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Sample records for arterial stiffness index

  1. Reproducibility of the ambulatory arterial stiffness index in hypertensive patients

    DEFF Research Database (Denmark)

    Dechering, D.G.; Steen, M.S. van der; Adiyaman, A.;

    2008-01-01

    BACKGROUND: We studied the repeatability of the ambulatory arterial stiffness index (AASI), which can be computed from 24-h blood pressure (BP) recordings as unity minus the regression slope of diastolic on systolic BP. METHODS: One hundred and fifty-two hypertensive outpatients recruited...

  2. Determinants of the ambulatory arterial stiffness index in 7604 subjects from 6 populations

    DEFF Research Database (Denmark)

    Adiyaman, Ahmet; Dechering, Dirk G; Boggia, José

    2008-01-01

    The ambulatory arterial stiffness index (AASI) is derived from 24-hour ambulatory blood pressure recordings. We investigated whether the goodness-of-fit of the AASI regression line in individual subjects (r(2)) impacts on the association of AASI with established determinants of the relation between...

  3. Need for insulin to control gestational diabetes is reflected in the ambulatory arterial stiffness index

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    Kärkkäinen Henna

    2013-01-01

    Full Text Available Abstract Background The aim was to evaluate the metabolic profile in conjunction with vascular function using the ambulatory arterial stiffness index (AASI in women with uncomplicated pregnancies and in women with gestational diabetes mellitus (GDM. Methods Plasma glucose, lipids, HOMA –IR (homeostasis model assessment of insulin resistance and AASI, as obtained from 24-hour ambulatory blood pressure monitoring in third trimester pregnancy and at three months postpartum, were measured in three groups of women: controls (N = 32, women with GDM on diet (N = 42 and women with GDM requiring insulin treatment (N = 10. Results Women with GDM had poorer glycemic control and higher HOMA-IR during and after pregnancy and their total and LDL (low density lipoprotein cholesterol levels were significantly higher after pregnancy than in the controls. After delivery, there was an improvement in AASI from 0.26 ± 0.10 to 0.17 ± 0.09 (P = 0.002 in women with GDM on diet, but not in women with GDM receiving insulin whose AASI tended to worsen after delivery from 0.30 ± 0.23 to 0.33 ± 0.09 (NS, then being significantly higher than in the other groups (P = 0.001-0.047. Conclusions Women with GDM had more unfavorable lipid profile and higher blood glucose values at three months after delivery, the metabolic profile being worst in women requiring insulin. Interestingly, the metabolic disturbances at three months postpartum were accompanied by a tendency towards arterial stiffness to increase in women requiring insulin.

  4. Correlation of arterial stiffness index with carotid atherosclerosis in patients with primary hypertension

    Institute of Scientific and Technical Information of China (English)

    Wen-Hua Cai; Li-Min Li; Xue-Min Wang; Cui-Qing Sun; Hai-Wei Zhao; Hui Wang; Rui-Chao Liu

    2016-01-01

    Objective:To explore the correlation of arterial stiffness index with carotid atherosclerosis in patients with primary hypertension.Methods:A total of 86 patients with primary hypertension who were admitted in our hospital from January, 2013 to September, 2015 were included in the study, and divided into the carotid atherosclerosis group (IMT≥0.9 mm, with plaque being detected) and the pure hypertension group (normal IMT) according to the carotid artery color Doppler ultrasound results. According to the ambulatory blood pressure monitoring results, the carotid atherosclerosis group was divided into the low BPV (7.02-9.57) group and the high BPV (>9.57-14.29) group. The non-invasive ambulatory blood pressure monitoring apparatus was used for 24 h blood pressure monitoring, measuring time in the daytime: 6:00-21:59, measuring one time every 30 min; measuring time in the nighttime: 22:00-5:59, measuring one time every 60 min. The dSBP, dDBP, nSBP, nDBP, 24 h SBP, and 24 h DBP were recorded. BPV was expressed as 24 h SCV and 24 h DCV.Results:The dSBP, nSBP, 24 h SBP, 24 h DBP, and 24 h SCV in the carotid atherosclerosis group were significantly higher than those in the pure hypertension group, while the comparison of dDBP, nDBP, and 24 h DCV between the two groups was not statistically significant. The common carotid artery and external carotid artery IMT, and the mean IMT in the high BPV group were significantly higher than those in the low BPV group, and the number of carotid plaques being detected was significantly greater than that in the low BPV group.Conclusions:BPV is involved in the arterial functional and structural changes, resulting in the target organ damage. Detection of carotid IMT is of great significance in evaluating the early vascular damage and predicting the cardiovascular events; therefore, BPV monitoring should be strengthened during the diagnosis and treatment of hypertension.

  5. Pharmacological modulation of arterial stiffness.

    LENUS (Irish Health Repository)

    Boutouyrie, Pierre

    2011-09-10

    Arterial stiffness has emerged as an important marker of cardiovascular risk in various populations and reflects the cumulative effect of cardiovascular risk factors on large arteries, which in turn is modulated by genetic background. Arterial stiffness is determined by the composition of the arterial wall and the arrangement of these components, and can be studied in humans non-invasively. Age and distending pressure are two major factors influencing large artery stiffness. Change in arterial stiffness with drugs is an important endpoint in clinical trials, although evidence for arterial stiffness as a therapeutic target still needs to be confirmed. Drugs that independently affect arterial stiffness include antihypertensive drugs, mostly blockers of the renin-angiotensin-aldosterone system, hormone replacement therapy and some antidiabetic drugs such as glitazones. While the quest continues for \\'de-stiffening drugs\\

  6. Arterial Stiffness: Recommendations and Standardization

    Science.gov (United States)

    Townsend, Raymond R.

    2017-01-01

    The use of arterial stiffness measurements in longitudinal cohorts of normal populations, hypertensive patients, diabetic patients, healthy elderly, and patients on hemodialysis have confirmed the value of this important measure of arterial health, and established its complementary role to measures of blood pressure. Its contribution to understanding cardiovascular and mortality risk beyond blood pressure measurements has moved measures of arterial stiffness into the ranks of factors such as elevated cholesterol, diabetes, and left ventricular hypertrophy in considering cardiovascular risk. The recent international collaboration's publication of reference ranges for normal people and those with hypertension, along with the American Heart Association's recent scientific statement on standardizing arterial stiffness measurements are important aspects to consider in future studies employing these valuable methods, particularly as interventions that not only lower blood pressure but improve arterial function are tested in the clinical arena. PMID:28275588

  7. Numerical assessment of the stiffness index.

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    Epstein, Sally; Vergnaud, Anne-Claire; Elliott, Paul; Chowienczyk, Phil; Alastruey, Jordi

    2014-01-01

    Elevated systemic vascular stiffness is associated with increased risk of cardiovascular disease. It has been suggested that the time difference between the two characteristic peaks of the digital volume pulse (DVP) measured at the finger using photoplethysmography is related to the stiffness of the arterial tree, and inversely proportional to the stiffness index (SI). However, the precise physical meaning of the SI and its relation to aortic pulse wave velocity (aPWV) is yet to be ascertained. In this study we investigated numerically the effect of changes in arterial wall stiffness, peripheral resistances, peripheral compliances or peripheral wave reflections on the SI and aPWV. The SI was calculated from the digital area waveform simulated using a nonlinear one-dimensional model of pulse wave propagation in a 75-artery network, which includes the larger arteries of the hand. Our results show that aPWV is affected by changes in aortic stiffness, but the SI is primarily affected by changes in the stiffness of all conduit vessels. Thus, the SI is not a direct substitute for aPWV. Moreover, our results suggest that peripheral reflections in the upper body delay the time of arrival of the first peak in the DVP. The second peak is predominantly caused by the impedance mismatch within the 75 arterial segments, rather than by peripheral reflections.

  8. Physical inactivity and arterial stiffness in COPD

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    Sievi NA

    2015-09-01

    Full Text Available Noriane A Sievi,1 Daniel Franzen,1 Malcolm Kohler,1,2 Christian F Clarenbach1 1Division of Pulmonology, University Hospital of Zurich, 2Zurich Center for Integrative Human Physiology, University of Zurich, Zurich, Switzerland Background: Arterial stiffness is an important predictor of cardiovascular risk besides classic cardiovascular risk factors. Previous studies showed that arterial stiffness is increased in patients with COPD compared to healthy controls and exercise training may reduce arterial stiffness. Since physical inactivity is frequently observed in patients with COPD and exercise training may improve arterial stiffness, we hypothesized that low daily physical activity may be associated with increased arterial stiffness. Methods: In 123 patients with COPD (72% men; mean [standard deviation] age: 62 [7.5] years; median [quartile] forced expiratory volume in 1 second 35 [27/65] %predicted, arterial stiffness was assessed by augmentation index (AI. Daily physical activity level (PAL was measured by an activity monitor (SenseWear Pro™ >1 week. The association between AI and PAL was investigated by univariate and multivariate regression analysis, taking into account disease-specific characteristics and comorbidities. Results: Patients suffered from moderate (35%, severe (32%, and very severe (33% COPD, and 22% were active smokers. Median (quartile PAL was 1.4 (1.3/1.5 and mean (standard deviation AI 26% (9.2%. PAL showed a negative association with AI (B=-9.32, P=0.017 independent of age, sex, blood pressure, and airflow limitation. Conclusion: In COPD patients, a higher PAL seems to favorably influence arterial stiffness and therefore may reduce cardiovascular risk. Clinical Trial Registration: www.ClinicalTrials.gov, NCT01527773 Keywords: activity monitor, airflow limitation, COPD, physical activity level

  9. Arterial stiffness as a risk factor for coronary artery disease.

    Science.gov (United States)

    Liao, Josh; Farmer, John

    2014-02-01

    Hypertension is a major modifiable risk factor, and clinical trials have demonstrated that successful reduction of elevated blood pressure to target levels translates into decreased risk for the development of coronary artery disease, stroke, heart failure, and renal failure. The arterial system had previously been regarded as a passive conduit for the transportation of arterial blood to peripheral tissues. The physiologic role the arterial system was greatly expanded by the recognition of the central role of the endothelial function in a variety of physiologic processes. The role of arterial function and structure in cardiovascular physiology was expanded with the development of a variety of parameters that evaluate arterial stiffness. Markers of arterial stiffness have been correlated with cardiovascular outcomes, and have been classified as an emerging risk factor that provides prognostic information beyond standard stratification strategies involving hypertension, diabetes, obesity, dyslipidemia and smoking. Multiple epidemiologic studies have correlated markers of arterial stiffness such as pulse-wave velocity, augmentation index and pulse pressure with risk for the development of fatal and nonfatal cardiovascular events. Additionally, measurements of arterial stiffness had clarified the results of clinical trials that demonstrated differing impacts on clinical outcomes, despite similar reductions in blood pressure, as measured by brachial and sphygmomanometry.

  10. Arterial Stiffness and Dialysis Calcium Concentration

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    Fabrice Mac-Way

    2011-01-01

    Full Text Available Arterial stiffness is the major determinant of isolated systolic hypertension and increased pulse pressure. Aortic stiffness is also associated with increased cardiovascular morbidity and mortality in patients with chronic kidney disease, hypertension, and general population. Hemodynamically, arterial stiffness results in earlier aortic pulse wave reflection leading to increased cardiac workload and decreased myocardial perfusion. Although the clinical consequence of aortic stiffness has been clearly established, its pathophysiology in various clinical conditions still remains poorly understood. The aim of the present paper is to review the studies that have looked at the impact of dialysis calcium concentration on arterial stiffness. Overall, the results of small short-term studies suggest that higher dialysis calcium is associated with a transient but significant increase in arterial stiffness. This calcium dependant increase in arterial stiffness is potentially explained by increased vascular smooth muscle tone of the conduit arteries and is not solely explained by changes in mean blood pressure. However, the optimal DCa remains to be determined, and long term studies are required to evaluate its impact on the progression of arterial stiffness.

  11. Genetic determinants of arterial stiffness: Results from the Rotterdam Study

    NARCIS (Netherlands)

    M.P.S. Sie (Mark)

    2007-01-01

    textabstractArterial stiffness increases with age. It is also associated with various diseases, such as diabetes mellitus and hypertension. Recently, arterial stiffness has also been found to independently predict cardiovascular disease. The pathogenesis of arterial stiffness, however, has n

  12. Reference values for local arterial stiffness. Part B : femoral artery

    NARCIS (Netherlands)

    Bossuyt, Jelle; Engelen, Lian; Ferreira, Isabel; Stehouwer, Coen D; Boutouyrie, Pierre; Laurent, Stéphane; Segers, Patrick; Reesink, Koen; Van Bortel, Luc M

    2015-01-01

    OBJECTIVE: Carotid-femoral pulse wave velocity (PWV) is considered the gold standard measure of arterial stiffness, representing mainly aortic stiffness. As compared with the elastic carotid and aorta, the more muscular femoral artery may be differently associated with cardiovascular risk factors (C

  13. Red wine, arterial stiffness and central hemodynamics.

    Science.gov (United States)

    Karatzi, Kalliopi; Papaioannou, Theodore G; Papamichael, Christos; Lekakis, John; Stefanadis, Christodoulos; Zampelas, Antonis

    2009-01-01

    Red wine is considered to reduce cardiovascular risk and decrease peripheral systolic and diastolic blood pressure. Central aortic pressures are often more sensitive clinical and prognostic factors than peripheral pressures, while arterial stiffness is an independent prognostic factor for cardiovascular events. Great efforts are being made to find natural sources of improving health. In order to clarify the mechanisms under which a widely used drink, like red wine, is affecting heart and vessels, we aimed to review the available data regarding the effects of red wine on arterial stiffness, wave reflections and central blood pressures. The effect of red wine on central hemodynamics has been poorly explored with divergent results. Possible consequences of acute and long-term intake on arterial stiffness, wave reflections and central pressures are not clear. This might make someone skeptical when suggesting the consumption of a glass of red wine, although its cardioprotective actions (when moderately consumed) are already shown from epidemiological studies.

  14. Aerobic exercise training increases plasma Klotho levels and reduces arterial stiffness in postmenopausal women.

    Science.gov (United States)

    Matsubara, Tomoko; Miyaki, Asako; Akazawa, Nobuhiko; Choi, Youngju; Ra, Song-Gyu; Tanahashi, Koichiro; Kumagai, Hiroshi; Oikawa, Satoshi; Maeda, Seiji

    2014-02-01

    The Klotho gene is a suppressor of the aging phenomena, and the secretion as well as the circulation of Klotho proteins decrease with aging. Although habitual exercise has antiaging effects (e.g., a decrease in arterial stiffness), the relationship between Klotho and habitual exercise remains unclear. In the present study, we investigated the effect of habitual exercise on Klotho, with a particular focus on arterial stiffness. First, we examined the correlation between plasma Klotho concentration and arterial stiffness (carotid artery compliance and β-stiffness index) or aerobic exercise capacity [oxygen uptake at ventilatory threshold (VT)] in 69 healthy, postmenopausal women (50-76 years old) by conducting a cross-sectional study. Second, we tested the effects of aerobic exercise training on plasma Klotho concentrations and arterial stiffness. A total of 19 healthy, postmenopausal women (50-76 years old) were divided into two groups: control group and exercise group. The exercise group completed 12 wk of moderate aerobic exercise training. In the cross-sectional study, plasma Klotho concentrations positively correlated with carotid artery compliance and VT and negatively correlated with the β-stiffness index. In the interventional study, aerobic exercise training increased plasma Klotho concentrations and carotid artery compliance and decreased the β-stiffness index. Moreover, the changes in plasma Klotho concentration and arterial stiffness were found to be correlated. These results suggest a possible role for secreted Klotho in the exercise-induced modulation of arterial stiffness.

  15. Experimental exposure to diesel exhaust increases arterial stiffness in man

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    Newby David E

    2009-03-01

    Full Text Available Abstract Introduction Exposure to air pollution is associated with increased cardiovascular morbidity, although the underlying mechanisms are unclear. Vascular dysfunction reduces arterial compliance and increases central arterial pressure and left ventricular after-load. We determined the effect of diesel exhaust exposure on arterial compliance using a validated non-invasive measure of arterial stiffness. Methods In a double-blind randomized fashion, 12 healthy volunteers were exposed to diesel exhaust (approximately 350 μg/m3 or filtered air for one hour during moderate exercise. Arterial stiffness was measured using applanation tonometry at the radial artery for pulse wave analysis (PWA, as well as at the femoral and carotid arteries for pulse wave velocity (PWV. PWA was performed 10, 20 and 30 min, and carotid-femoral PWV 40 min, post-exposure. Augmentation pressure (AP, augmentation index (AIx and time to wave reflection (Tr were calculated. Results Blood pressure, AP and AIx were generally low reflecting compliant arteries. In comparison to filtered air, diesel exhaust exposure induced an increase in AP of 2.5 mmHg (p = 0.02 and in AIx of 7.8% (p = 0.01, along with a 16 ms reduction in Tr (p = 0.03, 10 minutes post-exposure. Conclusion Acute exposure to diesel exhaust is associated with an immediate and transient increase in arterial stiffness. This may, in part, explain the increased risk for cardiovascular disease associated with air pollution exposure. If our findings are confirmed in larger cohorts of susceptible populations, this simple non-invasive method of assessing arterial stiffness may become a useful technique in measuring the impact of real world exposures to combustion derived-air pollution.

  16. Arterial stiffness, as monitored by cardio–ankle vascular index, is affected by obstructive sleep apnea, blood glucose control, and body weight – a case with 8 years follow up

    Science.gov (United States)

    Shimizu, Kazuhiro; Yamamoto, Tomoyuki; Shirai, Kohji

    2016-01-01

    The cardio–ankle vascular index (CAVI) is an indicator of arterial stiffness from the heart to the ankles. The CAVI increases as arteriosclerosis progresses, but it can be decreased by appropriate treatment. There are several risk factors for coronary artery disease, however, the degree of stress caused by each separate risk factor to arteries cannot be assessed. CAVI increases with age and according to the severity of atherosclerosis. We found that CAVI also changes in response to the control of risk factors, which may be associated with the functional stiffness of arteries. CAVI can be a useful indicator of risk control for coronary artery disease. We followed a patient aged 71 years who had diabetes mellitus and obstructive sleep apnea (OSA) by measuring CAVI for 8 years from age 63. He underwent coronary artery bypass grafting due to angina pectoris when he was 63 years old. Before coronary artery bypass grafting, CAVI was 11.8 on the right and 11.5 on the left. Three years later he was found to have OSA and received treatment with continuous positive airway pressure. There was a marked improvement in CAVI after continuous positive airway pressure (age 68; right 10.4, left 10.2). However, following a gradual increase in body weight and worsening of diabetes mellitus, CAVI showed an increasing trend. CAVI decreased with biguanides treatment, but increased again with an increase in body weight. In conclusion, CAVI responded to the patient’s conditions including obesity, diabetes mellitus, and OSA. CAVI is not only a marker of arterial stiffness, but can also be a useful indicator of physiological status; it may be effective in total risk control for coronary artery disease. PMID:27563259

  17. Arterial stiffness: pathophysiology and clinical impact.

    Science.gov (United States)

    London, Gérard M; Marchais, Sylvain J; Guerin, Alain P; Pannier, Bruno

    2004-01-01

    The ill effects of hypertension are usually attributed to a reduction in the caliber or the number of arterioles, resulting in an increase in total peripheral resistance (TPR). This definition does not take into account the fact that BP is a cyclic phenomenon with systolic and diastolic BP being the limits of these oscillations. The appropriate term to define the arterial factor(s) opposing LV ejection is aortic input impedance which depends on TPR, arterial distensibility (D), and wave reflections (WR). D defines the capacitive properties of arterial stiffness, whose role is to dampen pressure and flow oscillations and to transform pulsatile flow and pressure in arteries into a steady flow and pressure in peripheral tissues. Stiffness is the reciprocal value of D. These parameters are BP dependent, and arteries become stiffer at high pressure. In to D which provides information about the elasticity> of artery as a hollow structure, the elastic incremental modulus (Einc) characterizes the properties of the arterial wall biomaterials, independently of vessel geometry. As an alternative, arterial D can be evaluated by measuring the pulse wave velocity (PWV) which increases with the stiffening of arteries. Arterial stiffening increases left ventricular (LV) afterload and alters the coronary perfusion. With increased PWV, the WR impacts on the aorta during systole, increasing systolic pressures and myocardial oxygen consumption, and decreasing diastolic BP and coronary flow. The arterial stiffness is altered primarily in association with increased collagen content and alterations of extracellular matrix (arteriosclerosis) as classically observed during aging or in arterial hypertension. The arterial stiffening estimated by changes in aortic PWV and intensity of WR are independent predictors of survival in end stage renal disease (ESRD) and general population. Improvement of arterial stiffening could be obtained by antihypertensive treatmen as observed with the calcium

  18. Arterial Stiffness in Nonhypertensive Type 2 Diabetes Patients in Ghana

    Science.gov (United States)

    Antwi, Daniel A.; Gyan, Ben

    2016-01-01

    Background. Increased arterial stiffness is an independent cardiovascular risk factor in diabetes patients and general population. However, the contribution of diabetes to arterial stiffness is often masked by coexistent obesity and hypertension. In this study, we assessed arterial stiffness in nonhypertensive, nonobese type 2 diabetes (T2DM) patients in Ghana. Methods. In case-control design, 166 nonhypertensive, nonobese participants, comprising 96 T2DM patients and 70 nondiabetes controls, were recruited. Peripheral and central blood pressure (BP) indices were measured, and arterial stiffness was assessed as aortic pulse wave velocity (PWVao), augmentation index (AIx), cardioankle vascular index (CAVI), and heart-ankle pulse wave velocity (haPWV). Results. With similar peripheral and central BP indices, T2DM patients had higher PWVao (8.3 ± 1 versus 7.8 ± 1.3, p = 0.044) and CAVI (7.9 ± 1.2 versus 6.9 ± 0.7, p = 0.021) than nondiabetic control. AIx and haPWV were similar between T2DM and nondiabetic controls. Multiple regression models showed that, in the entire study participants, the major determinants of PWVao were diabetes status, age, gender, systolic BP, and previous smoking status (β = 0.22, 0.36, 0.48, 0.21, and 0.25, resp.; all p < 0.05); the determinants of CAVI were diabetes status, age, BMI, heart rate, HbA1c, total cholesterol, HDL cholesterol, and previous smoking status (β = 0.21, 0.38, 0.2, 0.18, 0.24. 0.2, −0.19, and 0.2, resp.; all p < 0.05). Conclusion. Our findings suggest that nonhypertensive, nonobese T2DM patients have increased arterial stiffness without appreciable increase in peripheral and central pressure indices.

  19. Abnormal pulmonary artery stiffness in pulmonary arterial hypertension: in vivo study with intravascular ultrasound.

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    Edmund M T Lau

    Full Text Available BACKGROUND: There is increasing recognition that pulmonary artery stiffness is an important determinant of right ventricular (RV afterload in pulmonary arterial hypertension (PAH. We used intravascular ultrasound (IVUS to evaluate the mechanical properties of the elastic pulmonary arteries (PA in subjects with PAH, and assessed the effects of PAH-specific therapy on indices of arterial stiffness. METHOD: Using IVUS and simultaneous right heart catheterisation, 20 pulmonary segments in 8 PAH subjects and 12 pulmonary segments in 8 controls were studied to determine their compliance, distensibility, elastic modulus and stiffness index β. PAH subjects underwent repeat IVUS examinations after 6-months of bosentan therapy. RESULTS: AT BASELINE, PAH SUBJECTS DEMONSTRATED GREATER STIFFNESS IN ALL MEASURED INDICES COMPARED TO CONTROLS: compliance (1.50±0.11×10(-2 mm(2/mmHg vs 4.49±0.43×10(-2 mm(2/mmHg, p<0.0001, distensibility (0.32±0.03%/mmHg vs 1.18±0.13%/mmHg, p<0.0001, elastic modulus (720±64 mmHg vs 198±19 mmHg, p<0.0001, and stiffness index β (15.0±1.4 vs 11.0±0.7, p = 0.046. Strong inverse exponential associations existed between mean pulmonary artery pressure and compliance (r(2 = 0.82, p<0.0001, and also between mean PAP and distensibility (r(2 = 0.79, p = 0.002. Bosentan therapy, for 6-months, was not associated with any significant changes in all indices of PA stiffness. CONCLUSION: Increased stiffness occurs in the proximal elastic PA in patients with PAH and contributes to the pathogenesis RV failure. Bosentan therapy may not be effective at improving PA stiffness.

  20. Critical appraisal of the differential effects of antihypertensive agents on arterial stiffness

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    Francesca Kum

    2010-06-01

    Full Text Available Francesca Kum, Janaka KarallieddeUnit for Metabolic Medicine, Cardiovascular Division, Kings College-Waterloo Campus, King’s College London, United KingdomAbstract: Increased central arterial stiffness, involving accelerated vascular ageing of the aorta, is a powerful and independent risk factor for early mortality and provides prognostic information above and beyond traditional risk factors for cardiovascular disease (CVD. Central arterial stiffness is an important determinant of pulse pressure; therefore, any pathological increase may result in left ventricular hypertrophy and impaired coronary perfusion. Central artery stiffness can be assessed noninvasively by measurement of aortic pulse wave velocity, which is the gold standard for measurement of arterial stiffness. Earlier, it was believed that changes in arterial stiffness, which are primarily influenced by long-term pressure-dependent structural changes, may be slowed but not reversed by pharmacotherapy. Recent studies with drugs that inhibit the renin–angiotensin–aldosterone system, advanced glycation end products crosslink breakers, and endothelin antagonists suggest that blood pressure (BP-independent reduction and reversal of arterial stiffness are feasible. We review the recent literature on the differential effect of antihypertensive agents either as monotherapy or combination therapy on arterial stiffness. Arterial stiffness is an emerging therapeutic target for CVD risk reduction; however, further clinical trials are required to confirm whether BP-independent changes in arterial stiffness directly translate to a reduction in CVD events.Keywords: aortic pulse wave velocity, augmentation index, blood pressure, renin–angiotensin–aldosterone system

  1. Arterial stiffness, as monitored by cardio–ankle vascular index, is affected by obstructive sleep apnea, blood glucose control, and body weight – a case with 8 years follow up

    Directory of Open Access Journals (Sweden)

    Shimizu K

    2016-08-01

    Full Text Available Kazuhiro Shimizu,1 Tomoyuki Yamamoto,2,3 Kohji Shirai2,4 1Department of Internal Medicine, Toho University Sakura Medical Center, Chiba, Japan; 2Department of Vascular Function, Toho University Sakura Medical Center, Chiba, Japan; 3Biological Information Analysis Section, Fukuda Denshi Co., Ltd., Tokyo, Japan; 4Department of Internal Medicine, Mihama Hospital, Chiba, Japan Abstract: The cardio–ankle vascular index (CAVI is an indicator of arterial stiffness from the heart to the ankles. The CAVI increases as arteriosclerosis progresses, but it can be decreased by appropriate treatment. There are several risk factors for coronary artery disease, however, the degree of stress caused by each separate risk factor to arteries cannot be assessed. CAVI increases with age and according to the severity of atherosclerosis. We found that CAVI also changes in response to the control of risk factors, which may be associated with the functional stiffness of arteries. CAVI can be a useful indicator of risk control for coronary artery disease. We followed a patient aged 71 years who had diabetes mellitus and obstructive sleep apnea (OSA by measuring CAVI for 8 years from age 63. He underwent coronary artery bypass grafting due to angina pectoris when he was 63 years old. Before coronary artery bypass grafting, CAVI was 11.8 on the right and 11.5 on the left. Three years later he was found to have OSA and received treatment with continuous positive airway pressure. There was a marked improvement in CAVI after continuous positive airway pressure (age 68; right 10.4, left 10.2. However, following a gradual increase in body weight and worsening of diabetes mellitus, CAVI showed an increasing trend. CAVI decreased with biguanides treatment, but increased again with an increase in body weight. In conclusion, CAVI responded to the patient’s conditions including obesity, diabetes mellitus, and OSA. CAVI is not only a marker of arterial stiffness, but can also be a

  2. ARTERIAL STIFFNESS AND CHRONIC KIDNEY DISEASE: CAUSES AND CONSEQUENCES

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    J. D. Kobalava

    2015-09-01

    Full Text Available Chronic kidney disease (CKD is associated with increased cardiovascular risk. CKD is characterized by accelerated aging of vessels in which the age-related arterial stiffness increase is exacerbated by a number of uremia-related processes. Increased arterial stiffness is associated with structural and functional disorders, as well as with the increase in cardiovascular mortality in patients with CKD. Increased arterial stiffness is diagnosed at an early stage of CKD. Modern understanding of the mechanisms of increased risk of cardiovascular complications in CKD, the factors contributing to the loss of elasticity of the arteries, arterial stiffness increase consequences are analyzed. Data illustrating the twoway interaction between CKD and arterial stiffness and mechanisms of accelerated progression of arterial stiffness in CKD are presented.

  3. Therapeutic modification of arterial stiffness: An update and comprehensive review

    OpenAIRE

    Wu, Ching-Fen; Liu, Pang-Yen; Wu, Tsung-Jui; Hung, Yuan; Yang, Shih-Ping; Lin, Gen-Min

    2015-01-01

    Arterial stiffness has been recognized as a marker of cardiovascular disease and associated with long-term worse clinical outcomes in several populations. Age, hypertension, smoking, and dyslipidemia, known as traditional vascular risk factors, as well as diabetes, obesity, and systemic inflammation lead to both atherosclerosis and arterial stiffness. Targeting multiple modifiable risk factors has become the main therapeutic strategy to improve arterial stiffness in patients at high cardiovas...

  4. Effects of safflower seed extract on arterial stiffness

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    Katsuya Suzuki

    2010-11-01

    Full Text Available Katsuya Suzuki1, Shigekazu Tsubaki2, Masami Fujita3, Naoto Koyama1, Michio Takahashi1, Kenji Takazawa41Research Institute for Health Fundamentals, Ajinomoto Co., Inc., Kawasaki; 2Samoncho Clinic, Tokyo; 3Shinanozaka Clinic, Tokyo; 4Tokyo Medical University Hachioji Medical Center, Tokyo, JapanAbstract: Safflower seed extract (SSE contains characteristic polyphenols and serotonin derivatives (N-(p-coumaroyl serotonin and N-feruloylserotonin, which are reported to inhibit oxidation of low-density lipoprotein (LDL, formation of atherosclerotic plaques, and improve arterial stiffness as assessed by pulse wave analysis in animal models. The effects of long-term supplementation with SSE on arterial stiffness in human subjects were evaluated. This double-blind, placebo-controlled study was conducted in 77 males (35–65 years and 15 postmenopausal females (55–65 years with high-normal blood pressure or mild hypertension who were not undergoing treatment. Subjects received SSE (70 mg/day as serotonin derivatives or placebo for 12 weeks, and pulse wave measurements, ie, second derivative of photoplethysmogram (SDPTG, augmentation index, and brachial-ankle pulse wave velocity (baPWV were conducted at baseline, and at weeks 4, 8, and 12. Vascular age estimated by SDPTG aging index improved in the SSE-supplemented group when compared with the placebo group at four (P = 0.0368 and 12 weeks (P = 0.0927. The trend of augmentation index reduction (P = 0.072 versus baseline was observed in the SSE-supplemented group, but reduction of baPWV by SSE supplementation was not observed. The SSE-supplemented group also showed a trend towards a lower malondialdehyde-modified-LDL autoantibody titer at 12 weeks from baseline. These results suggest long-term ingestion of SSE in humans could help to improve arterial stiffness.Keywords: safflower, serotonin derivatives, antioxidants, augmentation index, pulse wave velocity

  5. Ambulatory arterial stiffness indices and target organ damage in hypertension

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    Gómez-Marcos Manuel

    2012-01-01

    Full Text Available Abstract Background The present study was designed to evaluate which arterial stiffness parameter - AASI or the home arterial stiffness index (HASI - correlates best with vascular, cardiac and renal damage in hypertensive individuals. Methods A cross-sectional study was carried out involving 258 hypertensive patients. AASI and HASI were defined as the 1-regression slope of diastolic over systolic blood pressure readings obtained from 24-hour recordings and home blood pressure over 6 days. Renal damage was evaluated by glomerular filtration rate (GFR and microalbuminuria; vascular damage by carotid intima-media thickness (IMT, pulse wave velocity (PWV and ankle/brachial index (ABI; and left ventricular hypertrophy by the Cornell voltage-duration product (VDP and the Novacode index. Results AASI and HASI were not correlated with microalbuminuria, however AASI and HASI- blood pressure variability ratio (BPVR showed negative correlation with GRF. The Cornell PDV was positively correlated with AASI- BPVR-Sleep (r = 0.15, p Conclusions After adjusting for age, gender and 24-hour heart, the variables that best associated with the variability of IMT, PWV and ABI were AASI and Awake-AASI, and with GFR was HASI-BPVR.

  6. Association of Parental Hypertension With Arterial Stiffness in Nonhypertensive Offspring

    DEFF Research Database (Denmark)

    Andersson, Charlotte; Quiroz, Rene; Enserro, Danielle

    2016-01-01

    High arterial stiffness seems to be causally involved in the pathogenesis of hypertension. We tested the hypothesis that offspring of parents with hypertension may display higher arterial stiffness before clinically manifest hypertension, given that hypertension is a heritable condition. We compa...

  7. Noninvasive pulse wave analysis for the determination of central artery stiffness

    DEFF Research Database (Denmark)

    Wittrock, Marc; Scholze, Alexandra; Compton, Friederike;

    2009-01-01

    Central artery stiffness predicts cardiovascular structural damage and clinical outcome. It is controversial whether central artery stiffness can be determined by noninvasive measurements. We compared noninvasive determination of central artery stiffness obtained from applanation tonometry of the...

  8. Arterial stiffness response to exercise in persons with and without Down syndrome.

    Science.gov (United States)

    Hu, Min; Yan, Huimin; Ranadive, Sushant M; Agiovlasitis, Stamatis; Fahs, Christopher A; Atiq, Muhammed; Atique, Nazia; Fernhall, Bo

    2013-10-01

    This study compared arterial stiffness and wave reflection at rest and following maximal exercise between individuals with and without Down syndrome (DS), and the influence of body mass index (BMI), peak oxygen uptake (VO2 peak) on changes in arterial stiffness. Twelve people with DS (26.6 ± 2.6 yr) and 15 healthy controls (26.2 ± 0.6 yr) completed this study. Intima-media thickness (IMT) and stiffness of common carotid artery was examined. Hemodynamic and arterial variables were measured before and 3-min after exercise. Persons with DS had higher BMI and lower VO 2 peak than controls. IMT did not differ between groups. At rest, carotid β stiffness was significantly higher in persons with DS (PObesity and particularly VO 2 peak influenced these findings. These results suggest impaired vascular function in people with DS.

  9. Arterial Stiffness in Patients Taking Second-generation Antipsychotics

    Science.gov (United States)

    Fındıklı, Ebru; Gökçe, Mustafa; Nacitarhan, Vedat; Camkurt, Mehmet Akif; Fındıklı, Hüseyin Avni; Kardaş, Selçuk; Şahin, Merve Coşgun; Karaaslan, Mehmet Fatih

    2016-01-01

    Objective That treatment with second-generation antipsychotics (SGAs) causes metabolic side effects and atherosclerosis in patients with schizophrenia and bipolar disorder (BD) is well-known. Increased arterial stiffness is an important marker of arteriosclerosis and has been identified as an independent risk factor for cardiovascular diseases. We measured pulse wave velocity (PWV) as a marker of arteriosclerosis in patients with schizophrenia and BD who use SGAs. Methods Patients and controls were collected from our psychiatry outpatient clinics or family medicine. Mental illness was diagnosed according to the Diagnostic and Statistical Manual of Mental Disorders, 4th edition. Mean age, gender, systolic and diastolic blood pressure, body mass index, Framingham risk score (FRS), etc. were determined. Simultaneous electrocardiography and pulse wave were recorded with an electromyography device. The photo-plethysmographic method was used to record the pulse wave. Inclusion criteria included use of SGAs for at least the last six months. Patients with diseases that are known to cause stiffness and the use of typical antipsychotics were excluded. Results Ninety-six subject (56 patients, 40 controls) were included in our study. There were 49 females, 47 males. Patients had schizophrenia (n=17) and BD (n=39). Their treatments were quetiapine (n=15), risperidone (n=13), olanzapine (n=15), and aripiprazole (n=13). Although differences in mean age, gender, and FRS in the patient and control groups were not statistically significant (p=1), PWV was greater in patients in the antipsychotic group (p=0.048). Conclusion This study supported the liability to stiffness in patients with schizophrenia and BD. Using SGAs may contribute to arterial stiffness in these patients. PMID:27776389

  10. Hormones and arterial stiffness in patients with chronic kidney disease.

    Science.gov (United States)

    Gungor, Ozkan; Kircelli, Fatih; Voroneanu, Luminita; Covic, Adrian; Ok, Ercan

    2013-01-01

    Cardiovascular disease constitutes the major cause of mortality in patients with chronic kidney disease. Arterial stiffness is an important contributor to the occurrence and progression of cardiovascular disease. Various risk factors, including altered hormone levels, have been suggested to be associated with arterial stiffness. Based on the background that chronic kidney disease predisposes individuals to a wide range of hormonal changes, we herein review the available data on the association between arterial stiffness and hormones in patients with chronic kidney disease and summarize the data for the general population.

  11. Cocoa intake and arterial stiffness in subjects with cardiovascular risk factors

    Directory of Open Access Journals (Sweden)

    Recio-Rodríguez José

    2012-02-01

    Full Text Available Abstract Background To analyze the relationship of cocoa intake to central and peripheral blood pressure, arterial stiffness, and carotid intima-media thickness in subjects with some cardiovascular risk factor. Findings Design: A cross-sectional study of 351 subjects (mean age 54.76 years, 62.4% males. Measurements: Intake of cocoa and other foods using a food frequency questionnaire, central and peripheral (ambulatory and office blood pressure, central and peripheral augmentation index, pulse wave velocity, ambulatory arterial stiffness index, carotid intima-media thickness, and ankle-brachial index. Results: Higher pulse wave velocity and greater cardiovascular risk were found in non-cocoa consumers as compared to high consumers (p Conclusions In subjects with some cardiovascular risk factors, cocoa consumption does not imply improvement in the arterial stiffness values. Trial Registration Clinical Trials.gov Identifier: NCT01325064.

  12. Estimation of Stiffness Parameter on the Common Carotid Artery

    Science.gov (United States)

    Koya, Yoshiharu; Mizoshiri, Isao; Matsui, Kiyoaki; Nakamura, Takashi

    The arteriosclerosis is on the increase with an aging or change of our living environment. For that reason, diagnosis of the common carotid artery using echocardiogram is doing to take precautions carebropathy. Up to the present, several methods to measure stiffness parameter of the carotid artery have been proposed. However, they have analyzed at the only one point of common carotid artery. In this paper, we propose the method of analysis extended over a wide area of common carotid artery. In order to measure stiffness parameter of common carotid artery from echocardiogram, it is required to detect two border curves which are boundaries between vessel wall and blood. The method is composed of two steps. The first step is the detection of border curves, and the second step is the calculation of stiffness parameter using diameter of common carotid artery. Experimental results show the validity of the proposed method.

  13. Therapeutic modification of arterial stiffness: An update and comprehensive review.

    Science.gov (United States)

    Wu, Ching-Fen; Liu, Pang-Yen; Wu, Tsung-Jui; Hung, Yuan; Yang, Shih-Ping; Lin, Gen-Min

    2015-11-26

    Arterial stiffness has been recognized as a marker of cardiovascular disease and associated with long-term worse clinical outcomes in several populations. Age, hypertension, smoking, and dyslipidemia, known as traditional vascular risk factors, as well as diabetes, obesity, and systemic inflammation lead to both atherosclerosis and arterial stiffness. Targeting multiple modifiable risk factors has become the main therapeutic strategy to improve arterial stiffness in patients at high cardiovascular risk. Additionally to life style modifications, long-term ω-3 fatty acids (fish oil) supplementation in diet may improve arterial stiffness in the population with hypertension or metabolic syndrome. Pharmacological treatment such as renin-angiotensin-aldosterone system antagonists, metformin, and 3-hydroxy-3-methyl-glutaryl-CoA reductase inhibitors were useful in individuals with hypertension and diabetes. In obese population with obstructive sleep apnea, weight reduction, aerobic exercise, and continuous positive airway pressure treatment may also improve arterial stiffness. In the populations with chronic inflammatory disease such as rheumatoid arthritis, a use of antibodies against tumor necrosis factor-alpha could work effectively. Other therapeutic options such as renal sympathetic nerve denervation for patients with resistant hypertension are investigated in many ongoing clinical trials. Therefore our comprehensive review provides knowledge in detail regarding many aspects of pathogenesis, measurement, and management of arterial stiffness in several populations, which would be helpful for physicians to make clinical decision.

  14. Crosstalk between oxidative and nitrosative stress and arterial stiffness.

    Science.gov (United States)

    Mozos, Ioana; Luca, Constantin Tudor

    2017-02-01

    Arterial stiffness, the expression of reduced arterial elasticity, is an effective predictor of cardiovascular disorders. Oxidative stress is an imbalance between exposure to toxic reactive oxygen species (ROS) and antioxidant systems. The increase in reactive nitrogen species (RNS) is termed nitrosative stress. We review the main mechanisms and products linking arterial stiffness with oxidative and nitrosative stress in several disorders, focusing on recent experimental and clinical data, and the mechanisms explaining benefits of antioxidant therapy. Oxidative and nitrosative stress play important roles in arterial stiffness elevation in several disorders, including diabetes mellitus, hypertension, metabolic syndrome, obesity, peripheral arterial disease, chronic obstructive pulmonary disease, systemic lupus erythematosus, thalassemia, Kawasaki disease and malignant disorders. Oxidative and nitrosative stress are responsible for endothelial dysfunction due to uncoupling of the nitric oxide synthase, oxidative damage to lipids, proteins and DNA in vascular endothelial cells, associated with inflammation, arteriosclerosis and atherosclerosis. Regular physical exercise, caloric restriction, red wine, statins, sartans, metformin, oestradiol, curcumin and combinations of antioxidant vitamins are therapeutic strategies that may decrease arterial stiffness and oxidative stress thus reducing the risk of cardiovascular events. ROS and RNS represent potential therapeutic targets for preventing progression of arterial stiffness.

  15. Arterial stiffness & Sri Lankan chronic kidney disease of unknown origin

    Science.gov (United States)

    Gifford, Fiona; Kimmitt, Robert; Herath, Chula; Webb, David J.; Melville, Vanessa; Siribaddana, Sisira; Eddleston, Michael; Dhaun, Neeraj

    2016-09-01

    Chronic kidney disease (CKD) is common and independently associated with cardiovascular disease (CVD). Arterial stiffness contributes to CVD risk in CKD. In many developing countries a considerable proportion of CKD remains unexplained, termed CKDu. We assessed arterial stiffness in subjects with Sri Lankan CKDu, in matched controls without CKD and in those with defined CKD. Aortic blood pressure (BP), pulse wave velocity (PWV) and augmentation index (AIx) were assessed in 130 subjects (50 with CKDu, 45 with CKD and 35 without CKD) using the validated TensioMed™ Arteriograph monitor. Brachial and aortic BP was lower in controls than in CKDu and CKD subjects but no different between CKDu and CKD. Controls had a lower PWV compared to subjects with CKDu and CKD. Despite equivalent BP and renal dysfunction, CKDu subjects had a lower PWV than those with CKD (8.7 ± 1.5 vs. 9.9 ± 2.2 m/s, p groups (controls vs. CKDu vs. CKD: 6.7 ± 0.9 vs. 8.7 ± 1.5 vs. 10.4 ± 1.5 m/s, p < 0.001 for all). Sri Lankan CKDu is associated with less arterial stiffening than defined causes of CKD. Whether this translates to lower cardiovascular morbidity and mortality long term is unclear and should be the focus of future studies.

  16. Evaluation of carotid artery elasticity in patients with obstructive sleep apnea syndrome using quantitative arterial stiffness technique

    Institute of Scientific and Technical Information of China (English)

    俞飞虹

    2012-01-01

    Objective To explore the changes and clinical value of carotid elasticity index in patients with obstructive sleep apnea syndrome (OSAS) by quantitative arterial stiffness(OAS) technique. Methods Seventy-two OSAS patients were divided into 2 groups according to whether there was coexisting hypertension

  17. Relation of epicardial adipose tissue with arterial compliance and stiffness in patients with hypertension.

    Science.gov (United States)

    Korkmaz, Levent; Cirakoglu, Omer Faruk; Ağaç, Mustafa Tarik; Erkan, Hakan; Korkmaz, Ayca Ata; Acar, Zeydin; Kul, Selim; Hatem, Engin; Çelik, Şükrü

    2014-09-01

    The main aim of the present study was to investigate the association between epicardial adipose tissue (EAT) and arterial function in patients with asymptomatic hypertension. Patients with hypertension (n = 155) were enrolled consecutively. Patients with decreased arterial compliance (AC) and increased cardioankle vascular index (CAVI) had higher EAT values compared with those with normal AC and CAVI (6.23 ± 1.67 vs 4.91 ± 1.40, P arterial function in patients with asymptomatic hypertension. The link between EAT and arterial stiffness deserves further investigation.

  18. Arterial stiffness is not increased in patients with short duration rheumatoid arthritis and ankylosing spondylitis.

    Science.gov (United States)

    Dzieża-Grudnik, Anna; Sulicka, Joanna; Strach, Magdalena; Siga, Olga; Klimek, Ewa; Korkosz, Mariusz; Grodzicki, Tomasz

    2017-04-01

    Patients with rheumatoid arthritis (RA) and ankylosing spondylitis (AS) have increased cardiovascular (CV) morbidity and mortality. Arterial stiffness is an independent predictor of CV events. The aim of the study was to assess arterial stiffness and inflammatory markers in patients with short duration chronic arthritis. We assessed carotid-femoral pulse wave velocity (PWV), augmentation index (AIx), traditional CV risk factors and inflammatory and endothelial markers in 71 chronic arthritis patients (RA and AS) and in 29 healthy controls. We did not find differences in PWV (for RA, AS and controls, respectively: 10 [8.8-10.9] versus 10.7 [9.1-11.8] versus 9.2 [8.3-11.4] m/s; p = .14) and AIx (for RA, AS and controls, respectively: 24.3 ± 11.5 versus 5.7 ± 12.4 versus 10 ± 12.8%; p = .22). Both groups of arthritis patients had active disease with significantly elevated inflammatory markers compared to controls. There were no correlations between endothelial and inflammatory markers and parameters of arterial stiffness in arthritis patients. When analyzing arthritis patients according to median of PVW, there were no significant differences in inflammatory and endothelial markers. We found that in patients with short duration active RA and AS arterial stiffness was not increased and furthermore, there was no association between markers of systemic inflammation and arterial stiffness.

  19. Comparison of arterial stiffness and microcirculatory changes following abdominal aortic aneurysm grafting.

    LENUS (Irish Health Repository)

    Moloney, M A

    2012-02-01

    BACKGOUND: Abdominal aortic aneurysm (AAA) surgery provides a unique opportunity to study the impact of arterial stiffness on central haemodynamics, reflected in augmentation index (AI). The aneurysmal aorta is significantly stiffer than undilated age-matched aorta. AIM: We investigated whether replacement of an aneurysmal aorta with a compliant graft would result in a decrease in AI, which would thus decrease myocardial workload parameters. METHODS: Patients undergoing elective open or endovascular AAA repair were assessed with applanation tonometry and laser fluximetry pre-operatively, immediately and long-term post-operatively. RESULTS: Replacement of a small segment of abnormal conduit vessel resulted in improvements in AI, demonstrating that arterial stiffness can be surgically manipulated. CONCLUSIONS: These results reflect a decreased myocardial workload post-aortic grafting. This decrease in AI is important from a risk factor management perspective, and arterial stiffness should become a further recognised and screened for risk factor in patients with known aneurysmal disease.

  20. Comparison of arterial stiffness and microcirculatory changes following abdominal aortic aneurysm grafting.

    LENUS (Irish Health Repository)

    Moloney, M A

    2010-11-11

    BACKGOUND: Abdominal aortic aneurysm (AAA) surgery provides a unique opportunity to study the impact of arterial stiffness on central haemodynamics, reflected in augmentation index (AI). The aneurysmal aorta is significantly stiffer than undilated age-matched aorta. AIM: We investigated whether replacement of an aneurysmal aorta with a compliant graft would result in a decrease in AI, which would thus decrease myocardial workload parameters. METHODS: Patients undergoing elective open or endovascular AAA repair were assessed with applanation tonometry and laser fluximetry pre-operatively, immediately and long-term post-operatively. RESULTS: Replacement of a small segment of abnormal conduit vessel resulted in improvements in AI, demonstrating that arterial stiffness can be surgically manipulated. CONCLUSIONS: These results reflect a decreased myocardial workload post-aortic grafting. This decrease in AI is important from a risk factor management perspective, and arterial stiffness should become a further recognised and screened for risk factor in patients with known aneurysmal disease.

  1. Associations between bicycling and carotid arterial stiffness in adolescents

    DEFF Research Database (Denmark)

    Ried-Larsen, M; Grøntved, A; Østergaard, Lars;

    2015-01-01

    The aim of the study was to investigate the associations between bicycling and carotid arterial stiffness, independent of objectively measured moderate-and-vigorous physical activity. This cross-sectional study included 375 adolescents (age 15.7 ± 0.4 years) from the Danish site of the European...... Youth Heart Study. Total frequency of bicycle usage was assessed by self-report, and carotid arterial stiffness was assessed using B-mode ultrasound. After adjusting for pubertal status, body height, and objectively measured physical activity and other personal lifestyle and demographic factors, boys...... modulus [standard beta -0.48 (95% CI -0.91 to -0.06)]. Similar trends were observed when investigating the association between commuter bicycling and carotid arterial stiffness. These associations were not observed in girls. Our observations suggest that increasing bicycling in adolescence may...

  2. Modifiable risk factors for increased arterial stiffness in outpatient nephrology.

    Science.gov (United States)

    Elewa, Usama; Fernandez-Fernandez, Beatriz; Alegre, Raquel; Sanchez-Niño, Maria D; Mahillo-Fernández, Ignacio; Perez-Gomez, Maria Vanessa; El-Fishawy, Hussein; Belal, Dawlat; Ortiz, Alberto

    2015-01-01

    Arterial stiffness, as measured by pulse wave velocity (PWV), is an independent predictor of cardiovascular events and mortality. Arterial stiffness increases with age. However, modifiable risk factors such as smoking, BP and salt intake also impact on PWV. The finding of modifiable risk factors may lead to the identification of treatable factors, and, thus, is of interest to practicing nephrologist. We have now studied the prevalence and correlates of arterial stiffness, assessed by PWV, in 191 patients from nephrology outpatient clinics in order to identify modifiable risk factors for arterial stiffness that may in the future guide therapeutic decision-making. PWV was above normal levels for age in 85/191 (44.5%) patients. Multivariate analysis showed that advanced age, systolic BP, diabetes mellitus, serum uric acid and calcium polystyrene sulfonate therapy or calcium-containing medication were independent predictors of PWV. A new parameter, Delta above upper limit of normal PWV (Delta PWV) was defined to decrease the weight of age on PWV values. Delta PWV was calculated as (measured PWV) - (upper limit of the age-adjusted PWV values for the general population). Mean±SD Delta PWV was 0.76±1.60 m/sec. In multivariate analysis, systolic blood pressure, active smoking and calcium polystyrene sulfonate therapy remained independent predictors of higher delta PWV, while age, urinary potassium and beta blocker therapy were independent predictors of lower delta PWV. In conclusion, arterial stiffness was frequent in nephrology outpatients. Systolic blood pressure, smoking, serum uric acid, calcium-containing medications, potassium metabolism and non-use of beta blockers are modifiable factors associated with increased arterial stiffness in Nephrology outpatients.

  3. Modifiable risk factors for increased arterial stiffness in outpatient nephrology.

    Directory of Open Access Journals (Sweden)

    Usama Elewa

    Full Text Available Arterial stiffness, as measured by pulse wave velocity (PWV, is an independent predictor of cardiovascular events and mortality. Arterial stiffness increases with age. However, modifiable risk factors such as smoking, BP and salt intake also impact on PWV. The finding of modifiable risk factors may lead to the identification of treatable factors, and, thus, is of interest to practicing nephrologist. We have now studied the prevalence and correlates of arterial stiffness, assessed by PWV, in 191 patients from nephrology outpatient clinics in order to identify modifiable risk factors for arterial stiffness that may in the future guide therapeutic decision-making. PWV was above normal levels for age in 85/191 (44.5% patients. Multivariate analysis showed that advanced age, systolic BP, diabetes mellitus, serum uric acid and calcium polystyrene sulfonate therapy or calcium-containing medication were independent predictors of PWV. A new parameter, Delta above upper limit of normal PWV (Delta PWV was defined to decrease the weight of age on PWV values. Delta PWV was calculated as (measured PWV - (upper limit of the age-adjusted PWV values for the general population. Mean±SD Delta PWV was 0.76±1.60 m/sec. In multivariate analysis, systolic blood pressure, active smoking and calcium polystyrene sulfonate therapy remained independent predictors of higher delta PWV, while age, urinary potassium and beta blocker therapy were independent predictors of lower delta PWV. In conclusion, arterial stiffness was frequent in nephrology outpatients. Systolic blood pressure, smoking, serum uric acid, calcium-containing medications, potassium metabolism and non-use of beta blockers are modifiable factors associated with increased arterial stiffness in Nephrology outpatients.

  4. Is arterial stiffness predicted by continuous metabolic syndrome score in obese children?

    Science.gov (United States)

    Prochotska, Katarina; Kovacs, Laszlo; Vitariusova, Eva; Feber, Janusz

    2016-01-01

    The aim of the article was to evaluate arterial stiffness, an early marker of increased cardiovascular risk, in relation to obesity. The continuous metabolic syndrome (cMetS) score was calculated as sum of Z score of mean arterial pressure, body mass index, serum glucose, triglyceride, and high-density lipoprotein cholesterol in 144 obese patients and 66 nonobese controls. Ambulatory arterial stiffness index (AASI) was calculated as 1 minus regression slope of diastolic on systolic blood pressure from ambulatory blood pressure measurements. The mean AASI increased progressively with severity of obesity. The receiver operator curve analysis of body mass index and AASI showed area under the curve of 0.64 ± 0.06; cMetS area under the curve was 0.72 ± 0.05 suggesting a better predictive power of the cMetS for an increased AASI (>0.3). Patients with obesity have significantly higher arterial stiffness. A composite score such as cMetS seems to be better predictor of an increased stiffness than individual risk factors.

  5. Children and Adolescent Obesity Associates with Pressure-Dependent and Age-Related Increase in Carotid and Femoral Arteries' Stiffness and Not in Brachial Artery, Indicative of Nonintrinsic Arterial Wall Alteration

    Science.gov (United States)

    García-Espinosa, Victoria; Curcio, Santiago; Castro, Juan Manuel; Arana, Maite; Giachetto, Gustavo; Chiesa, Pedro; Zócalo, Yanina

    2016-01-01

    Aim. To analyze if childhood obesity associates with changes in elastic, transitional, and/or muscular arteries' stiffness. Methods. 221 subjects (4–15 years, 92 females) were assigned to normal weight (NW, n = 137) or obesity (OB, n = 84) groups, considering their body mass index z-score. Age groups were defined: 4–8; 8–12; 12–15 years old. Carotid, femoral, and brachial artery local stiffness was determined through systodiastolic pressure-diameter and stress-strain relationships. To this end, arterial diameter and peripheral and aortic blood pressure (BP) levels and waveforms were recorded. Carotid-femoral, femoropedal, and carotid-radial pulse wave velocities were determined to evaluate aortic, lower-limb, and upper-limb regional arterial stiffness, respectively. Correlation analysis between stiffness parameters and BP was done. Results. Compared to NW, OB subjects showed higher peripheral and central BP and carotid and femoral stiffness, reaching statistical significance in subjects aged 12 and older. Arterial stiffness differences disappeared when levels were normalized for BP. There were no differences in intrinsic arterial wall stiffness (elastic modulus), BP stiffness relationships, and regional stiffness parameters. Conclusion. OB associates with BP-dependent and age-related increase in carotid and femoral (but not brachial) stiffness. Stiffness changes would not be explained by intrinsic arterial wall alterations but could be associated with the higher BP levels observed in obese children. PMID:27066273

  6. Hemoglobin A1c and arterial and ventricular stiffness in older adults.

    Directory of Open Access Journals (Sweden)

    Susan J Zieman

    Full Text Available OBJECTIVE: Arterial and ventricular stiffening are characteristics of diabetes and aging which confer significant morbidity and mortality; advanced glycation endproducts (AGE are implicated in this stiffening pathophysiology. We examined the association between HbA(1c, an AGE, with arterial and ventricular stiffness measures in older individuals without diabetes. RESEARCH DESIGN & METHODS: Baseline HbA(1c was measured in 830 participants free of diabetes defined by fasting glucose or medication use in the Cardiovascular Health Study, a population-based cohort study of adults aged ≥ 65 years. We performed cross-sectional analyses using baseline exam data including echocardiography, ankle and brachial blood pressure measurement, and carotid ultrasonography. We examined the adjusted associations between HbA(1c and multiple arterial and ventricular stiffness measures by linear regression models and compared these results to the association of fasting glucose (FG with like measures. RESULTS: HbA(1c was correlated with fasting and 2-hour postload glucose levels (r = 0.21; p<0.001 for both and positively associated with greater body-mass index and black race. In adjusted models, HbA(1c was not associated with any measure of arterial or ventricular stiffness, including pulse pressure (PP, carotid intima-media thickness, ankle-brachial index, end-arterial elastance, or left ventricular mass (LVM. FG levels were positively associated with systolic, diastolic and PP and LVM. CONCLUSIONS: In this sample of older adults without diabetes, HbA(1c was not associated with arterial or ventricular stiffness measures, whereas FG levels were. The role of AGE in arterial and ventricular stiffness in older adults may be better assessed using alternate AGE markers.

  7. The Contribution of Osteoprogenitor Cells to Arterial Stiffness and Hypertension.

    Science.gov (United States)

    Pikilidou, Maria; Yavropoulou, Maria; Antoniou, Maria; Yovos, John

    2015-01-01

    Hypertension, the major cause of cardiovascular disease, is bidirectionally linked to arterial stiffness. Evidence shows that vascular calcification, either medial or intimal, induces arterial stiffening further worsening hypertension parallel to substantially increasing cardiovascular risk. The disturbance in the bone-vascular axis that leads to the increase of calcium deposition in the arterial wall may be the result of a shift in the functionality of bone marrow-derived circulating stem cells with a calcifying potential, namely osteoprogenitor cells. These cells deposit bone matrix proteins in the vascular wall that can subsequently become mineralized. The current notion is that these cells derive from diverse cell lines. The present review summarizes the current knowledge on the role of progenitor cells with a calcifying potential on arterial calcification, stiffness and hypertension.

  8. AGE, ARTERIAL STIFFNESS AND CARDIOVASCULAR RISK

    Institute of Scientific and Technical Information of China (English)

    蒋雄京; 刘国仗; 刘力生

    2001-01-01

    The recent researches on the structure and function of large artery find that increasing pulse pressure is associated with greater cardiovascular risk, especially risk of coronary events. Such risk is not explicable on the basis of increasing systolic pressure with age, and is apparent even when the major reason for increased pulse pressure is a relative decrease of diastolic pressure. The finding challenges the conventional approach to arterial pressure where diastolic pressure is traditionally viewed as the most robust indicator of caridovascular risk. An explanation is available. This is based on the perception of Harriet Dustan that hypertension in the older popula-

  9. Pre-diabetes and arterial stiffness in uraemic patients

    DEFF Research Database (Denmark)

    Hornum, Mads; Clausen, Peter; Kjaergaard, Jesper;

    2010-01-01

    In order to address factors of relevance for new onset diabetes mellitus and cardiovascular disease after kidney transplantation, we investigated the presence of pre-diabetes, arterial stiffness and endothelial dysfunction in patients with end-stage renal disease (ESRD) accepted for kidney...

  10. Association of microalbuminuria with ambulatory arterial stiffness index in patients with hypertension%动态动脉硬化指数与高血压患者微量白蛋白尿的关系

    Institute of Scientific and Technical Information of China (English)

    王雅琼; 胡亚蓉; 李燕; 李华; 初少莉; 朱鼎良; 高平进

    2011-01-01

    Objective To investigate the association of microalbuminuria (MAU) with 24-hour, daytime and nighttime ambulatory arterial stiffness index (AASI) in hypertensive inpatients. Methods A total of 444 hypertensive inpatients were included in the study. AASI was defined as one minus the regression slope of diastolic on systolic blood pressure obtained from individual 24-hour blood pressure readings. MAU was d efined as urinary albumincreatinine ratio (ACR) of at least 22 mg/g creatinine in males or of 31 mg/g in females. The subjects were divided into four groups according to 24-hour AASI in quartile: AASI<0.34, 0. 34≤AASI<0. 44, 0. 44≤AASI<0. 54 and AASI≥0. 54 group. The differences between the four groups were compared. The association of MAU with 24-hour, daytime and nighttime AASI were analyzed. Results With the AASI increased, the patients had higher urinary ACR and the prevalence of MAU [8. 1 ( 5.5- 16.6 ), 10. 4 ( 6.7 - 25.4) , 12.8 ( 7.3 - 31.5 ), 16. 3 ( 8.5 45. 2); 14. 3 %, 24. 5%, 30. 6 %, 37. 8 %; both P<0.01]. 24-hour AASI, daytime AASI and nighttime AASI in MAU group were significantly higher than those in normoalbuminuria (N-MAU) group (0. 48 vs 0. 42, P<0.01;0. 51 vs 0. 46, P<0. 01; 0. 44 vs 0. 40, P<0. 05). In unadjusted analyses, 24-hour AASI, daytime and nighttime AASI correlated with ACR (β=0. 216, 0. 172, 0. 150, all P<0. 01 ). Only 24-hour AASI(P=0. 014), rather than daytime ( P= 0. 107 ) nor nighttime ( P = 0. 215 ) AASI, was independently associated with ACR by multiple linear regression after adjusting for confounders. The risk of MAU incidence added by 33. 7% for every increase of 24hour AASI by one standard deviation ( i. e. 0. 14 unit) (P=0. 048 ). Conclusion As a new index of arterial stiffness,24-hour AASI, not daytime and nighttime AASI, was associated with ACR and could independently predict MAU.%目的 探讨住院高血压患者24 h,白天和夜间的动态动脉硬化指数(AASI)与微

  11. 新疆维吾尔族健康及冠心病人群中体质指数、腰围与动脉僵硬程度相关性研究%Correlation between the body mass index, the waist circumference and the arterial stiffness in ;healthy and coronary artery disease Uygur population of the Xinjiang

    Institute of Scientific and Technical Information of China (English)

    刘军; 潘硕; 马依彤; 陈铀; 陶静

    2014-01-01

    Objective To study the correlation between the body mass index, the waist circumference and the arterial stiffness in healthy and coronary artery disease Uygur population in Xinjiang. Methods The study included 113 coronary artery disease patients and 92 healthy people in the Xinjiang. Their body mass index, waist circumference, and brachial-ankle pulse wave index and biochemical value were measured. In the healthy people and the coronary artery disease patients, the linear correlation analysis is performed with the body mass index, the waist circumference and brachial-ankle pulse wave index. The confounding factors of the brachial-ankle pulse wave index were adjusted. Results In healthy people, the pulse wave index (PWV) was not correlated with body mass index (BMI)(r=0.076, P>0.05). The PWV was positively correlated with waist circumference(r=0.218, P<0.05). In coronary artery disease patients, the PWV was positively correlated with BMI(r=0.232, P<0.01).The PWV was positively correlated with waist circumference(r=0.256, P<0.01). After adjusting for age, gender, and other cardiovascular risk factors, each additional 1 kg/m2 in BMI may be accompanied with an increase of 0.053 m/s in the PWV, each 1 cm increase in waist circumference may be accompanied with an increase of 0.027 m/s in the PWV. Conclusion Whether in the healthy or coronary artery disease Uygur population, the measure of abdominal obesity (waist circumference) and general obesity (BMI) were positively associated with arterial stiffness presented by the PWV.%目的:研究新疆地区维吾尔族健康及冠心病人群中体质指数(BMI)、腰围与动脉僵硬程度相关性。方法本研究纳入新疆地区冠心病患者113例,健康人92人。测量其体质指数、腰围、臂踝脉搏波传导速度(PWV)及各项生化指标。分别在健康人群与冠心病人群中,用体质指数、腰围与PWV做线性相关性分析,并对PWV的影响因素进行校正。结果在健

  12. Effects of weight loss and insulin reduction on arterial stiffness in the SAVE trial

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    Hughes Timothy M

    2012-09-01

    Full Text Available Abstract Background Chronic arterial stiffness contributes to the negative health effects of obesity and insulin resistance, which include hypertension, stroke, and increased cardiovascular and all-cause mortality. Weight loss and improved insulin sensitivity are individually associated with improved central arterial stiffness; however, their combined effects on arterial stiffness are poorly understood. The purpose of this study was to determine how insulin levels modify the improvements in arterial stiffness seen with weight loss in overweight and obese young adults. Methods To assess the effects of weight loss and decreased fasting insulin on vascular stiffness, we studied 339 participants in the Slow the Adverse Effects of Vascular Aging (SAVE trial. At study entry, the participants were aged 20–45, normotensive, non-diabetic, and had a body-mass index of 25–39.9 kg/m2. Measures of pulse wave velocity (PWV in the central (carotid-femoral (cfPWV, peripheral (femoral-ankle (faPWV, and mixed (brachial-ankle (baPWV vascular beds were collected at baseline and 6 months. The effects of 6-month change in weight and insulin on measures of PWV were estimated using multivariate regression. Results After adjustment for baseline risk factors and change in systolic blood pressure, 6-month weight loss and 6-month change in fasting insulin independently predicted improvement in baPWV but not faPWV or cfPWV. There was a significant interaction between 6-month weight change and change in fasting insulin when predicting changes in baPWV (p baPWV. Conclusions Young adults with excess weight who both lower their insulin levels and lose weight see the greatest improvement in vascular stiffness. This improvement in vascular stiffness with weight loss and insulin declines may occur throughout the vasculature and may not be limited to individual vascular beds. Trial registration NCT00366990

  13. Arterial stiffness, central hemodynamics, and cardiovascular risk in hypertension

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    Palatini P

    2011-12-01

    Full Text Available Paolo Palatini1, Edoardo Casiglia1, Jerzy Gąsowski2, Jerzy Głuszek3, Piotr Jankowski4, Krzysztof Narkiewicz5, Francesca Saladini1, Katarzyna Stolarz-Skrzypek4, Valérie Tikhonoff1, Luc Van Bortel6, Wiktoria Wojciechowska4, Kalina Kawecka-Jaszcz41Department of Clinical and Experimental Medicine, University of Padova, Padua, Italy; 2Department of Internal Medicine and Gerontology, Jagiellonian University Medical College, Kraków, Poland; 3Department of Arterial Hypertension, University Hospital, Poznan, Poland; 4First Department of Cardiology and Hypertension, Jagiellonian University Medical College, Kraków, Poland; 5Department of Hypertension and Diabetology, Medical University of Gdansk, Gdansk, Poland; 6Heymans Institute of Pharmacology, Ghent University, Ghent, BelgiumAbstract: This review summarizes several scientific contributions at the recent Satellite Symposium of the European Society of Hypertension, held in Milan, Italy. Arterial stiffening and its hemodynamic consequences can be easily and reliably measured using a range of noninvasive techniques. However, like blood pressure (BP measurements, arterial stiffness should be measured carefully under standardized patient conditions. Carotid-femoral pulse wave velocity has been proposed as the gold standard for arterial stiffness measurement and is a well recognized predictor of adverse cardiovascular outcome. Systolic BP and pulse pressure in the ascending aorta may be lower than pressures measured in the upper limb, especially in young individuals. A number of studies suggest closer correlation of end-organ damage with central BP than with peripheral BP, and central BP may provide additional prognostic information regarding cardiovascular risk. Moreover, BP-lowering drugs can have differential effects on central aortic pressures and hemodynamics compared with brachial BP. This may explain the greater beneficial effect provided by newer antihypertensive drugs beyond peripheral BP

  14. Long-term pioglitazone therapy improves arterial stiffness in patients with type 2 diabetes mellitus.

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    Harashima, Keiichiro; Hayashi, Junichi; Miwa, Takashi; Tsunoda, Tooru

    2009-06-01

    Pioglitazone, a peroxisome proliferator-activated receptor gamma agonist, not only improves insulin resistance and glycemic control, but may also have additional beneficial vascular effects in patients with type 2 diabetes mellitus. We investigated whether pioglitazone had an influence on arterial stiffness, which is an independent predictor of cardiovascular events, in 204 patients with type 2 diabetes mellitus. A prospective, nonrandomized, open-label trial was performed that involved 41 patients treated with pioglitazone, 46 patients receiving sulfonylureas, 67 patients on insulin, and 50 patients on diet/exercise only. The follow-up period was 56 +/- 3 months. Arterial stiffness was evaluated by using the arterial stiffness index (ASI), which was based on analysis of the pulse wave amplitude pattern obtained during automated blood pressure measurement in the upper limb. The 4 groups had a similar baseline ASI, which was greater than the reference range in each group. Although antidiabetic therapies improved hemoglobin A(1c) and low-density lipoprotein cholesterol, ASI only decreased significantly in the pioglitazone group. Thus, pioglitazone improved abnormal arterial stiffness in patients with type 2 diabetes mellitus via a mechanism beyond the metabolic improvement. These findings may have important clinical implications in the use of pioglitazone in patients with type 2 diabetes mellitus.

  15. Differences in arterial stiffness at rest and after acute exercise between young men and women.

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    Doonan, Robert J; Mutter, Andrew; Egiziano, Giordano; Gomez, Yessica-Haydee; Daskalopoulou, Stella S

    2013-03-01

    There is controversy as to whether there are sex differences in arterial stiffness. Acute physical stress can elicit vascular abnormalities not present at rest. Our objective was to assess sex differences in arterial stiffness at rest and in response to acute physical stress. Healthy young men (n=67) and women (n=55) underwent pulse wave analysis and carotid-femoral pulse wave velocity measurements at rest and 2, 5, 10 and 15 min following an exercise test to exhaustion. At rest, aortic systolic, diastolic, pulse and mean pressures were all significantly higher in men as was aortic pulse pressure at 10 and 15 min post exercise and aortic systolic pressure at 15 min. Carotid-femoral pulse wave velocity was significantly higher in men (6.0±0.7 m s(-1) vs. 5.6±0.6 m s(-1), P=0.03) at rest and at all time points post exercise. Heart rate-adjusted augmentation index was significantly lower (-10.7±10.2% vs. -4.0±10.9, Psex differences in the arterial stiffness response to acute physical stress in young men and women. Although we were not able to elicit differences in vascular function after adjustment, which were not present at rest, we found that young men and women exhibit differences in arterial stiffness at rest and after acute physical stress.

  16. Acute effects of aerobic exercise intensity on arterial stiffness after glucose ingestion in young men.

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    Kobayashi, Ryota; Hashimoto, Yuto; Hatakeyama, Hiroyuki; Okamoto, Takanobu

    2016-10-18

    Arterial stiffness increases after glucose ingestion. Acute low- and moderate-intensity aerobic exercise decreases arterial stiffness. However, the acute effects of 30 min of cycling at low- and moderate-intensity [25% (LE trial) and 65% (ME trial) peak oxygen uptake, respectively] on arterial stiffness at 30, 60 and 120 min of a postexercise glucose ingestion. Ten healthy young men (age, 22·4 ± 0·5 years) performed LE and ME trials on separate days in a randomized controlled crossover fashion. Carotid-femoral (aortic) pulse wave velocity (PWV), femoral-ankle (leg) PWV, carotid augmentation index (AIx) and carotid blood pressure (BP) (applanation tonometry), brachial and ankle BP (oscillometric device), heart rate (HR) (electrocardiography), blood glucose (UV-hexokinase method) and blood insulin (CLEIA method) levels were measured at before (baseline) and at 30, 60 and 120 min after the 75-g OGTT. Leg PWV, ankle pulse pressure and BG levels significantly increased from baseline after the 75-g OGTT in the LE trial (P<0·05), but not in the ME trial. Insulin levels and HR significantly increased from baseline after the 75-g OGTT in both trials (P<0·05). Aortic PWV, carotid AIx, brachial BP and carotid BP did not change from baseline after the 75-g OGTT in both trials. The present findings indicate that aerobic exercise at moderate intensity before glucose ingestion suppresses increases leg arterial stiffness after glucose ingestion.

  17. Body composition, fitness score and arterial stiffness assesment in a chronic hemodialysis population

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    Adelina Mihăescu

    2011-12-01

    Full Text Available Patients undergoing long-term hemodialysis have a high risk of cardiovascular disease. Arterial stiffness is highly prevalent in this type of patients. The aim of our study was to analyse the relationship between body composition, blood chemistries and arterial stiffness in a poorly fit population of chronic hemodialysed patients. Patients and methods involved measuring body composition and fitness score by multifrequence bioimpedance with the body composition analyzer InBody720 and arterial stiffness by the measurement of aortic Pulse Wave Velocity (PWVao and Aortic Augmentation Index (Aix using an oscillometric method on 65 HD patients; measurements were made before a midweek dialysis session. Results: PWVao correlated significantly with weight (p=0.01, r2=1.14, body fat mass (p=0.007, r2=0.14, abdominal circumference (p=0.01, r2=0.12 and with fitness score (p=0.01, r2=0.11. Aix correlated with weight (p<0.05, r2=0.25, intracellular, extracellular- and total body water (p<0.05, r2=0.24 with body protein, soft lean mass, minerals, fat free mass and skeletal muscle mass (p<0.05, r2= 0.3 and with serum calcium (p=0.005, r2=0.2. Conclusions: Arterial stiffness is a common feature of the hemodialysed patients, significantly related to the blood calcium, fitness score and the body composition, especially fat body mass.

  18. Relationships between use of statins and arterial stiffness in normotensive and hypertensive patients with coronary artery disease

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    WANG Zhi-guang; CHEN Bing-wei; L(U) Na-qiang; CHENG Yan-mei; DANG Ai-min

    2013-01-01

    Background Statins improve arterial stiffness in patients with coronary artery disease (CAD).Hypertension is a predominant contributor of arterial stiffening.However,the influence of hypertension on the effect of statins for improving arterial stiffness in CAD patients has seldom been investigated.Therefore,in this study,we investigated the relationships between statin use and arterial stiffness in normotensive and hypertensive CAD patients.Methods Brachial-ankle pulse wave velocity (ba-PWV) was measured in 437 patients,including 220 hypertensive CAD patients (121 used statins,99 did not) and 217 normotensive CAD patients (105 used statins,112 did not).The normotensive and hypertensive CAD patients were matched according to age,sex,and body mass index (BMI).Results In the normotensive and hypertensive CAD patients,lipid profiles were significantly improved in the statin group compared with the non-statin group.No significant differences in the administered statins (i.e.,atorvastatin,simvastatin,rosuvastatin,and pravastatin) and statin therapy duration were found between normotensive and hypertensive CAD patients (all P>0.05).No significant correlation of ba-PWV and statin therapy duration was found in all CAD patients,normotensive CAD patients,or hypertensive CAD patients (all P>0.05).ba-PWV in the statin group was significantly lower than that in the non-statin group in normotensive CAD patients ((1331.68±167.52) cm/s vs.(1468.61±244.54) cm/s,P=0.002) but not in hypertensive CAD patients (P>0.05).In multiple linear regression analyses,statin therapy was significantly associated with ba-PWV after adjusting for confounding variables in normotensive CAD patients (P=0.018) but not in hypertensive CAD patients (P>0.05).Conclusions Statins may significantly improve arterial stiffness in CAD patients,and hypertension may probably influence the effectiveness of statin therapy in improving arterial stiffness in this population.Further studies are required to

  19. Mean Platelet Volume and Arterial Stiffness – Clinical Relationship and Common Genetic Variability

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    Panova-Noeva, Marina; Arnold, Natalie; Hermanns, M. Iris; Prochaska, Jürgen H.; Schulz, Andreas; Spronk, Henri M.; Binder, Harald; Pfeiffer, Norbert; Beutel, Manfred; Blankenberg, Stefan; Zeller, Tanja; Lotz, Johannes; Münzel, Thomas; Lackner, Karl J.; ten Cate, Hugo; Wild, Philipp S.

