Arterial Distensibility Research Articles

Differential postnatal cardiovascular course of donor-recipient twins and associated pathophysiology-a cohort study.

Fetal echocardiography in twin to twin transfusion pregnancies treated with photocoagulation noted impaired cardiac function. Systematic information about cardiac structure or function and arterial distensibility after birth is not available. This study evaluated cardiovascular function and arterial dynamic properties in survivors of twin to twin transfusion syndrome. Eleven pairs of donor-recipient twins were compared with each other, and with 20 singletons of comparable gestational age. The twin cohort was born at 31.5±2 weeks gestational age; birthweights of donors-recipients were comparable (donors: 1358±421g vs recipients: 1617±460g, P=0.2). Significant inter-twin differences were noted for cardiac function parameters. Recipients had greater septal thickness (donors: 2.3±0.15 vs recipients: 2.7±0.36mm, P=0.01) and globularity (lower sphericity index [donors: 1.76±0.1 vs recipients: 1.62±0.12, P=0.009]). They also had lower cardiac function (tricuspid annular plane systolic excursion [donors: 4.6±0.5 vs recipients: 4.1±0.4mm, P=0.02) and right ventricular fractional area change [donors: 30±1 vs recipients: 27.7±1.3%, P=0.0001]). Comparing with singletons, differences were statistically more significant for recipients. Arterial distensibility however, was more affected in donors (higher arterial wall stiffness index [donors: 2.5±0.2 vs recipients: 2.2±0.2, P=0.008] and lower pulsatile diameter [donors: 51±5 vs recipients: 63±10 µm, P<0.0001). Comparing with singletons, the differences were statistically more significant for donors. Evaluation in the neonatal period noted that cardiac function and arterial distensibility is affected in TTTS twins. These cohorts will benefit from close postnatal follow up for resolution of cardiac and arterial impairments.

Assessment of Thoracic Radiographic Alterations in Dogs with Heartworm and Their Correlation with Pulmonary Hypertension, Pre- and Post-Adulticide Treatment.

Pulmonary hypertension (PH) is a prevalent and severe complication in dogs infected with Dirofilaria immitis. This study aimed to elucidate the progression of PH by analyzing radiographic parameters and the Right Pulmonary Artery Distensibility (RPAD) Index at three key time points: diagnosis (day 0), discharge (day 90), and six months post-discharge (day 270). Fifty-two heartworm-infected dogs were divided into two groups: non-hypertensive and hypertensive. Radiographic measurements, including Vertebral Heart Size (VHS), CrPA/R4 ratio, and CdPA/R9 ratio, along with the RPAD Index, were assessed on Days 0, 90, and 270. Results indicated that, in Group A, the RPAD Index improved significantly from 42% on Day 0 to 43.16% on Day 90, with no significant change by Day 270 (42%). In contrast, hypertensive dogs exhibited a persistently low RPAD Index, averaging 17% throughout this study (p < 0.001). Radiographic parameters in hypertensive dogs showed continuous elevation compared to non-hypertensive dogs, with significant increases in VHS, CrPA/R4, and CdPA/R9 ratios on day 270 compared to day 0 (p < 0.05). The results confirmed that PH persisted in dogs with D. immitis after adulticide treatment, highlighting the importance of regular radiographic monitoring for assessing and managing long-term outcomes in dogs with PH during and after adulticide treatment. Continuous surveillance is thus essential for the effective post-treatment management of PH in dogs.

Closed-loop baroreflex model with biophysically detailed afferent pathway.

In this work, we couple a lumped-parameter closed-loop model of the cardiovascular system with a physiologically-detailed mathematical description of the baroreflex afferent pathway. The model features a classical Hodgkin-Huxley current-type model for the baroreflex afferent limb (primary neuron) and for the second-order neuron in the central nervous system. The pulsatile arterial wall distension triggers a frequency-modulated sequence of action potentials at the afferent neuron. This signal is then integrated at the brainstem neuron model. The efferent limb, representing the sympathetic and parasympathetic nervous system, is described as a transfer function acting on heart and blood vessel model parameters in order to control arterial pressure. Three in silico experiments are shown here: a step increase in the aortic pressure to evaluate the functionality of the reflex arch, a hemorrhagic episode and an infusion simulation. Through this model, it is possible to study the biophysical dynamics of the ionic currents proposed for the afferent limb components of the baroreflex during the cardiac cycle, and the way in which currents dynamics affect the cardiovascular function. Moreover, this system can be further developed to study in detail each baroreflex loop component, helping to unveil the mechanisms involved in the cardiovascular afferent information processing.

B-flow/spatiotemporal image correlation M-mode ultrasound provides novel method to quantify spiral artery remodeling during normal human pregnancy.

