Vascular Stiffness Parameters Research Articles

Foci of chronic infection and vascular rigidity in persons of military age

The role of focal infection as a possible risk factor for development of atherosclerotic cardiovascular diseases is discussed quite intensively now. Estimated some parameters of vascular stiffness in young men of military age with the features of their infectious-inflammatory medical history by the type of foci of chronic infection. It is established that in young men with foci of chronic infection such indicators of vascular stiffness, as peripheral augmentation index, augmentation index, normalized to heart rate, and augmentation index of the aorta were significantly higher than in their peers with a positive history. The differences in the first two indicators have reached a reliable level. It should be emphasized the presence of more low blood pressure in the presence of foci of chronic infection , which eliminates the distortion parameters of vascular status, influenced by the tensile effect from the blood pressure in the time of the study. The obtained data clearly indicate the higher rigidity of the walls of the aorta and large arteries in young men under the influence of their foci of chronic infection. Some tendency to development of left ventricular dysfunction in young people with presence of chronic tonsillitis and other infectious and inflammatory diseases was also revealed. This dysfunction is expressed in reducing the maximum rate of growth of blood pressure and increasing the period of expulsion of the left ventricle. The presented results confirm the concept of lifelong formation of «infectious-inflammatory load» in terms of increasing vascular rigidity and subclinical changes in the functioning of the myocardium at young age, subject to the presence of a focal chronic infection. These data allow us to regard foci of chronic infection as another risk factor of atherosclerosis, which in turn requires consideration when carrying out the relevant preventive measures among young population in the process of health checkups.

Assessment of Vascular Stiffness in Normotensive Patients With Familial Hypercholesterolemia

to analyze parameters of vascular stiffness and augmentation index in patients with familial hypercholesterolemia (FH). We compared parameters of vascular stiffness of 88 normotensive FH patients (mean age 41.95±1.43 years, 43 men [48.9 %]) and 68 subjects with normal blood lipid spectrum (mean age 37.58±1.02 years, 21 men [30.9 %]). FH was diagnosed according to the criteria of the Dutch Lipid Clinic Network. Examination included lipid profile, 24‑hour blood pressure (BP) monitoring with assessment of arterial stiffness. Normotensive FH patients had higher pulse wave velocity (PWV) (7.99±0.17 m/s) in comparison with patients with normal lipid spectrum (6.87±0.10 m/s), p.

Pulse wave analyzed cardiovascular parameters in young first degree relatives of hypertensives.

Background:First-degree relatives (FDRs) of hypertensive (HT) are predisposed to hypertension (HTN) which accelerates cardiovascular aging. Same can be studied noninvasively by pulse wave analysis (PWA), encompassing central hemodynamics such as central blood pressure (cBP), cardiac output, and stroke work (SW) and vascular stiffness parameters such as pulse wave velocity (PWV) and augmentation index at HR 75 (AIx@75). We studied PWA-derived cardiovascular parameters in FDRs of HT compared to controls.Materials and Methods:We conducted a case–control study in 119 FDRs of HT and 119 matched controls. Oscillometric PWA was performed by Mobil-o-Graph (IEM, Germany) and cardiovascular parameters were compared. P < 0.05 was considered statistically significant.Results:Groups were comparable with gender, age, height, weight, body mass index, and physical activity. FDRs of HT had significantly higher brachial and cBPs, SW (101.41 ± 25.44 vs. 88.31 ± 20.25, P = 0.001), rate pressure product-119.40 ± 25.34 vs. 108.34 ± 18.17, P < 0.0001), PWV (5.22 ± 0.46, P < 0.0001), and AIx@75 (31.48 ± 9.01 vs. 27.95 ± 9.4, P = 0.002) than control. Dependent study variables correlated with brachial blood pressure more in magnitude and significance level than age or anthropometric variables. PWA results of FDR with maternal inheritance did not differ significantly from those with paternal inheritance.Conclusion:PWA reveals early cardiovascular aging in young FDRs of HTs. It clues to future cardiovascular disease including HTN itself, need for primary prevention, and further study for consolidation of these results.

