Changes In baPWV Research Articles

Plasma Lipidomic Profiles Improve upon Traditional Risk Factors for the Prediction of Arterial Stiffness Among Patients with Type 2 Diabetes Mellitum: A Randomized, Placebo-Controlled Trial

Background: Exercise or vitamin D intervention can reduce the risk of arterial stiffness; however, the underlying mechanisms of lipid metabolism remain unexplored. To examine the effects of a 12-week moderate and vigorous exercise program (65–80% maximal heart rate, 60 min/time, 2~3 times/week) with or without vitamin D supplementation (1000 IU/day) on the reduction in arterial stiffness and further explore whether the effects of interventions could be associated with the basal lipidome among patients with Type 2 diabetes mellitum (T2DM). Method: 61 patients with T2DM were randomly assigned to the following groups: control (CON, n = 15), exercise (EX, n = 14), vitamin D (VD, n = 16), and exercise + vitamin D (EX + VD, n = 16). Arterial stiffness risk factors (ankle–brachial index (ABI); brachial–ankle pulse wave velocity (baPWV), systolic blood pressure (SBP), and diastolic blood pressure (DBP)) were evaluated before and after the intervention. The plasma lipidome was determined using ultra-performance liquid chromatography coupled with tandem mass spectrometry. Machine learning was applied to establish prediction models for the responsiveness to arterial stiffness. Result: Vitamin D supplementation could inhibit the decrease in the ankle–brachial index (mean ± SD: EX + VD and VD, −0.001 ± 0.058; EX + CON, −0.047 ± −0.089; p = 0.03). We observed high inter-individual variability in the arterial stiffness risk factors in response to the interventions. We also found that optimally selecting the lipid predictors at baseline, such as SM d44:6, LPE 18:2, and Hex2Cer 29:0, could enhance the predictive power by 100% for arm SBP changes in the exercise group. Basal levels of Cer (33:1) and GM3 (44:4) could enhance the predictive power by 100% for changes in baPWV in the vitamin D group. Conclusions: A 12-week vitamin D supplementation was beneficial in preventing arterial stiffness. Compared with traditional clinical risk factors, specific lipids at baseline could significantly improve the ability to predict intervention-induced changes in the reduction of arterial stiffness.

Impact of three-month treatment with pitavastatin on arterial stiffness in patients with hypercholesterolemia: a prospective observational study

BackgroundAlthough several studies have highlighted the benefits of statins in improving arterial stiffness, there is limited research on whether pitavastatin, a more recently developed statin, has similar effects. This study aimed to investigate the impact of pitavastatin on arterial stiffness in patients with hypercholesterolemia. MethodsThis prospective study enrolled 115 patients with hypercholesterolemia (mean age 59 years; 22% female) who had not previously been treated with statins. Participants underwent lifestyle interventions followed by administration of pitavastatin (2 or 4 mg daily) if target low-density lipoprotein (LDL) cholesterol levels were not achieved. The primary outcome measured was the change in brachial-ankle pulse wave velocity (baPWV) from baseline after three months of treatment. ResultsPitavastatin treatment significantly reduced LDL cholesterol by 41.1% (from 158 ± 28 to 93.0 ± 29.6 mg/dL; P < 0.001). Additionally, systolic blood pressure (SBP) decreased significantly from 130 ± 14 mmHg to 126 ± 14 mmHg (P < 0.001), representing a 2.9% reduction, and baPWV decreased significantly from 1,522 ± 325 to 1,407 ± 289 cm/s (P < 0.001), a 7.6% reduction. There was a significant correlation between changes in SBP and changes in baPWV (r = 0.565; P < 0.001). Even after adjusting for changes in SBP, the reduction in baPWV induced by pitavastatin remained statistically significant (P < 0.001). ConclusionsA three-month treatment with pitavastatin effectively reduced arterial stiffness in patients with hypercholesterolemia, alongside significant improvements in lipid profiles and blood pressure reductions. These findings support the use of pitavastatin for managing key cardiovascular risk factors.

