Pulse Wave Velocity Index Research Articles

Healthy vascular ageing protects community dwelling elderly from all-cause mortality: 5-year evidence from the North Shanghai Study

Abstract Background Healthy vascular ageing (HVA) defined by normal pulse wave velocity (PWV) has been recognized as a valuable indicator of vascular status. And HVA strongly correlates with preclinical targeted organ damage (TOD). While the long-term benefit of HVA remains to be investigated. Aims To investigate the long-term outcome of population with HVA based on large registered North Shanghai Study. Methods Since Jun. 2014, 3363 community-dwelling elderly Chinese (age ≥65 years) were enrolled in the Northern Shanghai Study. HVA was defined as normal carotid femoral PWV that stratified by age and blood pressure. TOD was measured and categorized as vascular TOD indicated by carotid-femoral PWV and ankle-brachial index, cardiac TOD indicated by left ventricular hypertrophy and diastolic dysfunction, and renal TOD indicated by estimated glomerular filtration rate and urinary albumin/creatinine ratio. Follow-up outcome including all-cause mortality, cardiovascular and non-cardiovascular mortalities were evaluated. Results 1016 participants (30.2%) with HVA were identified. Compared with non-HVA group, although no gender difference, HVA group had younger age, lower blood pressure, lower body mass index (BMI), and milder TODs. Through a follow-up period of 5.7±1.8 years, 233 (6.9%) all-cause deaths, including 94 (2.8%) cardiovascular deaths were observed. Participants with HVA showed significantly higher survival from all-cause deaths (Log-rank P=0.002) and cardiovascular deaths (Log-rank P=0.003), but statistically non-significant survival from non-cardiovascular deaths (Log-rank P=0.098).Subgroup analysis showed that HVA was a significant protective factor in female (HR 0.412 (0.245, 0.692), P=0.002), participants aged 65-70 (HR 0.417 (0.194, 0.897), P=0.025), participants with BMI<25 (0.570 (0.386, 0.842) P=0.005), and participants with at least 1 TOD (HR 0.634 (0.444, 0.907), P=0.013). Moreover, the protective value of HVA was only significant in participants without cardiac TOD (0.681, (0.464, 0.998), P=0.049), participants with renal TOD (0.547, (0.354, 0.844), P=0.006), and participants with vascular TOD (0.461 (0.251, 0.848), P=0.013). Conclusion In community-dwelling elderly, HVA could be a significant protective factor for all-cause deaths, especially in subpopulation of female, age 65-70, BMI<25 and with renal and/or vascular TOD.

Abstract 18786: The Association Between Aortic Abdomen Calcification, Systemic Immune Inflammation Index, Estimated Pulse Wave Velocity, Atherogenic Index of Plasma and Triglyceride-Glucose Index Among Non-Diabetic Patients: A NHANES 2013-2014 Cross Sectional Study

Background: Not enough studies showed the predictive value of systemic immune inflammation (SII) index, estimated pulse wave velocity (EPWV) index, atherogenic index of plasma (AIP) and triglyceride glucose (TyG) index for developing abdominal aortic calcification (AAC). This study assesses the relationship between the previous indexes and the risk of AAC. Methods: National Health and Nutrition Examination Survey (NHANES) data was utilized. The study included data from 2013 to 2014. We included non-diabetic participants aged 18 years or older. All studied indexes were divided into four quartiles, except AIP, into two categories. SPSS was used for the analysis. The sensitivity and specificity of the included indexes in predicting AAC were calculated by receiver operating characteristic (ROC) analysis. We performed univariate and multivariate logistic regression to analyze the associated factors with higher values of studied indexes. Results: The analysis included 1315 non-diabetic patients, of which 324 had AAC, and 74 had severe AAC. Except for SII index, all indexes showed a statistically significant association with the presence of AAC (P < 0.05). AAC was more prevalent among patients in the third and fourth quartiles of all Triglyceride-Glucose Index models, p-value<0.05. Participants in the second quartile of the AIP were more likely to be affected by AAC, p-value<0.05. In addition, all unadjusted regression models showed that higher values of the inquired indexes were significantly associated with the risk of abdominal aortic calcification. The areas under the curve (AUC) for TyG index, AIP, and EPWV were 0.558 (95% CI 0.52-0.59), 0.551(95% CI 0.51- 0.58), 0.692 (95% CI 0.65- 0.72) (p-value ≤ 0.05), respectively. Conclusion: Among all involved indexes, the estimated pulse wave velocity index was the best indicator for abdominal aortic calcification.

Noninvasive hemodynamic indices of vascular aging: an in silico assessment.

