Brachial Artery Distensibility Research Articles

Serum perfluoroalkyl substances and cardiometabolic consequences in adolescents exposed to the World Trade Center disaster and a matched comparison group

BackgroundLarge amounts of various chemical contaminants, including perfluoroalkyl substances (PFASs), were released at the time of the World Trade Center (WTC) disaster. Thousands of children who lived and/or attended school near the disaster site were exposed to these substances but few studies have examined the possible consequences related to these exposures. ObjectivesTo examine the relationship of PFASs serum levels with cardiometabolic profile in children and adolescents enrolled in the World Trade Center Health Registry (WTCHR) and a matched comparison group. MethodsWe evaluated WTCHR enrollees who resided in New York City and were born between September 11, 1993 and September 10, 2001, and a matched comparison group consisting of individuals who were ineligible for WTCHR participation upon distance of their home, school or work from the WTC and lack of participation in rescue and recovery activities. Matching was based on date of birth, sex, race, ethnicity, and income. We assessed exposure to PFASs, as measured by serum levels and association with cardiometabolic profile as measured by arterial wall stiffness, body mass index, insulin resistance, fasting total cholesterol, HDL, LDL and triglycerides. ResultsA total of 402 participants completed the study and serum samples were analyzed from 308 participants, 123 in the WTCHR group and 185 in the comparison group. In multivariable regression analysis, after adjusting for relevant confounders, we observed a significant, positive association of perfluorooctanoic acid (PFOA) with triglycerides (beta coefficient=0.14, 95% CI: 0.02, 0.27, 15.1% change), total cholesterol (beta coefficient=0.09, 95% CI: 0.04, 0.14, 9.2% change), and LDL cholesterol (beta coefficient=0.11, 95% CI: 0.03, 0.19, 11.5% change). Perfluorohexanesulfonic acid levels were associated with decreased insulin resistance (beta coefficient=−0.09, 95% CI: −0.18, −0.003, −8.6% change); PFOA and perfluorononanoic acid were associated with increased brachial artery distensibility. ConclusionsThis research adds to our knowledge of the physical health impacts in a large group of children exposed to the WTC disaster. Abnormal lipid levels in young adults might be an early marker of atherosclerosis and cardiovascular diseases and our findings highlight the importance of conducting longitudinal studies in this population.

Exposure to bisphenols and phthalates and association with oxidant stress, insulin resistance, and endothelial dysfunction in children.

BackgroundThe health effects of bisphenol A (BPA) and di-(2-ethylhexyl) phthalate (DEHP) have been studied extensively in children. The impact of other chemicals in these two classes has not been investigated as fully.MethodsWe conducted a cross-sectional pilot study of 10–13 year old healthy children. We assessed descriptive, univariable and multivariable associations of urinary metabolites of bisphenols and phthalates with oxidant stress, insulin resistance, body mass, and endothelial dysfunction. Possible associations with brachial artery distensibility, pulse wave velocity (markers of vascular stiffness), and serum endothelial cell-derived microparticle levels were also assessed.ResultsWe enrolled 41 participants, 12.1 ± 1.0 years, most of whom were Mexican-Americans (42%) or other Hispanics (34%). Increased BPA levels were associated with increased levels of F2-isoprostane (ng/ml) (P=0.02), with a similar trend for DEHP metabolites. Each log unit increase of high molecular weight (HMW) phthalate metabolites was associated with 0.550 increase in HOMA-IR units (p=0.019) and altered circulating levels of activated endothelial cell-derived microparticles (% per ml) (P=0.026). Bisphenol S (BPS), a replacement for BPA, was associated with increased albumin (mg):creatinine (g) ratio (P=0.04). Metabolites of HMW phthalates were also associated with decreased brachial artery distensibility (P=0.047).ConclusionsExposure to bisphenols and phthalates, including a BPA replacement, is associated with increased oxidant stress, insulin resistance, albuminuria, as well as disturbances in vascular function in healthy children.

