Arterial Stiffness In Patients Research Articles

Association of T-cell receptor repertoires and arterial stiffness in patients with essential hypertension

Background: Abnormal immune responses, particularly T-cell activity, are linked to vascular complications in hypertension, but mechanisms remain unknown. Our study aims to explore the association between arterial stiffness, assessed by brachial–ankle pulse wave velocity (baPWV), and T-cell receptor (TCR) repertoires in essential hypertension patients, focusing on understanding the role of T cells in the development of arterial stiffness in this population. Methods: The study included 301 essential hypertension patients and 48 age-matched normotensive controls. Essential hypertension patients were stratified into high (baPWV ≥1400 cm/s, n = 213) and low (baPWV <1400 cm/s, n = 88) baPWV groups. High-throughput sequencing analyzed peripheral TCRβ repertoires. Results: Significant TCRβ repertoire differences were observed between essential hypertension and normotensive groups, as well as between high and low baPWV essential hypertension subgroups. Specifically, patients in the high baPWV group exhibited notable variations in the utilization of specific TCR beta joining (TRBJ) and variable (TRBV) genes compared to the low baPWV group. These alterations were accompanied by reduced TCRβ diversity (represented by diversity 50 s), increased percentages of the largest TCRβ clones, and a higher number of TCRβ clones exceeding 0.1%. The presence of specific TCRβ clones was detected in both groups. Furthermore, reduced diversity 50s and elevated percentages of the largest TCRβ clones were independently correlated with baPWV, emerging as potential risk factors for increased baPWV in essential hypertension patients. Conclusion: TCR repertoires were independently associated with arterial stiffness in patients with essential hypertension, implicating a potential role for dysregulated T-cell responses in the pathogenesis of arterial stiffness in this patient population. Trial registration: ChiCTR2100054414.

High Urine Albumin-to-Creatinine Ratio is Associated with Increased Arterial Stiffness in Diabetes: A Chinese Cross-Sectional Study.

Elevated urine albumin-to-creatinine ratio (UACR) is an established risk factor for microvascular disease in the general population. However, it is unclear whether UACR is associated with arterial stiffness in diabetes. We aimed to assess the relationship between UACR levels and the risk of arterial stiffness in patients with diabetes. From July 2021 to February 2023, a total of 1039 participants were assessed for the risk of arterial stiffness, which was evaluated by brachial-ankle pulse wave velocity (baPWV). The value of UACR≥30 mg/g was defined as high UACR. The UACR level had an abnormal distribution and was log2-transformed for analyses to reduce skewness and volatility. High baPWV was evaluated as categorical variables divided by the highest quartile of the values by sex. The relationship between UACR and arterial stiffness was analyzed by linear curve fitting analyses. Multiple logistic regression models were used to analyze the crude and adjusted odds ratio (OR) of UACR for high baPWV with 95% confidence interval (CI). In addition to applying non-adjusted and multivariate-adjusted models, interaction and stratified analyses were also carried out. The baPWV level was significantly higher in the high UACR group compared with that in the normal UACR group (1861.84 ± 439.12 cm/s vs 1723.13 ± 399.63 cm/s, p<0.001). Adjusted smoothed plots suggested that there are linear relationships between log2-transformed UACR and high baPWV, and Spearman correlation coefficient was 0.226 (0.176-0.276, p<0.001). The OR (95% CI) between log2-transformed UACR and high baPWV were 1.26 (1.19-1.33, p<0.001), and 1.16 (1.08-1.25, p<0.001) respectively in diabetic patients before and after adjusting for potential confounders. The elevated UACR was associated with arterial stiffness in Chinese patients with diabetes.

Association of Arterial Stiffness With Mid- to Long-Term Home Blood Pressure Variability in the Electronic Framingham Heart Study: Cohort Study.