    2017-01-01

    Vessel wall stiffening is an important clinical parameter, but it is unknown whether platelets, key elements in the pathogenesis of arterial thrombosis, are associated with arterial stiffness. The present studies sought to determine whether mean platelet volume (MPV), a potential marker of platelet activation, is linked to vascular elasticity as assessed by the augmentation index (AIx), in 15,010 individuals from the population-based Gutenberg Health Study. Multivariable analysis showed that MPV in both males (β 0.776; 95thCI [0.250;1.16]; p = 0.0024) and females (β 0.881[0.328;1.43]; p = 0.0018) is strongly associated with AIx. Individuals with MPV and AIx above the sex-specific medians had worse survival. Association analysis between MPV-related genetic variants and arterial stiffness identified four genetic variants in males and one in females related with AIx. Cox regression analysis for mortality identified one of these joint genetic variants close to ring finger protein 145 gene (RNF145, rs10076782) linked with increased mortality (hazard ratio 2.02; 95thCI [1.35;3.02]; p = 0.00061). Thus, these population-based data demonstrate a close relation between platelet volume as a potential marker of platelet activation and arterial stiffness in both sexes. Further research is warranted to further elucidate the mechanisms underlying larger platelets‘ role in arterial stiffening including the role of shared common genetics. PMID:28059166

  20. Affecting Factors of Arterial Stiffness in Living Related Kidney Transplant Recipients

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    Serpil Ergülü EŞMEN

    2011-05-01

    Full Text Available Arterial stiffness might be affected by several factors including recipient as well as donors. In this study, we aimed to evaluate arterial stiffness in living related kidney transplant recipients before and after transplantation. We enrolled 47 living related kidney recipients and pulse wave velocity (PWV was determined before and after transplantation. Donor renal arterial biopsy, recipient iliac artery samples were taken during the operation and PWV was also determined for the donors. Forty-seven patients completed the study. Post-transplantation follow-up duration was 18.5±5.7 months. Before transplantation, the mean PWV 8.1±1.4 m/sec and it was 7.5±2.0 m/sec after the transplantation (p=0.014. The patients were divided into two groups as with (30 patients and without (17 patients a PWV decrease. Recipient age, gender, CRP, PTH, lipids, and blood pressures were not significantly different between the groups. The recipient body mass index was higher in patients with a PWV decrease. Donor-related factors were not different between the groups. We found that blood pressure and LDL cholesterol levels in recipients were associated with a decrease in PWV after the transplantation. In conclusion, donor-related factors do not seem to have an impact on arterial stiffness in recipients. Pretransplant BMI and posttransplant blood pressure and LDL cholesterol levels were associated with a decrease in PWV.

  1. Cystatin C Associates with Arterial Stiffness in Older Adults

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    Madero, Magdalena; Wassel, Christina L.; Peralta, Carmen A.; Najjar, Samer S.; Sutton-Tyrrell, Kim; Fried, Linda; Canada, Robert; Newman, Anne; Shlipak, Michael G.; Sarnak, Mark J.

    2009-01-01

    Large arteries commonly become stiff in kidney failure, but few studies have investigated arterial stiffness in earlier stages of kidney disease. We evaluated the association between kidney function and aortic pulse wave velocity (aPWV) and its potential modification by race, diabetes, or coronary heart disease in older adults. We measured aPWV in 2468 participants in the Health Aging and Body Composition (Health ABC) study; mean age was 73.7 yr, 40% were black, and 24% had diabetes. After categorizing kidney function into three groups on the basis of cystatin C level, multivariable analysis revealed that the medium and high cystatin C groups associated with a 5.3% (95% confidence interval 0.8 to 10.0%) and 8.0% (95% confidence interval 2.2 to 14.1%) higher aPWV than the low cystatin C group; however, chronic kidney disease, as defined by estimated GFR <60 ml/min per 1.73 m2, did not significantly associate with aPWV. We did not identify interactions between cystatin C and race, diabetes, or coronary heart disease. In conclusion, stiffness of large arteries, a major risk factor for cardiovascular disease, may partially mediate the association between cystatin C and cardiovascular risk in older adults. PMID:19357259

  2. Arterial wall stiffness in patients with essential hypertension at young age

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    Kolesnik E.L.

    2014-11-01

    Full Text Available Research objective was investigating arterial wall stiffness in patients with hypertension at young age and assessing the relationship between subclinical target organs damage and ambulatory blood pressure monitoring (ABPM parameters. 30 male patients aged 18-35 years with essential hypertension stage I and II, hypertension 1 and 2nd grade were surveyed. The examination included general clinical methods, echocardiography, ABPM and suprasystolic sfigmography. It was found that the pulse wave velocity (PWVao (r = 0,557 p <0,01, central aortic blood pressure (SBPao (r = 0,492 p <0,01 and augmentation index (AIxao (r = 0,489 p <0.01 significantly increased with the pa¬tients’ age. Abdominal obesity (r = 0,566 p <0,01 and BMI (r = 0,599 p <0,01 impacted on the PWVao acceleration. Increasing of the left ventricular mass index (LVMI is highly associated with SBPao (r = 0,506 p <0,05 and PWVao (r = 0,434 p <0,05. According to ABPM the most significant correlation with arterial wall stiffness parameters demon¬strated diastolic blood pressure (DBP daytime level (AIxao (r = 0,418 p <0,01, with PWVao (r = 0,699 p <0.01 and SBPao (r = 0,695 p <0,01. Thus, age, excessive body weight and obesity should be considered as unfavorable factors that worsen arterial wall stiffness in patients with hypertension at the age before 35 years. Increase of DBP levels especially during the day causes maximum negative impact on the arterial wall stiffness parameters according to ABPM. Increased SBPao and PWVao in patients with hypertension at a young age are associated with increased left ventricular mass index.

  3. Arterial Stiffness and Pulse Wave Reflection in Young Adult Heterozygous Sickle Cell Carriers

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    Tünzale Bayramoğlu

    2013-12-01

    Full Text Available OBJECTIVE: Pulse wave velocity (PWV and aortic augmentation index (AI are indicators of arterial stiffness. Pulse wave reflection and arterial stiffness are related to cardiovascular events and sickle cell disease. However, the effect of these parameters on the heterozygous sickle cell trait (HbAS is unknown. The aim of this study is to evaluate the arterial stiffness and wave reflection in young adult heterozygous sickle cell carriers. METHODS: We enrolled 40 volunteers (20 HbAS cases, 20 hemoglobin AA [HbAA] cases aged between 18 and 40 years. AI and PWV values were measured by arteriography. RESULTS: Aortic blood pressure, aortic AI, and brachial AI values were significantly higher in HbAS cases compared to the control group (HbAA (p=0.033, 0.011, and 0.011, respectively. A statistically significant positive correlation was found between aortic pulse wave velocity and mean arterial pressure, age, aortic AI, brachial AI, weight, and low-density lipoprotein levels (p=0.000, 0.017, 0.000, 0.000, 0.034, and 0.05, respectively in the whole study population. Aortic AI and age were also significantly correlated (p=0.026. In addition, a positive correlation between aortic PWV and systolic blood pressure and a positive correlation between aortic AI and mean arterial pressure (p=0.027 and 0.009, respectively were found in HbAS individuals. Our study reveals that mean arterial pressure and heart rate are independent determinants for the aortic AI. Mean arterial pressure and age are independent determinants for aortic PWV. CONCLUSION: Arterial stiffness measurement is an easy, cheap, and reliable method in the early diagnosis of cardiovascular disease in heterozygous sickle cell carriers. These results may depend on the amount of hemoglobin S in red blood cells. Further studies are required to investigate the blood pressure changes and its effects on arterial stiffness in order to explain the vascular aging mechanism in the HbAS trait population.

  4. Indices of vascular stiffness and wave reflection in relation to body mass index or body fat in healthy subjects.

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    Wykretowicz, Andrzej; Adamska, Karolina; Guzik, Przemyslaw; Krauze, Tomasz; Wysocki, Henryk

    2007-10-01

    1. Obesity appears to influence vascular stiffness, an important cardiovascular risk factor. An accurate picture of arterial stiffness may be obtained when a combination of various techniques is used. 2. The purpose of the present study was to assess whether the body mass index (BMI) and body fat content obtained by bioimpedance were of equal value in estimating the influence of body fatness on various indices of vascular stiffness and wave reflection. 3. A total of 175 healthy subjects was studied. Anthropometric measurements and total body bio-impedance analysis were performed to assess fat mass as a proportion of total body composition. Arterial stiffness and wave reflection were assessed using digital volume pulse analysis and tonometric measurement of the wave reflection indices and central haemodynamics. 4. Significant differences in the stiffness index (SI(DVP); P < 0.0001), peripheral augmentation index (pAI(x); P < 0.0001), central augmentation index (cAI(x); P < 0.0001), peripheral pulse pressure (pPP; P = 0.026) and central pulse pressure (cPP; P < 0.0001) were found when the population examined was divided accordingly to tertile of body fat content. However, subdividing various indices of arterial stiffness according to the tertile of BMI did not reveal any significant differences between groups, except for pPP and cPP. 5. Body fat content was significantly correlated with SI(DVP), pAI(x), cAI(x), pPP and cPP. The BMI correlated weakly with SI(DVP), pPP and cPP. 6. In conclusion, the BMI is not very useful in predicting changes in arterial stiffness and wave reflection due to obesity. However, stiffness and wave reflection indices derived from digital volume pulse analysis, the characteristics of radial and aortic pressure waveforms and peripheral and aortic pulse pressure are all related to body fat content, as estimated by bioimpedance.

  5. Serum Uric Acid Level and Diverse Impacts on Regional Arterial Stiffness and Wave Reflection

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    Suyan Bian

    2012-08-01

    Full Text Available Background: Both increased arterial stiffness and hyperuricaemia are associated with elevated cardiovascular risks. Little is known about the relations of serum uric acid (UA level to regional arterial stiffness and wave reflection. The aim of the study was to investigate the gender-specific association of serum UA and indices of arterial function in a community-based investigation in China.Methods: Cross-sectional data from 2374 adults (mean age 58.24 years who underwent routine laboratory tests, regional pulse wave velocity (PWV and pulse wave analysis measurements were analyzed in a gender-specific manner. None of the participants had atherosclerotic cardiovascular disease, chronic renal failure, systemic inflammatory disease, gout, or were under treatment which would affect serum UA level.Results: Men had higher serum UA level than women. Subjects with hyperuricaemia had significantly higher carotid-ankle PWV in both genders (P< 0.05, and the carotid-femoral PWV (PWVc-f was higher in women (P< 0.001 while the augmentation index was marginally lower in men (P = 0.049. Multiple regression analysis showed that serum UA was an independent determinant only for PWVc-f in women (β = 0.104, P = 0.027 when adjusted for atherogenic confounders. No other independent relationship was found between UA level and other surrogates of arterial stiffness.Conclusions: Serum UA levels are associated with alterations in systemic arterial stiffness that differ in men and women. Women might be more susceptible to large vascular damage associated with hyperuricaemia.

  6. Relationship between Abdominal Obesity Indexes and Arterial Stiffness in Adult Chinese of Beijing%腹型肥胖测量指标与动脉硬化的相关性分析

    Institute of Scientific and Technical Information of China (English)

    王凡; 郑延松; 赛晓勇; 赵威; 李磊

    2011-01-01

    check-up during Jan 2005 to May 2010 in the health screening center of the hospital were analyzed. Obesity was evaluated by BMI, WHR and percentage of body fat (FAT%). Arterial stiffness was determined by measuring carotid-femoral (cfPWV) and carotid-radial pulse wave velocity (crPWV). Results Pearson's correlation coefficients showed that WHR was associated with cfPWV in young men and young women (r=0.191, P=0.005 vs. R=0.306, P<0.001), in middle-aged men and women (r=0.239, P<0.001 vs. R=0.189, P<0.001) and in older women (r=0.093, P=0.017), while with cfPWV and crPWV in old men (r=0.134, P=0.011 ;r=0.145, P=0.001). BMI was associated with cfPWV (r=0.175, P=0.006) in young women. FAT% was associated with crPWV in middle-aged men (r=0.186, P=0.001) and in old men (r=0.168, P=0.003), but with cfPW V and crPWV in middle-aged women (r=0.050, P=0.032; r=0.174, P=0.001) and in old women (r=0.111, P=0.009; r=0.116, P=0.015). After adjusted for blood pressure, lipids, serum sugar and uric acid, the results of multiple linear regression showed WHR was independently associated with cfPWV in middle-aged men and with cfPWV and crPWV in older men (all P<0.05). WHR was independently associated with cfPWV in different age women and FAT% was only independently associated with crPWV in older women (all P<0.05). Conclusion The results show WHR is an independent related factor for arterial stiffness in adult Chinese, whereas the BMI isn' t. And FAT% is an independent related factor for crPW V in aged women.

  7. Children and Adolescent Obesity Associates with Pressure-Dependent and Age-Related Increase in Carotid and Femoral Arteries’ Stiffness and Not in Brachial Artery, Indicative of Nonintrinsic Arterial Wall Alteration

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    Victoria García-Espinosa

    2016-01-01

    Full Text Available Aim. To analyze if childhood obesity associates with changes in elastic, transitional, and/or muscular arteries’ stiffness. Methods. 221 subjects (4–15 years, 92 females were assigned to normal weight (NW, n=137 or obesity (OB, n=84 groups, considering their body mass index z-score. Age groups were defined: 4–8; 8–12; 12–15 years old. Carotid, femoral, and brachial artery local stiffness was determined through systodiastolic pressure-diameter and stress-strain relationships. To this end, arterial diameter and peripheral and aortic blood pressure (BP levels and waveforms were recorded. Carotid-femoral, femoropedal, and carotid-radial pulse wave velocities were determined to evaluate aortic, lower-limb, and upper-limb regional arterial stiffness, respectively. Correlation analysis between stiffness parameters and BP was done. Results. Compared to NW, OB subjects showed higher peripheral and central BP and carotid and femoral stiffness, reaching statistical significance in subjects aged 12 and older. Arterial stiffness differences disappeared when levels were normalized for BP. There were no differences in intrinsic arterial wall stiffness (elastic modulus, BP stiffness relationships, and regional stiffness parameters. Conclusion. OB associates with BP-dependent and age-related increase in carotid and femoral (but not brachial stiffness. Stiffness changes would not be explained by intrinsic arterial wall alterations but could be associated with the higher BP levels observed in obese children.

  8. Carotid intima media thickness and arterial stiffness in children with acute rheumatic fever.

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    Çiftel, Murat; Yılmaz, Osman; Kardelen, Fırat; Kocabaş, Abdullah

    2014-01-01

    Acute rheumatic fever (ARF) and rheumatic heart disease (RHD) constitute important public health problems in developing countries. Inflammation is present both in the early and late stages of the diseases. Chronic inflammation is known to be associated with atherosclerosis. We hypothesize that subclinical atherosclerosis and arterial stiffness may increase due to the ongoing inflammation as well as the increased pulse pressure and left-ventricular systolic dysfunction in RHD. The purpose of the present study was to investigate carotid intima media thickness (CIMT) and carotid artery stiffness in patients with ARF. Forty patients in follow-up due to ARF in the age group of 7-16 years (disease duration 1-10 years) and 36 volunteered subjects with similar body mass index were included in the study. The subjects included in the present study were compared regarding M-mode echocardiographic parameters and CIMT as well as carotid arterial strain (CAS), carotid artery distensibility (CAD), beta stiffness index (βSI), and pressure-strain elasticity modulus (Ep) as carotid artery stiffness parameters. CIMT (0.52 ± 0.08 and 0.48 ± 0.07 mm, p = 0.01), βSI (5.29 ± 2.98 and 3.02 ± 1.30, p < 0.001), and Ep (426.53 ± 210.50 and 254.44 ± 104.69 p < 0.001) were increased, whereas CAS (0.11 ± 0.01 and 0.19 ± 0.09, p < 0.001) and CAD (10.27 ± 4.69 and 17.76 ± 14.41, p < 0.001) were decreased in patients with ARF compared with the control group. There was a positive correlation between pulse pressure and βSI (r = 0.25, p = 0.02) and Ep (r = 0.28, p = 0.01) in addition to a correlation between left atrial dilatation and CIMT (r = 0.55 p < 0.001) in patients with ARF. CIMT and carotid artery stiffness were increased in patients with ARF. Patients with ARF may have an increased risk of subclinical atherosclerosis and cardiovascular events.

  9. Effect of beta-1-blocker, nebivolol, on central aortic pressure and arterial stiffness in patients with essential hypertension

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    Radhika Soanker

    2012-01-01

    Conclusion: Nebivolol 5 mg demonstrated antihypertensive efficacy in patients with essential hypertension by reducing not only peripheral brachial pressures, but also significantly reducing central aortic pressures, augmentation index, and carotid femoral pulse wave velocity, which is the marker of arterial stiffness.

  10. Adiponectin Genotype, Blood Pressures, and Arterial Stiffness: The Cardiometabolic Risk in Chinese (CRC) Study.

    Science.gov (United States)

    Liang, Jun; Qiu, Qinqin; Gong, Ying; Liu, Xuekui; Dou, Lianjun; Zou, Caiyan; Wang, Yu; Qi, Lu

    2015-05-01

    The authors examined whether the adiponectin gene (ADIPOQ) variant was associated with blood pressure and arterial stiffness in Chinese adults. A genome-wide association study of the adiponectin variant rs864265 in the ADIPOQ gene was genotyped in a total of 2364 participants. After adjustment for sex, age, body mass index (BMI), fasting glucose, and lipids, participants carrying the T allele of rs864265 showed a greater increase in carotid-femoral pulse wave velocity (cfPWV) and systolic blood pressure (SBP). Further adjustment for blood pressure did not appreciably change the association with cfPWV. The authors found significant interactions between rs864265 and BMI, waist circumference, body fat percentage, and SBP in relation to cfPWV (P for interaction = .035, .001, .003, .013, respectively). The T allele of rs864265 was associated with high blood pressure and arterial stiffness. BMI, body fat percentage, waist circumference, and SBP might modify the effects of genetic polymorphism on arterial stiffness.

  11. Blood pressure and arterial stiffness in obese children and adolescents.

    Science.gov (United States)

    Hvidt, Kristian Nebelin

    2015-03-01

    Obesity, elevated blood pressure (BP) and arterial stiffness are risk factors for cardiovascular disease. A strong relationship exists between obesity and elevated BP in both children and adults. Obesity and elevated BP in childhood track into adult life increasing the risk of cardiovascular disease in adulthood. Ambulatory BP is the most precise measure to evaluate the BP burden, whereas carotid-femoral pulse wave velocity (cfPWV) is regarded as the gold standard for evaluating arterial (i.e. aortic) stiffness. These measures might contribute to a better understanding of obesity's adverse impact on the cardiovascular system, and ultimately a better prevention and treatment of childhood obesity. The overall aim of the present PhD thesis is to investigate arterial stiffness and 24-hour BP in obese children and adolescents, and evaluate whether these measures are influenced by weight reduction. The present PhD thesis is based on four scientific papers.  In a cross-sectional design, 104 severe obese children and adolescents with an age of 10-18 years were recruited when newly referred to the Children's Obesity Clinic, Holbæk University Hospital, and compared to 50 normal weighted age and gender matched control individuals. Ambulatory BP was measured, and cfPWV was investigated in two ways in respect to the distance measure of aorta; the previously recommended length - the so called subtracted distance, and the currently recommended length - the direct distance. In a longitudinal design, the obese patients were re-investigated after one-year of lifestyle intervention at the Children's Obesity Clinic in purpose of reducing the degree of obesity. In the cross-sectional design, the obese group had higher measures of obesity, while matched for age, gender and height, when compared to the control group. In the longitudinal design, 74% of the 72 followed up obese patients experienced a significant weight reduction. CfPWV was dependent on the method used to measure the

  12. An update on the role of adipokines in arterial stiffness and hypertension.

    Science.gov (United States)

    Sabbatini, Andréa R; Fontana, Vanessa; Laurent, Stephane; Moreno, Heitor

    2015-03-01

    Adipokines are hormones produced by adipocytes and have been involved in multiple pathologic pathways, including inflammatory and cardiovascular complications in essential hypertension. Arterial stiffness is a frequent vascular complication that represents increased cardiovascular risk in hypertensive patients. Adipokines, such as adiponectin, leptin and resistin, might be implicated in hypertension, as well as in vascular alterations associated with this condition. Arterial stiffness has proven to be a predictor of cardiovascular events. Obesity and target-organ damage such as arterial stiffness are features associated with hypertension. This review aims to update the association between adipokines and arterial stiffness in essential and resistant hypertension (RHTN).

  13. Maternal arterial stiffness in women who subsequently develop pre-eclampsia.

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    Makrina D Savvidou

    Full Text Available BACKGROUND/OBJECTIVES: Pre-eclampsia (PE is associated with profound changes in the maternal cardiovascular system. The aim of the present study was to assess whether alterations in the maternal arterial stiffness precede the onset of PE in at risk women. METHODOLOGY/PRINCIPAL FINDINGS: This was a cross sectional study involving 70 pregnant women with normal and 70 women with abnormal uterine artery Doppler examination at 22-24 weeks of gestation. All women had their arterial stiffness (augmentation index and pulse wave velocity of the carotid-femoral and carotid-radial parts of the arterial tree assessed by applanation tonometry in the second trimester of pregnancy, at the time of the uterine artery Doppler imaging. Among the 140 women participating in the study 29 developed PE (PE group and 111 did not (non-PE group. Compared to the non-PE group, women that developed PE had higher central systolic (94.9 ± 8.6 mmHg vs 104.3 ± 11.1 mmHg; p  =  < 0.01 and diastolic (64.0 ± 6.0 vs 72.4 ± 9.1; p < 0.01 blood pressures. All the arterial stiffness indices were adjusted for possible confounders and expressed as multiples of the median (MoM of the non-PE group. The adjusted median augmentation index was similar between the two groups (p  =  0.84. The adjusted median pulse wave velocities were higher in the PE group compared to the non-PE group (carotid-femoral: 1.10 ± 0.14 MoMs vs 0.99 ± 0.11 MoMs; p < 0.01 and carotid-radial: 1.08 ± 0.12 MoMs vs 1.0 ± 0.11 MoMs; p < 0.01. CONCLUSIONS/SIGNIFICANCE: Increased maternal arterial stiffness, as assessed by pulse wave velocity, predates the development of PE in at risk women.

  14. Circulating vascular progenitor cells and central arterial stiffness in polycystic ovary syndrome.

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    Cecile Dessapt-Baradez

    Full Text Available OBJECTIVE: Subjects with Polycystic ovarian syndrome (PCOS are at increased risk of Type 2 diabetes mellitus (T2DM. The mechanism of this enhanced risk is unclear. Circulating vascular progenitor cells (VPC are immature bone marrow derived cells capable of differentiating into mature endothelial cells. VPC number/function and central arterial stiffness predict cardio-metabolic disease in at-risk populations. DESIGN: We studied VPC and arterial stiffness measures in non-obese PCOS subjects as compared to age and body mass index (BMI matched healthy controls in a cross-sectional study. METHODS: Fourteen subjects with PCOS and 12 controls of similar age, BMI (all <30 kg/m(2 and metabolic profile were studied. VPC number and in vitro function were studied by flow cytometry and tube formation assays respectively. Augmentation index (AIx, a measure of central arterial stiffness, and central (aortic blood pressures (BP were measured by applanation tonometry. RESULTS: Subjects with PCOS had a reduced number, mean±SEM, of circulating CD34(+133(+ VPCs (317.5±51.0 vs. 558.3±101.2, p = 0.03 and impaired in vitro tube formation (completed tube area 1.0±0.06 vs. 1.2±0.05×10(6 µm(2 p = 0.02. PCOS subjects had significantly higher AIx (18.4±1.9% vs. 4.9±2.0% and this difference remained significant even after adjustments for age, BMI and smoking (p = 0.003 in multivariate analyses. Central systolic and pulse pressure were higher in PCOS subjects but these differences were not statistically significant after adjustment for age. Brachial systolic and pulse pressures were similar. VPC number/function and arterial stiffness or BP measures were not correlated. CONCLUSIONS: Non-obese PCOS is characterized by a reduced VPC number, impaired VPC function and increased central arterial stiffness. These changes in novel vascular risk markers may explain the enhanced risk of T2DM and CVD in PCOS.

  15. Sex differences in flexibility-arterial stiffness relationship and its application for diagnosis of arterial stiffening: a cross-sectional observational study.

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    Masato Nishiwaki

    Full Text Available Arterial stiffness might be related to trunk flexibility in middle-aged and older participants, but it is also affected by age, sex, and blood pressure. This cross-sectional observational study investigated whether trunk flexibility is related to arterial stiffness after considering the major confounding factors of age, sex, and blood pressure. We further investigated whether a simple diagnostic test of flexibility could be helpful to screen for increased arterial stiffening.According to age and sex, we assigned 1150 adults (male, n = 536; female, n = 614; age, 18-89 y to groups with either high- or poor-flexibility based on the sit-and-reach test. Arterial stiffness was assessed by cardio-ankle vascular index.In all categories of men and in older women, arterial stiffness was higher in poor-flexibility than in high-flexibility (P<0.05. This difference remained significant after normalizing arterial stiffness for confounding factors such as blood pressure, but it was not found among young and middle-aged women. Stepwise multiple-regression analysis also supported the notion of the sex differences in flexibility-arterial stiffness relationship. Receiver operating characteristic curve analysis revealed that cut-off values for sit-and-reach among men and women were 33.2 (area under the curve [AUC], 0.711; 95% confidence interval [CI], 0.666-0.756; sensitivity, 61.7%; specificity, 69.7% and 39.2 (AUC, 0.639; 95% CI, 0.592-0.686; sensitivity, 61.1%; specificity, 62.0% cm, respectively.Our results indicate that flexibility-arterial stiffness relationship is not affected by BP, which is a major confounding factor. In addition, sex differences are observed in this relationship; poor trunk flexibility increases arterial stiffness in young, middle-aged, and older men, whereas the relationship in women is found only in the elderly. Also, the sit-and-reach test can offer a simple method of predicting arterial stiffness at home or elsewhere.

  16. Effects of dark chocolate and cocoa consumption on endothelial function and arterial stiffness in overweight adults.

    Science.gov (United States)

    West, Sheila G; McIntyre, Molly D; Piotrowski, Matthew J; Poupin, Nathalie; Miller, Debra L; Preston, Amy G; Wagner, Paul; Groves, Lisa F; Skulas-Ray, Ann C

    2014-02-01

    The consumption of cocoa and dark chocolate is associated with a lower risk of CVD, and improvements in endothelial function may mediate this relationship. Less is known about the effects of cocoa/chocolate on the augmentation index (AI), a measure of vascular stiffness and vascular tone in the peripheral arterioles. We enrolled thirty middle-aged, overweight adults in a randomised, placebo-controlled, 4-week, cross-over study. During the active treatment (cocoa) period, the participants consumed 37 g/d of dark chocolate and a sugar-free cocoa beverage (total cocoa = 22 g/d, total flavanols (TF) = 814 mg/d). Colour-matched controls included a low-flavanol chocolate bar and a cocoa-free beverage with no added sugar (TF = 3 mg/d). Treatments were matched for total fat, saturated fat, carbohydrates and protein. The cocoa treatment significantly increased the basal diameter and peak diameter of the brachial artery by 6% (+2 mm) and basal blood flow volume by 22%. Substantial decreases in the AI, a measure of arterial stiffness, were observed in only women. Flow-mediated dilation and the reactive hyperaemia index remained unchanged. The consumption of cocoa had no effect on fasting blood measures, while the control treatment increased fasting insulin concentration and insulin resistance (P= 0·01). Fasting blood pressure (BP) remained unchanged, although the acute consumption of cocoa increased resting BP by 4 mmHg. In summary, the high-flavanol cocoa and dark chocolate treatment was associated with enhanced vasodilation in both conduit and resistance arteries and was accompanied by significant reductions in arterial stiffness in women.

  17. Arterial stiffness in obese children: Role of adiposity and physical activity

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    Deepa S Pandit

    2014-01-01

    Full Text Available Objective: To explore association of adiposity and physical activity with arterial stiffness and to propose optimal waist circumference cutoffs, corresponding to 90 th percentile of NHANES (National Health and Nutrition Examination Survey for Indian children and adolescents. Materials and Methods: Data on weight, height, waist circumference, physical activity and right Carotid artery Intima-Media-Thickness (CIMT, pulse wave velocity (PWV, elasticity modulus (Ep, stiffness index(β, arterial compliance (AC were assessed in 250 children (72 normal-weight and 178 overweight/obese aged 6-17 years from Pune city, India. Body composition was measured using Dual energy X-ray absorptiometry. Results: Total, 37.1% normal-weight and 98.2% overweight/obese children had high adiposity (>95 th body fat percentile. Positive association of PWV and Ep (r = 0.5 also β(r = 0.25 with BMI (Body Mass Index, waist circumference and body fat (P < 0.05 was observed. Physical activity was inversely associated with PWV (r =-0.2, β(r =-0.13, Ep (r =-0.12 and positively with AC (r = 0.12 (P < 0.05. PWV significantly increased with increasing body fat for each tertile of physical activity (P < 0.05. Regression analysis revealed waist circumference, BMI, body fat and physical activity as independent associates for PWV after adjusting for age (P < 0.05. The cutoff of waist circumference yielding sensitivity and specificity for predicting the risk of high PWV was (−0.43, −0.44 for boys and girls with sensitivity in boys (girls of 78% (87% and specificity in boys (girls 51% (70%. The observed cutoffs are less than the NHANES-III cutoff values of waist circumference for 90 th percentiles according to age and sex. Conclusion: High adiposity and low physical activity are adversely related to arterial stiffness in Indian children.

  18. Arterial stiffness and wave reflections in patients with sickle cell disease.

    Science.gov (United States)

    Lemogoum, Daniel; Van Bortel, Luc; Najem, Boutaina; Dzudie, Anasthase; Teutcha, Charles; Madu, Ernest; Leeman, Marc; Degaute, Jean-Paul; van de Borne, Philippe

    2004-12-01

    We tested the hypothesis that lower blood pressure and increased vasodilatation reported in sickle cell disease (SCD) patients with hemoglobin SS genotype (SS) are translated by lower arterial stiffness determined by pulse wave velocity (PWV) and wave reflections assessed by augmentation index (AI). We enrolled 20 SS (8 females; 12 male) patients closely matched for age, gender, height, and body mass index to 20 subjects with hemoglobin AA genotype (AA). Carotid-femoral PWV (PWV(CF)) and carotid-radial PWV (PWV(CR)) were recorded with the Complior device. Aortic AI was derived from pressure wave analysis (SphygmocoR). PWV(CF) and PWV(CR) were lower in SS than in AA (4.5+/-0.7 m/s versus 6.9+/-0.9 m/s, P<0.0001 and 6.6+/-1.2 m/s versus 9.5+/-1.4 m/s, P<0.0001, respectively). AI was lower in SS than in AA (2+/-14% versus 11+/-8%, P=0.02). Multivariate analysis revealed that both PWV(CF) and PWV(CR) were negatively associated with hemoglobin SS type and positively related to mean arterial pressure (MAP), whereas AI was positively associated with MAP and total cholesterol (all P<0.0001). Multivariate analysis restricted to SS indicated a positive association between PWV(CF) and PWV(CR) with age but a negative association with MAP (R2=0.57 and 0.51, respectively, both P<0.001), whereas MAP and heart rate were independently associated with AI (R2=0.65, P<0.001). This study provides the first evidence that SCD is associated with both lower arterial stiffness and wave reflections. SS patients have a paradoxical negative association between PWV and MAP, suggesting that low MAP does not protect them against arterial stiffness impairment.

  19. Obstructive sleep apnea is associated with increased arterial stiffness in severe obesity.

    Science.gov (United States)

    Seetho, Ian W; Parker, Robert J; Craig, Sonya; Duffy, Nick; Hardy, Kevin J; Wilding, John P H

    2014-12-01

    Obstructive sleep apnea is associated with obesity and metabolic syndrome, leading to greater cardiovascular risk. Severely obese patients with obstructive sleep apnea may still be at risk of adverse health outcomes, even without previous cardiovascular disease. Pulse wave analysis non-invasively measures peripheral pulse waveforms and derives measures of haemodynamic status, including arterial stiffness, augmentation pressure and subendocardial viability ratio. We hypothesized that the presence of obstructive sleep apnea in severe obesity, even in the absence of an antecedent history of cardiovascular disease, would affect measurements derived from pulse wave analysis. Seventy-two severely obese adult subjects [obstructive sleep apnea 47 (body mass index 42 ± 7 kg m(-2) ), without obstructive sleep apnea (non-OSA) 25 (body mass index 40 ± 5 kg m(-2) )] were characterised using anthropometric, respiratory and cardio-metabolic parameters. Groups were similar in age, body mass index and gender. More subjects with obstructive sleep apnea had metabolic syndrome [obstructive sleep apnea 60%, without obstructive sleep apnea (non-OSA) 12%]. Those with obstructive sleep apnea had greater arterial stiffness, augmentation pressure and decreased subendocardial viability ratio (all P cardiovascular risk independently of metabolic abnormalities. The presence of obstructive sleep apnea in severe obesity identifies a group at high cardiovascular risk; clinicians should ensure that risk factors are managed appropriately in this group whether or not treatment of obstructive sleep apnea is offered or accepted by patients.

  20. Lung function is associated with arterial stiffness in children.

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    Julian G Ayer

    Full Text Available BACKGROUND: In older adults, an independent association exists between impaired lung function and cardiovascular disease. This interaction might be related to the effects of aging and/or smoking. In order to explore possible childhood antecedents to this association, we hypothesized that decreased lung function and vascular stiffness might be related, in early life. OBJECTIVE: To determine the relationship between lung function and carotid augmentation index (AIx, a measure of vascular stiffness, in 8-year old children. METHODS: Data on brachial blood pressure, lung function (FEV(1, FVC, FEV(1/FVC, obtained by spirometry and carotid AIx75 (AIx standardised to an arbitrary heart rate of 75 beats per minute, obtained by applanation tonometry was available in 249 community-based 8-year old children. These healthy children had been subjects in a randomised controlled trial of two interventions (omega-3 fatty acid supplementation and house-dust mite avoidance to prevent asthma. Smoking in pregnancy and childhood environmental tobacco smoke (ETS exposure was prospectively collected by questionnaire. The association between lung function and carotid AIx75 was assessed in multivariate models that included sex, height, smoking status during pregnancy, ETS exposure and randomisation groups (house dust mite avoidance and dietary intervention as covariates. RESULTS: In the fully adjusted models, Carotid AIx75 was independently associated with FEV1 (standardised β = -0.17,b = -6.72, partial R(2 = .02, p = 0.03, FVC (standardised β = -0.29, b = -9.31, partial R(2 = 0.04, p<0.001 and FEV1/FVC (standardised β = .13, b = 18.4, partial R(2 = 0.02, p = 0.04. CONCLUSION: Lower lung volumes are associated with increased vascular stiffness at an early age. The interaction between lung function and vascular stiffness may thus represent more than just age-related alterations in both the pulmonary and vascular systems.

  1. Association between arterial stiffness, disease activity and functional impairment in ankylosing spondylitis patients: a cross-sectional study.

    Science.gov (United States)

    Avram, Claudiu; Drăgoi, Răzvan Gabriel; Popoviciu, Horațiu; Drăgoi, Mihai; Avram, Adina; Amaricăi, Elena

    2016-08-01

    Cardiovascular risk is an important factor for increased morbidity and mortality in patients with ankylosing spondylitis. The aim of this study is to assess arterial stiffness in relation to the disease activity and functional limitation in patients with ankylosing spondylitis. Twenty-four patients (mean age 45.8 ± 11.7 years) suffering of ankylosing spondylitis (disease duration 11.1 ± 5.1 years) and 24 gender and age-matched healthy controls were included in the study. Clinical, biological, and functional status of ankylosing spondylitis patients was recorded. Arterial stiffness was assessed by measuring pulse wave velocity (PWV) and pulse wave analysis (PWA) was performed using applanation tonometry. We found significant differences between ankylosing spondylitis patients and healthy controls in regard to PWV (p = 0.047), aortic augmentation pressure-AP (p = 0.028), augmentation index-AIx (p = 0.038) and aortic augmentation index adjusted for heart rate-AIx75 (p = 0.011). PWV and AIx75 were significantly associated with the disease functioning score-BASFI (p = 0.012, r = 0.504; p = 0.041, r = 0.421). Aortic AP and augmentation indexes (AIx and AIx75) were all associated to ASDAS score (p = 0.028, r = 0.448; p = 0.005, r = 0.549; p = 0.025, r = 0.455). Our study showed that ankylosing spondylitis patients have a higher arterial stiffness than the age-matched controls, leading to an increased cardiovascular risk. We found that arterial stiffness is positively associated with disease activity and functional impairment. Chronic spondiloarthropaties should be screened for arterial stiffness, even in the absence of traditional cardiovascular risk factors, in order to benefit from primary prevention measures.

  2. Testosterone suppression in men with prostate cancer leads to an increase in arterial stiffness and hyperinsulinaemia.

    Science.gov (United States)

    Dockery, Frances; Bulpitt, Christopher J; Agarwal, Sanjiv; Donaldson, Mandy; Rajkumar, Chakravarthi

    2003-02-01

    The role of androgens in cardiovascular disease is uncertain. We aimed to determine the vascular effects of androgen suppression in men with prostate cancer. Arterial stiffness (or 'compliance') was measured in 16 men (71+/-9 years, mean+/-S.D.) prior to, and 3 months after, complete androgen suppression with gonadotrophin-releasing hormone analogues as treatment for prostate cancer. Fifteen control men (70+/-7 years) also had arterial stiffness studies at baseline and 3 months later. Two measures of arterial stiffness were employed: systemic arterial compliance (SAC) was measured by simultaneous recording of aortic flow and carotid artery pressure ('area method'), and pulse wave velocities (PWVs) were recorded with the 'Complior' system. The 16 cases underwent glucose-tolerance and fasting-lipids tests on both visits. After 3 months of testosterone suppression, there was a significant fall in SAC, which was not seen in the controls [mean change+/-S.E.M., -0.26+/-0.09 a.c.u. (arbitrary compliance unit) in the cases versus +0.06+/-0.11 in the controls; P =0.03). Central, but not peripheral, PWVs tended to increase in the cases (mean change+/-S.E.M. for aorto-femoral PWV, +0.5+/-0.4 m/s for cases versus -0.3+/-0.3 m/s for controls; P =0.08). After testosterone suppression, fasting insulin levels increased from 6.89+/-4.84 m-units/l to 11.34+/-8.16 m-units/l (mean+/-S.D.), total cholesterol increased from 5.32+/-0.77 mmol/l to 5.71+/-0.82 mmol/l and high-density lipoprotein cholesterol increased from 1.05+/-0.24 mmol/l to 1.26+/-0.36 mmol/l; P change occurred in body-mass index, serum glucose, low-density lipoprotein cholesterol or triacylglycerol (triglyceride) levels. Our results indicate that loss of androgens in men leads to an increase in aortic stiffness and serum insulin levels, and may therefore adversely affect cardiovascular risk.

  3. Impaired renal allograft function is associated with increased arterial stiffness in renal transplant recipients

    DEFF Research Database (Denmark)

    Kneifel, M; Scholze, A; Burkert, A;

    2006-01-01

    It is important whether impairment of renal allograft function may deteriorate arterial stiffness in renal transplant recipients. In a cross-sectional study, arterial vascular characteristics were non-invasively determined in 48 patients with renal allograft using applanation tonometry and digital...... of large arteries S1 and small arteries S2 in renal transplant recipients (each p renal allograft (p ...-Wallis test between groups). It is concluded that impairment of renal allograft function is associated with an increased arterial stiffness in renal transplant recipients....

  4. Association of glomerular filtration rate with arterial stiffness in Chinese women with normal to mildly impaired renal function

    Institute of Scientific and Technical Information of China (English)

    Su-Yan Bian; Hong-Yang Guo; Ping Ye; Lei-Ming Luo; Hong-Mei Wu; Wen-Kai Xiao; Li-Ping Qi; He-Peng Yu; Liu-Fa Duan

    2012-01-01

    Objective Both decreased glomerular filtration rate (GFR) and arterial stiffness were considered as risk factors for atherosclerosis. Previous studies have suggested the association between central arterial stiffness and the degree of GFR loss. Whether decreased GFR contributes to peripheral artery stiffness remains controversial. Moreover, data analyzed from a cohort of Chinese women are rare. Our aim was to explore the relationship between GFR and regional arterial stiffness in Chinese women. Methods In this cross-sectional study, we randomly recruited 1131 adult women residents with GFR ≥ 60 mL/min per 1.73 m2 estimated by the Chinese Modification of Diet in Renal Disease equation from three large communities. Central and peripheral arterial stiffness were estimated simultaneously by measuring carotid-femoral pulse wave velocity (PWVcf) and carotid-radial PWV (PWVcr) using a validated automatic device. Augmentation Index at heart rate 75 beats/minutes (AIx-75) was measured by pulse wave analysis as a composite parameter reflecting both large and distal arterial properties. Results The mean estimated GFR (eGFR) of the study group was 100.05 ± 23.26 mL/minute per 1.73 m2. Subjects were grouped by tertiles of eGFR level. PWVcf and AIx-75 increased ongoing from the top to the bottom eGFR tertile, while the values of PWVcr were comparable. Both univariate Pearson correlations and multiple stepwise regression analyses showed that eGFR significantly correlated to PWVcf, but not to PWVcr and AIx-75. Conclusions In Chinese women with normal to mildly impaired renal function, decreased eGFR affected carotid-to-femoral rather than carotid-to-radial stiffening. This provides rational to conduct future prospective studies to investigate predictors of atherosclerosis in this population.

  5. Arterial stiffness and sedentary lifestyle: Role of oxidative stress.

    Science.gov (United States)

    Lessiani, Gianfranco; Santilli, Francesca; Boccatonda, Andrea; Iodice, Pierpaolo; Liani, Rossella; Tripaldi, Romina; Saggini, Raoul; Davì, Giovanni

    2016-04-01

    Sedentary lifestyle is a risk factor for the development of cardiovascular disease, and leads to a quantifiable impairment in vascular function and arterial wall stiffening. We tested the hypothesis of oxidative stress as a determinant of arterial stiffness (AS) in physically inactive subjects, and challenged the reversibility of these processes after the completion of an eight-week, high-intensity exercise training (ET). AS was assessed before and after ET, measuring carotid to femoral pulse wave velocity (PWV) with a Vicorder device. At baseline and after ET, participants performed urine collection and underwent fasting blood sampling. Urinary 8-iso-PGF2α, an in vivo marker of lipid peroxidation, total, HDL and LDL cholesterol, and triglyceride concentrations were measured. ET was associated with significantly reduced urinary 8-iso-PGF2α(p<0.0001) levels. PWV was significantly reduced after ET completion (p<0.0001), and was directly related to urinary 8-iso-PGF2α(Rho=0.383, p=0.021). After ET, cardiovascular fitness improved [peak oxygen consumption (p<0.0001), peak heart rate (p<0.0001)]. However, no improvement in lipid profile was observed, apart from a significant reduction of triglycerides (p=0.022). PWV and triglycerides were significantly related (Rho=0.466, p=0.005) throughout the study period. PWV levels were also related to urinary 8-iso-PGF2α in our previously sedentary subjects. We conclude that regular physical exercise may be a natural antioxidant strategy, lowering oxidant stress and thereby the AS degree.

  6. Prognostic value of changes in arterial stiffness in men with coronary artery disease

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    Iana A Orlova

    2010-11-01

    Full Text Available Iana A Orlova, Eradzh Yu Nuraliev, Elena B Yarovaya, Fail T AgeevOutpatient department, Russian Cardiology Research Center, Moscow, Russian Federation Background: Men with coronary artery disease (CAD have been shown to have enhanced arterial stiffness. Arterial function may change over time according to treatment, but the prognostic value of these changes has not been investigated.Objectives: The aim of the present study was to assess whether an improvement in large artery rigidity in response to treatment, could predict a more favorable prognosis in a population of men with CAD.Methods: A total of 161 men with CAD (mean age 56.8 ± 10.9 years being treated with conventional therapy underwent brachial-ankle pulse wave velocity (PWVba measurements at baseline and after six months. Follow-up period was 3.5 years. End-points were major adverse cardiac events (MACE: acute myocardial infarction, unstable angina, coronary intervention, or cardiac death.Results: During the three-year follow-up period (since initial six-month follow-up, 30 patients experienced MACE. After six-month follow-up, PWVba had not improved (∆PWVba ≥ 0%, relative to baseline in 85 (52.8% of 161 men (Group 1, whereas it had improved (∆PWVba < 0% in the remaining 76 men (47.2% (Group 2. During follow-up, we noticed 24 cardiovascular events in Group 1 and six events in Group 2 (P < 0.001. Cox proportional hazards analyses demonstrated that independent of conventional risk factor changes, absence of PWVba decrease was a predictor of MACE (RR 3.99; 95% CI:1.81–8.78; P = 0.004. The sensitivity of ∆PWVba was 80% and its specificity was 54%.Conclusions: This study demonstrates that an improvement in arterial stiffness may be obtained after six months of conventional therapy and clearly identifies patients who have a more favorable prognosis.Keywords: arterial stiffness, coronary artery disease, prognosis

  7. Differential effects of nebivolol and metoprolol on arterial stiffness, circulating progenitor cells, and oxidative stress.

    Science.gov (United States)

    Hayek, Salim S; Poole, Joseph C; Neuman, Robert; Morris, Alanna A; Khayata, Mohamed; Kavtaradze, Nino; Topel, Matthew L; Binongo, Jose G; Li, Qunna; Jones, Dean P; Waller, Edmund K; Quyyumi, Arshed A

    2015-03-01

    Unlike traditional beta receptor antagonists, nebivolol activates nitric oxide. We hypothesized that therapy with nebivolol compared with metoprolol would improve arterial stiffness, increase levels of circulating progenitor cells (PC), and decrease oxidative stress (OS). In a randomized, double-blind, cross-over study, 30 hypertensive subjects received either once daily nebivolol or metoprolol succinate for 3 months each. Pulse wave velocity and augmentation index were measured using tonometry. Flow cytometry was used to measure circulating PC. OS was measured as plasma aminothiols. Measurements were performed at baseline, and repeated at 3 and 6 months. No significant differences were present between the levels of OS, arterial stiffness, and PC numbers during treatment with metoprolol compared with nebivolol. In subgroup analyses of beta-blocker naïve subjects (n = 19), nebivolol reduced pulse wave velocity significantly compared with metoprolol (-1.4 ± 1.9 vs. -0.1 ± 2.2; P = .005). Both nebivolol and metoprolol increased circulating levels of CD34+/CD133 + PC similarly (P = .05), suggesting improved regenerative capacity.

  8. Relationship of daily arterial blood pressure monitoring readings and arterial stiffness profile in male patients with chronic obstructive pulmonary disease combined with arterial hypertension

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    Karoli N.A.

    2013-06-01

    Full Text Available The aim of the study was to determine correlation between arterial blood pressure daily rhythm and daily profile of arterial stiffness in male patients with chronic obstructive pulmonary disease (COPD and arterial hypertension. Materials et methods: Prospective investigation comprised 45 male patients with COPD and arterial hypertension. Individuals of 40 years younger and 80 years elder, patients with diabetes, stroke, angina pectoris, or heart infarction, vascular diseases, and exacerbation of chronic disease, bronchial and pulmonary diseases of other etiology were excluded from the analyses. Comparison group included 47 patients with essential arterial hypertension and without chronic respiratory diseases closely similar on general parameters with patients from main clinical series. Twenty-four-hour arterial blood pressure monitoring (ABPM and daily arterial stiffness monitoring were performed using BPLab® MnSDP-2 apparatus (Petr Telegin, Russian Federation. Results: Patients with COPD combined with arterial hypertension with raised arterial stiffness measures prevail over individuals in essential hypertension group. There is pathological alteration of the ABPM circadian rhythm and raised «Pressure load» values in raised arterial stiffness group. Conclusion: We found ABPM raised parameters in patients with COPD and arterial hypertension. It confirms necessity of ABPM in daily arterial stiffness assessment in patients with COPD.

  9. Plasma homocysteine is associated with aortic arterial stiffness but not wave reflection in Chinese hypertensive subjects.

    Directory of Open Access Journals (Sweden)

    Wenkai Xiao

    Full Text Available OBJECTIVE: Elevated plasma total homocysteine (tHcy acts synergistically with hypertension to exert a multiplicative effect on cardiovascular diseases risk. The aim of this study was to determine the relationship between tHcy concentration and blood pressure, and to evaluate the role of plasma tHcy in arterial stiffness and wave reflection in hypertension. METHODS: In this cross-sectional study, a community-based sample of 1680 subjects (mean age 61.6 years was classified into four groups according to tHcy level (<21.6 vs. ≥ 21.6 µmol/l and blood pressure (hypertensive vs. normotensive. Levels of plasma tHcy and other biochemical parameters (e.g., lipids, glucose were determined. Central arterial blood pressure, reflected pressure wave, and carotid-femoral pulse wave velocity (cf-PWV were assessed by tonometry within 2 days of obtaining the blood specimen. RESULTS: Neither peripheral nor central blood pressure differed according to tHcy levels in normotensive and hypertensive subjects. Differences in cf-PWV according to tHcy were observed only in hypertensive subjects; differences in cf-PWV in normotensive subjects were not significant after adjusting for confounding factors. Central augmentation index did not differ according to tHcy level in either normotensive or hypertensive subjects. Results of univariate analysis revealed significant correlations between blood pressure parameters and tHcy concentration only among normotensive subjects; however, these correlations were not significant in a partial correlation analysis. Results of multiple regression analysis showed that plasma tHcy levels were independently correlated with cf-PWV in hypertensive subjects (β = 0.713, P = 0.004. The independent relationship between tHcy and central augmentation index was not significant by further multiple analyses in normotensive or hypertensive individuals. CONCLUSIONS: Plasma tHcy level is strongly and independently correlated with arterial

  10. Prevalence of arterial stiffness in North China, and associations with risk factors of cardiovascular disease: a community-based study

    Directory of Open Access Journals (Sweden)

    Wang Jin-Wen

    2012-12-01

    Full Text Available Abstract Background Brachial-ankle pulse wave velocity (baPWV, which reflects the stiffness of both central and peripheral muscular arteries, has been frequently used as a simple index for assessing arterial stiffness. The aim of the present study was to investigate the prevalence of arterial stiffness in North China based on baPWV measurements, and explore the associations between increased arterial stiffness and risk factors of cardiovascular diseases (CVD. Methods Twenty-three community populations were established in North China. For each participant, parameters for calculating baPWV, including blood pressures and pressure waveforms, were measured using a non-invasive automatic device. All participants were required to respond to an interviewer-led questionnaire including medical histories and demographic data, and to receive blood tests on biochemical indictors. Results A total of 2,852 participants were finally investigated. Among them, 1,201 people with low burden of CVD risk factors were chosen to be the healthy reference sample. The cut-off point of high baPWV was defined as age-specific 90th percentile of the reference sample. Thus, the prevalence of high baPWV was found to be 22.3% and 26.4% in men and women respectively. After adjusted for age, heart rate (HR, systolic blood pressure (SBP, fasting glucose level, and smoking were significantly associated with high baPWV in men; while level of serum total cholesterol (TC, HR, SBP, and diabetes were significantly associated with high baPWV in women. Conclusions Based on the age-specific cut-off points, the middle-aged population has a higher prevalence of high baPWV in North China. There exists a difference between men and women in terms of the potential risk factors associated with arterial stiffness.

  11. Arterial stiffness is inversely associated with a better running record in a full course marathon race

    OpenAIRE

    Jung, Su-Jeen; Park, Jae-Hyoung; Lee, Sewon

    2014-01-01

    [Purpose] Arterial stiffness is an independent predictor of cardiovascular risk and may contribute to reduced running capacity in humans. This study investigated the relationship between course record and arterial stiffness in marathoners who participated in the Seoul International Marathon in 2012. [Methods] A total of 30 amateur marathoners (Males n = 28, Females n = 2, mean age = 51.6 ± 8.3 years) were assessed before and after the marathon race. Brachial-ankle pulse wave velocity (ba-PWV)...

  12. Therapeutic modification of arterial stiffness:An update and comprehensive review

    Institute of Scientific and Technical Information of China (English)

    Ching-Fen; Wu; Pang-Yen; Liu; Tsung-Jui; Wu; Yuan; Hung; Shih-Ping; Yang; Gen-Min; Lin

    2015-01-01

    Arterial stiffness has been recognized as a marker of cardiovascular disease and associated with longterm worse clinical outcomes in several populations. Age, hypertension, smoking, and dyslipidemia, known as traditional vascular risk factors, as well as diabetes, obesity, and systemic inflammation lead to both atherosclerosis and arterial stiffness. Targeting multiple modifiable risk factors has become the main therapeutic strategy to improve arterial stiffness in patients at high cardiovascular risk. Additionally to life style modifications, long-term ω-3 fatty acids(fish oil) supplementation in diet may improve arterial stiffness in the population with hypertension or metabolic syndrome. Pharmacological treatment such as reninangiotensin-aldosterone system antagonists, metformin, and 3-hydroxy-3-methyl-glutaryl-Co A reductase inhibitors were useful in individuals with hypertension and diabetes. In obese population with obstructive sleep apnea, weight reduction, aerobic exercise, and continuous positive airway pressure treatment may also improve arterial stiffness. In the populations with chronic inflammatory disease such as rheumatoid arthritis, a use of antibodies against tumor necrosis factor-alpha could work effectively. Other therapeutic options such as renal sympathetic nerve denervation for patients with resistant hypertension are investigated in many ongoing clinical trials. Therefore our comprehensive review provides knowledge in detail regarding many aspects of pathogenesis, measurement, and management of arterial stiffness in several populations, which would be helpful for physicians to make clinical decision.

  13. Obese children and adolescents have elevated nighttime blood pressure independent of insulin resistance and arterial stiffness

    DEFF Research Database (Denmark)

    Hvidt, Kristian N; Olsen, Michael H; Holm, Jens-Christian

    2014-01-01

    BACKGROUND: Insulin resistance has been related to elevated blood pressure (BP) in obese children and may adversely affect the vasculature by arterial stiffening. The objective was to investigate whether daytime and nighttime BP were elevated and related to insulin resistance and arterial stiffness...... in obese children and adolescents. METHODS: Ninety-two obese patients aged 10-18 years were compared with 49 healthy control individuals. Insulin resistance was measured as the homeostatic assessment model (HOMA), and arterial stiffness was measured as carotid-femoral pulse wave velocity (cfPWV). RESULTS...... analyses, the higher nighttime BP in the obese group was independent of logHOMA and cfPWV. CONCLUSIONS: Obese children had a higher nighttime BP when compared with the control group independently of insulin resistance and arterial stiffness. No relationship was found between insulin resistance and arterial...

  14. Association between endothelial dysfunction and arterial stiffness in continuous ambulatory peritoneal dialysis patients

    Institute of Scientific and Technical Information of China (English)

    顾玥

    2014-01-01

    Objective To investigate the association between endothelial dysfunction and arterial stiffness in continuous ambulatory peritoneal dialysis(CAPD)patients.Methods Ninety-four stable CAPD patients from a single center were enrolled in this cross-sectional study.Ultrasound evaluation was conducted on brachial artery to estimate endothelial-dependent

  15. Whole-body vibration as a potential countermeasure for dynapenia and arterial stiffness

    Directory of Open Access Journals (Sweden)

    Arturo Figueroa

    2016-09-01

    Full Text Available Age-related decreases in muscle mass and strength are associated with decreased mobility, quality of life, and increased cardiovascular risk. Coupled with the prevalence of obesity, the risk of death becomes substantially greater. Resistance training (RT has a well-documented beneficial impact on muscle mass and strength in young and older adults, although the high-intensity needed to elicit these adaptations may have a detrimental or negligible impact on vascular function, specifically on arterial stiffness. Increased arterial stiffness is associated with systolic hypertension, left ventricular hypertrophy, and myocardial ischemia. Therefore, improvements of muscle strength and arterial function are important in older adults. Recently, whole-body vibration (WBV exercise, a novel modality of strength training, has shown to exhibit similar results on muscle strength as RT in a wide-variety of populations, with the greatest impact in elderly individuals with limited muscle function. Additionally, WBV training has been shown to have beneficial effects on vascular function by reducing arterial stiffness. This article reviews relevant publications reporting the effects of WBV on muscle strength and/or arterial stiffness. Findings from current studies suggest the use of WBV training as an alternative modality to traditional RT to countermeasure the age-related detriments in muscle strength and arterial stiffness in older adults.

  16. Altered arterial stiffness and subendocardial viability ratio in young healthy light smokers after acute exercise.

    Directory of Open Access Journals (Sweden)

    Robert J Doonan

    Full Text Available BACKGROUND: Studies showed that long-standing smokers have stiffer arteries at rest. However, the effect of smoking on the ability of the vascular system to respond to increased demands (physical stress has not been studied. The purpose of this study was to estimate the effect of smoking on arterial stiffness and subendocardial viability ratio, at rest and after acute exercise in young healthy individuals. METHODS/RESULTS: Healthy light smokers (n = 24, pack-years = 2.9 and non-smokers (n = 53 underwent pulse wave analysis and carotid-femoral pulse wave velocity measurements at rest, and 2, 5, 10, and 15 minutes following an exercise test to exhaustion. Smokers were tested, 1 after 12h abstinence from smoking (chronic condition and 2 immediately after smoking one cigarette (acute condition. At rest, chronic smokers had higher augmentation index and lower aortic pulse pressure than non-smokers, while subendocardial viability ratio was not significantly different. Acute smoking increased resting augmentation index and decreased subendocardial viability ratio compared with non-smokers, and decreased subendocardial viability ratio compared with the chronic condition. After exercise, subendocardial viability ratio was lower, and augmentation index and aortic pulse pressure were higher in non-smokers than smokers in the chronic and acute conditions. cfPWV rate of recovery of was greater in non-smokers than chronic smokers after exercise. Non-smokers were also able to achieve higher workloads than smokers in both conditions. CONCLUSION: Chronic and acute smoking appears to diminish the vascular response to physical stress. This can be seen as an impaired 'vascular reserve' or a blunted ability of the blood vessels to accommodate the changes required to achieve higher workloads. These changes were noted before changes in arterial stiffness or subendocardial viability ratio occurred at rest. Even light smoking in young healthy individuals

  17. Hypertension, Diabetes Type II, and Their Association: Role of Arterial Stiffness.

    Science.gov (United States)

    Smulyan, Harold; Lieber, Ari; Safar, Michel E

    2016-01-01

    In patients with both hypertension and type II diabetes, the systolic blood pressure (SBP) increases linearly with age, while that of diastolic blood pressure (DBP) declines curvilinearly as early as age 45, all suggesting the development of increased arterial stiffness. Increased stiffness is an important, independent, and significant risk predictor in subjects with hypertension and diabetes. In patients with both diseases, stiffness assessed at the same mean arterial pressure (MAP) was significantly higher in diabetic patients. Arterial stiffness is related to age, heart rate (HR), and MAP, but in diabetic patients, it also related to diabetes duration and insulin treatment (IT). In the metabolic syndrome (MetSyn), diabetes also acts on the small arteries through capillary rarefaction to reduce the effective length of the arterial tree, increases the reflected pulse wave and thus the pulse pressure (PP). These studies indicate that diabetes and hypertension additively contribute to increased pulsatility and suggest that any means to reduce stiffness would be beneficial in these conditions.

  18. To compare the effect of Telmisartan with Metoprolol on arterial stiffness in hypertension: Prospective randomized parallel group trial

    Science.gov (United States)

    Sumbria, Minakshi; Negi, Prakash C.; Sahai, Ashok K.; Kaundal, Purshotam K.

    2014-01-01

    Background Hypertension is often complicated by increased arterial stiffness and is an independent predictor of adverse cardiovascular (CV) outcome. Beta blockers and angiotensin receptor blockers (ARBs) are commonly used antihypertensive agents. The effect of beta blockers and ARBs on arterial stiffness has not been compared adequately. The aim of the present study is to compare the effect of telmisartan with metoprolol on arterial stiffness in hypertensive patients in prospective open label randomized parallel group intervention study. Methods 100 patients of hypertension, not on any antihypertensive agents, were enrolled after obtaining informed consent. Baseline recording of data related to demographics, CV risk factors, anthropometry and BP were made. Arterial stiffness was measured noninvasively by recording pulse wave velocity (PWV) using periscope (Genesis medical system). Left ventricular (LV) mass was measured using 2D guided M-mode echocardiography. Blood sugar, renal function, lipids and uric acid estimations were done in fasting state. Patients were randomized to receive metoprolol and telmisartan using stratified randomization technique. Dose of the study drugs were titrated to achieve target BP of <140/90 mmHg. Data related to PWV, BP, anthropometry and blood biochemistry was repeated after 6 months of treatment with study drugs. Results Telmisartan resulted in significantly greater reduction in arterial stiffness index (ASI) in left and right lower limb arterial bed (39.9 ± 11.7 vs. 46.8 ± 17.0 m/s, p < 0.02) and (36.4 ± 9.6 vs. 44.86 ± 15.1 m/s, p < 0.002) respectively and systolic blood pressure (SBP) (−4.9 mmHg with 95% C.I. of −8.0–1.7 mmHg, p < 0.003) compared to metoprolol. Reduction in diastolic blood pressure (DBP) in telmisartan and metoprolol groups was not different statistically (−1.0 mmHg with 95% C.I. of −3.3–1.2 mmHg, p < 0.3). The change in LV mass was not significantly different between the

  19. Astaxanthin vs placebo on arterial stiffness, oxidative stress and inflammation in renal transplant patients (Xanthin: a randomised controlled trial

    Directory of Open Access Journals (Sweden)

    Robertson Iain K

    2008-12-01

    Full Text Available Abstract Background There is evidence that renal transplant recipients have accelerated atherosclerosis manifest by increased cardiovascular morbidity and mortality. The high incidence of atherosclerosis is, in part, related to increased arterial stiffness, vascular dysfunction, elevated oxidative stress and inflammation associated with immunosuppressive therapy. The dietary supplement astaxanthin has shown promise as an antioxidant and anti-inflammatory therapeutic agent in cardiovascular disease. The aim of this trial is to investigate the effects of astaxanthin supplementation on arterial stiffness, oxidative stress and inflammation in renal transplant patients. Method and Design This is a randomised, placebo controlled clinical trial. A total of 66 renal transplant recipients will be enrolled and allocated to receive either 12 mg/day of astaxanthin or an identical placebo for one-year. Patients will be stratified into four groups according to the type of immunosuppressant therapy they receive: 1 cyclosporine, 2 sirolimus, 3 tacrolimus or 4 prednisolone+/-azathioprine, mycophenolate mofetil or mycophenolate sodium. Primary outcome measures will be changes in 1 arterial stiffness measured by aortic pulse wave velocity (PWV, 2 oxidative stress assessed by plasma isoprostanes and 3 inflammation by plasma pentraxin 3. Secondary outcomes will include changes in vascular function assessed using the brachial artery reactivity (BAR technique, carotid artery intimal medial thickness (CIMT, augmentation index (AIx, left ventricular afterload and additional measures of oxidative stress and inflammation. Patients will undergo these measures at baseline, six and 12 months. Discussion The results of this study will help determine the efficacy of astaxanthin on vascular structure, oxidative stress and inflammation in renal transplant patients. This may lead to a larger intervention trial assessing cardiovascular morbidity and mortality. Trial Registration

  20. Relationship between sleep duration and arterial stiffness in a multi-ethnic population: The HELIUS study

    Science.gov (United States)

    Anujuo, Kenneth; Stronks, Karien; Snijder, Marieke B.; Jean-Louis, Girardin; van den Born, Bert-Jan; Peters, Ron J.; Agyemang, Charles

    2017-01-01

    We examined the relationship between sleep duration and arterial stiffness among a multi-ethnic cohort, and whether the associations differed among ethnic minority groups in the Netherlands. Data were derived from 10 994 participants (aged 18–71 years) of the Healthy Life in an Urban Setting (HELIUS) study. Self-reported sleep duration was categorized into: short (<7 h/night), healthy (7–8 h/night) and long (≥9 h/night). Arterial stiffness was assessed by duplicate pulse-wave velocity (PWV in m/s) measurements using the Arteriograph system. The association of sleep duration with PWV was analysed using linear regression (β) with 95% confidence interval (CI). Results showed that neither short nor long sleep was related to PWV in all ethnic groups, except for long sleep in Dutch men which was associated with higher PWV (indicating stiffer arteries) after adjustment for potential confounders (β = 0.67, 95%CI, 0.23–1.11). Our study showed no convincing evidence that sleep duration was related to arterial stiffness among various ethnic groups. The link between sleep duration and cardiovascular outcomes does not seem to operate through arterial stiffness. Further research is needed to consolidate these findings. PMID:27058653

  1. Association between arterial stiffness and peritoneal small solute transport rate.

    Science.gov (United States)

    Zhe, Xing-wei; Tian, Xin-kui; Chen, Wei; Guo, Li-juan; Gu, Yue; Chen, Hui-min; Tang, Li-jun; Wang, Tao

    2008-05-01

    While cardiovascular disease accounts for 40-50% of the mortality in dialysis patients, and while a high peritoneal transport in continuous ambulatory peritoneal dialysis (CAPD) is an independent predictor of outcome, it is unclear if there are any links. Aortic stiffness has become established as a cardiovascular risk factor. We thus studied pulse wave velocity (PWV) in CAPD patients to explore the possible link between peritoneal small solute transport and aortic stiffness. CAPD patients (n = 76, 27 M/49 F) in our center were included in the present study. Aortic stiffness was assessed by brachial pulse pressure (PP) and carotid-femoral PWV. Patients' peritoneal small solute transport rate was assessed by D/P(cr) at 4 h. Extracellular water over total body water (E/T ratio) was assessed by means of bioimpedance analysis. C-reactive protein was also measured. Carotid-femoral PWV was positively associated with patients' age (r = 0.555; P < 0.01), time on peritoneal dialysis (r = 0.332; P < 0.01), diabetic status (r = 0.319; P < 0.01), D/P(cr) (r = 0.241; P < 0.05), PP (r = 0.475; P < 0.01), and E/T (r = 0.606; P < 0.01). In a multivariate regression analysis, carotid-femoral PWV was independently determined by E/T (P < 0.01), PP (P < 0.01), age (P < 0.01), and D/P(cr) (P < 0.05). D/P(cr), in addition to E/T, age, and PP, was an independent predictor of elevated carotid-femoral PWV in CAPD patients, suggesting that there might be a link between high aortic stiffness and increased peritoneal small solute transport rate.

  2. Association between arterial stiffness and risk of coronary artery disease in a community-based population

    Institute of Scientific and Technical Information of China (English)

    Zhang Yun; Ye Ping; Luo Leiming; Bai Yongyi; Xu Ruyi; Xiao Wenkai; Liu Dejun

    2014-01-01

    Background Arterial stiffness is well known as an important risk factor for coronary artery disease.In this study,we aimed to investigate the association between carotid-ankle pulse wave velocity (caPWV) and risk of coronary artery disease (CAD),and the interaction between pulse wave velocity (PWV) and other potential risk factors of CAD.Methods A community-based cross-sectional study was conducted for subjects living in Beijing,China.We collected 213 subjects with coronary artery disease and 1 266 subjects without CAD between September 2007 and January 2009 in a community center of Beijing.A multivariate Logistic regression analysis was carried out to assess the odds ratios of factors related to CAD.Results We found CAD subjects were more likely to have a higher body massindex (BMI),fasting glucose,uric acid,low-density lipoprotein (LDL) cholesterol,high-sensitivity Creactive protein (hs-CRP),carotic-femoral pulse wave velocity (cfPWV) and caPWV (P <0.05),and CAD subjects had a significantly lower HDL cholesterol levels (P <0.05).Moreover,the proportion of hypertension in CAD subjects was significantly higher than non-CAD subjects.The multiple Logistic regression analysis showed that hypertension,higher uric acid,hs-CRP,cfPWV and caPWV levels significantly increased the risk of CAD,with ORs (Cl) of 1.47 (1.25-1.74),1.17 (1.01-1.26),1.35 (1.10-1.67),1.15 (1.09-1.19) and 1.07 (1.01-1.15),respectively.Higher HDL cholesterol was significantly associated with reduced risk of CAD,with ORs (CI) of 0.58 (0.40-0.83).In addition,cfPWV had significant association with age,hypertension,LDL cholesterol,with Pearson's coefficients of 0.166,0.074,and 0.030,respectively.Conclusions cfPWV and caPWV are independently associated with significant CAD,and cfPWV has significant correlation with age and hypertension.cfPWV and caPWV may be used as a practical tool for predicting the risk of CAD.

  3. Stiffness of the large arteries in individuals with and without Down syndrome

    Directory of Open Access Journals (Sweden)

    Nunes Rodrigues A

    2011-06-01

    Full Text Available Anabel N Rodrigues1,2, Luan Cesar Coelho1, Washington LS Goncalves1,2, Sonia Alves Gouvea2, Maria José Rossi Vasconcellos1, Roberto S Cunha2, Glaucia R Abreu21School of Medicine, University Center of Espírito Santo, Colatina; 2Postgraduate Program in Physiological Sciences, Center for Health Sciences, Federal University of Espirito Santo, Vitória, BrazilBackground: Down syndrome is known to cause premature aging in several organ systems. However, it remains unclear whether this aging effect also affects the structure and function of the large arterial trunks. In this controlled study, the possibility of changes in the large arteries due to aging was evaluated in patients with Down syndrome.Methods: Eighty-two subjects of both genders were selected. The Down syndrome group had 41 active subjects consisting of 19 males and 22 females (mean age 21 ± 1, range 13–42 years without cardiovascular complications and who did not use vasoactive drugs. The control group consisted of 41 healthy individuals without trisomy 21 of the same gender and age as the Down syndrome group and who did not use vasoactive medication. Carotid–femoral pulse wave velocity was obtained as an index of aortic stiffness using an automatic noninvasive method.Results: Individuals with Down syndrome had significantly lower blood pressure than those in the control group. Systolic blood pressure for the Down syndrome group and control group was 106 ± 2 mmHg vs 117 ± 2 mmHg (P < 0.001, respectively; diastolic blood pressure was 66 ± 2 mmHg vs 77 ± 2 mmHg (P <0.001; and mean arterial pressure was 80 ± 1 mmHg vs 90 ± 1 mmHg (P < 0.001. Only age and systolic blood pressure were shown to correlate significantly with pulse wave velocity, but the slopes of the linear regression curves of these two variables showed no significant difference between the two study groups. Pulse wave velocity, which was initially significantly lower in the Down syndrome group (7.51 ± 0.14 m/s vs

  4. No association of dietary fiber intake with inflammation or arterial stiffness in youth with type 1 diabetes

    Science.gov (United States)

    Jaacks, Lindsay M.; Crandell, Jamie; Liese, Angela D.; Lamichhane, Archana P.; Bell, Ronny A.; Dabelea, Dana; D'Agostino, Ralph B.; Dolan, Lawrence M.; Marcovina, Santica; Reynolds, Kristi; Shah, Amy S.; Urbina, Elaine M.; Wadwa, R. Paul; Mayer-Davis, Elizabeth J.

    2014-01-01

    Aim To examine the association of dietary fiber intake with inflammation and arterial stiffness among youth with type 1 diabetes (T1D) in the US. Methods Data are from youth ≥ 10 years old with clinically diagnosed T1D for ≥ 3 months and ≥ 1 positive diabetes autoantibody in the SEARCH for Diabetes in Youth Study. Fiber intake was assessed by food frequency questionnaire with measurement error (ME) accounted for by structural sub-models derived using additional 24-hour dietary recall data in a calibration sample and the respective exposure-disease model covariates. Markers of inflammation, measured at baseline, included IL-6 (n=1405), CRP (n=1387), and fibrinogen (n=1340); markers of arterial stiffness, measured approximately 19 months post-baseline, were available in a subset of participants and included augmentation index (n=180), pulse wave velocity (n=184), and brachial distensibility (n=177). Results Mean (SD) T1D duration was 47.9 (43.2) months; 12.5% of participants were obese. Mean (SD) ME-adjusted fiber intake was 15 (2.8) g/day. In multivariable analyses, fiber intake was not associated with inflammation or arterial stiffness. Conclusion Among youth with T1D, fiber intake does not meet recommendations and is not associated with measures of systemic inflammation or vascular stiffness. Further research is needed to evaluate whether fiber is associated with these outcomes in older individuals with T1D or among individuals with higher intakes than those observed in the present study. PMID:24613131

  5. Does short-term whole-body vibration training affect arterial stiffness in chronic stroke? A preliminary study.

    Science.gov (United States)

    Yule, Christie E; Stoner, Lee; Hodges, Lynette D; Cochrane, Darryl J

    2016-03-01

    [Purpose] Previous studies have shown that stroke is associated with increased arterial stiffness that can be diminished by a program of physical activity. A novel exercise intervention, whole-body vibration (WBV), is reported to significantly improve arterial stiffness in healthy men and older sedentary adults. However, little is known about its efficacy in reducing arterial stiffness in chronic stroke. [Subjects and Methods] Six participants with chronic stroke were randomly assigned to 4 weeks of WBV training or control followed by cross-over after a 2-week washout period. WBV intervention consisted of 3 sessions of 5 min intermittent WBV per week for 4 weeks. Arterial stiffness (carotid arterial stiffness, pulse wave velocity [PWV], pulse and wave analysis [PWA]) were measured before/after each intervention. [Results] No significant improvements were reported with respect to carotid arterial stiffness, PWV, and PWA between WBV and control. However, carotid arterial stiffness showed a decrease over time following WBV compared to control, but this was not significant. [Conclusion] Three days/week for 4 weeks of WBV seems too short to elicit appropriate changes in arterial stiffness in chronic stroke. However, no adverse effects were reported, indicating that WBV is a safe and acceptable exercise modality for people with chronic stroke.

  6. Associations of metabolic variables with arterial stiffness in type 2 diabetes mellitus : focus on insulin sensitivity and postprandial triglyceridaemia

    NARCIS (Netherlands)

    van Dijk, RAJM; Bakker, SJL; Scheffer, PG; Heine, RJ; Stehouwer, CDA

    2003-01-01

    Background Type 2 diabetes mellitus is associated with an increased risk of atherothrombotic disease, which may in part be mediated through increased arterial stiffness. We investigated to what extent increased arterial stiffness is associated with cardiovascular risk factors that commonly cluster i

  7. Meta analysis of the changes of arterial stiffness of hypertension patients with CCB or ARB

    Institute of Scientific and Technical Information of China (English)

    张艺军

    2013-01-01

    Objective To evaluate the differences of the changes of arterial stiffness of hypertension patients with the treatment of calcium channel blocker(CCB) or angiotensin Ⅱ receptor blocker(ARB). Methods Based on the principles of evidence-based medicine,corresponding inclusion

  8. Etiology of End-Stage Renal Disease and Arterial Stiffness among Hemodialysis Patients

    Directory of Open Access Journals (Sweden)

    Balsam El Ghoul

    2017-01-01

    Full Text Available Background. Prior studies have demonstrated that conventional and emerging CV risk factors are associated with worsening arterial stiffness among end-stage renal disease (ESRD patients on hemodialysis. The present cross-sectional study evaluates the association between the etiology of ESRD and arterial stiffness among a cohort of hemodialysis patients. Methods. Etiology of ESRD was identified from patients’ medical records and classified as either vascular renal disease, diabetic nephropathy, nondiabetic glomerulopathy, tubular interstitial nephropathy, hereditary nephropathy, or ESRD of unconfirmed etiology. Results. A total of 82 subjects were enrolled. cfPWV was independently associated with the composite of either diabetic nephropathy or vascular renal disease (p=0.022, pulse pressure (p=0.001, and a history of CV events (p=0.025, but not history of hypertension or diabetes mellitus alone. The median cfPWVs in diabetic nephropathy and vascular renal disease were comparable and significantly higher than median cfPWVs in other etiologies of ESRD. Conclusion. The study suggests that the etiology of ESRD is independently associated with arterial stiffness among hemodialysis patients. Furthermore, arterial stiffness was higher among patients who developed renal sequelae of either diabetes mellitus or hypertension as compared with those who have a history of either diabetes mellitus or hypertension alone.

  9. Association between airway obstruction and peripheral arterial stiffness in elderly patients with chronic obstructive pulmonary disease

    Institute of Scientific and Technical Information of China (English)

    付志方

    2014-01-01

    Objective To evaluate the relationship between se-verity of airway obstruction and peripheral arterial stiffness in patients with chronic obstructive pulmonary disease(COPD).Methods 81 COPD patients[aged(78.32±6.98)yrs,73 males,8 females]from Jan2008 to Oct 2012 were enrolled in Geriatric Department

  10. Treatment with continuous subcutaneous insulin infusion is associated with lower arterial stiffness

    DEFF Research Database (Denmark)

    Vestergaard Rosenlund, Signe; Theilade, Simone; Hansen, Tine Willum;

    2014-01-01

    AIMS: To investigate the relationship between arterial stiffness and insulin treatment mode [continuous subcutaneous insulin infusion (CSII) versus multiple daily injections (MDI)] in type 1 diabetes patients. METHODS: Cross-sectional study, from 2009 to 2011, including 601 Caucasian type 1...

  11. A decreased level of serum soluble Klotho is an independent biomarker associated with arterial stiffness in patients with chronic kidney disease.