Age-related annual changes in arterial stiffness in healthy adults: Insights from a large Korean cohort study

Background and aimsArterial stiffness, a known cardiovascular risk factor, is associated with increasing age and arteriosclerosis. This study examines age-related annual changes in arterial stiffness in a large cohort of healthy individuals without cardiovascular disease, hypertension, or diabetes mellitus. MethodsThe study included 195,405 Korean adults aged 30–79 years who attended a health check-up between 2006 and 2019. Arterial stiffness was assessed using brachial-ankle pulse wave velocity (baPWV), and the final cohort for the baPWV annual change analysis comprised 147,313 participants. ResultsThe study found that baPWV values increase progressively with age in both sexes, with the most notable changes occurring in the 70–79 age group. The spread in baPWV measurements, as indicated by the interquartile ranges, generally increases with age but was particularly pronounced in women in the 50s and 60s age groups, with men showing a greater spread in the 70–79 age group. The average annual change in baPWV (ΔbaPWV) values increased from 1.48 cm/s (95 % CI: 0.80–2.16) in the 30–39 age group to 23.72 cm/s (95 % CI: 16.25–31.19) in the 70–79 age group in men. Similarly, for women, the average ΔbaPWV values increased from 1.80 cm/s (95 % CI: 0.93–2.68) to 18.51 cm/s (95 % CI: 7.18–29.85) in the 30–39 and 70–79 age groups, respectively. The study observed that arterial stiffness in men consistently increases across all age groups, whereas in women, it does not significantly increase annually before age 50 but shows a steeper rise after this age. ConclusionsThis study emphasizes the progressive nature of arterial stiffness with aging in a healthy population. It highlights notable differences in the rate of progression and the distribution of baPWV between men and women, with men exhibiting a greater spread in the oldest age group.

P051 ASSOCIATION OF BASELINE PLASMA ALDOSTERONE CONCENTRATION WITH ARTERIAL STIFFNESS PROGRESSION IN HYPERTENSIVE PATIENTS

Objective: Limited studies have examined the relationship between plasma aldosterone concentration (PAC) and arterial stiffness progression. The objective of this study was to investigate the longitudinal association between baseline PAC and arterial stiffness progression in hypertensive patients. Methods: A total of 1138 hypertensive patients were enrolled in the study. PAC was measured using standard techniques while in a sitting position. Arterial stiffness was quantified using brachial-ankle pulse wave velocity (baPWV), an indicator of arterial stiffness that is non-invasive in nature. Progression of baPWV was assessed using the baPWV change rate(the absolute difference between baseline and follow-up baPWV, divided by the follow-up time in years. Multivariate linear regression models were employed to idenitify the associations between baseline PAC and the baPWV change rate. Additionally, multivariable restricted cubic splines were utilized to investigate the dose-response relationship between baseline PAC and baPWV change rate. Results: Multivariate linear regression analyses revealed that an increase of one unit in PAC at baseline was associated with a 1.96 cm/s/year increase [95% confidence interval (CI), 0.99, 2.92] in baPWV change rate. Furthermore, RCS demonstrated a significant dose-response relationship between baseline PAC and the baPWV change rate. Conclusion: This study found that higher levels of PAC were associated with a faster progression of arterial stiffness. These findings should be confirmed by further investigations.

Long-term effects of COVID-19 on endothelial function, arterial stiffness, and blood pressure in college students: a pre-post-controlled study

BackgroundThe COVID-19 has been shown to have negative effects on the cardiovascular system, but it is unclear how long these effects last in college students. This study aimed to assess the long-term impact of COVID-19 on arterial stiffness, endothelial function, and blood pressure in college students.MethodsWe enrolled 37 college students who had been infected with COVID-19 for more than 2 months. Brachial artery flow-mediated dilation (FMD) was used to assess endothelial function, while arterial stiffness was evaluated using the ABI Systems 100, including variables such as ankle-brachial index (ABI), brachial-ankle pulse wave velocity (baPWV), carotid-femoral pulse wave velocity (cfPWV), heart rate (HR), and blood pressure (BP).ResultsOur results showed that FMD was significantly impaired after COVID-19 infection (p < 0.001), while cfPWV and systolic blood pressure (SBP) were significantly increased (p < 0.05). Simple linear regression models revealed a significant negative correlation between post-COVID-19 measurement time and baPWV change (p < 0.01), indicating an improvement in arterial stiffness over time. However, there was a significant positive correlation between post-COVID-19 measurement time and diastolic blood pressure (DBP) change (p < 0.05), suggesting an increase in BP over time. There were no significant differences in ABI and HR between pre- and post-COVID-19 measurements, and no significant correlations were observed with other variables (p > 0.05). Conclusion: Our study demonstrated that COVID-19 has long-term detrimental effects on vascular function in college students. However, arterial stiffness tends to improve over time, while BP may exhibit the opposite trend.

