Pulse Wave Research Articles

Association between exposure to air pollution and arterial stiffness in participants with and without atherosclerotic cardiovascular disease.

To assess the association of air pollution exposure at different time scales with arterial stiffness in participants with and without atherosclerotic cardiovascular disease (ASCVD). We measured participants' arterial stiffness with brachial-ankle pulse wave velocity (baPWV) from October 2016 to January 2020. Concentrations of air pollutants including fine particles < 2.5μm aerodynamic diameter (PM2.5), inhalable particles < 10μm aerodynamic diameter (PM10), sulfur dioxide (SO2), nitrogen dioxide (NO2), carbon monoxide (CO), and ozone (O3) measured by fixed ambient air monitoring stations were collected for short- (7-day) and long-term (365-day) exposure assessment. We used generalized estimating equations (GEEs) to analyze and further explored the modification effects between ASCVD and air pollutants. Seven hundred sixty-five participants were finally included and four hunderd sixty (60.1%) participants had a history of ASCVD. Based on the partial regression coefficients (β) and 95% confidence intervals (95% CI) calculated from GEEs using linear regression, each 10μg/m3 increase in long-term exposure to PM2.5 and PM10 was associated with 31.85cm/s (95% CI, 17.97 to 45.73) and 35.93cm/s (95% CI, 21.01to50.84) increase in baPWV. There was no association between short-term exposure to air pollution and arterial stiffness. Although no significant interaction effect was observed between air pollution and ASCVD, baPWV showed a greater increment in the subgroup without ASCVD. Long-term exposure to air pollution is closely associated with higher arterial stiffness in participants with and without ASCVD. Reducing air pollution exposure is essential in the primary and secondary prevention of ASCVD.

Direct-modulation optoelectronic oscillator for optical pulse and frequency comb generation

We report the generation of an optical pulse train with a 10 GHz repetition rate in a dual loop direct-modulation optoelectronic oscillator (OEO). Pulse generation is achieved using nonlinear compression in the OEO 5-km-long optical delay line. 3 ps pulses with a timing jitter of 13 fs are reported, while the OEO maintains a phase noise of −133dBc/Hz at 10 kHz from the carrier. Two architectures are compared experimentally and theoretically. A frequency comb with a 1.2 THz linewidth at −30dB is generated.

Design and Implementation of a Photonic-Based Electronic Warfare System

Nowadays, the Radio frequency (RF) Photonics become an inevitable candidate to address several military related potential applications including electronic warfare (EW), photonic signal processing (PSP), photonic-based RF transportation, and photonic communications. As part of this emerging technology development/requirement, we designed a photonic-based EW systems (PEWS) in the optisystem environment (later implemented using optoelectronic components) to extract various radar waveforms such as continuous wave (CW), pulsed wave, and frequency/phase modulated wave. All these radar waveforms are transmitted and captured by the proposed/implemented PEW system, and then processed to construct the radar signatures from its electromagnetic (EM) spectrum/signals. The key parameters of various waveforms generated and processed in our research work are varied, over the time, during the performance validation tests. The values of key parameters of the waveforms: RF CW signal frequencies, pulse repetition times (PRTs), pulse-widths, Barker code phase modulations, Frank code poly-phase modulations, sweep frequencies, and RF power levels; are 100 Hz through 8 GHz, 10 ms through 2 µs, 750 ns through 2 ns, 0o /80o, 0o /90o /180o /270o, and -84 dBm through 30 dBm, respectively. The details of PEWS design approaches, their implementation methodologies, and different performance validation experimental results are reported, and analyzed. The limitations, and possible immediate research contributions/requirements are also listed.