    Directory of Open Access Journals (Sweden)

    Masashi Kitagawa

    Full Text Available BACKGROUND: Klotho was originally identified in a mutant mouse strain unable to express the gene that consequently showed shortened life spans. In humans, low serum Klotho levels are related to the prevalence of cardiovascular diseases in community-dwelling adults. However, it is unclear whether the serum Klotho levels are associated with signs of vascular dysfunction such as arterial stiffness, a major determinant of prognosis, in human subjects with chronic kidney disease (CKD. METHODS: We determined the levels of serum soluble Klotho in 114 patients with CKD using ELISA and investigated the relationship between the level of Klotho and markers of CKD-mineral and bone disorder (CKD-MBD and various types of vascular dysfunction, including flow-mediated dilatation, a marker of endothelial dysfunction, ankle-brachial pulse wave velocity (baPWV, a marker of arterial stiffness, intima-media thickness (IMT, a marker of atherosclerosis, and the aortic calcification index (ACI, a marker of vascular calcification. RESULTS: The serum Klotho level significantly correlated with the 1,25-dihydroxyvitamin D level and inversely correlated with the parathyroid hormone level and the fractional excretion of phosphate. There were significant decreases in serum Klotho in patients with arterial stiffness defined as baPWV≥1400 cm/sec, atherosclerosis defined as maximum IMT≥1.1 mm and vascular calcification scores of ACI>0%. The serum Klotho level was a significant determinant of arterial stiffness, but not endothelial dysfunction, atherosclerosis or vascular calcification, in the multivariate analysis in either metabolic model, the CKD model or the CKD-MBD model. The adjusted odds ratio of serum Klotho for the baPWV was 0.60 (p = 0.0075. CONCLUSIONS: Decreases in the serum soluble Klotho levels are independently associated with signs of vascular dysfunction such as arterial stiffness in patients with CKD. Further research exploring whether therapeutic approaches

  12. Benidipine has effects similar to losartan on the central blood pressure and arterial stiffness in mild to moderate essential hypertension

    Institute of Scientific and Technical Information of China (English)

    Sang-Hyun Ihm; Hui-Kyung Jeon; Shung Chull Chae; Do-Sun Lim; Kee-Sik Kim; Dong-Ju Choi; Jong-Won Ha

    2013-01-01

    Background Central blood pressure (BP) is pathophysiologically more important than peripheral BP for the pathogenesis of cardiovascular disease.Arterial stiffness is also a good predictor of cardiovascular morbidity and mortality.The effects of benidipine,a unique dual L-/T-type calcium channel blocker,on central BP have not been reported.This study aimed to compare the effect of benidipine and losartan on the central BP and arterial stiffness in mild to moderate essential hypertensives.Methods This 24 weeks,multi-center,open label,randomized,active drug comparative,parallel group study was designed as a non-inferiority study.The eligible patients (n=200) were randomly assigned to receive benidipine (n=101)or losartan (n=99).Radial artery applanation tonometry and pulse wave analysis were used to measure the central BP,pulse wave velocity (PWV) and augmentation index (Alx).We also measured the metabolic and inflammatory markers.Results After 24 weeks,the central BP decreased significantly from baseline by (16.8+14.0/10.5+9.2) mmHg (1mmHg =0.133 kPa) (systolic/diastolic BP; P <0.001) in benidipine group and (18.9+14.7/12.1+10.2) mmHg (P <0.001)in losartan group respectively.Both benidipine and losartan groups significantly lowered peripheral BP (P <0.001) and Alx (P <0.05),but there were no significant differences between the two groups.The mean aortic,brachial and femoral PWV did not change in both groups after 24-week treatment.There were no significant changes of the blood metabolic and inflammatory biomarkers in each group.Conclusion Benidipine is as effective as losartan in lowering the central and peripheral BP,and improving arterial stiffness.

  13. Effect of passive heat stress on arterial stiffness in smokers versus non-smokers

    Science.gov (United States)

    Moyen, N. E.; Ganio, M. S.; Burchfield, J. M.; Tucker, M. A.; Gonzalez, M. A.; Dougherty, E. K.; Robinson, F. B.; Ridings, C. B.; Veilleux, J. C.

    2016-04-01

    In non-smokers, passive heat stress increases shear stress and vasodilation, decreasing arterial stiffness. Smokers, who reportedly have arterial dysfunction, may have similar improvements in arterial stiffness with passive heat stress. Therefore, we examined the effects of an acute bout of whole-body passive heat stress on arterial stiffness in smokers vs. non-smokers. Thirteen smokers (8.8 ± 5.5 [median = 6] cigarettes per day for >4 years) and 13 non-smokers matched for age, mass, height, and exercise habits (27 ± 8 years; 78.8 ± 15.4 kg; 177.6 ± 6.7 cm) were passively heated to 1.5 °C core temperature ( T C) increase. At baseline and each 0.5 °C T C increase, peripheral (pPWV) and central pulse wave velocity (cPWV) were measured via Doppler ultrasound. No differences existed between smokers and non-smokers for any variables (all p > 0.05), except cPWV slightly increased from baseline (526.7 ± 81.7 cm · s-1) to 1.5 °C Δ T C (579.7 ± 69.8 cm · s-1; p 0.05). Changes in cPWV and pPWV during heating correlated ( p < 0.05) with baseline PWV in smokers (cPWV: r = -0.59; pPWV: r = -0.62) and non-smokers (cPWV: r = -0.45; pPWV: r = -0.77). Independent of smoking status, baseline stiffness appears to mediate the magnitude of heating-induced changes in arterial stiffness.

  14. Roles of Arterial Stiffness and Blood Pressure in Hypertension-Associated Cognitive Decline in Healthy Adults.

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    Hajjar, Ihab; Goldstein, Felicia C; Martin, Greg S; Quyyumi, Arshed A

    2016-01-01

    Although there is strong evidence that hypertension leads to cognitive decline, especially in the executive domain, the relationship between blood pressure and cognition has been conflicted. Hypertension is characterized by blood pressure elevation and increased arterial stiffness. We aimed at investigating whether arterial stiffness would be superior to blood pressure in predicting cognitive decline and explaining the hypertension-executive decline association. A randomly selected asymptomatic population (n=591, age=49.2 years, 70% women, 27% black, and education=18 years) underwent annual vascular and cognitive assessments. Cognition was assessed using computerized versions commonly used cognitive tests, and principal component analysis was used for deriving cognitive scores for executive function, memory, and working memory. Arterial stiffness was measured by carotid-femoral pulse wave velocity (PWV). Higher PWV, but not blood pressure, was associated with a steeper decline in executive (P=0.0002), memory (P=0.05), and working memory (P=0.02) scores after adjusting for demographics, education, and baseline cognitive performance. This remained true after adjusting for hypertension. Hypertension was associated with greater decline in executive score (P=0.0029) and those with combined hypertension and elevated PWV (>7 m/s) had the greatest decline in executive score (P value hypertension×PWV=0.02). PWV explained the association between hypertension and executive function (P value for hypertension=0.0029 versus 0.24 when adjusting for PWV). In healthy adults, increased arterial stiffness is superior to blood pressure in predicting cognitive decline in all domains and in explaining the hypertension-executive function association. Arterial stiffness, especially in hypertension, may be a target in the prevention of cognitive decline.

  15. Association of arterial stiffness with coronary flow reserve in revascularized coronary artery disease patients

    Institute of Scientific and Technical Information of China (English)

    Vlassis Tritakis; Stavros Tzortzis; Ignatios Ikonomidis; Kleanthi Dima; Georgios Pavlidis; Paraskevi Trivilou; Ioannis Paraskevaidis; Giorgos Katsimaglis; John Parissis; John Lekakis

    2016-01-01

    AIM: To investigate the association of arterial wave reflection with coronary flow reserve(CFR) in coronary artery disease(CAD) patients after successful revascularization.METHODS: We assessed 70 patients with angiographically documented CAD who had undergone recent successful revascularization. We measured(1) reactive hyperemia index(RHI) using fingertip peripheral arterial tonometry(RH-PAT Endo-PAT);(2) carotid to femoral pulse wave velocity(PWVc-Complior);(3) augmentation index(AIx), the diastolic area(DAI%) and diastolic reflection area(DRA) of the central aortic pulse wave(Arteriograph);(4) CFR using Doppler echocardiography; and(5) blood levels of lipoprotein-phospholipase A2(LpPLA2).RESULTS: After adjustment for age, sex, blood pressure parameter, lipidemic, diabetic and smoking status, we found that coronary flow reserve was independently related to AIx(b =-0.38, r = 0.009), DAI(b = 0.36, P = 0.014), DRA(b = 0.39, P = 0.005) and RT(b =-0.29,P = 0.026). Additionally, patients with CFR < 2.5 had higher PWVc(11.6 ± 2.3 vs 10.2 ± 1.4 m/s, P = 0.019), SBPc(139.1 ± 17.8 vs 125.2 ± 19.1 mm Hg, P = 0.026), AIx(38.2% ± 14.8% vs 29.4% ± 15.1%, P = 0.011) and lower RHI(1.26 ± 0.28 vs 1.50 ± 0.46, P = 0.012), DAI(44.3% ± 7.9% vs 53.9% ± 6.7%, P = 0.008), DRA(42.2 ± 9.6 vs 51.6 ± 11.4, P = 0.012) and Lp PLA2(268.1 ± 91.9 vs 199.5 ± 78.4 ng/m L, P = 0.002) compared with those with CFR ≥ 2.5. Elevated Lp PLA2 was related with reduced CFR(r =-0.33, P = 0.001), RHI(r =-0.37, P < 0.001) and DRA(r =-0.35, P = 0.001) as well as increased PWVc(r = 0.34, P = 0.012) and AIx(r = 0.34, P = 0.001). CONCLUSION: Abnormal arterial wave reflections are related with impaired coronary flow reserve despite successful revascularization in CAD patients. There is a common inflammatory link between impaired aortic wall properties, endothelial dysfunction and coronary flow impairment in CAD.

  16. Combination treatment of rosuvastatin or atorvastatin, with regular exercise improves arterial wall stiffness in patients with coronary artery disease.

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    Kensuke Toyama

    Full Text Available OBJECTIVE: Statin- and exercise-therapy are both clinically beneficial by preventing cardiovascular events in patients with coronary artery disease (CAD. However, there is no information on the vascular effects of the combination of statins and exercise on arterial wall stiffness in CAD patients. METHODS: The present study is a sub-analysis of PRESET study that determined the effects of 20-week treatment with statins (rosuvastatin, n=14, atorvastatin, n=14 combined with regular exercise on arterial wall stiffness assessed by measurement of brachial and ankle pulse wave velocity (baPWV in CAD patients. RESULTS: The combination of statins and regular exercise significantly improved exercise capacity, lipid profile, including low- and high-density lipoprotein cholesterol, and high-sensitivity C-reactive protein (hs-CRP, baPWV (baseline: 1747 ± 355, at 20 weeks of treatment: 1627 ± 271 cm/s, p=0.008, and basophil count (baseline: 42 ± 32, 20 weeks: 26 ± 15 cells/µL, p=0.007, but had no effect on blood pressure (baseline: 125 ± 22, 20 weeks: 121 ± 16 mmHg. Changes in baPWV correlated significantly with changes in basophil count (r=0.488, p=0.008, but not with age, lipids profile, exercise capacity, or hs-CRP. CONCLUSION: In CAD patients, the combination treatment with statins and exercise resulted in significant amelioration of arterial wall stiffness, at least in part, through reduction of circulating basophils.

  17. The Association of Endothelin-1 with Markers of Arterial Stiffness in Black South African Women: The SABPA Study

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    Christine Susara du Plooy

    2015-01-01

    Full Text Available Background. Limited data exist regarding endothelin-1 (ET-1, a vasoactive contributor in vascular tone, in a population subjected to early vascular deterioration. We compared ET-1 levels and explored its association with markers of arterial stiffness in black and white South Africans. Methodology. This cross-sectional substudy included 195 black (men: n=99; women: n=95 and 197 white (men: n=99; women: n=98 South Africans. Serum ET-1 levels were measured as well as markers of arterial stiffness (blood pressure, pulse wave velocity, and arterial compliance. ET-1 levels were higher in black men and white women compared to their counterparts after adjusting for C-reactive protein. In both single and partial (adjusting for body mass index and gamma glutamyl transferase regression analyses ET-1 correlated with age, interleukin-6, high density lipoprotein cholesterol, systolic blood pressure, pulse pressure, and pulse wave velocity in black women. In multivariate regression analyses the independent association of ET-1 with systolic blood pressure (Adj. R2=0.13; β=0.28, p<0.01 and pulse pressure (Adj. R2=0.11; β=0.27, p<0.01 was confirmed in black women only. ET-1 additionally associated with interleukin-6 in black women (p<0.01. Conclusion. Our result suggests that ET-1 and its link with subclinical arteriosclerosis are potentially driven by low-grade inflammation as depicted by the association with interleukin-6 in the black female cohort.

  18. Increased arterial stiffness and extracellular matrix reorganization in intrauterine growth–restricted fetal sheep

    Science.gov (United States)

    Dodson, Reuben Blair; Rozance, Paul J.; Fleenor, Bradley S.; Petrash, Carson C.; Shoemaker, Lauren G.; Hunter, Kendall S.; Ferguson, Virginia L.

    2013-01-01

    BACKGROUND Fetal intrauterine growth restriction (IUGR) results in increased placental resistance to blood flow, fetal hypertension, and increased pulsatility stresses shown to lead to vascular remodeling. We tested our hypothesis that IUGR causes decreased compliance in the carotid and umbilical arteries due to altered extracellular matrix (ECM) composition and structure. METHODS A sheep model of placental insufficiency–induced IUGR (PI-IUGR) was created by exposure of the pregnant ewe to elevated ambient temperatures. Umbilical and carotid arteries from near-term fetuses were tested with pressure–diameter measurements to compare passive compliance in control and PI-IUGR tissues. ECM composition was measured via biochemical assay, and the organization was determined by using histology and second-harmonic generation imaging. RESULTS We found that PI-IUGR increased arterial stiffness with increased collagen engagement, or transition stretch. PI-IUGR carotid arteries exhibited increased collagen and elastin quantity, and PI-IUGR umbilical arteries exhibited increased sulfated glycosaminoglycans. Histomorphology showed altered collagen-to-elastin ratios with altered cellular proliferation. Increased stiffness indicates altered collagen-to-elastin ratios with less elastin contribution leading to increased collagen engagement. CONCLUSION Because vessel stiffness is a significant predictor in the development of hypertension, disrupted ECM deposition in IUGR provides a potential link between IUGR and adult hypertension. PMID:23154756

  19. Metabolic syndrome is associated with change in subclinical arterial stiffness - A community-based Taichung Community Health Study

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    Lin Wen-Yuan

    2011-10-01

    Full Text Available Abstract Background The aim of this study was to evaluate the effect of MetS on arterial stiffness in a longitudinal study. Methods Brachial-ankle pulse wave velocity (baPWV, a measurement interpreted as arterial stiffness, was measured in 1518 community-dwelling persons at baseline and re-examined within a mean follow-up period of 3 years. Multivariate linear regression with generalized estimating equations (GEE were used to examine the longitudinal relationship between MetS and its individual components and baPWV, while multivariate logistic regression with GEE was used to examine the longitudinal relationship between MetS and its individual components and the high risk group with arterial stiffness. Results Subjects with MetS showed significantly greater baPWV at the end point than those without MetS, after adjusting for age, gender, education, hypertension medication and mean arterial pressure (MAP. MetS was associated with the top quartile of baPWV (the high-risk group of arterial stiffness, adjusted odds ratio [95% confidence interval] 1.52 [1.21-1.90], and a significant linear trend of risk for the number of components of MetS was found (p for trend Conclusions MetS affects the subject's progression to arterial stiffness. Arterial stiffness increased as the number of MetS components increased. Management of MetS is important for preventing the progression to advanced arterial stiffness.

  20. Effect of Simvastatin on Arterial Stiffness in Patients with Statin Myalgia

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    Kevin D. Ballard

    2015-01-01

    Full Text Available Statins reduce arterial stiffness but are also associated with mild muscle complaints. It is unclear whether individuals with muscle symptoms experience the same vascular benefit or whether statins affect striated and smooth muscle cells differently. We examined the effect of simvastatin treatment on arterial stiffness in patients who did versus those who did not exhibit muscle symptoms. Patients with a history of statin-related muscle complaints (n=115 completed an 8 wk randomized, double-blind, cross-over trial of daily simvastatin 20 mg and placebo. Serum lipids and pulse wave velocity (PWV were assessed before and after each treatment. Muscle symptoms with daily simvastatin treatment were reported by 38 patients (33%. Compared to baseline, central PWV decreased (P=0.01 following simvastatin treatment but not placebo (drug ∗ time interaction: P=0.047. Changes in central PWV with simvastatin treatment were not influenced by myalgia status or time on simvastatin (P≥0.15. Change in central PWV after simvastatin treatment was inversely correlated with age (r=-0.207, P=0.030, suggesting that advancing age is associated with enhanced statin-mediated arterial destiffening. In patients with a history of statin-related muscle complaints, the development of myalgia with short-term simvastatin treatment did not attenuate the improvement in arterial stiffness.

  1. A new dimensionless index for evaluating cell stiffness-based deformability in microchannel.

    Science.gov (United States)

    Tsai, Chia-Hung Dylan; Sakuma, Shinya; Arai, Fumihito; Kaneko, Makoto

    2014-04-01

    This paper proposes a new index for evaluating the stiffness-based deformability of a cell using a microchannel. In conventional approaches, the transit time of a cell through a microchannel is often utilized for the evaluation of cell deformability. However, such time includes both the information of cell stiffness and viscosity. In this paper, we eliminate the effect from cell viscosity, and focus on the cell stiffness only. We find that the velocity of a cell varies when it enters a channel, and eventually reaches to equilibrium where the velocity becomes constant. The constant velocity is defined as the equilibrium velocity of the cell, and it is utilized to define the observability of stiffness-based deformability. The necessary and sufficient numbers of sensing points for evaluating stiffness-based deformability are discussed. Through the dimensional analysis on the microchannel system, three dimensionless parameters determining stiffness-based deformability are derived, and a new index is introduced based on these parameters. The experimental study is conducted on the red blood cells from a healthy subject and a diabetes patient. With the proposed index, we showed that the experimental data can be nicely arranged.

  2. Application of a four-channel vibrometer system for detection of arterial stiffness

    Science.gov (United States)

    Campo, Adriaan; Waz, Adam; Dudzik, Grzegorz; Dirckx, Joris; Abramski, Krzysztof

    2016-06-01

    Cardiovascular diseases (CD) are the most important cause of death in the world and their prevalence is only rising. A significant aspect in the etiology of CD is the stiffening of the large arteries (arteriosclerosis) and plaque formation (atherosclerosis) in the common carotid artery (CCA) in the neck. As shown by increasing evidence, both conditions can be detected by assessing pulse wave velocity (PWV) in the CCA, and several approaches allow local detection of PWV, including ultrasound (US) and magnetic resonance imaging (MRI). In previous studies, laser Doppler vibrometry (LDV) was introduced as an approach to assess arterial stiffness. In the present work, a new, compact four-channel LDV system is used for PWV detection in four phantom arteries mimicking real life CCA conditions. The high sensitivity of the LDV system allowed PWV to be assessed, and even local changes in phantom architecture could be detected. This method has potential for cardiovascular screening, as it allows arteriosclerosis assessment and plaque detection.

  3. Arterial stiffness and enlargement in mild-to-moderate chronic kidney disease.

    Science.gov (United States)

    Briet, M; Bozec, E; Laurent, S; Fassot, C; London, G M; Jacquot, C; Froissart, M; Houillier, P; Boutouyrie, P

    2006-01-01

    Chronic kidney disease (CKD) is associated with an increased risk of cardiovascular morbidity and mortality. Arterial stiffness and remodeling have been well documented in patients with end-stage renal disease, but little is known about arterial phenotype in CKD patients with moderate reduction in glomerular filtration rate (GFR). In total, 95 patients (58+/-15 years, mean+/-s.d.) with CKD and GFR measured by renal clearance of (51)Cr-ethylenediaminetetraacetate were compared to 121 hypertensive patients without CKD (59+/-11 years), and 57 normotensive subjects (56+/-6 years). Common carotid artery diameter, intima-media thickness (IMT), distensibility, and Young's elastic modulus were noninvasively determined with a high-definition echotracking system. Patients with CKD had a significantly larger carotid internal diameter than in hypertensives and normotensives (6.32+/-1.05, 5.84+/-0.74, and 5.50+/-0.64 m x 10(-3), respectively; Pelastic modulus did not significantly differ between CKD and hypertensives; normotensives had significantly higher distensibility and lower elastic modulus than CKD and hypertensive patients. Carotid-femoral pulse wave velocity was significantly higher in CKD patients than in hypertensives and normotensives. In multivariate analyses either involving the entire population or restricted to CKD patients, GFR was independently and strongly related to carotid diameter and elastic modulus. Arterial enlargement and increased arterial stiffness occur in parallel with the decline in renal function in patients with mild-to-moderate CKD.

  4. Longitudinal perspective on the conundrum of central arterial stiffness, blood pressure, and aging.

    Science.gov (United States)

    Scuteri, Angelo; Morrell, Christopher H; Orrù, Marco; Strait, James B; Tarasov, Kirill V; Ferreli, Liana Anna Pina; Loi, Francesco; Pilia, Maria Grazia; Delitala, Alessandro; Spurgeon, Harold; Najjar, Samer S; AlGhatrif, Majd; Lakatta, Edward G

    2014-12-01

    The age-associated increase in arterial stiffness has long been considered to parallel or to cause the age-associated increase in blood pressure (BP). Yet, the rates at which pulse wave velocity (PWV), a measure of arterial stiffness, and BP trajectories change over time within individuals who differ by age and sex have not been assessed and compared. This study determined the evolution of BP and aortic PWV trajectories during a 9.4-year follow-up in >4000 community-dwelling men and women of 20 to 100 years of age at entry into the SardiNIA Study. Linear mixed effects model analyses revealed that PWV accelerates with time during the observation period, at about the same rate over the entire age range in both men and women. In men, the longitudinal rate at which BP changed over time, however, did not generally parallel that of PWV acceleration: at ages>40 years the rates of change in systolic BP (SBP) and pulse pressure (PP) increase plateaued and then declined so that SBP, itself, also declined at older ages, whereas PP plateaued. In women, SBP, diastolic BP, and mean BP increased at constant rates across all ages, producing an increasing rate of increase in PP. Therefore, increased aortic stiffness is implicated in the age-associated increase in SBP and PP. These findings indicate that PWV is not a surrogate for BP and that arterial properties other than arterial wall stiffness that vary by age and sex also modulate the BP trajectories during aging and lead to the dissociation of PWV, PP, and SBP trajectories in men.

  5. Comparison of markers of oxidative stress, inflammation and arterial stiffness between incident hemodialysis and peritoneal dialysis patients – an observational study

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    Ratanjee Sharad

    2009-03-01

    Full Text Available Abstract Background Patients on peritoneal and hemodialysis have accelerated atherosclerosis associated with an increase in cardiovascular morbidity and mortality. The atherosclerosis is associated with increased arterial stiffness, endothelial dysfunction and elevated oxidative stress and inflammation. The aims of this study are to investigate the effects of peritoneal and hemodialysis on arterial stiffness, vascular function, myocardial structure and function, oxidative stress and inflammation in incident patients with end stage kidney disease. Methods This is an observational study. Eighty stage five CKD patients will be enrolled and followed for one-year. Primary outcome measures will be changes in 1 arterial stiffness measured by aortic pulse wave velocity, 2 oxidative stress assessed by plasma F2 isoprostanes and 3 inflammation measured by plasma pentraxin-3. Secondary outcomes will include additional measures of oxidative stress and inflammation, changes in vascular function assessed using the brachial artery reactivity technique, carotid artery intimal medial thickness, augmentation index and trans thoracic echocardiography to assess left ventricular geometry, and systolic and diastolic function. Patients will undergo these measures at baseline (6–8 weeks prior to starting dialysis therapy, then at six and 12 months after starting dialysis. Discussion The results of this study may guide the choice of dialysis modality in the first year of treatment. It may also lead to a larger study prospectively assessing the effect of dialysis modality on cardiovascular morbidity and mortality. Trial Registration ACTRN12609000049279

  6. Association between arterial stiffness and left ventricular diastolic function in relation to gender and age

    Science.gov (United States)

    Kim, Hack-Lyoung; Lim, Woo-Hyun; Seo, Jae-Bin; Chung, Woo-Young; Kim, Sang-Hyun; Kim, Myung-A.; Zo, Joo-Hee

    2017-01-01

    Abstract Left ventricular (LV) diastolic dysfunction and subsequent overt heart failure are more prevalent in elderly women. Close interaction between arterial stiffness and LV morphology/function has been reported. The aim of this study was to investigate whether there is an age- and gender-dependent relationship between arterial stiffness and LV diastolic function. A total of 819 subjects (58.6 ± 13.3 years, 50.2% men) without structural heart disease (LV ejection fraction ≥50%) were retrospectively analyzed. All participants underwent transthoracic echocardiography and brachial-ankle pulse wave velocity (baPWV) measurement on the same day. The association of baPWV with septal e′ velocity and average E/e′ was assessed. In the total study subjects, baPWV was negatively correlated with septal e′ velocity (r = 0.383, P  0.05 for each). In conclusion, baPWV was independently associated with septal e′ velocity and E/e′ in elderly women but not in younger women or men. The results of this study provide additional evidence that increased arterial stiffness plays an important role in the development of heart failure with preserved ejection fraction as well as LV diastolic dysfunction in elderly women. PMID:28072727

  7. Association between peroxisome proliferator-activated receptor gene single nucleotide polymorphisms and arterial stiffness in adult Chinese population

    Institute of Scientific and Technical Information of China (English)

    许如意

    2013-01-01

    Objective To analyze the association between single nucleotide polymorphisms(SNPs) of peroxisome proliferator-activated receptor(PPAR)and arterial stiffness in adult Chinese population(>50 years).Methods

  8. Arterial stiffness and endothelial dysfunction independently and synergistically predict cardiovascular and renal outcome in patients with type 1 diabetes

    DEFF Research Database (Denmark)

    Theilade, S; Lajer, Maria Stenkil; Jorsal, Anders;

    2012-01-01

    To evaluate whether pulse pressure alone or with placental growth factor as estimates of arterial stiffness and endothelial dysfunction, predicts mortality, cardiovascular disease and progression to end-stage renal disease in patients with Type 1 diabetes.......To evaluate whether pulse pressure alone or with placental growth factor as estimates of arterial stiffness and endothelial dysfunction, predicts mortality, cardiovascular disease and progression to end-stage renal disease in patients with Type 1 diabetes....

  9. A cohort evaluation on arterial stiffness and hypertensive disorders in pregnancy

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    Lim Wai Yee

    2012-12-01

    Full Text Available Abstract Background Hypertensive disorders in pregnancy are associated with systemic endothelial dysfunction leading to impaired physiological vasodilation. Recent evidence has shown central aortic pressures obtained through pulse wave analysis, at less than 14 weeks of gestation, to be predictive of pre-eclampsia. In light of this, we aimed to evaluate the role of central aortic stiffness in the prediction and discrimination of hypertensive disorders in pregnancy. Methods A cohort study of women with viable, singleton pregnancies at less than 14 weeks of amenorrhoea, and without multiple pregnancies, autoimmune or renal disease, diagnosed with aneuploidy or fetal anomaly will be recruited from a single maternity hospital and followed up till delivery and puerperium. A targeted sample size of 1000 eligible pregnant women will be enrolled into the study from antenatal clinics. Main exposure under study is central aortic pulse pressure using radial pulse wave recording, and the outcomes under follow-up are gestational hypertension and pre-eclampsia. Other measures include lifestyle factors such as smoking, physical exercise, psychometric evaluations, vasoactive factors, uterine artery pulsatility index, height and weight measurements. These measures will be repeated over 4 antenatal visits at 11-14, 18-22, 28-32 and above 34 weeks of gestation. Double data entry will be performed on Microsoft Access, and analysis of data will include the use of random effect models and receiver operating characteristic curves on Stata 11.2. Discussion The proposed study design will enable a longitudinal evaluation of the central aortic pressure changes as a marker for vascular compliance during pregnancy. As measures are repeated over time, the timing and severity of changes are detectable, and findings may yield important information on how aberrant vascular responses occur and its role in the early detection and prediction of hypertensive disorders.

  10. Association of circulating omentin-1 level with arterial stiffness and carotid plaque in type 2 diabetes

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    Yoo Hye

    2011-11-01

    Full Text Available Abstract Background Adipokines contribute directly to the atherosclerotic process, connecting metabolic disorders such as obesity and diabetes to cardiovascular disease. Omentin-1 is a recently discovered novel adipokine, so data about the relationship of this adipokine to vascular health in type 2 diabetes is limited. Methods We enrolled 60 people with type 2 diabetes, with or without carotid plaque, and 30 participants with normal glucose tolerance. We measured serum omentin-1, high-sensitivity C-reactive protein (hsCRP levels, and the homeostasis model assessment of insulin resistance (HOMA-IR, as well as other cardiovascular risk factors. Vascular health was assessed by brachial ankle pulse wave velocity (baPWV and carotid intima-media thickness (IMT. Results Serum omentin-1 levels were significantly decreased in type 2 diabetes patients compared to normal glucose controls and was further reduced in type 2 diabetes patients with carotid plaque compared to those without carotid plaque. Multiple stepwise regression analysis showed that age, systolic blood pressure, history of use of statins, angiotensin receptor blockers or angiotensin-converting enzyme inhibitors, and serum omentin-1 level were independent factors determining baPWV in people with type 2 diabetes (r2 = 0.637. Furthermore, in multivariate logistic regression analysis, circulating omentin-1 level was an independent decisive factor for the presence of carotid plaque in type 2 diabetes patients, even after adjusting for age, gender, body mass index, systolic blood pressure, fasting blood glucose, low density lipoprotein cholesterol, and history of smoking and medication (odds ratio, 0.621; 95% confidence interval, 0.420-0.919; P = 0.017. Conclusions Circulating omentin-1 level was independently correlated with arterial stiffness and carotid plaque in type 2 diabetes, even after adjusting for other cardiovascular risk factors and detailed medication history.

  11. The Relationship Between Osteoprotegerin/RANKL Axis and Arterial Stiffness in Osteopenic/Osteoporotic Renal Transplantation Recipients

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    İsmail KOÇYIĞI

    2015-09-01

    Full Text Available OBJECTIVE: Cardiovascular diseases are the main reason of death in patients with renal transplantation (Rtx. Osteoprotegerin (OPG is produced by osteoblasts and is linked to increased cardiovascular risk in Rtx. OPG acts as a decoy receptor binding receptor activator of nuclear factor kappa-B ligand (RANKL and this interaction plays a role in bone resorption and vascular function. This study aimed to investigate the relation between OPG, RANKL, osteoporosis and arterial stiffness in Rtx patients. MATERIAL and METHODS: This cross-sectional study included 80 adult Rtx recipients. Femoral neck mineral density was obtained by dual-energy X-ray absorptiometry. Serum OPG and RANKL were measured by the ELISA method. Pulse-wave analysis was measured in the carotid and femoral arteries using a pulse wave velocity (PWV machine. RESULTS: Patients were divided into two groups as normal (n:24 and osteopenia/osteoporosis group (n:56. Body mass index was significantly lower in the osteopenic/osteoporotic group compared to the normal group. Pulse wave velocity was positively correlated with age (r:0.204,p:0.072, osteoprotegerin (r:0.219,p:0.052, calcium x phosphate product (r:0.605,p:<0.001, and systolic blood pressure (r:0.198,p:0.058 and negatively correlated with RANKL (r:-0.261,p:0.020 and creatinine clearance (r:-0.220,p:0.051. PWV was independently predicted by calcium x phosphate product but not creatinine clearance, RANKL, osteoprotegerin and systolic blood pressure. CONCLUSION: In our study, serum calcium x phosphate product but not OPG and RANKL levels were found to be the main predictor of arterial stiffness in Rtx patients.

  12. The Effect of High Dose Cholecalciferol on Arterial Stiffness and Peripheral and Central Blood Pressure in Healthy Humans

    DEFF Research Database (Denmark)

    Bressendorff, Iain; Brandi, Lisbet; Schou, Morten

    2016-01-01

    and blood pressure in healthy normotensive adults. METHODS: 40 healthy adults were randomised in this double-blinded study to either oral cholecalciferol 3000 IU/day or matching placebo and were followed for 16 weeks to examine any effects on pulse wave velocity (PWV), augmentation index (AIx), peripheral...... and central blood pressure and 24-hour ambulatory blood pressure. RESULTS: 22 subjects in the cholecalciferol arm and 18 subjects in the placebo arm completed the 16 weeks of follow-up. There was no difference in changes in PWV, AIx corrected for heart rate or central or peripheral blood pressure between...... the two groups. There was no correlation between serum 25-hydroxy vitamin D and any of these parameters. CONCLUSIONS: Oral cholecalciferol 3000 IU/day does not affect arterial stiffness or blood pressure after 16 weeks of treatment in healthy normotensive adults. TRIAL REGISTRATION: ClinicalTrials.gov NCT...

  13. Metabolomic profiles of lipid metabolism, arterial stiffness and hemodynamics in male coronary artery disease patients

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    Kaido Paapstel

    2016-06-01

    Conclusions: We demonstrated an independent association between the serum medium- and long-chain acylcarnitine profile and aortic stiffness for the CAD patients. In addition to the lipid-related classical CVD risk markers, the intermediates of lipid metabolism may serve as novel indicators for altered vascular function.

  14. The role of tissue renin angiotensin aldosterone system in the development of endothelial dysfunction and arterial stiffness

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    Annayya R Aroor

    2013-10-01

    Full Text Available Epidemiological studies support the notion that arterial stiffness is an independent predictor of adverse cardiovascular events contributing significantly to systolic hypertension, impaired ventricular-arterial coupling and diastolic dysfunction, impairment in myocardial oxygen supply and demand, and progression of kidney disease. Although arterial stiffness is associated with aging, it is accelerated in the presence of obesity and diabetes. The prevalence of arterial stiffness parallels the increase of obesity that is occurring in epidemic proportions and is partly driven by a sedentary life style and consumption of a high fructose, high salt and high fat western diet. Although the underlying mechanisms and mediators of arterial stiffness are not well understood, accumulating evidence supports the role of insulin resistance and endothelial dysfunction. The local tissue renin angiotensin aldosterone system (RAAS in the vascular tissue and immune cells and perivascular adipose tissue is recognized as an important element involved in endothelial dysfunction which contributes significantly to arterial stiffness. Activation of vascular RAAS is seen in humans and animal models of obesity and diabetes, and associated with enhanced oxidative stress and inflammation in the vascular tissue. The cross talk between angiotensin and aldosterone underscores the importance of mineralocorticoid receptors in modulation of insulin resistance, decreased bioavailability of nitric oxide, endothelial dysfunction and arterial stiffness. In addition, both innate and adaptive immunity are involved in this local tissue activation of RAAS. In this review we will attempt to present a unifying mechanism of how environmental and immunological factors are involved in this local tissue RAAS activation, and the role of this process in the development of endothelial dysfunction and arterial stiffness and targeting tissue RAAS activation.

  15. Sex differences in associations between insulin resistance, heart rate variability, and arterial stiffness in healthy women and men: a physiology study.

    Science.gov (United States)

    Rannelli, Luke Anthony; MacRae, Jennifer M; Mann, Michelle C; Ramesh, Sharanya; Hemmelgarn, Brenda R; Rabi, Doreen; Sola, Darlene Y; Ahmed, Sofia B

    2016-11-02

    Diabetes confers greater cardiovascular risk to women than to men. Whether insulin-resistance-mediated risk extends to the healthy population is unknown. Measures of insulin resistance (fasting insulin, homeostatic model assessment, hemoglobin A1c, quantitative insulin sensitivity check index, glucose) were determined in 48 (56% female) healthy subjects. Heart rate variability (HRV) was calculated by spectral power analysis and arterial stiffness was determined using noninvasive applanation tonometry. Both were measured at baseline and in response to angiotensin II infusion. In women, there was a non-statistically significant trend towards increasing insulin resistance being associated with an overall unfavourable HRV response and increased arterial stiffness to the stressor, while men demonstrated the opposite response. Significant differences in the associations between insulin resistance and cardiovascular physiological profile exist between healthy women and men. Further studies investigating the sex differences in the pathophysiology of insulin resistance in cardiovascular disease are warranted.

  16. Association between aerobic exercise training effects of serum adropin level, arterial stiffness, and adiposity in obese elderly adults.

    Science.gov (United States)

    Fujie, Shumpei; Hasegawa, Natsuki; Kurihara, Toshiyuki; Sanada, Kiyoshi; Hamaoka, Takafumi; Iemitsu, Motoyuki

    2017-01-01

    Serum levels of adropin, which enhances endothelial cell release of nitric oxide (NO), are lower in obese patients. Although habitual aerobic exercise reduces arterial stiffness and adiposity, the relationship between these effects and circulating levels of adropin remains unclear. The purpose of this study was to determine if serum adropin level is associated with the effects of aerobic exercise training on arterial stiffness and adiposity in obese adults. In Experiment 1, we examined whether serum adropin levels are associated with cardiorespiratory fitness, carotid β-stiffness, plasma nitrite/nitrate (NOx) level, and abdominal visceral fat in 27 normal, 20 overweight, and 25 obese adults (age, 41-79 years). In Experiment 2, we examined the effects of an 8-week aerobic exercise training program on the relationship between serum adropin level and arterial stiffness or adiposity in 13 obese adults (age, 54-76 years). Serum adropin levels in normal, overweight, and obese adults negatively correlated with carotid β-stiffness and abdominal visceral fat, and positively correlated with plasma NOx level and cardiorespiratory fitness. After the 8-week exercise program, serum adropin levels in obese adults were elevated, and correlated with training-induced changes in carotid β-stiffness (r = -0.573, P exercise training-induced increase in serum adropin may be related to the training effects of arterial stiffness and adiposity in obese adults.

  17. Relationship of serum osteoprotegerin with arterial stiffness, preclinical atherosclerosis, and disease activity in patients with ankylosing spondylitis.

    Science.gov (United States)

    Serdaroğlu Beyazal, Münevver; Erdoğan, Turan; Türkyılmaz, Aysegül Kücükali; Devrimsel, Gül; Cüre, Medine Cumhur; Beyazal, Mehmet; Sahin, Ismail

    2016-09-01

    Patients with ankylosing spondylitis (AS) reportedly have a higher mortality and morbidity risk. Osteoprotegerin (OPG) was recently defined as an important cardiovascular (CV) marker in the general population. We aimed to assess the relationship of serum OPG levels with arterial stiffness, carotid intima media thickness (CIMT), and clinical and laboratory data in AS patients. We examined 60 AS patients without CV disease or risk factors and 50 healthy controls. Disease activity was evaluated using the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) and the Ankylosing Spondylitis Disease Activity Score (ASDAS), whereas functional capacity was evaluated using the Bath Ankylosing Spondylitis Functional Index (BASFI). Serum OPG levels were measured with the enzyme-linked immunosorbent assay. Carotid-femoral pulse wave velocity (PWV) was used as an indicator of arterial stiffness, whereas CIMT (examined via carotid ultrasonography) was used to evaluate preclinical atherosclerosis. The mean serum OPG level, PWV, and CIMT were significantly higher in AS patients than in controls (106.7 ± 50.9 vs. 58.1 ± 12.7 pg/mL; 7.4 ± 1.8 vs. 6.2 ± 1.2 m/s; 0.72 ± 0.13 vs. 0.57 ± 0.07 mm, respectively; P < 0.001 for all). In AS patients, the serum OPG levels were not significantly correlated with PWV and CIMT but were significantly correlated with erthrocyte sedimentation rate, BASFI, and ASDAS. AS patients without CV disease or risk exhibited high OPG levels and increased PWV and CIMT values. Although OPG levels were not significantly correlated with PWV or CIMT, future long-term follow-up studies will help define the predictive value of OPG in these patients.

  18. Relationship between uric acid and arterial stiffness in the elderly with metabolic syndrome components

    Institute of Scientific and Technical Information of China (English)

    SUN Ning; ZHANG Yun; TIAN Jian-li; WANG Hui

    2013-01-01

    Background High uric acid (UA) levels and metabolic syndrome (MS) are risk factors for atherosclerotic diseases.Brachial-ankle pulse wave velocity (baPWV) is a valid and reproducible measurement by which to assess arterial stiffness and a surrogate marker of atherosclerosis.However,little is known about the relationship between them,especially in elderly Chinese with MS components who are at high risk for atherosclerotic diseases.Methods One thousand and twenty Chinese subjects (159 women) older than 60 years of age (mean age (70.6±5.7)years) with at least one MS component underwent routine laboratory tests,and baPWV measurements were analyzed.Results Participants were divided into four groups by MS components.The mean age did not significantly differ among the MS component groups.We found that not only the diagnostic factors (blood pressure,body mass index (BMI),lipids,glucose) of MS but also baPWV,UA,insulin,homeostasis model of assessment for insulin resistence index (HOMAIR) levels increased,and high density lipoprotein (HDL)-C decreased with an increased number of MS components (test for trend P<0.05).The association between UA and baPWV was observed after adjustment for gender,age,blood pressure,BMI,serum creatinine and high density lipoprotein,and insulin resistance (r=0.186,P<0.0001).There were increases in the odds ratios for the association between the number of components of MS,UA and baPWV,even after adjustment for traditional risk factors.However,after adjustment for insulin or HOMA-IR,there were no significant differences in the multivariate odds ratios among the number of MS components for UA.Conclusions The UA level is positively associated with baPWV and MS,but the association between UA and MS is dependent on insulin resistance.Furthermore,baPWV is independently associated with MS in our study population.

  19. Association of Insulin Resistance, Arterial Stiffness and Telomere Length in Adults Free of Cardiovascular Diseases.

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    Irina Strazhesko

    Full Text Available Chronic inflammation and oxidative stress might be considered the key mechanisms of aging. Insulin resistance (IR is a phenomenon related to inflammatory and oxidative stress. We tested the hypothesis that IR may be associated with cellular senescence, as measured by leukocyte telomere length (LTL, and arterial stiffness (core feature of arterial aging, as measured by carotid-femoral pulse wave velocity (c-f PWV.The study group included 303 subjects, mean age 51.8 ±13.3 years, free of known cardiovascular diseases and regular drug consumption. For each patient, blood pressure was measured, blood samples were available for biochemical parameters, and LTL was analyzed by real time q PCR. C-f PWV was measured with the help of SphygmoCor. SAS 9.1 was used for statistical analysis.Through multiple linear regression analysis, c-f PWV is independently and positively associated with age (p = 0.0001 and the homeostasis model assessment of insulin resistance (HOMA-IR; p = 0.0001 and independently negatively associated with LTL (p = 0.0378. HOMA-IR seems to have a stronger influence than SBP on arterial stiffness. In all subjects, age, HOMA-IR, LTL, and SBP predicted 32% of the variance in c-f PWV. LTL was inversely associated with HOMA-IR (p = 0.0001 and age (p = 0.0001. In all subjects, HOMA-IR, age, sex, and SBP predicted 16% of the variance in LTL.These data suggest that IR is associated with cell senescence and arterial aging and could, therefore, become the main target in preventing accelerated arterial aging, besides blood pressure control. Research in telomere biology may reveal new ways of estimating cardiovascular aging and risk.

  20. Early Biomarkers of Renal Damage in Relation to Arterial Stiffness and Inflammation in Male Coronary Artery Disease Patients

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    Kaido Paapstel

    2016-07-01

    Full Text Available Background/Aims: Plasma neutrophil gelatinase-associated lipocalin (NGAL, urinary liver-type fatty acid-binding protein (L-FABP and urinary kidney injury molecule-1 (KIM-1 have emerged as promising biomarkers for both acute and chronic kidney injury that also provide prognostic value for cardiovascular morbidity and mortality. Our aim was to evaluate their relationships with arterial stiffness and inflammation in coronary artery disease (CAD patients and in clinically healthy controls. Methods: We studied 52 patients with CAD (age 63.2 ± 9.2 years and 41 healthy controls (age 60.1 ± 7.2 years. Urinary L-FABP and KIM-1 as well as serum NGAL, adiponectin and resistin levels were measured using the enzyme-linked immunosorbent assay method. The technique of applanation tonometry was used for non-invasive pulse wave analysis and pulse wave velocity assessments. Results: Urinary L-FABP and KIM-1 were independent determinants of cf-PWV for the CAD patients (R2=0.584, Pr=0.31, P=0.028 only for the patients, while NGAL correlated with WBC count (rho=0.29, P=0.038; r=0.35, P=0.029 and resistin (rho=0.60, PConclusion: Our findings suggest that urinary L-FABP and KIM-1 may be independently associated with aortic stiffness in individuals with CAD.

  1. Cardiac Organ Damage and Arterial Stiffness in Autonomic Failure: Comparison With Essential Hypertension.

    Science.gov (United States)

    Milazzo, Valeria; Maule, Simona; Di Stefano, Cristina; Tosello, Francesco; Totaro, Silvia; Veglio, Franco; Milan, Alberto

    2015-12-01

    Autonomic failure (AF) is characterized by orthostatic hypotension, supine hypertension, and increased blood pressure (BP) variability. AF patients develop cardiac organ damage, similarly to essential hypertension (EH), and have higher arterial stiffness than healthy controls. Determinants of cardiovascular organ damage in AF are not well known: both BP variability and mean BP values may be involved. The aim of the study was to evaluate cardiac organ damage, arterial stiffness, and central hemodynamics in AF, compared with EH subjects with similar 24-hour BP and a group of healthy controls, and to evaluate determinants of target organ damage in patients with AF. Twenty-seven patients with primary AF were studied (mean age, 65.7±11.2 years) using transthoracic echocardiography, carotid-femoral pulse wave velocity, central hemodynamics, and 24-hour ambulatory BP monitoring. They were compared with 27 EH subjects matched for age, sex, and 24-hour mean BP and with 27 healthy controls. AF and EH had similar left ventricular mass (101.6±33.3 versus 97.7±28.1 g/m(2), P=0.59) and carotid-femoral pulse wave velocity (9.3±1.8 versus 9.2±3.0 m/s, P=0.93); both parameters were significantly lower in healthy controls (Phypertensive heart disease and increased arterial stiffness, similar to EH with comparable mean BP values. Twenty-four-hour and nighttime systolic BP were determinants of cardiovascular damage, independent of BP variability.

  2. Effect of cigarette smoking on arterial stiffness re-interpreted using a structurally-based model

    DEFF Research Database (Denmark)

    Enevoldsen, Marie Sand; Humphrey, Jay D.; Lönn, Lars

    . The goal of this work was to use a structurally motivated nonlinear constitutive relation to quantify increased arterial stiffness based on available data. Specifically, we used a “four-fiber family model” that includes dominant effects of axial, circumferential, and symmetric-diagonal families of collagen...... parameters. The primary finding was that cigarette smoking induces significant increases in the material parameters describing the micromechanical properties of all four families of collagen fibers with increased duration of smoking. Additionally, there was a moderate increase in the material parameter...... describing the behaviour of the elastic fibers. These findings suggest that arterial stiffening in response to smoking is isotropic due to the changes in the material parameters seen in all fiber directions. Although changes are manifested in both elastic and collagen fibers, the predominant stiffening...

  3. High-Dose versus Low-Dose Vitamin D Supplementation and Arterial Stiffness among Individuals with Prehypertension and Vitamin D Deficiency

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    Amanda Zaleski

    2015-01-01

    Full Text Available Introduction. Vitamin D deficiency is associated with the onset and progression of hypertension and cardiovascular disease (CVD. However, mechanisms underlying vitamin D deficiency-mediated increased risk of CVD remain unknown. We sought to examine the differential effect of high-dose versus low-dose vitamin D supplementation on markers of arterial stiffness among ~40 vitamin D deficient adults with prehypertension. Methods. Participants were randomized to high-dose (4000 IU/d versus low-dose (400 IU/d oral vitamin D3 for 6 months. 24 hr ambulatory blood pressure (BP, carotid-femoral pulse wave velocity, and pulse wave analyses were obtained at baseline and after 6 months of vitamin D supplementation. Results. There were no changes in resting BP or pulse wave velocity over 6 mo regardless of vitamin D dose (all p>0.202. High-dose vitamin D decreased augmentation index and pressure by 12.3 ± 5.3% (p=0.047 and 4.0 ± 1.5 mmHg (p=0.02, respectively. However, these decreases in arterial stiffness were not associated with increases in serum 25-hydroxyvitamin D over 6 mo (p=0.425. Conclusion. High-dose vitamin D supplementation appears to lower surrogate measures of arterial stiffness but not indices of central pulse wave velocity. Clinical Trial Registration. This trial is registered with www.clinicaltrials.gov (Unique Identifier: NCT01240512.

  4. Arterial Stiffness by Aerobic Exercise Is Related with Aerobic Capacity, Physical Activity Energy Expenditure and Total Fat but not with Insulin Sensitivity in Obese Female Patients with Type 2 Diabetes

    OpenAIRE

    Ji Yeon Jung; Kyung Wan Min; Hee Jung Ahn; Hwi Ryun Kwon; Jae Hyuk Lee; Kang Seo Park; Kyung Ah Han

    2014-01-01

    Background Arterial stiffness is an important factor in atherosclerosis. Thus we examined whether aerobic exercise could reduce arterial stiffness in obese women with type 2 diabetes without diabetic complication. Methods A total of 35 women with type 2 diabetes (body mass index, 26.6±2.8 kg/m2; age, 56.4±1.9 years; duration of diabetes, 4.7±4.8 years) were assigned to aerobic exercise group (AEG) or control group (CG). AEG completed a 12-week exercise program (3.6 to 5.2 metabolic equivalent...

  5. Relationships Among Conventional Cardiovascular Risk Factors and Lifestyle Habits With Arterial Stiffness in Type 2 Diabetic Patients

    Science.gov (United States)

    Hamamura, Misako; Mita, Tomoya; Osonoi, Yusuke; Osonoi, Takeshi; Saito, Miyoko; Tamasawa, Atsuko; Nakayama, Shiho; Someya, Yuki; Ishida, Hidenori; Gosho, Masahiko; Kanazawa, Akio; Watada, Hirotaka

    2017-01-01

    Background While conventional cardiovascular risk factors and certain lifestyle habits are associated with arterial stiffness in patients with type 2 diabetes mellitus (T2DM), it is still unknown whether they are actually associated with arterial stiffness even after adjustment for conventional cardiovascular risk factors and lifestyle habits. The aim of this study was to identify variables that are associated with brachial-ankle pulse wave velocity (baPWV). Methods The study participants comprised 724 Japanese T2DM outpatients free of history of cardiovascular diseases. Lifestyle habits were analyzed using self-reported questionnaires. The associations among conventional cardiovascular risk factors and lifestyle habits with baPWV were investigated by multivariable linear regression analysis. Results The mean age of the study subjects was 57.8 ± 8.6 years, and 62.8% of those were males. The mean HbA1c was 7.0±1.0%, and the estimated duration of T2DM was 9.9 ± 7.2 years. Multiple linear regression analysis that included age and gender demonstrated that age and male sex were positively associated with baPWV. In a model adjusted for numerous conventional cardiovascular risk factors and lifestyle habits, age, duration of T2DM, systolic blood pressure, serum uric acid, urinary albumin excretion and poor sleep quality were positively associated with baPWV, while body mass index was negatively associated with baPWV. Conclusions In Japanese T2DM, in addition to several conventional cardiovascular risk factors, poor sleep quality was associated with baPWV even after adjustment for numerous conventional cardiovascular risk factors and lifestyle habits. PMID:28270889

  6. Future Treatment of Hypertension: Shifting the Focus from Blood Pressure Lowering to Arterial Stiffness Modulation?

    Science.gov (United States)

    Fok, Henry; Cruickshank, J Kennedy

    2015-08-01

    Isolated systolic hypertension is the commonest form of hypertension from middle age onwards. Achieving target systolic blood pressure (BP) control remains difficult in everyday clinical practice and even under clinical trial conditions. Most antihypertensive medicines were designed to lower peripheral vascular resistance, which was considered the haemodynamic determinant of hypertension; most are effective in reducing steady but not pulsatile components of BP. Arterial stiffness, defined via aortic length-specific pulse wave velocity (PWV), is thought to be an important determinant of pulse pressure widening through its effects on the timing and amplitude of pressure wave reflection, and/or the aorta's Windkessel function, or its excess 'reservoir' pressure. Whereas pulse pressure is neither an independent nor consistent cardiovascular risk factor, particularly below the age of about 60 years, PWV has become the most powerful predictor of cardiovascular outcomes including mortality, independent of systolic, pulse, mean or other BP components. PWV is therefore a more direct target for treatment. This review addresses the potential therapeutic options for targeting arterial stiffness and the role of pulse pressure.

  7. Effect of Cardio-Metabolic Risk Factors Clustering with or without Arterial Hypertension on Arterial Stiffness: A Narrative Review

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    Vasilios G. Athyros

    2013-11-01

    Full Text Available The clustering of cardio-metabolic risk factors, either when called metabolic syndrome (MetS or not, substantially increases the risk of cardiovascular disease (CVD and causes mortality. One of the possible mechanisms for this clustering's adverse effect is an increase in arterial stiffness (AS, and in high central aortic blood pressure (CABP, which are significant and independent CVD risk factors. Arterial hypertension was connected to AS long ago; however, other MetS components (obesity, dyslipidaemia, dysglycaemia or MetS associated abnormalities not included in MetS diagnostic criteria (renal dysfunction, hyperuricaemia, hypercoaglutability, menopause, non alcoholic fatty liver disease, and obstructive sleep apnea have been implicated too. We discuss the evidence connecting these cardio-metabolic risk factors, which negatively affect AS and finally increase CVD risk. Furthermore, we discuss the impact of possible lifestyle and pharmacological interventions on all these cardio-metabolic risk factors, in an effort to reduce CVD risk and identify features that should be taken into consideration when treating MetS patients with or without arterial hypertension.

  8. Index of powered support performance in terms of global stiffness matrix. Gosei matrix wo mochiita jiso shiho no seino hyoji

    Energy Technology Data Exchange (ETDEWEB)

    Sato, K.; Itakura, K.; Hirose, K. (Muroran Institute of Technology, Hokkaido (Japan))

    1990-11-25

    Powered supports were tentatively analyzed to establish a new index for evaluation of their performance. The new index was deduced by comparing the deformation characteristics of various powered supports mutually. The deformation characteristics of a powered support was able to be indicated in terms of a (2 {times} 2) global stiffness matrix. The global stiffness matrix depended on the mining height of powered support. The stiffness of hydraulic legs mainly determined the convergence component of the global stiffness, whereas the stiffness of caving shield determined its shear component. The convergence performance tended to sacrifice the shear deformation one, and vice versa. The principal direction of the global stiffness matrix allowed to select well-balanced deformation characteristics. To assure deformation performance as properly as possible, it was shown that the principal axis of the global matrix should be tilted by 15 to 25 degrees of the angle from the vertical towards the canopy tip. 4 refs., 13 figs., 2 tabs.

  9. Association between arterial stiffness, cerebral small vessel disease and cognitive impairment: a systematic review and meta-analysis

    Science.gov (United States)

    van Sloten, Thomas T; Protogerou, Athanase D; Henry, Ronald MA; Schram, Miranda T; Launer, Lenore J; Stehouwer, Coen DA

    2017-01-01

    Arterial stiffness may be a cause of cerebral small vessel disease and cognitive impairment. We therefore performed a systematic review and meta-analysis of studies on the association between stiffness, cerebral small vessel disease and cognitive impairment. For the associations between stiffness (i.e. carotid-femoral pulse wave velocity (cfPWV), brachial-ankle PWV (baPWV), carotid stiffness and pulse pressure) on the one hand and cerebral small vessel disease and cognitive impairment on the other, we identified 23 (n=15,666/22 cross-sectional/3 longitudinal) and 41 studies (n=57,671/30 cross-sectional/15 longitudinal), respectively. Pooled analyses of cross-sectional studies showed that greater stiffness was associated with markers of cerebral small vessel disease with odds ratios, per +1 SD, of 1.29 to 1.32 (P<.001). Studies on cognitive impairment could not be pooled due to large heterogeneity. Some (but not all) studies showed an association between greater stiffness and cognitive impairment, and the strength of this association was relatively weak. The present study supports the hypothesis that greater arterial stiffness is a contributor to microvascular brain disease. PMID:25827412

  10. Effect of cholesterol lowering on stiffness of aortic and femoral arterial walls in rabbits on a high fat diet

    Institute of Scientific and Technical Information of China (English)

    XUE Li; XU Wan-hai; XU Jin-zhi; ZHANG Tong; BI Hong-yuan; SHEN Bao-zhong

    2009-01-01

    Background Researches in arterial elasticity have increased over the past few years. We investigated the effects of simvastatin on vascular stiffness in fat fed rabbits by ultrasonography.Methods Thirty rabbits were assigned randomly to 3 groups: normal control group (A), the cholesterol group (B), simvastatin group (C: high fat diet for 4 weeks and high fat diet + simvastatin for further 4 weeks). Stiffness coefficient, pressure strain elastic modulus and velocity of pulse waves in abdominal aorta and femoral artery were measured by ultrasonographic echo tracking at the end of the 4th and the 8th weeks.Results At the end of the 4th week, stiffness coefficient, pressure strain elastic modulus and pulse wave velocity of femoral artery were significantly increased in group B compared with those in group A. Similarly, at the end of the 8th week, the same parameters of abdominal aorta were significantly increased in group B compared with those in group A. In contrast, stiffness coefficient, pressure strain elastic modulus and pulse wave velocity of femoral artery were significantly decreased in group C compared with those in group B, however, there was no significant difference in parameters of abdominal aorta between groups B and C.Conclusion Short term administration of simvastatin can improve the elasticity of femoral artery but not abdominal aorta.

  11. Increased tea consumption is associated with decreased arterial stiffness in a Chinese population.

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    Chung-Hao Li

    Full Text Available BACKGROUND: Tea has attracted considerable attention for its potential cardioprotective effects. The primary chemical components of tea are thought to have a beneficial effect by reducing arterial stiffness. The objective of this study was to assess the association between tea consumption and brachial-ankle pulse wave velocity (baPWV in a relatively healthy Chinese population. METHODS: We enrolled 3,135 apparently healthy subjects from October 2006 to August 2009. Subjects taking medication for diabetes, hypertension, or hyperlipidemia, or with a history of cardiovascular disease, were excluded from the study. The subjects were categorized into three groups according to their tea-drinking habits: (1 none to low (n = 1615, defined as non-habitual tea drinkers, or drinking for 450 mL per day. Multiple logistic regression was used to determine whether different levels of consumption were independently associated with the highest quartile of baPWV values, defined as ≥1428.5 cm/s. RESULTS: Of the 3,135 subjects, 48.5% had drunk >150 mL of tea per day for at least 1 year. In multivariate regression analysis with adjustment for co-variables, including, age, sex, current smoking, alcohol use, habitual exercise, total cholesterol/high-density lipoprotein cholesterol (TC/HDL-C ratio >5, obesity, newly diagnosed hypertension and diabetes, subjects with high tea consumption had a decreased risk of highest quartile of baPWV by 22% (odds ratio = 0.78, 95% confidence interval = 0.62-0.98, p = 0.032, while subjects with moderate tea consumption did not (p = 0.742, as compared subjects with none to low tea consumption. CONCLUSIONS: High, but not moderate, habitual tea consumption may decrease arterial stiffness.

  12. Effect of a tart cherry juice supplement on arterial stiffness and inflammation in healthy adults: a randomised controlled trial.

    Science.gov (United States)

    Lynn, Anthony; Mathew, Shilpa; Moore, Chris T; Russell, Jean; Robinson, Emma; Soumpasi, Vithleem; Barker, Margo E

    2014-06-01

    Tart cherries are a particularly rich source of anthocyanins. Evidence indicates that dietary intake of anthocyanins is inversely associated with arterial stiffness. We conducted an open-label randomised placebo controlled study to determine whether a tart cherry juice concentrate (Cherry Active) reduced arterial stiffness, inflammation and risk markers for cardiovascular disease in 47 healthy adults (30-50 years). Participants consumed 30 ml of cherry concentrate diluted to a volume of 250 ml with water or the same volume of an energy matched control drink daily for six weeks. Measurements were taken at baseline and at the end of the intervention. There was no effect of the intervention on arterial stiffness (P = 0.218), c-reactive protein (P = 0.220), systolic blood pressure (P = 0.163), diastolic blood pressure (P = 0.121), total cholesterol (P = 0.342) and high density lipoprotein cholesterol (P = 0.127). At the end of the intervention, plasma antioxidant capacity (measured as the ferric reducing ability of plasma (FRAP)) was significantly higher in the intervention group than the control group (P = 0.012). We conclude that a tart cherry juice concentrate rich in anthocyanins has no effect on arterial stiffness, c-reactive protein and risk markers for cardiovascular disease, but evokes a minor increase in antioxidant status in healthy adults.

  13. Association between Urine Creatinine Excretion and Arterial Stiffness in Chronic Kidney Disease: Data from the KNOW-CKD Study

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    Young Youl Hyun

    2016-08-01

    Full Text Available Background/Aims: Previous studies have shown that low muscle mass is associated with arterial stiffness, as measured by pulse wave velocity (PWV, in a population without chronic kidney disease (CKD. This link between low muscle mass and arterial stiffness may explain why patients with CKD have poor cardiovascular outcomes. However, the association between muscle mass and arterial stiffness in CKD patients is not well known. Methods: Between 2011 and 2013, 1,529 CKD patients were enrolled in the prospective Korean Cohort Study for Outcome in Patients With Chronic Kidney Disease (KNOW-CKD. We analyzed 888 participants from this cohort who underwent measurements of 24-hr urinary creatinine excretion (UCr and brachial-ankle PWV (baPWV at baseline examination. The mean of the right and left baPWV (mPWV was used as a marker of arterial stiffness. Results: The baPWV values varied according to the UCr quartile (1,630±412, 1,544±387, 1,527±282 and 1,406±246 for the 1st to 4th quartiles of UCr, respectively, PConclusion: Low muscle mass estimated by low UCr was associated high baPWV in pre-dialysis CKD patients in Korea. Further studies are needed to confirm the causal relationship between UCR and baPWV, and the role of muscle mass in the development of cardiovascular disease in CKD.

  14. Effects of sodium and potassium supplementation on blood pressure and arterial stiffness : a fully controlled dietary intervention study

    NARCIS (Netherlands)

    Gijsbers, L.; Dower, J. I.; Mensink, M.; Siebelink, E.; Bakker, S. J. L.; Geleijnse, J. M.

    2015-01-01

    We performed a randomised, placebo-controlled, crossover study to examine the effects of sodium and potassium supplementation on blood pressure (BP) and arterial stiffness in untreated (pre) hypertensive individuals. During the study, subjects were on a fully controlled diet that was relatively low

  15. Relationship between resistant hypertension and arterial stiffness assessed by brachial-ankle pulse wave velocity in the older patient

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    Chung CM

    2014-09-01

    Full Text Available Chang-Min Chung,1,2 Hui-Wen Cheng,2 Jung-Jung Chang,2 Yu-Sheng Lin,2 Ju-Feng Hsiao,2 Shih-Tai Chang,1 Jen-Te Hsu2,31School of Traditional Chinese Medicine, College of Medicine, Chang Gung University, 2Division of Cardiology, Chang Gung Memorial Hospital, Chiayi, 3Department of Medicine, College of Medicine, Chang Gung University, Taoyuan County, TaiwanBackground: Resistant hypertension (RH is a common clinical condition associated with increased cardiovascular mortality and morbidity in older patients. Several factors and conditions interfering with blood pressure (BP control, such as excess sodium intake, obesity, diabetes, older age, kidney disease, and certain identifiable causes of hypertension are common in patients resistant to antihypertensive treatment. Arterial stiffness, measured by brachial-ankle pulse wave velocity (baPWV, is increasingly recognized as an important prognostic index and potential therapeutic target in hypertensive patients. The aim of this study was to determine whether there is an association between RH and arterial stiffness. Methods: This study included 1,620 patients aged ≥65 years who were referred or self-referred to the outpatient hypertension unit located at a single cardiovascular center. They were separated into normotensive, controlled BP, and resistant hypertension groups. Home BP, blood laboratory parameters, echocardiographic studies and baPWV all were measured. Results: The likelihood of diabetes mellitus was significantly greater in the RH group than in the group with controlled BP (odds ratio 2.114, 95% confidence interval [CI] 1.194–3.744, P=0.010. Systolic BP was correlated in the RH group significantly more than in the group with controlled BP (odds ratio 1.032, 95% CI 1.012–1.053, P=0.001. baPWV (odds ratio 1.084, 95% CI 1.016–1.156, P=0.015 was significantly correlated with the presence of RH. The other factors were negatively correlated with the existence of RH.Conclusion: In

  16. Reproducibility of arterial stiffness and wave reflections in chronic obstructive pulmonary disease: the contribution of lung hyperinflation and a comparison of techniques.

    Science.gov (United States)

    Stone, Ian S; John, Leonette; Petersen, Steffen E; Barnes, Neil C

    2013-11-01

    Significant cardiovascular morbidity and mortality exists in chronic obstructive pulmonary disease (COPD). Arterial stiffness is raised in COPD and may be a mechanistic link. Non-invasive assessment of arterial stiffness has the potential to be a surrogate outcome measure, although no reproducibility data exists in COPD patients. Two studies (23 and 33 COPD patients) were undertaken to 1) assess the Vicorder reproducibility of carotid-femoral pulse wave velocity and Augmentation index in COPD; 2) compare it to SphygmoCor; and 3) assess the contribution of lung hyperinflation to measurement variability. There were excellent correlations and good agreement between repeat Vicorder measurements for carotid-femoral pulse wave velocity (r = 0.96 (p lung hyperinflation (as measured by residual volume percent predicted, total lung capacity percent predicted or the ratio of inspiratory capacity to residual volume) and variability of measurements in either study. In COPD, measurement of carotid-femoral pulse wave velocity is highly reproducible, not affected by lung hyperinflation and suitable as a surrogate endpoint in research studies. Day-to-day variation in augmentation index highlights the importance of such studies prior to the planning and undertaking of clinical COPD research.

  17. Effect of Aerobic Training on Cognitive Function and Arterial Stiffness in Sedentary Young Adults: A Pilot Randomized Controlled Trial

    Directory of Open Access Journals (Sweden)

    Samuel Asamoah

    2013-01-01

    Full Text Available This study measured cognitive and vascular responses to aerobic training in sedentary young adults. Ten adults (6 women, 4 men; 18–29 years were randomly assigned to an experimental or no-treatment control group. The experimental group engaged in a 6-week intervention, performed on exercise cycle and treadmill, 3x/week, 50 min/session; intensity was increased over time. Outcome measures included arterial stiffness (augmentation index, AIx, and pulse pressure, cardiorespiratory fitness (, and cognitive function (attention, processing speed, working memory, episodic memory, and executive function. Participants randomized to aerobic training improved processing speed versus control (, ES = 0.55. However, no group × time effects were noted in other domains of cognitive function. AIx was reduced by approximately 16% from before to after intervention in the experimental group; however, the improvement was not statistically significant versus control (, ES = 0.22. Pulse pressure did not change between groups over time (, ES = 0.0. increased by approximately 10% in the experimental group; however, the change was not significant between groups over time (, ES = 0.27. Vascular and cognitive adaptations to aerobic training may move in parallel. Robust trials simultaneously investigating a broad spectrum of aerobic training interventions and vascular and cognitive outcomes are warranted.

  18. Assessment of Pulmonary Artery Stiffness of Repaired Congenital Heart Disease Patients

    Science.gov (United States)

    Lee, Namheon; Banerjee, Rajit; Taylor, Michael; Hor, Kan

    2012-10-01

    Surgical correction or palliation of congenital heart disease (CHD) often requires augmenting the main pulmonary artery (MPA) with non-native material or placing a cylindrical graft. The degree to which this intervention affects PA compliance is largely unknown. In this study, the MPA stiffness characteristics were assessed by its compliance, distensibility, and pressure-strain modulus. Coregistered velocity encoded phase-contrast MRI and cardiac catheterization data were available for a cohort of repaired CHD patients (n=8) and controls (n=3). All patients were repaired with either an RV-PA conduit or a RV outflow tract patch. We measured the MPA area change by MRI and MPA pressure during the cath. The measurements were taken through or just distal to the conduit. The MPA compliance and distensibility for the patients were significantly lower than the controls: compliance (9.8±10.8 vs 28.3±7.7mm^2/mmHg, p<0.05), distensibility (2.2±1.5 vs 6.6±2.1%Area change/mmHg, p=0.05). The patients had a significantly higher pressure-strain modulus (152.3±116.4mmHg, p<0.05) than the controls (35.8±10.6mmHg). The abnormally elevated PA stiffness due to the rigidity of the conduit or patch material may cause a compliance mismatch resulting in high stress levels contributing to the observed progressive PA dilatation. This may be a factor in the progressive RV dilatation seen in this cohort of repaired CHD patients.

  19. Association of arterial stiffness and electrocardiography-determined left ventricular hypertrophy with left ventricular diastolic dysfunction.

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    Po-Chao Hsu

    Full Text Available OBJECTIVES: Increased arterial stiffness is associated with left ventricular diastolic dysfunction (LVDD, but this association may be influenced by left ventricular (LV performance. Left ventricular hypertrophy (LVH is not only a significant determinant of LV performance, but is also correlated with LVDD. This study is designed to compare LV diastolic function among patients divided by brachial-ankle pulse wave velocity (baPWV and electrocardiography (ECG-determined LVH and to assess whether increased baPWV and ECG-determined LVH are independently associated with LVDD. METHODS: This cross-sectional study enrolled 270 patients and classified them into four groups according to the median value of baPWV and with/without ECG-determined LVH. The baPWV was measured using an ABI-form device. ECG-determined LVH was defined by Sokolow-Lyon criterion. LVDD was defined as impaired relaxation, pseudonormal, and restrictive mitral inflow patterns. Groups 1, 2, 3, and 4 were patients with lower baPWV and without ECG-determined LVH, lower baPWV but with ECG-determined LVH, higher baPWV but without ECG-determined LVH, and higher baPWV and with ECG-determined LVH respectively. RESULTS: Early diastolic mitral velocity (Ea was gradually decreased from group 1 to group 4 (p≦0.027. Patients in group 4 had the highest prevalence of LVDD (all p<0.001. After multivariate analysis, both baPWV and ECG-determined LVH were independent determinants of Ea (β = -0.02, P<0.001; β = -1.77, P<0.001 respectively and LVDD (odds ratio = 1.02, P = 0.011 and odds ratio = 3.53, P = 0.013 respectively. CONCLUSION: Our study showed the group with higher baPWV and ECG-determined LVH had the lowest Ea and highest prevalence of LVDD. In addition, both baPWV and ECG-determined LVH were independently associated with Ea and LVDD. Hence, assessment of arterial stiffness by baPWV and LVH by ECG may be useful in identifying the high risk group of LVDD.

  20. Effect of continuous positive airway pressure on arterial stiffness in patients with obstructive sleep apnea and hypertension: a meta-analysis.

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    Lin, Xin; Chen, Gongping; Qi, Jiachao; Chen, Xiaofang; Zhao, Jiangming; Lin, Qichang

    2016-12-01

    Arterial stiffness has been recognized as a predictor of cardiovascular and all-cause mortality in hypertensive patients. However, the impact of continuous positive airway pressure (CPAP) on arterial stiffness in patients with OSA and hypertension remains inconclusive. We performed a meta-analysis to determine whether effective CPAP therapy could decrease arterial stiffness. Two reviewers independently searched PubMed, Embase, Web of Science and Cochrane Library prior to March 5, 2015. Information on characteristics of subjects, study design and pre- and post-CPAP treatment of arterial stiffness was extracted for analysis. Standardized mean difference (SMD) was used to analyze the summary estimates for CPAP therapy. Three articles with 186 patients were included in this meta-analysis, including two observational studies and one randomized controlled study. The meta-analysis showed that CPAP was associated with a statistically significant decrease in arterial stiffness in patients with OSA and hypertension (SMD = -0.65, 95 % confidence interval (CI) = -1.14 to -0.16, z = 2.60, p = 0.009). Our meta-analysis suggested that CPAP among OSA and hypertensive patients was significantly associated with a decrease in arterial stiffness. Further prospective large-scale multicenter RCTs are needed to explore the precise impact of CPAP therapy on arterial stiffness in patients with OSA and hypertension.

  1. Arterial stiffness in periodontitis patients and controls. A case–control and pilot intervention study.

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    Houcken, W; Teeuw, W J; Bizzarro, S; Alvarez Rodriguez, E; Mulders, T A; van den Born, B-Jh; Loos, B G

    2016-01-01

    Increased arterial stiffness (AS) is an important indicator for atherosclerotic cardiovascular disease (ACVD). Epidemiologically, periodontitis and ACVD are associated. Therefore, we aimed to investigate AS in periodontitis patients and controls. In addition, we explored the effect of periodontal therapy on AS in a sub-group of cases. Pulse-wave velocity (PWV), a non-invasive chair-side function test for AS, was measured in periodontitis patients (n=57; mean age 46.6 years) and compared with a reference group (n=48; mean age 45.5 years). In addition, 45 cases (mean age 46.9 years) were 6 months followed after periodontal treatment, to explore a possible effect on arterial function. Periodontitis patients showed a significantly increased PWV compared with the reference group (8.01±0.20 vs. 7.36±0.22 m s(-1) respectively; P=0.029) and this remained significant after adjustments for ACVD risk factors (P=0.019). After periodontal therapy, no significant reduction in PWV was seen (8.00±1.8 to 7.82±1.6 m s(-1); P=0.13), but systolic blood pressure (SBP) was significantly reduced (119.8±14.6 to 116.9±15.1 mm Hg; P=0.040). It can be concluded that periodontitis is associated with increased AS. This confirms with a new parameter the association of periodontitis with ACVD. Although periodontal treatment did not lower AS significantly, a modest reduction of SBP after 6 months was observed.

  2. Peripheral Endothelial (DysFunction, Arterial Stiffness and Carotid Intima-Media Thickness in Patients after Kawasaki Disease: A Systematic Review and Meta-Analyses.

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    Sanne M Dietz

    Full Text Available Kawasaki disease (KD is a systemic pediatric vasculitis. Its main complication is the development of coronary arterial aneurysms (CAA, causing an increased risk for ischemia and myocardial infarction. It is unclear whether KD patients, apart from the presence of CAA, have an increased cardiovascular disease (CVD risk due to the previous systemic vasculitis. The aim of this study was to systematically review and meta-analyse the literature regarding surrogate markers for CVD risk in KD patients.Medline and Embase were searched for articles comparing endothelial dysfunction (flow-mediated dilation, nitroglycerin-mediated dilation and peripheral arterial tonometry, vascular stiffness (stiffness index, pulse wave velocity and carotid intima-media thickness (cIMT between patients and controls. Two investigators assessed the articles for eligibility and evaluated quality.Thirty studies were included. For all outcomes, moderate to high heterogeneity between studies was found. Most studies reported a decreased flow-mediated dilation in the whole KD- and CAA-positive group compared to controls, while data on CAA-negative patients were conflicting. The stiffness index was increased in the majority of studies evaluating the whole KD- and CAA-positive group, but not in most studies on CAA-negative patients. Mean cIMT was neither significantly increased in the whole KD-group nor in the CAA-positive group nor in most studies studying CAA-negative patients. Studies measuring maximum cIMT were conflicting.Literature suggests that surrogate markers for CVD risk in KD patients are increased in CAA-positive but not in CAA-negative patients. This may indicate that CAA-positive patients should be monitored for CVD in later life. The results of this review have to be interpreted with care due to substantial heterogeneity between studies and methodological limitations, as well as the lack of long-term follow-up studies.

  3. Screening for Peripheral Artery Disease and Cardiovascular Disease Risk Assessment with Ankle Brachial Index in Adults

    Science.gov (United States)

    ... Force Recommendations Screening for Peripheral Artery Disease and Cardiovascular Disease Risk Assessment with Ankle Brachial Index in Adults ... on Screening for Peripheral Artery Disease (PAD) and Cardiovascular Disease (CVD) Risk Assessment with Ankle Brachial Index (ABI) ...

  4. Long-term use of first-line highly active antiretroviral therapy is not associated with carotid artery stiffness in human immunodeficiency virus-positive patients

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    Haohui Zhu

    2014-09-01

    Full Text Available Objective: To evaluate whether or not highly active antiretroviral therapy is associated with carotid artery stiffness in human immunodeficiency virus-positive patients in Henan Province, China. Method: Fifty human immunodeficiency virus-positive patients with at least a 5-year history of highly active antiretroviral therapy use and 50 human immunodeficiency virus-positive patients without a history of highly active antiretroviral therapy use were enrolled in this study. Carotid artery intima-media thickness and stiffness were determined by quantitative inter-media thickness and quantitative artery stiffness, respectively. Results: No statistically significant difference in carotid artery intima-media thickness and stiffness was observed between groups. A significant association between human immunodeficiency virus infection time and carotid artery stiffness was observed, but no significant association between human immunodeficiency virus infection time and intima-media thickness was found. No significant association between intima-media thickness, stiffness, and CD4+ and CD8+ T-cell counts were observed. Conclusion: The first-line highly active antiretroviral therapy currently used in China is not associated with carotid artery stiffness in human immunodeficiency virus-positive patients with good highly active antiretroviral therapy compliance. Human immunodeficiency virus may play a role in the development of atherosclerosis.

  5. Comparison of the effects of antihypertensive agents on central blood pressure and arterial stiffness in isolated systolic hypertension.

