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Okamoto T, Hashimoto Y, Iemitsu M, Ogoh S. Acute effects of static stretching exercise-induced decrease in arterial stiffness on maximal aerobic capacity. J Sports Med Phys Fitness 2024; 64:849-856. [PMID: 38842370 DOI: 10.23736/s0022-4707.24.15758-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2024]
Abstract
BACKGROUND We recently have reported that individual day-to-day arterial stiffness variations are associated with maximal aerobic capacity. However, the evidence of this phenomenon was not provided sufficiently. The present study aimed to examine whether a decrease in arterial stiffness through static stretching exercise could enhance maximal aerobic capacity. METHODS Twelve healthy young men (age 22±2 years, mean and standard deviation) participated in this study and underwent two separate sessions in a randomized controlled crossover design: a single session of a whole-body static stretching exercise protocol that involved the trunk, upper limb, and lower limb (stretch condition), and sedentary control where they rested in the exercise room. Brachial-ankle pulse wave velocity (baPWV) was measured as an index of systemic arterial stiffness before, immediately after and at 30 min after both conditions. Maximal oxygen uptake (V̇O2max) was assessed using a graded power test on an electronically braked cycle ergometer after these measurements. RESULTS As we expected, there was a significant decrease in the baPWV at 30 min after the stretch trial compared to baseline values (P=0.01). The baPWV in the stretch condition was lower than that of the control condition, while V̇O2max in the stretch condition was higher than that of the control condition (P=0.03). CONCLUSIONS Based on these findings, it can be inferred that an acute reduction in arterial stiffness may contribute to change in maximal aerobic capacity.
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Affiliation(s)
- Takanobu Okamoto
- Faculty of Sport Science, Nippon Sport Science University, Tokyo, Japan -
- Research Institute of Sports Science, Nippon Sport Science University, Tokyo, Japan -
| | - Yuto Hashimoto
- Research Institute of Sports Science, Nippon Sport Science University, Tokyo, Japan
| | - Motoyuki Iemitsu
- Faculty of Sport and Health Science, Ritsumeikan University, Shiga, Japan
| | - Shigehiko Ogoh
- Department of Biomedical Engineering, Toyo University, Saitama, Japan
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2
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Xiong L, Zhang Y, He B, Zhang K, Zhu J, Lang X. Optimum Parameters in Ultrasound Coherent Plane Wave Compounding for High LPWV Estimation: Validation on Phantom and Feasibility in 10 Subjects. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2024; 43:1469-1487. [PMID: 38700113 DOI: 10.1002/jum.16469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/25/2023] [Revised: 04/12/2024] [Accepted: 04/13/2024] [Indexed: 05/05/2024]
Abstract
OBJECTIVES The aim of this study is to determine the optimum and fine values of the number and transmission angles of tilted plane waves for coherent plane-wave compounding (CPWC)-based high local pulse wave velocity (LPWV) estimation. METHODS A Verasonics system incorporating a linear array probe L14-5/38 with 128 elements and a pulsatile pump, CompuFlow1000, were used to acquire radio frequency data of 3, 5, 7, and 9 tilted plane wave sequences with angle intervals from 0° to 12° with a coarse interval increment step of 1°, and the angle intervals from 0° to 2° with a fine interval increment step of 0.25° from a carotid vessel phantom with the LPWV of 13.42 ± 0.90 m/s. The mean value, standard deviation, and coefficients of variation (CV) of the estimated LPWVs were calculated to quantitatively assess the performance of different configurations for CPWC-based LPWV estimation. Ten healthy human subjects of two age groups were recruited to assess the in vivo feasibility of the optimum parameter values. RESULTS The CPWC technique with three plane waves (PRF of 12 kHz corresponding to a frame rate of 4000 Hz) with an interval of 0.75° had LPWVs of 13.52 ± 0.08 m/s with the lowest CV of 1.84% on the phantom, and 5.49 ± 1.46 m/s with the lowest CV of 12.35% on 10 subjects. CONCLUSIONS The optimum parameters determined in this study show the best repeatability of the LPWV measurements with a vessel phantom and 10 healthy subjects, which support further studies on larger datasets for potential applications.
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Affiliation(s)
- Li Xiong
- Department of Electronic Engineering, Information School, Yunnan University, Kunming, China
| | - Yufeng Zhang
- Department of Electronic Engineering, Information School, Yunnan University, Kunming, China
| | - Bingbing He
- Department of Electronic Engineering, Information School, Yunnan University, Kunming, China
| | - Kexin Zhang
- The Second Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Jingying Zhu
- Department of Electronic Engineering, Information School, Yunnan University, Kunming, China
| | - Xun Lang
- Department of Electronic Engineering, Information School, Yunnan University, Kunming, China
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Manning EP, Mishall P, Ramachandra AB, Hassab AHM, Lamy J, Peters DC, Murphy TE, Heerdt P, Singh I, Downie S, Choudhary G, Tellides G, Humphrey JD. Stiffening of the human proximal pulmonary artery with increasing age. Physiol Rep 2024; 12:e16090. [PMID: 38884325 PMCID: PMC11181131 DOI: 10.14814/phy2.16090] [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: 04/03/2024] [Revised: 05/16/2024] [Accepted: 05/16/2024] [Indexed: 06/18/2024] Open
Abstract
Adverse effects of large artery stiffening are well established in the systemic circulation; stiffening of the proximal pulmonary artery (PPA) and its sequelae are poorly understood. We combined in vivo (n = 6) with ex vivo data from cadavers (n = 8) and organ donors (n = 13), ages 18 to 89, to assess whether aging of the PPA associates with changes in distensibility, biaxial wall strain, wall thickness, vessel diameter, and wall composition. Aging exhibited significant negative associations with distensibility and cyclic biaxial strain of the PPA (p ≤ 0.05), with decreasing circumferential and axial strains of 20% and 7%, respectively, for every 10 years after 50. Distensibility associated directly with diffusion capacity of the lung (R2 = 0.71, p = 0.03). Axial strain associated with right ventricular ejection fraction (R2 = 0.76, p = 0.02). Aging positively associated with length of the PPA (p = 0.004) and increased luminal caliber (p = 0.05) but showed no significant association with mean wall thickness (1.19 mm, p = 0.61) and no significant differences in the proportions of mural elastin and collagen (p = 0.19) between younger (<50 years) and older (>50) ex vivo samples. We conclude that age-related stiffening of the PPA differs from that of the aorta; microstructural remodeling, rather than changes in overall geometry, may explain age-related stiffening.
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Affiliation(s)
- Edward P. Manning
- Section of Pulmonary, Critical Care, and Pulmonary MedicineYale School of MedicineNew HavenConnecticutUSA
- VA Connecticut Healthcare SystemWest HavenConnecticutUSA
| | - Priti Mishall
- Department of Anatomy and Structural BiologyAlbert Einstein College of MedicineBronxNew YorkUSA
- Department of Ophthalmology and Visual SciencesAlbert Einstein College of MedicineBronxNew YorkUSA
| | | | | | - Jerome Lamy
- Université Paris Cité, INSERM U970, PARCC, APHP Hôpital Européen Georges PompidouParisFrance
| | - Dana C. Peters
- Department of RadiologyYale School of MedicineNew HavenConnecticutUSA
| | - Terrence E. Murphy
- Department of Public Health SciencesThe Pennsylvania State University College of MedicineHersheyPennsylvaniaUSA
| | - Paul Heerdt
- Department of AnesthesiologyYale School of MedicineNew HavenConnecticutUSA
| | - Inderjit Singh
- Section of Pulmonary, Critical Care, and Pulmonary MedicineYale School of MedicineNew HavenConnecticutUSA
| | - Sherry Downie
- Department of Anatomy and Structural BiologyAlbert Einstein College of MedicineBronxNew YorkUSA
| | - Gaurav Choudhary
- Lifespan Cardiovascular Institute, Providence VA Medical CenterProvidenceRhode IslandUSA
- Warren Alpert Medical School, Brown UniversityProvidenceRhode IslandUSA
| | - George Tellides
- VA Connecticut Healthcare SystemWest HavenConnecticutUSA
- Department of Surgery (Cardiac)Yale School of MedicineNew HavenConnecticutUSA
| | - Jay D. Humphrey
- Department of Biomedical EngineeringYale UniversityNew HavenConnecticutUSA
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Girardin L, Stokes C, Thet MS, Oo AY, Balabani S, Díaz-Zuccarini V. Patient-Specific Haemodynamic Analysis of Virtual Grafting Strategies in Type-B Aortic Dissection: Impact of Compliance Mismatch. Cardiovasc Eng Technol 2024; 15:290-304. [PMID: 38438692 PMCID: PMC11239731 DOI: 10.1007/s13239-024-00713-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Accepted: 01/02/2024] [Indexed: 03/06/2024]
Abstract
INTRODUCTION Compliance mismatch between the aortic wall and Dacron Grafts is a clinical problem concerning aortic haemodynamics and morphological degeneration. The aortic stiffness introduced by grafts can lead to an increased left ventricular (LV) afterload. This study quantifies the impact of compliance mismatch by virtually testing different Type-B aortic dissection (TBAD) surgical grafting strategies in patient-specific, compliant computational fluid dynamics (CFD) simulations. MATERIALS AND METHODS A post-operative case of TBAD was segmented from computed tomography angiography data. Three virtual surgeries were generated using different grafts; two additional cases with compliant grafts were assessed. Compliant CFD simulations were performed using a patient-specific inlet flow rate and three-element Windkessel outlet boundary conditions informed by 2D-Flow MRI data. The wall compliance was calibrated using Cine-MRI images. Pressure, wall shear stress (WSS) indices and energy loss (EL) were computed. RESULTS Increased aortic stiffness and longer grafts increased aortic pressure and EL. Implementing a compliant graft matching the aortic compliance of the patient reduced the pulse pressure by 11% and EL by 4%. The endothelial cell activation potential (ECAP) differed the most within the aneurysm, where the maximum percentage difference between the reference case and the mid (MDA) and complete (CDA) descending aorta replacements increased by 16% and 20%, respectively. CONCLUSION This study suggests that by minimising graft length and matching its compliance to the native aorta whilst aligning with surgical requirements, the risk of LV hypertrophy may be reduced. This provides evidence that compliance-matching grafts may enhance patient outcomes.
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Affiliation(s)
- Louis Girardin
- Department of Mechanical Engineering, University College London, Torrington Place, London, WC1E 7JE, UK
- Wellcome/EPSRC Centre for Interventional and Surgical Sciences (WEISS), University College London, 43-45 Foley Street, London, W1W 7TS, UK
| | - Catriona Stokes
- Department of Mechanical Engineering, University College London, Torrington Place, London, WC1E 7JE, UK
- Wellcome/EPSRC Centre for Interventional and Surgical Sciences (WEISS), University College London, 43-45 Foley Street, London, W1W 7TS, UK
| | - Myat Soe Thet
- Department of Cardiothoracic Surgery, St Bartholomew's Hospital, West Smithfield, London, EC1A 7BE, UK
| | - Aung Ye Oo
- Department of Cardiothoracic Surgery, St Bartholomew's Hospital, West Smithfield, London, EC1A 7BE, UK
| | - Stavroula Balabani
- Department of Mechanical Engineering, University College London, Torrington Place, London, WC1E 7JE, UK
- Wellcome/EPSRC Centre for Interventional and Surgical Sciences (WEISS), University College London, 43-45 Foley Street, London, W1W 7TS, UK
| | - Vanessa Díaz-Zuccarini
- Department of Mechanical Engineering, University College London, Torrington Place, London, WC1E 7JE, UK.
- Wellcome/EPSRC Centre for Interventional and Surgical Sciences (WEISS), University College London, 43-45 Foley Street, London, W1W 7TS, UK.
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Alcici-Moreira AM, Vitarelli MO, Velloso TA, Carvalho-Ribeiro IA, Dario DM, Polese JC, Guimarães HP, Pena JLB, Tuesta M, de Rezende BA, Rodrigues-Machado MDG. Aortic pulse wave analysis and functional capacity of heart transplantation candidates: a pilot study. Sci Rep 2024; 14:10504. [PMID: 38714788 PMCID: PMC11076511 DOI: 10.1038/s41598-024-61152-w] [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: 09/01/2023] [Accepted: 05/02/2024] [Indexed: 05/10/2024] Open
Abstract
We compared cardiovascular parameters obtained with the Mobil-O-Graph and functional capacity assessed by the Duke Activity Status Index (DASI) before and after Heart Transplantation (HT) and also compared the cardiovascular parameters and the functional capacity of candidates for HT with a control group. Peripheral and central vascular pressures increased after surgery. Similar results were observed in cardiac output and pulse wave velocity. The significant increase in left ventricular ejection fraction (LVEF) postoperatively was not followed by an increase in the functional capacity. 24 candidates for HT and 24 controls were also compared. Functional capacity was significantly lower in the HT candidates compared to controls. Stroke volume, systolic, diastolic, and pulse pressure measured peripherally and centrally were lower in the HT candidates when compared to controls. Despite the significant increase in peripheral and central blood pressures after surgery, the patients were normotensive. The 143.85% increase in LVEF in the postoperative period was not able to positively affect functional capacity. Furthermore, the lower values of LVEF, systolic volume, central and peripheral arterial pressures in the candidates for HT are consistent with the characteristics signs of advanced heart failure, negatively impacting functional capacity, as observed by the lower DASI score.
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Affiliation(s)
- Adriana Marques Alcici-Moreira
- Post-Graduate Program in Health Sciences of Medical Sciences Faculty of Minas Gerais (FCM-MG), Alameda Ezequiel Dias, 275, Belo Horizonte, MG, 30130-110, Brazil
| | - Marcela Oliveira Vitarelli
- Post-Graduate Program in Health Sciences of Medical Sciences Faculty of Minas Gerais (FCM-MG), Alameda Ezequiel Dias, 275, Belo Horizonte, MG, 30130-110, Brazil
| | - Tiago Abreu Velloso
- Post-Graduate Program in Health Sciences of Medical Sciences Faculty of Minas Gerais (FCM-MG), Alameda Ezequiel Dias, 275, Belo Horizonte, MG, 30130-110, Brazil
| | - Igor Antônio Carvalho-Ribeiro
- Post-Graduate Program in Health Sciences of Medical Sciences Faculty of Minas Gerais (FCM-MG), Alameda Ezequiel Dias, 275, Belo Horizonte, MG, 30130-110, Brazil
| | - Daniella Moura Dario
- Post-Graduate Program in Health Sciences of Medical Sciences Faculty of Minas Gerais (FCM-MG), Alameda Ezequiel Dias, 275, Belo Horizonte, MG, 30130-110, Brazil
| | | | | | - José Luiz Barros Pena
- Post-Graduate Program in Health Sciences of Medical Sciences Faculty of Minas Gerais (FCM-MG), Alameda Ezequiel Dias, 275, Belo Horizonte, MG, 30130-110, Brazil
| | - Marcelo Tuesta
- Exercise and Rehabilitation Sciences Laboratory, School of Physical Therapy, Faculty of Rehabilitation Sciences, Universidad Andres Bello, Santiago, Chile
| | - Bruno Almeida de Rezende
- Post-Graduate Program in Health Sciences of Medical Sciences Faculty of Minas Gerais (FCM-MG), Alameda Ezequiel Dias, 275, Belo Horizonte, MG, 30130-110, Brazil
| | - Maria da Glória Rodrigues-Machado
- Post-Graduate Program in Health Sciences of Medical Sciences Faculty of Minas Gerais (FCM-MG), Alameda Ezequiel Dias, 275, Belo Horizonte, MG, 30130-110, Brazil.
