Augmentation Index Research Articles

Augmentation index as a predictor of right ventricular dysfunction in coronary artery disease: a cross-sectional study

BackgroundArterial stiffness is a well-established predictor of cardiovascular events and mortality. However, its relationship with right ventricular (RV) function in patients with coronary artery disease (CAD) remains unclear. We aimed to investigate the association between aortic augmentation index (AIx), a marker of arterial stiffness, and RV dysfunction in CAD patients.MethodsIn this cross-sectional study, 121 patients with stable CAD or acute coronary syndrome who underwent coronary angiography were enrolled. AIx was measured using radial artery applanation tonometry. Comprehensive echocardiography was performed to assess RV function using conventional and speckle-tracking derived parameters. Multivariable linear and logistic regression analyses were used to evaluate the relationship between AIx and RV function, adjusting for potential confounders.ResultsPatients with high AIx (> 80%, n = 53) had significantly worse RV systolic function compared to those with normal AIx (≤ 80%, n = 68), as evidenced by lower tricuspid annular plane systolic excursion (TAPSE), fractional area change (FAC), RV free wall longitudinal strain (RVLS), and RV systolic velocity (RV S’) (all P < 0.05). AIx correlated negatively with TAPSE (r=-0.421), FAC (r=-0.376), RVLS (r=-0.428), and RV S’ (r=-0.355) (all P < 0.001), and positively with pulmonary artery systolic pressure (r = 0.467, P < 0.001) and pulmonary vascular resistance (r = 0.297, P = 0.001). In multivariable analyses, AIx remained an independent predictor of RV dysfunction (adjusted odds ratio 3.42, 95% confidence interval 1.56–7.51, P = 0.002) after adjusting for age, sex, hypertension, diabetes, dyslipidemia, smoking, left ventricular ejection fraction, and Gensini score.ConclusionsIncreased aortic stiffness assessed by AIx is independently associated with RV dysfunction in patients with CAD. This association is evident across multiple echocardiographic parameters of RV systolic function and is independent of traditional cardiovascular risk factors, left ventricular systolic function, and the extent of coronary artery disease. Our findings suggest that arterial stiffness may play a role in the development of RV dysfunction in CAD patients and highlight the potential importance of assessing and targeting arterial stiffness in this population.

Differences in Biomarkers of Potential Harm After 2+ Years of Tobacco Heating System Use Compared to Cigarette Smoking: A Cross-Sectional Study

Background Growing evidence indicates that noncombustible products could be a tobacco harm reduction tool for smokers who do not quit. The Tobacco Heating System (THS) emits substantially lower levels of harmful cigarette smoke constituents, and previous randomized clinical studies showed improved levels of biomarkers of potential harm (BoPH) linked to smoking-related disease. Methods In this cross-sectional study of healthy participants (n = 982) who (i) smoked cigarettes, (ii) had voluntarily switched from smoking to THS use, or (iii) formerly smoked, blood and urine samples were assayed for nine BoPH. The co-primary endpoints were carboxyhemoglobin, total 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol, white blood cells, and 8-epi-prostaglandin-F2α. The key secondary endpoints were high-density lipoprotein cholesterol, soluble intercellular adhesion molecule-1, 11-dehydrothromboxane B2, central vascular augmentation index, and forced expiratory volume in 1 s (%predicted post-bronchodilator). Results THS users showed significant favorable differences in all nine BoPH compared to current smokers. Results in THS users were similar to those in former smokers. Conclusion Compared to current smokers, healthy participants who voluntarily switched from smoking to THS use for ≥2 years in the real world had favorable differences in BoPH related to oxygen delivery, genotoxicity, inflammation, oxidative stress, lipid metabolism, endothelial function, platelet activation, and cardiovascular and respiratory function. Clinical trial registration: Clinicaltrials.gov Identifier: NCT05385055. Date of registration: May 23, 2022. https://clinicaltrials.gov/study/NCT05385055

Preliminary insights into cardiovascular risk and erterial stiffness in patients with ankylosing spondylitis and psoriatic arthritis: a comparative study

