Measure Of Arterial Stiffness Research Articles

INTERMACHINE VARIABILITY BETWEEN THE SPHYGMOCOR CVMS AND SPHYGMOCOR XCEL DEVICE IN YOUNG HEALTHY ADULTS: A PILOT STUDY

Objective: Carotid-femoral pulse wave velocity (cf-PWV) is considered the gold-standard measure for arterial stiffness. The SphygmoCor CVMS uses applanation tonometry on the carotid and femoral arteries, synchronized with an ECG signal. The more recent SphygmoCor XCEL eliminates the need for ECG gating by utilizing leg cuff detection of the femoral pulse in conjunction with carotid tonometry. The latter method is more time-efficient, but may yield different cf-PWV values. The aim of this pilot study is to validate the use of the SphygmoCor XCEL against the SphygmoCor CVMS. Design and method: Measurements of the right carotid and femoral artery were conducted using the SphygmoCor CVMS (AtCor Medical), immediately followed by the SphygmoCor XCEL (AtCor Medical). These measurements were performed under standardized conditions, namely in a fasted state and after 15 minutes of rest in a supine position in a quiet room (20̊). All measurements were done in triplicate and were repeated when they did not meet the quality control guidelines, as defined by the manufacturer. The mean difference and SD of the difference between the two devices was calculated and visualized through scatter plot and Bland-Altman analysis. Correlation coefficient as well as intraclass correlation (ICC) was calculated. Results: A total of nine (5 females) non-smoking, physically active individuals were included, with a MEDIAN age of 21 years (21-36) and MEDIAN BMI of 21.8 (18,4-25,8). Mean cf-PWV measured by SphygmoCor CVMS was 8.11 ± 0.69 m/s and by SphygmoCor XCEL was 7.61 ± 0.16 m/s. Measurements by both techniques were significantly correlated (R = 0,75; P<0,05; Fig1). The mean difference between the two measurement techniques was 0.50 ± 0.81 m/s, which is ‘acceptable’ according to the ARTERY Society guidelines. Bland-Altman analysis revealed limits of agreement ranging from -1.09 to 2.09 m/s. A ‘moderate’ agreement was documented (ICC = 0.51). Conclusions: In this pilot study, the SphygmoCor XCEL demonstrated acceptable agreement with the SphygmoCor CVMS. Bland-Altman plots show that with higher cf-PWV values, there could be a tendency towards overestimation of the cf-PWV by the SphygmoCor EXCEL. Further validation is needed in larger cohorts and other populations.

WHAT IS THE SMALLEST CHANGE IN PULSE WAVE VELOCITY MEASUREMENTS THAT CAN BE ATTRIBUTED WITH CERTAINTY TO CLINICAL CHANGES IN ARTERIAL STIFFNESS? A RANDOMIZED CROSS-OVER STUDY

Objective: Pulse wave velocity (PWV), a direct measure of arterial stiffness, is a promising biomarker of cardiovascular risk and a cardiovascular surrogate outcome. However, there is no general agreement on the expected reproducibility of PWV which hampers identification of the smallest change in PWV that is clinically significant. The objectives of this study were to estimate the reproducibility of PWV measurements over the course of two weeks in a diverse group of participants and under experimental conditions that are clinically relevant (two observers, morning/afternoon sessions, different number of visits); and to investigate factors that could reduce this reproducibility. Design and method: Using the SphygmoCor CvMS and Arteriograph devices, we were able to estimate the level of PWV reproducibility as the range of intra-subject values that were observed during the study. Every participant was recorded a total of 12 times with each device, spread out over the course of three visits spaced one week apart, with each visit consisting of two morning and two afternoon recordings. Multilevel mixed-effect models were used to identified factors affecting large discrepancies between consecutive PWV measurements for each device. Results: We show that current guidance on PWV-estimation (at least two PWV measurements, and if their difference exceeds 0.5 m/s, a third measurement) is suboptimal because PWV range for most participants was outside 1 m/s threshold, which has been proposed as minimal clinically-important-difference. The best reproducibility was yielded with median of 4 measurements and 1.1 m/s threshold. Regarding PWV reproducibility and repeatability, which are frequently used interchangeably in studies, while the range showed distinct difference between them, commonly used relative measures of variability, such as coefficient of variability, were comparable. We also found that different physiological variables were predictors of discrepancy between consecutive measurements for two devices, which is likely due to their distinct modes of operation. Conclusions: The evidence base for PWV reproducibility is limited, and more research is needed to deepen our understanding of variation in arterial stiffness over time, as well as fluctuations within a population group and in an intervention setting.

