Evaluation Of Arterial Stiffness Research Articles

Stroke-volume-allocation model enabling wearable sensors for vascular age and cardiovascular disease assessment

Frequent and unobtrusive monitoring of cardiovascular conditions with consumer electronics is a widely pursued goal, since it provides the most economic and effective way of preventing and managing cardiovascular diseases (CVDs) ─ the leading causes of death worldwide. However, most current wearable and flexible devices can only support the measurement of one or two types of vital signs, such as heart rate and blood oxygen level, due to the lack of physiological models to link the measured signals to cardiovascular conditions. Here, we report a stroke-volume allocation (SVA) model to quantify the cushioning function of arteries and empower nearly all existing cardiac sensors with new functions, including arterial stiffness evaluation, dynamic blood pressure tracking and classification of CVD-related heart damage. Large-scale clinical data testing involving a hybrid dataset taken from 6 hospitals/research institutes (9 open databases and 4 self-built databases from 878 subjects in total) and diverse measurement approaches was carried out to validate the SVA model. The results show that the SVA-based parameters correlate well with the gold-standard measurements in arterial stiffness and blood pressure and outperform the commonly used vital sign (e.g., blood pressure) alone in detecting abnormalities in cardiovascular systems.

Wireless Photoplethysmography (PPG) Measurement with Pulse Wave Velocity (PWV) Method for Arterial Stiffness Evaluation

Indications of symptoms of cardiovascular disease can be seen from the level of elasticity of the arteries. The Pulse Wave Velocity (PWV) method using PPG signal analysis is used to determine the level of arterial stiffness based on the time difference between pulse waves of Photoplethysmography (PPG) signal measurements. PWV measurements use a non-invasive technique using pulse sensors on the fingers and toes, the measurement data is sent wirelessly using the ESP-NOW protocol. Analysis of the measured PPG signal is used as an approach to calculating the PWV value. Realization and testing can be used to measure the pulse in BPM and classify the index of arterial stiffness using the PWV method. The results of testing on 15 test volunteers from 3 age groups showed the results of an arterial stiffness index with indications of normal, stiff and very stiff arteries. The PWV value for the 20 year old group was 4.30-6.77 cm/s, normal arterial conditions. The age group of 30-40 years has a PWV value ranging from 5.11-8.77 cm/s, normal arterial conditions. The age group of 50-60 years had PWV values in the range of 10.69-18.43 cm/s, stiff and very stiff arterial conditions. Increasing age linearly affects the increase in PWV value. An increased PWV value may indicate an increase in arterial stiffness.

Mean platelet volume (MPV) as new marker of diabetic macrovascular complications in patients with different glucose homeostasis

BackgroundPlatelets play an important role in the development of cardiovascular disease (CVD). Mean platelet volume (MPV) is considered as biological marker of platelets activity and function. The aim of the present study was to evaluate MPV values and its possible correlation with arterial stiffness and subclinical myocardial damage, in normal glucose tolerance patients (NGT), in newly diagnosed type 2 diabetic (T2DM) patients and in individuals with pre-diabetes.MethodsWe enrolled 400 newly diagnosed hypertensive patients. All patients underwent an Oral Glucose Tolerance test (OGTT). Arterial stiffness (AS) was evaluated with the measurement of carotid-femoral pulse wave velocity (PWV), augmentation pressure (AP) and augmentation index (AI). Echocardiographic recordings were performed using an E-95 Pro ultrasound system.ResultsAmong groups there was an increase in fasting plasma glucose (FPG) (p < 0.0001), fasting plasma insulin (FPI) (p < 0.0001), high sensitivity c reactive protein (hs-CRP) levels (p < 0.0001) and a decrease in renal function as demonstrated by e-GFR values (p < 0.0001). From the NGT group to the T2DM group there was a rise in MPV value (p < 0.0001). Moreover, in the evaluation of arterial stiffness and subclinical myocardial damage, MPV showed a positive correlation with these parameters.ConclusionsIn the present study we highlighted that MPV is significantly increased, not only in newly diagnosed T2DM patients, but also in early stage of diabetes, indicating that subjects with pre-diabetes present increased platelets reactivity. Moreover, our results suggest that MPV is associated with increased arterial stiffness and subclinical myocardial damage, indicating MPV as new marker of CV risk.

