Carotid Artery Pulse Research Articles

Tapered fiber optic sensor for arterial pulse wave monitoring

Arterial pulse wave monitoring has been recognized as an effective medical diagnostic tool for various cardiovascular diseases. To overcome the barriers in traditional, complex, and expensive detection configurations, new electronic and optical sensors have been developed with their unique advantages. Particularly, various configurations of fiber-optic sensors have been proposed. This paper demonstrates the use of a tapered optical fiber structure to create a sensitive sensor that can detect carotid arterial pulse waves on the skin surface. The demonstrated fiber sensor probe utilizes an in-line Mach-Zehnder interferometer configuration and liquid-gold film coating on the sensor tip to enhance its sensitivity and demonstrate its use by encapsulating the sensor with a flexible elastomer material for detecting arterial pulse waves with a simple testing configuration. Considering the simple fabrication and high sensitivity without a complex demodulation scheme, the proposed sensor has broad implementation in biomedical health monitoring systems.

Buprenorphine affects the initiation and severity of interleukin-induced acute pancreatitis in mice.

Acute pancreatitis (AP) is a common disease with no targeted therapy and has varied outcomes ranging from spontaneous resolution to being lethal. Although typically painful, AP can also be painless. Various agents, including opioids, are used for pain control in AP; the risks and benefits of which are often debated. As experimental AP in mice is used to study the efficacy of potential therapies, we studied the effect of a commonly used opioid, buprenorphine, on the initiation and progression of AP. For this, we administered extended-release buprenorphine subcutaneously before inducing the previously established severe AP model that uses interleukins 12 and 18 (IL12,18) in genetically obese (ob/ob) mice and compared this to mice with AP but without the drug. Mice were monitored over 3 days, and parameters of AP induction and progression were compared. Buprenorphine significantly reduced serum amylase, lipase, pancreatic necrosis, and AP-associated fat necrosis, which is ubiquitous in obese mice and humans. Buprenorphine delayed the AP-associated reduction of carotid artery pulse distention and the development of hypothermia, hastened renal injury, and muted the early increase in respiratory rate versus IL12,18 alone. The site of buprenorphine injection appeared erythematous, inflamed, and microscopically showed thinning, loss of epidermal layers that had increased apoptosis. In summary, subcutaneous extended-release buprenorphine interfered with the induction of AP by reducing serum amylase, lipase, pancreatic and fat necrosis, the worsening of AP by delaying hypotension, hypothermia, while hastening renal injury, respiratory depression, and causing cutaneous injury at the site of injection.NEW & NOTEWORTHY Extended-release buprenorphine interferes with the initiation and progression of acute pancreatitis at multiple levels.

Comparative analysis of micro patterned PDMS-based piezoresistive pressure sensors with multifunctional strain and health monitoring applications

Flexible strain and pressure sensors are widely utilized for healthcare and wearable applications. But the majority of the sensors include sophisticated fabrication methodology, are less adaptable, expensive, and need to provide higher sensitivity. In this work, addressing these issues, we have investigated four different micropatterned Poly Dimethyl Siloxane (PDMS)-based device configurations to develop a cost-effective, high performance physical sensing form for both pressure and strain sensing. PDMS is poured into four different micropatterned molds, and the patterned surface of the PDMS is rendered conductive by the thermal evaporation of copper metal. Given the ease of fabrication and clean room-free approach, the optimized pressure sensor yields a sensitivity of 1.77 kPa−1 over the dynamic range of 100 N – 600 N and a response time of 0.31 s. Further, the PDMS-based pressure sensor is used for an ultrasensitive carotid arterial pulse and speech detection to demonstrate its real-time applications. When utilized as a strain sensor, the fabricated device exhibits a (GF) Gauge Factor of 22 and 0.2 s response time and could detect compressive and tensile strains ranging from 9.2–61.6 %. To illustrate its practicality, the PDMS-based strain sensor is also used for gesture detection. This excellent response of the fabricated sensor can be attributed to a piezoresistive working mechanism. The concept presented here paves the way for developing adaptive, low-cost, clean-room-free, simpler multipurpose sensors for medical applications and wearable consumer electronics by exploring different types of novel architectures with optimal performance.

Reduced reward responsiveness in treatment resistant depression of middle-aged adults: Association with carotid artery stiffness and tetrahydrobiopterin.

