Arterial Velocity Research Articles

Postexercise Arterial Compliance and Hemodynamic Responses to Various Durations and Intensities of Aerobic Exercise.

Karabulut, M, Bitting, M, and Bejar, J. Postexercise arterial compliance and hemodynamic responses to various durations and intensities of aerobic exercise. J Strength Cond Res 37(3): 589-596, 2023-The purpose of this study was to determine the effects of various aerobic training protocols using different intensities and durations on arterial compliance and hemodynamic responses. Seventeen male subjects (age = 23.1 ± 2.8 years) performed a maximal oxygen consumption (V̇ o2 max) test, followed by 3 randomly assigned exercise test sessions, each on a separate day. At the beginning of each test session, pre-exercise baseline assessments of arterial elasticity, hemodynamic variables, and pulse wave velocity (PWV) were performed after a 10-minute rest. After baseline measurements, participants performed either a bout of aerobic exercise on a treadmill for 60 minutes at 65% of V̇ o2 max (60min); 20 minutes at 40% of V̇ o2 max (20min); or for 20 minutes at 40% of V̇ o2 max with blood flow restriction (BFR; 20min-BFR). All baseline measurements were repeated at the completion of each testing session. Significance for this study was set at p ≤ 0.05. The 60min session resulted in significant increases in small artery elasticity (SAE) compared with the 20min-BFR session ( p < 0.03) and decreases in both systemic vascular resistance (SVR) and total vascular impedance (TVI) compared with both 20min sessions ( p < 0.01). The carotid to radial PWV was significantly lower after both the 60min and the 20min-BFR sessions compared with the 20min session ( p < 0.02). The findings indicate that the duration and the intensity of exercise are important factors for improving SAE, SVR, and TVI. In addition, 20min-BFR at 40% V̇ o2 max may result in site-specific modifications in PWV that is comparable with those seen after 60 minutes of exercise at 65% V̇ o2 max.

Determination of the Unilaterally Damaged Region May Depend on the Asymmetry of Carotid Blood Flow Velocity in Hemiparkinsonian Monkey: A Pilot Study.

The hemiparkinsonian nonhuman primate model induced by unilateral injection of 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP) into the carotid artery is used to study Parkinson's disease. However, there have been no studies that the contralateral distribution of MPTP via the cerebral collateral circulation is provided by both the circle of Willis (CoW) and connections of the carotid artery. To investigate whether MPTP-induced unilaterally damaged regions were determined by asymmetrical cerebral blood flow, the differential asymmetric damage of striatal subregions, and examined structural asymmetries in a circle of Willis, and blood flow velocity of the common carotid artery were observed in three monkeys that were infused with MPTP through the left internal carotid artery. Lower flow velocity in the ipsilateral common carotid artery and a higher ratio of ipsilateral middle cerebral artery diameter to anterior cerebral artery diameter resulted in unilateral damage. Additionally, the unilateral damaged monkey observed the apomorphine-induced contralateral rotation behavior and the temporary increase of plasma RANTES. Contrastively, higher flow velocity in the ipsilateral common carotid artery was observed in the bilateral damaged monkey. It is suggested that asymmetry of blood flow velocity and structural asymmetry of the circle of Willis should be taken into consideration when establishing more efficient hemiparkinsonian nonhuman primate models.

No evidence of pulmonary hypertension revealed in an echographic evaluation of right-sided hemodynamics in hyperthyroid cats.

Hyperthyroidism is a common endocrinopathy affecting middle-aged to elderly cats, with multisystemic repercussions. Hyperthyroid humans show decreased lung compliance and increased cardiac output with subsequent left heart failure leading to pulmonary capillary congestion. Prognosis worsens with the development of increased pulmonary vascular pressures (ie, pulmonary hypertension [PH]) in hyperthyroid humans. The effect of excess thyroid hormone concentration on pulmonary arterial hemodynamics is unknown in cats. Assessing pulmonary vascular pressures in veterinary medicine relies heavily on echocardiographic measurements performed at the level of the heart and pulmonary trunk. This study investigated right-sided cardiac and pulmonary arterial hemodynamics in hyperthyroid cats using echocardiography. Echocardiographic examinations of hyperthyroid cats identified through a bi-institutional database search were reviewed for the determination of systolic pulmonary arterial pressure (PAP) and 20 other metrics. Values were compared with those of a healthy cat group using non-parametric statistical analyses. Systolic PAP could not be determined in 23/26 hyperthyroid and 13/14 healthy cats owing to unmeasurable tricuspid regurgitation flow velocity. Hyperthyroid cats were roughly twice as old (P <0.001) and had 2-4-fold higher respiratory rates (P <0.001) than healthy cats. Hyperthyroid cats showed an increase in acceleration time-to-ejection time ratio of pulmonary flow (1.4-fold, P = 0.001), pulmonary artery velocity time integral (1.2-1.6-fold, P = 0.001), maximal pulmonary velocity (1.3-1.7-fold, P = 0.002), stroke volume (1.5-fold, P = 0.001) and cardiac output (1.6-fold, P <0.001) vs healthy cats. None of the other echocardiographic metrics reached statistical significance. Systolic PAP estimation proved unsuitable as a sole measurement for the assessment of PH in hyperthyroid cats owing to the frequent inability to interrogate tricuspid regurgitant flow velocity. Hyperthyroid cats have altered echocardiographic measures of pulmonary hemodynamics dissimilar to those reported in hyperthyroid humans. Differential effects of thyrotoxic cardiomyopathy on ventricular systolic function may underlie species differences.