During human pregnancy, placental extravillous trophoblasts replace vascular smooth muscle and elastic tissue within the walls of the uterine spiral arteries, thereby remodeling them into distensible low-resistance vessels to promote placental perfusion. The present study determined whether B-flow/spatiotemporal image correlation (STIC) M-mode ultrasonography provides an in-vivo imaging method able to digitally quantify spiral artery luminal distensibility as a physiological index of spiral artery remodeling during the advancing stages of normal human pregnancy. A prospective, longitudinal, observational study was conducted to quantify spiral artery distensibility (i.e. vessel luminal diameter at systole minus diameter at diastole) by B-flow/STIC M-mode ultrasonography during the first, second and third trimesters in 290 women exhibiting a normal pregnancy. Maternal serum levels of placental growth factor (PlGF) and soluble fms-like tyrosine kinase-1 (sFlt-1), growth factors that modulate important events in spiral artery remodeling, were quantified in a subset of the women in the first, second and third trimesters of pregnancy. Median (interquartile range (IQR)) spiral artery distensibility increased progressively between the first (0.17 (0.14-0.21) cm), second (0.23 (0.18-0.28) cm) and third (0.26 (0.21-0.35) cm) trimesters of pregnancy (P < 0.0001 for all). Median (IQR) spiral artery volume flow increased progressively between the first (2.49 (1.38-4.99) mL/cardiac cycle), second (3.86 (2.06-6.91) mL/cardiac cycle) and third (7.79 (3.83-14.98) mL/cardiac cycle) trimesters (P < 0.001 for all). In accordance with the elevation in spiral artery distensibility, the median (IQR) ratio of serum PlGF/sFlt-1 × 103 levels increased between the first (7.2 (4.5-10.0)), second (22.7 (18.6-42.2)) and third (56.2 (41.9-92.5)) trimesters (P < 0.001 for all). The present study shows that B-flow/STIC M-mode ultrasonography provides an in-vivo imaging technology to quantify digitally the structural and physiological expansion of the walls of the spiral arteries during the cardiac cycle as a consequence of their transformation into compliant vessels during advancing stages of normal human pregnancy. © 2024 International Society of Ultrasound in Obstetrics and Gynecology.

Carotid Artery Wall Echogenicity Measured by Gray Scale Median of the Intima-Media Complex From Childhood to Young Adulthood.

Echogenicity of the carotid arterial wall, measured by gray scale median of the intima-media complex (IM-GSM), is a novel subclinical atherosclerosis marker with lower values indicating greater lipid deposition. Our longitudinal study investigated IM-GSM from childhood to adulthood and its associated risk factors. A total of 240 participants from the Southern California CHS (Children's Health Study) underwent carotid artery ultrasounds in 2008 (mean age±SD): (11.2±0.6 years), and again around 2022 (24.2±1.6 years) to assess IM-GSM, carotid artery intima-media thickness, and carotid artery distensibility. Questionnaires and anthropometric and blood pressure measurements were completed by participants at both times. Mean and SD of IM-GSM were 108.2±24.6 in childhood and 75.6±15.8 in adulthood. Each 1-year increase in age was associated with -2.52 change in IM-GSM (95% CI, -2.76 to -2.27). Childhood and adulthood IM-GSMs were highly correlated (β=0.13 [95% CI, 0.05-0.22]). In childhood, Hispanic ethnicity, lower parental education levels and prenatal father smoking were significantly associated with lower IM-GSM. In adulthood, higher systolic blood pressure, carotid artery intima-media thickness, hypertension, and lower distensibility were significantly associated with lower IM-GSM. Weight status exhibited a consistent association with both childhood and adulthood IM-GSM. During the transition from childhood to adulthood, individuals who shifted from normal weight to overweight/obese or normal blood pressure to hypertension or experienced an increase in carotid artery intima-media thickness displayed lower levels of IM-GSM in adulthood. IM-GSM decreases with age. Maintaining healthy weight and blood pressure levels in children could potentially aid in preventing subclinical atherosclerosis.