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Norton GR, An DW, Aparicio LS, Yu YL, Wei FF, Niiranen TJ, Liu C, Stolarz-Skrzypek K, Wojciechowska W, Jula AM, Rajzer M, Martens DS, Verhamme P, Li Y, Kawecka-Jaszcz K, Nawrot TS, Staessen JA, Woodiwiss AJ. Mortality and Cardiovascular End Points In Relation to the Aortic Pulse Wave Components: An Individual-Participant Meta-Analysis. Hypertension 2024; 81:1065-1075. [PMID: 38390718 PMCID: PMC11025606 DOI: 10.1161/hypertensionaha.123.22036] [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: 09/27/2023] [Accepted: 02/11/2024] [Indexed: 02/24/2024]
Abstract
BACKGROUND Wave separation analysis enables individualized evaluation of the aortic pulse wave components. Previous studies focused on the pressure height with overall positive but differing results. In the present analysis, we assessed the associations of the pressure of forward and backward (Pfor and Pref) pulse waves with prospective cardiovascular end points, with extended analysis for time to pressure peak (Tfor and Tref). METHODS Participants in 3 IDCARS (International Database of Central Arterial Properties for Risk Stratification) cohorts (Argentina, Belgium, and Finland) aged ≥20 years with valid pulse wave analysis and follow-up data were included. Pulse wave analysis was done using the SphygmoCor device, and pulse wave separation was done using the triangular method. The primary end points consisted of cardiovascular mortality and nonfatal cardiovascular and cerebrovascular events. Multivariable-adjusted Cox regression was used to calculate hazard ratios. RESULTS A total of 2206 participants (mean age, 57.0 years; 55.0% women) were analyzed. Mean±SDs for Pfor, Pref, Tfor, and Tfor/Tref were 31.0±9.1 mm Hg, 20.8±8.4 mm Hg, 130.8±35.5, and 0.51±0.11, respectively. Over a median follow-up of 4.4 years, 146 (6.6%) participants experienced a primary end point. Every 1 SD increment in Pfor, Tfor, and Tfor/Tref was associated with 27% (95% CI, 1.07-1.49), 25% (95% CI, 1.07-1.45), and 32% (95% CI, 1.12-1.56) higher risk, respectively. Adding Tfor and Tfor/Tref to existing risk models improved model prediction (∆Uno's C, 0.020; P<0.01). CONCLUSIONS Pulse wave components were predictive of composite cardiovascular end points, with Tfor/Tref showing significant improvement in risk prediction. Pending further confirmation, the ratio of time to forward and backward pressure peak may be useful to evaluate increased afterload and signify increased cardiovascular risk.
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Affiliation(s)
- Gavin R. Norton
- Cardiovascular Pathophysiology and Genomics Research Unit, School of Physiology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa (G.R.N., A.J.W.)
| | - De-Wei An
- Department of Cardiovascular Medicine, Shanghai Key Laboratory of Hypertension, Shanghai Institute of Hypertension, State Key Laboratory of Medical Genomics, National Research Center for Translational Medicine, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, China (D.-W.A., Y.L.)
- Non-Profit Research Association Alliance for the Promotion of Preventive Medicine, Mechelen, Belgium (D.-W.A, Y.-L.Y., K.S.-S., J.A.S.)
- Research Unit Environment and Health, Department of Public Health and Primary Care (D.-W.A, Y.-L.Y., T.S.N.), University of Leuven, Belgium
| | - Lucas S. Aparicio
- Servicio de Clínica Médica, Sección Hipertensión Arterial, Hospital Italiano de Buenos Aires, Argentina (L.S.A.)
| | - Yu-Ling Yu
- Non-Profit Research Association Alliance for the Promotion of Preventive Medicine, Mechelen, Belgium (D.-W.A, Y.-L.Y., K.S.-S., J.A.S.)
- Research Unit Environment and Health, Department of Public Health and Primary Care (D.-W.A, Y.-L.Y., T.S.N.), University of Leuven, Belgium
| | - Fang-Fei Wei
- The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China (F.-F.W., C.L.)
| | - Teemu J. Niiranen
- Department of Chronic Disease Prevention, Finnish Institute for Health and Welfare, Turku, Finland (T.J.N., A.M.J.)
- Department of Medicine, Turku University Hospital and University of Turku, Finland (T.J.N., A.M.J.)
| | - Chen Liu
- The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China (F.-F.W., C.L.)
| | - Katarzyna Stolarz-Skrzypek
- Non-Profit Research Association Alliance for the Promotion of Preventive Medicine, Mechelen, Belgium (D.-W.A, Y.-L.Y., K.S.-S., J.A.S.)
- First Department of Cardiology, Interventional Electrocardiology and Hypertension, Jagiellonian University Medical College, Kraków, Poland (K.S.-S., W.W., K.K.-J., M.R.)
| | - Wiktoria Wojciechowska
- First Department of Cardiology, Interventional Electrocardiology and Hypertension, Jagiellonian University Medical College, Kraków, Poland (K.S.-S., W.W., K.K.-J., M.R.)
| | - Antti M. Jula
- Department of Chronic Disease Prevention, Finnish Institute for Health and Welfare, Turku, Finland (T.J.N., A.M.J.)
- Department of Medicine, Turku University Hospital and University of Turku, Finland (T.J.N., A.M.J.)
| | - Marek Rajzer
- First Department of Cardiology, Interventional Electrocardiology and Hypertension, Jagiellonian University Medical College, Kraków, Poland (K.S.-S., W.W., K.K.-J., M.R.)
| | - Dries S. Martens
- Center for Environmental Sciences, Hasselt University, Diepenbeek, Belgium (D.S.M., T.S.N)
| | - Peter Verhamme
- Center for Molecular and Vascular Biology, KU Leuven Department of Cardiovascular Sciences (P.V.), University of Leuven, Belgium
| | - Yan Li
- Department of Cardiovascular Medicine, Shanghai Key Laboratory of Hypertension, Shanghai Institute of Hypertension, State Key Laboratory of Medical Genomics, National Research Center for Translational Medicine, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, China (D.-W.A., Y.L.)
| | - Kalina Kawecka-Jaszcz
- First Department of Cardiology, Interventional Electrocardiology and Hypertension, Jagiellonian University Medical College, Kraków, Poland (K.S.-S., W.W., K.K.-J., M.R.)
| | - Tim S. Nawrot
- Research Unit Environment and Health, Department of Public Health and Primary Care (D.-W.A, Y.-L.Y., T.S.N.), University of Leuven, Belgium
- Center for Environmental Sciences, Hasselt University, Diepenbeek, Belgium (D.S.M., T.S.N)
| | - Jan A. Staessen
- Non-Profit Research Association Alliance for the Promotion of Preventive Medicine, Mechelen, Belgium (D.-W.A, Y.-L.Y., K.S.-S., J.A.S.)
- Biomedical Science Group, Faculty of Medicine (J.A.S.), University of Leuven, Belgium
| | - Angela J. Woodiwiss
- Cardiovascular Pathophysiology and Genomics Research Unit, School of Physiology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa (G.R.N., A.J.W.)
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Hong S, Coté G. Arterial Pulse Wave Velocity Signal Reconstruction Using Low Sampling Rates. BIOSENSORS 2024; 14:92. [PMID: 38392011 PMCID: PMC10887207 DOI: 10.3390/bios14020092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Revised: 12/28/2023] [Accepted: 02/06/2024] [Indexed: 02/24/2024]
Abstract
Pulse Wave Velocity (PWV) analysis is valuable for assessing arterial stiffness and cardiovascular health and potentially for estimating blood pressure cufflessly. However, conventional PWV analysis from two transducers spaced closely poses challenges in data management, battery life, and developing the device for continuous real-time applications together along an artery, which typically need data to be recorded at high sampling rates. Specifically, although a pulse signal consists of low-frequency components when used for applications such as determining heart rate, the pulse transit time for transducers near each other along an artery takes place in the millisecond range, typically needing a high sampling rate. To overcome this issue, in this study, we present a novel approach that leverages the Nyquist-Shannon sampling theorem and reconstruction techniques for signals produced by bioimpedance transducers closely spaced along a radial artery. Specifically, we recorded bioimpedance artery pulse signals at a low sampling rate, reducing the data size and subsequently algorithmically reconstructing these signals at a higher sampling rate. We were able to retain vital transit time information and achieved enhanced precision that is comparable to the traditional high-rate sampling method. Our research demonstrates the viability of the algorithmic method for enabling PWV analysis from low-sampling-rate data, overcoming the constraints of conventional approaches. This technique has the potential to contribute to the development of cardiovascular health monitoring and diagnosis using closely spaced wearable devices for real-time and low-resource PWV assessment, enhancing patient care and cardiovascular disease management.
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Affiliation(s)
- Sungcheol Hong
- Department of Biomedical Engineering, Texas A&M University, College Station, TX 77843, USA
| | - Gerard Coté
- Department of Biomedical Engineering, Texas A&M University, College Station, TX 77843, USA
- Department of Electrical Engineering, Texas A&M University, College Station, TX 77843, USA
- Center for Remote Health Technologies and Systems, Texas A&M Engineering Experiment Station, Texas A&M University, College Station, TX 77843, USA
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8
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Huang Y, Zhao L, Cai M, Zhu J, Wang L, Chen X, Zeng Y, Zhang L, Shi J, Guo CF. Arteriosclerosis Assessment Based on Single-Point Fingertip Pulse Monitoring Using a Wearable Iontronic Sensor. Adv Healthc Mater 2023; 12:e2301838. [PMID: 37602671 DOI: 10.1002/adhm.202301838] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Revised: 08/09/2023] [Indexed: 08/22/2023]
Abstract
Arteriosclerosis, which appears as a hardened and narrowed artery with plaque buildup, is the primary cause of various cardiovascular diseases such as stroke. Arteriosclerosis is often evaluated by clinically measuring the pulse wave velocity (PWV) using a two-point approach that requires bulky medical equipment and a skilled operator. Although wearable photoplethysmographic sensors for PWV monitoring are developed in recent years, likewise, this technique is often based on two-point measurement, and the signal can easily be interfered with by natural light. Herein, a single-point strategy is reported based on stable fingertip pulse monitoring using a flexible iontronic pressure sensor for heart-fingertip PWV (hfPWV) measurement. The iontronic sensor exhibits a high pressure-resolution on the order of 0.1 Pa over a wide linearity range, allowing the capture of characteristic peaks of fingertip pulse waves. The forward and reflected waves of the pulse are extracted and the time difference between the two waves is computed for hfPWV measurement using Hiroshi's method. Furthermore, a hfPWV-based model is established for arteriosclerosis evaluation with an accuracy comparable to that of existing clinical criteria, and the validity of the model is verified clinically. The work provides a reliable technique that can be used in wearable arteriosclerosis assessment systems.
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Affiliation(s)
- Yi Huang
- Department of Cardiology, Southern University of Science and Technology Hospital (SUSTech-Hospital), Shenzhen, 518071, China
| | - Lingyu Zhao
- Department of Materials Science and Engineering, Southern University of Science and Technology, Shenzhen, 518055, China
| | - Minkun Cai
- Department of Materials Science and Engineering, Southern University of Science and Technology, Shenzhen, 518055, China
| | - Jiaqi Zhu
- Department of Materials Science and Engineering, Southern University of Science and Technology, Shenzhen, 518055, China
| | - Liu Wang
- CAS Key Laboratory of Mechanical Behavior and Design of Materials, Department of Modern Mechanics, University of Science and Technology of China, Hefei, 230026, China
| | - Xinxing Chen
- Shenzhen Key Laboratory of Biomimetic Robotics and Intelligent Systems, Guangdong Provincial Key Laboratory of Human-Augmentation and Rehabilitation Robotics in Universities, Southern University of Science and Technology, Shenzhen, 518055, China
| | - Yumin Zeng
- Department of Sports Center, Southern University of Science and Technology, Shenzhen, 518055, China
| | - Liqing Zhang
- Department of Endocrinology, Southern University of Science and Technology Hospital (SUSTech-hospital), Shenzhen, 518071, China
| | - Jidong Shi
- Shenzhen Key Laboratory of Ultraintense Laser and Advanced Material Technology, Center for Advanced Material Diagnostic Technology, College of Engineering Physics, Shenzhen Technology University, Shenzhen, 518118, China
| | - Chuan Fei Guo
- Department of Materials Science and Engineering, Southern University of Science and Technology, Shenzhen, 518055, China
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9
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Campitelli R, Ferrario M, Su F, Creteur J, Herpain A, Carrara M. Pulse wave analysis as a tool for the evaluation of resuscitation therapy in septic shock. Physiol Meas 2023; 44:105002. [PMID: 37738987 DOI: 10.1088/1361-6579/acfc94] [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: 06/22/2023] [Accepted: 09/22/2023] [Indexed: 09/24/2023]
Abstract
Objective. Pulse wave analysis (PWA) can provide insights into cardiovascular biomechanical properties. The use of PWA in critically ill patients, such as septic shock patients, is still limited, but it can provide complementary information on the cardiovascular effects of treatment when compared to standard indices outlined in international guidelines. Previous works have highlighted how sepsis induces severe cardiovascular derangement with altered arterial blood pressure waveform morphology and how resuscitation according to standard haemodynamic targets is not able to restore the physiological functioning of the cardiovascular system. The aim of this work is to test the effectiveness of PWA in characterizing arterial waveforms obtained from a swine experiment involving polymicrobial septic shock and resuscitation with different drugs.Methods. During the experiment, morphological aortic waveform features, such as indices related to the dicrotic notch and inflection point, were extracted by means of PWA techniques. Finally, all the PWA indices were used to compute a clustering classification (mini batch K-means) of the pigs according to the different phases of the experiment. This analysis aimed to test if PWA features alone could be used to distinguish between the different responses to the administered therapies.Results. The PWA indices highlighted different cardiovascular conditions of the pigs in response to different treatments, despite the mean haemodynamic values typically used to guide therapy administration being similar in all animals. The clustering algorithm was able to distinguish between the different phases of the experiment and the different responses of the animals based on the unique information derived from the aortic PWA.Conclusion. Even when used alone, PWA indices were highly informative when assessing therapy responses in cases of septic shock.Significance. A complex pathological condition like septic shock requires extensive monitoring without neglecting important information from commonly measured signals such as arterial blood pressure. Future studies are needed to understand how individual differences in the response to therapy are associated with different cardiovascular conditions that may become specific therapy targets.
