Pulse Wave Research Articles

Efficacy of antihypertensive treatment for target organ protection in patients with masked hypertension (ANTI-MASK): a multicentre, double-blind, placebo-controlled trial

Masked hypertension is associated with target organ damage (TOD) and adverse health outcomes, but whether antihypertensive treatment improves TOD in patients with masked hypertension is unproven. In this multicentre, randomised, double-blind, placebo-controlled trial at 15 Chinese hospitals, untreated outpatients aged 30-70 years with an office blood pressure (BP) of <140/<90mm Hg and 24-h, daytime or nighttime ambulatory BP of ≥130/≥80, ≥135/≥85, or ≥120/≥70mm Hg were enrolled. Patients had ≥1 sign of TOD: electrocardiographic left ventricular hypertrophy (LVH), brachial-ankle pulse wave velocity (baPWV) ≥1400cm/s, or urinary albumin-to-creatinine ratio (ACR) ≥3.5mg/mmol in women and ≥2.5mg/mmol in men. Exclusion criteria included secondary hypertension, diabetic nephropathy, serum creatinine ≥176.8μmol/L, and cardiovascular disease within 6 months of screening. After stratification for centre, sex and the presence of nighttime hypertension, eligible patients were randomly assigned (1:1) to receive antihypertensive treatment or placebo. Patients and investigators were masked to group assignment. Active treatment consisted of allisartan starting at 80mg/day, to be increased to 160mg/day at month 2, and to be combined with amlodipine 2.5mg/day at month 4, if the ambulatory BP remained uncontrolled. Matching placebos were used likewise in the control group. The primary endpoint was the improvement of TOD, defined as normalisation of baPWV, ACR or LVH or a ≥20% reduction in baPWV or ACR over the 48-week follow-up. The intention-to-treat analysis included all randomised patients, the per-protocol analysis patients who fully adhered to the protocol, and the safety analysis all patients who received at least one dose of the study medication. This study is registered with ClinicalTrials.gov, NCT02893358. Between February 14, 2017, and October 31, 2020, 320 patients (43.1% women; mean age±SD 53.7±9.7 years) were enrolled. Baseline office and 24-h BP averaged 130±6.0/81±5.9mm Hg and 136±8.6/84±6.1mm Hg, and the prevalence of elevated baPWV, ACR and LVH were 97.5%, 12.5%, and 7.8%, respectively. The 24-h BP decreased on average (±SE) by 10.1±0.9/6.4±0.5mm Hg in 153 patients on active treatment and by 1.3±0.9/1.0±0.5mm Hg in 167 patients on placebo. Improvement of TOD occurred in 79 patients randomised to active treatment and in 49 patients on placebo: 51.6% (95% CI 43.7%, 59.5%) versus 29.3% (22.1, 36.5%; p<0.0001). Per-protocol and subgroup analyses were confirmatory. Adverse events were generally mild and occurred in 38 (25.3%) and 43 (26.4%) patients randomised to active treatment and placebo, respectively (p=0.83). Our results suggest that antihypertensive treatment improves TOD in patients with masked hypertension, highlighting the need of treatment. However, the long-term benefit in preventing cardiovascular complications still needs to be established. Salubris China.

Cardiovascular Risk Evaluation in Psoriatic Arthritis by Aortic Stiffness and the Systemic Coronary Risk Evaluation (SCORE): Results of the Prospective PSOCARD Cohort Study.

Psoriatic arthritis (PsA) is associated with increased cardiovascular (CV) risk and mortality. Aortic stiffness measured by carotid-femoral pulse wave velocity (cfPWV) has been shown to predict CV risk in the general population. The present study aimed to examine cfPWV values of patients with PsA compared to healthy controls and to evaluate associations of cfPWV with patient- and disease-associated characteristics, as well as with an established traditional CV prediction score of the European Society of Cardiology (Systemic Coronary Risk Evaluation; SCORE), for the first time. cfPWV and SCORE were evaluated in patients with PsA and healthy controls, along with clinical and laboratory disease parameters. Differences in cfPWV measurements between the two groups and associations of cfPWV with patient- and disease-associated characteristics were statistically evaluated. A total of 150 patients with PsA (PSOCARD cohort) and 88 control subjects were recruited. cfPWV was significantly higher in the PsA group compared to controls, even after adjustment for confounders (padj = 0.034). Moreover, cfPWV was independently associated with disease duration (r = 0.304, p = 0.001), age (rho = 0.688, p < 0.001), systolic arterial pressure (rho = 0.351, p < 0.001), glomerular filtration rate (inverse: rho = - 0.264, p = 0.001), and red cell distribution width, a marker of major adverse CV events (MACE) (rho = 0.190, p = 0.02). SCORE revealed an elevated CV risk in 8.73% of the patients, whereas cfPWV showed increased aortic stiffness and end-organ disease in 16.00% of the same cohort. In the largest cfPWV/PsA cohort examined to date, patients with PsA exhibited increased aortic stiffness compared to healthy controls. PsA duration was the most important independent disease-associated predictor of increased aortic stiffness, next to traditional CV risk factors. cfPWV measurements may help identify subclinical end-organ disease and abnormal aortic stiffness and thus assist CV risk classification in PsA.

