1
|
Correlation analysis of human upper arm parameters to oscillometric signal in automatic blood pressure measurement. Sci Rep 2022; 12:19763. [PMID: 36396796 PMCID: PMC9672327 DOI: 10.1038/s41598-022-24264-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Accepted: 11/14/2022] [Indexed: 11/18/2022] Open
Abstract
Cardiovascular diseases are the leading cause of global deaths, making cardiovascular health monitoring important. Measuring blood pressure using an automatic sphygmomanometer is the most widely used method to monitor cardiovascular health due to its accessibility, convenience, and strong correlation with cardiovascular diseases. In this work, in order to estimate brachial artery diameter, stiffness, or thickness using an automatic sphygmomanometer, the correlation between upper arm parameters and the oscillometric signal was intensively investigated through analytical, numerical, and experimental approaches. The parametric studies commonly revealed that the inner radius of the brachial artery is the most influential parameter in determining the amplitude of the oscillometric signal. The experimental results of using a cardiovascular simulator (a virtual patient) combined with upper arm phantoms with various inner radii of the brachial artery showed a 6.5% change in the oscillometric signal amplitude with a 10% artery radius variation. It was concluded that the oscillometric signal can be used to evaluate brachial artery diameter. Based on the clinical relationship between brachial artery diameter and cardiovascular risk factors such as hypertension, diabetes, and obesity, this study showed and verified a novel method to monitor brachial artery diameter and hence, cardiovascular risks while measuring blood pressure.
Collapse
|
2
|
Nwabuo CC, Vasan RS. Pathophysiology of Hypertensive Heart Disease: Beyond Left Ventricular Hypertrophy. Curr Hypertens Rep 2020; 22:11. [PMID: 32016791 DOI: 10.1007/s11906-020-1017-9] [Citation(s) in RCA: 74] [Impact Index Per Article: 18.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
PURPOSE OF REVIEW Given that the life expectancy and the burden of hypertension are projected to increase over the next decade, hypertensive heart disease (HHD) may be expected to play an even more central role in the pathophysiology of cardiovascular disease (CVD). A broader understanding of the features and underlying mechanisms that constitute HHD therefore is of paramount importance. RECENT FINDINGS HHD is a condition that arises as a result of elevated blood pressure and constitutes a key underlying mechanism for cardiovascular morbidity and mortality. Historically, studies investigating HHD have primarily focused on left ventricular (LV) hypertrophy (LVH), but it is increasingly apparent that HHD encompasses a range of target-organ damage beyond LVH, including other cardiovascular structural and functional adaptations that may occur separately or concomitantly. HHD is characterized by micro- and macroscopic myocardial alterations, structural phenotypic adaptations, and functional changes that include cardiac fibrosis, and the remodeling of the atria and ventricles and the arterial system. In this review, we summarize the structural and functional alterations in the cardiac and vascular system that constitute HHD and underscore their underlying pathophysiology.
Collapse
Affiliation(s)
| | - Ramachandran S Vasan
- Framingham Heart Study, 73 Mt. Wayte Avenue, Suite 2, Framingham, MA, 01702, USA. .,Departments of Epidemiology and Biostatistics, Boston University School of Public Health, Boston, MA, USA. .,Department of Medicine, Sections of Preventive Medicine and Epidemiology, and Cardiovascular Medicine, Boston University Schools of Medicine, Boston, MA, USA.
| |
Collapse
|
3
|
Mathews L, Subramanya V, Zhao D, Ouyang P, Vaidya D, Guallar E, Yeboah J, Herrington D, Hays AG, Budoff MJ, Michos ED. Endogenous Sex Hormones and Endothelial Function in Postmenopausal Women and Men: The Multi-Ethnic Study of Atherosclerosis. J Womens Health (Larchmt) 2019; 28:900-909. [PMID: 31170017 DOI: 10.1089/jwh.2018.7441] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Background: The relationship of endogenous sex hormones (SH) with vascular endothelial function and with cardiovascular disease (CVD) is incompletely understood. We examined the associations between SH and endothelial function measured by brachial artery flow-mediated dilation (FMD). Materials and Methods: We included 1368 postmenopausal women and 1707 men, free of clinical CVD, participating in MESA Visit 1 (2000-2002). Serum SH [total testosterone, SH binding globulin (SHBG), dehydroepiandrosterone (DHEA), estradiol] were measured; free testosterone was calculated. The percent FMD difference (%FMD) was measured by high-resolution ultrasound. Using multivariable-adjusted linear regression, we tested the cross-sectional associations of SH (log transformed, compared per one SD increment) with %FMD. Results: The mean age of women and men were 64.2 and 61.4 years, respectively. Among women, after adjusting for demographics, CVD risk factors, and hormone therapy, higher SHBG was associated with greater %FMD [β = 0.215% (95% CI 0.026-0.405)], whereas higher free testosterone was associated with a smaller %FMD [-0.209% (-0.402, -0.017)]. Estradiol and DHEA were not associated with %FMD in women after multivariable adjustment. There was an age interaction, with higher free testosterone and lower SHBG associated with worse FMD in women <65 years of age, but not in those ≥65 years (p = 0.04). We did not see similar associations in men. Conclusions: A more androgenic SH profile of higher free testosterone and lower SHBG was associated with worse %FMD in postmenopausal women. Changes in SH with aging and menopause may result in vascular changes in women. Further studies are needed to assess longitudinal changes in SH levels and their association with vascular function.