Association between the oxidative balance score and estimated pulse wave velocity from the National Health and Nutrition Examination Survey (2005–2018)

BackgroundNo research report has been conducted to investigate the impact of oxidation balance score (OBS) on the estimated pulse wave velocity(ePWV).We aimed to examine the association between OBS and ePWV.MethodWe evaluated data for 13,073 patients from the National Health and Nutrition Examination Survey (NHANES). The exposure variable was OBS. The outcome variables was combination of ePWV and arterial stiffness.ResultsWe observed a significant negative correlation between OBS (Per 1SD increase) and ePWV in the gradually adjusted models. Based on the aforementioned results, a two-piecewise logistic regression adjusted model was subsequently employed to establish the association between OBS and elevated ePWV, and the inflection point was determined as 5. The increased risk of elevated ePWV (OR:0.70; 95%CI:0.51–0.94) gradually decreases with the increase of OBS on the left side of the inflection point; however, when OBS exceeds 5, this decrease in risk of elevated ePWV(OR:1.00; 95%CI:0.96–1.04) is no longer observed (P for log likelihood ratio test = 0.028).ConclusionsThere exists a significant association between OBS and ePWV in the context of American adults. Specifically, OBS exhibits a negative correlation with ePWV; however, when considering an elevated ePWV, a saturation effect is observed in relation to OBS.

The Relationship between Healthy Vascular Aging with the Mediterranean Diet and Other Lifestyles in the Spanish Population: The EVA Study.

In this cross-sectional descriptive study, 501 individuals aged 35 to 75 years were recruited from five health centers by random sampling stratified by age and sex (55.90 ± 14.24 years, 49.70% men). HVA was determined in two steps. Step 1: Subjects with vascular damage to the carotid arteries or peripheral arterial disease were classified as non-HVA. Step 2: The study population was classified by age and sex using the percentiles of the vascular aging index (VAI), with VAI ≤p25 considered HVA and >p25 considered non-HVA. The VAI was estimated using the following formula (VAI = (log (1.09) × 10 cIMT + log (1.14) cfPWV) × 39.1 + 4.76. Carotid-femoral pulse wave velocity (cfPWV) was measured with the SphygmoCor® device, and carotid intima-media thickness using Sonosite Micromax® ultrasound. Mediterranean diet (MD) adherence, alcohol and tobacco use were recorded through validated questionnaires. Physical activity was assessed with the ActiGraph-GT3X® accelerometer. The mean VAI value was 61.23 ± 12.86 (men-63.47 ± 13.75 and women-59.04 ± 11.54; p < 0.001). HVA was found in 18.9% (men-19.9% and women-17.8%). In the multiple regression analysis after adjusting for possible confounding factors, the mean VAI value showed a positive association with alcohol use (β = 0.020) and sedentary hours per week (β = 0.109) and a negative association with hours of activity per week (β = -0.102) and with the number of healthy lifestyles (β = -0.640). In the logistic regression analysis, after adjusting for possible confounding factors and compared to those classified as non-HVA, subjects classified as HVA were more likely to show MD adherence (OR = 0.571), do more than 26 h per week of physical activity (OR = 1.735), spend under 142 h per week being sedentary (OR = 1.696), and have more than two healthy lifestyles (OR = 1.877). The results of this study suggest that the more time spent doing physical activity and the less time spent in a sedentary state, the lower the vascular aging index and the greater the likelihood of being classified in the group of subjects with HVA.

SESAM Q-switched Dy-doped fluoride fiber laser at 3.1 µm

We report on a passive Q-switching laser operation of an in-band pumped Dy-doped zirconium fluoride fiber using a commercially available semiconductor saturable absorber mirror (SESAM). Stable Q-switching pulse trains with minimum pulse duration of 460 ns, highest repetition frequency of 206 kHz, and pulse energy up to 1.7 µJ are demonstrated.

Generation of Soliton Frequency Combs in NEMS.

In this study, we present an innovative approach leveraging combination internal resonances within a NEMS platform to generate mechanical soliton frequency combs (FCs) spanning a broad spectrum. In the time domain, the FCs take the form of a periodic train of narrow pulses, a highly coveted phenomenon within the realm of nonlinear wave-matter interactions. Our method relies on an intricate interaction among multiple vibration modes of a bracket-nanocantilever enabled by the strong nonlinearity of the electrostatic field. Through numerical simulation and experimental validation, we demonstrate that by amplifying the motions of the NEMS with the external electrostatic forcing tuned to excite the superharmonic resonance of order-n of the fundamental mode and exploiting combination internal resonances, we can generate multiple stable localized mechanical wave packets with different lobe sizes embodying soliton states I and II. This represents a significant breakthrough with profound implications for quantum computing and metrology.

