Stiffness Index Beta Research Articles

Regular resistance training favorably affects central artery stiffness response following transient resistance exercise

High-intensity regular resistance training increases central arterial stiffness. In contrast, resistance-trained individuals experience a protective effect on vascular function response after transient resistance exercise. Central arterial stiffening with regular resistance training might be offset with each transient resistance exercise performed. The aim of the present study was to determine the effects of regular resistance training on the response of central arterial stiffness following a single bout of resistance exercise. All subjects were assigned to control (n = 8) and training (n = 14) groups. The training group underwent four weeks of regular resistance training. Before and after the regular training, they performed a transient resistance exercise consisting of unilateral resistance exercise using arm curls (5 sets of 10 repetitions at 75% of 1 repetition maximum). Beta stiffness index as a measure of central arterial stiffness was evaluated at baseline and 30 min and 60 min following transient resistance exercise. The training group showed that transient resistance exercise did not change the beta stiffness index before regular training. Nevertheless, regular training markedly decreased beta stiffness index after transient resistance exercise (following 30 min: change = − 3.8 ± 2.1 AU, p < 0.05), although it significantly increased beta stiffness index at rest (change = 1.5 ± 1.6 AU). The present findings suggest that regular resistance training remedies central arterial stiffness response following transient resistance exercise. Regular resistance training experience has a favorable effect on elastic properties of central arteries following transient resistance exercise (day-to-day practice in resistance-trained individuals).

PULSE PRESSURE SIGNIFICANTLY AND INDEPENDENTLY CORRELATES WITH CAROTID PULSE WAVE VELOCITY AND BETA-STIFFNESS INDEX IN PATIENTS WITH TYPE 2 DIABETES MELLITUS

Objective: Introduction: Pulse wave velocity (PWV) and beta-stiffness index (BSI) are the most popular echo-tracking parameters indicating increased carotid stiffness. Pulse pressure (PP) values turns out to be higher in patients with increased indices of arterial stiffness and is an independent predictor of cardiovascular disease and mortality. This is of greater importance for patients with type 2 Diabetes Mellitus (T2DM). Aim: To find out correlation between the pulse pressure and carotid stiffness indices. Design and method: 100 patients with T2DM without overt cardio-vascular diseases and 30 healthy age and sex matched controls were included in the study. All participants underwent carotid examination of PWV and BSI, by echo-tracking method with Aloka Hitachi Prosound alfa-7. Patients with uncontrolled blood pressure and history of CV diseases were excluded from the study. Results: Pulse pressure significantly correlated with left carotid artery PWV (r = 0.43; p = 0.0001) and BSI (r = 0.44; p = 0.001) and right carotid artery PWV (r = 0.38; p = 0.001), BSI (r = 0.39; p = 0.001). Multivariate regression analysis with independent variable PWV, revealed that PP remained a significant and independent determinant (B = 5.78; p &lt; 0.0001), similar to systolic blood pressure (B = 2.97; p = 0.003). Conclusions: PP is among the most important independent determinants associated with increased carotid stiffness in patients with T2DM without cardiovascular complications and with well controlled blood pressure. PP may serve as an early marker of increased cardiovascular risk in patients with T2DM.

CARBOXYLATED OSTEOCALCIN LEVELS CORRELATE WITH EARLY CHANGE OF ARTERIAL STIFFNESS PARAMETERS IN PATIENTS WITH TYPE 2 DIABETES MELLITUS

Objective: Osteocalcin (OC) is a bone derived protein with a recently discovered hormonal nature with a putative target organ the arterial wall. Under pathological conditions, OC synthesized locally by vascular smooth muscle cells. Arterial stiffness measurement is a modern method for diagnosing subclinical atherosclerosis. Of particular importance is to find a biomarker for early vascular damage in patients with Type 2 diabetes (T2DM). Aim: To evaluate the correlation of carboxylated (cOC) and uncarboxylated (ucOC) osteocalcin levels with parameters of arterial stiffness (AS) in patients with T2DM without cardio-vascular diseases. Design and method: 46 patients with T2DM (mean age 58 ± 7.6 men 45.6%) and 18 healthy age- and sex-matched controls were included in the study and examined for cOC and ucOC with ELISA kits (Takara Bio, Japan). One-point Echo-tacking measuring by Aloka Hitachi were performed on the common carotid artery (CA) with measuring Pulse Wave Velocity (PWV), Beta-stiffness index (BSI) and Modulus of elasticity (Ep). Results: We found significant correlations of cOC with the BSI (r = 0.31; p = 0.03) and the Ep (r = 0.29; p = 0.05), and lack of correlation with PWV (r = 0.23; p = 0.12). After adjusting confounding factors such as blood pressure, waist circumference, cOC significant and independently correlated with BSI (B = -0.34; P = 0.04). No correlations were found for ucOC. We additionally established correlations of cOC with HDL (r = 0.3; p = 0.01), BMI (r = -0.32; p = 0.007) and waist (r = -0.4; p = 0.0009). cOC were lower in patients with T2DM 7.84 ± 2.41 ng/ml than in controls 10.05 ± 4.57 ng/ml (p = 0.01). unOC levels were lower in patients with T2DM without significance 3.81 ± 5.12 ng/ml vs. 4.37 ± 3.0 ng/ml (p = 0.08). Conclusions: Our patients with T2DM had lower unOC and cOC levels. For cOC were observed a significant correlation with the arterial stiffness parameters BSI and Ep and therefore with subclinical atherosclerosis. Osteocalcin is involved in the process of vascular calcification and can be considered as a potential biomarker for vascular damage.

