The independent association between salivary alpha-amylase activity and arterial stiffness in Japanese men and women: the Toon Health Study

Dynamics of the State of Arterial Stiffness as a Possible Pathophysiological Factor of Unfavorable Long-Term Prognosis in Patients after Coronary Artery Bypass Grafting

The aim of this study was to examine the long-term prognostic value of changes in the cardio-ankle vascular index (CAVI) within a year after coronary artery bypass grafting (CABG).

METHODS

Patients with coronary artery disease (n = 251) in whom CAVI was assessed using the VaSera VS-1000 device before and one year after CABG. Groups with improved CAVI or worsened CAVI were identified. We assessed the following events at follow-up: all-causes death, myocardial infarction, and stroke/transient ischemic attack.

RESULTS

All-causes death was significantly more common in the group with worsened CAVI (27.6%) than in the group with CAVI improvement (14.8%; p = 0.029). Patients with worsened CAVI were more likely to have MACE, accounting for 42.2% cases, compared with patients with CAVI improvement, who accounted for 24.5%; p = 0.008. Worsened CAVI (p = 0.024), number of shunts (p = 0.006), and the presence of carotid stenosis (p = 0.051) were independent predictors of death from all causes at 10-year follow-up after CABG. The presence of carotid stenosis (p = 0.002) and the group with worsened CAVI after a year (p = 0.008) were independent predictors of the development of the combined endpoint during long-term follow-up.

CONCLUSIONS

Patients with worsening CAVI one year after CABG have a poorer prognosis at long-term follow-up than patients with improved CAVI. Future research would be useful to identify the most effective interventions to improve CAVI and correspondingly improve prognosis.

2023 update and perspectives

Total 276 manuscripts were published in Hypertension Research in 2022. Here our editorial members picked up the excellent papers, summarized the current topics from the published papers and discussed future perspectives in the sixteen fields. We hope you enjoy our special feature, 2023 update and perspectives in Hypertension Research.

Calculation of an Improved Stiffness Index Using Decomposed Radial Pulse and Digital Volume Pulse Signals

The stiffness index (SI) is used to estimate cardiovascular risk in humans. In this study, we developed a refined SI for determining arterial stiffness based on the decomposed radial pulse and digital volume pulse (DVP) waveforms. In total, 40 mature asymptomatic subjects (20 male and 20 female, 42 to 76 years of age) and 40 subjects with type 2 diabetes mellitus (T2DM) (23 male and 17 female, 35 to 78 years of age) were enrolled in this study. We measured subjects' radial pulse at the wrist and their DVP at the fingertip, and then implemented ensemble empirical mode decomposition (EEMD) to derive the orthogonal intrinsic mode functions (IMFs). An improved SI (SI_new) was calculated by dividing the body height by the mean transit time between the first IMF5 peak and the IMF6 trough. Another traditional index, pulse wave velocity (PWV_finger), was also included for comparison. For the PWV_finger index, the subjects with T2DM presented significantly higher SI_new values measured according to the radial pulse (SI_new-RP) and DVP signals (SI_new-DVP). Using a one-way analysis of variance, we found no statistically significant difference between SI_new-RP and PWV_finger when applied to the same test subjects. Binary logistic regression analysis showed that a high SI_new-RP value was the most significant risk factor for developing T2DM (SI_new-RP odds ratio 3.17, 95% CI 1.53-6.57; SI_new-DVP odds ratio 2.85, 95% CI 1.27-6.40). Our refined stiffness index could provide significant information regarding the decomposed radial pulse and digital volume pulse signals in assessments of arterial stiffness.