Mean Values Of Pulse Wave Velocity Research Articles

Abstract P446: Prediction of Cardiovascular Events by Algorithm- and Formula-based Pulse Wave Velocity: An Analysis of CARTaGENE

Background: Carotid-femoral pulse wave velocity (PWV) is a well-known marker of arterial stiffness and a cardiovascular risk factor. Novel estimations of PWV have been developed, but their ability to improve cardiovascular prediction made by clinical risk tools remains controversial. We hypothesized that PWV estimations can improve cardiovascular risk estimation beyong what is achievable from standard risk factors. Methods: Analysis of the population based CARTaGENE cohort, including participants aged between 40 and 69 years. PWV estimations were obtained using published formulas (fPWV) or algorithmic transformation of tonometry-based radial pulse waveforms captured at baseline (aPWV). 10-year cardiovascular risk for each participant was computed using the Atherosclerotic Cardiovascular Disease (ASCVD) and the SCORE-2 risk tools. All participants were passively followed during 10 years for major adverse cardiovascular events (MACE: cardiovascular death, stroke, myocardial infarction). Associations of fPWV and aPWV with MACEs were obtained using Cox models adjusted for ASCVD or SCORE-2 predictions. Results: 17,548 participants were eligible for the study (51.1% female, median age 53 yo, 8.9% diabetes, 13.9% prior cardiovascular disease), from which 2,263 (12.9%) experienced a MACE during follow-up. Mean PWV values at baseline were 8.4 ± 1.4 m/s (fPWV) and 7.9 ± 1.3 m/s (aPWV), and were closely correlated (correlation coefficient= 0.93). Both fPWV (HR= 1.52, 95% CI [1.47-1.58]) and aPWV (HR=1.60 [1.54-1.66]) were predictive of MACE in unadjusted models. Only aPWV remained significantly associated after adjustments for ASCVD (Hazard ratio [HR]= 1.16 [1.09-1.22]) and SCORE-2 (HR= 1.07 [1.00-1.13]). fPWV was significantly associated with MACE after adjustment for ASCVD, but not SCORE-2, only when this was tested in a population with similar exclusions as in the original fPWV derivation cohort. Conclusions: Algorithm-based PWV, but not formula-based PWV, improves cardiovascular prediction beyond what is achievable with recognized prediction tools.

Association between Biomarkers of Inflammation and 10-Year Changes in Aortic Stiffness: The Multi-Ethnic Study of Atherosclerosis.

Background. Chronic inflammation is associated with incident cardiovascular events. We study the association between biomarkers of inflammation and subclinical vascular dysfunction measured as proximal aortic stiffness. Methods. MRI imaging was performed in the Multi-Ethnic Study of Atherosclerosis (MESA) at baseline (2000) and at the 10-year follow-up. Aortic arch pulse wave velocity (PWV) and ascending and descending aorta distensibility (AAD, DAD) were measured in 1223 asymptomatic individuals at both exams. Linear regression was used to study the association of baseline inflammation-C-reactive protein (CRP), interleukin-6 (IL6), and fibrinogen (Fib)-with baseline and 10-year changes in aortic stiffness (PWV, AAD, DAD). Results. The mean age of the participants was 59 ± 9 years, 47.8% of them were men, 32.6% were hypertensive at baseline, and 7.6% were diabetic. At baseline and follow-up, the mean AAD values were, respectively, 1.73 × 10-3 mmHg-1 and 1.57 × 10-3 mmHg-1, the mean DAD values were 2.19 × 10-3 mmHg-1 and 1.99 × 10-3 mmHg-1, and the mean PWV values were 8.10 m/s and 8.99 m/s. At baseline, the AAD (in 10-3 mmHg-1) and DAD (in 10-3 mmHg-1) were inversely associated with CRP (in mg/L) (AAD coeff: -0.047, p-value: 0.011, DAD coeff: -0.068, p-value: <0.001) and IL6 (in pg/mL) (AAD coeff: -0.098, p-value: 0.003, DAD coeff: -0.14, p-value: <0.001) in a univariable analysis but not after adjustment for demographic variables or cardiovascular risk factors. The baseline DAD was inversely associated with Fib (in mg/dL) (coeff: -0.334, p-value: 0.001). The baseline PWV (in m/s) was positively associated with IL6 (in pg/mL) in a univariable analysis (coeff: 0.054, p-value: 0.014). In a longitudinal analysis, the 10-year changes in DAD were inversely associated with CRP, even after adjustment for demographics and risk factors (DAD coeff: -0.08, p-value 0.044). Conclusions. Higher CRP levels at baseline were independently associated with a 10-year increase in aortic stiffness, measured as decreased aortic distensibility.