CHANGE IN HEMODYNAMIC PARAMETERS AND CAROTID STIFFNESS INDICES AFTER VITAMIN K2 SUPPLEMENTATION IN PATIENTS WITH TYPE 2 DIABETES MELLITUS

Objective: Vitamin K2 is a cofactor of gamma-carboxylase activating group of vitamin K-dependent proteins involved in vascular calcification and arterial stiffness. Data on the protective effects of vitamin K2 supplementation in the progression of vascular damage in patients with type 2 diabetes mellitus (T2DM) are scarce. Aim: to investigate the change in systolic (SAP), diastolic (DAP), pulse (PP), mean (MAP) blood pressure, central systolic aortic pressure (CASP), pulse wave velocity (PWV) and beta-stiffness index (BSI) in patients with T2DM after vitamin K2 supplementation. Design and method: We included 18 patients with T2DM (mean age 59.09 ± 8.5 men 38.8%) who received Vitamin K2 (Menaquinone-7) 75 μg once daily for a period of 4 weeks. Patients with overt cardio-vascular diseases, uncontrolled blood pressure and vitamin K-antagonists intake were excluded from the study. Hemodynamic parameters were measured using an A-pulse CASP-AL device. Carotid stiffness indices were measured by one-point echo-tracking method with Aloka Hitachi Prosound on the both common carotid arteries (CA). Results: All hemodynamic parameters showed increased values compared to the baseline: SAP (+5 mmHg) (p = 0.1), DAP (+2.9mmHg) (p = 0.19), PP (+1.4mmHg) (p = 1.4), MAP (+3.4 mmHg) (p = 0.08). CASP increased from 119.8 ± 12.1mmHg to 126.8 ± 11.4 mmHg (+5 mmHg), and this change was significant (p = 0.02). PWV on the right CA did not change significantly before (7.0 ± 1.48 m/s) and after (7.19 ± 1.28 m/s) supplementation (p = 0.47), similar to BSI 10.08 ± 3.41 and respectively 10.51 ± 3.99 (p = 0.61). PWV on the left CA before supplementation is 7.01 ± 1.22 m/c, respectively after 7.19 ± 1.56 m/c (p = 0.49). BSI on the left CA is 9.97 ± 2.79, resp. 10.69 ± 5.07 (p = 0.43). Conclusions: Vitamin K2 supplementation for four weeks showed significant increase in CASP in our cohort of patients with T2DM. The other hemodynamic parameters as well as the indicators of carotid stiffness do not change significantly. A limitation of our study is the small number of patients included and the short period of intake of vitamin K2, which may not lead to morphological changes in the vessel wall. More extensive research is needed in the field.

DECREASED BLOOD PRESSURE AND INCREASED HEART RATE IN WOMEN WITH BREAST CANCER AFTER COMBINED CHEMOTHERAPY LEADS TO PSEUDO-POSITIVE CHANGES IN ARTERIAL STIFFNESS AND PULSE WAVE

Objective: The aim of the study was to study the effect of combined chemotherapy in women with breast cancer (BC) on arterial stiffness and pulse wave by ultrasound examination of the common carotid artery (CCA) using echo tracking technology Design and method: 40 women with triple negative breast cancer aged 27 to 75 years (47.5 ± 12.0) were examined initially and after chemotherapy with the inclusion of anthracyclines (doxorubicin),taxanes (paclitaxel) and platinum derivatives (cisplatin). Arterial stiffness parametres (beta-stiffness index, Ep-elastic modulus, AC-arterial compliance, PWV-pulse wave velocity) and AI – augmentation index were studied in the distal CCA at a distance of 2 cm from bifurcation on an Aloka ProSound alrha7 ultrasound machine using echo tracking technology. Results: After combined chemotherapy the parameters beta-index, Ep, PWV not significantly changed (9,3 ± 4,3 vs 8,9 ± 4,5, p = 0,63;128,73 ± 65,9 vs 119,0 ± 69,5 kPa, p = 0,29; 6,7 ± 1,5 vs 6,3 ± 1,5 m/s, p = 0,24 respectively). Statistically significant decrease in AI from 14, 5 ± 11,3 to 11,1 ± 10,6% (p = 0,009) and an increase in AC from 0,72 ± 0,25 to 0,87 ± 0.3 mm2 /kPa (p = 0,004) were demonstrated as well as decrease in systolic blood pressure (SBP) from 129,5 ± 14,0 to 118,5 ± 14,5 mm Hg (p = 0,0001) and an increase in heart rate from 67,9 ± 10,7 to 76,6 ± 12,1 bpm (p = 0,0004),lower the level of hemoglobin from 129,6 ± 20,4 to 102,2 ± 16,3 g/ l (p = 0,00001) and red blood cells from 4,7 ± 0,4 to 3,3 ± 0,6 1012 / l(p = 0,00001). SBP levels decreased both in women with AH (n = 12) who received anti-hypertensive therapy – from 146,5 ± 9,9 to 130,0 ± 14,6 mm Hg (p &lt; 0,01), and in eutonic women (n = 28) who received no antihypertensive treatment – from 122,2 ± 7,6 to 115,4 ± 8.3 mm Hg (p = 0,002). Conclusions: In women with breast cancer in the early period after combined chemotherapy with the inclusion of anthracyclines (doxorubicin),taxanes (paclitaxel) and platinum derivatives (cisplatin), there were no increased stiffness of the common carotid artery. Pseudo-positive changes in the form of an increase in the extensibility of the vascular wall and a decrease in the augmentation index are explained by general hemodynamic changes in the form of a decrease in the SBP, an increase in heart rate, as well as anemia during chemotherapy.

