghai General Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, 201812, China
| | - Cuiqin Shen
- Department of Ultrasound, Jiading Branch of Shanghai General Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, 201812, China
| | - Lianfang Du
- Department of Ultrasound, Shanghai General Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, 200080, China
| | - Xiaoyin She
- Department of Emergency and Critical Care, Jiading Branch of Shanghai General Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, 201812, China
| | - Zhaojun Li
- Department of Ultrasound, Jiading Branch of Shanghai General Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, 201812, China.
- Department of Ultrasound, Shanghai General Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, 200080, China.
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Zhang X, Jiang Y, Liang F, Lu J. Threshold values of brachial cuff-measured arterial stiffness indices determined by comparisons with the brachial-ankle pulse wave velocity: a cross-sectional study in the Chinese population. Front Cardiovasc Med 2023; 10:1131962. [PMID: 37522090 PMCID: PMC10381930 DOI: 10.3389/fcvm.2023.1131962] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2022] [Accepted: 06/23/2023] [Indexed: 08/01/2023] Open
Abstract
Background Arterial Velocity-pulse Index (AVI) and Arterial Pressure-volume Index (API), measured by a brachial cuff, have been demonstrated to be indicative of arterial stiffness and correlated with the risk of cardiovascular events. However, the threshold values of AVI and API for screening increased arterial stiffness in the general population are yet to be established. Methods The study involved 860 subjects who underwent general physical examinations (M/F = 422/438, age 53.4 ± 12.7 years) and were considered to represent the general population in China. In addition to the measurements of AVI, API and brachial-ankle pulse wave velocity (baPWV), demographic information, arterial blood pressures, and data from blood and urine tests were collected. The threshold values of AVI and API were determined by receiver operating characteristic (ROC) analyses and covariate-adjusted ROC (AROC) analyses against baPWV, whose threshold for diagnosing high arterial stiffness was set at 18 m/s. Additional statistical analyses were performed to examine the correlations among AVI, API and baPWV and their correlations with other bio-indices. Results The area under the curve (AUC) values in ROC analysis for the diagnosis with AVI/API were 0.745/0.819, 0.788/0.837, and 0.772/0.825 (95% CI) in males, females, and all subjects, respectively. Setting the threshold values of AVI and API to 21 and 27 resulted in optimal diagnosis performance in the total cohort, whereas the threshold values should be increased to 24 and 29, respectively, in order to improve the accuracy of diagnosis in the female group. The AROC analyses revealed that the threshold values of AVI and API increased markedly with age and pulse pressure (PP), respectively. Conclusions With appropriate threshold values, AVI and API can be used to perform preliminary screening for individuals with increased arterial stiffness in the general population. On the other hand, the results of the AROC analyses imply that using threshold values adjusted for confounding factors may facilitate the refinement of diagnosis. Given the fact that the study is a cross-sectional one carried out in a single center, future multi-center or follow-up studies are required to further confirm the findings or examine the value of the threshold values for predicting cardiovascular events.
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Affiliation(s)
- Xujie Zhang
- Department of Engineering Mechanics, School of Naval Architecture, Ocean & Civil Engineering, Shanghai Jiao Tong University, Shanghai, China
| | - Yumin Jiang
- Physical Examination Center, Shanghai Sixth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Fuyou Liang
- Department of Engineering Mechanics, School of Naval Architecture, Ocean & Civil Engineering, Shanghai Jiao Tong University, Shanghai, China
- World-Class Research Center “Digital biodesign and personalized healthcare”, Sechenov First Moscow State Medical University, Moscow, Russia
| | - Jianping Lu
- Physical Examination Center, Shanghai Sixth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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Jin L, Chen J, Wu L, Zhang M, Sun J, Shen C, Du L, Wang D, Li Z. Relative contributions of arterial stiffness to cardiovascular disease risk score in Chinese women in framingham and China-PAR model. Front Cardiovasc Med 2023; 10:1169250. [PMID: 37396573 PMCID: PMC10311511 DOI: 10.3389/fcvm.2023.1169250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Accepted: 06/06/2023] [Indexed: 07/04/2023] Open
Abstract
Background Arterial stiffness played an important role in the development of cardiovascular disease (CVD) events. The aim of this study was to verify the relative importance of arterial stiffness for different CVD risk scores in a large sample of Chinese women. Methods We measured arterial velocity pulse index (AVI) and CVD risk scores in 2220 female participants (mean age 57 years). Framingham Risk Score (FRS), and the prediction for Atherosclerotic Cardiovascular Disease Risk in China (China-PAR) were used to estimate CVD risk, respectively. The relationships between AVI and risk scores were investigated by linear regressions and restricted cubic spline (RCS) analysis. To determine the relative importance of AVI in predicting CVD risk scores, random forest analysis was used. Results There was a significant positive correlation between AVI and FRS, China-PAR in all subgroup groups stratified by age, blood pressure and BMI. AVI showed higher importance in predicting CVD risk scores in FRS model, compared with these traditional risk factors. In China-PAR model, although AVI was not as predictive as SBP, it had better predictive power than many known risk factors such as lipids. Furthermore, AVI had significant J-shaped associations both with FRS and China-PAR scores. Conclusions AVI was significantly associated with CVD risk score. In FRS and China-PAR model, AVI showed relatively high importance in predicting CVD risk scores. These findings may support the use of arterial stiffness measurements in CVD risk assessment.
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Affiliation(s)
- Lin Jin
- Department of Ultrasound, Jiading Branch of Shanghai General Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
- Department of Ultrasound, Guanghua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Jianxiong Chen
- Department of Ultrasound, Mindong Hospital Affiliated to Fujian Medical University, Ningde, China
| | - Lingheng Wu
- Department of Ultrasound, Mindong Hospital Affiliated to Fujian Medical University, Ningde, China
| | - Mengjiao Zhang
- Department of Ultrasound, Jiading Branch of Shanghai General Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Jiali Sun
- Department of Ultrasound, Jiading Branch of Shanghai General Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Cuiqin Shen
- Department of Ultrasound, Jiading Branch of Shanghai General Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Lianfang Du
- Department of Ultrasound, Shanghai General Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Dingqian Wang
- School of Informatics, College of Science & Engineering, The University of Edinburgh, Edinburgh, United Kingdom
| | - Zhaojun Li
- Department of Ultrasound, Jiading Branch of Shanghai General Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
- Department of Ultrasound, Shanghai General Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
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Jin L, Chen J, Zhang M, Sha L, Cao M, Tong L, Chen Q, Shen C, Du L, Li Z, Liu L. Relationship of Arterial Stiffness and Central Hemodynamics With Cardiovascular Risk In Hypertension. Am J Hypertens 2023; 36:201-208. [PMID: 36645322 DOI: 10.1093/ajh/hpad005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 01/03/2023] [Accepted: 01/14/2023] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND Hypertension is becoming a serious public health problem and noninvasive estimation of central hemodynamics and artery stiffness have been identified as important predictors of cardiovascular disease. METHODS The study included 4,311 participants, both sex and aged between 20 and 79 years. Arterial velocity pulse index, arterial pressure-volume index (AVI, API, and the index of artery stiffness), central systolic blood pressure, central artery pulse pressure (CSBP, CAPP, and estimated via oscillometric blood pressure monitor), and 10-year risk score of cardiovascular disease in China (China-PAR) and Framingham cardiovascular risk score (FCVRS) were assessed at baseline. Regression model was performed to identify factors associated with high cardiovascular disease risk stratification. The relationships between CSBP, CAPP and China-PAR, and FCVRS were analyzed by restrictive cubic spline functions. RESULTS The uncontrolled hypertension group showed the highest values of AVI, API, CSBP, and CAPP. In the regression analysis, CAPP and hypertension subtypes were identified as significant predictors of high cardiovascular risk stratification, and CAPP was strongly correlated with API in this cohort. Finally, CSBP and CAPP showed significant J-shaped relationships with China-PAR and FCVRS. CONCLUSIONS Subjects with uncontrolled hypertension present with elevated values of CAPP, CSBP, API, AVI, China-PAR, and FCVRS scores. CAPP was independently associated with high cardiovascular risk stratification, and there was a significant J-shaped relationship with China-PAR and FCVRS that may identify people with higher cardiovascular risk.