Hemodialysis Parameters and Pulse Wave Velocity.

The study aimed to evaluate the acute effect of ultrafiltration on the mechanical properties of the aorta using brachial-ankle pulse wave velocity (PWV) before and after hemodialysis (HD). This study included 80 patients who were on a long-term HD program. The input variables were anamnestic data, body composition monitor (BCM) parameters, and echocardiography findings. The assessment of hydration status was determined by BCM, whose work is based on the principle of multifrequency bioimpedance spectroscopy. Another diagnostic procedure was the use of an arteriograph apparatus to assess PWV and Augmentation Index (AIx). All measurements were performed before and after dialysis on the middle dialysis day of the week. The participants were divided into two groups based on hydration status: the experimental group consisted of 40 overhydrated participants and the control group consisted of 40 normovolemic participants. Statistically, the following BCM parameters correlated significantly positively with PWV: total body fat (r = 0.222; P < 0.05), overhydration (r = 0.290; P < 0.001), and relative overhydration (r = 0.290; P < 0.001). From echocardiography findings, only left atrial diameter correlated statistically significantly positively with PWV (r = 0.359; P < 0.001). Comparison of the mean PWV values within the experimental group before and after HD showed a statistically significant decrease from 14.32 ± 2.34 m/s to 8.72 ± 1.52 m/s (Z = 3.254; P = 0.0001). Mean PWV values within the control group did not decrease significantly from 13.39 ± 1.32 m/s to 10.39 ± 1.18 m/s (Z = 0.524; P = 0.742). If we compare the mean values of PWV between groups, then before HD treatment, there was no statistically significant difference between groups with PWV values in the experimental group of 14.32 ± 2.34 m/s and the control group of 13.39 ± 1.32 m/s (Z = 0.762; P = 0.852). According to the results of univariate regression analysis before and after HD treatment, only overhydration showed an absolute effect on PWV before and after HD. Overhydration showed an effect on brachial-ankle PWV before and after HD, and brachial-ankle PWV should be followed in HD patients.

Evaluation of augmentation index and pulse wave velocity measurements in central retinal vein occlusion patients with and without hypertension.

To evaluate arterial stiffness using the pulse wave velocity (PWV) and augmentation index (AI) in central retinal vein occlusion (CRVO) patients. Forty-two CRVO patients (i.e., CRVO group) and 54 healthy controls (i.e., control group) were included in this comparative and cross-sectional study. The PWV, AI and augmentation pressure were measured with a noninvasive, oscillometric method. The mean PWV, AI and augmentation pressure values were significantly higher in CRVO patients than in controls (p = 0.024, p <0.001 and p = 0.001, respectively). The mean augmentation pressure, AI and PWV measurements were not statistically significant between CRVO patients with and without hypertension (p = 0.856 and p <0.526, p = 0.432, respectively). Age, presence of hypertension, AI and PWV were found to be as independent risk factors of CRVO development (OR = 2.21, 95% CI [1.44, 3.38] and OR = 2.40, 95% CI [1.50, 3.86], OR = 3.2, 95% CI [1.70, 5.60] and OR = 5.70, 95% CI [2.00, 18.50], respectively). The AI and PWV values were significantly higher in CRVO patients than in controls. These results indicate that similar abnormalities in the arterial wall structure may play an important role in the pathogenesis of the CRVO and cardiovascular diseases. In addition, our findings show that each patient with RVO should be examined in terms of systemic vascular pathologies.

Dual impedance cardiography: An inexpensive and reliable method to assess arterial stiffness.