Evaluation of Arterial Stiffness in Patients with Bronchial Asthma and Co-Existent Chronic Obstructive Pulmonary Disease

The objective of the research was to determine the characteristics of arterial stiffness and cardiovascular risk in patients with co-existence of asthma and chronic obstructive pulmonary disease.Materials and methods. The study included patients with symptoms of chronic obstructive pulmonary disease, those with asthma and chronic obstructive pulmonary disease and the group of apparently healthy individuals.Results. In patients with obstructive lung disease, the parameters of vascular stiffness and central blood pressure reflecting the degree of cardiovascular risk were significantly higher as compared to those in apparently healthy individuals. They were significantly elevated in patients with chronic obstructive pulmonary disease and asthma-chronic obstructive pulmonary disease overlap. The indicators of central blood pressure were significantly higher in patients with asthma-chronic obstructive pulmonary disease overlap and more pronounced bronchial obstruction, and in patients with more obvious symptoms of obstructive pathology. Excess body weight or obesity had a strong and pronounced effect on the parameters of central blood pressure in patients with asthma-chronic obstructive pulmonary disease overlap. In patients with a comorbidity, a reliable correlation between the indicator of the presence of pulmonary hyperinflation and the degree of arterial stiffness was revealed.

PP.19.19] ANGIOLOGIC SCREENING OF YOUNG POPULATION IN SOUTH REGION OF RUSSIA

Objective: Conduction of mass estimate of the parameters of vascular stiffness of students, taking into account gender in university preventive project. Design and method: It was achieved survey of 175 students on basis of student's health Center of StSMU within the project The University - Health Area. It was analyzed occurrence of five main RF (burdened heredity, overweight, smoking, dyslipidemia, stress) and assessment of state of the vascular wall in terms of Cardio-Ankle Vascular Index (CAVI) with the help of software-diagnostic system VaSera-1500 (Fukuda Denshi, Japan). Groups formed by sex. We carried out step by step analysis of each of these groups in the aspect of the distribution of boys and girls through the levels CAVI values. Data processed by Statistica analysis package. Results: It was found CAVI among boys more than girls in average 0.1–0.2, minimum 0.2–0.3 and maximum 0.3–0.4 on different hands. Moreover, these parameters on left side somewhat higher than the right. It turned out that in range of studied index above 6.5 was placed boys in terms of R-CAVI 16,5% and L-CAVI 20,0%, and girls in terms of R-CAVI 8,4% and L-CAVI 20,3%, respectively. For young men 95 percentile was R-CAVI 7,1 and L-CAVI 7,2, and for girls R-CAVI 6,8 and L-CAVI 7,0 respectively. The average number of risk factors studied in groups of boys and girls with L-CAVI above 6.5 was in the 2.2 and 1.8-fold higher compared with those carriers of lower values of the studied parameter. At the same time blood pressure in these groups did not differ significantly. Conclusions: Both among boys and among girls left index CAVI is slightly higher than the right. Indicator Kavi probably less than 6.5 may be considered as admissible norm for people in this age category. The most significant in terms of asymmetry was observed in women - almost three times. Carriers of high level of CAVI have number of risk factors more significant than the other surveyed boys and girls. These data tools helpful to consider the formation of individual programs in-depth preventive intervention among young people.

Arterial-ventricular coupling and parameters of vascular stiffness in hypertensive patients: Role of gender.

ObjectiveNon-invasive estimation of arterial–ventricular coupling has been extensively used for the evaluation of cardiovascular performance, however, a relative small amount of data is available regarding arterial–ventricular coupling and its components in hypertension. The present study was designed to investigate the relationship between left ventricular elastance, arterial elastance, parameters of vascular stiffness and the influence of gender in a population of hypertensive individuals.MethodsIn 102 patients, trans-thoracic cardiac ultrasound, parameters of aortic stiffness (carotid-femoral pulse wave velocity) and wave reflection (augmentation index) were recorded. Ultrasound images of common carotid arteries were acquired for the assessment of intima-media thickness as well as carotid compliance and distensibility coefficient.ResultsMean age was 61 years, 32% diabetes, 56% dyslipidemia, 9% previous cardiovascular events; women (n = 32) and men were superimposable for cardiovascular risk factors prevalence. In the population, ventricular elastance was significantly correlated with arterial elastance (r = 0.887), age (r = 0.334), gender (r = −0.494), BMI (r = −0.313), augmentation index (r = 0.479) (all p < 0.001); and with carotid compliance and distensibility coefficient (r = 0.229 and r = − 0.250, respectively, both p < 0.05); however, only arterial elastance and gender were independently associated with ventricular elastance in multiple regression models adjusted for confounding factors. Gender-specific analysis revealed that arterial elastance and augmentation index remained statistically significant associated with ventricular elastance in men (r = 0.275, p = 0.04); instead augmentation index was no longer significant (r = 0.052, p = 0.77) in the female sex.ConclusionsIn hypertensive patients, main determinants of ventricular elastance are arterial elastance, as an integrated index of arterial vascular load, and gender; however, pressure augmentation might play an additional role in men.