Abstract 13297: Higher Maternal Serum Ferritin in the Third Trimester is Associated With Reduced Endothelial Function in the Preadolescent Child

Introduction: Elevated iron status in pregnancy has been implicated in gestational diabetes (GDM) development and in cardiovascular (CV) disease progression in adults. Animal models, however, have suggested maternal iron deficiency anemia may increase the offspring’s risk of CV disease. Whether maternal iron levels impact the CV health of the child in humans is unknown. This study investigated the relationship between maternal iron markers and the child’s CV health. Methods: This is a nested observational study tied to the Alberta Pregnancy Outcomes and Nutrition (APrON) Study. Children of mothers with and without GDM but otherwise uncomplicated pregnancies were prospectively recruited. Maternal serum ferritin, total iron binding capacity, and hemoglobin in the 2 nd and 3 rd trimesters were obtained. CV outcomes included: left ventricular mass Z-score, reactive hyperemia index score (lnRHI, EndoPAT), Doppler-based aortic and peripheral arterial pulse wave velocity, and carotid intima-media thickness. Univariate and multiple linear regression models, including maternal GDM as a covariate, were built to explore relationships between maternal iron markers and the child’s CV health. Results: Fifty-two children, 40 (77%) female, were assessed at a mean age of 10.9±0.7 years. Maternal serum ferritin in the 2 nd (median (IQR): 38.8 (39.2) ng/mL; B=-0.0039, p=0.01) and 3 rd trimesters (13.7 (9.0); B=-0.011, p=0.008) inversely related to the child’s lnRHI in univariate analyses, whereas no other relationships were observed between maternal iron markers and the child’s CV health. While the effect of 2 nd trimester serum ferritin was attenuated in a multiple linear model adjusting for maternal GDM, another model demonstrated a persistent relationship of 3 rd trimester serum ferritin with lnRHI (B=-0.028, p=0.007), not impacted by maternal GDM (B=-0.37, p=0.11) or their interaction term (B=0.020, p=0.07). Conclusions: High maternal serum ferritin in the 3 rd trimester may be associated with reduced endothelial function of the child. If validated, further work is needed to understand pathogenic mechanisms, and the impact of supplementation guidelines in pregnancy.

Abstract 12774: Detecting Change in Cardiopulmonary Bypass Blood Flow Rate With a Novel, Wireless, Wearable Doppler Ultrasound Patch: A Pilot Study

Introduction: Assessing preload reserve (PR) is important when managing cardiac surgery patients. Typically, a 10% change in cardiac output is used as a reference standard to gauge PR; how this change in cardiac output translates to common carotid artery (CCA) velocity is unknown. In this pilot study, we compared known changes in cardiopulmonary bypass (CPB) flow rate to those measured by a novel wireless, wearable Doppler ultrasound placed over the CCA. Methods: A sample of 14 adult patients undergoing elective CABG was studied. While on CPB, at least two changes in blood flow (one negative, one positive) were made. The corresponding change in CCA velocity was measured by a wearable continuous wave (CW) Doppler ultrasound patch. For each subject, CPB flow changes were determined from the displayed spectrogram by the peristaltic pulsation frequency and CCA velocity changes were calculated from the automated maximum velocity trace. 5-10s windows pre- and post-CPB speed changes were selected, with sufficient signal quality to determine both relative CPB flow and CCA velocity. A “dose-response” curve was fitted to the relative changes in flow and velocity for each subject, as shown in Fig. 1, and the CCA velocity change corresponding to a 10% change in CPB flow was calculated. Results: CPB flows ranged from 0.5-6.3L/min. Mean relative flow changes were -58 and 179%, corresponding to mean CCA velocity changes of -43 and 107%. A mean CCA velocity change of 14% was found to correspond to 10% CPB flow change, ranging from 1.5-27.8%. Conclusions: CCA velocity measured with the Doppler patch successfully tracked changes in CPB flow. A CCA velocity change of &gt;14% suggests a &gt;10% change in cardiac output. Although preliminary, these results provide another important parameter for predicting the response to preload using a novel, easy-to-use, wireless Doppler device.