EARLY DIAGNOSIS OF HYPERTENSIVE DISEASE IN YOUTH WITH NORMAL SYSTOLIC AND DIASTOLIC BLOOD PRESSURE LEVELS

Objective: Hypertensive cardiovascular disease can develop functional and/or structural organ damage by the increase of the volume/pressure and arterial stiffness, even before the current cut-off level of the systolic/diastolic blood pressure. The aim of this study was to evaluate in a young population with normal blood pressure levels if they presented any cardiovascular risk factors, arterial stiffness, signs, and symptoms of hypertensive disease. Design and method: This is a retrospective cross-sectional study developed between the years 2007/2022 from 9,600 non-invasive applanation tonometry, females-males 200-103 were entered, with an age range of 18 and 30 years old, and an average age of 24 years. Patients made their first cardiology visit without a previous diagnosis of arterial hypertension or decompensated associated diseases with a blood pressure not higher than 130/80 mmHg. Anthropological data, systolic/diastolic blood pressure, and heart rate were registered. Central Haemodynamics Parameters were measured with a SphygmoCor-PVX device (AtCor, Australia), a validated system employing the high-fidelity technique of applanation tonometry according to established protocols. Results: The average systolic/diastolic blood pressure among female-male was 112.9/72.4 mmHg-119.8/73.9 mmHg, respectively. Also, the Central Aortic Pressure in the female-male groups was 100.0 mmHg/103.7 mmHg, while the maximum values are 101.5 mmHg/106.0 mmHg, but the differences between the observed values and the normal levels of the Augmentation Index (a surrogate measure of arterial stiffness) were higher than normal in female-male 3.6%-4.6% indicating an incipient arterial stiffness. Into the female-male groups, were observed hyperlipidemia 10%-10%, smoking 26%-20%, minimal-mitral regurgitation 5%-8%, headache 46%-26%, palpitations 33%-25%, asthenia 22%-14%, sweating 9%-14%, and chest-pain 16%-27%, respectively. The percentage of women who had a history the polycystic ovarian syndrome was 19%, and the women in current or former estrogen-progesterone therapy were 17%-12%, respectively. Among the female-male groups that do not register any risk factor, symptoms, signs, or arterial stiffness were 8.5%-10%. Conclusions: In young people with normal blood pressure values, it is important to know the risk factors, symptoms, signs, and arterial stiffness of hypertensive disease for early diagnosis and to be able to optimize the time to start therapy.

EFFECT OF ORAL FLAVONOIDS ON ARTERIAL STIFFNESS IN CKD – A PILOT PROSPECTIVE STUDY

Objective: Flavonoids, the main category of polyphenols possess antioxidative and antihypertensive properties mediated through endothelial protection, renin-angiotensin-aldosterone and sympathetic system suppression. The aim of the study was to evaluate the effect of oral flavonoids administration in arterial stiffness indices and of oxidative stress markers in patients with Chronic Kidney Disease (CKD). Design and method: The enrolled patients received chocolate bars rich in polyphenols (200 mg) daily for a period of 3 months The patients underwent clinical examination and laboratory test arterial stiffness measurements with Sphygmocor. Markers of oxidative stress (total phenolic contents, total plasma antioxidant capacity, protein carbonyls) were also measured. Results: Sixteen patients were enrolled in the study, [median age 62.5 years (± 8,2), 14 patients (87,5%) were male]. Clinical characteristics, blood pressure measurements, arterial stiffness indices and markers of oxidative stress are summarized in table 1,2 and 3. Peripheral systolic Blood Pressure (PSBP) was decreased by 13,56 mmHg (± 2,57), (p<0,001). Pulse wave velocity (PWV) and central pulse pressure (CPP) were significantly decreased (8,2 m/sec (5,1-9,22), vs 8,85 m/sec (6,7-11,75), (p<0,001) and 47,63 (36,5-60) versus [59,13 mmHg (43,5-69 respectively) at the end of the study], (p = 0,003). Markers of oxidative stress were also improved. A decreased in plasma proteinic carbonyls 52,54 nmol/ml ± 25,04 versus (73,50 nmol/ml ± 18,65, (p<0,001) was observed while antioxidative capacity was increased 3,55% (1,15-6,38) versus 12,51% (6,26-17,66) (p = 0,013). Importantly no side effects were observed during the study period. Conclusions: In this pilot study, oral flavonoid supplementation in the dose of 200 mg may improve arterial stiffness indices and systolic blood pressure measurements and contribute to the improvement of antioxidative capacity in CKD patients.

