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Guberti D, Ferrario M, Liu S, Jakob SM, Carrara M. Wave Separation Analysis to Assess Cardiovascular Alterations Induced by Sepsis. IEEE Trans Biomed Eng 2024; 71:1719-1731. [PMID: 38163302 DOI: 10.1109/tbme.2023.3349104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2024]
Abstract
OBJECTIVE Sepsis induces a severe decompensation of arterial and cardiac functional properties, leading to important modifications of arterial blood pressure (ABP) waveform, not resolved by recommended therapy, as shown by previous works. The aim of this study is to quantify the changes in ABP waveform morphology and wave reflections during a long-term swine experiment of polymicrobial sepsis and resuscitation, to deepen the understanding of the cardiovascular response to standard resuscitation therapy. METHODS We analyzed 14 pigs: polymicrobial sepsis was induced in 9 pigs followed by standard resuscitation and 5 pigs were treated as sham controls. Septic animals were studied at baseline (T1), after sepsis development (T2), and after 24 h (T3) and 48 h (T4) of therapy administration, and sham controls at the same time points. ABP and arterial blood flow were measured in the left and right carotid artery, respectively. Pulse wave analysis and wave separation techniques were used to estimate arterial input impedance, carotid characteristic impedance, forward and backward waves, indices of wave reflections such as reflection magnitude and reflection index, and augmentation index. RESULTS Sepsis led to an acute alteration of ABP waveform passing from type A to type B or C; consistently, the reflection phenomena were significantly reduced. The resuscitation was successful in reaching targeted hemodynamic stability, but it failed in restoring a physiological blood propagation and reflection. CONCLUSION Septic pigs persistently showed altered reflected waves even after 48 hours of successful therapy according to guidelines, suggesting a persistent hidden cardiovascular disorder. SIGNIFICANCE The proposed indices may be useful to unravel the complex cardiovascular response to therapy administration in septic patients and could potentially be used for risk stratification of patient deterioration. Whether alterations of blood propagation and reflection contribute to persisting organ dysfunction after hemodynamic stabilization should be further investigated.
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Eagan LE, Mascone SE, Chesney CA, Ranadive SM. Acute inflammation elicits decreased blood pressure but similar arterial stiffness in young African American adults. Exp Physiol 2024; 109:445-455. [PMID: 38048059 PMCID: PMC10988684 DOI: 10.1113/ep091289] [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: 05/08/2023] [Accepted: 11/14/2023] [Indexed: 12/05/2023]
Abstract
African Americans (AA) have a higher risk for cardiovascular disease (CVD) as compared to their White (W) counterparts. CVD is characterized by increased blood pressure (BP), arterial stiffness and systemic inflammation. An acute inflammatory stimulus may explain physiological manifestations responsible for amplified CVD in AA that are not apparent at rest. The purpose of this study was to evaluate central and peripheral BP, central and local arterial stiffness, and indices of pulse wave morphology in young healthy AA and W participants in response to acute inflammation. Concentrations of the inflammatory cytokine interleukin-6 (IL-6) and measures of central and peripheral BP, central arterial stiffness (carotid-femoral pulse wave velocity (cfPWV)), local carotid arterial stiffness (β-stiffness, elastic modulus (Ep)), and indices of pulse wave morphology were assessed in 28 participants (21 ± 2 years, AA: n = 11) at baseline (BL), 24 h and 48 h post-inflammation. Changes in IL-6 concentrations (ΔIL-6) were significantly greater at 24 h as compared to 48 h post-inflammation (0.652 ± 0.644 vs. -0.146 ± 0.532 pg/μl, P ≤ 0.0001). Among AA participants, central and peripheral diastolic BP were significantly decreased at 24 h post-inflammation as compared to BL (aortic diastolic BP: -4 ± 4 mmHg, P = 0.016; brachial diastolic BP: -4 ± 4 mmHg, P = 0.014). AA participants also experienced a significant decrease in central and peripheral mean arterial BP at 48 h post-inflammation as compared to BL (aortic mean arterial pressure: -4 ± 4 mmHg, P = 0.009; brachial mean arterial pressure: -4 ± 4 mmHg, P = 0.012). Despite haemodynamic changes, there were no differences in central or local carotid arterial stiffness or indices of pulse wave morphology.