Collapse
Affiliation(s)
- Lena Mathews
- 1Division of Cardiology, Johns Hopkins School of Medicine, Baltimore, Maryland.,2Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Vinita Subramanya
- 1Division of Cardiology, Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Di Zhao
- 2Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Pamela Ouyang
- 1Division of Cardiology, Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Dhananjay Vaidya
- 2Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.,3Division of General Internal Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Eliseo Guallar
- 2Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Joseph Yeboah
- 4Section on Cardiovascular Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - David Herrington
- 4Section on Cardiovascular Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Allison G Hays
- 1Division of Cardiology, Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Matthew J Budoff
- 5David Geffen School of Medicine at University of California Los Angeles, Los Angeles, California
| | - Erin D Michos
- 1Division of Cardiology, Johns Hopkins School of Medicine, Baltimore, Maryland.,2Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| |
Collapse
|
4
|
Chyou AC, Klein BEK, Klein R, Barr RG, Cotch MF, Praestgaard A, Wong TY, Lima J, Bluemke DA, Kawut S. Retinal vascular changes and right ventricular structure and function: the MESA-Right Ventricle and MESA-Eye studies. Pulm Circ 2018; 9:2045894018819781. [PMID: 30622700 PMCID: PMC6304712 DOI: 10.1177/2045894018819781] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2018] [Accepted: 11/21/2018] [Indexed: 11/16/2022] Open
Abstract
Retinal vessel diameters have been associated with left ventricular morphology
and function but their relationship with the right ventricle (RV) has not been
studied. We hypothesized that wider retinal venules and narrower retinal
arterioles are associated with RV morphology and function. RV end-diastolic mass
(RVEDM), end-diastolic volume (RVEDV), end-systolic volume (RVESV), stroke
volume (RVSV), and ejection fraction (RVEF) were assessed using cardiac magnetic
resonance imaging (MRI) scans of 4204 participants without clinical
cardiovascular disease at the baseline examination; retinal photography was
obtained at the second examination. Mean diameters of retinal arterioles and
venules were measured and summarized as central retinal vein and artery
equivalents (“veins” and “arteries,” respectively). After adjusting for
covariates, wider veins were associated with greater RVEDM and RVEDV in women
(P = 0.04 and P = 0.02, respectively),
whereas there was an inverse association with RVEDV in men
(P = 0.02). In both sexes, narrower arteries were associated
with lower RVEDM (P < 0.001 in women and
P = 0.002 in men) and smaller RVEDV
(P < 0.001 in women and P = 0.04 in men) in
adjusted models. Narrower arteries were also associated with lower RVEF in men
but this was of borderline significance after adjusting for the LVEF
(P = 0.08). Wider retinal venular diameter was associated
with sex-specific changes in RVEDM and RVEDV in adults without clinical
cardiovascular disease. Narrower retinal arteriolar diameter was associated with
significantly lower RVEDM and smaller RVEDV in both sexes.
Collapse
Affiliation(s)
- Anthony C Chyou
- Division of Cardiology and the Department of Medicine, Weill Cornell Medical College, New York Presbyterian Hospital, New York City, NY, USA
| | - Barbara E K Klein
- Department of Ophthalmology and Visual Sciences, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Ronald Klein
- Department of Ophthalmology and Visual Sciences, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - R Graham Barr
- Department of Medicine, Columbia University College of Physicians and Surgeons, New York City, NY, USA
| | - Mary Frances Cotch
- National Eye Institute, National Institutes of Health, Bethesda, MD, USA
| | - Amy Praestgaard
- Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Tien Y Wong
- Singapore Eye Research Institute, National University of Singapore, Singapore, Republic of Singapore
| | - Joao Lima
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - David A Bluemke
- National Institute of Biomedical Imaging and Bioengineering, National Institutes of Health, Bethesda, MD, USA
| | - Steven Kawut
- Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.,Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| |
Collapse
|
5
|
Panagiotou M, Peacock AJ, Johnson MK. Respiratory and limb muscle dysfunction in pulmonary arterial hypertension: a role for exercise training? Pulm Circ 2015; 5:424-34. [PMID: 26401245 DOI: 10.1086/682431] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2015] [Accepted: 05/04/2015] [Indexed: 11/03/2022] Open
Abstract
Respiratory and limb muscle dysfunction is emerging as an important pathophysiological abnormality in pulmonary arterial hypertension (PAH). Muscle abnormalities appear to occur frequently and promote dyspnea, fatigue, and exercise limitation in patients with PAH. Preliminary data suggest that targeted muscle training may be of benefit, although further evidence is required to consolidate these findings into specific recommendations for exercise training in patients with PAH. This article reviews the current evidence on prevalence, risk factors, and implications of respiratory and limb muscle dysfunction in patients with PAH. It also reviews the impact of exercise rehabilitation on morphologic, metabolic, and functional muscle profile and outcomes in PAH. Future research priorities are highlighted.