Vascular aging (VA) involves structural and functional changes in blood vessels that contribute to cardiovascular disease. Several noninvasive pulse wave (PW) indices have been proposed to assess the arterial stiffness component of VA in the clinic and daily life. This study investigated 19 of these indices, identified in recent review articles on VA, by using a database comprising 3,837 virtual healthy subjects aged 25-75 yr, each with unique PW signals simulated under various levels of artificial noise to mimic real measurement errors. For each subject, VA indices were calculated from filtered PW signals and compared with the precise theoretical value of aortic Young's modulus (EAo). In silico PW indices showed age-related changes that align with in vivo population studies. The cardio-ankle vascular index (CAVI) and all pulse wave velocity (PWV) indices showed strong linear correlations with EAo (Pearson's rp > 0.95). Carotid distensibility showed a strong negative nonlinear correlation (Spearman's rs < -0.99). CAVI and distensibility exhibited greater resilience to noise compared with PWV indices. Blood pressure-related indices and photoplethysmography (PPG)-based indices showed weaker correlations with EAo (rp and rs < 0.89, |rp| and |rs| < 0.84, respectively). Overall, blood pressure-related indices were confounded by more cardiovascular properties (heart rate, stroke volume, duration of systole, large artery diameter, and/or peripheral vascular resistance) compared with other studied indices, and PPG-based indices were most affected by noise. In conclusion, carotid-femoral PWV, CAVI and carotid distensibility emerged as the superior clinical VA indicators, with a strong EAo correlation and noise resilience. PPG-based indices showed potential for daily VA monitoring under minimized noise disturbances.NEW & NOTEWORTHY For the first time, 19 noninvasive pulse wave indices for assessing vascular aging were examined together in a single database of nearly 4,000 subjects aged 25-75 yr. The dataset contained precise values of the aortic Young's modulus and other hemodynamic measures for each subject, which enabled us to test each index's ability to measure changes in aortic stiffness while accounting for confounding factors and measurement errors. The study provides freely available tools for analyzing these and additional indices.

COMPARISON BETWEEN CENTRAL AND AUTOMATED PERIPHERAL BLOOD PRESSURE MEASUREMENT FOR EARLY DETECTION OF KIDNEY DYSFUNCTION IN HYPERTENSIVE PATIENTS

Objective: To assess the difference of blood pressure measurements using central and automated peripheral blood pressure measurement (oscillometric) devices among patients with primary hypertension for early detection of kidney dysfunction and the validity of automated BP measurement device compared with non-invasive central BP measurement device for diagnosis of hypertension. Also, to link between parameters such as augmentation index and pulse wave velocity index and early kidney dysfunction markers. Design and method: The study is a case-comparative study that included 201 patients with primary hypertension (108 patients with chronic kidney disease and 93 patients without kidney disease). Exclusion criteria were patients presenting with secondary hypertension, diabetes mellitus (DM), end stage renal disease (ESRD) on regular dialysis, young patients below 40 and above 70 years old and patients with collagen diseases. All patients underwent blood pressure measurement by OMRON M2 and Mobil-O-Graph devices, kidney function assessment and abdominal ultrasonography. Results: Patients with chronic kidney disease were significantly older (60.02±9.1 vs. 55.33±8.5; P &lt; 0.001), with longer duration of hypertension (7.56±5.9 vs. 6.05±5.8; P = 0.020) in comparison to those without chronic kidney disease. Automated peripheral measurement of systolic blood pressure, diastolic blood pressure and pulse pressure were significantly higher in comparison to central blood pressure. Patients with chronic kidney disease had significantly higher augmentation index (24.06±12.6 vs. 19.02±10.8; P &lt; 0.001) and pulsed wave velocity (8.66±1.5 vs. 8.69±6.8; P = 0.004) in comparison to those without chronic kidney disease. Augmentation index had positive correlation with pulse wave velocity (r = 0.183, P = 0.005). There was negative correlation between both pulse wave velocity and augmentation index and estimated glomerular filtration rate (r = -0.318, P &lt; 0.001), and (r = -0.236, P &lt; 0.001), respectively. Hence, arterial stiffness parameters are good positive test for prediction of chronic kidney disease. Conclusions: There is a strong agreement between non-invasive centrally and automated peripherally measured blood pressure in diagnosis of hypertension. But non-invasive central measurements are preferred over automated measurements for early prediction and detection of renal impairment.