Abstract Introduction Chronic inflammation has long been considered as a driving factor for accelerated atherosclerosis and cardiovascular events in patients with rheumatic diseases like Ankylosing Spondylitis and Psoriatic Arthritis. Ultrasound examination of the carotid artery can reveal signs of early asymptomatic stage of atherosclerosis. Aim The study aimed to investigate the cardiovascular risk factors and arterial stiffness in patients with ankylosing spondylitis (AS) and psoriatic arthritis (PsA) compared to healthy controls. Patients and Methods: 180 participants, of which 109 with AS, 41 with PsA, and 30 healthy controls, were evaluated; 99 men and 81 women, (mean age 49±20). Cardiovascular risk was assessed using the Framingham score, SCORE2, and QRISK3 scales. Biochemical markers (cholesterol, triglycerides, LDL, HDL, ESR, CRP), hypertension, and smoking status were analyzed. Ultrasound examination of the carotid artery, using Aloka Prosound α7, with measurement of the carotid intima-media thickness (CIMT), beta stiffness, augmentation index (AI), pulse wave velocity (PWV), elastic modulus (Ep), and arterial compliance (AC), were analyzed. Statistical analyses included descriptive statistics, Pearson Chi-Square tests for categorical variables, and Mann-Whitney U and Kruskal-Wallis tests for continuous variables. Results All subjects were comparable in terms of age, hypertension, smoking status, lipid indices and risk scores. The ultrasound examination of the carotid artery revealed significant differences in carotid intima-media thickness (CIMT) between controls and patients with AS (p = 0.013) and PsA (p = 0.005), with elevated values in both patient groups, but no significant difference between AS and PsA (p = 0.370). Beta stiffness was markedly higher in both AS (p &amp;lt; 0.001) and PsA (p &amp;lt; 0.001) patients compared to controls, with no significant disparity between AS and PsA (p = 0.322). Pulse wave velocity (PWV) showed significant increases in AS (p &amp;lt; 0.001) and PsA (p = 0.001) patients compared to controls, but no variation between AS and PsA (p = 0.844). No significant differences were noted in the augmentation index (AI) across groups (p = 0.507). Elastic modulus (Ep) was significantly increased in AS (p &amp;lt; 0.001) and PsA (p = 0.001) patients compared to controls, with no significant difference between AS and PsA (p = 0.740). Arterial compliance (AC) did not show significant differences across groups (p = 0.094). (table.1). Conclusion This study reveals significant increase in parameters of arterial stiffness as a marker of premature atherosclerosis in patients with rheumatic diseases as ankylosing spondylitis and psoriatic arthritis in comparison with healthy subjects. Ultrasound examination of the carotid artery – indeces of PWV, AI, EP, AC, beta-stiffness, is an easy and accessible method for diagnosing early vascular impairment in rheumatic patients.

The effect of 4-month treatment with a dietary supplement containing glycosaminoglycans and fucoidanon endothelial glycocalyx integrity and vascular function in patients with psoriatic disease

Abstract Background/Introduction Psoriatic disease is associated with impaired endothelial and vascular function. Purpose We investigated whether intervention with Endocalyx (Microvascular Health Solutions),a dietary supplement containing glycosaminoglycans and fucoidan, can improve endothelial glycocalyx integrity and arterial stiffness in patients with psoriatic disease. Methods Thirty patients with psoriatic disease were randomized to receive Endocalyx (n=15) or placebo (n=15) for 4 months. We measured at baseline and at 4 months of treatment: a)perfused boundary region(PBR) of the sublingual microvessels with a lumen diameter ranging from 4 to 25 μm, as a marker of endothelial glycocalyx integrity and b)carotid-femoral pulse wave velocity (PWV - Complior SP ALAM) and augmentation index (AI). Results Four months after treatment, patients under Endocalyx showed a significant reduction of PBR 4-25μm (2.10±0.31 vs. 2.31±0.20μm), PBR 10-19 μm (2.41±0.43 vs. 2.54±0.31μm), PBR 20-25 μm (2.62±0.42 vs. 3.02±0.30μm), PWV (9.4±1.8 vs. 10.4±2.2m/s) and AI[-4 (-39 – 16) vs. 9.8 (-8 – 23) %] (p&amp;lt;0.05 for all comparisons).No significant changes in the aforementioned markers were observed in placebo group (p&amp;gt;0.05; Table). In patients who were treated with Endocalyx, the percentage reduction of PBR 4-25μm was associated with the corresponding decrease of PWV (r=0.39, p=0.032) and with the improvement of AI (r=0.48, p=0.024) at 4 months. Conclusions Four-month treatment with Endocalyx may improve endothelial glycocalyx integrity and vascular function in patients with psoriatic disease.

Impact of the treatment with TNF inhibitors and JAK Inhibitors on arterial stiffness and lipid parameters in rheumatoid arthritis patients: a cross-sectional study

Abstract Introduction Rheumatoid arthritis (RA) is a chronic inflammatory joint disease associated with an increased cardiovascular risk. Treating disease activity with biologic and synthetic disease-modifying antirheumatic drugs (DMARDs) diminishes cardiovascular risk, but the vascular effects of different biologic and targeted synthetic drugs are poorly understood. Echo-tracking parameters of carotid artery can reveal arterial stiffness as a marker of subclinical atherosclerosis. Methods Patients with RA of at least 6 months of duration, treated with TNF inhibitors or JAK inhibitor - upadacitinib(UPA) and healthy subjects underwent ultrasound examination of carotid artery using the Aloka ProSound Alpha 7. The measurements included pulse-wave velocity (PWVβ), beta-stiffness, augmentation index (AI), arterial compliance (AC), and Ep (Elastic Modulus) and laboratory examination of lipid parameters. Disease activity of RA was measured using Disease activity scores - DAS28-CRP, DAS28-ESR, and Clinical Disease Activity Index (CDAI). Data were analyzed with SPSS v29 and the Kruskal-Wallis test was used to determine statistical differences among the three groups. Results 97 subjects, mean age 55.36±11.84, 83% females. Of them 38 on TNF inhibitors, 36 on UPA, and 23 controls. The three groups were similar in age, BMI, smoking status, and Framingham risk score. Disease activity and disease duration did not differ between the two patients groups. PWV was significantly higher in the UPA group compared to controls but not significantly different from the TNF group. (6.825 vs. 5.8022 vs. 6.468, p=0.034 UPA vs. Control, p=0.59 UPA vs. TNF) (fig.1). AC was lower and Ep was higher in the UPA group compared to controls (0.6511 vs. 0.8678, p=0.032 and132 kPa vs. 92.3, p=0.04 respectively). Total cholesterol levels were higher in the UPA group compared to TNF treated patients and to the control group (fig.2). Conclusion Echo-traching examination of the carotid artery is an easily perfomed, non-invasive and highly informative method of detecting early signs of vascular impairment in patients with RA treated with TNF inhibititors and JAK inhibitor. Treatment with UPA increases the levels of total cholesterol.