Pulse Wave Velocity and Cardiac Abnormalities in Young Adults: Insights from Cardiac Magnetic Resonance Imaging

Pulse Wave Velocity and Cardiac Abnormalities in Young Adults: Insights from Cardiac Magnetic Resonance Imaging

Homocysteine, blood pressure and gene–diet interactions in relation to vascular function measures of black South Africans

Background and AimsWe investigated circulating homocysteine (Hcy), a cardiovascular disease (CVD) risk factor, examining its dietary associations to provide personalized nutrition advice. This study addressed the inadequacy of current dietary interventions to ultimately address the disproportionately high incidence of CVD in Black populations. Methods and Results: Cross-sectional analyses of 1,867 Black individuals of the PURE-SA study allowed the identification of dietary intake and cardiovascular measure interactions on three sub-categories: (1) normal blood pressure (BP), hypertension or Hcy-related hypertension (H-type), (2) low, normal or high Hcy concentrations, and (3) Hcy-related genetic combinations. Favorable body composition, but adverse dietary intake and cardiovascular determinants, were observed in higher Hcy categories. H-types, compared to regular hypertensives, had higher alcohol and lower macronutrient and micronutrient consumption. Inverse associations with carotid-radial pulse wave velocity were evident between monounsaturated fatty acid (FA) consumption and H-type hypertension as well as polyunsaturated FA and CBS883/ins68 TT carriers. Energy intake was positively associated with vascular cell adhesion molecule-1 (VCAM-1) in variant CBST883C/ins68 and CBS9276 GG carriers. VCAM-1 was also positively associated with plant protein intake in CBS9276 GG and MTR2756 AA carriers and negatively with total protein intake and CBS9276 GG carriers. Alcohol intake was positively associated with intercellular adhesion molecule-1 in MTR2756 minor allele carriers. Conclusion: Because Hcy gene-diet interactions are evident, personalized nutrition, by adjusting diets based on genetic profiles (e.g., CBS and MTR variations) and dietary interactions (e.g., FAs and proteins), can enhance cardiovascular outcomes by managing Hcy and related hypertension in genetically susceptible individuals.

Association between estimation of pulse wave velocity and all-cause mortality in critically ill patients with non-traumatic subarachnoid hemorrhage: an analysis based on the MIMIC-IV database

Association between estimation of pulse wave velocity and all-cause mortality in critically ill patients with non-traumatic subarachnoid hemorrhage: an analysis based on the MIMIC-IV database

Advancing the Local Pulse Wave Velocity Measurement-Wave Confluence Decomposition Using a Double Gaussian Propagation Model.