Reduced brachial artery distensibility in patients with type 1 diabetes

Background and aimsIn patients with type 1 diabetes mellitus (T1D), cardiovascular disease (CVD) events are more common and occur earlier in life than in non-diabetics. Reduced brachial artery distensibility (BrachD) is an independent risk factor for development of CVD. Our aim was to determine if adults with T1D have lower BrachD compared to adults without diabetes and also to determine how age and gender affect the relationship of BrachD with T1D status. Materials and methodsBrachD was measured using the Dynapulse instrument in 829 participants (352 with T1D, 477 non-diabetics). An ANCOVA model was used to test the association of BrachD with age, sex, and T1D, and the significance of an age*sex*T1D interaction. ResultsMean BrachD was lower in T1D patients vs. controls (6.43±1.46 vs. 7.16±1.48 % change per mmHg, p<0.0001). In a model adjusted for age, T1D, and sex, the interaction of age*T1D*sex was significant (p=0.0045). Younger women both with and without T1D had higher BrachD than men with and without T1D, but older women with and without T1D had lower BrachD compared to older men with and without T1D. Women with T1D had a steeper decline in BrachD with age than nondiabetic women. ConclusionsBrachD is lower in T1D patients than in non-diabetics, indicating increased vascular stiffness. Younger females have higher BrachD than males, but the decline with age in BrachD is steeper for women, particularly among those with T1D. BrachD may be an inexpensive, non-invasive method to ascertain increased CVD risk in this population.

Effect of weight loss induced by energy restriction on measures of arterial compliance: A systematic review and meta-analysis

AimTo conduct a systematic review and meta-analysis of clinical trials involving adults, to determine the effect of weight loss induced by energy restriction with or without exercise, anti-obesity drugs or bariatric surgery on measures of arterial stiffness and compliance. MethodsA systematic search of Pubmed, EMBASE, MEDLINE and the Cochrane Library was conducted to find intervention trials (randomised/non-randomised) that aimed to achieve weight loss and included the following outcome measures: cardio-ankle vascular index (CAVI), direct measures of area/diameter related to pressure change (including β-stiffness index, brachial or carotid artery compliance, aortic, carotid or brachial artery distensibility and strain), measures derived from peripheral pulse wave analysis (including augmentation index, augmentation pressure, distal oscillatory, proximal capacitive and systemic compliance) and pulse pressure. Data were analysed using Comprehensive Meta Analysis V2 using random effects analysis. Standardised mean difference (SMD) is reported with negative values indicating an improvement. ResultsA total of 43 studies, involving 4231 participants, were included in the meta-analysis. Mean weight loss was approximately 11% of initial body weight. Weight loss improved CAVI (SMD −0.48; p = 0.04), β-stiffness index (SMD = −0.98; p = 0.001), arterial compliance (SMD = −0.61; p = 0.0001) and distensibility (SMD −1.10; p = 0.005), distal oscillatory compliance (SMD = −0.41; p = 0.03), proximal capacitive compliance (SMD −0.66; p = 0.009), systemic arterial compliance (SMD −0.71; p = 0.003) and reflection time (SMD −0.51; p = 0.001). Augmentation index, strain, augmentation pressure and pulse pressure were not significantly changed with weight loss. ConclusionWeight loss induced by energy restriction improves some measures of arterial compliance and stiffness.

Low-Grade Inflammation and Increased Arterial Stiffness in Chinese Youth and Adolescents with Newly-Diagnosed Type 2 Diabetes Mellitus.

Objective:To investigate the relationship between low-grade inflammation (LI) and increased arterial stiffness in Chinese youth and adolescents with newly-diagnosed type 2 diabetes mellitus (T2DM).Methods:Ninety-eight subjects aged 10 to 24 years with newly-diagnosed T2DM were investigated for findings of general inflammation. Anthropometric measurements were taken. Data related to arterial stiffness [brachial artery distensibility (Branch D), augmentation index (AIx), carotid-femoral pulse wave velocity (CF-PWV)] were collected. The subjects were divided into a non-LI group (NLI, n=42) and a LI group (n=56) according to their high-sensitivity C-reactive protein (Hs-CRP) levels.Results:There were no significant differences in age and gender between the LI group and the NLI group. CF-PWV and AIx values of the LI group were higher than those of the NLI group (p<0.01), while Branch D values were lower in the LI group (p<0.01). Branch D, CF-PWV, and AIx values correlated significantly with Hs-CRP overall (r=-0.32, 0.34, 0.33, all p<0.01). Multivariate models revealed that in either group (LI or NLI), Hs-CRP, as a continuous variable, was an independent determinant of arterial stiffness parameters even after adjusting for other risk factors.Conclusion:Newly-diagnosed T2DM youth and adolescents with LI present a more adverse cardiovascular disease risk profile and stiffer arteries. Hs-CRP levels correlated with arterial stiffness parameters and constituted an independent determinant of arterial stiffness.

Effects of Anxiety and Depression on Arterial Elasticity of Subjects With Suboptimal Physical Health.