Impact of blood pressure management on cardiac mechanics and vascular function in patients with resistant hypertension- a longitudinal study

Abstract Introduction Resistant hypertension (RH) has been associated with increased arterial stiffness, impaired endothelial function, and abnormalities in cardiac mechanics. However, the impact of intensified blood pressure (BP) management on improving arterial stiffness, endothelial function, and especially left ventricular (LV) and left atrial (LA) mechanics in patients with RH remains unknown. Purpose The aim of this study was to examine the effects of intensified BP management on LV and LA mechanics, arterial stiffness, and endothelial function in people living with RH. Methods A prospective longitudinal study in which 16 RH patients (mean age 61±12 years; 37.5% females) were followed up for eight weeks after the intensification of antihypertensive treatment was initiated in a specialised hypertension clinic. Participants underwent anthropometric assessment, office and central BP measurements, pulse wave analysis to assess arterial stiffness determined by aortic augmentation index (AIx), brachial artery flow-mediated dilatation (FMD) to assess endothelial function, transthoracic echocardiography, and two-dimensional speckle tracking echocardiography analysis to assess LV and LA mechanics. Paired t-test and Wilcoxon signed-rank test were utilised to compare parametric data and non-parametric data, respectively. Results Following 8-weeks of optimising antihypertensive treatment, patients with RH demonstrated a reduction in both office systolic and diastolic BP (change of -16/-12 mmHg, P&amp;lt;0.001) and central systolic and diastolic BP (change of -17/-6 mmHg, P=0.002). RH patients exhibited reduced AIx (Baseline: 24.7% [21.7 – 35.0] vs follow-up: 16.7% [14.0 – 22.5], P&amp;lt;0.001) as well as improved FMD response compared to baseline (Baseline: 3.1±1.7% vs follow-up: 5.1±1.9%, P&amp;lt;0.001). Improvements in LV peak systolic global longitudinal strain (Baseline: -16.6±1.9% vs follow-up: -18.6±2.2%, P&amp;lt;0.001), circumferential strain (Baseline: -18.1±3.7% vs follow-up: -19.8±3.4%, P=0.002), and radial strain (Baseline: 32.3±8.2% vs follow-up: 35.1±7.3%, P&amp;lt;0.001) were also observed. No differences were detected in LV twist (Baseline: 10.6±2.9° vs follow-up: 10.0±2.3°, P=0.24). For the LA longitudinal strain indices, notable enhancements only in the LA reservoir strain (Baseline: 24.5±6.4% vs follow-up: 28.6±6.6%, P&amp;lt;0.001) and conduit strain (Baseline: -12.7±5.2% vs follow-up: -15.3±5.9%, P=0.009) were evident, with no difference in the LA contractile strain, compared to baseline (Baseline: -11.9% [-13.5 – -8.5] vs follow-up: -12.5% [-15.2 – -10.5] P=0.12) (Table 1). Conclusion Intensive BP management in patients with RH was effective in improving LV and LA mechanics, arterial stiffness, and endothelial function. These novel data identify important mechanistic effects of intensive BP treatment but also highlight the need for future studies to determine whether their improvements are associated with better clinical outcomes.

P0325 Is the augmentation index a good marker of cardiovascular risk in Crohn’s disease?