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Affiliation(s)
- Lin Jin
- Department of Ultrasound, First Hospital of Shanxi Medical University, Taiyuan 030001, China
| | - Jianxiong Chen
- Department of Ultrasound, Mindong Hospital Affiliated to Fujian Medical University, Ningde 355000, China
| | - Mengjiao Zhang
- Department of Medical Imaging, Weifang Medical University, Weifang 261053, China
| | - Lei Sha
- Department of Ultrasound, Jiading Branch of Shanghai General Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 201812, China
| | - Mengmeng Cao
- Department of Ultrasound, Jiading Branch of Shanghai General Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 201812, China
| | - Lanyue Tong
- Department of Ultrasound, Jiading Branch of Shanghai General Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 201812, China
| | - Qingqing Chen
- Department of Ultrasound, Jiading Branch of Shanghai General Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 201812, China
| | - Cuiqin Shen
- Department of Ultrasound, Jiading Branch of Shanghai General Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 201812, China
| | - Lianfang Du
- Department of Ultrasound, Shanghai General Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200080, China
| | - Zhaojun Li
- Department of Ultrasound, Jiading Branch of Shanghai General Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 201812, China.,Department of Ultrasound, Shanghai General Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200080, China
| | - Liping Liu
- Department of Ultrasound, First Hospital of Shanxi Medical University, Taiyuan 030001, China
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Jin L, Zhang M, Sha L, Cao M, Tong L, Chen Q, Shen C, Du L, Liu L, Li Z. Increased arterial pressure volume index and cardiovascular risk score in China. BMC Cardiovasc Disord 2023; 23:22. [PMID: 36646995 PMCID: PMC9841629 DOI: 10.1186/s12872-022-03035-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Accepted: 12/30/2022] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND AND OBJECTIVE The new non-invasive arterial stiffness indices, arterial pressure volume index (API) is explored as a novel marker of residual stress in the wall of the peripheral muscular arteries at zero-stress state in clinical settings. The present study aimed to study the association of API with cardiovascular disease (CVD) risk in China (China-PAR). METHODS According to China-PAR score, participants were divided into three groups: low risk (< 5%), medium risk (5-9.9%), and high risk (≥ 10.0%). API ≥ 31 was defined as high API, and the incidences of high API were compared. Logistic regression models were used to analyze the risk factors of high API and high risk China-PAR categories. The association between China-PAR and API was analyzed by restrictive cubic spline. RESULTS The study included 4311 participants. After adjustments for confounding factors, high API was independent factor associated with high risk China-PAR categories, and the probability of high API was 1.366 times higher than that in normal API subjects. While, the independent factors associated with high API were BMI, blood pressure and heart rate. Furthermore, API had a significant U-shaped association with China-PAR. CVD risk was lowest with API of 19 units, the fastest increase at 26 units and the flattest starting point at 59 units. CONCLUSION API, an indicator of arterial stiffness and residual stress, had a U-shaped association with China-PAR score and might play an important role in predicting CVD risk in Chinese natural populations.
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Affiliation(s)
- Lin Jin
- grid.412540.60000 0001 2372 7462Department of Ultrasound, Guanghua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, 200052 China ,grid.452461.00000 0004 1762 8478Department of Ultrasound, First Hospital of Shanxi Medical University, Taiyuan, 030001 Shanxi China
| | - Mengjiao Zhang
- grid.268079.20000 0004 1790 6079Department of Medical Imaging, Weifang Medical University, Weifang, 261053 Shandong China
| | - Lei Sha
- grid.16821.3c0000 0004 0368 8293Department of Ultrasound, Shanghai General Hospital Jiading Branch, Shanghai Jiaotong University School of Medicine, Shanghai, 201803 China
| | - Mengmeng Cao
- grid.16821.3c0000 0004 0368 8293Department of Ultrasound, Shanghai General Hospital Jiading Branch, Shanghai Jiaotong University School of Medicine, Shanghai, 201803 China
| | - Lanyue Tong
- grid.16821.3c0000 0004 0368 8293Department of Ultrasound, Shanghai General Hospital Jiading Branch, Shanghai Jiaotong University School of Medicine, Shanghai, 201803 China
| | - Qingqing Chen
- grid.16821.3c0000 0004 0368 8293Department of Ultrasound, Shanghai General Hospital Jiading Branch, Shanghai Jiaotong University School of Medicine, Shanghai, 201803 China
| | - Cuiqin Shen
- grid.16821.3c0000 0004 0368 8293Department of Ultrasound, Shanghai General Hospital Jiading Branch, Shanghai Jiaotong University School of Medicine, Shanghai, 201803 China
| | - Lianfang Du
- grid.16821.3c0000 0004 0368 8293Department of Ultrasound, Shanghai General Hospital, Shanghai Jiaotong University School of Medicine, 100 Haining Road, Hongkou District, Shanghai, 200080 China
| | - Liping Liu
- grid.452461.00000 0004 1762 8478Department of Ultrasound, First Hospital of Shanxi Medical University, Taiyuan, 030001 Shanxi China
| | - Zhaojun Li
- grid.16821.3c0000 0004 0368 8293Department of Ultrasound, Shanghai General Hospital Jiading Branch, Shanghai Jiaotong University School of Medicine, Shanghai, 201803 China ,grid.16821.3c0000 0004 0368 8293Department of Ultrasound, Shanghai General Hospital, Shanghai Jiaotong University School of Medicine, 100 Haining Road, Hongkou District, Shanghai, 200080 China
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Upper-Arm SBP Decline Associated with Repeated Cuff-Oscillometric Inflation Significantly Correlated with the Arterial Stiffness Index. J Clin Med 2022; 11:jcm11216455. [DOI: 10.3390/jcm11216455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Revised: 09/29/2022] [Accepted: 10/24/2022] [Indexed: 11/06/2022] Open
Abstract
We evaluated the clinical significance of the new non-invasive vascular indices to explore their potential utility using repeated cuff-oscillometric inflation. In 250 consecutive outpatients, we performed a cross-sectional, retrospective, single-center, observational study to investigate sequential differences in arterial stiffness using blood pressure, arterial velocity pulse index (AVI), and arterial pressure volume index (API) with repeated measurements. Males accounted for 62.7% of the patients, and the mean age was 68.1 ± 12.1 years. The mean systolic blood pressure (SBP) and diastolic blood pressure (DBP) of the first reading in repeated measurements were 133.07 ± 21.20 mmHg and 73.94 ± 13.56 mmHg, respectively. The mean AVI and API were 23.83 ± 8.30 and 31.12 ± 7.86, respectively. In each measurement of these parameters, although DBP and AVI did not show significant changes throughout repeated measurements, SBP and API decreased significantly according to the measurement orders. Furthermore, changes in SBP and API were significantly correlated in several of the models. In this study, it was concluded that upper-arm SBP decline associated with repeated cuff-oscillometric inflation was significantly correlated with the arterial stiffness index. The findings of this study will allow clinicians to easily recognize the progression of atherosclerosis through regular, routine practice. In conclusion, this study suggests that changes in repeated SBP measurements may be predictive of arterial stiffness and atherosclerosis.
