1
|
Wang J, Wang Z, Zhang Z, Li P, Pan H, Ren Y, Hou T, Wang C, Kwong CF, Zhang B, Yang S, Bie J. Simultaneous Measurement of Local Pulse Wave Velocities in Radial Arteries Using a Soft Sensor Based on the Fiber Bragg Grating Technique. MICROMACHINES 2024; 15:507. [PMID: 38675318 PMCID: PMC11052460 DOI: 10.3390/mi15040507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/26/2024] [Revised: 03/29/2024] [Accepted: 04/02/2024] [Indexed: 04/28/2024]
Abstract
Arterial stiffness has been proved to be an important parameter in the evaluation of cardiovascular diseases, and Pulse Wave Velocity (PWV) is a strong indicator of arterial stiffness. Compared to regional PWV (PWV among different arteries), local PWV (PWV within a single artery) outstands in providing higher precision in indicating arterial properties, as regional PWVs are highly affected by multiple parameters, e.g., variations in blood vessel lengths due to individual differences, and multiple reflection effects on the pulse waveform. However, local PWV is less-developed due to its high dependency on the temporal resolution in synchronized signals with usually low signal-to-noise ratios. This paper presents a method for the noninvasive simultaneous measurement of two local PWVs in both left and right radial arteries based on the Fiber Bragg Grating (FBG) technique via correlation analysis of the pulse pairs at the fossa cubitalis and at the wrist. Based on the measurements of five male volunteers at the ages of 19 to 21 years old, the average left radial PWV ranged from 9.44 m/s to 12.35 m/s and the average right radial PWV ranged from 11.50 m/s to 14.83 m/s. What is worth mentioning is that a stable difference between the left and right radial PWVs was observed for each volunteer, ranging from 2.27 m/s to 3.04 m/s. This method enables the dynamic analysis of local PWVs and analysis of their features among different arteries, which will benefit the diagnosis of early-stage arterial stiffening and may bring more insights into the diagnosis of cardiovascular diseases.
Collapse
Affiliation(s)
- Jing Wang
- Department of Electrical and Electronic Engineering, University of Nottingham Ningbo China, Ningbo 315100, China; (Z.W.); (Z.Z.); (P.L.); (H.P.); (C.W.); (C.-F.K.); (S.Y.)
- Nottingham Ningbo China Beacons of Excellence Research and Innovation Institute, University of Nottingham Ningbo China, Ningbo 315048, China
- Key Laboratory of More Electric Aircraft Technology of Zhejiang Province, University of Nottingham Ningbo China, Ningbo 315100, China
| | - Zhukun Wang
- Department of Electrical and Electronic Engineering, University of Nottingham Ningbo China, Ningbo 315100, China; (Z.W.); (Z.Z.); (P.L.); (H.P.); (C.W.); (C.-F.K.); (S.Y.)
| | - Zijun Zhang
- Department of Electrical and Electronic Engineering, University of Nottingham Ningbo China, Ningbo 315100, China; (Z.W.); (Z.Z.); (P.L.); (H.P.); (C.W.); (C.-F.K.); (S.Y.)
| | - Peiyun Li
- Department of Electrical and Electronic Engineering, University of Nottingham Ningbo China, Ningbo 315100, China; (Z.W.); (Z.Z.); (P.L.); (H.P.); (C.W.); (C.-F.K.); (S.Y.)
| | - Han Pan
- Department of Electrical and Electronic Engineering, University of Nottingham Ningbo China, Ningbo 315100, China; (Z.W.); (Z.Z.); (P.L.); (H.P.); (C.W.); (C.-F.K.); (S.Y.)
| | - Yong Ren
- Nottingham Ningbo China Beacons of Excellence Research and Innovation Institute, University of Nottingham Ningbo China, Ningbo 315048, China
- Department of Mechanics, Materials and Manufacturing Engineering, University of Nottingham Ningbo China, Ningbo 315100, China;
- Key Laboratory of Carbonaceous Wastes Processing and Process Intensification Research of Zhejiang Province, University of Nottingham Ningbo China, Ningbo 315100, China
| | - Tuo Hou
- Department of Mechanics, Materials and Manufacturing Engineering, University of Nottingham Ningbo China, Ningbo 315100, China;
| | - Chengbo Wang
- Department of Electrical and Electronic Engineering, University of Nottingham Ningbo China, Ningbo 315100, China; (Z.W.); (Z.Z.); (P.L.); (H.P.); (C.W.); (C.-F.K.); (S.Y.)
- Nottingham Ningbo China Beacons of Excellence Research and Innovation Institute, University of Nottingham Ningbo China, Ningbo 315048, China
| | - Chiew-Foong Kwong
- Department of Electrical and Electronic Engineering, University of Nottingham Ningbo China, Ningbo 315100, China; (Z.W.); (Z.Z.); (P.L.); (H.P.); (C.W.); (C.-F.K.); (S.Y.)
- Key Laboratory of More Electric Aircraft Technology of Zhejiang Province, University of Nottingham Ningbo China, Ningbo 315100, China
| | - Bei Zhang
- Department of Automation Science and Electrical Engineering, Beihang University, No. 37 Xueyuan Road, Haidian District, Beijing 100191, China;
| | - Sen Yang
- Department of Electrical and Electronic Engineering, University of Nottingham Ningbo China, Ningbo 315100, China; (Z.W.); (Z.Z.); (P.L.); (H.P.); (C.W.); (C.-F.K.); (S.Y.)
- Nottingham Ningbo China Beacons of Excellence Research and Innovation Institute, University of Nottingham Ningbo China, Ningbo 315048, China
| | - Jing Bie
- Department of Civil Engineering, University of Nottingham Ningbo China, Ningbo 315100, China;
| |
Collapse
|
2
|
Genovesi S, Tassistro E, Lieti G, Patti I, Giussani M, Antolini L, Orlando A, Salvi P, Parati G. Wall Properties of Elastic and Muscular Arteries in Children and Adolescents at Increased Cardiovascular Risk. J Clin Med 2023; 12:6919. [PMID: 37959384 PMCID: PMC10648428 DOI: 10.3390/jcm12216919] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Revised: 10/23/2023] [Accepted: 10/31/2023] [Indexed: 11/15/2023] Open
Abstract
BACKGROUND Pulse wave velocity (PWV) assessment represents a simple method to estimate arterial distensibility. At present, carotid-femoral PWV (cf-PWV) is considered the gold standard method in the non-invasive evaluation of the elastic properties of the aorta. On the other hand, the mechanical properties of muscular arteries can be evaluated on the axillo-brachial-radia axis by estimating the carotid-radial PWV (cr-PWV). While a number of studies have addressed these issues in adults, limited information is available on the respective features of cf-PWV and cr-PWV and on their modulating factors in children and adolescents at increased cardiovascular risk. METHODS The mechanical properties of the predominantly elastic (aorta) and muscular (axillo-brachial-radial axis) arteries were evaluated in a pediatric population characterized by either elevated blood pressure (BP) or excess body weight, and the main factors affecting cf-PWV and cr-PWV values in these individuals were investigated. RESULTS 443 children and adolescents (median age 11.5 years, 43.3% females) were enrolled; 25% had BP values >90th percentile and 81% were excess weight. The cf-PWV values were significantly lower than the cr-PWV values: median (Q1-Q3) = 4.8 m/s (4.3-5.5) and 5.8 m/s (5.0-6.5), respectively (p < 0.001). The pubertal development (p < 0.03), systolic BP and diastolic BP z-scores (p = 0.002), heart rate (p < 0.001), and waist-to-height ratio (p < 0.005) were significantly associated with cf-PWV values. No significant association was found between BMI z-score and cf-PWV. Predictors of high cf-PWV (>95th percentile) were the heart rate (OR 1.07, 95%CI 1.04-1.10, p < 0.001) and waist-to-height ratio (OR 1.06, 95%CI 1.0-1.13, p = 0.04). The variables significantly related with cr-PWV values were diastolic BP z-score (p = 0.001), heart rate (p < 0.01), and HOMA index (p < 0.02). No significant association was found between the cr-PWV and BMI z-score or waist-to-height ratio. CONCLUSIONS Systolic and diastolic BP values and central obesity are associated with aortic stiffness in a population of children and adolescents at increased cardiovascular risk. In contrast, diastolic BP, heart rate, and levels of insulin resistance appear to be related to distensibility of the upper limb vascular district.
Collapse
Affiliation(s)
- Simonetta Genovesi
- Department of Cardiology, Istituto Auxologico Italiano, IRCCS, 20100 Milan, Italy
- School of Medicine and Surgery, University of Milano-Bicocca, 20100 Milan, Italy
| | - Elena Tassistro
- School of Medicine and Surgery, University of Milano-Bicocca, 20100 Milan, Italy
| | - Giulia Lieti
- School of Medicine and Surgery, University of Milano-Bicocca, 20100 Milan, Italy
| | - Ilenia Patti
- School of Medicine and Surgery, University of Milano-Bicocca, 20100 Milan, Italy
| | - Marco Giussani
- Department of Cardiology, Istituto Auxologico Italiano, IRCCS, 20100 Milan, Italy
| | - Laura Antolini
- School of Medicine and Surgery, University of Milano-Bicocca, 20100 Milan, Italy
| | - Antonina Orlando
- Department of Cardiology, Istituto Auxologico Italiano, IRCCS, 20100 Milan, Italy
| | - Paolo Salvi
- Department of Cardiology, Istituto Auxologico Italiano, IRCCS, 20100 Milan, Italy
| | - Gianfranco Parati
- Department of Cardiology, Istituto Auxologico Italiano, IRCCS, 20100 Milan, Italy
- School of Medicine and Surgery, University of Milano-Bicocca, 20100 Milan, Italy
| |
Collapse
|
3
|
Park S, Kwon M, Nam H, Huh H. Interpolation time-optimized aortic pulse wave velocity estimation by 4D flow MRI. Sci Rep 2023; 13:16484. [PMID: 37777620 PMCID: PMC10542805 DOI: 10.1038/s41598-023-43799-z] [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: 01/31/2023] [Accepted: 09/28/2023] [Indexed: 10/02/2023] Open
Abstract
Four-dimensional flow magnetic resonance imaging-based pulse wave velocity (4D flow PWV) estimation is a promising tool for measuring regional aortic stiffness for non-invasive cardiovascular disease screening. However, the effect of variations in the shape of flow waveforms on 4D flow PWV measurements remains unclear. In this study, 4D flow PWV values were compared using cross-correlation algorithm with different interpolation times (iTs) based on flow rate and beat frequency. A critical iT (iTCrit) was proposed from in vitro study using flexible and stiff phantom models to simultaneously achieve a low difference and a low computation time. In vivo 4D flow PWV values from six healthy volunteers were also compared between iTCrit and the conventionally used interpolation time of 1 ms (iT1 ms). The results indicated that iTCrit reduced the mean difference of in vitro 4D flow PWV values by 19%, compared to iT1 ms. In addition, iTCrit measured in vivo 4D flow PWV, showing differences similar to those obtained with iT1 ms. A difference estimation model was proposed to retrospectively estimate potential differences of 4D flow PWV using known values of PWV and the used iT. This study would be helpful for understanding the differences of PWV generated by physiological changes and time step of obtained flow waveforms.
Collapse
Affiliation(s)
- Sungho Park
- Daegu-Gyeongbuk Medical Innovation Foundation, Medical Device Development Center, Daegu, 41061, South Korea
- Institute of Medical Devices, Kangwon National University, Chuncheon, South Korea
- Department of Radiology, Section of Pediatric Radiology, Children's Hospital Colorado, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Minseong Kwon
- Daegu-Gyeongbuk Medical Innovation Foundation, Medical Device Development Center, Daegu, 41061, South Korea
| | - Hyojin Nam
- Daegu-Gyeongbuk Medical Innovation Foundation, Medical Device Development Center, Daegu, 41061, South Korea
| | - Hyungkyu Huh
- Daegu-Gyeongbuk Medical Innovation Foundation, Medical Device Development Center, Daegu, 41061, South Korea.
| |
Collapse
|
4
|
Hurstel M, Joly L, Imbert L, Zimmermann G, Roch V, Schoepfer P, Lamiral Z, Salvi P, Benetos A, Verger A, Marie PY. Volume of the proximal half of the thoracic aorta is the most comprehensive FDG-PET/CT indicator of arterial aging throughout adulthood. Eur J Hybrid Imaging 2023; 7:11. [PMID: 37369917 DOI: 10.1186/s41824-023-00169-2] [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: 05/17/2023] [Accepted: 06/21/2023] [Indexed: 06/29/2023] Open
Abstract
INTRODUCTION 18F-fluorodeoxyglucose positron emission tomography (FDG-PET) and computed tomography (CT) features of the proximal and more elastic half of the thoracic aorta are known to correlate with aorta stiffness in older populations. This prospective study aimed to analyze the changes in these FDG-PET/CT features between young, middle-aged, and older adults, and investigate associations with arterial stiffness and blood pressure (BP). METHODS Young (< 40 years), middle-aged (40-to-60 years), and older (> 60 years) adults, who underwent an FDG-PET/CT, were prospectively recruited. FDG-PET/CT features of the proximal half of the thoracic aorta were analyzed relative to the age categories, BP and carotid-femoral pulse wave velocity (PWV), a reference indicator of aorta stiffness. RESULTS We included 79 patients (38 women; 22 young, 19 middle-aged, and 38 older adults). An increase in age category was associated with increases in mean standardized uptake values (SUVs) of blood and aorta and most significantly in aorta SUV heterogeneity, represented by SUV standard deviation (SUV-SD), aorta calcification volume, and the aorta volume indexed to body surface area. However, this indexed aorta volume was the sole variable: (i) exhibiting a stepwise increase from young (median: 25 cm3/m2 [interquartile range: 20-28 cm3/m2]), to middle-aged (41 [30-48] cm3/m2, p < 0.001 vs. Young), and older (62 [44-70] cm3/m2, p < 0.001 vs. middle-age) adults, and (ii) selected in the multivariate predictions of systolic, diastolic, and pulse BP. Indexed aorta volume was also a multivariate predictor of PWV but in association with SUV-SD and hypertension. CONCLUSION In a population of patients referred to an FDG-PET/CT investigation, the indexed volume of the proximal and more elastic half of the thoracic aorta is the most comprehensive indicator of arterial aging. This imaging parameter exhibits a stepwise increase from young to middle-aged and older adults, is strongly linked to inter-individual changes in both arterial stiffness and BP, and thus, could help assess the early phases of arterial aging. Trial registration ClinicalTrial.gov, NCT03345290. Registered 17 November 2017, https://clinicaltrials.gov/ct2/show/NCT03345290?term=NCT03345290&draw=2&rank=1.