Traffic-related NOx exposure and proximity to freeways are related to adverse changes in subclinical atherosclerosis measures from childhood to adulthood

Background: Chronic exposure to air pollutants is associated with increased risk of cardiovascular disease (CVD) among adults. However, little is known about how air pollution may affect the development of subclinical atherosclerosis in younger populations. Subclinical measures of atherosclerosis, including carotid artery intima-media thickness (CIMT) and arterial stiffness (CAS), may provide insight into early CVD pathogenesis. Methods: In a pilot study of 70 participants from the Southern California Children’s Health Study, we investigated subclinical atherosclerosis progression from childhood to adulthood. Using carotid artery ultrasound images obtained at age 10 and follow-up images from age 21-22, we examined associations between traffic-related pollutants and changes in CIMT and CAS. Lifetime average traffic-related NOx exposures were assigned using the CALINE4 (California Line Source) dispersion model. Distance to nearest roadways by class was assigned based on ESRI Streetmap Premium roadway data. Results: For each interquartile range increase in average lifetime NOx exposure, we observed a 12.12μm (95% CI: 1.11-23.13; p=0.03) increase in early adulthood attained CIMT and greater longitudinal changes in CIMT from childhood to adulthood (11.5μm, 95% CI: 1.29-21.73, p=0.03) over the follow-up period. Similar adverse changes in CIMT were observed with distance to nearest freeway. Changes in CAS were related to distance to freeway, such that living in closer proximity to freeways was related to greater adverse change in CAS over the follow-up period (stiffness index beta: 0.85; 95% CI: 1.50, 0.21, p=0.01; distensibility: -5.61; 95% CI: -0.93, -10.27, p=0.02).Conclusions: We observed greater adverse changes measures of carotid artery wall thickness and stiffness over time in relation to lifetime traffic-related NOx exposure and residential proximity to freeways. To our knowledge, this is the first study to evaluate the longitudinal impact of lifetime traffic-related air pollution exposure on changes in subclinical markers of atherosclerosis during the critical transition from childhood to adulthood.

Conventional risk factors and arterial bed parameters in patients with coronary artery disease younger and older than 50 years

Aim. To study conventional risk factors and arterial stiffness parameters to identify non-invasive markers of coronary atherosclerosis in patients with and without history of cardiovascular disease, with premature and physiological vascular aging.Material and methods. The study included 198 patients with coronary artery disease (CAD) and 57 healthy people. The subjects were divided into two cohorts: younger and older than 50 years. Each group included patients with newly diagnosed acute coronary syndrome with/without history of cardiovascular disease (CAD and/or hypertension). Conventional risk factors were analyzed in all subjects. Ultrasound radiofrequency of common carotid arteries (CCA), applanation tonometry, volume sphygmography were performed.Results. Analysis of arterial parameters in individuals &lt;50 years old revealed differences between healthy people and patients with CAD. In the subgroup of patients without a history of cardiovascular disease compared with healthy people, CCA were damaged in 77% (p&lt;0,05), aorta — in 13%, muscular arteries — in 29% (p&lt;0,05); in patients with a history of cardiovascular disease, in 71% (p&lt;0,05), 5% and 34% (p&lt;0,05), respectively. In the older age group of patients with and without history of cardiovascular disease, CCA were damaged in 84% and 94% (p&lt;0,05), aorta — in 92% and 87% (p&lt;0,05), muscular arteries — in 42-44% (p&lt;0,05), respectively. According to the ROC analysis, in patients &lt;50 years old, the area under the curve (AUC) for the intima-media thickness (IMT) was 0,830, the threshold — 622,3 (p=0,000); for the beta stiffness index — 0,850, threshold — 7,01 (p=0,002); for L-/CAVI1 — 0,742, threshold — 7,3 (p=0,000). In patients &gt;50 years of age, AUC for the IMT was 0,948, threshold — 607,5 (p=0,000); for the beta stiffness index — 0,740, threshold — 8,84 (p=0,000); for L-/CAVI1 — 0,861, threshold — 8,4 (p=0,000).Conclusion. Timely identification of atherosclerotic markers using noninvasive techniques can improve the prediction of cardiovascular events. A comprehensive non-invasive examination of the arteries with determination of IMT, beta stiffness index, and L-/CAVI1 will probably identify young people with an unfavorable absolute cardiovascular risk. .