Nearly one third of the population diagnosed with major depressive disorder (MDD) fail to respond to two or more antidepressant drugs of adequate dose and duration. This necessitates identification of confounding psychological and physiological factors that could contribute to treatment resistant depression (TRD). The present longitudinal study investigated the influence of behavioural inhibition system (BIS) and behavioural approach system (BAS) in treatment resistance. Further, the association of depression severity with physiological factors contributing to arterial stiffness was also investigated. Baseline data was acquired from 101 middle-aged (36-56 years) patients on immediate diagnosis with MDD using DSM-V criteria. Follow ups were conducted at 06 months and 12 months during treatment. Psychological assessment battery at baseline and follow ups comprised of Hamilton depression rating (HAM-D) for depression severity, WHODAS-2 and BIS-BAS score. Atherosclerosis and central arterial stiffness were measured by intima-media thickness of internal carotid artery and brachial-ankle pulse wave velocity. Physiological factors influencing central vascular function viz., body-mass index, estimated glomerular filtration rate, HbA1c, central systolic and diastolic blood pressure, heart rate and tetrahydrobiopterin were also investigated. Our results show lower reward responsiveness (BAS-RR) and higher BIS scores in TRD patients along with differentially higher intima-media thickness of left internal carotid artery. Higher depression severity at all stages of the study was correlated with lower tetrahydrobiopterin and BAS-RR scores. We, therefore, suggest that vascular depression resulting due to increased intima-media thickness of left carotid artery and lower tetrahydrobiopterin could be contributing factors for treatment resistance in middle-aged MDD patients.

Chronic SIRT1 supplementation in diabetic mice improves endothelial function by suppressing oxidative stress.

Enhancing SIRT1 activity exerts beneficial cardiovascular effects. In diabetes, plasma SIRT1 levels are reduced. We aimed to investigate the therapeutic potential of chronic recombinant murine SIRT1 (rmSIRT1) supplementation to alleviate endothelial and vascular dysfunction in diabetic mice (db/db). Left internal mammary arteries obtained from patients undergoing coronary artery bypass grafting with or without a diagnosis of diabetes were assayed for SIRT1 protein levels. Twelve-week-old male db/db mice and db/+ controls were treated with vehicle or rmSIRT1 intraperitoneally for 4 weeks, after which carotid artery pulse wave velocity (PWV) and energy expenditure/activity were assessed by ultrasound and metabolic cages, respectively. Aorta, carotid, and mesenteric arteries were isolated to determine endothelial and vascular function using the myograph system.Arteries obtained from diabetic patients had significantly lower levels of SIRT1 relative to non-diabetics. In line, aortic SIRT1 levels were reduced in db/db mice compared to db/+ mice, while rmSIRT1 supplementation restored SIRT1 levels. Mice receiving rmSIRT1 supplementation displayed increased physical activity and improved vascular compliance as reflected by reduced PWV and attenuated collagen deposition. Aorta of rmSIRT1-treated mice exhibited increased endothelial nitric oxide (eNOS) activity, while endothelium-dependent contractions of their carotid arteries were significantly decreased, with mesenteric resistance arteries showing preserved hyperpolarization. Ex vivo incubation with reactive oxygen species (ROS) scavenger Tiron and NADPH oxidase inhibitor apocynin revealed that rmSIRT1 leads to preserved vascular function by suppressing NADPH oxidase (NOX)-related ROS synthesis. Chronic rmSIRT1 treatment resulted in reduced expression of both NOX1 and NOX4, in line with a reduction in aortic protein carbonylation and plasma nitrotyrosine levels. In diabetic conditions, arterial SIRT1 levels are significantly reduced. Chronic rmSIRT1 supplementation improves endothelial function and vascular compliance by enhancing eNOS activity and suppressing NOX-related oxidative stress. Thus, SIRT1 supplementation may represent novel therapeutic strategy to prevent diabetic vascular disease.