Pulse wave velocity (PWV) is a common measure of arterial stiffness. Non-invasive methods to measure PWV are widely used in biomedical studies of aging and cardiovascular disease, but they are rarely used in psychophysiology. Barriers to wider use include the prohibitive costs of specialized equipment and need for trained technicians (e.g., ultrasonographers). Here, we describe an impedance cardiography method to measure PWV. By this method, impedance signals are dually collected from the thorax and calf. Combined with ensemble averaging of vascular signals, this dual impedance cardiography (d-ICG) method allows for the measurement of aortic flow onset and the arrival time of peripheral pulse waveforms to compute PWV. In a community sample of adults (aged 19-78years), PWV measured with d-ICG exhibited a strong positive correlation with age. Moreover, age-specific mean PWV values were within the normative reference intervals established by large scale studies using other techniques. PWV derived from d-ICG exhibited high test-retest reliability across several days, as well as excellent inter-rater reliability. Last, PWV exhibited expected associations with known cardiovascular disease risk factors and indicators of autonomic cardiovascular control. d-ICG is an inexpensive and reliable method to assess arterial stiffness.

Interleukin-8 is increased in chronic kidney disease in children, but not related to cardiovascular disease.

Introduction:In this study, we aimed to detect the cytokine that is involved in the early stage of chronic kidney disease and associated with cardiovascular disease.Methods:We included 50 patients who were diagnosed with predialytic chronic kidney disease and 30 healthy pediatric patients in Ege University Medical Faculty Pediatric Clinic, İzmir/Turkey. Interleukin-8 (IL-8), interleukin-10 (IL-10), interleukin-13 (IL-13), and transforming grow factor-β1 (TGF-β1) levels (pg/mL) were measured by ELISA. Carotid-femoral pulse wave velocity (PWV), augmentation index (Aix), carotid intima media thickness (cIMT), and left ventricular mass index (LVMI) were evaluated as markers of cardiovascular disease. The presence of a cardiovascular disease marker was defined as an abnormality in any of the parameters (cIMT, PWV, Aix, and left ventricular mass index (SVKI)). The patient group was divided into two groups as with and without cardiovascular disease.Results: Mean Aix and PWV values were higher in CKD patients than controls (Aix: CKD 32.8±11.11%, healthy subjects: 6.74±6.58%, PWV CKD: 7.31±4.34m/s, healthy subjects: 3.42±3.01m/s, respectively; p=0.02, p=0.03). The serum IL-8 levels of CKD were significantly higher than of healthy subjects 568.48±487.35pg/mL, 33.67±47.47pg/mL, respectively (p<0.001). There was no statistically significant difference between IL-8, IL-10, IL-13, TGF-1, in CKD patients with and without cardiovascular disease (p> 0.05).Discussion:IL-8 is the sole cytokine that increases in pediatric patients with chronic kidney disease among other cytokines (IL-10, IL-13 and TGF-β1). However, we did not show that IL-8 is related to the presence of cardiovascular disease.

The relationship between the severity of erectile dysfunction and aortic stiffness.

Aortic stiffness increases in patients with erectile dysfunction (ED) but it is not known whether aortic stiffness affects the degree of ED. In the present study, we aimed to determine whether there is any relationship between aortic stiffness and the severity of ED. Patients with ED were divided into 3 groups according to the International Index of Erectile Function (IIEF) scores. Mild ED was named as group 1, moderate ED as group 2 and severe ED as group 3. The values of fasting blood glucose (FBG), serum lipid values, total testosterone (T. tes), and free testosterone (F tes) were recorded. Aortic stiffness was determined by pulse wave velocity (PWV) and augmentation index (AIX) measurements. The mean or median values of the laboratory parameters among the groups were similar (p>.05). No statistical difference was found between the groups in terms of AIX value (p=.386). Mean PWV values were calculated as 7.26, 8.30 and 8.78 in group 1, group 2 and group 3 respectively. PWV values were significantly different between groups (p<.0001). PWV values were found to be increased with increasing severity of erectile dysfunction.

Evaluation of subclinical atherosclerosis by ultrasound radiofrequency data technology in patients with Behçet's disease.

