Wave Velocity Measurements Research Articles

Relationships between cardio-ankle vascular index and peptides related to hypertensive disorders of pregnancy in patients with lower extremity arterial disease

Introduction: Cardio-ankle vascular index (CAVI), a blood pressure-independent measure of heart-ankle pulse wave velocity, is a relatively new indicator of arterial stiffness. The absolute value of the difference in right CAVI and left CAVI (diff-CAVI) has been proposed as a new indicator of leg ischemia in patients with lower extremity arterial disease (LEAD). The aim of this study was to elucidate the relationships between diff-CAVI and peptides related to hypertensive disorders of pregnancy (HDP), which have been proposed as biomarkers for leg ischemia in patients with LEAD. Methods: The subjects were 165 outpatients with LEAD who had already received medication therapy for LEAD. The relationships between diff-CAVI and serum levels of the seven HDP-related peptides, which were measured by mass-spectrometry, were investigated. Results: HDP-related peptides with m/z 2091 (P-2091) and m/z 2378 (P-2378) showed significant positive correlations with diff-CAVI, and odds ratios (ORs) for large diff-CAVI (≥ 1.05) of the 3rd vs. 1st tertile groups of P-2091 (OR: 3.71 [1.24~11.15]) and P-2378 (OR: 4.46 [1.39~14.30]) were significantly higher (p < 0.01) than the reference level. The associations of P-2091 and P-2378 with diff-CAVI were shown to be independent of age, gender, habit of smoking, history of diabetes, BMI and blood pressure in multivariable analyses. The other peptides with m/z 2081, 2127, 2209, 2858 and 3156 did not show significant associations with diff-CAVI. Conclusion: P-2091 and P-2378 were associated with diff-CAVI and are thought to be useful indicators of leg ischemia in patients with LEAD.

Association of plasma aldosterone concentration with arterial stiffness progression in hypertensive patients: insights from a longitudinal analysis

ABSTRACT Purpose Limited studies have examined the relationship between plasma aldosterone concentration (PAC) and arterial stiffness progression. This study aimed to investigate the longitudinal association between baseline PAC and arterial stiffness progression in hypertensive patients. Patients and methods This was a longitudinal study conducted at the Hypertension Center of People’s Hospital of Xinjiang Uygur Autonomous Region between April 2020 and October 2023. The study included 1,138 hypertensive patients who had completed two measurements of brachial-ankle pulse wave velocity (baPWV) over the study period. Arterial stiffness was quantified using baPWV, and progression was assessed by the baPWV change rate, calculated as the absolute difference between baseline and follow-up baPWV divided by the follow-up time in years. The primary outcome was the association between baseline PAC and baPWV change rate. Results Multivariate linear regression analyses indicated that a 10-unit increase in baseline PAC was significantly associated with a 19.60 cm/s/year increase in baPWV change rate (95% CI, 9.93 to 29.21). This association remained significant after adjusting for potential confounders, including age, sex, body mass index, smoking status, systolic and diastolic blood pressure, total cholesterol, and the use of antihypertensive medications. Multivariable restricted cubic splines analysis confirmed a significant dose-response relationship between baseline PAC and baPWW change rate (P for overall trend = 0.002). Conclusion Higher baseline PAC levels were associated with faster progression of arterial stiffness in hypertensive patients, suggesting a potential role for aldosterone in vascular health. These findings warrant further investigation.

Central arterial stiffness in young adults with perinatal HIV exposure & infection.

