Carotid Pulse Wave Velocity Research Articles

HYPERTENSION PHENOTYPES IN YOUNG INDIVIDUALS BASED ON COMBINED OR ISOLATED ELEVATION OF OFFICE, HOME AND AMBULATORY BLOOD PRESSURE MEASUREMENTS AND ASSOCIATION WITH ORGAN DAMAGE

Objective: To assess the prevalence of white-coat (WCH) and masked (MH) hypertension detected by only ambulatory or only home blood pressure (BP) monitoring (isolated), or both (dual), and their association with preclinical target organ damage (TOD). Design and method: Young individuals referred for elevated BP and healthy volunteers aged 6–25 years were evaluated with office (2–3 visits; triplicate measurements), home (7 days, duplicate morning and evening measurements) and 24-hour ambulatory BP monitoring. TOD assessment included echocardiographic left ventricular mass index (LVMI), carotid intima-media thickness (IMT) and pulse wave velocity (PWV; Complior). Normotension (NT) was defined as normal office, home and ambulatory BP and sustained hypertension (SH) as all measurements being elevated. WCH and MH phenotypes were identified based on isolated or combined (dual) home and ambulatory BP values. Results: Analysis included 320 individuals (mean age 13.8 ± 3.8 years, 66.6% males, 32.2% children, 55.9% adolescents, 11.9% young adults, BMI 24.1 ± 4.8 kg/m2), of whom 276 had LVMI, 212 IMT and 168 PWV assessment. 182 (56.9%) participants had NT and 39 (12.2%) SH. Among 54 (16.9%) participants with WCH, 35 had dual WCH (64.8%) and 19 (35.2%) isolated ambulatory or home WCH. Among 45 (14.1%) with MH, 17 had dual MH (37.8%) and 28 isolated ambulatory or home MH (62.2%). Participants with dual and isolated intermediate phenotypes didn’t differ according to age, sex and BMI. Individuals with SH had higher LVMI, IMT and PWV than NT (all P < 0.05; Figure). Intermediate phenotypes based on selective or combined elevation of out-of-office BP presented intermediate values of indices of TOD between NT and SH. Isolated ambulatory or home WCH was associated with higher LVMI values than NT (P < 0.05), whereas dual MH was associated with higher IMT than NT (all P < 0.05). Conclusions: These findings suggest that in young individuals intermediate hypertension phenotypes with selective (isolated WCH) or combined elevation of BP (dual MH) in out-of-office measurement methods appear to carry an increased risk of preclinical TOD compared with NT.

OFFICE VERSUS HOME BLOOD PRESSURE VARIABILITY IN YOUNG INDIVIDUALS: COMPARISON AND ASSOCIATION WITH PRECLINICAL ORGAN DAMAGE

Objective: Studies in adults showed that blood pressure (BP) variability has independent prognostic value for cardiovascular outcome. This study investigated the relationship between office and home BP variability with indices of preclinical target organ damage in young individuals. Design and method: Healthy individuals aged 6–25 years referred for elevated BP and healthy volunteers were subjected to BP measurements in the office (2–3 visits, triplicate measurements, mercury sphygmomanometer) and at home (6–7 school/work days, duplicate morning and evening measurements, validated oscillometric arm-cuff devices) within 4 weeks. BP variability was quantified as the standard deviation and coefficient of variation of visit-to-visit office BP and day-to day home BP. Preclinical organ damage was assessed with ultrasonographic evaluation of left ventricular mass index (LVMI), determination of common carotid intima-media thickness (cIMT) and pulse wave velocity (PWV, piezoelectronic principle). Results: 233 individuals were analyzed (age 14.1 ± 4.0 years, 72% males, 32% children, 53% adolescents, 15% young adults, 4.3% healthy volunteers, 29.6% with office and 25.3% with home hypertension). All participants had office and home BP measurements and evaluation of at least one index of target organ damage (LVMI 189, cIMT 123, PWV 73). The variability of systolic office BP was higher than home (p < 0.05) whereas there was not such a difference for diastolic BP variability (Table). None of the office and home BP variability indexes exhibited a statistically significant association with LVMI, cIMT or PWV. Conclusions: This study in healthy children, adolescents and young adults showed higher systolic office than home BP variability, but none of them was associated with preclinical organ damage. The clinical relevance of BP variability, and the optimal index and method for its evaluation remain undefined and require further investigation.