Collapse
Affiliation(s)
- Moira Hurstel
- Department of Nuclear Medicine and Nancyclotep Molecular Imaging Platform, CHRU-Nancy, Université de Lorraine, 54000, Nancy, France
| | - Laure Joly
- Geriatric Department, CHRU Nancy, Université de Lorraine, Nancy, France
- INSERM, DCAC, Université de Lorraine, Vandœuvre-lès-Nancy, France
| | - Laetitia Imbert
- Department of Nuclear Medicine and Nancyclotep Molecular Imaging Platform, CHRU-Nancy, Université de Lorraine, 54000, Nancy, France
- IADI, INSERM U1254, Université de Lorraine, Nancy, France
| | - Gaetan Zimmermann
- Department of Nuclear Medicine and Nancyclotep Molecular Imaging Platform, CHRU-Nancy, Université de Lorraine, 54000, Nancy, France
| | - Véronique Roch
- Department of Nuclear Medicine and Nancyclotep Molecular Imaging Platform, CHRU-Nancy, Université de Lorraine, 54000, Nancy, France
| | - Pauline Schoepfer
- Geriatric Department, CHRU Nancy, Université de Lorraine, Nancy, France
| | - Zohra Lamiral
- INSERM, CIC 1433, Université de Lorraine, CHRU-Nancy, Nancy, France
| | - Paolo Salvi
- Department of Cardiology, Istituto Auxologico Italiano, IRCCS, Milan, Italy
| | - Athanase Benetos
- Geriatric Department, CHRU Nancy, Université de Lorraine, Nancy, France
- INSERM, DCAC, Université de Lorraine, Vandœuvre-lès-Nancy, France
| | - Antoine Verger
- Department of Nuclear Medicine and Nancyclotep Molecular Imaging Platform, CHRU-Nancy, Université de Lorraine, 54000, Nancy, France
- IADI, INSERM U1254, Université de Lorraine, Nancy, France
| | - Pierre-Yves Marie
- Department of Nuclear Medicine and Nancyclotep Molecular Imaging Platform, CHRU-Nancy, Université de Lorraine, 54000, Nancy, France.
- INSERM, DCAC, Université de Lorraine, Vandœuvre-lès-Nancy, France.
- Médecine Nucléaire, Hôpital de Brabois, CHRU-Nancy, rue Morvan, 54500, Vandoeuvre-lès-Nancy, France.
| |
Collapse
|
5
|
Overall and repeated measures agreement between brachial-femoral and carotid-femoral measures of pulse wave velocity in young and healthy individuals. Blood Press Monit 2022; 27:334-340. [PMID: 35866509 DOI: 10.1097/mbp.0000000000000614] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Carotid-femoral pulse-wave velocity (cfPWV) is the gold standard measure of arterial stiffness and independently predicts cardiovascular disease. However, obtaining cfPWV requires technical precision and can be difficult in some populations. Brachial-femoral PWV (bfPWV) is a simpler alternative, but there is limited research comparing the two measures. For physiological studies, it is important to know how well the measures agree at rest, and to what extent changes in the measures correspond after perturbation. OBJECTIVE To assess the overall and repeated measures agreement between cfPWV and bfPWV. METHODS cfPWV and bfPWV were measured in the supine and seated positions, both before and after a 3-h bout of prolonged sitting. The intraclass correlation coefficient (ICC) for overall agreement was calculated using the random variance components from linear mixed-model regression. Repeated measures agreement (change in cfPWV vs. change in bfPWV) was calculated using repeated measures correlation. RESULTS Complete data from 18 subjects (22.6 ± 3.1 years old, 33% female) were included in the analysis. There was strong (ICC ≥ 0.70) overall agreement (ICC, 0.75; 95% CI, 0.60-0.85) and very strong (ICC ≥ 0.90) repeated measures agreement (ICC, 0.90; 95% CI, 0.84-0.94) between cfPWV and bfPWV. DISCUSSION The current findings indicate strong overall agreement and very strong repeated measures agreement between bfPWV and cfPWV. bfPWV is a user-friendly alternative method that agrees with cfPWV-based assessments of central arterial stiffness.
Collapse
|
6
|
Non-Invasive Assessment of Arterial Stiffness: Pulse Wave Velocity, Pulse Wave Analysis and Carotid Cross-Sectional Distensibility: Comparison between Methods. J Clin Med 2022; 11:jcm11082225. [PMID: 35456316 PMCID: PMC9029786 DOI: 10.3390/jcm11082225] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Revised: 04/08/2022] [Accepted: 04/13/2022] [Indexed: 12/04/2022] Open
Abstract
Background: The stiffening of large elastic arteries is currently estimated in research and clinical practice by propagative and non-propagative models, as well as parameters derived from aortic pulse waveform analysis. Methods: Common carotid compliance and distensibility were measured by simultaneously recording the diameter and pressure changes during the cardiac cycle. The aortic and upper arm arterial distensibility was estimated by measuring carotid−femoral and carotid−radial pulse wave velocity (PWV), respectively. The augmentation index and blood pressure amplification were derived from the analysis of central pulse waveforms, recorded by applanation tonometry directly from the common carotid artery. Results: 75 volunteers were enrolled in this study (50 females, average age 53.5 years). A significant inverse correlation was found between carotid distensibility and carotid−femoral PWV (r = −0.75; p < 0.001), augmentation index (r = −0.63; p < 0.001) and central pulse pressure (r = −0.59; p < 0.001). A strong correlation was found also between the total slope of the diameter/pressure rate carotid curves and aortic distensibility, quantified from the inverse of the square of carotid−femoral PWV (r = 0.67). No correlation was found between carotid distensibility and carotid−radial PWV. Conclusions: This study showed a close correlation between carotid−femoral PWV, evaluating aortic stiffness by using the propagative method, and local carotid cross-sectional distensibility.
Collapse
|
7
|
Kang J, Han K, Hyung J, Hong GR, Yoo Y. Noninvasive Aortic Ultrafast Pulse Wave Velocity Associated With Framingham Risk Model: in vivo Feasibility Study. Front Cardiovasc Med 2022; 9:749098. [PMID: 35174228 PMCID: PMC8841772 DOI: 10.3389/fcvm.2022.749098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Accepted: 01/03/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundAortic pulse wave velocity (PWV) enables the direct assessment of aortic stiffness, which is an independent risk factor of cardiovascular (CV) events. The aim of this study is to evaluate the association between aortic PWV and CV risk model classified into three groups based on the Framingham risk score (FRS), i.e., low-risk (<10%), intermediate-risk (10~20%) and high-risk (>20%).MethodsTo noninvasively estimate local PWV in an abdominal aorta, a high-spatiotemporal resolution PWV measurement method (>1 kHz) based on wide field-of-view ultrafast curved array imaging (ufcPWV) is proposed. In the ufcPWV measurement, a new aortic wall motion tracking algorithm based on adaptive reference frame update is performed to compensate errors from temporally accumulated out-of-plane motion. In addition, an aortic pressure waveform is simultaneously measured by applanation tonometry, and a theoretical PWV based on the Bramwell-Hill model (bhPWV) is derived. A total of 69 subjects (aged 23–86 years) according to the CV risk model were enrolled and examined with abdominal ultrasound scan.ResultsThe ufcPWV was significantly correlated with bhPWV (r = 0.847, p < 0.01), and it showed a statistically significant difference between low- and intermediate-risk groups (5.3 ± 1.1 vs. 8.3 ± 3.1 m/s, p < 0.01), and low- and high-risk groups (5.3 ± 1.1 vs. 10.8 ± 2.5 m/s, p < 0.01) while there is no significant difference between intermediate- and high-risk groups (8.3 ± 3.1 vs. 10.8 ± 2.5 m/s, p = 0.121). Moreover, it showed a significant difference between two evaluation groups [low- (<10%) vs. higher-risk group (≥10%)] (5.3 ± 1.1 vs. 9.4 ± 3.1 m/s, p < 0.01) when the intermediate- and high-risk groups were merged into a higher-risk group.ConclusionThis feasibility study based on CV risk model demonstrated that the aortic ufcPWV measurement has the potential to be a new approach to overcome the limitations of conventional systemic measurement methods in the assessment of aortic stiffness.
Collapse
Affiliation(s)
- Jinbum Kang
- Deparment of Electronic Engineering, Sogang University, Seoul, South Korea
| | - Kanghee Han
- Deparment of Electronic Engineering, Sogang University, Seoul, South Korea
| | - Jihyun Hyung
- Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Yonsei University Health System, Seoul, South Korea
| | - Geu-Ru Hong
- Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Yonsei University Health System, Seoul, South Korea
| | - Yangmo Yoo
- Deparment of Electronic Engineering, Sogang University, Seoul, South Korea
- Deparment of Biomedical Engineering, Sogang University, Seoul, South Korea
- *Correspondence: Yangmo Yoo
| |
Collapse
|
8
|
Salvi P, Baldi C, Scalise F, Grillo A, Salvi L, Tan I, De Censi L, Sorropago A, Moretti F, Sorropago G, Gao L, Rovina M, Simon G, Fabris B, Carretta R, Avolio AP, Parati G. Comparison Between Invasive and Noninvasive Methods to Estimate Subendocardial Oxygen Supply and Demand Imbalance. J Am Heart Assoc 2021; 10:e021207. [PMID: 34465133 PMCID: PMC8649295 DOI: 10.1161/jaha.121.021207] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Background Estimation of the balance between subendocardial oxygen supply and demand could be a useful parameter to assess the risk of myocardial ischemia. Evaluation of the subendocardial viability ratio (SEVR, also known as Buckberg index) by invasive recording of left ventricular and aortic pressure curves represents a valid method to estimate the degree of myocardial perfusion relative to left ventricular workload. However, routine clinical use of this parameter requires its noninvasive estimation and the demonstration of its reliability. Methods and Results Arterial applanation tonometry allows a noninvasive estimation of SEVR as the ratio of the areas directly beneath the central aortic pressure curves obtained during diastole (myocardial oxygen supply) and during systole (myocardial oxygen demand). However, this “traditional” method does not account for the intra‐ventricular diastolic pressure and proper allocation to systole and diastole of left ventricular isometric contraction and relaxation, respectively, resulting in an overestimation of the SEVR values. These issues are considered in the novel method for SEVR assessment tested in this study. SEVR values estimated with carotid tonometry by "traditional” and "new” method were compared with those evaluated invasively by cardiac catheterization. The “traditional” method provided significantly higher SEVR values than the reference invasive SEVR: average of differences±SD= 44±11% (limits of agreement: 23% – 65%). The noninvasive “new” method showed a much better agreement with the invasive determination of SEVR: average of differences±SD= 0±8% (limits of agreement: ‐15% to 16%). Conclusions Carotid applanation tonometry provides valid noninvasive SEVR values only when all the main factors determining myocardial supply and demand flow are considered.
Collapse
Affiliation(s)
- Paolo Salvi
- Cardiology Unit Istituto Auxologico Italiano, IRCCS Milan Italy
| | - Corrado Baldi
- Medicina Clinica Azienda Sanitaria Universitaria Giuliano Isontina Trieste Italy
| | - Filippo Scalise
- Department of Interventional Cardiology Policlinico di Monza Monza Italy
| | - Andrea Grillo
- Medicina Clinica Azienda Sanitaria Universitaria Giuliano Isontina Trieste Italy
| | - Lucia Salvi
- Medicina II Cardiovascolare AUSL-IRCCS di Reggio Emilia Reggio Emilia Italy
| | - Isabella Tan
- Department of Biomedical Sciences Faculty of Medicine, Health and Human Science Macquarie University Sydney Australia
| | - Lorenzo De Censi
- Department of Medicine and Surgery University of Milano-Bicocca Milan Italy
| | - Antonio Sorropago
- Department of Interventional Cardiology Policlinico di Monza Monza Italy
| | - Francesco Moretti
- Department of Molecular Medicine Policlinico San Matteo Foundation, University of Pavia Italy
| | - Giovanni Sorropago
- Department of Interventional Cardiology Policlinico di Monza Monza Italy
| | - Lan Gao
- Department of Cardiology Peking University First Hospital Beijing China
| | - Matteo Rovina
- Medicina Clinica Azienda Sanitaria Universitaria Giuliano Isontina Trieste Italy
| | - Giulia Simon
- Medicina Clinica Azienda Sanitaria Universitaria Giuliano Isontina Trieste Italy
| | - Bruno Fabris
- Medicina Clinica Azienda Sanitaria Universitaria Giuliano Isontina Trieste Italy
| | - Renzo Carretta
- Department of Medical, Surgical and Health Sciences University of Trieste Italy
| | - Alberto P Avolio
- Department of Biomedical Sciences Faculty of Medicine, Health and Human Science Macquarie University Sydney Australia
| | - Gianfranco Parati
- Cardiology Unit Istituto Auxologico Italiano, IRCCS Milan Italy.,Department of Medicine and Surgery University of Milano-Bicocca Milan Italy
| |
Collapse
|
9
|
Fiori G, Fuiano F, Scorza A, Conforto S, Sciuto SA. Non-Invasive Methods for PWV Measurement in Blood Vessel Stiffness Assessment. IEEE Rev Biomed Eng 2021; 15:169-183. [PMID: 34166202 DOI: 10.1109/rbme.2021.3092208] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
In recent years, statistical studies highlighted an increasing incidence of cardiovascular diseases (CVD) which reflected on additional costs on the healthcare systems worldwide. Pulse wave velocity (PWV) measurement is commonly considered a CVD predictor factor as well as a marker of Arterial Stiffness (AS), since it is closely related to the mechanical characteristics of the arterial wall. An increase in PWV is due to a more rigid arterial system. Because of the prevalence of the elastic component, in young people the PWV is lower than in the elderly. Nowadays, invasive and non-invasive methods for PWV assessment are employed: there is an increasing attention in the development of non-invasive devices which mostly perform a regional PWV measurement (over a long arterial portion) rather than local (over a short arterial portion). The accepted gold-standard for non-invasive AS measurement is the carotid-femoral PWV used to evaluate the arterial damage, the corresponding cardiovascular risk and to adapt the proper therapy. This review article considers the main commercially available devices underlining their operating principles in terms of sensors, execution mode, pulse waveform acquired, site of measurement, distance and time estimation methods, as well as their main limitations in clinical practice.