Short-term blood pressure variability (BPV) is associated with arterial stiffness in patients with hypertension. Few studies have examined associations between arterial stiffness and digital home BPV over a mid- to long-term time span, irrespective of underlying hypertension. This study aims to investigate if arterial stiffness traits were associated with subsequent mid- to long-term home BPV in the electronic Framingham Heart Study (eFHS). We hypothesized that higher arterial stiffness was associated with higher home BPV over up to 1-year follow-up. At a Framingham Heart Study research examination (2016-2019), participants underwent arterial tonometry to acquire measures of arterial stiffness (carotid-femoral pulse wave velocity [CFPWV]; forward pressure wave amplitude [FWA]) and wave reflection (reflection coefficient [RC]). Participants who agreed to enroll in eFHS were provided with a digital blood pressure (BP) cuff to measure home BP weekly over up to 1-year follow-up. Participants with less than 3 weeks of BP readings were excluded. Linear regression models were used to examine associations of arterial measures with average real variability (ARV) of week-to-week home systolic (SBP) and diastolic (DBP) BP adjusting for important covariates. We obtained ARV as an average of the absolute differences of consecutive home BP measurements. ARV considers not only the dispersion of the BP readings around the mean but also the order of BP readings. In addition, ARV is more sensitive to measurement-to-measurement BPV compared with traditional BPV measures. Among 857 eFHS participants (mean age 54, SD 9 years; 508/857, 59% women; mean SBP/DBP 119/76 mm Hg; 405/857, 47% hypertension), 1 SD increment in FWA was associated with 0.16 (95% CI 0.09-0.23) SD increments in ARV of home SBP and 0.08 (95% CI 0.01-0.15) SD increments in ARV of home DBP; 1 SD increment in RC was associated with 0.14 (95% CI 0.07-0.22) SD increments in ARV of home SBP and 0.11 (95% CI 0.04-0.19) SD increments in ARV of home DBP. After adjusting for important covariates, there was no significant association between CFPWV and ARV of home SBP, and similarly, no significant association existed between CFPWV and ARV of home DBP (P>.05). In eFHS, higher FWA and RC were associated with higher mid- to long-term ARV of week-to-week home SBP and DBP over 1-year follow-up in individuals across the BP spectrum. Our findings suggest that higher aortic stiffness and wave reflection are associated with higher week-to-week variation of BP in a home-based setting over a mid- to long-term time span.

BREAKFAST SKIPPING IS ASSOCIATED WITH INCREASED RISK OF TYPE 2 DIABETES AMONG ADULTS : A SYSTEMATIC REVIEW

Background: While certain lifestyle habits may be associated with arterial stiffness, there is limited literature investigating the relationship between lifestyle habits and longitudinal changes in arterial stiffness in patients with type 2 diabetes mellitus (T2DM). Aims : This systematic review is to review the association of breakfast skipping and the risk of type 2 diabetes in adults. Methods: This study demonstrated compliance with all requirements by means of a comparison with the standards established by the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) 2020. Thus, the specialists were able to guarantee that the research was as current as feasible. Publications released between 2014 and 2024 were considered for this search strategy. This was accomplished by utilizing a number of distinct online reference sites, including Pubmed, ScienceDirect, and SagePub. It was determined that reviews, previously published works, and partially completed works would not be included. Result: In the PubMed database, the results of our search brought up 569 articles, whereas the results of our search on SAGEPUB brought up 2731 articles, our search on SCIENCE DIRECT brought up 1382 articles. The results of the search conducted for the last year of 2014 yielded a total 335 articles for PubMed, 1173 articles for SAGEPUB and 864 articles for SCIENCE DIRECT. In the end, we compiled a total of 7 papers, 4 of which came from PubMed, 1 of which came from SAGEPUB and 2 of which came from SCIENCE DIRECT. We included seven research that met the criteria. Conclusion: In summary, breakfast skipping is associated in increasing of type 2 diabetes in adults but also need more studies because the studies of this topic is limited and less reported.

Early Cardiac Rehabilitation Improves Carotid Arterial Stiffness in Patients with Myocardial Infarction.

Little is known about the effect of cardiac rehabilitation (CR) on carotid arterial stiffness (CAS) in patients with myocardial infarction (MI). Rehabilitation group (B) included 90 patients with MI subjected to CR, control group (K) consisted of 30 patients with MI not participatingin CR,and healthy group comprised 38 persons without cardiovascular risk factors. CAS was determined using echo-tracking before and after CR. Atbaseline, patients with MI (B+K) presented with significantly higher mean values of CAS parameters: beta-stiffness index (7.1 vs 6.4, p = 0.004), Peterson's elastic modulus (96 kPa vs 77 kPa, p < 0.001) and PWV-beta (6.1 m/s vs 5.2 m/s, p < 0.001) than healthy persons. Age (beta: r = 0.242, p = 0.008; EP: r = 0.250, p = 0.006; PWV-beta: r = 0.224, p = 0.014) and blood pressure: SBP (EP: r = 0.388, PWV-beta: r = 0.360), DBP (AC: r = 0.225) and PP (PWV-beta: r = 0.221) correlated positively with the initial parameters of CAS. Beta-stiffness index (Rho=-0.26, p = 0.04) and PWV-beta (Rho = 0.29, p = 0.03) correlated inversely with peak exercise capacity expressed in METs. After CR, mean values of beta-stiffness index (6.2 vs 7.1, p = 0.016), EP (78 kPa vs 101 kPa, p = 0.001) and PWV-beta (5.4 m/s vs 6.2 m/s, p = 0.001) in group B were significantly lower than in group K. In group B, CAS parameters decreased significantly after CR. Univariate analysis demonstrated that the likelihood of an improvement in CAS after CR was significantly higher in patients with baseline systolic blood pressure <120 mm Hg (OR = 2.74, p = 0.009) and left ventricular ejection fraction <43% (OR = 5.05, p = 0.005). In patients with MI,CR exerted a beneficial effect on CAS parameters.The improvement in CAS was predicted by lower SBPand LVEF at baseline.