Carotid Artery Stiffness in Metabolic Syndrome: Sex Differences.

IntroductionThe effect of metabolic syndrome (MS) on carotid stiffness (CS) in the context of gender is under research.ObjectiveWe examined the relationship between the MS and CS in men (M) and women (W) and investigated if the impact of cardiovascular risk factors on CS is modulated by gender.Patients and MethodsThe study included 419 subjects (mean age 54.3 years): 215 (51%) with MS (109 W and 106 M) and 204 (49%) without MS (98 W and 106 M). Carotid intima-media thickness (IMT) and CS parameters (beta stiffness index (beta), Peterson’s elastic modulus (Ep), arterial compliance (AC) and one-point pulse wave velocity (PWV-beta)) were measured with the echo-tracking (eT) system.ResultsANCOVA demonstrated that MS was associated with elevated CS indices (p = 0.003 for beta and 0.025 for PWV-beta), although further sex-specific analysis revealed that this relationship was significant only in W (p = 0.021 for beta). Age was associated with CS in both M and W, pulse pressure (PP) and body mass index turned out to be determinants of CS solely in W, while the effect of mean arterial pressure (MAP) and heart rate was more pronounced in M. MANOVA performed in subjects with MS revealed that age and diabetes mellitus type 2 were determinants of CS in both sexes, diastolic blood pressure and MAP – solely in M and systolic blood pressure, PP and waist circumference – solely in W (the relationship between the waist circumference and AC was paradoxical).ConclusionThe relationship between MS and CS is stronger in W than in M. In subjects with MS, various components of arterial pressure exert different sex-specific effects on CS – with the impact of the pulsative component of arterial pressure (PP) observed in W and the impact of the steady component (MAP) observed in M.

EXPLORING SEX DIFFERENCES ON ARTERIAL STIFFNESS IN RESPONSE TO HEAVY ROPE EXERCISE

PURPOSE: To evaluate sex differences on aortic and carotid arterial stiffness, and carotid artery compliance (CAC), following heavy rope exercise (HRE). METHODS: Twenty-seven resistance-trained individuals (Men: n=14, Mean±SD: Age: 23 ± 3 yrs; Women: n=13, Age: 22 ± 2yrs) participated. All measurements were collected at Rest, and 15 (Rec1), 30 (Rec2), and 60 (Rec3) minutes following HRE. Aortic arterial stiffness was assessed by pulse wave velocity (PWV), while carotid arterial stiffness, via beta stiffness index (BSI), and CAC, were collected via Doppler ultrasound. HRE utilized six 15-second exercise bouts using a double wave pattern (180bpm), with 30-second seated recovery. Two-way repeated measures ANOVAs were used to determine differences in PWV, BSI, and CAC, between the sexes across time. RESULTS: Men had significantly greater height (p ≤ 0.001) and weight (p ≤ 0.001). There were no significant sex by time interactions for PWV (p = 0.96) or BSI (p = 0.09). A significant main effect of time (p ≤ 0.001) showed that PWV significantly increased during Rec1, however, returned to below resting value at Rec3 (Men= Rest: 5.9 ± 0.7 m/s, Rec1: 6.2 ± 0.7 m/s, Rec2: 6.0 ± 0.7 m/s, Rec3: 5.7 ± 0.7 m/s; Women= Rest: 5.3 ± 0.8 m/s, Rec1: 5.7 ± 0.9 m/s, Rec2: 5.3 ± 0.7 m/s, Rec3: 5.1 ± 0.5 m/s). A main effect of time for BSI (p = 0.002) showed a significant increase during Rec1 and Rec2 from Rest, while Rec3 returned to Rest (Men= Rest: 3.2 ± 1.1 units, Rec1: 4.0 ± 1.5 units, Rec2: 3.5 ± 1.6 units, Rec3: 3.3 ± 1.5 units; Women= Rest: 2.6 ± 1.0 units, Rec1: 3.6 ± 1.6 units, Rec2: 4.3 ± 1.7 units, Rec3: 2.4 ± 0.8 units). There was a significant sex by time interaction for CAC (p = 0.05). Men did not significantly change across time, however, from Rest women significantly decreased during Rec2, then significantly increased from Rec2 to Rec3 (Men= Rest: 0.2 ± 0.1 mm2/mmHg, Rec1: 0.2 ± 0.1 mm2/mmHg, Rec2: 0.2 ± 0.1 mm2/mmHg, Rec3: 0.2 ± 0.1 mm2/mmHg; Women= Rest: 0.3 ± 0.1 mm2/mmHg, Rec1: 0.2 ± 0.1 mm2/mmHg, Rec2: 0.2 ± 0.1 mm2/mmHg, Rec3: 0.3 ± 0.1 mm2/mmHg). CONCLUSIONS: These data suggest that HRE does not produce differences in aortic or carotid arterial stiffness between sexes. The initial decrease in women’s CAC is likely due to greater relative intensity, while the increase in CAC back to resting values is potentially due to the cardioprotective effects of estrogen.

