Pulse Wave Velocity In Patients Research Articles

Comparative effects of sacubitril/valsartan and ACEI/ARB on endothelial function and arterial stiffness in patients with heart failure: a protocol for systematic review and meta-analysis

IntroductionHeart failure (HF) is a complex syndrome that affects millions of people worldwide and leads to significant morbidity and mortality. Sacubitril/valsartan, a combination drug consisting of a neprilysin inhibitor and...

Factors Affecting Arterial Stiffness and Brachial-Ankle Pulse Wave Velocity in Patients With Type 2 Diabetes

Factors Affecting Arterial Stiffness and Brachial-Ankle Pulse Wave Velocity in Patients With Type 2 Diabetes

Estimated versus measured aortic stiffness: implications of diabetes, chronic kidney disease, sex and height.

Aortic stiffness is measured by carotid-femoral pulse wave velocity (PWV), but it can also be estimated (ePWV) based on age and brachial mean arterial pressure (MAP). However, diabetes mellitus and/or chronic kidney disease (DM/CKD) may cause more pronounced damage to the arterial wall, changing the pressure and PWV relationship. Furthermore, sex and height could affect PWV through their relationship to the arterial diameter and path length. The aim of the present study was to quantify the extent to which DM/CKD, sex and height affect the validity of ePWV in predicting PWV. This cross-sectional study evaluated PWV in adult participants at high risk of aortic stiffness, using Complior and the second derivative transit time algorithm (PWV2nd). PWV2nd was converted into intersecting tangent PWV (PWVITc), and ePWV was calculated using the Reference Values for Arterial Stiffness Collaboration formulas. Among 825 patients (62% males), the mean age was 60 ± 17 years, 34% had diabetes mellitus, 69% had CKD, and 24% did not have DM/CKD. MAP, ePWV, PWV2nd, and PWVITc were, respectively, 96 ± 14 mmHg, 9.8 (8.1-11.8) m/s, 9.5 (7.8-11.9) m/s and 11.3 (8.8-15.9) m/s. There was a significant interaction between DM/CKD, sex, and the predictive value of ePWV. Increasing height lowered the intercept but did not affect the slope of the relationship between estimated and measured PWVs. These findings suggest that the current ePWV equations do not accurately predict PWV in patients with DM/CKD, and that sex and height should also be considered in the future ePWV equations.

Long-term prognostic implications of brachial-ankle pulse wave velocity in patients undergoing percutaneous coronary intervention.

The long-term clinical effect of arterial stiffness in high-risk disease entities remains unclear. The prognostic implications of brachial-ankle pulse wave velocity (baPWV) were assessed using a real-world registry that included patients who underwent percutaneous coronary intervention (PCI). Arterial stiffness was measured using baPWV before discharge. The primary outcome was net adverse clinical events (NACE), defined as a composite of all-cause death, non-fatal myocardial infarction, non-fatal stroke, or major bleeding. Secondary outcomes included major adverse cardiac and cerebrovascular events (MACCE: a composite of all-cause death, non-fatal myocardial infarction, or non-fatal stroke), and major bleeding. The outcomes were assessed over a 4-year period. Patients (n = 3,930) were stratified into high- and low-baPWV groups based on a baPWV cut-off of 1891 cm/s determined through time-dependent receiver operating characteristic curve analysis. baPWV was linearly correlated with 4-year post-PCI clinical events. The high baPWV group had a greater cumulative incidence of NACE, MACCE, and major bleeding. According to multivariable analysis, the high baPWV groups had a significantly greater risk of 4-year NACE (adjusted hazard ratio [HRadj]: 1.44; 95% confidence interval [CI]: 1.12-1.85; p = 0.004), MACCE (HRadj: 1.40; 95% CI: 1.07-1.83; p = 0.015), and major bleeding (HRadj: 1.94; 95% CI: 1.15-3.25; p = 0.012). In PCI-treated patients, baPWV was significantly associated with long-term clinical outcomes, including ischemic and bleeding events, indicating its value for identifying high-risk phenotypes.

Assessment of Arterial Stiffness and Biochemical Markers in Systemic Lupus Erythematosus in the Diagnosis of Subclinical Atherosclerosis.