To compare arterial stiffness between young adults with perinatally acquired HIV (YAPHIV) and young adults perinatally HIV exposed but uninfected (YAPHEU). Cross-sectional analysis of pulse wave velocity (PWV) measures among participants with echocardiography in the PHACS Cardiac Toxicity Substudy. A total of 150 participants (95 YAPHIV, 55 YAPHEU, mean 23.4 years, 60% female, 72% Black, 24% Hispanic) had echocardiography and PWV measured. We compared PWV between groups. Among YAPHIV, we fit linear regression models to evaluate the association of measures of HIV disease severity and antiretroviral treatment (ART) with PWV. We computed correlations between PWV and measures of left ventricular structure and function. Mean PWV did not differ by group (YAPHIV 5.63 vs YAPHEU 5.39 m/s; P = 0.50). HIV control was good (82% with viral load <400 copies/ml); 91% used combination ART. Mean PWV was normal, but 3 of 95 YAPHIV (3%) had values above 11.8 m/s (level associated with cardiovascular events in adults). Weak correlations (<0.20) were observed between PWV and echocardiographic measures. Among YAPHIV, current and historical HIV severity measures were not associated with PWV. YAPHIV on protease inhibitor (PI)-based ART had higher mean PWV than those on integrase strand inhibitors (1.68 m/s higher, 95% CI -0.36, 3.72) or nonnucleoside transcriptase inhibitors (1.58 m/s higher, 95% CI -0.94, 4.11). Our data shows no difference in PWV between those perinatally exposed to and perinatally infected with HIV. Therefore, CV risk reduction guidelines should be followed to prevent CV disease in all young adults.

Effects of continuous positive airway pressure treatment on arterial stiffness and inflammatory factors in patients with coronary heart disease complicated with obstructive sleep apnea

BackgroundContinuous Positive Airway Pressure (CPAP) treatment brings more benefits than risks to most coronary heart disease (CHD) patients with obstructive sleep apnea (OSA). However, the pathophysiological mechanism by which CPAP treatment improves the prognosis of patients with CHD and OSA remains unclear. The purpose of this study was to clarify whether CPAP can improve arterial stiffness and inflammatory factor levels in CHD patients with OSA, and to further improve prognosis.Method59 patients with coronary heart disease complicated by moderate to severe sleep apnea were divided into a CPAP treatment group (CPAP + coronary heart disease standard treatment) and a control group (only coronary heart disease standard treatment). Peripheral blood test reports were collected and pulse wave velocity (PWV) measurements were performed for each patient at the beginning, 3 months, and 6 months of treatment.ResultsAfter 6 months of treatment, the CPAP group showed more significant improvement in the levels of inflammatory factors such as white blood cell (WBC), neutrophil (N), C-reactive protein (CRP), interleukin-6 (IL-6), procalcitonin (PCT), and PWV than the control group.ConclusionAfter active treatment with CPAP, arterial stiffness and inflammatory cytokine levels in patients with coronary heart disease and OSA improved. This association should be given more attention in clinical practice, and sleep apnea should be actively treated.

Comparison of Influence of Office and 24-h Central Aortic Blood Pressure on Target Organ Damage in Hypertension.

The aim of this study was to explore whether 24-h ambulatory central (aortic) blood pressure (BP) has an advantage over office central aortic BP in screening for hypertension-mediated target organ damage (HMOD). A total of 714 inpatients with primary hypertension and the presence of several cardiovascular risk factors or complications involving clinical HMOD were enrolled. Twenty-four hour central aortic BP was measured by means of a noninvasive automated oscillometric device (Mobil-O-Graph). Office BP was measured with a validated oscillometric Omron device after a 5-min rest in a sitting position. Central aortic pressure waveforms were derived from the radial pressure waveforms with a validated transfer function of the Sphygmocor software, version 8.0 (Atcor Medical, Sydney, Australia). Carotid-femoral pulse wave velocity (cf-PWV) measurement was performed by sequential placement of the transducer on the femoral artery and carotid artery and determining transit time between the two pulses in reference to the R wave of the ECG. cf-PWV was calculated as the measured distance from the suprasternal notch to the femoral artery minus the distance from the suprasternal notch to the carotid artery divided by the pulse transit time. HMOD was defined as the presence of carotid intima-media thickness (IMT) above normal values and/or carotid plaque, left ventricular hypertrophy (LVH), renal abnormalities as assessed by urine albumin/creatinine ratio (ACR) above normal values and/or estimated glomerular filtration rate (eGFR) less than 60mL/min/1.73m2 and/or increased cf-PWV>10m/s. In the study cohort of 714 (age 54.52±13.24years, 74.6% male) patients with primary hypertension, LV mass index (LVMI) was significantly higher in males (p<0.002) and eGFR was significantly lower in males (p<0.001). However, there was no statistical significance between males and females in IMT, ACR, and cfPWV. When accounting for confounding factors (age, sex, BMI, triglycerides, total cholesterol, LDL, glucose, smoking, and heart rate), central systolic (cSBP), diastolic (DBP), and pulse (cPP) pressure obtained with 24-h monitoring was more strongly correlated with LVMI than office measurements. Twenty-four hour cSBP and cPP were more strongly correlated with IMT than those of office monitoring. The 24-h augmentation index (AIx) was more strongly correlated with eGFR than office AIX. Twnety-four hour cSBP and cPP were more strongly correlated with lgACR. Office AIx and cPP were more strongly correlated with c-fPWV than 24-h measurements while cSBP, DBP, and cPP obtained by both methods were equally correlated with c-fPWV. Ambulatory central (aortic) pressure may be more strongly related to HMOD than office CAP which may have an advantage in screening for c-fPWV. Trial Registration: Registration number: ChiCTR2000040308.