Racial Differences In Cardiovascular Responses Following Acute Bouts Of Anaerobic Exercise

Despite the growing popularity of high-intensity anaerobic exercise, few studies have examined the acute effects of this form of exercise on cardiovascular hemodynamics, or potential racial differences in these responses. In addition, post exercise hypotension may be absent in African Americans (AA) following aerobic exercise, consistent with their higher risk for hypertension. It is unknown whether AA and Caucasian Americans (CA) would exhibit different blood pressures following acute bouts of anaerobic exercise. PURPOSE: To assess hemodynamic changes in healthy, young AA and CA women following repeated bouts (two) of maximal anaerobic exercise. METHODS: Eight young, healthy AA women and 9 CA women completed this study. Vascular and hemodynamic measurements were taken at rest, and 5 (P5-1st), 15 (P15-1st), and 30 minutes (P30-1st) following a maximal anaerobic exercise test on cycle ergometer, and 5 (P5-2nd), 15 (P15-2nd), and 30 (P30-2nd) minutes following the second maximal anaerobic exercise test. Brachial systolic (SBP), diastolic (DBP) blood pressures, central aortic SBP, DBP and mean arterial blood pressure (aortic MAP) were measured. Carotid arterial stiffness (beta-stiffness index) were obtained using ultrasonography. RESULTS: Data were presented in Table 1 as mean ± standard error. Resting DBP and aortic DBP were significantly different between AA and CA (§ p<0.05). There was a significant race by time interaction for aortic MAP (* p<0.05). And there was a trend towards significance in race by time interaction for beta stiffness index (p=0.06). CONCLUSION: Acute bouts of anaerobic exercise increase aortic MAP in young AA but not in CA, and it may be related to increases in arterial stiffness in AA. The heightened BP and vascular responses to exercise stimulus may play a role in the pathogenesis of hypertension in AA. Supported by New England ACSM New Investigator Award to HY.Table 1: Hemodynamic responses to two acute bouts of maximal anaerobic exercise.

İnvestigation of endothelial dysfunction in children with acute rheumatic fever.

Background:Acute rheumatic fever (ARF) is an important cause of valvular heart disease in children. Endothelial dysfunction plays an important role in the pathogenesis of valvular heart diseases. The role of endothelial dysfunction in valvular heart diseases due to ARF is not exactly known. In ARF, autoimmune injury, inflammation, oxidative stress, and impairment of nitric oxide in valvular endothelium may be the causes of endothelial dysfunction. The purpose of this study is to evaluate endothelial dysfunction and arterial stiffness in children with ARF.Materials and Methods:Thirty-six patients diagnosed with ARF (the mean age was 11.80 ± 2.82 years) and 36 volunteered individuals with similar age, sex, and body mass index were included in the study. The study groups were compared in terms of M-mode echocardiography parameters, carotid arterial strain (CAS), beta-stiffness index (βSI), and flow-mediated dilation (FMD).Results:In patients with ARF, there was a decrease in FMD% (10.36 ± 7.26 and 12.76 ± 4.59; P < 0.001) compared to the control group. In addition, CAS (0.16 ± 0.06 and 0.18 ± 0.08; P = 0.44) and βSI (3.65 ± 1.61 and 3.57 ± 2.38; P = 0.24) were similar in the patient and the control groups. Furthermore, no correlation was detected between decreased FMD value and mitral regurgitation (r = −0.07; P = 0.66), aortic regurgitation (r = −0.04; P = 0.78), CAS (r = −0.08; P = 0.61), and βSİ (r = −0.20; P = 0.22).Conclusion:In our study, a decrease in FMD value, which is a marker of endothelial dysfunction, was found in children with rheumatic carditis.

The Acute Effects of High-Intensity Cycling Exercise on Arterial Stiffness in Adolescent Wrestlers.

The aim of this study was to determine the acute effects of high‐intensity cycling exercise on the variables of carotid artery compliance, distensibility and beta stiffness index in elite adolescent wrestlers. The subjects were elite athletes competing in national, European and World Championships, who attended a training camp in the province of Kahramanmaras organized by the Turkish Centre for Olympic Preparation. The study sample comprised 31 male elite wrestlers with a mean age of 15.90 ± 0.87 years, body height of 165.97 ± 9.7 cm and body mass of 66.3 ± 18.45 kg. The arterial stiffness variables of the wrestlers were measured with high‐resolution Doppler ultrasonography before and 5 min after 30 s of high‐intensity cycling exercise (the Wingate Anaerobic Cycling test). The results showed a statistically significant correlation between mean power performance and carotid artery compliance at the 5th min after a single cycling sprint exercise (p < 0.05). No correlation was determined between peak power and the arterial stiffness variables (p > 0.05). The study results indicate that acute changes in arterial stiffness variables are associated with the performance level of high‐intensity cycling exercise in a group of elite adolescent wrestlers.