Patients with systemic lupus erythematosus (SLE) are 2-10 times more likely to develop cardiovascular disease (CVD) than the general population. The assessment of the risk of developing CVD is an important direction for further clinical management. The study was conducted retrospectively and included patients with SLE. The aim of the study was to assess the measurements of pulse wave velocity (PWV), carotid intima-media thickness (CIMT), ankle-brachial index (ABI) and biochemical parameters. Subclinical atherosclerosis was also assessed. The study included 98 patients with SLE with an age- and sex-matched control group of 68 healthy adults. Statistical significance was found in the SLE group and the controls for N-terminal fragment of pro-B-type natriuretic peptide (NT proBNP) (144.87 vs. 36.41 pg/mL, p = 0.0018), high-sensitivity cardiac troponin (hs-cTn) (25.43 vs. 6.38 ng/L, p = 0.0303) and D-Dimer levels (0.73 vs. 0.36 µg/mL, p = 0.0088), left CIMT (1.03 vs. 0.62 mm, p < 0.0001), right CIMT (0.93 vs. 0.63 mm, p < 0.0001) and PWV CF (9.74 vs. 7.98 m/s, p = 0.0294). A positive correlation was found between NT proBNP and PWV CF (r = 0.6880, p = 0.0498) and hs-cTn and PVW carotid-femoral (CF) (r = 0.8862, p = 0.0499) in SLE. A positive correlation was reported between PWV CF and systolic blood pressure (r = 0.5025, p = 0.0487). The measurement of carotid-femoral PWV is a simple, non-invasive, and reproducible method and may independently predict future CVD events and their cause. Further studies are warranted to establish the prognostic value of PWV in patients with SLE, as it may be superior to CIMT measurements in the early stages of vascular disorders.

Serum Phenylacetylglutamine among Potential Risk Factors for Arterial Stiffness Measuring by Carotid-Femoral Pulse Wave Velocity in Patients with Kidney Transplantation.

Phenylacetylglutamine (PAG), a gut microbiota metabolite, is associated with cardiovascular diseases. Arterial stiffness (AS), which is a marker of aging-associated vascular diseases, is an independent risk factor for cardiovascular morbidity and mortality. This study aimed to assess the correlation between serum PAG levels and AS in kidney transplantation (KT) patients, potentially uncovering new insights into the cardiovascular risks in this population. In this study, 100 KT patients were included. Carotid-femoral pulse wave velocity (cfPWV) was measured, and patients with cfPWV > 10 m/s were categorized as the AS group. Serum PAG levels were assessed using liquid chromatography-tandem mass spectrometry. Thirty KT patients (30.0%) exhibited AS, with higher percentages of diabetes mellitus, older age, and elevated levels of systolic blood pressure, serum fasting glucose, and PAG than the control group. After adjusting for factors significantly associated with AS by multivariate logistic regression analysis, serum PAG, age, fasting glucose levels, and systolic blood pressure were independent factors associated with AS. Furthermore, PAG levels had a negative correlation with the estimated glomerular filtration rate and a positive correlation with cfPWV values. Serum PAG levels are positively associated with cfPWV values and are a biomarker of AS in KT patients.

Brachial-ankle pulse wave velocity increasing with heart rate accelerates.

Pulse wave velocity (PWV) indicates the degree of vascular stiffness. This study aimed to explore the association between heart rate (HR) and brachial-ankle (ba)-PWV in patients with pacemaker implantation. This retrospective observational study included patients who underwent permanent pacemaker implantation at the Second Hospital of Hebei Medical University between December 2018 and December 2021. All patients were pacemaker-dependent, and the ba-PWV values were collected during HR setted from 60 to 100 bpm. A total of 68 patients (34 males, aged 65.97 ± 9.90 years) were included in this study. There were significant difference of ba-PWV and diastolic blood pressure (DBP) among different HR (both P < 0.001). After adjusted systolic blood pressure (SBP), DBP, age, and sex, the generalized estimating equation showed ba-PWV was independently associated with HR, with increased HR showed higher coefficient: 70 bpm: β = 42.26 (95% CI: 15.34-69.18, P = 0.002), 80 bpm: β = 84.16 (95% CI: 52.48-115.84, P < 0.001), 90 bpm: β = 129.27 (95% CI: 52.48-115.84, P < 0.001), and 100 bpm: 186.31 (95% CI: 137.02-235.59, P < 0.001). The results demonstrate that changes in HR may affect the ba-PWV, the ba-PWV values tend to be higher when HR accelerates.