Central blood pressure and arterial stiffness in patients admitted with acute decompensated heart failure

Objective. To evaluate central systolic blood pressure (cSBP) and arterial stiffness (AS) in patients admitted with acute decompensated heart failure (ADHF) according to different phenotypes of ejection fraction (EF) and to assess their changes after 6 months of stable guideline-directed medical therapy. Design and methods. In 54 patients (61% males, median age 69,5 (62; 77) years, median EF 51% (interquartile range (IQR) 38; 55%), median N-terminal pro-B-type natriuretic peptide (NTproBNP) 623 (500; 1842) pg/ml; heart failure (HF) with reduced EF in 37%, HF with mildly reduced EF in 13%, HF with preserved EF in 50%), apart from routine tests, we assessed cSBP and AS with applanation tonometry (SphygmoCor). cSBP above individual reference values, central pulse pressure (PP) ≥ 50 mmHg, carotid-femoral pulse wave velocity (cfPWV) &gt; 10 m/s, cfPWV above individual reference values, and aortic-brachial stiffness mismatch (stiffness gradient as cfPWV/carotid-radial (cr)PWV) ≥ 1) were considered abnormal. The statistical analysis was performed in the groups with EF ≥ 50% and &lt; 50% р &lt; 0,05 was considered significant. Results. Brachial systolic blood pressure (bSBP) in the whole group was 117 (106; 130) mmHg; cSBP 109,5 (96; 120) mmHg. Uncontrolled blood pressure was observed in 40%, hypotension — in 3%. There were no differences between groups according to EF. cSBP elevation was observed in 33% (28,5% in EF ≥ 50% and 38,4% in EF &lt; 50%; р &gt; 0,05), and in 27,1% with normal bSBP. There were no significant differences in AS parameters between groups according to EF. Elevation of at least 1 marker of AS was present in 78,5%, cfPWV &gt; 10 ms — in 50%, cfPWV above individual reference values— in 55,5%, central PP ≥ 50 mmHg — in 16,6%, high AS gradient — in 70,3%. Abnormal AS gradient was observed in 48,1% of patients with normal cfPWV. Patients with more severe congestion according to bioimpedance vector analysis (BIVA) had lower cfPWV compared to less severe congestion: 9 (6,7; 10,2) vs 11,6 (6,9; 15,1) m/s, р = 0,04. There was significant correlation between the amount of extracellular fluid by BIVA and cfPWV (r = –0,36, p &lt; 0,05). There was significant increase in cSBP, PP, cfPWV and augmentation index and decrease in PP amplification in the whole group after 6 months. Conclusions. Patients admitted with ADHF have high frequency of cSBP elevation regardless of EF and blood pressure control. The most common marker of AS increase was cfPWV elevation above individual reference values and abnormal stiffness gradient. Patients with less congestion by BIVA had higher cfPWV. After 6 months there was increase in cSBP and parameters of AS.

Association between glycemia risk index and arterial stiffness in type 2 diabetes.

This study aims to investigate the association of glycemia risk index (GRI), a novel composite metric derived from continuous glucose monitoring (CGM), with arterial stiffness in patients with type 2 diabetes. A total of 342 adults with type 2 diabetes were enrolled between April and June 2023 from 11 communities in Shanghai, China. Medical examinations, including measurements of anthropometric parameters, blood pressure, and venous blood samples were conducted. Brachial-ankle pulse wave velocity (baPWV) was examined to evaluate arterial stiffness. All the participants underwent a 14 day CGM recording and GRI was calculated from the CGM data. The mean age was 70.3 ± 6.8 years, and 162 (47.4%) were male. Participants with a higher baPWV had significantly higher levels of GRI and hyperglycemia component (both P for trend < 0.05). Linear regression revealed the significant positive linear associations of the GRI with baPWV in unadjusted or adjusted models (All P < 0.05). In the multivariable logistic analysis, each increase in the GRI quartile was associated with a 1.30-fold (95% CI 1.01-1.68, P for trend < 0.05) higher prevalence of increased arterial stiffness after adjustment for age, sex, BMI, diabetes duration, current smoking status, blood pressure, and lipid profile. Subgroup analyses showed that the association between the GRI quartiles and increased arterial stiffness was stronger among participants with a diabetes duration ≥15 years (P for interaction = 0.014). Glycemia risk index assessed by continuous glucose monitoring is associated with increased arterial stiffness in type 2 diabetes.

Increased Cardio-ankle Vascular Index Values in Migraine Patients With Aura.