Abstract P2066: The Difference of With or Without Blood Pressure Adjustment for Pulse Wave Velocity as a Risk Factor for Cardiovascular Disease

Background: Arterial stiffness, assessed by pulse wave velocity (PWV), is an independent predictor of future cardiovascular (CV) events. While blood pressure (BP) functionally increases the value of PWV, the significance of this increase as a risk for CV disease (CVD) has not been fully clarified. The stiffness-index beta has been used as a less BP-influenced marker to assess arterial stiffness. Then, the present study examined whether BP-adjusted value of the PWV improve or attenuate the predictive value for the development of the hypertension, retinopathy, and renal dysfunction, or of future CV events as compared to brachial-ankle PWV (baPWV). Methods and Results: Study 1: In the 7-year prospective observation conducted in 3274 Japanese men without hypertension at the baseline for the development of hypertension and also in 3490 Japanese men for the development of organ damage, baPWV, BP, estimated glomerular filtration rate (eGFR), and fundus findings were measured at baseline and end of study period. During the study period, 474 subjects developed to hypertension, 29 subjects had renal dysfunction, and 91 subjects had the development of retinopathy. The area under the curve (AUC), in the receiver operator characteristic curve analysis, of baPWV was higher than that of BP-adjusted baPWV for the development of hypertension (0.73 vs. 0.59; p&lt;0.01), for eGFR &lt;60 mL/min/1.73m 2 and for the development of retinopathy. The baPWV rather than BP-adjusted baPWV showed a significant odds ratio for the development of hypertension (1.84 per standard deviation increase, p&lt;0.01) and that of retinopathy (1.25 per standard deviation increase, p&lt;0.01). Study 2: During the 3-year observation period in 511 patients with coronary artery disease, 72 CV events were confirmed. While the AUCs of both markers for the development of CV events were similar, the Cox proportional hazards model analysis revealed that baPWV rather than BP-adjusted baPWV showed a significant hazard ratio (1.38, P&lt;0.01) for the development of CV events. Conclusions: The BP adjustment, based on the concept of stiffness-index beta, may attenuate the significance of baPWV as a risk marker for the development of CVD, especially in its development related pathophysiological abnormalities in male subjects.

Association between serum homocysteine and arterial stiffness in patients with Behçet’s disease

Aim of the workTo study the effects of serum homocysteine (Hcy) on arterial wall properties, as a contributing risk factor for arterial atherosclerosis and thrombosis. Patients and methodsFifty Behçet's disease (BD) patients (M/F:37/13; age:34.8 ± 8.5 years) along with 50 healthy controls (M/F:32/18; age:31.9 ± 8.1 years) matched for age, sex, blood pressure, heart rate, height, total cholesterol and glucose levels were included. All were recruited Zagazig University Hospitals between January 2018 and December 2018. Disease activity was assessed using the Behçet's Disease Current Activity Form (BDCAF). Total Hcy was assayed by the Axis-Shield Homocysteine Enzyme Immunoassay (EIA) in serum. All subjects underwent carotid Doppler ultrasound to measure carotid artery intima-media thickness (C-IMT), arterial distensibility coefficient, Beta-stiffness index (ß) and carotid- femoral pulse wave velocity (PWV). ResultsThe main findings were significantly increased C-IMT (0.75 ± 0.71 mm), beta stiffness index (3.55 ± 0.34) and PWV (6.55 ± 1.07 m/second) and decreased distensibility (23.39 ± 1.89·10−3 × kPa−1) in patients compared to control (p < 0.001, p < 0.001, p = 0.02 and p < 0.001 respectively). The Hcy level was significantly higher in BD patients (17.3 ± 4.2 μmol/L) vs control (8.9 ± 2.3 μmol/L). The Hcy level > 15 μmol/L significantly correlated with the C-IMT (r = 0.54, p < 0.001), ß index (r = 0.78, p < 0.001), PWV (r = 0.56, p < 0.001) and distensibility (r = −0.65, p < 0.001) as well as with the presence of vascular lesions (r = 0.59, p < 0.001) with a tendency to correlate with the BDCAF (r = 0.11, p = 0.07). ConclusionsThese findings suggest higher risk for development of atherosclerosis and endothelial dysfunction in BD patients and highlights that future researches should focus on identification and prophylactic treatment of patients at risk of cardiovascular disease.

Effects of full-fat dairy products on subclinical vascular function in adults with elevated blood pressure: a randomized clinical trial.

High consumption of low- and non-fat dairy products improves vascular dysfunction associated with elevated arterial blood pressure (BP). Currently, it is unknown if conventional full-fat dairy products improve vascular functions. To determine if adding whole milk and full-fat dairy products to the normal routine diet improves vascular function in adults with elevated BP. Sixty adults (age ± SEM; 58 ± 2 years) with elevated BP (systolic/diastolic; 120-159/ < 99 mmHg) were randomized into a controlled crossover intervention trial consisting of two 4-week dietary periods. The high dairy condition consisted of adding four daily servings of whole milk or full-fat dairy products to the normal diet and eliminated all dairy intake during the control (no dairy) condition. A 2-week washout period separated the dietary conditions. Carotid-femoral pulse wave velocity (cfPWV) did not differ significantly between high dairy (11.3 ± 0.3 versus 10.9 ± 0.3 m/sec) and no dairy conditions (11.2 ± 0.3 versus 11.0 ± 0.3 m/sec). The results were consistent when ultrasound-derived vascular distension measures (arterial compliance, beta-stiffness index, and elastic modulus) were evaluated. Cardiovagal baroreceptor sensitivity (via Valsalva maneuver) demonstrated no significant difference for either dietary condition. Brachial arterial flow-mediated dilation (FMD) did not differ significantly during the high dairy (5.7 ± 0.5 versus 5.4 ± 0.6%) and no dairy conditions (6.5 ± 0.5 versus 5.6 ± 0.6%). The solitary addition of whole milk and full-fat dairy products has no effect on subclinical vascular function in adults with elevated BP.