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Affiliation(s)
- Riccardo Campitelli
- Department of Electronics, Information, and Bioengineering, Politecnico di Milano, Milan, Italy
| | - Manuela Ferrario
- Department of Electronics, Information, and Bioengineering, Politecnico di Milano, Milan, Italy
| | - Fuhong Su
- Experimental Laboratory of Intensive Care, Université Libre de Bruxelles, Brussels, Belgium
- Department of Intensive Care, Erasme Hospital, ULB, Brussels, Belgium
| | - Jacques Creteur
- Experimental Laboratory of Intensive Care, Université Libre de Bruxelles, Brussels, Belgium
- Department of Intensive Care, Erasme Hospital, ULB, Brussels, Belgium
| | - Antoine Herpain
- Experimental Laboratory of Intensive Care, Université Libre de Bruxelles, Brussels, Belgium
- Intensive care department, St-Pierre University Hospital, Brussels, Belgium
| | - Marta Carrara
- Department of Electronics, Information, and Bioengineering, Politecnico di Milano, Milan, Italy
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10
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Navodnik MP, Janež A, Žuran I. The Effect of Additional Treatment with Empagliflozin or Semaglutide on Endothelial Function and Arterial Stiffness in Subjects with Type 1 Diabetes Mellitus-ENDIS Study. Pharmaceutics 2023; 15:1945. [PMID: 37514131 PMCID: PMC10385568 DOI: 10.3390/pharmaceutics15071945] [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: 06/07/2023] [Revised: 07/05/2023] [Accepted: 07/10/2023] [Indexed: 07/30/2023] Open
Abstract
We investigated the effect of additional treatment with newer antidiabetic drugs on endothelium function and arterial stiffness in subjects with type 1 diabetes mellitus (T1DM) without cardiovascular diseases. A total of 89 participants, all users of CGMS (continuous monitoring glucose system), were randomized into three comparable groups, receiving empagliflozin (E; n = 30), receiving semaglutide (S; n = 30), and a control group (C; n = 29). At baseline and 12 weeks post treatment, we measured FMD (brachial artery flow-mediated dilation) and FBF (forearm blood flow as reactive hyperemia assessed with strain gauge plethysmography) as parameters of endothelial function, as well as pulse wave velocity (PWV) and peripheral resistance as parameters of arterial stiffness. Improvement in FMD was significant in both intervention groups compared to controls (E group 2.0-fold, p = 0.000 and S group 1.9-fold, p = 0.000), with no changes between those two groups (p = 0.745). During the evaluation of FBF, there were statistically insignificant improvements in both therapeutic groups compared to controls (E group 1.39-fold, p = 0.074 and S group 1.22-fold, p = 0.701). In arterial stiffness parameters, improvements were seen only in the semaglutide group, with a decline in peripheral resistance by 5.1% (p = 0.046). We can conclude that, for arterial stiffness, semaglutide seems better, but both drugs positively impact endothelial function and, thus, could also have a protective role in T1DM.
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Affiliation(s)
- Maja Preložnik Navodnik
- Department of Angiology, Endocrinology and Rheumatology, General Hospital Celje, Oblakova ul. 5, 3000 Celje, Slovenia
| | - Andrej Janež
- Department of Endocrinology, Diabetes and Metabolic Diseases, University Medical Centre Ljubljana, Zaloška Cesta 7, 1000 Ljubljana, Slovenia
| | - Ivan Žuran
- Department of Angiology, Endocrinology and Rheumatology, General Hospital Celje, Oblakova ul. 5, 3000 Celje, Slovenia
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11
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Gounaridi MI, Vontetsianos A, Oikonomou E, Theofilis P, Chynkiamis N, Lampsas S, Anastasiou A, Papamikroulis GA, Katsianos E, Kalogeras K, Pesiridis T, Tsatsaragkou A, Vavuranakis M, Koulouris N, Siasos G. The Role of Rehabilitation in Arterial Function Properties of Convalescent COVID-19 Patients. J Clin Med 2023; 12:2233. [PMID: 36983234 PMCID: PMC10056228 DOI: 10.3390/jcm12062233] [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: 12/27/2022] [Revised: 02/25/2023] [Accepted: 03/12/2023] [Indexed: 03/15/2023] Open
Abstract
Coronavirus disease (COVID-19) is a respiratory disease, although arterial function involvement has been documented. We assess the impact of a post-acute COVID-19 rehabilitation program on endothelium-dependent vasodilation and arterial wall properties. We enrolled 60 convalescent patients from COVID-19 and one-month post-acute disease, who were randomized at a 1:1 ratio in a 3-month cardiopulmonary rehabilitation program (study group) or not (control group). Endothelium-dependent vasodilation was evaluated by flow-mediated dilation (FMD), and arterial wall properties were evaluated by carotid-femoral pulse wave velocity (cf-PWV) and augmentation index (AIx) at 1 month and at 4 months post-acute disease. FMD was significantly improved in both the study (6.2 ± 1.8% vs. 8.6 ± 2.4%, p < 0.001) and control groups (5.9 ± 2.2% vs. 6.6 ± 1.8%, p = 0.009), but the improvement was significantly higher in the study group (rehabilitation) (p < 0.001). PWV was improved in the study group (8.2 ± 1.3 m/s vs. 6.6 ± 1.0 m/s, p < 0.001) but not in the control group (8.9 ± 1.8 m/s vs. 8.8 ± 1.9 m/s, p = 0.74). Similarly, AIx was improved in the study group (25.9 ± 9.8% vs. 21.1 ± 9.3%, p < 0.001) but not in the control group (27.6 ± 9.2% vs. 26.2 ± 9.8 m/s, p = 0.15). Convalescent COVID-19 subjects of the study group (rehabilitation) with increased serum levels of circulating IL-6 had a greater reduction in FMD. Conclusively, a 3-month cardiopulmonary post-acute COVID-19 rehabilitation program improves recovery of endothelium-dependent vasodilation and arteriosclerosis.
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Affiliation(s)
- Maria Ioanna Gounaridi
- 3rd Department of Cardiology, Sotiria Chest Disease Hospital, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Angelos Vontetsianos
- Rehabilitation Unit, 1st Respiratory Medicine Department, Sotiria Hospital, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Evangelos Oikonomou
- 3rd Department of Cardiology, Sotiria Chest Disease Hospital, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Panagiotis Theofilis
- 1st Department of Cardiology, Hippokration General Hospital, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Nikolaos Chynkiamis
- Rehabilitation Unit, 1st Respiratory Medicine Department, Sotiria Hospital, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Stamatios Lampsas
- 3rd Department of Cardiology, Sotiria Chest Disease Hospital, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Artemis Anastasiou
- 3rd Department of Cardiology, Sotiria Chest Disease Hospital, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Georgios Angelos Papamikroulis
- 3rd Department of Cardiology, Sotiria Chest Disease Hospital, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Efstratios Katsianos
- 3rd Department of Cardiology, Sotiria Chest Disease Hospital, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Konstantinos Kalogeras
- 3rd Department of Cardiology, Sotiria Chest Disease Hospital, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Theodoros Pesiridis
- 3rd Department of Cardiology, Sotiria Chest Disease Hospital, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Aikaterini Tsatsaragkou
- 3rd Department of Cardiology, Sotiria Chest Disease Hospital, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Manolis Vavuranakis
- 3rd Department of Cardiology, Sotiria Chest Disease Hospital, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Nikolaos Koulouris
- Rehabilitation Unit, 1st Respiratory Medicine Department, Sotiria Hospital, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Gerasimos Siasos
- 3rd Department of Cardiology, Sotiria Chest Disease Hospital, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
- Cardiovascular Division, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA 02115, USA
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12
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Hobson S, Arefin S, Rahman A, Hernandez L, Ebert T, de Loor H, Evenepoel P, Stenvinkel P, Kublickiene K. Indoxyl Sulphate Retention Is Associated with Microvascular Endothelial Dysfunction after Kidney Transplantation. Int J Mol Sci 2023; 24:ijms24043640. [PMID: 36835051 PMCID: PMC9960432 DOI: 10.3390/ijms24043640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Revised: 02/02/2023] [Accepted: 02/08/2023] [Indexed: 02/15/2023] Open
Abstract
Kidney transplantation (KTx) is the preferred form of renal replacement therapy in chronic kidney disease (CKD) patients, owing to increased quality of life and reduced mortality when compared to chronic dialysis. Risk of cardiovascular disease is reduced after KTx; however, it is still a leading cause of death in this patient population. Thus, we aimed to investigate whether functional properties of the vasculature differed two years post-KTx (postKTx) compared to baseline (time of KTx). Using the EndoPAT device in 27 CKD patients undergoing living-donor KTx, we found that vessel stiffness significantly improved while endothelial function worsened postKTx vs. baseline. Furthermore, baseline serum indoxyl sulphate (IS), but not p-cresyl sulphate, was independently negatively associated with reactive hyperemia index, a marker of endothelial function, and independently positively associated with P-selectin postKTx. Finally, to better understand the functional effects of IS in vessels, we incubated human resistance arteries with IS overnight and performed wire myography experiments ex vivo. IS-incubated arteries showed reduced bradykinin-mediated endothelium-dependent relaxation compared to controls via reduced nitric oxide (NO) contribution. Endothelium-independent relaxation in response to NO donor sodium nitroprusside was similar between IS and control groups. Together, our data suggest that IS promotes worsened endothelial dysfunction postKTx, which may contribute to the sustained CVD risk.
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Affiliation(s)
- Sam Hobson
- Division of Renal Medicine, Department of Clinical Science, Intervention and Technology, Karolinska, Institutet, 141 52 Stockholm, Sweden
| | - Samsul Arefin
- Division of Renal Medicine, Department of Clinical Science, Intervention and Technology, Karolinska, Institutet, 141 52 Stockholm, Sweden
| | - Awahan Rahman
- Division of Renal Medicine, Department of Clinical Science, Intervention and Technology, Karolinska, Institutet, 141 52 Stockholm, Sweden
| | - Leah Hernandez
- Division of Renal Medicine, Department of Clinical Science, Intervention and Technology, Karolinska, Institutet, 141 52 Stockholm, Sweden
| | - Thomas Ebert
- Division of Renal Medicine, Department of Clinical Science, Intervention and Technology, Karolinska, Institutet, 141 52 Stockholm, Sweden
- Medical Department III—Endocrinology, Nephrology, Rheumatology, University of Leipzig Medical Center, D-04103 Leipzig, Germany
| | - Henriette de Loor
- Nephrology and Renal Transplantation Research Group, Department of Microbiology, Immunology and Transplantation, Katholieke Universiteit Leuven, BE-3000 Leuven, Belgium
| | - Pieter Evenepoel
- Nephrology and Renal Transplantation Research Group, Department of Microbiology, Immunology and Transplantation, Katholieke Universiteit Leuven, BE-3000 Leuven, Belgium
- Department of Nephrology and Renal Transplantation, University Hospitals Leuven, BE-3000 Leuven, Belgium
| | - Peter Stenvinkel
- Division of Renal Medicine, Department of Clinical Science, Intervention and Technology, Karolinska, Institutet, 141 52 Stockholm, Sweden
| | - Karolina Kublickiene
- Division of Renal Medicine, Department of Clinical Science, Intervention and Technology, Karolinska, Institutet, 141 52 Stockholm, Sweden
- Correspondence:
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13
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Pivac VT, Herceg-Čavrak V, Hojsak I, Mišak Z, Jadrešin O, Kolaček S. Children with inflammatory bowel disease already have an altered arterial pulse wave. Eur J Pediatr 2023; 182:1771-1779. [PMID: 36763192 DOI: 10.1007/s00431-023-04858-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2022] [Revised: 01/20/2023] [Accepted: 02/02/2023] [Indexed: 02/11/2023]
Abstract
Adults with inflammatory bowel disease (IBD) have an increased risk for vascular events. This study aims to evaluate arterial parameters in paediatric IBD. Carotid intima-media thickness (CIMT) was measured by ultrasound, and Arteriograph was used to assess aortic pulse wave velocity (PWVao), brachial and aortic augmentation indexes (AixBrach, AixAo), central systolic blood pressure (SBPao), and heart rate (HR). A total of 161 children were included; 55 (34%) children with newly diagnosed IBD (median age 14.35 (11.88-16.31) years, 53% males), 53(33%) in remission (median age 15.62 (13.46-16.70) years, 66% males), and 53 (33%) controls (median age 14.09 (11.18-14.09) years, 55% males) were recruited into a case-control study. Compared to controls, patients with active disease and those in clinical remission had significantly lower AixBrach and AixAo (P < 0.001, P = 0.009; P < 0.001, P = 0.003). PWVao and CIMT were still normal. HR was higher in both IBD groups than in controls (P < 0.001; P = 0.006). HR positively correlated with disease duration (P = 0.001). In the ordinary least squares regression models, anti-tumour necrosis factor (TNF) α treatment predicted lower peripheral and central systolic blood pressures, in contrast to aminosalicylates and methotrexate. Aminosalicylate treatment predicted increased HR. Conclusion: Children with IBD have an increased heart rate, a lower augmentation index and, therefore, an altered pulse waveform. In paediatric IBD, arterial stiffness and CIMT are still normal, indicating the potential for adequate IBD treatment to preserve arterial health. What is Known: • Adult patients with inflammatory bowel disease (IBD) have increased carotid intima-media thickness and arterial stiffness, which positively correlates with cardiovascular risk and predicts mortality. Adequate treatment, especially anti-tumour necrosis factor (TNF) α medications, lower these risks. • Children with IBD have impaired endothelial function and reduced heart rate (HR) variability. What is New: • Children with IBD have impaired endothelial function and reduced heart rate (HR) variability. • Anti-TNFα treatment in children and adolescents with IBD lowers systolic pressure, whereas methotrexate and aminosalicylates have the opposite effect. Amiynosalyiciylate treatment also increases HR.