Background Pulse wave velocity (PWV) is a marker of arterial stiffness and local measurements could facilitate its widescale clinical use. However, confluence of incident and early reflected waves leads to biased spatiotemporal PWV estimates. Objective We introduce the Double Gaussian Propagation Model (DGPM) to measure local PWV in consideration of wave confluence (PWV[Formula: see text]) and compare it against conventional spatiotemporal PWV (PWV[Formula: see text]), with Bramwell-Hill PWV (PWV[Formula: see text]) and blood pressure (BP) as reference measures. Methods Ten subjects ranging from normotension to hypertension were repeatedly measured at rest and with induced PWV changes. Carotid distension waveforms over a 19 mm wide segment were acquired from ultrasonography, simultaneously with noninvasive continuous BP. Per cardiac cycle, the 8-parameter DGPM (amplitude, centroid, width, and velocity, respectively of forward and backward propagating wave) was fitted to the distension waveforms' systolic foot and dicrotic notch complexes. Corresponding PWV[Formula: see text] was computed from linear fittings of respective feature timings and distances. Regression analyses were conducted with PWV[Formula: see text] and PWV[Formula: see text] as predictors, and various PWV and BP measures as response variables. Results Whereas PWV[Formula: see text] correlations were insignificant, PWV[Formula: see text] estimated the reference PWV[Formula: see text] with a significant reduction in errors (P < 0.001), explained up to 65% PWV[Formula: see text] variability at rest, demonstrated higher intra-method consistency and correlated significantly with all BP measures (P < 0.001). Conclusion The proposed DGPM measures local carotid PWV in consideration of wave confluence, showing significant correlations with Bramwell-Hill PWV and BP at two distinct waveform complexes. Thereby PWV[Formula: see text] outperforms the conventional PWV[Formula: see text] in all investigated respects, potentially enabling PWV assessment in routine clinical practice.

Arterial stiffness and cardiovascular risk in patients with nephrolithiasis: a 10-year prospective study.

Nephrolithiasis is frequently associated with cardiovascular diseases. These conditions present common risk factors: systemic inflammation that promotes oxidative stress leading to arterial wall stiffening may also play a role in plaque formation predisposing to nephrolithiasis. The aim of this study was to evaluate arterial stiffness indices at baseline and after a 10-year follow-up, in patients with nephrolithiasis compared with patients without. A total of 82 patients (37 men; mean age 45 ± 13 years) were enrolled at the Geriatrics and Nephrology Outpatient Clinic: 66 were diagnosed with nephrolithiasis, whereas the control group consisted of 16 individuals. At baseline and after 10 years, they underwent clinical evaluation and arterial stiffness measurement, such as carotid-femoral pulse wave velocity (CF-PWV), by arterial applanation tonometry. At baseline, when compared with the control group, patients with nephrolithiasis showed higher SBP and CF-PWV. After 10 years, patients with nephrolithiasis, but not those without, showed a significant raise in CF-PWV, even after adjustment for age and sex. In a stepwise regression model, with CF-PWV changes during the follow-up as the dependent variable, and age, sex, follow-up years, Δ mean arterial pressure, BMI, hypertension and nephrolithiasis as independent variables, nephrolithiasis was proved to be the only significant predictor of ΔCF-PWV, accounting for 6% of the variance. Our study shows higher baseline CF-PWV and greater increase in ΔCF-PWV within 10 years in individuals with nephrolithiasis than in those without, demonstrating an increased cardiovascular risk for nephrolithiasis patients.

Cross-sectional and longitudinal evaluation of heart-to-brachium pulse wave velocity for cardiovascular disease risk.

Heart-brachium pulse wave velocity (hbPWV) is a promising measure of arterial stiffness including the proximal aorta. To characterize age-associated changes and the clinical utilities of hbPWV, we evaluated the impacts of age and cardiovascular disease (CVD) risks on hbPWV cross-sectionally (N = 7868) and longitudinally (N = 3710, followed by 9.1 ± 2.0 years). hbPWV were obtained using two validated equations for arterial path length (with and without considering age-related aortic elongations). Brachial-ankle pulse wave velocity (baPWV) was used as a comparative measure. Repeated-measures correlation (rmcorr) and regression analyses were used to characterize associations of PWVs with age and Framingham's general CVD risk score (FRS). In the cross-sectional study, hbPWVs derived by both equations showed stronger correlation with age (r = 0.746 ~ 0.796) and FRS (r = 0.714-0.749) than baPWV (r = 0.554 and r = 0.643). Furthermore, hbPWVs correlated with FRS even after controlling for age (r = 0.260 ~ 0.269, P < 0.0001). In the longitudinal study, hbPWVs demonstrated significantly higher rmcorr coefficient with age than baPWV (rrm=0.439-0.511 vs. 0.307, P < 0.0001). Across the adult lifespan, age-related increases in hbPWVs were almost consistent, starting from young adults, while baPWV displayed accelerated increases with age. A receiver operating characteristic curve analysis indicated that hbPWVs depicted more robust ability to stratify general CVD risk compared with baPWV (AUC = 0.896-0.913 vs. 0.833, P < 0.0001). The results of the follow-up study were consistent with the findings of the cross-sectional investigation. Our findings suggest that hbPWV undergoes a linear augmentation with age, commencing from an early adult life stage onward, rendering it a potential marker for discerning CVD risk.