Effect of Vitamin D on Arterial Stiffness in People with Type 2 Diabetes and Intermediate Chronic Kidney Disease

Background: The aim of this study was to investigate the effect of vitamin D therapy on arterial stiffness on diabetic type 2 with intermediate chronic kidney diseases patients. Study design: This was a cross sectional study conducted at Sialkot Medical College, Sialkot for six months from September 2022 to February 2023. Methods: There were 160 participants in total included both male and female gender. The age range was 40-75 years, but majority participants included male 90%. The pulse wave velocity (PWV), 2000 wave unit was measured the arterial stiffness. In an approved laboratory, biochemical parameters such vitamin D, FGF-23, iPTH were assessed by enzyme linked immunoassay, and chemiluminescence immunoassay. Results: A total of 160 participants who were randomly assigned to receive either a placebo (n = 60) or vitamin D (n = 100) were qualified for analysis. The eGFR, serum calcium, phosphate, HbA1c, total cholesterol level, and albumin excretion in both groups did not change significantly throughout therapy; p>0.005. Vitamin D deficiency was significantly increase, p <0.001** in participants, then increased aortic-PWV in the vitamin D therapy group compared to the placebo group. Ao-PWV did not change significantly at the end of the treatment, P>0.005. There is no significant impact of vitamin D on arterial stiffness. Conclusion: In T2DM with moderate CDK, the aortic-PWV, augmentation index, and pressure measurements of arterial stiffness were all substantially higher in the vitamin D deficient group compared to the vitamin D sufficient group. Keywords: Chronic kidney disorder, Diabetes type 2, Pulse wave velocity, Aortic.

Number of prior live births is associated with higher arterial stiffness but not its change in older women: the atherosclerosis risk in communities study.

Although studies have demonstrated a J-shaped association between parity and cardiovascular disease (CVD), the association with arterial stiffness is not fully understood. We examined the association between parity and carotid-femoral pulse wave velocity (cfPWV), a measure of central arterial stiffness. We conducted a longitudinal analysis of 1220 women (mean age 73.7 years) who attended the Atherosclerosis Risk in Communities Study visit 5 (2011-2013). At visit 2 (1990-1992), women self-reported parity (number of prior live births), which we categorized as: 0 (never pregnant or pregnant with no live births); 1-2 (referent); 3-4; and 5+ live births. Technicians measured cfPWV at visit 5 (2011-2013) and visit 6 or 7 (2016-2019). Multivariable linear regression modeled the associations of parity with visit 5 cfPWV and cfPWV change between visit 5 and 6/7 adjusted for demographics and potential confounding factors. Participants reported 0 (7.7%), 1-2 (38.7%), 3-4 (40.0%), or 5+ (13.6%) prior live births. In adjusted analyses, women with 5+ live births had a higher visit 5 cfPWV (β=50.6 cm/s, 95% confidence interval: 3.6, 97.7 cm/s) than those with 1-2 live births. No statistically significant associations were observed for other parity groups with visit 5 cfPWV or with cfPWV change. In later life, women with 5+ live births had higher arterial stiffness than those with 1-2 live births, but cfPWV change did not differ by parity, suggesting women with 5+ live births should be targeted for early primary prevention of CVD given their higher arterial stiffness at later-life.

Relationship between measures of adiposity, blood pressure and arterial stiffness in adolescents. The MACISTE study.

Children and adolescents with adiposity excess are at increased risk of future cardiovascular (CV) disease. Fat accumulation promotes the development of elevated blood pressure (BP) and arterial stiffness, two main determinants of CV risk which are strongly inter-related. We aimed at investigating whether the association between overweight and arterial stiffness, taken at different arterial segments, is mediated by increased BP or is BP-independent. Three hundred and twenty-two Italian healthy adolescents (mean age 16.9±1.4 years, 12% with overweight) attending the "G. Donatelli" High School in Terni, Italy, underwent measurement of arterial stiffness by arterial tonometry (aortic stiffness) and semiautomatical detection of pressure-volume ratio of the common carotid (carotid stiffness). The mediator effect of BP was tested for each anthropometric or biochemical measure of fat excess related to arterial stiffness. Both carotid and aortic stiffness showed positive correlations with body mass index, waist, hip, and neck circumferences (NC). Only carotid stiffness, but not aortic stiffness, was associated with serum markers of fat accumulation and metabolic impairment such as insulin, homeostatic model of insulin resistance (HOMA-IR), serum gamma-glutamyl transferase (sGGT) and uric acid. The association with NC was stronger for carotid than for aortic stiffness (Fisher z -to- R 2.07, P = 0.04), and independent from BP. In healthy adolescents, fat accumulation is associated with arterial stiffness. The degree of this association differs by arterial segments, since carotid stiffness is more strongly associated to adipose tissue excess than aortic stiffness and shows a BP-independent association with NC whereas aortic stiffness does not.