Prognostic value of brachial-ankle pulse wave velocity changes post-transcatheter aortic valve replacement.

Transcatheter aortic valve replacement (TAVR) offers a solution, especially for high-risk aortic stenosis (AS) patients. However, patient outcomes post-TAVR show variability, highlighting the need for reliable prognostic indicators. Brachial-ankle pulse wave velocity (baPWV), a measure of arterial stiffness, may predict outcomes post-TAVR. This study aims to explore baPWV's prognostic value in relation to all-cause mortality post-TAVR. This study prospectively enrolled 212 severe AS patients undergoing TAVR between September 2015 and December 2021, focusing on pre- and post-TAVR baPWV measurements to explore associations with all-cause mortality. Of the 212 patients (119 females, 93 males, mean age 85years), post-TAVR baPWV increased significantly from 1589 ± 376 to 2010 ± 521cm/s (p < 0.001). Aortic valve (AV) peak velocity and mean pressure gradient decreased, while AV area increased, indicating procedural success. Despite this, 88% of patients experienced an increase in baPWV, with higher pre-procedure AV peak velocity and mean pressure gradient identified as predictors of increased baPWV post-TAVR. Over 23months, 29 patients (14%) reached the primary endpoint of all-cause mortality. Notably, changes in baPWV, rather than baseline values, were significantly associated with event-free survival (HR: 0.64 per 1SD increase, p = 0.009). The study highlights the prognostic value of baPWV changes post-TAVR in predicting patient outcomes. Elevated baPWV post-TAVR may reflect a beneficial adaptation to altered hemodynamics, suggesting the need for individualized patient evaluation and the integration of baPWV measurements into clinical practice for improved post-TAVR management.

Association between triglyceride-glucose index and arterial stiffness progression: A retrospective cohort study.

Insulin resistance (IR) is closely associated with atherosclerosis and adverse cardiovascular events. The triglyceride-glucose (TyG) index is an effective indicator for assessing IR. This study aims to explore the relationship between the TyG index and the risk of arterial stiffness progression. This retrospective cohort study included adults who had undergone at least 2 health examinations with arteriosclerosis testing at the Health Management Medical Center of the Third Xiangya Hospital, Central South University, between January 2012 and December 2022. Clinical data were collected. The TyG index was calculated using the formula of ln (triglycerides×fasting blood glucose/2). The baseline TyG index was assessed as both a continuous variable and as a quartile-based categorical variable. The progression of arteriosclerosis was evaluated by the annual change rate of brachial-ankle pulse wave velocity (baPWV) and the new onset of increased arterial stiffness. Linear regression model and Cox proportional hazard model were used to explore whether the TyG index is an independent risk factor for arterial stiffness progression. Subgroup analyses were performed based on age, gender, body mass index (BMI), and the presence of type 2 diabetes, hypertension, or hyperlipidemia to determine the characteristics of the association between the TyG index and arterial stiffness progression. A total of 4 971 participants were included, with a follow-up period of (3.01±1.98) years. During follow-up, the annual baPWV change rate was (24.94±81.15) cm/s, and 278 cases of new onset of increased aterial stiffness were recorded. After fully adjusting for confounding factors, the baseline TyG index was independently positively correlated with both the annual baPWV change rate (β=17.5, 95% CI 9.00 to 25.94, P<0.001) and the risk of new onset of increased aterial stiffness [hazard ratio (HR)=1.43, 95% CI 1.18 to 1.74, P<0.001] when the TyG index was treated as a continuous variable. When treated as a categorical variable, higher TyG index quartiles were associated with progressively higher baPWV change rates and new onset of increased arterial stiffness (all P<0.05). In subgroups of participants aged ≥45 years, males, BMI<28 kg/m2, those with or without hypertension, and those without type 2 diabetes or hyperlipidemia, the baseline TyG index (both continuous and categorical) was significantly associated with new onset of increased arterial stiffness (all P<0.05), with no significant interactions observed across subgroups (all P>0.05). The TyG index is independently associated with an increased risk of arterial stiffness progression and may serve as a useful indicator for assessing arterial stiffness progression risk in health check-up populations.