We aimed to evaluate subclinical atherosclerosis based on carotid intima-media thickness (CIMT) and arterial stiffness measurements in patients with Behçet's disease (BD), using ultrasound (US) radiofrequency (RF) data technology. We included 33 BD patients and 33 healthy controls in this study. The participants did not have any primary cardiovascular risk factors, such as diabetes mellitus, hypertension, hyperlipidemia and obesity. All participants were evaluated using Doppler ultrasonography. Arterial stiffness and CIMT measurements were performed in bilateral common carotid arteries using the US RF data technology. The right, left and mean CIMT values were similar between the patient and control groups (P >0.05). There was also no statistically significant difference in the right side α and β stiffness indices despite higher values in the patient group (P> 0.05). The right, left and mean distensibility coefficient (DC) and compliance coefficient (CC) values of the patient group were significantly lower than the control group (P< 0.05). The left and mean α- and β-stiffness indices, and the right, left and mean pulse wave velocity (PWV) values were significantly higher in the patient group (P< 0.05). We found higher mean CIMT and PWV values, and α- and β-stiffness indices in patients with mucocutaneous involvement compared with those with major organ involvement, while the mean DC and CC values were lower in the former. However, these results did not reach a statistically significant level. This study demonstrated evidence of subclinical atherosclerosis in BD in the absence of major atherosclerotic risk factors.

Do patients with rheumatoid arthritis have aorta stiffer than general population?

ObjectiveThe aim of this study was to compare the aortic stiffness in patients with rheumatoid arthritis (RA) with the aortic stiffness in general population (GP) and to evaluate the determinants of their stiffness.Patients and methodsThe study group consisted of 80 patients with RA and 71 matched GP. Pulse wave velocity (PWV) was assessed by Doppler ultrasonography. Biochemical analyses were conducted for serum using standard laboratory procedures.ResultsThe mean PWV values were 7.687±1.03 versus 7.253±0.97 m/s in the patients with RA and GP, respectively. The average coordination of PWV and RA duration (RAD) variations is present by equation of linear regression: y=7.1309+0.0971x. By multiple regression analysis, C-reactive protein, (βst=0.1096, P=0.0009), RAD (βst=0.0917, P=0.0018), high-density lipoprotein cholesterol (βst=‒1.0610, P=0.0271), and cholesterol (βst=0.8491, P=0.0350) were independently associated with PWV in the patients with RA. C-reactive protein (βst=0.1057, P=0.0016), triglycerides (βst=0.1730, P=0.0117), low-density lipoprotein cholesterol (βst=0.1467, P=0.0206), and cholesterol (βst=0.0305, P=0.0261) were independently associated with PWV in the GP.ConclusionArterial stiffness was more pronounced in the patients with RA than in the GP. The independent determinants of arterial stiffness in both groups include traditional risk factors. RAD is determinant in patients with RA only.

The effects of age on pulse wave velocity in untreated hypertension.

Increased arterial stiffness is an important determinant of cardiovascular risk, able to predict morbidity and mortality, and closely associated with ageing and blood pressure. The aims of this study were: (1) To determine the age-dependent reference pulse wave velocity (PWV), and compare it with values from hypertensive patients, and (2) to evaluate the impact of isolated and untreated hypertension on arterial stiffness. A total of 1079 patients were enrolled and divided into a control group (NT) of asymptomatic normotensive patients and a group of asymptomatic hypertensive patients (HT). Blood pressure, carotid-femoral PWV, and body mass index were measured in each subject, whose blood was drawn for laboratory tests. Aortic mean PWV in the NT group was 6.85±1.66m/s, which increased linearly (R2 =0.62; P<.05) with age. In patients over 50years of age, PWV was significantly higher than in younger patients (8.35 vs 5.92m/s, respectively, P<.001). This significant difference persisted when observing male and female patients separately. In the hypertensive group, mean PWV value was 8.04±1.8m/s (range 4.5-15.8m/s) and increased (R2 =0.243; P<.05) with age. The PWV increase in HT was significantly higher (0.93m/s per decade, P<.001) than in NT (0.44m/s per decade). Our study provides normal values of PVW per decade, and shows that these values increase with age, especially after 50years of age, particularly in HT patients. This stiffness growth rate may be responsible for increased cardiovascular risk in both groups.