Lifetime change in central and peripheral haemodynamics in relation to exercise capacity

Exercise capacity as well as many resting central and peripheral haemodynamic features declines by age. We aimed to investigate which haemodynamic features change the most during life and which change in parallel to exercise capacity. We performed a maximal bicycle exercise test with gas exchange in 103 healthy subjects (24 young, 55 middle-aged and 24 elderly). Endothelial function, arterial compliance/stiffness and heart rate variability (HRV) were evaluated, and the myocardium and carotid arteries were investigated by ultrasound. Exercise capacity declined by almost 50% over the lifespan. Several markers reflecting arterial compliance/stiffness and HRV, as well as carotid intima-media thickness (IMT), showed lifetime impairments by >100%, while markers of LV systolic function, diastolic blood pressure and carotid artery blood flow showed only minor changes with age. The decline in exercise capacity clusters closely with many other variables measured during the exercise test, but also to resting vital capacity, left ventricular end-diastolic diameter and resting gas exchange (VO2 , VCO2 ) to a lesser degree. Resting vital capacity was closely related to exercise capacity in the middle-aged group. We conclude that many of the resting markers of central and peripheral haemodynamics declined during life, in parallel to the decline in exercise capacity. However, some haemodynamic features, such as LF/HF ratio at HRV, stiffness index beta of the carotid artery, and heart rate reserve at the exercise test, showed a more exaggerated decline, indicating that those are not closely linked to exercise capacity.

Association between large elastic artery stiffness and brain mechanical properties

Stiffening of the large elastic arteries (i.e., the aorta and carotid arteries) occurs with aging and may play a key role in memory impairment via a diminished pressure‐dampening effect, ultimately leading to loss of neuronal tissue integrity. In this regard, changes in brain tissue viscoelastic mechanical properties, an indirect measure of neuronal tissue integrity, may reflect the impact of elastic artery stiffening on brain health. Therefore, the purpose of this pilot study was to determine whether large elastic artery stiffness is associated with total brain viscoelasticity in healthy adults across the lifespan. All measures were performed in 13 healthy participants (6 females, mean age: 38 ± 15 y; age range: 22–69 y; mean BMI: 26 ± 5 kg/m2; mean BP: 111 ± 9/68 ± 10 mmHg). Carotid artery stiffness, beta‐stiffness index and compliance were assessed using B‐mode ultrasound (Logiq e, GE) coupled with applanation tonometry (SphygmoCor, AtCor Medical Inc.) and analyzed using commercial wall‐tracking software (Cardiovascular Suite, Quipu). Aortic stiffness was assessed as carotid‐to‐femoral pulse wave velocity (PWV) using applanation tonometry. Brain tissue viscoelastic mechanical properties (shear stiffness and damping ratio) were measured using magnetic resonance elastography (MRE). MRE data were acquired using 3T magnetic resonance imaging (Magnetom Prisma, Siemens, Inc.) while the brain viscoelastic property maps were generated using a nonlinear inversion algorithm. Associations between measures of age, large elastic artery stiffness and brain viscoelastic properties were determined using linear regression. PWV significantly increased with age (F = 25.6, p &lt; 0.05, r2 = 0.7) while total brain stiffness significantly decreased with age (F = 6.1, p &lt; 0.05, r2 = 0.36). Carotid artery stiffness (F = 4.3, p = 0.06, r2 = 0.28) and beta‐stiffness index (F = 2.9, p = 0.11, r2 = 0.21) tended to be inversely associated with total brain stiffness, whereas carotid artery compliance tended to be positively associated with total brain stiffness (F = 2.5, p = 0.14, r2 = 0.18). No relation was observed between PWV and total brain stiffness (F = 0.9, p = 0.37, r2 = 0.08). There were no associations between any measures of arterial stiffness and damping ratio. These preliminary data confirm that aging is associated with increase in arterial stiffness and loss of brain tissue integrity. They also indicate a possible association between large artery stiffening with brain tissue integrity and suggest that preserving elasticity of the carotid artery in particular may be important for protecting brain health with aging. Future work should assess the relation between carotid artery stiffness and brain mechanical properties in a larger group of individuals.Support or Funding InformationSupported by Center for Biomedical and Brain Imaging (CBBI) Pilot Grant P20GM103653 and Center of Biomedical Research Excellence (COBRE) Pilot Grant P20GM113125.This abstract is from the Experimental Biology 2019 Meeting. There is no full text article associated with this abstract published in The FASEB Journal.