Endothelial Dysfunction in Children With Nephrotic Syndrome: A Cross-Sectional Study.

Background Children with nephrotic syndrome (NS) have a higher risk of cardiovascular morbidity. Studies on the evaluation of arterial stiffness and endothelial function and its predictive risk factors in these children are limited. Objective The primary objective of the study was to determine arterial stiffness by measuring carotid intimal medial thickness, flow-mediated dilatation, and physiological parameters in children with nephrotic syndrome to predict the risk of premature atherosclerosis as compared to controls. Participants A total numberof 33 children with NS in the age group of 2-14 years in remission and 39 healthy controls were enrolled in the study. Out of 33 children with nephrotic syndrome, five were infrequently relapsing NS, eight were frequently relapsing, 16 were steroid dependent, and four were steroid-resistant NS. Intervention Relevant history, physical examination, anthropometric measurements, and laboratory investigations were done. Carotid intimal medial thickness (cIMT), flow-mediated dilatation (FMD), and other physiological parameters were measured in both children with NS and control groups. Outcome Carotid intimal medial thickness (cIMT), flow-mediated dilatation (FMD), and other physiological parameters were compared between children with NS and healthy controls for detecting arterial stiffness and endothelial dysfunction. Results Dyslipidaemia was seen in more than 50% of children during remission. There was neither significant difference in mean cIMT in the common carotid artery nor FMD between the control and study groups. There was a trend of lower Reactive Hyperemia Index (RHI) in children with NS. Conclusion Dyslipidemia persists even during the remission phase in NS. No statistically significant difference is observed in cIMT and percentage proportionate change in FMD in both the study and control groups. Nevertheless, RHIis notably lower in children with NS. These findings need further validation in future studies.

A noninvasive measurement technique for the initial bending stiffness of an arterial wall

Vascular disease poses a significant threat to human health. Effective detection methods for quantifying noninvasive arterial wall stiffness enable the early identification of populations exhibiting arteriosclerosis tendencies, providing substantial value for vascular disease prevention and treatment. However, current methods for evaluating arterial stiffness rely on simple tangent stiffness, which is affected by blood pressure fluctuations. This study utilizes a collapse model to investigate arterial deformation and pulse wave propagation under transmural pressure with different arterial wall thicknesses and material properties. Based on the pressure–area relationship of collapsed blood vessels, the relationship between pulse wave velocity and initial bending stiffness at the collapsed state is derived. A method is, then, proposed to evaluate the arterial wall bending stiffness incorporating cuff and photoplethysmography technology for assessing arteriosclerosis. This method is verified through a collapse experiment with a rubber tube and employed in measuring the initial bending stiffness of a human radial artery in vivo. The implementation of this measurement method facilitates vascular stiffness measurements beyond the restriction of tangent modulus and blood pressure changes, offering a quantitative evaluation of arterial wall stiffness. The technique can, therefore, amplify the precision and dependability of preliminary arteriosclerosis lesion diagnostic procedures.

Evaluation of Arterial Stiffness in Depression Patients.

It has been known that there is a significant correlation between depression and cardiovascular diseases. However, the reasons behind this correlation that could affect mortality and morbidity were not fully identified. The present study aimed to analyze arterial stiffness diagnosed with ultrasonography, which could be associated with cardiovascular disease risks in depression patients, and to compare the findings with those of healthy controls. The study was conducted with 35 depression patients and 35 healthy individuals. Routine complete blood and biochemistry tests were requested for all patients, and their weight and height, waist circumference, and diastolic and systolic arterial blood pressure were measured. Femoral and carotid artery intima-media thickness and other arterial stiffness parameters were determined with Doppler ultrasonography. It was determined that the systolic pressure (P = .028) was higher in the patient group (P = .028). Also, the carotid elastic modulus (P = .048) was significantly higher in the patient group. A negative and significant correlation was determined between femoral compliance and chlorpromazine equivalent dose (P = .021, r = -0.389). It was determined that the systolic blood pressure and carotid elastic modulus arterial stiffness parameters were significantly higher in depression patients. Measurable arterial stiffness parameters should be investigated in depression patients as cardiovascular risk markers. Furthermore, the determination of the effects of psychotropic drugs employed in arterial stiffness treatment could play an important role in the determination of cardiovascular disease risk in these patients.

