Carotid-radial Pulse Wave Velocity Research Articles

Central and peripheral fat and subclinical vascular damage in older women

the aim of this study was to evaluate the relationship between fat distribution and arterial compliance in a group of elderly women, in particular to test a possible independent role of abdominal fat mass and peripheral fat mass on subclinical vascular damage, defined by a pulse wave velocity (PWV) >12 m/s. in 96 women with age range 60-80 years (68.65 ± 4.98 years) and BMI range from 18.8 to 41.2 kg/m(2) (27.07 ± 4.61 kg/m(2)), we evaluated the body mass index, waist circumference, systolic and diastolic blood pressure, fasting glucose, cholesterol, LDL and HDL cholesterol, triglycerides and body composition by dual energy X-ray absorptiometry (DXA). Arterial stiffness was assessed by carotid-femoral (PWVcf) and carotid-radial pulse wave velocity (PWVcr). significant associations were found between PWVcf, age, waist circumference, BMI and trunk fat assessed by DXA, as well as TG and HDL cholesterol. After adjustment for the total fat mass a negative statistically significant association between PWVcf and leg fat mass was shown. In multiple regression analyses the mean arterial pressure, trunk fat mass and leg fat mass were significant predictors of vascular damage with OR, respectively, of 1.06 (CI: 1.01-1.11), 1.25 (CI: 1.06-1.48) and 0.73 (CI: 0.53-0.99). the results of this study show, in a sample of apparently healthy elderly women, that central and peripheral adiposity are independent predictors, with an opposite effect on subclinical vascular damage, confirming and strengthening the protective role of the gluteal-femoral fat on cardiovascular risk even in elderly.

The Association of 25(OH)D with Blood Pressure, Pulse Pressure and Carotid-Radial Pulse Wave Velocity in African Women

High susceptibility of the African population to develop cardiovascular disease obliges us to investigate possible contributing risk factors. Our aim was to determine whether low 25(OH)D status is associated with increased blood pressure and carotid-radial pulse wave velocity in black South African women. We studied 291 urban women (mean age: 57.56±9.00 yrs.). 25(OH)D status was determined by serum 25(OH)D levels. Women were stratified into sufficient (>30 ng/ml), and insufficient/deficient (<30 ng/ml) groups. Cardiovascular variables were compared between groups. Women with low 25(OH)D levels had significantly higher SBP (150.8±27.1 vs. 137.6±21.0), DBP (94.7±14.5 vs. 89.3±12.3) and PP (53.15(50.7;55.7) vs. 46.3(29.4;84.6)) compared to women with sufficient levels. No significant difference was observed with regards to c-rPWV. ANCOVA analyses still revealed significant differences between the two groups with regards to SBP, DBP as well as PP. Partial correlations revealed significant inverse association between SBP and 25(OH)D (p = .04;r = −.12). Women with low 25(OH)D levels were ∼2 times more likely to have high SBP (95% CI: 3.23;1.05). To conclude, women with deficient/insufficient 25(OH)D had significantly higher SBP compared to women with a sufficient 25(OH) status.

Descriptive study of possible link between cardioankle vascular index and homocysteine in vascular-related diseases

ObjectivesCardioankle vascular index (CAVI) is a new index of arterial stiffness independent of immediate blood pressure. Homocysteine (Hcy) is an independent risk factor for vascular diseases. The aim of this...