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

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

Regional and Global Aortic Pulse Wave Velocity in Patients with Abdominal Aortic Aneurysm

Abdominal aortic aneurysm (AAA) is commonly defined as a localised dilatation with a diameter > 30 mm. The pathophysiology of AAA includes chronic inflammation and enzymatic degradation of elastin, possibly increasing aortic wall stiffness and pulse wave velocity (PWV). Whether aortic stiffness is more prominent in the abdominal aorta at the aneurysm site is not elucidated. The aim of this study was to evaluate global and regional aortic PWV in patients with AAA. Experimental study of local PWV in the thoracic descending and abdominal aorta in patients with AAA and matched controls. The study cohort comprised 25 patients with AAA > 30 mm (range 36 - 70 mm, all male, age range 65 - 76 years) and 27 age- and sex-matched controls free of AAA. PWV was measured with applanation tonometry (carotid-femoral PWV, cfPWV) as well as 4D flow MRI technique, assessing regional aortic PWV. Blood pressure and anthropometrics were measured. Global aortic PWV was greater in men with AAA than controls, both by MRI (AAA 8.9 ± 2.4 m/s vs. controls 7.1 ± 1.5 m/s; p = .007) and cfPWV (AAA 11.0 ± 2.1 m/s vs. controls 9.3 ± 2.3 m/s; p = .007). Regionally, PWV was greater in the abdominal aorta in the AAA group (AAA 7.0 ± 1.8 m/s vs. controls 5.8 ± 1.0 m/s; p = .022), but similar in the thoracic descending aorta (AAA 8.7 ± 3.2 m/s vs. controls 8.2 ± 2.4 m/s; p = .59). Furthermore, PWV was positively associated with indices of central adiposity both in men with AAA and controls. PWV is higher in men with AAA compared with matched controls in the abdominal but not the thoracic descending aorta. Furthermore, aortic stiffness was linked with central fat deposition. It remains to be seen whether there is a causal link between AAA and increased regional aortic stiffness.

Serum Trimethylamine N-Oxide Level Is Positively Associated with Aortic Stiffness Measured by Carotid-Femoral Pulse Wave Velocity in Patients Undergoing Maintenance Hemodialysis.

Trimethylamine N-oxide (TMAO) is a biomarker that is effective in predicting major adverse cardiovascular (CV) events. Age-related vascular problems are significantly affected by aortic stiffness (AS), which is independently linked to CV morbidity and mortality. This study aimed to determine the association between serum TMAO levels and carotid-femoral pulse wave velocity (cfPWV) in patients receiving hemodialysis (HD) therapy. In total, 115 patients with HD were enrolled in this study. The AS group included patients whose cfPWV was >10 m/s. Using high-performance liquid chromatography and mass spectrometry, the levels of serum TMAO were measured. The AS group included 42 (36.5%) patients, and compared with the non-AS group, the rates of diabetes, hypertension, older age, systolic blood pressure, serum glucose, and TMAO levels were high. In the multivariate logistic regression analysis, serum TMAO and age were independently linked with AS after correcting for the factors significantly associated with AS. Following multivariate stepwise linear regression analysis, serum TMAO in these individuals was found to be strongly correlated with cfPWV values (p < 0.001). In patients on chronic HD, serum TMAO level is an independent measure of AS and strongly correlated with cfPWV.

A Systematic Review of Reviews on The Impact of Exercise Training on Pulse Wave Velocity in Adults.

Elevated pulse wave velocity (PWV) determined arterial stiffness is a prominent marker of cardiovascular disease (CVD) risk. Exercise training delays the progression of CVD, but existing reviews on the impact of training on PWV are conflicting. We synthesized the evidence on the effects of exercise training interventions on PWV. We searched Scopus, EMBASE, PubMed, CINAHL, and Academic Search Premier databases for systematic reviews including PWV, and examined the effects of exercise training on PWV. 842 citations were screened which resulted in 44 systematic reviews, including 22 meta-analyses [unique participants n=6719 (3390 females)]. Studies were conducted in general adults with/without disease(s) (n=19, 8 meta-analyses), kidney disease (n=9, 6 meta-analyses), increased CVD risk or CVD (n=7, 5 meta-analyses), type 2 diabetes mellitus (n=3, 2 meta-analyses), and other conditions (n=6, 2 meta-analyses). In general adults, PWV was reduced by aerobic exercise (β:-0.75 to -0.52 m/s) and low-to-moderate intensity resistance exercise training (β:-0.34 m/s). Exercise training was beneficial for patients with kidney disease (β:-1.13 to -0.56 m/s). Aerobic exercise improved PWV in adults with CVD or high CVD risk (β:-0.70 to -0.42 m/s). Combined aerobic and resistance exercise training decreased carotid-femoral PWV in patients with CVD (β:-1.15 m/s) and decreased brachial-ankle PWV in post-menopausal females (β:-1.18 m/s). Neither aerobic nor combined training improved PWV in individuals with type 2 diabetes. The potential physiological mechanisms involved are discussed. Overall, the included systematic reviews and meta-analyses documented that exercise training was an effective strategy to improve PWV, but the optimal type of training varied between populations.