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Affiliation(s)
- Lauren E. Eagan
- Department of Kinesiology, School of Public HealthUniversity of MarylandCollege ParkMarylandUSA
| | - Sara E. Mascone
- Department of Kinesiology, School of Public HealthUniversity of MarylandCollege ParkMarylandUSA
| | - Catalina A. Chesney
- Department of Kinesiology, School of Public HealthUniversity of MarylandCollege ParkMarylandUSA
| | - Sushant M. Ranadive
- Department of Kinesiology, School of Public HealthUniversity of MarylandCollege ParkMarylandUSA
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Springall GAC, Goldsmith G, Zannino D, Cheong J, Mynard JP, Yeo M, Cheung MMH. Carotid wave analysis in young adults with a history of adolescent anorexia nervosa: a case control study. J Eat Disord 2024; 12:21. [PMID: 38308371 PMCID: PMC10835867 DOI: 10.1186/s40337-023-00963-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Accepted: 12/29/2023] [Indexed: 02/04/2024] Open
Abstract
BACKGROUND Anorexia nervosa (AN) is associated with abnormalities that may increase the risk of future cardiovascular disease. This study assessed the cardiovascular health of individuals who recovered from AN during adolescence by conducting wave power analysis. METHODS Former AN patients discharged from the Royal Children's and Monash Children's Hospitals (N = 17) in Melbourne, Australia underwent ultrasound imaging of the right carotid artery. Wave power analysis was conducted to assess biomechanical interactions of the cardiovascular system. Patient measures were compared to healthy controls (N = 51). RESULTS Eighty-eight percent of the former AN patients and controls were female, aged approximately 25 years, with a healthy body mass index. Mean carotid flow and pulsatility index were not different between groups. Carotid arterial strain and distensibility were lower, and the wave speed and beta stiffness index higher in the former AN patients. Characteristic impedance was not different nor were the forward and backward wave amplitudes. However, wave reflection indices (ratios of backward-to-forward compression wave area, and wave-related effect on pressure and hydraulic power) were 12-18% lower in the former AN patients (p < 0.05). CONCLUSIONS Increased carotid artery stiffness and reduced wave reflection are evident in young adults who recovered from adolescent AN. This may relate to an adaptive process that helps to maintain or restore flow and characteristic impedance despite increased vessel stiffness, with this warranting future investigation.
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Affiliation(s)
- Gabriella A C Springall
- Department of Paediatrics, University of Melbourne, Parkville, VIC, Australia.
- Heart Research, Murdoch Children's Research Institute, Parkville, VIC, Australia.
| | - Greta Goldsmith
- Heart Research, Murdoch Children's Research Institute, Parkville, VIC, Australia
| | - Diana Zannino
- Clinical Epidemiology and Biostatistics Unit, Murdoch Children's Research Institute, Parkville, VIC, Australia
| | - Jeanie Cheong
- Heart Research, Murdoch Children's Research Institute, Parkville, VIC, Australia
- Department of Obstetrics and Gynaecology, University of Melbourne, Parkville, VIC, Australia
- Neonatal Services, Royal Women's Hospital, Parkville, VIC, Australia
| | - Jonathan P Mynard
- Department of Paediatrics, University of Melbourne, Parkville, VIC, Australia
- Heart Research, Murdoch Children's Research Institute, Parkville, VIC, Australia
- Department of Biomedical Engineering, University of Melbourne, Parkville, VIC, Australia
| | - Michele Yeo
- Department of Adolescent Medicine, Royal Children's Hospital, Parkville, VIC, Australia
| | - Michael M H Cheung
- Department of Paediatrics, University of Melbourne, Parkville, VIC, Australia
- Heart Research, Murdoch Children's Research Institute, Parkville, VIC, Australia
- Department of Cardiology, Royal Children's Hospital, Parkville, VIC, Australia
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Mynard JP, Kowalski R, Harrington HA, Kondiboyina A, Smolich JJ, Cheung MMH. Superiority of a Representative MRI Flow Waveform over Doppler Ultrasound for Aortic Wave Reflection Assessment in Children and Adolescents With/Without a History of Heart Disease. Ann Biomed Eng 2023; 51:2772-2784. [PMID: 37561232 PMCID: PMC10632254 DOI: 10.1007/s10439-023-03339-2] [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: 03/01/2023] [Accepted: 07/29/2023] [Indexed: 08/11/2023]
Abstract
Wave separation analysis (WSA) reveals the impact of forward- and backward-running waves on the arterial pressure pulse, but the calculations require a flow waveform. This study investigated (1) the variability of the ascending aortic flow waveform in children and adolescents with/without a childhood heart disease history (CHD); (2) the accuracy of WSA obtained with a representative flow waveform (RepFlow), compared with the triangulation method and published ultrasound-derived adult representative flow; (3) the impact of limitations in Doppler ultrasound on WSA; and (4) generalizability of results to adults with a history of CHD. Phase contrast MRI was performed in youth without (n = 45, Group 1, 10-19 years) and with CHD (n = 79, Group 2, 7-18 years), and adults with CHD history (n = 29, Group 3, 19-59 years). Segmented aortic cross-sectional area was used as a surrogate for the central pressure waveform in WSA. A subject-specific virtual Doppler ultrasound was performed on MRI data by extracting velocities from a sample volume. Time/amplitude-normalized ascending aortic flow waveforms were highly consistent amongst all groups. WSA with RepFlow therefore yielded errors < 10% in all groups for reflected wave magnitude and return time. Absolute errors were typically 1.5-3 times greater with other methods, including subject-specific (best-case/virtual) Doppler ultrasound, for which velocity profile skewing introduced waveform errors. Our data suggest that RepFlow is the optimal approach for pressure-only WSA in children and adolescents with/without CHD, as well as adults with CHD history, and may even be more accurate than subject-specific Doppler ultrasound in the ascending aorta.