Arterial stiffness progression in metabolic dysfunction–associated fatty liver disease subtypes: A prospective cohort study

Background and aimsWe aimed to investigate the correlation and to explore which MAFLD subtypes have the greatest influence on progression of arterial stiffness risk. Methods and resultsUsing data from a health examination-based cohort, a total of 12,129 participants who underwent two repeated health examinations that included brachial-ankle pulse wave velocity (baPWV) from 2012 to 2020 were enrolled. Participants were separated into non–MAFLD, overweight/obese (OW–MAFLD), lean/normal weight (lean–MAFLD) and diabetes (DM–MAFLD) groups. Among the participants with a median follow–up of 2.17 years, 4511 (37.2%) participants had MAFLD at baseline, among which 3954 (87.7%), 123 (2.7%), and 434 (9.6%) were OW–, lean– and DM–MAFLD, respectively. Analyses using linear regression models confirmed that compared with the non–MAFLD group, the elevated baPWV change rates (cm/s/year) were 12.87 (8.81–16.94), 25.33 (7.84–42.83) and 38.49 (27.88–49.10) in OW, lean and DM–MAFLD, respectively, while the increased change proportions (%) were 1.53 (1.10–1.95), 3.56 (1.72–5.40) and 3.94 (2.82–5.05), respectively. Similar patterns were observed when these two baPWV parameters were transformed in the form of the greatest increase using Cox proportional hazards model analyses. Furthermore, the risk of arterial stiffness progression across MAFLD subtypes presented a significant, gradient, inverse relationship in the order of DM–, lean–, OW with metabolic abnormalities (MA)–, and OW without MA–MAFLD. ConclusionMAFLD, especially DM–MAFLD and lean–MAFLD, was significantly associated with arterial stiffness progression, providing evidence that stratification screening and surveillance strategies for CVD risk have important clinical implications.

Changes in baPWV and the risk of clinical outcomes: a cohort study of Chinese community-based population.

It has not been fully investigated whether improved arterial stiffness (AS) can reduce the clinical outcomes risk in community population-based study. In this prospective study, a total of 5247 individuals with abnormal AS (at baseline) and repeated brachial-ankle pulse wave velocity (baPWV) measurement before 2018 years were enrolled from the Kailuan Study. According the second baPWV measurement, we divided the participants into two groups, improved AS (defined as transfer elevated AS status to normal) and persistent AS (defined as maintaining elevated AS status). The outcome was a composite event of stroke, myocardial infraction, and all-cause mortality. We used Cox proportional hazards regression to examine the association between AS status at the follow-up and the subsequent outcome. During a median of 5.2 years follow-up, we observed 413 end point events. After adjusted for potential confounders, comparing with the persistent AS group, individuals in the improved AS group had a 43% (hazard ratio [HR], 0.57; 95% confidence interval [CI] 0.35-0.94) decreased the risk of the primary composite events. We also found a baPWV decrease of 1 m/s was associated with a 3% decreased risk (HR, 0.97; 95% CI 0.94-0.99) for primary composite events. We further demonstrated that younger than 60 years, non-smoker, non-hypertension, and non-diabetes were associated with improved the AS status. In conclusion, improving AS status may reduce the risk of clinical events. In the future, more research should be performed to explore the target for improving the AS status.

Intensive blood pressure control on arterial stiffness among older patients with hypertension.

Arterial stiffening increases with age and blood pressure and is associated with cardiovascular disease (CVD), but the relationship between blood pressure lowering and arterial stiffening is still uncertain, especially in older people. This study aimed to evaluate the effect of intensive blood pressure treatment on the progression of arterial stiffness and risk of CVD in older patients with hypertension. The Strategy of Blood Pressure Intervention in the Elderly Hypertensive Patients (STEP) trial was a multicenter, randomized, controlled trial performed at 42 clinical centers throughout China, and 8511 patients aged 60-80 years with essential hypertension were enrolled and randomly assigned to systolic blood pressure (SBP) target of 110 mmHg to <130 mmHg (intensive treatment) or 130 mmHg to <150 mmHg (standard treatment). Patients underwent repeated examinations of the brachial-ankle pulse wave velocity (baPWV) and ankle-brachial index (ABI) at baseline, and the arterial stiffness was evaluated at the 3-year follow-up. A total of 5339 patients who had twice repeated measurements were included in this study. Changes in arterial stiffness between the intensive and standard treatment groups were analyzed using a multivariate linear regression model. The Cox proportional hazard regression model was used to evaluate the effect of intensive treatment on primary CVD outcomes. The changes in baPWV were 61.5 cm/s (95% confidence interval [CI]: 49.8-73.2 cm/s) in the intensive treatment group and 98.4 cm/s (95% CI: 86.7-110.1 cm/s) in the standard treatment group ( P <0.001). Intensive treatment significantly delayed the progression of arterial stiffness, with an annual change of 23.1 cm·s -1 ·year -1vs. 36.7 cm·s -1 ·year -1 of baPWV in the intensive and standard treatment groups, respectively. During a median follow-up period of 3.36 years, primary CVD outcomes occurred in 77 (2.9%) patients in the intensive treatment group compared with 93 (3.5%) in the standard treatment group. Intensive treatment resulted in a significantly lower CVD risk in patients aged 70-80 years or with SBP <140 mmHg. Intensive blood pressure control with an SBP target of 110 mmHg to <130 mmHg could delay the progression of arterial stiffness and reduce the risk of CVD in older patients with hypertension. http://www.clinicaltrials.gov ; No. NCT03015311.