Correlation among Waist Circumference and Central Measures of Blood Pressure.

ResumoFundamento:A rigidez arterial é um forte preditor de doença cardiovascular (DCV). Medidas de gordura corporal, como a circunferência da cintura (CC), têm sido associadas à DCV na idade adulta.Objetivos:O objetivo deste estudo foi avaliar a associação da rigidez arterial, medida por tonometria de aplanação-Sphygmocor, com a CC.Métodos:Estudo observacional com 240 participantes que fazem consultas de rotina no ambulatório de clínica médica de um hospital universitário. Os participantes foram entrevistados e tiveram as medidas centrais da pressão arterial (MCPA), parâmetros antropométricos, gordura abdominal e gordura visceral mensurados. Foram u tilizados os testes t pareado e não pareado e qui-quadrado. Foi a dotado nível de significância de 5%.Resultados:Dos 240 participantes, 51,82% era do sexo masculino com idade média de 59,71(±14,81) anos e CC média de 99,87 (±11,54) cm. Os valores médios das MCPA foram: Pressão arterial central (PAC) = 130,23 (91-223) mmHg, velocidade de onda de pulso (VOP) = 9,8 (5,28-19,6)m/s e Augmentation Index [Índice de amplificação (AI)] = 29,45 (-14-60). A VOP e a PAC foram altamente correlacionadas com uma CC com p<0,001 e p=0,02, respectivamente; porém, a mesma correlação positiva não foi encontrada entre a CC e o AI (p=0,06).Conclusão:O presente estudo mostrou uma associação positiva entre a CC e a rigidez arterial, através da velocidade de onda de pulso carotídeo femoral (VOP-cf) e o AI, sendo mais forte com a VOP-cf, sugerindo a avaliação do efeito da CC na saúde vascular como método de auxílio no tratamento precoce das DCV e na prevenção de desfechos clínicos.

The effects of melatonin administration on carotid intima-media thickness and pulse wave velocity in diabetic nephropathy: A randomized, double-blind, placebo-controlled trial.

Previous studies have reported that melatonin intake is inversely associated with reduced markers of atherosclerosis development such as carotid intima-media thickness (CIMT). This study was designed to assess the effects of melatonin administration on CIMT and pulse wave velocity (PWV) in patients with diabetic nephropathy (DN). This randomized, double-blind, placebo-controlled trial was conducted on 32 DN patients. Subjects were assigned to receive melatonin or placebo (starch) for 24 weeks. Individuals in the melatonin group (n=19) received 10mg/day. CIMT and PWV levels were taken at the study baseline and after 24 weeks of intervention. After 24 weeks of intervention, melatonin intake did not affect mean levels of left (P=0.51) and right (P=0.16) CIMT and maximum levels of left (P=0.76) and right (P=0.15) CIMT, and PWV (P=0.55) compared with the placebo. In addition, within-group difference demonstrated a significant reduction in mean levels of right CIMT (P=0.01) in the melatonin group. We did not observe any significant change in C-reactive protein (CRP) concentrations after melatonin intake (P=0.81). Melatonin intake did not affect mean levels of left and right CIMT and maximum levels of left and right CIMT, PWV, CRP levels compared with the placebo. In addition, within-group difference demonstrated a significant reduction in mean levels of right CIMT in the melatonin group. This trial was registered at www.irct.ir as http://www.irct.ir: IRCT20200527047584N2.

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.

Carotid pulse wave velocity by ultrafast ultrasound: A step forward for noninvasive assessment of diabetic patients.

Carotid pulse wave velocity by ultrafast ultrasound: A step forward for noninvasive assessment of diabetic patients.

Subject-Specific Pressure Normalization of Local Pulse Wave Velocity: Separating Intrinsic From Acute Load-Dependent Stiffening in Hypertensive Patients.