The Evaluation of Arterial Stiffness and Pulse Wave Velocity in Patients with Vasovagal Syncope

Amaç: Çalışmamızın amacı Vazovagal senkoplu hastalarda hemodinamik mekanizmayı etkileyebilecek kardiyovasküler otonomik modülasyonlardan biri olan arteriyel sertlik parametrelerini değerlendirmek.&#x0D; Gereç ve yöntemler: Çalışmamız retrospektif bir çalışmadır. Ocak 2012-Ocak 2016 tarihleri arasında kardiyoloji polikliniğine başvuran en az iki senkop atağı olan ve eğik masa testi pozitif olan 42 hastanın eğik masa testi sonuçlarını ve arteriyel sertlik parametrelerini topladık. Kontrol grubu olarak da yaş ve cinsiyete göre eşleştirilmiş 41 kişi aldık. Hastalardan damar özelliklerini etkileyebilecek durumları olan, ritim bozukluğu ve psikiyatrik bozukluğu olan hastaları çalışma dışı bıraktık. Hastaların arteriyel sertlik ölçümleri, tilt testi sonuçları, tıbbi öyküleri, sosyodemografik ve klinik bilgileri ile ilgili veriler tıbbi kayıtlarından elde edildi. Arteriyel sertliğinin belirteçleri olarak augmentasyon indeksi, merkezi nabız basıncı ve karotid ila radyal nabız dalga hızı dahil olmak üzere merkezi aort basıncı parametreleri elde edildi. Ardından 2 grup arasında değişkenler karşılaştırıldı.&#x0D; Bulgular: Periferik sistolik (125 ± 16,6 ve 121,1 ± 14,9, p: 0,31) ve diyastolik kan basınçları (79,6 ± 8,9 ve 77,7 ± 9,7, p: 0,38) VVS ve kontrol grupları arasında benzerdi. Merkezi sistolik kan basınçları ve merkezi güçlendirme basınçları da gruplar arasında anlamlı farklılık göstermedi. Vazovagal senkoplu hastalarda nabız dalga hızı sağlıklı kontrollere göre anlamlı derecede düşüktü (5.4 (1.4) and 5.9 (1.8), p= 0.04). Aort augmentasyon indeksi gruplar arasında istatistiksel olarak farklı olmasa da hasta grubunda daha yüksek bulduk.&#x0D; Sonuç: Çalışmamızda VVS grubunda nabız dalga yayılımı sağlıklı gruba göre daha düşük bulundu. Bu sonuçlar VVS hastalarında patofizyolojinin anlaşılmasına katkıda bulunabilir. Vazovagal senkoplu hastalarda nabız dalga hızının önemini anlamak için daha ileri çalışmalara ihtiyaç vardır.

Evaluation of arterial stiffness between peritoneal dialysis and hemodialysis in patients with renal replacement therapy

Objectives: The aortic stiffness index beta (ASI-β), calculated noninvasively with the pressure change caused by arterial strain and volume changes on echocardiography, shows a strong correlation with invasive measurements of arterial stiffness. This study aimed to compare arterial stiffness and distensibility between peritoneal dialysis (PD) and hemodialysis (HD) and patients in renal replacement therapy. Methods: This cross-sectional and observational study analyzed 108 patients under renal replacement therapy (PD and HD). The aortic stiffness index beta (ASI-β) was calculated for each group. Results: The mean age of the patients in the study was 58.2±11.1 years, and 49 (45.4%) of the patients were female and 59 (54.6%) were male. Age, gender, comorbid rates, and levels of blood pressure and heart rate did not differ between the PD and HD groups. Blood pressure levels and heart rate. Mean aortic strain (5.6±1.9 vs. 9.4±2.8, p &amp;lt; 0.001) and median distensibility (1.5 vs. 2.9 cm, p &amp;lt; 0.001) were lower in the PD group than the HD group, while median ASI-β (11.6 vs. 6.2, p &amp;lt; 0.001) and mean E/e’ (10.6±2.9 vs. 9.2±2.3, p = 0.006) were higher in the PD group. The rate of concentric hypertrophy was higher in the PD group (47.5% vs. 23.5%, p = 0.005). Conclusion: PD patients have higher arterial stiffness and lower distensibility levels compared to HD patients. Therefore, patients with PD may be more prone to diastolic dysfunction, cardiovascular disease, and events.