Prognostic impact of peripheral artery disease-related parameters in patients with acute coronary syndrome.

Lower extremity arterial disease (LEAD) and increased aortic stiffness are associated with higher mortality in patients with chronic coronary syndrome, while their prognostic significance after an acute coronary syndrome (ACS) is less known. We analyzed prevalence, clinical phenotypes and association of LEAD - assessed by the ankle-brachial index (ABI) - and increased aortic stiffness - assessed by the aortic pulse wave velocity (PWV) - with all-cause mortality and major adverse cardiovascular events (MACE) in patients admitted with an ACS. Among 270 patients admitted for ACS (mean age 67 years, 80% males), 41 (15%) had an ABI ≤0.9, with 14 of them (34%) presenting with intermittent claudication (symptomatic LEAD). Patients with symptomatic LEAD, compared with those with asymptomatic LEAD or without LEAD, had higher prevalence of cardiovascular risk factors, lower estimated glomerular filtration rate and higher high-sensitivity C-reactive protein. Patients with LEAD, either symptomatic or asymptomatic, more frequently presented with non-ST-elevation myocardial infarction and more frequently had multivessel coronary artery disease. Both symptomatic and asymptomatic LEAD were significantly associated with all-cause mortality after adjustment for confounders, including multivessel disease or carotid artery disease (hazard ratio 4.03, 95% confidence interval 1.61-10.08, P < 0.01), whereas PWV was not associated with the outcome in the univariable model. LEAD and PWV were not associated with a higher risk of MACE (myocardial infarction or unstable angina, stroke, or transient ischemic attack). LEAD, either clinical or subclinical, but not increased aortic stiffness, is an independent predictor of all-cause mortality in patients admitted for ACS.

Attosecond vortex pulse trains

The landscape of ultrafast structured light pulses has significantly advanced thanks to the ability of high-order harmonic generation (HHG) to translate the spatial properties of infrared laser beams to the extreme-ultraviolet (EUV) spectral range. In particular, the up-conversion of orbital angular momentum (OAM) has enabled the generation of high-order harmonics whose OAM scales linearly with the harmonic order and the topological charge of the driving field. Having a well-defined OAM, each harmonic is emitted as an EUV femtosecond vortex pulse. However, the order-dependent OAM across the harmonic comb precludes the synthesis of attosecond vortex pulses. Here we demonstrate a method for generating attosecond vortex pulse trains, i.e., a succession of attosecond pulses with a helical wavefront, resulting from the coherent superposition of a comb of EUV high-order harmonics with the same OAM. By driving HHG with a polarization tilt-angle fork grating, two spatially separated circularly polarized high-order harmonic beams with order-independent OAM are created. Our work opens the route towards attosecond-resolved light-matter interactions with two extra degrees of freedom, spin and OAM, which are particularly interesting for probing chiral systems and magnetic materials.

The influence of diabetes on sleep-derived cardiorespiratory features of the finger pulse wave signal – The population-based SCAPIS study

Study objectivesAdvanced signal processing of photoplethysmographic data enables novel analyses which may improve the understanding of the pathogenesis of dysglycemia associated with sleep disorders. We aimed to identify sleep-related pulse wave characteristics in diabetic patients compared to normoglycemic individuals, independent of cardiovascular-related comorbidities. MethodsThis cross-sectional evaluation of the population-based Swedish CArdioPulmonary bioImage Study (SCAPIS) included overnight oximetry-derived pulse wave data from 3997 subjects (45 % males, age 50–64 years). Metabolic status was classified as normoglycemic (n = 3220), pre-diabetic (n = 544), or diabetic (n = 233). Nine validated pulse wave features proposed to influence cardiovascular risk were derived and compared between metabolic status groups. Logistic prediction models and genetic matching were applied to capture diabetes-related pulse wave characteristics during sleep. The model was controlled for anthropometrics, lifestyle, sleep apnea, and in the final adjustment even for cardiometabolic factors like dyslipidaemia, hypertension, and coronary artery calcification. ResultsPulse wave-derived parameters differed between normoglycemic and diabetic individuals in eight dimensions in unadjusted as well as in the partially adjusted model (anthropometric factors and sleep apnea, p ≤ 0.001). All covariates confirmed significant differences between normoglycemic and diabetic subjects (all p ≤ 0.001). Reduced cardio-respiratory coupling (respiratory-related pulse oscillations) (β = −0.010, p = 0.012), as well as increased vascular stiffness (shortened pulse propagation time (β = −0.015, p = 0.001), were independently associated with diabetes even when controlled for cardiometabolic factors. These results were confirmed through a matched cohort comparative analysis. ConclusionsPhotoplethysmographic pulse wave analysis during sleep can be utilized to capture multiple features of modified autonomic regulation and cardiovascular consequences in diabetic subjects. Dampened heart rate variability and increased vascular stiffness during sleep showed the strongest associations with diabetes.