The authors investigated the effects of suboptimal health status (SHS; high-normal blood pressure, blood glucose, and blood lipids) on arterial elasticity in subjects with or without anxiety or depression. Suboptimal physical health status and anxiety or depression increase the risk of cardiovascular diseases. This was a cross-sectional, observational, multicenter study. Among 1520 subjects who underwent physical examination between May 2009 and December 2012 in Beijing and Chongqing, China, 955 were included. All subjects completed anxiety and depression questionnaires. Systemic vascular compliance (SVC), systemic vascular resistance, and brachial artery distensibility (BAD) were measured during arterial elasticity evaluation. Of 955 participants, 633 were classified as having SHS and 322 were classified as healthy. Systemic vascular compliance and BAD were worse in SHS subjects than in healthy subjects (SVC: 1.23 ± 0.22 vs 1.29 ± 0.25 mL/mm Hg; BAD: 6.26 ± 1.32 vs 6.61 ± 1.24%/mm Hg, respectively; both P < 0.05). Of 955 subjects, 37.7% and 43.9% had anxiety and depression, respectively. Systemic vascular compliance and BAD in SHS subjects with concomitant anxiety or depression were significantly lower than in SHS subjects without anxiety or depression (SVC: 1.22 ± 0.23 vs 1.23 ± 0.20 mL/mm Hg; BAD: 6.10 ± 1.36 vs 6.33 ± 1.20 %/mm Hg, respectively; both P < 0.05) and even lower than in healthy subjects. Though anxiety and depression had less impact on arterial elasticity in a healthy population, they may be involved in pathogenesis of vascular damage in the population with SHS.

Abstract 17579: Quantification of Femoral Adipose Tissue Provides Novel Mechanistic Insights Into the "Obesity Paradox": a Translational Approach

Introduction: Obesity has been paradoxically associated with a better outcome of CAD patients, while anthropometic measures of obesity provide limited information on adipose tissue (AT) biology. We hypothesised that quantification of femoral AT (FemAT) deposition using U/S can provide mechanistic insights into the obesity paradox. Methods: FemAT biopsies from 185 pts undergoing coronary bypass surgery (CABG) were cultured ex vivo for secretome and gene expression studies. FemAT thickness was measured by U/S at both the anterior and exterior surface of the thigh, at the mid point of the distance between the iliac crest and the knee, and the average of both thighs was calculated. Malondialdehyde (MDA), a marker of oxidative stress, was measured in plasma and FemAT culture supernatants. Brachial artery (BA) flow mediated dilatation (FMD) and distensibility were assessed by U/S. Results: FemAT thickness was only weakly correlated with BMI (r=0.235, p&lt;0.001) and waist-to-hip ratio (WHR, r=-0.179, p&lt;0.05), suggesting that it provides different information to classic anthropometrics in obesity. Patients with increased FemAT thickness had lower plasma MDA (A), better FMD (B) and greater BA distensibility (C), despite of being more obese. On the contrary BMI did not predict systemic oxidative stress or vascular function, while WHR was weakly correlated only with FMD (rho=-0.156, p&lt;0.05). Increased FemAT thickness was associated with lower MDA release from FemAT culture supernatants (D), and lower IL6-receptor (E) / CD68 (F) expression in FemAT samples, suggesting lower endogenous oxidative stress, and less macrophages’ infiltration. Conclusions: Femoral fat accumulation is associated with lower local AT inflammation and favourable systemic effects on vascular function in CAD. Combining imaging with AT biology could help to better understand the role of obesity-related vascular disease and provide an explanation to the “obesity paradox”.

Polycyclic aromatic hydrocarbons, brachial artery distensibility and blood pressure among children residing near an oil refinery

BackgroundPolycyclic aromatic hydrocarbons (PAH) are produced by the burning and processing of fuel oils, and have been associated with oxidant stress, insulin resistance and hypertension in adults. Few studies have examined whether adolescents are susceptible to cardiovascular effects of PAHs. ObjectiveTo study associations of PAH exposure with blood pressure (BP) and brachial artery distensibility (BAD), an early marker of arterial wall stiffness, in young boys attending three schools in Jeddah, Saudi Arabia in varying proximity to an oil refinery. MethodsAir samples collected from the three schools were analyzed for PAHs. PAH metabolites (total hydroxyphenanthrenes and 1-hydroxypyrene) were measured in urine samples from 184 adolescent males, in whom anthropometrics, heart rate, pulse pressure, brachial artery distensibility and blood pressure were measured. Descriptive, bivariate and multivariable analyses were performed to assess relationships of school location and urinary PAH metabolites with cardiovascular measures. ResultsTotal suspended matter was significantly higher (444±143μg/m3) at the school near the refinery compared to a school located near a ring road (395±65μg/m3) and a school located away from vehicle traffic (232±137μg/m3), as were PAHs. Systolic (0.47 SD units, p=0.006) and diastolic (0.53 SD units, p<0.001) BP Z-scores were highest at the school near the refinery, with a 4.36-fold increase in prehypertension (p=0.001), controlling for confounders. No differences in pulse pressure, BAD and heart rate were noted in relationship to school location. Urinary total hydroxyphenanthrenes and 1-hydroxypyrene were not associated with cardiovascular outcomes. ConclusionsProximity to an oil refinery in Saudi Arabia is associated with prehypertension and increases in PAH and particulate matter exposures. Further study including insulin resistance measurements, better control for confounding, and longitudinal measurement is indicated.