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Affiliation(s)
- Jonathan P Mynard
- Heart Research, Murdoch Children's Research Institute, 50 Flemington Road, Parkville, VIC, 3052, Australia.
- Department of Paediatrics, University of Melbourne, Parkville VIC, Australia.
- Department of Biomedical Engineering, University of Melbourne, Parkville VIC, Australia.
| | - Remi Kowalski
- Heart Research, Murdoch Children's Research Institute, 50 Flemington Road, Parkville, VIC, 3052, Australia
- Department of Paediatrics, University of Melbourne, Parkville VIC, Australia
- Department of Cardiology, Royal Children's Hospital, Parkville VIC, Australia
| | - Hilary A Harrington
- Heart Research, Murdoch Children's Research Institute, 50 Flemington Road, Parkville, VIC, 3052, Australia
| | - Avinash Kondiboyina
- Heart Research, Murdoch Children's Research Institute, 50 Flemington Road, Parkville, VIC, 3052, Australia
- Department of Paediatrics, University of Melbourne, Parkville VIC, Australia
| | - Joseph J Smolich
- Heart Research, Murdoch Children's Research Institute, 50 Flemington Road, Parkville, VIC, 3052, Australia
- Department of Paediatrics, University of Melbourne, Parkville VIC, Australia
| | - Michael M H Cheung
- Heart Research, Murdoch Children's Research Institute, 50 Flemington Road, Parkville, VIC, 3052, Australia
- Department of Paediatrics, University of Melbourne, Parkville VIC, Australia
- Department of Cardiology, Royal Children's Hospital, Parkville VIC, Australia
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Association of Systemic Immune Inflammation Index with Estimated Pulse Wave Velocity, Atherogenic Index of Plasma, Triglyceride-Glucose Index, and Cardiovascular Disease: A Large Cross-Sectional Study. Mediators Inflamm 2023; 2023:1966680. [PMID: 36846196 PMCID: PMC9946741 DOI: 10.1155/2023/1966680] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Revised: 01/13/2023] [Accepted: 02/04/2023] [Indexed: 02/17/2023] Open
Abstract
In the U.S. general population, there is a lack of understanding regarding the association between the systemic immune inflammation (SII) index and estimated pulse wave velocity (ePWV), atherogenic index of plasma (AIP), and triglyceride-glucose (TyG) index and cardiovascular disease (CVD). As a result, the objective of our research was to investigate the association between the SII index and ePWV, AIP, and TyG index and incident CVD. We used the National Health and Nutrition Examination Survey (NHANES) data from 1999 to 2018 to conduct this study. The correlation between the SII index and ePWV, AIP, and TyG index was examined using generalized additive models with smooth functions. In addition, the association between SII index and triglyceride (TC), high-density lipoprotein cholesterol (HDL-C), and fast glucose (FBG) also were explored. Finally, we further performed multivariable logistic regression analysis, restricted cubic spline (RCS) plots, and subgroup analysis to study the connection between the SII index and CVD. Our analysis included 17389 subjects from the NHANES database. A substantial positive association existed between SII, WV, and the TyG index. In addition, with the increase of the SII index, AIP showed a trend of decreasing first, then rising, and then decreasing. The SII index was inversely and linearly associated with triglyceride (TG), while positively and linearly associated with fast glucose (FBG). However, high-density lipoprotein cholesterol (HDL-C) had a tendency of first declining, then climbing, and finally falling with the rise in the SII index. After adjusting for potential confounders, compared with the lowest quartiles, the odds ratios with 95% confidence intervals for CVD across the quartiles were 0.914 (0.777, 1.074), 0.935 (0.779, 1.096), and 1.112 (0.956, 1.293) for SII index. The RCS plot showed an inverse U-shaped curve relationship between the SII index and CVD. Overall, this study found a strong correlation between a higher SII index and ePWV and the TyG index. Additionally, these cross-sectional data also revealed a U-shaped connection between the SII index and CVD.