Carotid arterial stiffness and cerebral blood flow variability in individuals with mild cognitive impairment

Background: It is unclear whether cerebral blood flow variability is a sign of impaired vascular function or an adaptation to chronic cerebral hypoperfusion in individuals with cognitive dysfunction. Elevated arterial stiffness increases transmission of pulsatile pressure to the brain, but the relationship between arterial stiffness, the magnitude of cerebral blood flow variability, and cognitive dysfunction is unknown. In this pilot study, we hypothesized that carotid artery stiffness would be higher in individuals with mild cognitive impairment (MCI) compared with individuals with normal cognition (NC), resulting in higher cerebral blood flow variability. Methods: In individuals with MCI (N=5) or NC (N=7), R-wave to common carotid artery (CCA) pulse wave velocity (PWV) was assessed as an index of arterial stiffness (via tonometry). CCA velocity (CCAv) and middle cerebral artery velocity (MCAv) were measured via transcranial Doppler ultrasound, with concurrent measurements of mean arterial pressure (MAP) via finger photoplethysmography. The amplitude of MAP, CCAv, and MCAv oscillations in the low frequency range (LF; 0.07-0.15 Hz) were assessed via fast Fourier transformation, and normalized to total power (0.04-0.4 Hz) for each participant to account for high inter-individual variability. Relationships between R-wave-carotid PWV and LF variability in CCAv and MCAv were assessed via correlational analyses. Results: There were no between-group differences for R-wave-carotid PWV (MCI: 0.91±0.16 m/s vs. NC: 0.87±0.07 m/s; P=0.70), mean CCAv (MCI: 31.8±8.8 cm/s vs. NC: 29.7±2.0 cm/s; P=0.54), mean MCAv (MCI: 50.9±6.5 cm/s vs. NC: 47.9±12.7 cm/s; P=0.63), or MAP (MCI: 102.1±10.2 mmHg vs. 104.7±13.8 mmHg; P=0.73). While there was also no difference between groups for nLF power of CCAv (MCI: 0.28±0.03 au vs. NC: 0.33±0.10 au; P=0.41), nLF power for MCAv was lower in the MCI group (MCI: 0.26±0.07 au vs. 0.43±0.12; P=0.02). Overall, there was a strong positive correlation between R-wave-carotid PWV and CCAv nLF power (R=0.81, P=0.005), but a weaker relationship for MCAv nLF power (R=0.56, P=0.09). While sub-group correlational analyses are limited based on the small sample sizes, relationships between R-wave-carotid PWV and CCAv nLF power were high for both MCI (R=0.98, P=0.02) and NC (R=0.79, P=0.06) groups, but were lower for MCAv nLF power (MCI: R=-0.12, P=0.88; NC: R=0.69, P=0.13). Conclusion: Contrary to our hypothesis, there were no differences in R-wave-carotid PWV between groups, and blood flow variability was either similar between groups (for CCAv), or lower in the MCI group (for MCAv). Overall, there was a strong positive relationship between R-wave-carotid PWV and blood flow variability in the CCA, which was also observed in sub-analysis of the MCI and NC groups. Future investigations with a larger sample size are needed to definitively determine the role of arterial stiffness on cerebral blood flow variability with cognitive dysfunction. R56AG068630, NIH National Institute for Aging (NIA), “Hemodynamic Mechanisms Linking Aortic Arch Stiffness with Brain Insult in Older Adults” This is the full abstract presented at the American Physiology Summit 2023 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.

A Highly Sensitive Flexible Pressure Sensor Based on Inter-Comb Structured Graphene Electrodes

Susceptible and flexible pressure sensors have broad application prospects and market demands in bionic skin, human–machine interface, and intelligent wearable electronic devices. However, optimizing the sensor’s sensitivity through a simple, low-cost process is still a considerable challenge. In this work, the sensitivity of a capacitive pressure sensor was effectively improved by optimizing the geometry of the laser-scribed graphene (LSG) electrodes. The pressure sensor, based on the inter-comb structured LSG electrodes and polyvinyl pyrrolidone nanofiber membrane (PVP NM) dielectric layer, has a high sensitivity (4.352 kPa <inline-formula xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink"> <tex-math notation="LaTeX">$^{-\text{1}}$</tex-math> </inline-formula> at 0–2 kPa), a fast response/recovery time (40/37 ms), an ultralow detection limit ( <inline-formula xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink"> <tex-math notation="LaTeX">$\sim$</tex-math> </inline-formula> 12 Pa), and excellent mechanical stability (6000 cycles). The sensor developed in this research can be used in health monitoring such as carotid artery pulsation and respiratory disease. In addition, the 6 <inline-formula xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink"> <tex-math notation="LaTeX">$\times$</tex-math> </inline-formula> 6 sensor array can precisely characterize the regional pressure distribution. This study demonstrates the significant potential of the inter-comb structured LSG electrodes in highly sensitive flexible pressure sensors.