    Science.gov (United States)

    Mackenzie, Isla S; McEniery, Carmel M; Dhakam, Zahid; Brown, Morris J; Cockcroft, John R; Wilkinson, Ian B

    2009-08-01

    Isolated systolic hypertension is an important risk factor for cardiovascular disease and results primarily from elastic artery stiffening. Although various drug therapies are used to lower peripheral blood pressure (BP) in patients with isolated systolic hypertension, the effects of the 4 major classes of antihypertensive agents on central BP, pulse pressure (PP) amplification, and arterial stiffness in this condition are not clear. Fifty-nine patients over the age of 60 years with untreated isolated systolic hypertension (systolic BP > or =140 mm Hg and diastolic BP hypertension, the choice of therapy may be influenced by these findings in the future.

  6. Indirect measure of visceral adiposity ‘A Body Shape Index’ (ABSI) is associated with arterial stiffness in patients with type 2 diabetes

    Science.gov (United States)

    Bouchi, Ryotaro; Asakawa, Masahiro; Ohara, Norihiko; Nakano, Yujiro; Takeuchi, Takato; Murakami, Masanori; Sasahara, Yuriko; Numasawa, Mitsuyuki; Minami, Isao; Izumiyama, Hajime; Hashimoto, Koshi; Yoshimoto, Takanobu; Ogawa, Yoshihiro

    2016-01-01

    Objective Among indirect measures of visceral adiposity, A Body Shape Index (ABSI), which is defined as waist circumference (WC)/(body mass index (BMI)2/3×height1/2), is unique in that ABSI is positively correlated with visceral adiposity and is supposed to be independent of BMI. ABSI has been also shown to be linearly and positively associated with visceral fat mass and all-cause and cardiovascular disease (CVD) in the general population. It is, however, uncertain whether ABSI could be associated with arterial stiffness in patients with diabetes. Methods This is a cross-sectional study of 607 patients with type 2 diabetes (mean age 64±12 years; 40.0% female). Visceral fat area (VFA, cm2) and subcutaneous fat area (SFA, cm2) were assessed with a dual-impedance analyzer. In order to estimate the risk for CVD, brachial-ankle pulse wave velocity (baPWV, cm) was used for the assessment of arterial stiffness. Results ABSI was significantly and positively correlated with VFA (r=0.138, p=0.001) and negatively associated with BMI (r=−0.085, p=0.037). The correlation of z-score for ABSI with VFA remained significant (r=0.170, p<0.001) but not with BMI (r=0.009, p=0.820). ABSI (standardized β 0.095, p=0.043) but not WC (standardized β −0.060, p=0.200) was significantly and positively correlated with baPWV in the multivariate model including BMI as a covariate. Conclusions ABSI appears to reflect visceral adiposity independently of BMI and to be a substantial marker of arterial stiffening in patients with type 2 diabetes. PMID:27026809

  7. Carotid Arterial Stiffness and Its Relationship to Exercise Intolerance in Older Patients with Heart Failure and Preserved Ejection Fraction

    OpenAIRE

    Kitzman, Dalane W.; Herrington, David M.; Brubaker, Peter H.; Moore, J. Brian; Eggebeen, Joel; Haykowsky, Mark J

    2012-01-01

    Heart failure with a preserved ejection fraction (HFpEF) is the dominant form of heart failure in the older population. The primary chronic symptom in HFpEF is severe exercise intolerance, however, its pathophysiology and therapy are not well understood. We tested the hypothesis that older patients with HFpEF have increased arterial stiffness beyond that which occurs with normal aging and that this contributes to their severe exercise intolerance.

  8. Short-term effects of nitrate-rich green leafy vegetables on blood pressure and arterial stiffness in individuals with high-normal blood pressure.

    Science.gov (United States)

    Bondonno, Catherine P; Liu, Alex H; Croft, Kevin D; Ward, Natalie C; Yang, Xingbin; Considine, Michael J; Puddey, Ian B; Woodman, Richard J; Hodgson, Jonathan M

    2014-12-01

    Evidence for a beneficial effect of dietary nitrate, through the nitrate-nitrite-NO pathway, on measures of cardiovascular function in healthy individuals is accumulating. It is less clear whether increased dietary nitrate intake from green leafy vegetables would have similar beneficial vascular effects in those at increased risk of developing hypertension. Our aim was to assess the effects of short-term regular consumption of increased nitrate from green leafy vegetables on blood pressure and arterial stiffness in individuals with high-normal blood pressure. Thirty-eight men and women ages 30-70 years with systolic blood pressure 120 to 139 mm Hg were recruited to a randomized controlled crossover trial. The effects of a 7-day high-nitrate diet intervention (increased nitrate intake by at least 300 mg/day from green leafy vegetables) were compared to a 7-day low-nitrate diet intervention. Outcome measures included pre- and postintervention salivary and plasma nitrate and nitrite concentrations; ambulatory, home, and office blood pressure; augmentation index; and carotid-femoral pulse wave velocity. The high-nitrate diet intervention resulted in at least a fourfold increase in salivary and plasma nitrate and nitrite (Pblood pressure and arterial stiffness were not different between the high-nitrate diet and the low-nitrate diet. Increasing dietary nitrate intake in those with high-normal blood pressure and at increased risk of hypertension may not be an effective short-term strategy to lower blood pressure.

  9. Association between serum 25-hydroxyvitamin D3 concentration,parathyroid hormone,and arterial stiffness in patients with type 2 diabetes

    Institute of Scientific and Technical Information of China (English)

    马笑堃

    2013-01-01

    Objective To evaluate the association between serum 25-hydroxyvitamin D3[25 (OH) D3],parathyroid hormone,and arterial stiffness in patients with type 2 diabetes.Methods Serum 25 (OH) D3and parathyroid hormone (PTH) were determined in a cross-sectional sample of 258 patients aged 30 years or over.Arterial stiffness was assessed by pulse wave velocity (PWV) obtained with a VP-1000 pulse wave unit.Fasting plasma HbA1C,

  10. Reduction of plasma aldosterone and arterial stiffness in obese pre- and stage1 hypertensive subjects after aerobic exercise

    Science.gov (United States)

    Collier, SR; Sandberg, K; Moody, AM; Frechette, V; Curry, CD; Ji, H; Gowdar, R; Chaudhuri, D; Meucci, M

    2017-01-01

    Obesity-related hypertension is associated with increased activity of the renin-angiotensin-aldosterone system (RAAS), increasing arterial stiffness. Aerobic exercise decreases pulse wave velocity (PWV), therefore a treatment option for hypertension and obesity. Assess RAAS activity and PWV before and after 4 weeks of aerobic training in unmedicated, pre-to-stage-1 hypertensives. Ten obese subjects (52±3.2 years, body mass index=33.5±1.4) performed 30 min of aerobic exercise on a treadmill 3 days per week at 65% of peak oxygen consumption (VO2peak). Descriptive characteristics, systolic and diastolic blood pressure (SBP and DBP), PWV, and a blood draw was performed at baseline, following the 4-week control and training interventions. No differences in descriptive characteristics during the control period were observed, however, a significant decrease in plasma aldosterone (ALDO) (255.4±75 to 215.8±66 pg ml−1, P=0.001), SBP (140±12 to 136±10.4 mm Hg; P=0.02), DBP (89±4.2 to 85±6.3 mm Hg; P =0.03) and central PWV (11.2±0.6 to 9.8±0.8 m s−1; P=0.04) was shown pre-to-post exercise training. Four weeks of moderate-intensity aerobic training in obese, hypertensives decreases plasma ALDO independently of body weight and is significantly correlated to decreases in PWV reductions. PMID:24785976

  11. A Novel Index Using Ankle Hemodynamic Parameters to Assess the Severity of Peripheral Arterial Disease: A Pilot Study

    Science.gov (United States)

    Tanno, Jun; Gatate, Yodo; Kasai, Takatoshi; Nakano, Shintaro; Senbonmatsu, Takaaki; Sato, Osamu; Ichioka, Shigeru; Kuro-o, Makoto; Nishimura, Shigeyuki

    2016-01-01

    In peripheral arterial disease (PAD) of the lower extremities, the presence of flow-limiting stenoses can be objectively detected by the ankle-brachial index (ABI). However, the severity of ischemic symptoms is not necessarily associated with the ABI value. Atherosclerotic plaque in lower extremity PAD induces ankle arterial stiffness and reduces ankle vascular resistance, which may decrease ankle blood flow and cause ischemic symptoms. We hypothesized that the ankle hemodynamic index (AHI), defined as the ratio of ankle arterial stiffness to ankle vascular resistance, could be used to assess the blood supply deficiency in a diseased lower limb in patients with PAD. The 85 consecutive patients with PAD who were retrospectively analyzed in this study had Rutherford grade 1 to grade 6 ischemia diagnosed as PAD and significant stenotic lesions (>50% diameter stenosis) of the lower extremity on contrast angiography. The AHI was calculated as the product of the ankle pulse pressure and the ratio of heart rate to ankle mean arterial pressure (ankle pulse pressure × heart rate/ankle mean arterial pressure). The Rutherford grade was significantly correlated with the AHI (r = 0.50, P < 0.001), but not with the ABI (r = 0.07, P = 0.52). Multiple ordinal regression analysis showed that anemia (odds ratio 0.66, P = 0.002) and AHI (odds ratio 1.04, P = 0.02) were independently associated with Rutherford grade. Our study shows that AHI, a novel parameter based on the ABI measurement, is well correlated with ischemic symptoms, and may be a useful means to assess the arterial blood supply of the lower extremities of patients with PAD. PMID:27760183

  12. Relationship between cardio-ankle vascular index (CAVI) and coronary artery calcification (CAC) in patients with type 2 diabetes mellitus.

    Science.gov (United States)

    Mineoka, Yusuke; Fukui, Michiaki; Tanaka, Muhei; Tomiyasu, Ki-ichiro; Akabame, Satoshi; Nakano, Koji; Yamazaki, Masahiro; Hasegawa, Goji; Oda, Yohei; Nakamura, Naoto

    2012-03-01

    Early detection of atherosclerosis is important for patients with type 2 diabetes mellitus because cardiovascular disease (CVD) is a main cause of death in these people. In this study, we investigated the relationship between an arterial stiffness parameter called cardio-ankle vascular index (CAVI) and coronary artery calcification (CAC). We performed a cross-sectional study in 371 type 2 diabetic patients with clinical suspicion of coronary heart disease (CHD). We evaluated the relationships between CAVI and CAC score determined by multislice computed tomography as well as major cardiovascular risk factors, including age, body mass index, hemoglobinA1c and the Framingham CHD risk score. CAVI was correlated with age (r = 0.301, p CAC + 1) (r = 0.303, p CAC >0, CAC >100, CAC >400, or CAC >1000. CAVI is positively correlated with CAC, and is considered to be a useful method to detect CAC.

  13. Increased burden and severity of metabolic syndrome and arterial stiffness in treatment naïve HIV+ patients from Cameroon

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    Ngatchou W

    2013-09-01

    Full Text Available William Ngatchou,1 Daniel Lemogoum,1 Pierre Ndobo,2,† Euloge Yagnigni,2 Emiline Tiogou,2 Elisabeth Nga,2 Charles Kouanfack,2 Philippe van de Borne,1 Michel P Hermans3 1Hypertension Clinic, Erasme University Hospital, Brussels, Belgium; 2Department of Cardiology, Central Hospital, Yaoundé, Cameroon; 3Department of Endocrinology and Nutrition, Cliniques Universitaires St-Luc, Brussels, Belgium †Professor Pierre Ndobo passed away on January 21, 2013 Background: Human immunodeficiency virus (HIV and its therapy are associated with increased aortic stiffness and metabolic syndrome (MetS phenotype in Caucasian patients. We hypothesized that, independently of antiretroviral therapy, HIV infection in native black African patients is associated with increased burden of cardiometabolic risk factors that may accelerate arterial structural damage and translate into increased aortic stiffness. Patients and methods: Ninety-six apparently healthy Cameroonian subjects (controls were compared to 108 untreated Cameroonian HIV+ patients (HIV-UT of similar age. In each participant, pulse wave velocity (Complior, aortic augmentation index (SphygmoCor, brachial blood pressure (Omron 705 IT, fasting plasma glucose (FPG, and lipids were recorded, as well as the prevalence and severity of MetS, based on the American Heart Association/National Heart, Lung, and Blood Institute score ≥3/5. Results: Prevalence of impaired fasting glucose (FPG 100–125 mg · dL-1 and of diabetes (FPG > 125 mg · dL-1 was higher in HIV-UT than in controls (47% versus 27%, and 26% versus 1%, respectively; both P < 0.01. Fasting triglycerides and the atherogenic dyslipidemia ratio were significantly higher in HIV-UT than in controls. Hypertension prevalence was high and comparable in both groups (41% versus 44%, respectively; not significant. HIV-UT patients exhibited a twice-higher prevalence of MetS than controls (47% versus 21%; P = 0.02. Age- and sex-adjusted pulse wave velocity was

  14. Monitoring of peripheral vascular condition using a log-linearized arterial viscoelastic index during endoscopic thoracic sympathectomy.

    Science.gov (United States)

    Hirano, Hiroki; Horiuchi, Tetsuya; Hirano, Harutoyo; Kurita, Yuichi; Ukawa, Teiji; Nakamura, Ryuji; Saeki, Noboru; Yoshizumi, Masao; Kawamoto, Masashi; Tsuji, Toshio

    2013-01-01

    This paper proposes a novel technique to support the monitoring of peripheral vascular conditions using biological signals such as electrocardiograms, arterial pressure values and pulse oximetry plethysmographic waveforms. In this approach, a second-order log-linearized model (referred to here as a log-linearized peripheral arterial viscoelastic model) is used to describe the non-linear viscoelastic relationship between blood pressure waveforms and photo-plethysmographic waveforms. The proposed index enables estimation of peripheral arterial wall stiffness changes induced by sympathetic nerve activity. The validity of the method is discussed here based on the results of peripheral vascular condition monitoring conducted during endoscopic thoracic sympathectomy (ETS). The results of ETS monitoring showed significant changes in stiffness variations between the periods before and during the procedures observed (p < 0.01) as well as during and after them (p < 0.01), so that it was confirmed that sympathetic nerve activity is drastically decreased in the area around the monitoring site after the thoracic sympathetic nerve trunk on the monitoring side is successfully blocked. In addition, no change was observed in the values of the proposed index during the ETS procedure on the side opposite that of the monitoring site. The experimental results obtained clearly show the proposed method can be used to assess changes in sympathetic nerve activity during ETS.

  15. Activation of SIRT1 Attenuates Klotho Deficiency-Induced Arterial Stiffness and Hypertension by Enhancing AMP-Activated Protein Kinase Activity.

    Science.gov (United States)

    Gao, Diansa; Zuo, Zhong; Tian, Jing; Ali, Quaisar; Lin, Yi; Lei, Han; Sun, Zhongjie

    2016-11-01

    Arterial stiffness is an independent risk factor for stroke and myocardial infarction. This study was designed to investigate the role of SIRT1, an important deacetylase, and its relationship with Klotho, a kidney-derived aging-suppressor protein, in the pathogenesis of arterial stiffness and hypertension. We found that the serum level of Klotho was decreased by ≈45% in patients with arterial stiffness and hypertension. Interestingly, Klotho haplodeficiency caused arterial stiffening and hypertension, as evidenced by significant increases in pulse wave velocity and blood pressure in Klotho-haplodeficient (KL(+/-)) mice. Notably, the expression and activity of SIRT1 were decreased significantly in aortic endothelial and smooth muscle cells in KL(+/-) mice, suggesting that Klotho deficiency downregulates SIRT1. Treatment with SRT1720 (15 mg/kg/d, IP), a specific SIRT1 activator, abolished Klotho deficiency-induced arterial stiffness and hypertension in KL(+/-) mice. Klotho deficiency was associated with significant decreases in activities of AMP-activated protein kinase α (AMPKα) and endothelial NO synthase (eNOS) in aortas, which were abolished by SRT1720. Furthermore, Klotho deficiency upregulated NADPH oxidase activity and superoxide production, increased collagen expression, and enhanced elastin fragmentation in the media of aortas. These Klotho deficiency-associated changes were blocked by SRT1720. In conclusion, this study provides the first evidence that Klotho deficiency downregulates SIRT1 activity in arterial endothelial and smooth muscle cells. Pharmacological activation of SIRT1 may be an effective therapeutic strategy for arterial stiffness and hypertension.

  16. Aerobic exercise training-induced changes in serum adropin level are associated with reduced arterial stiffness in middle-aged and older adults.

    Science.gov (United States)

    Fujie, Shumpei; Hasegawa, Natsuki; Sato, Koji; Fujita, Satoshi; Sanada, Kiyoshi; Hamaoka, Takafumi; Iemitsu, Motoyuki

    2015-11-15

    Aging-induced arterial stiffening is reduced by aerobic exercise training, and elevated production of nitric oxide (NO) participates in this effect. Adropin is a regulator of endothelial NO synthase and NO release, and circulating adropin level decreases with age. However, the effect of habitual aerobic exercise on circulating adropin levels in healthy middle-aged and older adults remains unclear. We sought to determine whether serum adropin level is associated with exercise training-induced changes in arterial stiffness. First, in a cross-sectional study, we investigated the association between serum adropin level and both arterial stiffness and cardiorespiratory fitness in 80 healthy middle-aged and older subjects (65.6 ± 0.9 yr). Second, in an intervention study, we examined the effects of 8-wk aerobic exercise training on serum adropin level and arterial stiffness in 40 healthy middle-aged and older subjects (67.3 ± 1.0 yr) divided into two groups: aerobic exercise training and sedentary controls. In the cross-sectional study, serum adropin level was negatively correlated with carotid β-stiffness (r = -0.437, P aerobic exercise training intervention, and training-induced changes in serum adropin level were correlated with training-induced changes in carotid β-stiffness (r = -0.399, P exercise-induced reduction of arterial stiffness.

  17. Estimated aortic blood pressure based on radial artery tonometry underestimates directly measured aortic blood pressure in patients with advancing chronic kidney disease staging and increasing arterial stiffness

    DEFF Research Database (Denmark)

    Carlsen, Rasmus K; Peters, Christian D; Khatir, Dinah S;

    2016-01-01

    we compared invasive aortic systolic BP (SBP) with estimated central SBP obtained by radial artery tonometry and examined the influence of renal function and arterial stiffness on this relationship. We evaluated 83 patients with stage 3 to 5 CKD (mean estimated glomerular filtration rate [eGFR] 30 ml......% confidence interval -14.9 to -11.4) mm Hg. Arterial stiffness was evaluated by carotid-femoral pulse wave velocity (cf-PWV) and was significantly increased in CKD patients compared with (versus) control patients (mean 10.7 vs. 9.3 m/s). The difference in BP significantly increased 1.0 mm Hg for every 10 ml....../min decrease in eGFR and by 1.6 mm Hg per 1 m/s increase in cfPWV. Using multivariate regression analysis including both eGFR and cfPWV, the difference between estimated central and invasive aortic SBP was significantly increased by 0.7 mm Hg. For the entire cohort brachial SBP significantly better reflected...

  18. Low Physical Activity Is Associated With Increased Arterial Stiffness in Patients Recently Diagnosed With Type 2 Diabetes

    DEFF Research Database (Denmark)

    Funck, Kristian L; Laugesen, Esben; Høyem, Pernille;

    2015-01-01

    AIMS: Several studies have indicated that low physical activity is associated with increased risk of cardiovascular disease (CVD) and all-cause mortality among patients with diabetes. The association between physical activity and subclinical cardiovascular changes preceding clinical events remains...... to be elucidated. We investigated the relationship between physical activity and arterial stiffness, an independent predictor of CVD, in patients with type 2 diabetes and controls. METHODS: We included 100 patients with type 2 diabetes and 100 sex- and age-matched controls in a cross-sectional study. Arterial...... of physical activity was defined according to the median level of activity (cpm = 31). RESULTS: Sixty-five patients and 65 controls were included in the final analysis (median age 59 years, 55% men, median diabetes duration 1.9 years). Participants with low physical activity had higher cfPWV compared...

  19. Sustained Improvement of Arterial Stiffness and Blood Pressure after Long-Term Rosuvastatin Treatment in Patients with Inflammatory Joint Diseases: Results from the RORA-AS Study.

    Directory of Open Access Journals (Sweden)

    Eirik Ikdahl

    Full Text Available Patients with inflammatory joint diseases (IJD have a high prevalence of hypertension and increased arterial stiffness. The aim of the present study was to evaluate the effect of long-term rosuvastatin treatment on arterial stiffness, measured by augmentation index (AIx and aortic pulse wave velocity (aPWV, and blood pressure (BP in IJD patients with established atherosclerosis.Eighty-nine statin naïve IJD patients with carotid atherosclerotic plaque(s (rheumatoid arthritis n = 55, ankylosing spondylitis n = 23, psoriatic arthritis n = 11 received rosuvastatin for 18 months to achieve low-density lipoprotein cholesterol goal ≤1.8 mmol/L. Change in AIx (ΔAIx, aPWV (ΔaPWV, systolic BP (ΔsBP and diastolic BP (ΔdBP from baseline to study end was assessed by paired samples t-tests. Linear regression was applied to evaluate associations between cardiovascular disease (CVD risk factors, rheumatic disease specific variables and medication, and ΔAIx, ΔaPWV, ΔsBP and ΔdBP.AIx, aPWV, sBP and dBP were significantly reduced from baseline to study end. The mean (95%CI changes were: ΔAIx: -0.34 (-0.03, -0.65% (p = 0.03, ΔaPWV: -1.69 (-0.21, -3.17m/s2 (p = 0.03, ΔsBP: -5.27 (-1.61, -8.93mmHg (p = 0.004 and ΔdBP -2.93 (-0.86, -5.00mmHg (p = 0.01. In linear regression models, ∆aPWV was significantly correlated with ΔsBP and ΔdBP (for all: p<0.001.There is an unmet need of studies evaluating CVD prevention in IJD patients. We have shown for the first time that long-term intensive lipid lowering with rosuvastatin improved arterial stiffness and induced a clinically significant BP reduction in patients with IJD. These improvements were linearly correlated and may represent novel insight into the pleiotropic effects by statins.ClinicalTrials.gov NCT01389388.

  20. Effects of neuromuscular electrical stimulation and aerobic exercise training on arterial stiffness and autonomic functions in patients with chronic heart failure.

    Science.gov (United States)

    Dobšák, Petr; Tomandl, Josef; Spinarova, Lenka; Vitovec, Jiri; Dusek, Ladislav; Novakova, Marie; Jarkovsky, Jiri; Krejci, Jan; Hude, Petr; Honek, Tomáš; Siegelova, Jarmila; Homolka, Pavel

    2012-10-01

    Neuromuscular electrical stimulation (NMES) of leg muscles has been introduced in clinical practice as a rehabilitation (RHB) method in patients with chronic heart failure (CHF); however, the role of NMES on the reduction of arterial stiffness and autonomic disbalance in these patients has not yet been studied. Sixty-one patients with stable CHF (mean age 58.9 [2.1] years; mean ejection fraction 31 [4.2]%, New York Heart Association II-III) were randomly assigned into two groups. Patients in (i) exercise training group (ET; n = 30) underwent 12 weeks of bicycle ET (3 × 40 min/week); (ii) group NMES (n = 31) performed 12 weeks of NMES of quadriceps and calf muscles (frequency 10 Hz, mode "20 s on-20 s off," intensity 60 mA), 2 × 60 min/day. Noninvasive assessment of arterial stiffness was done using the cardio-ankle vascular index (CAVI). CAVI and heart rate variability (HRV) and ·VO(2peak) were evaluated before and after RHB program. Both types of RHB reduced significantly CAVI (ET from 9.6 [0.2] to 8.9 [0.2], P < 0.012; NMES from 9.3 [0.2] to 8.7 [0.2], P < 0.013), increased high frequency (HF) component of HRV (+65.6%; P = 0.001) and decreased ratio of low frequency (LF) component with HF component (LF/HF ratio) in group ET (-39.8%; P < 0.001). Changes of HRV parameters in group NMES were not significant; however, a marked tendency to autonomic stabilization was present. Both types of RHB led also to significant increase of ·VO(2peak) (ET from 18.7 [0.7] to 20.8 [0.7] mL/kg/min, P < 0.004; NMES from 17.3 [0.7] to 19.0 [0.7] mL/kg/min, P < 0.001). ET or NMES has been shown to improve significantly arterial stiffness and to stabilize autonomic balance.

  1. Black Raspberry Extract Increased Circulating Endothelial Progenitor Cells and Improved Arterial Stiffness in Patients with Metabolic Syndrome: A Randomized Controlled Trial.

    Science.gov (United States)

    Jeong, Han Saem; Kim, Sohyeon; Hong, Soon Jun; Choi, Seung Cheol; Choi, Ji-Hyun; Kim, Jong-Ho; Park, Chi-Yeon; Cho, Jae Young; Lee, Tae-Bum; Kwon, Ji-Wung; Joo, Hyung Joon; Park, Jae Hyoung; Yu, Cheol Woong; Lim, Do-Sun

    2016-04-01

    Administration of black raspberry (Rubus occidentalis) is known to improve vascular endothelial function in patients at a high risk for cardiovascular (CV) disease. We investigated short-term effects of black raspberry on circulating endothelial progenitor cells (EPCs) and arterial stiffness in patients with metabolic syndrome. Patients with metabolic syndrome (n = 51) were prospectively randomized into the black raspberry group (n = 26, 750 mg/day) and placebo group (n = 25) during the 12-week follow-up. Central blood pressure, augmentation index, and EPCs, such as CD34/KDR(+), CD34/CD117(+), and CD34/CD133(+), were measured at baseline and at 12-week follow-up. Radial augmentation indexes were significantly decreased in the black raspberry group compared to the placebo group (-5% ± 10% vs. 3% ± 14%, P raspberry group compared to the placebo group (19 ± 109/μL vs. -28 ± 57/μL, P raspberry group compared to the placebo group (-0.5 ± 1.4 pg/mL vs. -0.1 ± 1.1 pg/mL, P raspberry group. The use of black raspberry significantly lowered the augmentation index and increased circulating EPCs, thereby improving CV risks in patients with metabolic syndrome during the 12-week follow-up.

  2. Association of Serum 25-hydroxy-vitamin D Concentration and Arterial Stiffness among Korean Adults in Single Center

    Science.gov (United States)

    Lee, Jung Hae

    2017-01-01

    Background There are growing concerns about the role of vitamin D deficiency in cardiovascular diseases. Therefore, we investigated the correlation between serum 25-hydroxy-vitamin D (25[OH]D) and arterial stiffness among Korean adults. Methods We retrospectively reviewed the medical charts of 302 people (115 women and 187 men) who visited a tertiary hospital from January 2015 to December 2016. Serum 25(OH)D was measured using the radioimmunoassay technique, and brachial-ankle pulse wave velocity (baPWV) was measured using an automatic wave analyzer. We obtained the doctor's report on the medical history of the participants, their alcohol consumption and smoking habits, and their exercise status. Metabolic syndrome was diagnosed based on guidelines from the National Cholesterol Education Program (NCEP)-Adult Treatment Panel (ATP III) and the International Diabetes Federation (IDF). Results of basic blood tests and physical assessment were also collected. Results In the Pearson correlation analysis, serum 25(OH)D and baPWV showed a statistically significant inverse relationship (r=-0.279, P<0.001). Using multiple regression analysis, and after adjusting for possible confounders, serum 25(OH)D concentration was found to be significantly associated with baPWV (β=-0.121, P=0.011). Conclusions We observed an association between serum 25(OH)D concentration and arterial stiffness. Further studies involving larger sample sizes will be needed to confirm this associations.

  3. Correlation between arterial wall stiffness, N-terminal prohormone of brain natriuretic peptide, functional and structural myocardial abnormalities in patients with type 2 diabetes mellitus and cardiac autonomic neuropathy

    Directory of Open Access Journals (Sweden)

    Viktoriya Aleksandrovna Serhiyenko

    2013-12-01

    Full Text Available Aim. To assess arterial wall stiffness, plasma levels of of N-terminal prohormone of brain natriuretic peptide (NT-proBNP, as well as functional state and structure of the myocardium in patients with type 2 diabetes mellitus (T2DM and cardiac autonomic neuropathy (CAN.Materials and Methods. The study involved a total of 65 patients with T2DM. 12 had no evidence of cardiovascular disease (CVD or CAN, 14 were diagnosed with subclinical stage of CAN, 18 – with functional stage, and 21 – with organic stage. We measured aortic pulse wave velocity (PWV, aortic augmentation index (AIx, brachial artery AIx, ambulatory arterial stiffness index (AASI and plasma levels of NT-proBNP. Clinical examination included ECG, Holter monitoring, ambulatory BP measurement and echocardiography.Results. Patients with isolated T2DM showed a trend for increased vascular wall stiffness. PWV was increased in patients with subclinical stage of CAN. Aortic and brachial AIx, PWV and AASI were elevated in patients with functional stage of CAN, PWV being significantly higher vs. subclinical CAN subgroup. Organic stage was characterized by pathologically increased values of all primary parameters; PWV and AASI were significantly higher compared with other groups. Development and progression of CAN was accompanied by an increase in NT-proBNP plasma levels. Concentration of NT-proBNP was in direct correlation with left ventricular mass (LVM and PWV. PWV and LVM values also directly correlated between themselves.Conclusion. Development and progression of CAN in patients with T2DM is accompanied by an increase in vascular wall stiffness. The elevation of plasma NT-proBNP in patients with T2DM correlates with the development of CAN and is significantly and independently associated with an increase in LVM and PWV. Our data suggests the pathophysiological interconnection between metabolic, functional and structural myocardial abnormalities in patients with T2DM and CAN.

  4. Evaluation of 24-Hour Arterial Stiffness Indices and Central Hemodynamics in Healthy Normotensive Subjects versus Treated or Untreated Hypertensive Patients: A Feasibility Study

    Directory of Open Access Journals (Sweden)

    Stefano Omboni

    2015-01-01

    Full Text Available Objective. Central blood pressure (BP and vascular indices estimated noninvasively over the 24 hours were compared between normotensive volunteers and hypertensive patients by a pulse wave analysis of ambulatory blood pressure recordings. Methods. Digitalized waveforms obtained during each brachial oscillometric BP measurement were stored in the device memory and analyzed by the validated Vasotens technology. Averages for the 24 hours and for the awake and asleep subperiods were computed. Results. 142 normotensives and 661 hypertensives were evaluated. 24-hour central BP, pulse wave velocity (PWV, and augmentation index (AI were significantly higher in the hypertensive group than in the normotensive group (119.3 versus 105.6 mmHg for systolic BP, 75.6 versus 72.3 mmHg for diastolic BP, 10.3 versus 10.0 m/sec for aortic PWV, −9.7 versus −40.7% for peripheral AI, and 24.7 versus 11.0% for aortic AI, whereas reflected wave transit time (RWTT was significantly lower in hypertensive patients (126.6 versus 139.0 ms. After adjusting for confounding factors a statistically significant between-group difference was still observed for central BP, RWTT, and peripheral AI. All estimates displayed a typical circadian rhythm. Conclusions. Noninvasive assessment of 24-hour arterial stiffness and central hemodynamics in daily life dynamic conditions may help in assessing the arterial function impairment in hypertensive patients.

  5. Effect of cinnamon on gastric emptying, arterial stiffness, postprandial lipemia, glycemia, and appetite responses to high-fat breakfast

    Directory of Open Access Journals (Sweden)

    Trinick Tom R

    2011-09-01

    Full Text Available Abstract Background Cinnamon has been shown to delay gastric emptying of a high-carbohydrate meal and reduce postprandial glycemia in healthy adults. However, it is dietary fat which is implicated in the etiology and is associated with obesity, type 2 diabetes and cardiovascular disease. We aimed to determine the effect of 3 g cinnamon (Cinnamomum zeylanicum on GE, postprandial lipemic and glycemic responses, oxidative stress, arterial stiffness, as well as appetite sensations and subsequent food intake following a high-fat meal. Methods A single-blind randomized crossover study assessed nine healthy, young subjects. GE rate of a high-fat meal supplemented with 3 g cinnamon or placebo was determined using the 13C octanoic acid breath test. Breath, blood samples and subjective appetite ratings were collected in the fasted and during the 360 min postprandial period, followed by an ad libitum buffet meal. Gastric emptying and 1-day fatty acid intake relationships were also examined. Results Cinnamon did not change gastric emptying parameters, postprandial triacylglycerol or glucose concentrations, oxidative stress, arterial function or appetite (p half and 1-day palmitoleic acid (r = -0.78, eiconsenoic acid (r = -0.84 and total omega-3 intake (r = -0.72. The ingestion of 3 g cinnamon had no effect on GE, arterial stiffness and oxidative stress following a HF meal. Conclusions 3 g cinnamon did not alter the postprandial response to a high-fat test meal. We find no evidence to support the use of 3 g cinnamon supplementation for the prevention or treatment of metabolic disease. Dietary fatty acid intake requires consideration in future gastrointestinal studies. Trial registration Trial registration number: at http://www.clinicaltrial.gov: NCT01350284

  6. Effect of androgen suppression compared with androgen receptor blockade on arterial stiffness in men with prostate cancer.

    Science.gov (United States)

    Dockery, Frances; Bulpitt, Christopher J; Agarwal, Sanjiv; Vernon, Clare; Rajkumar, Chakravarthi

    2009-01-01

    Endogenous testosterone and estradiol are thought to be cardio-protective in men. We wanted to determine the effects of 2 different anti-androgen therapies on arterial stiffness as one suppresses (goserelin--a gonadotrophin-releasing hormone analog) while the other increases (bicalutamide--an androgen receptor blocker) both testosterone and estradiol. We conducted a randomized trial on 43 men (mean age, 71.2 +/- 6.2 years) with localized prostate cancer. They received either goserelin or bicalutamide for 24 weeks. Carotid-femoral (C-F) and carotid-radial (C-R) pulse wave velocities (PWVs) were measured. Twenty age- and disease-matched men with prostate cancer on no active treatment were studied in a similar manner. After 12 weeks of goserelin, radial artery PWV increased significantly from baseline and a nonsignificant increase was observed in femoral PWV (change from baseline radial: +1.4 m/s, P = .002, femoral: +0.9 m/s, P = .127) Both PWV measures increased significantly with bicalutamide (change from baseline radial: +0.8, femoral: +0.9 m/s, P change from baseline radial: +1.7, femoral: +1.3 m/s, P change from baseline radial: +0.4, femoral: +0.4 m/s, P not significant [NS]); however, comparison of changes between the 2 drugs were not significantly different at either 12 or 24 weeks (P >or= .967 at 12 weeks and P >or= .07 at 24 weeks). The untreated men studied in parallel showed no changes at 12 or 24 weeks in either PWV measure. Anti-androgen treatment in men might increase large artery stiffness, an adverse cardiovascular risk factor; however, the effect was not maintained with testosterone receptor blockade, in the longer term, but tended to be sustained with suppression therapy. This could relate to the different sex hormone effects of the 2 therapies.

  7. Effect of cinnamon on gastric emptying, arterial stiffness, postprandial lipemia, glycemia, and appetite responses to high-fat breakfast

    LENUS (Irish Health Repository)

    Markey, Oonagh

    2011-09-07

    Abstract Background Cinnamon has been shown to delay gastric emptying of a high-carbohydrate meal and reduce postprandial glycemia in healthy adults. However, it is dietary fat which is implicated in the etiology and is associated with obesity, type 2 diabetes and cardiovascular disease. We aimed to determine the effect of 3 g cinnamon (Cinnamomum zeylanicum) on GE, postprandial lipemic and glycemic responses, oxidative stress, arterial stiffness, as well as appetite sensations and subsequent food intake following a high-fat meal. Methods A single-blind randomized crossover study assessed nine healthy, young subjects. GE rate of a high-fat meal supplemented with 3 g cinnamon or placebo was determined using the 13C octanoic acid breath test. Breath, blood samples and subjective appetite ratings were collected in the fasted and during the 360 min postprandial period, followed by an ad libitum buffet meal. Gastric emptying and 1-day fatty acid intake relationships were also examined. Results Cinnamon did not change gastric emptying parameters, postprandial triacylglycerol or glucose concentrations, oxidative stress, arterial function or appetite (p < 0.05). Strong relationships were evident (p < 0.05) between GE Thalf and 1-day palmitoleic acid (r = -0.78), eiconsenoic acid (r = -0.84) and total omega-3 intake (r = -0.72). The ingestion of 3 g cinnamon had no effect on GE, arterial stiffness and oxidative stress following a HF meal. Conclusions 3 g cinnamon did not alter the postprandial response to a high-fat test meal. We find no evidence to support the use of 3 g cinnamon supplementation for the prevention or treatment of metabolic disease. Dietary fatty acid intake requires consideration in future gastrointestinal studies. Trial registration Trial registration number: at http:\\/\\/www.clinicaltrial.gov: NCT01350284

  8. Arterial compliance in patients with cirrhosis: stroke volume-pulse pressure ratio as simplified index

    DEFF Research Database (Denmark)

    Fuglsang, S; Bendtsen, F; Christensen, E

    2001-01-01

    Arterial function may be altered in patients with cirrhosis. We determined compliance of the arterial tree (C(1)) in relation to systemic and splanchnic hemodynamic derangement and clinical variables. C(1) and the stroke volume-pulse pressure index (SV/PP) were significantly higher (+62% and +40%...... predictors of SV/PP (P abnormalities in the arterial compliance of these patients....

  9. The renal arterial resistive index and stage of chronic kidney disease in patients with renal allograft

    DEFF Research Database (Denmark)

    Winther, Stine O; Thiesson, Helle C; Poulsen, Lene N;

    2012-01-01

    The study investigated the optimal threshold value of renal arterial resistive index as assessed by Doppler ultrasonography determining chronic kidney disease stage 4 or higher in patients with renal allograft.......The study investigated the optimal threshold value of renal arterial resistive index as assessed by Doppler ultrasonography determining chronic kidney disease stage 4 or higher in patients with renal allograft....

  10. Arterial compliance in patients with cirrhosis: stroke volume-pulse pressure ratio as simplified index

    DEFF Research Database (Denmark)

    Henriksen, J H; Fuglsang, Stefan; Bendtsen, Flemming;

    2001-01-01

    Arterial function may be altered in patients with cirrhosis. We determined compliance of the arterial tree (C(1)) in relation to systemic and splanchnic hemodynamic derangement and clinical variables. C(1) and the stroke volume-pulse pressure index (SV/PP) were significantly higher (+62% and +40...... predictors of SV/PP (P index seems to reflect abnormalities in the arterial compliance of these patients....

  11. Uncertainty quantification of inflow boundary condition and proximal arterial stiffness coupled effect on pulse wave propagation in a vascular network

    CERN Document Server

    Brault, A; Lucor, D

    2016-01-01

    SUMMARY This work aims at quantifying the effect of inherent uncertainties from cardiac output on the sensitivity of a human compliant arterial network response based on stochastic simulations of a reduced-order pulse wave propagation model. A simple pulsatile output form is utilized to reproduce the most relevant cardiac features with a minimum number of parameters associated with left ventricle dynamics. Another source of critical uncertainty is the spatial heterogeneity of the aortic compliance which plays a key role in the propagation and damping of pulse waves generated at each cardiac cycle. A continuous representation of the aortic stiffness in the form of a generic random field of prescribed spatial correlation is then considered. Resorting to a stochastic sparse pseudospectral method, we investigate the spatial sensitivity of the pulse pressure and waves reflection magnitude with respect to the different model uncertainties. Results indicate that uncertainties related to the shape and magnitude of th...

  12. Azelnidipine plus olmesartan versus amlodipine plus olmesartan on arterial stiffness and cardiac function in hypertensive patients: a randomized trial

    Directory of Open Access Journals (Sweden)

    Takami T

    2013-04-01

    Full Text Available CorrigendumTakami T, Saito Y. Drug Design, Development and Therapy. 2013;7:175–183. On page 177, line 26, heading "Measurement of LVMI and LF diastolic function" should have been "Measurement of LVMI and LV diastolic function". Line 32, "Devereux et al18" should read "Devereux et al19". Line 40, "(E/e’ ratio were measured as previously described.19" should read "(E/e’ ratio were measured as previously described.20". On page 181, line 15, "baPWV with LVMI.20" should read "baPWV with LVMI.21". Line 23, "baPWV and LVMI, E/A ratio.20" should read "baPWV and LVMI, E/A ratio.21,22". Line 28 "diastolic dysfunction.21" should read "diastolic dysfunction.23". Line 38 "is high.22" should read "is high.24". Line 39, "in clinical treatment.23" should read "in clinical treatment.25". Line 57, "A recent cohort study24" should read "A recent cohort study21".On page 182, line 1, "diastolic heart failure.25" should read "diastolic heart failure.26". Line 3, "untreated hypertensive patients.26" should read "untreated hypertensive patients.27". Line 6, "linear regression analysis.27" should read "linear regression analysis.21".On page 183, the references 18 to 27 should be updated as shown below:18. Takami T. Evaluation of arterial stiffness in morning hypertension under high-dose valsartan compared to valsartan plus low-dose diuretic. Hypertens Res. 2009;32:1086–1090.19. Devereux RB, Palmieri V, Sharpe N, et al. Effects of once-daily angiotensin-converting enzyme inhibition and calcium channel blockade-based antihypertensive treatment regimens on left ventricular hypertrophy and diastolic filling in hypertension: the prospective randomized enalapril study evaluating regression of ventricular enlargement (PRESERVE trial. Circulation. 2001;104:1248–1254.20. Ito H, Ishii K, Kihara H, et al. Adding thiazide to a renin-angiotensin blocker improves left ventricular relaxation and improves heart failure in patients with hypertension. Hypertens Res. 2012;35:93

  13. The pulsatility index and the resistive index in renal arteries. Associations with long-term progression in chronic renal failure

    DEFF Research Database (Denmark)

    Petersen, L J; Petersen, J R; Talleruphuus, U

    1997-01-01

    The pulsatility index (PI) and the resistive index (RI) are used as pulsed-wave Doppler measurements of downstream renal artery resistance. PI and RI have been found to correlate with renal vascular resistance, filtration fraction and effective renal plasma flow in chronic renal failure. The aim...

  14. Cerebral Microbleeds and White Matter Hyperintensities in Cognitively Healthy Elderly: A Cross-Sectional Cohort Study Evaluating the Effect of Arterial Stiffness

    Directory of Open Access Journals (Sweden)

    Anna-Märta Gustavsson

    2015-05-01

    Full Text Available Background: Arterial stiffness reflects the ageing processes in the vascular system, and studies have shown an association between reduced cognitive function and cerebral small vessel disease. Small vessel disease can be visualized as white matter hyperintensities (WMH and lacunar infarcts but also as cerebral microbleeds on brain magnetic resonance imaging (MRI. We aimed to investigate if arterial stiffness influences the presence of microbleeds, WMH and cognitive function in a population of cognitively healthy elderly. Methods: The study population is part of the Swedish BioFinder study and consisted of 208 individuals without any symptoms of cognitive impairment, who scored >27 points on the Mini-Mental State Examination. The participants (mean age, 72 years; 59% women underwent MRI of the brain with visual rating of microbleeds and WMH. Arterial stiffness was measured with carotid-femoral pulse wave velocity (cfPWV. Eight cognitive tests covering different cognitive domains were performed. Results: Microbleeds were detected in 12% and WMH in 31% of the participants. Mean (±standard deviation, SD cfPWV was 10.0 (±2.0 m/s. There was no association between the presence of microbleeds and arterial stiffness. There was a positive association between arterial stiffness and WMH independent of age or sex (odds ratio, 1.58; 95% confidence interval, 1.04-2.40, p 0.05. Cognitive performance was not associated with microbleeds, but individuals with WMH performed slightly worse than those without WMH on the Symbol Digit Modalities Test (mean ± SD, 35 ± 7.8 vs. 39 ± 8.1, p Conclusions: Arterial stiffness was not associated with the presence of cerebral microbleeds or cognitive function in cognitively healthy elderly. However, arterial stiffness was related to the presence of WMH, but the association was attenuated when multiple adjustments were made. There was a weak negative association between WMH and performance in one specific test of attention

  15. Phylloquinone (vitamin K₁) intake and pulse pressure as a measure of arterial stiffness in older adults.

    Science.gov (United States)

    Vaccaro, Joan A; Huffman, Fatma G

    2013-01-01

    This study examined the relationships among ethnicity/race, lifestyle factors, phylloquinone (vitamin K₁) intake, and arterial pulse pressure in a nationally representative sample of older adults from four ethnic/racial groups: non-Hispanic Whites, non-Hispanic Blacks, Mexican Americans, and other Hispanics. This was a cross-sectional study of U.S. representative sample with data from the National Health and Nutrition Examination Surveys, 2007-2008 and 2009-2010 of adults aged 50 years and older (N = 5296). Vitamin K intake was determined by 24-hour recall. Pulse pressure was calculated as the difference between the averages of systolic blood pressure and diastolic blood pressure. Compared to White non-Hispanics, the other ethnic/racial groups were more likely to have inadequate vitamin K₁ intake. Inadequate vitamin K₁ intake was an independent predictor of high arterial pulse pressure. This was the first study that compared vitamin K₁ inadequacy with arterial pulse pressure across ethnicities/races in U.S. older adults. These findings suggest that vitamin K screening may be a beneficial marker for the health of older adults.

  16. Estimation of Arterial Stiffness by Time-Frequency Analysis of Pulse Wave

    Science.gov (United States)

    Saito, Masashi; Yamamoto, Yuya; Shibayama, Yuka; Matsukawa, Mami; Watanabe, Yoshiaki; Furuya, Mio; Asada, Takaaki

    2011-07-01

    Evaluation of a pulse wave is effective for the early diagnosis of arteriosclerosis because the pulse wave contains the reflected wave that is the age- and stiffness-dependent component. In this study, we attempted to extract the parameter reflecting the component by pulse wave analysis using continuous wavelet transform. The Morlet wavelet was used as the mother wavelet. We then investigated the relationship between the parameter and the reflected wave that was extracted from the pulse wave by our previously reported separation technique. Consequently, the result of wavelet transform of the differentiated pulse waveform changed markedly owing to age and had medium correlation with the peak of the reflected wave (R=0.68).

  17. Experimental study on efficacy of compression systems with a high static stiffness index for treatment of venous ulcer patients

    Directory of Open Access Journals (Sweden)

    Anneke Andriessen

    2013-03-01

    Full Text Available The experimental study measured interface pressure and static stiffness index of four different compression systems in fifty-two healthy volunteers. For the study interface pressure (3 cm ø probe was placed at the anatomical B1 point was recorded on application of the compression systems every 15 min for 4 h, in supine, standing, while sitting and during walking. For this purpose a portable Kikuhime (Harada Corp., Osaka, Japan device was used. Further static stiffness index (SSI was calculated. The evaluated systems were: short stretch bandage system (SSB Rosidal sys (Lohmann & Rauscher, Rengsdorf, Germany, multi-layer bandaging (LSB Profore (Smith & Nephew, Hull, UK, varistretch bandage (VSB Proguide (Smith & Nephew and tubular compression (CS Rosidal mobil (Lohmann & Rauscher. The mean interface pressure of SSB, LSB and VSB was significantly higher (P<0.05 in each position measured over 4 h, compared to CS. In supine VSB showed high-pressure levels, up to 60 mmHg, which remained high. The other systems had more tolerable levels of about 30 mmHg. Interface pressure exerted on limbs is an indicator of their clinical effect. The experimental study results showed different patterns of interface pressure and SSI, which may enable clinicians to predict the frequency of bandage application, supporting an adequate and safe choice of bandage system.

  18. Arterial Stiffness Alterations and Inflammatory Response Following Endovascular Aortic Repair: Based on a Presentation at the 2013 VEITH Symposium, November 19-23, 2013 (New York, NY, USA).

    Science.gov (United States)

    Moulakakis, Konstantinos G; Mylonas, Spyridon N; Kakisis, John; Kadoglou, Nikolaos P E; Papadakis, Ioannis; Sfyroeras, George S; Antonopoulos, Constantine C N; Mantas, George; Ikonomidis, Ignatios; Liapis, Christos D

    2015-04-01

    Endovascular abdominal aortic aneurysm repair (EVAR) and thoracic aortic aneurysm repair (TEVAR) have been widely incorporated into clinical practice. However, changes in arterial stiffness and post-implantation syndrome after aortic endografting remain important issues under investigation. The aneurysm sac wall motion after successful EVAR and TEVAR reflects complex interactions between all the components of the excluded aneurysm, including true compliance of the aneurysm wall itself, intra-aneurysm sac pressure, remodeling of the thrombus, and mechanical characteristics of the endograft. Experimental and clinical studies have shown that aortic endografting results in increased arterial stiffness in animal models. It can be assumed that the alterations of aortic mechanical properties can have a direct impact on heart output. The long-term impact of these mechanical changes on cardiovascular outcomes and the potential effects of different endografts on hemodynamics are important issues under investigation. Post-implantation syndrome (PIS) is a systemic inflammatory response frequently observed after endovascular treatment of aortic pathologies. The main features of PIS include fever, leukocytosis, elevated C-reactive protein levels, and coagulation disturbances. Endograft design appears to influence this inflammatory response following aortic endografting; woven polyester endografts have been shown to be associated with greater inflammatory response compared to PTFE stent grafts. The purpose of this paper is to review the literature to elucidate arterial stiffness alterations and inflammatory response after EVAR and TEVAR and the impact of endograft design on aortic stiffness and the post-inflammatory response.

  19. Digital image correlation for full-field time-resolved assessment of arterial stiffness

    Science.gov (United States)

    Campo, Adriaan; Soons, Joris; Heuten, Hilde; Ennekens, Guy; Goovaerts, Inge; Vrints, Christiaan; Lava, Pascal; Dirckx, Joris

    2014-01-01

    Pulse wave velocity (PWV) of the arterial system is a very important parameter to evaluate cardiovascular health. Currently, however, there is no golden standard for PWV measurement. Digital image correlation (DIC) was used for full-field time-resolved assessment of displacement, velocity, acceleration, and strains of the skin in the neck directly above the common carotid artery. By assessing these parameters, propagation of the pulse wave could be tracked, leading to a new method for PWV detection based on DIC. The method was tested on five healthy subjects. As a means of validation, PWV was measured with ultrasound (US) as well. Measured PWV values were between 3.68 and 5.19 m/s as measured with DIC and between 5.14 and 6.58 m/s as measured with US, with a maximum absolute difference of 2.78 m/s between the two methods. DIC measurements of the neck region can serve as a test base for determining a robust strategy for PWV detection, they can serve as reference for three-dimensional fluid-structure interaction models, or they may even evolve into a screening method of their own. Moreover, full-field, time-resolved DIC can be adapted for other applications in biomechanics.

  20. Effect of aliskiren on arterial stiffness, compared with ramipril in patients with mild to moderate essential hypertension

    Institute of Scientific and Technical Information of China (English)

    GUO Jian-qiang; WANG Hong-yi; SUN Ning-ling

    2013-01-01

    Background Aliskiren is a novel blood pressure-lowering agent acting as an oral direct renin inhibitor.The aim of this study was to assess the effect of aliskiren on arterial stiffness,compared with that of ramipril in mild to moderate essential hypertensive patients.Methods Following a two week placebo run-in period,patients with a mean sitting diastolic blood pressure (ms-DBP) >95 and <110 mmHg (1 mmHg=0.133 kPa),and a mean sitting systolic blood pressure (ms-SBP) <180 mmHg were randomly allocated to treatment with aliskiren (150 mg/d,n=20) or ramipril (5 mg/d,n=20) for eight weeks.Blood pressure,plasma renin activity,and the brachial-ankle pulse wave velocity (ba-PWV) were measured before and after eight weeks of treatment.Results Eight weeks of treatment significantly decreased systolic blood pressure and diastolic blood pressure in both the aliskiren group and ramipril group.The hypotensive effect did not differ between the two groups.Plasma renin activity decreased after aliskiren treatment and increased after ramipril treatment.There was no significant difference in baseline ba-PWV between the aliskiren and ramipril groups (P=-0.892).The ba-PWV was significantly reduced in both the aliskiren group (1535 (1405-1666) vs.1464 (1360-1506) cm/s) (P <0.01) and the ramipril group (1544 (1433-1673) vs.1447 (1327-1549) cm/s) (P <0.01).No statistically significant difference was found in the decline of ba-PWV between the two groups (P=0.766).Conclusions The current study revealed that aliskiren (150 mg/d) could ameliorate arterial stiffness and its effect was similar to ramipril (5 mg/d) in mild to moderate hypertensive patients,indicating that in addition to lowering blood pressure,aliskiren had beneficial effect on vascular protection.

  1. The pulsatility index and the resistive index in renal arteries in patients with hypertension and chronic renal failure

    DEFF Research Database (Denmark)

    Petersen, L J; Petersen, J R; Ladefoged, S D

    1995-01-01

    The pulsatility index (PI) and the resistive index (RI) are used as pulsed-wave Doppler measurement of downstream renal artery resistance. Little information is available on their value in chronic renal failure and their correlation to parameters of renal function and haemodynamics. The aim...... was to compare PI and RI of renal arteries in healthy volunteers and in patients with hypertension and chronic renal failure, and furthermore to study the correlation of these indices to measurements of renal haemodynamics and function by standard methods in patients with renal failure and hypertension....

  2. Is arterial stiffness in HIV-infected individuals associated with HIV-related factors?

    Energy Technology Data Exchange (ETDEWEB)

    Monteiro, P. [Serviço de Doenças Infecciosas, Faculdade de Medicina, Universidade de Pernambuco, Recife, PE (Brazil); Miranda-Filho, D.B. [Departamento de Medicina Clínica, Faculdade de Medicina, Universidade de Pernambuco, Recife, PE (Brazil); Bandeira, F. [Serviço de Endocrinologia, Faculdade de Medicina, Universidade de Pernambuco, Recife, PE (Brazil); Lacerda, H.R. [Departamento de Medicina Clínica, Faculdade de Medicina, Universidade de Pernambuco, Recife, PE (Brazil); Departamento de Medicina Tropical, Faculdade de Medicina, Universidade Federal de Pernambuco, Recife, PE (Brazil); Chaves, H. [Departamento de Cardiologia, Faculdade de Medicina, Universidade Federal de Pernambuco, Recife, PE (Brazil); Albuquerque, M.F.P.M. [Centro de Pesquisa Aggeu Magalhães,FIOCRUZ, Recife, PE (Brazil); Montarroyos, U.R. [Departamento de Medicina Tropical, Faculdade de Medicina, Universidade Federal de Pernambuco, Recife, PE (Brazil); Ximenes, R.A.A. [Departamento de Medicina Clínica, Faculdade de Medicina, Universidade de Pernambuco, Recife, PE (Brazil); Departamento de Medicina Tropical, Faculdade de Medicina, Universidade Federal de Pernambuco, Recife, PE (Brazil)

    2012-07-13

    We investigated the association between pulse wave velocity (PWV) and HIV infection, antiretroviral treatment-related characteristics, viral load, immune status, and metabolic changes in a cross-sectional study nested in a cohort of HIV/AIDS patients who have been followed for metabolic and cardiovascular changes since 2007. The study included patients recruited from the cohort (N = 261) and a comparison group (N = 82) of uninfected individuals, all enrolled from April to November 2009. Aortic stiffness was estimated using the carotid-femoral PWV (Complior-Artech, Paris, France). The groups were similar with respect to age, metabolic syndrome, diabetes mellitus, Framingham score, and use of antihypertensive and hypolipidemic medications. Hypertension was more frequent among the controls. Individuals with HIV had higher triglyceride, glucose and HDL cholesterol levels. Among individuals with HIV/AIDS, those with a nadir CD4{sup +} T-cell count <200 cells/mm{sup 3} had a higher PWV (P = 0.01). There was no statistically significant difference when subjects were stratified by gender. Heart rate, age, male gender, and blood pressure were independently correlated with PWV. Nadir CD4{sup +} T-cell count did not remain in the final model. There was no significance difference in PWV between HIV-infected individuals and uninfected controls. PWV was correlated with age, gender, and blood pressure across the entire population and among those infected with HIV. We recommend cohort studies to further explore the association between inflammation related to HIV infection and/or immune reconstitution and antiretroviral use and PWV.

  3. Arterial Stiffness by Aerobic Exercise Is Related with Aerobic Capacity, Physical Activity Energy Expenditure and Total Fat but not with Insulin Sensitivity in Obese Female Patients with Type 2 Diabetes

    Directory of Open Access Journals (Sweden)

    Ji Yeon Jung

    2014-12-01

    Full Text Available BackgroundArterial stiffness is an important factor in atherosclerosis. Thus we examined whether aerobic exercise could reduce arterial stiffness in obese women with type 2 diabetes without diabetic complication.MethodsA total of 35 women with type 2 diabetes (body mass index, 26.6±2.8 kg/m2; age, 56.4±1.9 years; duration of diabetes, 4.7±4.8 years were assigned to aerobic exercise group (AEG or control group (CG. AEG completed a 12-week exercise program (3.6 to 5.2 metabolic equivalents, 3 day/week, 60 min/day, with their exercise activities monitored by accelerometers. We measured abdominal total fat area (TFA, visceral fat area (VFA, and subcutaneous fat area (SFA by computed tomography, insulin sensitivity by insulin tolerance test (KITT, and augmentation index (AIx by SphygmoCor at baseline and at the end of the 12-week program.ResultsThe AIx was improved in the AEG compared with the CG (P<0.001. The percent change of AIx had significant correlation with the improvement of physical activity energy expenditure (PAEE, aerobic capacity, TFA, and SFA (r=-0.416, P=0.013; r=0.560, P<0.001; r=0.489, P=0.003; r=0.531, P=0.001, respectively, but not with insulin sensitivity, energy intake, or VFA.ConclusionImprovement in aortic stiffness by aerobic exercise is related with the improvement of aerobic capacity, PAEE, and total fat but not with insulin sensitivity or energy intake in obese women with type 2 diabetes.

  4. Pentraxin 3 Is a Predictor for Fibrosis and Arterial Stiffness in Patients with Nonalcoholic Fatty Liver Disease

    Directory of Open Access Journals (Sweden)

    Kadir Ozturk

    2016-01-01

    Full Text Available Objective. The aim of the present study was to investigate whether pentraxin 3 (PTX3 can be a new noninvasive marker for prediction of liver fibrosis in patients with NAFLD. We also aimed to evaluate the relationship between PTX3 and atherosclerosis in patients with NAFLD. Method. Fifty-four male patients with biopsy-proven NAFLD and 20 apparently healthy male volunteers were included. PTX3 levels were determined, using an ELISA method (R&D Sysytems, Quantikine ELISA, USA. To detect the presence of subclinical atherosclerosis in NAFLD, measurements of CIMT, FMD, and cf-PWV levels were performed. Results. PTX3 levels in NAFLD patients with fibrosis were higher than both NAFLD patients without fibrosis and controls (P=0.032 and P=0.028, respectively, but there was no difference between controls and NAFLD patients without fibrosis in terms of PTX3 levels (P=0.903. PTX3 levels were strongly correlated with cf-PWV (r=0.359, P=0.003, whereas no significant correlation was found with other atherosclerosis markers, CIMT and FMD. Conclusion. Elevated plasma PTX3 levels are associated with the presence of fibrosis in patients with NAFLD, independently of metabolic syndrome components. This study demonstrated that for the first time there is a close association between elevated PTX3 levels and increased arterial stiffness in patients with NAFLD.

  5. Vitamin D Status in Rheumatoid Arthritis: Inflammation, Arterial Stiffness and Circulating Progenitor Cell Number.

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    Alberto Lo Gullo

    Full Text Available Suboptimal vitamin D status was recently acknowledged as an independent predictor of cardiovascular diseases and all-cause mortality in several clinical settings, and its serum levels are commonly reduced in Rheumatoid Arthritis (RA. Patients affected by RA present accelerated atherosclerosis and increased cardiovascular morbidity and mortality with respect to the general population. In RA, it has been reported an impairment of the number and the activity of circulating proangiogenic haematopoietic cells (PHCs, including CD34+, that may play a role in endothelial homeostasis. The purpose of the study is to investigate the association between vitamin D levels and PHCs, inflammatory markers, and arterial stiffening in patients with RA.CD34+ cells were isolated from 27 RA patients and 41 controls. Vitamin D levels, C-reactive protein (CRP, fibrinogen, pulse wave velocity (PWV, and carotid intima-media thickness (cIMT were also evaluated. CD34+ count and vitamin D levels were lower in RA patients as compared to controls, while fibrinogen, CRP, PWV and cIMT were higher in RA patients. CD34+ cell number appeared to be associated with vitamin D levels, and negatively correlated to fibrinogen and early atherosclerosis markers (PWV and cIMT; vitamin D levels appear also to be inversely associated to fibrinogen.RA patients with moderate disease activity presented with low vitamin D levels, low CD34+ cell count, increased PWV and cIMT; we found that vitamin D deficiency is associated to CD34+ cell reduction in peripheral blood, and with fibrinogen levels. This suggests that vitamin D might contribute to endothelial homeostasis in patients with RA.

  6. Left atrial volume index and aortic stiffness index in adult hemodialysed patients - link between compliance and pressure mediated by endothelium dysfunction; a cross-sectional study

    Directory of Open Access Journals (Sweden)

    Zapolski Tomasz

    2012-11-01

    Full Text Available Abstract Background This study was performed to investigate the relationship between elastic properties of aorta and left atrium volume index (LAVI in hemodialyzed (HD patients. Methods Study group was consisted of 73 patients (age 51,6 ± 7,6 years treated by hemodialysis. In all patients standard echocardiography was performed. Aortic stiffness index (ASI was calculated using formula: ASI = log (SBP/DBP/[(Aomax-Aomin/Aomin]. LAVI was calculated according to the formula: LAVI = [π/6 x (LAmax x LAshort x LAlong]/m2. Additionally several indices were calculated: left ventricle mass (LVM, left ventricle mass index (LVMI, midwall fractional shortening (mFS, endsystolic stress (ESS, mFS/ESS. Additionally the laboratory parameters including lipidogram, troponin T (cTnT, NT-proBNP and asymmetric dimethylarginine (ADMA were measured. Results The ASI was strong and significantly correlated with left atrium volume (LAV and LAVI (respectively: 0,601; p  Conclusions There is correlation between ASI and ADMA, marker of endothelium dysfunction. There is also association between LAVI and NT-proBNP, signs of elevated left atrium pressure. The strong correlation between ASI and LAVI, improved by associations of specific biochemical markers with these echocardiographic indices, suggests there is the link between elastic properties of aorta and left atrium pressure in hemodialysed patients mediated by endothelial dysfunction.

  7. Associations of dietary intake patterns identified using reduced rank regression with markers of arterial stiffness among youth with type 1 diabetes

    Science.gov (United States)

    Lamichhane, Archana P.; Liese, Angela D.; Urbina, Elaine M.; Crandell, Jamie L.; Jaacks, Lindsay M.; Dabelea, Dana; Black, Mary Helen; Merchant, Anwar T.; Mayer-Davis, Elizabeth J.

    2014-01-01

    BACKGROUND/OBJECTIVES Youth with type 1 diabetes (T1DM) are at substantially increased risk for adverse vascular outcomes, but little is known about the influence of dietary behavior on cardiovascular disease (CVD) risk profile. We aimed to identify dietary intake patterns associated with CVD risk factors and evaluate their impact on arterial stiffness (AS) measures collected thereafter in a cohort of youth with T1DM. SUBJECTS/METHODS Baseline diet data from a food frequency questionnaire and CVD risk factors (triglycerides, LDL-cholesterol, systolic BP, HbA1c, C-reactive protein and waist circumference) were available for 1,153 youth aged ≥10 years with T1DM from the SEARCH for Diabetes in Youth Study. A dietary intake pattern was identified using 33 food-groups as predictors and six CVD risk factors as responses in reduced rank regression (RRR) analysis. Associations of this RRR-derived dietary pattern with AS measures [augmentation index(AIx75), n=229; pulse wave velocity(PWV), n=237; and brachial distensibility(BrachD), n=228] were then assessed using linear regression. RESULTS The RRR-derived pattern was characterized by high intakes of sugar-sweetened beverages (SSB) and diet soda, eggs, potatoes and high-fat meats, and low intakes of sweets/desserts and low-fat dairy; major contributors were SSB and diet soda. This pattern captured the largest variability in adverse CVD risk profile and was subsequently associated with AIx75 (β=0.47; p<0.01). The mean difference in AIx75 concentration between the highest and the lowest dietary pattern quartiles was 4.3% in fully adjusted model. CONCLUSIONS Intervention strategies to reduce consumption of unhealthful foods and beverages among youth with T1DM may significantly improve CVD risk profile and ultimately reduce the risk for AS. PMID:24865480

  8. Beneficial effects on arterial stiffness and pulse-wave reflection of combined enalapril and candesartan in chronic kidney disease--a randomized trial.

    Directory of Open Access Journals (Sweden)

    Marie Frimodt-Møller

    Full Text Available BACKGROUND: Cardiovascular disease (CVD is highly prevalent in patients with chronic kidney disease (CKD. Inhibition of the renin-angiotensinsystem (RAS in hypertension causes differential effects on central and brachial blood pressure (BP, which has been translated into improved outcome. The objective was to examine if a more complete inhibition of RAS by combining an angiotensin converting enzyme inhibitor (ACEI and an angiotensin receptor antagonist (ARB compared to monotherapy has an additive effect on central BP and pulse-wave velocity (PWV, which are known markers of CVD. METHODS: Sixty-seven CKD patients (mean GFR 30, range 13-59 ml/min/1.73 m(2 participated in an open randomized study of 16 weeks of monotherapy with either enalapril or candesartan followed by 8 weeks of dual blockade aiming at a total dose of 16 mg candesartan and 20 mg enalapril o.d. Pulse-wave measurements were performed at week 0, 8, 16 and 24 by the SphygmoCor device. RESULTS: Significant additive BP independent reductions were found after dual blockade in aortic PWV (-0.3 m/s, P<0.05 and in augmentation index (-2%, P<0.01 compared to monotherapy. Furthermore pulse pressure amplification was improved (P<0.05 and central systolic BP reduced (-6 mmHg, P<0.01. CONCLUSIONS: Dual blockade of the RAS resulted in an additive BP independent reduction in pulse-wave reflection and arterial stiffness compared to monotherapy in CKD patients. TRIAL REGISTRATION: Clinical trial.gov NCT00235287.

  9. Closed-loop Stiffness Modeling and Stiffness Index Analysis for Multi-axis Machining System%多轴加工系统闭链刚度场建模与刚度性能分析

    Institute of Scientific and Technical Information of China (English)

    闫蓉; 陈威; 彭芳瑜; 林森; 李斌

    2012-01-01

    During multi-axis machining process, complex surface can be machined flexibly while cutter's posture is changeable in available workspace, which directly affects general stiffness characteristics of multi-axis machining system and also machining performance. By establishing general stiffness model related to cutter posture, the distribution of stiffness performance of whole machining system is analyzed. Based on multi-body small deflection theory, a semi-analytic method about closed-loop stiffness modeling for multi-axis machining system is proposed, in which Jacobi matrix method, point transformation matrix method and finite element method are applied. The force ellipsoid corresponding to the decoupling stiffness model is established in 3D space. Stiffness index is derived from force ellipsoid, which is used to plot isolines of general stiffness performance of multi-axis machining system. The result of analysis about the distribution of stiffness performance can help direct tool motion planning.%在复杂曲面多轴加工中,刀具可以在一定范围内以不同姿态加工复杂曲面,刀具姿态的改变直接影响整体加工系统的综合刚度特性,从而影响到加工性能.建立与刀具位姿相关的综合刚度场模型,可用于分析整体加工系统的综合刚性分布规律.提出多轴加工系统刚度场半解析计算方法,其中针对机床运动轴及其传动部位、刀具、工件等关键部件的力学特性分别采用了雅可比矩阵法、点传递矩阵法、有限元法等方法建立相应的刚度矩阵,并根据多体小变形理论建立了多轴加工工艺系统闭链刚度场模型.根据该模型解耦得到三维空间的力椭球,从力椭球提取整体加工系统的刚度性能指标,绘制刚度性能等值线图,分析工作空间中多轴加工系统的刚度特性分布规律,可用于指导刀具运动规划.

  10. The pulsatility index and the resistive index in renal arteries. Associations with long-term progression in chronic renal failure

    DEFF Research Database (Denmark)

    Petersen, L J; Petersen, J R; Talleruphuus, U

    1997-01-01

    The pulsatility index (PI) and the resistive index (RI) are used as pulsed-wave Doppler measurements of downstream renal artery resistance. PI and RI have been found to correlate with renal vascular resistance, filtration fraction and effective renal plasma flow in chronic renal failure. The aim...... of the present study was to evaluate the potential relationship between these indices and the rate of decline in renal function, as reflected by changes in different parameters of renal function in patients with chronic renal failure....

  11. FGF-23/Vitamin D Axis in Type 1 Diabetes: The Potential Role of Mineral Metabolism in Arterial Stiffness.

    Directory of Open Access Journals (Sweden)

    Gemma Llauradó

    Full Text Available To investigate the usefulness of Fibroblast Growth Factor 23 (FGF-23 and vitamin D as possible biomarkers of pre-clinical atherosclerosis, assessed as arterial stiffness (AS, in a group of subjects with type 1 diabetes (T1DM and no previous cardiovascular events.68 T1DM patients and 68 age- and sex-matched controls were evaluated for 1 age, sex, diabetes duration, physical activity, smoking, alcohol intake, BMI, blood pressure, fasting plasma glucose, HbA1c, estimated glomerular filtration rate (eGFR and lipid profile; 2 microvascular complications; 3 blood concentrations of FGF-23 and mineral metabolism parameters (calcium, phosphate, parathyroid hormone (PTH and 25-hydroxy-vitamin D (25(OHD; 4 AS, assessed as aortic pulse wave velocity (aPWV; and 5 low-grade inflammation (hsCRP, IL-6, sTNFαR1, sTNFαR2 and endothelial dysfunction (ED markers (ICAM-1, VCAM-1, E-Selectin.Patients with T1DM had higher aPWV compared with controls (p<0.001, but they did not present differences in 25(OHD (70.3(50.4-86.2nmol/L vs. 70.7(59.7-83.0nmol/L; p = 0.462 and in FGF-23 plasma concentrations (70.1(38.4-151.9RU/mL vs. 77.6(51.8-113.9RU/mL; p = 0.329. In T1DM patients, higher concentrations of FGF-23 were positively associated with aPWV after adjusting for eGFR and classical cardiovascular risk factors (model 1: ß = 0.202, p = 0.026, other mineral metabolism parameters (model 2: ß = 0.214, p = 0.015, microvascular complications, low-grade inflammation and ED markers (model 3: ß = 0.170, p = 0.045. Lower 25(OHD concentrations were also associated with higher aPWV after adjusting for all the above-mentioned factors (model 3: ß = -0.241, p = 0.015.We conclude that both FGF-23 plasma concentrations (positively and 25(OHD serum concentrations (negatively are associated with AS in patients with T1DM and no previous cardiovascular events.

  12. Antihypertensive treatment decreases arterial stiffness at night but not during the day. Results from the Hypertension in the Very Elderly Trial.

    OpenAIRE

    2016-01-01

    The main Hypertension in the Very Elderly Trial (HYVET) demonstrated a very marked reduction in cardiovascular events by treating hypertensive participants 80 years or older with a low dose, sustained release prescription of indapamide (indapamide SR, 1.5 mg) to which was added a low dose of an angiotensin converting enzyme inhibitor in two-thirds of cases (perindopril 2–4 mg). This report from the ambulatory blood pressure sub-study investigates whether changes in arterial stiffness and ambu...

  13. Estimated aortic blood pressure based on radial artery tonometry underestimates directly measured aortic blood pressure in patients with advancing chronic kidney disease staging and increasing arterial stiffness.

    Science.gov (United States)

    Carlsen, Rasmus K; Peters, Christian D; Khatir, Dinah S; Laugesen, Esben; Bøtker, Hans Erik; Winther, Simon; Buus, Niels H

    2016-10-01

    Central blood pressure (BP) can be assessed noninvasively based on radial tonometry and may potentially be a better predictor of clinical outcome than brachial BP. However, the validity of noninvasively obtained estimates has never been examined in patients with chronic kidney disease (CKD). Here we compared invasive aortic systolic BP (SBP) with estimated central SBP obtained by radial artery tonometry and examined the influence of renal function and arterial stiffness on this relationship. We evaluated 83 patients with stage 3 to 5 CKD (mean estimated glomerular filtration rate [eGFR] 30 ml/min/1.73 m(2)) and 41 controls without renal disease undergoing scheduled coronary angiography. BP in the ascending aorta was measured through the angiography catheter and simultaneously estimated using radial tonometry. The mean difference between estimated central and aortic SBP was -13.2 (95% confidence interval -14.9 to -11.4) mm Hg. Arterial stiffness was evaluated by carotid-femoral pulse wave velocity (cf-PWV) and was significantly increased in CKD patients compared with (versus) control patients (mean 10.7 vs. 9.3 m/s). The difference in BP significantly increased 1.0 mm Hg for every 10 ml/min decrease in eGFR and by 1.6 mm Hg per 1 m/s increase in cfPWV. Using multivariate regression analysis including both eGFR and cfPWV, the difference between estimated central and invasive aortic SBP was significantly increased by 0.7 mm Hg. For the entire cohort brachial SBP significantly better reflected invasive SBP than estimated SBP. Thus, tonometry-based estimates of central BP progressively underestimate invasive central SBP with decreasing renal function and increasing arterial stiffness in CKD patients.

  14. Sex Differences in Peripheral Augmentation Index and Arterial Reservoir Pressure during Upper Limb Postural Shifts

    Directory of Open Access Journals (Sweden)

    Kevin S. Heffernan

    2014-01-01

    Full Text Available We examined the peripheral hemodynamic response to passive arm postural changes in young men and women. Radial artery pulse waveforms were captured using applanation tonometry in 20 men (age 27 ± 2 yrs, BMI 25 ± 1 kg/m2 and 20 women (age 27 ± 2 yrs, BMI 23±1 kg/m2. Arm position was maintained at either heart level or supported 14 cm above/below heart level in a randomized fashion. Systolic augmentation index (sAIx and diastolic augmentation index (dAIx were used as estimates of pressure from wave reflections arriving in systole and diastole, respectively. A novel reservoir-wave separation technique was used to obtain arterial reservoir pressure (pressure generated by arterial capacitance. Women showed a significant reduction in radial diastolic pressure-time integral (DPTI (P0.05 or dAIx (P>0.05 when moving the arm from below to above heart level. Conversely, men showed an attenuated change in radial DPTI (P>0.05 concomitant with significant increases in reservoir pressure (P<0.05, sAIx (P<0.05, and dAIx (P<0.05. Gravity-mediated changes in regional hemodynamics produced by passive arm postural shifts are sex specific. Men demonstrate less change in regional diastolic pressure concomitant with increased augmentation index and arterial reservoir pressure.

  15. Uncertainty quantification of inflow boundary condition and proximal arterial stiffness-coupled effect on pulse wave propagation in a vascular network.

    Science.gov (United States)

    Brault, Antoine; Dumas, Laurent; Lucor, Didier

    2016-12-10

    This work aims at quantifying the effect of inherent uncertainties from cardiac output on the sensitivity of a human compliant arterial network response based on stochastic simulations of a reduced-order pulse wave propagation model. A simple pulsatile output form is used to reproduce the most relevant cardiac features with a minimum number of parameters associated with left ventricle dynamics. Another source of significant uncertainty is the spatial heterogeneity of the aortic compliance, which plays a key role in the propagation and damping of pulse waves generated at each cardiac cycle. A continuous representation of the aortic stiffness in the form of a generic random field of prescribed spatial correlation is then considered. Making use of a stochastic sparse pseudospectral method, we investigate the sensitivity of the pulse pressure and waves reflection magnitude over the arterial tree with respect to the different model uncertainties. Results indicate that uncertainties related to the shape and magnitude of the prescribed inlet flow in the proximal aorta can lead to potent variation of both the mean value and standard deviation of blood flow velocity and pressure dynamics due to the interaction of different wave propagation and reflection features. Lack of accurate knowledge in the stiffness properties of the aorta, resulting in uncertainty in the pulse wave velocity in that region, strongly modifies the statistical response, with a global increase in the variability of the quantities of interest and a spatial redistribution of the regions of higher sensitivity. These results will provide some guidance in clinical data acquisition and future coupling of arterial pulse wave propagation reduced-order model with more complex beating heart models.

  16. Sprint interval and traditional endurance training induce similar improvements in peripheral arterial stiffness and flow-mediated dilation in healthy humans.