Evaluation of the Great Artery Mechanics with CarotidFemoral (Aortic) Pulse Wave Propagation Time in Patients with Rheumatoid Arthritis

Objectives: Rheumatoid arthritis (RA) is the most common chronic, systemic, rheumatic, autoimmune disease in adults, which has unknown etiology and targets primarily synovial tissue. Those patients have increased cardiovascular mortality based on inflammation and atherosclerosis. In our study, we evaluated great artery mechanics in newly diagnosed RA patients with inactive disease. Great artery mechanics, referred as arterial distensibility, elasticity, and compliance can be evaluated by pulse wave propagation time and pulse wave velocity. Methods: Our study included newly diagnosed and in inactive stage 25 RA patients ( mean age: 39.4±9.8 years, 21–63 years, 19 female, 6 male) and 29 healthy subjects (mean age: 36.9±9.9 years, 18–59 years, 13 female, 16 male). Aortic pulse wave propagation time and pulse wave velocitiy were determined using an automatic device, the Complior Colson (France), which allowed online recording and automatic calculation. Results: Height, waist circumference, and waist/hip ratio values were significantly higher in healthy objects. (p=0.006, p=0.030, p=0.004, respectively) pulse wave propagation time and pulse wave velocity were significantly lower and higher, respectively, in RA patients compared to healthy subjects (p=0.000, p=0.041, respectively). Conclusion: RA patients have decreased pulse wave propagation time and higher pulse wave velocity.

Pulse signal may be a key bridge connecting cardiology and pulse diagnosis of TCM

ObjectiveThis study extracts atherosclerosis indices from six channels of Cunkou and discusses the data distribution, aims to explore the connection between cardiology of modern medicine (MM) and traditional Chinese medicine (TCM) pulse diagnosis. MethodsWe use a device capable of simultaneously collecting the pulse signals of the Cun, Guan and Chi to test the population participating in routine physical examinations. Firstly, we collected pressure pulse waves from six channels of Cunkou of 1045 healthy subjects (578 men and 467 women, average age=37.99±16.02 years). Secondly, we extracted the two most common arteriosclerosis indices pulse transit time (PTT) and Augmentation index (AIx) from six-channel pulse waves. Lastly, T-test and correlation test were taken to analyze the differences and relevance of the atherosclerosis indices extracted from six channels of Cunkou. ResultsWhen analyzing AIx and PTT at different wrist, it was found that AIx of left wrist is significantly higher than that of right wrist (P<0.001), while the PTT of left wrist is significantly lower than that of right wrist (P<0.001), a phenomenon that is common in both men and women. Furthermore, regardless of whether it is left or right wrist, the AIx at Chi channel is higher than that at Cun (P<0.05) and Guan (P<0.05). At the same time, the PTT at Guan is bigger than that at Cun in two wrists (P<0.05). However, when the specific channel is not considered, there is no significant difference in AIx and PTT between each channel and the corresponding wrist (P>0.05). In addition, regardless of gender, when the specific channel is not considered, AIx and PTT of each wrist are significantly correlated with age (P<0.001). ConclusionsThe differences of the atherosclerosis indices AIx and PTT in six channels support that the method of six-channel pulse diagnosis is indispensable in TCM. Additionally, the pulse waves obtained from each channel can be utilized as a dependable foundation for diagnosing atherosclerotic conditions. This study is beneficial for promoting the integration of TCM and MM in diagnosing disease.