Collapse
|
10
|
Mean arterial pressure estimated by brachial pulse wave analysis and comparison with currently used algorithms. J Hypertens 2021; 38:2161-2168. [PMID: 32694334 DOI: 10.1097/hjh.0000000000002564] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Mean arterial pressure (MAP) is usually calculated by adding one-third of pulse pressure (PP) to DBP. This formula assumes that the average value of pulse waveform is constant in all individuals and coincides with 33.3% of PP amplitude (MAP = DBP + PP × 0.333). Other formulas were lately proposed to improve the MAP estimation, adding to DBP an established percentage of PP: MAP = DBP + PP × 0.40; MAP = DBP + PP × 0.412; MAP = DBP + PP × 0.333 + 5 mmHg. METHODS The current study evaluated the integral of brachial pulse waveform recorded by applanation tonometry in 1526 patients belonging to three distinct cohorts: normotensive or hypertensive elderly, hypertensive adults, and normotensive adults. RESULTS The percentage of PP to be added to DBP to obtain MAP was extremely variable among individuals, ranging from 23 to 58% (mean: 42.2 ± 5.5%), higher in women (42.9 ± 5.6%) than men (41.2 ± 5.1%, P < 0.001), lower in the elderly cohort (40.9 ± 5.3%) than in the general population cohort (42.8 ± 6.0%, P < 0.001) and in the hypertensive patients (42.4 ± 4.8%, P < 0.001). This percentage was significantly associated with DBP (β = 0.357, P < 0.001) and sex (β = 0.203, P < 0.001) and significantly increased after mental stress test in 19 healthy volunteers (from 39.9 ± 3.2 at baseline, to 43.0 ± 4.0, P < 0.0001). The average difference between MAP values estimated by formulas, compared with MAP assessed on the brachial tonometric curve, was (mean ± 1.96 × SD): -5.0 ± 6.7 mmHg when MAP = DBP + PP × 0333; -1.2 ± 6.1 mmHg when MAP = DBP + PP × 0.40; -0.6 ± 6.1 mmHg when MAP = DBP + PP × 0.412; -0.4 ± 6.7 mmHg when MAP = DBP + PP × 0.333 + 5. CONCLUSION Due to high interindividual and intraindividual variability of pulse waveform, the estimation of MAP based on fixed formulas derived from SBP and DBP is unreliable. Conversely, a more accurate estimation of MAP should be based on the pulse waveform analysis.
Collapse
|
11
|
Blood Pressure and Body Weight Have Different Effects on Pulse Wave Velocity and Cardiac Mass in Children. J Clin Med 2020; 9:jcm9092954. [PMID: 32932663 PMCID: PMC7565974 DOI: 10.3390/jcm9092954] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Revised: 09/07/2020] [Accepted: 09/10/2020] [Indexed: 11/16/2022] Open
Abstract
Background: High blood pressure (BP) and excess weight can lead to early cardiovascular organ damage already in children. Carotid-femoral pulse wave velocity (cf-PWV) is the non-invasive gold standard method for assessing aortic stiffness, while carotid-radial PWV (cr-PWV) provides information on the distensibility of the upper limb arteries. The aim of this study was to evaluate the relationship of BP and BMI z-scores with arterial stiffness and left ventricular mass index (LVMI) in a pediatric population. Methods: In 343 children (57.7% males; age ± SD 11.7 ± 2.9 years), systolic (SBP) and diastolic (DBP) BP, BMI, cf-PWV, cr-PWV and LVMI were measured. A multiple linear regression model was used to assess the impact of BMI and SBP (or DBP) z-scores on cf-PWV, cr-PWV and LVMI. Results: About 21% of children were normal weight, 34% were overweight and 45% obese. Adjusted for possible confounders, SBP and DBP z-scores were significantly associated with cf-PWV (p < 0.001), while only DBP z-scores were related to cr-PWV (p < 0.01). BMI was neither associated with cf-PWV nor with cr-PWV values but was a strong predictor of LVMI (<0.001), whereas cardiac mass and BP z-scores were not related. Conclusions: Our study suggests that, in children, elevated BP values and excess weight may have different effects on the heart and the vessels in causing early cardiovascular alterations.
Collapse
|
12
|
Salvi L, Alfonsi J, Grillo A, Pini A, Soranna D, Zambon A, Pacini D, Di Bartolomeo R, Salvi P, Parati G. Postoperative and mid-term hemodynamic changes after replacement of the ascending aorta. J Thorac Cardiovasc Surg 2020; 163:1283-1292. [PMID: 32624310 DOI: 10.1016/j.jtcvs.2020.05.031] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Revised: 04/08/2020] [Accepted: 05/08/2020] [Indexed: 11/26/2022]
Abstract
OBJECTIVES To evaluate aortic distensibility and pulse waveform patterns associated with the ascending aortic aneurysm, and to analyze the postoperative and mid-term hemodynamic changes induced by prosthetic replacement of the ascending aorta. METHODS Central blood pressure waves were recorded at the carotid artery level by means of a validated transcutaneous arterial tonometer in 30 patients undergoing prosthetic replacement of ascending aortic aneurysm and in 30 control patients. Measurements were obtained the day before surgery and 5 to 7 days and 16 to 20 months after surgery. RESULTS The ascending aortic aneurysm was associated with a less steep slope of early systolic phase of the pressure curve (pulsus tardus) compared with a control group (0.54 ± 0.18 mm Hg/ms vs 0.69 ± 0.26 mm Hg/ms; P = .011). Replacing the ascending aorta with a noncompliant vascular prosthesis steepened the pulse pressure slope during the early systolic phase in the postoperative period (0.77 ± .29 mm Hg/ms), providing values comparable with those of the control group in the mid-term (0.67 ± .20 mm Hg/ms). No change in aortic stiffness was found either postoperatively or in the mid-term after ascending aorta surgical replacement (carotid-femoral pulse wave velocity: preoperative, 9.0 ± 2.6 m/s; postoperative, 9.0 ± 2.9 m/s; mid-term postoperative, 9.3 ± 2.8 m/s). CONCLUSIONS This study does not confirm the assumption that substitution of the viscoelastic ascending aorta with a rigid prosthesis can cause serious hemodynamic alterations downstream, because we did not observe a worsening of global aortic distensibility after insertion of a rigid prosthetic aorta. The ascending aortic aneurysm is associated with a pulsus tardus.
Collapse
Affiliation(s)
- Lucia Salvi
- Foundation IRCCS Polyclinic San Matteo, University of Pavia, Pavia, Italy
| | - Jacopo Alfonsi
- Department of Cardiovascular Surgery, S Orsola Hospital, University of Bologna, Bologna, Italy
| | - Andrea Grillo
- Istituto Auxologico Italiano, IRCCS, Cardiology Unit, Milan, Italy; Department of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
| | - Alessandro Pini
- Vascular Cardiogenetic Unit, IRCCS Policlinico San Donato, San Donato Milanese, Italy
| | - Davide Soranna
- Istituto Auxologico Italiano, IRCCS, Cardiology Unit, Milan, Italy
| | - Antonella Zambon
- Istituto Auxologico Italiano, IRCCS, Cardiology Unit, Milan, Italy; Department of Statistics and Quantitative Methods, University of Milano-Bicocca, Milan, Italy
| | - Davide Pacini
- Department of Cardiovascular Surgery, S Orsola Hospital, University of Bologna, Bologna, Italy
| | - Roberto Di Bartolomeo
- Department of Cardiovascular Surgery, S Orsola Hospital, University of Bologna, Bologna, Italy
| | - Paolo Salvi
- Istituto Auxologico Italiano, IRCCS, Cardiology Unit, Milan, Italy.
| | - Gianfranco Parati
- Istituto Auxologico Italiano, IRCCS, Cardiology Unit, Milan, Italy; Department of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
| |
Collapse
|
13
|
Zemtsovskaja G, Pilt K, Samarin A, Abina J, Meigas K, Viigimaa M. Construction of gender-specific regression models for aortic length estimation based on computed tomography images. HEALTH AND TECHNOLOGY 2020. [DOI: 10.1007/s12553-019-00391-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
14
|
Salvi P, Furlanis G, Grillo A, Pini A, Salvi L, Marelli S, Rovina M, Moretti F, Gaetano R, Pintassilgo I, Faini A, Fabris B, Carretta R, Parati G. Unreliable Estimation of Aortic Pulse Wave Velocity Provided by the Mobil-O-Graph Algorithm-Based System in Marfan Syndrome. J Am Heart Assoc 2019; 8:e04028. [PMID: 31020905 PMCID: PMC6512139 DOI: 10.1161/jaha.118.011440] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2018] [Accepted: 03/19/2019] [Indexed: 12/29/2022]
Abstract
Background Several devices have been proposed to assess arterial stiffness in clinical daily use over the past few years, by estimating aortic pulse wave velocity (PWV) from a single measurement of brachial oscillometric blood pressure, using patented algorithms. It is uncertain if these systems are able to provide additional elements, beyond the contribution carried by age and blood pressure levels, in the definition of early vascular damage expressed by the stiffening of the arterial wall. Methods and Results The aim of our study was to compare the estimated algorithm-based PWV values, provided by the Mobil-O-Graph system, with the standard noninvasive assessment of aortic PWV in patients with Marfan syndrome (ie, in subjects characterized by premature aortic stiffening and low blood pressure values). Aortic stiffness was simultaneously evaluated by carotid-femoral PWV with a validated arterial tonometer and estimated with an arm cuff-based ambulatory blood pressure monitoring Mobil-O-Graph device on 103 patients with Marfan syndrome (50 men; mean± SD age, 38±15 years). Aortic PWV, estimated by the Mobil-O-Graph, was significantly ( P<0.0001) lower (mean± SD, 6.1±1.3 m/s) than carotid-femoral PWV provided by arterial tonometry (mean± SD , 8.8±3.1 m/s). The average of differences between PWV values provided by the 2 methods (±1.96×SD) was -2.7±5.7 m/s. Conclusions The Mobil-O-Graph provides PWV values related to an ideal subject for a given age and blood pressure, but it is not able to evaluate early vascular aging expressed by high PWV in the individual patient. This is well shown in patients with Marfan syndrome.
Collapse
Affiliation(s)
- Paolo Salvi
- Department of Cardiovascular, Neural and Metabolic SciencesIstituto Auxologico ItalianoIRCCSMilanItaly
| | - Giulia Furlanis
- Department of MedicalSurgical and Health SciencesUniversity of TriesteTriesteItaly
| | - Andrea Grillo
- Department of Cardiovascular, Neural and Metabolic SciencesIstituto Auxologico ItalianoIRCCSMilanItaly
- Department of Medicine and SurgeryUniversity of Milano‐BicoccaMilanItaly
| | - Alessandro Pini
- Department of CardiologyAzienda Socio Sanitaria Territoriale Fatebenefratelli SaccoRare Disease Center “Marfan Clinic”MilanItaly
| | - Lucia Salvi
- Department of Internal Medicine and TherapeuticsFondazione IRCCS Policlinico San MatteoUniversity of PaviaPaviaItaly
| | - Susan Marelli
- Department of CardiologyAzienda Socio Sanitaria Territoriale Fatebenefratelli SaccoRare Disease Center “Marfan Clinic”MilanItaly
| | - Matteo Rovina
- Department of MedicalSurgical and Health SciencesUniversity of TriesteTriesteItaly
| | - Francesco Moretti
- Department of Molecular MedicineFondazione IRCCS Policlinico San MatteoUniversity of PaviaItaly
| | | | | | - Andrea Faini
- Department of Cardiovascular, Neural and Metabolic SciencesIstituto Auxologico ItalianoIRCCSMilanItaly
| | - Bruno Fabris
- Department of MedicalSurgical and Health SciencesUniversity of TriesteTriesteItaly
| | - Renzo Carretta
- Department of MedicalSurgical and Health SciencesUniversity of TriesteTriesteItaly
- Institute of Biomedicine and Molecular Immunology “A. Monroy,”National Research Council of Italy (CNR)PalermoItaly
| | - Gianfranco Parati
- Department of Cardiovascular, Neural and Metabolic SciencesIstituto Auxologico ItalianoIRCCSMilanItaly
- Department of Medicine and SurgeryUniversity of Milano‐BicoccaMilanItaly
| |
Collapse
|
15
|
Hwang JW, Kim EK, Jang SY, Chung TY, Ki CS, Sung K, Kim SM, Ahn J, Carriere K, Choe YH, Chang SA, Kim DK. Comparación del efecto del aliskireno frente a controles negativos en la rigidez aórtica de los pacientes con síndrome de Marfan tratados con atenolol. Rev Esp Cardiol (Engl Ed) 2018. [DOI: 10.1016/j.recesp.2017.10.040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
|
16
|
Salvi P, Grillo A, Tan I, Simon G, Salvi L, Gao L, Rovina M, Butlin M, Yang Y, Meneghin E, Meng L, Faini A, Barin E, Pini A, Carretta R, Huo Y, Avolio A, Parati G. Systolic time intervals assessed from analysis of the carotid pressure waveform. Physiol Meas 2018; 39:084002. [PMID: 30033934 DOI: 10.1088/1361-6579/aad51b] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
OBJECTIVE The timing of mechanical cardiac events is usually evaluated by conventional echocardiography as an index of cardiac systolic function and predictor of cardiovascular outcomes. We aimed to measure the systolic time intervals, namely the isovolumetric contraction time (ICT) and pre-ejection period (PEP), by arterial tonometry. APPROACH Sixty-two healthy volunteers (age 47 ± 17 years) and 42 patients with heart failure and reduced ejection fraction were enrolled (age 66 ± 14 years). Pulse waves were recorded at the carotid artery by arterial tonometry together with simultaneous aortic transvalvular flow by Doppler-echocardiography, synchronized by electrocardiographic gating. The ICT was determined from the time delay between the electrical R wave and the carotid pressure waveform, after adjustment for the pulse transit time from the aortic valve to the carotid artery site, estimated by an algorithm based on the carotid-femoral pulse wave velocity. The PEP was evaluated by adding the electrical QR duration to the ICT. MAIN RESULTS The ICT derived from carotid pulse wave analysis was closely related to that measured by echocardiography (r = 0.90, p < 0.0001), with homogeneous distribution in Bland-Altman analysis (mean difference and 95% confidence interval = 0.2 from -14.2 to 14.5 ms). ICT and PEP were higher in cardiac patients than in healthy volunteers (p < 0.0001). The ratio between PEP and left ventricular ejection time was related to the ejection fraction measured with echocardiography (r = 0.555, p < 0.0001). SIGNIFICANCE The timing of electro-mechanical cardiac events can be reliably obtained from the carotid pulse waveform and carotid-femoral PWV, evaluated using arterial tonometry. Systolic time intervals assessed with this approach showed good agreement with measurements performed with conventional echocardiography and may represent a promising additional application of arterial tonometry.