Central systolic blood pressure as a risk for the accelerated progression of arterial stiffness

Abstract In the arterial tree, the systolic blood pressure (SBP) exhibits a pressure gradient from central to peripheral and is higher in the periphery because of pressure wave reflection. However, this gradient is attenuated with the elevation of central SBP (cSBP) in case with abnormal pressure wave reflection in arterial tree. It remains unclear whether increase of the cSBP might be an independent risk for the accelerated progression of arterial stiffness. Using the latent growth curve model (LGCM) analysis, this prospective observational study was conducted to examine whether elevation of the cSBP might be an independent risk for the accelerated progression of arterial stiffness in middle-aged Japanese men.In this 9-year prospective observational study, 3862 middle-aged Japanese men (42 ± 9 years old) without cerebrocardiovascular disease at the study baseline underwent annual measurements of the brachial-ankle pulse wave velocity (baPWV), and cSBP, estimated by radial pressure wave analysis as the second peak of radial pressure wave form (SBP2). During the follow-up period (6.4 ± 2.5), significant increases of baPWV and SBP2 were observed in all subjects. Analysis using the LGCM confirmed that the SBP2, a maker of cSBP (B=0.260, P &amp;lt; 0.001) was significant determinants of the slope of annual changes of baPWV during the study period. Our finding suggests that elevated cSBP is an independent risk for the accelerated progression of arterial stiffness in middle-aged Japanese men.

Effects of acute aerobic exercise on arterial stiffness in transgender men.

Testosterone replacement therapy (TRT) in transgender men (TM) results in side effects such as elevated triglycerides and increased arterial stiffness. Exercise may be useful to ameliorate such effects, but no studies have examined the effects of acute aerobic exercise in TM. This study aimed to investigate the effects of acute aerobic exercise on arterial stiffness in TM. Thirty-six participants were included, comprising 12TM (duration of TRT: 57.4 ± 30.3 months), 12 males and 12 females. All participants performed acute aerobic exercise on a treadmill at 50% heart rate reserve for 30min. Arterial stiffness as measured by brachial-ankle pulse wave velocity (baPWV) was measured before exercise (Pre), 30min after exercise (Post30), and 60min after exercise (Post60). Serum sex hormone levels, and serum lipid profile were determined only before exercise. Serum low-density lipoprotein cholesterol (LDL-C) levels before exercise were significantly higher in TM than in males or females (males: p < 0.01; females: p < 0.05). At all points, baPWV in TM was significantly higher than in females (p < 0.05) and significantly lower than in males (p < 0.05). However, when comparing changes in baPWV over time in each group, significant decreases in Post30 and Post60 were seen in males compared to Pre (both p < 0.05), but no significant change after aerobic exercise was seen in TM or females. These results suggest that acute aerobic exercise yield different effects in TM than in males, but is unlikely to reduce arterial stiffness in TM receiving TRT.

The effect of home-based cardiac rehabilitation on arterial stiffness and peak oxygen consumption in patients with myocardial infarction.