    Science.gov (United States)

    Rakobowchuk, Mark; Tanguay, Sophie; Burgomaster, Kirsten A; Howarth, Krista R; Gibala, Martin J; MacDonald, Maureen J

    2008-07-01

    Low-volume sprint interval training (SIT), or repeated sessions of brief, intense intermittent exercise, elicits metabolic adaptations that resemble traditional high-volume endurance training (ET). The effects of these different forms of exercise training on vascular structure and function remain largely unexplored. To test the hypothesis that SIT and ET would similarly improve peripheral artery distensibility and endothelial function and central artery distensibility, we recruited 20 healthy untrained subjects (age: 23.3 +/- 2.8 yr) and had them perform 6 wk of SIT or ET (n = 5 men and 5 women per group). The SIT group completed four to six 30-s "all-out" Wingate tests separated by 4.5 min of recovery 3 days/wk. The ET group completed 40-60 min of cycling at 65% of their peak oxygen uptake (Vo2peak) 5 days/wk. Popliteal endothelial function, both relative and normalized to shear stimulus, was improved after training in both groups (main effect for time, P < 0.05). Carotid artery distensibility was not statistically altered by training (P = 0.29) in either group; however, popliteal artery distensibility was improved in both groups to the same degree (main effect, P < 0.05). We conclude that SIT is a time-efficient strategy to elicit improvements in peripheral vascular structure and function that are comparable to ET. However, alterations in central artery distensibility may require a longer training stimuli and/or greater initial vascular stiffness than observed in this group of healthy subjects.

  17. Vascular Health Assessment of The Hypertensive Patients (VASOTENS) Registry: Study Protocol of an International, Web-Based Telemonitoring Registry for Ambulatory Blood Pressure and Arterial Stiffness

    Science.gov (United States)

    Parati, Gianfranco; Avolio, Alberto; Rogoza, Anatoly N; Kotovskaya, Yulia V; Mulè, Giuseppe; Muiesan, Maria Lorenza; Orlova, Iana A; Grigoricheva, Elena A; Cardona Muñoz, Ernesto; Zelveian, Parounak H; Pereira, Telmo; Peixoto Maldonado, João Manuel

    2016-01-01

    Background Hypertension guidelines recommend ambulatory blood pressure (ABP), central aortic pressure (CAP), and pulse wave velocity (PWV) as parameters for estimating blood pressure (BP) control and vascular impairment. Recent advances in technology have enabled devices to combine non-invasive estimation of these parameters over the 24-hour ABP monitoring. However, currently there is limited evidence on the usefulness of such an approach for routine hypertension management. Objective We recently launched an investigator-initiated, international, multicenter, observational, prospective study, the Vascular health Assessment Of The Hypertensive patients (VASOTENS) Registry, aimed at (1) evaluating non-invasive 24-hour ABP and arterial stiffness estimates (through 24-hour pulse wave analysis, PWA) in hypertensive subjects undergoing ambulatory blood pressure monitoring (ABPM) for clinical reasons; (2) assessing the changes in estimates following treatment; (3) weighing the impact of 24-hour PWA on target organ damage and cardiovascular prognosis; (4) assessing the relationship between arterial stiffness, BP absolute mean level and variability, and prognosis; and (5) validating the use of a 24-hour PWA electronic health (e-health) solution for hypertension screening. Methods Approximately 2000 subjects, referred to 20 hypertension clinics for routine diagnostic evaluation and follow-up of hypertension of any severity or stage, will be recruited. Data collection will include ABPM, performed with a device allowing simultaneous non-invasive assessment of 24-hour CAP and arterial stiffness (BPLab), and clinical data (including cardiovascular outcomes). As recommended by current guidelines, each patient will be followed-up with visits occurring at regular intervals (ideally every 6 months, and not less than once a year depending on disease severity). A Web-based telemedicine platform (THOLOMEUS) will be used for data collection. The use of the telemedicine system will allow

  18. 超重和肥胖与动脉僵硬度的相关性研究%Association between overweight, obesity and arterial stiffness in community residents

    Institute of Scientific and Technical Information of China (English)

    黄晖明; 李森; 许浩

    2011-01-01

    Objective To evaluate the relationship between overweight,obesity and arterial stiffness in community residents.Methods A total of 4585 community-dwelling adults in Jiangsu province,China were surveyed with the method of stratified and cluster sampling from 2007 to 2009.Overweight and obesity were defined by body mass index (BMI) and arterial stiffness was assessed by brachial-ankle pulse wave velocity (baPWV).Statistical analysis of arteriosclerosis included multivariate logistic regression testing among which BMI was viewed as continuous variable( 1 kg/m2 increasing to BMI)and categorical variables (underweight,normal,overweight and obesity) respectively.Odds ratio,population attributable risk percent and the optimal cut-off points for BMI to evaluate arteriosclerosis were analyzed using receiver operator characteristic (ROC) curve.Results ( 1 ) After age control,BMI of male or female were positively correlated with baPWV (r =0.213,P <0.01; r =0.186,P <0.01).baPWV and prevalence of arteriosclerosis were significantly higher in obese residents compared with normal body weight group ( all P < 0.01 ).(2)As a continuous variable,the odds ratio value of BMI on predicting arteriosclerosis was 1.146 (95%CI:1.117 - 1.175,P < 0.01 ) after adjusting of age,gender and hypertension.As categorical variables,the odds ratio value of BMI was 0.369(95% CI:0.141 -0.962,P <0.05) for underweight group,1.576 (95% CI:1.333 - 1.863 ) for overweight group and 2.087 ( 95% CI:1.615 - 2.698 ) for obesity group (all P <0.01 ).(3) The population attributable arteriosclerosis risk was 19.1% and 11.6%in overweight and obesity groups,respectively.The area under the ROC curve was 0.661 (95% CI:0.645 -0.678,P < 0.01 ) and the optimal cut-off point for BMI to evaluate arteriosclerosis was 24.25 kg/m2.Conclusions Overweight and obese residents faced higher risk for arteriosclerosis than normal population.Overweight and obesity are independent risk factors for

  19. Relationship between chest pain severity and physiological indexes in patients with coronary artery disease

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    Ali Fakhr-Movahedi

    2016-05-01

    Full Text Available Background: Coronary artery disease is considered as main factor for patients’ hospitalization. Chest pain is the most common symptoms of patients and its assessment is an important factor in coronary artery disease. So, this study aimed to determine the relationship between the severity of chest pain with physiological indexes in patients with coronary artery disease. Methods: This study was a descriptive-analytical design that performed on 80 patients with that were hospitalized in coronary care unit of Shahid Mofatteh Hospital in Varamin city, Iran, from March to September, 2014. In this study, the relationship between the chest pain severity and blood pressure, pulse rate, respiratory rate, O2 saturation and ST segment alterations were assessed. Finally, the gathered data were analyzed by descriptive and inferential statistics. Results: The mean of chest pain severity was 6.51±2.14 in patients. Patients’ age was between 26 to 85 years old and the mean of age was 60.79±13.79 and there was no significant correlation between age and chest pain severity (P=0.985. Also male and female patients were equal. There was no significant difference between chest pain severity of men and women (P=0.471. The findings of study showed no correlation between chest pain severity and heart rate (r=-0.174 and P=0.122, respiratory rate (r=-0.013 and P=0.909, O2 saturation (r=0.051 and P=0.651, ST segment alterations (r=0.07 and P=0.539. Also, there was no significant difference between chest pain severity and systolic pressure (P=0.353, diastolic blood pressure (P=0.312 and body mass index (P=0.256 among patients. Conclusion: In this study, there were not enough evidences for relation between chest pain and physiological indexes in patients with coronary artery disease. So performing more studies in another settings and conditions recommended.

  20. Prevalence of peripheral vascular disease and its association with carotid intima-media thickness and arterial stiffness in type 2 diabetes: the Chennai urban rural epidemiology study (CURES 111).

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    Pradeepa, Rajendra; Chella, Sundarapandi; Surendar, Jayagopi; Indulekha, Karunakaran; Anjana, Ranjit Mohan; Mohan, Viswanathan

    2014-05-01

    We investigated the prevalence of peripheral vascular disease (PVD) and its association with preclinical atherosclerotic markers [intima-media thickness (IMT)] and arterial stiffness among 1755 urban south Indian type 2 diabetic subjects recruited from the Chennai Urban Rural Epidemiology Study (CURES). Doppler studies were performed, and PVD was defined as ankle-brachial index (ABI) of ≤0.9. IMT of the common carotid artery was determined using high-resolution B-mode ultrasonography, and augmentation index (AGI) was measured using the Sphygmocor apparatus. The overall prevalence of PVD was 8.3% (age-standardized 6.5%). The prevalence of PVD was higher among known diabetic subjects (n = 1401) compared to newly detected diabetic subjects (n = 354) (8.6% vs 6.8%, p = 0.250). The mean IMT and AGI in subjects with PVD were significantly higher compared to subjects without PVD (IMT: 0.99 ± 0.26 mm vs 0.83 ± 0.19 mm; AGI: 28.1 ± 9.6% vs 25.7 ± 9.8%, respectively). IMT was independently associated with PVD even after adjusting for age [odds ratio (OR) = 2.9 (1.2-6.7), p = 0.016 for second tertile and OR = 3.9 (1.7-9.3), p = 0.002 for third tertile compared to first tertile]. AGI was also associated with PVD in the unadjusted model [OR = 1.8 (1.1-3.1), p = 0.027 for second tertile compared to first tertile]. However, when adjusted for age, the significance was lost. In conclusion, among urban south Indian type 2 diabetic subjects, the prevalence of PVD is 8.3% and IMT is more strongly associated with PVD than AGI.

  1. Vitamin D deficiency is associated with digital ulcer but not with atherosclerosis or arterial stiffness in patients with systemic sclerosis: a pilot study.

    Science.gov (United States)

    Park, Eun-Kyoung; Park, Ji-Heh; Kweon, Seong-Min; Kim, Geun-Tae; Lee, Seung-Geun

    2017-04-01

    The objective of this study was to investigate the association of vitamin D deficiency with digital ulcers (DUs) that result from microvasculopathy, carotid intima-media thickness (CIMT) as surrogate markers of atherosclerosis, and brachial-ankle pulse wave velocity (baPWV) representing arterial stiffness in patients with systemic sclerosis (SSc). In this cross-sectional study, 40 female SSc patients and 80 healthy controls matched for sex, age, and blood sampling season were recruited. Vitamin D deficiency was defined as serum 25-OHD levels D deficiency was more prevalent in SSc patients than in controls (30 vs. 11.3%). Regarding SSc patients, 9 (22.5%) had DUs ever, and the mean CIMT and baPWV were 0.68 mm and 1561.1 cm/s, respectively; carotid plaque was detected in 13 (34.2%) patients. The frequency of DUs ever was significantly higher for SSc patients with vitamin D deficiency than those without this feature (50 vs. 10.7%, p = 0.012), but the median CIMT and baPWV and the frequency of carotid plaque did not differ according to the presence of vitamin D deficiency. Multivariable logistic regression analysis showed that vitamin D deficiency was an independent risk factor for DUs ever (OR = 7.72, p = 0.024). Vitamin D deficiency was associated with DUs, but not with atherosclerosis or arterial stiffness, potentially indicating that vitamin D may have different effects on the microvascular and macrovascular involvement in SSc pathophysiology.

  2. Correlation between body mass index and the risk factors and severity of coronary artery disease

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    Jing LI

    2011-04-01

    Full Text Available Objective To assess the correlation between body mass index and the risk factors and severity of coronary artery disease.Methods Five thousand two hundred and ninety-four patients with suspected coronary artery disease,who underwent coronary angiography from Jan.2001 to Mar.2007 at 20 medical centers in China,were enrolled in the present study.The patients were divided into normal,overweight and obesity group,and body mass index(BMI,blood pressure(BP,blood glucose,serum total cholesterol(TC,triglyceride(TG,low-density lipoprotein cholesterol(LDL-C and high-density lipoprotein cholesterol(HDL-C were measured.The correlation between BMI and the risk factors and severity of coronary artery disease(CAD was analyzed.And the correlation between gender in different BMI group and CAD rick factors was also evaluated.Results The BMI was correlated with BP,TC,blood glucose,age and HDL-C(P 0.05 in male group.The BMI was correlated with BP,TC,TG,LDL-C and high blood glucose(P 0.05 in female group.Logistic regression analysis showed that hypertension was a prominent predictor of overweight and obesity(OR=2.102,95%CI 1.762~2.509.Conclusion BMI is significantly correlated with blood glucose,BP,TG,TC,LDL-C and HDL-C,but it is not an independent risk factor for CAD.

  3. Drug therapies and presence of coronary artery disease may affect aortic stiffness in Alzheimer’s disease

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    Bektaş O

    2015-02-01

    Full Text Available Osman Bektaş,1 Zeki Yüksel Günaydin,1 Ahmet Karagöz,2 Ahmet Kaya1 1Ordu University, Department of Cardiology, Ordu, 2Giresun University, Department of Cardiology, Giresun, TurkeyWe have read the original research entitled "Altered diastolic function and aortic stiffness in Alzheimer’s disease" by Çalık et al1 which was published in the July 2014 issue of Clinical Interventions in Aging, with great interest. We would like to touch on some points about this article.View original paper by Çalık and colleagues

  4. Comparison of knee-high Mediven ulcer kit and Mediven Plus compression stockings: measurement of leg volume, interface pressure and static stiffness index changes

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    Győző Szolnoky

    2013-06-01

    Full Text Available Ulcer stockings are produced to have higher interface pressure and easier application compared to those of classic medical compression stockings. We aimed to compare volume decrease, pressure loss and stiffness index of a classical medical compression stocking and an ulcer stocking of the same interface pressure range in 10 patients with bilateral venous and 10 persons with lymphatic insufficiency. Interface pressure measurement in supine and standing positions and optoelectronic volumetry served for primary outcome variables. Both stockings were capable of inducing remarkable gradual volume reductions in different time points except classic stocking at 2 h in phleboedema care. Ulcer stocking pressures in lymph- and phleboedema were highly superior. In lymphedema a gradual interface pressure loss was attributed to both stockings regardless of body positions. Static stiffness indices did not differ statistically except classic stocking at baseline (P=0.0312 and 2 h (P=0.0082 comprising venous edema patients. Both stockings acted similarly but ulcer stocking had considerably higher interface pressures in each measurement and raised stiffness indices initially and the two-layer system facilitates donning therefore ulcer stocking could serve an alternative of classic medical compression stocking even in the treatment of leg edema.

  5. Resistive index(RI) of the intratesticular artery in orchitis: comparison with normal testis

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    Yang, Dal Mo; Kim, Hyung Sik; Lee, Young Seok; Yoon, Myung Hwan; Lee, Jong Bouk; Yun, Jung Chul [Chung Ang Gil Hospital, Incheon (Korea, Republic of)

    1994-12-15

    Color doppler ultrasound is ideally suited for diagnosing acute scrotal disease as it provides simultaneous display of tissue morphology and blood flow. This study was performed in order to evaluate the utility of resistive index(RI) of intratesticular arteries in orchitis. We retrospectively analyzed 18 testes of 15 patients confirmed by means of appropriate response to antibiotic treatment and 20 testes of 10 asymptomatic volunteers.The resistive indexes ranged from 0.25 to 0.60 (mean, 0.48) in orchitis, and from 0.50 to 0.71 (mean, 0.62) in volunteers. Thus, the resistive index in orchitis is significantly lower than that of the volunteers (p<0.05).With a cut-off point of resistive index at 0.6, the sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were 94%, 90%, 89%, 95% and 92%m respectively. We conclude that decreased resistive index is a helpful finding in the diagnosis of orchitis, and we suggest the resistive index of 0.6 as a cut-off point

  6. Arterial pulsatility as an index of cerebral microangiopathy in diabetes type 2.

    Science.gov (United States)

    Agha, M S; Alboudi, A

    2014-01-09

    Transcranial doppler is an inexpensive, non-invasive investigation. This study assessed its validity in determining cerebral small vessel disease in patients with type 2 diabetes mellitus. Flow velocity and pulsatility index were measured in the middle cerebral, basilar and intracranial internal carotid arteries of a sample of 141 diabetic patients with no other risk factors, and 132 age- and sex-matched healthy controls. The patients were divided into 2 groups: 73 with complicated and 68 with uncomplicated diabetes. There was a statistically significant difference between the complicated diabetes and control groups for the 3 arteries and most indices. The differences between the uncomplicated diabetes patients and the controls were also statistically significant but less strongly. Transcranial doppler may be useful in early diagnosis of cerebral small vessel disease in patients with type 2 diabetes mellitus.

  7. The effect of new-onset diabetes after renal transplantation on arterial stiffness%肾移植术后新发糖尿病的危险因素及其对动脉僵硬度的影响

    Institute of Scientific and Technical Information of China (English)

    刘航; 史屹; 沈中阳

    2009-01-01

    目的 探讨肾移植术后新发糖尿病(NODAT)的影响因素以及动脉僵硬度与移植术后新发糖尿病之间的相关性.方法 195例肾移植患者,根据糖耐量检查的结果分为NODAT与非NODAT两组.应用动脉硬化检测仪检测患者的肱一踝脉搏波传导速度(baPWV)、踝肘血压指数(ABPI)以及颈动脉内膜中层厚度(IMT),同时对入选对象进行血清学检测,根据动脉僵硬度指标分析两组之间的差异.结果 29例移植术后诊断为NODAT,与非NODAT患者相比,移植术前的空腹血糖(FPG)、血压以及丙型肝炎病毒(HCV)感染率都处于一个相当高的水平.多变量回归分析提示,术前HCV感染率、FPG水平以及收缩压是关系到NODAT发生的危险因素.NODAT患者的baPWV明显快于非NODAT患者,同时高血压、年龄以及术后糖化血红蛋白是动脉僵硬度进展的独立决定性因素.结论 肾移植术前高水平的FPG、HCV感染以及持续的高血压状态是引起NODAT的危险因素;高血压、年龄偏大以及糖化血红蛋白升高对动脉僵硬度的进展具有重要影响.%Objective To investigate the risk factor for new-onset diabetes after transplantation (NODAT) and the relationship between NODAT and arterial stiffness. Methods Oral glucose tolerance test (OGTT) was performed on 195 patients with renal transplantation. The degree of arterial stiffness, which was determined by brachial ankle pulse wave velocity (baPWV), anklebrachial blood pressure index (ABPI) and intima-media thickness (IMT) of the carotid artery, was evaluated. Results Twenty-nine patients diagnosed as NODAT had significantly higher fasting plasma glucose before transplantation, blood pressure and incidence of hepatitis C virus (HCV) infection than in patients without NODAT. Multivariate regression analysis revealed that the risk factor of NODAT was fasting plasma glucose pre-transplantation, HCV infection and systolic blood pressure.The independent determinant of the

  8. PREVALENCE OF PERIPHERAL ARTERIAL DISEASE IN TYPE - 2 DIABETES MELLITUS AND ITS CORRELATION WITH CORONARY ARTERY DISEASE USING ANKLE - BRACHIAL INDEX

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    Basawaraj

    2015-02-01

    Full Text Available OBJECTIVES: Peripheral vascular disease is one of the macrovascular complications of diabetes mellitus. The purpose of this study was to examine the peripheral arterial disease (PAD complicating type 2 diabetes, in particular the influence of PAD on the risk of coronary artery disease. METHODS: Randomly selected T2DM pat ients admitted to Basaweshwara Teaching and General Hospital were included. In addition to a detailed history and physical examination, anthropometric parameters like body mass index was measured. Relevant laboratory investigations were performed. Modified Rose questionnaire was used to diagnose coronary artery disease (CAD. Colour Doppler examination of the arteries of the lower limbs was performed. A cut off of 7% were significant predictors of PAD. Older age, higher HbA1c levels microalbuminuria and deranged lipid profile were found to be significant predictors of CAD. CONCLUSION: We found evidence of PAD in 16% of type 2 dia betics using ankle brachial index. The prevalence of CAD was higher in patients with PAD. So there is definite and strong correlation between PAD and CAD. Thus the early diagnosis of PAD should alert the clinician to a high probability of underlying CAD. KEYWORDS: D i abetes mellitus; Coronary artery disease; Peripheral artery disease; Ankle - brachial index.

  9. High trans but not saturated fat beverage causes an acute reduction in postprandial vascular endothelial function but not arterial stiffness in humans.

    Science.gov (United States)

    Lane-Cordova, Abbi D; Witmer, Jordan R; Dubishar, Kaitlyn; DuBose, Lyndsey E; Chenard, Catherine A; Siefers, Kyle J; Myers, Janie E; Points, Lauren J; Pierce, Gary L

    2016-10-01

    A diet high in trans-fatty acids (TFAs) is associated with a higher risk of cardiovascular disease (CVD) than a diet high in saturated fatty acids (SFAs), but the mechanisms remain unclear. We hypothesized that a beverage high in TFAs would cause a larger reduction in postprandial endothelial function and an increase in arterial stiffness, in part from greater reductions in insulin sensitivity, compared with a beverage high in SFAs. Eleven healthy adults (aged 47±5 years) ingested a warm test beverage (520 kcal, 56 g total fat, 5 g carbohydrate, 1 g protein) high in either TFAs or SFAs in a randomized cross-over study. Ingestion of the beverage high in TFAs (phigh in SFAs (p=0.49) decreased endothelial function (brachial artery flow-mediated dilation, mmΔ) at 3-4 hours (phigh in TFAs but not SFAs results in a postprandial reduction in endothelial function and a trend for decreased insulin sensitivity, potentially explaining the higher risk of CVD with a diet high in TFAs.

  10. Relative Importance of Aortic Stiffness and Volume as Predictors of Treatment-Induced Improvement in Left Ventricular Mass Index in Dialysis.

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    Panagiotis I Georgianos

    Full Text Available This study aimed to explore the relative contribution of aortic stiffness and volume in treatment-induced change of left ventricular mass in dialysis. Hypertension in Hemodialysis Patients Treated with Atenolol or Lisinopril trial compared the effect of lisinopril versus atenolol in reducing left ventricular mass index; 179 patients with echo measurements of aortic pulse wave velocity and left ventricular mass at baseline were included. In unadjusted analysis, overall reductions of 26.24 g/m2 (95% CI: -49.20, -3.29 and 35.67 g/m2 (95% CI: -63.70, -7.64 in left ventricular mass index were noted from baseline to 6 and 12 months respectively. Volume control emerged as an important determinant of regression of left ventricular mass index due to the following reasons: (i additional control for change in ambulatory systolic blood pressure mitigated the reduction in left ventricular mass index in the statistical model above [6-month visit: -18.6 g/m2 (95% CI: -43.7, 6.5; 12-month visit: -22.1 g/m2 (95% CI: -52.2, 8.0] (ii regression of left ventricular hypertrophy was primarily due to reduction in left ventricular chamber and not wall thickness and (iii adjustment for inferior vena cava diameter (as a proxy for volume removed the effect of time on left ventricular mass index reduction [6-month visit: -6.6 g/m2 (95% CI: (-41.6, 28.4; 12-month visit: 0.6 g/m2 (95% CI: -39.5, 40.7]. In contrast, aortic pulse wave velocity was neither a determinant of baseline left ventricular mass index nor predictor of its reduction. Among dialysis patients, ambulatory systolic pressure, a proxy for volume expansion, but not aortic stiffness is more important predictor of reduction in left ventricular mass index. Improving blood pressure control via adequate volume management appears as an effective strategy to improve left ventricular hypertrophy in dialysis.

  11. Relation of Dietary Glycemic Index and Glycemic Load to Coronary Artery Calcium in Asymptomatic Korean Adults.

    Science.gov (United States)

    Choi, Yuni; Chang, Yoosoo; Ryu, Seungho; Cho, Juhee; Kim, Mi Kyung; Ahn, Younjhin; Lee, Jung Eun; Sung, Eunju; Kim, Boyoung; Ahn, Jiin; Kim, Chan-Won; Rampal, Sanjay; Zhao, Di; Zhang, Yiyi; Pastor-Barriuso, Roberto; Lima, Joao A C; Chung, Eun Chul; Shin, Hocheol; Guallar, Eliseo

    2015-08-15

    The relation between glycemic index, glycemic load, and subclinical coronary atherosclerosis is unknown. The aim of the study was to evaluate the associations between energy-adjusted glycemic index, glycemic load, and coronary artery calcium (CAC). This study was cross-sectional analysis of 28,429 asymptomatic Korean men and women (mean age 41.4 years) without a history of diabetes or cardiovascular disease. All participants underwent a health screening examination between March 2011 and April 2013, and dietary intake over the preceding year was estimated using a validated food frequency questionnaire. Cardiac computed tomography was used for CAC scoring. The prevalence of detectable CAC (CAC score >0) was 12.4%. In multivariable-adjusted models, the CAC score ratios (95% confidence intervals) comparing the highest to the lowest quintile of glycemic index and glycemic load were 1.74 (1.08 to 2.81; p trend = 0.03) and 3.04 (1.43 to 6.46; p trend = 0.005), respectively. These associations did not differ by clinical subgroups, including the participants at low cardiovascular risk. In conclusion, these findings suggest that high dietary glycemic index and glycemic load were associated with a greater prevalence and degree of CAC, with glycemic load having a stronger association.

  12. In-vivo analysis of thoracic mechanical response under belt loading: the role of body mass index in thorax stiffness.

    Science.gov (United States)

    Poulard, David; Bermond, François; Compigne, Sabine; Bruyère, Karine

    2013-03-15

    Thoracic injuries are a major cause of mortality in frontal collisions, especially for elderly and obese people. Car occupant individual characteristics like BMI are known to influence human vulnerability in crashes. In the present study, thoracic mechanical response of volunteers quantified by optical method was linked to individual characteristics. 13 relaxed volunteers of different anthropometries, genders and age were submitted to non-injurious sled tests (4 g, 8 km/h) with a sled buck representing the environment of a front passenger restrained by a 3-point belt. A resulting shoulder belt force was computed using the external and internal shoulder belt loads and considering shoulder belt geometry. The mid sternal deflection was calculated as the distance variation between markers placed at mid-sternum and the 7th vertebra spinous process of the subject. Force-deflection curves were constructed using resulting shoulder belt force and midsternal deflection. Average maximum chest compression was 7.9±2.3% and no significant difference was observed between overweight subjects (BMI≥25 kg/m²) and normal subject (BMI<25 kg/m²). The overweight subjects exhibited significantly greater resultant belt forces than normal subjects (715±132 N vs. 527±111 N, p<0.05), higher effective stiffness (30.9±10.6N/mm vs. 19.6±8.9 N/mm, p<0.05) and lower dynamic stiffness (42.7±8.71 N/mm vs. 61.7±15.5 N/mm, p<0.05).

  13. Left Ventricular Mass index and Pulmonary Artery Pressure in Patients with the Obstructive Sleep Apnea Syndrome

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    Seyed Hashem Sezavar

    2016-07-01

    Full Text Available Background: Sleep apnea is accompanied by some cardiovascular complications. It has even been hypothesized that sleep apnea, itself, can induce some of these complications. Given such controversies, we assessed the left ventricular mass index (LVMI and systolic pulmonary artery pressure in patients with sleep apnea.Methods: Through convenience sampling, 56 patients with the obstructive sleep apnea syndrome (OSAS were included in the present descriptive cross-sectional study. Patients with any past history of hypertension and diabetes mellitus were excluded. The apnea severity was assessed via the polysomnography-derived apnea-hypopnea index (AHI. All the patients underwent transthoracic echocardiography. In this cross-sectional study - data regarding age, gender, smoking, systolic and diastolic blood pressures, polysomnographic parameters (AHI, severity of disease, mean heart rate, mean oxygen saturation [SaO2], lowest SaO2, and duration of SaO2 below 90% [d.SaO2 < 90%], and  echocardiographic parameters (systolic pulmonary artery pressure and LVMI were accumulated and processed.Results: Fifty-two men and 14 women at a mean age of 49.29 ± 11.79 years participated in this study. Systolic and was significantly high in the severe group compared with the mild group (128.21 ± 9.73 mmHg vs. 119.23 ± 12.5 mmHg; p value = 0.007. The LVMI was increased parallel to an increase in the severity of the OSAS, but that increase was not statistically significant (p value = 0.161. The d.SaO2 < 90% was positively correlated with the LVMI, and this relationship remained true after adjustment for the body mass index (r = 0.27; p value = 0.042.Conclusion: Severe OSAS was accompanied by a higher blood pressure. The LVMI did not differ significantly between the patients with the OSAS and those who did not suffer from other risk factors of cardiac diseases.

  14. Evaluation of Asymptomatic Peripheral Arterial Disease by Ankle-brachial Index in Patients with Concomitant Coronary Arterial Disease

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    Hosein Vakili

    2012-12-01

    Full Text Available Background: Peripheral arterial disease is associated with adverse cardiovascular outcomes. As such, it is found that screening for peripheral arterial disease (PAD improves risk assessment. Thus, intensive risk factor modification and medical treatment in these patients are necessary. Objectives: The purpose of this study was to determine the prevalence of asymptomatic peripheral arterial disease in patients with concomitant coronary arterial disease. Methods: Asymptomatic peripheral arterial disease was investigated in 400 patients (60% males, 40% females, aged 59.7± 11.3 with a documented coronary arterial disease. Results: Among patients with documented CAD, 12% had asymptomatic PAD with the ABI ratio of less than 0.9. Conclusions: It is advisable to screen for PAD not only as a disease but also as a risk assessment method for atherosclerosis.

  15. Arterial function of carotid and brachial arteries in postmenopausal vegetarians

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    Su T

    2011-08-01

    Full Text Available Ta-Chen Su1, Pao-Ling Torng2, Jiann-Shing Jeng3, Ming-Fong Chen1, Chiau-Suong Liau1,41Division of Cardiology, Department of Internal Medicine, 2Department of Obstetrics and Gynecology, 3Department of Neurology, National Taiwan University Hospital, National Taiwan University College of Medicine, 4Cardiovascular Center, Taipei Buddist Tzu-Chi Hospital, Hsin-Dian, Taipei, TaiwanBackground: Vegetarianism is associated with a lower risk of cardiovascular disease. However, studies of arterial function in vegetarians are limited.Methods: This study investigated arterial function in vegetarianism by comparing 49 healthy postmenopausal vegetarians with 41 age-matched omnivores. The arterial function of the common carotid artery was assessed by carotid duplex, while the pulse dynamics method was used to measure brachial artery distensibility (BAD, compliance (BAC, and resistance (BAR. Fasting blood levels of glucose, lipids, lipoprotein (a, high-sensitivity C-reactive protein, homocysteine, and vitamin B12 were also measured.Results: Vegetarians had significantly lower serum cholesterol, high-density and low-density lipoprotein, and glucose compared with omnivores. They also had lower vitamin B12 but higher homocysteine levels. Serum levels of lipoprotein (a and high-sensitivity C-reactive protein were no different between the two groups. There were no significant differences in carotid beta stiffness index, BAC, and BAD between the two groups even after adjustment for associated covariates. However, BAR was significantly lower in vegetarians than in omnivores. Multiple linear regression analysis revealed that age and pulse pressure were two important determinants of carotid beta stiffness index and BAD. Vegetarianism is not associated with better arterial elasticity.Conclusion: Apparently healthy postmenopausal vegetarians are not significantly better in terms of carotid beta stiffness index, BAC, and BAD, but have significantly decreased BAR than

  16. 中心动脉脉压是影响大动脉僵硬度的主要因素%Central pulse pressure but not brachial blood pressure is the predominant factor affecting aortic arterial stiffness

    Institute of Scientific and Technical Information of China (English)

    肖文凯; 叶平; 白永怿; 骆雷鸣; 吴红梅; 高鹏

    2015-01-01

    目的:观察高血压患者及血压正常人群中心动脉血流动力学差异;探讨哪种血压指标与动脉僵硬度及血管损害标志物更密切相关。方法从北京地区社区人群中筛选出820名高血压患者,同时入选820名与之年龄、性别相匹配的血压正常者。采用脉搏波传播速度(PWV)自动测量系统测定颈-股动脉PWV和颈-桡动脉PWV;应用张力测量法测量中心动脉压和中心动脉脉搏波增强指数(AIx)。同时血浆同型半胱氨酸(HCY),高敏C反应蛋白(HsCRP)及N末端脑利钠肽前体(NT-proBNP)被测定。结果无论是高血压患者还是血压正常人群,中心动脉收缩压和脉压显著低于相应的肱动脉收缩压和脉压,这种脉压扩增在血压正常组9.85±6.55 mmHg明显低于高血压组12.64±6.69 mmHg,但在脉压扩增比上两组未见差异。大动脉僵硬度受血压及年龄的影响,高血压组具有较高的颈股动脉PWV和中心动脉AIx,脉压扩增比随年龄的增长而递减。单因素分析见中心脉压相对其它血压指标与动脉僵硬度和血管损害标志物的相关性更强;多元逐步回归分析显示颈股动脉PWV和中心动脉AIx受中心脉压的独立影响而外周平均动脉压及脉压未进入回归方程。结论中心动脉脉压相对其它血压指标可能是中心动脉僵硬度更直接的指示器和更好的血管老化的标志,未来的临床试验中可能更多地将中心动脉压作为治疗的靶目标值。%Objective To investigate the differences in central hemodynamic indices between hypertensive and normotensive subjects and identify the blood pressure index that the most strongly correlate with arterial stiffness and vascular damage markers. Methods A cohort of 820 hypertensive patients and 820 normotensive individuals matched for age and gender were enrolled in this study. We measured carotid-femoral and carotid-radial pulse wave velocity (PWV), aortic

  17. Zusammenhang zwischen maximaler Sauerstoffaufnahme und arterieller Gefäßsteifigkeit in Ruhe und während eines Cold Pressure Tests // Relationship between Maximal Oxygen Consumption and Arterial Stiffness at Rest and during Cold Pressor Stress Testing

    Directory of Open Access Journals (Sweden)

    Milatz F

    2016-01-01

    Full Text Available iIntroduction:/i The favorable influence of endurance exercise on arterial stiffness (AS is widely known. It is also well accepted that stress contributes the development of arterial stiffness and predict the risk of cardiovascular events. The aim of this study was to investigate the relationship between maximal oxygen consumption (VO2max and arterial stiffness (AS, quantified by aortic pulse wave velocity (aPWV and augmentation index (AIx, at rest, but in par- ticular during stress testing.br iMethods:/i 32 recreationally active men completed a cardiopulmonary exercise testing. aPWV and AIx were measured non-invasively at rest and during a 2 minute cold pressor test (CPT using Mobil-O-Graph®. After applying partial correlation analysis, the cohort was divided into tertiles of VO2max. Thereafter, ANCOVAs adjusted for age, body mass index and height were performed. br iResults:/i In the total cohort VO2max showed negative correlations with AIx (r = –0.49, p = 0.006 at rest and with AIx (r = –0.51, p = 0.005 as well as aPWV (r = –0.55, r = 0.001 stress test-related. Subjects in the highest tertile of VO2max showed significantly lower stiffness parameters than subjects in the lowest tertile. This was true for AIx (1.1% vs 10.2%, p = 0.012 at rest and for AIx (3.3% vs 13.9%, p = 0.015 as well as aPWV (6.0 m/s vs 6.9 m/s, p = 0.006 during CPT, respectively.br iDiscussion:/i The study provides evidence for an inverse relationship between VO2max and stress test-related AS. Furthermore higher VO2max values seem to be associated with more favorable effects on arterial compliance during stress testing irrespective of known factors influencing AS. p bKurzfassung: /biEinleitung:/i Ausdauertraining besitzt bekanntermaßen günstige Effekte auf die arterielle Gefäßsteifigkeit (AS. Evidenzen aus der kardiovaskulären Forschung sprechen jedoch dafür, dass das kardiovaskuläre Risiko insbesondere durch die Gefäßcompliance während körperlicher und

  18. Coronary artery calcification is associated with insulin resistance index in patients with type 1 diabetes

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    T.C. Rodrigues

    2010-11-01

    Full Text Available The objective of the present study was to evaluate the risk factors associated with the presence of coronary artery calcification (CAC in patients with type 1 diabetes (T1D. A cross-sectional study was conducted on 100 consecutive T1D patients without coronary artery disease, with at least 5 years of diabetes and absence of end-stage renal disease. Mean age was 38 ± 10 years and 57% were males. CAC score was measured by multidetector computed tomography (Siemens Sensation 64 Cardiac. The insulin resistance index was measured using the estimated glucose disposal rate (eGDR. The eGDR was lower among CAC-positive patients than among CAC-negative patients, suggesting an increased insulin resistance. In a logistic regression model adjusted for age (at 10-year intervals, eGDR, diabetic nephropathy and gender, CAC was associated with age [OR = 2.73 (95%CI = 1.53-4.86, P = 0.001] and with eGDR [OR = 0.08 (95%CI = 0.02-0.21, P = 0.004]. In T1D subjects, insulin resistance is one of the most important risk factors for subclinical atherosclerosis.

  19. Central retinal artery resistive index and optical coherence tomography in assessment of glaucoma progression

    Institute of Scientific and Technical Information of China (English)

    Ahmed; F.Abdel; Ghany; Samer; M.Botros; Tamer; M.El-Raggal

    2015-01-01

    AIM: To assess the relation between central retinal artery(CRA) resistive index(RI) and retinal nerve fiber thickness measured by optical coherence tomography(OCT) in assessment of disease progress in cases of open angle glaucoma.METHODS: Twenty-three patients with diagnosed open angle glaucoma were included in this study. They were examined by colored duplex ultrasonography of CRA with estimation of RI of CRA and ophthalmic artery(OA)with estimation of CRA/OA RI ratio as well as OCT measurement of the average retinal nerve fiber layer(RNFL) thickness in order to assess the disease progress.RESULTS: There was strong inverse relation between the increased RI in CRA as well as the increased CRA/OA RI ratio and the decrease in average RNFL thickness in cases of open angle glaucoma.CONCLUSION: Assessment of CRA RI can indirectly assess the vascular changes associated with glaucoma and can assess the degree of retinal atrophy helping in evaluating prognosis thus guiding the choice of treatment.

  20. Correlation between arterial stiffness and left ventricular function in patients with primary hypertension%原发性高血压患者动脉僵硬度与心脏重构的相关性研究

    Institute of Scientific and Technical Information of China (English)

    曾锋; 汤达鹏; 余钷; 罗柳玲; 刘建芬; 梁国华

    2013-01-01

    目的 探讨原发性高血压患者动脉僵硬度与左心功能的相关性.方法 纳入原发性高血压患者79例,根据颈桡脉搏波传导速度(PWV)将患者分为对照组(PWV<0.9m/s,n=42)和观察组(PWV≥0.9m/s,n=37),两组患者均行心脏彩超检查比较心功能参数差异.结果 两组患者间左室舒张末期内径(LVEDd)、左室射血分数(LVEF)、左室质量指数(LVMI)、二尖瓣舒张早期血流峰速(E)、舒张晚期血流峰速(A)及二者比值(E/A)差异具有统计学意义(P<0.05);Pearson相关分析显示PWV与LVMI存在显著的相关性(r=0.347,P<0.05).结论 原发性高血压患者动脉僵硬度与左心重构存在显著的相关性,在临床上检测动脉弹性对于评价高血压患者心脏重构具有显著的临床意义.%Objective To discuss the correlation between arterial stiffness and left ventricular function in patients with primary hypertension. Methods The patients ( n=79 ) were divided, according to carotid-radial pulse wave velocity ( PWV ) , into control group ( PWV<0.9 m/s, n=42 ) and observation group ( PWV ≥ 0.9 m/s, n=37 ) . All patients were given the examination of color Doppler echocardiography, and the difference in cardiac function parameters were compared between two groups. Results The difference in cardiac function parameters, including left ventricular end-diastolic inner diameter ( LVEDd ) , left ventricular ejection fraction ( LVEF ) , left ventricular mass index ( LVMI ) , mitral early diastole inflow velocity ( E ) , late diastole inflow velocity ( A ) and ratio of E to A ( E/A ) , had statistical significance between two groups ( P<0.05 ) . Pearson correlation analysis showed that there was a significant correlation between PWV and LVMI ( r=0.347, P<0.05 ) . Conclusion The arterial stiffness is significantly correlated to left ventricular function, and examination of arterial elasticity is significant for reviewing ventricular remodeling in in patients with primary

  1. Randomized Controlled Trial on the Effect of Channa striatus Extract on Measurement of the Uterus, Pulsatility Index, Resistive Index of Uterine Artery and Superficial Skin Wound Artery in Post Lower Segment Caesarean Section Women

    Science.gov (United States)

    Abdul Karim, Ahmad Helmy; Nik Hussain, Nik Hazlina; Mohd Noor, Norhayati; Omar, Julia; Bin Bai @ Bae, Saringat; Wan Mahmood, Wan Haslindawani; Abdul Razak, Asrenee; Yunus, Rohaizan

    2015-01-01

    Aim To compare the mean of anteroposterior (AP) measurements of the uterus in longitudinal and oblique transverse planes, and the pulsatility index (PI) and resistive index (RI) of the uterine artery and superficial skin wound artery between patients taking Channa striatus and placebo. Background Channa striatus, also known as haruan, is a fresh water snakehead fish consumed in many parts of Southeast Asia. Channa striatus is also normally consumed by women postpartum to promote wound healing as well as to reduce post-operative pain. Methodology This study is a randomised, double blind, placebo-controlled study conducted in women after Lower Segment Caesarean Section (LSCS). Subjects were randomised to either a Channa striatus or a placebo group and were given a daily dosage of 500 mg of Channa striatus extract or 500 mg maltodextrin, respectively, for six weeks post LSCS. The anteroposterior measurements of the uterus in the longitudinal and oblique transverse planes, and the pulsatility index (PI) and resistive index (RI) of the uterine and superficial skin wound arteries were assessed using pelvic Gray-scale ultrasound and Doppler ultrasound at baseline (Day 3) and at two weeks, four weeks and six weeks post-operatively. Results Sixty-six subjects were randomised into the study with 33 in the Channa striatus group and 33 in the placebo group. No significant differences were detected in terms of the pulsatility index (PI) and the resistive index (RI) of the uterine and superficial skin wound arteries between the Channa striatus and placebo groups. However, in the Channa striatus group, the AP measurements of the uterus on the longitudinal and oblique transverse planes were significantly lower compared to the placebo group (p<0.05 and p<0.001, respectively). Conclusion Daily intake of Channa striatus extract results in marked differences compared to placebo in terms of uterine involution and recovery in women post LSCS. Trial Registration www.isrctn.com 11960786

  2. Randomized Controlled Trial on the Effect of Channa striatus Extract on Measurement of the Uterus, Pulsatility Index, Resistive Index of Uterine Artery and Superficial Skin Wound Artery in Post Lower Segment Caesarean Section Women.

    Directory of Open Access Journals (Sweden)

    Mohd Rizal Abu Bakar

    Full Text Available To compare the mean of anteroposterior (AP measurements of the uterus in longitudinal and oblique transverse planes, and the pulsatility index (PI and resistive index (RI of the uterine artery and superficial skin wound artery between patients taking Channa striatus and placebo.Channa striatus, also known as haruan, is a fresh water snakehead fish consumed in many parts of Southeast Asia. Channa striatus is also normally consumed by women postpartum to promote wound healing as well as to reduce post-operative pain.This study is a randomised, double blind, placebo-controlled study conducted in women after Lower Segment Caesarean Section (LSCS. Subjects were randomised to either a Channa striatus or a placebo group and were given a daily dosage of 500 mg of Channa striatus extract or 500 mg maltodextrin, respectively, for six weeks post LSCS. The anteroposterior measurements of the uterus in the longitudinal and oblique transverse planes, and the pulsatility index (PI and resistive index (RI of the uterine and superficial skin wound arteries were assessed using pelvic Gray-scale ultrasound and Doppler ultrasound at baseline (Day 3 and at two weeks, four weeks and six weeks post-operatively.Sixty-six subjects were randomised into the study with 33 in the Channa striatus group and 33 in the placebo group. No significant differences were detected in terms of the pulsatility index (PI and the resistive index (RI of the uterine and superficial skin wound arteries between the Channa striatus and placebo groups. However, in the Channa striatus group, the AP measurements of the uterus on the longitudinal and oblique transverse planes were significantly lower compared to the placebo group (p<0.05 and p<0.001, respectively.Daily intake of Channa striatus extract results in marked differences compared to placebo in terms of uterine involution and recovery in women post LSCS.www.isrctn.com 11960786.

  3. Low-sodium dietary approaches to stop hypertension diet reduces blood pressure, arterial stiffness, and oxidative stress in hypertensive heart failure with preserved ejection fraction.

    Science.gov (United States)

    Hummel, Scott L; Seymour, E Mitchell; Brook, Robert D; Kolias, Theodore J; Sheth, Samar S; Rosenblum, Hannah R; Wells, Joanna M; Weder, Alan B

    2012-11-01

    Recent studies suggest that oxidative stress and vascular dysfunction contribute to heart failure with preserved ejection fraction (HFPEF). In salt-sensitive HFPEF animal models, diets low in sodium and high in potassium, calcium, magnesium, and antioxidants attenuate oxidative stress and cardiovascular damage. We hypothesized that the sodium-restricted Dietary Approaches to Stop Hypertension diet (DASH/SRD) would have similar effects in human hypertensive HFPEF. Thirteen patients with treated hypertension and compensated HFPEF consumed the DASH/SRD for 21 days (all food/most beverages provided). The DASH/SRD reduced clinic systolic (155-138 mm Hg; P=0.02) and diastolic blood pressure (79-72 mm Hg; P=0.04), 24-hour ambulatory systolic (130-123 mm Hg; P=0.02) and diastolic blood pressure (67-62 mm Hg; P=0.02), and carotid-femoral pulse wave velocity (12.4-11.0 m/s; P=0.03). Urinary F2-isoprostanes decreased by 31% (209-144 pmol/mmol Cr; P=0.02) despite increased urinary aldosterone excretion. The reduction in urinary F2-isoprostanes closely correlated with the reduction in urinary sodium excretion on the DASH/SRD. In this cohort of HFPEF patients with treated hypertension, the DASH/SRD reduced systemic blood pressure, arterial stiffness, and oxidative stress. These findings are characteristic of salt-sensitive hypertension, a phenotype present in many HFPEF animal models and suggest shared pathophysiological mechanisms linking these 2 conditions. Further dietary modification studies could provide insights into the development and progression of hypertensive HFPEF.

  4. Biliary Cast Syndrome: Hepatic Artery Resistance Index, Pathological Changes, Morphology and Endoscopic Therapy

    Directory of Open Access Journals (Sweden)

    Hu Tian

    2015-01-01

    Full Text Available Background: Biliary cast syndrome (BCS was a postoperative complication of orthotopic liver transplantation (OLT, and the reason for BSC was considered to relate with ischemic type biliary lesions. This study aimed to evaluate the relationship between BCS following OLT and the hepatic artery resistance index (HARI, and to observe pathological changes and morphology of biliary casts. Methods: Totally, 18 patients were diagnosed with BCS by cholangiography following OLT using choledochoscope or endoscopic retrograde cholangiopancreatography. In addition, 36 patients who did not present with BCS in the corresponding period had detectable postoperative HARI on weeks 1, 2, 3 shown by color Doppler flow imaging. The compositions of biliary casts were analyzed by pathological examination and scanning electron microscopy. Results: HARI values of the BCS group were significantly decreased as compared with the non-BCS group on postoperative weeks 2 and 3 (P 1 (OR = 1.300; 1.223; and 1.889, respectively. The OR of HARI 3 was statistically significant (OR = 1.889; 95% confidence interval = 1.166-7.490; P = 0.024. The compositions of biliary casts were different when bile duct stones were present. Furthermore, vascular epithelial cells were found by pathological examination in biliary casts. Conclusions: HARI may possibly serve as an independent risk factor and early predictive factor of BCS. Components and formation of biliary casts and bile duct stones are different.

  5. Effects of ozone therapy on haemostatic and oxidative stress index in coronary artery disease.

    Science.gov (United States)

    Martínez-Sánchez, Gregorio; Delgado-Roche, Livan; Díaz-Batista, Arquímides; Pérez-Davison, Gema; Re, Lamberto

    2012-09-15

    Coronary artery disease (CAD) is the most common cause of sudden death, and death of people over 20 years of age. Because ozone therapy can activate the antioxidant system and improve blood circulation and oxygen delivery to tissue, the aim of this study was to investigate the therapeutic efficacy of ozone in patients with CAD, treated with antithrombotic therapy, Aspirin and policosanol. A randomized controlled clinical trial was performed with 53 patients divided into two groups: one (n=27) treated with antithrombotic therapy and other (n=26) treated with antithrombotic therapy plus rectal insufflation of O(3). A parallel group (n=50) age and gender matched was used as reference for the experimental variables. The efficacy of the treatments was evaluated by comparing hemostatic indexes and biochemical markers of oxidative stress in both groups after 20 day of treatment. Ozone treatment significantly (Ptherapy only group, without modifying bleeding time. Combination antithrombotic therapy+O(3) improved the antioxidant status of patients reducing biomarkers of protein and lipid oxidation, enhancing total antioxidant status and modulating the level of superoxide dismutase and catalase with a 57% and 32% reduction in superoxide dismutase and catalase activities respectively, moving the redox environment to a status of low production of O(2)(•-) with an increase in H(2)O(2) detoxification. No side effects were observed. These results show that medical ozone treatment could be a complementary therapy in the treatment of CAD and its complications.

  6. Glycaemic index and load values tested in normoglycemic adults for five staple foodstuffs: pounded yam, pounded cassava-plantain, placali, attieke and maize meal stiff porridge.

    Science.gov (United States)

    Kouamé, Adam C; Kouassi, Kouakou N; N'dri, Yao D; Amani, N'guessan G

    2015-02-16

    There is currently an increased global interest in the published glycaemic index (GI) and glycaemic load (GL) values of foods. However, data on the GI and GL values of different varieties of foods within Côte d'Ivoire are very limited. The study therefore aimed at finding the GI and GL of the main food staples in Côte d'Ivoire. Following the International Standard Organisation's protocol (ISO/FDI 26642:2010), a selection of five staple foodstuffs were tested for their GI and GL. Fasted healthy subjects were given 50 g of available carbohydrate servings of a glucose reference, which was tested twice, and test foods which were tested once, on separate occasions. Excepted attieke (GI 63), the majority of foods tested have a high GI (GI>70). Attieke (agbodjama) had a high GL (GL 29) while placali (GL 17) and maize meal stiff porridge (GL 16) had medium GLs. The GLs of pounded cassava-plantain and pounded yam are 26 and 22. Consumption of attieke could minimize postprandial blood glucose spikes, in spite of high GL and potentially have benefit in the management and prevention of some chronic diseases.

  7. Glycaemic Index and Load Values Tested in Normoglycemic Adults for Five Staple Foodstuffs: Pounded Yam, Pounded Cassava-Plantain, Placali, Attieke and Maize Meal Stiff Porridge

    Directory of Open Access Journals (Sweden)

    Adam C. Kouamé

    2015-02-01

    Full Text Available There is currently an increased global interest in the published glycaemic index (GI and glycaemic load (GL values of foods. However, data on the GI and GL values of different varieties of foods within Côte d’Ivoire are very limited. The study therefore aimed at finding the GI and GL of the main food staples in Côte d’Ivoire. Following the International Standard Organisation’s protocol (ISO/FDI 26642:2010, a selection of five staple foodstuffs were tested for their GI and GL. Fasted healthy subjects were given 50 g of available carbohydrate servings of a glucose reference, which was tested twice, and test foods which were tested once, on separate occasions. Excepted attieke (GI 63, the majority of foods tested have a high GI (GI > 70. Attieke (agbodjama had a high GL (GL 29 while placali (GL 17 and maize meal stiff porridge (GL 16 had medium GLs. The GLs of pounded cassava-plantain and pounded yam are 26 and 22. Consumption of attieke could minimize postprandial blood glucose spikes, in spite of high GL and potentially have benefit in the management and prevention of some chronic diseases.

  8. Prediction of low birth weight: the placental T2* estimated by MRI versus the uterine artery pulsatility index

    DEFF Research Database (Denmark)

    Sinding, Marianne Munk; Peters, David Alberg; Frøkjær, Jens Brøndum;

    CONTROL ID: 2516296 ABSTRACT FINAL ID: P22.05 TITLE: Prediction of low birth weight: the placental T2* estimated by MRI versus the uterine artery pulsatility index AUTHORS (FIRST NAME, LAST NAME): Marianne Sinding1, David Peters2, Jens B. Frøkjær3, 4, Ole B. Christiansen1, 4, Astrid Petersen5...... (MRI) variable T2* reflects the placental oxygenation and thereby placental function. Therefore, we aimed to evaluate the performance of placental T2* in the prediction of low birth weight using the uterine artery (UtA) pulsatility index (PI) as gold standard. Methods: The study population...... was a selected, mixed population regarding the risk of low birth weight. According to our national guidelines, pregnancies with ultrasound estimated fetal weight (EFW) birth weight. We included 96 pregnancies at 20-40 weeks' gestation, of which 68 had an EFW ≥ -15% and 28...

  9. Reference values of one-point carotid stiffness parameters determined by carotid echo-tracking and brachial pulse pressure in a large population of healthy subjects.

    Science.gov (United States)

    Vriz, Olga; Aboyans, Victor; Minisini, Rosalba; Magne, Julien; Bertin, Nicole; Pirisi, Mario; Bossone, Eduardo

    2017-03-02

    Arterial stiffness can predict cardiovascular events, and the aim of this study was to produce age- and sex-specific reference values for echo-tracking carotid stiffness in healthy subjects. A total of 900 subjects (500 males, mean age 45.8±19 years) were enrolled. Common carotid artery stiffness and compliance, using a high-definition echo-tracking ultrasound system, were evaluated. To compare stiffness parameters across the different age groups, individual scores were transformed into T-scores, indicating how many standard deviation (s.d.) units an individual's score was above or below the mean that was observed in the group including same-sex individuals aged 36 to 44 years. Carotid stiffness was similar among genders, except compliance, which was lower in women (Pgroups. Stiffness parameters increased significantly with age, but the opposite occurred for compliance. The T-score was found to increase significantly across all age groups, with a steeper increase in stiffness around the age of 60 years in women. For each T-score s.d., the corresponding carotid absolute values for arterial stiffness and compliance were obtained. In a multivariate model, carotid stiffness parameters were constantly and independently associated with age, mean arterial pressure, pulse pressure, heart rate and body mass index. Our study provides a normogram of carotid arterial stiffness and compliance indices obtained with the echo-tracking method in a large population of healthy subjects stratified by gender and age that can be used in clinical practice.Hypertension Research advance online publication, 2 March 2017; doi:10.1038/hr.2017.24.

  10. Quantitative Indexes of Leukocytes in Spontaneously Hypertensive Rats During Various Periods of Arterial Hypertension Development.

    Science.gov (United States)

    Aliev, O I; Anishchenko, A M; Sidekhmenova, A V; Shamanaev, A Yu; Fedorova, E P; Plotnikov, M B

    2015-10-01

    SHR rats were examined in the period before arterial hypertension development (5th week), during the increase in BP (6th-10th weeks), and under conditions of constantly elevated BP (11th-12th weeks). The total number of leukocytes did not differ in SHR and normotensive WKY rats. However, the relative number of lymphocytes and monocytes was shown to differ in various periods of arterial hypertension development. Our results suggest that white blood cells (primarily lymphocytes) are involved in the development of arterial hypertension.

  11. Reference ranges for uterine artery pulsatility index during the menstrual cycle: a cross-sectional study.

    Directory of Open Access Journals (Sweden)

    Luís Guedes-Martins

    Full Text Available Cyclic endometrial neoangiogenesis contributes to changes in local vascular patterns and is amenable to non-invasive assessment with Doppler sonography. We hypothesize that the uterine artery (UtA impedance, measured by its pulsatility index (PI, exhibits a regular pattern during the normal menstrual cycle. Therefore, the main study objective was to derive normative new day-cycle-based reference ranges for the UtA-PI during the entire cycle from days 1 to 34 according to the isolated time effect and potential confounders such as age and parity.From January 2009 to December 2012, a cross-sectional study of 1,821 healthy women undergoing routine gynaecological ultrasound was performed. The Doppler flow of the right and left UtA-PI was studied transvaginally by colour and pulsed Doppler imaging. The mean right and left values and the presence or absence of a bilateral protodiastolic notch were recorded. Reference intervals for the PI according to the cycle day were generated by classical linear regression.The majority of patients (97.5% presented unilateral or bilateral UtA notches. The crude 5th, 50th, and 95th reference percentile curves of the UtA-PI at 1-34 days of the normal menstrual cycle were derived. In all curves, a progressive significant decrease occurred during the first 13 days, followed by an increase and recovery in the UtA-PI. The adjusted 5th, 50th, and 95th reference percentile curves for the effects of age and parity were also obtained. These two conditions generated an approximately identical UtA-PI pattern during the cycle, except with small but significant reductions at the temporal extremes.The median, 5th, and the 95th percentiles of the UtA-PI decrease during the first third of the menstrual cycle and recover to their initial values during the last two thirds of the cycle. The rates of decrease and recovery depend significantly on age and parity.

  12. Gender-related difference in arterial elastance during exercise in patients with hypertension.

    Science.gov (United States)

    Park, Sungha; Ha, Jong-Won; Shim, Chi Young; Choi, Eui-Young; Kim, Jin-Mi; Ahn, Jeong-Ah; Lee, Se-Wha; Rim, Se-Joong; Chung, Namsik

    2008-04-01

    Exercise intolerance and heart failure with preserved ejection fraction are common in females. Recently, arterial stiffness has been suggested to be a significant contributor in the development of heart failure. How gender difference affects arterial stiffening and its response to exercise is not well known. We hypothesized that arterial elastance index during exercise would be more abnormal in females with hypertension than males. Arterial elastance index was estimated as arterial end systolic pressure/stroke volume controlled for body surface area and was measured at rest and during graded supine bicycle exercise (25 watts, 3-minute increments) in 298 patients with hypertension (149 males; 149 females; mean age, 59). The subjects were divided into 2 groups by gender. Exercise duration was significantly shorter in females compared to males (692+/-222 versus 483+/-128 seconds, Parterial elastance index at baseline was significantly higher in males, the magnitude of increase was steeper in females with the magnitude of change at 75 W of exercise being significantly higher in females compared to males (0.69+/-0.83 versus 0.43+/-0.69, P=0.018). Arterial elastance index at each stage of exercise up to 75 W was independently associated with decreased exercise duration. In conclusion, despite lower arterial elastance index at rest, the increase during exercise was steeper in women with hypertension, suggesting a gender-related difference in dynamic arterial stiffness. The arterial elastance index during exercise was significantly associated with exercise duration in patients with hypertension.

  13. Risk factors and ankle brachial indexes in cerebral infarction combined with peripheral arterial disease

    Institute of Scientific and Technical Information of China (English)

    Huihua Liu; Jun Wang

    2006-01-01

    BACKGROUND: Ankle brachial index(ABI)is widely involved in researches and clinical application of peripheral vascular injury of patients with diabetes (DM);however ,the application in cerebral infarction(CI)is rare.OBJECTIVE: To investigate the possible risk factor of cerebral infarction plus peripheral arterial disease(PAD),compare metabolic characteristics of patients who having CI plus PAD or only having CI,and understand the significance of ABI on screening and diagnosing CI plus PAD of lower limb.DESIGN: Contrast observation based on CI patients.SETTING: Deparment of Neurology,Nanxishan Hospital of Guangxi Zhang Autonomous Region.PARTICIPANTS:A total of 124 CI patients were selected from Department of Neurology.Nanxishan Hospital of Guangxi Zhuang Autonomous Region from July 2005 to April 2006,including 72 males and 52 females aged from 45 to 88 years.All patients met the diagnostic criteria of cerebrovascular disease established by National Academic Conference of Cerebrovascular Diseases in 1995 and determined as cerebral infarction with MRI or CT examination.All patients provided informed consent.There were 46 cases(37.2%)with CI plus PAD and 78 cases(62.8%)only with CI.METHODS: Blood pressure of bilateral ankles and upper extremities was measured at plain clinostatism with DINAMAP blood pressure monitor(GE Company).The ratio between average systolic pressure of lateral ankle and average systolic pressure of both upper extremities was regarded as ABI.The normal ABI was equal to or more than 0.9.If ABI<0.9 occurred at one side,patients were diagnosed as PAD.On the second morning after hospitalization,blood was collected to measure fasting blood glucose(FBG),2-hour postprandial blood glucose(PBG2h),glycosylated hemoglobin(HbAlc),triglycerides(TG),total cholesterol(TC),high-density lipoprotein cholesterol(HDL-C)and low-density lipoprotein cholesterol(LDL-C).Among them,blood glucose.lipid and other biochemical markers were measured with enzyme chemistry assay

  14. Stiff railguns

    Science.gov (United States)

    Weldon, W. F.; Bacon, J. L.; Weeks, D. A.; Zowarka, R. C., Jr.

    1991-01-01

    Stiff guns have been operated with both plasma and solid armatures. A performance gain was seen in the plasma railgun as stiffness was increased. A stiff gun will help to maintain the bore shape and preserve the integrity of the seam between rail and insulator under the extreme asymmetric loads sustained during high-pressure operation. The hydraulically preloaded moly and ceramic gun has been fired six times at pressures as high as 87 ksi, and the bore still holds roughing vacuum up to two hours after the test. The elimination of seam leakage helps control bore erosion associated with plasma reconstitution from the rail and plasma perturbation that might result in loss-initiating instabilities. Reduced rail deflection allows solid and transitioning armatures to track the bore surface. An analysis of the strain energy associated with the deflection of the railgun structure is presented, and this mechanism is found to be a small fraction of the energy associated with armature loss and the rail resistive loss.

  15. 健康教育对健康体检人群动脉僵硬度的影响%Effect of health education in arterial stiffness of healthy subjects

    Institute of Scientific and Technical Information of China (English)

    史鸿燕; 刘金波; 王琦; 张承杰; 宋月洁; 赵红薇; 王宏宇

    2014-01-01

    -PWV) weremeasured by Complior apparatus.After PWV measured, health education was done according to the resultsof PWV.And PWV were measured in January 2012 and January 2013 during the follow-up, respectively.The measurement data were processed by analysis of variance (ANOVA) .Results Compared with 2011baseline examination results,2012 and 2013 follow-up results demonstrated that the levels of body mass index(25.7 ±2.6) vs (25.8 ±3.6) vs (25.5 ±2.8) kg/m2 , F =0.151, P =0.860, systolic blood pressure(138 ±12) vs (138 ±17) vs (140 ±14) mmHg, F =0.682, P =0.507), diastolic blood pressure (89 ±9) vs (90 ±10) vs (92 ±11) mmHg, F =1.232, P =0.295) and CF-PWV ((10.50 ±1.23) m/s vs(10.36 ±1.52) m/s vs (11.54 ±1.32)m/s, F =1.988, P =0.596 ) were not changed significantlyduring the 2-year follow-up.However results of CR-PWV in 2012 and 2013, Were decreased significantlycompared to the 2011 baseline level ((10.75 ±1.50) m/s vs (10.25 ±1.79)m/s vs (9.77 ±1.29) m/s, F =5.653, P =0.003) during the 2-year follow up.Conclusion Our present study suggested that healtheducation is useful for the improvement of arterial function, and health management could reduce the progressof arterial stiffness to reduce the occurrence of vascular disease.

  16. Aspartate aminotransferase-lymphocyte ratio index and systemic immune-inflammation index predict overall survival in HBV-related hepatocellular carcinoma patients after transcatheter arterial chemoembolization.

    Science.gov (United States)

    Yang, Zongguo; Zhang, Jianliang; Lu, Yunfei; Xu, Qingnian; Tang, Bozong; Wang, Qiang; Zhang, Wensi; Chen, Shishi; Lu, Lingqing; Chen, Xiaorong

    2015-12-15

    It has been suggested that lymphocytes play central roles in host antitumor immune responses and control cancer outcome. We reviewed the clinical parameters of 189 hepatocellular carcinoma (HCC) patients and investigated the prognostic significance of lymphocyte-related scores in HCC patients following transcatheter arterial chemoembolization (TACE). Survival analysis revealed that an elevated aspartate aminotransferase-lymphocyte ratio index (ALRI) > 57 and a systemic immune-inflammation index (SII) > 300 were negatively associated with overall survival in HBV-related HCC (HR = 2.181, P = 0.003 and HR = 2.453, P = 0.003; respectively). Spearman chi-square analysis showed that ALRI had a specificity of 82.4% and that SII index had a sensitivity of 71.9% for HCC overall survival. ALRI and SII had negative predictive values of 74.6% and 80%, respectively for HCC overall survival. Additionally, Barcelona Clinic Liver Cancer (BCLC) stage C patients had significantly higher ALRI and SII scores (both P SII scores (P SII should be used as negative predictive factors for overall survival in HBV-related HCC in clinical practice.

  17. Arterial–ventricular coupling and parameters of vascular stiffness in hypertensive patients: Role of gender

    Science.gov (United States)

    Bruno, Rosa Maria; Buralli, Simona; Barzacchi, Marta; Dal Canto, Elisa; Ghiadoni, Lorenzo; Taddei, Stefano

    2017-01-01

    Objective Non-invasive estimation of arterial–ventricular coupling has been extensively used for the evaluation of cardiovascular performance, however, a relative small amount of data is available regarding arterial–ventricular coupling and its components in hypertension. The present study was designed to investigate the relationship between left ventricular elastance, arterial elastance, parameters of vascular stiffness and the influence of gender in a population of hypertensive individuals. Methods In 102 patients, trans-thoracic cardiac ultrasound, parameters of aortic stiffness (carotid-femoral pulse wave velocity) and wave reflection (augmentation index) were recorded. Ultrasound images of common carotid arteries were acquired for the assessment of intima-media thickness as well as carotid compliance and distensibility coefficient. Results Mean age was 61 years, 32% diabetes, 56% dyslipidemia, 9% previous cardiovascular events; women (n = 32) and men were superimposable for cardiovascular risk factors prevalence. In the population, ventricular elastance was significantly correlated with arterial elastance (r = 0.887), age (r = 0.334), gender (r = −0.494), BMI (r = −0.313), augmentation index (r = 0.479) (all p arterial elastance and gender were independently associated with ventricular elastance in multiple regression models adjusted for confounding factors. Gender-specific analysis revealed that arterial elastance and augmentation index remained statistically significant associated with ventricular elastance in men (r = 0.275, p = 0.04); instead augmentation index was no longer significant (r = 0.052, p = 0.77) in the female sex. Conclusions In hypertensive patients, main determinants of ventricular elastance are arterial elastance, as an integrated index of arterial vascular load, and gender; however, pressure augmentation might play an additional role in men. PMID:28210489

  18. Аrterial stiffness and cardiovascular autonomic neuropathy relationship in children and adolescents with type 1 diabetes mellitus

    Directory of Open Access Journals (Sweden)

    Dmitriy Nikitich Laptev

    2015-03-01

    Full Text Available AimTo evolve the association between cardiac autonomic function and arterial stiffness in children and adolescents with type 1 diabetes mellitus (T1DM.Materials and methods72 T1DM patients aged 7–18 years without history of macrovascular complications or renal disease, including microalbuminuria, were involved in the study. Cardiac function was assessed by the cardiovascular tests and 24-hour ECG monitoring with automatic calculation of QT interval and heart rate variability (HRV parameters. Artery stiffness was assessed by measurement of pulse wave velocity (PWV and augmentation index (AI obtained from arterial blood pressure monitoring for 24 hours.ResultsEstimated prevalence of cardiovascular autonomic neuropathy (CAN was 31,9%. CAN+ patients had significantly higher PWV and AI than those without CAN. A negative correlation between PWV and AI with some cardiovascular tests and HRV parameters was observed. In multivariable analysis, AI was independent predictor of autonomic dysfunction defined as number of positive cardiovascular tests, HRV parameters below normal values and prolongation of QT interval (β=0,18; p=0,035.ConclusionCardiac autonomic function is an independent predictor of arterial stiffness, in children and adolescents with T1D without macrovascular and renal complications. The presence of cardiovascular risk factors and arterial stiffness in children and adolescents with T1DM may contribute to the increased cardiovascular morbidity and mortality in adulthood in patients with CAN.

  19. Subendocardial viability ratio as an index of impaired coronary flow reserve in hypertensives without significant coronary artery stenoses.

    Science.gov (United States)

    Tsiachris, D; Tsioufis, C; Syrseloudis, D; Roussos, D; Tatsis, I; Dimitriadis, K; Toutouzas, K; Tsiamis, E; Stefanadis, C

    2012-01-01

    Subendocardial viability ratio (SEVR), calculated through pulse wave analysis, is an index of myocardial oxygen supply and demand. Our aim was to evaluate the relationship between coronary flow reserve (CFR) and SEVR in 36 consecutive untreated hypertensives (aged 57.9 years, 12 males, all Caucasian) with indications of myocardial ischaemia and normal coronary arteries in coronary angiography. CFR was calculated by a 0.014-inch Doppler guidewire (Flowire, Volcano, San Diego, CA, USA) in response to bolus intracoronary administration of adenosine (30-60 μg). SEVR was calculated by radial applanation tonometry, while diastolic function was evaluated by means of transmitral flow and tissue Doppler imaging. Hypertensive patients with low CFR (n=24) compared with those with normal CFR (n=12) exhibited significantly decreased SEVR by 24.5% (P=0.002). In hypertensives with low CFR, CFR was correlated with SEVR (r=0.651, P=0.001). After applying multivariate linear regression analysis, age, left ventricular mass index, Em/Am, 24-h diastolic blood pressure (BP) and SEVR turned out to be the only independent predictors of CFR (adjusted R(2)=0.718). Estimation of SEVR by using applanation tonometry may provide a reliable tool for the assessment of coronary microcirculation in essential hypertensives with indications of myocardial ischaemia and normal coronary arteries.

  20. Abnormal arterial flows by a distributed model of the fetal circulation.

    Science.gov (United States)

    van den Wijngaard, Jeroen P H M; Westerhof, Berend E; Faber, Dirk J; Ramsay, Margaret M; Westerhof, Nico; van Gemert, Martin J C

    2006-11-01

    Modeling the propagation of blood pressure and flow along the fetoplacental arterial tree may improve interpretation of abnormal flow velocity waveforms in fetuses. The current models, however, either do not include a wide range of gestational ages or do not account for variation in anatomical, vascular, or rheological parameters. We developed a mathematical model of the pulsating fetoumbilical arterial circulation using Womersley's oscillatory flow theory and viscoelastic arterial wall properties. Arterial flow waves are calculated at different arterial locations from which the pulsatility index (PI) can be determined. We varied blood viscosity, placental and brain resistances, placental compliance, heart rate, stiffness of the arterial wall, and length of the umbilical arteries. The PI increases in the umbilical artery and decreases in the cerebral arteries, as a result of increasing placental resistance or decreasing brain resistance. Both changes in resistance decrease the flow through the placenta. An increased arterial stiffness increases the PIs in the entire fetoplacental circulation. Blood viscosity and peripheral bed compliance have limited influence on the flow profiles. Bradycardia and tachycardia increase and decrease the PI in all arteries, respectively. Umbilical arterial length has limited influence on the PI but affects the mean arterial pressure at the placental cord insertion. The model may improve the interpretation of arterial flow pulsations and thus may advance both the understanding of pathophysiological processes and clinical management.

  1. RELATIONSHIP BETWEEN EFFICENCIES OF SEGMENTAL HEPATIC ARTERY CHEMOEMBOLIZATION AND PCNA LABELING INDEX IN HCC

    Institute of Scientific and Technical Information of China (English)

    李玉亮; 邵广瑞

    2004-01-01

    Objective: To evaluate the relationship between the efficiencies of subsegmental TAE and the expression of PCNA with ABC immunohistochemical staining in HCCs. Methods: Ultrasound-guided needle biopsies were performed in 43 patients (41 men, 2 women; age range: 32~75 years, mean, 55.6 years). PCNA were examined using ABC immunohistochemical staining. Tumor scores of PCNA were assessed by counting the positive nuclei per 1,000 cells. All the cases received subsegmental TAE with iodized oil and gelatin sponge. A correlation between the expression of PCNA and the efficiencies of subsegmental TAE was sought. Normality test, rank sum test and Chi-square test were used in statistical analyses with SAS package. Results: The mean PCNA labeling index was 58±29(range, 27-100%) in 43 patients. When compared with the macroscopic and pathologic parameters, PCNA labeling index was found to be significantly related to the presence and activity of cirrhosis. PCNA labeling index did not related to patients' age, sex, HbsAg status or serum α-fetoprotein level. The PCNA labeling index corresponded to the degree of histological differentiation (Edmenderson- Steiner grading). The survival rates after subsegmental TAE were respectively 86.05%, 65.12% and 51.16% in one-, two- and three-years, and were significantly higher in the low labeling index group than that in the high labeling index group. Conclusion: The PCNA labeling index was shown to be closely related to histological characteristics and survival of the patients.

  2. Pulsatility Index of Blood Echogenicity of the Human Radial and Common Carotid Arteries: Relation with Age and Stroke

    Energy Technology Data Exchange (ETDEWEB)

    Bok, Tae Hoon; Kong, Qi; Nam, Kweon Ho; Choi, Jay Chol; Paeng, Dong Guk [Department of Ocean System Engineering, Jeju National University, Jeju (Korea, Republic of)

    2012-10-15

    In the present paper, the ultrasound blood images were measured at both the human radial artery(RA) and common carotid artery(CCA), depending on the age, and the pulsatility index of blood echogenicity(PIBE) was analyzed. In addition, the ultrasound blood images were measured at both RA and CCA of both the stroke patients and the control group, and PIBE was compared. PIBE of RA for the young group was similar with that for the old group (0.13{+-}0.21 and 0.16{+-}0.03). PIBE of CCA for the young group, however, was larger than that for the old group (0.70{+-}0.21 and 0.32{+-}0.01), and was more variable depending on the subject. Similarly, the fibrinogen concentrations of the patients (336{+-}61 and 340{+-}126 mg/dl) were more than that of the control group (264{+-}38 and 43 mg/dl), for both RA and CCA. The results indicate the possibility of the ultrasonic test on the correlation between erythrocyte aggregation and stroke, and it is expected that the in-vivo EA measurement would be clinically useful.

  3. Correlation between Patient-Reported Symptoms and Ankle-Brachial Index after Revascularization for Peripheral Arterial Disease.

    Science.gov (United States)

    Je, Hyung Gon; Kim, Bo Hyun; Cho, Kyoung Im; Jang, Jae Sik; Park, Yong Hyun; Spertus, John

    2015-01-01

    Improvement in quality of life (QoL) is a primary treatment goal for patients with peripheral arterial disease (PAD). The current study aimed to quantify improvement in the health status of PAD patients following peripheral revascularization using the peripheral artery questionnaire (PAQ) and ankle-brachial index (ABI), and to evaluate possible correlation between the two methods. The PAQ and ABI were assessed in 149 symptomatic PAD patients before, and three months after peripheral revascularization. Mean PAQ summary scores improved significantly three months after revascularization (+49.3 ± 15 points, p PAQ scores relating to patient symptoms showed the largest improvement following revascularization. The smallest increases were seen in reported treatment satisfaction (all p's PAQ. Twenty-two percent of PAD patients were identified as having a poor response to revascularization (increase in ABI PAQ, although this was less marked than in patients with an increase in ABI > 0.15 following revascularization. In conclusion, data from the current study suggest a significant correlation between improvement in patient-reported outcomes assessed by PAQ and ABI in symptomatic PAD patients undergoing peripheral revascularization.

  4. Correlation between Patient-Reported Symptoms and Ankle-Brachial Index after Revascularization for Peripheral Arterial Disease

    Directory of Open Access Journals (Sweden)

    Hyung Gon Je

    2015-05-01

    Full Text Available Improvement in quality of life (QoL is a primary treatment goal for patients with peripheral arterial disease (PAD. The current study aimed to quantify improvement in the health status of PAD patients following peripheral revascularization using the peripheral artery questionnaire (PAQ and ankle-brachial index (ABI, and to evaluate possible correlation between the two methods. The PAQ and ABI were assessed in 149 symptomatic PAD patients before, and three months after peripheral revascularization. Mean PAQ summary scores improved significantly three months after revascularization (+49.3 ± 15 points, p < 0.001. PAQ scores relating to patient symptoms showed the largest improvement following revascularization. The smallest increases were seen in reported treatment satisfaction (all p’s < 0.001. As expected the ABI of treated limbs showed significant improvement post-revascularization (p < 0.001. ABI after revascularization correlated with patient-reported changes in the physical function and QoL domains of the PAQ. Twenty-two percent of PAD patients were identified as having a poor response to revascularization (increase in ABI < 0.15. Interestingly, poor responders reported improvement in symptoms on the PAQ, although this was less marked than in patients with an increase in ABI > 0.15 following revascularization. In conclusion, data from the current study suggest a significant correlation between improvement in patient-reported outcomes assessed by PAQ and ABI in symptomatic PAD patients undergoing peripheral revascularization.

  5. Index finger radial digital proper artery transfer and sleeve anastomosis to treat thumb digital artery defect%食指桡侧指固有动脉转位套入法治疗拇指断指

    Institute of Scientific and Technical Information of China (English)

    姚阳; 李崇杰

    2014-01-01

    Objective To investigate the effect of index finger radial digital proper artery transfer and sleeve anastomosis on treatment of thumb digital artery defect. Methods 10 cases of complete or incomplete thumb amputation with digital artery defect, but without tendon or nerve defect, were replanted by index finger radial digital proper artery transfer and sleeve anastomosis to thumb ulnar digital proper artery. Results All of 10 cases survived after operation, finger pulp was plump, color and lustre was florid. The patients were followed up for 10 months to 2 years, the hand function has obtained satisfactory recovery, and extrinsic feature was natural. Conclusion Index finger radial digital proper artery transfer and sleeve anastomosis is especially adaptive to the treatment of thumb digital artery defect.%目的:探讨食指桡侧指固有动脉转位套入法治疗拇指断指的疗效。方法对10例指动脉缺损而无肌腱神经缺损的拇指完全或不完全离断病例,采用食指桡侧指固有动脉转位与拇指尺侧指固有动脉行套入吻合法修复动脉,再植拇指。结果本组10例再植拇指均成活,指腹饱满,色泽红润,经6~24个月随访,患者手部功能恢复满意,外观自然,2例出现虎口狭窄,经手术改善。结论食指桡侧指固有动脉转位套入法适用于单纯拇指指动脉缺损的再植治疗。

  6. A single serving of blueberry (V. corymbosum) modulates peripheral arterial dysfunction induced by acute cigarette smoking in young volunteers: a randomized-controlled trial.