Evaluation of the Great Artery Mechanics with CarotidFemoral (Aortic) Pulse Wave Propagation Time in Patients with Rheumatoid Arthritis

Objectives: Rheumatoid arthritis (RA) is the most common chronic, systemic, rheumatic, autoimmune disease in adults, which has unknown etiology and targets primarily synovial tissue. Those patients have increased cardiovascular mortality based on inflammation and atherosclerosis. In our study, we evaluated great artery mechanics in newly diagnosed RA patients with inactive disease. Great artery mechanics, referred as arterial distensibility, elasticity, and compliance can be evaluated by pulse wave propagation time and pulse wave velocity. Methods: Our study included newly diagnosed and in inactive stage 25 RA patients ( mean age: 39.4±9.8 years, 21–63 years, 19 female, 6 male) and 29 healthy subjects (mean age: 36.9±9.9 years, 18–59 years, 13 female, 16 male). Aortic pulse wave propagation time and pulse wave velocitiy were determined using an automatic device, the Complior Colson (France), which allowed online recording and automatic calculation. Results: Height, waist circumference, and waist/hip ratio values were significantly higher in healthy objects. (p=0.006, p=0.030, p=0.004, respectively) pulse wave propagation time and pulse wave velocity were significantly lower and higher, respectively, in RA patients compared to healthy subjects (p=0.000, p=0.041, respectively). Conclusion: RA patients have decreased pulse wave propagation time and higher pulse wave velocity.

Longitudinal study of birthweight, blood pressure, and markers of arterial stiffness in children age six among the TIDES cohort.

Although some studies have observed an association between birthweight and cardiovascular disease in adulthood, fewer have investigated whether birthweight is linked to cardiovascular health in early childhood. This study assesses the association between birthweight and cardiovascular outcomes in children 6 years of age. Birthweight, blood pressure (BP), and markers of arterial stiffness in children, including brachial artery distensibility and carotid-femoral pulse wave velocity (cfPWV), were obtained from 324 participants in The Infant Development and the Environment Study, a prospective multisite pregnancy cohort. Birthweight was converted into sex-specific birthweight-for-gestational-age (bw/ga) z -scores based on the INTERGROWTH-21st standard. Following 2017 American Academy of Pediatrics guidelines, SBP and DBP were transformed into sex, age, and height-specific z -scores. Associations between birthweight and cardiovascular outcomes were assessed using nested multivariable linear regression models among the overall and sex-stratified samples. Among the overall sample, bw/ga z -score was positively associated with cfPWV [b = 0.11 m/s, 95% confidence interval (CI): 0.01 m/s, 0.21 m/s] in crude and adjusted models. No associations between birthweight and cardiovascular outcomes were detected among the sex-stratified analyses. Overall, birthweight was not related to cardiovascular outcomes in children 6 years old. However, infants born with a higher birthweight may be at risk for higher cfPWV in childhood. Early intervention in pregnant people at risk of delivering high birthweight infants may be warranted if results are replicated.

EFFECT OF STATIC PHYSICAL ACTIVITY ON CENTRAL HEMODYNAMICS AND ARTERIAL DISTENSIBILITY IN ADOLESCENT ATHLETES INVOLVED IN SWIMMING AND CROSS-COUNTRY SKIING

The purpose of the paper is to compare arterial distensibility in endurance sports atheletes (track and field athletes and swimmers), in whom adaptation to muscle activity is formed in interaction with various environmental factors. Materials and methods. Qualified athletes (adolescents aged 13–17) performed a 5-minute isometric handgrip exercise, corresponding to 20 % of the maximum compression force. The authors assessed athletes’ hemodynamics, arterial elasticity and cardiac parameters using the SphygmoCor technology. Results. At rest, swimmers demonstrated increased systolic blood pressure, lower values of heart rate, augmentation index and relative systole duration. Immediately after load, swimmers showed an increase in blood pressure, augmentation pressure, and left ventricular contractility as a consequence of sympathoadrenal system activation during exercise. In skiers the answers were reduced. After 20-minute recovery, diastolic pressure and augmentation index in swimmers dropped below the baseline. It was probably due to the vasodilatory effect of acidic metabolic products washed out after exercise from isometrically contracted ischemic forearm muscles. Conclusion. The characteristic aspects of aquatic training influence background hemodynamic parameters, arterial distensibility and responsiveness to local isometric load.

Association between Thoracic Radiographic Changes and Indicators of Pulmonary Hypertension in Dogs with Heartworm Disease.

Pulmonary hypertension (PH) is a consequence of pulmonary endarteritis during infection with Dirofilaria immitis in dogs. Echocardiography is the technique of choice but is not always accessible to all clinicians. This study aimed to evaluate the association of the radiological findings in dogs with heartworm disease and the presence or absence of echocardiographically characterised PH. The study included 62 heartworm-infected dogs that underwent thoracic radiographs and echocardiography. The studied dogs showed moderate to severe PH when the Right Pulmonary Artery Distensibility (RPAD) Index was <29.5%. The RPAD Index was used for comparison with thoracic radiographs. The Vertebral Heart Size (VHS), right cranial pulmonary artery passing through the fourth rib in the laterolateral projection (CrPA/R4) ratio, and right caudal pulmonary artery to the ninth rib in the dorsoventral projection (CdPA/R9) ratio showed significant differences between dogs with/without PH (p < 0.001). Sensitivity (sen) and specificity (sp) cut-off values were obtained: VHS ≥ 9.53 (sen 93.75%, sp 63.33%); CrPA/R4 ≥ 1.08 (sen 87.5%, sp 70%); and CdPA/R9 ≥ 1.10 (sen 96.88%, sp 76.66%). The CrPA/R4 and CdPA/R9 ratios showed potential as a preliminary screening tool for PH in heartworm-infected dogs, suggesting that they may reliably indicate the presence of PH and guide the decision for further diagnostic testing.