This study aims to investigate the effectiveness of home-based cardiac rehabilitation (CR) on arterial stiffness in patients with acute myocardial infarction (AMI). Between January 2015 and December 2017, a total of 135 patients (120 males, 15 females; mean age: 58.8±11.1 years) with AMI who were referred for CR were included. Home-based CR was prescribed based on a cardiopulmonary exercise test (CPET) for at least six months. All patients completed three consecutive CPETs and brachial-ankle pulse wave velocity (baPWV) measurements at one, four, and seven months after onset. After six months of CR, there was an improvement in peak oxygen consumption (pVO2) (Month 1, 28.7±6.4 mL/kg/min; Month 4, 31.6±6.3 mL/kg/min; Month 7, 31.2±7.1 mL/kg/min, p<0.001) and a reduction in baPWV (Month 1, left, 1546.0±311.2 cm/sec, right 1545.5±301.5 cm/sec; Month 4, left, 1374.9±282.5 cm/sec, right 1371.6±287.5 cm/sec; Month 7, left, 1362.9±287.0 cm/sec, right 1365.5±281.1 cm/sec, p<0.001). In patients with AMI, arterial stiffness and aerobic capacity improved after six months of home-based CR, particularly in the early stages of rehabilitation. These results suggest that changes in baPWV are useful in determining the effectiveness of CR and pVO2 in the initial stages of CR.

Discordance between remnant cholesterol and low-density lipoprotein cholesterol predicts arterial stiffness progression

BackgroundCross-sectional studies have shown that remnant cholesterol (RC) was associated with arterial stiffness. The present study evaluated the association of RC and the discordance between RC and low-density lipoprotein cholesterol (LDL-C) with arterial stiffness progression. MethodsData were derived from the Kailuan study. RC was calculated as total cholesterol – high-density lipoprotein cholesterol – LDL-C. Discordant RC with LDL-C were defined by residuals, cutoff points, and median values. Arterial stiffness progression was assessed by the brachial-ankle pulse wave velocity (baPWV) change, baPWV change rate, and increase/persistently high baPWV. Multivariable linear regression models and logistic regression models were used to explore the association of RC and discordant RC versus LDL-C with the arterial stiffness progression. ResultsA total of 10,507 participants were enrolled in this study, with the mean age of 50.8 ± 11.8 years, 60.9% (6,396) of male. Multivariable regression analyses showed that, each 1 mmol/L increase in the RC level was associated with a 12.80 cm/s increase in baPWV change, a 3.08 cm/s/year increase in the baPWV change rate, and 13% (95% CI, 1.05-1.21) of increase in the risk for increase in/persistently high baPWV. Discordant high RC was associated with a 13.65 cm/s increase in baPWV change and 19% (95% CI, 1.06-1.33) of increase in the risk for increase in/persistently high baPWV compared to those with concordant group. ConclusionDiscordantly high RC with LDL-C was associated with an increased risk of arterial stiffness progression. The findings demonstrated that RC may be an important marker of future coronary artery disease risk.

Arterial stiffness and blood pressure in treated hypertension: a longitudinal study.

It has been reported that an increase in arterial stiffness precedes an increase in blood pressure (BP) in the general population. Whether BP lowering results from of reducing arterial wall or vice versa in antihypertensive treatment is unclear. This study aimed to investigate the association between arterial stiffness and BP in patients with treated hypertension. This study included 3277 participants who were treated with antihypertensive agents and with repeated measurements of branchial-ankle pulse wave velocity (baPWV) and BP during 2010-2016 from the Kailuan study. Temporal relation between baPWV and BP was assessed by cross-lagged path analyses. After adjustment for potential confounders, the standard regression coefficient from baseline baPWV to follow-up SBP was 0.14 [95% confidence interval (95% CI), 0.10-0.18], which was significantly greater than that from baseline SBP to follow-up baPWV (0.05; 95% CI, 0.02-0.08) ( P < 0.0001 for difference). Similar results were observed for the cross-lagged analysis with changes of baPWV and mean arterial pressure. Further analysis showed that the yearly rate of change in SBP during the follow-up period significantly varied across increasing quartiles of baseline baPWV ( P < 0.0001), whereas the yearly rate of change in baPWV showed a nonsignificantly varied trend across quartiles of baseline SBP ( P = 0.2443). These findings provided strong evidence that reduction in arterial stiffness through antihypertensive treatment could precede BP lowering.