The Impact of Osteocalcin, Osteoprotegerin and Osteopontin on Arterial Stiffness in Chronic Renal Failure Patients on Hemodialysis

Background/Aims: This cross-sectional study was designed to assess the relationship between vascular stiffness (VS) and bone-related proteins involved in the development of arteriosclerosis in patients on regular hemodialysis (HD). Methods: 68 consecutive patients in stable clinical condition who received regular HD in the FMC Dialysis Center, Pécs were included. VS parameters (carotid-femoral pulse wave velocity – PWV, aortic augmentation index - AIx) were determined by applanation tonometry (SphygmoCor, AtCor Medical, Sidney) and the routine latoratory test were completed with measurements of osteocalcin (OC), osteopontin (OP) and osteoprotegerin (OPG) by using commercially available ELISA kits. 35 heathcare workers served as controls. Results: In patients on regular HD PWV markedly increased and there was several-fold elevation in the interrelated bone-specific proteins (OC, OP, OPG). PWV was found to be independently associated only with OC (β:-0.25, p<0.029) and age (r=0.411,p<0.000), but risk factors for arterial calcification had significant impact on OC (systolic blood pressure, hsCRP, BMI), OPG (age, BMI) and OP (LDL-cholesterol). Conclusion: Except for OC, our results failed to document direct association of vascular lesion with OP and OPG, therefore their high circulating levels may be an epiphenomenon or they may have counter-regulatory role to attenuate the uremic calcification process.

Cardio-ankle vascular index and carotid-femoral pulse wave velocity are closely associated with chronological age

Background: Vascular stiffening is part of the ageing process. However, it is not clear which vascular stiffness parameters are closely associated with chronological age. Methods: Fifty-eight participants (38 men), age 69.57 ± 10.46 (mean ± SD, range = 47-90 years) who have had transient ischaemic attack or lacunar stroke within the last 2 weeks, had vascular stiffness parameters, brachial and central blood pressures measured. Cardio-ankle vascular index (CAVI) was measured with VaSera VS-1500N® (Fukuda Denshi, Japan); carotid-femoral pulse wave velocity (cfPWV) and carotid-radial pulse wave velocity (crPWV) were measured with Complior® (ALAM Medical, France); radial augmentation index (rAIx) and central blood pressure were measured with SphygmoCor® (AtCor, Australia). Results: The mean and standard error of the mean for each parameter (mean ± SEM) was as follows: CAVI=9.77 ± 0.21, cfPWV = 10.61 ± 0.46 m/s, crPWV = 11.05 ± 0.30 m/s, rAIx = 31.34 ± 1.60 %, and central pulse pressure (cPP) = 50.22 ± 1.81 mmHg. In a bivariate analysis, CAVI (r = 0.59, p<0.01) and cfPWV (r = 0.39, p<0.01) were significantly associated with age, but rAIx (r = 0.12, p = 0.371) and crPWV (r = 0.06, p=0.682) were not. A multivariate regression analysis, performed with age as the dependent factor and CAVI, cfPWV, crPWV, cPP, and rAIx as independent parameters, showed that CAVI was the only significant parameter (β = 0.49, p = 0.002) associated with age. Conclusion: CAVI and cfPWV are closely associated with chronological age, whereas crPWV and rAIx are less so. We suggest that the vascular parameter which best predicts biological age is CAVI, followed closely by cfPWV.