Abstract Background The axiom which defines that the high prevalence of cardiovascular risk factors is by definition correlated with the risk of cardiovascular events does not seem to apply to subjects with IBD, according to several studies which have reported that the prevalence of classic cardiovascular risk factors is lower in subjects with IBD than in the general population. This leads us to look for other markers to identify this risk at an early stage. The Augmentation index (Aix) is one such marker, based on the reflection of the pulse wave in the blood, and is a recognised measure of arterial stiffness and a risk factor for cardiovascular disease Methods This was a prospective cross-sectional study of 107 patients with Crohn’s disease (CD) diagnosed on the basis of clinical, endoscopic, morphological and histological criteria. Classical cardiovascular risk factors were analysed, as well as data concerning CD: duration, location, phenotype, clinical relapse, extradigestive manifestations, ano-perineal lesions (APL) and C-reactive protein (CRP). The augmentation index (Aix) was assessed using the SphygmoCor-XCEL Sydney. The Chi2 test was used for qualitative variables and the Kruskal Wallis test for quantitative variables. The informed consent of all patients was obtained. Results 57.9% were men, mean age was 36.9 ± 11.7 years, 5.6% of patients had coronary heredity, 11.2% hypertensive, mean systolic blood pressure: 120.1 ± 12.7 mm/hg, mean diastolic blood pressure: 74.4 ± 8.1 mm/hg, pulse pressure: 45.7 ±9.3 mm/hg, AIx was positive in 31.8% of patients, 7.5% of women were postmenopausal, mean BMI was 22 ± 5.91 Kg/m2, 9.3% were obese, 11.2% were sedentary, 20.6% were active smokers, only two patients were diabetic. 57.9% had dyslipidaemia, and 13.1% had a low cardiovascular risk according to the Framingham score. 74% had an ileal location, 6.8% colonic and 19.2% ileocolic, 19.8% had an inflammatory form, 43,4% stenosing and 36,8% penetrating, 25.5% with ano-perineal lesions, 31.4% had an extradigestive manifestation, 59.4% of patients were in clinical relapse, 47.2% of whom had a CRP &amp;gt; 6mg/l, 38% of subjects had had at least one relapse in the year prior to recruitment, and the mean duration of the disease was 57.3 ± 57 months. Statistical analysis showed a significant association between AIx and clinical relapse (p=0.03), disease duration (p=0.008), and no significant association with phenotype, location, APL, extradigestive manifestations and CRP (p&amp;gt;0.05). Conclusion Our results suggest that the augmentation index could be a good tool for detecting subclinical cardiovascular damage in Crohn’s disease. Clinical relapse and the duration of the disease would be two predominant factors in the increase in this index

Arterial stiffness in middleaged men with essential hypertension and arterial hypertension associated with type 2 diabetes mellitus

Objective. Comparison of vascular stiffness and a presence of traditional risk factors of cardiovascular diseases (CVD) in middle-aged men with arterial hypertension (HTN) and type 2 diabetes mellitus (DM). Design and methods. We examined 180 middle-aged men. All patients were divided into 3 groups of 60 people: group 1 (control) — healthy normotensive patients, group 2 (HTN) — patients with hypertension and group 3 (HTN and DM) — with hypertension and diabetes. All subjects underwent 24hours ABPM with assessment of routine and average daily parameters of blood pressure (BP), indicators of central and peripheral vascular stiffness. Results. The average daily values of systolic blood pressure (SBP) and pulse blood pressure (PBP) differ significantly between all pairs of groups, with the highest PBP in group 2. Subjects in groups 2 (HTN) and 3 (HTN + DM) had significantly higher average diastolic blood pressure (DBP). The average indicators of BP variability are worse in group 3 (HTN + DM), both for DBP and SBP. The following differences in central parameters of vascular stiffness and central pressure in the aorta were identified: DBP in the aorta (DBP ao) and mean blood pressure in the aorta (MAP ao) are higher in group 2. The augmentation index in the aorta (Alx ao) is higher in group 3, PAD amplification (PPA) and reflected wave propagation time (RWTT) are higher in group 2. Conclusions. In middle-aged men with HTN central SBP and PBP, aortic and peripheral stiffness are greater than in the control group. Central stiffness is more severe in HTN patients. Peripheral indicators of vascular stiffness are more increased in patients with HTN and DM.

Artificial intelligence-based, non-invasive assessment of the central aortic pressure in adults after operative or interventional treatment of aortic coarctation

BackgroundAortic coarctation (CoA) is a congenital anomaly leading to upper-body hypertension and lower-body hypotension. Despite surgical or interventional treatment, arterial hypertension may develop and contribute to morbidity and mortality. Conventional...

The long-term and post-prandial effects of berry consumption on endothelial dysfunction in adults: a systematic review and meta-analysis of randomised controlled trials

This systematic review and meta-analysis evaluated the long-term and post-prandial effects of berry consumption on endothelial dysfunction (ED) in adults. To identify relevant randomised controlled trials (RCTs), a systematic search was run and studies that examined the effects of berries consumption on ED markers were included. A total of 45 RCTs were included, focusing on markers such as flow-mediated dilation (FMD), pulse wave velocity (PWV), augmentation index (AIx), reactive hyperaemia index (RHI) and total peripheral resistance (TPR). The meta-analysis revealed that long-term berry consumption significantly increased FMD and decreased PWV. However, no significant effects were found for AIx, RHI or TPR. In post-prandial studies, berry consumption also improved FMD, but had no significant impact on PWV, AIx or RHI. Overall, berries were found to benefit endothelial function, particularly in improving FMD, though the effects on other cardiovascular markers were less consistent. Factors like trial design and berry type influenced outcomes.

Early and Late Effects of Medium Cutoff Dialyzer on Arterial Stiffness in Maintenance Hemodialysis Patients.