P432 ARTERIAL STIFFNESS AND CARDIOVASCULAR RISK IN PATIENTS WITH NEPHROLITIASIS: A 10–YEAR PROSPECTIVE STUDY

Abstract Nephrolithiasis is frequently associated with several cardiovascular diseases, and the pathophysiological connection may rely on some common risk factors. In fact, systemic inflammation, promoting oxidative stress, may lead to arterial wall stiffening (which is considered an independent predictor of cardiovascular risk); however, the same mechanism may also play a role in Randall’s plaques deposition, which is a predisposing step to nephrolithiasis. This study aims to examine the correlation between arterial stiffness and nephrolithiasis, exploring its trend across aging. 82 patients (mean age 45±13 years, 36 males) referred to Geriatrics and Nephrology Outpatient Clinic were prospectively enrolled: at baseline and after 10 years they underwent a clinical evaluation (with particular focus on cardiovascular events and risk factors), and arterial stiffness measurement, obtaining carotid–femoral Pulse Wave Velocity (PWVcf) by arterial applanation tonometry. 66 patients were diagnosed with nephrolithiasis, whereas the remaining 16 formed the control group. At baseline, compared to the control group, patients with nephrolithiasis showed higher systolic blood pressure and PWVcf (128±18 vs 117±16 mmHg, p 0.02 and 7.78±1.53 vs 6.50±1.13 m/s, p 0.001 respectively). After 10 years, patients with nephrolithiasis (p 0.001), but not patients without (p 0.081), had a significant raise in PWVcf, as compared to the baseline evaluation (10.64±3 vs 7.78±1.55 m/s); this trend was confirmed even after adjustment for age and sex. In a backward regression model, considering PWVcf variation over the follow up years (ΔPWVcf) as dependent variable, and age, sex, follow up years, Δ mean arterial pressure, Body Mass Index, hypertension and nephrolithiasis as independent variables, nephrolithiasis was proved to be the only significant predictor of ΔPWVcf, accounting for 6.9% of the variance (p 0.027). In conclusion, the present study outlines an increased cardiovascular risk in patients affected by nephrolithiasis, which is represented by higher baseline PWVcf and wider increase in ΔPWVcf within 10 years. These findings endorse a comprehensive evaluation in subjects with nephrolithiasis, moving beyond the nephrological condition, and considering the patient’s cardiovascular risk profile, to identify, to prevent or to treat any possible organ damage.

Endovascular aortic repair impact on myocardial contractility: A prospective study.

This study aimed to estimate if the altered sphygmic wave transmission may affect the left ventricular (LV) contractile function in patients undergoing endovascular aortic repair (EVAR). A prospective single-centre study was carried out on consecutive patients undergoing EVAR for abdominal aortic aneurysm. A preoperative and 6-month single photon emission computed tomography (SPECT) with arterial stiffness measurement were performed to evaluate variations in pressure wave curve and myocardial perfusion parameters. From 2018 to 2020 a total of 16 patients were included in the study. Among the parameters evaluated, we found a measurable reduction of the reflected wave transit time from pre- to postoperative period, for both stress (115.13 ± 7.2 ms-111.1 ± 7.0 ms, p = .08) and rest SPECT acquisitions (115.3 ± 6.2 ms-112.2 ± 5.6 ms, p = .1). Unidirectional increase of both LV end-systolic volume (34 ± 9 mL-39 ± 8 mL, p = .02) and end-diastolic volume (85 ± 34 mL-89 ± 29 mL, p = .6) was also observed. Lastly, the ratio between the end-systolic pressure and the end-systolic volume (maximal systolic myocardial stiffness) decreased from 3.6 ± 1.5 mmHg/mL to 2.66 ± .74 mmHg/mL (p = .03). Our data showed that EVAR induced an altered transmission of the sphygmic wave associated with an early LV contractile impairment.

The effect of isometric exercise training on arterial stiffness: A randomized crossover controlled study.