Collapse
Affiliation(s)
- Paolo Salvi
- Istituto Auxologico Italiano, IRCCS, Department of Cardiovascular, Neural and Metabolic Sciences, Milan, Italy
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
17
|
Abstract
The aorta has 2 main functions, conduit and cushion, and is designed to transmit blood to the periphery and buffer pulsatile stress from ventricular contraction. In the interaction between the structural and functional changes of the aorta, aging and disease processes impact on aortic material properties and hemodynamics. For a comprehensive assessment of changes in aortic structure and function associated with aging and disease, noninvasive cardiovascular imaging techniques, especially magnetic resonance imaging, have recently been developed. Magnetic resonance imaging allows for direct and accurate measurement of different aortic characteristics including structural measures such as aortic area or volume, aortic length, curvature, and aortic wall thickness and functional measures such as aortic strain, distensibility, and pulse wave velocity. Excellent reproducibility of magnetic resonance imaging methods allows us to assess the response of the whole aorta to both pharmacological and nonpharmacological therapies. Aortic flow and functional assessment could be added to clinical routine cardiac magnetic resonance as a comprehensive imaging modality primarily performed for the noninvasive evaluation of left ventricular function, left ventricular load, and vascular/ventricular coupling. New techniques such as 4-dimensional flow could provide and further elucidate the combined age-related effects of altered aortic geometry and function. This following review will describe the pathophysiological aspects of the aorta and the ability, value, and prospects of cardiovascular imaging, especially magnetic resonance imaging, to study age-related changes in aortic structure and function and assess the relationship between these alterations and cardiovascular disease.
Collapse
Affiliation(s)
- Yoshiaki Ohyama
- Departments of Cardiology/Medicine and Radiology, Johns Hopkins University, Baltimore, MD (Y.O., B.A.V., J.A.C.L.). Sorbonne Universités, UPMC University Paris 06, INSERM 1146, CNRS 7371, Laboratoire d'Imagerie Biomédicale, Paris, France (A.R., N.K.). Department of Cardiovascular Imaging and Interventional Radiology, Institute of Cardiology, Hôpital Pitié-Salpêtrière (AP-HP), Paris, France (A.R.). Clinical Investigation and Research Unit, Gunma University Hospital, Maebashi, Japan (Y.O.)
| | - Alban Redheuil
- Departments of Cardiology/Medicine and Radiology, Johns Hopkins University, Baltimore, MD (Y.O., B.A.V., J.A.C.L.). Sorbonne Universités, UPMC University Paris 06, INSERM 1146, CNRS 7371, Laboratoire d'Imagerie Biomédicale, Paris, France (A.R., N.K.). Department of Cardiovascular Imaging and Interventional Radiology, Institute of Cardiology, Hôpital Pitié-Salpêtrière (AP-HP), Paris, France (A.R.). Clinical Investigation and Research Unit, Gunma University Hospital, Maebashi, Japan (Y.O.)
| | - Nadjia Kachenoura
- Departments of Cardiology/Medicine and Radiology, Johns Hopkins University, Baltimore, MD (Y.O., B.A.V., J.A.C.L.). Sorbonne Universités, UPMC University Paris 06, INSERM 1146, CNRS 7371, Laboratoire d'Imagerie Biomédicale, Paris, France (A.R., N.K.). Department of Cardiovascular Imaging and Interventional Radiology, Institute of Cardiology, Hôpital Pitié-Salpêtrière (AP-HP), Paris, France (A.R.). Clinical Investigation and Research Unit, Gunma University Hospital, Maebashi, Japan (Y.O.)
| | - Bharath Ambale Venkatesh
- Departments of Cardiology/Medicine and Radiology, Johns Hopkins University, Baltimore, MD (Y.O., B.A.V., J.A.C.L.). Sorbonne Universités, UPMC University Paris 06, INSERM 1146, CNRS 7371, Laboratoire d'Imagerie Biomédicale, Paris, France (A.R., N.K.). Department of Cardiovascular Imaging and Interventional Radiology, Institute of Cardiology, Hôpital Pitié-Salpêtrière (AP-HP), Paris, France (A.R.). Clinical Investigation and Research Unit, Gunma University Hospital, Maebashi, Japan (Y.O.)
| | - Joao A C Lima
- Departments of Cardiology/Medicine and Radiology, Johns Hopkins University, Baltimore, MD (Y.O., B.A.V., J.A.C.L.). Sorbonne Universités, UPMC University Paris 06, INSERM 1146, CNRS 7371, Laboratoire d'Imagerie Biomédicale, Paris, France (A.R., N.K.). Department of Cardiovascular Imaging and Interventional Radiology, Institute of Cardiology, Hôpital Pitié-Salpêtrière (AP-HP), Paris, France (A.R.). Clinical Investigation and Research Unit, Gunma University Hospital, Maebashi, Japan (Y.O.).
| |
Collapse
|
18
|
Influence of carotid atherosclerotic plaques on pulse wave assessment with arterial tonometry. J Hypertens 2018; 35:1609-1617. [PMID: 28350575 DOI: 10.1097/hjh.0000000000001366] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Aortic stiffness and central pressure measurements have become increasingly important for the overall estimation of cardiovascular risk. The aim of this study is to verify whether the presence of stenosis in the carotid arteries due to atherosclerotic plaques may induce a bias in the measurement of carotid-femoral pulse wave velocity (PWV) and in the analysis of central pulse waveform variables assessed by carotid tonometry. METHODS Eighty-four patients (age: 67.1 ± 12.4 years) undergoing screening for carotid atherosclerosis were enrolled, divided into three groups according to carotid ultrasound findings (NASCET criteria): 28 patients without significant stenosis, 30 patients with bilateral plaques, and 26 patients with right or left monolateral stenosis. PWV and other variables derived from the central pulse waveform analysis (central blood pressure, augmentation index and forward and backward waves) were measured at both right and left carotid arteries by a validated PulsePen tonometer. A repeatability study was performed in 28 young healthy patients (age: 25.4 ± 2.9 years). RESULTS A high degree of correlation was found between bilateral measurements in all groups, and particularly in groups with monolateral carotid stenosis, with no significant difference attributable to lateralized stenosis. Right-left differences in asymmetric groups were 0.35 ± 5.12 mmHg (R = 0.960) for central blood pressure, -2.12 ± 7.39% (R = 0.743) for augmentation index, 0.64 ± 1.56 m/s (R = 0.947) for PWV, 0.08 ± 8.48 mmHg for forward wave (R = 0.742) and 0.35 ± 2.35 mmHg for backward wave (R = 0.907). CONCLUSION Measurement of PWV and of variables derived from the central pulse waveform analysis by carotid tonometry is not biased by the presence of local atherosclerotic plaques.
Collapse
|
19
|
Acute effects of sauna bathing on cardiovascular function. J Hum Hypertens 2017; 32:129-138. [DOI: 10.1038/s41371-017-0008-z] [Citation(s) in RCA: 47] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2017] [Revised: 09/03/2017] [Accepted: 09/19/2017] [Indexed: 01/23/2023]
|
20
|
Grillo A, Parati G, Rovina M, Moretti F, Salvi L, Gao L, Baldi C, Sorropago G, Faini A, Millasseau SC, Scalise F, Carretta R, Salvi P. Short-Term Repeatability of Noninvasive Aortic Pulse Wave Velocity Assessment: Comparison Between Methods and Devices. Am J Hypertens 2017; 31:80-88. [PMID: 29059329 DOI: 10.1093/ajh/hpx140] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2017] [Accepted: 07/24/2017] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Aortic pulse wave velocity (PWV) is an indirect index of arterial stiffness and an independent cardiovascular risk factor. Consistency of PWV assessment over time is thus an essential feature for its clinical application. However, studies providing a comparative estimate of the reproducibility of PWV across different noninvasive devices are lacking, especially in the elderly and in individuals at high cardiovascular risk. METHODS Aimed at filling this gap, short-term repeatability of PWV, estimated with 6 different devices (Complior Analyse, PulsePen-ETT, PulsePen-ET, SphygmoCor Px/Vx, BPLab, and Mobil-O-Graph), was evaluated in 102 high cardiovascular risk patients hospitalized for suspected coronary artery disease (72 males, 65 ± 13 years). PWV was measured in a single session twice, at 15-minute interval, and its reproducibility was assessed though coefficient of variation (CV), coefficient of repeatability, and intraclass correlation coefficient. RESULTS The CV of PWV, measured with any of these devices, was <10%. Repeatability was higher with cuff-based methods (BPLab: CV = 5.5% and Mobil-O-Graph: CV = 3.4%) than with devices measuring carotid-femoral PWV (Complior: CV = 8.2%; PulsePen-TT: CV = 8.0%; PulsePen-ETT: CV = 5.8%; and SphygmoCor: CV = 9.5%). In the latter group, PWV repeatability was lower in subjects with higher carotid-femoral PWV. The differences in PWV between repeated measurements, except for the Mobil-O-Graph, did not depend on short-term variations of mean blood pressure or heart rate. CONCLUSIONS Our study shows that the short-term repeatability of PWV measures is good but not homogenous across different devices and at different PWV values. These findings, obtained in patients at high cardiovascular risk, may be relevant when evaluating the prognostic importance of PWV.
Collapse
Affiliation(s)
- Andrea Grillo
- Department of Cardiovascular Neural and Metabolic Sciences, Istituto Auxologico Italiano, Italy
- Department of Medicine and Surgery, University of Milano-Bicocca, Italy
| | - Gianfranco Parati
- Department of Cardiovascular Neural and Metabolic Sciences, Istituto Auxologico Italiano, Italy
- Department of Medicine and Surgery, University of Milano-Bicocca, Italy
| | - Matteo Rovina
- Department of Medical, Surgical and Health Sciences, University of Trieste, Italy
| | - Francesco Moretti
- Department of Cardiovascular Neural and Metabolic Sciences, Istituto Auxologico Italiano, Italy
| | - Lucia Salvi
- Department of Internal Medicine, IRCCS Policlinico San Matteo Foundation, University of Pavia, Italy
| | - Lan Gao
- Department of Cardiology, Peking University First Hospital, China
| | - Corrado Baldi
- Department of Medical, Surgical and Health Sciences, University of Trieste, Italy
| | | | - Andrea Faini
- Department of Cardiovascular Neural and Metabolic Sciences, Istituto Auxologico Italiano, Italy
| | | | - Filippo Scalise
- Department of Interventional Cardiology, Policlinico di Monza, Italy
| | - Renzo Carretta
- Department of Medical, Surgical and Health Sciences, University of Trieste, Italy
| | - Paolo Salvi
- Department of Cardiovascular Neural and Metabolic Sciences, Istituto Auxologico Italiano, Italy
| |
Collapse
|
21
|
Hwang JW, Kim EK, Jang SY, Chung TY, Ki CS, Sung K, Kim SM, Ahn J, Carriere K, Choe YH, Chang SA, Kim DK. Comparison of the Effect of Aliskiren Versus Negative Controls on Aortic Stiffness in Patients With Marfan Syndrome Under Treatment With Atenolol. ACTA ACUST UNITED AC 2017; 71:743-749. [PMID: 29198406 DOI: 10.1016/j.rec.2017.10.028] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2017] [Accepted: 10/11/2017] [Indexed: 12/23/2022]
Abstract
INTRODUCTION AND OBJECTIVES The aim of this study was to evaluate the effect of aliskiren on aortic stiffness in patients with Marfan syndrome (MS). METHODS Twenty-eight MS patients (mean age ± standard deviation: 32.6 ± 10.6 years) were recruited from November 2009 to October 2014. All patients were receiving atenolol as standard beta-blocker therapy. A prospective randomization process was performed to assign participants to either aliskiren treatment (150-300mg orally per day) or no aliskiren treatment (negative control) in an open-label design. Central aortic distensibility and central pulsed wave velocity (PWV) by magnetic resonance imaging (MRI), peripheral PWV, central aortic blood pressure and augmentation index by peripheral tonometry, and aortic dilatation by echocardiography were examined initially and after 24 weeks. The primary endpoint was central aortic distensibility by MRI. RESULTS In analyses of differences between baseline and 24 weeks for the aliskiren treatment group vs the negative control group, central distensibility (overall; P = .26) and central PWV (0.2 ± 0.9 vs 0.03 ± 0.7 [m/s]; P = .79) by MRI were not significantly different. Central systolic aortic blood pressure tended to be lower by 14mmHg in patients in the aliskiren treatment group than in the control group (P = .09). A significant decrease in peripheral PWV (brachial-ankle PWV) in the aliskiren treatment group (-1.6 m/s) compared with the control group (+0.28 m/s) was noted (P = .005). CONCLUSIONS Among patients with MS, the addition of aliskiren to beta-blocker treatment did not significantly improve central aortic stiffness during a 24-week period.