Abstract P097: Maternal Vascular Changes during Pregnancy may Persist Postpartum

Introduction: Higher parity (number of births) is associated with increased subclinical cardiovascular disease (CVD) in mid-life and older women, and with increased risk of CVD overall. In the only study of reproductive age women, common carotid artery intima-media thickness (CCA IMT) was greater after each birth. Prospective studies of arterial change throughout normal pregnancy are lacking; without them it is unclear whether unhealthy changes of the vasculature during pregnancy persist postpartum and raise women’s risk of CVD. The goal of this study was to prospectively assess normal vascular adaptation in healthy pregnant women. Hypotheses: During the course of healthy pregnancy: 1. CCA adventitial diameter (AD) will increase, then return to baseline postpartum, 2. CCA IMT will initially thin, then thicken as pregnancy progresses, then return to baseline postpartum, and 3. brachial artery distensibility will not change. Methods: We assessed 43 healthy women during each trimester of their first pregnancy and 6-8 weeks postpartum with B-mode ultrasound imaging of the CCA IMT and AD, independent predictors of CVD risk. Brachial artery distensibility, representing elasticity of the artery, was measured using the DynaPulse wave form analyzer. Linear mixed models were used to compare measures of CCA IMT, adventitial diameter, and brachial artery distensibility at each time point, after adjustment for age and pre-pregnancy BMI. Results: There were 37 women (age 28.2 ± 4.5 years, pre-pregnant BMI 24.4 ± 3.2 kg/m 2 ) with uncomplicated pregnancies. Six women with pregnancy complications were excluded from these analyses. After adjustment for age and pre-pregnancy BMI, mean (SE) CCA AD (mm) increased each trimester, from 6.38(0.08) in the 1 st trimester to 6.92(0.09) in the 3 rd trimester, and returned to baseline, 6.35 (0.07), postpartum. Pairwise comparisons were all statistically significant at p&lt;.01. Mean (SE)CCA IMT (mm) was increased postpartum (0.567 (0.01)) compared to 1 st (0.539 (0.01)) and 2 nd trimester values (0.546 (0.01), p &lt; .05 for each). Mean (SE) brachial artery distensibility (%/mmHg) decreased from 7.64 (0.28) 1st trimester to 6.84 (0.21) 3rd trimester (p &lt; .01) and then remained unchanged at 6.82 (0.21) postpartum. Conclusions: As we hypothesized, in uncomplicated first pregnancies CCA AD increased throughout and returned to baseline postpartum. However, contrary to our hypotheses, CCA IMT increased postpartum, and the brachial artery stiffened during pregnancy and remained stiffer 6-8 weeks postpartum. In uncomplicated first pregnancies, some vascular changes resolved (CCA AD) and others persisted (CCA IMT and brachial artery stiffness). Whether this indicates that persistence of specific vascular effects of pregnancy may inform long term CVD risk remains to be explored.

Impact of a smoking cessation lifestyle intervention on vascular mechanics in young women.

We tested the hypotheses that smoking-induced changes in vascular mechanics would be detected earlier in the lumped properties of peripheral vascular beds, which include the properties of microvasculature, than in the local properties of central conduits, and that such changes are reversible with lifestyle changes that include smoking cessation and exercise. Vascular measures were made in 53 young (18-40 years) female smokers and 25 age-matched non-smokers. Twenty-two of the smokers were tested before and after a 14-week smoking cessation program and, of these, 13 were tested again after 52 weeks of smoking cessation. Compared with non-smokers, lumped forearm vascular bed compliance (C: mL/mm Hg) was lower, while lumped viscoelasticity (K: mm Hg/(mL·min)) and resistance (R: mm Hg/(mL·min)) were higher in the smoker group. Neither the carotid-to-toe pulse wave velocity nor local carotid artery elasticity indices were different between groups. Compared with non-smokers, brachial artery distensibility was less, and other markers of stiffness higher, in the smoker group. At 14 and 52 weeks of smoking cessation, forearm vascular R was reduced and C was increased while K was unchanged. The changes in C and R occurred while maintaining a constant R×C value, which represents a dynamic time constant. Thus, early changes in K were observed in the forearm vascular bed of smokers, which were not reflected in the local properties of central conduit vessels. Forearm C, but not K, was reversed following smoking cessation, a finding that may represent a persistent effect of smoking on the intercellular matrix of the vessel wall.