Removing uremic toxins from the body is one of the most critical points in the maintenance hemodialysis (MHD) population. This study aimed to evaluate the effects of medium cutoff (MCO) membranes on pulse wave velocity (PWV) and augmentation index (AIx), early markers of arterial stiffness, in MHD patients over both short- and long-term periods. Twenty MHD patients were included in this study. Patients were switched from low-flux to MCO membranes. Hemodynamic parameters and laboratory results were recorded in the low-flux membrane as baseline and the second week and the sixth month after switching to the MCO membranes. PWV and AIx were measured using the IME Mobil-O-Graph. The median was 69.5 years old, with 60% female predominance. 35% of the patients were diabetic, 70% had hypertension, and 21.1% were smokers. The median systolic, diastolic blood pressure, mean arterial pressure, and pulse were similar at all study time points. The pulse pressure tended to decrease with a significant reduction in the sixth month (p = 0.73 and p = 0.03). We did not observe any significant differences regarding the PWV measurements (p = 0.71 and p = 0.62) and total vascular resistance (p = 0.23 and p = 0.79). The median AIx decreased during the study time points, with a significant difference between the second-week MCO and the sixth-month MCO measurements (p = 0.04). Our findings underscore the potential benefits of MCO membranes to provide a favorable cardiovascular profile in conventional HD setting.

Association of maternal body mass index with hemodynamic and vascular alterations at 35-37 weeks' gestation.

Globally, one in four pregnant women is classified as overweight or obese, based on their prepregnancy body mass index (BMI). Obese pregnant women are at increased risk of adverse pregnancy outcomes and long-term cardiovascular disease that occurs earlier in life. This study aimed to assess maternal hemodynamic and vascular parameters at 35-37 weeks' gestation, to understand the alterations that may occur in association with increased maternal BMI and gestational weight gain, and to evaluate obesity-related pregnancy outcomes. This was a prospective observational study of 11 731 women with a singleton pregnancy attending for a routine hospital visit at 35 + 0 to 36 + 6 weeks' gestation at King's College Hospital, London, UK, between December 2021 and June 2024. Women were categorized based on their BMI at 11-13 weeks' gestation, as normal weight (BMI, 18.5-24.9 kg/m2), overweight (BMI, 25.0-29.9 kg/m2) or obese (BMI, ≥ 30 kg/m2). We recorded details regarding maternal demographic characteristics and medical history, used Doppler ultrasound to assess the uterine artery pulsatility index (UtA-PI) (as a marker for uteroplacental perfusion) and ophthalmic artery peak systolic velocity (PSV) ratio (as a marker for small vessel peripheral circulation), and measured carotid-to-femoral pulse-wave velocity, augmentation index (as direct and indirect markers of aortic stiffness, respectively), cardiac output, total peripheral resistance (TPR), and central systolic and diastolic blood pressure. Multivariable analysis was performed to examine the relationship of BMI and gestational weight gain with hemodynamic and vascular measures, adjusting for maternal demographics, medical history, pregnancy characteristics and pregnancy outcomes (including pre-eclampsia and gestational diabetes mellitus). Overweight and obese women were more often of black ethnicity, and had higher central systolic and diastolic blood pressure, cardiac output, aortic stiffness and UtA-PI, compared with normal-weight women. There was no significant difference between overweight or obese women and normal-weight women with regard to TPR and ophthalmic artery PSV ratio. On multivariable analysis, increasing BMI at 11-13 weeks and gestational weight gain between 11-13 weeks and 35-37 weeks were independently associated with increases in all cardiovascular indices (including ophthalmic artery PSV ratio), apart from TPR. Women with a high BMI in early pregnancy vs normal-weight women, and those with higher gestational weight gain, had worse maternal hemodynamic and vascular indices at 35-37 weeks' gestation, independent of baseline and pregnancy characteristics. Our findings support the notion that optimization of prepregnancy weight and gestational weight gain may improve maternal hemodynamics and vascular function during pregnancy, and therefore may improve pregnancy outcomes. © 2025 The Author(s). Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.

The Effects of Endurance Training and High-Intensity Resistance Training on Pulse Wave Velocity and QT Dispersion.

Objectives: This study aimed to examine the effects of endurance and high-intensity resistance training on arterial stiffness and ventricular repolarization in elite athletes. Methods: A total of 50 male athletes from different sports disciplines (volleyball, football, judo, and wrestling) and a sedentary group of 30 males participated in this study. Data collected from all participants included age, height, body weight, cardiovascular hemodynamic parameters, arterial stiffness parameters, and ECG measurements. Results: There was no significant age difference between the athlete group (20.42 ± 1.903 years) and the control group (20.97 ± 1.771 years) (p > 0.05). However, body mass index (BMI) values in the control group (24.83 ± 2.22 kg/m2) were significantly different from those in the athlete group (22.39 ± 2.663 kg/m2) (p < 0.05). Significant differences were found between the athlete and control groups in QT dispersion, systolic blood pressure, pulse pressure, and central pulse pressure values (p < 0.05), while similar results were obtained for arterial stiffness parameters (p > 0.05). Conclusions: The lack of a difference in pulse wave velocity and augmentation index (AIx) values between the athletes and the control group suggests that athletes do not bear additional risks regarding arterial stiffness. However, increased systolic blood pressure, pulse pressure, and central pulse pressure, among the hemodynamic parameters, indicate potential variations in vascular wall compliance and hemodynamic responses in the cardiovascular system. The increase in QT dispersion suggests that athletes may exhibit a heterogeneous repolarization process and an elevated risk of ventricular arrhythmias compared to the general population.