PS-C29-8: EFFECT OF WEIGHT GAIN ON ARTERIAL STIFFNESS AND PRESSURE WAVE REFLECTION: A 9-YEAR LONGITUDINAL STUDY

Background and Aim: Obesity is a causal factor for conventional risk factors for cardiovascular disease (CVD), and these risk factors affect increased arterial stiffness and also abnormal pressure wave reflection in arterial tree. Even so, because of the potent direct influences of these risk factors on arterial stiffness and pressure wave reflection, the direct effect of obesity on these vascular abnormalities has been still controversial. Then, the present study examined the effect of weight gain on those vascular abnormalities. Methods and Results: In 4016 middle-aged (43 ± 9 years) healthy Japanese men without CVD at the study baseline, body weight, risk factors for CVD, brachial-ankle pulse wave velocity (baPWV), and radial augmentation index (rAI) were measured at the baseline and end of study period (mean duration of follow-up was 6.3 years). The study subjects were divided into 3 groups by the change of BMI during the study period. While the change of baPWV in the highest tertile range of increase in BMI (57 ± 138 cm/sec) was larger than that in the lowest tertile range of increase in BMI (46 ± 136 cm/sec)(P &lt; 0.05), these differences were not significant after the adjustment of changes of blood pressure. In addition, the change of rAI was similar between both groups. Conclusions: Weight gain may affect increase in arterial stiffness rather than abnormal pressure wave reflection, and this effect may be mediated by increase in blood pressure related to weight gain rather than the direct effect of weight gain.

PS-BPC02-4: RELATIONSHIP BETWEEN EXERCISE CAPACITY AND CHANGES OF PULSE WAVE VELOCITY AFTER CARDIAC REHABILITATION IN PATIENTS WITH ACUTE MYOCARDIAL INFARCTION

Objective: Guidelines strongly recommend exercise-based cardiac rehabilitation (CR) to reduce cardiovascular mortality in patients with acute myocardial infarction (AMI). Reduction of central aortic systolic pressure, augmentation index, and pulse wave velocity (PWV) after aerobic exercise may be associated with better clinical outcomes after CR. However, the change of pulse wave velocity after CR in patients with AMI has been rarely investigated. Design and Method: Sixty-five patients (age 55.3 ± 10.1 years, 63 men) with AMI who completed the 6-month CR and evaluation program were included in this study. Maximal oxygen uptake (VO2max) during cardiopulmonary exercise (CPX) testing and brachial-ankle PWV (baPWV) were measured before exercise program and after 6 months. Based on the results of baseline CPX testing, each exercise program which included target metabolic equivalent, target heart rate, and exercise duration, was prescribed. Patients were recommended to attend the outpatient CR program which composed of 8 to 12 visits during 4 to 6 weeks. Self-exercise program was educated for each patient who finished or denied the outpatient CR program. Results: After 6 months, VO2max was increased from 28.9 ± 5.79 to 31.7 ± 6.5 mL/kg/min (p &lt; 0.001) and baPWV was decreased from 14.68 ± 2.66 to 13.54 ± 2.92 m/sec (p &lt; 0.001). Changes of baPWV (Delta-baPWV) showed a significant negative correlation with 6-month VO2max (r = -0.339, p = 0.006). Patient were divided into group 1 (n = 32, Delta-baPWV &lt;-1.13 m/sec) and group 2 (n = 33, Delta-baPWV &gt; = -1.13 m/sec). Group 1 showed higher 6-month VO2max (33.5 ± 6.7 vs. 29.9 ± 5.9 mL/kg/min; p = 0.023). On logistic regression analysis, 6-month VO2max was a significant determining factor for Delta-baPWV (OR 1.159, 95% CI 1.030–1.305, p = 0.014) after adjustment of age, sex, height and baseline baPWV. Conclusions: Patients with better exercise capacity after CR program showed more decreased PWV.

One-month changes in blood pressure-adjusted pulse wave velocity for predicting long-term cardiovascular outcomes in patients undergoing percutaneous coronary intervention.

The prognostic value of changes in arterial stiffness has not been well evaluated. This study was conducted to investigate whether the change in arterial stiffness one month after percutaneous coronary intervention (PCI) affects the long-term cardiovascular prognosis. A total of 405 patients (mean age, 62.0 ± 11.0 years; female sex, 27.7%) who underwent PCI with drug-eluting stent (DES) implantation was prospectively enrolled. The measurement of brachial-ankle pulse wave velocity (baPWV) was taken in all the study patient at the time of admission for index PCI. Major adverse cardiovascular event (MACE), a composite of cardiac death, nonfatal myocardial infarction, coronary revascularization and ischemic stroke, was assessed during clinical follow-up after index PCI. During the median follow-up duration of 5.3 years (interquartile range. 2.9-7.9 years), there was 65 MACE (16.0%). There was no significant difference in clinical characteristics between patients with and without MACE except for higher prevalence of triple vessel disease in those with MACE. The baPWV value decreased at one month after index PCI (1560 ± 305 to 1530 ± 318 cm, P < 0.001). In multivariable cox regression analysis, the change of baPWV at one month was not associated with MACE occurrence ( P > 0.05). However, the change in systolic blood pressure (SBP)-adjusted baPWV (baPWV/SBP) at one month (increased vs . decreased) was significantly associated with MACE occurrence even after controlling for potential confounders (hazard ratio, 2.25; 95% confidence interval, 1.37-3.69; P = 0.001). The baPWV/SBP change at one month was associated with long-term MACE in patients undergoing DES implantation. The results of this study suggest that baPWV/SBP changes at one month may be helpful in risk stratification of patients at a high coronary risk.