Assessment of Liquefaction Potential in the Piura Region Using SPT and Shear Wave Velocity Measurements

Assessment of Liquefaction Potential in the Piura Region Using SPT and Shear Wave Velocity Measurements

Probing iron in Earth’s core with molecular-spin dynamics

Dynamic compression of iron to Earth-core conditions is one of the few ways to gather important elastic and transport properties needed to uncover key mechanisms surrounding the geodynamo effect. Herein, a machine-learned ab initio derived molecular-spin dynamics (MSD) methodology with explicit treatment for longitudinal spin-fluctuations is utilized to probe the dynamic phase-diagram of iron. This framework uniquely enables an accurate resolution of the phase-transition kinetics and Earth-core elastic properties, as highlighted by compressional wave velocity and adiabatic bulk moduli measurements. In addition, a unique coupling of MSD with time-dependent density functional theory enables gauging electronic transport properties, critically important for resolving geodynamo dynamics.

The Associations of Arterial Stiffness and Central Hemodynamics with Carotid Atherosclerosis in Patients at a High Coronary Risk: A Cross-Sectional Study

Introduction: It is not well-known which indicator, central blood pressure (CBP) or arterial stiffness, has a greater impact on carotid atherosclerosis. This study aimed to assess the associations of carotid atherosclerosis with arterial stiffness and CBP in the same individuals. Methods: A total of 142 patients (mean age: 69 years; 43% female) with documented atherosclerotic cardiovascular disease or multiple risk factors were analyzed. Brachial-ankle pulse wave velocity (baPWV) and CBP measurements, along with carotid ultrasound, were performed on the same day. CBP was assessed using radial artery tonometry. Results: In simple linear regression analysis, only baPWV exhibited a significant correlation with carotid intima-media thickness (CIMT) (r = 0.272; p = 0.001), whereas none of the CBP parameters (systolic, diastolic, pulse pressures, and augmentation index) correlated with CIMT (p > 0.05 for each). Multiple linear regression analysis indicated that baPWV had no significant association with CIMT after adjusting for age (p = 0.264). A higher baPWV (≥1,656 cm/s) was significantly associated with carotid plaque presence, even after accounting for potential confounders (odds ratio: 3.66; 95% confidence interval: 1.65–8.12; p = 0.001). Moreover, as the number of carotid plaques increased, there was a linear rise in baPWV (p < 0.001). None of CBP parameters were associated with the presence of carotid plaque (p > 0.05 for each). Conclusions: Among a high-risk Korean population, baPWV demonstrated a stronger association with carotid plaque presence and extent compared to CBP parameters. Thus, baPWV may serve as a valuable marker for identifying carotid plaque.