Medicalising and medicating unhappiness

Objectives Cardioankle vascular index (CAVI) is a new index of arterial stiffness independent of immediate blood pressure. Homocysteine (Hcy) is an independent risk factor for vascular diseases. The aim of this study was to investigate the relationship between Hcy and CAVI in the vascular-related diseases. Design Descriptive research. Participants 88 patients (M/F 46/42) with or without hypertension, coronary artery disease or arteriosclerosis obliterans were enrolled to our study. They were divided into two groups according to the level of Hcy. Methods CAVI, carotid-femoral pulse wave velocity (CFPWV) and carotid-radial pulse wave velocity (CR-PWV) were measured by VS-1000 and Complior apparatus. Results There was significant correlation between Hcy and CF-PWV, CR-PWV, CAVI in the entire group (r=0.33, P=0.002; r=0.51, P<0.001; r=0.42, P<0.001, respectively). And there was significant correlation between Hcy and CF-PWV, CR-PWV, CAVI in the vascular-related disease group (r=0.23, P=0.048; r=0.51, P<0.001; r=0.392, P= 0.001, respectively). The level of Hcy was significantly higher in patients with one or more vascular diseases than in patients without vascular diseases. The levels of CF-PWV, CR-PWV and CAVI were significantly higher in Hcy ≥15 μmol/L group than in Hcy<5 μmol/L group (13.7±3.0 vs 10.8±2.5, P< 0.001; 10.6±2.1 vs 9.2±1.6, P=0.001; 9.30±2.1 vs 7.79±2.1, P= 0.001, respectively). Multiple linear regression showed that Hcy, body mass index (BMI) and age were independent associating factors of CAVI in the entire study group (β=0.421, P=0.001; β=-0.309, P=0.006; β=0.297, P=0.012, respectively). And Hcy, BMI and age were independent influencing factors of CAVI in the vascular-related disease group (β=0.434, P=0.001; β=-0.331, P=0.009; β=0.288, P=0.022, respectively). Conclusions CAVI was positively correlated with Hcy in the vascular-related diseases.

Associations between COPD related manifestations: a cross-sectional study

BackgroundCardiovascular disease, osteoporosis and emphysema are associated with COPD. Associations between these factors and whether they predict all-cause mortality in COPD patients are not well understood. Therefore, we examined associations between markers of cardiovascular disease (coronary artery calcification [CAC], thoracic aortic calcification [TAC] and arterial stiffness), bone density (bone attenuation of the thoracic vertebrae), emphysema (PI-950 and 15th percentile) and all-cause mortality in a COPD cohort.MethodsWe assessed CAC, TAC, bone attenuation of the thoracic vertebrae, PI-950 and 15th percentile on low-dose chest computed tomography in COPD subjects. We measured arterial stiffness as carotid-radial pulse wave velocity (PWV), and identified deaths from the national register.ResultsWe studied 119 COPD subjects; aged 67.8 ±7.3, 66% were males and mean FEV1% predicted was 46.0 ±17.5. Subjects were classified into three pre-specificed groups: CAC = 0 (n = 14), 0 < CAC ≤ 400 (n = 41) and CAC > 400 (n = 64). Subjects with higher CAC were more likely to be older (p < 0.001) and male (p = 0.03), and more likely to have higher systolic blood pressure (p = 0.001) and a history of hypertension (p = 0.002) or ischemic heart disease (p = 0.003). Higher CAC was associated with higher PWV (OR 1.62, p = 0.04) and lower bone attenuation (OR 0.32, p = 0.02), but not with 15th percentile, after adjustment for age, sex and pack-years of smoking. In a Cox proportional hazards model, CAC, TAC and 15th percentile predicted all-cause mortality (HR 2.01, 2.09 and 0.66, respectively).ConclusionsIncreased CAC was associated with increased arterial stiffness and lower bone density in a COPD cohort. In addition, CAC, TAC and extent of emphysema predicted all-cause mortality.Trial registrationLothian NHS Board, Lothian Research Ethics Committee, LREC/2003/8/28.

Synergistic effects of serum uric acid and cardiometabolic risk factors on early stage atherosclerosis: the cardiometabolic risk in Chinese study.

ObjectiveTo comprehensively examine the associations of serum uric acid (SUA) with central and peripheral arterial stiffness in Chinese adults, and particularly assess the interactions between SUA and other cardiometabolic risk factors.MethodsThe study included 3,772 Chinese men and women with carotid radial pulse wave velocity (crPWV), carotid femoral PWV (cfPWV), carotid artery dorsalis pedis PWV (cdPWV) and SUA measured.ResultsAfter adjustment for age, sex, and BMI, the levels of SUA were significantly associated with increasing trend of cfPWV, crPWV and cdPWV (P for trend <0.0001). Further adjustment for heart rate (HR), blood pressure (BP) and lipids attenuated the associations with crPWV and cdPWV to be non-significant (P = 0.1, P = 0.099 respectively), but the association between SUV and cfPWV remained significant (P = 0.004). We found significant interactions between SUA and HR or BP in relation to cfPWV (P for interaction = 0.03, 0.003 respectively). The associations between SUA and cfPWV were more evident among individuals with higher HR or normal BP than those with lower HR or hypertension.ConclusionsSUA was associated with elevated aortic arterial stiffness in Chinese adults, independent of conventional cardiovascular risk factors. BP and HR might modify the deleterious effects of SUA.