Arterial Distension Monitoring Scheme Using FPGA-Based Inference Machine in Ultrasound Scanner Circuit System.

This paper presents an arterial distension monitoring scheme using a field-programmable gate array (FPGA)-based inference machine in an ultrasound scanner circuit system. An arterial distension monitoring requires a precise positioning of an ultrasound probe on an artery as a prerequisite. The proposed arterial distension monitoring scheme is based on a finite state machine that incorporates sequential support vector machines (SVMs) to assist in both coarse and fine adjustments of probe position. The SVMs sequentially perform recognitions of ultrasonic A-mode echo pattern for a human carotid artery. By employing sequential SVMs in combination with convolution and average pooling, the number of features for the inference machine is significantly reduced, resulting in less utilization of hardware resources in FPGA. The proposed arterial distension monitoring scheme was implemented in an FPGA (Artix7) with a resource utilization percentage less than 9.3%. To demonstrate the proposed scheme, we implemented a customized ultrasound scanner consisting of a single-element transducer, an FPGA, and analog interface circuits with discrete chips. In measurements, we set virtual coordinates on a human neck for 9 human subjects. The achieved accuracy of probe positioning inference is 88%, and the Pearson coefficient (r) of arterial distension estimation is 0.838.

Arterial structure and function in children with inflammatory bowel disease.

People with inflammatory bowel disease (IBD) have an increased risk of cardiovascular disease, including in younger adulthood. This may arise in part from chronic, systemic low-grade inflammation. The process of atherosclerosis may begin in childhood. We sought to determine whether pediatric IBD is associated with adverse changes in arterial structure and function as a marker of early increased cardiovascular risk. We performed a case-control study comparing children with IBD for a median disease duration of 2.49 (interquartile range 1.23, 4.38) years with healthy children. In a single visit, we collected baseline clinical and anthropometric data, and measured blood pressure, pulse wave velocity, carotid artery distensibility, and aortic and carotid intima-media thickness. High-sensitivity C-reactive protein and fasting lipids were measured. We enrolled 81 children with IBD (40 with Crohn's disease, 40 with ulcerative colitis, and 1 with unspecified IBD) and 82 control participants. After adjusting for age, sex, body mass index z-score, blood pressure, and low-density lipoprotein cholesterol, there was no difference in measures of arterial structure and function in children with IBD compared with controls, nor between those with Crohn's disease or ulcerative colitis. We did not show any differences in arterial structure and function in children with a history of IBD for less than 5 years compared with healthy controls. IBD diagnosed in childhood may provide a window of opportunity to actively reduce standard cardiovascular risk factors and improve future cardiovascular outcomes.

Oxidative DNA damage promotes vascular aging associated with changes in extracellular matrix-regulating proteins.

Vascular aging is characterized by vessel stiffening, with increased deposition of extracellular matrix (ECM) proteins including collagens. Oxidative DNA damage occurs in vascular aging, but how it regulates ECM proteins and vascular stiffening is unknown. We sought to determine the relationship between oxidative DNA damage and ECM regulatory proteins in vascular aging. We examined oxidative DNA damage, the major base excision repair (BER) enzyme 8-Oxoguanine DNA Glycosylase (Ogg1) and its regulators, multiple physiological markers of aging, and ECM proteomics in mice from 22-72w. Vascular aging was associated with increased oxidative DNA damage, and decreased expression of Ogg1, its active acetylated form, its acetylation regulatory proteins P300 and CBP, and the transcription factor Foxo3a. Vascular stiffness was examined in vivo in control, Ogg1-/-, or mice with vascular smooth muscle cell-specific expression of Ogg1+ (Ogg1) or an inactive mutation (Ogg1KR). Ogg1-/- and Ogg1KR mice showed reduced arterial compliance and distensibility, and increased stiffness and pulse pressure, whereas Ogg1 expression normalised all parameters to 72w. ECM proteomics identified major changes in collagens with aging, and downregulation of the ECM regulatory proteins Protein 6-lysyl oxidase (LOX) and WNT1-inducible-signaling pathway protein 2 (WISP2). Ogg1 overexpression upregulated LOX and WISP2 both in vitro and in vivo, and downregulated Transforming growth factor β1 (TGFb1) and Collagen 4α1 in vivo compared with Ogg1KR. Foxo3a activation induced Lox, while Wnt3 induction of Wisp2 also upregulated LOX and Foxo3a, and downregulated TGFβ1 and fibronectin 1. In humans, 8-oxo-G increased with vascular stiffness, while active OGG1 reduced with both age and stiffness. Vascular aging is associated with oxidative DNA damage, downregulation of major BER proteins, and changes in multiple ECM structural and regulatory proteins. Ogg1 protects against vascular aging, associated with changes in ECM regulatory proteins including LOX and WISP2.