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Negoro H, Kobayashi R. A Workcation Improves Cardiac Parasympathetic Function during Sleep to Decrease Arterial Stiffness in Workers. Healthcare (Basel) 2022; 10:healthcare10102037. [PMID: 36292483 PMCID: PMC9601559 DOI: 10.3390/healthcare10102037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Revised: 10/07/2022] [Accepted: 10/11/2022] [Indexed: 11/16/2022] Open
Abstract
A “Workcation” (combining work and vacation) has become increasingly common. Traditionally, the workcation focus has been on productivity; however, data showing associations between workcations and improvements in employees’ health are lacking. Therefore, this study examines the effects of a workcation on blood pressure, arterial stiffness, heart rate, autonomic nervous system function, and physical activity. Twenty healthy employees participating in a five-day workcation project at a large private company agreed to participate in this study. Data on arterial stiffness, heart rate, autonomic nerve activity, and physical activity were collected before, during, and after the workcation. Arterial stiffness, blood pressure, and heart rate significantly decreased (p < 0.05); meanwhile, physical activity levels and parasympathetic function during sleep significantly increased during the workcation (p < 0.05). Thus, a workcation implies a new way of working that improves employees’ cardiovascular indices and parasympathetic function during sleep.
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Affiliation(s)
- Hideyuki Negoro
- Faculty of Medicine, Nara Medical University, Nara 634-8521, Japan
- Harvard Center for Polycystic Kidney Disease Research, Boston, MA 02115, USA
- Correspondence: ; Tel.: +81-90-2337-0913
| | - Ryota Kobayashi
- Faculty of Life & Environmental Sciences, Teikyo University of Science, Tokyo 120-0045, Japan
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Glucose variability and predicted cardiovascular risk after gastrectomy. Surg Today 2022; 52:1634-1644. [PMID: 35357573 DOI: 10.1007/s00595-022-02496-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Accepted: 02/27/2022] [Indexed: 01/19/2023]
Abstract
PURPOSE To investigate the correlation between glycemic trends and cardiovascular risk after gastrectomy for gastric cancer. METHODS We enrolled 105 gastric cancer patients who underwent gastrectomy at our hospital between October 2017 and July 2020. Postoperative glucose concentrations, trends, and patterns were recorded using a continuous glucose monitoring (CGM) device. Cardiovascular risk was calculated using the Framingham stroke risk profile score (FSRPS), the Framingham risk score (FRS), and the Suita score. We examined the correlations between glycemic variability and cardiovascular risk scores. RESULTS There were significant differences in the standard deviation (SD) of glucose levels between the high and low FSRPS groups (p = 0.049), the high and low FRS groups (p = 0.011), and the high and low Suita score groups (p = 0.044). The SD of glucose levels was significantly higher in patients with diabetes mellitus (DM) (p < 0.001) and those who underwent total gastrectomy (TG) (p = 0.017). Additionally, the CGM data available for 38 patients 1 year post-gastrectomy were analyzed for glucose level dynamics, and the SD was found to be significantly higher than that at 1 month (p < 0.001). CONCLUSION Our findings suggest that long-term follow-up and therapeutic strategies tailored to glycemic trends may be necessary for gastric cancer patients after gastrectomy, especially those with DM and those who have undergone TG, to prevent cardiovascular events.
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Hu J, Liu M, Yang R, Wang L, Liang L, Yang Y, Jia S, Chen R, Liu Q, Ren Y, Zhu L, Cai M. Effects of high-intensity interval training on improving arterial stiffness in Chinese female university students with normal weight obese: a pilot randomized controlled trial. J Transl Med 2022; 20:60. [PMID: 35109880 PMCID: PMC8809004 DOI: 10.1186/s12967-022-03250-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Accepted: 01/14/2022] [Indexed: 12/24/2022] Open
Abstract
Background High intensity interval training (HIIT) has been reported to exert better effects on cardiovascular fitness in obesity, but little known about the arterial stiffness (AS) in female university students with normal weight obesity (NWO). Thus, this study aimed to investigate the effects of HIIT on the body composition, heart rate (HR), blood pressure (BP), blood lipids metabolism as well as the novel parameters of propensity for AS (arterial velocity pulse index [AVI], arterial pressure volume index [API]) for female university students with NWO. Methods Forty female university students with NWO were randomly assigned to control group (n = 20) and HIIT group (3 bouts of 9‑min intervals at 90% of the maximal heart rate [HRmax], interspersed by 1 min rest, 5 days a week, n = 20). Tests were performed before and after 4 weeks of training. Repeated measures ANOVA and simple effect test analysis were used to analyze dependent variable changes. Results After 4 weeks HIIT statistically significantly improved the body composition by decreasing the body mass index, body fat percent, total body fat mass (BFM), BFM of left arm, measured circumference of left arm, and obesity degree, and increasing the total body skeletal muscle mass, protein content, total body water, fat free mass, body cell mas, and InBody score. HIIT also statistically significantly decreased the HR and BP. As for the lipid profile, HIIT obviously ameliorated the blood lipids metabolism by decreasing the levels of total cholesterol (TC), triglyceride, low-density lipoprotein, and TC/HDL, and increasing the levels of high-density lipoprotein (HDL). In addition, the AVI and API were markedly decreased via HIIT intervention. Conclusions HIIT produced significant and meaningful benefits for body composition, HR, BP, and blood lipids metabolism, and could decrease AS in female university students with NWO. This suggests that HIIT may effectively reduce the risk of arteriosclerosis and protect the cardiovascular function for female university students with NWO. Trial registration ChiCTR2100050711. Registered 3 September 2021. Retrospectively registered.
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Kobayashi R, Asaki K, Hashiguchi T, Negoro H. Effect of aerobic exercise training frequency on arterial stiffness in middle-aged and elderly females. J Phys Ther Sci 2022; 34:347-352. [PMID: 35527837 PMCID: PMC9057678 DOI: 10.1589/jpts.34.347] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Accepted: 02/01/2022] [Indexed: 11/24/2022] Open
Abstract
[Purpose] This study aimed to determine the effects of aerobic exercise training
frequency on arterial stiffness in postmenopausal females. [Participants and Methods] This
study included 45 postmenopausal females randomly assigned to one of the following three
groups: 1) low-frequency training group (aerobic exercise training twice per week); 2)
high-frequency training group (aerobic exercise training four times per week); and 3)
control group (no training). Each group was subjected to an 8-week intervention period.
Both traditional and newer indexes were measured immediately before and after the 8-week
intervention period. [Results] In the low-frequency training group, carotid-femoral pulse
wave velocity and arterial velocity pulse index decreased post 8 weeks compared with those
at baseline. In the high-frequency training group, carotid-femoral, brachial-ankle, and
heart-brachial pulse wave velocities and arterial velocity pulse and arterial
pressure-volume indexes decreased post 8 weeks compared to those at baseline. In the
control group, no change in any indices post 8 weeks compared to those at baseline was
observed. [Conclusion] Carotid-femoral pulse wave velocity was lower after aerobic
training than before training in both the exercise groups. Thus, aerobic exercise training
might have a beneficial effect on aortic stiffness, regardless of the training frequency
in this population.
