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Zhang H, Leng S, Gao F, Kovalik JP, Wee HN, Chua KV, Ching J, Allen JC, Zhao X, Tan RS, Wu Q, Leiner T, Koh AS, Zhong L. Characteristics of pulmonary artery strain assessed by cardiovascular magnetic resonance imaging and associations with metabolomic pathways in human ageing. Front Cardiovasc Med 2024; 11:1346443. [PMID: 38486706 PMCID: PMC10937542 DOI: 10.3389/fcvm.2024.1346443] [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: 11/29/2023] [Accepted: 02/20/2024] [Indexed: 03/17/2024] Open
Abstract
Background Pulmonary artery (PA) strain is associated with structural and functional alterations of the vessel and is an independent predictor of cardiovascular events. The relationship of PA strain to metabolomics in participants without cardiovascular disease is unknown. Methods In the current study, community-based older adults, without known cardiovascular disease, underwent simultaneous cine cardiovascular magnetic resonance (CMR) imaging, clinical examination, and serum sampling. PA global longitudinal strain (GLS) analysis was performed by tracking the change in distance from the PA bifurcation to the pulmonary annular centroid, using standard cine CMR images. Circulating metabolites were measured by cross-sectional targeted metabolomics analysis. Results Among n = 170 adults (mean age 71 ± 6.3 years old; 79 women), mean values of PA GLS were 16.2 ± 4.4%. PA GLS was significantly associated with age (β = -0.13, P = 0.017), heart rate (β = -0.08, P = 0.001), dyslipidemia (β = -2.37, P = 0.005), and cardiovascular risk factors (β = -2.49, P = 0.001). Alanine (β = -0.007, P = 0.01) and proline (β = -0.0009, P = 0.042) were significantly associated with PA GLS after adjustment for clinical risk factors. Medium and long-chain acylcarnitines were significantly associated with PA GLS (C12, P = 0.027; C12-OH/C10-DC, P = 0.018; C14:2, P = 0.036; C14:1, P = 0.006; C14, P = 0.006; C14-OH/C12-DC, P = 0.027; C16:3, P = 0.019; C16:2, P = 0.006; C16:1, P = 0.001; C16:2-OH, P = 0.016; C16:1-OH/C14:1-DC, P = 0.028; C18:1-OH/C16:1-DC, P = 0.032). Conclusion By conventional CMR, PA GLS was associated with aging and vascular risk factors among a contemporary cohort of older adults. Metabolic pathways involved in PA stiffness may include gluconeogenesis, collagen synthesis, and fatty acid oxidation.
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Affiliation(s)
- Hongzhou Zhang
- Department of Cardiovascular Medicine, First Affiliated Hospital of Gannan Medical University, Ganzhou, Jiangxi, China
- National Heart Research Institute Singapore, National Heart Centre Singapore, Singapore, Singapore
| | - Shuang Leng
- National Heart Research Institute Singapore, National Heart Centre Singapore, Singapore, Singapore
- Duke-NUS Medical School, Singapore, Singapore
| | - Fei Gao
- National Heart Research Institute Singapore, National Heart Centre Singapore, Singapore, Singapore
- Duke-NUS Medical School, Singapore, Singapore
| | - Jean-Paul Kovalik
- Duke-NUS Medical School, Singapore, Singapore
- Department of Endocrinology, Singapore General Hospital, Singapore, Singapore
| | | | | | - Jianhong Ching
- Duke-NUS Medical School, Singapore, Singapore
- KK Research Centre, KK Women’s and Children’s Hospital, Singapore, Singapore
| | | | - Xiaodan Zhao
- National Heart Research Institute Singapore, National Heart Centre Singapore, Singapore, Singapore
| | - Ru-San Tan
- National Heart Research Institute Singapore, National Heart Centre Singapore, Singapore, Singapore
- Duke-NUS Medical School, Singapore, Singapore
| | - Qinghua Wu
- Department of Cardiology, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Tim Leiner
- Department of Radiology, Mayo Clinic, Rochester, MN, United States
| | - Angela S. Koh
- National Heart Research Institute Singapore, National Heart Centre Singapore, Singapore, Singapore
- Duke-NUS Medical School, Singapore, Singapore
| | - Liang Zhong
- National Heart Research Institute Singapore, National Heart Centre Singapore, Singapore, Singapore
- Duke-NUS Medical School, Singapore, Singapore
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Wen Q, Wright A, Tong Y, Zhao Y, Risacher SL, Saykin AJ, Wu YC, Limaye K, Riley K. Paravascular fluid dynamics reveal arterial stiffness assessed using dynamic diffusion-weighted imaging. NMR IN BIOMEDICINE 2024; 37:e5048. [PMID: 37798964 PMCID: PMC10810720 DOI: 10.1002/nbm.5048] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Revised: 09/02/2023] [Accepted: 09/05/2023] [Indexed: 10/07/2023]
Abstract