CAROTID-FEMORAL PULSE WAVE VELOCITY AND STIFFNESS INDEX MEASURED 5-15 YEARS EARLIER WERE SIGNIFICANTLY HIGHER IN DECEASED THAN IN STILL LIVING TREATED FINNISH HYPERTENSIVE PATIENTS

Objective: To clarify if there is a difference in pulse wave velocity (PWV) measured in the years 2006-2014 (n = 251) comparing in the years 2015-2022 deceased (n = 40) and in the beginning of the year 2023 still living (n = 211) Finnish drug-treated hypertensive patients participating that PWV measurement. Design and method: A Doppler ultrasonography device (Micro Medical PulseTrace PWV and PCA, Micro Medical Ltd, Rochester, Kent, UK) was used to measure carotid-femoral (C-F) PWV and photoplethysmographic transducer of the same machine to measure stiffness index (SI) and resistance index (RI) in 251 Finnish drug-treated hypertensive patients (126 females and 125 males) during the years 2006-2014. At the time of measurement the mean age of the patients was 64.0 (8.3) years. Results: The age at death of the deceased patients was 79.6 (SD 8.14, median 82, range 62-91) years (n = 40). The age in 01Jan2023 living patients was 75.1 (SD 7.6, median 76, range 45-91) years (n = 211), p = 0.0001 between the two groups. The mean C-F PWV was 12.5 (3.6) in deceased and 10.4 (2.2) m/s (p = 0.0001) in living and SI respectively 11.0 (3.4) and 9.6 (2.9) m/s (p = 0.007). No significant difference between the groups was seen in RI. Mean office systolic blood pressure was 150.0 (18.8) mmHg in deceased and 137.5 (14.5) in living (p = 0.003) and respectively mean office diastolic pressure 86.4 (9.2) and 83.4 (9.2) mmHg (p = 0.058). The three most common causes of death were malignancy (n = 13), sudden death (n = 10) and high age (n = 9). Dementia was noticed before death in 13 patients. Conclusions: Carotid-femoral PWV and stiffness index measured 5-15 years earlier were significantly higher in deceased than in still living treated Finnish hypertensive patients Deceased patients were older and their systolic blood pressure was higher which may explain the difference. Malignancies were a common cause of death as also diagnosed dementia in these hypertensive patients. More studies are needed concerning the predictive value of PWV in hypertensive patients.

HEALTHY VASCULAR AGEING PROTECTS COMMUNITY DWELLING ELDERLY FROM ALL-CAUSE MORTALITY: 5-YEAR EVIDENCE FROM THE NORTH SHANGHAI STUDY

Objective: Healthy vascular ageing (HVA) defined by normal pulse wave velocity (PWV) has been recognized as a valuable indicator of vascular status. And HVA strongly correlates with preclinical targeted organ damage (TOD). While the long-term benefit of HVA remains to be investigated. The study aims to investigate the long-term outcome of population with HVA based on large registered North Shanghai Study. Design and method: Since Jun. 2014, 3363 community-dwelling elderly Chinese (age larger than 65 years) were enrolled in the Northern Shanghai Study. HVA was defined as normal carotid femoral PWV that stratified by age and blood pressure. TOD was measured and categorized as vascular TOD indicated by carotid-femoral PWV and ankle-brachial index, cardiac TOD indicated by left ventricular hypertrophy and diastolic dysfunction, and renal TOD indicated by estimated glomerular filtration rate and urinary albumin/creatinine ratio. Follow-up outcome including all-cause mortality, cardiovascular and non-cardiovascular mortalities were evaluated. Results: 1016 participants (30.2%) with HVA were identified. Compared with non-HVA group, although no gender difference, HVA group had younger age, lower blood pressure, lower body mass index (BMI), and milder TODs. Through a follow-up period of 5.7±1.8 years, 233 (6.9%) all-cause deaths, including 94 (2.8%) cardiovascular deaths were observed. Participants with HVA showed significantly higher survival from all-cause deaths (Log-rank P = 0.002) and cardiovascular deaths (Log-rank P = 0.003), but statistically non-significant survival from non-cardiovascular deaths (Log-rank P = 0.098). Subgroup analysis showed that HVA was a significant protective factor in female (HR 0.412 (0.245, 0.692), P = 0.002), participants aged 65-70 (HR 0.417 (0.194, 0.897), P = 0.025), participants with BMI&lt;25 (0.570 (0.386, 0.842) P = 0.005), and participants with at least 1 TOD (HR 0.634 (0.444, 0.907), P = 0.013). Moreover, the protective value of HVA was only significant in participants without cardiac TOD (0.681, (0.464, 0.998), P = 0.049), participants with renal TOD (0.547, (0.354, 0.844), P = 0.006), and participants with vascular TOD (0.461 (0.251, 0.848), P = 0.013). Conclusions: In community-dwelling elderly, HVA could be a significant protective factor for all-cause deaths, especially in subpopulation of female, age 65-70, BMI&lt;25 and with renal and/or vascular TOD.