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Affiliation(s)
| | - Vesna Herceg-Čavrak
- Children's Hospital Zagreb, Klaićeva 16, Zagreb, Croatia.,Libertas International University, Trg John F Kennedy, Zagreb, Croatia
| | - Iva Hojsak
- Children's Hospital Zagreb, Klaićeva 16, Zagreb, Croatia
| | - Zrinjka Mišak
- Children's Hospital Zagreb, Klaićeva 16, Zagreb, Croatia.,University of Zagreb, School of Medicine, Šalata 3b, Zagreb, Croatia
| | - Oleg Jadrešin
- Children's Hospital Zagreb, Klaićeva 16, Zagreb, Croatia
| | - Sanja Kolaček
- Children's Hospital Zagreb, Klaićeva 16, Zagreb, Croatia.,University of Zagreb, School of Medicine, Šalata 3b, Zagreb, Croatia
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14
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Gomes E, Naima R, Liao C, Shay O. Waveform Morphology Comparison in Wearable Blood Pressure Sensors. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2022; 2022:2902-2905. [PMID: 36086617 DOI: 10.1109/embc48229.2022.9870890] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Wearable devices for continuous non-invasive blood pressure monitoring must be capable of providing a continuous waveform representative of arterial blood pressure. This paper establishes the distinctions in waveform morphology between wearable sensor modalities, specifically millimeter-wave radar and photoplethysmography, when compared to a reference continuous non-invasive blood pressure monitor. An analysis of a 115-subject dataset was conducted to assess waveform suitability. Millimeter-wave radar waveform morphology was found to more closely resemble continuous non-invasive blood pressure than photoplethysmography. Clinical Relevance- This paper compares the waveform morphology and content of signals from wearable sensors in the context of continuous non-invasive blood pressure monitoring.
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15
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Liu W, Du S, Zhou S, Mei T, Zhang Y, Sun G, Song S, Xu L, Yao Y, Greenwald SE. Noninvasive estimation of aortic pressure waveform based on simplified Kalman filter and dual peripheral artery pressure waveforms. COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE 2022; 219:106760. [PMID: 35338889 DOI: 10.1016/j.cmpb.2022.106760] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/17/2021] [Revised: 03/06/2022] [Accepted: 03/14/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND AND OBJECTIVE Aortic pressure (Pa) is important for the diagnosis of cardiovascular disease. However, its direct measurement is invasive, not risk-free, and relatively costly. In this paper, a new simplified Kalman filter (SKF) algorithm is employed for the reconstruction of the Pa waveform using dual peripheral artery pressure waveforms. METHODS Pa waveforms obtained in a previous study were collected from 25 patients. Simultaneously, radial and femoral pressure waveforms were generated from two simulation experiments, using transfer functions. In the first, the transfer function is a known finite impulse response; and in the second, it is derived from a tube-load model. To analyze the performance of the proposed SKF algorithm, variable amounts of noise were added to the observed output signal, to give a range of signal-to-noise ratios (SNRs). Additionally, central aortic, brachial and femoral pressure waveforms were simultaneously collected from 2 Sprague-Dawley rats and the measured and reconstructed Pa waveforms were compared. RESULTS The proposed SKF algorithm outperforms canonical correlation analysis (CCA), which is the current state-of-the-art blind system identification method for the non-invasive estimation of central aortic blood pressure. It is also shown that the proposed SKF algorithm is more noise-tolerant than the CCA algorithm over a wide range of SNRs. CONCLUSION The simulations and animal experiments illustrate that the proposed SKF algorithm is accurate and stable in the face of low SNRs. Improved methods for estimating central blood pressure as a measure of cardiac load adds to their value as a prognostic and diagnostic tool.
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Affiliation(s)
- Wenyan Liu
- College of Medicine and Biological and Information Engineering, Northeastern University, Shenyang 110169, China
| | - Shuo Du
- College of Medicine and Biological and Information Engineering, Northeastern University, Shenyang 110169, China
| | - Shuran Zhou
- College of Medicine and Biological and Information Engineering, Northeastern University, Shenyang 110169, China
| | - Tiemin Mei
- School of Automation and Electrical Engineering, Shenyang Ligong University, Shenyang 110159, China.
| | - Yuelan Zhang
- First Hospital of China Medical University, Shenyang 110122, China
| | - Guozhe Sun
- First Hospital of China Medical University, Shenyang 110122, China
| | - Shuang Song
- School of Mechanical Engineering and Automation, Harbin Institute of Technology Shenzhen Graduate School, Shenzhen 518055, China
| | - Lisheng Xu
- College of Medicine and Biological and Information Engineering, Northeastern University, Shenyang 110169, China; Key Laboratory of Medical Image Computing, Ministry of Education, Shenyang 110169, China; Neusoft Research of Intelligent Healthcare Technology, Co. Ltd., Shenyang 110169, China.
| | - Yudong Yao
- College of Medicine and Biological and Information Engineering, Northeastern University, Shenyang 110169, China
| | - Stephen E Greenwald
- Blizard Institute, Barts & The London School of Medicine & Dentistry, Queen Mary University of London, United Kingdom
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16
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Yao Y, Zhou S, Alastruey J, Hao L, Greenwald SE, Zhang Y, Xu L, Xu L, Yao Y. Estimation of central pulse wave velocity from radial pulse wave analysis. COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE 2022; 219:106781. [PMID: 35378395 DOI: 10.1016/j.cmpb.2022.106781] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/17/2021] [Revised: 03/13/2022] [Accepted: 03/26/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND AND OBJECTIVE Arterial stiffness, commonly assessed by carotid-femoral pulse wave velocity (cfPWV), is an independent biomarker for cardiovascular disease. The measurement of cfPWV, however, has been considered impractical for routine clinical application. Pulse wave analysis using a single pulse wave measurement in the radial artery is a convenient alternative. This study aims to identify pulse wave features for a more accurate estimation of cfPWV from a single radial pulse wave measurement. METHODS From a dataset of 140 subjects, cfPWV was measured and the radial pulse waveform was recorded for 30 s twice in succession. Features were extracted from the waveforms in the time and frequency domains, as well as by wave separation analysis. All-possible regressions with bootstrapping, McHenry's select algorithm, and support vector regression were applied to compute models for cfPWV estimation. RESULTS The correlation coefficients between the measured and estimated cfPWV were r = 0.81, r = 0.81, and r = 0.8 for all-possible regressions, McHenry's select algorithm, and support vector regression, respectively. The features selected by all-possible regressions are physiologically interpretable. In particular, the amplitude ratio of the diastolic peak to the notch of the radial pulse waveform (Rn,dr,P) is shown to be correlated with cfPWV. This correlation was further evaluated and found to be independent of wave reflections using a dataset (n = 3,325) of simulated pulse waves. CONCLUSIONS The proposed method may serve as a convenient surrogate for the measurement of cfPWV. Rn,dr,P is associated with aortic pulse wave velocity and this association may not be dependent on wave reflection.
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Affiliation(s)
- Yang Yao
- School of Information Science and Technology, ShanghaiTech University, Shanghai, 201210, China; College of Medicine and Biological Information Engineering, Northeastern University, Shenyang, Liaoning 110169, China
| | - Shuran Zhou
- College of Medicine and Biological Information Engineering, Northeastern University, Shenyang, Liaoning 110169, China
| | - Jordi Alastruey
- Department of Biomedical Engineering, King's College London, London SE1 7EH, United Kingdom; World-Class Research Center, "Digital Biodesign and Personalized Healthcare", Sechenov University, Moscow, Russia
| | - Liling Hao
- College of Medicine and Biological Information Engineering, Northeastern University, Shenyang, Liaoning 110169, China
| | - Stephen E Greenwald
- Blizard Institute, Barts & The London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom
| | - Yuelan Zhang
- The First Hospital of China Medical University, Shenyang, Liaoning 110122, China
| | - Lin Xu
- School of Information Science and Technology, ShanghaiTech University, Shanghai, 201210, China
| | - Lisheng Xu
- College of Medicine and Biological Information Engineering, Northeastern University, Shenyang, Liaoning 110169, China; Neusoft Research of Intelligent Healthcare Technology, Co. Ltd., Shenyang, Liaoning 110169, China.
| | - Yudong Yao
- Department of Electrical and Computer Engineering, Stevens Institute of Technology, Hoboken, NJ, United States of America
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17
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Improving Cuff-Less Continuous Blood Pressure Estimation with Linear Regression Analysis. ELECTRONICS 2022. [DOI: 10.3390/electronics11091442] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
In this work, the authors investigate the cuff-less estimation of continuous BP through pulse transit time (PTT) and heart rate (HR) using regression techniques, which is intended as a first step towards continuous BP estimation with a low error, according to AAMI guidelines. Hypertension (the ‘silent killer’) is one of the main risk factors for cardiovascular diseases (CVDs), which are the main cause of death worldwide. Its continuous monitoring can offer a valid tool for patient care, as blood pressure (BP) is a significant indicator of health and, using it together with other parameters, such as heart and breath rates, could strongly improve prevention of CVDs. The novelties introduced in this work are represented by the implementation of pre-processing and by the innovative method for features research and features processing to continuously monitor blood pressure in a non-invasive way. Currently, invasive methods are the only reliable methods for continuous monitoring, while non-invasive techniques measure the values every few minutes. The proposed approach can be considered the first step for the integration of these types of algorithms on wearable devices, in particular on those developed for the SINTEC project.
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18
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Nandi M, Anton M, Lyle JV. Cardiovascular waveforms - can we extract more from routine signals? JRSM Cardiovasc Dis 2022; 11:20480040221121438. [PMID: 36092374 PMCID: PMC9459482 DOI: 10.1177/20480040221121438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Accepted: 08/03/2022] [Indexed: 11/16/2022] Open
Abstract
Cardiovascular waveforms such as blood pressure, ECG and photoplethysmography (PPG), are routinely acquired by specialised monitoring devices. Such devices include bedside monitors, wearables and radiotelemetry which sample at very high fidelity, yet most of this numerical data is disregarded and focus tends to reside on single point averages such as the maxima, minima, amplitude, rate and intervals. Whilst, these measures are undoubtedly of value, we may be missing important information by simplifying the complex waveform signal in this way. This Special Collection showcases recent advances in the appraisal of routine signals. Ultimately, such approaches and technologies may assist in improving the accuracy and sensitivity of detecting physiological change. This, in turn, may assist with identifying efficacy or safety signals for investigational new drugs or aidpatient diagnosis and management, supporting scientific and clinical decision making.
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Affiliation(s)
- Manasi Nandi
- Reader in integrative pharmacology, School of Cancer and Pharmaceutical
Science, Faculty of Life Sciences and Medicine, King's College London, London, UK
| | - Mary Anton
- NIHR pre-doctoral nursing fellow, Royal Brompton Hospital (paediatric intensive
care), London, UK
| | - Jane V. Lyle
- Department of Mathematics, University of Surrey, Guildford, UK
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19
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Lyle JV, Aston PJ. Symmetric projection attractor reconstruction: Embedding in higher dimensions. CHAOS (WOODBURY, N.Y.) 2021; 31:113135. [PMID: 34881593 DOI: 10.1063/5.0064450] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Accepted: 10/18/2021] [Indexed: 06/13/2023]
Abstract
Symmetric Projection Attractor Reconstruction (SPAR) provides an intuitive visualization and simple quantification of the morphology and variability of approximately periodic signals. The original method takes a three-dimensional delay coordinate embedding of a signal and subsequently projects this phase space reconstruction to a two-dimensional image with threefold symmetry, providing a bounded visualization of the waveform. We present an extension of the original work to apply delay coordinate embedding in any dimension N≥3 while still deriving a two-dimensional output with some rotational symmetry property that provides a meaningful visualization of the higher dimensional attractor. A generalized result is developed for taking N≥3 delay coordinates from a continuous periodic signal, where we determine invariant subspaces of the phase space that provide a two-dimensional projection with the required rotational symmetry. The result in each subspace is shown to be equivalent to following each pair of coefficients of the trigonometric interpolating polynomial of N evenly spaced points as the signal is translated horizontally. Bounds on the mean and the frequency response of our new coordinates are derived. We demonstrate how this aids our understanding of the attractor properties and its relationship to the underlying waveform. Our generalized result is then extended to real, approximately periodic signals, where we demonstrate that the higher dimensional SPAR method provides information on subtle changes in different parts of the waveform morphology.
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Affiliation(s)
- J V Lyle
- Department of Mathematics, University of Surrey, Guildford GU2 7XH, United Kingdom
| | - P J Aston
- Department of Mathematics, University of Surrey, Guildford GU2 7XH, United Kingdom
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Flores-Ramírez AG, Tovar-Villegas VI, Maharaj A, Garay-Sevilla ME, Figueroa A. Effects of L-Citrulline Supplementation and Aerobic Training on Vascular Function in Individuals with Obesity across the Lifespan. Nutrients 2021; 13:nu13092991. [PMID: 34578869 PMCID: PMC8466140 DOI: 10.3390/nu13092991] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2021] [Revised: 08/19/2021] [Accepted: 08/19/2021] [Indexed: 12/20/2022] Open
Abstract
Children with obesity are at higher risk for developing cardiometabolic diseases that once were considered health conditions of adults. Obesity is commonly associated with cardiometabolic risk factors such as dyslipidemia, hyperglycemia, hyperinsulinemia and hypertension that contribute to the development of endothelial dysfunction. Endothelial dysfunction, characterized by reduced nitric oxide (NO) production, precedes vascular abnormalities including atherosclerosis and arterial stiffness. Thus, early detection and treatment of cardiometabolic risk factors are necessary to prevent deleterious vascular consequences of obesity at an early age. Non-pharmacological interventions including L-Citrulline (L-Cit) supplementation and aerobic training stimulate endothelial NO mediated vasodilation, leading to improvements in organ perfusion, blood pressure, arterial stiffness, atherosclerosis and metabolic health (glucose control and lipid profile). Few studies suggest that the combination of L-Cit supplementation and exercise training can be an effective strategy to counteract the adverse effects of obesity on vascular function in older adults. Therefore, this review examined the efficacy of L-Cit supplementation and aerobic training interventions on vascular and metabolic parameters in obese individuals.