Visceral fat might impact left ventricular remodeling through changes in arterial stiffness in type 2 diabetes: A cross-sectional study

AimsVisceral fat (VF) influences left ventricular (LV) structure and diastolic function in type 2 diabetes (T2DM). However, there are limited data on the association among them based on different BMI levels as well as accounting for arterial stiffness. This study investigated the association of fat distribution, arterial stiffness, left ventricular (LV) structure and diastolic function in T2DM patients. Materials and methodsThis cross-sectional study comprised 905 patients. VF area (VFA) and subcutaneous fat area (SFA) were assessed by a dual bioelectrical impedance analyzer. Brachial-ankle pulse wave velocity (baPWV) was measured by a volume-plethysmographic apparatus and LV structure and diastolic function were echocardiography. Patients were divided into three groups based on BMI levels. Linear and logistic regression analysis were used to investigate the association. ResultsIn multivariate linear regression, relative wall thickness (RWT) was negatively correlated with E/A in obese patients (β = −0.203, p = 0.004). LV mass/height2.7 was positively correlated with E/E' in normal weight (β = 0.232, p = 0.002) and obese patients (β = 0.232, p = 0.008). In multivariate logistic regression, baPWV was an independent determinant of LV remodeling (LVRM) in normal weight (OR = 1.001; 95% CI, 1.000, 1.002; P = 0.006), overweight (OR = 1.001; 95% CI, 1.000, 1.002; P = 0.008) and obese groups (OR = 1.003; 95% CI, 1.001, 1.004; P = 0.001), while VFA was correlated with arterial stiffness in normal weight (OR = 1.032; 95% CI, 1.017, 1.047; P < 0.001) and overweight groups (OR = 1.011; 95% CI, 1.002, 1.021; P = 0.015). ConclusionsVF might impact LVRM through changes in baPWV in T2DM patients, thus influencing diastolic function.

Skeletal Muscle Mass is Associated with HDL Cholesterol Levels and the Ratio of LDL to HDL Cholesterol in Young Men: A Pilot Study

Background: It is unclear whether greater skeletal muscle mass is beneficial for improving cardiometabolic health in young individuals. Our purpose was to investigate the association between skeletal muscle mass and cardiometabolic risk factors in young males. Methods: Data were collected from thirty-seven young males (23.2 ± 0.3 years). Participants were categorized based on skeletal muscle mass (skeletal muscle index-percentile score, SMI-PS) assessed by bioelectrical impedance analysis. They were divided into two group: standard skeletal muscle mass group (SMG, n = 17, SMI-PS = 102.2 ± 1.0%), high skeletal muscle mass group (HMG, n = 20, SMI-PS = 120.5 ± 1.8%). Arterial stiffness assessed by brachial-ankle pulse wave velocity (baPWV) and blood parameters including high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), total cholesterol (TC), triglycerides (TG), fasting glucose (FG) and hemoglobin A1c (HbA1c) were assessed. Results: The level of HDL-C in HMG was significantly higher compared to SMG (p &lt; 0.001), whereas the ratio of LDL-C to HDL-C in HMG was significantly lower compared to SMG (p &lt; 0.001). However, no changes in baPWV, TC, LDL-C, TG, FG, and HbA1c were found between groups. Interestingly, there was a positive correlation between SMI-PS and HDL-C (r = 0.469, p = 0.003), whereas there was a negative correlation between SMI-PS and LDL-C/HDL-C (r = –0.38, p = 0.02). Conclusions: This study suggests that an increase in skeletal muscle mass may have an additive benefit on improving lipid components through the increased HDL-C level and decreased the ratio of LDL-C to HDL-C in young men.