Evaluation of Arterial Stiffness and Subfoveal Choroidal Thickness in Patients with Coronary Slow Flow.

Coronary slow flow may not only affect the coronary arteries, but it may also be a vascular problem affecting the rest of the arterial system. The aim of this study was to determine peripheral arterial stiffness and the thickness of the choroid layer in patients with slow coronary flow. Fifty consecutive patients (age, 54.3 ± 11.4 years, 38 male) with coronary slow flow and 25 consecutive patients (age, 50.5 ± 9.9 years, 16 male) with normal coronary arteries both documented by coronary angiography were included. Arterial stiffness parameters were measured noninvasively using a Mobil-O-Graph arteriography system. The choroidal thickness was assessed using the enhanced depth imaging optical coherence tomography method. The patients with coronary slow flow had significantly higher peripheral systolic blood pressure, peripheral pulse pressure, central pulse pressure, and pulse wave velocity (PWV) and significantly thinner choroidal thickness compared to the controls. Thrombolysis in myocardial infarction frame count was positively correlated with PWV (r: 0.237, p = 0.041) and negatively correlated with choroidal thickness (r: -0.249, p = 0.031). There was also a negative correlation between PWV and mean choroidal thickness (r: -0.565, p < 0.001). Linear regression analysis showed that coronary slow flow was an independent predictor of both PWV and choroidal thickness when adjusted by age and sex. The acceleration of average peripheral arterial PWV with a thinning of choroidal thickness in patients with coronary slow flow may support the idea that this phenomenon may be a coronary presentation of a systemic microvascular disorder.

Blood pressure levels within normotensive range are independently associated with increased risk of arterial stiffness in adults without hypertension or prehypertension

Background and aimsHigh blood pressure (BP) indices, including systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP), and pulse pressure (PP) predict cardiovascular diseases and mortality. However, the association of these BP indices with arterial stiffness (AS) in the normotensive population (BP < 120/80 mmHg) remains unclear. Methods and resultsStudy participants who underwent health checkups at a tertiary referred center were recruited between November 2018 to December 2019. 2129 participants were enrolled after excluding those aged <18 years old, with elevated BP, history of hypertension, cardiovascular disease, and stroke, or with incomplete data. The brachial-ankle pulse wave velocity (baPWV) values were examined for evaluation of AS. Participants with higher blood pressure indices had significantly higher baPWV. Multiple linear regression revealed that all BP indices were positively associated with baPWV. According to the binary logistic regression analysis, participants in the higher SBP and MAP quartiles were significantly related to AS. The odds ratio (OR) for SBP Q2, Q3 and Q4 vs. Q1 were 6.06, 10.06 and 17.78 whereas the OR for MAP Q2, Q3 and Q4 vs. Q1 were: 5.07, 5.28 and 10.34. For DBP and PP, only participants belonging to the highest quartile were associated with AS(OR for DBP Q4 vs. Q1: 2.51; PP Q4 vs Q1: 1.94). ConclusionsBP indices were linearly related to the baPWV. Normotensive participants with higher quartiles of SBP, DBP, MAP, and PP, remained associated with increased AS. The SBP and MAP levels exhibited a more prominent relationship with AS.

Arterial stiffness tested by pulse wave velocity and augmentation index for cardiovascular risk stratification in antiphospholipid syndrome.