Paravascular cerebrospinal fluid (pCSF) surrounding the cerebral arteries within the glymphatic system is pulsatile and moves in synchrony with the pressure waves of the vessel wall. Whether such pulsatile pCSF can infer pulse wave propagation-a property tightly related to arterial stiffness-is unknown and has never been explored. Our recently developed imaging technique, dynamic diffusion-weighted imaging (dynDWI), captures the pulsatile pCSF dynamics in vivo and can explore this question. In this work, we evaluated the time shifts between pCSF waves and finger pulse waves, where pCSF waves were measured by dynDWI and finger pulse waves were measured by the scanner's built-in finger pulse oximeter. We hypothesized that the time shifts reflect brain-finger pulse wave travel time and are sensitive to arterial stiffness. We applied the framework to 36 participants aged 18-82 years to study the age effect of travel time, as well as its associations with cognitive function within the older participants (N = 15, age > 60 years). Our results revealed a strong and consistent correlation between pCSF pulse and finger pulse (mean CorrCoeff = 0.66), supporting arterial pulsation as a major driver for pCSF dynamics. The time delay between pCSF and finger pulses (TimeDelay) was significantly lower (i.e., faster pulse propagation) with advanced age (Pearson's r = -0.44, p = 0.007). Shorter TimeDelay was further associated with worse cognitive function in the older participants. Overall, our study demonstrated pCSF as a viable pathway for measuring intracranial pulses and encouraged future studies to investigate its relevance with cerebrovascular functions.
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Affiliation(s)
- Qiuting Wen
- Department of Radiology and Imaging Sciences, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Adam Wright
- Department of Radiology and Imaging Sciences, Indiana University School of Medicine, Indianapolis, Indiana, USA
- Weldon School of Biomedical Engineering, Purdue University, West Lafayette, Indiana, USA
| | - Yunjie Tong
- Weldon School of Biomedical Engineering, Purdue University, West Lafayette, Indiana, USA
| | - Yi Zhao
- Department of Biostatistics and Health Data Science, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Shannon L. Risacher
- Department of Radiology and Imaging Sciences, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Andrew J. Saykin
- Department of Radiology and Imaging Sciences, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Yu-Chien Wu
- Department of Radiology and Imaging Sciences, Indiana University School of Medicine, Indianapolis, Indiana, USA
- Stark Neuroscience Research Institute, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Kaustubh Limaye
- Department of Neurology, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Kalen Riley
- Department of Clinical Radiology, Indiana University School of Medicine, Indianapolis, Indiana, USA
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Spronck B, Sharman JE, Daskalopoulou SS. Author reply. BJOG 2024; 131:239-240. [PMID: 37789545 DOI: 10.1111/1471-0528.17682] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Accepted: 09/14/2023] [Indexed: 10/05/2023]
Affiliation(s)
- Bart Spronck
- Department of Biomedical Engineering, CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, The Netherlands
- Macquarie Medical School, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, New South Wales, Australia
| | - James E Sharman
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - Stella S Daskalopoulou
- Division of Experimental Medicine, Department of Medicine, McGill University, Montreal, Quebec, Canada
- Division of Internal Medicine, Department of Medicine, McGill University, Montreal, Quebec, Canada
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Pucci G, Martina MR, Bianchini E, D’abbondanza M, Curcio R, Battista F, Anastasio F, Crapa ME, Sanesi L, Gemignani V, Vaudo G. Relationship between measures of adiposity, blood pressure and arterial stiffness in adolescents. The MACISTE study. J Hypertens 2023; 41:1100-1107. [PMID: 37071447 PMCID: PMC10241423 DOI: 10.1097/hjh.0000000000003433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2022] [Accepted: 03/06/2023] [Indexed: 04/19/2023]
Abstract
OBJECTIVE Children and adolescents with adiposity excess are at increased risk of future cardiovascular (CV) disease. Fat accumulation promotes the development of elevated blood pressure (BP) and arterial stiffness, two main determinants of CV risk which are strongly inter-related. We aimed at investigating whether the association between overweight and arterial stiffness, taken at different arterial segments, is mediated by increased BP or is BP-independent. METHODS Three hundred and twenty-two Italian healthy adolescents (mean age 16.9±1.4 years, 12% with overweight) attending the "G. Donatelli" High School in Terni, Italy, underwent measurement of arterial stiffness by arterial tonometry (aortic stiffness) and semiautomatical detection of pressure-volume ratio of the common carotid (carotid stiffness). The mediator effect of BP was tested for each anthropometric or biochemical measure of fat excess related to arterial stiffness. RESULTS Both carotid and aortic stiffness showed positive correlations with body mass index, waist, hip, and neck circumferences (NC). Only carotid stiffness, but not aortic stiffness, was associated with serum markers of fat accumulation and metabolic impairment such as insulin, homeostatic model of insulin resistance (HOMA-IR), serum gamma-glutamyl transferase (sGGT) and uric acid. The association with NC was stronger for carotid than for aortic stiffness (Fisher z -to- R 2.07, P = 0.04), and independent from BP. CONCLUSIONS In healthy adolescents, fat accumulation is associated with arterial stiffness. The degree of this association differs by arterial segments, since carotid stiffness is more strongly associated to adipose tissue excess than aortic stiffness and shows a BP-independent association with NC whereas aortic stiffness does not.