The Effect Of Co2-Brine-Rock Interaction Towards Sand Onset Modeling In Dolomite-Rich Sandstone: A Case Study In Air Benakat Formation, South Sumatera, Indonesia

Carbon Capture Utilization Storage (CCUS) into geological storage (e.g., Enhanced Oil or Gas Recovery) provides a solution to reduce CO­2 emissions. However, it still remains a potential operational problem, such as sand problem phenomena in producer wells. This study observes the phenomenon of sand problems in production wells possibly triggered by CO2-brine-rock interactions on CO2 injection in rich dolomite sandstone reservoir. This research performs several experimental works (i.e., time-lapse dry mass measurements, X-Ray Diffraction (XRD), Scanning Electron Microscope (SEM), and elastic wave measurements) by using CO2-brine-rock batch experimental setup as well as geochemical simulation to observe mineral dissolution, pore structures alteration as well as rock physics alteration due to CO2-brine-rock interactions. We used an outcrop sample of dolomite-rich sandstone from the Air Benakat Formation, South Sumatera, Indonesia. Our experimental and simulation works show that dolomite dissolution (dolomite reduction of ~4% after 14 soaking days), secondary porosity development (11% of visible porosity improvement), as well as rock strength reduction, occur indirectly (shown by elastic wave velocity, i.e. and reduction of ~3.8% and ~4.4%, respectively) due to CO2-brine-rock interactions. Subsequently, the results of elastic wave velocity measurements were then used to modify a considerable sand onset prediction (sand-free envelope) model. The modified model showed that the production well was more prone to sand problems due to CO2-brine-rock interactions. Thus, it is concluded that the sand onset prediction model with considering CO2-brine-rock interactions could help to design a better sand management strategy in producer wells.

A centrifuge modelling setup for dewatering, rewetting, and characterising soil deposits

Dewatering in soils serves various purposes in the field of geotechnical engineering as well as other disciplines. In geotechnical engineering, dewatering is effective for improving stability, reducing settlements, and limiting seepage of contaminated pore fluid. This study details the development of an experimental setup that enables dewatering and rewetting soil deposits in-flight in a geotechnical centrifuge while the pore pressures/suctions and moisture contents are measured. Cone penetration tests and shear wave velocity measurements are also used to characterise the material in-flight. Detailed discussion is provided regarding the construction of the tensiometers and calibration of the moisture content probes. Tests are performed on two coal combustion products (CCPs) to exemplify the capabilities of the equipment. Illustrative test results provide time histories and profiles of soil suction and water content at different depths, agreeing well with measurements from laboratory soil water retention curves. The results also show that dewatering of the CCP deposits leads to significant increases in strength and stiffness and, after subsequent rewetting, the material maintains a permanent increase in stiffness. The developed system enables an economical and reliable study of the impacts related to dewatering and rewetting cycles to fulfil research purposes in a broad range of engineering disciplines.

Effects of viscosity and induced magnetic fields on weakly nonlinear wave transmission in a viscoelastic tube using physics-informed neural networks

This study presents an advanced deep learning methodology that utilizes physics-informed neural networks (PINNs), to analyze the transmission of weakly nonlinear waves in a prestressed viscoelastic arterial tube. Using the long wave approximation, a mathematical model is constructed to replicate the propagation of weakly nonlinear waves in a viscoelastic arterial tube filled with viscous nanofluid, taking into account the influence of an induced magnetic field. The perturbed Burger, perturbed Korteweg–de Vries, and perturbed Korteweg–de Vries-Burgers equations are formulated based on the combined effects of nanofluid viscosity and the applied magnetic field using the reductive perturbation technique. Semi-supervised physics-informed neural network models are utilized to solve these perturbed evolutionary equations, trained on a limited dataset within their rectangular domain of definition. Gaussian process-based Bayesian optimization is used to determine the hyperparameters of the neural network, ensuring optimal model is performance. The effectiveness of the optimal models is evaluated by calculating the residual losses associated with the perturbed partial differential equations (PDEs). Visual representations of weakly non-linear wave propagation, considering nanofluid viscosity and induced magnetic fields, enhance the comprehension of dissipative effects in the cardiovascular system. These insights aid in obtaining precise measurements of pulse wave velocity for cardiovascular health monitoring. Consequently, the application of PINN proves to be a valuable tool for solving real-world PDEs and highlights its importance in advancing medical machine learning fields.

Shear wave elastography in the assessment of gastrocnemius spastic muscle elasticity: influences of ankle position and muscle contraction.