Cardiovascular disease is a major cause of morbidity and mortality in Antiphospholipid syndrome (APS). Arterial stiffness (ArS) has emerged as a predictor of future cardiovascular events in the general population. We aimed to assess ArS in patients with thrombotic APS versus diabetes mellitus (DM) and healthy controls (HC) and identify predictors of increased ArS in APS. ArS was evaluated by carotid-femoral pulse wave velocity (cfPWV) and augmentation index normalized to 75 beats/min (AIx@75) using the SphygmoCor device. Participants also underwent carotid/femoral ultrasound for atherosclerotic plaque detection. We used linear regression to compare ArS measures among groups and assess ArS determinants in the APS group. We included 110 patients with APS (70.9% female, mean age 45.4 years), 110 DM patients and 110 HC, all age/sex matched. After adjustment for age, sex, cardiovascular risk factors and plaque presence, APS patients exhibited similar cfPWV [β = -0.142 (95% CI -0.514, 0.230), p = 0.454] but increased AIx@75 [β = 4.525 (95% CI 1.372, 7.677), p = 0.005] compared with HC and lower cfPWV (p < 0.001) but similar AIx@75 (p = 0.193) versus DM patients. In the APS group, cfPWV was independently associated with age [β = 0.056 (95% CI 0.034, 0.078), p < 0.001], mean arterial pressure (MAP) [β = 0.070 (95% CI 0.043, 0.097), p < 0.001], atherosclerotic femoral plaques [β = 0.732 (95% CI 0.053, 1.411), p = 0.035] and anti-β2-glycoprotein I IgM positivity [β = 0.696 (95% CI 0.201, 1.191), p = 0.006]. AIx@75 was associated with age [β = 0.334 (95% CI 0.117, 0.551), p = 0.003], female sex [β = 7.447 (95% CI 2.312, 12.581), p = 0.005] and MAP [β = 0.425 (95% CI 0.187, 0.663), p = 0.001]. APS patients exhibit elevated AIx@75 vs HC and similar to DM patients, indicating enhanced arterial stiffening in APS. Given its prognostic value, ArS evaluation may help to improve cardiovascular risk stratification in APS.

The association between brachial-ankle pulse-wave velocity and adverse cardiovascular events in 5719 community participants a prospective cohort study.

The brachial-ankle pulse-wave velocity (baPWV) is regarded as the gold standard in the evaluation of arterial stiffness. Its prognostic significance for major adverse cardiovascular events (MACE) has been demonstrated. However, the factors influencing the association between baPWV and MACE risk have not been determined. In this study, we investigated the association of baPWV and MACE risk and whether it is affected by the risk factors for different cardiovascular diseases (CVDs). This was a prospective cohort study that initially enrolled 6850 participants from 12 communities in Beijing. The participants were divided into three subgroups according to their baPWV values. The primary outcome was the first occurrence of MACE, defined as hospitalization from cardiovascular diseases, first occurrence of a nonfatal myocardial infarction, or nonfatal stroke. Cox proportional hazards regression and restricted cubic spline analyses were used to examine the association between baPWV and MACE. The effect of CVD risk factors on the relationship between baPWV and MACE was explored in subgroup analyses. The final study population consisted of 5719 participants. During a median follow-up of 34.73 months, MACE occurred in 169 participants. The restricted cubic spline analysis indicated a positive linear relationship between baPWV and MACE risk. After adjustment for cardiovascular risk factors, the hazard ratio (HR) for MACE risk per SD increase in baPWV was 1.272 [95% confidence interval (CI): 1.149-1.407, P < 0.001], and the HR for MACE in the high-baPWV vs. the low-baPWV group was 1.965 (95% CI: 1.296-2.979, P = 0.001). Adding baPWV to the conventional cardiovascular risk factors significantly improved the model's prediction performance and the net reclassification (NRI) [NRI: 0.379 (95% CI: 0.072-0.710), P = 0.025] in MACE discrimination. However, in the subgroup analysis, two CVD risk factors, stable coronary heart disease and hypertension, showed significant interaction effects (Pinteraction both < 0.05). This result indicated that the effect of CVD risk factors must be taken into account when assessing the relationship between baPWV and MACE. baPWV is a potential marker to improve the identification of MACE risk in the general population. A positive linear correlation was firstly determined between baPWV and MACE risk, but it may not be valid in participants with stable coronary heart disease and hypertension.

LONG TERM EFFECT OF RENAL DENERVATION ON 24 HOUR ABPM AND BLOOD PRESSURE LOAD IS LARGELY DEPENDENT OF BASELINE ARTERIAL STIFFNESS