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Lefferts EC, Hibner BA, Lefferts WK, Lima NS, Baynard T, Haus JM, Lane‐Cordova AD, Phillips SA, Fernhall B. Oral vitamin C restores endothelial function during acute inflammation in young and older adults. Physiol Rep 2021; 9:e15104. [PMID: 34762777 PMCID: PMC8582295 DOI: 10.14814/phy2.15104] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Accepted: 10/14/2021] [Indexed: 11/24/2022] Open
Abstract
Oxidative stress has been linked to reductions in vascular function during acute inflammation in young adults; however, the effect of acute inflammation on vascular function with aging is inconclusive. The aim of this study was to determine if oral antioxidant administration eliminates vascular dysfunction during acute inflammation in young and older adults. Brachial flow-mediated dilation (FMD) and carotid-femoral pulse wave velocity (PWV) were measured in nine young (3 male, 24 ± 4 yrs, 26.2 ± 4.9 kg/m2 ) and 16 older (13 male, 64 ± 5 yrs, 25.8 ± 3.2 kg/m2 ) adults before and 2-h after oral consumption of 2 g of vitamin C. The vitamin C protocol was completed at rest and 24 h after acute inflammation was induced via the typhoid vaccine. Venous blood samples were taken to measure markers of inflammation and vitamin C. Both interleukin-6 (Δ+0.7 ± 1.8 pg/ml) and C-reactive protein (Δ+1.9 ± 3.1 mg/L) were increased at 24 h following the vaccine (p < 0.01). There was no change in FMD or PWV following vitamin C administration at rest (p > 0.05). FMD was lower in all groups during acute inflammation (Δ-1.4 ± 1.9%, p < 0.01), with no changes in PWV (Δ-0.0 ± 0.9 m/s, p > 0.05). Vitamin C restored FMD back to initial values in young and older adults during acute inflammation (Δ+1.0 ± 1.8%, p < 0.01) with no change in inflammatory markers or PWV (p > 0.05). In conclusion, oral vitamin C restored endothelial function during acute inflammation in young and older adults, with no effect on aortic stiffness. The effect of vitamin C on endothelial function did not appear to be due to reductions in inflammatory markers. The exact mechanisms should be further investigated.
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Affiliation(s)
- Elizabeth C. Lefferts
- Department of Kinesiology and NutritionUniversity of Illinois at ChicagoChicagoIllinoisUSA
- Department of KinesiologyIowa State UniversityAmesIowaUSA
| | - Brooks A. Hibner
- Department of Kinesiology and NutritionUniversity of Illinois at ChicagoChicagoIllinoisUSA
| | - Wesley K. Lefferts
- Department of Kinesiology and NutritionUniversity of Illinois at ChicagoChicagoIllinoisUSA
- Department of KinesiologyIowa State UniversityAmesIowaUSA
| | - Natalia S. Lima
- Department of Kinesiology and NutritionUniversity of Illinois at ChicagoChicagoIllinoisUSA
| | - Tracy Baynard
- Department of Kinesiology and NutritionUniversity of Illinois at ChicagoChicagoIllinoisUSA
| | - Jacob M. Haus
- School of KinesiologyUniversity of MichiganAnn ArborMichiganUSA
| | - Abbi D. Lane‐Cordova
- Department of Exercise ScienceArnold School of Public HealthUniversity of South CarolinaColumbiaSouth CarolinaUSA
| | - Shane A. Phillips
- Department of Physical TherapyUniversity of Illinois at ChicagoChicagoIllinoisUSA
| | - Bo Fernhall
- Department of Kinesiology and NutritionUniversity of Illinois at ChicagoChicagoIllinoisUSA
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Caughey MC, Qiao Y, Meyer ML, Palta P, Matsushita K, Tanaka H, Wasserman BA, Heiss G. Relationship Between Central Artery Stiffness, Brain Arterial Dilation, and White Matter Hyperintensities in Older Adults: The ARIC Study-Brief Report. Arterioscler Thromb Vasc Biol 2021; 41:2109-2116. [PMID: 33882687 PMCID: PMC8478115 DOI: 10.1161/atvbaha.120.315692] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Accepted: 04/01/2021] [Indexed: 11/16/2022]
Abstract
[Figure: see text].
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Affiliation(s)
- Melissa C. Caughey
- Joint Department of Biomedical Engineering, University of North Carolina and North Carolina State University; Chapel Hill, NC
| | - Ye Qiao
- Department of Radiology, Johns Hopkins School of Medicine; Baltimore, MD
| | - Michelle L. Meyer
- Department of Emergency Medicine, University of North Carolina School of Medicine; Chapel Hill, NC
| | - Priya Palta
- Department of Medicine, Columbia University School of Medicine; New York, NY
| | - Kunihiro Matsushita
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health; Baltimore, MD
| | | | - Bruce A. Wasserman
- Department of Radiology, Johns Hopkins School of Medicine; Baltimore, MD
| | - Gerardo Heiss
- Department of Epidemiology, University of North Carolina Gillings School of Global Public Health; Chapel Hill, NC
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