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Affiliation(s)
- Giacomo Pucci
- Department of Medicine and Surgery, University of Perugia – Unit of Internal Medicine, “Santa Maria” University Hospital, Terni
| | - Maria R. Martina
- Institute of Clinical Physiology, Italian National Research Council, Pisa
| | | | - Marco D’abbondanza
- Department of Medicine and Surgery, University of Perugia – Unit of Internal Medicine, “Santa Maria” University Hospital, Terni
| | - Rosa Curcio
- Department of Medicine and Surgery, University of Perugia – Unit of Internal Medicine, “Santa Maria” University Hospital, Terni
| | - Francesca Battista
- Sports and Exercise Medicine Division, Department of Medicine, University of Padova, Padova
| | | | - Mariano E. Crapa
- U.O. Medicina Interna, Asl Taranto, Presidio Ospedaliero Occidentale, Castellaneta, Italy
| | - Leandro Sanesi
- Department of Medicine and Surgery, University of Perugia – Unit of Internal Medicine, “Santa Maria” University Hospital, Terni
| | - Vincenzo Gemignani
- Institute of Clinical Physiology, Italian National Research Council, Pisa
| | - Gaetano Vaudo
- Department of Medicine and Surgery, University of Perugia – Unit of Internal Medicine, “Santa Maria” University Hospital, Terni
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Rasool DA, Ismail HJ, Yaba SP. Fully automatic carotid arterial stiffness assessment from ultrasound videos based on machine learning. Phys Eng Sci Med 2023; 46:151-164. [PMID: 36787022 DOI: 10.1007/s13246-022-01206-3] [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: 07/24/2022] [Accepted: 12/01/2022] [Indexed: 02/15/2023]
Abstract
Arterial stiffness (AS) refers to the loss of arterial compliance and alterations in vessel wall properties. The study of local carotid stiffness (CS) is particularly important since carotid artery stiffening raises the risk of stroke, cognitive impairment, and dementia. So, stiffness measurement as a screening tool approach is crucial because it can reduce mortality and facilitate therapy planning. This study aims to evaluate the stiffness of the CCA using machine learning (ML) through the features of diameter change (ΔD) and stiffness parameters. This study was conducted in seven stages: data collection, preprocessing, CCA segmentation, CCA lumen diameter (DCCA) computing during cardiac cycles, denoising signals of DCCA, computational of AS parameters, and stiffness assessment using ML. The 51 videos (with 25 s) of CCA B-mode ultrasound (US) were used and analyzed. Each US video yielded approximately 750 sequential frames spanning about 24 cardiac cycles. Firstly, US preset settings with time gain compensation with a U-pattern were employed to enhance CCA segmentations. The study showed that auto region-growing, employed three times, is appropriate for segmenting walls with a short running time (4.56 s/frame). The diameter computed for frames constructs a signal (diameter signal) with noisy parts in the shape of peak variance and an un-smooth side. Among the 12 employed smoothing methods, spline fitting with a mean peak difference per cycle (MPDCY) of 0.58 pixels was the most effective for the diameter signal. The authors propose the MPDCY as a new selection criterion for smoothing methods with highly preserved peaks. The ΔD (Dsys-Ddia) determined in this study was validated by statistical analysis as a viable replacement for manual ΔD measurement. Statistical analysis was carried out by Mann-Whitney t-test with a p-value of 0.81, regression line R2 = 0.907, and there was no difference in means between the two groups for box plots. The stiffness parameters of the carotid arteries were calculated based on auto-ΔD and pulse pressure. Five ML models, including K-nearest neighbor (KNN), support vector machine (SVM), decision tree (DT), logistic regression (LR), and random forest (RF), fed by distension (ΔD) and five stiffness parameters, were used to distinguish between the stiffened and un-stiffened CCA. Except for SVM, all models performed excellently in terms of specificity, sensitivity, precision, and area under the curve (AUC). In addition, the scatterplot and statistical analysis of the fed features confirm these remarkable outcomes. The scatter plot demonstrates that a linear hyperline can easily distinguish between the two classes. The statistical analysis shows that the stiffness parameters computed from the database of this work were statistically (p < 0.05) distributed into the non-stiffness and stiffness groups. The presented models are validated by applying them to additional datasets. Applying models to other datasets reveals a model performance of 100%. The proposed ML models could be applied in clinical practice to detect CS early, which is essential for preventing stroke.