Pulse wave velocity (PWV) is a powerful predictor of cardiovascular events. However, its intrinsic blood pressure (BP)-dependency complicates distinguishing between acute and chronic effects of increased BP on arterial stiffness. Based on the assumption that arteries exhibit a nearly exponential pressure-area (P-A) relationship, this study proposes a method to assess intersubject differences in local PWV independently from BP. The method was then used to analyze differences in local carotid PWV (cPWV) between hypertensive and healthy normotensive people before and after BP-normalization. Pressure (P) and diameter (D) waveforms were simultaneously acquired via tonometer at the left and ultrasound scanning at right common carotid artery (CCA), respectively, in 22 patients with Grade 1 or 2 hypertension and 22 age- and sex-matched controls. cPWV was determined using the D2P-loop method. Then, the exponential modeling of the P-area (A = πD2/4) relationships allowed defining a mathematical formulation to compute subject-specific changes in cPWV associated with BP changes, thus enabling the normalization of cPWV against intersubject differences in BP at the time of measurement. Carotid systolic BP (SBP) and diastolic BP (DBP) were, on average, 17.7 (p < 0.001) and 8.9 mmHg (p < 0.01) higher in hypertensives than controls, respectively. cPWV was 5.56 ± 0.86 m/s in controls and 6.24 ± 1.22 m/s in hypertensives. BP alone accounted for 68% of the cPWV difference between the two groups: 5.80 ± 0.84 vs. 6.03 ± 1.07 m/s after BP-normalization (p = 0.47). The mechanistic normalization of cPWV was in agreement with that estimated by analysis of covariance (ANCOVA). In conclusion, the proposed method, which could be easily implemented in the clinical setting, allows to assess the intersubject differences in PWV independently of BP. Our results suggested that mild hypertension in middle-aged subjects without target organ damage does not significantly alter the stiffness of the CCA wall independently of acute differences in BP. The results warrant further clinical investigations to establish the potential clinical utility of the method.

Clinical significance and influencing factors of carotid pulse wave velocity in patients with diabetic microangiopathy.

To evaluate the utility of carotid ultrafast pulse wave velocity (PWV) and explore its influencing factors in patients with type 2 diabetes mellitus (T2DM) microangiopathy. Seventy-seven patients with T2DM were divided into two groups according to the absence (Group A, n=45) or presence (Group B, n=32) of microangiopathy. The control group comprised 1544 healthy volunteers. Two-dimensional ultrasonography was used to measure intima-media thickness (IMT) of the carotid arteries, and ultrafast ultrasound imaging was used to measure PWV of the carotid arteries at the beginning of systole (PWV-BS) and the end of systole (PWV-ES). The IMT, PWV-BS, and PWV-ES were higher in the T2DM group than in the control group, and the values in T2DM Group B were higher than those in Group A. IMT was positively correlated with PWV-BS and PWV-ES. Age and uric acid were influencing factors of PWV-ES, while age, uric acid, body mass index, glycated hemoglobin, and urine albumin/creatinine ratio were influencing factors of PWV-BS. PWV-ES was a more sensitive predictor than PWV-BS, and a PWV-ES critical value predicted carotid elasticity in patients with T2DM microangiopathy. Ultrafast PWV can reflect early atherosclerosis and provide a noninvasive assessment of microangiopathy in patients with T2DM.

Helicobacter pylori infection and the progression of atherosclerosis: A systematic review and meta-analysis.

In recent years, many studies have tried to prove whether Helicobacter pylori (H. pylori) can promote the progression of atherosclerosis (AS), but the reported results are conflicting. Carotid intima-media thickness (CIMT), flow-mediated dilation (FMD), or pulse wave velocity (PWV) are the most commonly used indicators to evaluate the progress of AS. So, we collected and evaluated these three indicators to provide evidence-based medicine for the clinic. We included and evaluated studies on H. pylori infection and CIMT, FMD, or PWV from PubMed, Cochrane trials, and Embase databases before September 1, 2021, and language restrictions: English. Research types include cross-sectional studies, cohort studies, and case-control studies. The MINORS scale was used to evaluate the quality of these studies. For all studies, we choose a random-effects model and calculate the weighted mean difference (WMD) for analysis, and all our analyses use STATA software. Meta-analysis shows that H. pylori infection can significantly increase CIMT (WMD=0.059, 95% CI: 0.039, 0.079, p<0.001). Based on subgroup analysis, we found that the relationship between the two is more significant in the young and middle-aged people younger than 60years old and people without cardiovascular disease. In addition, we also found an association between H. pylori infection and FMD (WMD=-3.873, 95% CI: -5.684, -2.062, p<0.001), but it is a pity that there are few literatures that meet the standards. Finally, We concluded that H. pylori infection can significantly increase PWV (WMD=88.033, 95%CI: 67.297,108.768. I2 =99.63%, p<0.001). In the subgroup analysis, we also found that this correlation is similar to CIMT, and it is more significant in the young and middle-aged population under 60 and those without cardiovascular disease. We also found in the sub-analysis that there was a significant increase in CIMT in CagA-positive individuals in H. pylori-infected patients (WMD=0.16, 95%CI: 0.02, 0.29. p=0.03). Helicobacter pylori infection can promote the process of AS, especially in people under the age of 60 and people without cardiovascular risk factors, and we hope that our meta-analysis can provide ideas for the early prevention of AS.