Assessment of local pulse wave velocity distribution in mice using k-t BLAST PC-CMR with semi-automatic area segmentation

BackgroundLocal aortic pulse wave velocity (PWV) is a measure for vascular stiffness and has a predictive value for cardiovascular events. Ultra high field CMR scanners allow the quantification of local PWV in mice, however these systems are yet unable to monitor the distribution of local elasticities.MethodsIn the present study we provide a new accelerated method to quantify local aortic PWV in mice with phase-contrast cardiovascular magnetic resonance imaging (PC-CMR) at 17.6 T. Based on a k-t BLAST (Broad-use Linear Acquisition Speed-up Technique) undersampling scheme, total measurement time could be reduced by a factor of 6. The fast data acquisition enables to quantify the local PWV at several locations along the aortic blood vessel based on the evaluation of local temporal changes in blood flow and vessel cross sectional area. To speed up post processing and to eliminate operator bias, we introduce a new semi-automatic segmentation algorithm to quantify cross-sectional areas of the aortic vessel. The new methods were applied in 10 eight-month-old mice (4 C57BL/6J-mice and 6 ApoE (−/−)-mice) at 12 adjacent locations along the abdominal aorta.ResultsAccelerated data acquisition and semi-automatic post-processing delivered reliable measures for the local PWV, similiar to those obtained with full data sampling and manual segmentation. No statistically significant differences of the mean values could be detected for the different measurement approaches. Mean PWV values were elevated for the ApoE (−/−)-group compared to the C57BL/6J-group (3.5 ± 0.7 m/s vs. 2.2 ± 0.4 m/s, p < 0.01). A more heterogeneous PWV-distribution in the ApoE (−/−)-animals could be observed compared to the C57BL/6J-mice, representing the local character of lesion development in atherosclerosis.ConclusionIn the present work, we showed that k-t BLAST PC-MRI enables the measurement of the local PWV distribution in the mouse aorta. The semi-automatic segmentation method based on PC-CMR data allowed rapid determination of local PWV. The findings of this study demonstrate the ability of the proposed methods to non-invasively quantify the spatial variations in local PWV along the aorta of ApoE (−/−)-mice as a relevant model of atherosclerosis.

PS 09-03 ARTERIAL STIFFNESS IN A RANDOM SAMPLE OF A MULTI-ETHNIC POPULATION IN SURINAME

Objective: Patients of South Asian and African descent are known to have a high cardiovascular risk. Increased arterial stiffness has been shown to be independently associated with cardiovascular risk and mortality, however, at present, few studies have investigated ethnic differences in aortic pulse wave velocity (PWV), as measure of arterial stiffness, in these groups. Therefore, we studied PWV in South Asians, Indonesians, Creoles and Maroons, living in Suriname, South America. Design and Method: In a cross-sectional setting we selected a random representative sample of 864 participants living in an urban setting in Paramaribo, Suriname. We estimated the aortic pulse wave velocity (PWV) non-invasively in the supine position by analysis of the oscillometric pressure curves registered on the upper arm, using the Arteriograph (TensioMed, Budapest, Hungary). We used the mean of two consecutive measurements for our analyses by age and ethnicity, and by blood pressure and ethnicity. Results: We included 864 participants (mean age 44 years, 46% man, 41.2% hypertension, 12% hypercholesterolemia, 14.6% diabetes). The mean PWV value was 8.5 ± 2.4 m/s. The distribution of mean PWV values classified by age, ethnicity, and blood pressure are summarized in the Table. Conclusions: We found relatively high mean PWV values across ethnic groups, compared to the mean values with optimal blood pressure, reflecting the high prevalence of hypertension and possible early vascular ageing in these groups with high cardiovascular risk.