    Science.gov (United States)

    Del Bo', Cristian; Porrini, Marisa; Fracassetti, Daniela; Campolo, Jonica; Klimis-Zacas, Dorothy; Riso, Patrizia

    2014-12-01

    Cigarette smoking causes oxidative stress, hypertension and endothelial dysfunction. Polyphenol-rich foods may prevent these conditions. We investigated the effect of a single serving of fresh-frozen blueberry intake on peripheral arterial function and arterial stiffness in young smokers. Sixteen male smokers were recruited for a 3-armed randomized-controlled study with the following experimental conditions: smoking treatment (one cigarette); blueberry treatment (300 g of blueberry) + smoking; control treatment (300 mL of water with sugar) + smoking. Each treatment was separated by one week of wash-out period. The blood pressure, heart rate, peripheral arterial function (reactive hyperemia and Framingham reactive hyperemia), and arterial stiffness (digital augmentation index, digital augmentation index normalized for a heart rate of 75 bpm) were measured before and 20 min after smoking with Endo-PAT2000. Smoking impaired the blood pressure, heart rate and peripheral arterial function, but did not affect the arterial stiffness. Blueberry consumption counteracted the impairment of the reactive hyperemia index induced by smoking (-4.4 ± 0.8% blueberry treatment vs. -22.0 ± 1.1% smoking treatment, p smoking treatment, p smoking treatment, mmHg, p smoking. No effect was observed for arterial stiffness and other vital signs. In conclusion, data obtained suggest a protective role of blueberry on reactive hyperemia, Framingham reactive hyperemia, and systolic blood pressure in subjects exposed to smoke of one cigarette. Future studies are necessary to elucidate the mechanisms involved.

  7. Age, hypertension and arterial function.

    Science.gov (United States)

    McEniery, Carmel M; Wilkinson, Ian B; Avolio, Albert P

    2007-07-01

    1. Ageing exerts a marked effect on the cardiovascular system and, in particular, the large arteries. Using a variety of techniques to assess arterial stiffness, many cross-sectional studies have demonstrated a significant relationship between age and aortic stiffness, although the age-related changes observed in peripheral arteries appear to be less marked. 2. The relationship between arterial stiffness and hypertension is more complex. The distending, or mean arterial, pressure is an important confounder of measurements of arterial stiffness and, therefore, must be taken into consideration when assessing arterial stiffness in hypertensive subjects or investigating the effect of antihypertensive agents. Current methods for correcting for differences in distending pressure involve pharmacological manipulation, statistical correction or mathematical manipulation of stiffness indices. 3. Many studies have provided evidence that both peripheral (muscular) and central (elastic) arteries are stiffer in subjects with mixed (systolic/diastolic) hypertension compared with normotensive subjects. However, it is unclear to what extent differences in mean arterial pressure explain the observed differences in hypertensive subjects. In contrast, isolated systolic hypertension is associated with increased aortic, but not peripheral artery, stiffness, although the underlying mechanisms are somewhat unclear. 4. Traditional antihypertensive agents appear to reduce arterial stiffness, but mostly via an indirect effect of lowering mean pressure. Therefore, therapies that target the large arteries to reduce stiffness directly are urgently required. Agents such as nitric oxide donors and phosphodiesterase inhibitors may be useful in reducing stiffness via functional mechanisms. In addition, inhibitors or breakers of advanced glycation end-product cross-links between proteins, such as collagen and elastin, hold substantial promise.

  8. Evaluating changes of carotid artery in patients with impaired glucose tolerance and type 2 diabetes mellitus with quantitative intima-media thickness and quantitative arterial stiffness%内中膜厚度定量及动脉僵硬度分析技术评价糖耐量减低及2型糖尿病者颈总动脉改变

    Institute of Scientific and Technical Information of China (English)

    谭丽芳; 艾红; 王娟; 石秀英; 淡敏

    2012-01-01

    目的 应用血管内中膜厚度定量(QIMT)及动脉僵硬度分析(QAS)技术评价糖耐量减低(IGT)和2型糖尿病(T2DM)患者颈总动脉结构及功能的改变.方法 对病例组68例患者[30例IGT(IGT亚组)和38例T2DM(T2DM亚组)]及58名正常对照(NC)组的右侧颈总动脉行QIMT、QAS及相关血清学检查,获取以下参数:内中膜厚度(IMT)、顺应性系数(CC)、扩张性系数(DC)、僵硬度参数(β)、2 h血糖值(2hPG)、甘油三酯(TG),胆固醇(Ch),低密度脂蛋白(LDL),糖化血红蛋白(GHb),并分析NC组与病例组各亚组之间的差异及相关性.结果 T2DM亚组DC低于NC组(P<0.05),其余参数组间两两比较差异均有统计学意义(P均<0.05);IGT和T2DM亚组β和IMT、2hPG、LDL与GHb均呈正相关(P均<0.01).结论 QIMT及QAS技术可反映动脉血管的早期结构及功能变化,对诊断IGT及T2DM患者早期动脉粥样硬化具有一定价值.%Objective To investigate the structural and functional changes of carotid artery in patients with type 2 diabetes mellitus (T2DM) and impaired glucose tolerance (IGT) with quantitative intima-media thickness (QIMT) and quantitative arterial stiffness (QAS) technique. Methods The right side-of common carotid artery of 68 patients (30 IGT and 38 T2DM ) and 58 healthy controls (NC group) were examined with QIMT, QAS technique and relative serological testing. Parameters including triglyceride (TG), low-density lipoprotein ( LDL) , cholesterol (Ch), glycosylated hemoglobin (GHb), intima-media thickness (IMT), compliance coefficient (CO, distensibility coefficient (DC), stiffness index (β) and 2 h plasma glucose (2hPG) of carotid obtained were acquired and the statistically analyzed. Results DC in T2DM subgroup was lower than in NC group, while the other parameters all had statistical differences among groups (all P<0. 05). There was positive correlation between β and IMT, 2hPG. LDL, GHb in IGT and T2DM subgroup (all P<0. 01). Conclusion QIMT and QAS

  9. Body mass index and risk for mental stress induced ischemia in coronary artery disease.

    Science.gov (United States)

    Soufer, Robert; Fernandez, Antonio B; Meadows, Judith; Collins, Dorothea; Burg, Matthew M

    2016-05-19

    Acute emotionally reactive mental stress (MS) can provoke prognostically relevant deficits in cardiac function and myocardial perfusion, and chronic inflammation increases risk for this ischemic phenomenon. We have described parasympathetic withdrawal and generation of inflammatory factors in MS. Adiposity is also associated with elevated markers of chronic inflammation. High body mass index (BMI) is frequently used as a surrogate for assessment of excess adiposity, and associated with traditional CAD risk factors, and CAD mortality. BMI is also associated with autonomic dysregulation, adipose tissue derived proinflammatory cytokines, which are also attendant to emotion provoked myocardial ischemia. Thus, we sought to determine if body mass index (BMI) contributes to risk of developing myocardial ischemia provoked by mental stress. We performed a prospective interventional study in a cohort of 161 patients with stable CAD. They completed an assessment of myocardial blood flow with single photon emission computed tomography (SPECT) simultaneously during 2 conditions: laboratory mental stress and at rest. Multivariate logistic regression determined the independent contribution of BMI to the occurrence of mental-stress induced ischemia. Mean age was 65.6±9.0 years; 87.0% had a history of hypertension, and 28.6% had diabetes. Mean BMI was 30.4±4.7. Prevalence of mental stress ischemia was 39.8%. BMI was an independent predictor of mental stress ischemia, OR=1.10, 95% CI [1.01-1.18] for one-point increase in BMI and OR=1.53, 95% CI [1.06-2.21] for a 4.7 point increase in BMI (one standard deviation beyond the cohort BMI mean), p=0.025 for all. These data suggest that BMI may serve as an independent risk marker for mental stress ischemia. The factors attendant with greater BMI, which include autonomic dysregulation and inflammation, may represent pathways by which high BMI contribute to this risk and serve as a conceptual construct to replicate these findings in larger

  10. Indexed

    CERN Document Server

    Hagy, Jessica

    2008-01-01

    Jessica Hagy is a different kind of thinker. She has an astonishing talent for visualizing relationships, capturing in pictures what is difficult for most of us to express in words. At indexed.blogspot.com, she posts charts, graphs, and Venn diagrams drawn on index cards that reveal in a simple and intuitive way the large and small truths of modern life. Praised throughout the blogosphere as “brilliant,” “incredibly creative,” and “comic genius,” Jessica turns her incisive, deadpan sense of humor on everything from office politics to relationships to religion. With new material along with some of Jessica’s greatest hits, this utterly unique book will thrill readers who demand humor that makes them both laugh and think.

  11. Right Pulmonary Artery Distensibility Index (RPAD Index). A field study of an echocardiographic method to detect early development of pulmonary hypertension and its severity even in the absence of regurgitant jets for Doppler evaluation in heartworm-infected dogs.

    Science.gov (United States)

    Venco, Luigi; Mihaylova, Liliya; Boon, June A

    2014-11-15

    Despite the term "heartworm disease" Dirofilaria immitis infection in dogs should be considered a pulmonary arterial disease that might only involve the right heart structures in its late stage. Chronic infection by adult heartworms in dogs results in proliferative endoarteritis leading to progressively increasing pulmonary artery pressure due to reduced elasticity. Elasticity allows the pulmonary arteries to stretch in response to each pulse and helps maintain a relatively constant pressure in the arteries despite the pulsating nature of the blood flow. Pulmonary artery distensibility for both acute and chronic pulmonary hypertension has been investigated in humans using MRI and has been correlated with the severity of hypertension and its outcome and treatment response. The aim of the present study was to investigate whether echocardiographic measurement of the percentage change in diameter of the right pulmonary artery in systole and diastole (distensibility) may be of value in assessing the presence and severity of pulmonary hypertension in heartworm-infected dogs. The Right Pulmonary Artery Distensibility Index (RPAD Index) (which is calculated as the difference in diameter of the right pulmonary artery in systole and diastole) was calculated in healthy and naturally infected heartworm-positive dogs. The right pulmonary artery was chosen because it is usually affected earlier and to a greater degree. Data were obtained from healthy heartworm-free dogs without any clinical, radiographic, or echocardiographic signs of pulmonary hypertension; naturally infected heartworm-positive dogs in different stages of the disease in which pulmonary pressure could be measured by Doppler echocardiography (using tricuspid and or pulmonary regurgitation velocity and pressure gradient); and naturally infected heartworm-positive dogs in different stages of the disease (with or without tricuspid and or pulmonary regurgitation) in which the pulmonary pressure was measured

  12. Can mean platelet component be used as an index of platelet activity in stable coronary artery disease?

    LENUS (Irish Health Repository)

    Cooke, John

    2012-01-31

    Acute coronary syndrome is associated with intracoronary thrombosis secondary to platelet activation. Previous groups have investigated platelet activation in both stable and unstable vascular disease. Most measures of platelet activation are not routinely available or easily adaptable to large scale clinical use. Recently, measurement of the mean platelet component (MPC) has become part of the routine data provided by an automated full blood count analyser, the Advia 120. MPC measures platelet density which changes on platelet activation. Our objectives were to determine if platelet activation, as measured by MPC, is increased in patients with stable coronary artery disease (CAD) and to determine if MPC could be useful in differentiating people with stable CAD from controls on an everyday clinical basis. Three hundred and forty-five consecutive patients attending for elective coronary angiography had full blood count analysis and MPC measurement performed using an ADVIA-120 analyser. Three hundred and twenty-four were analysed in our final dataset. Two hundred and fifty-three (78%) had CAD. Patients with CAD were significantly (p<0.001) older than those without (63.8 versus 56.0 years). Results failed to demonstrate a difference (p=0.467) in MPC between patients with CAD and those with normal coronary arteries (25.8 versus 26.0). Likewise, there was no correlation between MPC and the severity of CAD (Kendall\\'s tau b=-0.086, p=0.04). MPC is not a useful index of platelet activity in stable CAD when used in everyday clinical practice.

  13. Can mean platelet component be used as an index of platelet activity in stable coronary artery disease?

    LENUS (Irish Health Repository)

    Cooke, John

    2009-04-01

    Acute coronary syndrome is associated with intracoronary thrombosis secondary to platelet activation. Previous groups have investigated platelet activation in both stable and unstable vascular disease. Most measures of platelet activation are not routinely available or easily adaptable to large scale clinical use. Recently, measurement of the mean platelet component (MPC) has become part of the routine data provided by an automated full blood count analyser, the Advia 120. MPC measures platelet density which changes on platelet activation. Our objectives were to determine if platelet activation, as measured by MPC, is increased in patients with stable coronary artery disease (CAD) and to determine if MPC could be useful in differentiating people with stable CAD from controls on an everyday clinical basis. Three hundred and forty-five consecutive patients attending for elective coronary angiography had full blood count analysis and MPC measurement performed using an ADVIA-120 analyser. Three hundred and twenty-four were analysed in our final dataset. Two hundred and fifty-three (78%) had CAD. Patients with CAD were significantly (p<0.001) older than those without (63.8 versus 56.0 years). Results failed to demonstrate a difference (p=0.467) in MPC between patients with CAD and those with normal coronary arteries (25.8 versus 26.0). Likewise, there was no correlation between MPC and the severity of CAD (Kendall\\'s tau b=-0.086, p=0.04). MPC is not a useful index of platelet activity in stable CAD when used in everyday clinical practice.

  14. Relations between a novel, reliable, and rapid index of arterial compliance (PP-HDI) and well-established inidices of arterial blood pressure (ABP) in a sample of hypertensive elderly subjects.

    Science.gov (United States)

    Bergamini, L; Finelli, M E; Bendini, C; Ferrari, E; Veschi, M; Neviani, F; Manni, B; Pelosi, A; Rioli, G; Neri, M

    2009-01-01

    Hypertension is a risk factor for a long-lasting arterial wall-remodelling leading to stiffness. The rapid method measuring the pulse pressure (PP) by means of the tool of Hypertension Diagnostic Instruments (HDI) called PP-HDI, overcomes some of the problems arising with more-time consuming methods, like ambulatory blood pressure monitoring (ABPM), and give information about the elasticity of the arterial walls. We studied the relationship between the PP-HDI, the large artery compliance (LA-C) and small artery compliance (SA-C) and few well-established indices of arterial blood pressure (ABP) in a sample of 75 hypertensive subjects, aged 65 years and over. Significant correlations between LA-C and heart rate (HR), PP-ABPM and PP-HDI were found. SA-C relates with HR and systolic blood pressure (SBP) measured in lying and standing positions. Applying a stepwise regression analysis, we found that LA-C variance stems from PP-HDI and HR, while SA-C variance stems from SBP in lying position. Receiver operator characteristic (ROC) curves for thresholds of PP showed that PP-HDI reached levels of sensitivity/specificity similar to PP-ABPM. In conclusion, surveillance of ABP through hemo-dynamic indices, in particular of SBP, is essential, nevertheless the advantage of this control is not known in an elderly population where the organ damage is already evident. PP needs necessarily an instrumental measurement. The PP-HDI result is similar in reliability with respect to PPABPM, but is more rapid and well applicable in an elderly population.

  15. The mixing rate of the arterial blood pressure waveform Markov chain is correlated with shock index during hemorrhage in anesthetized swine.

    Science.gov (United States)

    Adibuzzaman, Mohammad; Kramer, George C; Galeotti, Loriano; Merrill, Stephen J; Strauss, David G; Scully, Christopher G

    2014-01-01

    Identifying the need for interventions during hemorrhage is complicated due to physiological compensation mechanisms that can stabilize vital signs until a significant amount of blood loss. Physiological systems providing compensation during hemorrhage affect the arterial blood pressure waveform through changes in dynamics and waveform morphology. We investigated the use of Markov chain analysis of the arterial blood pressure waveform to monitor physiological systems changes during hemorrhage. Continuous arterial blood pressure recordings were made on anesthetized swine (N=7) during a 5 min baseline period and during a slow hemorrhage (10 ml/kg over 30 min). Markov chain analysis was applied to 20 sec arterial blood pressure waveform segments with a sliding window. 20 ranges of arterial blood pressure were defined as states and empirical transition probability matrices were determined for each 20 sec segment. The mixing rate (2(nd) largest eigenvalue of the transition probability matrix) was determined for all segments. A change in the mixing rate from baseline estimates was identified during hemorrhage for each animal (median time of 13 min, ~10% estimated blood volume, with minimum and maximum times of 2 and 33 min, respectively). The mixing rate was found to have an inverse correlation with shock index for all 7 animals (median correlation coefficient of -0.95 with minimum and maximum of -0.98 and -0.58, respectively). The Markov chain mixing rate of arterial blood pressure recordings is a novel potential biomarker for monitoring and understanding physiological systems during hemorrhage.

  16. N-acetylcysteine infusion reduces the resistance index of renal artery in the early stage of systemic sclerosis

    Institute of Scientific and Technical Information of China (English)

    Edoardo ROSATO; Rosario CIANCI; Biagio BARBANO; Ginevra MENGHI; Antonietta GIGANTE; Carmelina ROSSI; Enrico M ZARDI; Antonio AMOROSO; Simonetta PISARRI; Felice SALSANO

    2009-01-01

    Aim: To evaluate resistance index (RI) changes in renal artery after N-acetylcysteine infusion in patients with systemic sclerosis. Methods: In an open-label study 40 patients with systemic sclerosis (SSc) were treated with N-acetylcysteine (NAC) iv infusion over 5 consecutive hours, at a dose of 0.015g·kg~(-1)·h~(-1).Renal haemodynamic effects were evaluated by color Doppler examination before and after NAC infusion. Results: NAC infusion significantly reduced RI in a group of sclerodermic patients with early/active capillaroscopic pattern, modified Rodnan Total Skin Score (mRTSS)14 and severe-end stage score to the vascular domain of DSS. In patients with reduction of RI after NAC infusion, diffusion capacity for carbon monoxide mean value was significantly higher than in those patients with an increase of RI. No significant differences in renal blood flow were found between patients with different subsets of SSc. Conclusion: In patients with low disease severity NAC ameliorates vascular renal function.

  17. Stiffness after total knee arthroplasty.

    Science.gov (United States)

    Manrique, Jorge; Gomez, Miguel M; Parvizi, Javad

    2015-04-01

    Stiffness after total knee arthroplasty (TKA) adversely affects outcome and impacts patient function. Various risk factors for stiffness after TKA have been identified, including reduced preoperative knee range of motion, history of prior knee surgery, etiology of arthritis, incorrect positioning or oversizing of components, and incorrect gap balancing. Mechanical and associated causes, such as infection, arthrofibrosis, complex regional pain syndrome, and heterotopic ossification, secondary gain issues have also been identified. Management of stiffness following TKA can be challenging. The condition needs to be assessed and treated in a staged manner. A nonsurgical approach is the first step. Manipulation under anesthesia may be considered within the first 3 months after the index TKA, if physical therapy fails to improve the range of motion. Beyond this point, consideration should be given to surgical intervention such as lysis of adhesions, either arthroscopically or by open arthrotomy. If the cause of stiffness is deemed to be surgical error, such as component malpositioning, revision arthroplasty is indicated. The purpose of this article is to evaluate the various aspects of management of stiffness after TKA.

  18. Ankle-brachial pressure index estimated by laser Doppler in patients suffering from peripheral arterial obstructive disease.

    Science.gov (United States)

    Ludyga, Tomasz; Kuczmik, Waclaw B; Kazibudzki, Marek; Nowakowski, Przemyslaw; Orawczyk, Tomasz; Glanowski, Michal; Kucharzewski, Marcin; Ziaja, Damion; Szaniewski, Krzysztof; Ziaja, Krzysztof

    2007-07-01

    Ankle-brachial index (ABI) measurements are widely used for evaluating the functional state of circulation in the lower limbs. However, there is some evidence that the value of ABI does not accurately reflect the degree of walking impairment in symptomatic patients with peripheral arterial obstructive disease (PAOD). We investigated the diagnostic value of ABI estimated by means of laser Doppler flowmetry (IT) for evaluating limb ischemia. We wanted to know whether laser Doppler could be more sensitive than the Doppler method in predicting walking capacity in patients with stable intermittent claudication. We analyzed a group of 30 patients with intermittent claudication (Fontain II, II/III) who were admitted for reconstructive treatment. There were 21 men and 9 women, aged 46-74 (mean 61) years. All patients underwent the treadmill test, and pain-free walking distances were measured. In each patient, we measured ABI using the two different methods: Doppler ultrasound device (ABI-Doppler) and laser Doppler (ABI-laser Doppler). The claudication distances were 25-200 m (mean 73 +/- 50.2 m). ABI-Doppler was 0.2-0.7 (0.582 +/- 0.195). ABI-laser Doppler measurements were 0.581 (+/-0.218). A correlation was found between ABI-Doppler and claudication distance (r = 0.46, P = 0.009). Also, ABI-laser Doppler values significantly correlated with claudication distances (r = 0.536, P = 0.002). The ABI evaluated by laser Doppler correlated well with claudication distances in patients with PAOD. Comparison of Doppler and laser Doppler measurements used for determining ABI showed that both methods have similar predictive power for walking capacity; however, higher correlation was observed between claudication distances and ABI measured by laser Doppler flowmetry. ABI-laser Doppler measurements are easier, are quicker, and seem to be better suited for noncompliant patients. Further investigation should be undertaken to determine whether laser Doppler is superior to the Doppler

  19. Aortic augmentation index: reference values in a large unselected population by means of the SphygmoCor device

    DEFF Research Database (Denmark)

    Janner, Julie; Godtfredsen, Nina S; Ladelund, Steen

    2010-01-01

    Arterial stiffness and pulse wave reflection are associated with cardiovascular disease (CVD). Pulse wave analyses (PWAs) allow the estimation of the central augmentation index (AIx), a measurement of pulse wave reflection. To understand the predictive role of AIx, reference values for AIx are ne...

  20. Estimating Gear Teeth Stiffness

    DEFF Research Database (Denmark)

    Pedersen, Niels Leergaard

    2013-01-01

    The estimation of gear stiffness is important for determining the load distribution between the gear teeth when two sets of teeth are in contact. Two factors have a major influence on the stiffness; firstly the boundary condition through the gear rim size included in the stiffness calculation...

  1. 老年女性腹型肥胖与血压昼夜节律及动脉僵硬度的关系%Relationship of abdominal obesity with circadian blood pressure rhythm and arterial stiffness in elderly women

    Institute of Scientific and Technical Information of China (English)

    许建超; 刘振东; 路方红; 刁玉涛; 张华; 赵颖馨; 孙尚文; 王舒建

    2014-01-01

    Objective To study the relationship of abdominal obesity with circadian blood pressure rhythm and arterial stiffness in elderly women .Methods Three hundred and fifty-three elderly women were divided into non-abdominal obesity group (n= 160) and abdominal obesity group (n=193)according to their waist circumference .Their carotid radial pulse wave velocity(crPWV) and 24 h ambulatory blood pressure were monitored .Results The non-dipper blood pressure , crPWV and symmetric AASI were significantly higher in abdominal obesity group than in non-abdominal obesity group (32 .6% vs 10 .0% ,11 .83 ± 1 .19 m/s vs 10 .90 ± 1 .04 m/s ,0 .31 ± 0 .15 vs 0 .24 ± 0 .17 ,P<0 .05) wile the nocturnal systolic and diastolic blood pressure were significantly lower in abdominal obesity group than in non-abdominal obesity group (P<0 .01) .Multiple linear regression analysis showed that waist circumference was the main risk factor for crPWV and sym-metric AASI after adjustment for age ,blood lipid and BMI (P<0 .05) .Logistic regression analysis revealed that abdominal obesity was the main risk factor for circadian blood pressure rhythm (OR=1 .104 ,95% CI:1 .074 -1 .134 ,P<0 .05) .Conclusion Abdominal fat deposit can signifi-cantly affect circadian blood pressure rhythm and arterial stiffness in elderly women .It is of great importance to control waist circumference in preventing arteriosclerosis .%目的:探讨老年女性腹型肥胖与血压昼夜节律及动脉僵硬度的关系。方法选择老年女性353例,根据腰围将受试者分为2组,即非腹型肥胖组160例,腹型肥胖组193例。所有受试者监测颈桡动脉脉搏波传导速度(crPWV)、24 h动态血压。结果腹型肥胖组非杓型血压(32.6% vs 10.0%)、crPWV [(11.83±1.19)m/s vs (10.90±1.04)m/s]、对称动态动脉硬化指数[(0.31±0.15) vs (0.24±0.17)]显著高于非腹型肥胖组,夜间收缩压下降率、夜间舒张压下降率显著

  2. State stiffness parameters of the vascular wall in hypertensive patients complex therapy cytoprotector and sartans

    Directory of Open Access Journals (Sweden)

    V. P. Mikhin

    2015-01-01

    Full Text Available A randomized study of the state of stiffness parameters arteries wall (CAVI — cardio-ankle vascular index, AI (augmentation index PEP (duration of the voltage of the left ventricle using «VaSera-1000» («Fukuda Denshi», Japan in primary hypertension patients (80 not treated with systemic antihypertensive therapy. The effect of long-term (3 months was be marketed. Losartan combined with Mexicor 300mg/day or mildronate 1000 mg/day for the specified parameters. It sets the initial reduction the properties of the arterial wall in patients with hypertension, in contrast to healthy individuals. Mexicor or mildronat accompanied by improvement east-cal properties of the arterial wall, reducing CAVI and AI in 3 months on 9.4% and 8.9%, 14.9% and 15.4%, respectively. In the control group-term change CAVI and AI no. Mexicor led to a more pronounced increase in PEP, than mildronate, respectively, on 23.7% and 18.9%. Losartan monotherapy results in a less pronounced decrease in the stiffness of the vessel wall.

  3. Stiff person syndrome.

    Science.gov (United States)

    Ciccoto, Giuseppe; Blaya, Maike; Kelley, Roger E

    2013-02-01

    Recognizing stiff person syndrome is clinically important. It is uncommon, characterized by body stiffness associated with painful muscle spasms, and varies in location and severity. It is subdivided into stiff trunk versus stiff limb presentation, and as a progressive encephalomyelitis. Stiff person-type syndrome also reflects a paraneoplastic picture. Most patients demonstrate exaggerated lumbar lordosis. Roughly 60% of patients have antiglutamic acid decarboxylase antibodies in the blood and the cerebrospinal fluid. The differential diagnosis includes many severe conditions. There are reports of response to muscle relaxants, immunosuppressants, intravenous gamma globulin, plasma exchange, a number of anticonvulsants, and botulinum toxin.

  4. Correlation of vitamin D deficiency and arterial stiffness in patients with chronic kidney disease%慢性肾脏病患者维生素D缺乏与动脉僵硬度的相关性

    Institute of Scientific and Technical Information of China (English)

    王来亮; 高燕红; 罗群

    2015-01-01

    目的 探讨慢性肾脏病患者维生素D缺乏与动脉僵硬度的相关性.方法 选取慢性肾脏病(CKD l~5期)患者300例,根据血25(OH)D3浓度分为维生素D缺乏组[25 (OH)D3<20 μg/L]和维生素D非缺乏组[25(OH)D3≥20 μg/L].采集临床资料数据,测定动脉僵硬度指标肱踝脉搏波传导速度(baPWV).对血25(OH)D3水平与baPWV间的关系进行单因素相关分析及多元线性回归分析. 结果 维生素D缺乏组188例(62.7%),维生素D非缺乏组112例(37.3%).全部CKD患者25(OH)D3平均浓度为(17.62±8.54) μg/L,维生素D缺乏组和非缺乏组分别为(12.38±4.55) μg/L与(26.44±6.05) μg/L(P<0.01).维生素D缺乏组baPWV值高于非缺乏组[(1 827.34±429.11) cm/s比(1 555.31±353.14) cm/s,P<0.01].单因素相关分析显示全体CKD患者(r=-0.38,P<0.01)以及CKD 2~5期患者[r=-0.30,P<0.05;r=-0.26,P<0.05;r=-0.46,P<0.01;r=-0.57,P<0.01]血25(OH)D3浓度与baPWV均呈负相关.多元线性回归分析显示血25 (OH)D3浓度下降与baPWV的增加独立相关(模型1:β=-0.18,P<0.01;模型2:β=-0.17,P=0.01),回归模型1与模型2均可解释baPWV变化的50%.结论 CKD患者普遍存在维生素D缺乏,维生素D缺乏与动脉僵硬度增加相关.维生素D替代治疗可能影响CKD患者的心血管预后,但有待未来研究的进一步明确.%Objective To evaluate the association between serum 25-hydroxyvitamin D3 [25 (OH)D3] and arterial stiffness in patients with chronic kidney disease (CKD).Methods Three hundred patients with CKD were included,and were divided into two groups based on serum 25(OH)D3 levels:vitamin D deficient [25(OH)D3 < 20 μg/L] and vitamin D non-deficient [25(OH)D3≥20 μg/L].Brachial ankle pulse wave velocity (baPWV),which reflected arterial stiffness,was calculated using the single-point method.Clinical data were collected in details.Correlation between serum 25(OH)D3 level and baPWV was assessed by the single factor correlation test and multiple

  5. P-wave dispersion and its relationship to aortic stiffness in patients with acute myocardial infarction after cardiac rehabilitation

    Science.gov (United States)

    Acar, Rezzan Deniz; Bulut, Mustafa; Ergün, Sunay; Yesin, Mahmut; Boztosun, Bilal; Akçakoyun, Mustafa

    2014-01-01

    BACKGROUND The aim of our study was to investigate the P-wave dispersion from standard electrocardiograms (ECGs) in patients with acute myocardial infarction (AMI) after cardiac rehabilitation (CR) and determine its relation to arterial stiffness. METHODS This is a prospective study included 33 patients with AMI and successfully re-vascularized by percutaneous coronary intervention (PCI) underwent CR. Left ventricular ejection fraction (LVEF) was measured by biplane Simpson’s method. Left atrium (LA) volume was calculated. The maximum and minimum durations of P-waves (Pmax and Pmin, respectively) were detected, and the difference between Pmax and Pmin was defined as P-wave dispersion (Pd = Pmax-Pmin). Aortic elasticity parameters were measured. RESULTS LVEF was better after CR. The systolic and diastolic blood pressures decreased after CR, these differences were statistically significant. With exercise training, LA volume decreased significantly. Pmax and Pd values were significantly shorter after the CR program. The maximum and minimum P-waves and P-wave dispersion after CR were 97 ± 6 ms, 53 ± 5 ms, and 44 ± 5 ms, respectively. Aortic strain and distensibility increased and aortic stiffness index was decreased significantly. Aortic stiffness index was 0.4 ± 0.2 versus 0.3 ± 0.2, P = 0.001. Aortic stiffness and left atrial volume showed a moderate positive correlation with P-wave dispersion (r = 0.52, P = 0.005; r = 0.64, P < 0.001, respectively). CONCLUSION This study showed decreased arterial stiffness indexes in AMI patient’s participated CR, with a significant relationship between the electromechanical properties of the LA that may raise a question of the preventive effect of CR from atrial fibrillation and stroke in patients with acute myocardial infarction. PMID:25258633

  6. Simvastatin Ameliorates Matrix Stiffness-Mediated Endothelial Monolayer Disruption.

    Directory of Open Access Journals (Sweden)

    Marsha C Lampi

    Full Text Available Arterial stiffening accompanies both aging and atherosclerosis, and age-related stiffening of the arterial intima increases RhoA activity and cell contractility contributing to increased endothelium permeability. Notably, statins are 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA reductase inhibitors whose pleiotropic effects include disrupting small GTPase activity; therefore, we hypothesized the statin simvastatin could be used to attenuate RhoA activity and inhibit the deleterious effects of increased age-related matrix stiffness on endothelial barrier function. Using polyacrylamide gels with stiffnesses of 2.5, 5, and 10 kPa to mimic the physiological stiffness of young and aged arteries, endothelial cells were grown to confluence and treated with simvastatin. Our data indicate that RhoA and phosphorylated myosin light chain activity increase with matrix stiffness but are attenuated when treated with the statin. Increases in cell contractility, cell-cell junction size, and indirect measurements of intercellular tension that increase with matrix stiffness, and are correlated with matrix stiffness-dependent increases in monolayer permeability, also decrease with statin treatment. Furthermore, we report that simvastatin increases activated Rac1 levels that contribute to endothelial barrier enhancing cytoskeletal reorganization. Simvastatin, which is prescribed clinically due to its ability to lower cholesterol, alters the endothelial cell response to increased matrix stiffness to restore endothelial monolayer barrier function, and therefore, presents a possible therapeutic intervention to prevent atherogenesis initiated by age-related arterial stiffening.

  7. Simvastatin Ameliorates Matrix Stiffness-Mediated Endothelial Monolayer Disruption.

    Science.gov (United States)

    Lampi, Marsha C; Faber, Courtney J; Huynh, John; Bordeleau, Francois; Zanotelli, Matthew R; Reinhart-King, Cynthia A

    2016-01-01

    Arterial stiffening accompanies both aging and atherosclerosis, and age-related stiffening of the arterial intima increases RhoA activity and cell contractility contributing to increased endothelium permeability. Notably, statins are 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase inhibitors whose pleiotropic effects include disrupting small GTPase activity; therefore, we hypothesized the statin simvastatin could be used to attenuate RhoA activity and inhibit the deleterious effects of increased age-related matrix stiffness on endothelial barrier function. Using polyacrylamide gels with stiffnesses of 2.5, 5, and 10 kPa to mimic the physiological stiffness of young and aged arteries, endothelial cells were grown to confluence and treated with simvastatin. Our data indicate that RhoA and phosphorylated myosin light chain activity increase with matrix stiffness but are attenuated when treated with the statin. Increases in cell contractility, cell-cell junction size, and indirect measurements of intercellular tension that increase with matrix stiffness, and are correlated with matrix stiffness-dependent increases in monolayer permeability, also decrease with statin treatment. Furthermore, we report that simvastatin increases activated Rac1 levels that contribute to endothelial barrier enhancing cytoskeletal reorganization. Simvastatin, which is prescribed clinically due to its ability to lower cholesterol, alters the endothelial cell response to increased matrix stiffness to restore endothelial monolayer barrier function, and therefore, presents a possible therapeutic intervention to prevent atherogenesis initiated by age-related arterial stiffening.

  8. Renal arterial resistive index is associated with severe histological changes and poor renal outcome during chronic kidney disease

    Directory of Open Access Journals (Sweden)

    Bigé Naïke

    2012-10-01

    Full Text Available Abstract Background Chronic kidney disease (CKD is a growing public health problem and end stage renal disease (ESRD represents a large human and economic burden. It is important to identify patients at high risk of ESRD. In order to determine whether renal Doppler resistive index (RI may discriminate those patients, we analyzed whether RI was associated with identified prognosis factors of CKD, in particular histological findings, and with renal outcome. Methods RI was measured in the 48 hours before renal biopsy in 58 CKD patients. Clinical and biological data were collected prospectively at inclusion. Arteriosclerosis, interstitial fibrosis and glomerulosclerosis were quantitatively assessed on renal biopsy in a blinded fashion. MDRD eGFR at 18 months was collected for 35 (60% patients. Renal function decline was defined as a decrease in eGFR from baseline of at least 5 mL/min/ 1.73 m2/year or need for chronic renal replacement therapy. Pearson’s correlation, Mann–Whitney and Chi-square tests were used for analysis of quantitative and qualitative variables respectively. Kaplan Meier analysis was realized to determine renal survival according to RI value using the log-rank test. Multiple logistic regression was performed including variables with p Results Most patients had glomerulonephritis (82%. Median age was 46 years [21–87], eGFR 59 mL/min/ 1.73m2 [5–130], percentage of interstitial fibrosis 10% [0–90], glomerulosclerosis 13% [0–96] and RI 0.63 [0.31-1.00]. RI increased with age (r = 0.435, p = 0.0063, pulse pressure (r = 0.303, p = 0.022, renal atrophy (r = −0.275, p = 0.038 and renal dysfunction (r = −0.402, p = 0.0018. Patients with arterial intima/media ratio ≥ 1 (p = 0.032, interstitial fibrosis > 20% (p = 0.014 and renal function decline (p = 0.0023 had higher RI. Patients with baseline RI ≥ 0.65 had a poorer renal outcome than those with baseline RI Conclusions Our results suggest that RI ≥ 0.65 is associated

  9. A relation between blood pressure and stiffness of joints and skin

    NARCIS (Netherlands)

    Uiterwaal, CSPM; Grobbee, DE; Sakkers, RJB; Helders, PJM; Bank, RA; Engelbert, RHH

    2003-01-01

    Background. Blood pressure, particularly pulse pressure, is associated with arterial wall stiffness, but little is known about its relation to stiffness of other parts of the body. We examined the extent to which blood pressure levels in young healthy children are related to stiffness of various tis

  10. Ankle Brachial Index <0.9 Underestimates the Prevalence of Peripheral Artery Occlusive Disease Assessed with Whole-Body Magnetic Resonance Angiography in the Elderly

    Energy Technology Data Exchange (ETDEWEB)

    Wikstroem, J.; Hansen, T.; Johansson, L.; Lind, L.; Ahlstroem, H. [Dept. of Radiology and Dept. of Medical Sciences, Uppsala Univ. Hospital, Uppsala (Sweden)

    2008-03-15

    Background: Whole-body magnetic resonance angiography (WBMRA) permits noninvasive vascular assessment, which can be utilized in epidemiological studies. Purpose: To assess the relation between a low ankle brachial index (ABI) and high-grade stenoses in the pelvic and leg arteries in the elderly. Material and Methods: WBMRA was performed in a population sample of 306 subjects aged 70 years. The arteries below the aortic bifurcation were graded after the most severe stenosis according to one of three grades: 0-49% stenosis, 50-99% stenosis, or occlusion. ABI was calculated for each side. Results: There were assessable WBMRA and ABI examinations in 268 (right side), 265 (left side), and 258 cases (both sides). At least one {>=}50% stenosis was found in 19% (right side), 23% (left side), and 28% (on at least one side) of the cases. The corresponding prevalences for ABI <0.9 were 4.5%, 4.2%, and 6.6%. An ABI cut-off value of 0.9 resulted in a sensitivity, specificity, and positive and negative predictive value of 20%, 99%, 83%, and 84% on the right side, and 15%, 99%, 82%, and 80% on the left side, respectively, for the presence of a {>=} 50% stenosis in the pelvic or leg arteries. Conclusion: An ABI <0.9 underestimates the prevalence of peripheral arterial occlusive disease in the general elderly population.

  11. The effect of lower sodium concentration in dialysate on arterial stiffness in hemodialysis patients%低钠透析对血液透析患者大动脉僵硬度的影响

    Institute of Scientific and Technical Information of China (English)

    孙芳; 周亦伦; 刘婧; 马丽洁; 沈洋; 黄静; 崔太根; 刘淼冰

    2012-01-01

    目的 大动脉僵硬度的金标准—腹主动脉脉搏波传导速度(pulse wave velocity,PWV)是终末期肾脏病患者全因死亡和心血管死亡的独立危险因素.在非透析人群,饮食钠摄入增多可升高PWV;反之,限盐可降低PWV.本研究旨在观察应用低钠透析液增加透析钠清除对血液透析患者大动脉僵硬度的影响.方法 选择处于干体质量的稳定血液透析患者16名.先应用标准透析液(钠浓度138mmol/L)透析一1个月,再将透析液钠浓度降为136mm01/L透析4个月(低钠透析).研究期间未对饮食钠进行限制和干预,并且每个月应用生物电阻抗仪对干体质量进行调节,以保持透析后容量状态稳定.同时测量PWV、44h动态血压,记录透析间期体质量增长、每月透析中低血压和肌肉痉挛的发生率.结果 随着低钠透析,腹主动脉PWV显著下降(12.61±2.30比11.74±2.65m/s,P=0.005); 44h动态收缩压和舒张压分别较基线水平下降10 mm Hg和6 mmHg(1mmHg=0.133kpa),而透析后容量状态无明显变化;透析间期体重增长轻度下降(2.89±0.66比2.67±0.63kg,P=0.051).低血压和肌肉痉挛的发生率无明显变化.结论 降低透析液钠浓度可显著改善透析患者的大动脉僵硬度.%Objective Aortic stiffness, as evaluated by pulse wave velocity (PWV), is an independent predictor for all-cause mortality and cardiovascular mortality in hemodialysis (HD) patients. In general population, dietary salt loading increases PWV significantly, and lower sodium intake decreases PWV. In this study, we investigated whether the increase of sodium removal during dialysis by lower sodium concentration in dialysate could improve arterial stiffness in HD patients. Methods A total of 16 stable HD patients without chronic volume overload were enrolled. After one month period of dialysis using routine dialysate (138 mmol/ L sodium), patients were treated with dialysate of lower sodium concentration (136 mmol/L sodium) in HD

  12. Altered diastolic function and aortic stiffness in Alzheimer’s disease

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    Çalık AN

    2014-07-01

    Full Text Available Ali Nazmi Çalik,3 Kazim Serhan Özcan,4 Gülbün Yüksel,2 Baris Güngör,1 Emre Arugarslan,1 Figen Varlibas,2 Ahmet Ekmekci,1 Damirbek Osmonov,1 Mustafa Adem Tatlisu,1 Mehmet Karaca,1 Osman Bolca,1 Izzet Erdinler1 1Department of Cardiology, Siyami Ersek Cardiovascular and Thoracic Surgery Center, Istanbul, Turkey; 2Department of Neurology, Haydarpasa Numune Training and Research Hospital, Istanbul, Turkey; 3Department of Cardiology, Yozgat State Hospital, Yozgat, Turkey; 4Department of Cardiology, Derince Training and Research Hospital, Kocaeli, Turkey Background: Alzheimer’s disease (AD is closely linked to cardiovascular risk factors.Methods: Echocardiographic studies were performed, including left ventricular diastolic functions, left and right atrial conduction times, and arterial stiffness parameters, namely stiffness index, pressure-strain elastic modulus, and distensibility, on 29 patients with AD and 24 age-matched individuals with normal cognitive function.Results: The peak mitral flow velocity of the early rapid filling wave (E was lower, and the peak velocity of the late filling wave caused by atrial contraction (A, deceleration time of peak E velocity, and isovolumetric relaxation time were higher in the AD group. The early myocardial peak (Ea velocity was significantly lower in AD patients, whereas the late diastolic (Aa velocity and E/Ea ratio were similar between the two groups. In Alzheimer patients, stiffness index and pressure-strain elastic modulus were higher, and distensibility was significantly lower in the AD group compared to the control. Interatrial electromechanical delay was significantly longer in the AD group.Conclusion: Our findings suggest that patients with AD are more likely to have diastolic dysfunction, higher atrial conduction times, and increased arterial stiffness compared to the controls of same sex and similar age. Keywords: diastolic dysfunction, atrial conduction timeA Letter to the Editor has been

  13. Distribution of peripheral arterial stiffness and endothelial function as well as their correlations with cardiovascular risk factors in children and adolescents%儿童青少年外周动脉顺应性、血管内皮功能的年龄变化规律及与心血管疾病危险因素的关系

    Institute of Scientific and Technical Information of China (English)

    穆锴; 张羿; 牛大彦; 叶莹; 严卫丽

    2016-01-01

    Objective To investigate the distribution of peripheral arterial stiffness,endothelial function and their correlations with cardiovascular risk factors in the 7-17 year-olds.Methods Normal weight and obese subjects aged 7-17 years with completed data on questionnaires,anthropometric and blood biochemical tests,were recruited from a cross-sectional population-based study on childhood hypertension in Minhang district of Shanghai.Automatic waveform analyzer (BP-203RPE-I) and Endopat 2000 were used to measure the arterial stiffness.Endothelial function with brachial-ankle pulse wave velocity (baPWV) and reactive hyperemia index (RHI) were recorded.BaPWV and RHI were standardized by age.Skewed biochemical variables were log transformed.Linear correlation analysis was performed to observe association between baPWV,RHI and other measured variables.Results A total of 452 normal-weight and 94 obese subjects were recruited,including 299 males.Data showed that baPWV and RHI increased with age in normal weight subjects (r=0.33,P<0.01;r=0.36,P<0.01).Results from Linear correlation analysis revealed that baPWV was positively correlated with BMI (r=0.13,P=0.002),systolic blood pressure (SBP) (r=0.20,P<0.01),diastolic blood pressure (DBP) (r=0.27,P<0.01),triglycerides (TG) (r=0.11,P=0.010),insulin (r=0.21,P=0.004) and the HOMA insulin resistance index (r=0.21,P=0.005),but negatively correlated with high-density lipoprotein cholesterol (r=-0.09,P=0.039).RH1 was positively correlated with BMI (r=0.10,P=0.018) but negatively correlated with DBP (r=-0.10,P=0.016).Males had higher baPWVs than females (P=0.04).However,RHI did not differ between genders.Conclusions The fact that baPWV and RHI increased along with age,indicated that the arterial stiffness and endothelial function continued to develop in normal weight childhood and adolescence.Arterial stiffness was correlated with cardiovascular risk-related parameters whereas endothelial function was not.BaPWV might be more

  14. Stiffness of compression devices

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    Giovanni Mosti

    2013-03-01

    Full Text Available This issue of Veins and Lymphatics collects papers coming from the International Compression Club (ICC Meeting on Stiffness of Compression Devices, which took place in Vienna on May 2012. Several studies have demonstrated that the stiffness of compression products plays a major role for their hemodynamic efficacy. According to the European Committee for Standardization (CEN, stiffness is defined as the pressure increase produced by medical compression hosiery (MCH per 1 cm of increase in leg circumference.1 In other words stiffness could be defined as the ability of the bandage/stockings to oppose the muscle expansion during contraction.

  15. Experimental investigation of the influence of the aortic stiffness on hemodynamics in the ascending aorta.

    Science.gov (United States)

    Gülan, Utku; Lüthi, Beat; Holzner, Markus; Liberzon, Alex; Tsinober, Arkady; Kinzelbach, Wolfgang

    2014-11-01

    A three-dimensional (3-D) pulsatile aortic flow in a human ascending aorta is studied to investigate the effect of the aortic stiffness on the flow field and turbulent fluctuating velocities in the ascending aorta. A nonintrusive optical measurement technique, 3-D particle tracking velocimetry (3D-PTV), has been applied to anatomically accurate phantoms under clinically realistic conditions. A compliant silicon phantom was used to mimic the healthy aorta, and a rigid model was used to imitate the pathological case that appears in aortas for example as a result of aging. The realistic models are transparent which allows optical access to the investigation domain, and the index of refraction was matched to avoid optical distortions. Our results revealed that the aortic stiffness leads to an increase in systolic velocity and a decrease in the Windkessel effect, which is associated with the diastolic blood pressure. Furthermore, we found that the turbulent kinetic energy is about an order of magnitude higher for the rigid aorta, that is, an increase in aortic stiffness increases the magnitude of turbulent fluctuating velocities. The spatial distribution of the flow velocity showed that the flow is more organized and coherent spiraling patterns develop for the compliant aorta which helps to dampen the influence of disturbed flow. Finally, we observed higher Lagrangian acceleration and hence higher instantaneous forces acting on blood particles in the stiff case which implies that aging and hence arterial stiffening provokes distinctive alterations in blood flow, and these alterations may cause pathological symptoms in the cardiovascular system.

  16. Doença arterial obstrutiva periférica e índice tornozelo-braço em pacientes submetidos à angiografia coronariana Peripheral arterial occlusive disease and ankle-brachial index in patients who had coronary angiography

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    Sthefano Atique Gabriel

    2007-03-01

    Full Text Available OBJETIVO: Avaliar a prevalência de doença arterial obstrutiva periférica (DAOP em coronariopatas. Avaliar a relação entre Índice Tornozelo-Braço (ITB e doença coronariana, e sua correlação com fatores de risco cardiovascular. MÉTODO: ITB investigado com ultra-sonografia Doppler. Características clínicas pesquisadas: idade, sexo, diabetes mellitus, hipertensão arterial sistêmica, etilismo, tabagismo e obesidade. População: 113 pacientes submetidos à angiografia coronariana. Primeira análise: 2 grupos - ausência e presença de coronariopatia. Segunda análise: 3 grupos - Grupo 1 - ausência de lesão coronariana; Grupo 2 - estenose 70%. Terceira análise: 2 grupos - ausência e presença de DAOP. RESULTADOS: 90,76% dos coronariopatas apresentaram DAOP. Houve diferença significante quanto à faixa etária (pOBJECTIVE: To evaluate the prevalence of peripheral arterial disease (PAD in patients with coronary arterial disease. To evaluate the relation between ankle-brachial index (ABI and coronary arterial disease, and its correlation with cardiovascular risk factors. METHOD: ABI investigated with Doppler ultrasonic device. Clinical characteristics researched: age, gender, diabetes, hypertension, alcoholism, smoking and obesity. Population: 113 patients who had coronary angiography. First analyses: 2 groups - absence and presence of coronary arterial disease. Second analyses: 3 groups - Group 1 - absence of coronary lesion; Group 2 - stenosis 70%. Third analyses: 2 groups - absence and presence of PAD. RESULTS: 90.76% of patients with coronary arterial disease presented PAD. There were significant difference including age (p<0.001, hypertension (p<0.001. smoking (p<0.001, body mass index (BMI (p<0.001, systolic blood pressure (SBP (p<0.001, diastolic blood pressure (DBP (p<0.001 and pulse pressure (PP (p<0.001 and ABI (p<0.001 between patients with and without coronary lesion. There were significant difference including age (p<0

  17. Kidney transplantation improves arterial function measured by pulse wave analysis and endothelium-independent dilatation in uraemic patients despite deterioration of glucose metabolism

    DEFF Research Database (Denmark)

    Hornum, Mads; Clausen, Peter; Idorn, Thomas

    2011-01-01

    BACKGROUND: The aim of this study is to investigate the effect of kidney transplantation on arterial function in relation to changes in glucose metabolism. METHODS: Included were 40 kidney recipients (Tx group, age 38 ± 13 years) and 40 patients without known diabetes remaining on the waiting list...... for kidney transplantation (uraemic control group, age 47 ± 11 years). Arterial function was estimated by the pulse wave velocity (PWV) of the carotid-femoral pulse wave, aortic augmentation index (AIX), flow-mediated (FMD) and nitroglycerin-induced vasodilatation (NID) of the brachial artery performed...... before transplantation and after 12 months. PWV recorded sequentially at the carotid and femoral artery is an estimate of arterial stiffness; AIX is an integrated index of vascular and ventricular function. FMD and NID are the dilatory capacities of the brachial artery after increased flow (endothelium...

  18. Analysis on relationship between stiffness of large artery and variability of blood pressure in patients with chronic kidney disease without dialysis%非透析慢性肾脏病合并血压变异患者大动脉僵硬度分析

    Institute of Scientific and Technical Information of China (English)

    陈灿

    2015-01-01

    目的:探讨非透析慢性肾脏病(CKD)患者血压变异性与大动脉僵硬度的关系。方法选取2010年4月至2014年4月诊断为 CKD 3~5期非透析患者,检测24 h 动态血压,根据患者是否患有高血压以及血压变异性进行分组,分析各组各项指标的差异以及血压变异性与大动脉僵硬度的关系。结果共收集 CKD 合并高血压患者368例, CKD 血压正常患者64例。直线相关分析发现 CKD 合并高血压患者血压变异性与脉搏波传导速度(PWV)呈显著的负相关( r =-0.583,P ﹤0.05)。CKD 血压正常患者血压变异性与 PWV 呈显著的负相关( r =-0.844,P ﹤0.05)。多元线性回归分析患者各项观察指标与患者 PWV 的关系发现,CKD 合并高血压患者收缩压、舒张压、脉压、血压变异性、CKD 分期与患者 PWV 显著相关;CKD 血压正常患者血压变异性和 CKD 分期与患者 PWV 显著相关。结论 CKD 患者是否合并高血压,其血压的昼夜异常变化与患者大动脉僵硬度关系密切。%Objective To explore the relationship between variability of blood pressure and stiffness of large artery in patients with chronic kidney disease(CKD)without dialysis. Methods Patients with CKD at phase 3 ~ 5 without dialysis admitted in the department of internal medi-cine in this hospital during April 2010 to April 2014 were allocated in this study. Twenty four hours dynamic blood pressure had been examined, and patients were grouped according to whether they suffered from high blood pressure and variability of blood pressure. The difference in each in-dex of each group and the relationship between variability of blood pressure and stiffness of large artery had been analyzed. Results There were 368 patients with CKD and hypertension and 64 patients with CKD were allocated for this study. There was significant negative correlation between variability of blood pressure and PWV in patients with CKD and

  19. What Is the Clinical Utility of the Ankle-Brachial Index in Patients With Diabetic Foot Ulcers and Radiographic Arterial Calcification?

    Science.gov (United States)

    Álvaro-Afonso, Francisco Javier; Lázaro-Martínez, José Luis; Aragón-Sánchez, Javier; García-Morales, Esther; García-Álvarez, Yolanda; Molines-Barroso, Raúl Juan

    2015-12-01

    The purpose of this study was to analyze the influence of radiographic arterial calcification (RAC) on the clinical interpretation of ankle-brachial index (ABI) values in patients with diabetic foot ulcers. We analyzed a retrospective clinical database of 60 patients with diabetic foot ulcers from the Diabetic Foot Unit (Complutense University, Madrid, Spain) between January 2012 and March 2014. For each patient, anteroposterior XR-plains were evaluated, and the ABI and toe-brachial index (TBI) were assessed by an experienced clinician. To analyze the correlation among quantitative variables, we applied the Pearson correlation coefficient. Fifty percent (n = 9/18) of our patients with a normal ABI and RAC had a TBI diabetic foot ulcers, or RAC.

  20. Insulin levels and HOMA index are associated with exercise capacity in patients with type 2 diabetes and coronary artery disease

    OpenAIRE

    Byrkjeland, Rune; Edvardsen, Elisabeth; Njerve, Ida Unhammer; Arnesen, Harald; Seljeflot, Ingebjørg; Solheim, Svein

    2014-01-01

    Background: Previous studies on type 2 diabetes have shown an association between exercise capacity and insulin resistance. In patients with coronary artery disease (CAD) exercise capacity is often reduced due to exercise-induced ischemia. We have investigated the association between glucometabolic control, including the homeostatic model assessment (HOMA) of insulin resistance, and exercise capacity in patients with type 2 diabetes and CAD with and without exercise-induced ischemia. Meth...

  1. Correlation between coronary artery disease severity, left ventricular mass index and carotid intima media thickness, assessed by radio-frequency

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    Ciccone Marco M

    2011-11-01

    Full Text Available Abstract Background Intima-media thickness of the common carotid artery (CCA-IMT is a validated marker of systemic atherosclerosis process. The aim of this study was to evaluate the association between coronary artery disease (CAD, left ventricular hypertrophy (LVH and CCA-IMT, assessed by Radio Frequency-Quality Intima Media Thickness (RFQIMT method, the next generation of IMT real-time measurement, based on the direct analysis of the radiofrequency signal and endowed with high accuracy and reproducibility in early detection of arterial wall thickness. Methods 115 patients (76 men, mean age: 65.1 ± 12 years referred to our department and shown significant (≥ 70% luminal obstruction stenosis at least in one major epicardial coronary artery were studied. Coronary angiograms were divided for severity and extent of the disease: 79 patients (69% had one, 24 patients (21% two, 12 patients (10% three major epicardial coronary arteries with ≥ 70% stenosis. All patients underwent echocardiography and carotid ultrasound examination, assessed by RF. Results Dividing RFQIMT data in tertiles, dyslipidaemia (31 patients with IMT ≥ 1.20 mm vs 16 with IMT = 0.91-1.19 vs 25 with IMT ≤ 0.9, p = 0.004, LVMI (153.5 ± 20.6 g/m2 in IMT ≥ 1.20 mm vs 131.2 ± 8.4 g/m2 in IMT = 0.91-1.19 mm vs 114.3 ± 11.1 g/m2 in IMT ≤ 0.9 mm, P 2 = 0.88, RFQIMT remained significantly associated with the dyslipidemia (regression coefficient ± standard error [SE]: 0.057 ± 0.023; p = 0.017, LVMI (regression coefficient ± SE: 0.01 ± 0.001; P Conclusions RFQIMT is a sophisticated method for carotid ultrasound evaluation. Its evaluation in patients with at least one important major epicardial coronary vessel stenosis would help the accuracy in the general assessment of the number of coronary lesions in these patients.

  2. Assessment of conduit artery vasomotion using photoplethysmography

    Science.gov (United States)

    Kanders, Karlis; Grabovskis, Andris; Marcinkevics, Zbignevs; Aivars, Juris Imants

    2013-11-01

    Vasomotion is a spontaneous oscillation of vascular tone. The phenomenon has been observed in small arterioles and capillaries as well as in the large conduit arteries. The layer of smooth muscle cells that surrounds a blood vessel can spontaneously and periodically change its tension and thereby the arterial wall stiffness also changes. As the understanding of the phenomenon is still rather obscure, researchers would benefit from a low-cost and reliable investigation technique such as photoplethysmography (PPG). PPG is an optical blood pulsation measurement technique that can offer substantial information about the arterial stiffness. The aims of this pilot study were to evaluate the usefulness of the PPG technique in the research of vasomotion and to investigate vasomotion in the relatively large conduit arteries. Continuous 15 minute long measurements of posterior tibial artery wall stiffness were taken. Artery diameter, electrocardiogram, blood pressure and respiration were also simultaneously registered. Fast Fourier Transform power spectra were calculated to identify unique stiffness oscillations that did not correspond to fluctuations in the systemic parameters and thus would indicate vasomotion. We concluded that photoplethysmography is a convenient method for the research of the vasomotion in large arteries. Local stiffness parameter b/a is more accurate to use and easier to measure than the pulse wave velocity which describes stiffness of a segment of an artery. Conduit arteries might exhibit a low amplitude high frequency vasomotion ( 9 to 27 cycles per minute). Low frequency vasomotion is problematic to distinguish from the passive oscillations imposed by the arterial pressure.

  3. Stiffness of Railway Soil-Steel Structures

    Science.gov (United States)

    Machelski, Czesław

    2015-12-01

    The considerable influence of the soil backfill properties and that of the method of compacting it on the stiffness of soil-steel structures is characteristic of the latter. The above factors (exhibiting randomness) become apparent in shell deformation measurements conducted during construction and proof test loading. A definition of soil-shell structure stiffness, calculated on the basis of shell deflection under the service load, is proposed in the paper. It is demonstrated that the stiffness is the inverse of the deflection influence function used in structural mechanics. The moving load methodology is shown to be useful for testing, since it makes it possible to map the shell deflection influence line also in the case of group loads (concentrated forces), as in bridges. The analyzed cases show that the shell's span, geometry (static scheme) and the height of earth fill influence the stiffness of the structure. The soil-steel structure's characteristic parameter in the form of stiffness k is more suitable for assessing the quality of construction works than the proposed in code geometric index ω applied to beam structures. As shown in the given examples, parameter k is more effective than stiffness parameter λ used to estimate the deformation of soil-steel structures under construction. Although the examples concern railway structures, the methodology proposed in the paper is suitable also for road bridges.

  4. Obesity and arterial compliance alterations.

    Science.gov (United States)

    Seifalian, Alexander M; Filippatos, Theodosios D; Joshi, Jatin; Mikhailidis, Dimitri P

    2010-03-01

    Obesity is associated with increased cardiovascular disease (CVD) risk, especially when excess body fat is distributed preferentially within the abdominal region. Obese subjects usually have increased arterial stiffness compared with non-obese subjects of similar age. The factors associated with increased arterial stiffness in obesity include endothelial dysfunction (decreased nitric oxide bioavailability), impaired smooth muscle cell function, insulin resistance, as well as elevated cholesterol and C-peptide levels. Furthermore, visceral fat, the adipose tissue-related renin-angiotensin-aldosterone system and hyperleptinaemia contribute to the obesity-associated impaired arterial compliance. Weight loss improves CVD risk factors and arterial compliance. Because increased arterial stiffness is a marker of CVD risk these findings support the concept that the presence of obesity has vascular implications.

  5. Posttraumatic stiff elbow

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    Ravi Mittal

    2017-01-01

    Full Text Available Posttraumatic stiff elbow is a frequent and disabling complication and poses serious challenges for its management. In this review forty studies were included to know about the magnitude of the problem, causes, pathology, prevention, and treatment of posttraumatic stiff elbow. These studies show that simple measures such as internal fixation, immobilization in extension, and early motion of elbow joint are the most important steps that can prevent elbow stiffness. It also supports conservative treatment in selected cases. There are no clear guidelines about the choice between the numerous procedures described in literature. However, this review article disproves two major beliefs-heterotopic ossification is a bad prognostic feature, and passive mobilization of elbow causes elbow stiffness.

  6. Posttraumatic stiff elbow

    Science.gov (United States)

    Mittal, Ravi

    2017-01-01

    Posttraumatic stiff elbow is a frequent and disabling complication and poses serious challenges for its management. In this review forty studies were included to know about the magnitude of the problem, causes, pathology, prevention, and treatment of posttraumatic stiff elbow. These studies show that simple measures such as internal fixation, immobilization in extension, and early motion of elbow joint are the most important steps that can prevent elbow stiffness. It also supports conservative treatment in selected cases. There are no clear guidelines about the choice between the numerous procedures described in literature. However, this review article disproves two major beliefs-heterotopic ossification is a bad prognostic feature, and passive mobilization of elbow causes elbow stiffness.

  7. Correlation of liver enzymes and sonographic findings with pulsatile index of middle cerebral and basilar arteries in nonalcoholic fatty liver

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    Gholamreza Rezamand

    2014-04-01

    Conclusion: Considering the increase of cerebral arteries PI in advanced liver disease, absence of increase in vascular PI of patients in the present study could be attributed to the short duration of disease from diagnosis to perform TCD, lack of advanced liver involvement (absence of liver dysfunction and the response effect to treatment before the TCD. Therefore, to assess vascular changes over time, repeating the TCD with assess other parameters such as Fibroscan and K18 factor that has more compatibility of liver function, could help to understand the pathophysiology of liver diseases and its effect on vascular resistance.

  8. An Obesity Paradox of Asian Body Mass Index after Cardiac Surgery: Arterial Oxygenations in Duration of Mechanic Ventilation

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    Chiu-Hsia Chang

    2013-01-01

    Full Text Available Background. Numerous studies have documented an obesity paradox that overweight of Caucasian patients has better prognosis after cardiac surgery. This study is to examine Asian patients’ BMI to see whether an obesity paradox exists in DMV after cardiac surgery. Methods. A retrospective study consisted of 428 patients after cardiac surgery from January 2006 to December 2010 in the medical center of Taiwan. The Asian BMI was divided into 3 groups: under-normal weight patients (; , overweight patients (BMI 24 to <27; , and obese patients (; . Multivariable analysis and paired were used to compare all variables. Results. Overweight patients were significantly associated with the shortest DMV. Under-normal weight patients had significantly better oxygenations of AaDO2 and P/F ratio in the DMV; however, they correlated with the longest DMV, older age, more female, lower LVSV, higher BUN, more dialysis-dependent, and poorer outcomes, namely, 1-year mortality, HAP, reintubation, tracheotomy, and LOS. Conclusions. Asian overweight patients after cardiac surgery have better prognosis. Under-normal weight patients have higher risk factors, longer DMV, and poorer outcomes; even though they have better arterial oxygenations, they seem to need better arterial oxygenations for successful weaning ventilator.

  9. Autonomic nervous activation triggered during induction of reactive hyperemia exerts a greater influence on the measured reactive hyperemia index by peripheral arterial tonometry than on flow-mediated vasodilatation of the brachial artery in patients with hypertension.

    Science.gov (United States)

    Tomiyama, Hirofumi; Yoshida, Masanobu; Higashi, Yukihito; Takase, Bonpei; Furumoto, Tomoo; Kario, Kazuomi; Ohya, Yusuke; Yamashina, Akira

    2014-10-01

    Flow-mediated vasodilatation of the brachial artery (FMD) and reactive hyperemia index (RHI) measured by peripheral arterial tonometry are known to be weakly associated with one another, but the mechanisms underlying this weak association remain to be clarified. We examined whether the autonomic nervous activation induced by the 5 min forearm clamping used to induce reactive hyperemia might exert any influence on the FMD and RHI in subjects with hypertension. In 115 subjects with hypertension (age 61±1 years), the FMD and RHI were measured simultaneously, and the heart rate variability (HRV) parameters (low-frequency component (LF), high-frequency component (HF), and the ratio (LF/HF) between the two) were calculated from the electrocardiographic recordings obtained before and after the start of forearm clamping. A multivariate linear regression analysis with adjustments for confounding variables demonstrated that the RHI, but not the FMD, was significantly associated with the percent change of the LF/HF associated with forearm clamping (beta=-0.204, P=0.043). In conclusion, autonomic nervous system activation, especially sympathetic activation, induced by 5-min forearm clamping utilized to provoke reactive hyperemia may significantly affect the RHI rather than FMD in subjects with hypertension.

  10. Correlation Between Biophysical Profile and Middle Cerebral/Umbilical Artery Resistance Index Ratio in the Assessment of Prenatal Outcome in High Risk Pregnancies

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    Nazanin Eshraghi

    2009-01-01

    Full Text Available  Introduction: Antenatal fetal surveillance tests have led to a significant decrease in perinatal mortality and morbidity rates, especially in high risk pregnancies (e.g placenta previa, intrauterine growth retardation. But there is no concurrence on the best and accurate modality yet. The aim of this study is to evaluate the accuracy of antenatal assessment with biophysical profile and Doppler sonography (cerebral and umbilical artery regarding fetal acidosis and asphyxia. "nMaterials and Methods: This is a cross-sectional study on fetuses of seventy women with a 28-42 week singleton pregnancy who had hypertension (pre eclampsia, diabetes mellitus or intra uterine growth retardation and were admitted as high risk pregnancies to AL-Zahra hospital. The study population routinely underwent sonographic evaluation of cerebral and umbilical arteries and a biophysical profile twice a week until the end of pregnancy. "nResults: Infants who had a lower score of biophysical profile, had a lower umbilical PH and a negative base deficit. Fetuses with a lower MCA/Umb. A RI had a higher base deficit and acidosis (measured from umbilical blood after birth. Apgar on minute 5 was higher in infants with a history of higher profile score as well as a higher MCA/Umb. A. RI ratio. On the other hand; there was no significant correlation between MCA RI and umbilical PH. Correlation between Umb. A. RI and umbilical PH was not significant either. "nConclusion: Biophysical profile and assessment of the umbilical and cerebral arteries are valuable modalities for predicting the fetal condition and the outcome in high risk pregnancies. MCA/Umb. A RI Index ratio is a better indicator compared to its components.

  11. Effects of arterial blood flow on walls of the abdominal aorta: distributions of wall shear stress and oscillatory shear index determined by phase-contrast magnetic resonance imaging.

    Science.gov (United States)

    Sughimoto, Koichi; Shimamura, Yoshiaki; Tezuka, Chie; Tsubota, Ken'ichi; Liu, Hao; Okumura, Kenichiro; Masuda, Yoshitada; Haneishi, Hideaki

    2016-07-01

    Although abdominal aortic aneurysms (AAAs) occur mostly inferior to the renal artery, the mechanism of the development of AAA in relation to its specific location is not yet clearly understood. The objective of this study was to evaluate the hypothesis that even healthy volunteers may manifest specific flow characteristics of blood flow and alter wall shear or oscillatory shear stress in the areas where AAAs commonly develop. Eight healthy male volunteers were enrolled in this prospective study, aged from 24 to 27. Phase-contrast magnetic resonance imaging (MRI) was performed with electrocardiographic triggering. Flow-sensitive four-dimensional MR imaging of the abdominal aorta, with three-directional velocity encoding, including simple morphological image acquisition, was performed. Information on specific locations on the aortic wall was applied to the flow encodes to calculate wall shear stress (WSS) and oscillatory shear index (OSI). While time-framed WSS showed the highest peak of 1.14 ± 0.25 Pa in the juxtaposition of the renal artery, the WSS plateaued to 0.61 Pa at the anterior wall of the abdominal aorta. The OSI peaked distal to the renal arteries at the posterior wall of the abdominal aorta of 0.249 ± 0.148, and was constantly elevated in the whole abdominal aorta at more than 0.14. All subjects were found to have elevated OSI in regions where AAAs commonly occur. These findings indicate that areas of constant peaked oscillatory shear stress in the infra-renal aorta may be one of the factors that lead to morphological changes over time, even in healthy individuals.

  12. MIGRAINE, CAROTID STIFFNESS AND GENETIC POLYMORPHISM.

    Science.gov (United States)

    Kes, Vanja Basić; Jurasić, Miljenka-Jelena; Zavoreo, Iris; Corić, Lejla; Rotim, Kresimir

    2015-12-01

    Recently migraine has been associated with increased arterial stiffness, procoagulant state, increased incidence of cerebral white matter lesions (WML) and stroke. Our aim was to compare the characteristics of migraineurs to headache free controls regarding their functional carotid ultrasound parameters. Sixty patients (45 women) with migraine (mean age 40.42 ± 10.61 years) were compared with 45 controls (30 women) with no prior history of repeating headache (mean age 38.94 ± 5.46 years) using E-tracking software on Alpha 10 ultrasound platform. Student's t-test was used on statistical analysis with alpha < 0.05. All tested carotid vascular parameters were worse in patients with migraine including increased intima-media thickness, greater carotid diameter and carotid diameter change, as well as several arterial stiffness indices. Additionally, patients with migraine had greater incidence of homozygous mutations for procoagulant genes (MTHFR (C677T), PAI-1 and ACE I/D) than expected. Computed tomography and magnetic resonance imaging of the brain showed WML in 11 patients, four of them migraine with aura patients. Since we established increased carotid stiffness and higher frequency of procoagulant gene mutations in migraineurs, we propose prospective ultrasound monitoring in such patients, especially those with detected WML, in order to timely commence more active and specific preventive stroke management strategies.

  13. Aortic stiffness is associated with white matter integrity in patients with type 1 diabetes

    Energy Technology Data Exchange (ETDEWEB)

    Tjeerdema, Nathanja; Schinkel, Linda D. van [Leiden University Medical Center, Department of Endocrinology and General Internal Medicine (C7-Q), Albinusdreef 2, PO Box 9600, Leiden (Netherlands); Westenberg, Jos J.; Elderen, Saskia G. van; Buchem, Mark A. van; Grond, Jeroen van der; Roos, Albert de [Leiden University Medical Center, Department of Radiology, Leiden (Netherlands); Smit, Johannes W. [Leiden University Medical Center, Department of Endocrinology and General Internal Medicine (C7-Q), Albinusdreef 2, PO Box 9600, Leiden (Netherlands); University Medical Center Nijmegen, Department of General Internal Medicine, Nijmegen (Netherlands)

    2014-09-15

    To assess the association between aortic pulse wave velocity (PWV) as a marker of arterial stiffness and diffusion tensor imaging of brain white matter integrity in patients with type 1 diabetes using advanced magnetic resonance imaging (MRI) technology. Forty-one patients with type 1 diabetes (23 men, mean age 44 ± 12 years, mean diabetes duration 24 ± 13 years) were included. Aortic PWV was assessed using through-plane velocity-encoded MRI. Brain diffusion tensor imaging (DTI) measurements were performed on 3-T MRI. Fractional anisotropy (FA) and apparent diffusion coefficient (ADC) were calculated for white and grey matter integrity. Pearson correlation and multivariable linear regression analyses including cardiovascular risk factors as covariates were assessed. Multivariable linear regression analyses revealed that aortic PWV is independently associated with white matter integrity FA (β = -0.777, p = 0.008) in patients with type 1 diabetes. This effect was independent of age, gender, mean arterial pressure, body mass index, smoking, duration of diabetes and glycated haemoglobin levels. Aortic PWV was not significantly related to grey matter integrity. Our data suggest that aortic stiffness is independently associated with reduced white matter integrity in patients with type 1 diabetes. (orig.)

  14. Indirect effect of financial strain on daily cortisol output through daily negative to positive affect index in the Coronary Artery Risk Development in Young Adults Study.

    Science.gov (United States)

    Puterman, Eli; Haritatos, Jana; Adler, Nancy E; Sidney, Steve; Schwartz, Joseph E; Epel, Elissa S

    2013-12-01

    Daily affect is important to health and has been linked to cortisol. The combination of high negative affect and low positive affect may have a bigger impact on increasing HPA axis activity than either positive or negative affect alone. Financial strain may both dampen positive affect as well as increase negative affect, and thus provides an excellent context for understanding the associations between daily affect and cortisol. Using random effects mixed modeling with maximum likelihood estimation, we examined the relationship between self-reported financial strain and estimated mean daily cortisol level (latent cortisol variable), based on six salivary cortisol assessments throughout the day, and whether this relationship was mediated by greater daily negative to positive affect index measured concurrently in a sample of 776 Coronary Artery Risk Development in Young Adults (CARDIA) Study participants. The analysis revealed that while no total direct effect existed for financial strain on cortisol, there was a significant indirect effect of high negative affect to low positive affect, linking financial strain to elevated cortisol. In this sample, the effects of financial strain on cortisol through either positive affect or negative affect alone were not significant. A combined affect index may be a more sensitive and powerful measure than either negative or positive affect alone, tapping the burden of chronic financial strain, and its effects on biology.

  15. Dopplerfluxometria das artérias renais: valores normais das velocidades sistólica e diastólica e do índice resistivo nas artérias renais principais Renal arteries Dopplerfluxometry: normal systolic and diastolic flow velocities and resistive index values in the main renal arteries

    Directory of Open Access Journals (Sweden)

    M.B. Melo

    2006-08-01

    Full Text Available Dopplerfluxometry of renal arteries has been used to estimate renal perfusion in humans. The aim of this study was to use Dopplerfluxometry technique to calculate the resistive index of main renal arteries in dogs, measuring their systolic and diastolic blood flow velocities. Twenty (10 males, 10 females, adult mongrel dogs, were used in this study. The dogs were submitted to Doppler sonographic evaluation of left and right main renal arteries. The systolic and diastolic blood flow velocities, expressed (in centimeters per second as mean and standard deviation were 79.96± 8.82 and 28.86± 5.11 in the right main renal artery and 80.22± 6.99 and 29.62± 4.14 in the left main renal artery. The value of resistive index expressed as mean ± standard deviation was 0.64± 0.04 for the right main renal artery and 0.63± 0.028 in the left main renal artery.

  16. Stiff Quantum Polymers

    OpenAIRE

    Kleinert, H

    2007-01-01

    At ultralow temperatures, polymers exhibit quantum behavior, which is calculated here for the second and fourth moments of the end-to-end distribution in the large-stiffness regime. The result should be measurable for polymers in wide optical traps.

  17. Dynamic stiffness of suction caissons

    DEFF Research Database (Denmark)

    Ibsen, Lars Bo; Liingaard, Morten; Andersen, Lars

    The purpose of this report is to evaluate the dynamic soil-structure interaction of suction caissons for offshore wind turbines. The investigation is limited to a determination of the vertical dynamic stiffness of suction caissons. The soil surrounding the foundation is homogenous with linear...... of the skirt length, Poisson's ratio and the ratio between soil stiffness and skirt stiffness. Finally the dynamic behaviour at high frequencies is investigated....... viscoelastic properties. The dynamic stiffness of the suction caisson is expressed by dimensionless frequency-dependent dynamic stiffness coefficients corresponding to the vertical degree of freedom. The dynamic stiffness coefficients for the foundations are evaluated by means of a dynamic three...

  18. Parameters which Affect the Stiffness of Bitumen and Bituminous Hot Mixes

    OpenAIRE

    2001-01-01

    This paper deals with bitumen and bituminous mixes, using suitable mathematical models that take into account the parameters affecting their elastic and plastic stiffnesses. These parameters are stress level and acting time, penetration index, softening time and temperature. Viscosity and the total acting time of the load affect the elastic stiffness of bitumen. The elastic stiffness of bitumen and the voluminous concentration of the aggregate influence the elastic stiffness of th...