PS 05-63 PRO- AND ANTI-INFLAMMATORY FACTORS AND VASCULAR STIFFNESS IN END-STAGE RENAL DISEASE PATIENTS

Objective: Vascular calcification (VC) has crucial importance in the accelerated arteriosclerosis of chronic renal disease patients. The aim of this study was to assess the extent of arteriosclerotic lesions and to relate vascular stiffness parameters to pro-inflammatory markers (hsCRP, TNF-α, TGF-β1) and to protective factors (α-Klotho, fetuin-A, vitamin D3) in patients on chronic hemodialysis. Design and Method: 96 consecutive patients in stable condition were enrolled. 20 healthy individuals served as controls. Beside routine biochemical parameters, TNF-α, TGF-β1 α-Klotho and fetuin-A were measured with ELISA. Carotid-femoral pulse wave velocity was measured using applanation tonometry (SphygmoCor, AtCor Medical Australia) before hemodialysis sessions. Carotid-femoral pulse wave velocity (cfPWV) was calculated. Results: Pro-inflammatory (pro-calcigenic) biomarkers (hsCRP, TNF-α, TGF-β1) were elevated (p < 0.01), whereas anti-inflammatory (anti-atherosclerotic) factors (fetuin-A: p < 0.05, α-Klotho: p < 0.01, vitamin D3 p < 0.01) depressed compared to controls. cfPWV correlated positively with total cholesterol (r = 0.244, p < 0.05) and fetuin-A (r = 0.282, p < 0.05) but inversely with the time spent on dialysis (r = -0.262, p < 0.05). hsCRP was negatively influenced by plasma vitamin D3 (β = −0.23, p < 0.01), sodium (β = −0.26, p < 0.00) and albumin levels (β = −0.36, p < 0.00), positively by BMI (β = 0.76, p < 0.00). TNFα and TGFβ1 as dependent variables were found to correlate with α-Klotho (β = 0.41, p < 0.00) and plasma creatinine (β = 0.30, p < 0.003), as well as with fetuin-A (β = −0.24, p < 0.02) and plasma albumin (β = 0.33, p < 0.002), Fetuin-A showed significant negative correlation with age (β = −0.225, p < 0.05), TGF-β1 (β = −0.228, p < 0.02), and dialysis time (β = −0.26, p < 0.01), while positive relationship was found between fetuin-A and triglyceride levels (β = 0.43, p < 0.00). α-Klotho correlated positively with TNF-α (β = 0.44, p < 0.00) and negatively with plasma calcium (β = −0.24, p < 0.01). Conclusions: Our study confirmed that the pro-inflammatory cascade of arteriosclerosis was activated and inflammatory biomarkers (hsCRP, TNF-α, TGF-β1) prevailed over protective factors (vitamin D, α-Klotho, Fetuin-A) in patients on hemodialysis. We demonstrated that PWV was significantly affected by total cholesterol, fetuin-A and dialysis time. Several clinical and laboratory factors were associated with pro- and anti-inflammatory biomarkers rather than PWV.

Circadian CLOCK Gene Variants, Parameters of Arterial Stiffness and Blood Pressure Levels in Subjects Without Arterial Hypertension

CLOCK gene polymorphic variants, parameters of arterial stiffness and blood pressure (BP) variability were studied in 115 normotensive Russian patients without cardiovascular diseases (62 men, 53 women; mean age 36.4+/-1.01 years). Examination included ECG, 24h BP monitoring, duplex scan of carotid arteries, registration of vascular stiffness parameters, and genotyping of the following polymorphic markers of CLOCK: 3111T>C (3-untranslated region), 862T>C (exon 9) and 257T>G (promoter region) by PCR-RFLP method. Pulse wave velocity was not significantly different among carriers of various 257T>G, 862T>C, 3111T>C genotypes. Augmentation index (Aix night, Aix max) values were lower in individuals with genotypes allegedly associated with essential hypertension and ischemic heart disease (257GG, 862CC, 3111CC). Arterial stiffness index (ASI) was significantly higher in men having CC genotype of 862T>C. Polymorphic variants 257T>G and 862T>C SNPs of CLOCK gene were found to be associated with parameters reflecting BP variability (morning rise of diastolic BP and rate of BP rise). These results provide a basis for suggestion that the CLOCK gene polymorphism is one of factors determining elastic properties of vascular wall. The suggestion is supported by discussion of possible molecular mechanisms of circadian genes impact on elasticity and rigidity of vessel.