Arterial Stiffness and Pulse-Pressure Amplification in Overweight/Obese African- American Adolescents: Relation With Higher Systolic and Pulse Pressure

Obesity is associated with a higher systolic blood pressure (BP) and pulse pressure (PP) in African-American youths, increasing their risk for developing hypertension. However, it is unknown whether arterial stiffness and wave reflection are associated with a higher systolic BP and PP or with smaller PP amplification in overweight/obese (OW/OB) African-American adolescents. We measured carotid-femoral pulse wave velocity (CF-PWV), carotid-radial PWV (CR-PWV), the augmentation index (AIx) adjusted to a heart rate of 75 bpm (AI75), the augmentation pressure (AugP), PP amplification, and body composition in 227 healthy African-American adolescents (age, 16.9 ± 0.2 years; 54% male). Adolescents who were OW/OB (n = 86, body mass index (BMI) ≥ 85th percentile) demonstrated 5%-6%, 13%-16%, and 2.5% higher aortic and brachial systolic BP, brachial and aortic PP, and mean arterial pressure (MAP), respectively (all P < 0.05), than adolescents of normal-weight (NW, n = 141, BMI < 85th percentile). The OW/OB adolescents had a 7% higher CF-PWV, 5% lower CR-PWV, and 3.5% lower PP amplification than the NW group (all P < 0.05), but no differences in AI75 or AugP. In the entire cohort after adjustment for age, sex, heart rate, height, and MAP, CF-PWV was positively correlated, and CR-PWV and PP amplification were negatively correlated, with total and abdominal/hip adiposity. Additionally, CF-PWV, AI75, and AugP were positively correlated with MAP and negatively correlated with PP amplification. CR-PWV, AI75, and AugP were negatively correlated with brachial and aortic PP. Higher aortic stiffness is associated with smaller PP amplification with increasing adiposity in African-American adolescents. Whether a reduction in PP amplification predicts increased CVD risk in obese African-American adolescents requires further study.

Changes in carotid-radial pulse wave velocity and radial-finger tip skin vascular bed transit time during and after graded aerobic exercise

Changes in carotid-radial pulse wave velocity and radial-finger tip skin vascular bed transit time during and after graded aerobic exercise

O603 CAROTID-RADIAL PULSE WAVE VELOCITY AS AN ALTERNATIVE TOOL FOR THE EVALUATION OF ENDOTHELIAL FUNCTION: POTENTIAL ROLE IN PREDICTING AND CLASSIFYING HYPERTENSIVE DISORDERS OF PREGNANCY

International Journal of Gynecology & ObstetricsVolume 119, Issue S3 p. S473-S474 Free communication (oral) presentations O603 CAROTID-RADIAL PULSE WAVE VELOCITY AS AN ALTERNATIVE TOOL FOR THE EVALUATION OF ENDOTHELIAL FUNCTION: POTENTIAL ROLE IN PREDICTING AND CLASSIFYING HYPERTENSIVE DISORDERS OF PREGNANCY J.F. Torrado, J.F. TorradoSearch for more papers by this authorI. Farro, I. FarroSearch for more papers by this authorF. Farro, F. FarroSearch for more papers by this authorD. Bia, D. BiaSearch for more papers by this authorY. Zocalo, Y. ZocaloSearch for more papers by this authorC. Sosa, C. SosaSearch for more papers by this authorS. Scasso, S. ScassoSearch for more papers by this authorS. Zunini, S. ZuniniSearch for more papers by this authorR.L. Armentano, R.L. ArmentanoSearch for more papers by this authorJ. Alonso, J. AlonsoSearch for more papers by this author J.F. Torrado, J.F. TorradoSearch for more papers by this authorI. Farro, I. FarroSearch for more papers by this authorF. Farro, F. FarroSearch for more papers by this authorD. Bia, D. BiaSearch for more papers by this authorY. Zocalo, Y. ZocaloSearch for more papers by this authorC. Sosa, C. SosaSearch for more papers by this authorS. Scasso, S. ScassoSearch for more papers by this authorS. Zunini, S. ZuniniSearch for more papers by this authorR.L. Armentano, R.L. ArmentanoSearch for more papers by this authorJ. Alonso, J. AlonsoSearch for more papers by this author First published: 22 October 2012 https://doi.org/10.1016/S0020-7292(12)61033-9AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat No abstract is available for this article. Volume119, IssueS3Abstracts of XX FIGO World Congress of Gynecology and ObstetricsOctober 2012Pages S473-S474 RelatedInformation