The association between statin adherence and pulse wave velocity in patients with familial hypercholesterolemia

The association between statin adherence and pulse wave velocity in patients with familial hypercholesterolemia

Impact of Disulfide/Thiol Redox Couple on Pulse Wave Velocity in Patients with Normal Coronary Angiography

Introduction: The oxidized thiol/disulfide couple has been investigated and reported as a potential risk factor for cardiovascular diseases. Additionally, an increased pulse wave velocity has been identified as a predictor of cardiovascular events. Patients and Methods: 262 patients were included in our study. Native and total thiol levels, total disulfide levels, disulfide per total thiol ratios, native thiol per total thiol ratios, and disulfide per native thiol level ratios were calculated. Results: Patients were divided into Pulse Wave Velocity (PWV) low and PWV high groups. Native and total thiol levels were higher in PWV low group compared to PWV high group (p&lt; 0.001 for both). The median disulfide value was higher in PWV high group (p= 0.002). Disulfide per native thiol and disulfide per total thiol ratio values were higher in PWV high group (p&lt; 0.001). Native thiol per total thiol ratios were higher in the PWV-low group (p&lt; 0.001). Conclusion: The disulfide/native thiol pathway may be an indicator for predicting future atherosclerotic cardiovascular events.

Brachial - ankle pulse wave velocity in patients with rheumatoid arthritis

Objective. To evaluate brachial-ankle pulse wave velocity (baPWV) in patients with rheumatoid arthritis (RA); and find out the relationship between baPWV and risk factors, disease-related factors, some echocardiographic indicators. Methods. A cross-sectional study was conducted on 47 patients with RA who were admitted to the Hue University Hospital Department of Cardiology. A control group that included 34 patients without RA who agreed to participate in the investigation was enrolled. Results. The average baPWV of the RA group was 1736.6±436.8 cm/s and was higher than that of the control group (1275.8±224.2 cm/s), p&lt;0.001. There were moderate correlations between baPWV and the SCORE index (r=0.583, p&lt;0.001). With the same risk factors such as age, gender, obesity, hypertension, and smoking, the baPWV of the RA group was higher than the control group. There were moderate correlations between baPWV and velocity A (r=0.562, p&lt;0.001), E/e’ ratio (r=0.394, p=0.006), E/A ratio (r= -0.449, p=0.002), septal e’(r = -0.488, p&lt;0.001), lateral e’(r= -0.397, p= 0.006). Conclusion. RA is associated with increased arterial stiffness compared to subjects without RA.