Patients with migraine with aura are at an increased risk of cardiovascular disease. There are limited data on arterial stiffness in migraine patients with aura. The present study evaluated arterial stiffness in these patients using the cardio-ankle vascular index (CAVI). This prospective study included 50 patients with migraine with aura (43 female, mean age 38.9 ± 9.9years). The patient group was matched for age and gender with 50 healthy individuals with no history of migraine (43 female, mean age 39.3 ± 10.3years). All patients and control subjects underwent a comprehensive clinical evaluation by an experienced neurologist and were interviewed about their headache histories. There was no significant difference in baseline demographic characteristics and echocardiographic parameters between migraine with aura patients and the control group. Both right and left CAVI values were significantly higher in the patients with migraine with aura (6.5 ± 1.2 vs 6.1 ± 0.7, P = .043 and 6.6 ± 1.2 vs 6.1 ± 0.7, P = .009, respectively). Arterial stiffness is an important mediator of cardiovascular diseases. We found that CAVI, a novel marker of the arterial stiffness, is increased in patients with migraine with aura.

Assessment of aortic and peripheral arterial stiffness in patients with knee osteoarthritis by ultrasound Doppler derived pulse wave velocity

Information regarding regional arterial stiffness assessment in osteoarthritis (OA) was scarce and sometimes contradictory. We aimed to investigate the aortic, lower limb peripheral arterial stiffness and their associations with knee OA. Patients with primary knee OA and matched non-OA controls were prospectively enrolled from two medical centers in China. The carotid-femoral pulse wave velocity (cfPWV) and femoral-ankle pulse wave velocity (faPWV) were measured using a novel ultrasound technique. A total of 238 participants (including 128 patients with knee OA and 110 controls) were included. In OA patients, cfPWV was significantly higher than that of non-OA controls (9.40 ± 1.92 vs 8.25 ± 1.26 m/s, P < 0.0001). However, faPWV measurements in OA patients (12.10 ± 2.09 m/s) showed no significant difference compared with that of the controls (11.67 ± 2.52 m/s, P = 0.130). Multiple regression analysis revealed that cfPWV was independently associated with knee OA (P < 0.0001) after adjusting for the confounding factors including age, gender, smoking, mean blood pressure, body mass index, heart rate, high-sensitivity C-reactive protein and lipids profiles. In contrast, faPWV did not show independent association with knee OA (P = 0.372) when after adjusting for confounding factors. In addition, Spearman’s correlation analysis showed cfPWV had a significant correlation with Kellgren-Lawrence score (rs = 0.2333, P = 0.008), but no correlation was founded between faPWV with Kellgren-Lawrence score (rs = 0.1624, P = 0.067) in OA patients. This study demonstrated that stiffening of aorta, but not lower limb arteries, was independently associated with knee OA. Our findings may call for further implementation of routine aortic stiffness assessments so as to evaluate cardiovascular risk in patients with OA.

Potential Of The Novel START Index In Assessing Arterial Stiffness In Patients With Coronary Artery Disease

Background — Recently, a novel method for assessing arterial stiffness was developed under the name of START (STiffness of ARTeries), which, unlike the conventional stiffness parameter β, is calculated based on other physical principles. Our study aimed to investigate the possibility of using the new START index in patients with coronary artery disease (CAD). Methods — The study included 353 patients with CAD: 277 men and 76 women. Their median age was 57.0 (53.0; 64.0) years. The arterial stiffness was assessed in all subjects using VaSera VS-1000 sphygmomanometer. The novel arterial stiffness index (START) was analyzed retrospectively. We assessed the correlation of cardio-ankle vascular index (CAVI) and START index, as well as each of these indices with risk factors in the entire cohort of those examined, and also separately for men and women. Results — In examined CAD patients, the median value of the CAVI was within the borderline values (8.0-9.0) [5]: 8.3 (7.6; 9.2) on the right side and 8.3 (7.6; 9.2) on the left side. A median value of the START index was 8.3 (7.1; 9.8) on the right and 8.1 (7.0; 9.6) on the left. A strong relationship between CAVI and START was revealed in the total sample (r=0.879, p&lt;0.001). Women exhibited a more pronounced association (r=0.982, p&lt;0.001) than men (r=0.805, p&lt;0.001). For the total sample, we revealed a strong dependence of the indices on age (r=0.4, p&lt;0.001 for CAVI; r=0.36, p&lt;0.001 for the START index). Both stiffness indices exhibited a weak but significant correlation with glomerular filtration rate (GFR) in the entire sample of study subjects (r=-0.168, p=0.003 for CAVI; r=-0.0159, p=0.004 for START). Conclusion — In patients with CAD, the START index was strongly associated with the CAVI throughout the entire cohort, albeit the correlation in women was slightly stronger than in men. Also, these indices had similar associations with clinical factors and age. Strong correlation between these indices is important for the subsequent practical application of the START index. The possibility of using START index in similar clinical situations as the CAVI requires confirmation in further studies.