Abstract 11126: Longitudinal MRI-Based Superficial Femoral Artery Velocity Measurements in Peripheral Artery Disease: An Analysis of the Effect of Lipid Modification on Peripheral Artery Disease After Endovascular Intervention Trial (ELIMIT)

Introduction: Peripheral artery disease (PAD) causes lower extremity dysfunction and is associated with an increased risk of cardiovascular mortality and morbidity. We analyzed longitudinal associations of non-invasive 2-dimensional-phase-contrast magnetic resonance imaging (2D-PC-MRI) velocity markers of the distal superficial femoral artery (SFA) with characteristics of PAD. Hypothesis: Longitudinal changes in MRI-based measures of SFA velocity are associated with changes in SFA lumen volumes in PAD. Methods: A total of 33 (11 diabetic, 22 non-diabetic) PAD patients, who completed baseline and 2-year follow-up MRI were included in this secondary analysis of ELIMIT. Electrocardiographically-gated 2D-PC-MRI was performed at a proximal and a distal imaging location of the distal SFA territory. SFA lumen, wall, and total vessel volumes were averaged over all distal SFA MRI slices. Results: Baseline characteristics did not differ between diabetic and non-diabetic PAD patients (Table). Proximal and distal SFA velocity measures did not differ between baseline and 2-years (41.98: IQR (23.58, 72.6) cm/s; vs. 40.31: IQR (26.69, 61.29) cm/s; p=0.30, for maximum SFA velocity). The velocity amplitude (defined as the difference between the SFA minimum and maximum velocity) was significantly lower in the distal compared to the proximal SFA location at both baseline and at the 2-year visit (p=0.003, p&lt;0.001). In a pooled analysis of all 33 PAD patients, the 2-year change of the average SFA velocity was significantly associated with the 2-year change in the averaged SFA lumen volume (beta: 0.00011, r 2 : 0.175, p=0.017). In a subgroup analysis, a similar pattern was observed in diabetic patients (beta: 0.00006, r 2 : 0.714, p=0.001), but not in non-diabetics (beta: -0.000019, r 2 : 0.0095, p=0.68). Conclusion: Longitudinal 2D-PC-MRI SFA velocity changes are associated with 2-year SFA lumen changes. 2D-PC-MRI velocity measures may be of interest in assessing PAD.

Abstract 11363: Renal Artery Velocity Time Integral is a Predictor of Improvement in Renal Function After Transcatheter Aortic Valve Implantation

Background: It has been reported that renal function (RF) is improved in a certain number of patients who undergo TAVI. However, the mechanisms and predictors of RF improvement remain unclear. We investigated whether preoperative renal hemodynamics assessed by intrarenal doppler ultrasonography (IRD) could predict RF improvement after TAVI. Methods and Results: We enrolled consecutive 84 patients with severe aortic stenosis (AS) who underwent TAVI in our hospital. To assess preoperative intrarenal hemodynamics, we measured renal artery velocity time integral (RA-VTI) as a marker of renal perfusion and renal venous stasis index (RVSI) as a marker of renal congestion using IRD before TAVI (Fig 1). We calculated RVSI as follows: (cardiac cycle time - venous flow time)/cardiac cycle time. RF improvement was defined as an increase &gt;10% of estimated glomerular filtration rate (eGFR) after TAVI. Of the 84 patients, 45 patients (53.5%) showed RF improvement and remaining 39 patients did not. Clinical characteristics including STS score, clinical frailty scale, comorbidities, medications, amount of contrast media and occurrence of procedural complications associated with TAVI were comparable between the two groups. In addition, laboratory data including baseline eGFR and echocardiographic parameters including severity of AS, left ventricular ejection fraction and stroke volume index were also similar between the two groups. RA-VTI determined by IRD was significantly lower in patients with RF improvement compared to those without RF improvement (34.0 ± 12.6 vs. 39.9 ± 12.5 cm, P=0.03). In contrast, there was no difference in RVSI (0.08 ± 0.13 vs. 0.05 ± 0.09, P=0.19). Logistic regression analysis indicated that RA-VTI was a predictor for RF improvement after TAVI (odds ratio 0.96, 95% confidence interval 0.93-0.99, P=0.04). Conclusions: Preoperative RA-VTI, a marker of renal perfusion, is a predictor for RF improvement after TAVI.