Changes in the cardiovascular risk profile in children approaching kidney replacement therapy

Despite significant cardiovascular (CV) morbidity in children on dialysis and after kidney transplantation, data on the evolution of CV damage in children with chronic kidney disease (CKD) approaching kidney replacement therapy (KRT) is unknown. The burden, progression, and predictors of CV damage before KRT onset were explored in two prospective multicenter cohorts from Europe and Canada: Cardiovascular Comorbidity in Children with CKD (4C) and Haemodiafiltration, Heart and Height (3H) studies, conducted from 2009-19 and 2013-16, respectively. CV damage and risk factors were evaluated (i) cross sectionally at KRT-start (n=248), and (ii) longitudinally over the 2-years preceding KRT start (n=157; 331 patient-visits). Longitudinal analyses with mixed-effects models estimated associations of modifiable CV risk factors with change in carotid intima-media thickness (cIMT) standard deviation score (SDS), pulse wave velocity (PWV-SDS), left ventricular (LV) mass and systolic dysfunction. 248 patients, age 14.3 (12.2, 16.2) years were evaluated at median 35 (28-114) days before KRT start. Elevated cIMT-SDS and PWV-SDS were present in 43% and 25%, and LV hypertrophy and systolic dysfunction in 49% and 33%. Aortic stiffness and LV hypertrophy significantly increased, especially in the year before KRT start (adjusted odds ratio, OR 0.33, P=0.002 and OR 0.54, P=0.01, respectively). 79% of children had >3 modifiable CV risk factors at KRT onset. Diastolic BP and BMI were strongly associated with a linear increase in all CV measures. After controlling for CV risk factors, the time to KRT onset no longer predicted the burden of CV damage. This comprehensive CV evaluation shows the progressive accrual of modifiable risk factors and a high burden of CV damage in the years preceding KRT onset. CV damage in the pre-KRT period is preventable. Supported by EU4Health Programme (101085068) and Kidney Research UK (RP39/2013).

Perfusion and pulsatile pressure: their relationship with target organ damage in the African-PREDICT study

BackgroundHypertension is the leading risk factor for subclinical target-organ damage (TOD) and cardiovascular disease (CVD). Little is known about the relationship between different pressure measures and subclinical TOD, especially in young populations. We compared the strength of associations of subclinical TOD markers with perfusion and pulsatile pressure in young adults.MethodsA total of 1 187 young adults from the African-PREDICT study were included. Ambulatory mean arterial pressure (MAP) and pulse pressure (PP) was obtained. Markers of subclinical TOD were measured and included left ventricular mass index (LVMi), carotid intimamedia thickness (cIMT), carotidfemoral pulse wave velocity (cfPWV), central retinal arteriolar equivalent (CRAE) and albumin to creatinine ratio (ACR).ResultsMeasures of sub-clinical TOD (cIMT, cfPWV and CRAE), associated stronger with perfusion pressure (all p < 0.001) than pulsatile pressure in unadjusted models. Stronger associations were found between cfPWV (adjusted R2 = 0.26), CRAE (adjusted R2 = 0.12) and perfusion pressure (all p ≤ 0.001) than pulsatile pressure independent of several non-modifiable and modifiable risk factors.ConclusionsIn young, healthy adults, perfusion pressure is more strongly associated with subclinical TOD markers than pulsatile pressure. These findings contribute to the understanding of the development of early cardiovascular changes and may guide future intervention strategies.

Pulse program for improving learning accuracy and reducing programming energy consumption of ferroelectric synaptic transistor

Neuromorphic computing is a next‐generation computing technology featured by parallel data processing and adaptive learning. Two significant factors that improve learning accuracy are the ‘dynamic range’ and ‘linearity’ of the weight update. In a ferroelectric synaptic transistor, the weight update can be modulated by adjusting the applied voltage. The voltage pulse train should be carefully optimized to improve the learning accuracy and reduce programming energy consumption. In this study, we investigated the learning accuracy of neuromorphic computing based on the characteristics of synaptic devices and the program energy consumption according to pulse programs. We demonstrated changes in the analog conductance characteristics of ferroelectric thin‐film transistors by varying the pulse program for synaptic plasticity, discussed the characteristics for improving learning accuracy, and compared the programming energy consumption according to the pulse programs. We proposed a logarithmic‐incremental‐step pulse program that reduces programming energy consumption and improves learning accuracy.