Association between helicobacter pylori infection and subclinical atherosclerosis: A systematic review and meta-analysis.

Background:The relationship between Helicobacter pylori (H. pylori) infection and subclinical atherosclerosis has been confirmed, but these conclusions are still controversial. Therefore, we have performed a systematic review and meta-analysis to assess the association between H. pylori infection and subclinical atherosclerosis.Methods:Databases including PubMed, Embase, Web of Science were searched for the articles on the association of carotid intima-media thickness or pulse wave velocity with H. pylori infection published up to January 1, 2020. Stata 12.0 was used to calculate standardized mean difference (SMD) and 95% confidence interval (95% CI); the I2 test was used to evaluate heterogeneity between studies and sensitivity analysis and subgroup analysis were used to explore the source of heterogeneity. Funnel plot, Begg test, and Egger test were used to estimate publication bias.Results:Data were extracted from 18 studies involving 6776 subjects with H. pylori positive and 7794 with H. pylori negative. H. pylori positive subjects is significantly associated with increased subclinical atherosclerosis as determined by carotid intima-media thickness (SMD: 0.376 mm; 95% CI: 0.178, 0.574; P < .001, I2 = 90.6%), pulse wave velocity (SMD: 0.320 m/s; 95% CI: 0.242, 0.398; P < .001, I2 = 52.6%), compared with H. pylori negative. Similar results were observed when subgroups analysis were stratified according to age, male ratio, geographical location, H. pylori diagnosis, and study design. Sensitivity analyses showed that our results were robust. The Begg test or Egger test showed no significant publication bias (all P > .05).Conclusions:This meta-analysis confirmed a significant association between H. pylori and subclinical atherosclerosis, which will help H. pylori patients to establish effective strategies for the prevention and control of cardiovascular events.

Abstract 10777: Circulating and Adipose Tissue Levels of CD147 Are Linked to Vascular Dysfunction in Obese Diabetic Adults

Background: Extracellular matrix metalloproteinase inducer (EMMPRIN; CD147) is a transmembrane glycoprotein that stimulates the production of matrix metalloproteinases (MMPs). These MMPs mediate vascular remodeling and are considered biomarkers for cardiovascular risk. The activity of CD147 depends mainly on its glycosylation, which varies significantly among different conditions. However, it is unclear if CD147 glycosylation or its role in MMP upregulation is influenced by the diabetic milieu characterized by high glucose levels and abundant glycation end products (AGEs). In this study, we sought to investigate the differential expression and glycosylation levels of CD147 in obese, diabetic (OB-T2D) individuals compared to non-OB controls. Methods: Blood and adipose tissue (AT) samples were obtained from OB-T2D individuals and controls (n=40, each). DEXA scanning was used for body composition analyses. Flow-induced dilation (FID) was assessed in vivo in the brachial artery and ex vivo in AT-isolated arterioles. Other cardiometabolic risk factors related to glucose and lipid metabolism and systemic inflammation were measured. Results: Circulating CD147 was considerably greater in OB individuals, mirroring the glycosylated CD147 and the N-acetylglucosaminyltransferase, MGAT5 protein levels in the AT. Within the OB-T2D group, AT and circulating CD147 correlated with higher body mass index, total and visceral fat percentage, fasting plasma glucose and insulin, insulin resistance measurement (HOMA-IR), glycosylated hemoglobin, systolic BP, and plasma levels of MMP2/9, AGEs (Carboxymethyl lysine and methyl-glyoxal-lysine dimer), C-reactive protein, interleukin 6, and tumor necrosis factor-alpha. AT-arteriolar FID was significantly lower in the OB-T2D individuals across all pressure gradients, while carotid pulse wave velocity (PWV) was higher, indicating arterial stiffness. CD147 correlated negatively with brachial artery and AT-arteriolar FID and flow-induced nitric oxide production and positively with PWV. Conclusion: Our findings imply that vascular dysfunction in OB-T2D patients is linked to higher levels of CD147 and its glycosylated fraction, which in turn is associated with other cardiometabolic risk factors.