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Affiliation(s)
- Ryota Kobayashi
- Center for Fundamental Education, Department of Natural & Environmental Science, Teikyo University of Science: 2-2-1 Senju, Sakuragi, Adachi-ku, Tokyo 120-0045, Japan
| | - Kenji Asaki
- Department of Tokyo Judo Therapy, Teikyo University of Science, Japan
| | - Takeo Hashiguchi
- Department of School Education, Teikyo University of Science, Japan
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12
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Jia S, Wu Y, Wang W, Lin W, Chen Y, Zhang H, Xia S, Zhou H. An Exploratory Study on the Relationship between Brachial Arterial Blood Flow and Cardiac Output. JOURNAL OF HEALTHCARE ENGINEERING 2021; 2021:1251199. [PMID: 34976321 PMCID: PMC8718296 DOI: 10.1155/2021/1251199] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Revised: 10/31/2021] [Accepted: 11/09/2021] [Indexed: 01/16/2023]
Abstract
Background We have obtained prospective clinical outcomes using the brachial artery largely, such as Korotkoff sound and vasomotor function measurement by ultrasound guidance to predict the prognosis of cardiovascular diseases. Very few reports on the quantitative measurement of the relationship between the brachial artery blood flow and cardiac output have been reported. Purpose (1) To investigate whether the quantitative relationship between the brachial artery blood flow and cardiac output existed. (2) To provide a theoretical basis for taking advantage of artificial intelligence (AI) using Korotkoff sound analogously as far as possible to predict the cardiac output. Methods A total of 586 patients who underwent cardiac color ultrasound in our center from 2021.3 to 2021.7 were included for analyses. The vascular parameters of the right upper limb brachial artery (such as the Diameter, Area, Blood Velocity, and Flow) were measured immediately after the cardiac color ultrasound, and some basic clinical parameters (Age, Sex, BMI, and Disease) were recorded subsequently. Ultimately, the Mann-Whitney and independent sample T-test were used to analyze the data. Results (1) The mean Rate of the brachial arterial blood flow to cardiac output was 1.23%, and the mean 95% CI was (1.18%, 1.29%), indicating that the value was mainly concentrated in the current value interval. The indicator demonstrates that there is no significant difference currently among the patients with hypertension, coronary heart disease, and cardiac dysfunction. (2) The brachial artery wall diameter (Dist) is significantly thicker in patients with coronary heart disease and hypertension compared to patients with other cardiovascular diseases. (3) Cardiac output augments remarkably in patients with hypertension. Conclusion Our study suggests that the Rate (brachial artery blood flow/cardiac output) is a constant of 1.23% approximately. It provides a theoretical basis for the subsequent application of the artificial intelligence (AI) method to predict heart function using Korotkoff sound, cope with large computational amounts, and improve computational speed. It is also indirectly proved that hypertension can lead to a change in peripheral vascular hyperplasia and increase cardiac output.
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Affiliation(s)
- Sixiang Jia
- Department of Heart Center, The Fourth Affiliated Hospital of Zhejiang University School of Medicine, N1 Shangcheng Road, Yiwu 322000, China
| | - Yiteng Wu
- Department of Heart Center, The Fourth Affiliated Hospital of Zhejiang University School of Medicine, N1 Shangcheng Road, Yiwu 322000, China
| | - Wei Wang
- Department of Heart Center, The Fourth Affiliated Hospital of Zhejiang University School of Medicine, N1 Shangcheng Road, Yiwu 322000, China
| | - Wenting Lin
- Department of Heart Center, The Fourth Affiliated Hospital of Zhejiang University School of Medicine, N1 Shangcheng Road, Yiwu 322000, China
| | - Yiwen Chen
- Department of Heart Center, The Fourth Affiliated Hospital of Zhejiang University School of Medicine, N1 Shangcheng Road, Yiwu 322000, China
| | - Huanyu Zhang
- College of Biomedical Engineering & Instrument Science, Zhejiang University, Hangzhou 310000, China
| | - Shudong Xia
- Department of Heart Center, The Fourth Affiliated Hospital of Zhejiang University School of Medicine, N1 Shangcheng Road, Yiwu 322000, China
| | - Hong Zhou
- College of Biomedical Engineering & Instrument Science, Zhejiang University, Hangzhou 310000, China
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13
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Zhou J, Wang Y, Feng Y, Chen X, Zhang Q. New indices of arterial stiffness correlate with disease severity and mid-term prognosis in acute decompensated heart failure. Intern Emerg Med 2021; 16:661-668. [PMID: 32888111 DOI: 10.1007/s11739-020-02486-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2020] [Accepted: 08/21/2020] [Indexed: 02/05/2023]
Abstract
Arterial stiffness has been implicated in pathophysiology of heart failure (HF) since it is involved in the ventricular-vascular coupling. Recently, new indices obtained by a cuff oscillometric technique, the arterial velocity pulse index (AVI) for the stiffness of central arteries and the arterial pressure volume index (API) for the stiffness of peripheral arteries have been developed and validated. However, the AVI and API measurement has not been attempted in HF population. This study aimed to investigate the relationship between the AVI, API and clinical parameters and outcomes in HF patients. A prospective cohort of patients with acute decompensated HF were enrolled within 6 months, who were admitted to a tertiary referral hospital in China. Measurement of the AVI and API (AVE-1500, Shisei Datum, Tokyo, Japan) was performed on the day of admission and discharge. Patients were followed up to 6 months for the composite endpoint of all-cause death and rehospitalization for HF. A total of 127 patients were recruited for analysis (60 ± 15 years, 70% male). 80% of the patients were in New York Heart Association (NYHA) Class III or IV at admission with mean left ventricular ejection fraction (LVEF) of 34 ± 9%. During hospitalization, all patients received guideline-directed medical therapy if not contraindicated. The AVI (27.3 ± 5.0 vs. 28.6 ± 6.7, P = 0.002) and API (24.9 ± 4.9 vs. 26.0 ± 6.5, P = 0.05) were lower at discharge than at admission. By dividing the patients into mild to severe group based on systolic blood pressure (SBP) and LVEF or into tertiles according to the amino-terminal pro-brain natriuretic peptide (NT-proBNP), transmitral E velocity over mitral annular e' velocity (E/e' ratio), it was observed that the AVI increased with a higher level of NT-proBNP (P for trend < 0.001), a larger E/e' (P for trend < 0.001) and a lower LVEF (P for trend = 0.0183), while the API increased as the E/e' and systolic blood pressure became higher (both P for trend < 0.05). The improvement in AVI at discharge was correlated with LVEF (R = - 0.3024, P < 0.05) and NT-proBNP improvement (R = 0.3118, P < 0.05), while the change in API was positively correlated with SBP change (R = 0.3897, P < 0.001). In 6 months after discharge, there were 52 predefined events including 15 deaths and 44 rehospitalization for HF. Apart from the level of NT-proBNP, the AVI at discharge of ≥ 26 showed a trend of being associated with the composite outcome (HR 2.747, 95% CI 1.411-5.349, P < 0.001 for univariate analysis; HR 1.864, 95% CI 0.892-3.893, P = 0.09761 for multivariate analysis). New noninvasive arterial stiffness indices as the AVI and API reflected severity of illness and midterm prognosis in admitted HF patients. Further studies are warranted for understanding its mechanisms and developing clinical applications.