Long-term exposure to ambient air pollution and measures of central hemodynamics and arterial stiffness among multiethnic Chicago residents

ObjectivesTo examine whether long-term air pollution exposure is associated with central hemodynamic and brachial artery stiffness parameters.MethodsWe assessed central hemodynamic parameters including central blood pressure, cardiac parameters, systemic vascular compliance and resistance, and brachial artery stiffness measures [including brachial artery distensibility (BAD), compliance (BAC), and resistance (BAR)] using waveform analysis of the arterial pressure signals obtained from a standard cuff sphygmomanometer (DynaPulse2000A, San Diego, CA). The long-term exposures to particles with an aerodynamic diameter < 2.5 μm (PM2.5) and nitrogen dioxide (NO2) for the 3-year periods prior to enrollment were estimated at residential addresses using fine-scale intra-urban spatiotemporal models. Linear mixed models adjusted for potential confounders were used to examine associations between air pollution exposures and health outcomes.ResultsThe cross-sectional study included 2,387 Chicago residents (76% African Americans) enrolled in the ChicagO Multiethnic Prevention And Surveillance Study (COMPASS) during 2013–2018 with validated address information, PM2.5 or NO2, key covariates, and hemodynamics measurements. We observed long-term concentrations of PM2.5 and NO2 to be positively associated with central systolic, pulse pressure and BAR, and negatively associated with BAD, and BAC after adjusting for relevant covariates. A 1-µg/m3 increment in preceding 3-year exposures to PM2.5 was associated with 1.8 mmHg higher central systolic (95% CI: 0.98, 4.16), 1.0 mmHg higher central pulse pressure (95% CI: 0.42, 2.87), a 0.56%mmHg lower BAD (95% CI: -0.81, -0.30), and a 0.009 mL/mmHg lower BAC (95% CI: -0.01, -0.01).ConclusionThis population-based study provides evidence that long-term exposures to PM2.5 and NO2 is related to central BP and arterial stiffness parameters, especially among African Americans.

CENTRAL BLOOD PRESSURE AND VASCULAR RESPONSES TO DIFFERENT PHYSICAL EXERCISE INTENSITIES IN NORMAL AND HIGH-NORMAL BLOOD PRESSURE AS A TOOL TO IDENTIFY EARLY VASCULAR DAMAGE

Objective: To evaluate acute changes in arterial distensibility and central pressure by high-intensity interval physical exercise (HIIPE) compared to moderate intensity continuous physical exercise (MICPE) sessions in subjects with normal and high-normal blood pressure (BP). Design and method: A randomized two-period crossover trial with 29 subjects (48±7years, 76%female, BMI=28.3±4.3kg/m2) divided into two groups according to Normal BP (120-129 and/or 80-84 mmHg) or HighNormal BP (130-139 and 85-89 mmHg) levels. They underwent either MICPE-HIIPE or HIIPE-MICPE sequences. Exercise intensity was defined according to the cardiopulmonary exercise test. The measures included aortic pulse wave velocity (PWV) and applanation tonometry (Sphygmocor®) changes at baseline, immediately, and 24 hours after each physical exercise session. Results: In HighNormal BP group, PWV was significantly lower 24h after MICPE compared to baseline (7.49 ±0.95 vs 8.20± 0.64 m/s; p=0.022). Aortic SBP was significantly lower immediately after HIIPE than baseline and 24h after MICPE (113 ± 8; 124±9 and 121±9; p &lt; 0.05). Comparison between groups, aortic SBP was higher in HighNormal BP at baseline and immediately after MICPE compared to Normal BP (124 ±9 and 122 ±17 vs 114± 9 and 110 ±8; respectively p=0.012). Conclusions: In subjects with normal and high-normal BP, vascular distensibility response to exercise is more dependent on basal levels of stiffness and more sensitive to the stimulus of MICPE; however, changes in aortic BP are more dependent on basal BP levels and more sensitive to high-intensity stimuli.