Cognitive Impairment in Long-Term Survivors of Testicular Cancer More Than 20 Years after Treatment

Simple SummaryImpaired cognition can be a late effect after treatment in long-term testicular cancer survivors, negatively affecting their daily life. However, little data is available beyond 20 years post-treatment. We assessed cognitive impairment in very-long-term survivors after treatment. In this study, we enrolled testicular cancer survivors with a follow-up duration ≥ 20 years—and age-matched healthy controls. Cognitive testing included the Auditory Verbal Learning Test, Letter Fluency Test, and Trail Making Test. We used fasting blood samples to assess the presence of hypogonadism and measured cardiovascular damage and aging parameters. We included 184 testicular cancer survivors (66 chemotherapy patients, 53 radiotherapy patients, and 65 orchiectomy only patients) and 70 healthy controls. The median follow-up was 26 years. Testicular cancer survivors performed worse on cognitive tests compared to controls. In univariate analysis, the presence of hypogonadism was associated with lower cognitive scores. Physicians and patients should be informed about timely cardiovascular risk management and testosterone supplementation therapy during follow-up to reduce the risk of cognitive impairment.Background: Impaired cognition can be a late effect after treatment in long-term testicular cancer (TC) survivors, negatively affecting their daily life. However, little data is available beyond 20 years post-treatment. We assessed cognitive impairment in very long-term TC survivors after CT or RT and compared the results with stage I TC survivors and controls. Methods: In this cross-sectional multicenter cohort study, we enrolled TC survivors (treated with orchiectomy followed by CT or RT or orchiectomy only)—with a follow-up duration ≥ 20 years—and age-matched healthy controls. Cognitive testing included the Auditory Verbal Learning Test, Letter Fluency Test, Category Fluency Test, and Trail Making Test. We used fasting blood samples to assess the presence of hypogonadism and measured cardiovascular aging parameters, including carotid pulse wave velocity (c-PWV) and advanced glycation end products (AGEs). Results: We included 184 TC survivors (66 CT patients, 53 RT patients, and 65 orchiectomy-only patients) and 70 healthy controls. The median follow-up was 26 years (range: 20–42). TC survivors had a lower combined score of the cognitive tests (mean cumulative Z-score −0.85; 95% CI −1.39 to −0.33) compared to controls (mean 0.67; 95% CI −0.21 to 1.57, p < 0.01). In univariate analysis, the presence of hypogonadism (β −1.50, p < 0.01), high c-PWV (β −0.35, p = 0.09), and high AGEs (β −1.27, p = 0.02) were associated with lower cognitive scores, while only AGEs (β −1.17, p = 0.03) remained a significant predictor in multivariate analysis (Model R2 0.31, p < 0.01). Conclusions: Long-term TC survivors performed worse on cognitive tests compared to controls. Physicians and patients should be informed about timely cardiovascular risk management and testosterone supplementation therapy during follow-up to reduce the risk of cognitive impairment. Trial Registration: NCT02572934.

The Role of SGLT2 Inhibitors in Atherosclerosis: A Narrative Mini-Review.