Evolution of arterial stiffness and association with cardiovascular risk factors in the Spanish population. Follow-up EVA.

To analyse the increase of arterial stiffness over a five-year period and its relationship with cardiovascular risk factors and sex-based differences in a Spanish population without cardiovascular disease. Longitudinal study. Analysis of the increase in arterial stiffness measures evaluated with SphygmoCor and Vasera of 480 subjects followed for 5 years of the 501 subjects included in the baseline evaluation, selected through random sampling stratified by age and sex, mean age of 55.9 years, 50.3% women. Increases per year: carotid-femoral pulse wave velocity (cf-PWV), 0.22 (SD 0.36) m/sec, brachial-ankle pulse wave velocity (ba-PWV), 0.18 (SD 0.30) m/sec, Cardio-Ankle Vascular Index (CAVI), 0.04 (SD 0.18) and Central Augmentation Index (CAI), 0.38 (SD 2.66). Multiple regression, increases in cf-PWV and ba-PWV showed an association with mean arterial pressure in global (β=0.02; β=-0.02) and in men (β=0.02; β=-0.03). In women, increases in ba-PWV and CAVI showed a negative association with BMI (β=-0.06; β=--0.03). The four measures of arterial stiffness increase over five years globally and by sex. These increases differ according to the measure used, age, sex and associated cardiovascular risk factors. Hypertensive people has greater increases in ba-PWV in global and by sex. The average blood pressure is associated with increases in cf-PWV and ba-PWV in global and in men. BMI is negatively associated with increases in ba-PWV and CAVI in women. Study registered at ClinicalTrials.gov. (NCT02623894).

Comparative Effects of Different Exercise Types on Cardiovascular Health and Executive Function in Sedentary Young Individuals.

The present study aimed to compare the impacts of different exercise types on cardiovascular health and executive function in sedentary young individuals, and to determine the associations between cardiovascular function and executive function (EF) after exercise. Sixty-three sedentary participants were randomly divided into high-intensity interval training (HIIT), moderate-intensity continuous training (MICT), resistance exercise (RE), and control groups. Macro- and microvascular endothelial function were assessed using brachial artery flow-mediated dilation and fingertip reactive hyperemia index, respectively. Arterial stiffness was evaluated through carotid-femoral pulse wave velocity, ankle-brachial index, and augmentation index. EF performance was evaluated using the Stroop and N-back tasks. Functional near-infrared spectroscopy was employed to measure cortical activation and real-time oxyhemoglobin concentration (Oxy-Hb) changes in different cerebral regions. Key circulating biomarkers for vascular and cognitive function, including BDNF, irisin, VEGF, IGF-1, and TNF-α, were measured using enzyme-linked immunosorbent assays. Eight weeks of HIIT, MICT, and RE effectively improved macro- and microvascular endothelial function while reducing arterial stiffness in sedentary young individuals. Furthermore, exercise-induced increase in BDNF level was correlated with enhanced macrovascular endothelial function, while increase in IGF-1 level was associated with enhanced microvascular endothelial function and reduced arterial stiffness. Notably, both HIIT and MICT, but not RE, efficiently enhanced Oxy-Hb level in certain brain regions, such as the FPA and DLPFC, leading to the improvement in EF performance. Exercise-induced increase in Oxy-Hb level and EF performance were correlated with enhanced BDNF level and endothelial function and reduced arterial stiffness. Our study demonstrated that 8 weeks of HIIT, MICT, and RE effectively improved endothelial function in both macro- and microvessels, and arterial stiffness among sedentary young individuals. However, HIIT and MICT, but not RE, notably increased blood oxygen level in the FPA and DLPFC brain regions and improved EF performance. Due to the efficiency and time-saving features of HIIT, the present study highlights HIIT as an effective exercise prescription for promoting vascular and EF in sedentary young individuals. Importantly, the observed improvements in cardiovascular function following exercise training is pivotal in improving EF, and elevated circulating levels of biomarkers like BDNF and IGF-1, induced by exercise, are involved in the regulatory mechanisms.

Sodium Glucose Cotransporter-2 Inhibitors Improve Endothelial Function and Arterial Stiffness in Diabetic Individuals: A Systematic Review and Network Meta-Analysis.