Following upper motor neuron syndromes (UMNS), intrinsic viscoelastic muscle properties such as elastic stiffness may be altered, which leads to muscle hyper-resistance to passive mobilization. So far, no gold standard assessment of hyper-resistance, whether clinical or instrumental, is available. Shear wave elastography (SWE) has been increasingly used for non-invasive evaluation of elastic stiffness of skeletal muscles in people with hyper-resistance. Our study aimed to evaluate the validity of SWE at ankle neutral resting position (ANRP). Additional objectives included assessing the influence of ankle position, muscle contraction, and laterality on elastic stiffness, and evaluating the reproducibility and responsiveness of SWE. Observational cohort study. Outpatients of the physical and rehabilitation medicine department of a university hospital in Brussels. Thirty hemiparetic patients following UMNS with hyper-resistance in gastrocnemii muscles. Elastic stiffness was quantified by shear wave velocity (SWV) measurements of gastrocnemii muscles. A higher SWV corresponds to a higher elastic stiffness. Measurements were performed on the affected and less-affected limbs in ANRP, in passive dorsiflexion and during isometric contraction. Assessments were performed 3 times. Criterion validity, reproducibility, and responsiveness were evaluated. A linear mixed model was used to study position and laterality effect. In ANRP, reproducibility was excellent and SWV was significantly higher in the affected limb than in the less-affected limb. This laterality effect disappeared in passive dorsiflexion and was even reversed during isometric contraction. SWV was significantly higher on both sides in passive dorsiflexion and during contraction than in ANRP. Our results suggest that SWE measurements in ANRP are reliable and may provide a more valid measurement of gastrocnemii elastic stiffness following UMNS. SWE may be a useful clinical tool as an extension of the physical exam for longitudinal monitoring of passive muscle elastic stiffness, to assist with treatment decisions and to better quantify the therapeutic effect of procedures to reduce muscle overactivity. However, a standardized protocol should be used. ANRP seems to be the most valid position for assessing gastrocnemius elastic stiffness in neurological populations. This should be kept in mind for the choice of positioning in further studies.

Rock Physics Modeling Studies on the Elastic and Anisotropic Properties of Organic-Rich Shale

Shale gas reservoirs have a large amount of resources, a wide range of burial, and great development potential. In order to evaluate the elastic properties of the shale, elastic wave velocity and anisotropy measurements of Longmaxi shale samples were carried out in the laboratory. Combined with the results of back scattering scanning electron microscopy (SEM) and digital mineral composition tests, the relationship between the anisotropy and the mineral components of the shale samples is discussed. It is found that the clay and kerogen combination distributed with an inorganic mineral background is the main cause of anisotropy. Then, the elastic properties of the organic-rich shale are analyzed with the anisotropic differential equivalent medium model (DEM). The clay and kerogen combination is established with kerogen as the background medium and clay mineral as the additive phase. The bond transformation is used to rotate the combination so that its directional arrangement is consistent with the real sedimentary situation of the stratum. Then, the clay and kerogen combination is added to the inorganic mineral matrix, with the organic and inorganic pores added to characterize the anisotropy of the shale to the greatest extent. It is found that the error between the wave velocity results calculated from the model and measured in the laboratory is less than 10%, which means the model is reliable. Finally, the effects of the microcracks and aspect ratio, kerogen content, and maturity on the elastic and anisotropic properties of shale rocks are simulated and analyzed with this model. The degree of anisotropy increases with the decrease in the pore aspect ratio and the increase in the microcracks content. The greater the kerogen content and maturity, the greater the anisotropy of rock. This study is of great significance for predicting the “sweet spot” of shale gas and optimizing hydraulic fracturing layers.

Sex-specific responses of central artery stiffness to cold pressor test-mediated sympathetic activation