Hypertension intervention program organized by tertiary hospitals with community health centers

Five hundred and nineteen patients with essential hypertension from 6 community health centers in Baoshan Distract of Shanghai were enrolled in the program,all patients received direct or indirect comprehensive interventions.These interventions were conducted by doctors from tertiary hospitals and community health serwice centers.Among these hyperpietic,462 patients were followed-up for 1 year.After interventions,the awareness rate of hypertension was significantly increased,unhealthy life styles were changed; blood pressure control rate and risk factors control rate were also increased; carotid-femoral artery pulse wave velocity and carotid-radial artery pulse wave velocity were decreased (P ＜ 0.01 or P ＜ 0.05).The results indicate that comprehensive interventions organized by tertiary hospitals with community health centers are effectivc in managcmcnt of hypcrtension. Key words: Hypertension; Disease management

Arterial stiffness is increased in patients with inflammatory bowel disease

Recent studies have reported early atherosclerosis in patients with inflammatory bowel disease (IBD). In these patients, the chronic low-grade inflammation may predispose to vascular remodelling and arterial stiffening. We aimed at studying arterial stiffness in IBD patients. Thirty-two IBD patients without cardiovascular risk factors and 32 matched controls were enrolled (age 19-49 years). SphygmoCor device (AtCor Medical, Sydney, Australia) was used to measure carotid-femoral and carotid-radial (muscular artery) pulse wave velocity (PWV), augmentation index and central blood pressure. Carotid-femoral PWV was higher in IBD patients than in controls (6.6 ± 1.4 vs. 6.0 ± 0.8 m/s, respectively, P < 0.05), as well as carotid-radial PWV (8.5 ± 1.2 vs. 7.2 ± 1.0 m/s, P < 0.001). Central pulse pressure was higher in IBD than in controls (32 ± 6 vs. 28 ± 7 mmHg, P < 0.05). Aging was an important determinant of carotid-femoral PWV in both groups and carotid-radial PWV only in IBD patients. In fully adjusted model performed in both groups of patients considered as a whole, age was positively associated with carotid-femoral PWV [R(2) = 0.10; +0.05 m/s per 1 year of aging, 95% confidence interval (CI) 0.01-0.08 m/s, P < 0.05], as well as IBD (R(2) = 0.10; +0.72 m/s if IBD present, 95% CI 0.19-1.26 m/s, P < 0.05). In IBD patients, carotid-radial PWV was positively associated with the disease duration (R(2) = 0.20; +0.11 m/s per 1 year of aging, 95% CI 0.03-0.19 m/s, P < 0.05). Arterial stiffness is increased in patients with IBD independently of conventional cardiovascular risk factors.