Isometric exercise training (IET) is an effective intervention for the management of resting blood pressure (BP). However, the effects of IET on arterial stiffness remain largely unknown. Eighteen unmedicated physically inactive participants were recruited. Participants were randomly allocated in a cross-over design to 4 weeks of home-based wall squat IET and control period, separated by a 3-week washout period. Continuous beat-to-beat hemodynamics, including early and late systolic (sBP 1 and sBP 2, respectively) and diastolic blood pressure (dBP) were recorded for a period of 5 min and waveforms were extracted and analyzed to acquire the augmentation index (AIx) as a measure of arterial stiffness. sBP 1 (-7.7 ± 12.8 mmHg, p = 0.024), sBP 2 (-5.9 ± 9.9 mmHg, p = 0.042) and dBP (-4.4 ± 7.2 mmHg, p = 0.037) all significantly decreased following IET compared to the control period. Importantly, there was a significant reduction in AIx following IET (-6.6 ± 14.5%, p = 0.02) compared to the control period. There were also adjacent significant reductions in total peripheral resistance (-140.7 ± 65.8 dynes·cm-5, p = 0.042) and pulse pressure (-3.8 ± 4.2, p = 0.003) compared to the control period. This study demonstrates an improvement in arterial stiffness following a short-term IET intervention. These findings have important clinical implications regarding cardiovascular risk. Mechanistically, these results suggest that reductions in resting BP following IET are induced via favorable vascular adaptations, although the intricate details of such adaptations are not yet clear.

Age-related impacts of wave transmission at the aorta-carotid bifurcation on local and global measures of arterial stiffness

Wave reflections in the periphery have been key in the understanding of aging-related changes in global arterial stiffness, as measured by carotid-femoral pulse-wave velocity (cfPWV). However, recent investigations have demonstrated benefits of using local measures of aortic arch PWV (aaPWV) in addition to considering cfPWV. The contribution of proximal wave reflections at the aorta-carotid bifurcation to aaPWV, as well as to the increasing discordance between aaPWV and cfPWV previously observed with aging, remain poorly understood. The purpose of the present investigation was to examine the impact of transmission of pressure and flow at the aorta-carotid bifurcation on aaPWV and cfPWV in healthy younger and older individuals. We hypothesized that aging-related stiffening of the carotid artery would enhance pressure transmission at the aorta-carotid bifurcation and redirect flow transmission towards a greater relative flow in the distal aortic arch, increasing cfPWV but having minimal impact on aaPWV. We recruited 15 participants, stratified into young adults (YA; n = 8, 4 women; age 20 ± 2.7 years) and older adults (OA; n = 7, 4 women; age 53 ± 2.2 years). Both aaPWV and cfPWV were assessed with ultrasound (Logiq S8, GE Healthcare) via the conventional foot-to-foot velocity waveform method. Carotid artery PWV (caPWV) was calculated using the Bramwell-Hill equation using M-mode scans and carotid pressure waveforms. Carotid, proximal, and distal aortic impedances were derived using estimated blood density, PWV values, and vessel cross-sectional areas. These impedance values allowed for calculation of the pressure and flow transmission coefficients describing the aorta-carotid bifurcation. Sex and BMI were not significantly different between groups (p > 0.05). YA had significantly lower cfPWV (5.2 ± 0.6 vs. 6.8 ± 0.8 m/s, p < 0.05) and caPWV (10.6 ± 0.9 vs. 16.9 ± 1.2 m/s, p < 0.05); however, aaPWV was similar between groups (p > 0.05). This resulted in a reduced pressure transmission coefficient in YA (0.91 ± 0.07 vs. 0.99 ± 0.05, p < 0.05) as well as a greater transmission of flow into the carotid artery relative to the distal aortic arch, represented as the carotid flow transmission coefficient over the distal aortic flow transmission coefficient (0.70 ± 0.20 vs. 0.41 ± 0.1, p <0.05). Linear regression indicated a significant association between caPWV and cfPWV in the entire group, even after adjustment for age, sex and BMI (β = 0.597, p = 0.01) whereas caPWV was not associated with aaPWV in univariate or multivariate analyses. Consistent with our hypothesis, present analyses suggest a role for pressure and flow transmission at the aorta-carotid bifurcation in the dissociation between local stiffness of the proximal aorta (aaPWV) and global arterial stiffness (cfPWV). This highlights the systemic nature of cfPWV, and suggests a need for specificity in the measure of arterial stiffness used and the target outcome of a given study. This is the full abstract presented at the American Physiology Summit 2023 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.

Study protocol of the InterVitaminK trial: a Danish population-based randomised double-blinded placebo-controlled trial of the effects of vitamin K (menaquinone-7) supplementation on cardiovascular, metabolic and bone health

IntroductionVitamin K has been suggested to have protective effects against progression of vascular calcification and development of cardiovascular disease (CVD). However, few well-powered randomised controlled trials have examined whether vitamin...