Features of the arterial hypertension course and arterial stiffness in patients with ankylosing spondylitis who get infected COVID-19

Objective: to evaluate the features of development and course of arterial hypertension (AH) and changes in vascular stiffness in patients with ankylosing spondylitis (AS) who underwent COVID-19. Materials and methods: 60 patients with a reliable diagnosis of AS were included in the study. Patients were divided into 2 groups depending on the presence of COVID - 19 in anamnesis. The main group consisted of 30 patients with AS who had suffered COVID-19 of varying severity during the previous 12 months. The comparison group consisted of 30 patients with AS who had no laboratory and clinically confirmed COVID-19 infection within the last year. Patients were interviewed regarding the severity of their previous coronavirus infection and persisting symptoms in the post-COVID-19 period. AS activity was evaluated by ASDAS (CRB, BASDAI-index). BP measurement and study of arterial stiffness parameters by oscillographic method, evaluation of the results of ambulatory BP measurement were performed. Results: 6 (20%) patients had BP destabilization at the outpatient stage during home BP measurement early after COVID-19. After 12 months, BP elevation persisted in only 2 (7%) patients, the rest had BP stabilization with withdrawal of antihypertensive drugs. No correlation between BP level, arterial stiffness and AS activity was found. There was a weak inverse correlation between the severity of coronavirus infection and the level of systolic blood pressure, between age and pulse wave velocity. No significant differences in systolic, diastolic blood pressure, pulse wave velocity, aortic augmentation index were found in patients with AS with and without coronavirus infection. In the main group, 1 fatal outcome due to the development of acute ST-elevation myocardial infarction 6 months after COVID-19 was recorded, and no adverse cardiovascular events were registered among patients in the comparison group. Conclusion: it was hypothesized that patients with AS who underwent COVID-19 would be more likely to show BP elevation than those who did not undergo COVID-19. It was found that early after COVID-19 (first three months) a reversible increase in BP without significant changes in arterial stiffness is possible. However, no significant differences in the frequency of BP elevation, BP level, and arterial stiffness were found in patients with AS and COVID-19 or without COVID-19 in anamnesis.

Association Between Physical Activity and Arterial Stiffness in Patients with Type 2 Diabetes in Ningbo, China: A Cross-Sectional Study.

The study aimed to investigate the association between physical activity and arterial stiffness in patients with type 2 diabetes mellitus (T2DM) in Ningbo, China. A cross-sectional study was conducted using the Metabolic Management Center (MMC) dataset of The First Affiliated Hospital of Ningbo University from 1st March 2018 to 28th February 2023. 4444 adults with T2DM were included in the study. Physical activity was assessed using the International Physical Activity Questionnaire (IPAQ)-Short and was categorized into high, moderate, and low. Arterial stiffness was defined as brachial-ankle pulse wave velocity (baPWV) ≥1800cm/s or common carotid artery intima-media thickness (CCA IMT) ≥1mm. Multiple logistic regression analyses were performed to identify the association between physical activity and arterial stiffness. 6.5%, 47.0%, and 46.5% of patients with T2DM had high, moderate, and low physical activity, respectively. 18.8% and 17.5% of patients had arterial stiffness based on baPWV and CCA IMT, respectively. The odds of arterial stiffness (based on baPWV) were lower in patients having moderate to high physical activity (OR 0.82, 95% CI 0.68 to 0.98 and OR 0.58, 95% CI 0.39 to 0.87, respectively). The odds of arterial stiffness (based on CCA IMT) were found to be lower in patients having high physical activity (OR 0.49, 95% CI 0.33 to 0.74). Higher physical activity was found to be associated with lower arterial stiffness in patients with T2DM in Ningbo, China. This was a cross-sectional study, and there is a need to conduct longitudinal studies on this topic.