Considerable attention has been devoted to investigating whether acute activation of the sympathetic nervous system, triggered by daily life stressors, increases central artery stiffness (CAS). Overt sex differences in sympathetic neurovascular transduction lead to distinct cardiovascular responses to sympathoexcitation in men versus women. Our study aimed to determine if the cold pressor test (CPT), chosen to simulate highly painful stressors individuals encounter daily, would induce CAS augmentation in a sex-balanced cohort of young individuals and whether any observed CAS increase would differ between sexes. Twenty-eight participants (14 men, 14 women) provided baseline and CPT measurements of carotid-femoral pulse wave velocity (cf-PWV), mean arterial pressure (MAP), cardiac output (CO), total peripheral resistance (TPR), and heart rate (HR). CPT involved immersing participants' feet in 5 °C ice-water slurry. Data were analyzed using 2-way analysis of variance and post hoc testing, where applicable. CPT significantly increased (p < 0.01) cf-PWV values in our population, with women showing lower collective CAS values compared to men across baseline and CPT conditions. CPT augmented (p < 0.01) MAP, HR, and CO without altering stroke volume (SV), but increased (p = 0.002) TPR only in men. Men collectively exhibited higher (p < 0.01) CO and SV values across baseline and CPT conditions, as well as lower (p < 0.01) TPR values compared to women. These results support the notion that CPT increases CAS in a healthy young population. Despite observed sex differences in peripheral vascular responses to CPT, these variances did not differently impact the central pressor response or central artery stiffening between sexes. Given the well-documented sex differences in cardiovascular risk and incidence, these findings deepen understanding of how cardiocirculatory responses differ between sexes under stress. These findings support sex-specific approaches in cardiovascular medicine and prevention, including tailored coping strategies for managing stress.

Evaluation of arterial stiffness and quality of life in the treatment of moderate to severe obstructive sleep apnea with Continuous Positive Airway Pressure or Mandibular Advancement Appliance: a cross-sectional study

BackgroundObstructive sleep apnea (OSA) is highly associated with a significant reduction in the Quality of Life (QoL) and is associated with deleterious effects on the cardiovascular system. Arterial stiffness is characterized by morphofunctional changes in the arteries and its assessment can be obtained non-invasively mainly through the measurement of pulse wave velocity (PWV). Arterial stiffness has been proposed as a predictor of cardiovascular diseases.ObjectiveTo compare arterial stiffness as well as QoL in patients diagnosed with moderate to severe OSA treated with Continuous Positive Airway Pressure (CPAP) or Mandibular Advancement Appliance (MAA) therapies.MethodsThis is a cross-sectional study involving 105 participants diagnosed with moderate to severe OSA categorized into three independent groups: A Non-treated Control Group and CPAP and MAA treated Groups. QoL was assessed by the Quebec Sleep Questionnaire (QSQ) and arterial stiffness was assessed noninvasively by Mobil-O-Graph.ResultsThe groups were homogeneous, except for the polysomnographic parameters Apnea and Hypopnea Index (AHI) (p = 0.036) and Minimum O2 saturation (p = 0.011) (evaluated to diagnose the OSA condition before treatment) and Body Mass Index (BMI) (p < 0.001). The MAA group presented higher scores in all QoL domains (p < 0.05), except Social Interactions in relation to the Control group. For the CPAP group, only Nocturnal Symptoms presented significantly higher scores compared to the control group (p = 0.39). For Arterial Stiffness, no statistical differences were observed among comparisons.ConclusionsOur results show better QoL scores in patients with OSA treated by CPAP and mainly by MAA. Differently, arterial stiffness parameters did not differ between the groups treated with CPAP and MAA and the control group.

Coil-Only High-Frequency Lamb Wave Generation in Nickel Sheets.

This study presents a novel, coil-only magnetostrictive ultrasonic detection method that operates effectively without permanent magnets, introducing a simpler alternative to conventional designs. The system configuration is streamlined, consisting of a single meander coil, an excitation source, and a nickel sheet, with both the bias magnetic field and ultrasonic excitation achieved by a composite excitation containing both DC and AC components. This design offers significant advantages, enabling high-frequency Lamb wave generation in nickel sheets for ultrasonic detection while reducing device complexity. Experimental validation demonstrated that an S0-mode Lamb wave at a frequency of 2.625 MHz could be effectively excited in a 0.2 mm nickel sheet using a double-layer meander coil. The experimentally measured wave velocity was 4.9946 m/s, with a deviation of only 0.4985% from the theoretical value, confirming the accuracy of the method. Additionally, this work provides a theoretical basis for future development of flexible MEMS-based magnetostrictive ultrasonic transducers, expanding the potential for miniaturized magnetostrictive patch transducers.