The effect of statin therapy on the elastic properties of blood vessels in patients with arterial hypertension

Annotation. It is common knowledge that the elastic properties of blood vessels change with age. Many domestic and foreign authors acknowledge the impact of the increase in stiffness and decrease in elasticity of large arteries on the pathogenesis of most cardiovascular diseases, particularly in the development of arterial hypertension. The aim is to evaluate the comparative effectiveness of atorvastatin and rosuvastatin on vascular stiffness in patients with arterial hypertension. 75 patients with arterial hypertension aged 44.4±0.99 years were examined. 15 apparently healthy individuals were selected for the control group. All patients were divided into 3 groups depending on the therapy. Pulse wave velocity (PWV) measurements were performed twice using the generally accepted carotid-femoral technique. The inclusion criteria for participation in the study were: patient age up to 59 years; arterial hypertension of the I and II degrees. Statistical data processing was carried out using the Statistica 10.0 program. The significance of the differences between the groups in quantitative terms was assessed using the Student's t-test. In all the studied groups, the initial index of PWV exceeded its norm. Against the background of treatment, a significant decrease in this indicator was observed in all 3 groups. The most positive effect was obtained in patients who additionally received statins. Rosuvastatin showed the best results. Thus, the modern strategy of treating patients with arterial hypertension should also be aimed at achieving regression of vascular remodeling. The use of statins improves the elastic properties of blood vessels.

Neighborhood characteristics and arterial stiffness among Black adults - Results from the Jackson Heart Study and Morehouse-Emory Cardiovascular Center for Health Equity.

Poor quality neighborhood environments are independent risk factors for cardiovascular disease (CVD) but are understudied in Black adults, who face large CVD health disparities. Arterial stiffness, a marker of early vascular aging, precedes development of hypertension and adverse CVD events but the effect of neighborhood on arterial stiffness among Black adults remains unknown. We compared the association between neighborhood environment and arterial stiffness among Black adults in Jackson, MS and Atlanta, GA. We studied 1582 Black adults (mean age 53 ± 10, 35% male) living in Jackson, MS from the Jackson Heart Study (JHS) and 451 Black adults (mean age 53 ± 10, 39% male) living in Atlanta, GA from the Morehouse-Emory Cardiovascular Center for Health Equity (MECA) study, without known CVD. Neighborhood problems (includes measures of aesthetic quality, walking environment, food access), social cohesion (includes activity with neighbors), and violence/safety were assessed using validated questionnaires. Arterial stiffness was measured as pulse wave velocity (PWV) using magnetic resonance imaging in JHS and as PWV and augmentation index (AIx) using applanation tonometry (SphygmoCor, Inc.) in MECA. Multivariable linear regression models were used to examine the association between neighborhood characteristics and arterial stiffness, adjusting for potential confounders. Improved social characteristics, measured as social cohesion in JHS (β = -0.32 [-0.63, -0.02], p = 0.04) and activity with neighbors (β = -0.23 [-0.40, -0.05], p = 0.01) in MECA, were associated with lower PWV in both cohorts and lower AIx (β = -1.74 [-2.92, - 0.56], p = 0.004) in MECA, after adjustment for CVD risk factors and income. Additionally, in MECA, better food access (β = -1.18 [-2.35, - 0.01], p = 0.05) was associated with lower AIx and, in JHS, lower neighborhood problems (β = -0.33 [-0.64, - 0.02], p = 0.04) and lower violence (β = -0.30 [-0.61, 0.002], p = 0.05) were associated with lower PWV. Neighborhood social characteristics show an independent association with the vascular health of Black adults, findings that were reproducible in two distinct American cities.

Early Vascular Aging in Obese Individuals with Low Cardiovascular Health

The American Heart Association updated the original recommendations for cardiovascular health (CVH) promotion, defining the Life's Essential 8 (L8). the aim of this cross-sectional study was to compare vascular function, central hemodynamics and autonomic modulation in obese individuals with low and moderate CVH-L8. Both sexes, aged 40-70 years and Body Mass Index ≥30 and <40kg/m2, were submitted to anthropometric and biochemical evaluation, assessment of heart rate variability, endothelial function by flow-mediated dilatation (FMD) and central parameters by oscillometry. The CVH-L8 score was determined using the eight metrics defined in the new classification. Patients (n = 82) were divided according to CVH-L8 classification: moderate group (score CVH-L8 ≥ 50 ≤ 79 points, n = 47) and low group (score CVH-L8 ≤ 49 points, n = 35). Peripheral (119 ± 10 vs 125 ± 15 mmHg, p = 0.048) and central (111 ± 10 vs 118 ± 15 mmHg; p = 0.016) systolic blood pressures and pulse wave velocity (PWV) adequacy (- 0.08 ± 0.34 vs 0.15 ± 0.42m/s, p = 0.008) were significantly higher in low CVH-L8 group. Brachial FMD (9.24 ± 5.41 vs 6.79 ± 4.74%, p = 0.043) were lower in this same group. Only in the low CVH-L8 group low frequency/high frequency (LF/HF) ratio was significantly correlated with PWV (r = 0.338, p = 0.047) and atherogenic index of plasma with Framingham risk score (r = 0.446, p = 0.008), even after adjustment for age and sex. In this sample of obese individuals, low CVH-L8 was associated with higher peripheral and central blood pressures, and evidence of early vascular aging with arterial stiffness and endothelial dysfunction.