Increase of Arterial Stiffness in Patients with Polycythemia Vera

Introduction: Preventing thrombotic adverse events (TAEs) is crucial in Polycythemia Vera (PV), as it is the leading cause of death. A targeted approach is required to achieve this, aiming to lower hematocrit (HCT) blood levels and manage thrombocytosis through cytoreductive therapy and anti-platelet treatments. The reasons behind the higher incidence of TAEs in PV are partially known. A novel perspective considers that increased blood vessel content may result in a stiffer aorta, which is clinically measurable with the Pulse Wave Velocity (PWV). The stiffer aorta, a proxy of arterial aging, has been recognized as a significant independent contributor to TAEs. Objectives: This study aimed to investigate the impact of hematological parameters on arterial stiffness in PV patients Methods: Clinical and laboratory information was collected for each patient. Aorta PWV (PWV) was estimated using the SphygmoCor System (AtCor Medical Pty Ltd., Head Office, West Ryde, Australia). The patients were observed and measured twice with a minimum interval of six months between sessions. Results: We evaluated patients with a diagnosis of PV according to WHO 2016 classification, attending from November 2021 to March 2023, the Hematology Unit of the Businco Hospital in Cagliari, Italy. The study involved 26 patients aged 27 to 77 years old. Among them, 58% were female. The median follow-up between diagnosis and PWV evaluation was 7±3 years. The median Hemoglobin (Hb) level was 13.9±1.7 g/dl, with an HCT level of 44.1±4.6 %. Leucocytes and platelets at evaluation time were 9.1±4.2×10 3/μL and 395±227 ×10 3/μL, respectively. Fourteen (53.8%) patients reported a high-risk thrombotic score at diagnosis, and 65.3% had at least one comorbidity. Two (7.7%) patients had diabetes. Moreover, 15.4% showed dyslipidemia, while 38.5% had arterial hypertension. The median body mass index (BMI) was 24.8 ± 3.6 Kg/m2, and the median waist circumference was 94.4 ±13.4 cm. Characteristics of patients were resumed in Table 1. A significant correlation with a high level of PWV was found with age (r:0.54, p=0.004), systolic and diastolic blood pressure (r:0.55, p=0.004 and r:0.44, p=0.025 respectively), heart rate (r:0.47, p=0.02), Hb (r:0.50, p=0.009), and use of hydroxycarbamide (r:0.42, p=0.03). Even after adjusting for age, waist circumference, BMI, and hypertension, the hemoglobin level still significantly correlated with PWV (β0.64 ± 0.27, p&amp;lt;0.05). No associations were found with hematocrit levels (β0.09 ± 0.12, p=0.42). When comparing patients treated only with phlebotomy versus those treated with hydroxycarbamide, PWV was significantly higher (stiffer artery) in the second group (8.9 ± 1.8 vs 11.2 ± 3.2, p&amp;lt; 0.05, respectively). Still, the difference lost significance when accounting for age and blood pressure levels. Conclusion: In PV, Hb levels showed a significant positive correlation with arterial stiffness, indexed as PWV, regardless of PV-specific treatment. The stiffer artery may contribute to the higher TAEs in PV patients. Reducing Hb levels in PV patients also seems beneficial for arterial aging. Further studies are necessary to determine the possible role of PWV in defining and preventing thrombotic events.

Elevated Lipoprotein(a) Levels Measured by Cardio-Ankle Vascular Index are Associated with Arterial Stiffness in Patients Undergoing Peritoneal Dialysis

Elevated Lipoprotein(a) Levels Measured by Cardio-Ankle Vascular Index are Associated with Arterial Stiffness in Patients Undergoing Peritoneal Dialysis

Increased arterial stiffness in patients with ischemia and no obstructive coronary artery disease

Abstract Introduction Recent studies have shown that patients with angina pectoris and no obstructive coronary artery disease are a heterogeneous population with an elevated risk of major adverse cardiovascular events. The current literature lacks evidence regarding the possible association between arterial stiffness and coronary microvascular dysfunction (CMD). Purpose The aim of this study is to determine whether arterial stiffness is increased among patients with CMD compared to hypertensive control group. Methods We examined 25 patients [10 female, 40%, mean age: 60.7±9.6 years, mean office blood pressure (BP) : 141/88±17/9 mmHg] and 35 CMD patients (22 female, 63%, mean age : 62.4±4.9 years, average office BP: 129/79±15/10 mmHg). In the group of patients with chronic angina, CMD was defined by a standardized systematic protocol in which coronary flow reserve (CFR) and index of microvascular resistance (IMR) were measured in the left anterior descending coronary artery using a temperature/pressure sensor-tipped guidewire. In addition, in all participants, arterial stiffness was assessed using aortic augmentation index (AIx), derived from the analysis of central pulse waveforms, recorded by applanation tonometry directly from the radial artery. Results In the CMD group, mean CFR and IMR were 1.3±0.9 and 45.7±35, respectively. Out of the 35 CMD patients with abnormal CFR 12 of them (34%) had a normal value of IMR, indicating functional microvascular dysfunction. On the other hand, 23 patients (66%) had an abnormal IMR, indicating structural microvascular dysfunction. In CMD group compared to asymptomatic controls, AIx was found significantly higher (35.6±10.5 vs 25.1±12.1%, p=0.03). This difference in AIx between groups was found to be statistically significant after adjustment for age, gender and levels of BP (p&amp;lt;0.05). Moreover, no significant differences were found in body mass index, renal function, history of dyslipidemia, diabetes mellitus and smoking status between the two groups (p=NS for all). Conclusion CMD patients are characterized by increased arterial stiffness in comparison with asymptomatic controls, independently of demographic and hemodynamic confounders. These results indicate that impairment of the microvasculature is associated with large artery stiffening. Thus, potential clinical benefit could be derived from specific therapies targeting AIx in patients with CMD.