Значимость нарушений ретинальной микроциркуляции как предикторов прогрессирования глаукомной оптической нейропатии

Purpose – to assess the significance of retinal microcirculation disorders in progression of glaucomatous optic neuropathy (GON). Material and methods. In this 2-year prospective study 85 patients (124 eyes) the vessel density of the superficial parafoveal plexus (VD parafovea) and peripapillary retina (VD ppr) were measured with optical coherence tomography angiography, peripheral resistance index (RI) and blood flow velocity of the posterior short ciliary arteries (PSCA) and the central retinal artery (CRA) were studied by color Doppler flow mapping method. The predictor properties of each indicator were calculated from the area under the ROC curve (AUC). Results. The results of the study revealed a high significance of the values of relative density of the superficial plexus vessels in the parafoveolar region (VD parafovea AUC 0.70 ± 0.07), and the relative density of the microvasculature of the optic nerve head (ONH) and peripapillary retina (VD ppr 0.715 ± 0.07) as predictors of the progression of GON. Keywords: primary open-angle glaucoma, glaucomatous optic neuropathy, ocular blood flow, optical coherence tomography angiography

Diagnostic Value of Color Doppler Ultrasound and Contrast-Enhanced Ultrasound in the Artery Steal Syndrome After Orthotopic Liver Transplantation.

This study aimed to investigate the application of color Doppler ultrasound (CDU) and contrast-enhanced ultrasound (CEU) in the early diagnosis of arterial steal syndrome (ASS) after orthotopic liver transplantation (OLT). A total of 1827 patients received OLT in our department between January 2007 and December 2021, and CDU and CEU were performed after surgery. Ultrasonographic data were collected and further analyzed. ASS was confirmed by digital subtraction angiography (DSA), and the use of splenic artery embolization was dependent on the DSA findings and clinical conditions. The ultrasonographic data were collected before and after embolization. ASS was found in 23 patients (23/1827; 1.26%). CDU: the portal vein velocity was higher than normal in 17 patients (52.83±21.74 cm/s); the hepatic artery flow signals disappeared in 7 patients; the hepatic artery velocity was 13.57±5.85 cm/s in 16 patients. In 23 patients, the spleen artery velocity was 170.12±32.04 cm/s. CEU: the hepatic artery was observed in 7 patients without hepatic artery flow signals on CDU; in 23 patients, the contrast agent reached the portal vein at the presence of contrast in the hepatic artery or earlier (difference: 2.21±1.09 s). Splenic artery embolization was done in 17 of 23 patients with ASS. The hepatic artery flow velocity, hepatic artery resistance index, splenic artery velocity and time to the presence of contrast were significantly improved after embolization (P<0.05). CDU and CEU are the preferred, effective tools in the diagnosis of ASS. Reduced peak hepatic artery velocity, increased spleen artery velocity and reduced time difference in the contrast reaching the portal vein and hepatic artery are indicative of ASS.

Preoperative high-frequency color Doppler ultrasound assessment of the blood vessels of the fibular myocutaneous flap.

The fibular myocutaneous flap is a classic flap used to reconstruct oral and maxillofacial defects. This study aimed to evaluate the effectiveness of high-frequency color Doppler ultrasound in detecting the blood vessels in the fibular myocutaneous flap, analyze the influence of variations in the peroneal vessels and perforating peroneal arteries on the surgical design, and explore the value of this technology in preoperatively assessing the blood vessels of the fibular myocutaneous flap. Twenty-five patients with mandibular disease or defect underwent preoperative evaluation of the blood vessels of the calf by high-frequency color Doppler ultrasound. The inner diameter and peak systolic velocity (PSV) of the peroneal arteries and veins and the perforating peroneal arteries were compared between different groups. The consistency between the perforating peroneal arteries marked by ultrasonography and the intraoperative findings was analyzed. The initial segment of the peroneal artery had a larger inner diameter (p<0.001) and lower PSV (p<0.05) than the middle segment. The perforating peroneal arteries were mainly distributed in the middle of the fibula. The inner diameter of the perforating peroneal artery was larger in men than in women (p<0.05). In comparison with surgical exploration as the gold standard, high-frequency color Doppler ultrasound results showed good consistency (Kappa=0.684, 95% CI: 0.512-0.856, p<0.001), with a sensitivity of 89.36%, specificity of 78.57%, and accuracy of 85.33%. High-frequency color Doppler ultrasound can detect, quantitatively evaluate, and accurately mark the peroneal artery and vein and perforating peroneal artery before fibular myocutaneous flap transplantation.