Impact of Aging on the Windkessel Function of Carotid Artery

Large elastic arteries dampen cyclic mechanical forces of cardiac pulsations by extending and recoiling against intermittent cardiac blood flow ejection. This function (called “Windkessel”) acts to attenuates left ventricular after load, preserves coronary perfusion, and protects vulnerable microvasculature such as the brain. However, the impact of aging on the carotid artery Wind kessel function, especially recoiling ability, is not well known. Therefore, the aim of this study was to characterize carotid artery Windkessel function in healthy individuals across the adult lifespan. Carotid arterial pressure (CAP, via applanationtonometry) and diameter (CAD, via ultrasonography) were simultaneously recorded in 81 participants (age range=29–85 years, 47 women). Carotid arterial systolic blood pressure and beta-stiffness index increased (r=0.390 and r=0.455, P<0.001) and arterial compliance decreased (r=−0.492, P<0.001) with advancing age. Time constant of CAP shortened (r=−0.266, P<0.05), whereas that of CAD extended (r=0.239, P<0.05). The diastolic slope (from the dicrotic notch to the end-diastole) obtained from the pressure-diameter loop was significantly greater than the systolic slope (from systolic foot to the first systolic peak). The systolic and diastolic slopes blunted with aging (r=−0.463 and r=−0.500, P<0.001). In the age-group comparison, there was a significant difference in systolic peak between the first (< 50 years) and third age-group(≥ 70 years), whereas the diastolic peak of the second (50–69 years) and third age-groups were significantly lower than the first age-group. These results suggest that age-related impairment of carotidartery Windkessel function manifests earlier in diastolic recoiling than in systolic expanding. Support or Funding Information This work was supported by JSPS KAKENHI 16KK0011 and 17H02186. Systolic and diastolic slopes obtained from the carotid artery pressure-diameter loop. Data are mean and SD. *P<0.05 vs. < 50 years. This abstract is from the Experimental Biology 2019 Meeting. There is no full text article associated with this abstract published in The FASEB Journal.

Effect of uric acid serum levels on carotid arterial stiffness and intima-media thickness: A high resolution Echo-Tracking Study.

Serum uric acid (UA) has been shown to be a predictor of cardiovascular (CV) morbidity and mortality, and it may play a role in the pathogenesis of CV disease affecting vascular structure and function. However, there is limited evidence of its specific association with carotid artery stiffness and structure. The aim of our study was to evaluate whether UA is associated with early signs of atherosclerosis, namely local carotid arterial stiffness and intima-media thickening. We evaluated 698 consecutive asymptomatic patients, referred to the Cardiovascular Department for risk factors evaluation and treatment. All patients underwent carotid artery ultrasonography with measurement of common carotid intima-media thickness (IMT) and echo-tracking carotid artery stiffness index Beta. Patients with hyperuricemia (defined as serum uric acid ≥7 mg/dL in men and ≥6 mg/dL in women) had higher IMT (0.97±0.22 vs 0.91±0.18, p<0.001) and stiffness index Beta (8.3±3.2 vs 7.5±2.7, p=0.005). UA levels correlated with both IMT (r=0.225; p<0.001) and stiffness index Beta (r=0.154; p<0.001); the correlations were statistically significant in males and females. In a multivariate model which included age, arterial pressure, serum glucose and LDL-cholesterol, serum UA emerged as an independent explanatory variable of IMT and stiffness index Beta. Carotid IMT and local arterial stiffness are related to UA independently of established CV risk factors; UA may play a role in the early development of atherosclerosis.

The pressure-dependency of local measures of arterial stiffness.

To determine which ultrasound-based, single-point arterial stiffness estimate is least dependent on blood pressure (BP) to improve assessment of local vascular function. Ultrasound was used to assess blood flow and diameters at the left brachial artery of 20 healthy adults [55% female, 27.9 years (5.2), 24.2 (2.8) kg/m]. BP of both arms was measured simultaneously. Experimental (left) arm BP was then systematically manipulated by adjusting its position ABOVE (+30°) and BELOW (-30°) heart level in a randomized order following measurement at heart level (0°). The control (right) arm remained at heart level. Six stiffness measurements were calculated: compliance, distensibility, beta-stiffness, and three estimates of pulse wave velocity (PWV) (Bramwell Hill, blood flow, and beta-stiffness). We considered the measurement technique with the least significant change across positions to be the least pressure-dependent. There was a large effect change in mean arterial pressure (np = 0.75, P < 0.001) in the experimental arm when it was ABOVE (Δ-4.4 mmHg) and BELOW (Δ10.4 mmHg) heart level. There was a main effect (P < 0.05) of arm position on all arterial stiffness measures. From least to most pressure-dependent, the arterial stiffness measurements were: PWV (blood flow method), compliance coefficient, beta-stiffness, distensibility coefficient, PWV (Bramwell-Hill method), and PWV (beta-stiffness index method). All single-point measures assessed are pressure-dependent. The PWV (blood flow method) may be the least pressure-dependent single-point measure, and may be the most suitable single-point measure to assess local vascular function.