#3829 ARTERIAL STIFFNESS AND METABOLIC SYNDROME INDICES IN RENAL TRANSPLANTATION PATIENTS

Abstract Background and Aims Although renal transplantation improves survival, cardiovascular morbidity and mortality still remain as a significant problem compared with nonrenal populations. In end stage renal disease metabolic cardiovascular risk factors such as hypertension, hyperuricemia, obesity and diabetes mellitus have been confirmed to be positively correlated with arterial stiffness. Arterial stiffness is an important characteristic of the arterial wall and can be assessed noninvasively by the measurement of carotid-femoral pulse wave velocity (PWv). The aim of this study is to evaluate the risk factors for arterial stiffness in kidney transplant recipients. Method One hundred and forty nine kidney transplant recipients from our renal transplant outpatient clinic were enrolled into the study. All patients were evaluated for their standard clinical (age, gender, duration of hemodialysis, post-transplant time), biochemical parameters. Anthropometric and body composition analyses were performed for all patients. Body compositions were analyzed by using the Body Composition Analyzer (Tanita BC- 420MA). PWv was determined from pressure tracing over carotid and femoral arteries using the SphygmoCor system. Results Patients were divided into two groups according to PWv levels. The frequency of patients with PWv ≥ 7 m/s was higher in patients with new onset diabetes (55.9%), hyperuricemia (uric acid level type="Periodical" type="Periodical" type="Periodical" type="Periodical" type="Periodical" type="Periodical" type="Periodical" type="Periodical"&amp;gt; 7 mg/dl) (p:0.029, 0.05). Higher carotid-femoral PWv was significantly related with systolic (p:0.003) and diastolic blood pressure (p:0.002), uric acid (p:0.0001) and fasting glucose (p: 0.02) levels. According to body composition analyses, muscle mass, visceral fat ratio and body weight were significantly higher in patients with PWv ≥ 7 m/s (p &amp;lt; 0.005). In patients with high PWv, sagittal abdominal diameters and waist circumferences were significantly higher than patients with PWv &amp;lt; 7 m/s. When criteria for metabolic syndrome were assessed there were a significant increase in pulse wave velocity in patients with 0-1; 2-3; and 4-5criteria (p &amp;lt; 0.01). Conclusion In post transplantation period, metabolic syndrome indices as high blood pressure, hyperuricemia, hyperglycemia and increased waist and hip circumferences are closely related with arterial stiffness. For cardiovascular risk reduction after renal transplantation; blood pressure, serum glucose and uric acid levels should be under strict control.

ARTERIAL STIFFNESS IN NORMOTENSIVE PATIENTS WITH HYPOPARATHYROIDISM COMPARED TO CONTROLS

Objective: Hypoparathyroidism is a rare disease characterized by the inability of parathyroid hormone (PTH) to maintain calcium homeostasis. Multiple etiologies, congenital or acquired can cause this morbidity. However, the most common cause is hormone deficiency secondary to cervical surgical explorations. Patients with post-surgical hypoparathyroidism have an increased risk of mortality, with various clinical and molecular evidence of the effects on the cardiovascular system. This study aimed to assess arterial stiffness by measuring the carotid-femoral pulse wave velocity (PWV) in a population of patients with hypoparathyroidism. Design and method: This is a cross-sectional study with 30 patients with post-surgical hypoparathyroidism and 25 normal volunteers from the Endocrinology Outpatient Clinic of the Medical School. Arterial stiffness was evaluated by the analysis of PWV using SphygmoCor system. Statistical analysis was made with software IBM-SPSS Statistics 27 (IBM Corporation, NY, USA). Results: The average PWV in patients with hypoparathyroidism was not different compared to controls (8.70 vs 7.50; p = 0.084). However, when comparing only normotensive patients in both groups (21 hypoparathyroidism and 16 controls), levels of PWV in patients with hypoparathyroidism was higher and statistically significant (7.64 vs 6.50; p = 0.039). Age, hypertension, LDL cholesterol levels, ionized calcium, total calcium, and the Calcium x Phosphorus product were independent predictor variables for PWV. Conclusions: Post-surgical hypoparathyroidism increases arterial stiffness in normotensive individuals, evaluated by PWV and total calcium level, as well the Calcium x Phosphorus product are involved in this condition. Therefore, vascular stiffness may be one of the pathophysiologic mechanisms of the cardiovascular disease in patients with hypoparathyroidism. Further studies are necessary to elucidate this condition.

ASSOCIATIONS BETWEEN ADHERENCE TO THE MEDITERRANEAN DIET AND 24-HOUR PULSE WAVE VELOCITY IN HYPERTENSIVE PATIENTS

Objective: A Mediterranean diet (MeDi) is characterized by high consumption of plant-based food and fish, moderate consumption of red wine, and low intake of red and processed meat, and is associated with improvement in cardiometabolic risk factors. Arterial stiffness measured by pulse wave velocity (PWV) is considered a predictor of cardiovascular events, but the association between dietary intake according to MeDi and arterial stiffness is not yet clear. The aim of this study was to determine possible associations between MeDi adherence and PWV in patients with arterial hypertension (AH). Design and method: This study included 420 participants with AH of which 50.2% were women, with an overall median age of 63.5 years (IQR = 17.3). To assess 24-hour PWV parameter, a 24-hour ambulatory blood pressure monitor IEM Mobil-O-Graph based on the oscillometry was used. In order to determine adherence to the MeDi, a validated Mediterranean Diet Serving Score (MDSS) questionnaire was used. For every participant, data about comorbidities was collected from their medical records combined with their self reports. Results: Adherence to the MeDi defined as MDSS score &gt;14 was found in 6.4% of participants. The mean value of 24-hour PWV was 9.08±1.88 m/s. Significant differences in PWV value were not found among high adherence, medium adherence and low adherence to MeDi. Positive predictors of 24-hour PWV were older age (beta = 0.128, p&lt;0.001), presence of chronic kidney disease (beta = 0.312, p&lt;0.001) and adherence to the legumes intake recommendation (beta = 0.169, p = 0.037), while the negative predictor was adherence to the dairy intake recommendation (beta = -0.174, p = 0.024). Conclusions: Exceptionally low adherence to the principles of the MeDi was noticed in hypertensive patients, with dairy and legumes suggested as predictors of 24-hour PWV. This suggests a need for structural nutritional intervention to increase adherence to the MeDi in order to decrease and reduce cardiovascular risk in this population of patients.