A Characterization of the Cardiac Physiology and Aortic Pulse Wave Properties of Artistic Swimmers Across Competitive Levels.

The distinct physical and environmental stressors of artistic swimming (previously termed synchronized swimming) result in unique hemodynamic stimuli. Given that the hemodynamic stress associated with participation in an exercise modality drives adaptation of the heart and central vasculature, artistic swimming may produce a distinct cardiovascular phenotype. Presumably, athletes competing at the highest levels also have greater training exposure and, thus, exhibit more adaptation. The purpose of this study was to characterize cardiovascular form and function across the competitive spectrum of artistic swimmers. Cardiovascular structure and function were compared in a cross-sectional study of healthy controls, varsity, and elite artistic swimmers, using pulse wave analysis, pulse wave velocity, and echocardiographic images both at rest and during isometric handgrip exercise. Aortic stiffness was similar across all groups, as were characteristics of the decomposed aortic pressure waveform. At rest, both varsity and elite swimmers demonstrated similar systolic function compared to controls. However, peak left ventricular twist was greater in varsity and elites (controls: 8.0 ± 3.9, varsity: 12.8 ± 8.6, elites: 13.4 ± 3.9; both p < 0.02). Furthermore, elites demonstrated greater peak left ventricular radial strain (controls: 29.2 ± 9.9, varsity: 32.5 ± 10.3, elites: 53.9 ± 15.1; both p < 0.001) and longitudinal strain (controls: -16.9 ± 1.6, varsity: -16.5 ± 1.8, elites: -19.5 ± 3.2; both p < 0.04). In contrast to controls, both varsity and elite artistic swimmers demonstrated no change in peak late diastolic transmitral filling velocity (controls: Δ0.2 ± 0.04 m/s, varsity: Δ0.06 ± 0.04 m/s, elites: Δ0.05 ± 0.04 m/s) during isometric handgrip exercise (both p > 0.05), with elites demonstrating lower peak velocity than varsity swimmers, (p = 0.048) indicating preservation of diastolic function. Artistic swimmers demonstrate distinct cardiac physiology at rest and during isometric handgrip, with a greater extent of distinguishing features observed in those competing at the highest level of competition.

Mykonos: A pulsed power driver for science and innovation

Sandia National Laboratories has been operating the Mykonos linear transformer driver (LTD) in a five-cavity configuration since 2014. The machine operates at 1MA output current, 500kV output voltage, with a 10-90% current rise time of 85ns, which enables small scale physics and engineering pulsed power experiments. Mykonos provides hands-on pulsed power experimental training for students and staff along-side senior Sandia scientists in an environment that is more accessible than the Z Facility. Over the years, we have fielded and accumulated a wide variety of optical, x-ray and electrical diagnostics and we are preparing to open this facility to outside users. Here, we are presenting the pulsed power and diagnostic capability of Mykonos as well as some recent experiments that have been performed on the facility. The goal of this publication is to attract researchers across the pulsed power and high energy density (HED) community to collaborate with Sandia on exciting, innovative science and to train the next generation of researchers for the National Nuclear Security Agency (NNSA) and the nation. As such, we have established a Mykonos Academic Access Program (MAAP) as part of ZNetUS to enable academic utilization of the Mykonos Pulsed Power Facility.

An accurate tidal peak localization method in radial arterial pulse signals based on hybrid neural networks