Objective: Sodium glucose cotransporter 2 inhibitors (SGLT2-is) are antidiabetic drugs that improve glycemic control by limiting urinary glucose reuptake in the proximal tubule. SGLT2-is might suppress atherosclerotic processes and ameliorate the prognosis of patients with diabetes mellitus diagnosed with or at high risk of atherosclerotic cardiovascular disease (ASCVD). In this mini review, we examine the role of SGLT2-is in the development and progression of atherosclerosis throughout its spectrum, from subclinical atherosclerosis to ASCVD. Data Sources—PubMed and Google Scholar were searched for publications related to SGLT2-is and atherosclerosis. All types of articles were considered, including clinical trials, animal studies, in vitro observations, and reviews and meta-analyses. Data were examined according to their impact and clinical relevance. Synopsis of Content—We first review the underlying mechanisms of SGLT2-is on the development and progression of atherosclerosis, including favorable effects on lipid metabolism, reduction of systemic inflammation, and improvement of endothelial function. We then discuss the putative impact of SGLT2-is on the formation, composition, and stability of atherosclerotic plaque. Furthermore, we evaluate the effects of SGLT2-is in subclinical atherosclerosis assessed by carotid intima media thickness and pulse wave velocity. Subsequently, we summarize the effects of SGLT2-is in ASCVD events, including ischemic stroke, angina pectoris, myocardial infarction, revascularization, and peripheral artery disease, as well as major adverse cardiovascular events, cardiovascular mortality, heart failure, and chronic kidney disease. Moreover, we examine factors that could modify the role of SGLT2-is in atherosclerosis, including sex, age, diabetes, glycemic control, ASCVD, and SGLT2-i compounds. Additionally, we propose future directions that can improve our understanding of SGLT2-is and atherosclerosis.

Ultrafast Ultrasound-Derived Muscle Strain Measure Correlates with Carotid Local Pulse Wave Velocity in Habitual Resistance-Trained Individuals

Purpose: this study investigated the effects of the intensity of machine-based bicep curl resistance exercise on ultrafast ultrasound-derived muscle strain rate and carotid ultrafast pulse wave velocity (ufPWV), and examined the association between muscle strain rate, ufPWV, and established carotid function measures in habitual resistance-trained individuals. Methods: twenty-three young habitual resistance-trained males (age: 24 ± 1 year, body mass index = 24 ± 1 kg/m2) were recruited to participate in two bouts of acute bicep curl exercise. After one-repetition maximum determination (1RM), the participants were randomly assigned to engage in bicep curls at 40 or 80%1RM intensity (10 reps × five sets) by a crossover study design. The muscle strain rate of bicep muscle, carotid ufPWV during systole(ufPWV-sys), and diastole (ufPWV-dia) were obtained pre- and post-exercise. In addition, carotid function measures were calculated by obtained carotid diameter and central blood pressure changes. Results: compared with pre-exercise, the reduction in post-exercise muscle strain rate and its area under the curve of 80%1RM was greater than those of 40%1RM. Both ufPWV-sys and ufPWV-dia increased regardless of exercise intensity. Baseline bicep muscle strain rate correlated not only with ufPWV-sys (r = −0.71, p = 0.001), ufPWV-dia (r = −0.74, p = 0.001), but also carotid compliance (r = 0.49, p = 0.02), distensibility (r = 0.54, p = 0.01) and ß stiffness (r= −0.84, p &lt; 0.0001). The ufPWVs also correlated with ß stiffness (r = 0.64–0.76, p = 0.01). Conclusion: muscle stiffness measured by ultrafast ultrasound elastography increases positively with resistance exercise intensity, and it appears to correlate with carotid ufPWV and established carotid function measures in habitual resistance-trained individuals.

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.

Associations between respiratory and vascular function in early childhood.

The link between respiratory and vascular health is well documented in adult populations. Impaired lung function is consistently associated with thicker arteries and higher incidence of cardiovascular disease. However, there are limited data on this relationship in young children and the studies that exist have focussed on populations at high risk of cardiorespiratory morbidity. We determined if an association exists between respiratory and cardiovascular function in young children and, if so, whether it is confounded by known cardiorespiratory risk factors. Respiratory and vascular data from a prospective cohort study established to evaluate the health implications 3 years after coal mine fire smoke exposure in children aged 3-5 years were used. Respiratory function was measured using the forced oscillation technique and included resistance at 5Hz (R5 ), reactance at 5Hz (X5 ) and area under the reactance curve (AX). Vascular health was measured by carotid intima-media thickness (ultrasound) and pulse wave velocity (arterial tonometry). Regression analyses were used to examine the relationship between the respiratory Z-scores and cardiovascular measures. Subsequent analyses were adjusted for potential confounding by maternal smoking during pregnancy, maternal education and exposure to fine particulate matter <2.5μm in aerodynamic diameter (PM2.5 ). Peripheral lung function (X5 and AX), but not respiratory system resistance (R5 ), was associated with vascular function. Adjustment for maternal smoking, maternal education and early life exposure to PM2.5 had minimal effect on these associations. These observations suggest that peripheral lung stiffness is associated with vascular stiffness and that this relationship is established early in life.