Sodium Glucose cotransporter-2 inhibitors (SGLT2is) possess pleiotropic effects, such as antioxidant, antifibrotic, anti-inflammatory, and vascular remodeling activities. Considering the lack of literature, a network meta-analysis was conducted to explore the impact of SGLT2is on endothelial dysfunction and arterial stiffness in the diabetic population. Electronic databases were searched to identify randomized clinical trials evaluating the effects of SGLT2is on outcomes, such as Flow-mediated Vasodilation (FMV), Pulse Wave Velocity (PWV), and Augmentation Index (AIx). Direct, indirect, and mixed treatment comparisons generated pooled estimates using random-effects modeling. Effect sizes were reported as Hedges' g with 95% Confidence Interval (95% CI). Bootstrap and permutation meta-analyses were performed using ranking plots. The certainty of evidence was graded. Twelve low risk of bias articles (706 participants) were included. SGLT2is were associated with significant improvements in FMV (g: 0.48; 95% CI: 0.08, 0.88), confirmed by bootstrap metaanalysis (g: 0.48; 95% CI: 0.1, 0.85) and permutation meta-analysis of FMD (g: 0.48; 95% CI: 0.05, 0.9). Within SGLT2is, dapagliflozin (g: 0.39; 95% CI: 0.14, 0.65) and empagliflozin (g: 0.66; 95% CI: -0.65, 1.97) significantly improved FMV, and dapagliflozin (g: -0.61, 95% CI: -0.98, -0.24) and tofogliflozin (g: -3.51; 95% CI: -4.05, -2.98) significantly improved PWV. A low risk of publication bias was observed, and the ranking plots revealed dapagliflozin to have the best probability (0.99) of being the most effective for improving FMV. Low certainty of evidence was observed for all outcomes. SGLT2 inhibitors improve endothelial function and arterial stiffness in the diabetic population. Clinical studies evaluating the association between improvements in endothelial function with SGLT2is and reduced adverse cardiovascular and cardiorenal events and mortality are urgently needed.

Photoplethysmography in assessment of skin microcirculation in pregnant women with gestational arterial hypertension

Introduction. One of the urgent problems of modern obstetrics is gestational arterial hypertension (GAH), which entails a whole range of complications for both mother and fetus. In this regard, it is necessary to search for economically accessible, informative and safe methods for early diagnosis of uteroplacental blood flow disorders in pregnant women.The aim of the study was to investigate the features of peripheral and uteroplacental blood flow in pregnant women with GAH, to assess the state of the vascular wall of pregnant women using photoplethysmography and to determine its association with uteroplacental blood flow disorders. Materials and methods. A total of 78 patients with 22 to 40 weeks of pregnancy, divided into two groups, were clinically examined: the first group (n=42) were pregnant women with GAH, the second group the control group (n=36) consisted of patients with physiological course of gestation. The study included assessment of the objective clinical status of the pregnant woman, recording and contour analysis of photoplethysmograms, ultrasound examination of the uteroplacental and fetoplacental blood flow, and statistical processing of the results.Results. When comparing the anthropometric characteristics of the studied groups, an increase in BMI was found in the group of pregnant women with GAG (p&lt;0.05). Contour analysis of photoplethysmography (PPG) data showed an increase in the augmentation index in pregnant women with GAG by 73.47 % (p=0.054), an increase in central arterial pressure by 3.6 % (p&lt;0.05). Changes in peripheral hemodynamics in pregnant women with hypertensive disorder were associated with impaired fetoplacental blood flow (rxy = 0.52-0.86, p &lt; 0.05), which was accompanied by lower fetal biometry parameters (p&lt;0.05).Conclusion. Hemodynamic disturbances in the mother-placenta-fetus system correlate with changes in the parameters of peripheral circulation, which allows us to consider the additional use of the photoplethysmography method as promising in terms of early diagnostics and prevention of perinatal complications in mother and fetus.

Dyslipidemia Impacts Cardiometabolic Health and CVD Risk in a Relatively Young Otherwise Healthy Population.

Dyslipidemia, abnormal levels of lipids in the bloodstream, is associated with cardiovascular disease risk (CVD). The purpose of this study was to evaluate the effects of dyslipidemia on cardiometabolic health in relatively young, healthy adults. Participants were 54 healthy males and females aged 18-60years. Participants were assessed for anthropometrics, body composition, blood pressure and vascular stiffness indicators, microvascular health, and glucose and lipid levels. Using a cross-sectional approach, participants were characterized and grouped as having dyslipidemia or not, and then statistically assessed to determine whether differences in other cardiometabolic health measures existed between the groups. There were significant differences between groups for body weight and composition (total mass, muscle mass, visceral fat, bone mass, and body mass index, all, p<0.027, Cohen's d>0.605) with the dyslipidemia group being higher. There were significant differences between groups for peripheral and central blood pressures (all, p<0.003, Cohen's d>0.899), as well as for vascular stiffness indicators (pulse pressure, augmentation pressure, augmentation index, augmentation index 75) (all, p<0.022, Cohen's d>0.672) with elevations noted in the dyslipidemia group. Ten-year CVD risk was significantly different between groups, with an average risk of 0.8% in the normal lipids group and a risk of 5.4% in the dyslipidemia group (p<0.001, Cohen's d=1.260). However, there were no significant differences in macro- or micronutrient intake between groups (all, p>0.166, Cohen's d<0.412). There is a significant impact on cardiometabolic health in individuals with dyslipidemia who are otherwise healthy, which may increase individual risk for CVD. Trial Registration: ClinicalTrials.gov identifier: NCT06544915.