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Pierce GL, Coutinho TA, DuBose LE, Donato AJ. Is It Good to Have a Stiff Aorta with Aging? Causes and Consequences. Physiology (Bethesda) 2022; 37:154-173. [PMID: 34779281 PMCID: PMC8977146 DOI: 10.1152/physiol.00035.2021] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Revised: 10/28/2021] [Accepted: 11/08/2021] [Indexed: 01/09/2023] Open
Abstract
Aortic stiffness increases with advancing age, more than doubling during the human life span, and is a robust predictor of cardiovascular disease (CVD) clinical events independent of traditional risk factors. The aorta increases in diameter and length to accommodate growing body size and cardiac output in youth, but in middle and older age the aorta continues to remodel to a larger diameter, thinning the pool of permanent elastin fibers, increasing intramural wall stress and resulting in the transfer of load bearing onto stiffer collagen fibers. Whereas aortic stiffening in early middle age may be a compensatory mechanism to normalize intramural wall stress and therefore theoretically "good" early in the life span, the negative clinical consequences of accelerated aortic stiffening beyond middle age far outweigh any earlier physiological benefit. Indeed, aortic stiffness and the loss of the "windkessel effect" with advancing age result in elevated pulsatile pressure and flow in downstream microvasculature that is associated with subclinical damage to high-flow, low-resistance organs such as brain, kidney, retina, and heart. The mechanisms of aortic stiffness include alterations in extracellular matrix proteins (collagen deposition, elastin fragmentation), increased arterial tone (oxidative stress and inflammation-related reduced vasodilators and augmented vasoconstrictors; enhanced sympathetic activity), arterial calcification, vascular smooth muscle cell stiffness, and extracellular matrix glycosaminoglycans. Given the rapidly aging population of the United States, aortic stiffening will likely contribute to substantial CVD burden over the next 2-3 decades unless new therapeutic targets and interventions are identified to prevent the potential avalanche of clinical sequelae related to age-related aortic stiffness.
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Affiliation(s)
- Gary L Pierce
- Department of Health and Human Physiology, University of Iowa, Iowa City, Iowa
- Department of Internal Medicine, University of Iowa, Iowa City, Iowa
- Abboud Cardiovascular Research Center, University of Iowa, Iowa City, Iowa
- Fraternal Order of Eagles Diabetes Research Center, University of Iowa, Iowa City, Iowa
| | - Thais A Coutinho
- Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada
- Divisions of Cardiology and Cardiac Prevention and Rehabilitation, University of Ottawa Heart Institute, Ottawa, Ontario, Canada
| | - Lyndsey E DuBose
- Division of Geriatrics, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - Anthony J Donato
- Department of Internal Medicine, University of Utah, Salt Lake City, Utah
- Department of Nutrition and Integrative Physiology, University of Utah, Salt Lake City, Utah
- Department of Biochemistry, University of Utah, Salt Lake City, Utah
- Geriatric Research Education and Clinical Center, VA Salt Lake City, Salt Lake City, Utah
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7
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Vallée A. Arterial Stiffness Determinants for Primary Cardiovascular Prevention among Healthy Participants. J Clin Med 2022; 11:jcm11092512. [PMID: 35566636 PMCID: PMC9105622 DOI: 10.3390/jcm11092512] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 04/13/2022] [Accepted: 04/27/2022] [Indexed: 12/27/2022] Open
Abstract
Background: Arterial stiffness (AS), measured by arterial stiffness index (ASI), can be considered as a major denominator in cardiovascular (CV) diseases. Thus, it remains essential to highlight the risk factors influencing its increase among healthy participants. Methods: According to European consensus, AS is defined as ASI > 10 m/s. The purpose of this study was to investigate the determinants of the arterial stiffness (ASI > 10 m/s) among UK Biobank normotensive and healthy participants without comorbidities and previous CV diseases. Thus, a cross-sectional study was conducted on 22,452 healthy participants. Results: Participants were divided into two groups, i.e., ASI > 10 m/s (n = 5782, 25.8%) and ASI < 10 m/s (n = 16,670, 74.2%). All the significant univariate covariables were included in the multivariate analysis. The remaining independent factors associated with AS were age (OR = 1.063, threshold = 53.0 years, p < 0.001), BMI (OR = 1.0450, threshold = 24.9 kg/m2, p < 0.001), cystatin c (OR = 1.384, threshold = 0.85 mg/L, p = 0.011), phosphate (OR = 2.225, threshold = 1.21 mmol/L, p < 0.001), triglycerides (OR = 1.281, threshold = 1.09 mmol/L, p < 0.001), mean BP (OR = 1.028, threshold = 91.2 mmHg, p < 0.001), HR (OR = 1.007, threshold = 55 bpm, p < 0.001), Alkaline phosphate (OR = 1.002, threshold = 67.9 U/L, p = 0.004), albumin (OR = 0.973, threshold = 46.0 g/L, p < 0.001), gender (male, OR = 1.657, p < 0.001) and tobacco use (current, OR = 1.871, p < 0.001). Conclusion: AS is associated with multiple parameters which should be investigated in future prospective studies. Determining the markers of increased ASI among healthy participants participates in the management of future CV risk for preventive strategies.