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Affiliation(s)
- Anaisa Genoveva Flores-Ramírez
- Department of Medical Science, Division of Health Science, University of Guanajuato, Campus León, León 37320, Mexico; (A.G.F.-R.); (V.I.T.-V.)
| | - Verónica Ivette Tovar-Villegas
- Department of Medical Science, Division of Health Science, University of Guanajuato, Campus León, León 37320, Mexico; (A.G.F.-R.); (V.I.T.-V.)
| | - Arun Maharaj
- Department of Kinesiology and Sport Management, Texas Tech University, Lubbock, TX 79409, USA;
| | - Ma Eugenia Garay-Sevilla
- Department of Medical Science, Division of Health Science, University of Guanajuato, Campus León, León 37320, Mexico; (A.G.F.-R.); (V.I.T.-V.)
- Correspondence: (M.E.G.-S.); (A.F.)
| | - Arturo Figueroa
- Department of Kinesiology and Sport Management, Texas Tech University, Lubbock, TX 79409, USA;
- Correspondence: (M.E.G.-S.); (A.F.)
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Agham ND, Chaskar UM. An advanced LAN model based on optimized feature algorithm: Towards hypertension interpretability. Biomed Signal Process Control 2021. [DOI: 10.1016/j.bspc.2021.102760] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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22
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Lone T, Alday A, Zakerzadeh R. Numerical analysis of stenoses severity and aortic wall mechanics in patients with supravalvular aortic stenosis. Comput Biol Med 2021; 135:104573. [PMID: 34174758 DOI: 10.1016/j.compbiomed.2021.104573] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2021] [Revised: 06/09/2021] [Accepted: 06/09/2021] [Indexed: 11/28/2022]
Abstract
Supravalvular aortic stenosis (SVAS) is an aortic malformation characterized by a narrowing of the ascending aorta, resulting in abnormal hemodynamics and pressure drop across the stenosed region. It has been observed that the pressure drops measured from Doppler ultrasound exams often tend to be higher than those obtained from invasive cardiac catheterization. These misleadingly elevated pressure measurements may drive the decision to refer patients for surgical treatment prematurely. Considering this strong clinical association, the purpose of this work is to develop a computational modeling approach using a two-way coupled fluid-structure interaction methodology to determine an accurate prediction of trans-stenotic pressure drop and to further highlight the discrepancy between the SVAS assessment methods. Blood is modeled using Navier-Stokes equations while the aortic wall is simulated by a composite poroelastic structure to represent the three main layers of the arterial wall. The relationship between aortic wall elasticity and the blood flow conditions is examined in varying levels of stenosis, ranging from mild to severe degrees of vessel diameter narrowing. A substantial overestimation of the traditional Doppler pressure drop measurement is observed, especially for severe stenosis levels. The simulation results indicate that elasticity of the aortic wall has a relatively little effect on trans-stenotic pressure drop for the range of mild to moderate SVAS cases, but predicted to have a profound effect for severe SVAS cases. Moreover, significant sensitivity to the pressure drop across the SVAS region from stenosis severity is observed.
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Affiliation(s)
- Talha Lone
- Department of Engineering, Rangos School of Health Sciences, Duquesne University, Pittsburgh, PA, USA
| | - Angelica Alday
- Department of Engineering, Rangos School of Health Sciences, Duquesne University, Pittsburgh, PA, USA
| | - Rana Zakerzadeh
- Department of Engineering, Rangos School of Health Sciences, Duquesne University, Pittsburgh, PA, USA.
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Cortical thinning is associated with brain pulsatility in older adults: An MRI and NIRS study. Neurobiol Aging 2021; 106:103-118. [PMID: 34274697 DOI: 10.1016/j.neurobiolaging.2021.05.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Revised: 03/29/2021] [Accepted: 05/03/2021] [Indexed: 11/21/2022]
Abstract
Aging is accompanied by global brain atrophy occurring unequally across the brain. Cortical thinning is seen with aging with a larger loss in the frontal and temporal subregions. We explored the link between regional cortical thickness and regional cerebral pulsatility. Sixty healthy individuals were divided into two age groups, young (aged 19-31) and older (aged 65-75) adults. Each participant underwent a near-infrared spectroscopy (NIRS) scan to index regional brain pulsatility from cerebral pulse-transit-time-to-the peak-of-the-pulse (PTTp), an anatomical magnetic resonance imaging (MRI) and a phase-contrast MRI (PC-MRI) scan to measure arterial and cerebrospinal fluid (CSF) pulsatility. In older adults, the greatest association between cerebral pulsatility and cortical thickness was found in superior and middle temporal and superior, middle and inferior frontal areas, which are the regions perfused first by the internal carotid arteries. This association dropped in the postcentral and superior parietal regions. These findings suggest higher brain pulsatility as a potential risk factor contributing to cortical thinning for some brain regions more than others.
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Tucker T. Arterial stiffness as a vascular contribution to cognitive impairment: a fluid dynamics perspective. Biomed Phys Eng Express 2021; 7. [PMID: 33482655 DOI: 10.1088/2057-1976/abdf36] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Accepted: 01/22/2021] [Indexed: 11/11/2022]
Abstract
A model of cerebral pulsatile blood through multiple arterial bifurcations is developed, based on the physics of wave propagation in compliant vessels. The model identifies the conditions for the optimum antegrade flow of blood into the arterioles as a function of the areas and stiffnesses of the arteries. The model predicts and quantifies the reduction in vessel diameter which occurs in progressing from the large central arteries into the arterioles. It also predicts and quantifies the change in vessel compliance which occurs in progressing from the large central arteries, through the small arteries, into the arterioles. Physics predicts that the clinically observed compliance changes are consistent with the efficient delivery of blood to the cerebral capillary bed. The model predicts that increasing arterial stiffening with age, reduces pulsatile cerebral blood flow substantially, potentially resulting in ischemia, hypoperfusion and hypoxia, with attendant neurological and cognition consequences. The model predicts that while central pulse pressure increases with aging, small vessel pulse pressure reduces, contrary to the concept of a pressure wave tsunami in the small vessels. The model also predicts that increased luminal diameters with increasing age, mitigate, somewhat the negative consequences of arterial stiffening, a form of adaptive arterial remodelling.
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Affiliation(s)
- Trevor Tucker
- Independent Researcher, Independent Researcher, Ottawa, Ontario, CANADA
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25
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Clark JL, Taylor CG, Zahradka P. Black beans and red kidney beans induce positive postprandial vascular responses in healthy adults: A pilot randomized cross-over study. Nutr Metab Cardiovasc Dis 2021; 31:216-226. [PMID: 32917495 DOI: 10.1016/j.numecd.2020.07.042] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Revised: 07/15/2020] [Accepted: 07/25/2020] [Indexed: 11/18/2022]
Abstract
BACKGROUND AND AIMS Consuming pulses (dry beans, dry peas, chickpeas, lentils) over several weeks can improve vascular function and decrease cardiovascular disease risk; however, it is unknown whether pulses can modulate postprandial vascular responses. The objective of this study was to compare different bean varieties (black, navy, pinto, red kidney) and white rice for their acute postprandial effects on vascular and metabolic responses in healthy individuals. METHODS AND RESULTS The study was designed as a single-blinded, randomized crossover trial with a minimum 6 days between consumption of the food articles. Vascular tone (primary endpoint), haemodynamics and serum biochemistry (secondary endpoints) were measured in 8 healthy adults before and at 1, 2, and 6 h after eating ¾ cup of beans or rice. Blood pressure and pulse wave velocity (PWV) were lower at 2 h following red kidney bean and pinto bean consumption compared to rice and navy bean, respectively (p < 0.05). There was greater vasorelaxation 6 h following consumption of darker-coloured beans, as shown by decreased vascular tone: PWV was lower after consuming black bean compared to pinto bean, augmentation pressure was lower after consuming black bean compared to rice and pinto bean, and wave reflection magnitude was lower after consuming red kidney bean and black bean compared to rice, navy bean, and pinto bean (p < 0.05). LDL-cholesterol concentrations were lower 6 h after black bean consumption compared to rice (p < 0.05). CONCLUSION Overall, red kidney and black beans, the darker-coloured beans, elicited a positive effect on the tensile properties of blood vessels, and this acute response may provide insight for how pulses modify vascular function.
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Affiliation(s)
- Jaime L Clark
- Department of Food and Human Nutritional Sciences, Faculty of Agricultural and Food Sciences, University of Manitoba, Winnipeg, MB, R3T 2N2, Canada; Canadian Centre for Agri-Food Research in Health and Medicine, St. Boniface Hospital Albrechtsen Research Centre, Winnipeg, MB, R2H 2A6, Canada.
| | - Carla G Taylor
- Department of Food and Human Nutritional Sciences, Faculty of Agricultural and Food Sciences, University of Manitoba, Winnipeg, MB, R3T 2N2, Canada; Canadian Centre for Agri-Food Research in Health and Medicine, St. Boniface Hospital Albrechtsen Research Centre, Winnipeg, MB, R2H 2A6, Canada; Department of Physiology and Pathophysiology, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, R3E 0T5, Canada.
| | - Peter Zahradka
- Department of Food and Human Nutritional Sciences, Faculty of Agricultural and Food Sciences, University of Manitoba, Winnipeg, MB, R3T 2N2, Canada; Canadian Centre for Agri-Food Research in Health and Medicine, St. Boniface Hospital Albrechtsen Research Centre, Winnipeg, MB, R2H 2A6, Canada; Department of Physiology and Pathophysiology, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, R3E 0T5, Canada.
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Oinonen L, Tikkakoski A, Koskela J, Eräranta A, Kähönen M, Niemelä O, Mustonen J, Pörsti I. Parathyroid hormone may play a role in the pathophysiology of primary hypertension. Endocr Connect 2021; 10:54-65. [PMID: 33289696 PMCID: PMC7923049 DOI: 10.1530/ec-20-0446] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Accepted: 12/03/2020] [Indexed: 12/15/2022]
Abstract
Parathyroid hormone has been related with the risk of hypertension, but the matter remains controversial. We examined the association of parathyroid hormone with central blood pressure and its determinants in 622 normotensive or never-treated hypertensive subjects aged 19-72 years without diabetes, cardiovascular or renal disease, or cardiovascular medications. The methods were whole-body impedance cardiography and analyses of pulse wave and heart rate variability. Cardiovascular function was examined in sex-specific tertiles of plasma parathyroid hormone (mean concentrations 3.0, 4.3 and 6.5 pmol/L, respectively) during head-up tilt. Explanatory factors for haemodynamics were further investigated using linear regression analyses. Mean age was 45.0 (s.d. 11.7) years, BMI 26.8 (4.4) kg/m2, seated office blood pressure 141/90 (21/12) mmHg, and 309 subjects (49.7%) were male. Only five participants had elevated plasma parathyroid hormone and calcium concentrations. Highest tertile of parathyroid hormone presented with higher supine and upright aortic diastolic blood pressure (P < 0.01) and augmentation index (P < 0.01), and higher upright systemic vascular resistance (P < 0.05) than the lowest tertile. The tertiles did not present with differences in pulse wave velocity, cardiac output, or measures of heart rate variability. In linear regression analyses, parathyroid hormone was an independent explanatory factor for aortic systolic (P = 0.005) and diastolic (P = 0.002) blood pressure, augmentation index (P = 0.002), and systemic vascular resistance (P = 0.031). To conclude, parathyroid hormone was directly related to central blood pressure, wave reflection, and systemic vascular resistance in subjects without cardiovascular comorbidities and medications. Thus, parathyroid hormone may play a role in the pathophysiology of primary hypertension.
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Affiliation(s)
- Lasse Oinonen
- Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
- Correspondence should be addressed to L Oinonen:
| | - Antti Tikkakoski
- Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
- Department of Clinical Physiology, Tampere University Hospital, Tampere, Finland
| | - Jenni Koskela
- Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
- Department of Internal Medicine, Tampere University Hospital, Tampere, Finland
| | - Arttu Eräranta
- Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Mika Kähönen
- Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
- Department of Clinical Physiology, Tampere University Hospital, Tampere, Finland
| | - Onni Niemelä
- Department of Laboratory Medicine and Medical Research Unit, Seinäjoki Central Hospital, Seinäjoki, Finland
| | - Jukka Mustonen
- Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
- Department of Internal Medicine, Tampere University Hospital, Tampere, Finland
| | - Ilkka Pörsti
- Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
- Department of Internal Medicine, Tampere University Hospital, Tampere, Finland
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Yeter HH, Karacalik C, Eraslan E, Akcay OF, Derici U, Ronco C. Effect of remote patient management in peritoneal dialysis on haemodynamic and volume control. Nephrology (Carlton) 2020; 25:856-864. [PMID: 32621370 DOI: 10.1111/nep.13751] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Revised: 06/22/2020] [Accepted: 06/26/2020] [Indexed: 11/28/2022]
Abstract
AIM Reduced treatment compliance in patients with peritoneal dialysis facilitates the development of fluid overload and as a result increased blood pressure and vascular stiffness in the long term. We aimed to evaluate blood pressure change and anti-hypertensive needs of patients within 1 year after the changeover to remote monitoring automated peritoneal dialysis (RM-APD) and compare the effect of RM-APD and continuous ambulatory peritoneal dialysis (CAPD) on peripheral and central haemodynamic parameters, volume status of patients and anti-hypertensive drug needs. METHODS This was an observational and cross-sectional study. We enrolled 15 patients performing CAPD, 20 patients performing RM-APD, and 38 age, and gender-matched healthy control. We measured pulse wave velocity to assess arterial stiffness, peripheral and central haemodynamic parameters. We measured the volume status of participants via bioimpedance spectroscopy. RESULTS The mean excess hydration of patients who underwent CAPD were higher than those who performed RM-APD and healthy control (P = .02). We found that mean diastolic blood pressure, heart rate, central systolic and diastolic blood pressure, and central pulse pressure were significantly different between the RM-APD, CAPD and healthy control (P = .02, P = .05, P = .007, P = .05 and P = .005, respectively). Post hoc analysis of these results showed that the differences between the groups were caused by the healthy control group and the patients with underwent CAPD. Daily anti-hypertensive drug count in patients with performing RM-APD was reduced over time (P < .001). CONCLUSION The RM-APD provides better control of peripheral blood pressure and decrease of central haemodynamic parameters via controlling the excess body water.