Objective: The aim of the study was to evaluate the long term effect of renal sympathetic denervation (RSD) on 24h ambulatory blood pressure measurement (ABPM) and blood pressure load (BP load) in patients with resistant hypertension depending of the baseline arterial stiffness status. Design and method: Consecutive patients with resistant hypertension who underwent RSD workout at the University Hospital Saint Anna, Sofia, ESH Excellence center of hypertension, were included. RSD was performed on the grounds of resistant hypertension defined as mean daytime systolic BP &gt;135 mmHg or diastolic BP &gt;85 mmHg in 24-hr ambulatory blood pressure measurement (ABPM) despite the intake of at least three antihypertensive agents, including a diuretic. Cardio ankle vascular index (CAVI) was measured using the VaSera system (Fukuda Denshi Co, Japan). RSD was performed with the Symplicity Flex™ catheter (Medtronic, Minneapolis, MN, USA) according to a standardized protocol. Results: The study included 32 patients with treatment-resistant hypertension and performed successful RSD. CAVI was measured before the intervention and the results of the procedure on 24h daytime, nighttime and 24 blood pressure and systolic and diastolic BP load were evaluated by serial ABPM measurements. A long-term effect of the RSD, reported as a reduction in 24-hour systolic blood pressure above 10 mmHg at month 12, was found in 22 patients (68.8%). Despite similar baseline out-of-office and office blood pressure and concomitant antihypertensive therapy, patients with lower arterial stiffness had a more significant blood pressure effect of renal denervation, a result that persisted within 12 months of follow-up. Along with reduction of all ABPM parameters more profound and clinically meaningful change of BP load during daytime, nighttime and 24h period was also noticed in this group of patients. (Table 1) Conclusions: The long term effect of renal denervation on 24h ABPM and BP load is largely dependent of baseline arterial stiffness. The results of the present study justify the incorporation of arterial stiffness evaluation in clinical decision workout of the procedure.

Combined Evaluation of Arterial Stiffness and Blood Pressure Promotes Risk Stratification of Peripheral Arterial Disease

BackgroundPrevious studies have reported the separate association of arterial stiffness (AS) and blood pressure with peripheral arterial disease (PAD). ObjectivesThe aim of this study was to investigate the risk stratification capacity of AS on incident PAD beyond blood pressure status. MethodsA total of 8,960 participants from Beijing Health Management Cohort were enrolled at the first health visit between 2008 and 2018 and then followed until the incidence of PAD or 2019. Elevated AS was defined as brachial-ankle pulse-wave velocity (baPWV) >1,400 cm/s, including moderate stiffness (1,400 ≤ baPWV <1,800 cm/s) and severe stiffness (baPWV ≥1,800 cm/s). PAD was defined as ankle-brachial index <0.9. A frailty Cox model was used to calculate the HR, integrated discrimination improvement, and net reclassification improvement. ResultsDuring follow-up, 225 participants (2.5%) developed PAD. After adjusting for confounding factors, the highest risk for PAD was observed in the group with elevated AS and blood pressure (HR: 2.253; 95% CI: 1.472-3.448). Among participants with ideal blood pressure and those with well-controlled hypertension, PAD risk was still significant for severe AS. The results remained consistent in multiple sensitivity analyses. In addition, baPWV significantly improved the predictive capacity for PAD risk beyond systolic and diastolic blood pressures (integrated discrimination improvement 0.020 and 0.190, net reclassification improvement 0.037 and 0.303). ConclusionsThis study suggests the clinical importance of combined evaluation and control of AS and blood pressure for the risk stratification and prevention of PAD.

Role of Preoperative Ultrasound Shear-Wave Elastography and Radiofrequency-Based Arterial Wall Tracking in Assessing the Vulnerability of Carotid Plaques: Preliminary Results.

We aimed at evaluating the ability of point shear-wave elastography (pSWE) and of a radiofrequency (RF) echo-tracking-based method in preoperatively assessing the vulnerability of the carotid plaque in patients undergoing carotid endarterectomy (CEA) for significant asymptomatic stenosis. All patients who underwent CEA from 03/2021 to 03/2022 performed a preoperative pSWE and an RF echo-based wall evaluation of arterial stiffness using an Esaote MyLab ultrasound system (EsaoteTM, Genova, Italy) with dedicated software. The data derived from these evaluations (Young's modulus (YM), augmentation index (AIx), pulse-wave velocity (PWV)) were correlated with the outcome of the analysis of the plaque removed during the surgery. Data were analyzed on 63 patients (33 vulnerable and 30 stable plaques). In stable plaques, YM was significantly higher than in vulnerable plaques (49.6 + 8.1 kPa vs. 24.6 + 4.3 kPa, p = 0.009). AIx also tended to be slightly higher in stable plaques, even if it was not statistically significant (10.4 + 0.9% vs. 7.7 + 0.9%, p = 0.16). The PWV was similar (12.2 + 0.9 m/s for stable plaques vs. 10.6 + 0.5 m/s for vulnerable plaques, p = 0.16). For YM, values >34 kPa had a sensitivity of 50% and a specificity of 73.3% in predicting plaque nonvulnerability (area under the curve = 0.66). Preoperative measurement of YM by means of pSWE could be a noninvasive and easily applicable tool for assessing the preoperative risk of plaque vulnerability in asymptomatic patients who are candidates for CEA.