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Affiliation(s)
- Alexandre Vallée
- Department of Epidemiology-Data-Biostatistics, Delegation of Clinical Research and Innovation (DRCI), Foch Hospital, 92150 Suresnes, France
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Heimark S, Rindal OMH, Seeberg TM, Stepanov A, Boysen ES, Bøtker-Rasmussen KG, Mobæk NK, Søraas CL, Stenehjem AE, Fadl Elmula FEM, Waldum-Grevbo B. Blood pressure altering method affects correlation with pulse arrival time. Blood Press Monit 2022; 27:139-146. [PMID: 34855653 PMCID: PMC8893131 DOI: 10.1097/mbp.0000000000000577] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Accepted: 11/07/2021] [Indexed: 11/28/2022]
Abstract
OBJECTIVE Pulse arrival time (PAT) is a potential main feature in cuff-less blood pressure (BP) monitoring. However, the precise relationship between BP parameters and PAT under varying conditions lacks a complete understanding. We hypothesize that simple test protocols fail to demonstrate the complex relationship between PAT and both SBP and DBP. Therefore, this study aimed to investigate the correlation between PAT and BP during two exercise modalities with differing BP responses using an unobtrusive wearable device. METHODS Seventy-five subjects, of which 43.7% had a prior diagnosis of hypertension, participated in an isometric and dynamic exercise test also including seated periods of rest prior to, in between and after. PAT was measured using a prototype wearable chest belt with a one-channel electrocardiogram and a photo-plethysmography sensor. Reference BP was measured auscultatory. RESULTS Mean individual correlation between PAT and SBP was -0.82 ± 0.14 in the full protocol, -0.79 ± 0.27 during isometric exercise and -0.77 ± 0.19 during dynamic exercise. Corresponding correlation between PAT and DBP was 0.25 ± 0.35, -0.74 ± 0.23 and 0.39 ± 0.41. CONCLUSION The results confirm PAT as a potential main feature to track changes in SBP. The relationship between DBP and PAT varied between exercise modalities, with the sign of the correlation changing from negative to positive between type of exercise modality. Thus, we hypothesize that simple test protocols fail to demonstrate the complex relationship between PAT and BP with emphasis on DBP.
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Affiliation(s)
- Sondre Heimark
- Department of Nephrology, Oslo University Hospital
- Section for Cardiovascular and Renal Research, Oslo University Hospital
- Institute of Clinical Medicine, University of Oslo
| | | | | | | | | | | | | | - Camilla L. Søraas
- Section for Cardiovascular and Renal Research, Oslo University Hospital
- Section for Environmental and Occupational Medicine, Oslo University Hospital
| | | | - Fadl Elmula M. Fadl Elmula
- Section for Cardiovascular and Renal Research, Oslo University Hospital
- Department of Acute Medicine, Oslo University Hospital, Oslo, Norway
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Fortier C, Garneau CA, Paré M, Obeid H, Côté N, Duval K, Goupil R, Agharazii M. Modulation of Arterial Stiffness Gradient by Acute Administration of Nitroglycerin. Front Physiol 2021; 12:774056. [PMID: 34975528 PMCID: PMC8715004 DOI: 10.3389/fphys.2021.774056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Accepted: 11/12/2021] [Indexed: 11/16/2022] Open
Abstract
Background: Physiologically, the aorta is less stiff than peripheral conductive arteries, creating an arterial stiffness gradient, protecting microcirculation from high pulsatile pressure. However, the pharmacological manipulation of arterial stiffness gradient has not been thoroughly investigated. We hypothesized that acute administration of nitroglycerin (NTG) may alter the arterial stiffness gradient through a more significant effect on the regional stiffness of medium-sized muscular arteries, as measured by pulse wave velocity (PWV). The aim of this study was to examine the differential impact of NTG on regional stiffness, and arterial stiffness gradient as measured by the aortic-brachial PWV ratio (AB-PWV ratio) and aortic-femoral PWV ratio (AF-PWV ratio). Methods: In 93 subjects (age: 61 years, men: 67%, chronic kidney disease [CKD]: 41%), aortic, brachial, and femoral stiffnesses were determined by cf-PWV, carotid-radial (cr-PWV), and femoral-dorsalis pedis artery (fp-PWV) PWVs, respectively. The measurements were repeated 5 min after the sublingual administration of NTG (0.4 mg). The AB-PWV and AF-PWV ratios were obtained by dividing cf-PWV by cr-PWV or fp-PWV, respectively. The central pulse wave profile was determined by radial artery tonometry through the generalized transfer function. Results: At baseline, cf-PWV, cr-PWV, and fp-PWV were 12.12 ± 3.36, 9.51 ± 1.81, and 9.71 ± 1.89 