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Affiliation(s)
- Hasan H Yeter
- Department of Nephrology Dialysis and Transplantation, Gazi University Faculty of Medicine, Ankara, Turkey
| | - Ceren Karacalik
- Department of Internal Medicine, Gazi University Faculty of Medicine, Ankara, Turkey
| | - Esra Eraslan
- Department of Internal Medicine, Gazi University Faculty of Medicine, Ankara, Turkey
| | - Omer F Akcay
- Department of Nephrology Dialysis and Transplantation, Gazi University Faculty of Medicine, Ankara, Turkey
| | - Ulver Derici
- Department of Internal Medicine, Gazi University Faculty of Medicine, Ankara, Turkey
| | - Claudio Ronco
- Department of Nephrology Dialysis and Transplantation, San Bortolo Hospital, Vicenza, Italy
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Central blood pressure predicts the development of hypertension in the general population. Hypertens Res 2020; 43:1301-1308. [DOI: 10.1038/s41440-020-0493-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2019] [Revised: 04/28/2020] [Accepted: 05/21/2020] [Indexed: 01/31/2023]
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29
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Fluid overload as a therapeutic target for the preservative management of chronic kidney disease. Curr Opin Nephrol Hypertens 2020; 29:22-28. [DOI: 10.1097/mnh.0000000000000563] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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30
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Heffernan KS, Lefferts WK, Atallah-Yunes NH, Glasgow AC, Gump BB. Racial Differences in Left Ventricular Mass and Wave Reflection Intensity in Children. Front Pediatr 2020; 8:132. [PMID: 32296669 PMCID: PMC7138203 DOI: 10.3389/fped.2020.00132] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2020] [Accepted: 03/10/2020] [Indexed: 12/14/2022] Open
Abstract
The burden of heart failure is disproportionately higher in African Americans, with a higher prevalence seen at an early age. Examination of racial differences in left ventricular mass (LVM) in childhood may offer insight into risk for cardiac target organ damage (cTOD) in adulthood. Central hemodynamic load, a harbinger of cTOD in adults, is higher in African Americans. The purpose of this study was to examine racial differences in central hemodynamic load and LVM in African American and non-Hispanic white (NHW) children. Two hundred sixty-nine children participated in this study (age, 10 ± 1 years; n = 149 female, n = 154 African American). Carotid pulse wave velocity (PWV), forward wave intensity (W1) and reflected wave intensity (negative area, NA) was assessed from simultaneously acquired distension and flow velocity waveforms using wave intensity analysis (WIA). Wave reflection magnitude was calculated as NA/W1. LVM was assessed using standard 2D echocardiography and indexed to height as LVM/[height (2.16) + 0.09]. A cutoff of 45 g/m (2.16) was used to define left ventricular hypertrophy (LVH). LVM was higher in African American vs. NHW children (39.2 ± 8.0 vs. 37.2 ± 6.7 g/m (2.16), adjusted for age, sex, carotid systolic pressure and socioeconomic status; p < 0.05). The proportion of LVH was higher in African American vs. NHW children (25 vs. 12 %, p < 0.05). African American and NHW children did not differ in carotid PWV (3.5 ± 4.9 vs. 3.3 ± 1.3 m/s; p > 0.05). NA/W1 was higher in African American vs. NHW children (8.5 ± 5.3 vs. 6.7 ± 2.9; p < 0.05). Adjusting for NA/W1 attenuated racial differences in LVM (38.8 ± 8.0 vs. 37.6 ± 7.0 g/m (2.16); p = 0.19). In conclusion, racial differences in central hemodynamic load and cTOD are present in childhood. African American children have greater wave intensity from reflected waves and higher LVMI compared to NHW children. WIA offers novel insight into early life origins of racial differences in central hemodynamic load and cTOD.
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Affiliation(s)
- Kevin S Heffernan
- Department of Exercise Science, Syracuse University, Syracuse, NY, United States
| | - Wesley K Lefferts
- Division of Academic Internal Medicine, Department of Medicine, University of Illinois-Chicago, Chicago, IL, United States
| | - Nader H Atallah-Yunes
- Division of Pediatric Cardiology, SUNY Upstate Medical University, Syracuse, NY, United States
| | - Alaina C Glasgow
- Department of Exercise Science, Syracuse University, Syracuse, NY, United States
| | - Brooks B Gump
- Department of Public Health, Syracuse University, Syracuse, NY, United States
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WANG LEI, WANG LINLIN, LI QIAN, ZHANG WENLU, WANG YAN. EVALUATION INDEX OF ADULT MALE BLOOD VESSEL AGE-BASED ON PULSE WAVE WAVEFORM CHARACTERISTIC PARAMETERS. J MECH MED BIOL 2019. [DOI: 10.1142/s0219519419400578] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
The aim of this study was to find a non-invasive pulse wave waveform index that was highly correlated with cardiovascular disease and to establish an effective model for cardiovascular health assessment in middle-aged men to provide early warning of possible cardiovascular and cerebrovascular diseases. Considering the characteristics of pulse wave easy to detect and rich physiological information, the paper collected pulse waves of healthy males at six age groups, and collected 50 samples per age group. The pulse wave waveform parameters of each sample were extracted, including inflow time, outflow time, total beat time, fast inflow time, inflow time ratio and waveform coefficient [Formula: see text] value, the differences of which in different age groups were analyzed. Stepwise regression analysis was used to establish the relationship between age and pulse waveform parameters. The results show that the indicators of inflow time, inflow time ratio and fast inflow time have obvious differences with age, and with the increase of age, these three indicators show a steady upward trend. The indicators of outflow time, total beat time, and waveform coefficient are not sensitive to age changes. A predictive model of vessel age was established: [Formula: see text] time ([Formula: see text]). The pulse wave inflow time of hypertensive patients was substituted into the above-mentioned model, and the calculated blood vessel age was greater than the actual age. The age difference is greater than 5 years old. This study suggests that the pulse wave parameters of inflow time, fast inflow time and inflow time ratio has a significant and stable trend with age, indicating that they are closely related to vascular elasticity, compliance and stiffness, and can be used as predictors of cardiovascular disease.
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Affiliation(s)
- LEI WANG
- Institute of Biomedical Engineering, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin 300192, P. R. China
- Province-Ministry Joint Key Laboratory of Electromagnetic Field and Electrical Apparatus Reliability, Hebei University of Technology, Tianjin 300130, P. R. China
| | - LINLIN WANG
- Institute of Biomedical Engineering, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin 300192, P. R. China
| | - QIAN LI
- Institute of Biomedical Engineering, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin 300192, P. R. China
| | - WENLU ZHANG
- Institute of Biomedical Engineering, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin 300192, P. R. China
| | - YAN WANG
- Institute of Biomedical Engineering, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin 300192, P. R. China
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Wang CH, Chang RW, Wu ET, Hsiao YJ, Wu MS, Yu HY, Chen YS, Lai LC, Yu SL. Extracorporeal Life Support Enhances the Forward Pressure Wave to Cause a Mismatch between Cardiac Oxygen Demand and Supply. Sci Rep 2019; 9:13882. [PMID: 31554923 PMCID: PMC6761175 DOI: 10.1038/s41598-019-50428-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2018] [Accepted: 09/11/2019] [Indexed: 11/17/2022] Open
Abstract
Extracorporeal life support (ECLS) is a world-famous life-saving method. Until now, changes in arterial wave properties due to ECLS have remained unexamined. In this study, we determined the effects of ECLS on arterial wave properties and ventricular/arterial coupling in male Wistar rats with the measured aortic pressure alone. Ascending aortic pressure signals were measured before ECLS and at 30, 60, and 90 min after weaned off. The aortic pressure signal then calculated by fourth-order derivative to obtain an assumed triangular flow wave. The ratio of mean systolic pressure to mean diastolic pressure (Pms/Pmd), a parameter for evaluating the matching condition between myocardial oxygen demand and supply, was significantly higher after ECLS. The magnitude of forward pressure (|Pf|) augmented by ECLS prevailed over the backward pressure (|Pb|), leading to a decline in wave reflection factor. Pms/Pmd was positively linearly correlated with |Pf| (Pms/Pmd = 0.9177 + 0.0078 × |Pf|, r = 0.8677; P < 0.0001). These findings suggest that |Pf| was a predominant factor responsible for the mismatch between the myocardial oxygen demand and supply in rats after ECLS phase of experiment.
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Affiliation(s)
- Chih-Hsien Wang
- Cardiovascular Surgery, Department of Surgery, National Taiwan University Hospital, Taipei, Taiwan.
| | - Ru-Wen Chang
- Cardiovascular Surgery, Department of Surgery, National Taiwan University Hospital, Taipei, Taiwan
| | - En- Ting Wu
- Department of Pediatrics, College of Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Yi-Jing Hsiao
- Department of Clinical and Laboratory Sciences and Medical Biotechnology, National Taiwan University College of Medicine, Taipei, Taiwan
| | - Ming-Shiou Wu
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Hsi-Yu Yu
- Cardiovascular Surgery, Department of Surgery, National Taiwan University Hospital, Taipei, Taiwan
| | - Yih-Sharng Chen
- Cardiovascular Surgery, Department of Surgery, National Taiwan University Hospital, Taipei, Taiwan
| | - Liang-Chuan Lai
- Department of Physiology, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Sung-Liang Yu
- Department of Clinical and Laboratory Sciences and Medical Biotechnology, National Taiwan University College of Medicine, Taipei, Taiwan
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Impact of low-intensity resistance and whole-body vibration training on aortic hemodynamics and vascular function in postmenopausal women. Hypertens Res 2019; 42:1979-1988. [DOI: 10.1038/s41440-019-0328-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2019] [Revised: 07/31/2019] [Accepted: 08/20/2019] [Indexed: 12/13/2022]
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Schroeder EC, Lefferts WK, Hilgenkamp TIM, Fernhall B. Acute systemic inflammation reduces both carotid and aortic wave reflection in healthy adults. Physiol Rep 2019; 7:e14203. [PMID: 31402635 PMCID: PMC6689683 DOI: 10.14814/phy2.14203] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2019] [Accepted: 07/26/2019] [Indexed: 01/15/2023] Open
Abstract
Acute inflammation increases the risk of cardiac and cerebrovascular events, possibly related to alterations in the hemodynamic load. Wave reflection at the aorta and carotid provides insight into downstream vascular changes and hemodynamic load at the heart and brain. Acute inflammation has been suggested to reduce wave reflection via downstream vasodilation; however, this is not firmly established and has only been investigated at the aorta. We sought to explore the effect of acute inflammation on aortic and carotid hemodynamics in healthy, young adults. Pressure waveforms were collected via radial and carotid applanation tonometry in 23 adults (26 ± 4 years) before and 24 h after a typhoid vaccination. Waveforms were calibrated to brachial mean and diastolic pressure, and waveform separation analyses (WSA) were performed, yielding augmentation index, reflection index, time to reflection (Tr), forward (Pf) and reflected (Pb) wave magnitude, and pulse wave velocity. Arterial diameters and carotid stiffness were measured via ultrasonography. Acute inflammation reduced wave reflection at 24 h in both the aorta and carotid (P < 0.05) without changes in mean pressure. WSA did not reveal independent changes in Pf, Pb, or Tr (P > 0.05). Arterial stiffness did not change; however, brachial and carotid artery diameters increased. Acute inflammation reduces wave reflection in the aorta and carotid artery in young adults, potentially due to downstream/peripheral vasodilation. Reduced aortic wave reflection did not disturb the cardiac workload; however, reductions in carotid wave reflection may render the brain vulnerable to pulsatile hemodynamics. These findings may have implications for cardiac and cerebrovascular risk during acute inflammation.
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Affiliation(s)
- Elizabeth C. Schroeder
- Integrative Physiology Laboratory, College of Applied Health SciencesUniversity of Illinois at ChicagoChicagoIllinois
| | - Wesley K. Lefferts
- Integrative Physiology Laboratory, College of Applied Health SciencesUniversity of Illinois at ChicagoChicagoIllinois
| | - Thessa I. M. Hilgenkamp
- Integrative Physiology Laboratory, College of Applied Health SciencesUniversity of Illinois at ChicagoChicagoIllinois
| | - Bo Fernhall
- Integrative Physiology Laboratory, College of Applied Health SciencesUniversity of Illinois at ChicagoChicagoIllinois
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Nabeel PM, Kiran VR, Joseph J, Abhidev VV, Sivaprakasam M. Local Pulse Wave Velocity: Theory, Methods, Advancements, and Clinical Applications. IEEE Rev Biomed Eng 2019; 13:74-112. [PMID: 31369386 DOI: 10.1109/rbme.2019.2931587] [Citation(s) in RCA: 58] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Local pulse wave velocity (PWV) is evolving as one of the important determinants of arterial hemodynamics, localized vessel stiffening associated with several pathologies, and a host of other cardiovascular events. Although PWV was introduced over a century ago, only in recent decades, due to various technological advancements, has emphasis been directed toward its measurement from a single arterial section or from piecewise segments of a target arterial section. This emerging worldwide trend in the exploration of instrumental solutions for local PWV measurement has produced several invasive and noninvasive methods. As of yet, however, a univocal opinion on the ideal measurement method has not emerged. Neither have there been extensive comparative studies on the accuracy of the available methods. Recognizing this reality, makes apparent the need to establish guideline-recommended standards for the measurement methods and reference values, without which clinical application cannot be pursued. This paper enumerates all major local PWV measurement methods while pinpointing their salient methodological considerations and emphasizing the necessity of global standardization. Further, a summary of the advancements in measuring modalities and clinical applications is provided. Additionally, a detailed discussion on the minimally explored concept of incremental local PWV is presented along with suggestions of future research questions.
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Myocardial preload alters central pressure augmentation through changes in the forward wave. J Hypertens 2019; 36:544-551. [PMID: 29016531 DOI: 10.1097/hjh.0000000000001583] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
OBJECTIVE Augmentation index (AIx) is often used to quantify the contribution of wave reflection to central pulse pressure. Recent studies have challenged this view by showing how contractility-induced changes in the forward pressure wave can markedly impact AIx. We hypothesized that changes in preload will also affect AIx through changes in the forward wave and studied this in two experiments. METHODS Noninvasively obtained aortic pressure was used to study central haemodynamics and wave morphology. In the first experiment, we examined the effects of head-up tilt with and without unilateral thigh cuff in 12 young healthy volunteers (mean age 26 years, 50% men). In the second experiment, we examined the effects of active standing in 31 middle-aged patients (mean age 57 years, 65% men) before and after phlebotomy. RESULTS Head-up tilt or active standing significantly decreased AIx [-17.7 ± 10.4 percentage point (pp) in the young population, -4.7 ± 12.3 pp in the middle-aged population, both P < 0.05]. The fall in AIx was associated with increases in HR, diastolic pressure and systemic vascular resistance and a decrease in stroke volume (all P < 0.05). Inflation of a unilateral thigh cuff reduced the decrease in AIx by 10.7 pp, whereas 500 ml of blood loss augmented the fall in AIx by 5.9 pp (both P < 0.05). The changes in AIx were related to a preload-induced change in forward pressure wave shape (earlier peaking and steeper downstroke). CONCLUSION Next to inotropic and chronotropic effects, preload emerges as another myocardial factor that obscures the relation between wave reflection and AIx.