Collapse
Affiliation(s)
- Ji-Won Hwang
- Division of Cardiology, Department of Medicine, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Eun Kyoung Kim
- Division of Cardiology, Department of Medicine, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Shin Yi Jang
- Division of Cardiology, Department of Medicine, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Tae-Young Chung
- Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Chang-Seok Ki
- Department of Laboratory Medicine and Genetics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Kiick Sung
- Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Sung Mok Kim
- Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Joonghyun Ahn
- Statistics and Data Center, Samsung Medical Center, Seoul, Korea
| | - Keumhee Carriere
- Department of Mathematical and Statistical Sciences, University of Alberta, Edmonton, Alberta, Canada
| | - Yeon Hyeon Choe
- Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Sung-A Chang
- Division of Cardiology, Department of Medicine, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Duk-Kyung Kim
- Division of Cardiology, Department of Medicine, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
| |
Collapse
|
22
|
Caterini JE, Banks L, Wells GD, Cifra B, Slorach C, McCrindle BW, Seed M. Magnetic resonance imaging reveals elevated aortic pulse wave velocity in obese and overweight adolescents. Clin Obes 2017; 7:360-367. [PMID: 28834246 DOI: 10.1111/cob.12206] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2017] [Revised: 06/07/2017] [Accepted: 07/07/2017] [Indexed: 12/01/2022]
Abstract
The aortic pulse wave velocity (PWV) measured via cardiac magnetic resonance (CMR) can be used to non-invasively assess changes in arterial stiffness and potential underlying vascular dysfunction. This technique could unmask early arterial dysfunction in overweight and obese youth at risk for cardiovascular disease. We sought to determine the association between vascular stiffness, percentage body fat, body mass index (BMI), and cardiac function in adolescents across the weight spectrum through both CMR and standard applanation tonometry (AT)-based PWV measurements. PWV and left-ventricular cardiac function were assessed using 3.0 T CMR in obese and overweight (OB/OW) participants (n = 12) and controls (n = 7). PWV was also estimated via carotid-femoral AT. OB/OW participants did not differ from healthy-weight controls regarding cardiometabolic risk factors or physical activity levels, but there was a trend towards higher levels of triglycerides in obese/overweight participants (P = 0.07). Mean PWV was higher in obese participants when corrected for age and sex (P = 0.01), and was positively associated with BMI (β = 0.51, P = 0.02). PWV estimated through AT was not significantly different between groups. Cardiac function measured by left-ventricular ejection fraction z-score was inversely associated with mean PWV (β = -0.57, P = 0.026). Increasing arterial stiffness and decreasing cardiac function were evident among our overweight and obese cohort. PWV estimated by CMR could detect early increases in arterial stiffness vs. traditional AT measurements of PWV.
Collapse
Affiliation(s)
- J E Caterini
- Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, Canada
| | - L Banks
- Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, Canada
- Labatt Family Heart Centre, Hospital for Sick Children, Toronto, Canada
| | - G D Wells
- Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, Canada
- Translational Medicine, Hospital for Sick Children, Toronto, Canada
| | - B Cifra
- Labatt Family Heart Centre, Hospital for Sick Children, Toronto, Canada
| | - C Slorach
- Labatt Family Heart Centre, Hospital for Sick Children, Toronto, Canada
| | - B W McCrindle
- Labatt Family Heart Centre, Hospital for Sick Children, Toronto, Canada
- Department of Pediatrics, Faculty of Medicine, University of Toronto, Toronto, Canada
| | - M Seed
- Labatt Family Heart Centre, Hospital for Sick Children, Toronto, Canada
- Department of Pediatrics, Faculty of Medicine, University of Toronto, Toronto, Canada
| |
Collapse
|
23
|
Grillo A, Salvi P, Marelli S, Gao L, Salvi L, Faini A, Trifirò G, Carretta R, Pini A, Parati G. Impaired Central Pulsatile Hemodynamics in Children and Adolescents With Marfan Syndrome. J Am Heart Assoc 2017; 6:JAHA.117.006815. [PMID: 29114001 PMCID: PMC5721771 DOI: 10.1161/jaha.117.006815] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Background Marfan syndrome is characterized by aortic root dilation, beginning in childhood. Data about aortic pulsatile hemodynamics and stiffness in pediatric age are currently lacking. Methods and Results In 51 young patients with Marfan syndrome (12.0±3.3 years), carotid tonometry was performed for the measurement of central pulse pressure, pulse pressure amplification, and aortic stiffness (carotid‐femoral pulse wave velocity). Patients underwent an echocardiogram at baseline and at 1 year follow‐up and a genetic evaluation. Pathogenetic fibrillin‐1 mutations were classified between “dominant negative” and “haploinsufficient.” The hemodynamic parameters of patients were compared with those of 80 sex, age, blood pressure, and heart‐rate matched controls. Central pulse pressure was significantly higher (38.3±12.3 versus 33.6±7.8 mm Hg; P=0.009), and pulse pressure amplification was significantly reduced in Marfan than controls (17.9±15.3% versus 32.3±17.4%; P<0.0001). Pulse wave velocity was not significantly different between Marfan and controls (4.98±1.00 versus 4.75±0.67 m/s). In the Marfan group, central pulse pressure and pulse pressure amplification were independently associated with aortic diameter at the sinuses of Valsalva (respectively, β=0.371, P=0.010; β=−0.271, P=0.026). No significant difference in hemodynamic parameters was found according to fibrillin‐1 genotype. Patients who increased aortic Z‐scores at 1‐year follow‐up presented a higher central pulse pressure than the remaining (42.7±14.2 versus 32.3±5.9 mm Hg; P=0.004). Conclusions Central pulse pressure and pulse pressure amplification were impaired in pediatric Marfan syndrome, and associated with aortic root diameters, whereas aortic pulse wave velocity was similar to that of a general pediatric population. An increased central pulse pressure was present among patients whose aortic dilatation worsened at 1‐year follow‐up.
Collapse
Affiliation(s)
- Andrea Grillo
- Department of Cardiovascular Neural and Metabolic Sciences, Istituto Auxologico Italiano, Milan, Italy.,Department of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
| | - Paolo Salvi
- Department of Cardiovascular Neural and Metabolic Sciences, Istituto Auxologico Italiano, Milan, Italy
| | - Susan Marelli
- Department of Cardiology, Rare Disease Center 'Marfan Clinic,' ASST Fatebenefratelli Sacco, Milan, Italy
| | - Lan Gao
- Department of Cardiology, Peking University First Hospital, Beijing, China
| | - Lucia Salvi
- Department of Internal Medicine, IRCCS Policlinico San Matteo Foundation, University of Pavia, Pavia, Italy
| | - Andrea Faini
- Department of Cardiovascular Neural and Metabolic Sciences, Istituto Auxologico Italiano, Milan, Italy
| | | | - Renzo Carretta
- Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy
| | - Alessandro Pini
- Department of Cardiology, Rare Disease Center 'Marfan Clinic,' ASST Fatebenefratelli Sacco, Milan, Italy
| | - Gianfranco Parati
- Department of Cardiovascular Neural and Metabolic Sciences, Istituto Auxologico Italiano, Milan, Italy.,Department of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
| |
Collapse
|
24
|
Lee E, Laukkanen T, Kunutsor SK, Khan H, Willeit P, Zaccardi F, Laukkanen JA. Sauna exposure leads to improved arterial compliance: Findings from a non-randomised experimental study. Eur J Prev Cardiol 2017; 25:130-138. [PMID: 29048215 DOI: 10.1177/2047487317737629] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Background Heat therapy has been suggested to improve cardiovascular function. However, the effects of hot sauna exposure on arterial compliance and the dynamics of blood flow and pressure have not been well documented. Thus, we investigated the short-term effects of sauna bathing on arterial stiffness and haemodynamics. Design The design was an experimental non-randomised study. Methods There were 102 asymptomatic participants (mean age, 51.9 years) who had at least one cardiovascular risk factor. Participants were exposed to a single sauna session (duration: 30 min; temperature: 73℃; humidity: 10-20%). Pulse wave velocity, augmentation index, heart rate, blood pressure, mean arterial pressure, pulse pressure, augmented pressure and left ventricular ejection time were assessed before, immediately after, and 30 min after a single sauna session. Results Sauna bathing led to reductions in pulse wave velocity, blood pressure, mean arterial pressure and left ventricular ejection time. Mean pulse wave velocity value before sauna was 9.8 m/s and decreased to 8.6 m/s immediately after sauna bathing ( p < 0.001 for difference), and was 9.0 m/s after the 30-minute recovery period ( p < 0.001 for analysis of variance). Systolic blood pressure was 137 mm Hg before sauna bathing, decreasing to 130 mm Hg after sauna ( p < 0.001), which remained sustained during the 30-minute recovery phase ( p < 0.001 for analysis of variance). After a single sauna session, diastolic blood pressure decreased from 82 to 75 mm Hg, mean arterial pressure from 99.4 to 93.6 mm Hg and left ventricular ejection time from 307 to 278 m/s ( p < 0.001 for all differences). Pulse pressure was 42.7 mm Hg before the sauna, 44.9 mm Hg immediately after the sauna, and reduced to 39.3 mm Hg after 30-minutes recovery ( p < 0.001 for analysis of variance). Heart rate increased from 65 to 81 beats/min post-sauna ( p < 0.001); there were no significant changes for augmented pressure and pulse pressure amplification. Conclusion This study shows that pulse wave velocity, systolic blood pressure, diastolic blood pressure, mean arterial pressure, left ventricular ejection time and diastolic time decreased immediately after a 30-minute sauna session. Decreases in systolic blood pressure and left ventricular ejection time were sustained during the 30-minute recovery phase.
Collapse
Affiliation(s)
- Earric Lee
- 1 Department of Biology of Physical Activity, University of Jyväskylä, Finland
| | - Tanjaniina Laukkanen
- 2 Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Finland
| | - Setor K Kunutsor
- 3 Translational Health Sciences, Bristol Medical School, University of Bristol, UK
| | - Hassan Khan
- 4 Division of Cardiology, Department of Medicine, Emory University, USA
| | - Peter Willeit
- 5 Department of Neurology, Medical University Innsbruck, Austria.,6 Department of Public Health and Primary Care, University of Cambridge, UK
| | | | - Jari A Laukkanen
- 2 Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Finland.,8 Department of Internal Medicine, Central Finland Hospital District, Finland
| |
Collapse
|
25
|
P M N, Joseph J, Sivaprakasam M. A Magnetic Plethysmograph Probe for Local Pulse Wave Velocity Measurement. IEEE TRANSACTIONS ON BIOMEDICAL CIRCUITS AND SYSTEMS 2017; 11:1065-1076. [PMID: 28866598 DOI: 10.1109/tbcas.2017.2733622] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
OBJECTIVE We present the design and experimental validation of an arterial compliance probe with dual magnetic plethysmograph (MPG) transducers for local pulse wave velocity (PWV) measurement. The MPG transducers (positioned at 23 mm distance apart) utilizes Hall-effect sensors and permanent magnets for arterial blood pulse detection. METHODS The MPG probe was initially validated on an arterial flow phantom using a reference method. Further, 20 normotensive subjects (14 males, age = 24 ± 3.5 years) were studied under two different physical conditions: 1) Physically relaxed condition, 2) Postexercise condition. Local PWV was measured from the left carotid artery using the MPG probe. Brachial blood pressure (BP) was measured to investigate the correlation of BP with local PWV. RESULTS The proposed MPG arterial compliance probe was capable of detecting high-fidelity blood pulse waveforms. Reliable local pulse transit time estimates were assessed by the developed measurement system. Beat-by-beat local PWV was measured from multiple subjects under different physical conditions. A profound increment was observed in the carotid local PWV for all subjects after exercise (average increment = 0.42 ± 0.22 m/s). Local PWV values and brachial BP parameters were significantly correlated (r ≥ 0.72), except for pulse pressure (r = 0.42). CONCLUSION MPG arterial compliance probe for local PWV measurement was validated. Carotid local PWV measurement, its variations due to physical exercise and correlation with BP levels were examined during the in vivo study. SIGNIFICANCE A novel dual MPG probe for local PWV measurement and potential use in cuffless BP measurement.
Collapse
|
26
|
Okada Y, Shibata S, Fujimoto N, Best SA, Levine BD, Fu Q. Long-term effects of a renin inhibitor versus a thiazide diuretic on arterial stiffness and left ventricular diastolic function in elderly hypertensive patients. Am J Physiol Regul Integr Comp Physiol 2017; 313:R400-R409. [PMID: 28724547 DOI: 10.1152/ajpregu.00125.2017] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2017] [Revised: 07/12/2017] [Accepted: 07/13/2017] [Indexed: 01/15/2023]
Abstract
Arterial stiffness and cardiac function are important predictors of cardiovascular events in patients with hypertension, even with adequate blood pressure (BP) control. We evaluated whether a direct renin inhibitor, aliskiren, reduces arterial stiffness and modulates left ventricular function compared with a diuretic, hydrochlorothiazide, in elderly hypertensive patients. Twenty-one hypertensive patients [67 ± 14 (SD) yr] were randomly assigned to receive 6-mo aliskiren (n = 11) or hydrochlorothiazide (n = 10)-based therapy. We assessed β-stiffness of the local arteries, arterial elastance (Ea), and echocardiographic variables, including early (E) and late (A) mitral inflow velocity, deceleration time of E, early (E') and late (A') diastolic mitral annular velocity, and left ventricular end-systolic elastance (Ees) before and after treatment. BP decreased similarly (P < 0.001) after both therapies. β-Stiffness of the carotid artery decreased after aliskiren but increased after hydrochlorothiazide treatment (aliskiren: 6.42 ± 2.34 pre vs. 5.07 ± 1.29 post; hydrochlorothiazide: 5.05 ± 1.78 vs. 7.25 ± 2.68, P = 0.001 for interaction). β-Stiffness of the femoral and radial arteries were not different after either treatment. Different from aliskiren, E decreased (73 ± 16 vs. 67 ± 14 cm/s, P = 0.026), and the deceleration time was prolonged (218 ± 40 vs. 236 ± 35 ms, P = 0.032) after hydrochlorothiazide therapy, whereas the E/A, and E' remained unchanged after both treatments. Ea and Ees decreased after aliskiren therapy (both P < 0.05), whereas the Ea/Ees (ventricular-arterial coupling) was maintained after both treatments. Thus, aliskiren decreased the stiffness of carotid artery and left ventricular end-systolic elastance with maintenance of ventricular-arterial coupling without any effects on diastolic filling, while hydrochlorothiazide increased carotid arterial stiffness and slowed early diastolic filling in elderly hypertensive patients.