The association of maternal prenatal psychosocial stress with vascular function in the child at age 10–11 years: findings from the Avon longitudinal study of parents and children

ObjectiveTo investigate whether (1) maternal psychosocial stress (depression/anxiety) during pregnancy is associated with offspring vascular function and (2) whether any association differs depending on the gestational timing of exposure to stress. We also investigated whether any association is likely to be due to intrauterine mechanisms by (3) comparing with the association of paternal stress with offspring vascular function and (4) examining whether any prenatal association is explained by maternal postnatal stress.Methods and resultsAssociations were examined in a UK birth cohort, with offspring outcomes (systolic and diastolic blood pressure, SBP and DBP, endothelial function assessed by brachial artery flow-mediated dilatation (FMD); arterial stiffness assessed by carotid to radial pulse wave velocity (PWV), brachial artery distensibility (DC), and brachial artery diameter (BD) assessed at age 10–11 years (n = 4318). Maternal depressive symptoms and anxiety were assessed at 18 and 32 weeks gestation and 8 months postnatally. Paternal symptoms were assessed at week 19. With the exception of DBP and BD, there were no associations of maternal depressive symptoms with any of the vascular outcomes. Maternal depressive and anxiety symptoms were associated with lower offspring DBP and wider BD, though the latter attenuated to the null with adjustment for confounding factors. Paternal symptoms were not associated with offspring outcomes. Maternal postnatal depressive symptoms were associated with lower offspring SBP.ConclusionsWe found no evidence to support the hypothesis that maternal stress during pregnancy adversely affects offspring vascular function at age 10–12 years via intrauterine mechanisms.

ASSA13-10-20 Characteristics and Related Risk Factors of Arterial Elasticity in Prehypertensive Persons

<h3>Objective</h3> To investigate the characteristics and related risk factors of arterial elasticity in persons with prehypertension, high-normal blood lipid and/or impaired glucose regulation (impaired fasting glucose and/or impaired glucose tolerance). <h3>Methods</h3> After receiving physical and biochemical examinations, a totol of 1238 persons were enrolled in this study. Among these enrolled persons, 65 persons were with prehypertension, 156 persons with high-normal blood lipid, 159 persons with impaired glucose regulation, 85 persons with prehypertension and high-normal blood lipid, 77 persons with prehypertension and impaired glucose regulation, 55 persons with high-normal blood lipid and impaired glucose regulation, 9 persons with prehypertension, high-normal blood lipid and impaired glucose regulation. 332 healthy persons, 113 hypertensive patients, 150 hyperlipidemic patients and 37 diabetic patients were enrolled as controls. Systemic vascular compliance (SVC), systemic vascular resistance (SVR), brachial artery distensibility (BAD) of all persons were measured with Dynapulse 200 M (Pulse Metric, Inc., USA). <h3>Results</h3> In persons with prehypertension, SVC was lower than healty group (<i>P</i> &lt; 0.0001) and higher than hypertensive group (<i>P</i> = 0.0109), SVR was higher than healty group (<i>P</i> = 0.0123) and lower than hypertensive group (<i>P</i> &lt; 0.0001), BAD was lower than healty group (<i>P</i> &lt; 0.0001). Among different groups with prehypertension, high-normal blood lipid and/or impaired glucose regulation, SVC, SVR and BAD were all with significant differences. Multiple linear regression analysis indicated, blood pressure was the independent risk factor of arterial elasticity. <h3>Conclusions</h3> Vascular function had been damaged in prehypertensive stage. Blood pressure was the independent risk factor, which had more strong effect than lipid and blood glucose. More cardiovascular risk factors with high-normal value will affect vascular function more strongly.