Relationships among Gonadotropins, Sex Hormones, and Vascular Function in Adolescents with Normal Weight or Obesity

Objective: Childhood obesity may lead to premature cardiovascular disease in adulthood. Excess adiposity suppresses gonadotropin [luteinizing hormone (LH), follicle-stimulating hormone (FSH)] production in both adolescent males and females, which act upon the gonads, leading to the release of the sex hormones (estrogen and testosterone). Both estrogen and testosterone have been linked to vascular function. Relationships among gonadotropins, sex hormones, and vascular function are not completely understood in male and female adolescents across the weight-status spectrum. We, therefore, sought to examine associations among gonadotropins, sex hormones, and vascular health in adolescents with normal weight or obesity. We hypothesized that increased levels of gonadotropins would be associated with worsened vascular function, and higher levels of estrogen would be associated with favorable vascular function. Methods and Data: Adolescents (n=58; 12– &lt;18-years of age) were stratified according to body mass index (BMI) percentile into normal weight (5th – &lt;85th BMI percentile; n=25) and obesity (³95th BMI percentile; n=33) categories. Fasting blood samples were collected to measure FSH, LH, testosterone, estradiol, total cholesterol, triglycerides, low-density lipoprotein cholesterol (LDL), very-low-density lipoprotein cholesterol (VLDL), high-density lipoprotein cholesterol (HDL), glucose, and insulin. Insulin resistance was calculated using the homeostatic model assessment (HOMA-IR). Vascular function was measured via ultrasonography for measures of carotid artery compliance and distensibility [i.e., diameter compliance (cDC), incremental elastic modulus (cIEM)], and brachial artery flow mediated dilation (FMD). Results: Female adolescents with obesity had a significantly greater ( p=0.009) FMD compared to females with normal weight. Triglycerides, VLDL, total cholesterol-to-HDL ratio, HOMA-IR, and insulin were also significantly greater (all p&lt;0.05) in adolescents with obesity compared to those with normal weight, while HDL was significantly lower ( p&lt;0.0001). FSH, LH, testosterone, and estradiol did not statistically significantly differ between the normal weight and obesity groups in either sex. After adjusting for age, multiple comparisons, and stratifying by sex, higher testosterone was associated with decreased cDC (p=0.018) in females. Additionally in females, higher testosterone was associated with increased cIEM ( p=0.002). In adolescent males, higher estrogen was associated with decreased cDC ( p=0.006) and increased cIEM ( p=0.003). Conclusion: Adding to previous research showing relationships between sex hormones and vascular health in adults, the current study shows associations between sex hormones and cDC and cIEM in adolescents. That said, we found no associations between gonadotropins and measures of vascular function in adolescents with normal weight or obesity. Future studies are needed to confirm these results in a larger cohort and among those with BMI in the overweight (85th - &lt;95th BMI percentile) category and differentiating severe obesity (&gt;120% of the 95th percentile, or &gt;35 kg/m2). Dr. Kelly serves as an unpaid investigator, consultant, and educator for Eli Lilly, Novo Nordisk, and Vivus; an unpaid consultant for Boehringer Ingelheim; receives donated study medication from Novo Nordisk and Vivus for NIDDK-funded clinical trials. Dr. Bomberg has served as a site principal investigator and site co-investigator for Novo Nordisk. His research program is supported by the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) of the National Institutes of Health (NIH) under award number K23DK125668. The content is solely the responsibility of the authors and does not necessarily represent the offcial views of the NIH. This is the full abstract presented at the American Physiology Summit 2024 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.

Association between arterial health and cognition in adolescents: The PANIC study.

We investigated the associations of the measures of arterial health with cognition in adolescents and whether physical activity (PA) or sedentary time (ST) confounds these associations. One hundred sixteen adolescents (71 boys) aged 15.9 ± 0.4 participated in the study. PA and ST were assessed using a combined accelerometer/heart rate monitor. Overall cognition was computed from the results of psychomotor function, attention, working memory, and paired-associate learning tests. Pulse wave velocity was measured by impedance cardiography, carotid intima-media thickness, and carotid artery distensibility by carotid ultrasonography. Systolic and diastolic blood pressure (SBP and DBP) were measured using an aneroid sphygmomanometer. SBP was inversely associated with overall cognition (standardized regression coefficient [β] = -0.216, 95% confidence interval (CI) -0.406 to -0.027, p = 0.025). Pulse wave velocity (β = -0.199, 95% CI -0.382 to -0.017, p = 0.033) was inversely associated with working memory task accuracy. SBP was directly associated with reaction time in the attention (β = 0.256, 95% CI 0.069 to 0.443, p = 0.008) and errors in the paired-associate learning tasks (β = 0.308, 95% CI 0.126 to 0.489, p = 0.001). Blood pressure was inversely associated with overall cognition. PA or ST did not confound the associations. Results suggest that preventing high blood pressure is important for promoting cognition in adolescents.