Gekko gecko as a model organism for understanding aspects of laryngeal vocal evolution.

The ability to communicate through vocalization plays a key role in the survival of animals across all vertebrate groups. Although avian reptiles have received much attention relating to their stunning sound repertoire, non-avian reptiles have been wrongfully assumed to have less elaborate vocalization types, and little is known about the biomechanics of sound production and their underlying neural pathways in this group. We investigated alarm calls of Gekko gecko using audio and cineradiographic recordings. Acoustic analysis revealed three distinct call types: a sinusoidal call type (type 1); a train-like call type, characterized by distinct pulse trains (type 3); and an intermediate type, which showed both sinusoidal and pulse train components (type 2). Kinematic analysis of cineradiographic recordings showed that laryngeal movements differ significantly between respiratory and vocal behavior. During respiration, animals repeatedly moved their jaws to partially open their mouths, which was accompanied by small glottal movements. During vocalization, the glottis was pulled back, contrasting with what has previously been reported. In vitro retrograde tracing of the nerve innervating the laryngeal constrictor and dilator muscles revealed round to fusiform motoneurons in the hindbrain-spinal cord transition ipsilateral to the labeled nerve. Taken together, our observations provide insight into the alarm calls generated by G. gecko, the biomechanics of this sound generation and the underlying organization of motoneurons involved in the generation of vocalizations. Our observations suggest that G. gecko may be an excellent non-avian reptile model organism for enhancing our understanding of the evolution of vertebrate vocalization.

Machine Learning-Assisted Analysis of Sublingual Microcirculatory Dysfunction for Early Cardiovascular Risk Evaluation and Cardiovascular-Kidney-Metabolic Syndrome Stage in Patients With Type 2 Diabetes Mellitus.

To examine whether sublingual microcirculation can be used as an effective and noninvasive method for assessing cardiovascular, kidney, and metabolic risks in patients with type 2 diabetes mellitus (T2DM). This cross-sectional observational study enrolled 186 patients with T2DM. All patients were evaluated using the Framingham General Cardiovascular Risk Score (FGCRS) and cardiovascular-kidney-metabolic (CKM) syndrome stage. Side-stream dark-field microscopy was used for sublingual microcirculation, including total and perfused vessel density (TVD and PVD). Multiple machine-learning prediction models have been developed for CKM risk and stage assessment in T2DM patients. Receiver operating characteristic (ROC) curves were generated to determine cutoff points. Compared to patients with T2DM, diabetic patients with subclinical atherosclerosis (SA) had a greater CV risk, as measured by the FGCRS, accompanied by markedly decreased microcirculation perfusion. Microcirculatory parameters (TVD and PVD), including carotid intima-media thickness (IMT), brachial-ankle pulse wave velocity (ba-PWV), and FGCRS, were closely associated with SA incidence. Microcirculatory parameters, Index (DMSA screen), and cut-off points were used to screen for SA in patients with T2DM. Furthermore, a new set of four factors identified through machine learning showed optimal sensitivity and specificity for detecting CKM risk in patients with T2DM. Decreased microcirculatory perfusion served as a useful early marker for CKM syndrome risk stratification in patients with T2DM without SA. Sublingual microcirculatory dysfunction is closely correlated with the risk of SA and CKM risk in T2DM patients. Sublingual microcirculation could be a novel tool for assessing the CKM syndrome stage in patients with T2DM.

Design of an Optimized Terahertz Time-Domain Spectroscopy System Pumped by a 30 W Yb:KGW Source at a 100 kHz Repetition Rate with 245 fs Pulse Duration

Ytterbium laser sources are state-of-the-art systems that are increasingly replacing Ti:Sapphire lasers in most applications requiring high repetition rate pulse trains. However, extending these laser sources to THz Time-Domain Spectroscopy (THz-TDS) poses several challenges not encountered in conventional, lower-power systems. These challenges include pump rejection, thermal lensing in nonlinear media, and pulse durations exceeding 100 fs, which consequently limit the detection bandwidth in TDS applications. In this article, we describe our design of a THz-TDS beamline that seeks to address these issues. We report on the effectiveness of temperature controlling the Gallium Phosphide (GaP) used to generate the THz radiation and its impact on increasing the generation efficiency and aiding pump rejection while avoiding thermal distortions of the residual pump laser beam. We detail our approach to pump rejection, which can be implemented with off-the-shelf products and minimal customization. Finally, we describe our solution based on a commercial optical parametric amplifier to obtain a temporally compressed probe pulse of 55 fs duration. Our study will prove useful to the increasing number of laboratories seeking to move from the high-energy, low-power THz time-domain spectroscopy systems based on Ti:Sapphire lasers, to medium-energy, high-power systems driven by Yb-doped lasers.