Coronary microvascular dysfunction in patients with heart failure with reduced and mildly reduced ejection fraction: results from the PANACEA study

Abstract Aims Coronary microvascular dysfunction (CMD) is common and associated with impaired survival in patients with heart failure with preserved ejection fraction (HFpEF). In patients with heart failure with reduced ejection fraction (HFrEF) and mildly reduced ejection fraction (HFmrEF) the impact of CMD is not fully known. Purpose We aimed to investigate the prevalence of CMD and its association with phenotype, biomarkers, endothelial function and echocardiographic measurements in patients with HFrEF or HFmrEF. Method A prospective, exploratory bi-center study in patients with chronic stable heart failure, New York Heart Association (NYHA) Class II-IV, and ejection fraction (EF) &amp;lt;50% was performed. Study procedures included echocardiography, adenosine-based transthoracic Doppler echocardiography to assess coronary flow reserve (CFR), physical examination, fasting blood and urine sample, pulse wave velocity (PWV) and hemodynamic measurements. The cutoff of CFR&amp;lt;2.5 was used to diagnose CMD. A multivariable linear regression analysis with CFR as dependent variable, adjusted for age, sex, body mass index, smoking, atrial fibrillation and left ventricular mass, was performed to explore biomarkers, endothelial function, and echocardiographic measurements associated with CMD. Results Of 112 included patients, 87 (78%) were men, with a mean age of 73.3 (±7.5) years. Among patients with a successful CFR measurement (n=62), CMD was present in 40 (65%), mean age of 75.4 (±5.8) years (Table 1). Patients with CMD had higher N-terminal pro B-type natriuretic peptide (NTproBNP) and Troponin T (p&amp;lt;0.05), and more often HFrEF ( p=0.06). Patients with CMD had larger ventricles with greater left ventricular mass and larger end-diastolic volumes (p&amp;lt;0.05). In a linear regression analysis CMD was associated with higher NTproBNP, lower EF, PWV and global strain (table 2). Conclusion CMD was common and present in two thirds of patients with HFrEF or HFmrEF. Further CMD was associated with markers of more severe heart failure and systemic endothelial dysfunction indicating that CMD may be an important predictor of outcome in patients with HFrEF and HFmrEF.

Incremental prognostic value of combined information of arterial stiffness and the result of treadmill exercise test in patients with suspected coronary artery disease

Abstract Background The effectiveness of diagnostic tools can be enhanced by their combination. We aimed to investigate whether arterial stiffness data, obtained by brachial-ankle pulse wave velocity (baPWV) measurement, could improve prognostic value to exercise treadmill test (ETT) to predict future cardiovascular events. Methods A total of 1,788 consecutive subjects (mean age 55.8 ± 10.7 years, 59.1% men) with suspected of having coronary artery disease (CAD), who underwent ETT and baPWV on the same day were prospectively recruited. The study outcome was major adverse cardiac and cerebrovascular event (MACCE), a composite of cardiac death, non-fatal myocardial infarction, coronary revascularization and ischemic stroke. Results During a mean follow-up period of 875 days (interquartile range, 116–2,212 days), there were 88 cases of MACCE (4.9%). The elevated baPWV (≥ 1,440 cm/s) (hazard ratio [HR] 5.18; 95% confidence interval [CI] 2.68–10.0; P &amp;lt; 0.001) and positive ETT result (HR 2.81; 95% CI 1.77–4.47; P &amp;lt; 0.001) were associated with MACCE even after adjustment for potential confounders. The combination of baPWV to traditional risk factors and ETT result further stratified the subjects’ risk (low baPWV and negative ETT result vs. high baPVW and positive ETT result; HR 16.44; 95% CI 6.17–43.78; P &amp;lt; 0.001). Conclusions Arterial stiffness, assessed by baPWV, had incremental prognostic value to ETT result in patients with suspected of CAD. baPWV can serve as a useful clinical tool for risk stratification in this high-risk patient population.Kaplan-Meier survival curveMultivariable cox analysis

Serpina3c deficiency aggravates vascular dysfunction and VSMC dysregulation through regulating adamts4 pathway activity in obese mice