Screening left ventricular systolic dysfunction in children using intrinsic frequencies of carotid pressure waveforms measured by a novel smartphone-based device

Objective. Children with heart failure have higher rates of emergency department utilization, health care expenditure, and hospitalization. Therefore, a need exists for a simple, non-invasive, and inexpensive method of screening for left ventricular (LV) dysfunction. We recently demonstrated the practicality and reliability of a wireless smartphone-based handheld device in capturing carotid pressure waveforms and deriving cardiovascular intrinsic frequencies (IFs) in children with normal LV function. Our goal in this study was to demonstrate that an IF-based machine learning method (IF-ML) applied to noninvasive carotid pressure waveforms can distinguish between normal and abnormal LV ejection fraction (LVEF) in pediatric patients. Approach. Fifty patients ages 0 to 21 years underwent LVEF measurement by echocardiogram or cardiac magnetic resonance imaging. On the same day, patients had carotid waveforms recorded using Vivio. The exclusion criterion was known vascular disease that would interfere with obtaining a carotid artery pulse. We adopted a hybrid IF- Machine Learning (IF-ML) method by applying physiologically relevant IF parameters as inputs to Decision Tree classifiers. The threshold for low LVEF was chosen as <50%. Main results. The proposed IF-ML method was able to detect an abnormal LVEF with an accuracy of 92% (sensitivity = 100%, specificity = 89%, area under the curve (AUC) = 0.95). Consistent with previous clinical studies, the IF parameter was elevated among patients with reduced LVEF. Significance. A hybrid IF-ML method applied on a carotid waveform recorded by a hand-held smartphone-based device can differentiate between normal and abnormal LV systolic function in children with normal cardiac anatomy.

Difference analysis of Doppler ultrasound blood flow of Cunkou (radial artery) pulse, Renying (carotid artery) pulse, and Fuyang (anterior tibial artery) pulse.

To analyze the Doppler ultrasound blood flow of Renying (carotid artery) pulse, Cunkou (radial artery) pulse, and Fuyang (anterior tibial artery) pulse in the normal group and the functional constipation with gastrointestinal heat (FCGH) group, and to compare and explore the differences of Renying, Cunkou and Fuyang pulses. Sixty normal subjects and 60 patients with gastrointestinal heat constipation were collected in the department of ultrasound, Beijing Anzhen Hospital, Capital Medical University. Doppler ultrasound was used to observe the blood flow indexes including maximum systolic velocity (Vp), maximum diastolic velocity (Vd), mean velocity (Vm), pulse index (PI), resistance index (RI), vascular diameter (D), and circulation blood flow cycle (ET) of Renying pulse, Cunkou pulse and Fuyang pulse in the normal group and patients with gastrointestinal heat constipation. The differences of these three pulses were compared between the normal group and the FCGH group. The PI, Vp, Vm, RI, and D of the three pulses in the normal group were statistically significant different ( < 0.01). In the comparison of Doppler flow diagram of three pulses in the FCGH group, there were significant differences in PI, Vd, Vp, Vm, RI, and D ( < 0.01). Under normal conditions, the indexes of Renying pulse Doppler flow diagram, Cunkou pulse Doppler flow diagram, and Fuyang pulse Doppler flow diagram are significantly different. In the FCGH group, most of the indexes of Renying pulse Doppler flow diagram, Cunkou pulse Doppler flow diagram, and Fuyang pulse Doppler flow diagram are different. This result verified the necessity of simultaneous examinations of all Renying, Cunkou, and Fuyang pulses in modern Chinese medicine.

An FBG-Based Sensor With Both Wearable and Handheld Forms for Carotid Arterial Pulse Waveform Measurement

An FBG-Based Sensor With Both Wearable and Handheld Forms for Carotid Arterial Pulse Waveform Measurement

Deep Learning‐Enabled MXene/PEDOT:PSS Acoustic Sensor for Speech Recognition and Skin‐Vibration Detection

Flexible acoustic sensors with high sensitivity, excellent mechanical strength, and easy integration are urgently needed for wearable electronics. MXene holds great promise as a sensing material for this application. However, low flexibility and stability limit the performance of MXene‐based composites. To alleviate the aforementioned issue, a flexible pressure sensor based on MXene/poly(3,4‐ethylenediox‐ythiophene)‐poly(styrenesulfonate) (PEDOT:PSS) is fabricated and used as an acoustic sensor inhibiting high sensitivity, fast response time (57 ms), ultra‐thin thickness (30 μm), and remarkable stability. Excellent performance enables the sensor to detect and identify weak muscle movements and skin vibrations, such as word pronunciation and carotid artery pulse. Furthermore, by combining the proposed deep learning model based on number recognition convolutional neural network (NR‐CNN), speech recognition toward different pronunciations of numbers that appear frequently in daily conversations can be realized. High recognition accuracy (91%) is achieved by training and testing the proposed NR‐CNN with large amounts of data recorded by the sensor. Results demonstrate that the flexible and wearable MXene/PEDOT:PSS acoustic sensor accelerates intelligent artificial acoustics and possesses great potential for applications involving speech recognition and health monitoring.