EFFECT OF OBSTRUCTIVE SLEEP APNEA SYNDROME ON ARTERIAL STIFFNESS IN PATIENTS AT HIGH CARDIOVASCULAR RISK

Aim. To assess the impact of metabolic abnormalities in combination with obstructive sleep apnea on endothelial function and vascular stiffness parameters in patients with arterial hypertension 1-2 degrees. Material and methods. Patients (n=74) with metabolic syndrome and obstructive sleep apnea were included into the study. All patients underwent cardiorespiratory monitoring of sleep using SomnoCheck2 device (Wiennmann, Germany) and were divided into two groups based on its results. Patients with apnea-hypopnea index (AHI) 30 episodes per hour – into group 2. Monitoring of ambulatory blood pressure (BP) and arterial stiffness was performed by the device BPLab (Peter Telegin, Russia). Endothelial function was assessed in a probe of flow-mediated dilation by the ultrasound device MyLab 90 (Esaote, Italy). Diameter of the common carotid artery (DCCA) and the intima-media thickness (IMT) were determined. Results. Patients with AHI >30 episodes per hour had higher mean daily and night systolic BP and pulse BP in aorta and brachial artery. Pulse wave velocity in aorta in per day averaged was also higher in these patients (8.2±0.8 vs 9.1±1.1 m/sec; p (8.8% (5.6; 13.1) vs 4.5% (2.2; 8.0); p<0.05). Prevalence of negative index of reactivity in group 2 was 2 times higher than this in group 1. An increase in IMT and DCCA in patients with severe obstructive sleep apnea was also revealed. Conclusion. Severe sleep apnea in patients with metabolic syndrome in combination with hypertension aggravates structural changes and endothelial dysfunction of the main arteries, as well as contributes to the progression of atherosclerosis.

Study of main arteries stiffness in patients with coronary heart disease depending on prevalence of atherosclerosis

ObjectiveTo study the vascular wall stiffness in patients with coronary artery disease based on the prevalence of atherosclerotic lesion. Materials and methodsThe study involved 90 patients diagnosed with unstable angina class II B, the control group consisted of 27 healthy individuals. By using the SphygmoCor (AtCor Medical, Australia) apparatus, stiffness indicators, like pulse wave velocity (PWV) and augmentation index (AIx) were studied by means of the applanation tonometry method. Coronary angiography was performed on the Allura CV-20 (Philips, The Netherlands) unit, the state of the carotid arteries was studied by duplex ultrasonography, involvement of femoral arteries was evaluated based on ankle-brachial index <0.9. In case of doubt, the patients underwent ultrasound duplex scanning. In the main group, patients were divided into 3 subgroups: subgroup A covered patients with isolated coronary lesion; subgroup B covered patients with bifocal atherosclerosis (combined lesion of coronary and carotid arteries or coronary and femoral arteries); subgroup C was represented by multifocal atherosclerosis patients who had atherosclerosis lesion in three vascular basins: carotid, coronary and femoral arteries. ResultsValues of PWV (11.2±1.5m/s) and AIx (19.8±5.0%) in patients with coronary heart disease were 1.5 (p<0.001) and 2.4 (p<0.001) times higher than in those in healthy individuals. During the analysis carried out within the groups, the PWV in all three subgroups was accelerated with maximal values in the subgroup C (13.3±1.5m/s), which with sufficient level of confidence exceeds the value of this index in the subgroups A (10.1±0.6, p<0.01) and B (11.0±0.9, p<0.05). The value of augmentation index AIx was also highest in the subgroup C (26.8±6.4%), relative to the subgroups A (13.7±2.9%, p<0.001) and B (18.9±4.3%, p<0.01). ConclusionPatients with coronary heart disease, have demonstrated growing vascular wall stiffness, which is manifested in higher pulse wave velocity (p<0.001) and augmentation index (p<0.001) compared with healthy individuals. Whereas in the multifocal atherosclerosis (coronary, carotid and peripheral arteries) were higher AA (p<0.05), AIx (p<0.001), PWV (p<0.01) and the age of patients (p<0.01). That allows to consider the studied parameters of vascular stiffness as surrogate markers to assess prevalence and progression of atherosclerosis, as well as the effectiveness of pharmacological interventions.