PRECLINICAL VASCULAR ORGAN DAMAGE AND VASCULAR AGEING ASSESMENT IN NON-ALCOHOLIC FATTY LIVER DISEASE AND METABOLIC ASSOCIATED FATTY LIVER DISEASE PATIENTS

Objective: Non-alcoholic fatty liver disease (NAFLD) and metabolic associated fatty liver disease (MAFLD) are a growing health problem, with a growing prevalence due to its association with metabolic syndrome and diabetes. It is known to be a risk factor for the development of cirrhosis and hepatocarcinoma, but it is also known to be an important cardiovascular risk factor. The aim of this study is to assess the burden of preclinical vascular organ damage. Design and method: The study enrolled 80 consecutive patients (mean age 63.3±15.0) who underwent hepatological evaluation in our department, with evaluation of liver fibrosis score (APRI score, FIB-4) and liver stiffness, and quantification of cardiovascular risk according to Guidelines (2021 ESC Guidelines on cardiovascular disease prevention in clinical practice). Carotid atherosclerotic burden was evaluated by B-mode ultrasound in each segment (common, bulb, internal), bilaterally, and expressed as mean of maximum IMT (M-MAX), right common carotid artery distensibility and stiffness (CardioVascular Suite 4, Quipu, Italy). Aortic stiffness was evaluated as carotid-femoral pulse wave velocity (PWV), measured by applanation tonometry (PulsePen DiaTecne, Italy), with calculation of vascular ageing. Results: We found no significant correlation between ultrasound or tonometry parameters and liver stiffness and fibrosis scores. VPWV was significantly above upper limit of normal of 10 m/s (11.6±6.0 m/s, p=0.02), and the percentiles for age were significantly higher than 50th (61.7±25.1, p&lt;0.001), with 52,5% of patients showing increased PWV. Similarly, M-MAX was higher than the upper normality level of 0.9 mm (1.09±0.30 mm, p&lt;0.001). 70% of patients had an increased M-MAX. Vascular age based on arterial stiffness resulted significantly higher than biological age (mean difference 4.6 years, p&lt;0.001). 76.2% (71/80) of the overall cohort and 45,2% (14/31) of patients classified as low risk showed at least one type of vascular organ damage. Conclusions: Patients with NAFLD or MAFLD showed a large prevalence of arterial stiffening and increased IMT and an enhanced vascular ageing, even among those classified at low cardiovascular risk according to Guidelines. Vascular organ damage evaluation could be useful to identify preclinical organ damage in these patients

Right main pulmonary artery distensibility on dynamic ventilation CT and its association with respiratory function

BackgroundHeartbeat-based cross-sectional area (CSA) changes in the right main pulmonary artery (MPA), which reflects its distensibility associated with pulmonary hypertension, can be measured using dynamic ventilation computed tomography (DVCT) in patients with and without chronic obstructive pulmonary disease (COPD) during respiratory dynamics. We investigated the relationship between MPA distensibility (MPAD) and respiratory function and how heartbeat-based CSA is related to spirometry, mean lung density (MLD), and patient characteristics.MethodsWe retrospectively analyzed DVCT performed preoperatively in 37 patients (20 female and 17 males) with lung cancer aged 70.6 ± 7.9 years (mean ± standard deviation), 18 with COPD and 19 without. MPA-CSA was separated into respiratory and heartbeat waves by discrete Fourier transformation. For the cardiac pulse-derived waves, CSA change (CSAC) and CSA change ratio (CSACR) were calculated separately during inhalation and exhalation. Spearman rank correlation was computed.ResultIn the group without COPD as well as all cases, CSACR exhalation was inversely correlated with percent residual lung volume (%RV) and RV/total lung capacity (r = -0.68, p = 0.003 and r = -0.58, p = 0.014). In contrast, in the group with COPD, CSAC inhalation was correlated with MLDmax and MLD change rate (MLDmax/MLDmin) (r = 0.54, p = 0.020 and r = 0.64, p = 0.004) as well as CSAC exhalation and CSACR exhalation.ConclusionIn patients with insufficient exhalation, right MPAD during exhalation was decreased. Also, in COPD patients with insufficient exhalation, right MPAD was reduced during inhalation as well as exhalation, which implied that exhalation impairment is a contributing factor to pulmonary hypertension complicated with COPD.Relevance statementAssessment of MPAD in different respiratory phases on DVCT has the potential to be utilized as a non-invasive assessment for pulmonary hypertension due to lung disease and/or hypoxia and elucidation of its pathogenesis.Key points• There are no previous studies analyzing all respiratory phases of right main pulmonary artery distensibility (MPAD).• Patients with exhalation impairment decreased their right MPAD.• Analysis of MPAD on dynamic ventilation computed tomography contributes to understanding the pathogenesis of pulmonary hypertension due to lung disease and/or hypoxia in patients with expiratory impairment.Graphical