Upper-Arm SBP Decline Associated with Repeated Cuff-Oscillometric Inflation Significantly Correlated with the Arterial Stiffness Index.

We evaluated the clinical significance of the new non-invasive vascular indices to explore their potential utility using repeated cuff-oscillometric inflation. In 250 consecutive outpatients, we performed a cross-sectional, retrospective, single-center, observational study to investigate sequential differences in arterial stiffness using blood pressure, arterial velocity pulse index (AVI), and arterial pressure volume index (API) with repeated measurements. Males accounted for 62.7% of the patients, and the mean age was 68.1 ± 12.1 years. The mean systolic blood pressure (SBP) and diastolic blood pressure (DBP) of the first reading in repeated measurements were 133.07 ± 21.20 mmHg and 73.94 ± 13.56 mmHg, respectively. The mean AVI and API were 23.83 ± 8.30 and 31.12 ± 7.86, respectively. In each measurement of these parameters, although DBP and AVI did not show significant changes throughout repeated measurements, SBP and API decreased significantly according to the measurement orders. Furthermore, changes in SBP and API were significantly correlated in several of the models. In this study, it was concluded that upper-arm SBP decline associated with repeated cuff-oscillometric inflation was significantly correlated with the arterial stiffness index. The findings of this study will allow clinicians to easily recognize the progression of atherosclerosis through regular, routine practice. In conclusion, this study suggests that changes in repeated SBP measurements may be predictive of arterial stiffness and atherosclerosis.

THE RELATIONSHIP BETWEEN CENTRAL BLOOD FLOW AND MICROCIRCULATION WITH THE AMOUNT OF ELASTIC COMPRESSION IN POST-THROMBOPHLEBOTIC SYNDROME IN THE STAGE OF DECOMPENSATION

Summary. Aim. To determine the influence of elastic compression on the venous and arterial velocity of the main blood flow of the lower limb and the skin microcirculation of the anterior part of the foot in patients with a decompensated form of postthrombophlebotic syndrome.&#x0D; Materials and methods. 21 patient with post-thrombophlebotic syndrome in the stage of decompensation participated in the study. Among them were 12 (57 %) women and 9 (43 %) men. The average age of the patients was (58.5±6.4) years. All subjects of the study were measured for the ankle-brachial pressure index, deep femoral-popliteal index, regional perfusion index, tcpO2, tcpCO2, arterial blood flow velocity in the femoral artery, and venous blood flow velocity distal to the saphenofemoral junction. After the measurements, the following measurements were performed after using elastic medical knitwear of different compression classes.&#x0D; Research results. With I class compression, the venous blood flow rate was (0.064±0.007) (p=0.0001). The venous velocity of the femoral blood flow significantly decreased, on average, by 7.4 times compared to the initial conditions when using class IV compression (p=0.0001). values of tcpCO2 increased significantly already at the 1st compression class. (p=0.0001) and continued to increase until the end of the study. Analyzing the changes in tcpO2 and tcpCO2, it was established that at the 3rd compression class, there was a cross between the oxygen and carbon dioxide tension indicators, which was accompanied by the predominance of tcpCO2 pressure over tcpO2 at the next increase in the compression class.&#x0D; Conclusions. The arterial blood flow rate decreased by 8.5 times compared to the input data at the maximum pressure of the fourth compression class (p=0.0001). Venous velocity of blood flow in the femoral vein at the maximum pressure of elastic compression decreased venous velocity by 7.4 times compared to the initial normal (p=0.0001). tcpCO2 significantly increases at compression of 15 mmHg (p=0.0001).

Asymptomatic course of overt primary hypothyroidism with a very high peak systolic velocity of the superior thyroid arteries: A case report

This study reports the case of a 59-year-old woman with asymptomatic overt hypothyroidism who presented with signs of increased thyroid exertion involving the autonomic nervous system. These signs included significantly increased peak systolic velocity (PSV) of the superior thyroid arteries (STA) and moderately increased blood flow intensity. The findings suggest an increase in the rate of thyroxine deiodination and the sufficiency of free triiodothyronine (FT3) for the functional needs of the body. The absence of typical symptoms of hypothyroidism may depend on the sufficiency of FT3 in the serum and additional nonhormonal circumstances. Hence, FT3 should always be measured in addition to thyroid-stimulating hormone and free thyroxine levels. When Doppler ultrasound is used, the intensity of blood flow and PSV-STA from both sides should be determined to assess the magnitude of thyroid exertion. Probably, PSV-STA may not be an absolute criterion for the diagnosis of Graves’ disease.