Effects of first-line antidiabetic drugs on the improvement of arterial stiffness: A Bayesian network meta-analysis.

Changes in vascular function are closely associated with the development of cardiovascular disease (CVD). Pulse wave velocity (PWV) is a potential indicator of vascular dysfunction; it allows noninvasive assessment of arterial stiffness. Currently, evidence for the effects of different classes of antidiabetic drugs on arterial stiffness remains limited. In this study, a network meta-analysis (NMA) was performed to explore the associations between changes in arterial stiffness and first-line antidiabetic drugs by evaluating PWV in patients with different metabolic abnormalities. We systematically searched several electronic databases for randomized controlled trials (RCTs) published from inception until 25 August 2022, without language restrictions. The primary outcome was the change in PWV (ΔPWV) in all included studies; subgroup analysis was performed for patients with abnormal glucose metabolism, including prediabetes and diabetes mellitus. NMA was performed to calculate the mean differences (MDs) with 95% confidence intervals (CIs) as effect sizes to evaluate the ΔPWV. Among the 2257 candidate articles identified in the initial search, 18 RCTs were eventually included in the analysis. In all studies, two classes of new antidiabetic drugs, glucagon-like peptide-1 receptor (GLP-1R) agonists and sSodium-glucose co-transporter 2 (SGLT-2) inhibitors, improved arterial stiffness by decreasing PWV compared with placebo (MD = -1.11, 95% CI: -1.94 to 0.28) and (MD = -0.76, 95% CI: -1.45 to -0.08). A conventional antidiabetic drug, metformin, also showed similar efficacy compared with placebo (MD = -0.73, 95% CI: -1.33 to -0.12). Finally, in subgroup studies of patients with abnormal glucose metabolism diseases, GLP-1R agonists (MD = -1.06, 95% CI: -2.05 to -0.10) significantly decreased PWV compared with placebo. Three classes of antidiabetic drugs-GLP-1R agonists, SGLT-2 inhibitors, and metformin-have the potential to improve arterial stiffness. Among the six classes of antidiabetic drugs analyzed, GLP-1R agonists constitute the only class of drugs that improves arterial stiffness in patients with abnormal glucose metabolism diseases.

The Impact of Differential Atrioventricular Delays on Arterial Distensibility Measured by Pulse Wave Velocity in Patients with Dual-chamber Pacing

The Impact of Differential Atrioventricular Delays on Arterial Distensibility Measured by Pulse Wave Velocity in Patients with Dual-chamber Pacing

Arterial Stiffness Assessment by Pulse Wave Velocity in Patients with Metabolic Syndrome and Its Components: Is It a Useful Tool in Clinical Practice?

Metabolic syndrome (MS) is not a single disease but a cluster of metabolic disorders associated with increased risk for development of diabetes mellitus and its complications. Currently, the definition of MS published in 2009 is widely used, but there are more versions of the diagnostic criteria, making it difficult to conduct scientific discourse in this area. Increased arterial stiffness (AS) can predict the development of cardiovascular disease both in the general population and in patients with MS. Pulse wave velocity (PWV), as a standard method to assess AS, may point out subclinical organ damage in patients with hypertension. The decrease in PWV level during antihypertensive therapy can identify a group of patients with better outcomes independently of their reduction in blood pressure. The adverse effect of metabolic disturbances on arterial function can be offset by an adequate program of exercises, which includes mainly aerobic physical training. Non-insulin-based insulin resistance index can predict AS due to a strong positive correlation with PWV. The purpose of this paper is to present the results of the review of the literature concerning the relationship between MS and its components, and AS assessed by PWV, including clinical usefulness of PWV measurement in patients with MS and its components.