Characteristics and related risk factors of arterial elasticity in prehypertensive persons

To explore the characteristics and related risk factors of arterial elasticity in persons with prehypertension, high-normal blood lipid and(or) impaired glucose regulation(impaired fasting glucose and(or) impaired glucose tolerance). After receiving physical and biochemical examinations, a total of 1238 persons were enrolled. Among them, the etiologies were prehypertension (n = 65), high-normal blood lipid (n = 156), impaired glucose regulation (n = 159), prehypertension and high-normal blood lipid (n = 85), prehypertension and impaired glucose regulation (n = 77), high-normal blood lipid and impaired glucose regulation (n = 55) and prehypertension, high-normal blood lipid and impaired glucose regulation (n = 9). Also 332 healthy subjects, 113 hypertensive patients, 150 hyperlipidemics and 37 diabetics were enrolled as controls. Systemic vascular compliance (SVC), systemic vascular resistance (SVR), brachial artery distensibility (BAD) were measured with Dynapulse 200 M (Pulse Metric, Inc., USA). In persons with prehypertension, SVC was lower than healty group ((1.14 ± 0.20) ml vs (1.26 ± 0.23) ml, P < 0.01)and higher than hypertensive group ((1.11 ± 0.18) ml, P = 0.011), SVR higher than healty group (157 ± 29) kPa×s×L(-1) vs (148 ± 25) kPa×s×L(-1), P = 0.012) and lower than hypertensive group ((166 ± 36) kPa×s×L(-1), P < 0.01)and BAD lower than healty group(5.93% ± 1.14% vs 6.50% ± 1.30%, P < 0.01). Among different groups with prehypertension, high-normal blood lipid and(or) impaired glucose regulation, SVC, SVR and BAD had significant differences. As indicated by multiple linear regression analysis, blood pressure was an independent risk factor of arterial elasticity. Vascular function becomes damaged in prehypertensive stage. As an independent risk factor, blood pressure had more potent effect than lipid and blood glucose. Multiple cardiovascular risk factors with high-normal value may affect vascular function more strongly.

Influence of Erythropoietin on Arterial Stiffness and Endothelial Function in Renal Transplant Recipients

Background/Aims: Recent retrospective studies suggest an association of therapy with erythropoiesis-stimulating agents (ESAs) and increased mortality in renal transplant recipients (RTR). Large artery structure and function are significantly impaired in RTR which contributes to their high cardiovascular morbidity and could be altered by erythropoietin. We aimed to examine the influence of ESA therapy on large artery stiffness and endothelial function in RTR. Methods: 63 RTR with chronic allograft dysfunction and renal anemia were randomized to a group receiving darbepoetin alfa (Dar) and a control group (Co). At baseline and after 8 months of treatment (cumulative Dar dose 11.1 µg/kg b.w.) brachial and common carotid artery distensibility coefficients, aortic pulse wave velocity, brachial artery flow-mediated and nitroglycerin-mediated vasodilation were measured as well as the following biomarkers of vascular function: vWF, sVCAM, sICAM, E-selectin, t-PA and PAI-1. Results: 23 patients in the Dar group and 17 patients in the Co group were available for per-protocol analysis. Hemoglobin increased significantly from 10.9 to 12.6 g/dl after 8 months in the Dar group, whereas it remained stable at 11.3 g/dl in the Co group. Effects on large artery stiffness, endothelial function and biomarkers of vascular function did not differ significantly between the two groups. Conclusion: Therapy with Dar during 8 months did not significantly impact parameters of large artery stiffness and endothelial function in RTR. These data suggest that therapy with erythropoietin does not deteriorate arterial stiffness and endothelial function in RTR.

Abstract P299: BMI and BP Predict Brachial Distensibility in Healthy Adolescents and Young Adults

Introduction: CV risk-factor (CVRF) related increase in arterial stiffness is associated with adverse CV events in adults. Cross-sectional studies in youth show a relationship between CVRF and arterial stiffness. Longitudinal data are lacking. Hypothesis: CVRFs will predict decreased brachial artery distensibility (BrachD). Methods: Demographics, anthropometrics, BP, fasting glucose, insulin, lipids and BrachD were measured in 425 healthy youth in a school-based longitudinal cohort (age 17.4 +2.1 yrs, 41% male, 61% Caucasian). Anthropometrics, BP and BrachD were repeated 2.1 + 0.3 years later. Mean values for baseline and follow-up variables were evaluated by paired t-test. Characteristics of subjects with decrease in BrachD (N=167) were compared by t-test with subjects without BrachD decrease. The multivariable model to determine predictors of follow-up BrachD contained baseline and change of age, sex, BMI, MAP, HR, baseline lipids, glucose and insulin. Results: Over 2 years, the cohort increased in HT, WT, BMI, SBP and BrachD (all p&lt;0.02). Predictors of decrease in BrachD were greater baseline and change in BMI, MAP and HR (R 2 = 0.36, model p &lt;0.0001, parameter p&lt; 0.02, BrachD at follow-up = 2.7 + 0.04*Age at baseline + 0.4*Sex (male=1, female=2) − 0.02 Age at baseline*Sex − 0.33*BMI at baseline − 0.02*BMI change - 0.005*MAP at baseline - 0.004*MAP change - 0.002*HR at baseline - 0.003*HR change). BMI at baseline and change in BMI contributed the majority of the variance in BrachD at follow-up (16 and 4%). Subjects with decrease in BrachD were more likely to have gained more BMI (1.3 vs 0.6 kg/m 2 ) or increased more in MAP (0.8 vs −1.3 mmHg) and HR (1.1 vs −2.0 beats/min, all p&lt;0.002). Conclusions: Development of obesity with subsequent changes in BP and HR may lead to development of arterial dysfunction. Prevention of obesity may be the most important approach to improve the CV health of adolescents and young adults.