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Affiliation(s)
- Junteng Zhou
- Department of Cardiology, West China Hospital, Sichuan University, No. 37 Guoxue Alley, Chengdu, 610041, China
| | - Yushu Wang
- Department of Cardiology, Chengdu First People's Hospital, No. 18 North Wanxiang Road, Chengdu, 610041, China
| | - Yizhou Feng
- Department of Cardiology, West China Hospital, Sichuan University, No. 37 Guoxue Alley, Chengdu, 610041, China
| | - Xiaojing Chen
- Department of Cardiology, West China Hospital, Sichuan University, No. 37 Guoxue Alley, Chengdu, 610041, China
| | - Qing Zhang
- Department of Cardiology, West China Hospital, Sichuan University, No. 37 Guoxue Alley, Chengdu, 610041, China.
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14
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Wan J, Liu S, Yang Y, Wang D, Ran F, Xia S, Ma S, Hou J, Zhou P, Sun Y, Wang P. Roles of arterial pressure volume index and arterial velocity pulse index trajectories in risk prediction in hypertensive patients with heart failure with preserved ejection fraction. Clin Exp Hypertens 2020; 42:469-478. [PMID: 31851528 DOI: 10.1080/10641963.2019.1705319] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Background: Arterial pressure volume index (API) and arterial velocity pulse index (AVI) contribute to the development of vascular damage and cardiovascular disease. However, the relationship between common API/AVI trajectories and cardiovascular outcomes in hypertensive patients with heart failure with preserved ejection fraction (HFpEF) is unknown.Methods: A total of 488 consecutive hypertensive patients with HFpEF who repeatedly underwent API/AVI measurements were prospectively examined. We then applied API/AVI measurements into actual clinical practice. Latent mixture modeling was performed to identify API/AVI trajectories. Hazards ratios (HRs) were measured using Cox proportional hazard models.Results: We identified four distinct API/AVI trajectory patterns: low (7.6%), moderate (43.8%), high (28.9%), and very high (19.7%). Compared with the low group, higher API trajectories were associated with increased risk of total cardiovascular events (high group, adjusted HR: 2.91, 95% confidence interval [CI]: 1.97-4.26; very high group, adjusted HR: 2.46, 95%CI: 1.18-3.79). Consistently, higher AVI trajectories were also associated with a higher risk of total cardiovascular events (high group, adjusted HR: 2.58, 95%CI: 1.23-5.47; very high group, adjusted HR: 3.12, 95%CI: 1.83-6.08), compared with the low trajectory group.Conclusion: High API/AVI trajectories are strong predictors of cardiovascular risk in hypertensive patients with HFpEF. Among these patients, measuring API/AVI may improve risk stratification and provide additional information to tailor treatment strategies.
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Affiliation(s)
- Jindong Wan
- Department of Cardiology, The First Affiliated Hospital, Chengdu Medical College, Chengdu, Sichuan, PR China.,Department of Cardiology, Key Laboratory of Aging and Vascular Homeostasis of Sichuan Higher Education Institutes, Chengdu, Sichuan, PR China
| | - Sen Liu
- Department of Cardiology, The First Affiliated Hospital, Chengdu Medical College, Chengdu, Sichuan, PR China.,Department of Cardiology, Key Laboratory of Aging and Vascular Homeostasis of Sichuan Higher Education Institutes, Chengdu, Sichuan, PR China
| | - Yi Yang
- Department of Cardiology, The First Affiliated Hospital, Chengdu Medical College, Chengdu, Sichuan, PR China.,Department of Cardiology, Key Laboratory of Aging and Vascular Homeostasis of Sichuan Higher Education Institutes, Chengdu, Sichuan, PR China
| | - Dan Wang
- Department of Cardiology, The First Affiliated Hospital, Chengdu Medical College, Chengdu, Sichuan, PR China.,Department of Cardiology, Key Laboratory of Aging and Vascular Homeostasis of Sichuan Higher Education Institutes, Chengdu, Sichuan, PR China
| | - Fei Ran
- Department of Cardiology, The First Affiliated Hospital, Chengdu Medical College, Chengdu, Sichuan, PR China.,Department of Cardiology, Key Laboratory of Aging and Vascular Homeostasis of Sichuan Higher Education Institutes, Chengdu, Sichuan, PR China
| | - Siwei Xia
- Department of Cardiology, The First Affiliated Hospital, Chengdu Medical College, Chengdu, Sichuan, PR China.,Department of Cardiology, Key Laboratory of Aging and Vascular Homeostasis of Sichuan Higher Education Institutes, Chengdu, Sichuan, PR China
| | - Shuangtao Ma
- Division of Nanomedicine and Molecular Intervention, Department of Medicine, Michigan State University, East Lansing, MI, USA
| | - Jixin Hou
- Department of Cardiology, The First Affiliated Hospital, Chengdu Medical College, Chengdu, Sichuan, PR China.,Department of Cardiology, Key Laboratory of Aging and Vascular Homeostasis of Sichuan Higher Education Institutes, Chengdu, Sichuan, PR China
| | - Peng Zhou
- Department of Cardiology, The First Affiliated Hospital, Chengdu Medical College, Chengdu, Sichuan, PR China.,Department of Cardiology, Key Laboratory of Aging and Vascular Homeostasis of Sichuan Higher Education Institutes, Chengdu, Sichuan, PR China
| | - Yun Sun
- Department of Party Secretary, The First Affiliated Hospital, Chengdu Medical College, Chengdu, Sichuan, PR China
| | - Peijian Wang
- Department of Cardiology, The First Affiliated Hospital, Chengdu Medical College, Chengdu, Sichuan, PR China.,Department of Cardiology, Key Laboratory of Aging and Vascular Homeostasis of Sichuan Higher Education Institutes, Chengdu, Sichuan, PR China
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15
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Kobayashi R, Kasahara Y, Ikeo T, Asaki K, Sato K, Matsui T, Iwanuma S, Ohashi N, Hashiguchi T. Effects of different intensities and durations of aerobic exercise training on arterial stiffness. J Phys Ther Sci 2020; 32:104-109. [PMID: 32158071 PMCID: PMC7032987 DOI: 10.1589/jpts.32.104] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2019] [Accepted: 11/04/2019] [Indexed: 11/25/2022] Open
Abstract
[Purpose] In the present study, we investigated the effects of regular aerobic training
with different intensities and durations on new indices of arterial stiffness measured via
an upper-arm oscillometric device. [Participants and Methods] We gathered data from 41
middle-aged and older people (age 65.0 ± 11.7 years). Participants were randomly divided
into five groups: (1) 15 minutes of low intensity aerobic training (n=10); (2) 30 minutes
of low intensity training (n=7); (3) 15 minutes of moderate-intensity training (n=9); (4)
30 minutes of moderate-intensity training (n=8); and (5) a non-training group (n=7).
Training was conducted for 8 weeks, three times per week. Arterial pulse wave index,
arterial pressure-volume index, brachial-ankle and heart-brachial pulse wave velocity,
cardio-ankle vascular index, brachial and ankle blood pressure, heart rate, and peak
oxygen uptake were measured before and after the intervention. [Results] All indicators of
arterial stiffness and brachial and ankle blood pressure in the exercise groups were
significantly lower after versus before the intervention. Peak oxygen uptake did not
differ before versus after the intervention. [Conclusion] The present findings indicate
that regular aerobic exercise may be important in reducing arterial stiffness regardless
of the intensity or duration of aerobic exercise.