Background: cardiovascular diseases (CVDs) have become the leading causes of death worldwide. Arterial stiffness and elasticity are important indicators of cardiovascular health. Pulse wave analysis (PWA) is essential for analyzing arterial stiffness and elasticity, which are highly dependent on the tidal peak (P 2). P 2 is one of the four key physiological points, which also include percussion peaks (P 1), diastolic notches (P 3), and diastolic peaks (P 4). P 1, P 3, and P 4 are often local maxima or minima, facilitating their identification via the second derivatives method, a classic localization method for key physiological points. Classic methods such as the second derivative method, Empirical Mode Decomposition (EMD), and Wavelet Transform (WT), have been employed for the extraction and analysis of the P 2. Due to individual variation and arterial stiffness, locating the P 2 using classic methods is particularly challenging. Methods: we propose a hybrid neural network based on Residual Networks (ResNet) and bidirectional Long Short-Term Memory Networks (Bi-LSTM), successfully achieving high-precision localization of the P 2 in radial artery pulse signals. Meanwhile, we compared our method with the second derivative method, EMD, WT, Convolutional Neural Networks (CNN) and the hybrid model with ResNet and LSTM. Results: the results indicate that our proposed model exhibits significantly higher accuracy compared to other algorithms. Overall, MAEs and RMSEs for our proposed method are 62.60% and 58.84% on average less than those for other algorithms. The average R Adj 2 is 29.20% higher. The outcomes of the efficiency evaluation suggest that the hybrid model performs more balancedly without any significant shortcomings, which indicates that the Bi-LSTM structure upgrades the performances of LSTM. Significance: our hybrid model can provide the medical field with improved diagnostic tools and promote the development of clinical practice and research.

Longitudinal study of birthweight, blood pressure, and markers of arterial stiffness in children age six among the TIDES cohort.

Although some studies have observed an association between birthweight and cardiovascular disease in adulthood, fewer have investigated whether birthweight is linked to cardiovascular health in early childhood. This study assesses the association between birthweight and cardiovascular outcomes in children 6 years of age. Birthweight, blood pressure (BP), and markers of arterial stiffness in children, including brachial artery distensibility and carotid-femoral pulse wave velocity (cfPWV), were obtained from 324 participants in The Infant Development and the Environment Study, a prospective multisite pregnancy cohort. Birthweight was converted into sex-specific birthweight-for-gestational-age (bw/ga) z -scores based on the INTERGROWTH-21st standard. Following 2017 American Academy of Pediatrics guidelines, SBP and DBP were transformed into sex, age, and height-specific z -scores. Associations between birthweight and cardiovascular outcomes were assessed using nested multivariable linear regression models among the overall and sex-stratified samples. Among the overall sample, bw/ga z -score was positively associated with cfPWV [b = 0.11 m/s, 95% confidence interval (CI): 0.01 m/s, 0.21 m/s] in crude and adjusted models. No associations between birthweight and cardiovascular outcomes were detected among the sex-stratified analyses. Overall, birthweight was not related to cardiovascular outcomes in children 6 years old. However, infants born with a higher birthweight may be at risk for higher cfPWV in childhood. Early intervention in pregnant people at risk of delivering high birthweight infants may be warranted if results are replicated.

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.

Patient-specific compliant simulation framework informed by 4DMRI-extracted pulse wave Velocity: Application post-TEVAR

We introduce a new computational framework that utilises Pulse Wave Velocity (PWV) extracted directly from 4D flow MRI (4DMRI) to inform patient-specific compliant computational fluid dynamics (CFD) simulations of a Type-B aortic dissection (TBAD), post-thoracic endovascular aortic repair (TEVAR). The thoracic aortic geometry, a 3D inlet velocity profile (IVP) and dynamic outlet boundary conditions are derived from 4DMRI and brachial pressure patient data. A moving boundary method (MBM) is applied to simulate aortic wall displacement. The aortic wall stiffness is estimated through two methods: one relying on area-based distensibility and the other utilising regional pulse wave velocity (RPWV) distensibility, further fine-tuned to align with in vivo values. Predicted pressures and outlet flow rates were within 2.3 % of target values. RPWV-based simulations were more accurate in replicating in vivo hemodynamics than the area-based ones. RPWVs were closely predicted in most regions, except the endograft. Systolic flow reversal ratios (SFRR) were accurately captured, while differences above 60 % in in-plane rotational flow (IRF) between the simulations were observed. Significant disparities in predicted wall shear stress (WSS)-based indices were observed between the two approaches, especially the endothelial cell activation potential (ECAP). At the isthmus, the RPWV-driven simulation indicated a mean ECAP>1.4 Pa-1 (critical threshold), indicating areas potentially prone to thrombosis, not captured by the area-based simulation.RPWV-driven simulation results agree well with 4DMRI measurements, validating the proposed pipeline and facilitating a comprehensive assessment of surgical decision-making scenarios and potential complications, such as thrombosis and aortic growth.

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