Abstract Background Obesity leads to arterial stiffness (AS), which is an independent risk factor for cardiovascular disease. Vascular smooth muscle cell (VSMC) dysfunction is a critical step in the development of AS. Adamts4 (a disintegrin and metalloproteinase with thrombospondin motifs 4) promoting the ECM remodeling can regulate VSMC differentiation. Serpina3c is a serine protease inhibitor that plays a key role in VSMC proliferation and metabolic diseases. Purpose The present study aimed to investigate the function of Serpina3c in high-fat diet (HFD)-induced AS and regulation of VSMC phenotypic switching and possible mechanisms. Methods 8-week-old male Serpina3c-/- and C57BL/6 mice were fed normal diet (ND) or HFD for 12 weeks. The adipocyte-specific Serpina3c overexpression (AAV8-Serpina3c) were constructed and injected in situ into visceral or perivascular adipose tissue (AT) of Serpina3c-/- mice fed a 12-week HFD to test in vivo effect of AT-derived Serpina3c on arterial stiffness. In vivo vascular stiffness was analyzed by obtaining pulse wave velocity (PWV) measurements. Aortic rings were dissected to assess the ex-vivo effects of Serpina3c deprivation on vascular contractile and diastolic function. Elastin van Gieson (EVG) and Hematoxylin-eosin (H&amp;E) staining were implemented to observe the pathological morphology of aortas. IP-Western analysis was performed for identifying Serpina3c-adamts4 interactions. Results The obese WT mice exhibited significantly increased PWV values, compared with ND-fed mice, which were further increased in HFD+Serpina3c-/- mice (Fig. 1A). Phenylephrine-induced vascular constriction was impaired in HFD fed mice and further deteriorated with Serpina3c deficiency (Fig. 1B). No differences were noted in the endothelial-dependent acetylcholine-mediated relaxation in HFD-fed mice. Notably, Serpina3c-/- mice exhibited poorer endothelium-independent sodium nitroprusside induced relaxation (Fig. 1C and D). The HFD+Serpina3c-/- mice showed an increased breakage of elastin fibres and medial thickness compared with the aortas of HFD+WT mice (Fig. 1E and F). Serpina3c deprivation aggravated collagen deposition and matrix metalloproteinases (MMPs, MMP2 and MMP9) accumulation. VSMC contractile gene α smooth muscle actin were upregulated and synthetic phenotype marker osteopontin were downregulated in HFD+WT mice. The effect was more pronounced in aortas with Serpina3c deficiency (Fig. 1G and H). Overexpression of serpina3c in both visceral and perivascular AT or adamts4 deprivation reversed the above phenotypes. Computer simulations and IP-Western results indicate that Serpina3c and adamts4 bind to and maintain the latter low-expression in response to obesity (Fig. 2). Conclusion Serpina3c interacts with adamts4 to maintain contractile phenotype of VSMC and suppress AS development in the context of nutrient excess. Serpina3c is a novel target for the prevention and treatment of obesity associated artery disease.Serpina3c maintains vascular functionSerpina3c interacts with adamts4

Bayesian Ensemble Kalman Filter for Gaussian Mixture Models

Inverse theory and data assimilation methods are commonly used in earth and environmental science studies to predict unknown variables, such as the physical properties of underground rocks, from a set of measured geophysical data, like geophysical seismic or electromagnetic data. A new Bayesian approach based on the ensemble Kalman filter using Gaussian mixture models is presented to overcome the assumption of Gaussian distribution of the unknown variables commonly used in the data assimilation literature and to generalize the algorithm to inverse problems with multimodal probability distributions. In applications of subsurface characterization, the multimodality of the unknown variables is generally due to the presence of different rock types, also known as geological facies. In the proposed method, the weights of the Gaussian mixture model represent the facies proportions, and they follow a Markov chain model. The proposed Bayesian model generates the unknown model parameters conditioned on measured data using a Markov chain Monte Carlo sampler. The validity of the method is demonstrated on a data assimilation problem where the goal is to estimate the posterior distribution of the unknown rock density from a set of repeated measurements of acoustic wave velocity measured at different times. The proposed method provides accurate estimates with efficient computational times.