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Affiliation(s)
- Ryota Kobayashi
- Center for Fundamental Education, Teikyo University of Science: 2-2-1 Senju, Sakuragi, Adachi-ku, Tokyo 120-0045, Japan
| | | | | | - Kenji Asaki
- Department of Tokyo Judo Therapy, Teikyo University of Science, Japan
| | - Kaori Sato
- Health and Physical Education Program, International Christian University, Japan
| | - Takamitsu Matsui
- Department of School Education, Teikyo University of Science, Japan
| | - Soichiro Iwanuma
- Department of School Education, Teikyo University of Science, Japan
| | - Nobuyuki Ohashi
- Department of Sport and Medical Science, Teikyo University, Japan
| | - Takeo Hashiguchi
- Department of School Education, Teikyo University of Science, Japan
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16
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Screening System for Cardiac Problems through Non-Invasive Identification of Blood Pressure Waveform. INFORMATION 2020. [DOI: 10.3390/info11030150] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
This paper presents the initial development of a non-invasive system for identification of the pulse pressure waveform to be used for screening cardiac problems. The system employs a tonometric method using an off-the-shelf force sensor and custom-designed electronic circuits. Initial results on the use of the system are presented.
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17
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Increased arterial velocity pulse index is an independent factor related to skeletal muscle mass reduction and tissue damage in patients with cardiovascular disease. Hypertens Res 2020; 43:534-542. [DOI: 10.1038/s41440-020-0404-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2019] [Revised: 11/09/2019] [Accepted: 12/23/2019] [Indexed: 11/08/2022]
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18
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Hitsumoto T. Clinical Significance of Arterial Velocity Pulse Index in Patients With Stage B Heart Failure With Preserved Ejection Fraction. Cardiol Res 2019; 10:142-149. [PMID: 31236176 PMCID: PMC6575108 DOI: 10.14740/cr864] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2019] [Accepted: 04/17/2019] [Indexed: 11/11/2022] Open
Abstract
Background In clinical settings, the arterial velocity pulse index (AVI) is explored as a novel marker of atherosclerosis using pulse wave analysis; however, data regarding the correlations between AVI and heart failure (HF) are limited. This study aimed to elucidate the clinical significance of AVI in patients with stage B HF with preserved ejection fraction (HFpEF). Methods In this cross-sectional study, 345 patients with stage B HFpEF (no symptoms despite evidence of cardiac structural or functional impairment, and left ventricular ejection fraction which is estimated by echocardiography ≥ 50%) were enrolled. Patients with a history of HF hospitalization were excluded. The AVI was measured using a commercial device, and associations between AVI and various clinical parameters were examined. Results Significant correlations between AVI and various clinical parameters, such as E/e' as a maker of left ventricular diastolic function (r = 0.35; P < 0.001), high-sensitivity cardiac troponin T levels as a marker of myocardial injury (r = 0.47; P < 0.001), reactive oxygen metabolite levels as an oxidative stress marker (r = 0.31; P < 0.001), urinary albumin concentration as a marker of kidney function (r = 0.34; P < 0.001) and calf circumference as a marker of muscle mass volume (r = -0.42; P < 0.001) were observed. Furthermore, multiple regression analyses revealed that these clinical parameters were selected as independent variables when AVI was used as a subordinate factor. Conclusions This study shows that AVI might be a determining factor for prognosis in patients with stage B HFpEF. Nevertheless, further comprehensive prospective studies, including intervention therapies, are warranted to validate the findings of this study.
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Affiliation(s)
- Takashi Hitsumoto
- Hitsumoto Medical Clinic, 2-7-7, Takezakicyou, Shimonoseki City, Yamaguchi 750-0025, Japan.
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19
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Kita T, Kitamura K. Seasonal variation of novel arterial stiffness indexes in Japanese hypertensive patients. Clin Exp Hypertens 2018; 41:670-674. [PMID: 30409046 DOI: 10.1080/10641963.2018.1539092] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Background and Objective: Seasonal variation of blood pressure (BP) is well known, and a relationship between increases in BP and the incidence of cardiovascular accidents (CVAs) in the winter has been reported. Parameters of arterial stiffness may exhibit seasonal variation; however, available data are currently limited. Novel arterial stiffness indexes, namely the arterial velocity pulse index (AVI) and arterial pressure-volume index (API), can be determined through usual maneuver for BP measurement during the regular examination in the outpatient clinic.The present study assessed the seasonal variation of AVI and API in 59 hypertensive patients undergoing stable treatment and regularly visiting our outpatient clinic over a period of 30 months. Methods: BP, pulse rate (PR), AVI, and API were measured using the AVE-1500 (Pasesa) in the sitting position. Six time frames of assessment were established. All measurements (average: 17.9 measurements per person) were sorted using these six time frames, and their averages were used for analysis. Results: Significant seasonal variations in PR (P < 0.001) and AVI (P < 0.001), along with weak variation in systolic BP (SBP) (P = 0.047) and marginal variation in API (P = 0.055), were confirmed by repeated analysis of variance. SBP, API, and PR were decreased, whereas AVI was increased in the summer. Coefficient variations were SBP 5.1%, PR 4.9%, AVI 12.6%, and API 10.6%. Conclusion: AVI was associated with reflected wave like as augmentation index. Thus, a high AVI may suggest increased central wave reflection. Although the significance of seasonal variation of AVI remains unknown, AVI may influence seasonal variations in the incidence of CVA.
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Affiliation(s)
- Toshihiro Kita
- a Division of Circulatory and Body Fluid Regulation, Department of Internal Medicine, Faculty of Medicine, University of Miyazaki , Miyazaki , Japan
| | - Kazuo Kitamura
- a Division of Circulatory and Body Fluid Regulation, Department of Internal Medicine, Faculty of Medicine, University of Miyazaki , Miyazaki , Japan
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20
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Murata N, Shiina K, Yamashita J, Tanaka N, Chikamori T, Yamashina A, Tomiyama H. Increase in the Arterial Velocity Pulse Index of Patients with Peripheral Artery Disease. Pulse (Basel) 2018; 5:154-160. [PMID: 29761091 DOI: 10.1159/000486162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2017] [Revised: 12/06/2017] [Indexed: 11/19/2022] Open
Abstract
Background Recently, a simple parameter calculated from the brachial pressure waveform recorded using an oscillometric device (arterial velocity pulse index [AVI]: ratio of the forward/reflected pressure wave amplitudes) has become available to assess the pathophysiological abnormalities associated with vascular damage. Peripheral artery disease (PAD) represents one of the disease entities associated with the advanced stages of atherosclerotic vascular damage. The present study was conducted to examine whether an increase in the AVI might be influenced by the presence of PAD. Methods and Results The AVI was measured from oscillometric recordings of the brachial pressure waveform, and the ankle-brachial pressure index (ABPI) was determined by an oscillometric method. Study 1: In 341 consecutive patients admitted for the management of cardiovascular disease and/or cardiovascular risk factors, the ABPI and the AVI were measured simultaneously. An ABPI ≤0.90 was observed in 19 subjects, and logistic regression analysis revealed a significant association between AVI and ABPI ≤0.90 (odds ratio = 1.81; 95% confidence interval = 1.15-2.84; p = 0.01). Study 2: In another 19 patients with PAD, percutaneous transluminal angioplasty resulted in a decrease in the AVI from 31 ± 8 to 27 ± 8 (p < 0.01). Conclusion Possible presence of PAD must be taken into account while applying the AVI for the assessment of vascular damage.