m/s, respectively. After the administration of NTG, there was a significant reduction in cr-PWV of 0.86 ± 1.27 m/s (p < 0.001) and fp-PWV of 1.12 ± 1.74 m/s (p < 0.001), without any significant changes in cf-PWV (p = 0.928), leading to a significant increase in the AB-PWV ratio (1.30 ± 0.39 vs. 1.42 ± 0.46; p = 0.001) and AF-PWV ratio (1.38 ± 0.47 vs. 1.56 ± 0.53; p = 0.001). There was a significant correlation between changes in the AF-PWV ratio and changes in the timing of wave reflection (r = 0.289; p = 0.042) and the amplitude of the heart rate-adjusted augmented pressure (r = − 0.467; p < 0.001). Conclusion: This study shows that acute administration of NTG reduces PWV of muscular arteries (brachial and femoral) without modifying aortic PWV. This results in an unfavorable profile of AB-PWV and AF-PWV ratios, which could lead to higher pulse pressure transmission into the microcirculation.
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Affiliation(s)
- Catherine Fortier
- CHU de Québec Research Center-Université Laval, L’Hôtel-Dieu de Québec Hospital, Québec, QC, Canada
- Division of Nephrology, Faculty of Medicine, Université Laval, Québec, QC, Canada
- Research Center of the Hôpital du Sacré-Coeur de Montréal, Montréal, QC, Canada
| | - Charles-Antoine Garneau
- CHU de Québec Research Center-Université Laval, L’Hôtel-Dieu de Québec Hospital, Québec, QC, Canada
- Division of Nephrology, Faculty of Medicine, Université Laval, Québec, QC, Canada
| | - Mathilde Paré
- CHU de Québec Research Center-Université Laval, L’Hôtel-Dieu de Québec Hospital, Québec, QC, Canada
- Division of Nephrology, Faculty of Medicine, Université Laval, Québec, QC, Canada
| | - Hasan Obeid
- CHU de Québec Research Center-Université Laval, L’Hôtel-Dieu de Québec Hospital, Québec, QC, Canada
| | - Nadège Côté
- CHU de Québec Research Center-Université Laval, L’Hôtel-Dieu de Québec Hospital, Québec, QC, Canada
- Division of Nephrology, Faculty of Medicine, Université Laval, Québec, QC, Canada
| | - Karine Duval
- CHU de Québec Research Center-Université Laval, L’Hôtel-Dieu de Québec Hospital, Québec, QC, Canada
| | - Rémi Goupil
- Research Center of the Hôpital du Sacré-Coeur de Montréal, Montréal, QC, Canada
| | - Mohsen Agharazii
- CHU de Québec Research Center-Université Laval, L’Hôtel-Dieu de Québec Hospital, Québec, QC, Canada
- Division of Nephrology, Faculty of Medicine, Université Laval, Québec, QC, Canada
- *Correspondence: Mohsen Agharazii,
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Neutel CHG, Corradin G, Puylaert P, De Meyer GRY, Martinet W, Guns PJ. High Pulsatile Load Decreases Arterial Stiffness: An ex vivo Study. Front Physiol 2021; 12:741346. [PMID: 34744784 PMCID: PMC8569808 DOI: 10.3389/fphys.2021.741346] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Accepted: 09/23/2021] [Indexed: 11/13/2022] Open
Abstract
Measuring arterial stiffness has recently gained a lot of interest because it is a strong predictor for cardiovascular events and all-cause mortality. However, assessing blood vessel stiffness is not easy and the in vivo measurements currently used provide only limited information. Ex vivo experiments allow for a more thorough investigation of (altered) arterial biomechanical properties. Such experiments can be performed either statically or dynamically, where the latter better corresponds to physiological conditions. In a dynamic setup, arterial segments oscillate between two predefined forces, mimicking the diastolic and systolic pressures from an in vivo setting. Consequently, these oscillations result in a pulsatile load (i.e., the pulse pressure). The importance of pulse pressure on the ex vivo measurement of arterial stiffness is not completely understood. Here, we demonstrate that pulsatile load modulates the overall stiffness of the aortic tissue in an ex vivo setup. More specifically, increasing pulsatile load softens the aortic tissue. Moreover, vascular smooth muscle cell (VSMC) function was affected by pulse pressure. VSMC contraction and basal tonus showed a dependence on the amplitude of the applied pulse pressure. In addition, two distinct regions of the aorta, namely the thoracic descending aorta (TDA) and the abdominal infrarenal aorta (AIA), responded differently to changes in pulse pressure. Our data indicate that pulse pressure alters ex vivo measurements of arterial stiffness and should be considered as an important variable in future experiments. More research should be conducted in order to determine which biomechanical properties are affected due to changes in pulse pressure. The elucidation of the underlying pulse pressure-sensitive properties would improve our understanding of blood vessel biomechanics and could potentially yield new therapeutic insights.