Excess adiposity contributes to higher ambulatory central blood pressure and arterial stiffness in physically inactive young adults.

It remains unknown if physical inactivity and excess adiposity increases 24-h central blood pressure and arterial stiffness in young adults. This study examined 24-h central blood pressure and indirect measures of arterial stiffness (e.g., central pulse pressure) in physically inactive young adults with and without excess adiposity. Body fat and ambulatory 24-h blood pressure were measured in 31 young adults (men: 22±4 years, N.=15; women: 22±5 years, N=16). Multi-frequency bioelectrical impedance measured body fat. Normal adiposity was defined as <20% body fat in men and <32% body fat in women, whereas excess adiposity was defined as ≥20% and ≥32% in men and women, respectively. Ambulatory 24-h central blood pressure was calculated based on brachial blood pressure and volumetric displacement waveforms. By design, the normal adiposity group had a lower body fat percentage (men: 15.5±4.6%; women: 20.8±2.5%) compared to the physically inactive excess adiposity group (men: 29.8±5.4%; women: 34.3±7.5%). Men and women with excess adiposity group had elevated central blood pressure (central systolic, P<0.05 vs. normal adiposity groups). Central pulse pressure was elevated in the excess adiposity group (men: 45±5 mmHg; women: 41±9 mmHg) compared to normal adiposity groups (men: 36±4 mmHg; women: 32±3 mmHg, P<0.05 for both), while other arterial stiffness (augmentation index and ambulatory arterial stiffness index) measures trended toward significance only in men with excess adiposity. Physically inactive men and women with excess adiposity have increased 24h central blood pressure and pulse pressure compared to physically inactive young adults with normal adiposity.

Hypertension Reduces Aortic Strain in Both Sexes, but only Aorta from Female Rats Showed Increase in Stress: The Role of Appropriate Normalization Method to Evaluate Strain-Stress Parameters

The gold standard of arterial stiffness measurements in isolated aorta is the stress-strain (SS) relationship. Wall thickness (WT) and artery inner diameter (ID) are variables that plot the SS curve and should be normalized to the dimensions of the individual subject. Previously, we used measurements from the current literature, but the data collected were not accurate. Therefore, we hypothesized that the measurements of the vascular structure using echocardiogram (ECHO) should be applied to evaluate tissue puller to obtain SS data. With that, we also hypothesized that aorta from spontaneously hypertensive rats (SHR) has greater stress and lower strain levels than normotensive Wistar rats. To test this hypothesis, thoracic aorta parameters from 3-month-old male Wistar (WM) (body weight: 449±6.87g, n=4), SHR male (SM) (body weight: 295±3.34g, n=4), Wistar Female (WF) (body weight: 250±8.50g, n=4), and SHR Female (SF 169.4±2.69g, n=4) rats were measured from an ECHO. After, animals were killed and aortas were cut in 2 mm segments and mounted on Tissue Puller to measure SS. The inner diameter (ID) and wall thickness (WT) were measured by the ECHO for all animals: [WM (WT: 0.519±0.014mm, ID: 2.042±0.11mm), SM (WT: 0.485±0.026mm, ID: 2.023±0.055mm), WF (WT: 0.504±0.01mm, ID: 1.628±0.092mm), SF (WT: 0.521±0.011mm, ID: 1.64±0.099mm)] and there were no significant difference between these values. We then normalized the SS curves to each of the arteries’ parameters for ECHO and we found there were significant decreases in the strain values in aorta from hypertensive rats, regardless of sex (WM: 1.775±0.108 vs SM: 1.370±0.058; p=0.0146), and (WF: 2.056±0.218 vs. SF: 1.713±0.224; p=0.0517). We found a trend in the stress from female rats (WF: 1367±61 mN/mm2 vs SF 2361±391 mN/mm2; p=0.0597). There were no differences between male rats (WM:1.269±153 mN/mm2 vs SM: 1319±80 mN/mm2; p=0.671).Overall, these data show that ECHO should be used to accurately measure rat aorta structural parameters under the tissue puller. They also show SHR and Wistar were different in both sexes in strain, but only female SHR vs Wistar showed differences in stress. National Institutes of Health - R00GM118885, R01HL149762, and R00HL151889. and McNair Junior Fellows (MJF) Program This is the full abstract presented at the American Physiology Summit 2023 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.

Estimated pulse wave velocity is associated with all-cause and cardio-cerebrovascular disease mortality in stroke population: Results from NHANES (2003-2014).