  19. Thoracic epidural analgesia in obese patients with body mass index of more than 30 kg/m 2 for off pump coronary artery bypass surgery

    Directory of Open Access Journals (Sweden)

    Sharma Munish

    2010-01-01

    Full Text Available Perioperative Thoracic epidural analgesia (TEA is an important part of a multimodal approach to improve analgesia and patient outcome after cardiac and thoracic surgery. This is particularly important for obese patients undergoing off pump coronary artery bypass surgery (OPCAB. We conducted a randomized clinical trial at tertiary care cardiac institute to compare the effect of TEA and conventional opioid based analgesia on perioperative lung functions and pain scores in obese patients undergoing OPCAB. Sixty obese patients with body mass index> 30 kg/m 2 for elective OPCAB were randomized into two groups (n=30 each. Patients in both the groups received general anesthesia but in group 1, TEA was also administered. We performed spirometry as preoperative assessment and at six hours, 24 hours, second, third, fourth and fifth day after extubation, along with arterial blood gases analysis. Visual analogue scale at rest and on coughing was recorded to assess the degree of analgesia. The other parameters observed were: time to endotracheal extubation, oxygen withdrawal time and intensive care unit length of stay. On statistical analysis there was a significant difference in Vital Capacity at six hours, 24 hours, second and third day postextubation. Forced vital capacity and forced expiratory volume in one second followed the same pattern for first four postoperative days and peak expiratory flow rate remained statistically high till second postoperative day. ABG values and PaO 2 /FiO 2 ratio were statistically higher in the study group up to five days. Visual analogue scale at rest and on coughing was significantly lower till fourth and third postoperative day respectively. Tracheal extubation time, oxygen withdrawal time and ICU stay were significantly less in group 1. The use of TEA resulted in better analgesia, early tracheal extubation and shorter ICU stay and should be considered for obese patients undergoing OPCAB.

  20. Correlation between Carotid Artery Intima-Media Thickness and Luminal Diameter with Body Mass Index and Other Cardiovascular Risk Factors in Adults

    Directory of Open Access Journals (Sweden)

    Sameeah A. Rashid

    2015-08-01

    Full Text Available Objectives: This study aimed to examine the correlation between carotid artery intima-media thickness (IMT and luminal diameter (LD with body mass index (BMI and other cardiovascular risk factors. Methods: This observational cross-sectional study took place between June 2013 and March 2014 in the Radiology Department of Rizgary Teaching Hospital in Erbil, Iraq. Non-randomly selected subjects ≥20 years old (n = 140 were divided into BMI groups and evaluated for the following cardiovascular risk factors: gender, age, hypertension (HTN, diabetes (DM, smoking, alcohol consumption, blood pressure, serum total cholesterol and triglyceride (TG levels. IMT and LD of the extracranial carotid arteries were measured by B-mode ultrasonography. Results: The mean IMT was 0.8 ± 0.3 mm, ranging from a total mean of 0.7 mm in the normal BMI group to 1.0 mm in the extremely obese group. A significant correlation was found between IMT and BMI (P = 0.04, but not between BMI and LD (P = 0.3. No significant difference in mean IMT or LD was seen between genders. Significant correlations were found between IMT and age, HTN, DM, high serum cholesterol and TG levels (P <0.001. An increase of one BMI unit caused a 0.009 mm increase in IMT and an increase of one year in age caused a 0.011 mm increase in IMT. Conclusion: Age, obesity, HTN, DM, high serum cholesterol and TG levels were found to have an impact on carotid IMT, which is a strong marker for the early development of atherosclerosis.

  1. Association of hepatic lipase -514T allele with coronary artery disease and ankle-brachial index, dependence on the lipoprotein phenotype: the GENES study.

    Directory of Open Access Journals (Sweden)

    Céline Verdier

    Full Text Available OBJECTIVES: Relationship between hepatic lipase (LIPC polymorphism and coronary artery disease (CAD has often led to contradictory results. We studied this relation by genotyping rs1800588 in the LIPC promoter in a case-control study on CAD (the GENES study. We also investigated the relationship between this polymorphism and the ankle-brachial index (ABI, which is predictive of atherosclerosis progression and complications in patients at high cardiovascular risk. METHODS: 557 men aged 45-74 with stable coronary artery disease and 560 paired controls were genotyped for rs1800588. Medical data, clinical examination including determination of ABI and biological measurements related to cardiovascular risk factors enabled multivariate analyses and multiple adjustments. RESULTS: CAD cases showed a higher T-allele frequency than controls (0.246 vs 0.192, p = 0.003. An interaction has been found between LIPC polymorphism and triglycerides (TG levels regarding risk of CAD: TT-homozigosity was associated with an Odds ratio (OR of 6.4 (CI: 1.8-22.3 when TG were below 1.5 g/L, but no association was found at higher TG levels (OR = 1.34, CI: 0.3-5.9. The distribution of LIPC genotypes was compared between CAD patients with normal or abnormal ABI and impact of LIPC polymorphism on ABI was determined. Following multiple adjustments, association of the T-allele with pejorative ABI (<0.90 was significant for heterozygotes and for all T-carriers (OR = 1.55, CI: 1.07-2.25. CONCLUSION: The -514T LIPC allele is associated with CAD under normotriglyceridemic conditions and constitutes an independent determinant of pejorative ABI in coronary patients.

  2. Genetics of Stiff Child Syndrome

    Directory of Open Access Journals (Sweden)

    J Gordon Millichap

    2005-11-01

    Full Text Available A Chinese boy with a DYT1 gene mutation presented with muscle stiffness, painful muscle spasms, myoclonus, and dystonia, compatible with stiff child syndrome, and is reported from Queen Mary Hospital, the University of Hong Kong.

  3. Independent Factors of Changes of Ankle-Brachial Index in Peripheral Arterial Occlusive Disease in Elderly Patients with or without Diabetes

    Directory of Open Access Journals (Sweden)

    Ewelina Bąk

    2016-11-01

    Full Text Available Peripheral arterial disease (PAD belongs to the commonly-occurring pathologies associated with elderly age. A simple tool for defining the severity of PAD is the ankle-brachial index (ABI. The purpose of this research was to determine independent factors of changes of ABI in elderly patients with occlusive PAD disease (PAOD with and without diabetes. The research was carried out on 49 elderly patients with PAOD, including 29 patients with type 2 diabetes, and 20 patients without diabetes. The concentration of interleukin-6 (IL-6, E-selectin, fibrinogen, and C-reactive protein (CRP in the blood serum was marked. In all patients, the independent factors of changes of ABI were determined with the use of the multiple logistic regression analysis. Our results show that in the group of patients with PAOD suffering from diabetes, it was demonstrated that the ABI was related to age, the duration of the symptoms of PAD, body mass index (BMI, low-density lipoprotein cholesterol, fibrinogen, and sex (determination coefficient R2 = 0.699. In patients with PAOD without diabetes, the ABI was related to age, the duration of the symptoms of PAD, the levels of CRP, E-selectin, high-density lipoprotein cholesterol, and the glomerular filtration rate(determination coefficient R2 = 0.844. We conclude that in elderly patients with PAOD with and without diabetes, the participation of independent factors related to the ABI is diversified; in patients with diabetes, the concentration of IL-6 and fibrinogen is lower, and the concentration of E-selectin is higher than in patients without diabetes.

  4. On gear tooth stiffness evaluation

    DEFF Research Database (Denmark)

    Pedersen, Niels Leergaard; Jørgensen, Martin Felix

    2014-01-01

    The estimation of gear stiffness is important for determining the load distribution between the gear teeth when two sets of teeth are in contact. Two factors have a major influence on the stiffness; firstly the boundary condition through the gear rim size included in the stiffness calculation...... and secondly the size of the contact. In the FE calculation the true gear tooth root profile is applied. The meshing stiffnesses of gears are highly non-linear, it is however found that the stiffness of an individual tooth can be expressed in a linear form assuming that the contact width is constant. © 2014...

  5. Social relationships and longitudinal changes in body mass index and waist circumference: the coronary artery risk development in young adults study.

    Science.gov (United States)

    Kershaw, Kiarri N; Hankinson, Arlene L; Liu, Kiang; Reis, Jared P; Lewis, Cora E; Loria, Catherine M; Carnethon, Mercedes R

    2014-03-01

    Few studies have examined longitudinal associations between close social relationships and weight change. Using data from 3,074 participants in the Coronary Artery Risk Development in Young Adults Study who were examined in 2000, 2005, and 2010 (at ages 33-45 years in 2000), we estimated separate logistic regression random-effects models to assess whether patterns of exposure to supportive and negative relationships were associated with 10% or greater increases in body mass index (BMI) (weight (kg)/height (m)(2)) and waist circumference. Linear regression random-effects modeling was used to examine associations of social relationships with mean changes in BMI and waist circumference. Participants with persistently high supportive relationships were significantly less likely to increase their BMI values and waist circumference by 10% or greater compared with those with persistently low supportive relationships after adjustment for sociodemographic characteristics, baseline BMI/waist circumference, depressive symptoms, and health behaviors. Persistently high negative relationships were associated with higher likelihood of 10% or greater increases in waist circumference (odds ratio = 1.62, 95% confidence interval: 1.15, 2.29) and marginally higher BMI increases (odds ratio = 1.50, 95% confidence interval: 1.00, 2.24) compared with participants with persistently low negative relationships. Increasingly negative relationships were associated with increases in waist circumference only. These findings suggest that supportive relationships may minimize weight gain, and that adverse relationships may contribute to weight gain, particularly via central fat accumulation.

  6. Cardiac power index, mean arterial pressure, and Simplified Acute Physiology Score II are strong predictors of survival and response to revascularization in cardiogenic shock.

    Science.gov (United States)

    Popovic, Batric; Fay, Renaud; Cravoisy-Popovic, Aurelie; Levy, Bruno

    2014-07-01

    Short-term prognostic factors in patients with cardiogenic shock (CS) have previously been established using only hemodynamic parameters without taking into account classic intensive care unit (ICU) severity score or organ failure/support. The aim of this study was to assess early predictors of in-hospital mortality of a monocentric cohort of patients with ST-elevation myocardial infarction complicated by early CS. We retrospectively studied 85 consecutive patients with CS complicating acute myocardial infarction and Thrombolysis in Myocardial Infarction flow grade 3 after percutaneous coronary revascularization. All patients were managed according to the following algorithm: initial resuscitation by a mobile medical unit or in-hospital critical care physician unit followed by percutaneous coronary revascularization and CS management in the ICU. Prehospital CS was diagnosed in 69% of cases, initially complicated by an out-of-hospital cardiac arrest in 64% of cases. All patients were treated with vasopressors, 82% were ventilated, and 22% underwent extrarenal epuration. The 28-day mortality rate was 39%. Under multivariate analysis, initial cardiac power index, mean arterial pressure of less than 75 mmHg at hour 6 of ICU management, and Simplified Acute Physiology Score II were independent predictive factors of in-hospital mortality. In conclusion, parameters directly related to cardiac performance and vascular response to vasopressors and admission Simplified Acute Physiology Score II are strong predictors of in-hospital mortality.

  7. Weight reduction and aortic stiffness in obese children and adolescents

    DEFF Research Database (Denmark)

    Hvidt, K. N.; Olsen, M. H.; Ibsen, H.

    2015-01-01

    Little is known about the effect of weight reduction on aortic stiffness and especially so in the young. The present study investigates whether weight reduction influences aortic stiffness in obese children and adolescents. Carotid-femoral pulse wave velocity (cfPWV) and augmentation index at heart...... (%): beta = 0.7, 95% CI 0.1-1.3, P = 0.02) when adjusted for gender and relevant baseline confounders. In conclusion, no clear effect of weight reduction was found on aortic stiffness, although changes in AIx@HR75 were associated with changes in both abdominal fat and total body fat percent. The higher cf...

  8. The detection of coronary stiffness in cardiac allografts using MR imaging

    Energy Technology Data Exchange (ETDEWEB)

    Lin, Kai, E-mail: kai-lin@northwestern.edu [Department of Radiology, Northwestern University, 737 N Michigan Avenue, Suite 1600, Chicago, IL 60611 (United States); Lloyd-Jones, Donald M. [Department of Preventive Medicine, Northwestern University, 680 N Lake Shore Drive, Suite 1400, Chicago, IL 60611 (United States); Taimen, Kirsi; Liu, Ying [Department of Radiology, Northwestern University, 737 N Michigan Avenue, Suite 1600, Chicago, IL 60611 (United States); Bi, Xiaoming [Cardiovascular MR R and D, Siemens Healthcare, 737 N Michigan Avenue, Suite 1600, Chicago, IL 60611 (United States); Li, Debiao; Carr, James C. [Department of Radiology, Northwestern University, 737 N Michigan Avenue, Suite 1600, Chicago, IL 60611 (United States)

    2014-08-15

    Objective: To test the hypothesis that biomechanical changes are quantitatively related to morphological features of coronary arteries in heart transplant (HTx) recipients. Materials and methods: With IRB approval, three-dimensional (3D) magnetic resonance (MR) angiography and two-dimensional (2D) black-blood stead-state free precession (SSFP) MR imaging were performed to image coronary arteries of 36 HTx patients. Contours of coronary wall were manually drawn. For each coronary segment, coronary wall thickness, wall area, lumen area (in systole and diastole) were acquired. Coronary distensibility index (CDI) and the percent of the coronary wall occupying the vessel area (PWOV) were calculated. Results: There are totally 98 coronary segments eligible for quantitative analysis from 27 HTx patients. The CDI is 4.90 ± 2.44 mmHg{sup −1}. The mean wall thickness is 1.49 ± 0.24 mm and the PWOV is 74.6% ± 7.5%. CDI has moderate correlations with wall thickness (r = −0.531, P < 0.001) and with PWOV (R = −0.435, P < 0.001). Conclusions: Detected with coronary MR imaging, CDI is quantitatively correlated with the morphological features of the coronary artery in HTx patients. Coronary stiffness has the potential to become an alternative imaging biomarker for the quantitative assessment of the status of cardiac allografts.

  9. NAFLD and Increased Aortic Stiffness: Parallel or Common Physiopathological Mechanisms?

    Science.gov (United States)

    Villela-Nogueira, Cristiane A.; Leite, Nathalie C.; Cardoso, Claudia R. L.; Salles, Gil F.

    2016-01-01

    Non-alcoholic fatty liver disease (NAFLD) has become the leading cause of chronic liver diseases worldwide. Liver inflammation and fibrosis related to NAFLD contribute to disease progression and increasing liver-related mortality and morbidity. Increasing data suggest that NAFLD may be linked to atherosclerotic vascular disease independent of other established cardiovascular risk factors. Central arterial stiffness has been recognized as a measure of cumulative cardiovascular risk marker load, and the measure of carotid-femoral pulse wave velocity (cf-PWV) is regarded as the gold standard assessment of aortic stiffness. It has been shown that increased aortic stiffness predicts cardiovascular morbidity and mortality in several clinical settings, including type 2 diabetes mellitus, a well-known condition associated with advanced stages of NAFLD. Furthermore, recently-published studies reported a strong association between NAFLD and increased arterial stiffness, suggesting a possible link in the pathogenesis of atherosclerosis and NAFLD. We sought to review the published data on the associations between NAFLD and aortic stiffness, in order to better understand the interplay between these two conditions and identify possible common physiopathological mechanisms. PMID:27104526

  10. Meta Analysis of the Changes of Arterial Stiffness of Hypertension Patients with CCB or ARB%钙离子拮抗剂和血管紧张素Ⅱ受体阻断剂对高血压患者动脉僵硬度影响的Meta分析

    Institute of Scientific and Technical Information of China (English)

    张艺军; 裴静娴; 吴平生

    2012-01-01

    目的 系统评价钙离子拮抗剂(CCB)和血管紧张素Ⅱ受体阻断剂(ARB)对高血压患者血管功能的作用差异.方法 按循证医学的要求,制定相应的纳入、排除标准及其检索策略.通过PubMed、Embase、Ovid EMBReviews、中国期刊全文数据库、中文科技期刊全文数据库、万方数据库检索相关的临床对照研究,检索各数据库从建库至2012年1月;纳入CCB和ARB治疗原发性高血压的随机对照试验.采用RevMan5.0软件进行统计分析.比较CCB和ARB对高血压患者脉搏波传导速度、收缩压、舒张压、脉压等指标的影响.结果 共纳入6个随机对照试验,共计411例患者.Meta分析结果显示,ARB在改善动脉僵硬度方面优于CCB(均数差为183.33,95% CI为79.32 ~ 287.33),差异有统计学意义.但是在降低收缩压(均数差为-2.66,95% CI为-3.35 ~-1.96)和舒张压(均数差为-5.43,95% CI为-8.8 ~-2.07)方面较CCB弱.结论 ARB在改善高血压患者动脉僵硬度方面优于CCB,该作用与其降压作用无关.但仍需要大样本多中心的随机对照临床试验来进一步证实.%Aim To evaluate the differences of the changes of arterial stiffness of hypertension patients with the treatment of calcium channel blocker ( CCB) or angiotensin Ⅱ receptor blocker ( ARB) . Methods Based on the principles of evidence-based medicine, corresponding inclusion and exclusion criteria, along with search strategies were developed. We searched the Ovid EMB Reviews, Pubmed, EMBASE, Chinese Biomedical Literature Database, Chinese Scientific Journal Full-text Database, and Chinese Journal Full-text Database up to January 2012 to identify randomized controlled trials ( RCT) comparing the effects of CCB with that of ARB on arterial stiffness of hypertension patients. Two reviewers independently evaluated the quality of the included studies, extracted data with a unified form, and analyzed the data by Cochrane Collaboration' s RevMan 5. 0

  11. 血管回声跟踪技术评价抗氧化剂干预吸烟对肱动脉弹性的影响%Echo-tracking technique in evaluation on effects of antioxidant to smoking-induced brachial arterial wall stiffness in healthy volunteers

    Institute of Scientific and Technical Information of China (English)

    薛莉; 罗春英; 王谦谦; 李学奇; 申宝忠

    2011-01-01

    Objective To investigate whether the oral administration of vitamin C (Vit C ) can prevent the smoking-induced acceleration arterial stiff'ness in short -term smoking healthy volunteers with echo -tracking (ET ) technique . Methods Sixty healthy smokers were enrolled and divided into treatment group (oral administrating Vit C ) and control group (oral administrating placebo ) . ET technique was used to measure the parameters of elasticity of brachial artery including stiffness (β) , pressure strain elastic modulus (Ep) , arterial compliance (AC ) . The hlood pressure and heart rate before and after smoking in healthy volunteers were also measured . Results In treatment group , β , Ep of brachial artery increased and AC decreased immediately after smoking than those before smoking ( P< 0. 05 ) . The level of β, Ep and AC measured at 5 min after smoking had no difference with those measured before smoking . In control group , β , Ep increased significantly and AC decreased significantly at O , 5 , 10 min after smoking than those before smoking ( P< 0. 05 ) . The level of β, Ep and AC measured at 15 min after smoking had no difference with those measured before smoking . The level ofβ , Ep in treatment group were lower than those in control group at 0 , 5 . 10 min after smoking ( P<0. 05 ) , w hile AC measured at 0 , 5 min after smoking were higher than those in control group ( P< 0. 05 ) . The changes of blood pressure and heart rate had no difference between the two groups (all P>0. 05 ) . Conclusion Smoking may lead to acute transient increase in blood pressure , heart rate and elasticity of branchial artery . Single-dose oral administrating Vit C may ameliorate the smoking-induced aaleleration arterial stiffness in healthy volunteers , but has no intervention effect on blood pressure and heart rate .%目的 应用血管回声跟踪(ET)技术探讨单剂口服维生素C(Vit C)拮抗吸烟对短期吸烟者肱动脉弹性的影响.方法 60名健康

  12. Effect of Heart Rate and Body Mass Index on the Interscan and Interobserver Variability of Coronary Artery Calcium Scoring at Prospective ECG-Triggered 64-Slice CT

    Energy Technology Data Exchange (ETDEWEB)

    Horiguchi, Jun; Kiguchi, Masao; Fujioka, Chikako [Hiroshima University Hospital, Hiroshima (Japan); Matsuura, Noriaki; Yamamoto, Hideya; Kitagawa, Toshiro; Ito, Katsuhide [Hiroshima University, Hiroshima (Japan)

    2009-08-15

    To test the effects of heart rate, body mass index (BMI) and noise level on interscan and interobserver variability of coronary artery calcium (CAC) scoring on a prospective electrocardiogram (ECG)-triggered 64-slice CT. One hundred and ten patients (76 patients with CAC) were scanned twice on prospective ECG-triggered scans. The scan parameters included 120 kV, 82 mAs, a 2.5 mm thickness, and an acquisition center at 45% of the RR interval. The interscan and interobserver variability on the CAC scores (Agatston, volume, and mass) was calculated. The factors affecting the variability were determined by plotting it against heart rate, BMI, and noise level (defined as the standard deviation: SD). The estimated effective dose was 1.5 {+-} 0.2 mSv. The mean heart rate was 63 {+-} 12 bpm (range, 44-101 bpm). The patient BMIs were 24.5 {+-} 4.5 kg/m{sup 2} (range, 15.5-42.3 kg/m2). The mean and median interscan variabilities were 11% and 6%, respectively by volume, and 11% and 6%, respectively, by mass. Moreover, the mean and median of the algorithms were lower than the Agatston algorithm (16% and 9%, respectively). The mean and median interobserver variability was 10% and 4%, respectively (average of algorithms). The mean noise levels were 15 {+-} 4 Hounsfield unit (HU) (range, 8-25 HU). The interscan and interobserver variability was not correlated with heart rate, BMI, or noise level. The interscan and interobserver variability of CAC on a prospective ECG-triggered 64-slice CT with high image quality and 45% of RR acquisition is not significantly affected by heart rate, BMI, or noise level. The volume or mass algorithms show reduced interscan variability compared to the Agatston scoring (p < 0.05)

  13. 健康人不同部位脉搏波传导速度、反射波增强指数之间的相关性及影响因素%Associations and related factors between pulse wave velocity and arterial system and augmentation index measured on different sites in a healthy population

    Institute of Scientific and Technical Information of China (English)

    张明华; 叶平; 骆雷鸣; 肖文凯; 吴红梅; 刘德军

    2010-01-01

    Objective To explore the associations and related factors between pulse wave velocity (PWV) and arterial system and augmentation index (AI) measured on different sites in a healthy population. Methods All subjects were selected from a local community investigation study which included 5116 people living in Haidian District or Daxing District, Beijing, China. A total of 729 healthy subjects [age 17-85 years, mean (39.2 ± 12.2 )years, 413 men] were included in this study. Carotid-femoral pulse wave velocity ( CF-PWV), carotid-radial pulse wave velocity (CR-PWV) and carotid-ankle pulse wave velocity (CA-PWV) were measured using Complior. Pulse wave analysis at the right radial artery was measured and AI was calculated using SphygmoCor device. Results CF-PWV correlated significantly with CR-PWV or CA-PWV (all P <0. 01 ) by both Pearson and Partial Correlation analysis adjusted by age,body mass index, waist-hip ratio, systolic blood pressure, diastolic pressure and heart rate. There was no significant correlation between AI and CR-PWV (r = -0. 072, P = 0. 053 ) and between AI and CR-PWV ( r = 0. 024, P = 0. 528 ), AI and CA-PWV ( r = 0. 068, P = 0. 070 ) while AI was significantly correlated with CF-PWV ( r = 0. 110, P = 0. 003 ). Multiple stepwise regression analyses showed that age, systolic blood pressure and heart rate were positively while female gender was negatively correlated with CF-PWV. CRPWV was positively correlated with diastolic blood pressure and negatively correlated with pulse pressure and female gender (R2 =0. 155). CA-PWV was positively correlated with systolic blood pressure and age while negatively correlated with pulse pressure and female gender. Multiple stepwise regression analysis also demonstrated that AI was positively correlated with age, diastolic blood pressure, low density lipoprotein cholesterol and female gender, and negatively correlated with heart rate, height and serum creatinine level (R2 = 0. 536). Conclusions CA-PWV, covering

  14. Case Report: Urgent endovascular treatment of subclavian artery injury after blunt trauma [v1; ref status: indexed, http://f1000r.es/4x8

    Directory of Open Access Journals (Sweden)

    Taka-aki Nakada

    2014-12-01

    Full Text Available Subclavian arterial injury is rare and potentially life-threatening, particularly when it leads to arterial occlusion, causing limb ischemia, retrograde thromboembolization and cerebral infarction within hours after injury. Here we report a blunt trauma case with subclavian arterial injury, upper extremity ischemia, and the need for urgent treatment to salvage the limb and prevent cerebral infarction. A 41-year-old man had a left, open, mid-shaft clavicle fracture and left subclavian artery injury accompanied by a weak pulse in the left radial artery, decreased blood pressure of the left arm compared to the right, and left hand numbness. Urgent debridement and irrigation of the open clavicle fracture was followed by angiography for the subclavian artery injury. The left distal subclavian artery had a segmental dissection with a thrombus. Urgent endovascular treatment using a self-expanding nitinol stent successfully restored the blood flow and blood pressure to the left upper extremity. Endovascular treatment is a viable option for cases of subclavian artery injury where there is a risk of extremity ischemia and cerebral infarction.

  15. Avaliação da circulação arterial pela medida do índice tornozelo/braço em doentes de úlcera venosa crônica Evaluation of arterial circulation using the ankle/brachial blood pressure index in patients with chronic venous ulcers

    Directory of Open Access Journals (Sweden)

    Fabiane Noronha Bergonse

    2006-03-01

    Full Text Available FUNDAMENTOS: As úlceras venosas dos membros inferiores são freqüentes e têm grande impacto na qualidade de vida e produtividade do indivíduo, além de alto custo para a saúde pública. OBJETIVOS: Detecção de alterações arteriais em pacientes de úlcera venosa crônica dos membros inferiores com emprego de método não invasivo, de modo a discriminar aqueles em que estaria contra-indicado o tratamento compressivo. MÉTODOS: Foram estudados 40 doentes portadores de úlcera venosa crônica, com o intuito de se avaliar a presença de doença arterial periférica pela medida do índice tornozelo/braço por doppler-ultra-som. RESULTADOS: O índice tornozelo/braço mostrou-se alterado (menor que 1 em 9/22 (40,9% doentes com úlcera venosa crônica e hipertensão arterial concomitante, e apenas em 1/13 (7,7% doentes de úlcera venosa crônica sem hipertensão arterial. CONCLUSÕES: Doentes de úlcera venosa crônica e hipertensão arterial concomitantes devem ser submetidos rotineiramente à medida do índice tornozelo/braço para detecção de possível insuficiência arterial periférica associada.BACKGROUND: Chronic venous ulcers are extremely frequent and have a significant impact on quality of life and work productivity of individuals, in addition to high costs to public health. OBJECTIVES: Detection of arterial circulation alterations in chronic venous ulcer legs using a non-invasive method to discriminate patients not indicated to have compressive treatment. METHODS: Forty patients with chronic venous ulcers were investigated for the presence of peripheral arterial disease with measurement of the ankle/brachial index by Doppler ultrasound. RESULTS: The resting ankle/brachial pressure index was abnormal (lower than 1 in 9/22 (40.9% patients with concomitant chronic venous ulcers and hypertension and only in one out of 13 (7.7% patients with chronic venous ulcers and no hypertension. CONCLUSIONS: Patients with concomitant chronic venous

  16. Static Stiffness Analysis of a New Type 6-DOF Micro-manipulation Robot

    Institute of Scientific and Technical Information of China (English)

    YE Xin; ZHANG Zhi-jing; YAO Can; YANG Bo; LI Yuan

    2007-01-01

    A 6-DOF micro-manipulation robot based on a 3-PPTTRS mechanism is proposed in this paper. Its static stiffness is an important index to evaluate load capacity and positioning accuracy. However, it is insufficient to consider the static stiffness only when the robot is in its initial pose. The stiffness in different positions and poses in its work space must be analyzed also. Thus a method to analyze the relationship between static stiffness and poses in the whole work space is presented. A static stiffness model is proposed first, and the relationship between structural parameters and static stiffness in different poses is discussed. The static stiffness analysis provides foundation for structural parameter design.

  17. 缺血性卒中患者踝臂指数与颅内动脉狭窄数量的关系%Relationship between Ankle Brachial Index and Number of Intracerebral Artery Stenosis in Patients with Ischemic Stroke

    Institute of Scientific and Technical Information of China (English)

    李轶; 孙海欣; 董可辉; 王拥军

    2011-01-01

    目的 探讨缺血性脑卒中患者踝臂指数(ABI)与颅内动脉狭窄支数的相关性.方法 测量314例行脑血管造影的缺血性卒中患者的ABI值,并收集其相关临床资料.结果 ABI异常、年龄与缺血性卒中患者颅内动脉狭窄数量有关.ABI值与患者具备的危险因素(高血压、糖尿病、冠心病及缺血性卒中史)数量之间存在负相关性,两者之间存在线性趋势(x2=36.35,P<0.001).ABI值与狭窄血管数量之间存在负相关性,两者之间存在线性趋势.结论 缺血性脑卒中患者ABI值与颅内动脉狭窄数量具有相关性.%Objective To investigate the relationship of ankle brachial index and the number of intracranial artery stenosis. Methods Ankle brachial index were measured in 314 patients with ischemic cerebrovascular disease received cerebral angiograpathy. Their data including general information and medical history were collected. Results Abnormality of ankle brachial index and age were associated with the number of intracranial artery stenosis in patients with ischemic stroke. Ankle brachial index was negative correlation with the number of risk factors( hyperten-tion/diabetes/coronary heart disease/ischemic stroke history) (r, = -0. 292,P <0. 001). Linear trend analysis showed linear trend between them(x2 =36. 35 ,P<0.001). Ankle brachial index was negative correlation with the number of intracranial artery stenosis(r, = -0. 161 ,P = 0.004). Trend analysis showed linear trend between them(x2 = 6. 53,P = 0. 01). Conclusion Ankle brachial index was associated with the number of intracerebral artery stenosis.

  18. Body mass index and the prevalence, severity, and risk of coronary artery disease: an international multicentre study of 13 874 patients

    Science.gov (United States)

    Labounty, Troy M.; Gomez, Millie J.; Achenbach, Stephan; Al-Mallah, Mouaz; Berman, Daniel S.; Budoff, Matthew J.; Cademartiri, Filippo; Callister, Tracy Q.; Chang, Hyuk-Jae; Cheng, Victor; Chinnaiyan, Kavitha M.; Chow, Benjamin; Cury, Ricardo; Delago, Augustin; Dunning, Allison; Feuchtner, Gudrun; Hadamitzky, Martin; Hausleiter, Jorg; Kaufmann, Philipp; Kim, Yong-Jin; Leipsic, Jonathon; Lin, Fay Y.; Maffei, Erica; Raff, Gilbert; Shaw, Leslee J.; Villines, Todd C.; Min, James K.

    2013-01-01

    Aims Obesity is associated with the presence of coronary artery disease (CAD) risk factors and cardiovascular events. We examined the relationship between body mass index (BMI) and the presence, extent, severity, and risk of CAD in patients referred for coronary computed tomographic angiography (CCTA). Methods and results We evaluated 13 874 patients from a prospective, international, multicentre registry of individuals without known CAD undergoing CCTA. We compared risk factors, CAD findings, and risk of all-cause mortality and non-fatal myocardial infarction (MI) amongst individuals with underweight (18.5–20.0 kg/m2), normal (20.1–24.9 kg/m2), overweight (25–29.9 kg/m2), and obese (≥30 kg/m2) BMI. The mean follow-up was 2.4 ± 1.2 years with 143 deaths and 193 MIs. Among underweight, normal weight, overweight, and obese individuals, there was increasing prevalence of diabetes (7 vs.10% vs. 12 vs. 19%), hypertension (37 vs. 40% vs. 46 vs. 59%), and hyperlipidaemia (48 vs. 52% vs. 56 vs. 56%; P < 0.001 for trend). After multivariable adjustment, BMI was positively associated with the prevalence of any CAD [odds ratio (OR) 1.25 per +5 kg/m2, 95% confidence interval (CI): 1.20–1.30, P < 0.001] and obstructive (≥50% stenosis) CAD (OR: 1.13 per +5 kg/m2, 95% CI: 1.08–1.19, P < 0.001); a higher BMI was also associated with an increased number of segments with plaque (+0.26 segments per +5 kg/m2, 95% CI: 0.22–0.30, P < 0.001). Larger BMI categories were associated with an increase in all-cause mortality (P = 0.004), but no difference in non-fatal MI. After multivariable adjustment, a higher BMI was independently associated with increased risk of MI (hazards ratio: 1.28 per +5 kg/m2, 95% CI: 1.12–1.45, P < 0.001). Conclusions Amongst patients with suspected CAD referred for CCTA, individuals with increased BMI have greater prevalence, extent, and severity of CAD that is not fully explained by the presence of traditional risk factors. A higher BMI is

  19. Meta Analysis of the Effects of Calcium Channel Blockers or Renin-Angiotensin System Blockers on Arterial Stiffness in Hypertension%钙离子拮抗剂和肾素-血管紧张素系统阻断剂对高血压动脉僵硬度作用差异的荟萃分析

    Institute of Scientific and Technical Information of China (English)

    张艺军; 裴静娴; 王月刚; 吴平生

    2012-01-01

    -angiotensin system Mockers on arterial stiffness of hypertension patients after more than 12 weeks treatment. Analyzed the data by Cochrane Collaboration's RevMan 5.0 software. We performed the comparisons of the effects of calcium channel blockers and Renin-angiotensin system blockers on arterial stiffness, systolic blood pressure, diastolic blood pressure and pulse pressure in hypertension patients. Results Seven randomized controlled trials involving 524 patients were included. The results of meta analysis showed that Renin-angiotensin system blockers was better than calcium channel blockers in reducing arterial stiffness (MD = 160.15, 95%CI 57.10-263.21), but it was weaker than calcium channel blockers in reducing systolic blood pressure (MD=-2.94, 95%CI-4.59~-1.29)and diastolic blood pressure (MD=-6.63, 95%CI -9.56-3.70). There is no significant difference in pulse pressure between the two drugs (MD=-6.12,95%CI-2.3~14.55). Conclusions The effect of Renin-angiotensin system blockers is stronger than that of calcium channel blockers on reducing arterial stiffness in hypertension patients, and was independent of reduction in blood pressure by these drugs.

  20. A Reply to Stiff and Boster.

    Science.gov (United States)

    Petty, Richard E.; And Others

    1987-01-01

    Addresses the major errors and misconceptions perpetuated by Stiff and Boster's response to criticism of Stiff's 1986 article. Focuses on the major conceptual and methodological issues of Stiff's model. (NKA)

  1. Stiffness of desiccating insect wings

    Energy Technology Data Exchange (ETDEWEB)

    Mengesha, T E; Vallance, R R [Department of Mechanical Engineering, The George Washington University, 738 Phillips Hall, 801 22nd St NW, Washington, DC 20052 (United States); Mittal, R, E-mail: vallance@gwu.edu [Department of Mechanical Engineering, Johns Hopkins University, 126 Latrobe Hall, 3400 N Charles Street, Baltimore, MD 21218 (United States)

    2011-03-15

    The stiffness of insect wings is typically determined through experimental measurements. Such experiments are performed on wings removed from insects. However, the wings are subject to desiccation which typically leads to an increase in their stiffness. Although this effect of desiccation is well known, a comprehensive study of the rate of change in stiffness of desiccating insect wings would be a significant aid in planning experiments as well as interpreting data from such experiments. This communication presents a comprehensive experimental analysis of the change in mass and stiffness of gradually desiccating forewings of Painted Lady butterflies (Vanessa cardui). Mass and stiffness of the forewings of five butterflies were simultaneously measured every 10 min over a 24 h period. The averaged results show that wing mass declined exponentially by 21.1% over this time period with a time constant of 9.8 h, while wing stiffness increased linearly by 46.2% at a rate of 23.4 {mu}N mm{sup -1} h{sup -1}. For the forewings of a single butterfly, the experiment was performed over a period of 1 week, and the results show that wing mass declined exponentially by 52.2% with a time constant of 30.2 h until it reached a steady-state level of 2.00 mg, while wing stiffness increased exponentially by 90.7% until it reached a steady-state level of 1.70 mN mm{sup -1}. (communication)

  2. Fibulin-1 is a marker for arterial extracellular matrix alterations in type 2 diabetes

    DEFF Research Database (Denmark)

    Cangemi, Claudia; Skov, Vibe; Poulsen, Michael Kjaer

    2011-01-01

    Extracellular matrix alterations are important elements in the arterial changes seen in diabetes, being associated with increased vascular stiffness and the development of cardiovascular diseases. However, no biomarkers for diabetes-related arterial changes have been defined.......Extracellular matrix alterations are important elements in the arterial changes seen in diabetes, being associated with increased vascular stiffness and the development of cardiovascular diseases. However, no biomarkers for diabetes-related arterial changes have been defined....

  3. Analytical theory for shape stiffness

    Institute of Scientific and Technical Information of China (English)

    2000-01-01

    The shape stiffness of mill m is defined as the crosswise rigidity of the unit width of steel plate, that is, m=k/b. By differentiating the steel plate crown equation in the vector model of steel plate shape, a new concise equation for the shape stiffness, kc=m+q, is obtained. Furthermore, by combining the calculation equation for steel plate crown derived from Castigliano's theorem, an analytical calculation equation for the shape rigidity of rolled steel plate is derived. The correctness and practicability of the theory for the shape stiffness are demonstrated by comparing the results from the numerical calculation with the practical data of a rolling mill.

  4. Analytical theory for shape stiffness

    Institute of Scientific and Technical Information of China (English)

    张进之

    2000-01-01

    The shape stiffness of mill m is defined as the crosswise rigidity of the unit width of steel plate, that is, m = k/b. By differentiating the steel plate crown equation in the vector model of steel plate shape, a new concise equation for the shape stiffness, kc = m + q, is obtained. Furthermore, by combining the calculation equation for steel plate crown derived from Castigliano’s theorem, an analytical calculation equation for the shape rigidity of rolled steel plate is derived. The correctness and practicability of the theory for the shape stiffness are demonstrated by comparing the results from the numerical calculation with the practical data of a rolling mill.

  5. Level Classifications of Foundation Stiffness

    DEFF Research Database (Denmark)

    Ibsen, Lars Bo; Liingaard, Morten

    2007-01-01

    This article describes a foundation module developed and implemented in both HAWC and FLEX capable of to simulate the frequency dependent stiffness and damping of foundations e.g. pile, gravitation and bucket foundations.......This article describes a foundation module developed and implemented in both HAWC and FLEX capable of to simulate the frequency dependent stiffness and damping of foundations e.g. pile, gravitation and bucket foundations....

  6. Paired changes in electromechanical delay and musculo-tendinous stiffness after endurance or plyometric training.

    Science.gov (United States)

    Grosset, Jean-Francois; Piscione, Julien; Lambertz, Daniel; Pérot, Chantal

    2009-01-01

    When measured in vivo electromechanical delay (EMD) depends mainly on the elastic properties of the muscle-tendon unit. Recent studies have shown changes in stiffness of the triceps surae (TS) following a period of training. To confirm the influence of musculo-tendinous stiffness on EMD, this study investigates paired changes in these two parameters after a training period. Two types of training known to induce opposite changes in stiffness were analysed. EMD and musculo-tendinous stiffness were measured on adult subjects before and after 10 weeks of endurance (n = 21) or plyometric (n = 9) trainings. EMD was defined as the time lag between the TS M-wave latency and the onset of muscle twitch evoked at rest by supramaximal electrical stimulations of the posterior tibial nerve. Quick release tests were used to evaluate the musculo-tendinous stiffness of the ankle plantar flexors. The stiffness index was defined as the slope of the relationship between angular stiffness and external torque values. Endurance training, known to preferentially activate the slow, stiffer muscle fibers, leads to a decrease in EMD and to an increase in stiffness index. Following plyometric training, which specifically recruits fast, more compliant fibers, EMD and the stiffness index exhibited adaptations directionally opposite to those seen with endurance training. When pooling the data for the two subject groups, a correlation was found between changes in EMD and changes in musculo-tendinous stiffness indexes. Thus, changes in EMD values are proposed to indirectly link to changes in musculo-tendinous stiffness for subjects involved in muscle training.

  7. Hemodynamic Correlates of Late Systolic Flow Velocity Augmentation in the Carotid Artery

    Directory of Open Access Journals (Sweden)

    Kevin S. Heffernan

    2013-01-01

    Full Text Available Background. The contour of the common carotid artery (CCA blood flow velocity waveform changes with age; CCA flow velocity increases during late systole, and this may contribute to cerebrovascular disease. Late systolic flow velocity augmentation can be quantified using the flow augmentation index (FAIx. We examined hemodynamic correlates of FAIx to gain insight into determinants of CCA flow patterns. Methods. CCA Doppler ultrasound and wave intensity analysis (WIA were used to assess regional hemodynamics in 18 young healthy men (age 22 ± 1 years. Forward waves ( and backward waves (negative area, NA were measured and used to calculate the reflection index (NA/ = RIx. Additional parameters included which is a forward travelling expansion/decompression wave of myocardial origin that produces suction, CCA single-point pulse wave velocity (PWV as a measure of arterial stiffness, and CCA pressure augmentation index (AIx. Results. Primary correlates of FAIx included , logRIx , and AIx . FAIx was not associated with CCA stiffness . Conclusions. FAIx is a complex ventricular-vascular coupling parameter that is associated with both increased expansion wave magnitude (increased suction from the left ventricle and increased pressure from wave reflections.

  8. Impact of dry weight determined by calf bioimpedance ratio on carotid stiffness and left ventricular hypertrophy in hemodialysis patients.

    Science.gov (United States)

    Zhou, Yi-Lun; Liu, Jing; Ma, LiJie; Sun, Fang; Shen, Yang; Huang, Jing; Cui, TaiGen

    2014-04-01

    Our previous study has shown that modification of bioimpedance technique by the measurement of bioimpedance ratio in the calf (calf-BR) was a simple and practical method in assessing fluid status in hemodialysis patients. However, the consequences of periodical dry weight (DW) adjustment under the guidance of calf-BR on target organ damage have not been investigated. One hundred fifteen hemodialysis patients were enrolled in this pilot trial. Patients were divided into bioimpedance group and control group according to their dialysis schedule. In the bioimpedance group, DW was routinely adjusted under the guidance of calf-BR every 3 months. In the control group, the assessment of DW remained a clinical judgment. Carotid stiffness, left ventricular mass index (LVMI), and calf-BR were measured at baseline and at the 12th month in both groups. Home blood pressure (BP) was monitored monthly. Episodes of dialysis-related adverse events were recorded. No significant differences were observed in parameters between the two groups at baseline. Compared with the control group, the bioimpedance group had significantly lower values in terms of the annual averages of systolic home BP (147.4 ± 15.3 mm Hg vs. 152.6 ± 16.9 mm Hg, P = 0.019), carotid stiffness index β (10.7 ± 3.3 vs. 12.2 ± 3.1, P = 0.003), LVMI (155.21 ± 15.64 g/m(2) vs. 165.17 ± 16.76 g/m(2) , P measurement improved arterial stiffness and left ventricular hypertrophy with good tolerability in hemodialysis patients.

  9. Peripheral Arterial Disease in Older People with Intellectual Disability in The Netherlands Using the Ankle-Brachial Index: Results of the HA-ID Study

    Science.gov (United States)

    de Winter, C. F.; Bastiaanse, L. P.; Kranendonk, S. E.; Hilgenkamp, T. I. M.; Evenhuis, H. M.; Echteld, M. A.

    2013-01-01

    Older people with an intellectual disability (ID) have been shown to have similar to increased cardiovascular risks as compared to the general population. Peripheral arterial disease (PAD), atherosclerosis distal from the aortic bifurcation, is associated with increased cardiovascular morbidity and mortality. The prevalence of PAD has not been…

  10. A computational analysis of the long-term regulation of arterial pressure [v2; ref status: indexed, http://f1000r.es/2hm

    Directory of Open Access Journals (Sweden)

    Daniel A. Beard

    2013-12-01

    Full Text Available The asserted dominant role of the kidneys in the chronic regulation of blood pressure and in the etiology of hypertension has been debated since the 1970s. At the center of the theory is the observation that the acute relationships between arterial pressure and urine production—the acute pressure-diuresis and pressure-natriuresis curves—physiologically adapt to perturbations in pressure and/or changes in the rate of salt and volume intake. These adaptations, modulated by various interacting neurohumoral mechanisms, result in chronic relationships between water and salt excretion and pressure that are much steeper than the acute relationships. While the view that renal function is the dominant controller of arterial pressure has been supported by computer models of the cardiovascular system known as the “Guyton-Coleman model”, no unambiguous description of a computer model capturing chronic adaptation of acute renal function in blood pressure control has been presented. Here, such a model is developed with the goals of: 1. representing the relevant mechanisms in an identifiable mathematical model; 2. identifying model parameters using appropriate data; 3. validating model predictions in comparison to data; and 4. probing hypotheses regarding the long-term control of arterial pressure and the etiology of primary hypertension. The developed model reveals: long-term control of arterial blood pressure is primarily through the baroreflex arc and the renin-angiotensin system; and arterial stiffening provides a sufficient explanation for the etiology of primary hypertension associated with ageing. Furthermore, the model provides the first consistent explanation of the physiological response to chronic stimulation of the baroreflex.

  11. A computational analysis of the long-term regulation of arterial pressure [v1; ref status: indexed, http://f1000r.es/1xq

    Directory of Open Access Journals (Sweden)

    Daniel A. Beard

    2013-10-01

    Full Text Available The asserted dominant role of the kidneys in the chronic regulation of blood pressure and in the etiology of hypertension has been debated since the 1970s. At the center of the theory is the observation that the acute relationships between arterial pressure and urine production—the acute pressure-diuresis and pressure-natriuresis curves—physiologically adapt to perturbations in pressure and/or changes in the rate of salt and volume intake. These adaptations, modulated by various interacting neurohumoral mechanisms, result in chronic relationships between water and salt excretion and pressure that are much steeper than the acute relationships. While the view that renal function is the dominant controller of arterial pressure has been supported by computer models of the cardiovascular system known as the “Guyton-Coleman model”, no unambiguous description of a computer model capturing chronic adaptation of acute renal function in blood pressure control has been presented. Here, such a model is developed with the goals of: 1. capturing the relevant mechanisms in an identifiable mathematical model; 2. identifying model parameters using appropriate data; 3. validating model predictions in comparison to data; and 4. probing hypotheses regarding the long-term control of arterial pressure and the etiology of primary hypertension. The developed model reveals: long-term control of arterial blood pressure is primarily through the baroreflex arc and the renin-angiotensin system; and arterial stiffening provides a sufficient explanation for the etiology of primary hypertension associated with ageing. Furthermore, the model provides the first consistent explanation of the physiological response to chronic stimulation of the baroreflex.

  12. Effect of Combination of Antihypertensive and Lipid Lowering Therapy on Arterial Stiffness in Elderly Patients with Mild to Moderate Essential Hypertension%降压降脂联合治疗对老年高血压患者动脉僵硬度的影响

    Institute of Scientific and Technical Information of China (English)

    胡小亮; 路方红; 刘振东; 赵颖馨; 孙尚文; 王舒健

    2011-01-01

    目的 探讨降压降脂联合治疗对老年高血压患者动脉僵硬度的影响.方法 纳入轻、中度老年高血压患者216例,给予双氢克尿噻( 25 mg/d)作为基础治疗,2周后随机分为4组,每组54例,分别为强化降压降脂组(双氢克尿噻25 mg/d,坎地沙坦8 mg/d,瑞舒伐他汀10 mg/d)、强化降压组(双氢克尿噻25 mg/d,坎地沙坦8 mg/d)、降压降脂组(双氢克尿噻25 mg/d,瑞舒伐他汀10 mg/d)和对照组(双氢克尿噻25 mg/d).治疗12个月后比较4组测量血压(BP)、血生化、颈桡动脉脉搏波传导速度(crPWV)的变化.结果 治疗12个月后,4组SBP、DBP、PP、crPWV均较治疗前明显降低(P<0.05),其中降压降脂联合治疗对降低老年高血压患者SBP、DBP、PP、CrPWV存在交互作用,F值分别为40.765、4.869、24.829和53.149,P值均<0.05.结论 降压联合降脂治疗能显著降低老年高血压患者的颈桡脉搏波传导速度,改善动脉僵硬度,优于单一降压或降脂治疗.%Objective To observe the effect of combination of antihypertensive and lipid lowering therapy on arterial stiffness in elderly patients with mild to moderate essential hypertension. Methods A total of 216 elderly patients with mild to moderate essential hypertension were enrolled and treated by hydrochlorothiazide as the basic therapy for two weeks. Then the patients were randomly divided into four groups. Namely, the intensified antihypertensive and lipid lowering therapy group (hydrochlorothiazide 25 mg/d, Candesartan 8 mg/d, Rosuvastatin 10 mg/d, n=54), the intensified antihypertensive treatment group (hydrochlorothiazide 25 mg/d, Candesartan 8 mg/d, n=54), the antihypertensive and lipid lowering therapy group (hydrochlorothiazide 25 mg/d, Rosuvastatin 10 mg/d, n=54), and the control group (hydrochlorothiazide 25 mg/d, n=54). After 12-month treatment, the blood pressure, blood lipid and carotid-radial pulse wave velocity (crPWV) of each group were recorded. Results Twelve months

  13. Usefulness of the Sum of Pulmonary Capillary Wedge Pressure and Right Atrial Pressure as a Congestion Index that Prognosticates Heart Failure Survival (from the Evaluation Study of Congestive Heart Failure and Pulmonary Artery Catheterization Effectiveness Trial).

    Science.gov (United States)

    Ma, Tony S; Paniagua, David; Denktas, Ali E; Jneid, Hani; Kar, Biswajit; Chan, Wenyaw; Bozkurt, Biykem

    2016-09-15

    In the Evaluation Study of Congestive Heart Failure and Pulmonary Artery Catheterization Effectiveness (ESCAPE) trial, use of a pulmonary artery catheter did not significantly affect advanced heart failure outcomes. However, the success of achieving the targeted hemodynamic goals of pulmonary capillary wedge pressure (PCWP) of 15 mm Hg and right atrial pressure (RAP) of 8 mm Hg and the association of these goals with clinical outcomes were not addressed. Furthermore, goals with 2 independent variables, PCWP and RAP, left room for uncertainties. We assessed the ability of a single hemodynamic target to achieve a threshold sum of PCWP and RAP as a predictor of all-cause mortality, death-or-transplantation (DT), or death-or-rehospitalization (DR) at 6 months in the pulmonary artery catheter-guided treatment arm of ESCAPE (n = 206). Patients with a posttreatment PCWP + RAP of <30 mm Hg had characteristics similar to those of the population who achieved the ESCAPE hemodynamic goals. This group had 8.7% mortality, 13.0% DT, and 58.7% DR at 6 months. The contrasting cohort with PCWP + RAP of ≥30 mm Hg had 45.3% mortality, 54.7% DT, and 84.9% DR at 6 months, with greater relative risk (RR) of death (RR 5.76), DT (RR 4.92), and DR (RR 1.80) and higher prevalence of jugular venous pulsation, edema, hepatomegaly, and ascites at admission and discharge. In conclusion, PCWP + RAP of 30 mm Hg posttreatment, obtained early in the index hospitalization, may represent as a simple congestion index that has prognostic value for heart failure survival and readmission rates at 6 months and as a warning signal for more aggressive intervention, thus warranting further validation.

  14. Cryotherapy induces an increase in muscle stiffness.

    Science.gov (United States)

    Point, Maxime; Guilhem, Gaël; Hug, François; Nordez, Antoine; Frey, Alain; Lacourpaille, Lilian

    2017-03-06

    Although cold application (i.e., cryotherapy) may be useful to treat sports injuries and to prevent muscle damage, it is unclear whether it has adverse effects on muscle mechanical properties. This study aimed to determine the effect of air-pulsed cryotherapy on muscle stiffness estimated using ultrasound shear wave elastography. Myoelectrical activity, ankle passive torque, shear modulus (an index of stiffness) and muscle temperature of the gastrocnemius medialis were measured before, during an air-pulsed cryotherapy (-30°) treatment of 4 sets of 4 minutes with 1 min recovery in between, and during a 40-min post-cryotherapy period. Muscle temperature significantly decreased after the second set of treatment (10 min: 32.3 ± 2.5°C; P < 0.001), peaked at 29 min (27.9 ± 2.2°C; P < 0.001) and remained below baseline values at 60 minutes (29.5 ± 2.0°C; P < 0.001). Shear modulus increased by +11.5 ± 11.8% after the second set (10 min; P = 0.011), peaked at 30 min (+34.7 ± 42.6%; P < 0.001) and remained elevated until the end of the post-treatment period (+25.4 ± 17.1%; P < 0.001). These findings provide evidence that cryotherapy induces an increase in muscle stiffness. This acute change in muscle mechanical properties may lower the amount of stretch that the muscle tissue is able to sustain without subsequent injury. This should be considered when using cryotherapy in athletic practice. This article is protected by copyright. All rights reserved.

  15. Thompson′s quadricepsplasty for stiff knee

    Directory of Open Access Journals (Sweden)

    Kundu Z

    2007-01-01

    Full Text Available Background : Stiffness of the knee after trauma and/or surgery for femoral fractures is one of the most common complications and is difficult to treat. Stiffness in extension is more common and can be reduced by vigorous physiotherapy. If it does not improve then quadricepsplasty is indicated. The present study was undertaken to evaluate the results of Thompsons quadricepsplasty. Materials and Methods : 22 male patients (age range 20-45 years with posttraumatic knee stiffness following distal femoral fractures underwent Thompson′s quadricepsplasty where knee flexion range was less than 45°. The index injury in these patients was treated with plaster cast (n=5, plates (n=3, intramedullary nailing (n=3 and external fixator for open fractures (n=9. Thompson′s quadricepsplasty was performed in all the patients using anterior approach, with incision extending from upper thigh to tibial tubercle. Release of rectus femoris from underlying vastus intermedius and release of intraarticular adhesions were performed. After surgery the patients needed parentral analgesia for three days and then oral analgesics for three weeks. Active assisted knee mobilization exercises were started on the first post-operative day. Continous passive motion machine was used from the same day. Supervised physiotherapy was continued in hospital for six weeks followed by intensive knee flexion and extension exercise including cycling at home for atleast another six months. Results : Out of 22 patients, 20 had excellent to good results and two patients had poor results using criteria devised by Judet. One poor result was due to peroperative fracture of patella which was then internally fixed and hence the flexion of knee could not be started immediately. There was peroperative avulsion of tibial tuberosity in another patient who finally gained less than 50° knee flexion and hence a poor result. Conclusion : Thompsons quadricepsplasty followed by a strict and rigourous

  16. Flow cytometric assessment of circulating platelet and erythrocytes microparticles in young thalassemia major patients: relation to pulmonary hypertension and aortic wall stiffness.

    Science.gov (United States)

    Tantawy, Azza A G; Adly, Amira A M; Ismail, Eman A R; Habeeb, Nevin M

    2013-06-01

    Heart disease is the leading cause of mortality and morbidity in β-thalassemia major (β-TM). Aggregability of abnormal red cells and membrane-derived microparticles (MPs) stemming from activated platelets and erythrocytes are responsible for thrombotic risk. We measured platelet and erythrocyte MPs (PMPs and ErMPs) in 60 young β-TM patients compared with 40 age- and sex-matched healthy controls and assessed their relation to clinicopathological characteristics and aortic elastic properties. Patients were studied stressing on transfusion history, splenectomy, thrombotic events, chelation therapy, hematological and coagulation profiles, flow cytometric measurement of PMPs (CD41b(+) ) and ErMPs (glycophorin A(+) ) as well as echocardiographic assessment of aortic elastic properties. Aortic stiffness index and pulmonary artery pressure were significantly higher, whereas aortic strain and distensibility were lower in TM patients than controls (P 2500 μg/L (P < 0.001). Compliant patients on chelation therapy had lower MPs levels than non-compliant patients (P < 0.001). PMPs and ErMPs were positively correlated to markers of hemolysis, serum ferritin, D-dimer, vWF Ag, and aortic stiffness, whereas negatively correlated to hemoglobin level and aortic distensibility (P < 0.05). We suggest that increased MPs may be implicated in vascular dysfunction, pulmonary hypertension risk, and aortic wall stiffness observed in thalassemia patients. Their quantification could provide utility for early detection of cardiovascular abnormalities and monitoring the biological efficacy of chelation therapy.

  17. Lase Ultrasonic Web Stiffness tester

    Energy Technology Data Exchange (ETDEWEB)

    Tim Patterson, Ph.D., IPST at Ga Tech

    2009-01-12

    The objective is to provide a sensor that uses non-contact, laser ultrasonics to measure the stiffness of paper during the manufacturing process. This will allow the manufacturer to adjust the production process in real time, increase filler content, modify fiber refining and as result produce a quality product using less energy. The sensor operates by moving back and forth across the paper web, at pre-selected locations firing a laser at the sheet, measuring the out-of-plane velocity of the sheet then using that measurement to calculate sheet stiffness.

  18. Structural and functional changes of the coronary arteries in elderly senile patients with essential hypertension.

    Science.gov (United States)

    Hu, Jun; Zhu, Fu; Xie, Jun; Cheng, Xinhai; Chen, Guiyu; Tai, Haifen; Fan, Shaohua

    2013-11-01

    The aim of this study was to evaluate the effect of aging on the changes to the structure and function of coronary arteries in senile elderly patients with essential hypertension. Patients (aged 60-80 years) were divided into three groups. The 195 hypertensive patients were divided into four sub-groups according to the duration of hypertension. The changes to the coronary arteries (left and right) of all those patients were tested using the following index by 64 coronary computed tomography (CT) scans. The 24 h systolic blood pressure (SBP) and other blood biochemical parameters were assayed for all patients. We found that the value of the body mass index (BMI), total cholesterol (TC) and low density lipoproteins (LDL) were lower, but age and high density lipoproteins (HDL) were higher in the group of very elderly patients with hypertension (Group I; Phypertension (Group III). The left anterior descending branch calcification score (CSLAD), total calcification score (CST), pulse pressure (PP), the left main branch calcification score (CSLM), the left circumflex branch calcification score (CSLCX) were significantly increased in Group I compared with Group III (Phypertension' group (Group II). Hence, in elderly patients, a decrease in the levels of BMI, HDL, TC and LDL accompanies aging. Furthermore, the decline of arterial compliance and increase in arterial stiffness develops with age. Aging is more likely to lead to atherosclerosis in the coronary arteries, particularly in the left main coronary artery and its main branches. Aging is an uncontrollable risk factor, which plays a crucial role in coronary artery atherosclerosis.

  19. Effects of repeated Achilles tendon vibration on triceps surae stiffness and reflex excitability.

    Science.gov (United States)

    Lapole, Thomas; Pérot, Chantal

    2011-02-01

    Clinical studies frequently report an increase in stiffness and a loss of range of motion at joints placed in disuse or immobilization. This is notably the case for subjects maintained in bed for a long period, whilst their joints are not affected. Recently we documented on healthy subjects the benefit in terms of force and activation capacities of the triceps surae offered by vibrations applied to the Achilles tendon. Knowing that stiffness changes may contribute to force changes, the aim of the present study was to investigate the effects of tendon vibration on the triceps surae stiffness of healthy subjects. The vibration program consisted in 14 days of 1h daily Achilles tendon vibration applied at rest. Nineteen healthy students were involved in this study. Before and at the end of the vibration program, musculo-tendinous stiffness in active conditions was determined by use of a quick-release test. Passive stiffness was also analyzed by a flexibility test: passive torque-angle relationships were established from maximal plantar-flexion to maximal dorsiflexion. Passive stiffness indexes at 10°, 15° and 20° dorsiflexion were defined as the slope of the relationships at the corresponding angle. Tendinous reflex, influenced by stiffness values, was also investigated as well as the H reflex to obtain an index of the central reflex excitability. After the program, musculo-tendinous stiffness was significantly decreased (p=.01). At the same time, maximal passive dorsiflexion was increased (p=.005) and passive stiffness indexes at 10°, 15° and 20° dorsiflexion decreased (ptriceps surae parameters are diminished after the vibration program, it could be beneficial to immobilized persons as hypo-activity is known to increase muscular stiffness.

  20. Agreement between cardiac index measured with FloTrac-Vigileo system and pulmonary artery catheter in patients undergoing off-pump coronary artery bypass grafting%非体外循环冠状动脉旁路移植术患者FloTrac-Vigileo系统与肺动脉导管技术监测心指数的一致性

    Institute of Scientific and Technical Information of China (English)

    杜伯祥; 史宏伟; 宋杰

    2014-01-01

    Objective To determine if the cardiac index (Cl) measured with FloTrac-Vigileo system agrees with that measured with pulmonary artery catheter (PAC).Methods Forty-three ASA Ⅱ or Ⅲ patients aged 53-75 yr weighing 46-100 kg undergoing off-pump coronary artery bypass grafting were included in this study.Anesthesia was induced with midazolam,sufentanil,propofol and rocuronium and maintained with propofol,remifentanil and atracurium.One MAC sevoflurane was inhaled at breast bone splitting and closing.Cl was measured with FloTrac-Vigileo system and PAC before,and at 5,15 min of sevoflurane inhalation and recorded.All data were compared by Bland-Altman analysis and with kappa coefficient for agreement and percentage error was calculated.Results Bland-Altman comparison of FloTrac-Vigileo system and PAC:matching data of 258 measurements:Cl (2.8 ± 0.6) L·min-1 ·m-2,bias was 0.23 L·min-1 ·m-2 and limit of agreement was (-0.57,1.02) L·min-1 ·m-2,resulting in κ =0.546 and an overall percentage error of 28.6%.Conclusion Cl values obtained by FloTrac-Vigileo system agrees well with that obtained by thermodilution technique using PAC in patients undergoing off-pump coronary artery bypass grafting.

  1. Prognostic value of aortic stiffness and calcification for cardiovascular events and mortality in dialysis patients: outcome of the calcification outcome in renal disease (CORD) study

    DEFF Research Database (Denmark)

    Verbeke, Francis; Van Biesen, Wim; Honkanen, Eero;

    2011-01-01

    BACKGROUND AND OBJECTIVES: Radiographic calcification and arterial stiffness each individually are predictive of outcome in dialysis patients. However, it is unknown whether combined assessment of these intermediate endpoints also provides additional predictive value. DESIGN, SETTING, PARTICIPANT...

  2. 代谢综合征患者可溶性晚期糖基化终产物受体与动脉僵硬度的关系%Correlation between soluble receptor for advanced glycation endproducts and arterial stiffness in patients with metabolic syndrome

    Institute of Scientific and Technical Information of China (English)

    田朝伟; 王丽; 晋荣; 钟赟; 刘世明

    2015-01-01

    Objective investigate the correlation between plasma soluble receptor for advanced glycation endproducts (sRAGE) and arterial stiffness in patients with different types of metabolic syndrome (MS).Methods A total of 180 subjects were drawn from a epidemiologic follow-up study,including 60 cases non-metabolic syndrome (NMS),60 cases metabolic syndrome without diabetes mellitus (NDMMS),60 cases metabolic syndrome with diabetes mellitus (DMMS).Carotid femoral arterial pulse wave velocity (CFPWV) was assessed by the French KangPuLe atherosclerosis measurement instrument,and plasma sRAGE levels were measured by ELISA.Comparison of mean in multiple groups was conducted by analysis of variance.Multivariate analysis was done with multiple linear stepwise regression analysis.P < 0.05 was considered as statistically significant difference.Results Compared with NMS group,plasma sRAGE levels were significantly lower in DMMS and NDMMS groups [(635.07 ± 229.20) pg/mL vs.(671.17 ± 358.16) pg/mL vs.(992.99 ± 427.83) pg/mL,P =0.001].CFPWV of DMMS group was significantly higher than that of NMDMS and NMS groups (14.22 ±3.14) m/s vs.(12.15 ±2.79) m/s vs.(11.66 ± 2.52) m/s,P =0.002).Plasma sRAGE level was negatively correlated with CFPWV (r =-0.278,P =0.005).(3) Multiple linear regression analysis demonstrated that age (β =-0.091,95% CI-0.096 ~-0.095,P =0.031),HDL-C (β =1.295,95% CI 1.231 ~ 1.360,P =0.022) and sRAGE (β =0.119,95% CI 0.118 ~ 0.130,P =0.032) had a significant effect on CFPWV.Conclusions The increased arterial stiffness is closely related to the discreased plasma sRAGE levels in MS.Plasma sRAGE maybe a novel target for vascular disease prevention and treatment in patients with metabolic syndrome.%目的 探讨在不同类型代谢综合征(metabolic syndrome,MS)患者血浆中可溶性晚期糖基化终产物受体(soluble receptor for advanced glycation endproducts,sRAGE)与动脉僵硬度的关系.方法 采用病例对照的方

  3. Correlation of Different Obesity Indexes and Intracranial Arterial Stenosis%不同肥胖指标与颅内动脉狭窄的相关性研究

    Institute of Scientific and Technical Information of China (English)

    王安心; 周永; 赵性泉; 吴寿岭; 罗艳侠; 刘小雪; 陈朔华; 郭秀花

    2012-01-01

    Objective To explore the relationship between different obesity indexes(body mass index[BMI], waist circumference[WC], waist-to-height ratio[WHtR], waist-to-hip ratio[WHpR]) and intracranial arterial stenosis. Methods The cross-sectional method was used and 5440 subjects were selected from 101 510 employees including retired ones aging over 40-years old who took part in health examination from July to October 2006 based on Kailuan Group Company. The clinical data collected consist of demography information, clinical baseline data and transcranial doppler(TCD) data. The relation between different obesity indexes and intracranial arterial stenosis was obtained using univariate and multivariate logistic regression analysis. Results The average age of the subjects is 55.17±11.78 years. Among 5440 subjects, the number of male subjects is 3257(59.87%) and female is 2183(40.13%). Intracranial arterial stenosis is found in 716 subjects and the incidence is 13.16%, The univariate and multivariate logistic regression analysis shows that different obesity indexes correlate with intracranial arterial stenosis to a certain degree. The comparison between the second, third, forth quartile and the first quartile of WHpR are statistically significant(P<0.05). The adjusted odds ratio and 95% confidence interval are 1.33(1.04-1.70), 1.34(1.05-1.73) and 1.38(1.08-176) respectively. Conclusion The prevalence of intracranial arterial stenosis is 13.16%; obesity is an important risk factor for intracranial arterial stenosis, and WHpR is a better representative index compared with other obesity indexes.%目的 研究不同肥胖指标[体重指数(body mass index,BMI),腰围(waist circumference、WC)、腰围身高比(waist-to-height ratio,WHtR)、腰臀比(waist-to-hip ratio,WHpR)]与颅内动脉狭窄的关系,方法 本研究采用横断面研究方法,以参加2006年7月至2007年10月健康查体的101510例开滦集团在职及离退休职工,年龄大于40岁人群作为抽样

  4. Exercise Helps Ease Arthritis Pain and Stiffness

    Science.gov (United States)

    ... pain, and helps combat fatigue. Of course, when stiff and painful joints are already bogging you down, ... can make your joints even more painful and stiff. That's because keeping your muscles and surrounding tissue ...

  5. Explicit Time-Stepping for Stiff ODEs

    CERN Document Server

    Eriksson, Kenneth; Logg, Anders; 10.1137/S1064827502409626

    2012-01-01

    We present a new strategy for solving stiff ODEs with explicit methods. By adaptively taking a small number of stabilizing small explicit time steps when necessary, a stiff ODE system can be stabilized enough to allow for time steps much larger than what is indicated by classical stability analysis. For many stiff problems the cost of the stabilizing small time steps is small, so the improvement is large. We illustrate the technique on a number of well-known stiff test problems.

  6. Energy-Efficient Variable Stiffness Actuators

    NARCIS (Netherlands)

    Visser, Ludo C.; Carloni, Raffaella; Stramigioli, Stefano

    2011-01-01

    Variable stiffness actuators are a particular class of actuators that is characterized by the property that the apparent output stiffness can be changed independent of the output position. To achieve this, variable stiffness actuators consist of a number of elastic elements and a number of actuated

  7. Shoulder Stiffness : Current Concepts and Concerns

    NARCIS (Netherlands)

    Itoi, Eiji; Arce, Guillermo; Bain, Gregory I.; Diercks, Ronald L.; Guttmann, Dan; Imhoff, Andreas B.; Mazzocca, Augustus D.; Sugaya, Hiroyuki; Yoo, Yon-Sik

    2016-01-01

    Shoulder stiffness can be caused by various etiologies such as immobilization, trauma, or surgical interventions. The Upper Extremity Committee of ISAKOS defined the term "frozen shoulder" as idiopathic stiff shoulder, that is, without a known cause. Secondary stiff shoulder is a term that should be

  8. Association between non-alcoholic fatty liver disease and arterial stiffness in the non-obese, non-hypertensive, and non-diabetic young and middle-aged Chinese population%非肥胖、高血压和糖尿病的中国中青年人群中非酒精性脂肪性肝病和动脉硬度的关系研究

    Institute of Scientific and Technical Information of China (English)

    Xin-yan YU; Yi ZHAO; Xiao-xiao SONG; Zhen-ya SONG

    2014-01-01

    研究目的:探讨在非肥胖、高血压和糖尿病的中国中青年群人中非酒精性脂肪性肝病(NAFLD)和动脉硬度的关系。  创新要点:在非肥胖、高血压和糖尿病的中青年人群中,阐明NAFLD和动脉硬度的关系,对预防和诊断早期动脉硬度有重要临床意义。  研究方法:在非肥胖、高血压和糖尿病的中青年体检人群中进行一项大型横断面研究。用B超诊断脂肪肝,用臂踝脉搏波指数(baPWV)测量动脉硬度,根据是否有NAFLD和baPWV水平分组。  重要结论:NAFLD 组患者的 baPWV 水平明显高于对照组((1321±158) cm/s vs.(1244±154) cm/s;P<0.001),NAFLD患病率在 baPWV升高组明显高于 baPWV正常组(29.3% vs.16.9%;P<0.001),且NAFLD患病率随baPWV水平和动脉硬度程度的升高而升高(两者趋势P值<0.001)。多因素线性回归分析表明,NAFLD发生与baPWV独立相关。因此,在非肥胖、高血压和糖尿病的中国中青年群人中,NAFLD发生与动脉硬度密切相关。%Background and objective:Non-alcoholic fatty liver disease (NAFLD) is associated with arterial stiffness in the general population. Age, obesity, hypertension, and diabetics are risk factors for arterial stiffness. In this study, we aimed to investigate the association between NAFLD and arterial stiffness as measured by brachial-ankle pulse wave velocity (baPWV) in the non-obese, non-hypertensive, and non-diabetic young and middle-aged Chinese population. Methods:A cross-sectional study with 1296 non-obese, non-hypertensive, and non-diabetic young and middle-aged (20-65 years) subjects undergoing routine medical check-ups in the International Health Care Center of the Second Affiliated Hospital of School of Medicine of Zhejiang University was carried out. Fatty liver was diagnosed by ultra-sonography, and baPWV was measured using an automatic waveform analyzer. The subjects were classified into two groups

  9. Negative stiffness in gear contact

    Directory of Open Access Journals (Sweden)

    Půst L.

    2015-12-01

    Full Text Available The tooth contact stiffness is very often included in dynamic mathematical models of gear drives. It is an important value for calculation of torsion eigenfrequencies as well as the dynamic properties of the whole transmission systems. Planetary gear drives have several advantages over simple parallel axis gears, especially due to theirs compact design and great torque-to-weight ratio caused by multiple parallel paths. However, the dimensional or mounting errors can cause that some planets have the tendency to take more load than the others. One of the ways how to improve load sharing is the application of flexible planetary pins or by using a free central wheel. However in such cases, the wheels motion is defined in one rotation coordinate and two translation coordinates — tangential and radial. The reaction force at radial change of axis distance is usually neglected. The focus of this contribution is to derive the stiffness of this radial connection and to analyse the influence of radial stiffness on planetary gear dynamics.

  10. Initial exploration of early carotid artery endothelial dysfunction in type 2 diabetes mellitus patients evaluated by ultrasound radio-frequency technique

    Institute of Scientific and Technical Information of China (English)

    LI Miao-shan; WANG Man-li; WU Li-sang; ZHU Wu; WU Yan-ping

    2016-01-01

    Background The early endothelial dysfunction of carotid artery in patients with type 2 diabetes mellitus (T2DM) has been recognized.However,the feasibility and significance of carotid artery endothelial dysfunction detected by ultrasound radio-frequency technology has been seldom studied.Methods The 2D ultrasound images of the bilateral common carotid arteries from 112 cases of T2DM patients and 50 cases of normal subjects in our hospital were collected to measure intima-media thickness means (IMTm),end-systolic inner diameter (Ds),end-diastolic inner diameter (Dd),resistance index (RI),pulse index (PI),and the systole/diastole ratio (S/D).We also observed the variation of the intima-media thickness (IMT) as well as the elasticity indexes of the common carotid artery,such as the compliance coefficient (CC),elasticity coefficient (β),pulse wave velocity (PWV) and augmentation index (AIx) through instruments with built-in ultrasound radio-frequency techniques,including quantitative intima-media thickness (QIMT) and quantitative analysis of arterial stiffness (QAS).The differences of the above-mentioned parameters between the two groups were analyzed.Results There were no statistically significant differences in IMTm,Ds,Dd,RI,PI and S/D raito of the common carotid arteries between group T2DM and the normal group (P > 0.01).The β,PWV and AIx in group T2DM were remarkably higher than those in the control group,with CC value being significantly lower than the later (P < 0.01 or 0.05).Conclusion Ultrasound radio-frequency technique offers earlier and more effective evaluation of carotid artery endothelial dysfunction in T2DM patients when compared with conventional 2D ultrasound,establishing imaging foundation for the early prevention and treatment of cardio-cerebrovascular complications in T2DM patients.

  11. Aortic Stiffness and Cardiovascular Risk in Women with Previous Gestational Diabetes Mellitus.

    Directory of Open Access Journals (Sweden)

    Tove Lekva

    Full Text Available Gestational diabetes mellitus (GDM is a significant risk factor for cardiovascular disease (CVD in later life, but the mechanism remains unclear. The aim of the study was to investigate indices of glucose metabolism, dyslipidemia, and arterial stiffness (as measured by pulse wave velocity (PWV, in women with and without a history of GDM, using both the old WHO and new IADPSG diagnostic criteria, at 5 years after the index pregnancy. Dyslipidemia and PWV were used as surrogate markers for CVD risk. The population-based prospective cohort included 300 women from the original STORK study. All participants had an oral glucose tolerance test (OGTT during pregnancy. Five years later, the OGTT was repeated along with dual-energy x-ray absorptiometry, lipid analysis, and PWV analysis. Measurements were compared between those women who did and did not have GDM based on both the WHO and IADPSG criteria. We found that women with GDM based on the old WHO criteria had higher CVD risk at 5 years than those without GDM, with markedly elevated PWV and more severe dyslipidemia (higher triglycerides (TG/HDL cholesterol ratio. After adjusting for known risk factors, the most important predictors for elevated PWV and TG/HDL-C ratio at 5-year follow-up were maternal age, BMI, GDM, systolic blood pressure, and indices of glucose metabolism in the index pregnancy. In conclusion, we found a higher risk for CVD, based on the surrogate markers PWV and TG/HDL-C ratio, at 5-year follow-up in women diagnosed with GDM in the index pregnancy when using the old WHO diagnostic criteria.

  12. Aortic Stiffness and Cardiovascular Risk in Women with Previous Gestational Diabetes Mellitus.

    Science.gov (United States)

    Lekva, Tove; Bollerslev, Jens; Norwitz, Errol R; Aukrust, Pål; Henriksen, Tore; Ueland, Thor

    2015-01-01

    Gestational diabetes mellitus (GDM) is a significant risk factor for cardiovascular disease (CVD) in later life, but the mechanism remains unclear. The aim of the study was to investigate indices of glucose metabolism, dyslipidemia, and arterial stiffness (as measured by pulse wave velocity (PWV)), in women with and without a history of GDM, using both the old WHO and new IADPSG diagnostic criteria, at 5 years after the index pregnancy. Dyslipidemia and PWV were used as surrogate markers for CVD risk. The population-based prospective cohort included 300 women from the original STORK study. All participants had an oral glucose tolerance test (OGTT) during pregnancy. Five years later, the OGTT was repeated along with dual-energy x-ray absorptiometry, lipid analysis, and PWV analysis. Measurements were compared between those women who did and did not have GDM based on both the WHO and IADPSG criteria. We found that women with GDM based on the old WHO criteria had higher CVD risk at 5 years than those without GDM, with markedly elevated PWV and more severe dyslipidemia (higher triglycerides (TG)/HDL cholesterol ratio). After adjusting for known risk factors, the most important predictors for elevated PWV and TG/HDL-C ratio at 5-year follow-up were maternal age, BMI, GDM, systolic blood pressure, and indices of glucose metabolism in the index pregnancy. In conclusion, we found a higher risk for CVD, based on the surrogate markers PWV and TG/HDL-C ratio, at 5-year follow-up in women diagnosed with GDM in the index pregnancy when using the old WHO diagnostic criteria.

  13. Analysis of Arterial Mechanics During Head-Down-Tilt Bed Rest

    Science.gov (United States)

    Elliott, Morgan B.; Martin, David S.; Westby, Christian M.; Stenger, Michael B.; Platts, Steven H.

    2014-01-01

    Carotid, brachial, and tibial arteries reacted differently to HDTBR. Previous studies have not analyzed the mechanical properties of the human brachial or anterior tibial arteries. After slight variations during bed-rest, arterial mechanical properties and IMT returned to pre-bed rest values, with the exception of tibial stiffness and PSE, which continued to be reduced post-bed rest while the DC remained elevated. The tibial artery remodeling was probably due to decreased pressure and volume. Resulting implications for longer duration spaceflight are unclear. Arterial health may be affected by microgravity, as shown by increased thoracic aorta stiffness in other ground based simulations (Aubert).