PS 05-59 Pulse Wave Velocity and Carotid Intima Medial Thickness

Objective: Carotid artery intima-media thickness (CCIMT) and pulse wave velocity (PWV) are considered as surrogates of arterial stiffness and related to cardiovascular risk (CVR). To analyze, in normotensive subjects (NT), without CVR: the age related normal values for CCIMT and PWV, their relationship and the rate of changes with aging. In subjects with arterial hypertension (HT), as unique risk factor (RF), the age and hypertension impact on PWV and CCIMT. Design and Method: 1079 subjects were randomly enrolled and divided in asymptomatic non-smoking NT (n = 780, 40 ± 8.5 years old), without diabetes, dyslipidemia and first degree family history of hypertension and asymptomatic non-smoking HT, as only RF, (n = 299, 50 ± 14.8 years old). In 611 out of the 1079 subjects included (39.8 ± 16.5 years), the reference values of CCIMT and the 95% confidence intervals values were also calculated for each decade of age (10–81 years). Carotid-Femoral PWV was continuously measured for, at least 10 cardiac cycles, and the mean value considered as the subject PWV. CCIMT was measured with a B mode ultrasound echocardiograph (EsaoteMyLab 40) with specific software. Results: In NT, mean PWV value was 6.85 ± 1.66 m/s with a linear increase related with age (r = 0.79; p < 0.05) and a decade growth of 0.245 m/sec. Similarly, CCIMT mean value was 0.554 ± 0.130 mm and increases linearly with aging (r = 0.79; p < 0.05), with a progressive decade related increase (0.06 ± 0.001 mm). In HT, mean PWV value was 8.04 ± 1.8 m/s (p < 0.01) and, as in NT, increased linearly with age (r = 0.49; p < 0.05) with a decade growing of 0.589 m/sec (p < 0.001). PWV and IMT were significantly related (r = 0.42, p < 0.001). No gender differences were observed either in NT or HT. Conclusions: It is suggest that CVR related to the ageing process is further increased when other RF, as arterial hypertension, are added.

Epicardial Fat Volume and Aortic Stiffness in Healthy Individuals: A Quantitative Cardiac Magnetic Resonance Study.

To determine epicardial fat volume (EFV) and aortic stiffness (assessed by aortic pulse wave velocity (PWV)) in healthy individuals, and to investigate the relationship of these parameters, and their association with body mass index (BMI) and age. 58 subjects (29 men, mean age 44.7 ± 13.9 years[y]) underwent a CMR exam at 1.5 Tesla. A 2 D velocity-encoded CMR scan was acquired to determine PWV. The EFV was measured based on a 3 D-mDixon sequence. Group comparisons were made between younger (age < 45y; n = 30; mean age 33.4 ± 6.6y) and older (> 45y; n = 28; 56.7 ± 8.4y) subjects and between subjects with a BMI < 25 kg/m(2) (n = 28; BMI 21.9 ± 2.5 kg/m(2)) and a BMI > 25 kg/m(2) (n = 30; 28.7 ± 4.0 kg/m(2)). Associations between the determined parameters were assessed by analyses of covariance (ANCOVAs). The mean values of PWV and EFV (normalized to body surface area) were 6.9 ± 1.9 m/s and 44.2 ± 25.0 ml/m(2), respectively. The PWV andEFV were significantly higher in the oldergroup (PWV = 7.9 ± 2.0 m/s vs. 6.0 ± 1.2 m/s; EFV = 54.7 ml/m² vs. 34.5 ml/m²; p < 0.01, each), with no significant differences in BMI or sex. In the overweighted group the EFV was significantly higher than in subjects with a BMI < 25 kg/m² (EFV = 56.1 ± 27.1 ml/m(2) vs. 31.5 ± 14.6 ml/m(2); p < 0.01) but without a significant difference in PWV. ANCOVA revealed a significant correlation between EFV and PWV, also after adjustment for age (p = 0.025). An association was found between age and EFV as well as PWV. EFV and PWV were related to each other also after adjustment for age. The metabolic and pro-inflammatory activity found with increased epicardial fat volume may promote the development of atherosclerosis and aortic stiffness. CMR may be valuable for future studies investigating the relationship between EFV and PWV in patients with increased cardiovascular risk. • EFV and PWV can be assessed in a single CMR exam.• EFV and aortic stiffness are both associated with cardiovascular risk.• EFV correlates with aortic stiffness, possibly due to similar pro-inflammatory mechanisms. Citation Format: • Homsi R, Thomas D, Gieseke J et al. Epicardial Fat Volume and Aortic Stiffness in Healthy Individuals: A Quantitative Cardiac Magnetic Resonance Study. Fortschr Röntgenstr 2016; 188: 853 - 858.