Comparison of Influence of Office and 24-h Central Aortic Blood Pressure on Target Organ Damage in Hypertension.

The aim of this study was to explore whether 24-h ambulatory central (aortic) blood pressure (BP) has an advantage over office central aortic BP in screening for hypertension-mediated target organ damage (HMOD). A total of 714 inpatients with primary hypertension and the presence of several cardiovascular risk factors or complications involving clinical HMOD were enrolled. Twenty-four hour central aortic BP was measured by means of a noninvasive automated oscillometric device (Mobil-O-Graph). Office BP was measured with a validated oscillometric Omron device after a 5-min rest in a sitting position. Central aortic pressure waveforms were derived from the radial pressure waveforms with a validated transfer function of the Sphygmocor software, version 8.0 (Atcor Medical, Sydney, Australia). Carotid-femoral pulse wave velocity (cf-PWV) measurement was performed by sequential placement of the transducer on the femoral artery and carotid artery and determining transit time between the two pulses in reference to the R wave of the ECG. cf-PWV was calculated as the measured distance from the suprasternal notch to the femoral artery minus the distance from the suprasternal notch to the carotid artery divided by the pulse transit time. HMOD was defined as the presence of carotid intima-media thickness (IMT) above normal values and/or carotid plaque, left ventricular hypertrophy (LVH), renal abnormalities as assessed by urine albumin/creatinine ratio (ACR) above normal values and/or estimated glomerular filtration rate (eGFR) less than 60mL/min/1.73m2 and/or increased cf-PWV>10m/s. In the study cohort of 714 (age 54.52±13.24years, 74.6% male) patients with primary hypertension, LV mass index (LVMI) was significantly higher in males (p<0.002) and eGFR was significantly lower in males (p<0.001). However, there was no statistical significance between males and females in IMT, ACR, and cfPWV. When accounting for confounding factors (age, sex, BMI, triglycerides, total cholesterol, LDL, glucose, smoking, and heart rate), central systolic (cSBP), diastolic (DBP), and pulse (cPP) pressure obtained with 24-h monitoring was more strongly correlated with LVMI than office measurements. Twenty-four hour cSBP and cPP were more strongly correlated with IMT than those of office monitoring. The 24-h augmentation index (AIx) was more strongly correlated with eGFR than office AIX. Twnety-four hour cSBP and cPP were more strongly correlated with lgACR. Office AIx and cPP were more strongly correlated with c-fPWV than 24-h measurements while cSBP, DBP, and cPP obtained by both methods were equally correlated with c-fPWV. Ambulatory central (aortic) pressure may be more strongly related to HMOD than office CAP which may have an advantage in screening for c-fPWV. Trial Registration: Registration number: ChiCTR2000040308.

Psoriasis treatments in the stabilization of atherosclerosis: a systematic review

Abstract This systematic review explores the relationship between achieving minimal disease activity in psoriasis and the progression of atherosclerosis. It investigates how biologic therapies and other treatments impact atherosclerosis markers, offering insights into therapeutic strategies. A comprehensive search of PubMed, Embase, and Web of Science was conducted from January 1, 2000, to April 1, 2023, using terms such as psoriasis, psoriatic arthritis, atherosclerosis, biologic therapy, vascular stiffness, carotid intima-media thickness (CIMT), and coronary computed tomography angiography (CCTA). Eligible studies were those involving human subjects over 18, written in English, that provided quantitative atherosclerosis markers, including CIMT, CCTA, arterial pulse wave velocity (aPWV), fat attenuation index (FAI), and augmentation index (Aix). From an initial pool of 217 studies, 21 were included, grouped by treatments, including TNF-α inhibitors, IL-12/23 inhibitors, IL-17 inhibitors, DMARDs, phototherapy, and fumaric acid esters. The review found that TNF-α inhibitors significantly improved atherosclerosis markers such as CIMT, aPWV, FAI, and C-reactive protein (CRP), with reductions in these markers compared to no treatment, phototherapy, and IL-12/23 inhibitors. Additionally, IL-17 inhibitors demonstrated similar reductions in FAI compared to TNF-α inhibitors but showed a greater effect in reducing non-calcified plaque burden (12% vs. 5% for TNF-α inhibitors, p &lt; 0.001) and also decreased CRP levels. Fumaric acid improved cholesterol metabolism (p &lt; 0.04), and TNF-α inhibitors enhanced endothelial function (p &lt; 0.01). Mixed results were observed when compared to DMARDs, indicating that patient-specific factors should guide treatment choices. In conclusion, TNF-α inhibitors are highly effective in reducing atherosclerosis progression in psoriasis patients, consistently improving vascular health markers like CIMT, aPWV, FAI, and CRP. IL-17 inhibitors also show significant efficacy, particularly in reducing non-calcified plaque burden, making them a valuable alternative to TNF-α inhibitors. Fumaric acid’s role in cholesterol metabolism suggests its potential in combination therapies. These findings support integrating TNF-α and IL-17 inhibitors into treatment protocols for psoriasis patients with comorbid atherosclerosis, improving cardiovascular outcomes.