78 CHARACTERISTICS OF PULSE WAVE VELOCITIES IN ELASTIC AND MUSCULAR ARTERIES

Background: Although aortic pulse wave velocity (PWV) has been accepted as the gold standard of arterial stiffness, and applied as a cardiovascular risk factor in various populations, the characteristics of PWVs in other arteries has never been reported. Methods: We measured carotid-femoral, carotid-pedis, carotid-radial, and femoral-pedis PWVs by a validated tonometry PulsePen (DiaTecne s.r.l., Milan, Italy), and assessed body fat percentage and carotid intema-media thickness (IMT) by bioelectrical impedance analyzer and ultrasonograph in 198 consecutive patients from our ambulatory cardiovascular department. Results: Carotid-femoral and carotid-pedis PWVs increased significantly and progressively with age in both men and women (P≤0.03), while only in men, a slight increase and decrease in carotid-radial and femoral-pedis PWVs were observed with age (P≤0.006). Carotid-femoral and carotid-pedis PWVs, but not carotid-radial and femoral-pedis PWVs, were significantly associated with age, body height and body fat percentage, brachial mean blood pressure (MBP) and pulse pressure (PP), carotid PP, PP amplification, and IMT (r: -0.24 to 0.51, P≤0.047). In full adjustment models, carotid-femoral PWV increased by 0.93 ± 0.21, 0.82 ± 0.27, 0.40 ± 0.16, 0.55 ± 0.23 m/s, with an increase of 10 years in age, of 10 mmHg in brachial PP, of 100 μm in IMT, and of 10 mmHg in brachial MBP, respectively, whereas carotid-pedis PWV increased by 0.34 ± 0.12 and 0.30 ± 0.11 m/s with an increase of 10 mmHg in brachial MBP and 10 years in age, respectively. Conclusion: Arterial stiffness in elastic arteries, but not in muscular arteries, increased significantly and progressively with age, and was more closely associated with BP and arterial wall thickness.Carotid-femoral (filled circles with solid line), carotid-pedis (filled circles with spotted line), carotid-radial (unfilled circles with solid line), and pedis-femoral (unfilled circles with spotted line) pulse wave velocities were presented in different age groups, in men and women, respectively.

Association of glomerular filtration rate with arterial stiffness in Chinese women with normal to mildly impaired renal function

ObjectiveBoth decreased glomerular filtration rate (GFR) and arterial stiffness were considered as risk factors for atherosclerosis. Previous studies have suggested the association between central arterial stiffness and the degree of GFR loss. Whether decreased GFR contributes to peripheral artery stiffness remains controversial. Moreover, data analyzed from a cohort of Chinese women are rare. Our aim was to explore the relationship between GFR and regional arterial stiffness in Chinese women.MethodsIn this cross-sectional study, we randomly recruited 1131 adult women residents with GFR ≥ 60 mL/min per 1.73 m2 estimated by the Chinese Modification of Diet in Renal Disease equation from three large communities. Central and peripheral arterial stiffness were estimated simultaneously by measuring carotid-femoral pulse wave velocity (PWVcf) and carotid-radial PWV (PWVcr) using a validated automatic device. Augmentation Index at heart rate 75 beats/minutes (AIx-75) was measured by pulse wave analysis as a composite parameter reflecting both large and distal arterial properties.ResultsThe mean estimated GFR (eGFR) of the study group was 100.05 ± 23.26 mL/minute per 1.73 m2. Subjects were grouped by tertiles of eGFR level. PWVcf and AIx-75 increased ongoing from the top to the bottom eGFR tertile, while the values of PWVcr were comparable. Both univariate Pearson correlations and multiple stepwise regression analyses showed that eGFR significantly correlated to PWVcf, but not to PWVcr and AIx-75.ConclusionsIn Chinese women with normal to mildly impaired renal function, decreased eGFR affected carotid-to-femoral rather than carotid-to-radial stiffening. This provides rational to conduct future prospective studies to investigate predictors of atherosclerosis in this population.

Supervised walking groups to increase physical activity in elderly women with and without hypertension: effect on pulse wave velocity

To date, only a few studies have evaluated the effect of physical activity on PWVcf in the elderly. In the current study, 21 community-dwelling women, with a mean age of 68.19±5.72 years and a mean BMI of 28.63±4.69 kg m(-2), participated in moderate physical activity sessions for 1 h per day and 2 days each week under the supervision of a qualified physical education instructor for a total of 24 weeks. At the beginning of the study, at 3 months and at 6 months, the study participants' body weight, waist circumference, sagittal abdominal diameter (SAD) and body composition by dual energy X-ray absorptiometry (DEXA) were recorded along with the participants' Physical Activity Scale for the Elderly questionnaire. Total low-density-lipoprotein and high-density lipoprotein cholesterol; triglycerides (TGs) and HbA1c; blood pressure (BP); and arterial stiffness, as determined by carotid-femoral and carotid-radial pulse wave velocity (PWVcf, PWVcr), were also assessed. During the follow-up period, the waist and SAD significantly decreased, whereas fat-free mass, BMI and weight did not decrease. A significant decline in TGs was observed. A significant decline in PWVcf, even after adjusting for mean arterial pressure, heart rate triglycerides and waist diameter changes, was observed. In a sub-analysis that examined the effect of physical activity separately in the hypertensive and normotensive subjects, we observed a significant decline in PWVcf in the hypertensive subjects and a nonsignificant tendency in the normotensive subjects. The data showed an association between light aerobic physical activity in the elderly and decreased PWVcf, even after adjusting for changes in systolic BP (SBP), TGs and central adiposity. These results suggest a beneficial effect of moderate physical activity on subclinical vascular damage, particularly in hypertensive subjects.