Evaluation of the carotid artery using wavelet-based analysis of the pulse wave signal

&lt;p&gt;The use of pulse wave analysis may assist cardiologists in diagnosing patients with vascular diseases. However, it is not common in clinical practice to interpret and analyze pulse wave data and utilize them to detect the abnormalities of the signal. This paper presents a novel approach to the clinical application of pulse waveform analysis using the wavelet technique by decomposing the normal and pathology signal into many levels. The discrete wavelet transform (DWT) decomposes the carotid arterial pulse wave (CAPW) signal, and the continuous wavelet transform (CWT) creates images of the decomposed signal. The wavelet analysis technique in this work aims to strengthen the medical benefits of the pulse wave. The obtained results show a clear difference between the signal and the images of the arterial pathologies in comparison with normal ones. The certain distinct that were achieved are promising but further improvement may be required in the future.&lt;/p&gt;

Usefulness of the Atherosclerosis Risk Score for Patients With Acute Infarction in the Lenticulostriate Artery Region.

Background and purposeInternal carotid artery intima-media thickness (IMT) and pulse wave velocity (PWV) are risk factors of cerebrovascular disease and coronary artery disease. They are known as independent predictors of arteriosclerotic disease. It has been reported that IMT and PWV are useful factors for predicting stroke subtype and/or outcome.Coronary artery disease onset is proportional to atherosclerosis progression, and the Framingham Risk Score (FRS) and Suita score (SS) are standard risk predictors. This study examined whether FRS and SS can be useful for patient outcomes with acute infarction in the lenticulostriate artery (LSA) region without special tests or invasive procedures while using IMT or PWV as predictive factors.MethodsWe screened 629 consecutive patients with ischemic stroke and reviewed 84 patients with acute infarction in the LSA region who were admitted between January 2018 and December 2020. An early deterioration (ED) group was defined. In addition, the clinical characteristics, FRS, SS, treatment therapy, and neurovascular findings were evaluated.ResultsFRS and SS (FRS: 11.6 vs. 8.3, p < 0.01, SS: 58.2 vs. 53.7, p = 0.01, respectively), pre-symptomatic modified Rankin Scale (mRS) (p = 0.03), mRS at discharge (p < 0.01), and deterioration of manual muscle test (MMT) (<0.01) were significantly higher in patients in the ED (34 patients) group than in the no-ED group (54 patients). FRS and SS were correlated with mRS deterioration (FRS: r = 0.47; p < 0.01, SS: r = 0.23; p = 0.03). Among the laboratory parameters, total cholesterol (TC) (p < 0.01) and low-density lipoprotein cholesterol (LDL-C) (p < 0.01) were significantly higher in the ED group, and no significant differences in any acute therapeutic interventions.ConclusionAtherosclerosis risk scores, such as FRS and SS, may be useful for predicting outcomes in patients with acute LSA-region infarctions within 48 hours of onset.

Feasibility of Specular Reflection Imaging for Extraction of Neck Vessel Pressure Waveforms.

Cardiovascular disease (CVD) is a leading cause of death worldwide and was responsible for 31% of all deaths in 2015. Changes in fluid pressures within the vessels of the circulatory system reflect the mechanical function of the heart. The jugular venous (JV) pulse waveform is an important clinical sign for assessing cardiac function. However, technology able to aid evaluation and interpretation are currently lacking. The goal of the current study was to develop a remote monitoring tool that aid clinicians in robust measurements of JV pulse waveforms. To address this need, we have developed a novel imaging modality, Specular Reflection Vascular Imaging (SRVI). The technology uses specular reflection for visualization of skin displacements caused by pressure pulsations in blood vessels. SRVI has been tested on 10 healthy volunteers. 10-seconds videos of the neck illuminated with a diffuse light source were captured at 250 fps. SRVI was able to identify and discriminate skin displacements caused by carotid artery and jugular vein pulsations to extract both carotid artery and jugular vein waveforms, making them easier to be visualized and interpreted. The method provided a 6-fold improvement in signal strength over a comparator remote PPG dataset. The current pilot study is a proof-of-concept demonstration of the potential of Specular Reflection Vascular Imaging for extraction of JV pulse waveforms.