Effect of sodium-glucose co-transporter inhibitors on arterial stiffness in patients with type 2 diabetes mellitus

Abstract Introduction Selective sodium-glucose co-transporter 2 inhibitors (SGLT2i) reduce cardiovascular morbidity and mortality in patients with type 2 diabetes mellitus (T2DM). In addition to glucose homeostasis the impaired arterial stiffness may participate in this morbidity and mortality. Purpose The aim of this study was to investigate the effect of administration of SGLT2i therapy on arterial stiffness parameters, including aortic pulse wave velocity (PWV) and central systolic blood pressure (SBPao), which have significant prognostic value for predicting cardiovascular events. Methods Our prospective, observational study included 40 patients with T2DM (mean age: 60.3±9.9 years, 24 males). Biochemical and arterial stiffness parameters were analysed before starting SGLT2i therapy (14 patients on dapagliflozin, 25 patients on empagliflozin, 1 patient on ertugliflozin), at 3, 6 months and an average of 3.3±1.3 years follow-up period. Arterial stiffness parameters were determined using an invasively validated oscillometric based Arteriograph (AG) method. Changes in the variables and their interrelation was analysed by repeated data ANOVA and multivariate linear regression. Results Significant decrease in PWV and HgbA1c were observed 3 months after the initiation of SGLT2i therapy (PWV: 10.68±1.35 m/s vs. 10.05±1.40 m/s and HgbA1c: 7.86±0.55 vs. 6.83±0.66 %, p&amp;lt;0,05) and this long-term effect continued during the 3.3-years follow-up period (PWV: 9.96±1.25 m/s and HgbA1c: 7.19±0.81 %, p&amp;lt;0,005, Figure 1). Pearson's correlation analysis and multivariate linear regression analysis showed no association between decreased PWV and BMI, brachial diastolic blood pressure (DBPb) while significant, but weak correlation was observed with HgbA1c and brachial systolic blood pressure (SBPb) (r=0.22-0.26, p&amp;lt;0.05, Figure 2). SBPao results showed non-significant decrease and a subsequent non-significant long-term increase comparing to baseline during the 3.3 years follow-up. Conclusion Short and long-term SGLT2i therapy in T2DM significantly improved PWV values and this effect is independent of changes in SBPao. All these findings emphasize the clinical relevance of arterial stiffness as a biomarker in the SGLT2i induced beneficial effect on the vasculature, however further clarification, long-term evaluation needed to define the role of PWV in the prediction of cardiovascular events.Figure 1Figure 2

Abstract 16797: The Role of Adiposity on Microvascular Dysfunction and Arterial Stiffness in Patients With New Onset Breast Cancer

INTRODUCTION: Increased adiposity is a risk factor for both cardiovascular disease (CVD) and cancer. Microvascular endothelial dysfunction and arterial stiffness are independent risk factors for CVD and can accelerate vascular aging. Whether or not adiposity plays a role in vascular aging over time in patients with new-onset breast cancer (BC) has yet to be elucidated. Hypothesis: Adiposity impacts microvascular dysfunction and arterial stiffness differently in women undergoing therapy for recent BC diagnoses. Methods: Two lean (L; BMI &lt; 25 kg/m 2 ) and four overweight and obese (Ow/Ob; BMI &gt; 25 kg/m 2 ) women diagnosed with BC within the last 3 months participated in the study. Using laser Doppler imaging, microvascular endothelial function was assessed with three protocols: 1) cutaneous post-occlusion reactive hyperemia (PORH), 2) local thermal heating (LTH), and 3) iontophoresis of acetylcholine. Arterial stiffness was assessed using pulse wave velocity (PWV) and pulse wave analysis (PWA). Assessments were made at baseline and at 3 and 6 months following enrollment. Data are reported as means ± SE. Results: No differences in age, height, blood pressure, or total cholesterol (all p &gt;0.05) were observed between L and Ow/Ob groups. Microvascular function and arterial stiffness were similar at baseline between groups. There was a greater decrease in LTH responses from baseline to 6 months post-baseline in Ow/Ob women (Δ-48±4 PU; p =0.001) compared to L women (Δ-16±13 PU; p =0.125). Similar responses in both groups were noted for PORH ( p =0.886) and iontophoresis ( p =0.784). PWV was similar from baseline to 6 months post-baseline in both groups; however, the PWA tended to increase over time in Ow/Ob women (Δ2.5±4.7) and decrease in L women (Δ-3.0±5.0). CONCLUSION: Ow/Ob women have a greater rate of decline in LTH responses compared with L women, whereas similar responses between L and OW/OB women were observed over time for PORH and iontophoresis. In addition, central aortic stiffness increased in Ow/Ob women and decreased in L women, while no change in PWV was observed. These findings suggest that adiposity may impact vascular beds differently over time following the initial diagnosis of breast cancer.

Cross-Sectional Relationship Between Atrial Conduction Delay and Arterial Stiffness in Patients with Obstructive Sleep Apnea.