Ultra-high frequency repetitive TMS at subthreshold intensity induces suprathreshold motor response via temporal summation.

Objective.The transcranial magnetic stimulation (TMS) coil induces an electric field that diminishes rapidly upon entering the brain. This presents a challenge in achieving focal stimulation of a deep brain structure. Neuronal elements, including axons, dendrites, and cell bodies, exhibit specific time constants. When exposed to repetitive TMS pulses at a high frequency, there is a cumulative effect on neuronal membrane potentials, resulting in temporal summation. This study aims to determine whether TMS pulse train at high-frequency and subthreshold intensity could induce a suprathreshold response.Approach.As a proof of concept, we developed a TMS machine in-house that could consistently output pulses up to 250 Hz, and performed experiments on 22 awake rats to test whether temporal summation was detectable under pulse trains at 100, 166, or 250 Hz.Main results.Results revealed that TMS pulses at 55% maximum stimulator output (MSO, peak dI/dt= 68.5 A/μs at 100% MSO, pulse width = 48μs) did not induce motor responses with either single pulses or pulse trains. Similarly, a single TMS pulse at 65% MSO failed to evoke a motor response in rats; however, a train of TMS pulses at frequencies of 166 and 250 Hz, but not at 100 Hz, successfully triggered motor responses and MEP signals, suggesting a temporal summation effect dependent on both pulse intensities and pulse train frequencies.Significance.We propose that the temporal summation effect can be leveraged to design the next-generation focal TMS system: by sequentially driving multiple coils at high-frequency and subthreshold intensity, areas with the most significant overlapping E-fields undergo maximal temporal summation effects, resulting in a suprathreshold response.

Analysis of CFRP inter‐laminar cracking location under laser impacts

AbstractIn this study, a combination of theoretical analysis and experimental verification was used to investigate the effects of laser parameters and shock wave shape on the location of layer cracks in carbon fiber‐reinforced plastics specimens. Firstly, the propagation coupling process of trapezoidal, rectangular, and triangular pulses in the material was investigated based on the one‐dimensional stress wave propagation theory. The study analyzed the effects of shock wave pressure amplitude, pulse width, and other factors on the location of layer cracks in the material. Subsequently, laser impact experiments with varying energies and pulse widths were conducted on specimens of different thicknesses to investigate the impact of shock wave pressure amplitude and laser pulse width on the location of layer cracking. The results show that the theoretical analysis of triangular shock waves has broader applicability and can serve as a representative analytical model to describe single‐layer crack damage.Highlights Laser impact experiments with various specimen thicknesses. Laser pulse width determines the initial location of inter‐laminar cracking. The applicability of the triangular pulsed layer cracking formula. The effect of laser energy on pulse amplitude.

Tapered fiber optic sensor for arterial pulse wave monitoring

Arterial pulse wave monitoring has been recognized as an effective medical diagnostic tool for various cardiovascular diseases. To overcome the barriers in traditional, complex, and expensive detection configurations, new electronic and optical sensors have been developed with their unique advantages. Particularly, various configurations of fiber-optic sensors have been proposed. This paper demonstrates the use of a tapered optical fiber structure to create a sensitive sensor that can detect carotid arterial pulse waves on the skin surface. The demonstrated fiber sensor probe utilizes an in-line Mach-Zehnder interferometer configuration and liquid-gold film coating on the sensor tip to enhance its sensitivity and demonstrate its use by encapsulating the sensor with a flexible elastomer material for detecting arterial pulse waves with a simple testing configuration. Considering the simple fabrication and high sensitivity without a complex demodulation scheme, the proposed sensor has broad implementation in biomedical health monitoring systems.

Effects of high-intensity interval training versus moderate-intensity continuous training on vascular function among individuals with overweight and obesity-a systematic review.