Wpływ stentowania tętnicy udowej powierzchownej i poszczególnych czynników ryzyka wystąpienia miażdżycy na zmiany wybranych parametrów globalnej funkcji śródbłonka u pacjentów z przewlekłym niedokrwieniem kończyn dolnych. Badanie pilotażowe

ENWEndNote BIBJabRef, Mendeley RISPapers, Reference Manager, RefWorks, Zotero AMA Budzyński J, Wiśniewska J, Wasielewski M, Suppan K. Original paperThe effect of superficial femoral artery stenting and some atherosclerosis risk factors on changes in selected global endothelial function tests in patients with chronic lower limb ischemia. A pilot study. Advances in Interventional Cardiology/Postępy w Kardiologii Interwencyjnej. 2012;8(3):205-215. doi:10.5114/pwki.2012.30400. APA Budzyński, J., Wiśniewska, J., Wasielewski, M., & Suppan, K. (2012). Original paperThe effect of superficial femoral artery stenting and some atherosclerosis risk factors on changes in selected global endothelial function tests in patients with chronic lower limb ischemia. A pilot study. Advances in Interventional Cardiology/Postępy w Kardiologii Interwencyjnej, 8(3), 205-215. https://doi.org/10.5114/pwki.2012.30400 Chicago Budzyński, Jacek, Joanna Wiśniewska, Marcin Wasielewski, and Karol Suppan. 2012. "Original paperThe effect of superficial femoral artery stenting and some atherosclerosis risk factors on changes in selected global endothelial function tests in patients with chronic lower limb ischemia. A pilot study". Advances in Interventional Cardiology/Postępy w Kardiologii Interwencyjnej 8 (3): 205-215. doi:10.5114/pwki.2012.30400. Harvard Budzyński, J., Wiśniewska, J., Wasielewski, M., and Suppan, K. (2012). Original paperThe effect of superficial femoral artery stenting and some atherosclerosis risk factors on changes in selected global endothelial function tests in patients with chronic lower limb ischemia. A pilot study. Advances in Interventional Cardiology/Postępy w Kardiologii Interwencyjnej, 8(3), pp.205-215. https://doi.org/10.5114/pwki.2012.30400 MLA Budzyński, Jacek et al. "Original paperThe effect of superficial femoral artery stenting and some atherosclerosis risk factors on changes in selected global endothelial function tests in patients with chronic lower limb ischemia. A pilot study." Advances in Interventional Cardiology/Postępy w Kardiologii Interwencyjnej, vol. 8, no. 3, 2012, pp. 205-215. doi:10.5114/pwki.2012.30400. Vancouver Budzyński J, Wiśniewska J, Wasielewski M, Suppan K. Original paperThe effect of superficial femoral artery stenting and some atherosclerosis risk factors on changes in selected global endothelial function tests in patients with chronic lower limb ischemia. A pilot study. Advances in Interventional Cardiology/Postępy w Kardiologii Interwencyjnej. 2012;8(3):205-215. doi:10.5114/pwki.2012.30400.

Influence of hyperglycemia during and after pregnancy on postpartum vascular function