24-hour arterial stiffness monitoring in comorbid patients with cardiovascular pathology

Aim. To evaluate 24-hour dynamics of the arterial stiffness main indicators in patients with arterial hypertension associated with metabolic syndrome, coronary heart disease and type 2 diabetes mellitus.Methods. The study included 54 patients with hypertension, who formed main groups: the first group - 17 patients with hypertension amid the metabolic syndrome, the second - 21 patients with metabolic syndrome and coronary heart disease, the third group - 16 patients with hypertension and type 2 diabetes mellitus. All patients underwent the vascular stiffness parameters study using a multifunctional complex for the 24-hour monitoring and office measurements of blood pressure and vessels condition. At the same time blood pressure, cardiac function and vascular stiffness indicators were examined: PWVao - pulse wave velocity in the aorta (m/s); PWTT - the pulse wave transit time (m/s); Aix - augmentation index (%); Asi - the arterial stiffness index. (mmHg).Results. When comparing the 24-hour arterial stiffness dynamics indicators, changes were found in all main patients groups compared to the healthy group. Thus, a statistically significant increase in the pulse wave velocity in the aorta (PWVao) in all groups of patients compared with the control group, a decrease in the index of the pulse wave transit time (PWTT) in all main groups of patients and a significant increase in arterial stiffness index (Asi) were found. When assessing the results of arterial stiffness monitoring at night time significantly larger values of the pulse wave velocity in the aorta were observed in patients with the metabolic syndrome and combination of metabolic syndrome and coronary heart disease. The obtained data are indicative of improvement in vascular stiffness indicators at night time in healthy individuals group, as well as maintaining a high degree of the vascular wall stiffness both in the night and in the daytime in a group of examined patients, especially in groups with the metabolic syndrome, and a combination of metabolic syndrome and coronary heart disease.Conclusion. 24-hour monitoring of vascular stiffness indicators in comorbid patients have revealed variability of the main indicators during the day; such arterial stiffness indicators as the pulse wave transit time, pulse wave velocity in the aorta, the arterial stiffness index, augmentation index can be used to assess early signs of the major arteries remodeling.

Изменение показателей эндотелиальной функции и жесткости артериального русла у больных ревматоидным артритом на фоне терапии лефлуномидом

The article presents the results of evaluation of leflunomide impact on endothelial function and vascular stiffness parameters in patients with rheumatoid arthritis (RA), but without cardiovascular diseases. 46 patients with RA satisfying ACR (1987) or ACR/EULAR (2010) classification criteria were examined. Investigations of endothelial function and arterial stiffness, based on the pulse wave contour analysis and the reactive hyperemia test (“AngioScan-01” device used), were conducted before the treatment and 12 months thereafter. It was determined that patients with RA suffered from subclinical damage of large arteries, characterized by endothelial dysfunction at micro- and macrocirculatory levels, and the increase in augmentation (AIp), stiffness (SI), and reflection (RI) indices, whose value correlated with RA duration, DAS28 activity index, RF level, and ACCP concentration. Leflunomide use in patients with RA was accompanied by statistically significant decrease in DAS28 index. It was shown that along with high anti-inflammatory activity leflunomide is also able of decreasing the signs of subclinical arterial damage, which is confirmed by the restoration of the endothelial function both in the system of small resistant vessels (increase in amplitude occlusion index) and large muscular arteries (increase in the value of phase shift between channels), and the decrease in stiffness of large arteries.

MINERAL'NAYa PLOTNOST' KOSTI I SOSTOYaNIE SOSUDISTOY STENKI V ZAVISIMOSTI OT STATUSA REPLIKATIVNOGO KLETOChNOGO STARENIYa U ZhENShchIN V POSTMENOPAUZAL'NOM PERIODE