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Li RX, Apostolakis IZ, Kemper P, McGarry MDJ, Ip A, Connolly ES, McKinsey JF, Konofagou EE. Pulse Wave Imaging in Carotid Artery Stenosis Human Patients in Vivo. ULTRASOUND IN MEDICINE & BIOLOGY 2019; 45:353-366. [PMID: 30442386 PMCID: PMC6375685 DOI: 10.1016/j.ultrasmedbio.2018.07.013] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/13/2017] [Revised: 06/29/2018] [Accepted: 07/16/2018] [Indexed: 05/03/2023]
Abstract
Carotid stenosis involves narrowing of the lumen in the carotid artery potentially leading to a stroke, which is the third leading cause of death in the United States. Several recent investigations have found that plaque structure and composition may represent a more direct biomarker of plaque rupture risk compared with the degree of stenosis. In this study, pulse wave imaging was applied in 111 (n = 11, N = 13 plaques) patients diagnosed with moderate (>50%) to severe (>80%) carotid artery stenosis to investigate the feasibility of characterizing plaque properties based on the pulse wave-induced arterial wall dynamics captured by pulse wave imaging. Five (n = 5 patients, N = 20 measurements) healthy volunteers were also imaged as a control group. Both conventional and high-frame-rate plane wave radiofrequency imaging sequences were used to generate piecewise maps of the pulse wave velocity (PWV) at a single depth along stenotic carotid segments, as well as intra-plaque PWV mapping at multiple depths. Intra-plaque cumulative displacement and strain maps were also calculated for each plaque region. The Bramwell-Hill equation was used to estimate the compliance of the plaque regions based on the PWV and diameter. Qualitatively, wave convergence, elevated PWV and decreased cumulative displacement around and/or within regions of atherosclerotic plaque were observed and may serve as biomarkers for plaque characterization. Intra-plaque mapping revealed the potential to capture wave reflections between calcified inclusions and differentiate stable (i.e., calcified) from vulnerable (i.e., lipid) plaque components based on the intra-plaque PWV and cumulative strain. Quantitatively, one-way analysis of variance indicated that the pulse wave-induced cumulative strain was significantly lower (p < 0.01) in the moderately and severely calcified plaques compared with the normal controls. As expected, compliance was also significantly lower in the severely calcified plaques regions compared with the normal controls (p < 0.01). The results from this pilot study indicated the potential of pulse wave imaging coupled with strain imaging to differentiate plaques of varying stiffness, location and composition. Such findings may serve as valuable information to compensate for the limitations of currently used methods for the assessment of stroke risk.
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Affiliation(s)
- Ronny X Li
- Ultrasound and Elasticity Imaging Laboratory, Department of Biomedical Engineering, Columbia University, New York, New York, USA
| | - Iason Z Apostolakis
- Ultrasound and Elasticity Imaging Laboratory, Department of Biomedical Engineering, Columbia University, New York, New York, USA
| | - Paul Kemper
- Ultrasound and Elasticity Imaging Laboratory, Department of Biomedical Engineering, Columbia University, New York, New York, USA
| | - Matthew D J McGarry
- Ultrasound and Elasticity Imaging Laboratory, Department of Biomedical Engineering, Columbia University, New York, New York, USA
| | - Ada Ip
- Ultrasound and Elasticity Imaging Laboratory, Department of Biomedical Engineering, Columbia University, New York, New York, USA
| | - Edward S Connolly
- Department of Neurologic Surgery, New York-Presbyterian Hospital/Columbia University Medical Center, New York, New York, USA
| | - James F McKinsey
- Division of Vascular Surgery and Endovascular Interventions, New York-Presbyterian Hospital/Columbia University Medical Center, New York, New York, USA
| | - Elisa E Konofagou
- Ultrasound and Elasticity Imaging Laboratory, Department of Biomedical Engineering, Columbia University, New York, New York, USA; Department of Radiology, Columbia University Medical Center, New York, New York, USA.
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Yamashita K, Kohjitani A, Miyata M, Ohno S, Tohya A, Ohishi M, Sugimura M. Predictive Factors of Postoperative Blood Pressure Abnormalities Following a Minor-to-Moderate Surgery. Int Heart J 2018; 59:1359-1367. [PMID: 30369572 DOI: 10.1536/ihj.17-612] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Myocardial ischemic events after non-cardiac surgery is still a serious problem, especially in older, high-risk patients. However, the prevalence and risk factors of blood pressure (BP) abnormalities, which may possibly lead to myocardial ischemic attack, have not been reported. Our aim is to elucidate predictive factors of postoperative BP abnormalities following a minor-to-moderate surgery, employing preoperative left ventricular diastolic function. Patients who underwent cardiac echocardiogram examination and received oral and maxillofacial surgery under general anesthesia were enrolled. The echocardiographic parameters of diastolic function were compared between patients who had postoperative BP abnormalities (hypertension-systolic blood pressure [SBP] ≥ 170 mmHg-or hypotension-SBP < 80 mmHg-episode) that required therapeutic interventions until 7 days after surgery and those who had no BP abnormalities. Of the 173 patients analyzed, 25 (14.4%) had BP abnormalities. BP abnormalities patients were older, having a larger proportion of diabetes mellitus, lower E/A ratio and e', and larger E/e' and left atrial dimension than those without BP abnormalities. Subanalyses revealed that the independent risk factors responsible for hypertension episodes (14 patients) were the mean e' (odd ratio [OR]: 0.434; 95% confidence interval [CI]: 0.229-0.824), diabetes mellitus (OR: 5.018; 95% CI: 1.030-24.436), SBP at hospitalization (OR: 1.099; 95% CI: 1.036-1.165), and operation time (hour; OR: 1.326; 95%CI: 1.109-1.586), while hypotension episodes (11 patients) were associated solely with operation time (OR: 1.206; 95% CI: 1.046-1.391). In conclusion, left ventricular diastolic dysfunction, increased insulin resistance, boosted SBP at hospitalization, and prolonged operation should be taken into consideration as risk factors of postoperative BP abnormalities, especially hypertension, following minor-to-moderate surgery.
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Affiliation(s)
- Kaoru Yamashita
- Department of Dental Anesthesiology, Graduate School of Medical and Dental Sciences, Kagoshima University
| | - Atsushi Kohjitani
- Department of Dental Anesthesiology, Graduate School of Medical and Dental Sciences, Kagoshima University
| | - Masaaki Miyata
- Department of Cardiovascular Medicine and Hypertension, Graduate School of Medical and Dental Sciences, Kagoshima University
| | - Sachi Ohno
- Department of Dental Anesthesiology, Graduate School of Medical and Dental Sciences, Kagoshima University
| | - Akina Tohya
- Department of Dental Anesthesiology, Graduate School of Medical and Dental Sciences, Kagoshima University
| | - Mitsuru Ohishi
- Department of Cardiovascular Medicine and Hypertension, Graduate School of Medical and Dental Sciences, Kagoshima University
| | - Mitsutaka Sugimura
- Department of Dental Anesthesiology, Graduate School of Medical and Dental Sciences, Kagoshima University
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Nandi M, Venton J, Aston PJ. A novel method to quantify arterial pulse waveform morphology: attractor reconstruction for physiologists and clinicians. Physiol Meas 2018; 39:104008. [PMID: 30256216 PMCID: PMC6372136 DOI: 10.1088/1361-6579/aae46a] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Current arterial pulse monitoring systems capture data at high frequencies (100-1000 Hz). However, they typically report averaged or low frequency summary data such as heart rate and systolic, mean and diastolic blood pressure. In doing so, a potential wealth of information contained in the high-fidelity waveform data is discarded, data which has long been known to contain useful information on cardiovascular performance. Here we summarise a new mathematical method, attractor reconstruction, which enables the quantification of arterial waveform shape and variability in real-time. The method can handle long streams of non-stationary data and does not require preprocessing of the raw physiological data by the end user. Whilst the detailed mathematical proofs have been described elsewhere (Aston et al 2008 Physiol. Meas. 39), the authors were motivated to write a summary of the method and its potential utility for biomedical researchers, physiologists and clinician readers. Here we illustrate how this new method may supplement and potentially enhance the sensitivity of detecting cardiovascular disturbances, to aid with biomedical research and clinical decision making.
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Affiliation(s)
- Manasi Nandi
- School of Cancer and Pharmaceutical Sciences, Faculty of Life Sciences and Medicine, King's College London, Franklin Wilkins Building, 150 Stamford Street, London SE1 9NH, United Kingdom. School of Cardiovascular Medicine and Sciences, Faculty of Life Sciences and Medicine, King's College London, Franklin Wilkins Building, 150 Stamford Street, London SE1 9NH, United Kingdom
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Son Y, Lee SB, Kim H, Song ES, Huh H, Czosnyka M, Kim DJ. Automated artifact elimination of physiological signals using a deep belief network: An application for continuously measured arterial blood pressure waveforms. Inf Sci (N Y) 2018. [DOI: 10.1016/j.ins.2018.05.018] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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41
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Monge García MI, Santos A, Diez Del Corral B, Guijo González P, Gracia Romero M, Gil Cano A, Cecconi M. Noradrenaline modifies arterial reflection phenomena and left ventricular efficiency in septic shock patients: A prospective observational study. J Crit Care 2018; 47:280-286. [PMID: 30096635 DOI: 10.1016/j.jcrc.2018.07.027] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2018] [Revised: 07/03/2018] [Accepted: 07/26/2018] [Indexed: 01/23/2023]
Abstract
PURPOSE To determine whether noradrenaline alters the arterial pressure reflection phenomena in septic shock patients and the effects on left ventricular (LV) efficiency. MATERIAL AND METHODS Thirty-seven septic shock patients with a planned change in noradrenaline dose. Timing and magnitude (Reflection Magnitude and Augmentation Index) of arterial reflections were evaluated. Total, steady, and oscillatory LV power (also expressed as fraction of the total power), subendocardial viability ratio (SEVR), energy efficiency and transmission ratios were used as a marker of LV efficiency. RESULTS An incremental change in noradrenaline increased Reflection Magnitude [0.28(0.09) to 0.31(0.1], Augmentation Index [-6.4(23.6) to 4.8(20.7)%], and LV total power [0.79(IQR:0.47-1) to 0.98(IQR:0.57-1.27)W], all p < 0.001; whereas decreased arrival time of reflected waves [from 95(87 to 121) to 83(79 to 101)ms; p < 0.001]. Variables of LV performance showed a decreased efficiency: oscillatory fraction and energy efficiency ratio increased [20.9(5.7) to 22.8(4.9)%, and 8.2(1.7) to 10.1(2) mW.min.litre-1; p < 0.001, respectively]; and energy transmission ratio and SEVR decreased [73.8(9.9) to 72(9.8)% and 146(IQR:113-188) to 143(IQR:109-172)%, p = 0.003 and p = 0.041, respectively]. CONCLUSIONS Noradrenaline increased reflection phenomena, increasing LV workload and worsening LV performance in septic shock patients. These conditions could explain the detrimental effects during long-term use of noradrenaline.
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Affiliation(s)
- Manuel Ignacio Monge García
- Servicio de Cuidados Intensivos, Hospital SAS de Jerez, C/Circunvalación s/n, 11407 Jerez de la Frontera, Spain.
| | - Arnoldo Santos
- Hedenstierna Laboratory, Department of Surgical Sciences, Section of Anaesthesiology and Critical Care, Uppsala University, Akademiska sjukhuset ing 40 2 tr, 751 85 Uppsala, Sweden; CIBER de enfermedades respiratorias (CIBERES), Avd. Monforte de Lemos 3-5, Pabellón 11, planta 0, 28029 Madrid, Spain
| | - Beatriz Diez Del Corral
- Servicio de Cuidados Intensivos, Hospital SAS de Jerez, C/Circunvalación s/n, 11407 Jerez de la Frontera, Spain
| | - Pedro Guijo González
- Servicio de Cuidados Intensivos, Hospital SAS de Jerez, C/Circunvalación s/n, 11407 Jerez de la Frontera, Spain
| | - Manuel Gracia Romero
- Servicio de Cuidados Intensivos, Hospital SAS de Jerez, C/Circunvalación s/n, 11407 Jerez de la Frontera, Spain
| | - Anselmo Gil Cano
- Servicio de Cuidados Intensivos, Hospital SAS de Jerez, C/Circunvalación s/n, 11407 Jerez de la Frontera, Spain
| | - Maurizio Cecconi
- Department of Intensive Care Medicine, St. George's Healthcare NHS Trust and St George's University of London, Tooting, London SW17 0QT, UK
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Armenian SH, Rinderknecht D, Au K, Lindenfeld L, Mills G, Siyahian A, Herrera C, Wilson K, Venkataraman K, Mascarenhas K, Tavallali P, Razavi M, Pahlevan N, Detterich J, Bhatia S, Gharib M. Accuracy of a Novel Handheld Wireless Platform for Detection of Cardiac Dysfunction in Anthracycline-Exposed Survivors of Childhood Cancer. Clin Cancer Res 2018; 24:3119-3125. [DOI: 10.1158/1078-0432.ccr-17-3599] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2017] [Revised: 01/15/2018] [Accepted: 03/06/2018] [Indexed: 11/16/2022]
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Kusche R, Klimach P, Ryschka M. A Multichannel Real-Time Bioimpedance Measurement Device for Pulse Wave Analysis. IEEE TRANSACTIONS ON BIOMEDICAL CIRCUITS AND SYSTEMS 2018; 12:614-622. [PMID: 29877824 DOI: 10.1109/tbcas.2018.2812222] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
Pulse wave analysis is an important method used to gather information about the cardiovascular system. Instead of detecting the pulse wave via pressure sensors, bioimpedance measurements can be performed to acquire minuscule changes in the conductivity of the tissue, caused by the pulse wave. This work presents a microcontroller-based bioimpedance measurement system, which has the capability to acquire impedance measurements from up to four independent channels simultaneously. By combining a problem-specific analog measurement circuit with a 24 bits analog-to-digital converter, the system is capable of acquiring 1000 impedances per second with a signal-to-noise ratio in a range from 92 to 96 dB. For data storage and analysis, the digitized data are sent via universal serial bus to a host PC. A graphical user interface filters and plots the data of all channels in real-time. The performance of the system regarding measuring constant impedances, as well as impedance changes over time is demonstrated. Two different applications for pulse wave analysis via multichannel bioimpedance measurements are presented. Additionally, first measurement results from a human subject are shown to demonstrate the system's applicability of analyzing the pulse wave morphology as well as the aortic pulse wave velocity.