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Affiliation(s)
- Naotaka Murata
- Department of Cardiology, Tokyo Medical University, Tokyo, Japan
| | - Kazuki Shiina
- Department of Cardiology, Tokyo Medical University, Tokyo, Japan
| | - Jun Yamashita
- Department of Cardiology, Tokyo Medical University, Tokyo, Japan
| | - Nobuhiro Tanaka
- Department of Cardiology, Tokyo Medical University, Tokyo, Japan
| | | | - Akira Yamashina
- Department of Cardiology, Tokyo Medical University, Tokyo, Japan
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21
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Doi H, Ishigami T, Nakashima-Sasaki R, Kino T, Chen L, Arakawa K, Teranaka S, Minegishi S, Abe K, Ishikawa T, Sugano T, Tamura K. New non-invasive indexes of arterial stiffness are significantly correlated with severity and complexity of coronary atherosclerosis. Clin Exp Hypertens 2018; 41:1-7. [PMID: 29737880 DOI: 10.1080/10641963.2018.1465072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2017] [Revised: 04/01/2018] [Accepted: 04/09/2018] [Indexed: 10/17/2022]
Abstract
BACKGROUND Endothelial dysfunction and increased arterial stiffness gradually develop before the manifestation of catastrophic cardiovascular events. Therefore, detection and assessment of vascular function are required to address pre-existing pathological conditions. However, the currently available diagnostic devices and methods are insufficient due to variability among investigators and the time-consuming nature of manual procedures. METHODS Recently, novel devices were developed for the detection of both arterial stiffness and endothelial dysfunction in a single blood pressure measurement using a cuff-oscillometric technique (AVE-1500, Shisei Datum, Japan). API (arterial pressure volume index) is defined as the reciprocal of the slope of the tangent of the brachial artery pressure-volume curve, and AVI (arterial velocity pulse index) is defined as the ratio of the difference between the ejection and reflection waves. In the present study, we performed retrospective, cross-sectional analyses of subjects (n = 102; mean age = 70.5 ± 10.4 years) with detailed coronary angiographic examinations and clinical background parameters. RESULTS After adjusting for various variables using multiple linear regression analyses, we found that API, but not AVI, was significantly correlated with coronary artery severity and complexity scores. CONCLUSIONS We propose that API may be a new vascular index useful for monitoring and assessing the severity and complexity of atherosclerosis in subjects with coronary artery disease and for evaluating atherosclerotic diseases.
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Affiliation(s)
- Hiroshi Doi
- a Department of Medical Science and Cardiorenal Medicine , Yokohama City University Graduate School of Medicine , Yokohama , Japan
- b Department of Cardiology , Yokohama City University Hospital , Yokohama , Japan
| | - Tomoaki Ishigami
- a Department of Medical Science and Cardiorenal Medicine , Yokohama City University Graduate School of Medicine , Yokohama , Japan
- b Department of Cardiology , Yokohama City University Hospital , Yokohama , Japan
| | - Rie Nakashima-Sasaki
- a Department of Medical Science and Cardiorenal Medicine , Yokohama City University Graduate School of Medicine , Yokohama , Japan
- b Department of Cardiology , Yokohama City University Hospital , Yokohama , Japan
| | - Tabito Kino
- a Department of Medical Science and Cardiorenal Medicine , Yokohama City University Graduate School of Medicine , Yokohama , Japan
- b Department of Cardiology , Yokohama City University Hospital , Yokohama , Japan
| | - Lin Chen
- a Department of Medical Science and Cardiorenal Medicine , Yokohama City University Graduate School of Medicine , Yokohama , Japan
- b Department of Cardiology , Yokohama City University Hospital , Yokohama , Japan
| | - Kentaro Arakawa
- a Department of Medical Science and Cardiorenal Medicine , Yokohama City University Graduate School of Medicine , Yokohama , Japan
- b Department of Cardiology , Yokohama City University Hospital , Yokohama , Japan
| | - Sae Teranaka
- a Department of Medical Science and Cardiorenal Medicine , Yokohama City University Graduate School of Medicine , Yokohama , Japan
- b Department of Cardiology , Yokohama City University Hospital , Yokohama , Japan
| | - Shintaro Minegishi
- a Department of Medical Science and Cardiorenal Medicine , Yokohama City University Graduate School of Medicine , Yokohama , Japan
- b Department of Cardiology , Yokohama City University Hospital , Yokohama , Japan
| | - Kaito Abe
- a Department of Medical Science and Cardiorenal Medicine , Yokohama City University Graduate School of Medicine , Yokohama , Japan
- b Department of Cardiology , Yokohama City University Hospital , Yokohama , Japan
| | - Toshiyuki Ishikawa
- a Department of Medical Science and Cardiorenal Medicine , Yokohama City University Graduate School of Medicine , Yokohama , Japan
- b Department of Cardiology , Yokohama City University Hospital , Yokohama , Japan
| | - Teruyasu Sugano
- a Department of Medical Science and Cardiorenal Medicine , Yokohama City University Graduate School of Medicine , Yokohama , Japan
- b Department of Cardiology , Yokohama City University Hospital , Yokohama , Japan
| | - Kouichi Tamura
- a Department of Medical Science and Cardiorenal Medicine , Yokohama City University Graduate School of Medicine , Yokohama , Japan
- b Department of Cardiology , Yokohama City University Hospital , Yokohama , Japan
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22
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Kobayashi R, Iwanuma S, Ohashi N, Hashiguchi T. New indices of arterial stiffness measured with an upper-arm oscillometric device in active versus inactive women. Physiol Rep 2018; 6:e13574. [PMID: 29484841 PMCID: PMC5827568 DOI: 10.14814/phy2.13574] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2017] [Revised: 12/12/2017] [Accepted: 12/13/2017] [Indexed: 11/24/2022] Open
Abstract
Arterial velocity pulse index (AVI) and arterial pressure-volume index (API), new indicators of arterial stiffness, are risk factors for the development of cardiovascular disease. Regular aerobic exercise decreases arterial stiffness. In fact, pulse wave velocity (PWV), index of arterial stiffness, is lower in endurance-trained than in untrained young adults. However, the effect of regular aerobic exercise on AVI and API remains unknown. This study investigates the effect of regular aerobic exercise on AVI and API, new indicators of arterial stiffness. We gathered data from 18 recreationally active females (active group, age: 18 ± 1 years, 2 ± 2 h/week, 3 ± 2 times/week, ≥2 years of aerobic endurance training) and 18 recreationally inactive females (inactive group, age: 18 ± 1 years, ≥2 years without such training) in a cross-sectional study. Height, body weight, body mass index, AVI, API, brachial blood pressure, heart rate, and 20-m multistage shuttle run test were measured in a quiet room at a temperature between 24°C and 25°C. AVI and API were lower in the active group than in the inactive group (P < 0.01). Number of 20-m shuttles was negatively correlated with AVI (P < 0.01, r = -0.8) and API (P < 0.01, r = -0.8). These results suggest that regular aerobic exercise training decreases AVI and API in young females.