Abstract 64: Risk Factors for Carotid Artery Lipid Deposition Measured by Gray Scale Median of the Intima-Media in Children and Young Adults Over the Life Course

Introduction: Echogenicity of the carotid arterial wall, measured by gray scale median of the intima-media (GSM-IM), is a unitless measure that reflects lipid deposition in the arterial wall, with lower values indicating greater lipid deposition and atherosclerosis. Due to the relative novelty of GSM-IM, its progression and associated risk factors are incompletely understood. This study investigated the GSM profile in childhood and young adulthood using a longitudinal cohort of individuals followed over time, and conducted a priori analysis on the behavioral, psychosocial, and health risk factors for GSM. Methods: Data were collected as part of the Meta-Air2 follow-up study of participants enrolled in the Southern California Children’s Health Study. A total of 240 study participants underwent a carotid artery ultrasound examination in 2008 (mean age±standard deviation [ SD] : 11.2±0.6 years), and again between 2018 and 2023 (24.2±1.6 years) to assess changes in carotid artery health, including GSM-IM, carotid artery intima-media thickness (CIMT), and carotid artery distensibility. Participants self-reported lifestyle behaviors, psychosocial health, and underwent anthropometric and blood pressure measures at both time points. Mixed effects models were used to predict GSM-IM changes with repeated measurements of lifestyle behaviors, perceived stress, BMI, and blood pressure. Results: Means and SDs of GSM-IM were 110.0±27.4 in childhood, and 75.6±15.8 in adulthood, with an annual change rate of -2.6 per year. Individuals of Hispanic ethnicity, and those with lower parental education levels had significantly lower GSM-IM in both childhood and adulthood. GSM-IM was significantly correlated with other measures of carotid artery atherosclerosis, including CIMT (r=0.28; p &lt;0.001) and carotid artery distensibility (r=0.36; p &lt;0.001). Results of mixed effects models adjusting for covariates, indicated that higher BMI (β=-1.35; 95% confidence interval [CI], -1.70, -0.99; p &lt;0.001) and systolic blood pressure (β=-0.32, 95% CI, -0.55, -0.09; p=0.007) were significantly associated with lower GSM-IM. A significant interaction between BMI and age (β difference=0.14; 95% CI, 0.09, 0.20; p &lt;0.001) suggested that a per-unit change in BMI has a greater effect on GSM-IM among adolescents compared to young adults. Health compromising behaviors, including less sleeping time, smoking, drug use, and higher perceived stress were significantly associated with lower GSM-IM in unadjusted models. However, these associations were attenuated after adjustment for covariates. Conclusion: Our study highlights the influence of BMI, particularly during childhood, blood pressure and lifestyle behaviors on adverse changes in GSM-IM, indicative of greater lipid deposition. These risk factors may be key targets for early prevention for atherosclerosis.

The associations of depressive symptoms and perceived stress with arterial health in adolescents.

Cardiovascular and mental diseases are among the most important global health problems, but little is known on the associations between mental and arterial health in adolescents. Therefore, we investigated the associations of arterial health with depressive symptoms and perceived stress in adolescents. A total of 277 adolescents, 151 boys, 126 girls, aged 15-17 years participated in the study. Depressive symptoms were assessed using the Beck Depression Inventory and perceived stress by the Cohen Perceived Stress Scale. Arterial health was assessed by measures from carotid ultrasonography (carotid intima-media thickness, Young's Elastic Modulus, carotid artery distensibility, stiffness index), impedance cardiography (pulse wave velocity, cardio-ankle vascular index), and pulse contour analysis (reflection index, stiffness index). The data were analyzed using linear regression models adjusted for age and sex. Depressive symptoms or perceived stress were not associated with indices of arterial health in the whole study group (β = -0.08 to 0.09, p > 0.05), in boys (β = -0.13 to 0.10, p > 0.05) or in girls (standardized regression coefficient β = -0.16 to 0.08, p > 0.05). We found no associations of depressive symptoms and perceived stress with arterial health in adolescents. These observations suggest that the association between mental and arterial health problems develop in later life.