Comparison of carotid-femoral and brachial-ankle pulse wave velocity in association with carotid plaque in a Chinese community-based population.

Pulse wave velocity (PWV) is the most widely used measurement of arterial stiffness in clinical practice. This study aimed to evaluate and compare the relationships between carotid-femoral pulse wave velocity (cfPWV) and brachial-ankle PWV (baPWV) and the presence of carotid plaque. This study was designed cross-sectionally and included 6027 participants from a community-based cohort in Beijing. Logistic regression analyses were performed to evaluate and compare the associations of cfPWV and baPWV with the presence of carotid plaque. The mean (SD) cfPWV and baPWV were 8.55±1.83 and 16.79±3.36, respectively. The prevalence of carotid plaque was 45.26% (n=2728). Both cfPWV (per 1m/s increase: OR=1.11, 95% CI: 1.07-1.16) and baPWV (OR=1.04, 95% CI: 1.02-1.06) were independently associated with carotid plaque after adjusting for various confounders. Compared with bottom quartile (cfPWV ≤7.31m/s and baPWV ≤14.44m/s), the top quartile of cfPWV and baPWV had a significantly higher prevalence of carotid plaque (for cfPWV: OR=1.59, 95% CI: 1.32-1.92; for baPWV: OR=1.53, 95% CI: 1.26-1.86). However, the relationship of baPWV and carotid plaque was nonlinear, with a positive trend only when baPWV<16.85m/s. When comparing relationships between PWV indices and carotid plaque in one model, both cfPWV and baPWV were significantly associated with carotid plaque in participants with baPWV<16.85m/s; however, only cfPWV was independently associated with carotid plaque in participants with baPWV ≥16.85m/s. Both cfPWV and baPWV were significantly associated with carotid plaque in the Chinese community-based population. Furthermore, cfPWV was more strongly correlated with carotid plaque than baPWV in participants with baseline baPWV ≥16.85m/s.

White coat hypertension is another clinical characteristic of patients with inflammatory bowel disease: A cross-sectional study.

In this cross-sectional study, our aim was to analyze association of ambulatory blood pressure monitoring (ABPM) values with pulse wave velocity (PWV) in inflammatory bowel disease (IBD) patients as well as the prevalence and characteristics of white coat hypertension (WCH) in this group of patients with chronic inflammation and high prevalence of anxiety. We enrolled 120 consecutive IBD patients (77 Crohn´s disease; 43 ulcerative colitis) who were not treated with antihypertensive drugs without cardiovascular, cerebrovascular and renal morbidity. Office blood pressure, ABPM, and PWV were measured with Omrom M6, SpaceLab 90207, and Arteriograph, respectively. The prevalence of true normotension, sustained hypertension and WCH was analyzed in IBD patients. WCH was found in 27.5% patients. IBD-WCH patients had significantly lower prevalence of traditional risk factors than general WCH subjects. PWV and augmentation index (AIx) values were higher in WCH than in true normotensive patients. When adjusted for age and duration of IBD, only PWV was a positive predictor of WCH, and patients with higher PWV and longer disease duration had OR´s for WCH of 0.69 and 2.50, respectively. IBD patients had significantly higher prevalence of WCH and higher PWV values than healthy control patients. WCH is highly prevalent in IBD patients but IBD-WCH patients have lower frequency of traditional cardiovascular risk factors than general WCH population. Our results suggest that WCH could be considered as another clinical characteristic of IBD which is associated with increased arterial stiffness and those patients should be monitored more closely.

Lp(a) is not associated with arterial stiffness: a Mendelian randomization study

Abstract Background Deeper understanding of the potential causal relationship between Lp(a) and vascular injury will provide further insight to related pathways to be monitored and targeted by emerging treatments. Accumulating evidence supports the causal association of lipoprotein(a) [Lp(a)] with cardiovascular disease and calcific aortic valve disease (AVD). Arterial stiffening is mechanistically linked with cardiovascular disease and AVD severity. We hypothesized that Lp(a) may be causally associated with pulse-wave velocity (PWV) as the gold-standard marker of arterial stiffness. Aim To investigate the potential causal association of Lp(a) levels with PWV. Methods We performed a two sample Mendelian randomization (MR) analysis of LP(a) on PWV by combining the summary data of two independent Genetic-Wide Association Study (GWASs). Genetic variants associated with Lp(a) were retrieved from the UK Biobank (N=220,497). A GWAS based on a cohort in Germany (N=7,000) was used to obtain genetic associations for PWV index (outcome). We assessed two different measures of arterial stiffness, brachial ankle (baPWV) and carotid femoral pulse (cfPWV) wave velocity. In total, we used 170 SNPs as Instrument Variables (IV's) and applied a two sample MR with the main technique of Inverse Variance Weighting method (IVW). We conducted sensitivity analyses (MR-Egger and Median based) to detect pleiotropy of the causal variants and to test for robustness of our findings. Results Our analyses based on all 170 SNP's did not find evidence for causal relationship between Lp(a) and PWV for neither measurement [bivw (baPWV) = −0.0005, CI (−0.0043, 0.0034), P=0.8 and bivw (cfPWV) = −0.006, CI (−0.013, 0.002), P=0.16 for brachial ankle and carotid-femoral PWV, respectively]. Sensitivity analyses, including weighted median and mode-based estimation, did not show significant association of Lp (a) with neither baPWV nor cfPWV. Conclusions Lp(a) is not causally associated with arterial stiffness. These findings suggest that arterial stiffening is not involved Lp(a)-mediated cardiovascular and aortic valve disease. Funding Acknowledgement Type of funding sources: None.