Association of renal function with vascular stiffness in older adults: the Rotterdam study.

arterial stiffening is a marker of vascular ageing and an independent risk factor for cardiovascular disease. A potential mechanism linking cardiovascular disease to chronic kidney disease might be the change in arterial elasticity. We aim to determine the association between renal function and arterial stiffness in older subjects. cross-sectional study. Rotterdam study, a population-based cohort study. we included 3,279 subjects from 1997 to 1999 with a mean age of 71.9 years. estimation of glomerular filtration rate (eGFR) was used to assess renal function. Aortic pulse wave velocity (PWV) and carotid distensibility coefficient were used as measures of arterial stiffness. each standard deviation increase in eGFR, adjusting for age and sex, was associated with 0.14 m/s lower PWV [95% confidence interval (CI): -0.23, -0.05]. Further adjustments for socio-demographic and cardiovascular risk factors did not change the association (β: -0.16 m/s; 95% CI: -0.26, -0.06). There was a linear association between mean values of PWV and quartiles of glomerular filtration rate (P for trend = 0.006). There was no association between decreased renal function and carotid distensibility. There was no statistical difference in the strength of the association between renal function and PWV in subgroups of participants with and without cardiovascular risk factors. in this large population-based study of elderly subjects, our findings suggest that renal impairment is associated with aortic stiffness. This association is independent of cardiovascular risk factors.

Characterizing household air pollution exposures and cardiovascular risk in rural Chinese women

China has a large and growing cardiovascular disease burden. Household air pollution (HAP) has been associated with higher blood pressure and is thought to increase risk of cardiovascular outcomes, though the empirical evidence is limited and mechanisms are unclear. We assessed personal HAP exposure, markers of arterial stiffness and function, and biological markers of oxidative stress in Chinese women cooking and heating with solid fuels. We enrolled 42 rural Chinese women (mean age=55±12) and measured their blood pressure and 24-hr exposure to PM2.5 and black carbon (BC) using personal gravimetric systems. In a subsample of women (n=25), we measured telomere length from buccal swabs, a biomarker linked to oxidative stress, and assessed pulse wave velocity (PWV) and augmentation index (AI) using a noninvasive device. To our knowledge, this is the first study to measure these important vascular endpoints in a rural, developing country setting. Women’s 24-hr BC exposure ranged from 1-129 ?g/m3 (mean: 21) and PM2.5 exposure ranged from 20-1365 ?g/m3 (mean: 207), far exceeding the WHO PM2.5 guideline (25 ?g/m3). Age-adjusted pollution exposure was associated with shorter telomere length (PM2.5: -0.4 per 10 ?g/m3 (95% CI:-0.9, 0.1); BC: -0.8 per 10-?g/m3 (95% CI:-3.0, 1.1). Higher PM2.5 exposure was associated with higher systolic blood pressure (3.0 mmHg, 95% CI:-3.4, 9.5), after adjusting for age, income, waist circumference and other covariates. Mean PWV (7.9±1.1 m/s) and AI (23.8±4.9%) values in our study subset increased with both higher blood pressure and age, but were lower than those observed in urban Chinese women. In multivariate models, a log-increase in PM2.5 exposure was associated with higher AI (2.2%; 95% CI:-1.4, 6.0), but lower PWV (-0.5 m/s; 95% CI:-1.2, 0.3). While these data are from a small initial assessment, they offer the possibility that changes in vascular function and stiffness from HAP exposure may impact cardiovascular risk, with oxidative stress potentially mediating this relationship.

AB0683 Parameters of arterial stiffness in a population of SLE patients with long disease duration: Something new to be examined?

BackgroundPatients with Systemic Lupus Erythematosus (SLE) are at increased risk to develop cardiovascular (CV) events. Arterial stiffness (AS) expresses structural changes in the arterial wall. The presence of AS can...

Accelerated progression of arterial stiffness in dialysis patients compared with the general population

Background/AimsThe aim of this study was to compare the progression of aortic stiffness in chronic hemodialysis patients (CHP) with that of general population patients (GPP) over a 36-month period and to evaluate the determinants of this progression.MethodsThe study group included 80 patients undergoing hemodialysis (aged 59.3 ± 11.8 years; duration of dialysis 5.47 ± 5.16 years). The control group consisted of 60 patients (aged 57.5 ± 10.9 years) with a glomerular filtration rate of > 60 mL/min/1.73 m2. Pulse wave velocity (PWV) was determined from time diversity propagation of the common carotid artery and femoral artery by Doppler ultrasound. Clinical and biochemical parameters were determined in serum using standard laboratory procedures.ResultsThe mean PWV values at baseline and 36 months were 11.18 ± 2.29 and 11.82 ± 2.34 m/sec in the CHP group, and 9.02 ± 1.89 and 9.29 ± 1.93 m/sec in the GPP group, respectively. The average PWV progressions were 63.95 ± 18.373 cm/sec in CHP and 27.28 ± 28.519 cm/sec in GPP. By multiple regression analysis, hemoglobin (standardized coefficient β [βst] = -0.405, p = 0.004; βst = -0.364, p = 0.011), albumin (βst = -0.349, p = 0.042; βst = -0.303, p = 0.034), CRP (βst = 0.458, p = 0.002; βst = 0.187, p = 0.008), and total cholesterol (βst = 0.236, p = 0.038; βst = 0.171, p = 0.078) were independently associated with PWV in the CHP and GPP groups, respectively.ConclusionsAccelerated arterial stiffness was more pronounced in the CHP group than in the GPP group. The independent determinants of this progression in both groups include traditional risk factors and blood levels of hemoglobin, albumin and CRP. Cholesterol and uremia-related factors are determinants only in CHP.