Effects of One-Year Tofacitinib Therapy on Lipids and Adipokines in Association with Vascular Pathophysiology in Rheumatoid Arthritis.

Background: Cardiovascular (CV) morbidity, mortality and metabolic syndrome are associated with rheumatoid arthritis (RA). A recent trial has suggested increased risk of major CV events (MACE) upon the Janus kinase (JAK) inhibitor tofacitinib compared with anti-tumor necrosis factor α (TNF-α) therapy. In our study, we evaluated lipids and other metabolic markers in relation to vascular function and clinical markers in RA patients undergoing one-year tofacitinib therapy. Patients and methods: Thirty RA patients treated with either 5 mg or 10 mg bid tofacitinib were included in a 12-month follow-up study. Various lipids, paraoxonase (PON1), myeloperoxidase (MPO), thrombospondin-1 (TSP-1) and adipokine levels, such as adiponectin, leptin, resistin, adipsin and chemerin were determined. In order to assess flow-mediated vasodilation (FMD), common carotid intima-media thickness (IMT) and arterial pulse-wave velocity (PWV) ultrasonography were performed. Assessments were carried out at baseline, and 6 and 12 months after initiating treatment. Results: One-year tofacitinib therapy significantly increased TC, HDL, LDL, APOA, APOB, leptin, adipsin and TSP-1, while significantly decreasing Lp(a), chemerin, PON1 and MPO levels. TG, lipid indices (TC/HDL and LDL/HDL), adiponectin and resistin showed no significant changes. Numerous associations were found between lipids, adipokines, clinical markers and IMT, FMD and PWV (p < 0.05). Regression analysis suggested, among others, association of BMI with CRP and PWV (p < 0.05). Adipokines variably correlated with age, BMI, CRP, CCP, FMD, IMT and PWV, while MPO, PON1 and TSP-1 variably correlated with age, disease duration, BMI, RF and PWV (p < 0.05). Conclusions: JAK inhibition by tofacitinib exerts balanced effects on lipids and other metabolic markers in RA. Various correlations may exist between metabolic, clinical parameters and vascular pathophysiology during tofacitinib treatment. Complex assessment of lipids, metabolic factors together with clinical parameters and vascular pathophysiology may be utilized in clinical practice to determine and monitor the CV status of patients in relation with clinical response to JAK inhibition.

Ultrasound parameters associated with stroke in patients with moyamoya disease: a logistic regression analysis

BackgroundMoyamoya disease can lead to stroke with devastating consequences, it is necessary to find a non-invasive and effective approach to identify the occurrence of stroke. In this study, we aim to analyze the association between ultrasound parameters and ipsilateral cerebral hemisphere stroke in patients with moyamoya disease by logistic regression analysis.MethodsIn this retrospective case–control study, 88 patients with MMD (153 cerebral hemispheres) hospitalized in Beijing Tiantan Hospital, Capital Medical University from November 2020 to October 2021 were analyzed. According to the occurrence of stroke, the 153 cerebral hemispheres were divided into a stroke group and a non-stroke group. Clinical data and ultrasound parameters of the ipsilateral internal carotid artery, superficial temporal artery, maxillary artery, and posterior cerebral artery were recorded. The ultrasound parameters were divided into four groups according to interquartile range, and then they were compared between the stroke group and the non-stroke group. Those with significant differences were scored by multivariate logistic regression analysis.ResultsThere were 75 cerebral hemispheres (49.0%) in the stroke group and 78 cerebral hemispheres (51.0%) in the non-stroke group. Logistic regression analysis showed that the internal diameter of the internal carotid artery, peak systolic velocity of the internal carotid artery and peak systolic velocity of the posterior cerebral artery were independently correlated factors for stroke in patients with MMD. The fourth quartile group of the above three ultrasound parameters was taken as the reference group, and the odds ratio of the first quartile group were 11.679 (95% CI 2.918–46.749, P = 0.001), 19.594 (95% CI 4.973–77.193, P < 0.001), and 11.657 (95% CI 3.221–42.186, P < 0.001), respectively.ConclusionUltrasound parameters are independently correlated with ipsilateral cerebral stroke in patients with MMD. Ultrasound provides a new way to identify stroke in MMD patients. Future prospective cohort studies are needed to verify the clinical value of ultrasound in identifying patients with MMD at high risk of stroke.