The study aimed to investigate and systematically review the evidence relating to the effects of high-intensity interval training (HIIT) versus moderate-intensity continuous training (MICT) on vascular function such as arterial diameter, arterial stiffness, pulse wave velocity, blood flow, etc. in individuals with overweight and obesity. The entire content of PubMed (MEDLINE), Scopus, SPORT Discus® (via EBSCO host), CINAHL, and Web of Science were searched. Only experimental research studies conducted in adult participants aged ≥18 years, published in English before January 2023 were included. A total of 5397 studies were reviewed for the title and abstract with 11 studies being included for data extraction. The review resulted in a total of 346 individuals with overweight and obesity with body mass index (BMI) ranging between 25-36 kg/m2. HIIT and MICT intensities resulted in 85%-95% and 60%-70% maximal heart rate (MHR) respectively. Seven out of 11 studies showed some concerns about the overall risk of bias. Six of 11 studies reported improving vascular function following HIIT than MICT. HIIT is a more effective and time-efficient exercise for enhancing vascular functions in individuals with overweight and obesity, leading to improvements in flow-mediated dilation by 3.9% and arterial diameter by 4.8%, compared to MICT.

Pilot Assessment of Piezoelectric Transducers as a Cost-Effective Alternative to EndoPAT

Introduction: Current microvascular assessments may not be practical or accessible requiring experienced personnel and/or ongoing equipment costs. Piezoelectric transducers can reliably obtain finger blood pressure waves, similar to peripheral arterial tonometry devices; thus, they could be used to estimate microvascular function. We aimed to validate piezoelectric transducers as an alternative measure of microvascular function compared to EndoPAT. Methods: Twenty-five adults (aged 20–64 years) completed reactive hyperemia (5 min forearm circulatory occlusion and 3 min recovery) with piezoelectric transducers on the middle fingers and EndoPAT probes on the index fingers. Average area under the curve (AUC) of the pulse wave signal for the occluded and control arms was determined at baseline, every 30 s post-occlusion, and 10 s around the peak response. Microvascular function index (MFI) was calculated as the ratio of AUC post-occlusion to AUC baseline in the test arm, then normalized to the same ratio in the control arm. MFI at each time point was correlated with the reactive hyperemia index (RHI) from the EndoPAT. Results: The greatest significance was found between RHI and MFI at 10 s around the peak response (Spearman’s r = 0.67, p = 0.0002; Pearson’s r = 0.76, p = 0.00001). Conclusion: MFI is a reusable and user-friendly microvascular function assessment that could provide better access to vascular health screening.

Are aortic biomechanical properties early markers of dilatation in patients with Marfan syndrome? A systematic review and meta-analysis.

Although tissue stiffness is known to play an important role in aortic dilatation, the current guidelines for offering preventative surgery in patients with Marfan syndrome rely solely on the aortic diameter. In this systematic review and meta-analysis, we analyze and compare literature on in vivo aortic stiffness measures in Marfan patients. Our aim is to assess the potential of these measurements as early indicators of aortic dilatation. Following the PRISMA guidelines, we collected literature on diameter and three in vivo stiffness measures: Pulse wave velocity (PWV), -stiffness index (SI) and distensibility, at five different aortic locations in patients with Marfan syndrome. Results were reviewed and compared against each other. For meta-analysis, an augmented dataset was created by combining data from the literature. Regression with respect to age and statistical comparisons were performed. Thirty articles reporting data from 1925 patients with Marfan and 836 patients without Marfan were reviewed. PWV was found to be higher in Marfan, but only in dilated aortas. Distensibility was found to be lower even in non-dilated aortas, and its decrease was associated with higher chances of developing aortic dilatation. -SI was higher in Marfan patients and was positively correlated with the rate of aortic dilatation, emphasizing its role as a valuable indicator. In our meta-analysis, all stiffness measures showed a significant variation with age. Distensibility and -stiffness index were different in Marfan patients at all locations, and the difference was more pronounced after accounting for age-related variation. From the literature, -SI and distensibility emerge as the best predictors of future aortic dilatation. Our meta-analysis quantifies age-related changes in aortic stiffness and highlights the importance of accounting for age in comparing these measurements. Missing diameter values in the literature limited our analysis. Further investigation of criteria combining stiffness and diameter is recommended to better assist clinical decisions for prophylactic surgery.