Collapse
Affiliation(s)
- Yoshiyuki Okada
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, Dallas, Texas.,University of Texas Southwestern Medical Center, Dallas, Texas; and.,Department of Special Care Dentistry, Matsumoto Dental University, Nagano, Japan
| | - Shigeki Shibata
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, Dallas, Texas.,University of Texas Southwestern Medical Center, Dallas, Texas; and
| | - Naoki Fujimoto
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, Dallas, Texas.,University of Texas Southwestern Medical Center, Dallas, Texas; and
| | - Stuart A Best
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, Dallas, Texas.,University of Texas Southwestern Medical Center, Dallas, Texas; and
| | - Benjamin D Levine
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, Dallas, Texas.,University of Texas Southwestern Medical Center, Dallas, Texas; and
| | - Qi Fu
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, Dallas, Texas; .,University of Texas Southwestern Medical Center, Dallas, Texas; and
| |
Collapse
|
27
|
Revera M, Salvi P, Faini A, Giuliano A, Gregorini F, Bilo G, Lombardi C, Mancia G, Agostoni P, Parati G. Renin–Angiotensin–Aldosterone System Is Not Involved in the Arterial Stiffening Induced by Acute and Prolonged Exposure to High Altitude. Hypertension 2017; 70:75-84. [DOI: 10.1161/hypertensionaha.117.09197] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2017] [Revised: 02/17/2017] [Accepted: 04/29/2017] [Indexed: 11/16/2022]
Abstract
This randomized, double-blind, placebo-controlled study was designed to explore the effects of exposure to very high altitude hypoxia on vascular wall properties and to clarify the role of renin–angiotensin–aldosterone system inhibition on these vascular changes. Forty-seven healthy subjects were included in this study: 22 randomized to telmisartan (age, 40.3±10.8 years; 7 women) and 25 to placebo (age, 39.3±9.8 years; 7 women). Tests were performed at sea level, pre- and post-treatment, during acute exposure to 3400 and 5400-m altitude (Mt. Everest Base Camp), and after 2 weeks, at 5400 m. The effects of hypobaric hypoxia on mechanical properties of large arteries were assessed by applanation tonometry, measuring carotid–femoral pulse wave velocity, analyzing arterial pulse waveforms, and evaluating subendocardial oxygen supply/demand index. No differences in hemodynamic changes during acute and prolonged exposure to 5400-m altitude were found between telmisartan and placebo groups. Aortic pulse wave velocity significantly increased with altitude (
P
<0.001) from 7.41±1.25 m/s at sea level to 7.70±1.13 m/s at 3400 m and to 8.52±1.59 m/s at arrival at 5400 m (
P
<0.0001), remaining elevated during prolonged exposure to this altitude (8.41±1.12 m/s;
P
<0.0001). Subendocardial oxygen supply/demand index significantly decreased with acute exposure to 3400 m: from 1.72±0.30 m/s at sea level to 1.41±0.27 m/s at 3400 m (
P
<0.001), remaining significantly although slightly less reduced after reaching 5400 m (1.52±0.33) and after prolonged exposure to this altitude (1.53±0.25;
P
<0.001). In conclusion, the acute exposure to hypobaric hypoxia induces aortic stiffening and reduction in subendocardial oxygen supply/demand index. Renin–angiotensin–aldosterone system does not seem to play any significant role in these hemodynamic changes.
Clinical Trial Registration—
URL:
https://www.clinicaltrialsregister.eu/
. Unique identifier: 2008-000540-14.
Collapse
Affiliation(s)
- Miriam Revera
- From the Department of Cardiovascular, Neural, and Metabolic Sciences, Istituto Auxologico Italiano, Milan (M.R., P.S., A.F., A.G., F.G., G.B., C.L., G.M., G.P.); Department of Medicine and Surgery, Università di Milano-Bicocca, Italy (G.B., G.M., G.P.); Centro Cardiologico Monzino, Milan, Italy (P.A.); and Department of Clinical Sciences and Community Health, Cardiovascular Section, Università degli Studi di Milano, Italy (P.A.)
| | - Paolo Salvi
- From the Department of Cardiovascular, Neural, and Metabolic Sciences, Istituto Auxologico Italiano, Milan (M.R., P.S., A.F., A.G., F.G., G.B., C.L., G.M., G.P.); Department of Medicine and Surgery, Università di Milano-Bicocca, Italy (G.B., G.M., G.P.); Centro Cardiologico Monzino, Milan, Italy (P.A.); and Department of Clinical Sciences and Community Health, Cardiovascular Section, Università degli Studi di Milano, Italy (P.A.)
| | - Andrea Faini
- From the Department of Cardiovascular, Neural, and Metabolic Sciences, Istituto Auxologico Italiano, Milan (M.R., P.S., A.F., A.G., F.G., G.B., C.L., G.M., G.P.); Department of Medicine and Surgery, Università di Milano-Bicocca, Italy (G.B., G.M., G.P.); Centro Cardiologico Monzino, Milan, Italy (P.A.); and Department of Clinical Sciences and Community Health, Cardiovascular Section, Università degli Studi di Milano, Italy (P.A.)
| | - Andrea Giuliano
- From the Department of Cardiovascular, Neural, and Metabolic Sciences, Istituto Auxologico Italiano, Milan (M.R., P.S., A.F., A.G., F.G., G.B., C.L., G.M., G.P.); Department of Medicine and Surgery, Università di Milano-Bicocca, Italy (G.B., G.M., G.P.); Centro Cardiologico Monzino, Milan, Italy (P.A.); and Department of Clinical Sciences and Community Health, Cardiovascular Section, Università degli Studi di Milano, Italy (P.A.)
| | - Francesca Gregorini
- From the Department of Cardiovascular, Neural, and Metabolic Sciences, Istituto Auxologico Italiano, Milan (M.R., P.S., A.F., A.G., F.G., G.B., C.L., G.M., G.P.); Department of Medicine and Surgery, Università di Milano-Bicocca, Italy (G.B., G.M., G.P.); Centro Cardiologico Monzino, Milan, Italy (P.A.); and Department of Clinical Sciences and Community Health, Cardiovascular Section, Università degli Studi di Milano, Italy (P.A.)
| | - Grzegorz Bilo
- From the Department of Cardiovascular, Neural, and Metabolic Sciences, Istituto Auxologico Italiano, Milan (M.R., P.S., A.F., A.G., F.G., G.B., C.L., G.M., G.P.); Department of Medicine and Surgery, Università di Milano-Bicocca, Italy (G.B., G.M., G.P.); Centro Cardiologico Monzino, Milan, Italy (P.A.); and Department of Clinical Sciences and Community Health, Cardiovascular Section, Università degli Studi di Milano, Italy (P.A.)
| | - Carolina Lombardi
- From the Department of Cardiovascular, Neural, and Metabolic Sciences, Istituto Auxologico Italiano, Milan (M.R., P.S., A.F., A.G., F.G., G.B., C.L., G.M., G.P.); Department of Medicine and Surgery, Università di Milano-Bicocca, Italy (G.B., G.M., G.P.); Centro Cardiologico Monzino, Milan, Italy (P.A.); and Department of Clinical Sciences and Community Health, Cardiovascular Section, Università degli Studi di Milano, Italy (P.A.)
| | - Giuseppe Mancia
- From the Department of Cardiovascular, Neural, and Metabolic Sciences, Istituto Auxologico Italiano, Milan (M.R., P.S., A.F., A.G., F.G., G.B., C.L., G.M., G.P.); Department of Medicine and Surgery, Università di Milano-Bicocca, Italy (G.B., G.M., G.P.); Centro Cardiologico Monzino, Milan, Italy (P.A.); and Department of Clinical Sciences and Community Health, Cardiovascular Section, Università degli Studi di Milano, Italy (P.A.)
| | - Piergiuseppe Agostoni
- From the Department of Cardiovascular, Neural, and Metabolic Sciences, Istituto Auxologico Italiano, Milan (M.R., P.S., A.F., A.G., F.G., G.B., C.L., G.M., G.P.); Department of Medicine and Surgery, Università di Milano-Bicocca, Italy (G.B., G.M., G.P.); Centro Cardiologico Monzino, Milan, Italy (P.A.); and Department of Clinical Sciences and Community Health, Cardiovascular Section, Università degli Studi di Milano, Italy (P.A.)
| | - Gianfranco Parati
- From the Department of Cardiovascular, Neural, and Metabolic Sciences, Istituto Auxologico Italiano, Milan (M.R., P.S., A.F., A.G., F.G., G.B., C.L., G.M., G.P.); Department of Medicine and Surgery, Università di Milano-Bicocca, Italy (G.B., G.M., G.P.); Centro Cardiologico Monzino, Milan, Italy (P.A.); and Department of Clinical Sciences and Community Health, Cardiovascular Section, Università degli Studi di Milano, Italy (P.A.)
| |
Collapse
|
28
|
Dupont AC, Poussel M, Hossu G, Marie PY, Chenuel B, Felblinger J, Mandry D. Aortic compliance variation in long male distance triathletes: A new insight into the athlete's artery? J Sci Med Sport 2016; 20:539-542. [PMID: 27838232 DOI: 10.1016/j.jsams.2016.10.009] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2016] [Revised: 09/21/2016] [Accepted: 10/21/2016] [Indexed: 01/03/2023]
Abstract
OBJECTIVES To assess cardiac and vascular adaptations in long-distance male triathletes and the influence of an increased training volume on these parameters. DESIGN Case-control study using long-distance male triathletes (Tri) (n=12) and an age-matched cohort of sedentary volunteers (Ctrl). METHODS All participants gave an informed consent and underwent a Cardiovascular Magnetic Resonance imaging (CMR) exam to measure left and right ventricle functional parameters, and aortic parameters (surface, strain, compliance, pulse wave velocity). This exam was repeated in the triathletes' group after an increased training volume of at least 2h/week for six weeks. RESULTS Compared to control volunteers, triathletes presented at baseline a typical pattern of athlete's heart (higher end-diastolic, end-systolic and stroke volumes index, p≤0.009, and lower cardiac rate, p=0.015) but similar vascular characteristics except a trend towards an enlarged ascending aorta (surface 942±106 vs 812±127mm2, p=0.058). Between the two visits, the triathletes increased their weekly training time from 9.67±2.43 (Tri1) to 12.15±3.01h (Tri2): no modifications were found regarding cardiac parameters, but compliance and distensibility of the ascending aorta increased, from 2.60 to 3.34mm2/mmHg (p=0.028) and from 3.36 to 4.40×10-3mmHg-1 (p=0.048) respectively. CONCLUSIONS Using CMR, we showed that vascular characteristics of the ascending aorta may vary along the sport season in endurance athletes. This remodelling could be considered as a physiological adaptation, but could eventually lead to an adverse vascular remodelling.
Collapse
Affiliation(s)
| | - Mathias Poussel
- CHRU Nancy, Department of Pulmonary Function Testing and Exercise Physiology, France; Universite de Lorraine, EA 3450 DevAH-Development, Adaptation and Disadvantage, Cardiorespiratory Regulations and Motor Control, France
| | | | - Pierre-Yves Marie
- CHRU Nancy, Department of Medical Imaging, France; INSERM UMR-1116, France; Universite de Lorraine, France
| | - Bruno Chenuel
- CHRU Nancy, Department of Pulmonary Function Testing and Exercise Physiology, France; Universite de Lorraine, EA 3450 DevAH-Development, Adaptation and Disadvantage, Cardiorespiratory Regulations and Motor Control, France
| | - Jacques Felblinger
- INSERM, IADI U 947, France; INSERM, CIC-IT 1433, France; CHRU Nancy, Department of Medical Imaging, France
| | - Damien Mandry
- INSERM, IADI U 947, France; CHRU Nancy, Department of Medical Imaging, France; Universite de Lorraine, France.
| |
Collapse
|
29
|
Oscillometric assessment of arterial stiffness in everyday clinical practice. Hypertens Res 2016; 40:140-145. [DOI: 10.1038/hr.2016.115] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2016] [Revised: 06/21/2016] [Accepted: 07/16/2016] [Indexed: 12/16/2022]
|
30
|
Affiliation(s)
- Magnus Bäck
- From the Department of Cardiology, Karolinska University Hospital, Stockholm, Sweden (M.B.); INSERM U1116, Université de Lorraine, Nancy, France (M.B., P.-Y.M.); and Pôle Imagerie, Centre Hospitalier Universitaire Nancy, Nancy, France (P.-Y.M.).
| | - Pierre-Yves Marie
- From the Department of Cardiology, Karolinska University Hospital, Stockholm, Sweden (M.B.); INSERM U1116, Université de Lorraine, Nancy, France (M.B., P.-Y.M.); and Pôle Imagerie, Centre Hospitalier Universitaire Nancy, Nancy, France (P.-Y.M.)
| |
Collapse
|
31
|
Joly L, Mandry D, Verger A, Labat C, Watfa G, Roux V, Karcher G, Marie PY, Benetos A. Influence of Thoracic Aortic Inflammation and Calcifications on Arterial Stiffness and Cardiac Function in Older Subjects. J Nutr Health Aging 2016; 20:347-54. [PMID: 26892585 DOI: 10.1007/s12603-015-0574-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
BACKGROUND Vascular aging is accompanied by gradual remodeling affecting both arterial and cardiac structure and mechanical properties. Hypertension is suggested to exert pro-inflammatory actions enhancing arterial stiffness. OBJECTIVE To determine the influence of thoracic aortic inflammation and calcifications on arterial stiffness and cardiac function in hypertensive and normotensive older subjects. DESIGN A prospective study. SETTING An acute geriatrics ward of the University Hospital of Nancy in France. SUBJECTS Thirty individuals ≥ 65 years were examined, including 15 hypertensive subjects and 15 controls well-matched for age and sex. MEASUREMENTS Applanation tonometry was used to measure aortic pulse wave velocity (AoPWV) and carotid/brachial pulse pressure amplification (PPA). Left ventricular parameters were measured with magnetic resonance imaging. Local thoracic aortic inflammation and calcification were measured by 18 F-fluorodeoxyglucose positron emission tomography/computed tomography imaging. Biomarkers of low-grade inflammation were also quantified. RESULTS AoPWV was higher in elderly hypertensive subjects comparatively to normotensive controls (15.5±5.3 vs. 11.9±2.5, p=0.046), and hypertensives had a higher calcification volume. In the overall population, calcifications of the thoracic descending aorta and inflammation of the ascending aorta accounted for respectively 18.1% (p=0.01) and 9.6% (p=0.07) of AoPWV variation. Individuals with high levels of calcifications and/or inflammation had higher AoPWV (p=0.003). Inflammation had a negative effect on PPA explaining 13.8% of its variation (p<0.05). CONCLUSION This study highlights the importance of local ascending aortic inflammation as a potential major actor in the determination of PPA while calcifications and hypertension are more linked to AoPWV. Assessment of PPA in the very elderly could provide complementary information to improve diagnostic and therapeutic strategies targeting ascending aortic inflammation.