Evaluation of Arterial Stiffness and Its Relation to Innovative Anthropometric Indices in Persian Adults.

BMI has been evaluated as an old criterion to evaluate obesity in individuals, but it does not assess abdominal obesity and lean mass. We aimed to evaluate the possible relationship of new anthropometric indices (namely, a body shape index (ABSI), the body roundness index (BRI), the visceral adiposity index (VAI), the visceral fat area (VFA), and waist-hip ratio (WHR)), with one of the known critical factors of atherosclerosis, arterial stiffness. Overall 5921 individuals were enrolled and were divided into four groups according to BMI. Novel anthropometric parameters including, ABSI, BRI, VAI, VFA, and WHR were calculated. The carotid-femoral pulse wave velocity (cf-PWV) was used to evaluate arterial stiffness. Multiple regression analysis was performed to assess the relationship between cf-PWV and innovative Anthropometric indices. This study population consisted of 3109 women and 2812 males. In men with overweight, cf-PWV was significantly related to BMI, ABSI, BRI, WC, VAI, VFA, and WHR. However, among men with obesity, cf-PWV was associated with BRI, VAI, and VFA. Among women with overweight, cf-PWV was also related to all mentioned indices except ABSI; although, cf-PWV was only associated with VFA and WHR in women with obesity. Our results showed that VFA in women and VAI in men are strongly related to arterial stiffness and can be used to identify predictors of vascular disease or organic vascular dysfunction.

The role of asymmetric dimethylarginine in endothelial dysfunction and abnormal nitric oxide metabolism in systemic sclerosis: results from a pilot study.

Systemic sclerosis (SSc) is characterized by generalized vasculopathy affecting mainly small vessels while macrovascular involvement is less investigated. The aim of this study was to examine associations between asymmetric dimethylarginine (ADMA) - a biomarker of atherosclerosis - and assessments of macrovascular endothelial function in patients with SSc. This was a cross-sectional study including consecutive SSc patients attending the Scleroderma Outpatient Clinic. ADMA measurement in serum samples was based on an enzyme immunoassay technique. Participants underwent blood pressure measurement according to 2018 ESC/ESH Guidelines, applanation tonometry for the evaluation of arterial stiffness, and carotid ultrasound for the measurement of the intima-media thickness (cIMT). Eighty-one Caucasians (82.3% female) SSc individuals with mean age 55.44 ± 13.4years were included in this analysis. The correlation analysis of ADMA levels (unadjusted and adjusted values) with functional and morphological parameters of atherosclerosis revealed no statistically significant associations. Subgroup analysis based on disease duration (≤ 4years), immunologic profile (SCL-70 and ACA antibodies), disease type (limited, diffuse), and inflammatory status (erythrocyte sedimentation rate [ESR] > 25mm/h and C-reactive protein [CRP] > 5mg/L) showed no associations, except from a significant positive correlation between ADMA levels and cΙΜΤmean (r = 0.370, p = 0.044) in individuals with early SSc. The results of the study suggest that ADMA may be related with accelerated atherosclerosis in early stages of the disease. However, the lack of association between other morphological and functional parameters of endothelial dysfunction may suggest that other regulators of nitric oxide metabolism may contribute to macrovascular injury in SSc in various phases of the disease. Key Points • ADMA is a biomarker of atherosclerosis and has been linked with microvascular complications of SSc. •ADMA was not correlated with morphological and functional parameters of atherosclerosis in the population of the study. •The demonstrated association between ADMA and cIMT in patients with early SSc may suggest a role of NO/ADMA pathway in the initiation of macrovascular injury in SSc.