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Affiliation(s)
- Cédric H. G. Neutel
- Laboratory of Physiopharmacology, Faculty of Medicine and Health Sciences, University of Antwerp, Campus Drie Eiken, Antwerp, Belgium
| | - Giulia Corradin
- Department of Pharmaceutical and Pharmacological Sciences, University of Padua, Padua, Italy
| | - Pauline Puylaert
- Laboratory of Physiopharmacology, Faculty of Pharmaceutical, Biomedical and Veterinary Sciences, University of Antwerp, Campus Drie Eiken, Antwerp, Belgium
| | - Guido R. Y. De Meyer
- Laboratory of Physiopharmacology, Faculty of Pharmaceutical, Biomedical and Veterinary Sciences, University of Antwerp, Campus Drie Eiken, Antwerp, Belgium
| | - Wim Martinet
- Laboratory of Physiopharmacology, Faculty of Pharmaceutical, Biomedical and Veterinary Sciences, University of Antwerp, Campus Drie Eiken, Antwerp, Belgium
| | - Pieter-Jan Guns
- Laboratory of Physiopharmacology, Faculty of Medicine and Health Sciences, University of Antwerp, Campus Drie Eiken, Antwerp, Belgium
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Lee K, Yoo HJ. Simultaneous Electrical Bio-Impedance Plethysmography at Different Body Parts: Continuous and Non-Invasive Monitoring of Pulse Wave Velocity. IEEE TRANSACTIONS ON BIOMEDICAL CIRCUITS AND SYSTEMS 2021; 15:1027-1038. [PMID: 34559662 DOI: 10.1109/tbcas.2021.3115021] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
A simultaneous and time-synchronized electrical bio-impedance plethysmography (BPG) sensor system is implemented for long-term, continuous, and non-invasive measurement of arterial pulse wave velocity (PWV). The proposed BPG sensor system electrically separates each ground plane of two BPG channels and controller, and the two different BPG channels are time-synchronized by the controller transmitting periodic pulse signal to the two BPG channels. Furthermore, net parasitic capacitance between the ground planes is minimized by removing isolated DC-DC converter, limiting the number of digital capacitive isolators, and adopting optimal layout of the ground planes. The proposed sensor system is integrated on 278cm2 printed circuit board. The sensor system consumes 0.35 W/channel, and outstanding channel-to-channel isolation is expected by coupling factor performance of -77.7 dB. In addition, modified electrode configuration for BPG at chest drastically reduces baseline wandering by respiratory motion artifact, thereby further facilitating long-term, continuous, and non-invasive PWV measurement. As a result, long-term, continuous, and non-invasive PWV measurement more than 95 minutes is successfully performed to pave the way for developing pulse transit time (PTT)-based cuff-less blood pressure (BP) estimation technique.
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Beutel F, Van Hoof C, Rottenberg X, Reesink K, Hermeling E. Pulse Arrival Time Segmentation Into Cardiac and Vascular Intervals - Implications for Pulse Wave Velocity and Blood Pressure Estimation. IEEE Trans Biomed Eng 2021; 68:2810-2820. [PMID: 33513094 DOI: 10.1109/tbme.2021.3055154] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE This study demonstrates a novel method for pulse arrival time (PAT) segmentation into cardiac isovolumic contraction (IVC) and vascular pulse transit time to approximate central pulse wave velocity (PWV). METHODS 10 subjects (38 ± 10 years, 121 ± 12 mmHg SBP) ranging from normotension to hypertension were repeatedly measured at rest and with induced changes in blood pressure (BP), and thus PWV. ECG was recorded simultaneously with ultrasound-based carotid distension waveforms, a photoplethysmography-based peripheral waveform, noninvasive continuous and intermittent cuff BP. Central PAT was segmented into cardiac and vascular time intervals using a fiducial point in the carotid distension waveform that reflects the IVC onset. Central and peripheral PWVs were computed from (segmented) intervals and estimated arterial path lengths. Correlations with Bramwell-Hill PWV, systolic and diastolic BP (SBP/DBP) were analyzed by linear regression. RESULTS Central PWV explained more than twice the variability (R2) in Bramwell-Hill PWV compared to peripheral PWV (0.56 vs. 0.27). SBP estimated from central PWV undercuts the IEEE mean absolute deviation threshold of 5 mmHg, significantly lower than peripheral PWV or PAT (4.2 vs. 7.1 vs. 10.1 mmHg). CONCLUSION Cardiac IVC onset signaled in carotid distension waveforms enables PAT segmentation to obtain unbiased vascular pulse transit time. Corresponding PWV estimates provide the basis for single-site assessment of central arterial stiffness, confirmed by significant correlations with Bramwell-Hill PWV and SBP. SIGNIFICANCE In a small-scale cohort, we present proof-of-concept for a novel method to estimate central PWV and BP, bearing potential to improve the practicality of cardiovascular risk assessment in clinical routines.