Soluble TWEAK level: is it a marker for cardiovascular disease in long-term hemodialysis patients?

Reduced soluble tumor necrosis factor-like weak inducer of apoptosis (sTWEAK) levels follow declining renal function, are strongly associated with endothelial dysfunction and predict cardiovascular events in nondialyzed chronic kidney disease patients. In contrast, elevated levels of sTWEAK predict poor survival in hemodialysis (HD) patients. Recent evidence suggests a role for sTWEAK in the pathophysiology of vascular calcification. The aim of the study was to investigate plausible links between sTWEAK, atherosclerosis, arterial stiffness and vascular calcification in HD patients. Coronary artery calcification score (CACs) determined by multislice computed tomography, arterial stiffness by pulse wave velocity (PWV) and carotid artery intima-media thickness (CA-IMT) by carotid Doppler ultrasonography were assessed in 131 long-term prevalent HD patients. sTWEAK levels were measured by ELISA (Bender MedSystems, Vienna, Austria). Mean serum sTWEAK level was 237.0 ± 147.5 pg/mL (range 78-937). sTWEAK level was inversely correlated with CA-IMT at a borderline significance (r=-0.168, p=0.05). Neither carotid-radial PWV nor carotid-femoral PWV values correlated with sTWEAK. sTWEAK level was higher in patients with severe vascular calcification (CACs ≥400) compared to patients with CACs <400 (264.5 ± 146.8 pg/mL vs. 205.04 ± 122.4 pg/mL, p=0.02).The association between sTWEAK and vascular calcification persisted after multivariate adjustment. There exists a weak inverse correlation between sTWEAK and carotid atherosclerosis and a positive correlation with coronary artery calcification in long-term HD patients. Our data give support for a role for sTWEAK in the pathogenesis of vascular injury in HD patients.

Aging and the effect of autonomic blockade on central and peripheral pulse wave velocity

Pulse wave velocity (PWV) and sympathetic nerve activity increase with age. However, it is unknown if the age‐related increase in sympathetic activity influences PWV. We determined the effect of autonomic blockade on peripheral and central arterial stiffness in young (23 ± 4 yr) and older, postmenopausal (57 ± 3 yr) women before and during administration of trimethaphan camsylate. Arterial tonometry was used to measure carotid‐radial (peripheral) and carotid‐femoral (central) PWV. The groups did not differ in height, weight, BMI, or mean arterial pressure (MAP). At baseline, peripheral PWV did not differ between the groups. However, central PWV was significantly greater in older women compared with young women (8.2 vs. 6.1 m/s, respectively; p&lt;0.05). Trimethaphan infusion caused a substantial drop in MAP; therefore, we corrected PWV for the change in MAP. Peripheral PWV was greater in older women compared with young women (0.12 vs. 0.08 m/s·mmHg−1; p&lt;0.05). In addition, central PWV remained higher in older women during trimethaphan infusion (0.11 vs. 0.08 m/s·mmHg−1 in young; p&lt;0.05). In conclusion, central PWV was greater in older women before and during autonomic blockade, whereas peripheral PWV was only higher in the older women after autonomic blockade. This suggests that peripheral PWV is influenced by sympathetic activity to a greater extent in young vs. older women.Funded by NIH