Arterial stiffness is a significant determinant and evaluation of cardio-cerebrovascular disease and all-cause mortality risk in the stroke population. Estimated pulse wave velocity (ePWV) is a well-established indirect measure of arterial stiffness. We examined the association of ePWV with all-cause and cardio-cerebrovascular disease (CCD) mortality in the stroke population in a large sample of US adults. The study design was a prospective cohort study with data from the National Health and Nutrition Examination Survey (NHANES) from 2003 to 2014, between the ages of 18-85 years, with follow-up through December 31, 2019. 1,316 individuals with stroke among 58,759 participants were identified and ultimately, 879 stroke patients were included in the analysis. ePWV was calculated from a regression equation using age and mean blood pressure according to the following formula: ePWV = 9.587 - (0.402 × age) + [4.560 × 0.001 × (age2)] - [2.621 × 0.00001 × (age2) × MBP] + (3.176 × 0.001 × age × MBP) - (1.832 × 0.01 × MBP). Survey-weighted Cox regression models were used to assess the association between ePWV and all-cause and CCD mortality risk. The high ePWV level group had a higher increased risk of all-cause mortality and CCD mortality compared to the low ePWV level group after fully adjusting for covariates. With an increase in ePWV of 1 m/s, the risk of all-cause and CCD mortality increased by 44%-57% and 47%-72% respectively. ePWV levels were linearly correlated with the risk of all-cause mortality (P for nonlinear = 0.187). With each 1 m/s increase in ePWV, the risk of all-cause mortality increased by 44% (HR 1.44, 95% CI: 1.22-1.69; P < 0.001). When ePWV was <12.1 m/s, an increase in ePWV per 1 m/s was associated with a 119% (HR 2.19, 95% CI: 1.43-3.36; P < 0.001) increase in CCD mortality risk; when ePWV was ≥12.1 m/s, an increase in ePWV per 1 m/s was not associated with in CCD mortality risk. ePWV is an independent risk factor for all-cause and CCD mortality in stroke patients. Higher levels of ePWV are associated with higher all-cause mortality and CCD mortality in stroke patients.

51. Clinical Outcomes and Arterial Stiffness Measurement of White-Coat Hypertension: A Systematic Review and Meta-Analysis

Background: As one of the risk factor of cardiovascular diseases, white-coat hipertension (WCH) prognosis is remains debatable regarding its clinical outcomes. Current study results on the association between WCH and cardiovascular outcomes as well as arterial stiffness are inconsistent. Objective: To assess the risk of cardiovascular outcomes as well as arterial stiffness measurement in untreated participants with WCH compared to that with normotension. Method: Based on prespecified search strategies and inclusion criteria, PubMed, ScienceDirect, Cochrane Library databases were reviewed. Literatures were screened for data extraction and quality assessment. Our primary outcomes of interest were all-cause mortality, and onset of cardiovascular disease (stroke and cardiac events), as well as the arterial stiffness measurement using carotid-femoral pulse wave velocity (cf-PWV). Overall analysis and subgroup analysis were conducted in RevMan version 5.4 software. Results: We identified 29 studies that involve 28,836 participants. Overall analysis showed that increased risks for cardiovascular outcome defined by onset of cardiovascular disease or death [RR 1.33 (95% CI 1.11, 1.58; p = 0.002; I2 = 0.04)] in WCH group compared with NT group. Arterial stiffness measurement utilizing cf-PWV was significantly higher in WCH group [SMD 0.58 (95% CI 0.39, 0.77; p = 0.00001; I2 = 0.84)]. In contrast, no significant differences were observed in the risk for stroke, cardiac outcomes or all-cause mortality in both groups. Conclusion: This meta-analysis showed that untreated WCH may increase the risk of cardiovascular disease in term of onset of cardiovascular disease or death. Increase in arterial stiffness measured by cf-PWV is also significantly higher with WCH.

Cardiovascular and cerebral vascular health in females with postacute sequelae of COVID-19.