Sleep Apnea is Associated With Accelerated Vascular Aging: Results From 2 European Community-Based Cohort Studies.

BackgroundThe mechanisms underlying the association between obstructive sleep apnea (OSA) and cardiovascular disease may include accelerated vascular aging. The aim was to compare the magnitude of vascular aging in patients with high versus low risk of OSA.Methods and ResultsIn 2 community‐based studies, the PPS3 (Paris Prospective Study 3) and the Maastricht Study, high risk of OSA was determined with the Berlin questionnaire (a screening questionnaire for OSA). We assessed carotid artery properties (carotid intima‐media thickness, Young’s elastic modulus, carotid‐femoral pulse wave velocity, carotid pulse wave velocity, carotid diameter using high precision ultrasound echography), and carotid‐femoral pulse wave velocity (in the Maastricht Study only). Regression coefficients were estimated on pooled data using multivariate linear regression. A total of 8615 participants without prior cardiovascular disease were included (6840 from PPS3, 62% men, mean age 59.5±6.2 years, and 1775 from the Maastricht Study, 51% men, 58.9±8.1 years). Overall, high risk of OSA prevalence was 16.8% (n=1150) in PPS3 and 23.8% (n=423) in the Maastricht Study. A high risk of OSA was associated with greater carotid intima‐media thickness (β=0.21; 0.17–0.26), Young’s elastic modulus (β=0.21; 0.17–0.25), carotid‐femoral pulse wave velocity (β=0.24; 0.14–0.34), carotid pulse wave velocity (β=0.31; 0.26–0.35), and carotid diameter (β=0.43; 0.38–0.48), after adjustment for age, sex, total cholesterol, smoking, education level, diabetes mellitus, heart rate, and study site. Consistent associations were observed after additional adjustments for mean blood pressure, body mass index, or antihypertensive medications.ConclusionsThese data lend support for accelerated vascular aging in individuals with high risk of OSA. This may, at least in part, underlie the association between OSA and cardiovascular disease.

Noninvasive carotid pressure-diameter loops to identify viscoelastic properties in ageing, hypertension and type 2 diabetes.

Arterial stiffness as pulse wave velocity (PWV) predicts cardiovascular events independently of blood pressure (BP). PWV does not distinguish between stiffness in systole and diastole. This cross-sectional study aimed to test the hypothesis that viscous and elastic carotid wall properties differ between systole and diastole, distinguishing effects of ageing, hypertension and T2 diabetes (T2DM). We examined carotid visco-elasticity in 307 people (180 men), with hypertension alone (n = 69), combined hypertension/T2DM (H-T2DM, n = 99), normotensive (N-T2DM, n = 25) and healthy controls (n = 114). Diameter (D)/pressure (P) waveforms were measured at right /left common carotid arteries, respectively. Local carotid PWV and distensibility in systole and diastole were evaluated by the D2P-loop method, and wall viscosity from hysteresis, the area (HA) within the P--D loop, as a dynamic measure of systolic loading and diastolic unloading. Controls' hysteresis fell quadratically with age (R2 = 0.23, P < 0.001). Yet mean HA in hypertensive patients (0.95, 95% CI 0.65-1.23) was six-fold higher than in age-matched controls (0.14, -0.20 to 0.49, P < 0.001) with a 2.5× difference between diastolic (dDs) to systolic (sDs) distensibility (P < 0.05) in hypertensive patients. HA was higher in hypertensive patients and H-T2DMs (0.80, 0.58-1.04) than N-T2DMs (0.20, -0.17 to 0.54, P < 0.05), but similar between controls and N-T2DMs. BP-adjusted carotid diameters in all T2DM were significantly greater compared with controls and hypertensive patients. Higher BP increased wall viscosity, hysteresis and relative difference between systolic and diastolic distensibility across groups. Carotid diameters were increased in all T2DMs, more in H-T2DM, probably altering BP-flow dynamics in T2DM.