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van der Bruggen MM, Reesink KD, Spronck PJM, Bitsch N, Hameleers J, Megens RTA, Schalkwijk CG, Delhaas T, Spronck B. An integrated set-up for ex vivo characterisation of biaxial murine artery biomechanics under pulsatile conditions. Sci Rep 2021; 11:2671. [PMID: 33514757 PMCID: PMC7846753 DOI: 10.1038/s41598-021-81151-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Accepted: 12/07/2020] [Indexed: 01/19/2023] Open
Abstract
Ex vivo characterisation of arterial biomechanics enables detailed discrimination of the various cellular and extracellular contributions to arterial stiffness. However, ex vivo biomechanical studies are commonly performed under quasi-static conditions, whereas dynamic biomechanical behaviour (as relevant in vivo) may differ substantially. Hence, we aim to (1) develop an integrated set-up for quasi-static and dynamic biaxial biomechanical testing, (2) quantify set-up reproducibility, and (3) illustrate the differences in measured arterial stiffness between quasi-static and dynamic conditions. Twenty-two mouse carotid arteries were mounted between glass micropipettes and kept fully vasodilated. While recording pressure, axial force (F), and inner diameter, arteries were exposed to (1) quasi-static pressure inflation from 0 to 200 mmHg; (2) 300 bpm dynamic pressure inflation (peaking at 80/120/160 mmHg); and (3) axial stretch (λz) variation at constant pressures of 10/60/100/140/200 mmHg. Measurements were performed in duplicate. Single-point pulse wave velocities (PWV; Bramwell-Hill) and axial stiffness coefficients (cax = dF/dλz) were calculated at the in vivo value of λz. Within-subject coefficients of variation were ~ 20%. Dynamic PWVs were consistently higher than quasi-static PWVs (p < 0.001); cax increased with increasing pressure. We demonstrated the feasibility of ex vivo biomechanical characterisation of biaxially-loaded murine carotid arteries under pulsatile conditions, and quantified reproducibility allowing for well-powered future study design.
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Affiliation(s)
- Myrthe M van der Bruggen
- Department of Biomedical Engineering, CARIM School for Cardiovascular Diseases, Maastricht University, Universiteitssingel 50, Room 3.359, 6229ER, Maastricht, The Netherlands
| | - Koen D Reesink
- Department of Biomedical Engineering, CARIM School for Cardiovascular Diseases, Maastricht University, Universiteitssingel 50, Room 3.359, 6229ER, Maastricht, The Netherlands
| | | | - Nicole Bitsch
- Muroidean Facility, CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, The Netherlands
| | - Jeroen Hameleers
- Department of Biomedical Engineering, CARIM School for Cardiovascular Diseases, Maastricht University, Universiteitssingel 50, Room 3.359, 6229ER, Maastricht, The Netherlands
| | - Remco T A Megens
- Department of Biomedical Engineering, CARIM School for Cardiovascular Diseases, Maastricht University, Universiteitssingel 50, Room 3.359, 6229ER, Maastricht, The Netherlands.,Institute for Cardiovascular Prevention, Ludwig-Maximilians-Universität, Munich, Germany
| | - Casper G Schalkwijk
- Department of Internal Medicine, CARIM School for Cardiovascular Diseases, Maastricht University Medical Centre+, Maastricht, The Netherlands
| | - Tammo Delhaas
- Department of Biomedical Engineering, CARIM School for Cardiovascular Diseases, Maastricht University, Universiteitssingel 50, Room 3.359, 6229ER, Maastricht, The Netherlands
| | - Bart Spronck
- Department of Biomedical Engineering, CARIM School for Cardiovascular Diseases, Maastricht University, Universiteitssingel 50, Room 3.359, 6229ER, Maastricht, The Netherlands. .,Department of Biomedical Engineering, School of Engineering & Applied Science, Yale University, New Haven, CT, USA.
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