Ultrasonography Combined with Blood Biochemistry on the Early Diagnosis of Diabetic Kidney Disease.

Objective Diabetic kidney disease (DKD) has been well recognized as a microvascular complication of diabetes mellitus. Perfusion of intrarenal arteries is closely related with development of DKD. The aim of the present study was to investigate relation of ultrasonography performance of intrarenal arteries and grade of DKD. Methods From May to December at 2021, a total of 54 DKD patients and 36 non-DKD cases were recruited. Ultrasonography performance of intrarenal and arteries at lower extremity was examined by high-resolution ultrasound diagnostic equipment; maximum (Vsmax) as well as minimum (Vdmin) blood velocity of arteries were recorded, and resistance index (RI) of arteries were calculated. Blood routine and biochemical parameters were determined from clinical laboratory of our hospital. Results According to eGFR grading, 42.50% of the 54 DKD cases are at Grade 1, and 18.52%, 11.11%, 9.26%, and 18.52% cases were at Grade 2, 3a, 3b, and 4-5, respectively. Blood urea and creatinine were significantly positively related with progress of DKD, while level of Hb was negatively related with DKD. By ultrasonography; we found that Vsmax and Vdmin of main renal artery (MRA), segmental renal artery (SRA), and interlobular renal artery (IRA) were significantly reduced compared with healthy cases; IR of the above arteries was dramatically elevated, and changes of the above data were more obvious than that of lower extremity. Vdmin of MRA, SRA, and IRA was negatively related with grading of DKD, while RI was positively related with the grading. Converging from RI and level of Hb, we found that the level of Hb is positively related with healthy status of the kidney, while RI of the arteries is negatively with that. Conclusions Resistance index (RI) of intrarenal arteries, obtained from ultrasonography combining with level of hemoglobin (Hb), is the predictor of progress of DKD.

Home monitoring of arterial pulse-wave velocity during COVID-19 total or partial lockdown using connected smart scales.

AimsTo investigate the impact of coronavirus disease 2019 lockdown on trajectories of arterial pulse-wave velocity in a large population of users of connected smart scales that provide reliable measurements of pulse-wave velocity.Methods and resultsPulse-wave velocity recordings obtained by Withings Heart Health & Body Composition Wi-Fi Smart Scale users before and during lockdown were analysed. We compared two demonstrative countries: France, where strict lockdown rules were enforced (n = 26 196) and Germany, where lockdown was partial (n = 26 847). Subgroup analysis was conducted in users of activity trackers and home blood pressure monitors. Linear growth curve modelling and trajectory clustering analyses were performed. During lockdown, a significant reduction in vascular stiffness, weight, blood pressure, and physical activity was observed in the overall population. Pulse-wave velocity reduction was greater in France than in Germany, corresponding to 5.2 month reduction in vascular age. In the French population, three clusters of stiffness trajectories were identified: decreasing (21.1%), stable (60.6%), and increasing pulse-wave velocity clusters (18.2%). Decreasing and increasing clusters both had higher pulse-wave velocity and vascular age before lockdown compared with the stable cluster. Only the decreasing cluster showed a significant weight reduction (−400 g), whereas living alone was associated with increasing pulse-wave velocity cluster. No clusters were identified in the German population.ConclusionsDuring total lockdown in France, a reduction in pulse-wave velocity in a significant proportion of French users of connected smart bathroom scales occurred. The impact on long-term cardiovascular health remains to be established.Lay SummaryPulse-wave velocity (PWV) measurements from users of connected smart bathroom scales showed that during the first COVID-19 imposed lockdown in France and Germany, arterial stiffness decreased, with greater improvement in France, where three distinct patterns of PWV progression could be identified.