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Affiliation(s)
- Ryota Kobayashi
- Center for Fundamental EducationTeikyo University of ScienceTokyoJapan
| | - Soichiro Iwanuma
- Department of School EducationTeikyo University of ScienceTokyoJapan
| | - Nobuyuki Ohashi
- Department of School EducationTeikyo University of ScienceTokyoJapan
| | - Takeo Hashiguchi
- Department of School EducationTeikyo University of ScienceTokyoJapan
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Nonogaki K, Murakami M, Yamazaki T, Nonogaki N. Low-frequency and low-intensity ultrasound irradiation to the forearm improves an index of arterial stiffness in subjects with type 2 diabetes and hypertension. IJC HEART & VASCULATURE 2017; 16:4-6. [PMID: 28868339 PMCID: PMC5554931 DOI: 10.1016/j.ijcha.2017.08.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2017] [Revised: 07/26/2017] [Accepted: 08/01/2017] [Indexed: 11/26/2022]
Abstract
Objectives The arterial pressure-volume index (API) is a non-invasive assessment of arterial stiffness, and is suggested as a useful predictor of future cardiovascular events. The aim of the present study was to determine the effects of low-frequency and low-intensity ultrasound applied to the forearm for 10 min on the API in Japanese subjects with type 2 diabetes and hypertension. Methods We examined the effects of low-frequency and low-intensity ultrasound (800 kHz, 25 mW/cm2) applied to the forearm for 10 min on the API, blood pressure (BP) and pulse rate in 40 Japanese subjects (13 men and 27 women; mean age ± SE, 70 ± 2 years) with type 2 diabetes and hypertension, who had the API > 30 and systolic BP > 140 mmHg at a clinic visit. We also examined the effects of the ultrasound irradiation for 10 min on the API, BP and pulse rate in 33 Japanese subjects (11 men and 22 women; mean age ± SE, 65 ± 2 years) with type 2 diabetes and hypertension, who had the API > 30 and systolic BP (SBP) < 140 mmHg. Results The API, systolic BP and pulse rate in the ultrasound treatment group was significantly lower than the baseline values in the subjects who had the API > 30 and either the baseline of systolic BP > 140 mmHg or systolic BP < 140 mmHg. Conclusions The low-frequency and low-intensity ultrasound irradiation to the forearm for 10 min might be useful as a preventive application for arterial stiffness in subjects with type 2 diabetes and hypertension.
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Abstract
PURPOSE OF REVIEW Arterial pulse waveform analysis has a long tradition but has not pervaded medical routine yet. This review aims to answer the question whether the methodology is ready for prime time use. The current methodological consensus is assessed, existing technologies for waveform measurement and pulse wave analysis are discussed, and further needs for a widespread use are proposed. RECENT FINDINGS A consensus document on the understanding and analysis of the pulse waveform was published recently. Although still some discrepancies remain, the analysis using both pressure and flow waves is favoured. However, devices which enable pulse wave measurement are limited, and the comparability between devices is not sufficiently given. Pulse waveform analysis has the potential for prime time. It is currently on a way towards broader use, but still needs to overcome challenges before settling its role in medical routine.
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Hitsumoto T. Relationships between the arterial velocity pulse index as a novel marker of atherosclerosis and biomarkers of cardiac or renal condition in patients with type 2 diabetes mellitus. Diabetol Int 2017; 9:48-55. [PMID: 30603349 DOI: 10.1007/s13340-017-0329-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2017] [Accepted: 07/04/2017] [Indexed: 12/16/2022]
Abstract
BACKGROUND The arterial velocity pulse index (AVI) has been explored as a novel marker of atherosclerosis using pulse wave analysis in the clinical setting. The aim of this study was to clarify the relationships between the AVI and biomarkers of cardiac or renal condition in patients with type 2 diabetes mellitus. METHODS In total, 301 outpatients with type 2 diabetes mellitus (116 males and 185 females; mean age ± standard deviation: 63 ± 12 years) without a history of cardiovascular events were enrolled in this study. The AVI and biomarkers of cardiac or renal condition were measured using a commercial device, and the relationships between the AVI and the biomarkers were examined. RESULTS The AVI was significantly associated with biomarkers of cardiac condition such as the blood levels of brain natriuretic peptide (r = 0.29, P < 0.001) and high-sensitivity cardiac troponin T (hs-cTnT) (r = 0.48, P < 0.001). The AVI was also significantly associated with biomarkers of renal condition such as the estimated glomerular filtration rate (r = -0.22, P < 0.001) and urinary albumin excretion (r = 0.42, P < 0.001). Multiple regression analysis revealed that hs-cTnT and urinary albumin excretion were independent variables that were correlated with the AVI when it was used as a subordinate factor. CONCLUSION The results of this study indicate that the AVI is significantly associated with hs-cTnT and urinary albumin excretion in patients with type 2 diabetes mellitus.
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Affiliation(s)
- Takashi Hitsumoto
- Hitsumoto Medical Clinic, 2-7-7, Takezakicyou, Shimonoseki-City, Yamaguchi 750-0025 Japan
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Hitsumoto T. Arterial Velocity Pulse Index as a Novel Marker of Atherosclerosis Using Pulse Wave Analysis on High Sensitivity Troponin T in Hypertensive Patients. Cardiol Res 2017; 8:36-43. [PMID: 28515820 PMCID: PMC5421484 DOI: 10.14740/cr545w] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/05/2017] [Indexed: 01/29/2023] Open
Abstract
Background The arterial velocity pulse index (AVI) is explored as a novel marker of atherosclerosis using pulse wave analysis in clinical settings. Recent clinical studies have reported that the level of high-sensitivity troponin T (hs-cTnT) is an important biomarker in hypertensive patients. The aim of this study was to clarify the impact of AVI on hs-cTnT in these patients. Methods This study enrolled 455 hypertensive outpatients (181 males and 274 females; mean age, 65 ± 11 years (mean ± standard deviation)) without a history of cardiovascular events. AVI and hs-cTnT levels were measured using a commercial device, and relations among various clinical parameters, including AVI and hs-cTnT, were examined. Results Hs-cTnT was detected in 405 patients (89.0%). AVI was significantly higher in patients with detectable hs-cTnT than in those without (28 ± 7 vs. 24 ± 8, respectively, P < 0.001). In patients with detectable hs-cTnT, there was a significant positive correlation between AVI and hs-cTnT (r = 0.42, P < 0.001). Furthermore, multiple regression analyses revealed that AVI was an independent variable when hs-cTnT was used as a subordinate factor. On the other hand, hs-cTnT age, Cornell electrocardiographic voltage, height, urinary albumin excretion, pulse rate, and derivatives of reactive oxygen metabolites test were independent variables when AVI was used as a subordinate factor. Conclusion The results of this study indicate that AVI reflects features of arterial wave reflection and is an important factor for hs-cTnT elevation in hypertensive patients.
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Affiliation(s)
- Takashi Hitsumoto
- Hitsumoto Medical Clinic, 2-7-7, Takezakicyou, Shimonoseki City, Yamaguchi 750-0025, Japan.
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Zhang Y, Yin P, Xu Z, Xie Y, Wang C, Fan Y, Liang F, Yin Z. Non-Invasive Assessment of Early Atherosclerosis Based on New Arterial Stiffness Indices Measured with an Upper-Arm Oscillometric Device. TOHOKU J EXP MED 2017; 241:263-270. [DOI: 10.1620/tjem.241.263] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Affiliation(s)
- Yaping Zhang
- Department of Cardiology, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine
| | - Ping Yin
- Department of Cardiology, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine
| | - Zuojun Xu
- Department of Cardiology, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine
| | - Yushui Xie
- Department of Cardiology, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine
| | - Changqian Wang
- Department of Cardiology, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine
| | - Yuqi Fan
- Department of Cardiology, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine
| | - Fuyou Liang
- Shanghai Jiao Tong University and Chiba University International Cooperative Research Center, School of Naval Architecture, Ocean and Civil Engineering, Shanghai Jiao Tong University
| | - Zhaofang Yin
- Department of Cardiology, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine
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