Hemodialysis Parameters and Pulse Wave Velocity.

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

ARTERIAL STIFFNESS GRADIENT PREDICTS INDEPENDENTLY FUNCTIONAL OUTCOME AFTER ISCHEMIC STROKE

Objective: Arterial stiffness is a strong predictor of morbidity in various clinical conditions, including ischemic stroke. However, the prognostic significance of the newly emerged aortic–brachial arterial stiffness gradient, defined as carotid–femoral/radial -carotid pulse wave velocity (PWV ratio) for functional outcome in ischemic stroke remains unknown. Design and method: We enrolled 144 patients (114 males, age 63.1 ± 12.4 years, mean ± SD) with acute ischemic stroke (NIHSS score at admission 6.6 ± 5.3 points). Carotid-femoral pulse wave velocity (PWV), radial –carotid PWV and peripheral blood pressure (BP) were measured (SphygmoCorâ) within several (6 ± 2) days after stroke onset. Functional outcome was evaluated 90 days after stroke using the modified Rankin Scale (mRS) with an mRS score of 3 to 6 (dependency or death) considered as a poor outcome. Results: PWV ratio was higher in patients with a poor stroke outcome than in patients of the reference group (1.34 ± 0.58 vs 1.17 ± 0.30; p = 0.017). In a multivariate analysis, the predictive value of PWV ratio remained significant (OR, 3.62; 95% CI, 1.04–12.75; p = 0.044) after adjustment for covariates. In contrast, CF PWV had no significant predictive value for stroke poor outcome. Conclusions: We found that the higher PWV ratio in patients in the subacute phase of ischemic stroke is independently associated with a poor outcome. This PWV index might be useful in clinical practice, including therapeutic decisions, but needs broader studies in patient populations of stroke subtypes.

Effect of alpha-lipoic acid on arterial stiffness parameters in type 2 diabetes mellitus patients with cardiac autonomic neuropathy.

Objective. Significantly underdiagnosed, diabetes-associated cardiac autonomic neuropathy (CAN) causes a wide range of cardiac disorders that may cause life-threatening outcomes. This study investigated the effects of alpha-lipoic acid (ALA) on arterial stiffness and insulin resistance (IR) parameters in type 2 diabetes mellitus (T2D) patients and definite CAN. Methods. A total of 36 patients with T2D and a definite stage of CAN were recruited. This investigation was carried out on two separate arms: traditional hypoglycemic therapy (n=18, control) and ALA (n=18) 600 mg in film-coated tablets/q.d. in addition to traditional hypoglycemic therapy. The duration of the study was three months. Results. In subjects with T2D and definite stage of СAN, treatment with ALA resulted in a significant decrease of glucose, immunoreactive insulin concentration, and Homeostasis Model Assessment (HOMA)-IR (HOMA-IR) parameters; pulse wave velocity (PWV), aorta augmentation index (AIxao) during the active period of the day and decrease of PWV, AIxao, and brachial augmentation index during the passive period of the day compared with the results, obtained in the control group. Therefore, the administration of ALA to patients with T2D for three months promotes the improvement of glucose metabolism and arterial stiffness parameters. Conclusions. In patients with T2D and definite stage of СAN treatment with ALA improved HOMA-IR and arterial stiffness parameters. These findings can be of clinical significance for the complex treatment of diabetes-associated CAN.