The diagnostic value of left-anterior-descending artery velocity assessed by transthoracic Doppler echocardiography for microvascular dysfunction in stenotic left-anterior-descending artery

Abstract Background Index of microcirculatory resistance (IMR) has been used as a clinical measure of microvascular function. Transthoracic Doppler echocardiography (TDE) can provide information on the functional status of coronary artery circulation. This study aims to assess the diagnostic value of left-anterior-descending artery (LAD) flow velocity by TDE for microvascular dysfunction. Methods Consecutive patients who were scheduled for elective percutaneous coronary intervention (PCI) for LAD lesions were prospectively enrolled in the single tertiary-care center between April 2020 and July 2021. Pre-PCI LAD diastolic peak velocity (DPV) by TDE at rest and hyperemia were measured. By invasive coronary angiography, quantitative coronary angiography and invasive wire-based physiological indices including fractional flow reserve (FFR) and index of microcirculatory resistance (IMR) were measured. Results A total of 104 patients were studied. Median FFR and IMR values were 0.70 (0.60–0.74) and 20.68 (14.92–31.69), respectively. No significant relationship was observed between FFR and IMR. The prevalence of microvascular dysfunction defined as IMR≥25 was 39.4%. Basal DPV was 25 (20–33) cm/sec, and hyperemic DPV was 51 (41–67) cm/sec. In lesions with IMR≥25, reference diameter (RD) was significantly greater [2.63 (2.22–3.19) mm vs 2.39 (2.09–2.66) mm, p=0.019], basal DPV was lower [26 (18–29) cm/sec vs 29 (22–37) cm/sec, p=0.022)] and hyperemic DPV was lower [49 (19–54) cm/sec vs 56 (42–70) cm/sec, p=0.023] compared to lesions with IMR&amp;lt;25. ROC analysis showed basal DPV and RD are significant predictors of IMR≥25 [basal DPV: AUC 0.633 (0.525–0.742), best cutoff 29cm/sec RD: AUC 0.636 (0.523–0.750), best cutoff 2.84mm]. Multivariable logistic regression analysis showed basal DPV&amp;lt;29cm/sec and RD&amp;gt;2.84mm are independent predictors for IMR≥25 [Odds ratio: 3.08 (1.22–7.78), p=0.017; odds ratio 4.40 (1.55–12.50), p=0.005]. Conclusion Basal DPV by non-invasive pre-PCI TDE and reference diameter can predict lesions with coexisting microvascular dysfunction in LAD territory with functionally significant lesions without the need of vasodilator-induced hyperemia and a wire-based invasive physiological measurement. Funding Acknowledgement Type of funding sources: None.

THE NON-INVASIVE ASSESSMENT OF PERIPHERAL MICROVASCULAR AND ENDOTHELIAL FUNCTION IN WOMEN WITH NON-OBSTRUCTIVE CORONARY ARTERY DISEASE

THE NON-INVASIVE ASSESSMENT OF PERIPHERAL MICROVASCULAR AND ENDOTHELIAL FUNCTION IN WOMEN WITH NON-OBSTRUCTIVE CORONARY ARTERY DISEASE

Is External Carotid Artery Hemodynamics Helpful in Detecting Internal Carotid Artery Stenosis?

Introduction: There is a paucity of validated external carotid artery (ECA) velocity criteria and data on the association between ECA velocities and internal carotid artery (ICA) stenosis by carotid duplex ultrasound (CDU) scanning. Our objectives were to determine the relationships between ECA peak systolic velocity (PSV) and percent stenosis seen on confirmatory imaging, as well as to correlate ECA hemodynamics with known ICA disease by CDU. Methods: A retrospective chart review was performed for patients who had CDU, as well as confirmatory testing such as angiography, at a single academic medical center. ICA stenosis was grouped into 4 categories (0 = &lt;50%, 1 = 50%-69%, 2 = 70%-99%, 3 = 100%) based on validated CDU criteria. ECA PSVs were analyzed, in addition to degree of both ECA and ICA stenosis from the same CDU study. Results: Of 247 carotid arteries reviewed, 136 vessels were included in the final analysis. The mean PSV of the normal ECA cohort (&lt;50% ECA stenosis per the NASCET measurement method) was 135.3 ± 82.1 cm/s, and the mean PSV of the diseased ECA cohort was 279.7 ± 112.2 cm/s. Mean ECA PSV for each category of ICA stenosis was: ICA category 0 = 119.9 cm/s; category 1 = 200.4 cm/s; category 2 = 167.7 cm/s; and category 3 = 155.5 cm/s. There was a statistically significant but non-linear difference in ECA velocities between ICA stenosis categories 0 vs 1 (mean rank diff. −49.91 cm/s; P = .0007); and 0 vs 2 (mean rank diff. −32.61 cm/s; P = .0047). Conclusion: We have demonstrated a possible separation of &lt;50% vs ≥50% stenosis of the ICA using ECA PSV. Although the data suggest a weak but statistically significant correlation between ECA PSV and degree of ICA stenosis, further data with a larger sample size and confirmatory studies are needed to utilize ECA hemodynamics to indicate ICA disease.