Objective: to examine the relationship between bone mineral density (BMD), the parameters of vascular stiffness and biomarkers of cellular aging in postmenopausal women. Materials and Methods: In a cross-sectional study107 patients were included: women at the age range of 45 to 82 years who were observed outpatient and signed a written informed consent. Assessment of BMD was performed using DXA (Delphi W, Hologic, USA). The intima-media thickness (IMT), the presence and quantity of atherosclerotic plaques (AP), and the degree of carotid stenosis were examined by duplex scanning. The pulse wave velocity (PWV), augmentation index (Aix) were measured by applanation tonometry (SphygmoCor).To determine telomere length (DT) in leukocytes the method of real-time PCR was used. This was done by measuring the relative telomere length in the genomic DNA. Determination of telomerase activity (Aix) was carried out on pure monocyte fraction of isolated blood cells on the basis of telomerase polymerase reaction.Statistical analysis was performed using the software application Statistical Analysis System (USA). Results: With the increase in duration of menopause a gradual increase in the stiffness rate (PWV, AI), IMT and decrease of BMD was noticed in all examined parts of the skeleton. The maximal values of vascular stiffness, minimal values of BMD and the shortest telomeres were found in patients with 10+ years of menopause. The risk of bone mass loss and osteoporosis increased by 3 times in patients with high values of PWV ≥10 m/sec[OP-3,1, 95%CI, 1,13-9,89 (p&lt;0,05)], by more than 4 times in patients with AI≥ 20% [OP-4,35, 95%CI, 1,02-11,0 (p&lt;0,05)]and the IMT &gt;0,9 mm by 2,45 times in patients with presence of AP in the carotid arteries and with the shortest telomeres [OP-2,45, 95%CI, 1,05-6,08 (p&lt;0,05)]. During multivariate regression analysis after adjusting for age and menopause duration the negative relationship between IA, IMT and BMD remained highly significant, while in relation to PWV, AP presence and telomere length, such a correlation was not confirmed. Conclusion: In postmenopausal women low BMD is associated with high rates of Aix and the thickness of the IMT. The independent relationship of BMD with Aix, rather than with PWV, apparently could be explained by the involvement of small vessels -arterioles. Short telomeres are 2.45 times more frequent in patients with low bone mass, but the relationship has not been confirmed in the regression analysis, which excludes the independent nature of this aging marker with BMD.

Relation of parameters of vascular stiffness to cardiac structure and function in patients at risk of or with type 2 diabetes

Relation of parameters of vascular stiffness to cardiac structure and function in patients at risk of or with type 2 diabetes

COMPLEX EVALUATION PARAMETERS OF CENTRAL AORTIC BLOOD PRESSURE AND MAIN ARTERIES STIFFNESS IN PATIENTS WITH CORONARY ARTERY DISEASE, DEPENDING ON THE PREVALENCE OF ATHEROSCLEROSIS

Objective: to study the parameters of central aortic blood pressure and main arteries stiffness in patients with coronary artery disease (CAD) depending on the prevalence of atherosclerotic lesions. Material and methods: the study involved 90 patients with a diagnosis of unstable angina class II B (E. Braunwald et al., 1989) the control group consisted of 27 healthy people. The method of applanation tonometry using the apparatus of SphygmoCor («AtCor Medical», Australia) studied the performance stiffness: pulse wave velocity (PWV) and augmentation index (AIx). Coronary angiography was performed at the facility Allura CV-20 (Philips, The Netherlands), the state of the carotid arteries was studied by duplex ultrasonography, evaluation of involvement of femoral arteries was based on ankle-brachial index <0.9, in case of doubt, underwent ultrasound duplex scanning. In the main group, patients were divided into 3 subgroups: subgroup A defined patients with isolated coronary lesion; subgroup B was presented by patients who diagnosed combined lesion: coronary arteries with carotid arteries or coronary arteries with femoral arteries; subgroup C was presented with multifocal atherosclerosis patients who had atherosclerosis lesion in three vascular beds: the carotid, coronary and femoral arteries. Results: values PWV (11,2±1,5 m/s), and AIx (19,8±5,0%) in patients with CAD were, respectively, 1.5 (p<0.001) and 2.4 (p<0.001) times higher than in healthy persons. During the intragroup analysis in all three subgroups PWV was accelerated, with maximum values in the subgroup C (13,3±1,5 m/s), which significantly exceeds the value of this index in the subgroup A (10,1±0,6, p<0.01) and B (11,0±0,9, p<0.05). The value of augmentation index AIx was also highest in the subgroup C 26,8±6,4%, relative to the subgroup A (13,7±2,9%, p<0.001) and subgroup B (18,9±4,3%, p<0, 01). Conclusion: the obtained results allow to recommend studied parameters of vascular stiffness as surrogate markers to assess the prevalence and progression of atherosclerosis, as well as efficacy of pharmacological interventions.