Masked hypertension risk as condition of arterial stiffness in cardiovascular risk patients: a pilot single-stage screening observational study

Background. Masked arterial hypertension (MAH) is associated with asymptomatic injury of both heart and kidneys. Links between MAH and arterial stiffness are unclear, with debates ongoing on their mutual causative relation. Research into the arterial stiffness contribution to MAH development is a perspective area of cardiology.Objectives. The MAH risk assessment as a condition of arterial stiffness in patients at cardiovascular risk (CVR) without a verified cardiovascular disease (CVD).Methods. A single-stage screening observational study included a total of 92 CVR patients without a verified cardiovascular disease. The trial conducted general clinical examination, daily blood pressure monitoring (DBPM), volumetric sphygmoplethysmography with reading cardio-ankle vascular index (CAVI1), aortic and carotid artery pulse wave velocity (PWV), carotid-femoral PWV (CFV) and augmentation index.Results. Patients were assigned in two cohorts by MAH presence, the primary MAH (58; 63.0%) and normal BP in DBPM (34; 37.0% patients) cohorts. The cohorts did not discord by age, major CVR factors, comorbidity or clinical profile. Men prevailed over women in the MAH cohort (p = 0.028). The cohorts had similar CFV, aortic PWV and augmentation index. Carotid PWV was higher in the MAH cohort both in mean values and elevation rate (p = 0.002 and p = 0.035, respectively). OR and HR were 3.29 and 2.35 (95% CI for OR 1.08–10.49, HR 1.05– 6.02), respectively. MAH was associated with increased CAVI1 for mean values and CAVI1 &gt; 8 incidence rate (p = 0.010 and 0.049, respectively); OR 3.29 (95% CI 1.00–11.41), HR 2.46 (95% CI 1.00–7.10). Correlation analysis revealed a moderate direct dependence between the MAH presence and elevation rate of C-PWV (Q = 0.53) and CAVI1 &gt; 8 (Q = 0.53).Conclusion. The risk of MAH development in CVR patients is both gender and arterial stiffness-dependent. MAH development is associated with increased CAVI1 and carotid PWV.

Abstract 003: Neighborhood Characteristics And Arterial Stiffness Among Black Adults - Results From The Jackson Heart Study &amp; Morehouse Emory Center For Health Equity

Introduction: Poor quality neighborhoods are independent risk factors for cardiovascular disease (CVD) but are understudied in Blacks, who face large CVD health disparities. Arterial stiffness (AS) precedes development of hypertension and adverse CVD events but the effect of neighborhood on AS among Blacks remain unknown. Objective: We compared the association between neighborhood environment and AS among Blacks in Jackson, MS and Atlanta, GA. Methods: We studied 1592 Blacks (age 58 ± 10, 38% male) living in Jackson, MS from the Jackson Heart Study (JHS) and 451 Blacks (age 53 ± 10, 39% male) living in Atlanta, GA from the Morehouse/Emory Center for Health Equity (MECA) study, without known CVD. Neighborhood problems (includes measures of aesthetic quality, walking environment, food access), social cohesion (includes activity with neighbors), and violence/safety were assessed using validated questionnaires. AS was measured as pulse wave velocity (PWV) using MRI in JHS and as PWV and augmentation index (AIx) using applanation tonometry (Sphygmocor Inc) in MECA. Multivariable linear regression models were used to examine the association between neighborhood characteristics and AS, adjusting for potential confounders. Results: Improved social characteristics, measured as social cohesion in JHS (β = -0.32 [-0.63, - 0.02], p=0.04) and activity with neighbors (β = -0.23 [-0.40, - 0.05] p=0.01) in MECA, were associated with lower PWV in both cohorts and lower AIx (β = -1.74 [-2.92, - 0.56], p=0.004) in MECA, after adjustment for CVD risk factors and income. Additionally, in MECA better food access (β = -1.18 [-2.35, - 0.01], p=0.05) was associated with lower AIx, and in JHS, lower neighborhood problems (β = -0.33 [-0.64, - 0.02], p=0.04) and lower violence (β = -0.30 [-0.61, 0.002], p=0.05) were associated with lower PWV (Fig). Conclusion: Neighborhood social characteristics show an independent association with vascular health of Blacks, findings that were reproducible in two distinct American cities.

ARTERIAL STIFFNESS AND WAVE REFLECTIONS IN PATIENTS WITH SERONEGATIVE SPONDYLOARTHROPATHIES TREATED WITH TUMOR NECROSIS ALPHA BLOCKERS