Many individuals who had coronavirus disease 2019 (COVID-19) develop detrimental persistent symptoms, a condition known as postacute sequelae of COVID-19 (PASC). Despite the elevated risk of cardiovascular disease following COVID-19, limited studies have examined vascular function in PASC with equivocal results reported. Moreover, the role of PASC symptom burden on vascular health has not been examined. We tested the hypothesis that peripheral and cerebral vascular function would be blunted and central arterial stiffness would be elevated in patients with PASC compared with age-matched controls. Furthermore, we hypothesized that impairments in vascular health would be greater in those with higher PASC symptom burden. Resting blood pressure (BP; brachial and central), brachial artery flow-mediated dilation (FMD), forearm reactive hyperemia, carotid-femoral pulse wave velocity (PWV), and cerebral vasodilator function were measured in 12 females with PASC and 11 age-matched female controls without PASC. The severity of persistent symptoms in those with PASC was reported on a scale of 1-10 (higher score: greater severity). Brachial BP (e.g., systolic BP, 126 ± 19 vs.109 ± 8 mmHg; P = 0.010), central BP (P < 0.050), and PWV (7.1 ± 1.2 vs. 6.0 ± 0.8 m/s; P = 0.015) were higher in PASC group compared with controls. However, FMD, reactive hyperemia, and cerebral vasodilator function were not different between groups (P > 0.050 for all). Total symptom burden was not correlated with any measure of cardiovascular health (P > 0.050 for all). Collectively, these findings indicate that BP and central arterial stiffness are elevated in females with PASC, whereas peripheral and cerebral vascular function appear to be unaffected, effects that appear independent of symptom burden.NEW & NOTEWORTHY We demonstrate for the first time that resting blood pressure (BP) and central arterial stiffness are higher in females with PASC compared with controls. In contrast, peripheral and cerebral vascular functions appear unaffected. Moreover, there was no relationship between total PASC symptom burden and measures of BP, arterial stiffness, or vascular function. Collectively, these findings suggest that females with PASC could be at greater risk of developing hypertension, which appears independent of symptom burden.

Carotid–Femoral Pulse Wave Velocity Could Be a Marker to Predict Cardiovascular and All-Cause Mortality of Hemodialysis Patients

Among hemodialysis (HD) patients, cardiovascular disease (CVD) is recognized as a major contributor to the high risk of mortality, and emerging evidence has ascertained arterial stiffness as an independent predictor of adverse cardiovascular (CV) outcomes. We aimed to investigate the efficacy of arterial stiffness measurement in predicting CV and all-cause mortality in patients on HD (n = 130). Carotid-femoral pulse wave velocity (cfPWV) was measured by a validated tonometry system. A cfPWV of >10 m/s was used to assign patients to the arterial stiffness group (n = 64). Baseline and biochemical characteristics, as well as all-cause and CV mortality, were recorded. During the 3-year follow-up period, a total of 32 deaths (25%) occurred. The patients who died had clinically significant high cfPWV levels; were relatively old; and had hypoalbuminemia, low creatinine levels, and diabetes. After adjustment for the prognostic variables, patients with elevated cfPWV had significantly higher all-cause (p = 0.036) and CV mortality (p = 0.017), compared with the mortality rates in the normal group. In this study, cfPWV was found to be an independent predictor of all-cause and CV mortality in HD patients.

Effect of home-based, overground robotic-assisted gait training on vascular health in people with chronic stroke.

https://clinicaltrials.gov, identifier NCT03104127.

Higher HbA1c variability is associated with increased arterial stiffness in individuals with type 1 diabetes

BackgroundBoth long-term glycaemic variability and arterial stiffness have been recognized as cardiovascular risk factors. This study aims to investigate whether an association between these phenomena exists in individuals with type 1 diabetes.MethodsThis cross-sectional study included 673 adults (305 men, 368 women) with type 1 diabetes and combined available retrospective laboratory data on HbA1c from the preceding 10 years with outcome data on arterial stiffness and clinical variables from a comprehensive study visit. HbA1c variability was calculated as adjusted standard deviation (adj-HbA1c-SD), coefficient of variation (HbA1c-CV) and average real variability (HbA1c-ARV). As measures of arterial stiffness, carotid-femoral pulse wave velocity (cfPWV; n = 335) and augmentation index (AIx; n = 653) were assessed using applanation tonometry.ResultsThe study population had a mean age of 47.1 (± 12.0) years and a median duration of diabetes of 31.2 (21.2–41.3) years. The median number of HbA1c assessments per individual was 17 (12–26). All three indices of HbA1c variability were significantly correlated with both cfPWV and AIx after adjustment for sex and age (p < 0.001). In separate multivariable linear regression models, adj-HbA1c-SD and HbA1c-CV were significantly associated with cfPWV (p = 0.032 and p = 0.046, respectively) and AIx (p = 0.028 and p = 0.049, respectively), even after adjustment for HbA1c-mean. HbA1c-ARV was not associated with cfPWV or AIx in the fully adjusted models.ConclusionsAn association independent of HbA1c-mean was found between HbA1c variability and arterial stiffness, suggesting a need to consider multiple HbA1c metrics in studies assessing cardiovascular risk in type 1 diabetes. Longitudinal and interventional studies are needed to confirm any causal relationship and to find strategies for reducing long-term glycaemic variability.