5B.03

Objective: The present study was designed to investigate the relationship between left ventricular elastance (ELV), arterial elastance (EA), parameters of vascular stiffness and the influence of gender in a population of hypertensive individuals at high cardiovascular (CV) risk. Design and method: Seventy eight subjects participated in the study. Trans-thoracic cardiac ultrasound exam and parameters of aortic stiffness (carotid-femoral pulse wave velocity, PWV) wave reflection (augmentation index, AIx), aortic and carotid pulse pressure (PP) were obtained. Ultrasound images of the common carotid artery were acquired for the assessment of intima-media thickness (IMT) as well as carotid compliance (CC) and distensibility coefficient (DC). Results: The mean age of subjects was 62,5 years old, 37,2% had diabetes, 48,7% dyslipidemia, 7,7% previous CV events. Women (43%) and men were superimposable for CV risk factors except for older age (63.3 ± 9.2 vs 57.5 ± 10.4 years, p < 0.001) and greater prevalence of dyslipidemia (66% vs 35%, p = 0.04). In the overall population ELV was significantly correlated with EA (r = 0.79,p < 0.001), age, gender and BMI (r = 0.30,p = 0.07,r = -0.64,p < 0.001,r = -0.32,p = 0.004 respectively), AIx (r = 0.53,p < 0.001), aortic PP (r = 0.39,p < 0.001) CC (r = -0.44, p < 0.001) and DC (r = -0.27, p = 0.02), but not with PWV (r = 0.13,p = 0.28). In the multiple regression model including EA, ELV was still significantly correlated with EA, BMI, gender (all p < 0.001) and aortic PP (p = 0.004). Conversely, DC and PWV were not. DC, CC, PWV and IMT were similar in men and women. ELV (p < 0.0001) and EA (p = 0.0002) were higher in women than in men, while EA/ELV was lower (p = 0.0003). While EA and BMI were significantly correlated with ELV both in men (r = 0.74,p < 0.0001) and women (r = 0.77,p < 0.0001), DC was correlated with ELV only in women (women r = 0.04,p = 0.03, men r = -0.21,p = 0.17), and aortic PP (men r = 0.44,p = 0.002, women r = 0.44, p = 0.01) and AIX (men r = 0.37,p = 0.002, women r = 0.33, p = 0.06) only in men. Conclusions: In hypertensive individuals, main determinants of ventricular elastance are arterial elastance as an integrated index of arterial vascular load, central PP, gender and BMI. However, large artery stiffness in women and pressure augmentation in men might play an additional role.

PP.20.31

Objective: The objective of our study was to assess the dynamics of vascular wall stiffness and central aortic pressure in patients with an active form of acromegaly after adenomectomy. Design and method: We examined 52 patients with active acromegaly, and 14 patients (4 men, 10 women; average age - 50,7 ± 10,6 years) underwent transnasal adenomectomy. The mean disease duration was 7.84 (1–30) years. Hypertension was diagnosed in 11 patients. At baseline and 12 months after the surgery all patients underwent applanation tonometry for the assessment of vascular stiffness and central blood pressure (BP) (Sphygmocor, Australia). Results: Baseline parameters were as following: pulse wave velocity (PWV) 6.44 ± 1.49 m/c, central systolic BP 113.6 ± 12.3 mmHg, central diastolic BP 73.1 ± 10.2 mm Hg, augmentation index (AI) 22.2 ± 13.1%. Compared to baseline parameters, 12 months after the surgery there was a significant increase of central systolic and diastolic BP on average by 8 (4; 13) and 8 (1; 13.5) mm Hg, respectively (p = 0.004 and p = 0.006). Office BP increased by an average of 10 (-0.5; 17) mm Hg (p = 0.026). The elevation of PWV and AI was also registered 12 months post-surgery, however, the changes were non-significant: 0.46 (0.07; 2.45) m/s and 5 (1.5; 10)%, respectively (p = 0.13; p = 0.12). Conclusions: In patients with acromegaly average parameters of vascular stiffness and central BP are within the normal range. Twelve months after adenomectomy there is a significant increase in central BP along with the elevation of the office BP, which is probably due to the lack of hypertension control in the postoperative period.

Age-dependent differences in carotid artery circumferential strain measurements, independent of blood pressure, aerobic fitness capacity, gender and conventional non-invasive parameters of vascular stiffness

Age-dependent differences in carotid artery circumferential strain measurements, independent of blood pressure, aerobic fitness capacity, gender and conventional non-invasive parameters of vascular stiffness