Photometric recorder of the carotid artery pulse wave with a system for stabilizing the clamping force

Preventive monitoring, which increases the possibility of diagnosing and curing a disease at an early stage, is interesting and relevant in medical diagnostics. Recently, both minimally invasive and non-invasive diagnostic techniques have become widespread. They include the areas of cardiographic, encephalographic and myographic analyzers designed to study the state of the heart, the brain and striated muscles. The study of the functioning of the smooth muscles of the gastrointestinal tract is carried out using gastro-enterography methods. To obtain an integral assessment of the effectiveness of the circulatory system, the plethysmography method can be successfully applied, which allows modeling vascular tone and blood flow using models of hydrodynamics and the theory of elasticity. The present article analyzes the range of static (or dynamic) informative hemo-parameters that allow diagnosing at the initial stage arterial hypertension, aortic insufficiency or stenosis, atherosclerosis, diabetes mellitus and some other diseases. The photometric reflex absorption in the infrared range, followed by an assessment of blood flow in the aortas and arteries with recording of the shape of pulse waves were used as methods in our research work. The result of the work is a method and a system of computer control of the rod current acting on biological tissues (using the Bluetooth protocol, LabView environment, virtual digital filters and biomedical data archives) that allows non-invasively recording of the parameters of the carotid artery pulse wave.

Performance-enhanced flexible piezoelectric nanogenerator via layer-by-layer assembly for self-powered vagal neuromodulation

Vagus nerve stimulation (VNS) has emerged as a promising device-based neuromodulatory therapy that is expected to replace part of the traditional drugs, to treat various neuropsychiatric, inflammatory-immune, and cardiovascular diseases. Thus VNS device modification to enhance function features and improve operation safety is of great significance for expanding clinical application. Herein, we design a self-powered VNS device based on piezoelectric nanogenerator (PENG) that is battery-free and can successfully harvest biomechanical energy from the carotid artery pulsation to stimulate the vagus nerve. Among them, the flexible PENGs are prepared through electrospinning and layer-by-layer assembly using poly(vinylidene fluoride-co-trifluoroethylene) [P(VDF-TrFE)]/BaTiO 3 (BTO). Multi-unit PENG shows outstanding output performance due to more generation units and ameliorated stress distribution. The maximum instantaneous power density is superior to most devices prepared with the same raw materials. COMSOL simulation results prove the notable amelioration in stress distribution inside multi-unit PENG. When the self-powered VNS device releases electrical stimulation to the vagus nerve, the heart rate of the four canines decreased significantly. This work not only broadens the application scope of the flexible PENG for energy harvesting, but also puts forward the novel concept of PENG-based self-powered vagal neuromodulation system. Inspired by the self-powered technique based on nanogenerators, we present the first self-powered vagus nerve stimulation device based on piezoelectric nanogenerator and successfully achieved vagal neuromodulation in the canine model. • The layer-by-layer assembly structure boosts the output performance of the flexible PENG. • The simulation results demonstrate a notable amelioration in stress distribution. • A self-powered vagus nerve stimulation device has successfully achieved vagal neuromodulation in the canine model.

Masked hypertension risk as condition of arterial stiffness in cardiovascular risk patients: a pilot single-stage screening observational study