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Espinosa MG, Taber LA, Wagenseil JE. Reduced embryonic blood flow impacts extracellular matrix deposition in the maturing aorta. Dev Dyn 2018; 247:914-923. [PMID: 29696727 DOI: 10.1002/dvdy.24635] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2018] [Revised: 04/15/2018] [Accepted: 04/18/2018] [Indexed: 11/07/2022] Open
Abstract
BACKGROUND Perturbations to embryonic hemodynamics are known to adversely affect cardiovascular development. Vitelline vein ligation (VVL) is a model of reduced placental blood flow used to induce cardiac defects in early chick embryo development. The effect of these hemodynamic interventions on maturing elastic arteries is largely unknown. We hypothesize that hemodynamic changes impact maturation of the dorsal aorta (DA). RESULTS We examined the effects of VVL on hemodynamic properties well into the maturation process and the corresponding changes in aortic dimensions, wall composition, and gene expression. In chick embryos, we found that DA blood velocity was reduced immediately postsurgery at Hamburger-Hamilton (HH) stage 18 and later at HH36, but not in the interim. Throughout this period, DA diameter adapted to maintain a constant shear stress. At HH36, we found that VVL DAs showed a substantial decrease in elastin and a modest increase in collagen protein content. In VVL DAs, up-regulation of elastic fiber-related genes followed the down-regulation of flow-dependent genes. Together, these suggest the existence of a compensatory mechanism in response to shear-induced delays in maturation. CONCLUSIONS The DA's response to hemodynamic perturbations invokes coupled mechanisms for shear regulation and matrix maturation, potentially impacting the course of vascular development. Developmental Dynamics 247:914-923, 2018. © 2018 Wiley Periodicals, Inc.
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Affiliation(s)
- M Gabriela Espinosa
- Department of Biomedical Engineering, Washington University, Saint Louis, Missouri
| | - Larry A Taber
- Department of Biomedical Engineering, Washington University, Saint Louis, Missouri
| | - Jessica E Wagenseil
- Department of Mechanical Engineering and Materials Science, Washington University, Saint Louis, Missouri
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Intermittent versus constant aerobic exercise in middle-aged males: acute effects on arterial stiffness and factors influencing the changes. Eur J Appl Physiol 2018; 118:1625-1633. [PMID: 29796858 DOI: 10.1007/s00421-018-3893-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2017] [Accepted: 05/13/2018] [Indexed: 10/16/2022]
Abstract
PURPOSE Both constant and intermittent acute aerobic exercises have been found to decrease arterial stiffness. However, direct comparisons of these two types of exercise are sparse. It is not known which type of exercise has the greatest effect. METHODS We evaluated the haemodynamic responses in 15 males (age 48.5 ± 1.3 years; BMI 27.5 ± 0.8 kg m-2) following acute constant (CE) and intermittent cycling exercise (IE). Duration and heart rate were matched during both exercises (131.8 ± 3.2 bpm for CE and 132.0 ± 3.1 bpm for IE). Central and peripheral arterial stiffness was assessed through pulse wave velocity (PWV). Plasma concentrations of nitric oxide (NO), atrial natriuretic peptide (ANP), blood lactate, noradrenaline, and adrenaline were measured before and after each exercise. RESULTS Central (+ 1.8 ± 7.4 and - 6.5 ± 6.8% for CE and IE) and upper limb PWV (+ 2.7 ± 6.2 and - 8 ± 4.6% for CE and IE) were not significantly altered although a small decrease (small effect size) was observed after IE. However, lower limb PWV significantly decreased after exercises (- 7.3 ± 5.7 and - 15.9 ± 4% after CE and IE), with a larger effect after IE. CONCLUSIONS Greater decrease in lower limb PWV occurred after IE despite greater heart rate. This may be due to the higher blood levels of lactate during IE, while NO, ANP, noradrenaline, and adrenaline levels remained not statistically different from CE. These results underlined the importance of lactate in triggering the post-exercise vascular response to exercise, as well as its regional characteristic.
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Gerringer JW, Wagner JC, Vélez-Rendón D, Valdez-Jasso D. Lumped-parameter models of the pulmonary vasculature during the progression of pulmonary arterial hypertension. Physiol Rep 2018; 6. [PMID: 29411543 PMCID: PMC5901176 DOI: 10.14814/phy2.13586] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2017] [Revised: 12/16/2017] [Accepted: 12/19/2017] [Indexed: 01/04/2023] Open
Abstract
A longitudinal study of monocrotaline-induced pulmonary arterial hypertension (PAH) was carried out in Sprague-Dawley rats to investigate the changes in impedance (comprising resistance and compliance) produced by elevated blood pressure. Using invasively measured blood flow as an input, blood pressure was predicted using 3- and 4-element Windkessel (3WK, 4WK) type lumped-parameter models. Resistance, compliance, and inductance model parameters were obtained for the five different treatment groups via least-squares errors. The treated animals reached levels of hypertension, where blood pressure increased two folds from control to chronic stage of PAH (mean pressure went from 24 ± 5 to 44 ± 6 mmHg, P < 0.0001) but blood flow remained overall unaffected. Like blood pressure, the wave-reflection coefficient significantly increased at the advanced stage of PAH (0.26 ± 0.09 to 0.52 ± 0.09, P < 0.0002). Our modeling efforts revealed that resistances and compliance changed during the disease progression, where changes in compliance occur before the changes in resistance. However, resistance and compliance are not directly inversely related. As PAH develops, resistances increase nonlinearly (Rd exponentially and R at a slower rate) while compliance linearly decreases. And while 3WK and 4WK models capture the pressure-flow relation in the pulmonary vasculature during PAH, results from Akaike Information Criterion and sensitivity analysis allow us to conclude that the 3WK is the most robust and accurate model for this system. Ninety-five percent confidence intervals of the predicted model parameters are included for the population studied. This work establishes insight into the complex remodeling process occurring in PAH.
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Affiliation(s)
- Jesse W Gerringer
- Department of Bioengineering, University of Illinois at Chicago, Chicago, Illinois.,Department of Biomedical Engineering, Marquette University, Milwaukee, Wisconsin
| | - Julie C Wagner
- Department of Bioengineering, University of Illinois at Chicago, Chicago, Illinois.,Department of Biomedical Engineering, Marquette University, Milwaukee, Wisconsin
| | - Daniela Vélez-Rendón
- Department of Bioengineering, University of Illinois at Chicago, Chicago, Illinois
| | - Daniela Valdez-Jasso
- Department of Bioengineering, University of Illinois at Chicago, Chicago, Illinois.,Department of Bioengineering, University of California at San Diego, La Jolla, California
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Sugiura T, Dohi Y, Takase H, Ito A, Fujii S, Ohte N. Differential effects of brachial and central blood pressures on circulating levels of high-sensitivity cardiac troponin I in the general population. Atherosclerosis 2018; 269:185-191. [DOI: 10.1016/j.atherosclerosis.2018.01.015] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2017] [Revised: 11/21/2017] [Accepted: 01/12/2018] [Indexed: 01/17/2023]
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Gupta SK, Bodakhe SH. Development of pharmacological screening method for evaluation of effect of drug on elevated pulse pressure and arterial stiffness. J Pharmacol Toxicol Methods 2018; 91:59-65. [PMID: 29382548 DOI: 10.1016/j.vascn.2018.01.560] [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: 01/29/2017] [Revised: 01/25/2018] [Accepted: 01/26/2018] [Indexed: 10/18/2022]
Abstract
INTRODUCTION Elevated pulse pressure (PP) and amplification of arterial stiffness (AS) are responsible for various cardiovascular disease and deaths. Numerous investigations have identified that different antihypertensive agents influence PP and AS differently. None of the previous studies described any reliable animal model particularly to screen drugs having effects on PP and AS. In present study, we developed an animal model to screen such drugs particularly affecting PP and AS. METHODS Elevation of PP and amplification of AS were induced in rats by uninephrectomy along with high salt intake (NaCl 4% w/v) for a period of six weeks, and weekly changes in body weight, PP, systolic, diastolic, mean pressure and pulse wave velocity (PWV) were estimated. After six weeks, collagen elastin ratio of aortic segment was estimated. Histomorphometry of abdominal aortic section of rats was done using trinocular microscope. RESULTS After six weeks, uninephrectomized rats that were kept on high salt drinking water shown significant increase (P < 0.001) in MAP, PP and PWV indicates that hypertension along with elevated PP developed in rats, and increase in collagen/elastin ratio (P < 0.001) as well as PWV as compared to normal rats indicates the increase in AS. CONCLUSION The development of condition of hypertension in conjunction with increase in PP and AS in rats can be used as in-vivo screening model to determine the potency of drugs for the treatment of hypertension or other cardiovascular diseases associated with high PP and AS.
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Affiliation(s)
- Sanjay K Gupta
- Institute of Pharmaceutical Sciences, Guru Ghasidas Vishwavidyalaya, Bilaspur, C.G. 495009, India
| | - Surendra H Bodakhe
- Institute of Pharmaceutical Sciences, Guru Ghasidas Vishwavidyalaya, Bilaspur, C.G. 495009, India.
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Nardone M, Incognito AV, Millar PJ. Evidence for Pressure-Independent Sympathetic Modulation of Central Pulse Wave Velocity. J Am Heart Assoc 2018; 7:JAHA.117.007971. [PMID: 29378730 PMCID: PMC5850264 DOI: 10.1161/jaha.117.007971] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Background Whether the sympathetic nervous system can directly alter central aortic stiffness remains controversial, mainly because of the difficulty in experimentally augmenting peripheral vasoconstrictor activity without changing blood pressure. Methods and Results To address this limitation, we utilized low‐level cardiopulmonary baroreflex loading and unloading shown previously to alter sympathetic outflow without evoking parallel hemodynamic modulation. Blood pressure and carotid‐femoral aortic pulse wave velocity (cf‐PWV) were measured in 32 healthy participants (24±2 years; women: n=15) before and during 12‐minute applications of low‐level lower body negative pressure; −7 mm Hg) and lower body positive pressure; +7 mm Hg), applied in a random order. Fibular nerve microneurography was used to collect muscle sympathetic nerve activity (MSNA) in a subset (n=8) to confirm peripheral sympathetic responses. During lower body negative pressure, heart rate, blood pressure, stroke volume, cardiac output, and total peripheral resistance were not statistically different (all P>0.05); MSNA burst frequency (+15%; P=0.007), total MSNA (+44%; P=0.006), and cf‐PWV (∆+0.3±0.2 m/s; P<0.001) increased. In total, 28 (88%) of participants observed an increase in cf‐PWV greater than the baseline typical error of measurement. During lower body positive pressure, heart rate, stroke volume, cardiac output, and total peripheral resistance were not statistically different (all P>0.05), though blood pressure increased (P<0.05) and pulse pressure decreased (P=0.01); MSNA burst frequency (−4%; P=0.37), total MSNA (−7%; P=0.89), and cf‐PWV (∆0.0±0.2 m/s; P=0.68) were not statistically different. Conclusions These findings provide evidence that acute elevations in peripheral sympathetic activity can increase central aortic PWV in young participants independent of a change in distending or pulsatile blood pressure or heart rate.
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Affiliation(s)
- Massimo Nardone
- Department of Kinesiology, University of Guelph-Humber, Toronto, Ontario, Canada
| | - Anthony V Incognito
- Department of Human Health and Nutritional Sciences, University of Guelph, Guelph, Ontario, Canada
| | - Philip J Millar
- Department of Human Health and Nutritional Sciences, University of Guelph, Guelph, Ontario, Canada .,Toronto General Research Institute, Toronto General Hospital, Toronto, Ontario, Canada
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Kang J, Kim HL, Lim WH, Seo JB, Zo JH, Kim MA, Kim SH. Relationship between brachial-ankle pulse wave velocity and invasively measured aortic pulse pressure. J Clin Hypertens (Greenwich) 2018; 20:462-468. [PMID: 29370481 DOI: 10.1111/jch.13200] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2017] [Revised: 10/11/2017] [Accepted: 10/20/2017] [Indexed: 01/02/2023]
Abstract
Although brachial-ankle pulse wave velocity (baPWV) has been widely used as an index of arterial stiffness, no consensus exists about whether baPWV can reflect central aortic stiffness. The authors investigated the association between baPWV and invasively measured aortic pulse pressure (APP) in a total of 109 consecutive patients (mean age, 62.3 ± 11.3 years; 67.9% men). Most patients (91%) had obstructive coronary artery disease, and mean baPWV and APP values were 1535 ± 303 cm/s and 66.8 ± 22.5 mm Hg, respectively. In univariate analysis, there was a significant linear correlation between baPWV and APP (r = .635, P < .001). The correlation between baPWV and APP remained significant even after controlling for potential confounders (β = 0.574, P < .001; R2 = .469). Arterial stiffness measured by baPWV showed a strong positive correlation with invasively measured APP, independent of clinical confounders. Therefore, baPWV can be a good marker of central aortic stiffness.
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Affiliation(s)
- Jeehoon Kang
- Division of Cardiology, Department of Internal Medicine, Boramae Medical Center, Seoul National University College of Medicine, Seoul, Korea.,Molecular Medicine and Biopharmaceutical Sciences, Seoul National University, Seoul, Korea
| | - Hack-Lyoung Kim
- Division of Cardiology, Department of Internal Medicine, Boramae Medical Center, Seoul National University College of Medicine, Seoul, Korea
| | - Woo-Hyun Lim
- Division of Cardiology, Department of Internal Medicine, Boramae Medical Center, Seoul National University College of Medicine, Seoul, Korea
| | - Jae-Bin Seo
- Division of Cardiology, Department of Internal Medicine, Boramae Medical Center, Seoul National University College of Medicine, Seoul, Korea
| | - Joo-Hee Zo
- Division of Cardiology, Department of Internal Medicine, Boramae Medical Center, Seoul National University College of Medicine, Seoul, Korea
| | - Myung-A Kim
- Division of Cardiology, Department of Internal Medicine, Boramae Medical Center, Seoul National University College of Medicine, Seoul, Korea
| | - Sang-Hyun Kim
- Division of Cardiology, Department of Internal Medicine, Boramae Medical Center, Seoul National University College of Medicine, Seoul, Korea
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