Collapse
Affiliation(s)
- L Joly
- Laure Joly, MD, PhD; Department of Geriatrics; CHU-Nancy, 54511 Vandoeuvre les Nancy, France, Tel: +(33) 383 15 33 22; fax: +(33) 383 15 76 68; E-mail:
| | | | | | | | | | | | | | | | | |
Collapse
|
32
|
Pereira T, Correia C, Cardoso J. Novel Methods for Pulse Wave Velocity Measurement. J Med Biol Eng 2015; 35:555-565. [PMID: 26500469 PMCID: PMC4609308 DOI: 10.1007/s40846-015-0086-8] [Citation(s) in RCA: 149] [Impact Index Per Article: 16.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2015] [Accepted: 09/14/2015] [Indexed: 12/22/2022]
Abstract
The great incidence of cardiovascular (CV) diseases in the world spurs the search for new solutions to enable an early detection of pathological processes and provides more precise diagnosis based in multi-parameters assessment. The pulse wave velocity (PWV) is considered one of the most important clinical parameters for evaluate the CV risk, vascular adaptation, and therapeutic efficacy. Several studies were dedicated to find the relationship between PWV measurement and pathological status in different diseases, and proved the relevance of this parameter. The commercial devices dedicate to PWV estimation make a regional assessment (measured between two vessels), however a local measurement is more precise evaluation of artery condition, taking into account the differences in the structure of arteries. Moreover, the current devices present some limitations due to the contact nature. Emerging trends in CV monitoring are moving away from more invasive technologies to non-invasive and non-contact solutions. The great challenge is to explore the new instrumental solutions that allow the PWV assessment with fewer approximations for an accurately evaluation and relatively inexpensive techniques in order to be used in the clinical routine.
Collapse
Affiliation(s)
- Tânia Pereira
- Physics Department, Instrumentation Center, University of Coimbra, Rua Larga, 3004-516 Coimbra, Portugal
| | - Carlos Correia
- Physics Department, Instrumentation Center, University of Coimbra, Rua Larga, 3004-516 Coimbra, Portugal
| | - João Cardoso
- Physics Department, Instrumentation Center, University of Coimbra, Rua Larga, 3004-516 Coimbra, Portugal
| |
Collapse
|
33
|
Townsend RR, Wilkinson IB, Schiffrin EL, Avolio AP, Chirinos JA, Cockcroft JR, Heffernan KS, Lakatta EG, McEniery CM, Mitchell GF, Najjar SS, Nichols WW, Urbina EM, Weber T. Recommendations for Improving and Standardizing Vascular Research on Arterial Stiffness: A Scientific Statement From the American Heart Association. Hypertension 2015; 66:698-722. [PMID: 26160955 DOI: 10.1161/hyp.0000000000000033] [Citation(s) in RCA: 972] [Impact Index Per Article: 108.0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
|
34
|
Weir-McCall JR, Struthers AD, Lipworth BJ, Houston JG. The role of pulmonary arterial stiffness in COPD. Respir Med 2015; 109:1381-90. [PMID: 26095859 PMCID: PMC4646836 DOI: 10.1016/j.rmed.2015.06.005] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2015] [Revised: 05/10/2015] [Accepted: 06/10/2015] [Indexed: 12/23/2022]
Abstract
COPD is the second most common cause of pulmonary hypertension, and is a common complication of severe COPD with significant implications for both quality of life and mortality. However, the use of a rigid diagnostic threshold of a mean pulmonary arterial pressure (mPAP) of ≥25mHg when considering the impact of the pulmonary vasculature on symptoms and disease is misleading. Even minimal exertion causes oxygen desaturation and elevations in mPAP, with right ventricular hypertrophy and dilatation present in patients with mild to moderate COPD with pressures below the threshold for diagnosis of pulmonary hypertension. This has significant implications, with right ventricular dysfunction associated with poorer exercise capability and increased mortality independent of pulmonary function tests. The compliance of the pulmonary artery (PA) is a key component in decoupling the right ventricle from the pulmonary bed, allowing the right ventricle to work at maximum efficiency and protecting the microcirculation from large pressure gradients. PA stiffness increases with the severity of COPD, and correlates well with the presence of exercise induced pulmonary hypertension. A curvilinear relationship exists between PA distensibility and mPAP and pulmonary vascular resistance (PVR) with marked loss of distensibility before a rapid rise in mPAP and PVR occurs with resultant right ventricular failure. This combination of features suggests PA stiffness as a promising biomarker for early detection of pulmonary vascular disease, and to play a role in right ventricular failure in COPD. Early detection would open this up as a potential therapeutic target before end stage arterial remodelling occurs. Pulmonary hypertension is common in COPD. Right ventricular remodeling occurs at pressures below the diagnostic threshold of PH. Pulmonary arterial stiffening occurs early in the development of PH. Non-invasive measurement of pulmonary stiffness may serve as an early biomarker of PH.
Collapse
Affiliation(s)
- Jonathan R Weir-McCall
- Division of Cardiovascular and Diabetes Medicine, Medical Research Institute, University of Dundee, Dundee, United Kingdom.
| | - Allan D Struthers
- Division of Cardiovascular and Diabetes Medicine, Medical Research Institute, University of Dundee, Dundee, United Kingdom
| | - Brian J Lipworth
- Scottish Centre for Respiratory Research, Medical Research Institute, University of Dundee, Dundee, United Kingdom
| | - J Graeme Houston
- Division of Cardiovascular and Diabetes Medicine, Medical Research Institute, University of Dundee, Dundee, United Kingdom
| |
Collapse
|
35
|
Abbas A, Cecelja M, Hussain T, Greil G, Modarai B, Waltham M, Chowienczyk PJ, Smith A. Thoracic but not abdominal phase contrast magnetic resonance-derived aortic pulse wave velocity is elevated in patients with abdominal aortic aneurysm. J Hypertens 2015; 33:1032-8. [DOI: 10.1097/hjh.0000000000000516] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
|
36
|
|
37
|
Central pulse pressure is a determinant of heart and brain remodeling in the elderly: a quantitative MRI and PET pilot study. J Hypertens 2015; 33:1378-85. [PMID: 25827431 DOI: 10.1097/hjh.0000000000000566] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
OBJECTIVE The sustained elevation of blood pressure (BP) and especially of central pulse pressure (cPP) leads to heart and brain damage. This pilot study was aimed to precise the relationships between peripheral and central BP levels, and the remodeling of heart and brain as objectively quantified by cardiac MRI and brain F-fluorodeoxyglucose (FDG)-PET imaging in the elderly. METHODS Twenty-eight apparently healthy elderly individuals (66-85 years old, 14 women) were prospectively recruited and allocated into two half groups, one with and one without hypertension, and all were referred for the quantitative determinations of peripheral and central BP using applanation tonometry, indexed left ventricular mass (per m of body surface area) using cardiac MRI, and brain metabolism with a voxel-based analysis of FDG-PET images adjusted for age and sex. RESULTS Indexed left ventricular mass, reflecting cardiac remodeling, was correlated with the overall pressure variables involving both peripheral and central levels of systolic and pulse pressure (all P ≤ 0.001). By contrast, brain metabolism was significantly correlated with only cPP (P < 0.02). A cPP of at least 50 mmHg was associated with both a lower metabolism in frontal areas (P = 0.005) and a higher indexed left ventricular mass (P = 0.03). CONCLUSION This pilot study suggests that, when quantified by MRI and PET imaging, left ventricular mass and brain metabolism of elderly individuals are related to the cPP and to the 50 mmHg threshold, corresponding to what has previously been documented for the risk of cardiovascular event.
Collapse
|
38
|
Joint scientific statement of the European Association for the Study of Obesity and the European Society of Hypertension. J Hypertens 2015; 33:425-34. [DOI: 10.1097/hjh.0000000000000473] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
|
39
|
Association between serum uric acid, hypertension, vascular stiffness and subclinical atherosclerosis: data from the Brisighella Heart Study. J Hypertens 2014; 32:57-64. [PMID: 24309486 DOI: 10.1097/hjh.0b013e328365b916] [Citation(s) in RCA: 126] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE Serum uric acid (SUA) levels correlate with many recognized cardiovascular risk factors, including age, male sex, hypertension, diabetes mellitus, hypertriglyceridemia, obesity, and insulin resistance. The aim of our study was to verify in a large well characterized population sample the relationship between SUA values, hypertension, arterial stiffness and subclinical atherosclerosis. METHODS For this study, we selected 248 men and 371 women adult patients enrolled in the last Brisighella Heart Study population survey for which a full set of data were available and not consuming antihypertensive, antidiabetic, lipid-lowering and uric acid-lowering drugs. SUA and other available variables were related to blood pressure level, carotid-femoral pulse wave velocity (cfPWV) and carotid intima-media thickness (cIMT). RESULTS Hypertension prevalence was strongly related to SUA quartiles: we found significant differences between the 2nd (23.0%) and the 3rd quartiles (36.4%; P vs. 2nd < 0.05), and between the 3rd and the 4th quartile (56.3%; P vs. 3rd < 0.05). Similarly, the metabolic syndrome prevalence increased significantly at 39.5% in the 3rd SUA quartile (P < 0.05 vs. 2nd) and at 58.9% in the 4th quartile (P < 0.05 vs. 3rd). Intima-media thickness gradually and significantly rose along quartiles of SUA (P for trend < 0.0001), in particular, it was 0.86 mm in the 1st quartile, 0.90 in the 2nd, 0.94 in the 3rd, and 0.97 in the last quartile, with significant differences between each quartiles (all P < 0.05). In multivariate regression analyses, SUA resulted to be significantly associated to hypertension and metabolic syndrome prevalence, and IMT. Even if a significant association between SUA and cfPWV was found in univariate analysis (P = 0.002), when adjusting for age, the trend became nonsignificant (0.20). CONCLUSION In the studied population sample, after adjustment for a large number of parameters, SUA appears to be significantly correlated to hypertension and IMT, but not to aortic stiffness.
Collapse
|
40
|
Jacobs L, Thijs L, Jin Y, Zannad F, Mebazaa A, Rouet P, Pinet F, Bauters C, Pieske B, Tomaschitz A, Mamas M, Diez J, McDonald K, Cleland JGF, Brunner-La Rocca HP, Heymans S, Latini R, Masson S, Sever P, Delles C, Pocock S, Collier T, Kuznetsova T, Staessen JA. Heart 'omics' in AGEing (HOMAGE): design, research objectives and characteristics of the common database. J Biomed Res 2014; 28:349-59. [PMID: 25332706 PMCID: PMC4197385 DOI: 10.7555/jbr.28.20140045] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2014] [Revised: 03/31/2014] [Accepted: 06/24/2014] [Indexed: 01/06/2023] Open
Abstract
Heart failure is common in older people and its prevalence is increasing. The Heart ‘omics’ in AGEing (HOMAGE) project aims to provide a biomarker approach that will improve the early diagnosis of heart failure. A large clinical database, based on (1) prospective population studies or (2) cross-sectional, prospective studies or randomized controlled trials (RCTs) of patients at risk for or with overt cardiovascular disease will be constructed to determine most promising ‘omics’-based biomarkers to identify the risk of developing heart failure and/or comorbidities. Population studies, patient cohorts and RCTs are eligible for inclusion in the common database, if they received ethical approval to obtain and share data and have baseline information on cardiovascular risk factors. Currently, the HOMAGE database includes 43,065 subjects, from 20 studies in eight European countries, including healthy subjects from three population studies in France, Belgium and Italy (n = 7,124), patients with heart failure (n = 4,312) from four cohorts in the UK, Spain and Switzerland and patients at high risk for cardiovascular disease (n = 31,629) in 13 cohorts. It is anticipated that more partners will join the consortium and enlarge the pooled data. This large merged database will be a useful resource with which to identify candidate biomarkers that play a role in the mechanism underlying the onset and progression of heart failure.
Collapse
Affiliation(s)
- Lotte Jacobs
- Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium
| | - Lutgarde Thijs
- Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium
| | - Yu Jin
- Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium
| | - Faiez Zannad
- Centre d'Investigation Clinique Pierre Drouin and U 961, Hypertension and Heart Failure Unit, Institut Lourrain du Coeur et des Vaisseaux, Inserm, Nancy, France
| | - Alexandre Mebazaa
- Department of Anesthesiology and Critical Care Medicine, InsermUMR-S942, Hôpital Lariboisière, Université Paris Diderot, Paris, France
| | - Philippe Rouet
- Equipe obésité et insuffisance cardiaque, Université UPS, Inserm I2MC, UMR 1048, Toulouse, France
| | | | | | - Burkert Pieske
- Department of Cardiology, Medical University Graz, Austria
| | | | - Mamas Mamas
- Cardiovascular Institute, University of Manchester, Manchester, UK
| | - Javier Diez
- Division of Cardiovascular Sciences, Foundation for Applied Medical Research, University of Navarra, Pamplona, Spain
| | - Kenneth McDonald
- Heart Failure Unit, St Vincent's University Hospital, University College Dublin, Dublin, Ireland
| | | | | | - Stephane Heymans
- Center for Heart Failure Research, Department of Cardiology, Maastricht University, Netherlands
| | - Roberto Latini
- Department of Cardiovascular Research, IRCCS - Istituto di Ricerche Farmacologiche "Mario Negri", Milan, Italy
| | - Serge Masson
- Department of Cardiovascular Research, IRCCS - Istituto di Ricerche Farmacologiche "Mario Negri", Milan, Italy
| | - Peter Sever
- International Center for Circulatory Health, Imperial College London, UK
| | - Christian Delles
- Institute of Cardiovascular and Medical Sciences, BHF Glasgow Cardiovascular Research Center, University of Glasgow, Glasgow, UK
| | - Stuart Pocock
- London School of Hygiene and Tropical Medicine, London, UK
| | | | - Tatiana Kuznetsova
- Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium
| | - Jan A Staessen
- Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium
| |
Collapse
|
41
|
Wentland AL, Grist TM, Wieben O. Review of MRI-based measurements of pulse wave velocity: a biomarker of arterial stiffness. Cardiovasc Diagn Ther 2014; 4:193-206. [PMID: 24834415 DOI: 10.3978/j.issn.2223-3652.2014.03.04] [Citation(s) in RCA: 62] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2014] [Accepted: 03/11/2014] [Indexed: 11/14/2022]
Abstract
Atherosclerosis is the leading cause of cardiovascular disease (CVD) in the Western world. In the early development of atherosclerosis, vessel walls remodel outwardly such that the vessel luminal diameter is minimally affected by early plaque development. Only in the late stages of the disease does the vessel lumen begin to narrow-leading to stenoses. As a result, angiographic techniques are not useful for diagnosing early atherosclerosis. Given the absence of stenoses in the early stages of atherosclerosis, CVD remains subclinical for decades. Thus, methods of diagnosing atherosclerosis early in the disease process are needed so that affected patients can receive the necessary interventions to prevent further disease progression. Pulse wave velocity (PWV) is a biomarker directly related to vessel stiffness that has the potential to provide information on early atherosclerotic disease burden. A number of clinical methods are available for evaluating global PWV, including applanation tonometry and ultrasound. However, these methods only provide a gross global measurement of PWV-from the carotid to femoral arteries-and may mitigate regional stiffness within the vasculature. Additionally, the distance measurements used in the PWV calculation with these methods can be highly inaccurate. Faster and more robust magnetic resonance imaging (MRI) sequences have facilitated increased interest in MRI-based PWV measurements. This review provides an overview of the state-of-the-art in MRI-based PWV measurements. In addition, both gold standard and clinical standard methods of computing PWV are discussed.