Background. Masked arterial hypertension (MAH) is associated with asymptomatic injury of both heart and kidneys. Links between MAH and arterial stiffness are unclear, with debates ongoing on their mutual causative relation. Research into the arterial stiffness contribution to MAH development is a perspective area of cardiology.Objectives. The MAH risk assessment as a condition of arterial stiffness in patients at cardiovascular risk (CVR) without a verified cardiovascular disease (CVD).Methods. A single-stage screening observational study included a total of 92 CVR patients without a verified cardiovascular disease. The trial conducted general clinical examination, daily blood pressure monitoring (DBPM), volumetric sphygmoplethysmography with reading cardio-ankle vascular index (CAVI1), aortic and carotid artery pulse wave velocity (PWV), carotid-femoral PWV (CFV) and augmentation index.Results. Patients were assigned in two cohorts by MAH presence, the primary MAH (58; 63.0%) and normal BP in DBPM (34; 37.0% patients) cohorts. The cohorts did not discord by age, major CVR factors, comorbidity or clinical profile. Men prevailed over women in the MAH cohort (p = 0.028). The cohorts had similar CFV, aortic PWV and augmentation index. Carotid PWV was higher in the MAH cohort both in mean values and elevation rate (p = 0.002 and p = 0.035, respectively). OR and HR were 3.29 and 2.35 (95% CI for OR 1.08–10.49, HR 1.05– 6.02), respectively. MAH was associated with increased CAVI1 for mean values and CAVI1 &gt; 8 incidence rate (p = 0.010 and 0.049, respectively); OR 3.29 (95% CI 1.00–11.41), HR 2.46 (95% CI 1.00–7.10). Correlation analysis revealed a moderate direct dependence between the MAH presence and elevation rate of C-PWV (Q = 0.53) and CAVI1 &gt; 8 (Q = 0.53).Conclusion. The risk of MAH development in CVR patients is both gender and arterial stiffness-dependent. MAH development is associated with increased CAVI1 and carotid PWV.

Ultrasonic evaluation of carotid artery elasticity in People Living with HIV

Objective To evaluate the quantitative parameters of carotid elasticity in healthy people and People Living With HIV(PLWH) by ultrasonic vascular elasticity quantitative technique, and to explore the feasibility of this technique in non-invasive evaluation of preclinical arterial elasticity in patients with PLWH atherosclerosis. Methods Subjects with carotid intima-media thickness (IMT) &lt; 1.5mm were divided into three groups: healthy control group (n = 60), HIV baseline group (n = 291) and HAART group (n = 67) with HIV infection who had received highly active antiretroviral therapy ((HAART) for more than 5 years. Quantitative analysis of ultrasonic vascular elasticity was performed in all subjects, and the software automatically quantified carotid artery IMT, artery internal diameter, motion amplitude, vascular hardness coefficient and carotid artery pulse wave velocity,( caPWV), and thean to compare the ultrasonic parameters and blood lipids of each group. In HAART group, the correlation between brachial-ankle pulse wave velocity (baPWV) measured by traditional pressure wave method and caPWV was analyzed. Results Total Cholesterol (TC), triglyceride (TG) and high-density lipoprotein cholesterol (HDL-C) in HAART group were higher than those in baseline group (P &lt; 0.017). Hardness coefficient and caPWV of bilateral carotid arteries in HAART group were higher than those in baseline group (P &lt; 0.017), but the movement amplitude was lower than that in baseline group. In the healthy group, there was no significant difference between the left and right carotid arteries (P &gt; 0.05). In HAART group, baPWV was linearly correlated with caPWV, with the left side correlation coefficient of 0.60 and the right side correlation coefficient of 0.57. Conclusion There is a decrease in preclinical elasticity of carotid artery in patients with PLWH who take antiviral therapy for a long time, and ultrasound vascular elasticity quantitative technique is helpful to identify this change.

Comparison of femoral and carotid arteries in terms of pulse check in cardiopulmonary resuscitation: A prospective observational study

Detecting the presence of a pulse is pivotal to initiating and guiding cardiopulmonary resuscitation (CPR). Palpating the carotid or femoral artery pulse are historically the most common areas providers assess during a resuscitation. Unfortunately manual palpation of a pulse is operator dependent and varies based on patient anatomical differences and vital signs. The Advanced Cardiac Life Support (ACLS) guidelines defined by the American Heart Association (AHA) states that pulse checks should be accomplished quickly to minimize time between chest compressions in CPR.

Comparison of femoral and carotid arteries in terms of pulse check in cardiopulmonary resuscitation: A prospective observational study

Detecting the presence of a pulse is pivotal to initiating and guiding cardiopulmonary resuscitation (CPR). Palpating the carotid or femoral artery pulse are historically the most common areas providers assess during a resuscitation. Unfortunately manual palpation of a pulse is operator dependent and varies based on patient anatomical differences and vital signs. The Advanced Cardiac Life Support (ACLS) guidelines defined by the American Heart Association (AHA) states that pulse checks should be accomplished quickly to minimize time between chest compressions in CPR. Manual pulse checks are the most common, but there is no consensus on the most accurate and efficient location to perform a manual pulse check.