Terapia antirretroviral altamente eficaz para infecção pelo vírus da imunodeficiência humana aumenta a rigidez aórtica

Highly active antiretroviral therapy for AIDS is known to increase cardiovascular risk, but the effects of potent antiretroviral agents according to gender are unknown. The present study evaluated the impact of HIV infection treatment on aortic stiffness according to gender. From university-affiliated hospitals, we recruited 28 AIDS patients undergoing highly active antiretroviral treatment (HAART), 28 treatment-naïve HIV-infected patients, 44 patients with type 2 diabetes, and 30 controls. Aortic stiffness was determined by measuring pulse wave velocity (PWV) using a validated and non-invasive automatic device. The crude mean PWV values and 95% confidence intervals (95% CI) for HAART, diabetics, and controls were 9.77 m/s (95% CI 9.17-10.36), , 9.00 m/s (95% CI 8.37-9.63), 9.90 m/s (95% CI 9.32-10.49), and 9.28 m/s (95% CI 8.61-9.95), respectively, for men (P-value for trend = 0.14), and 9.61 m/s (95% CI 8.56-10.66), 8.45 m/s (95% CI 7.51-9.39), 9.83 (95% CI 9.21-10.44), and 7.79 m/s (95% CI 6.99-8.58), respectively, for women (P-value for trend <0.001). Post-hoc analysis revealed a significant difference between the mean PWV values in the HAART group and controls in women (P-value <0.01). After adjusting for other potential covariates, including systolic blood pressure and diabetes, these results did not change. The findings indicate that the impact of HAART treatment on aortic stiffness was amplified in women with hypertension, dyslipidemia, and metabolic syndrome. Potent anti-retroviral agents used in the treatment of HIV infection increases aortic stiffness, mainly among women with higher cardiovascular risk.

Epicardial adipose tissue volume and cardiovascular disease in hemodialysis patients

ObjectiveEpicardial adipose tissue (EAT) is proposed as a cardiovascular risk marker in non-uremic subjects. However, little is known about its role in patients with higher cardiovascular risk profile such as chronic kidney disease. The aim of this study was to investigate the relationship between EAT and several cardiovascular surrogate markers (coronary artery calcification (CAC), arterial stiffness and atherosclerosis) in patients on maintenance hemodialysis. MethodsA total of 191 prevalent hemodialysis patients were enrolled in this cross-sectional study. EAT and CAC scores (CACs) were determined by multi-slice computerized tomography, arterial stiffness by carotid-femoral pulse wave velocity (PWV), and carotid artery intima-media thickness (CA-IMT) by B-mode doppler ultrasonography. ResultsMean age was 59 ± 13 years and time on hemodialysis 75 ± 44 months. Twenty percent of the patients had diabetes. Mean EAT volume was 62.6 ± 26.8 cm3/m2. Mean CA-IMT and PWV values increased across the EAT tertiles. EAT was correlated with age, female gender, body mass index, albumin and lipid parameters. Additionally, CA-IMT and PWV values were positively correlated with EAT. EAT volume was significantly higher in patients with CACs >10 compared to the patients with CACs ≤10. Despite the univariate associations between EAT and cardiovascular surrogate markers, only age, body mass index and total cholesterol levels were associated with EAT in adjusted models. ConclusionsIn prevalent hemodialysis patients, EAT is correlated with atherosclerosis, arterial stiffness and the presence of CAC. However, this correlation is not independent of other risk factors.