Collapse
Affiliation(s)
- Andrew L Wentland
- 1 Department of Medical Physics, 2 Department of Radiology, University of Wisconsin School of Medicine and Public Health,1111 Highland Avenue, Madison, WI 53705-2275, USA
| | - Thomas M Grist
- 1 Department of Medical Physics, 2 Department of Radiology, University of Wisconsin School of Medicine and Public Health,1111 Highland Avenue, Madison, WI 53705-2275, USA
| | - Oliver Wieben
- 1 Department of Medical Physics, 2 Department of Radiology, University of Wisconsin School of Medicine and Public Health,1111 Highland Avenue, Madison, WI 53705-2275, USA
| |
Collapse
|
42
|
Kozor R, Grieve SM, Buchholz S, Kaye S, Darke S, Bhindi R, Figtree GA. Regular cocaine use is associated with increased systolic blood pressure, aortic stiffness and left ventricular mass in young otherwise healthy individuals. PLoS One 2014; 9:e89710. [PMID: 24717541 PMCID: PMC3981670 DOI: 10.1371/journal.pone.0089710] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2013] [Accepted: 01/22/2014] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND The cardiovascular impact of cocaine use in otherwise healthy individuals who consider themselves 'social' users is not well established. METHODS/RESULTS Twenty regular cocaine users and 20 control subjects were recruited by word-of-mouth. Cardiovascular magnetic resonance was performed to assess cardiac and vascular structure and function. Cocaine users had higher systolic blood pressure compared to non-users (134±11 vs 126±11 mmHg, p = 0.036), a finding independent of age, body surface area, smoking and alcohol consumption. Cocaine use was associated with increased arterial stiffness - reflected by reduced aortic compliance (1.3±0.2 vs 1.7±0.5 cm2×10-2.mmHg-1, p = 0.004), decreased distensibility (3.8±0.9 vs 5.1±1.4 mmHg-1.10-3, p = 0.001), increased stiffness index (2.6±0.6 vs 2.1±0.6, p = 0.005), and higher pulse wave velocity (5.1±0.6 vs 4.4±0.6 m.s-1, p = 0.001). This change in aortic stiffness was independent of vessel wall thickness. Left ventricular mass was 18% higher in cocaine users (124±25 vs 105±16 g, p = 0.01), a finding that was independent of body surface area, and left atrial diameter was larger in the user group than controls (3.8±0.6 vs 3.5±0.3 cm, p = 0.04). The increased left ventricular mass, systolic blood pressure and vascular stiffness measures were all associated with duration and/or frequency of cocaine use. No late gadolinium enhancement or segmental wall motion abnormalities were seen in any of the subjects. CONCLUSIONS Compared with the non-user control cohort, cocaine users had increased aortic stiffness and systolic blood pressure, associated with greater left ventricular mass. These measures are all well known risk factors for premature cardiovascular events, highlighting the dangers of cocaine use, even in a 'social' setting, and have important public health implications.
Collapse
Affiliation(s)
- Rebecca Kozor
- North Shore Heart Research Group, Kolling Institute of Medical Research, University of Sydney, Sydney, Australia
- Department of Cardiology, Royal North Shore Hospital, Sydney, Australia
| | - Stuart M. Grieve
- North Shore Heart Research Group, Kolling Institute of Medical Research, University of Sydney, Sydney, Australia
- Sydney Translational Imaging Laboratory, Sydney Medical School, University of Sydney, Sydney, Australia
| | - Stefan Buchholz
- Department of Cardiology, Royal North Shore Hospital, Sydney, Australia
| | - Sharlene Kaye
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia
| | - Shane Darke
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia
| | - Ravinay Bhindi
- North Shore Heart Research Group, Kolling Institute of Medical Research, University of Sydney, Sydney, Australia
- Department of Cardiology, Royal North Shore Hospital, Sydney, Australia
| | - Gemma A. Figtree
- North Shore Heart Research Group, Kolling Institute of Medical Research, University of Sydney, Sydney, Australia
- Department of Cardiology, Royal North Shore Hospital, Sydney, Australia
| |
Collapse
|
43
|
Salvi P, Palombo C, Salvi GM, Labat C, Parati G, Benetos A. Left ventricular ejection time, not heart rate, is an independent correlate of aortic pulse wave velocity. J Appl Physiol (1985) 2013; 115:1610-7. [PMID: 24052034 DOI: 10.1152/japplphysiol.00475.2013] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Several studies showed a positive association between heart rate and pulse wave velocity, a sensitive marker of arterial stiffness. However, no study involving a large population has specifically addressed the dependence of pulse wave velocity on different components of the cardiac cycle. The aim of this study was to explore in subjects of different age the link between pulse wave velocity with heart period (the reciprocal of heart rate) and the temporal components of the cardiac cycle such as left ventricular ejection time and diastolic time. Carotid-femoral pulse wave velocity was assessed in 3,020 untreated subjects (1,107 men). Heart period, left ventricular ejection time, diastolic time, and early-systolic dP/dt were determined by carotid pulse wave analysis with high-fidelity applanation tonometry. An inverse association was found between pulse wave velocity and left ventricular ejection time at all ages (<25 years, r(2) = 0.043; 25-44 years, r(2) = 0.103; 45-64 years, r(2) = 0.079; 65-84 years, r(2) = 0.044; ≥ 85 years, r(2) = 0.022; P < 0.0001 for all). A significant (P < 0.0001) negative but always weaker correlation between pulse wave velocity and heart period was also found, with the exception of the youngest subjects (P = 0.20). A significant positive correlation was also found between pulse wave velocity and dP/dt (P < 0.0001). With multiple stepwise regression analysis, left ventricular ejection time and dP/dt remained the only determinant of pulse wave velocity at all ages, whereas the contribution of heart period no longer became significant. Our data demonstrate that pulse wave velocity is more closely related to left ventricular systolic function than to heart period. This may have methodological and pathophysiological implications.
Collapse
Affiliation(s)
- Paolo Salvi
- Department of Cardiology, San Luca Hospital, IRCCS Istituto Auxologico Italiano, Milan, Italy
| | | | | | | | | | | |
Collapse
|
44
|
Crucial importance of using a sliding calliper to measure distance for carotid-femoral pulse wave velocity assessment. J Hypertens 2013; 31:940-5. [DOI: 10.1097/hjh.0b013e32835e2a2f] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
|
45
|
Kim EK, Chang SA, Jang SY, Kim Y, Kim SM, Oh JK, Choe YH, Kim DK. Assessment of regional aortic stiffness with cardiac magnetic resonance imaging in a healthy Asian population. Int J Cardiovasc Imaging 2013; 29 Suppl 1:57-64. [PMID: 23504214 DOI: 10.1007/s10554-013-0206-x] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2013] [Accepted: 03/10/2013] [Indexed: 01/21/2023]
Abstract
The aim of this study was to determine the normal values for aortic pulse wave velocity (PWV) and distensibility using cine and phase contrast cardiac magnetic resonance imaging (CMRI) in patients without cardiovascular risk factors. PWV and distensibility are indispensible predictors of global and regional cardiovascular risk. Regional heterogeneity in aortic stiffness plays an important role in the pathogenesis of cardiovascular disease. Contrary to global estimates of aortic PWV that are commonly measured with tonometry, CMRI has emerged as an important method for estimating regional PWV and distensibility. A total of 124 Korean patients, aged 20-79 years and free of cardiovascular risk factors, were categorized by age decade. Using cine and phase contrast sequences, the cross-sectional area for distensibility and average blood flow were measured at four aortic levels: the ascending, upper descending thoracic, lower thoracic and abdominal aorta. Regional PWV was determined in four aortic segments: proximal, descending thoracic, abdominal aorta and across the entire aorta. Distensibility at the four levels of the aorta from the ascending to distal (4.4 ± 2.5, 4.0 ± 1.6, 5.2 ± 1.9, and 3.3 ± 1.7 × 10(-3) mm/Hg, respectively) was higher in women (P < 0.001) and decreased with age. The regional PWV was highest in the descending thoracic aorta and increased with age. The present study is the first to show the heterogeneity in aortic PWV and distensibility, as well to provide normal values for these parameters using CMRI in an Asian sample.
Collapse
Affiliation(s)
- Eun Kyoung Kim
- Division of Cardiology, Department of Medicine, Cardiovascular Imaging Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | | | | | | | | | | | | | | |
Collapse
|
46
|
Salvi P, Revera M, Faini A, Giuliano A, Gregorini F, Agostoni P, Becerra CGR, Bilo G, Lombardi C, O'Rourke MF, Mancia G, Parati G. Changes in subendocardial viability ratio with acute high-altitude exposure and protective role of acetazolamide. Hypertension 2013; 61:793-9. [PMID: 23438935 DOI: 10.1161/hypertensionaha.111.00707] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
High-altitude tourism is increasingly frequent, involving also subjects with manifest or subclinical coronary artery disease. Little is known, however, on the effects of altitude exposure on factors affecting coronary perfusion. The aim of our study was to assess myocardial oxygen supply/demand ratio in healthy subjects during acute exposure at high altitude and to evaluate the effect of acetazolamide on this parameter. Forty-four subjects (21 men, age range: 24-59 years) were randomized to double-blind acetazolamide 250 mg bid or placebo. Subendocardial viability ratio and oxygen supply/demand ratio were estimated on carotid artery by means of a validated PulsePen tonometer, at sea level, before and after treatment, and after acute and more prolonged exposure to high altitude (4559 m). On arrival at high altitude, subendocardial viability ratio was reduced in both placebo (from 1.63±0.15 to 1.18±0.17; P<0.001) and acetazolamide (from 1.68±0.25 to 1.35±0.18; P<0.001) groups. Subendocardial viability ratio returned to sea level values (1.65±0.24) after 3 days at high altitude under acetazolamide but remained lower than at sea level under placebo (1.42±0.22; P<0.005 versus baseline). At high altitude, oxygen supply/demand ratio fell both under placebo (from 29.6±4.0 to 17.3±3.0; P<0.001) and acetazolamide (from 32.1±7.0 to 22.3±4.6; P<0.001), its values remaining always higher (P<0.001) on acetazolamide. Administration of acetazolamide may, thus, antagonize the reduction in subendocardial oxygen supply triggered by exposure to hypobaric hypoxia. Further studies involving also subjects with known or subclinical coronary artery disease are needed to confirm a protective action of acetazolamide on myocardial viability under high-altitude exposure.
Collapse
Affiliation(s)
- Paolo Salvi
- Department of Cardiology, San Luca Hospital, IRCCS Istituto Auxologico Italiano, Milan, Italy
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
47
|
Methodological aspects in the measurement of pulse wave velocity by means of applanation tonometry. J Hypertens 2013; 31:35-8. [DOI: 10.1097/hjh.0b013e32835c0e0f] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
48
|
ZHANG YONGLIANG, MA ZUCHANG, LUNG CHIWEN, SUN YINING, LI XINHUI. A NEW APPROACH FOR ASSESSMENT OF PULSE WAVE VELOCITY AT RADIAL ARTERY IN YOUNG AND MIDDLE-AGED HEALTHY HUMANS. J MECH MED BIOL 2012. [DOI: 10.1142/s0219519412500285] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Pulse wave velocity (PWV), based on two-site measurement, is a well-known predictor of arterial stiffness. Interest focused increasingly on simplifying the PWV measurement results in attempts at determining it at a single site. We aimed to validate a new tonometric method (IIM-2010A) for assessment of PWV at radial artery in healthy subjects <65 years of age. PWV measurements were performed in 46 healthy adults (25 men and 21 women) aged 21–65 years (39.6 ± 15.5 years) using Complior device and IIM-2010A respectively. In a subgroup of 21 humans, the measurements were repeated after 1 week using IIM-2010A with the same protocol. There was a strong correlation between PWV obtained by IIM-2010A and PWV obtained by Complior, as well as between pulse transit time (PTT) measurements (r = 0.79 and r = 0.85, respectively, P < 0.01 for both). Although PTT was significantly lower measured by IIM-2010A, no significant difference was found in PWV. The mean difference of PWV with SD was -0.1 ± 1.2 m/s between two repeated measurements at intervals of 1 week. Bland–Altman's plot indicated no trend for the reproducibility of measurements to vary with their underlying mean value. Intraclass correlation coefficient (= 0.87) confirmed this excellent week-to-week reproducibility of PWV. The method provides a simple, easily-obtainable, and reproducible measurement of PWV in young and middle-aged subjects, and has potential to detect premature arterial aging for the management of primary prevention.
Collapse
Affiliation(s)
- YONG-LIANG ZHANG
- Institute and Intelligent of Machines, Chinese Academy of Sciences, Hefei 230031, Anhui, P. R. China
- Department of Automation, University of Science and Technology of China, Hefei 230027, Anhui, P. R. China
| | - ZU-CHANG MA
- Institute and Intelligent of Machines, Chinese Academy of Sciences, Hefei 230031, Anhui, P. R. China
| | - CHI-WEN LUNG
- Department of Creative Product Design, Asia University, Taichung, Taiwan
| | - YI-NING SUN
- Institute and Intelligent of Machines, Chinese Academy of Sciences, Hefei 230031, Anhui, P. R. China
| | - XIN-HUI LI
- Department of Nursing, Medical College of Shihezi University, Shihezi 832002, Xinjiang Uyghur Autonomous Region, P. R. China
| |
Collapse
|
49
|
|
50
|
Watfa G, Soulis G, Tartagni E, Kearney-Schwartz A, Borghi C, Salvi P, Benetos A. Relationship between tissue glycation measured by autofluorescence and pulse wave velocity in young and elderly non-diabetic populations. DIABETES & METABOLISM 2012; 38:413-9. [DOI: 10.1016/j.diabet.2012.04.004] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/03/2012] [Revised: 04/06/2012] [Accepted: 04/06/2012] [Indexed: 11/30/2022]
|