Role of Birth Weight and Postnatal Growth on Pulse Wave Velocity in Teenagers

Low birth weight and accelerated postnatal growth appear to play a significant role in the pathogenesis of hypertension and cardiovascular disease in adulthood. The aim of the present study was to characterize the factors determining pulse wave velocity (PWV) in teenagers and, in particular, to verify the relationship with birth weight, postnatal growth, timing of adiposity rebound, lifestyle, and hemodynamic parameters. Carotid-femoral and carotid-radial pulse wave velocities of 558 healthy teenagers (age range: 16.2-19.9 years) were determined by means of a PulsePen tonometer. Birth weight and gestational age were obtained from obstetrical records, and data regarding postnatal growth were obtained from pediatric clinical records. No change in aortic PWV was found in association with birth weight, postnatal growth, and timing of adiposity rebound. However, the study showed a strong association between accelerated growth from 0 to 12 months and carotid-radial PWV (trend: p = .02). Subjects with birth weight values <2,500 g showed higher values of upper limb PWV (p < .05) and higher values of diastolic and mean arterial pressure (p < .05). Stepwise regression analysis revealed that mean arterial pressure, age, and height were the main independent factors determining aortic PWV in this young population. These results suggest that there is no linear correlation between birth weight and hemodynamic parameters in teenagers; however, subjects characterized by very low birth weight and accelerated postnatal weight gain appear to demonstrate increased upper limb PWV and diastolic and mean arterial pressure values.

Assessment of vascular remodeling after the Fontan procedure using a novel very high resolution ultrasound method: arterial wall thinning and venous thickening in late follow-up

The Fontan circulation is associated with an increased central venous pressure, decreased ventricular preload, and increased afterload. We postulated that these central hemodynamic abnormalities would have consequences for the structural and functional properties of the peripheral arteries and veins, and performed a cross-sectional study in a tertiary health-care setting. We prospectively examined venous and arterial wall morphology by very high resolution ultrasound (VHRU, 25-55MHz), and function by conventional vascular ultrasound (flow-mediated dilatation, FMD) and applanation tonometry (pulse wave velocity, PWV) in 28 patients after the Fontan procedure (age 14.8±1.3years) and 54 age-matched controls. Pig venous samples were studied with VHRU and compared with histology for accuracy. The precision of the venous VHRU method was studied in healthy volunteers. The lumen dimension was reduced in Fontans compared with controls in the common carotid, brachial, radial, and femoral arteries (p<0.05). The common carotid, brachial, radial, ulnar, femoral, and dorsal tibial artery intima-media thicknesses (IMTs) and the brachial, ulnar, and femoral artery adventitial thicknesses were decreased (p<0.05 for all), while the cubital and dorsal tibial vein IMTs were increased in Fontans (p<0.001). FMD, abdominal aortic stiffness, and carotid-femoral PWV were similar, while carotid-radial artery PWV was increased in Fontans (p<0.01). Venous wall layer assessment with VHRU was accurate and precise. The Fontan circulation is associated with significant arterial and venous remodeling, presumably reflecting abnormalities of central hemodynamics. These novel data may be of clinical importance in the circulatory management as well as the understanding of the early pathogenesis of vasculopathy in patients after the Fontan procedure.

The association between preeclampsia and arterial stiffness

A systematic review and meta-analysis was conducted using MEDLINE, EMBASE, and the Cochrane Library to investigate the association between preeclampsia and arterial stiffness. Twenty-three relevant studies were included. A significant increase in all arterial stiffness indices combined was observed in women with preeclampsia vs. women with normotensive pregnancies [standardized mean difference 1.62, 95% confidence interval (CI) 0.73-2.50]; carotid-femoral pulse wave velocity (cfPWV) and augmentation index (AIx) were also significantly increased (weighted mean difference, WMDcfPWV 1.04, 95% CI 0.34-1.74; WMDAIx 15.10, 95% CI 5.08-25.11), whereas carotid-radial PWV (crPWV) increase did not reach significance (WMDcrPWV 0.99, 95% CI -0.07 to 2.05). Significant increases in arterial stiffness measurements were noted in women with preeclampsia compared with those with gestational hypertension. Arterial stiffness measurements may also be useful in predicting preeclampsia and may play a role in the increased risk of future cardiovascular complications seen in women with a history of preeclampsia.

Effects of acetazolamide on blood pressure and pulse waveform changes induced by high altitude exposure

A tonometric evaluation of arterial properties (PulsePen, DiaTecne, Milan) by assessing carotid-femoral and carotid-radial PWV (CF-PWV, CR-PWV) and pulse wave analysis (augmentation index, AIx and subendocardial viability ratio, SEVR, i.e. the ratio between diastolic and systolic area under the pulse pressure curve) was performed in the following conditions: • at baseline (SL pre) • after 2 days of randomized treatment at SL (SL post) • within 6 hours from arrival at HA (HA1) • and on 3rd full day of exposure to HA (HA2)