Exercise Training Duration and Intensity Are Associated With Thicker Carotid Intima-Media Thickness but Improved Arterial Elasticity in Active Children and Adolescents.

Even though exercise generally has a positive effect on health, intensive exercise can have adverse effects on the vascular system of adults. This study aimed to investigate the association between training duration and intensity and vascular structure and function in 427 physically active children and adolescents (14.0 ± 1.94 years). In this study, we examined carotid intima-media thickness (cIMT), carotid diameter, and cIMT:diameter-ratio as parameters of carotid arterial structure and arterial compliance (AC), stiffness index β (β), elastic modulus (Ep), and carotid pulse wave velocity (PWVβ) as parameters of carotid arterial function with high-resolution ultrasound. We collected central systolic blood pressure (cSBP) and aortic pulse wave velocity (aPWV) as parameters of central arterial stiffness with an oscillometric device. We used the MoMo Physical Activity Questionnaire to record training duration and intensity. Training duration (p = 0.022) and intensity (p = 0.024) were associated with higher cIMT. Further, training duration was associated with lower central arterial stiffness (cSBP: p = 0.001; aPWV: p = 0.033) and improved AC (p < 0.001). Higher training intensity was related to improved AC (p < 0.001) and larger carotid diameter (p = 0.040). Boys presented thicker cIMT (p = 0.010), improved AC (p = 0.006), and lower central arterial stiffness (cSBP: p < 0.001; aPWV: p = 0.016) associated with higher training duration. Girls presented improved AC (p = 0.023) and lower Ep (p = 0.038) but higher β (p = 0.036) associated with higher training duration. Only boys demonstrated thicker cIMT (p = 0.016) and improved AC (p = 0.002) associated with higher training intensity. A quintile analyses of the training duration revealed thicker cIMT of children and adolescents in Q1 and Q5 than that in Q4 and Q5. Besides, Q1 showed lower cSBP compared to Q4 and Q5. Regarding training intensity, Q5 had thicker cIMT than Q2 and Q3. Although a higher training load is associated with thicker cIMT, the common carotid artery is also more elastic. This suggests that a higher training load leads to a functional adaptation of the carotid artery in youth.

Exploring biomarkers associated with deteriorating vascular health using a targeted proteomics chip: The SABPA study.

In this observational study, by the use of a multiplex proteomic platform, we aimed to explore associations between 92 targeted proteins involved in cardiovascular disease and/or inflammation, and phenotypes of deteriorating vascular health, with regards to ethnicity.Proteomic profiling (92 proteins) was carried out in 362 participants from the Sympathetic activity and Ambulatory Blood Pressure in Africans (SABPA) study of black and white African school teachers (mean age 44.7 ± 9.9 years, 51.9% women, 44.5% Black Africans, 9.9% with known cardiovascular disease). Three proteins with <15% of samples below detectable limits were excluded from analyses. Associations between multiple proteins and prevalence of hypertension as well as vascular health [Carotid intima-media thickness (cIMT) and pulse wave velocity (PWV)] measures were explored using Bonferroni-corrected regression models.Bonferroni-corrected significant associations between 89 proteins and vascular health markers were further adjusted for clinically relevant co-variates. Hypertension was associated with growth differentiation factor 15 (GDF-15) and C-X-C motif chemokine 16 (CXCL16). cIMT was associated with carboxypeptidase A1 (CPA1), C-C motif chemokine 15 (CCL15), chitinase-3-like protein 1 (CHI3L1), scavenger receptor cysteine-rich type 1 protein M130 (CD163) and osteoprotegerin, whereas PWV was associated with GDF15, E-selectin, CPA1, fatty acid-binding protein 4 (FABP4), CXCL16, carboxypeptidase B (CPB1), and tissue-type plasminogen activator. Upon entering ethnicity into the models, the associations between PWV and CPA1, CPB1, GDF-15, FABP4, CXCL16, and between cIMT and CCL-15, remained significant.Using a multiplex proteomic approach, we linked phenotypes of vascular health with several proteins. Novel associations were found between hypertension, PWV or cIMT and proteins linked to inflammatory response, chemotaxis, coagulation or proteolysis. Further, we could reveal whether the associations were ethnicity-dependent or not.