Endothelial dysfunction is commonly observed in women with a previous diagnosis of gestational diabetes mellitus (GDM). Whether arterial stiffness is also related to pregnancy and/or postpartum glucose intolerance has not been determined. We examined the influence of GDM during pregnancy and hyperglycemia in the postpartum period on arterial function. Thirty postpartum women were stratified into one of three groups: 1) normoglycemic pregnancy, normoglycemic postpartum (NORM), 2) GDM during pregnancy, normoglycemic postpartum (GDM-N); and 3) GDM during pregnancy, hyperglycemic postpartum (GDM-H). Ten never-pregnant controls were also recruited (Control). All measures were made at 2 mo postpartum or in the early follicular phase in Control women. Arterial stiffness was assessed by pulse wave velocity (PWV) and brachial and carotid artery distensibility. Endothelial function was determined by flow-mediated dilation (FMD). PWV was not different between the four groups. Distensibility of the brachial and carotid arteries was lower in GDM-N women (brachial: 1.1 × 10(-3) mmHg(-1) ± 3.6 × 10(-4); carotid: 2.0 × 10(-3) ± 3.3 × 10(-4)) and GDM-H (brachial: 1.4 × 10(-3) mmHg(-1) ± 4.1 × 10(-4); carotid: 1.8 × 10(-3) mmHg(-1) ± 5.0 × 10(-4)) compared with NORM women (brachial: 3.4 × 10(-3) mmHg(-1) ± 7.0 × 10(-4); carotid: 3.9 × 10(-3) ± 7.4 × 10(-4)). However, only brachial artery distensibility returned to Control levels by 2 mo postpartum in the NORM women. FMD was lower in previously GDM women (GDM-N: 4.1% ± 2.3; GDM-H: 4.4% ± 0.9) compared with NORM women (10.8% ± 1.3; P < 0.01). These findings suggest that the vascular function of women in the early postpartum period is influenced by GDM during pregnancy and the persistence of clinical and/or subclinical hyperglycemia after delivery.

Insulin resistance and arterial stiffness in healthy adolescents and young adults

Increased arterial stiffness is a risk factor for adverse cardiovascular events in adults with obesity-related insulin resistance (IR) or type 2 diabetes mellitus. Adolescents with type 2 diabetes have stiffer vessels. Whether stiffness is increased in obesity/IR in youth is not known. We sought to determine if IR was a determinant of arterial stiffness in youth, independent of obesity and cardiovascular risk factors. We measured cardiovascular risk factors, IR, adipocytokines and arterial stiffness (brachial artery distensibility [BrachD], pulse wave velocity [PWV]) and wave reflection (augmentation index [AIx]) in 343 adolescents and young adults without type 2 diabetes (15-28 years old, 47% male, 48% non-white). Individuals <85th percentile of BMI were classified as lean (n = 232). Obese individuals were grouped by HOMA index as not insulin resistant (n = 46) or insulin resistant (n = 65) by the 90th percentile for HOMA for lean. Mean differences were evaluated by ANOVA. Multivariate models evaluated whether HOMA was an independent determinant of arterial stiffness. Risk factors deteriorated from lean to obese to obese/insulin resistant (all p ≤ 0.017). Higher AIx, lower BrachD and higher PWV indicated increased arterial stiffness in obese and obese/insulin-resistant participants. HOMA was not an independent determinant. Age, sex, BMI and BP were the most consistent determinants, with HDL-cholesterol playing a role for BrachD and leptin for PWV (AIx R²= 0.34; BrachD R² = 0.37; PWV R² = 0.40; all p ≤ 0.02). Although IR is associated with increased arterial stiffness, traditional cardiovascular risk factors, especially obesity and BP, are the major determinants of arterial stiffness in healthy young people.

O1-2.4 Hypertensive disorders of pregnancy and offspring vascular, inflammatory and lipid outcomes in childhood: findings from the Avon Longitudinal Study of Parents and Children

IntroductionOffspring of hypertensive pregnancies have higher blood pressure (BP) in later life. Whether this is accompanied by impaired vascular function and worse cardiovascular risk profiles suggesting mediation by intrauterine exposure...

Cardiac and Vascular Consequences of Pre‐Hypertension in Youth

Hypertension is associated with increased left ventricular mass (LVM) and carotid intima-media thickness (cIMT), which predict cardiovascular (CV) events in adults. Whether target organ damage is found in pre-hypertensive youth is not known. The authors measured body mass index, blood pressure, fasting glucose, insulin, lipids and C-reactive protein, LVM/height(2.7) (LVM index), diastolic function, cIMT, carotid stiffness, augmentation index, brachial artery distensibility, and pulse wave velocity (PWV) in 723 patients aged 10 to 23 years (29% with type 2 diabetes mellitus). Patients were stratified by blood pressure level (normotensive: 531, pre-hypertensive: 65, hypertensive: 127). Adiposity and CV risk factors worsened across blood pressure group. There was a graded increase in cIMT, arterial stiffness, and LVM index and decrease in diastolic function from normotension to pre-hypertension to hypertension. In multivariable models adjusted for CV risk factors, status as pre-hypertension or hypertension remained an independent determinant of target organ damage for LVM, diastolic function, internal cIMT, and carotid and arterial stiffness. Pre-hypertension is associated with cardiovascular target organ damage in adolescents and young adults.