Collapse
Affiliation(s)
- Marios Panagiotou
- Scottish Pulmonary Vascular Unit, Golden Jubilee National Hospital, Clydebank, United Kingdom
| | - Andrew J Peacock
- Scottish Pulmonary Vascular Unit, Golden Jubilee National Hospital, Clydebank, United Kingdom
| | - Martin K Johnson
- Scottish Pulmonary Vascular Unit, Golden Jubilee National Hospital, Clydebank, United Kingdom
| |
Collapse
|
6
|
Kurtipek E, Büyükterzi Z, Büyükterzi M, Alpaydın MS, Erdem SS. Endothelial dysfunction in patients with pulmonary thromboembolism: neutrophil to lymphocyte ratio and platelet to lymphocyte ratio. CLINICAL RESPIRATORY JOURNAL 2015; 11:78-82. [DOI: 10.1111/crj.12308] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/18/2014] [Revised: 03/13/2015] [Accepted: 04/21/2015] [Indexed: 12/19/2022]
Affiliation(s)
- Ercan Kurtipek
- Department of Chest Diseases; Konya Training and Research Hospital; Konya Turkey
| | - Zafer Büyükterzi
- Department of Cardiology; Konya Training and Research Hospital; Konya Turkey
| | - Meral Büyükterzi
- Department of Radiology; Konya Training and Research Hospital; Konya Turkey
| | | | - Said Sami Erdem
- Department of Biochemistry; Konya Training and Research Hospital; Konya Turkey
| |
Collapse
|
7
|
The association of brachial artery diameter with noncalcified coronary plaque burden in apparently healthy individuals. Coron Artery Dis 2014; 24:657-62. [PMID: 24077324 DOI: 10.1097/mca.0000000000000034] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Coronary atherosclerosis has been associated with systemic arterial remodeling even in nonatherosclerotic vessels. However, it is not known whether systemic remodeling is differentially associated with the cumulative atherosclerotic process, reflected by putatively quiescent calcified plaque (CP), or with active atherosclerosis, consisting of noncalcified plaque (NCP). We thus examined the association of brachial artery diameter (BAD), an artery that does not suffer clinical atherosclerosis, with the presence and the extent of coronary CP and NCP. METHODS We studied 688 apparently healthy, asymptomatic participants from 350 families with a history of early-onset coronary artery disease (<60 years of age) by measuring coronary artery disease risk factors and coronary plaque using dual-source computed tomographic angiography. Plaque volumes were quantified using a validated automated method. BAD was measured during diastole using B-mode ultrasound. The association of resting BAD with any detectable plaque, and log-transformed CP and NCP volumes if detectable, was tested using generalized estimating equations adjusted for age, sex, race, current smoking, diabetes, hypertension, BMI, and non-HDL and HDL cholesterol. RESULTS Higher quintiles of BAD were associated with greater age and male sex (both P<0.001). In the fully adjusted analysis, CP volume was not associated with BAD (P=0.65) but a 1 ml greater NCP volume was associated with a 0.65 mm larger BAD (P=0.027). CONCLUSION Our results suggest that systemic arterial remodeling of nonatherosclerotic arteries is a dynamic process that is correlated with the extent of putatively active atherosclerotic processes in distant beds but not with inactive accumulated plaque burden.
Collapse
|
8
|
Takata M, Amiya E, Watanabe M, Ozeki A, Watanabe A, Kawarasaki S, Nakao T, Hosoya Y, Uno K, Saito A, Murasawa T, Ono M, Nagai R, Komuro I. Brachial artery diameter has a predictive value in the improvement of flow-mediated dilation after aortic valve replacement for aortic stenosis. Heart Vessels 2014; 30:218-26. [DOI: 10.1007/s00380-014-0475-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2013] [Accepted: 01/17/2014] [Indexed: 11/24/2022]
|