Combined evaluation of arterial stiffness, glycemic control and hypertension for macrovascular complications in type 2 diabetes

BackgroundArterial stiffness, glycemic control and blood pressure are risk factors of macrovascular complications in type 2 diabetes. This study aimed to investigate the combined association of arterial stiffness, glycemic control and hypertension status with the occurrence of diabetic macrovascular complication.MethodsA total of 1870 patients of diabetes were enrolled from Beijing Health Management Cohort between 2008 and 2018 as baseline, and then followed for macrovascular complication onset. We proposed a composite risk score (0–4) by arterial stiffness severity, pool glycemic control and hypertension status. Cox model was used to estimate the hazard ratio (HR) and 95% confidence interval (CI).ResultsThe mean age (SD) of this population was 59.90 (12.29) years. During a median follow-up of 4.0 years, 359 (19.2%) patients developed macrovascular complication. Compared to the normal arterial stiffness and good glycemic control group, patients with severe arterial stiffness and pool glycemic control had the highest risk of macrovascular complications (HR: 2.73; 95% CI: 1.42–5.25). Similarly, those of severe arterial stiffness and hypertension had the highest risk (HR: 2.69; 95% CI: 1.61–4.50). Patients of the composite score > 2 had a significantly increased risk of macrovascular complication.ConclusionThis study suggested the clinical importance of combined evaluation of arterial stiffness, glycemic control and hypertension status for the risk stratification and management of macrovascular complication of type 2 diabetes.

Evaluation of Arterial Stiffness and Carotid Intima-Media Thickness in Children with Primary and Renal Hypertension.

Hypertension is an increasing disease in children and the risk of endothelial damage and target organ damage increases in the presence of additional risk factors such as obesity. In our study, the effect of hypertension on early atherosclerotic changes and target organ damage in children was investigated. Twenty four-hour ambulatory pulse wave analysis was performed by oscillometric method in 71 children aged 8-18years, 17 of whom were diagnosed with primary hypertension without obesity, 18 had both primary hypertension and obesity, and 16 had renal hypertension. Twenty healthy normotensive children were included as the control group. Carotid intima-media thickness (CIMT) and Left Ventricular Mass Index were measured. Central systolic blood pressure (cSBP), central diastolic blood pressure (cDBP), systolic blood pressure (SBP) and diastolic blood pressure (DBP) were higher in the primary hypertension group compared to controls (p = 0.001, p = 0.005, p = 0.001, p = 0.009, respectively), cSBP was higher in the renal hypertension group than the control group (p = 0.018). There was no difference between the groups in terms of pulse wave analysis parameters, CIMT, or left ventricular mass index (p > 0.05). Pulse wave velocity was positively correlated with SBP, DBP, cSBP, cDBP (p < 0.001). Augmentation index was positively correlated with DBP and cDBP (p = 0.01, p = 0.002, respectively). Our findings show that high blood pressure is associated with arterial stiffness and target organ damage beginning in childhood. The detection of early atherosclerotic vascular changes using pulse wave analysis allows to take necessary precautions such as lifestyle changes to prevent target organ damage in hypertensive children.

Arterial Stiffness as a Cardiovascular Risk Factor After Successful Kidney Transplantation in Diabetic and Nondiabetic Patients

It is known that kidney transplantation (KTx) decreases mortality rate and increases life expectancy about 10 years compared with dialysis, particularly in patients with diabetes. However, cardiovascular disease is still the most common cause of death after transplantation. The evaluation of the cardiovascular risk after successful KTx in diabetic and nondiabetic patients. We enrolled 344 patients after KTx (mean age 52.7 years, M -62.5%). The cohort was divided into 2 groups diabetes (+) and diabetes (-). Arterial stiffness parameters (brachial-ankle and carotid-femoral pulse wave velocity, pulse pressure, pulsatile stress was assessed by an automated oscillometric device. All body composition parameters were evaluated based on bioelectrical impedance analysis and laboratory parameters were obtained from medical files of the patients. Arterial stiffness parameters were higher in the diabetes (+) compared with diabetes (-) group, significantly. Body mass index was significantly higher in the diabetes (+) group, as well as body fat mass and visceral fat area. In the diabetes (+) group compared with the diabetes (-) group, whole-body phase angle was lower (4.54 vs 4.90 P=.006). Visceral fat area and whole-body phase angle correlated significantly with arterial stiffness parameters. The evaluation of arterial stiffness and phase angle is a useful method for identifying patients at high cardiovascular risk. Therefore, we suggest that patients with diabetes after successful KTx due to the baseline high cardiolovascular risk, should be regularly assessed to monitor changes in blood vessels, body composition and undergo dietary intervention.