Objective: The seronegative spondyloarthropathies (SpA) are a group of rheumatic disorders characterized by oligoarticular arthritis, enthesitis and axial involvement. Cardiovascular manifestations play a pivotal role in determining the excess mortality in SpA, owing to the linkage between systemic inflammation and accelerated atherogenesis. Arterial stiffness measured as carotid-femoral pulse-wave velocity (PWV) and wave reflections are validated markers of cardiovascular disease. Anti-inflammatory therapy with anti-tumor necrosis factor-α (TNFα) agents may have a role in reducing arterial stiffening in some disease models but data in patients with SpA are inconclusive. Design and method: Twenty-three patients with a short duration and high disease activity SpA (8 males, 15 females, mean age 53.9 ± 11.5 years) and without overt cardiovascular disease were enrolled. PWV and augmentation index (AIx, as a measure of wave reflections) were measured by a validated arterial tonometer (PulsePen, DiaTecne, Milan). Patients were compared with 23 controls matched for age, gender, blood pressure and heart rate. Arterial tonometry was repeated in 10 patients after 16 weeks of treatment with an anti-TNFα agent (Adalimumab, in 9 patients; Certolizumab, in 1 patient). Results: Of the patients enrolled, 14 had ankylosing spondylitis, 8 psoriatic SpA, 1 Crohn's disease-associated SpA. The median duration of the disease from diagnosis was 2 years (2–11 years). In the comparison with matched controls, no significant differences in PWV or AIx were found (PWV: SpA 8.9 ± 2.0 m/s, controls 9.2 ± 3.8m/s, p = 0.80; AIx: SpA 18.3 ± 14.7, controls 19.5 ± 12.0, P = 0.77). During the 16-weeks follow-up of patients treated with anti-TNFα therapy, despite significant improvement in disease activity parameters (ASDAS-CRP: 2.75 ± 0.8 to 1.67 ± 0.4, P &lt; 0.01; BASDAI: 5.05 ± 1.9 to 3,0 ± 1.2, P 0.05), no significant change was found in the hemodynamic parameters (PWV: 8.5 ± 1.8 to 9.7 ± 3.5 m/s, p = 0.11; AIx 16.6 ± 15.5 to 13.7 ± 10.0, p = 0.47). Conclusions: In patients with a short duration SpA, arterial stiffness and wave reflections are not significantly impaired. Anti-TNFα agents have no effects on arterial stiffness parameters in the short term, despite control of clinical and inflammatory burden. Forthcoming studies should explore the cardiovascular effects of novel therapeutics opportunities (anti-IL12/23 and anti-IL17) in patients with SpA.

The relevance of performing 24-hour ambulatory blood pressure and pulse waveanalysis in kidney transplant recipients.

Hypertension guidelines recommend out-of-office blood pressure (BP) measurement especially 24-hour ambulatory measurement (ABPM), to diagnose and manage hypertension but this is not routinely performed in kidney transplant units. This study was to determine if 24-hour ABPM, compared with office BP in kidney transplant recipients, would be more informative regarding BP management, and if pulse wave analysis (PWA) would assist in risk stratification. This study included patients older than 18 years, with working graft kidney for &gt;12months, and without problems affecting BP measurement and interpretation. After performing office BP measurements, a 24-hour ABPM with additional capability of calculating pulse wave velocity (PWV), augmentation index and central BP was undertaken. Patients were assessed for controlled hypertension, uncontrolled hypertension, masked hypertension, nocturnal hypertension, white coat hypertension, and dipping BP status. Data were analyzed using standard statistical tests. Of 30 patients, 15 were Black Africans and 15 were of Mixed Ancestry with a mean age of 48.9 years. 17 patients were males and 36.7% had controlled hypertension, 30% uncontrolled hypertension, 6.7% white coat hypertension, and 33.3% masked hypertension, of whom 70% had isolated nocturnal hypertension. 70% had a non-dipping, 26.7% a reverse dipping and only 3.3% had a normal dipping BP pattern. The mean difference between brachial systolic BP and central systolic BP was 10.4mmHg, whereas PWV and augmentation index were similar to healthy populations. Conclusion: In kidney transplant recipients, 24-hour ABPM was superior to office BP in defining hypertensive status that qualified for modification of therapy, but PWA did not contribute to risk assessment.

PTX3 as a biomarker of lowered arterial stiffness due to weight loss in overweight and obese Japanese men

Background: Obesity, an independent cardiovascular disease risk factor, is the leading cause of death in the world. It has been previously shown that arterial stiffness,which is an index of cardiovascular disease, is significantly higher in Japanese overweight and obese men. Increased levels of pentraxin3 (PTX3), a novel anti-inflammatory substance mainly produced in the atherosclerotic region, due to weight reduction has been proposed to reflect an improvement in arterial stiffness. However, this has not been investigated. Methods: Here, we elucidate whether an individual who has significantly increased plasma PTX3 concentration result in a significantly decreased arterial stiffness compared to a smaller change in PTX3 level after a 12-week dietary modified weight reduction program in twenty overweight or obese Japanese men. A well-balanced dietary modification weight-loss program was implemented for overweight and obese men over a course of 12-week. Results: Prior to and after the program, we measured anthropometric variables, blood pressure, arterial stiffness, and circulating biochemistry, including plasma PTX3 concentrations. We then compared the differences in arterial stiffness between two groups, low or high ΔPTX3 groups, based on the median of delta of plasma PTX3 levels before and after weight reduction via modified diet habit in men with overweight and obesity. Carotid-femoral pulse wave velocity (PWV) as index of central arterial stiifness and brachial-ankle PWV as index of whole body arterial stiffness were significantly decreased in the high ΔPTX3 group after dietary modification. Conclusions: Our present results suggest that PTX3 could be a clinically useful biochemical index for monitoring appropriate arterial function maintenance in obese weight control.