Prolonged P-wave duration (PWD), which indicates atrial conduction delay, is a potent precursor of atrial fibrillation (AF) that may be induced by obstructive sleep apnea (OSA). The cardio-ankle vascular index (CAVI), which is an arterial stiffness parameter, is elevated in patients with OSA; moreover, an increased CAVI is associated with atrial conduction delay through left atrium enlargement in association with left ventricular diastolic dysfunction. We aimed to examine the relationship between the CAVI and PWD in patients with OSA. We included patients with a sinus rhythm who underwent overnight polysomnography. We measured the PWD and CAVI on standard 12-lead electrocardiograms; further, we analyzed the relationship between PWD and CAVI. We analyzed data from 300 participants (men, 89.0%; mean age, 52.3 ± 13.1 years; and body mass index, 26.2 ± 3.9 kg/m2). The mean PWD was 104.4 ± 10.4 ms while the mean CAVI was 7.5 ± 1.5. PWD was significantly correlated with CAVI (r = 0.478, p < 0.001); additionally, PWD and CAVI were directly associated with OSA severity (p = 0.002 and p = 0.002, respectively). Multivariate regression analysis revealed an independent significant correlation of PWD and CAVI with OSA severity. In patients with OSA, an increase in arterial stiffness is associated with atrial conduction delay.

Influence of a new coronavirus infection on the arterial stiffness in patients with hypertension

Objective. The aim of the study was to compare the parameters of lipid profile, arterial stiffness and endothelial function in patients with arterial hypertension (HTN), examined before the COronaVIrus Disease-2019 (COVID-19) pandemic, and patients with HTN who underwent COVID-19.Design and methods. In total, 133 people were included: 72 patients with HTN examined in 2010–2015, 61 patients with HTN who survived after COVID-19. A biochemical blood test was performed to determine the level of glucose, total cholesterol, triglycerides, and high-density lipoprotein cholesterol. The level of low-density lipoprotein cholesterol and non-high-density lipoprotein cholesterol was calculated. The parameters of arterial stiffness were assessed using volume sphygmography, endothelial function was determined based on the values obtained in the sample with post-occlusive reactive hyperemia.Results. According to the results of a biochemical blood test, a significantly higher level of total cholesterol and non-high-density lipoprotein cholesterol was noted in patients with HTN who underwent COVID-19. In the compared groups, comparable indicators of endothelial function were registered with post-occlusive reactive hyperemia. At the same time, according to volume sphygmography, the highest values of arterial stiffness indicators (pulse wave velocity in the aorta, pulse wave velocity in elastic arteries, cardio-ankle vascular index on the right and left) were found in patients with HTN who had undergone COVID-19. A univariate regression analysis was carried out, which confirmed a significant negative effect of the transferred COVID-19 on the parameters of arterial stiffness.Conclusions. Patients with HTN in the post-COVID period represent a particularly vulnerable cohort of the population in terms of the risk of developing and progressing cardiovascular pathology, including vascular events. The inclusion of volume sphygmography in the list of examinations will probably allow early detection of an increase in arterial stiffness with subsequent drug correction.

Impact of sleep-disordered breathing on overnight changes in arterial stiffness in patients with acute heart failure.

Overnight increases in arterial stiffness associated with sleep-disordered breathing may adversely affect patients with acute heart failure. Thus, we investigated overnight changes in arterial stiffness and their association with sleep-disordered breathing in patients hospitalized for acute heart failure. Consecutive patients with acute heart failure were enrolled. All participants underwent overnight full polysomnography following the initial improvement of acute signs and symptoms of acute heart failure. The arterial stiffness parameter, cardio-ankle vascular index (CAVI), was assessed before and after polysomnography. Overall, 60 patients (86.7% men) were analyzed. CAVI significantly increased overnight (from 8.4 ± 1.6 at night to 9.1 ± 1.7 in the morning, P < 0.001) in addition to systolic and diastolic blood pressure (from 114.1 mmHg to 121.6 mmHg, P < 0.001; and from 70.1 mmHg to 78.2 mmHg, P < 0.001, respectively). Overnight increase in CAVI (ΔCAVI ≥ 0) was observed in 42 patients (70%). The ΔCAVI ≥ 0 group was likely to have moderate-to-severe sleep-disordered breathing (i.e., apnea-hypopnea index ≥15, 55.6% vs 80.9%, P = 0.047) and greater obstructive respiratory events (29.4% vs 58.5%, P = 0.041). In multivariable analysis, moderate-to-severe sleep-disordered breathing and greater obstructive respiratory events were independently correlated with an overnight increase in CAVI (P = 0.033 and P = 0.042, respectively). In patients hospitalized for acute heart failure, arterial stiffness, as assessed by CAVI, significantly increased overnight. Moderate-to-severe sleep-disordered breathing and obstructive respiratory events may play an important role in the overnight increase in cardio-ankle vascular index.