  14. 高血压患者动态脉压指数与冠状动脉病变的相关性分析%Correlation between ambulatory pulse pressure indexes and coronary artery lesions in patients with hypertension

    Institute of Scientific and Technical Information of China (English)

    冯玉平; 石慧荣; 赵立平

    2013-01-01

    Objective To investigate the correlation between ambulatory pulse pressure indexes (APPI) and coronary artery disease (CHD) in patients with hypertension. Methods The hypertensive patients (n=355) with coronary angiography (CAG) were chose from Apr. 2010 to Apr. 2013 and then divided into CHD group (n=237) and non-CHD group (n=118) according to CAG resutls. All patients were given 24-hour ambulatory blood pressure monitoring. The changes of SBP, DBP and pulse pressure (PP) were recorded and mean pressure [MBP=(SBP+DBP)/2] and PP index (PPI=PP/SBP) were calculated. The correlation between the above mentioned indexes and coronary artery lesions was analyzed. Results The levels of PP and APPI were higher in CHD group than those in non-CHD group [PP:(77.8±8.7) mmHg vs. (64.7±7.6) mmHg;APPI:(0.52±0.08) vs. (0.45±0.10) , P<0.05]. In CHD patients, the higher APPI value, the more severe coronary artery lesions (P<0.01). The results of Logistic analysis showed that APPI (OR=1.39), PP (OR=1.23) and SBP (OR=1.27) were risk factors of CHD (all P<0.01). Conclusion APPI value can be used for predict the severity of coronary artery lesions in patients with hypertension.%目的探讨高血压患者动态脉压指数(pluse pressure index,PPI)与冠状动脉病变的相关性。方法纳入2010年4月~2013年4月实施冠状动脉造影(CAG)的高血压患者355例。根据CAG结果将患者分为冠心病组(n=237)及非冠心病组(n=118)。对所有研究对象均进行24 h动态血压监测,记录收缩压(SBP)、舒张压(DBP)和脉压(PP),计算脉压指数(PPI,PPI=PP/SBP)。分析上述因素与冠状动脉病变的相关性。结果与非冠心病组相比,冠心病组患者PP及PPI水平更高,分别为(77.8±8.7)mmHg vs.(64.7±7.6)mmHg,(0.52±0.08) vs.(0.45±0.10),差异有统计学意义(P<0.05)。在冠心病患者中,PPI值越高,患者冠脉病变数值越高(P<0.01

  15. Measurement and Treatment of Passive Muscle Stiffness

    DEFF Research Database (Denmark)

    Kirk, Henrik

    This PhD thesis is based on research conducted at the University of Copenhagen and Helene Elsass Center from 2012 to 2015. Measurements and treatment of passive muscle stiffness in people with cerebral palsy (CP) comprise the focus of the thesis. The thesis summarizes the results from four studies...... stiffness. I introduce how to evaluate and distinguish between passive muscle stiffness and reflex-mediated stiffness in research and in clinical practice. Furthermore, I present ”the Portable Spasticity Assessment Device”, which was developed as a part of the PhD study. I discuss the validity......-mediated stiffness was considered a major problem. However, this study shows that significantly reduced RFD and increased passive muscle stiffness, rather than reflex-mediated stiffness, are the major contributors to impaired gait function in adults with CP, compared with neurologically healthy subjects. The third...

  16. Distinct effects of losartan and atenolol on vascular stiffness in Marfan syndrome.

    Science.gov (United States)

    Bhatt, Ami B; Buck, J Stewart; Zuflacht, Jonah P; Milian, Jessica; Kadivar, Samoneh; Gauvreau, Kimberlee; Singh, Michael N; Creager, Mark A

    2015-08-01

    We conducted a randomized, double-blind trial of losartan (100 mg QD) versus atenolol (50 mg QD) for 6 months in adults with Marfan syndrome. Carotid-femoral pulse wave velocity (PWV), central augmentation index (AIx), aortic diameter and left ventricular (LV) function were assessed with arterial tonometry and echocardiography. Thirty-four subjects (18 female; median age 35 years, IQR 27, 45) were randomized. Central systolic and diastolic blood pressure decreased comparably with atenolol and losartan (p = 0.64 and 0.31, respectively); heart rate decreased with atenolol (p = 0.02), but not with losartan. PWV decreased in patients treated with atenolol (-1.15 ± 1.68 m/s; p = 0.01), but not in those treated with losartan (-0.22 ± 0.59 m/s; p = 0.15; between-group difference p = 0.04). In contrast, AIx decreased in the losartan group (-9.6 ± 8.6%; p Marfan syndrome, 6 months of treatment with atenolol improves PWV, whereas losartan reduces the AIx. By improving vascular stiffness via distinct mechanisms of action, there is physiologic value to considering the use of both medications in individuals with Marfan syndrome.

  17. The effects of changes in the metabolic syndrome detection status on arterial stiffening: a prospective study.

    Science.gov (United States)

    Tomiyama, Hirofumi; Hirayama, Yoji; Hashimoto, Hideki; Yambe, Minoru; Yamada, Jiko; Koji, Yutaka; Motobe, Kohki; Shiina, Kazuki; Yamamoto, Yoshio; Yamashinai, Akira

    2006-09-01

    We conducted a prospective study to examine the effects of alterations of the metabolic syndrome detection status on the rate of progression of arterial stiffness, which is recognized as a marker of arterial damage and an indicator of cardiovascular risk. Brachial-ankle pulse wave velocity as an index of arterial stiffening was recorded twice over a 3-year period in 2080 Japanese men (age, 42 +/- 9 years). At the start of the prospective study, pulse wave velocity was higher in the subjects with metabolic syndrome (n=125) than in those without metabolic syndrome (n=1,955) even after adjusting for mean blood pressure. The annual rate of increase of the pulse wave velocity was higher in the group with persistent metabolic syndrome (27 +/- 51 cm/s/year, n=71) than in the group with regression of metabolic syndrome (6 +/- 39 cm/s/year, n=54) or the group in which metabolic syndrome was absent (13 +/- 37 cm/s/year, n=1843; p changes in blood pressure. In conclusion, the changes in the metabolic syndrome detection status of the subjects during the study period affected the annual rate of progression of arterial stiffening, and persistent metabolic syndrome during the study period was associated with acceleration of arterial stiffening in middle-aged Japanese men. On the other hand, resolution of metabolic syndrome may be associated with attenuation of the progression of arterial damage. Therefore, the increased cardiovascular risk associated with the presence of metabolic syndrome may be at least partly mediated by acceleration of the progression of arterial stiffening.

  18. Correlation Study of Ankle Brachial Index,Superficial Femoral Artery Intima-media Thickness and the Coronary Heart Disease%踝臂指数及股浅动脉内中-膜厚度与冠心病相关性研究

    Institute of Scientific and Technical Information of China (English)

    应卫华; 李浙成; 胡智星; 童跃锋

    2012-01-01

    目的 探讨踝臂指数(ABI)及股浅动脉内-中膜厚度(IMT)与冠心病相关性.方法 对132例入选对象行冠状动脉造影检查、超声测定股浅动脉IMT及用全自动动脉硬化检测仪检测ABI,并调查年龄、性别、吸烟、血压、家族史、体质指数(BMI)等.用冠状动脉病变血管的数量和GAS积分评价冠脉病变的程度,分析、对比不同病变程度下股浅动脉IMT及ABI.结果 冠心病组股浅动脉IMT明显大于非冠心病组,冠心病组ABI明显小于非冠心病组,差异存在统计学意义,P值均小于0.05;股浅动脉IMT随着冠状动脉病变程度的加重而增加,但冠心病各组间比较无显著差异;ABI随着冠状动脉病变程度的加重而降低,且ABI值在各组间比较,P<0.05,差异具有统计学意义.结论 股浅动脉IMT及ABI与冠心病显著相关.对于冠心病患者,对比股浅动脉IMT与ABI,ABI是更能间接反映冠状动脉病变严重程度的良好指标.%Objective To discuss correlation of the superficial femoral artery intima-media thickness (IMT),ankle brachial index (ABI) and coronary heart disease. Methods .132 cases of hospitalized patients were selected to performed coronary artery angiography and ultrasound measurement of superficial femoral artery intima-media thickness (IMT) and automatic arteriosclerosis detection instrument of ankle brachial index (ABI),and the age, sex,smoking, blood pressure,family history,body weight index (BMI) etc were investigated. With coronary artery lesion volume and GAS integral evaluation of coronary lesion extent,the different extent of lesions of the superficial femoral artery intima-media thickness and ankle brachial index (ABI) were analysed. Results The superficial femoral artery intima-media thickness of coronary heart disease group was significantly greater than that of non-CHD group; ankle brachial index (ABI)was significantly lower than that of non-CHD group,there were statistically significant difference

  19. Association of thyroid function with arterial pressure in normotensive and hypertensive euthyroid individuals: A cross-sectional study

    Directory of Open Access Journals (Sweden)

    Saltiki Katerina

    2008-09-01

    Full Text Available Abstract Background Overt hypothyroidism has been associated with arterial hypertension and increased arterial stiffness. Results in euthyroid individuals have been conflicting. We investigated associations of thyroid function with systolic (SAP and diastolic (DAP arterial pressure in euthyroid subjects. Methods 311 euthyroid individuals (185 women, mean age 43.9 ± 9 without a history of diabetes attending a preventive medicine program were examined. Subjects receiving thyroxine (10.6% were excluded; 19.3% had hypertension, 43% had a family history for hypertension. TSH, fT4, thyroid autoantibodies, insulin, glucose were measured. The "fT4.TSH product", which has been suggested as a T4 resistance-index, was calculated. Results TSH range was 0.1–8, median 1.4 mU/L, fT4 range was 11.5–25.2 pmol/L, median 17.4. TSH and the "fT4.TSH product" were positively associated with DAP (p 2 mU/L (35.3% vs 21.3%, p = 0.045. Conclusion In euthyroid individuals the association of thyroid function with diastolic arterial pressure remains significant even when a stricter "normal range" for TSH levels is considered. The "freeT4.TSH" product appears to be an even stronger predictor of DAP, independently of HOMA insulin resistance index and obesity.

  20. Effects of Low versus High Glycemic Index Sugar-Sweetened Beverages on Postprandial Vasodilatation and Inactivity-Induced Impairment of Glucose Metabolism in Healthy Men.

    Science.gov (United States)

    Keller, Judith; Kahlhöfer, Julia; Peter, Andreas; Bosy-Westphal, Anja

    2016-12-10

    Intake of sugar-sweetened beverages (SSB) may contribute to cardiovascular risk. The aim of this study was to investigate whether functional sugars with low compared to high glycemic index (GI) have beneficial effects on arterial stiffness during a period of low-physical activity. In a controlled cross-over dietary intervention (55% CHO, 30% fat, 15% protein), 13 healthy men (age: 23.7 ± 2.2 years, body mass index: 23.6 ± 1.9 kg/m²) completed 2 × 1 week of low physical activity following 1 week of normal physical activity (2363 ± 900 vs. 11,375 ± 3124 steps/day). During inactive phases participants consumed either low-GI (isomaltulose) or high-GI SSB (maltodextrin-sucrose), providing 20% of energy requirements. Postprandial vasodilatation (augmentation index, AIx), insulin sensitivity (IS) and Glucagon-like-peptide 1 (GLP-1) responses were measured during a meal test before and after SSB-intervention. Compared to maltodextrin-sucrose-SSB, postprandial vasodilatation was prolonged (AIx after 120 min: 9.9% ± 4.3% vs. 11.4% ± 3.7%, p low-physical activity led to impaired IS that was attenuated with low-GI SSB consumption, but did not affect arterial stiffness (p > 0.05). Higher postprandial GLP-1 secretion after intake of low compared to high-GI beverages may contribute to improved postprandial vasodilatation. Although one week of low-physical activity led to marked impairment in IS, it had no effect on arterial stiffness in healthy men.

  1. A new index for non-invasive assessment of liver fibrosis

    Institute of Scientific and Technical Information of China (English)

    Naohiro; Ichino; Keisuke; Osakabe; Toru; Nishikawa; Hiroko; Sugiyama; Miho; Kato; Shiho; Kitahara; Senju; Hashimoto; Naoto; Kawabe; Masao; Harata; Yoshifumi; Nitta; Michihito; Murao; Takuji; Nakano; Yuko; Arima; Hiroaki; Shimazaki; Koji; Suzuki; Kentaro; Yoshioka

    2010-01-01

    AIM:To construct and evaluate a new non-invasive fibrosis index for assessment of the stage of liver f ibrosis. METHODS:A new f ibrosis index (Fibro-Stiffness index) was developed in 165 of 285 patients with chronic hepatitis C, and was validated in the other 120 patients where liver biopsy was performed. Its usefulness was compared with liver stiffness (LS) measured by FibroScan, the aminotransferase-to-platelet ratio index, the Forns index and the FibroIndex. RESULTS: The Fibro-Stiffness index consists of...

  2. Transcutaneous oximetry but not arterial toe blood pressure or ankle-brachial index is related to macular thickness in patients with chronic diabetic foot ulcers

    Directory of Open Access Journals (Sweden)

    Per Katzman

    2013-04-01

    Full Text Available Objectives: Diabetes related vascular complications of the lower extremity could be classified as micro- and macrovascular. Ankle-brachial index (ABI and toe blood pressure (TBP measurements evaluate macro-circulation, whereas transcutaneous oximetry (TcPO2 is considered to be a composite measure of vascular function, thereby also reflecting microcirculation. Microvascular disease in the eye involves abnormal capillary permeability and possibly thereby increased macular thickness. The aim of the present clinical study was to evaluate if microvascular disease in the eye was related to measures of foot ischemia in patients with diabetes mellitus. Methods: Twenty consecutive patients with diabetes and chronic full-thickness foot ulcers were included. Peripheral ischemia was diagnosed using TcPO2, TBP and ABI. Macular thickness was measured with optical coherence tomography technique. Results: Based on TcPO2, TBP and ABI measurements 14, 13 and 13 patients, respectively, were classified as ischemic. Patients with ischemic TcPO2 levels at the dorsum of the foot had significantly higher macular thicknesses. This was not the case in patients with ischemic TBP or ABI levels. Conclusion: TcPO2, unlike TBP and ABI, seems to be a clinically relevant measure of peripheral microvascular disease in patients with diabetes mellitus and may, if low, indicate an increased risk of macular edema. [J Exp Integr Med 2013; 3(2.000: 81-85

  3. Stiffness estimation of a parallel kinematic machine

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

    This paper presents a simple yet comprehensive approach to quickly estimating the stiff-ness of a tripod-based parallel kinematic machine. This approach can be implemented in two steps. Inthe first step, the machine structure is decomposed into two substructures associated with the machineframe and parallel mechanism. The stiffness models of these two substructures are formulated bymeans of virtual work principle. This is followed by the second step that enables the stiffness model ofthe machine structure as a whole to be achieved by linear superposition. The 3D representations of themachine stiffness within the usable workspace are depicted and the contributions of different componentrigidities to the machine stiffness are discussed. The result is compared with that obtained through finiteelement analysis.

  4. Textural and sensory properties of trifoliate yam (Dioscorea dumetorum) flour and stiff dough 'amala'.

    Science.gov (United States)

    Abiodun, O A; Akinoso, R

    2015-05-01

    The use of trifoliate yam (Dioscorea dumetorum) flour for stiff dough 'amala' production is one of the ways to curb under-utilization of the tuber. The study evaluates the textural and sensory properties of trifoliate yam flour and stiff dough. Freshly harvested trifoliate yam tubers were peeled, washed, sliced and blanched (60 (°)C for 10 min). The sliced yam were soaked in water for 12 h, dried and milled into flour. Pasting viscosities, functional properties, brown index and sensory attributes of the flour and stiff dough were analyzed. Peak, holding strength and final viscosities ranged from 84.09 to 213.33 RVU, 81.25 to 157.00 RVU and 127.58 to 236.17 RVU respectively. White raw flour had higher viscosity than the yellow flours. The swelling index, water absorption capacity and bulk density ranged from 1.46 to 2.28, 2.11 to 2.92 ml H2O/g and 0.71 to 0.88 g/cm(3) respectively. Blanching method employed improved the swelling index and water absorption capacity of flour. The brown index values of flour and stiff dough ranged from 6.73 to 18.36 and 14.63-46.72 respectively. Sensory evaluation revealed significant differences in the colour, odour and general acceptability of the product when compared with the stiff dough from white yam.

  5. Arterial stiffening precedes systolic hypertension in diet-induced obesity.

    Science.gov (United States)

    Weisbrod, Robert M; Shiang, Tina; Al Sayah, Leona; Fry, Jessica L; Bajpai, Saumendra; Reinhart-King, Cynthia A; Lob, Heinrich E; Santhanam, Lakshmi; Mitchell, Gary; Cohen, Richard A; Seta, Francesca

    2013-12-01

    Stiffening of conduit arteries is a risk factor for cardiovascular morbidity. Aortic wall stiffening increases pulsatile hemodynamic forces that are detrimental to the microcirculation in highly perfused organs, such as the heart, brain, and kidney. Arterial stiffness is associated with hypertension but presumed to be due to an adaptive response to increased hemodynamic load. In contrast, a recent clinical study found that stiffness precedes and may contribute to the development of hypertension although the mechanisms underlying hypertension are unknown. Here, we report that in a diet-induced model of obesity, arterial stiffness, measured in vivo, develops within 1 month of the initiation of the diet and precedes the development of hypertension by 5 months. Diet-induced obese mice recapitulate the metabolic syndrome and are characterized by inflammation in visceral fat and aorta. Normalization of the metabolic state by weight loss resulted in return of arterial stiffness and blood pressure to normal. Our findings support the hypothesis that arterial stiffness is a cause rather than a consequence of hypertension.

  6. Numerical Analysis of Plastic Gear Stiffness

    Institute of Scientific and Technical Information of China (English)

    2005-01-01

    This paper established practical 3-D gear models to study the stiffness influencing factors of a loaded gear by finite element method, such as friction parameters, material properties, and gear structures. The research shows that, in elastic deformation, gear stiffness increases when sliding friction ability of contact pair decreases;meanwhile, the gear structure, especially asymmetric design in gear's shaft direction will also decrease gear stiffness.

  7. Matrix Stiffness Modulates Proliferation, Chemotherapeutic Response and Dormancy in Hepatocellular Carcinoma Cells

    Science.gov (United States)

    Schrader, Jörg; Gordon-Walker, Timothy T; Aucott, Rebecca L; van Deemter, Mariëlle; Quaas, Alexander; Walsh, Shaun; Benten, Daniel; Forbes, Stuart J; Wells, Rebecca G; Iredale, John P

    2010-01-01

    There is increasing evidence that the physical environment is a critical mediator of tumor behavior. Hepatocellular carcinoma (HCC) develops within an altered biomechanical environment and increasing matrix stiffness is a strong predictor of HCC development. The aim of this study was to establish whether changes in matrix stiffness, which are characteristic of inflammation and fibrosis, regulate HCC cell proliferation and chemotherapeutic response. Using an in vitro system of “mechanically-tunable” matrix-coated polyacrylamide gels, matrix stiffness was modeled across a pathophysiologically-relevant range, corresponding to values encountered in normal and fibrotic livers. Results Increasing matrix stiffness was found to promote HCC cell proliferation. The proliferative index (assessed by Ki67 staining) of Huh7 and HepG2 cells was 2.7-fold and 12.2-fold higher, respectively, when the cells were cultured on stiff (12kPa) versus soft (1kPa) supports. This was associated with stiffness-dependent regulation of basal and HGF-stimulated mitogenic signaling through extracellular regulated kinase (ERK), protein kinase B (PKB/Akt) and signal transducer and activator of transcription 3 (STAT3). β1-integrin and focal adhesion kinase (FAK) were found to modulate stiffness-dependent HCC cell proliferation. Following treatment with cisplatin, we observed reduced apoptosis in HCC cells cultured on a stiff versus soft (physiological) supports. Interestingly, however, surviving cells from soft supports had significantly higher clonogenic capacity than surviving cells from a stiff microenvironment. This was associated with enhanced expression of cancer stem cell markers, including CD44, CD133, c-kit, CXCR4, octamer-4 (OCT4) and NANOG. Conclusion Increasing matrix stiffness promotes proliferation and chemotherapeutic resistance, whereas a soft environment induces reversible cellular dormancy and stem cell characteristics in HCC. This has implications for both the treatment of

  8. WAY TO DETERMINE STIFFNESS FUNCTION OF STRUCTURE

    Institute of Scientific and Technical Information of China (English)

    WANG De-ming; GAI Bing-zheng

    2005-01-01

    For calculating the stiffness function of a structure, the differential equation of the vibration of the structure was divided into the differential equation on the original stiffness function that was known, and Fredholm integral equation of the first kind on the undetermined stiffness function that was unknown. And the stable solutions of the integral equation, when the smooth factor was equal to zero, was solved by the extrapolation with p smooth factors. So the stiffness function of the structure is obtained. Applied examples show that the method is feasible and effective.

  9. A new approach to determine press stiffness

    DEFF Research Database (Denmark)

    Arentoft, Mogens; Wanheim, Tarras

    2004-01-01

    A new procedure is proposed for measuring press stiffness, including separated horizontal and vertical loading of the press frame. The load can be eccentrically positioned for measuring rotational stiffnesses. Two loading devices and corresponding measuring equipment for registration of press...... deflections are designed. The press stiffness is presented as a 6 by 6 flexibility matrix. The approach has been tested by measuring the stiffness of a 5000 kN O-frame, ring element, hydraulic press, a 10000 kN O-frame, pillar element, hydraulic press and a 10000 kN O-frame, ring element mechanical press...

  10. Hereditary and environmental influences on arterial function.

    Science.gov (United States)

    Hayward, C S; Benetos, A

    2007-07-01

    1. With the ageing population and increasing heart failure, arterial function has been shown to contribute to cardiovascular risk because of its adverse effects on ventriculovascular coupling. Population studies have confirmed independent prognostic information of arterial stiffening on cardiovascular survival. 2. The term 'arterial function' encompasses a range of phenotypes, including measures of arterial structure/remodelling, measures of arterial wall mechanics, surrogate measures of stiffness and of wave reflection. There exists significant interaction between these measures and none is truly independent of the others. Added to this complexity is the recognition that, although arterial function has a strong genetic component, quantification requires a range of techniques from twin to family and population studies. 3. The contribution of heritability is often derived from statistical models with input from genomic scanning and candidate gene studies. Studies to date confirm a significant heritable component for the majority of phenotypes examined. However, it has also been recognized that the factors involved in blood pressure maintenance are likely to be separate to those in arterial structural degeneration with ageing. Candidate genes for arterial function go beyond those of the sympathetic and renin-angiotensin systems and include genes involved in signalling pathways and extracellular matrix modulation. 4. The present review examines the evidence for heritability of the major arterial function phenotypes with environmental and ageing modulation. A brief overview of the impact of atherosclerotic risk factors on arterial function is included.

  11. Acute arterial occlusion - kidney

    Science.gov (United States)

    Acute renal arterial thrombosis; Renal artery embolism; Acute renal artery occlusion; Embolism - renal artery ... kidney can often result in permanent kidney failure. Acute arterial occlusion of the renal artery can occur after injury or trauma to ...

  12. Differences in superior thyroid artery and inferior thyroid artery blood flow spectrum parameters in subacute thyroiditis

    Institute of Scientific and Technical Information of China (English)

    Jin-Bo Li

    2016-01-01

    Objective:To study the differences in superior thyroid artery and inferior thyroid artery blood flow spectrum parameters in subacute thyroiditis. Methods:A Total of 40 cases of patients with subacute thyroiditis and 40 cases of healthy volunteers were selected for study and enrolled in pathology group and control group respectively, color Doppler ultrasonography was conducted to detect peak blood flow velocities (Vmax) of superior thyroid artery and inferior thyroid artery as well as resistance index (RI), and serum was collected to detect thyroid hormone contents, infection indexes and oxidative stress indexes. Results:Peak blood flow velocities Vmax of superior thyroid artery and inferior thyroid artery of pathology group were significantly higher than those of control group, and resistance index RI was not different from that of control group;FT3, FT4, TT3, TT4, ESR, CRP, PCT and MDA of pathology group were significantly higher than those of control group, and SOD and TAOC were significantly lower than those of control group;Vmax of superior thyroid artery and inferior thyroid artery were positively correlated with FT3, FT4, TT3, TT4, ESR, CRP, PCT and MDA, and negatively correlated with SOD and TAOC. Conclusion:Peak blood flow velocities (Vmax) of superior thyroid artery and inferior thyroid artery in subacute thyroiditis are significantly accelerated, Vmax has good consistency with thyroid hormone contents, infection indexes and oxidative stress indexes, and it can accurately assess the severity of the disease.

  13. Association of metabolic syndrome with arterial compliance in children and adolescents

    Institute of Scientific and Technical Information of China (English)

    ZHANG Li; MI Jie; LI Ming; JIANG Benyu

    2007-01-01

    The association of metabolic syndrome (MS)with arterial compliance in children and adolescents was explored.337 subjects (188 men and 149 women) aged 6-18 (10.95±3.01) years,out of "Beijing Child Metabolic Syndrome Study",were divided into three ease groups (one component,two components,three & more components of MS) and one control group based on the Cook's MS definition in children and adolescents.Measurements including anthropometry,blood pressure,fasting plasma glucose and insulin,serum lipid profile were done.Homeostasis model assessment for insulin resistance (HOMA-IR) index was calculated for estimating individual insulin resistance.Arterial compliance was measured using digital pulse wave analyzing method from the pulse trace machine (Micro medical,London),and then the stiffness index (SI) was determined.The mean value of SI in MS group was significant higher than that in control group [(7.69±1.63) vs (6.25 + 0.86) m/s,P < 0.01 ].With the increase of the clustering of MS components,SI and HOMA-IR were gradually increased.After taking account of gender,age and pubertal development,the partial correlation analysis showed that the amount of components of MS and HOMA-IR were positively correlated with SI (both P values were less than 0.05).The arterial compliance of MS group was significantly lowered in children and adolescents,and with the increase of the clustering of MS components,arterial compliance was gradually decreased.It was suggested that arterial compliance assessment in children and adolescents was important for early prevention of cardiovascular diseases.

  14. Effects of Low versus High Glycemic Index Sugar-Sweetened Beverages on Postprandial Vasodilatation and Inactivity-Induced Impairment of Glucose Metabolism in Healthy Men

    Science.gov (United States)

    Keller, Judith; Kahlhöfer, Julia; Peter, Andreas; Bosy-Westphal, Anja

    2016-01-01

    Intake of sugar-sweetened beverages (SSB) may contribute to cardiovascular risk. The aim of this study was to investigate whether functional sugars with low compared to high glycemic index (GI) have beneficial effects on arterial stiffness during a period of low-physical activity. In a controlled cross-over dietary intervention (55% CHO, 30% fat, 15% protein), 13 healthy men (age: 23.7 ± 2.2 years, body mass index: 23.6 ± 1.9 kg/m2) completed 2 × 1 week of low physical activity following 1 week of normal physical activity (2363 ± 900 vs. 11,375 ± 3124 steps/day). During inactive phases participants consumed either low-GI (isomaltulose) or high-GI SSB (maltodextrin-sucrose), providing 20% of energy requirements. Postprandial vasodilatation (augmentation index, AIx), insulin sensitivity (IS) and Glucagon-like-peptide 1 (GLP-1) responses were measured during a meal test before and after SSB-intervention. Compared to maltodextrin-sucrose-SSB, postprandial vasodilatation was prolonged (AIx after 120 min: 9.9% ± 4.3% vs. 11.4% ± 3.7%, p 0.05). Higher postprandial GLP-1 secretion after intake of low compared to high-GI beverages may contribute to improved postprandial vasodilatation. Although one week of low-physical activity led to marked impairment in IS, it had no effect on arterial stiffness in healthy men. PMID:27973411

  15. Analysis of Arterial Mechanics During Head-down Tilt Bed Rest

    Science.gov (United States)

    Elliot, Morgan; Martin, David S.; Westby, Christian M.; Stenger, Michael B.; Platts, Steve

    2014-01-01

    Arterial health may be affected by microgravity or ground based analogs of spaceflight, as shown by an increase in thoracic aorta stiffness1. Head-down tilt bed rest (HDTBR) is often used as a ground-based simulation of spaceflight because it induces physiological changes similar to those that occur in space2, 3. This abstract details an analysis of arterial stiffness (a subclinical measure of atherosclerosis), the distensibility coefficient (DC), and the pressure-strain elastic modulus (PSE) of the arterial walls during HDTBR. This project may help determine how spaceflight differentially affects arterial function in the upper vs. lower body.

  16. Vertical Dynamic Stiffness of Offshore Foundations

    DEFF Research Database (Denmark)

    Latini, Chiara; Cisternino, Michele; Zania, Varvara

    2016-01-01

    ) is investigated by numerical analyses of representative finite element models. The 3D numerical model is compared and validated with existing analytical solutions. A parametric study is carried out analyzing the effect of the slenderness ratio Hp/d and the height and the stiffness of the soil layer on the dynamic...... stiffness and damping....

  17. Stiff person syndrome: a case report.

    Science.gov (United States)

    Kelly, Patricia A; Kuberski, Carolyn

    2014-08-01

    The case report features a patient who had a diagnosis of a common type of breast cancer with an uncommon neurologic syndrome. She had extreme pain and progressive stiffness with cognitive and functional decline. This article includes the pathogenesis and treatment options for a rare, but treatable, autoimmune disorder of malignancy called stiff person syndrome.

  18. Hemodynamic correlates of late systolic flow velocity augmentation in the carotid artery.

    Science.gov (United States)

    Heffernan, Kevin S; Lefferts, Wesley K; Augustine, Jacqueline A

    2013-01-01

    Background. The contour of the common carotid artery (CCA) blood flow velocity waveform changes with age; CCA flow velocity increases during late systole, and this may contribute to cerebrovascular disease. Late systolic flow velocity augmentation can be quantified using the flow augmentation index (FAIx). We examined hemodynamic correlates of FAIx to gain insight into determinants of CCA flow patterns. Methods. CCA Doppler ultrasound and wave intensity analysis (WIA) were used to assess regional hemodynamics in 18 young healthy men (age 22 ± 1 years). Forward waves (W 1) and backward waves (negative area, NA) were measured and used to calculate the reflection index (NA/W 1 = RIx). Additional parameters included W 2 which is a forward travelling expansion/decompression wave of myocardial origin that produces suction, CCA single-point pulse wave velocity (PWV) as a measure of arterial stiffness, and CCA pressure augmentation index (AIx). Results. Primary correlates of FAIx included W 2 (r = - 0.52, P 0.05). Conclusions. FAIx is a complex ventricular-vascular coupling parameter that is associated with both increased expansion wave magnitude (increased suction from the left ventricle) and increased pressure from wave reflections.

  19. 间隔缺损性先天性心脏病胎儿脐动脉及大脑中动脉搏动指数的变化%Change of Umbilical Artery and Middle Cerebral Artery Pulsatility Index in Fetuses with Congenital Heart Diseases of Septal Defect

    Institute of Scientific and Technical Information of China (English)

    刘金蓉; 吕国荣; 吴秀明; 候敏

    2011-01-01

    Objective To evaluate the significance of change in umbilical artery(UA)and middle cerebral artery (MCA)pulsatility index(PI)in fetuses with congenital heart disease(CHD)of septal defect. Methods Umbilical artery (UA)and middle cerebral artery(MCA) pulsatility index(PI) were retrospectively analyzed in 82 fetuses with CHD, including 25 cases of atrioventricular septal defect(AVSD) ,51 cases of ventricular septal defect(VSD)and 6 cases of atrial septal defect(ASD). The control group comprised 660 healthy fetuses of uncomplicated pregnancies matched for gestational age. Individual PI measurements were converted into Z-scores for statistical analysis. Results Fetuses with AVSD、VSD and all CHD had an increased UA-PI compared to the controls respectively(P<0. 05), but no difference was observed in UA-PI between fetuses with ASD and the controls(P>0. 05). There was no significant difference in MCA-PI between fetuses with AVSD,VSD,ASD,all CHD and the controls(P>0. 05). Conclusions UA-PI in fetuses with AVSD and VSD may increase,however, MCA-PI does not change remarkably.%目的 探讨几种间隔缺损性的先天性心脏病胎儿的脐动脉搏动指数(UA-PI)、大脑中动脉搏动指数(MCA-PI)的变化.方法 回顾性分析82例间隔缺损性的先天性心脏病胎儿(疾病组)的脐动脉(UA)和大脑中动脉(MCA)的搏动指数(PI),其中包括25例房室隔缺损(又称心内膜垫缺损,AVSD组)、51例室间隔缺损(VSD组),6例房间隔缺损(ASD组);另随机选择660例按孕龄分组的正常的胎儿作为正常对照组.对所有PI值进行标准正态转换后再进行统计分析.结果 疾病组AVSD组,VSD组胎儿的UA-PI均比正常对照组胎儿高(P<0.05),而ASD组胎儿与正常对照组胎儿的UA-PI无明显差别(P>0.05);疾病组AVSD组、VSD组、ASD组胎儿与正常对照组胎儿的MCA-PI均无明显差别(P>0.05).结论 AVSD、VSD的胎儿在官内可能会出现UA-PI增高,而MCA-PI无明显改变.

  20. Comparison of two diets of varying glycemic index on carotid subclinical atherosclerosis in obese children.

    Science.gov (United States)

    Iannuzzi, Arcangelo; Licenziati, Maria Rosaria; Vacca, Maria; De Marco, Donata; Cinquegrana, Giorgio; Laccetti, Marco; Bresciani, Alessandro; Covetti, Giuseppe; Iannuzzo, Gabriella; Rubba, Paolo; Parillo, Mario

    2009-11-01

    Childhood obesity is associated with an increased carotid intima-media thickness (IMT) and stiffness. Increased carotid wall thickening and rigidity are considered markers of subclinical atherosclerosis. The aim of the present study was to test the effect of two hypocaloric diets of varying glycemic index on weight loss and markers of subclinical atherosclerosis in obese children. Seventy consecutive obese children attending the Outpatient Weight Clinic of the Department of Pediatrics were invited to participate in an intensive dietary protocol. Twenty-six accepted and were randomly assigned to two different groups: the first group followed a hypocaloric low-glycemic index diet and the second a hypocaloric high-glycemic index diet. Anthropometric measures and biochemical tests were performed in all children. Quantitative B-mode ultrasound scans were used to measure intima-media thickness (IMT) and diameters of the common carotid artery. Considering both groups together, at 6 months, body mass index decreased from 28.3 +/- 3.1 to 25.8 +/- 3.3 kg/m(2), systolic blood pressure from 119 +/- 12 to 110 +/- 11 mmHg (Pglycemic index diet. These results justify the advice to obese children to follow a low-glycemic index diet in order to improve their cardiometabolic profile.

  1. [Ultrasonographic study of blood flow in the renal arteries of patients with arterial hypertension].

    Science.gov (United States)

    Makarenko, E S; Dombrovskiĭ, V I; Nelasov, N Iu

    2012-01-01

    Vascular duplex ultrasound duplex with simultaneous ECG registration was made to estimate the quantitative and time parameters of blood flow in the renal arteries with grade 1-2 arterial hypertension. There were increases in vascular resistance indices and acceleration phase index and a reduction in systolic phase index. There were correlations of the time parameters of blood flow in the renal arteries with age and lipidogram values.

  2. Heart transplantation and arterial elasticity

    Directory of Open Access Journals (Sweden)

    Colvin-Adams M

    2013-12-01

    Full Text Available Monica Colvin-Adams,1 Nonyelum Harcourt,1 Robert LeDuc,2 Ganesh Raveendran,1 Yassir Sonbol,3 Robert Wilson,1 Daniel Duprez11Cardiovascular Division, University of Minnesota, Minneapolis, MN, USA; 2Division of Biostatistics University of Minnesota, Minneapolis, MN, USA; 3Cardiovascular Division, St Luke's Hospital System, Sugar Land, TX, USAObjective: Arterial elasticity is a functional biomarker that has predictive value for cardiovascular morbidity and mortality in nontransplant populations. There is little information regarding arterial elasticity in heart transplant recipients. This study aimed to characterize small (SAE and large (LAE artery elasticity in heart transplant recipients in comparison with an asymptomatic population free of overt cardiovascular disease. A second goal was to identify demographic and clinical factors associated with arterial elasticity in this unique population.Methods: Arterial pulse waveform was registered noninvasively at the radial artery in 71 heart transplant recipients between 2008 and 2010. SAEs and LAEs were derived from diastolic pulse contour analysis. Comparisons were made to a healthy cohort of 1,808 participants selected from our prevention clinic database. Multiple regression analyses were performed to evaluate associations between risk factors and SAE and LAE within the heart transplant recipients.Results: LAE and SAE were significantly lower in heart transplant recipients than in the normal cohort (P <0.01 and P < 0.0001, respectively. Female sex and history of ischemic cardiomyopathy were significantly associated with reduced LAE and SAE. Older age and the presence of moderate cardiac allograft vasculopathy were also significantly associated with reduced SAE. Transplant duration was associated with increased SAE.Conclusion: Heart transplants are associated with peripheral endothelial dysfunction and arterial stiffness, as demonstrated by a significant reduction in SAE and LAE when compared with a

  3. Stiffness Control of Surgical Continuum Manipulators

    Science.gov (United States)

    Mahvash, Mohsen; Dupont, Pierre E.

    2013-01-01

    This paper introduces the first stiffness controller for continuum robots. The control law is based on an accurate approximation of a continuum robot’s coupled kinematic and static force model. To implement a desired tip stiffness, the controller drives the actuators to positions corresponding to a deflected robot configuration that produces the required tip force for the measured tip position. This approach provides several important advantages. First, it enables the use of robot deflection sensing as a means to both sense and control tip forces. Second, it enables stiffness control to be implemented by modification of existing continuum robot position controllers. The proposed controller is demonstrated experimentally in the context of a concentric tube robot. Results show that the stiffness controller achieves the desired stiffness in steady state, provides good dynamic performance, and exhibits stability during contact transitions. PMID:24273466

  4. Rolling Element Bearing Stiffness Matrix Determination (Presentation)

    Energy Technology Data Exchange (ETDEWEB)

    Guo, Y.; Parker, R.

    2014-01-01

    Current theoretical bearing models differ in their stiffness estimates because of different model assumptions. In this study, a finite element/contact mechanics model is developed for rolling element bearings with the focus of obtaining accurate bearing stiffness for a wide range of bearing types and parameters. A combined surface integral and finite element method is used to solve for the contact mechanics between the rolling elements and races. This model captures the time-dependent characteristics of the bearing contact due to the orbital motion of the rolling elements. A numerical method is developed to determine the full bearing stiffness matrix corresponding to two radial, one axial, and two angular coordinates; the rotation about the shaft axis is free by design. This proposed stiffness determination method is validated against experiments in the literature and compared to existing analytical models and widely used advanced computational methods. The fully-populated stiffness matrix demonstrates the coupling between bearing radial, axial, and tilting bearing deflections.

  5. Measurement and Treatment of Passive Muscle Stiffness

    DEFF Research Database (Denmark)

    Kirk, Henrik

    2016-01-01

    This PhD thesis is based on research conducted at the University of Copenhagen and Helene Elsass Center from 2012 to 2015. Measurements and treatment of passive muscle stiffness in people with cerebral palsy (CP) comprise the focus of the thesis. The thesis summarizes the results from four studies......, which aimed to investigate: 1) The development of a clinical method to evaluate and distinguish neural (reflex mediated stiffness) and non-neural (passive muscle stiffness) components of muscle stiffness in adults with CP by objective and reliable measurements 2) The association between increased......, and good correlation to measurements from a stationary dynamometer. The second part of the thesis discusses the finding of a significant correlation between gait function, reduced rate of force development (RFD), and increased passive muscle stiffness in adults with CP. Previously, the reflex...

  6. Determination of 6 stiffnesses for a press

    DEFF Research Database (Denmark)

    Arentoft, Mogens; Eriksen, Morten; Wanheim, Tarras

    2000-01-01

    the workpiece will result in deflections of the press, which will decrease the tolerances of the component. At present, it is possible to measure the reaction forces from the workpiece, for instance by use of the model material technique as described in [1-2]. If the stiffness and clearances of the press...... is known too, the final dimensions can be predicted by divide the force by the stiffness and add the clearance. If the stiffness of the press is known, it is possible to optimize the orientation of the workpiece too, so the direction, in which the best tolerances is demanded, is equal to the direction...... in which the press has the highest stiffness. Furthermore, knowledge about the stiffnesses of all presses in a production system makes it possible to choose the press which best fit to a specific process....

  7. Changes and related factors of pulse wave velocity on different sites of the arterial system and augmentation index in patients with essential hypertension%高血压患者不同部位脉搏波速度和反射波增强指数的变化及相关因素

    Institute of Scientific and Technical Information of China (English)

    张明华; 叶平; 骆雷鸣; 肖文凯; 吴红梅; 刘德军

    2012-01-01

    Objective:To study the changes and impact factors of pulse wave velocity (PWV) on different sites of the arterial system and augmentation index (AI) in patients with essential hypertension (EH). Method: Two hundred and thirty-seven patients with EH (EH group) and 253 healthy subjects (control group) were recruited. Carotid-femoral pulse wave velocity (CFPWV), carotid-radial pulse wave velocity (CRPWV) and carotid-ankle pulse wave velocity (CAPWV) were measured using Complior system. System pulse wave analysis at the right radial artery was performed by using SphygmoCor device. AI was calculated by using software of the device. The fasting glucose, lipid, uric acid and other biochemical parameters were also measured. Result: CFPWV, CRPWV and CAPWV were significantly higher in EH group compared with control group (all P<0. 01). There was no significant difference in AI between the two groups. A stepwise multiple regressive analysis demonstrated that age [β(standardized coefficient) = 0. 324, P<0.0l], systolic blood pressure (β = 0.284, P<0.01) and sex (β = -0. 126, P<0. 05) were predisposed factors for CFPWV (R2 =0. 230). Sex (β= -0. 353, P<0. 01) and dias-tolic blood pressure (β=0. 175, P<0. 01) were independent determine factors for CRPWV (R2=0. 167), while systolic blood pressure (β=0. 222, P<0. 01), age (β=0. 174, P<0. 01) and sex (β= — 0. 108, P<0. 05) were predictive factors for CAPWV (R2 = 0. 105). Height (β=— 0.399, P<0. 01), heart rate (β=—0.352, P< 0. 01) and systolic blood pressure (β=0. 140, P<0. 01) were independent determine factors for AI (R2=0. 290). Conclusion: PWVs on different sites of the arterial system are significantly higher in patients with essential hypertension. Age, blood pressure and sex are independent influencing factors. AI may not be a suitable indicator of arterial stiffness.%目的:研究高血压患者颈-股动脉脉搏波传导速度(CFPWV)、颈-桡动脉脉搏波传导速度(CRP-WV)、颈-踝动脉脉搏波传

  8. Regular cocaine use is associated with increased systolic blood pressure, aortic stiffness and left ventricular mass in young otherwise healthy individuals.

    Directory of Open Access Journals (Sweden)

    Rebecca Kozor

    Full Text Available BACKGROUND: The cardiovascular impact of cocaine use in otherwise healthy individuals who consider themselves 'social' users is not well established. METHODS/RESULTS: Twenty regular cocaine users and 20 control subjects were recruited by word-of-mouth. Cardiovascular magnetic resonance was performed to assess cardiac and vascular structure and function. Cocaine users had higher systolic blood pressure compared to non-users (134±11 vs 126±11 mmHg, p = 0.036, a finding independent of age, body surface area, smoking and alcohol consumption. Cocaine use was associated with increased arterial stiffness - reflected by reduced aortic compliance (1.3±0.2 vs 1.7±0.5 cm2×10-2.mmHg-1, p = 0.004, decreased distensibility (3.8±0.9 vs 5.1±1.4 mmHg-1.10-3, p = 0.001, increased stiffness index (2.6±0.6 vs 2.1±0.6, p = 0.005, and higher pulse wave velocity (5.1±0.6 vs 4.4±0.6 m.s-1, p = 0.001. This change in aortic stiffness was independent of vessel wall thickness. Left ventricular mass was 18% higher in cocaine users (124±25 vs 105±16 g, p = 0.01, a finding that was independent of body surface area, and left atrial diameter was larger in the user group than controls (3.8±0.6 vs 3.5±0.3 cm, p = 0.04. The increased left ventricular mass, systolic blood pressure and vascular stiffness measures were all associated with duration and/or frequency of cocaine use. No late gadolinium enhancement or segmental wall motion abnormalities were seen in any of the subjects. CONCLUSIONS: Compared with the non-user control cohort, cocaine users had increased aortic stiffness and systolic blood pressure, associated with greater left ventricular mass. These measures are all well known risk factors for premature cardiovascular events, highlighting the dangers of cocaine use, even in a 'social' setting, and have important public health implications.

  9. Relationship of 24-hour urinary sodium-to-potassium excretion with blood pressure and arterial stiffness in hypertensive patients%高血压人群中24h尿钠钾水平与血压和动脉僵硬度的关系

    Institute of Scientific and Technical Information of China (English)

    韩伟中; 孙宁玲

    2012-01-01

    目的 探索高血压人群中尿钠、尿钾和尿钠钾比值水平与血压和动脉僵硬度的关系.方法 入选未服用降压药的高血压患者224例,按照标准留取24 h尿标本,检测尿钾、尿钠含量和尿钠钾比值.根据24 h尿钠水平分为3组,尿钠≤100 mmol/24 h(A组)、>100~200(B组)和>200 mmol/24 h组(C组).对上述患者进行24 h动态血压监测和臂踝动脉脉搏波传导速度(baPWV)检查.结果 人群平均24 h尿钠值为(160.0±69.4)mmol/24 h,所对应食盐摄入量为9.6 g/d,平均尿钠钾比值为4.8.A、B、C3组人群的平均尿钠值分别为(84.9±12.7)、(147.0±26.7)和(256.1±42.6)mmol/24 h,所对应平均摄盐量为5.1、8.8和15.3 g/d.C组24 h、白昼、夜间收缩压、舒张压明显高于A组(P<0.01).全人群多元线性回归分析显示,尿钠和钠钾比值与24 h收缩压、舒张压以及脉压呈正相关(β值分别为0.221、0.188,0146、0.211,0.136、0.142,均P<0.05).A、B、C3组人群的baPWV分别为(1621.6±288.3)、(1645.7±301.0)和(1741.9±307.0)cm/s,C组明显高于A组和B组(P=0.032,P=0.046),多元线性回归分析显示,尿钠和钠钾比值是baPWV的独立影响因素(β值分别为0.126,0.158,均P<0.05).结论 尿钠和钠钾比值不仅与血压水平密切相关,而且与baPWV密切相关,这种关系是独立于血压作用之外的.%Objective To explore the relationship of 24-hour urinary sodium, urinary potassium and urinary sodium/ potassium excretion with blood pressure and arterial stiffness in hypertension patients. Methods A total of 224 patients with untreated hypertension were recruited. 24-hour urine specimens were collected for detecting urinary sodium, urinary potassium and urinary sodium/potassium ratio. According to the level of 24-hour urinary sodium,the patients were divided into three groups:group A(urinary sodium≤100 mmol/24 h) , group B(urinary sodium 100-200 mmol/24 h) and group C(urinary sodium>200 mmol/24 h). All the subjects

  10. Stiff substrates enhance cultured neuronal network activity.

    Science.gov (United States)

    Zhang, Quan-You; Zhang, Yan-Yan; Xie, Jing; Li, Chen-Xu; Chen, Wei-Yi; Liu, Bai-Lin; Wu, Xiao-an; Li, Shu-Na; Huo, Bo; Jiang, Lin-Hua; Zhao, Hu-Cheng

    2014-08-28

    The mechanical property of extracellular matrix and cell-supporting substrates is known to modulate neuronal growth, differentiation, extension and branching. Here we show that substrate stiffness is an important microenvironmental cue, to which mouse hippocampal neurons respond and integrate into synapse formation and transmission in cultured neuronal network. Hippocampal neurons were cultured on polydimethylsiloxane substrates fabricated to have similar surface properties but a 10-fold difference in Young's modulus. Voltage-gated Ca(2+) channel currents determined by patch-clamp recording were greater in neurons on stiff substrates than on soft substrates. Ca(2+) oscillations in cultured neuronal network monitored using time-lapse single cell imaging increased in both amplitude and frequency among neurons on stiff substrates. Consistently, synaptic connectivity recorded by paired recording was enhanced between neurons on stiff substrates. Furthermore, spontaneous excitatory postsynaptic activity became greater and more frequent in neurons on stiff substrates. Evoked excitatory transmitter release and excitatory postsynaptic currents also were heightened at synapses between neurons on stiff substrates. Taken together, our results provide compelling evidence to show that substrate stiffness is an important biophysical factor modulating synapse connectivity and transmission in cultured hippocampal neuronal network. Such information is useful in designing instructive scaffolds or supporting substrates for neural tissue engineering.

  11. Dynamic stiffness of suction caissons - vertical vibrations

    Energy Technology Data Exchange (ETDEWEB)

    Ibsen, Lars Bo; Liingaard, M.; Andersen, Lars

    2006-12-15

    The dynamic response of offshore wind turbines are affected by the properties of the foundation and the subsoil. The purpose of this report is to evaluate the dynamic soil-structure interaction of suction caissons for offshore wind turbines. The investigation is limited to a determination of the vertical dynamic stiffness of suction caissons. The soil surrounding the foundation is homogenous with linear viscoelastic properties. The dynamic stiffness of the suction caisson is expressed by dimensionless frequency-dependent dynamic stiffness coefficients corresponding to the vertical degree of freedom. The dynamic stiffness coefficients for the foundations are evaluated by means of a dynamic three-dimensional coupled Boundary Element/Finite Element model. Comparisons are made with known analytical and numerical solutions in order to evaluate the static and dynamic behaviour of the Boundary Element/Finite Element model. The vertical frequency dependent stiffness has been determined for different combinations of the skirt length, Poisson's ratio and the ratio between soil stiffness and skirt stiffness. Finally the dynamic behaviour at high frequencies is investigated. (au)

  12. Cooperative effects of matrix stiffness and fluid shear stress on endothelial cell behavior.

    Science.gov (United States)

    Kohn, Julie C; Zhou, Dennis W; Bordeleau, François; Zhou, Allen L; Mason, Brooke N; Mitchell, Michael J; King, Michael R; Reinhart-King, Cynthia A

    2015-02-03

    Arterial hemodynamic shear stress and blood vessel stiffening both significantly influence the arterial endothelial cell (EC) phenotype and atherosclerosis progression, and both have been shown to signal through cell-matrix adhesions. However, the cooperative effects of fluid shear stress and matrix stiffness on ECs remain unknown. To investigate these cooperative effects, we cultured bovine aortic ECs on hydrogels matching the elasticity of the intima of compliant, young, or stiff, aging arteries. The cells were then exposed to laminar fluid shear stress of 12 dyn/cm(2). Cells grown on more compliant matrices displayed increased elongation and tighter EC-cell junctions. Notably, cells cultured on more compliant substrates also showed decreased RhoA activation under laminar shear stress. Additionally, endothelial nitric oxide synthase and extracellular signal-regulated kinase phosphorylation in response to fluid shear stress occurred more rapidly in ECs cultured on more compliant substrates, and nitric oxide production was enhanced. Together, our results demonstrate that a signaling cross talk between stiffness and fluid shear stress exists within the vascular microenvironment, and, importantly, matrices mimicking young and healthy blood vessels can promote and augment the atheroprotective signals induced by fluid shear stress. These data suggest that targeting intimal stiffening and/or the EC response to intima stiffening clinically may improve vascular health.

  13. Arterial mechanics at rest and during exercise in adolescents and young adults after arterial switch operation for complete transposition of the great arteries.

    Science.gov (United States)

    Chen, Robin H; Wong, Sophia J; Wong, Wilfred H; Cheung, Yiu-Fai

    2014-02-15

    We sought to determine the arterial mechanics at rest and during exercise in adolescents and young adults with complete transposition of the great arteries after arterial switch operation and their relations with neoaortic complications. Thirty patients (22 men) aged 16.2 ± 2.1 years and 22 controls (15 men) were studied. Central and peripheral arterial pulse wave velocities, carotid and radial augmentation indices, and central systolic blood pressure (cSBP) were determined by oscillometry and applanation tonometry, whereas arterial dimensions were measured by 2-dimensional echocardiography. Arterial strain, distensibility, and stiffness were determined at rest and during supine bicycle exercise testing. At rest, patients had significantly higher heart-carotid pulse wave velocity, carotid and radial augmentation indices, and cSBP than controls. At rest and during submaximal exercise, patients had significantly lower aortic strain and distensibility, greater aortic and carotid stiffness, and higher SBP than controls. Dilated aortic sinus found in 23 (76.7%) patients was associated with lower aortic distensibility, greater aortic stiffness, and higher cSBP at rest and lower aortic distensibility and strain at submaximal exercise. Significant aortic regurgitation found in 20% (6 of 30) of patients was associated with significantly higher neoaortic z scores. Multivariate analysis identified aortic stiffness at rest (β = 0.46, p = 0.003) and age at operation (β = 0.44, p = 0.004) as significant determinants of aortic sinus z scores. In conclusion, altered mechanics of the central arteries are present at rest and during exercise in adolescents and young adults after arterial switch operation. These findings may have important implications on progression of neoaortic root dilation, exercise recommendations, and medical therapy.

  14. Accelerated Solutions for Transcendental Stiffness Matrix Eigenproblems

    Directory of Open Access Journals (Sweden)

    F.W. Williams

    1996-01-01

    Full Text Available This article outlines many existing and forthcoming methods that can be used alone, or in various combinations, to accelerate the solutions of the transcendental stiffness matrix eigenproblems that arise when the stiffness matrix is assembled from exact member stiffnesses, which are obtained by solving the member differential equations exactly. Thus distributed member mass and/or the flexural effect of axial loading are incorporated exactly, and the solutions are the natural frequencies for vibration problems or the critical load factors for buckling problems.

  15. Circunferência da cintura e índice de massa corporal como preditores da hipertensão arterial Waist circumference and body mass index as predictors of hypertension

    Directory of Open Access Journals (Sweden)

    Maria do Rosário Gondim Peixoto

    2006-10-01

    Full Text Available OBJETIVO: Avaliar a associação entre índices antropométricos, índice de massa corporal (IMC e circunferência da cintura (CC e hipertensão arterial (HA e avaliar a capacidade desses índices na predição da HA. MÉTODOS: Estudo transversal populacional realizado em Goiânia (GO, em 2001, com amostra de 1.238 adultos, de vinte a 64 anos. Foi definida como obesidade total (IMC > 30 kg/m², como obesidade abdominal (CC no nível 2 - CC > 88 cm para mulheres e > 102 cm para homens e como HA (pressão sistólica > 140 mmHg ou pressão diastólica > 90 mmHg, ou uso de hipotensores. Foi realizada análise de regressão logística múltipla para avaliar as associações entre os índices antropométricos e a HA. Análise de curva ROC para avaliar a sensibilidade e especificidade do IMC (> 30 e nível 2 da CC na predição da HA e para determinar os pontos de corte com melhor predição da HA. RESULTADOS: A CC apresentou associação com a HA em ambos os sexos. O nível 2 da CC e o IMC >30 kg/m² apresentaram baixa sensibilidade em identificar a HA. Os pontos de corte com melhor capacidade preditiva de HA coincidiram com o nível 1 da CC (> 80 cm e com o IMC >25 kg/m² (sobrepeso, para as mulheres, e foram inferiores aos valores do nível 1 da CC e de sobrepeso, para os homens. CONCLUSÃO: O nível 2 da CC e o IMC > 30 kg/m² não são adequados para identificar os grupos de maior risco de HA, já que esse risco se eleva com pequenos aumentos na adiposidade.OBJECTIVE: To evaluate the association between anthropometric indexes - body mass index (BMI and waist circumference (WC - and hypertension, and to evaluate the predictive value of these indexes in detecting hypertension. METHODS: Cross-sectional population study conducted in the city of Goiânia (GO with a sample of 1,238 adults aged twenty to 64 years, in 2001. Total obesity was defined as BMI > 30 kg/m²; abdominal obesity was defined as level 2 WC > 88 cm for women and > 102 cm for men, and

  16. Vitamin E reduces liver stiffness in nonalcoholic fatty liver disease

    Institute of Scientific and Technical Information of China (English)

    Aiko; Fukui; Naoto; Kawabe; Senju; Hashimoto; Michihito; Murao; Takuji; Nakano; Hiroaki; Shimazaki; Toshiki; Kan; Kazunori; Nakaoka; Masashi; Ohki; Yuka; Takagawa; Tomoki; Takamura; Hiroyuki; Kamei; Kentaro; Yoshioka

    2015-01-01

    AIM: To evaluate the efficacy of vitamin E treatment on liver stiffness in nonalcoholic fatty liver disease(NAFLD).METHODS: Thirty-eight NAFLD patients were administered vitamin E for > 1 year. The doses of vitamin E were 150, 300, or 600 mg; three times per day after each meal. Responses were assessed by liver enzyme levels [aspartate aminotransferase(AST), alanine aminotranferease(ALT), and γ-glutamyl transpeptidase(γ-GTP)], noninvasive scoring systems of hepatic fibrosis-4 [FIB-4 index and aspartate aminotransferaseto-platelet index(APRI)], and liver stiffness [velocity of shear wave(Vs)] measured by acoustic radiation force impulse elastography. Vs measurements were performed at baseline and 12 mo after baseline. The patients were genotyped for the patatin-like phospholipase domain containing 3(PNPLA3) polymorphisms and then divided into either the CC/CG or GG group to examine each group’s responses to vitamin E treatment. RESULTS: We found marked differences in the platelet count, serum albumin levels, alkaline phosphatase levels, FIB-4 index, APRI, and Vs at baseline depending on the PNPLA3 polymorphism. AST, ALT, and γ-GTP levels(all P < 0.001); FIB-4 index(P = 0.035); APRI(P < 0.001); and Vs(P < 0.001) significantly decreased from baseline to 12 mo in the analysis of all patients. In the subset analyses of PNPLA3 genotypes, AST levels(P = 0.011), ALT levels(P < 0.001), γ-GTP levels(P = 0.005), APRI(P = 0.036), and Vs(P = 0.029) in genotype GG patients significantly improved, and AST and ALT levels(both P < 0.001), γ-GTP levels(P = 0.003), FIB-4 index(P = 0.017), and APRI(P < 0.001) in genotype CC/CG patients. CONCLUSION: One year of vitamin E treatment improved noninvasive fibrosis scores and liver stiffness in NAFLD patients. The responses were similar between different PNPLA3 genotypes.

  17. SUBJECT INDEX

    Institute of Scientific and Technical Information of China (English)

    2013-01-01

    13th lymph nodes,sentinels,periampullary carcinoma,20133151p21 deletion,multiple myeloma,thalidomide-based first line treatment,201347425-dihydroxy,vitamin D3,kidney,aquaporin 2,2013233-protein 2,renal tubular epithelal cells,201344225-hydroxyvitamin D,metabolic syndrome,2103440-parathyroid hormone,type 2 diabetes mellitus,20134413-dimensional speckle tracking imaging,left ventricular function,coronary artery disease,2013451A1 segment,artery aneurysms,cerebral artery,morphological features,2013128

  18. Stiff Neck, Torticollis, and Pseudotumor Cerebri

    Directory of Open Access Journals (Sweden)

    J Gordon Millichap

    2002-05-01

    Full Text Available Three prepubertal children diagnosed with pseudotumor cerebri and presenting with stiff neck and torticollis are reported from Schneider Children’s Medical Center, Sackler School of Medicine, Tel Aviv, Israel.

  19. Observed variations of monopile foundation stiffness

    DEFF Research Database (Denmark)

    Kallehave, Dan; Thilsted, C.L.; Diaz, Alberto Troya

    2015-01-01

    The soil-structure stiffness of monopile foundations for offshore wind turbines has a high impact on the fatigue loading during normal operating conditions. Thus, a robust design must consider the evolution of pile-soil stiffness over the lifetime of the wind farm. This paper present and discuss...... full-scale measurements obtained from one offshore wind turbine structure located within Horns Reef II offshore wind farm. Data are presented for a 2.5 years period and covers normal operating conditions and one larger storm event. A reduction of the pile-soil stiffness was observed during the storm...... events, followed by a complete regain to a pre-storm level when the storm subsided. In additional, no long term variations of the pile-soil stiffness was observed. The wind turbine is located in dense to very dense sand deposits....

  20. Stiff person syndrome and myasthenia gravis.

    Directory of Open Access Journals (Sweden)

    Saravanan P

    2002-01-01

    Full Text Available Association of stiff person syndrome, an immune related disorder of anterior horn cells and myasthenia gravis an endplate disorder with similar pathogenesis, is rare. This communication documents this association in the Indian literature for the first time.

  1. Vascular Stiffness in Insulin Resistance and Obesity

    Directory of Open Access Journals (Sweden)

    Guanghong eJia

    2015-08-01

    Full Text Available Obesity, insulin resistance, and type 2 diabetes are associated with a substantially increased prevalence of vascular fibrosis and stiffness, with attendant increased risk of cardiovascular and chronic kidney disease. Although the underlying mechanisms and mediators of vascular stiffness are not well understood, accumulating evidence supports the role of metabolic and immune dysregulation related to increased adiposity, activation of the renin angiotensin aldosterone system, reduced bioavailable nitric oxide, increased vascular extracellular matrix (ECM and ECM remodeling in the pathogenesis of vascular stiffness. This review will give a brief overview of the relationship between obesity, insulin resistance and increased vascular stiffness to provide a contemporary understanding of the proposed underlying mechanisms and potential therapeutic strategies.

  2. Strength and stiffness of engineering systems

    CERN Document Server

    Leckie, Frederick A

    2009-01-01

    This book on the stiffness and strength of engineering systems integrates a wide array of topics into a unified text, including plasticity, fracture, composite materials, energy approaches, and mechanics of microdevices (MEMs)..

  3. Measurement of endothelial dysfunction via peripheral arterial tonometry predicts vasculogenic erectile dysfunction

    Science.gov (United States)

    Kovac, Jason R.; Gomez, Lissette; Smith, Ryan P.; Coward, Robert M.; Gonzales, Marshall A.; Khera, Mohit; Lamb, Dolores J.; Lipshultz, Larry I.

    2014-01-01

    Introduction Endothelial cell dysfunction is associated with cardiovascular disease and vasculogenic erectile dysfunction (ED). Measured via Peripheral Artery Tonometry (PAT), endothelial dysfunction in the penis is an independent predictor of future cardiovascular events. Aim Determine whether measurement of endothelial dysfunction differentiates men with vasculogenic ED identified by duplex ultrasound from those without. Methods A total of 142 men were retrospectively assessed using patient history, penile duplex ultrasonography (US) and PAT (EndoPAT 2000). ED was self reported and identified on history. Vasculogenic ED was identified in men who exhibited a peak systolic velocity (PSV) of ≤25 cm/s obtained 15 minutes following vasodilator injection. The reactive hyperemia index (RHI), a measurement of endothelial dysfunction in medium/small arteries and the Augmentation Index (AI), a measurement of arterial stiffness, were recorded via PAT. Results Penile duplex US separated men into those with ED (n=111) and without (n=31). The cohort with ED had a PSV of 21±1 cm/s (left cavernous artery) and 22±1 cm/s (Right). The control group without ED had values of 39±2 cm/s (Left) and 39±2 (Right). Given the potential for altered endothelial function in diabetes mellitus, we confirmed that hemoglobin A1c, urinary microalbumin, and vibration pulse threshold were not different in men with vasculogenic ED and those without. RHI in patients with ED (1.85±0.06) was significantly decreased compared to controls (2.15±0.2) (p<0.05). The AI was unchanged when examined in isolation, and when standardized to heart rate. Conclusions Measurement of endothelial function with EndoPAT differentiates men with vasculogenic ED from those without. RHI could be used as a non-invasive surrogate in the assessment of vasculogenic ED and to identify those patients with higher cardiovascular risk. PMID:24784889

  4. Irbesartan improves arterial compliance more than lisinopril

    OpenAIRE

    2009-01-01

    Khalid Ali,1 Chakravarthi Rajkumar,1 Francesco Fantin,2 Rebekah Schiff,3 Christopher J Bulpitt31Academic Department of Geriatrics, Brighton and Sussex Medical School, Brighton, UK; 2Department of Geriatrics, University of Verona, Italy; 3Section of Geriatric Medicine, Imperial College School of Medicine, London, UKBackground: Antihypertensive agents can reduce arterial stiffness. We hypothesized that an angiotensin receptor blocker (ARB) irbesartan and an angiotensin converting enzyme inhibit...

  5. CARDIAC TRANSPLANT REJECTION AND NON-INVASIVE COMON CAROTID ARTERY WALL FUNCTIONAL INDICES

    Directory of Open Access Journals (Sweden)

    A. O. Shevchenko

    2015-01-01

    Full Text Available Allograft rejection would entail an increase in certain blood biomarkers and active substances derived from activated inflammatory cells which could influence entire vascular endothelial function and deteriorate arterial wall stiffness. We propose that carotid wall functional indices measured with non-invasive ultrasound could we valuable markers of the subclinical cardiac allograft rejection. Aim. Our goal was to analyze the clinical utility of functional common carotid wall (CCW variables measured with high-resolution Doppler ultrasound as a non-invasive screening tool for allograft rejection in cardiac transplant patients (pts. Methods. One hundred and seventy one pts included 93 cardiac recipients, 30 dilated cardiomyopathy waiting list pts, and 48 stable coronary artery disease (SCAD pts without decompensated heart failure were included. Along with resistive index (Ri, pulsative index (Pi, and CCW intima-media thickness (IMT, CCW rigidity index (iRIG was estimated using empirical equation. Non-invasive evaluation was performed in cardiac transplant recipients prior the endomyo- cardial biopsy. Results. Neither of Ri, Pi, or CCW IMT were different in studied subgroups. iRIG was signifi- cantly lower in SCAD pts when compared to the dilated cardiomyopathy subgroup. The later had similar values with cardiac transplant recipients without rejection. Antibody-mediated and cellular rejection were found in 22 (23.7% and 17 (18.3% cardiac recipients, respectively. Mean iRIG in pts without rejection was significantly lower in comparison to antibody-mediated rejection and cell-mediated (5514.7 ± 2404.0 vs 11856.1 ± 6643.5 and 16071.9 ± 10029.1 cm/sec2, respectively, p = 0.001. Area under ROC for iRIG was 0.90 ± 0.03 units2. Analysis showed that iRIG values above estimated treshold 7172 cm/sec2 suggested relative risk of any type of rejection 17.7 (95%CI = 6.3–49.9 sensitivity 80.5%, specificity – 81.1%, negative predictive value – 84

  6. Índice de massa corporal e hipertensão arterial em indivíduos adultos no Centro-Oeste do Brasil Índice de masa corporal e hipertensión arterial en individuos adultos en el Centro Oeste del Brasil Body mass index and hypertension in adult subjects in Brazil's Midwest

    Directory of Open Access Journals (Sweden)

    Nadia Mohamed Amer

    2011-01-01

    . OBJETIVO: Investigar posibles factores asociados a las alteraciones en el índice de masa corporal (IMC. MÉTODOS: Estudio desarrollado en Nova Andradina - Mato Grosso do Sul, con 369 individuos registrados en el programa Estrategia Salud de la Familia en el año 2007. Los datos fueron colectados en los domicilios, por medio de entrevista semiestructurada y evaluación antropométrica. En el análisis de los datos, fueron utilizados los tests chi-cuadrado y Mantel Haensel, para respuestas categóricas, y ANOVA y Tukey, para las continuas. RESULTADOS: Las prevalencias de sobrepeso y obesidad fueron de 33,3% y 23,0%, respectivamente. En su mayoría, los individuos presentaban las siguientes características: sexo femenino (85,4%, inactivos (89,7%, relación cintura-cadera (RCC inadecuada (83,7% y portaban algún problema de salud crónico (31,9%, especialmente la hipertensión arterial. Los factores de riesgo para sobrepeso y obesidad pueden ser relacionados a las variables estado civil viudo, RCC inadecuada, renta más baja y problemas de salud. Ya la hipertensión arterial puede ser asociada apenas a la obesidad. CONCLUSIÓN: El porcentual de personas que se encontraban encima del peso y de aquellas que no practicaban actividad física en Nova Andradina indica que esas cuestiones constituyen desafío importante para el sector salud también en las pequeñas ciudades. Por eso, es urgente la implantación de programas de intervención multidisciplinares en el ámbito de la atención básica.BACKGROUND: Overweight and obesity are an important public health problem in society, due to the growth in all age groups and their association with various chronic diseases, especially hypertension OBJECTIVE: To investigate possible factors associated with changes in body mass index (BMI. METHODS: Study developed in the city of Nova Andradina, State of Mato Grosso do Sul, with 369 subjects registered in the Family Health Strategy Program in 2007. Data were collected at the subjects

  7. New Combined Parameter of Liver and Splenic Stiffness as Determined by Elastography in Healthy Volunteers

    Science.gov (United States)

    Kassym, Laura; Nounou, Mohammed A.; Zhumadilova, Zauresh; Dajani, Asad I.; Barkibayeva, Nurgul; Myssayev, Ayan; Rakhypbekov, Tolebay; Abuhammour, Adnan M.

    2016-01-01

    Background: The diagnosis of chronic liver disease (CLD) leading to fibrosis, cirrhosis, and portal hypertension had witnessed dramatic changes after the introduction of noninvasive figure accessible tools over the past few years. Imaging techniques that are based on evaluation of the liver stiffness was particularly useful in this respect. Acoustic radiation force impulse (ARFI) emerged as an interesting figure tool with reliable repute and high precision. Aims: To evaluate liver stiffness measurement (LSM) and splenic stiffness measurement (SSM) in healthy volunteers as concluded by the ARFI technique and to out a numeric calculated ratio that may reflect their correlation in the otherwise healthy liver. Patients and Methods: A ratio (splenic stiffness/liver stiffness in kPa) was determined in 207 consenting healthy subjects and was investigated with respect to age, gender, ethnic origin, body mass index (BMI), liver and spleen sizes healthy volunteers, alanine aminotransferase (ALT), aspartate aminotransferase (AST), platelet count (PLT), APRI, and FIB-4 scores. Results: Data from this work led to computing an index of 4.72 (3.42–7.33) in healthy persons on an average. Females had a higher index than males 6.37 vs 4.92, P=0.002. There was not any significant difference of the ratio in different age groups; ethnic origins; any correlation between SSM/LSM ratio and BMI; liver and spleen sizes; or ALT, AST, PLT, APRI, and FIB-4 scores. Conclusions: A quantifiable numeric relationship between splenic and liver stiffness in the healthy subjects could be computed to a parameter expressed as SSM/LSM ratio. We believe that this ratio can be a useful reference tool for further researches in CLD. PMID:27488328

  8. 2型糖尿病趾肱指数临床分析%Toe-brachial index in the diagnosis of peripheral artery disease and its risk factors in the patients with type 2 diabetes

    Institute of Scientific and Technical Information of China (English)

    张翼; 孙志纯; 牟仑盼; 卓雅芬; 何伟民; 王爱红

    2014-01-01

    目的:研究趾肱指数( TBI)在诊断2型糖尿病患者下肢动脉病变中临床意义与影响因素。方法采用多普勒血流探测仪检测2型糖尿病患者足趾动脉与肱动脉血压的比值,以TBI≤0.7为切割点分成低TBI组与正常TBI组,并分析比较两组临床及代谢参数。结果238例2型糖尿病患者中TBI≤0.7的32例,占总例数13.4%。低TBI组与正常TBI组比较,其年龄更高,舒张压更低,高血压、冠心病、脑血管病合并率增高;逐步回归分析显示,年龄、舒张压是TBI独立影响因素。结论TBI在诊断2型糖尿病下肢动脉病变中具有重要意义;低TBI患者有更高的心脑血管患病率;高龄、舒张压低是TBI的主要危险因素。%Objective To investigate toe-brachial index ( TBI) in the diagnosis of peripheral artery disease ( PAD) and its risk factors in the patients with type 2 diabetes.Methods TBI was examined in the 238 patients with type 2 diabetes.The patients were divided into the group with low TBI ( TBI≤0.7 ) and the group with normal ABI ( TBI>0.7 ) .The two groups were compared for clinical parameters.Results Thirty two patients (13.4%)with abnormal ABI (TBI≤0.7) showed older age [(63.8 ±9.9) yrs vs (54.9 ±10.8) yrs, P =0.000] , lower diastolic blood pressure [(70.5 ±6.9) mmHg vs (74.9 ±9.1) mmHg, P =0.003], more frequency of hypertension (56.3%vs 38.3%, P =0.043), coronary artery heart disease (28.7%vs 10.7%, P =0.020) and cere-bral vascular disease (15.6%vs 4.4%, P =0.025).Step-wise analysis screened that age and diastolic blood pressure were the inde-pendent risk factors for TBI .Conclusions Aging and hypertension were the risk factors in the patients with abnormal TBI in type 2 di-abetes.TBI was an easy and economical method for diagnosing PAD in patients with type 2 diabetes.

  9. Arterial structure and function in vascular ageing: are you as old as your arteries?

    Science.gov (United States)

    Thijssen, Dick H J; Carter, Sophie E; Green, Daniel J

    2016-04-15

    Advancing age may be the most potent independent predictor of future cardiovascular events, a relationship that is not fully explained by time-related changes in traditional cardiovascular risk factors. Since some arteries exhibit differential susceptibility to atherosclerosis, generalisations regarding the impact of ageing in humans may be overly simplistic, whereas in vivo assessment of arterial function and health provide direct insight. Coronary and peripheral (conduit, resistance and skin) arteries demonstrate a gradual, age-related impairment in vascular function that is likely to be related to a reduction in endothelium-derived nitric oxide bioavailability and/or increased production of vasoconstrictors (e.g. endothelin-1). Increased exposure and impaired ability for defence mechanisms to resist oxidative stress and inflammation, but also cellular senescence processes, may contribute to age-related changes in vascular function and health. Arteries also undergo structural changes as they age. Gradual thickening of the arterial wall, changes in wall content (i.e. less elastin, advanced glycation end-products) and increase in conduit artery diameter are observed with older age and occur similarly in central and peripheral arteries. These changes in structure have important interactive effects on artery function, with increases in small and large arterial stiffness representing a characteristic change with older age. Importantly, direct measures of arterial function and structure predict future cardiovascular events, independent of age or other cardiovascular risk factors. Taken together, and given the differential susceptibility of arteries to atherosclerosis in humans, direct measurement of arterial function and health may help to distinguish between biological and chronological age-related change in arterial health in humans.

  10. Diverging effects of diabetes mellitus in patients with peripheral artery disease and abdominal aortic aneurysm and the role of advanced glycation end products:: ARTERY study. Protocol for a multicenter cross-sectional study

    OpenAIRE

    Vos, L.C. de; Boersema, J.; Hillebrands, J. L.; Schalkwijk, C. G.; Meerwaldt, R.; Breek, J.C.; Smit, A. J.; C. J. Zeebregts; Lefrandt, J.D.

    2016-01-01

    Introduction: Diabetes mellitus is a well-defined risk factor for peripheral artery disease (PAD), but protects against the development and growth of abdominal aortic aneurysm (AAA). Diabetes mellitus is associated with arterial stiffening and peripheral arterial media sclerosis. Advanced glycation end products (AGEs) are increased in diabetes mellitus and cardiovascular disease. AGEs are known to form cross-links between proteins and are associated with arterial stiffness. Whether AGEs contr...

  11. Noninvasive Stiffness Sensing of Ventricular Wall Based on a Thick-walled Cylinder Model

    Science.gov (United States)

    Higashimori, Mitsuru; Ojio, Takeshi; Takeda, Yasuharu; Sakata, Yasushi; Yamamoto, Kazuhiro; Kaneko, Makoto

    This paper discusses a concept of a noninvasive sensing method that can estimate a left ventricular wall stiffness towards a medical diagnosis. Focusing on not only the strain of ventricular wall but also the displacements of epicardium during diastole of heart beat, we propose an index of ventricular wall stiffness based on a thick-walled cylinder model. Applying the proposed method to the echocardiography, we show statistical results where normal and HFpEF (Heart Failure with preserved Ejection Fraction) can be separated towards a medical diagnosis.

  12. The stable stiffness triangle - drained sand during deformation cycles

    DEFF Research Database (Denmark)

    Sabaliauskas, Tomas; Ibsen, Lars Bo

    2017-01-01

    Cyclic, drained sand stiffness was observed using the Danish triaxial appa- ratus. New, deformation dependant soil property (the stable stiffness triangle) was detected. Using the the stable stiffness triangle, secant stiffness of drained sand was plausible to predict (and control) even during ir...

  13. Waves in geomaterials exhibiting negative stiffness behaviour

    Science.gov (United States)

    Esin, Maxim; Dyskin, Arcady; Pasternak, Elena

    2016-04-01

    Negative stiffness denotes the type of material behaviour when the force applied to the body decreases the body's deformation increases. Some geomaterials, for instance, rocks, demonstrate behaviour of this type at certain loads: during the compression tests the loading curves exhibit descending branch (post-peak softening). One of the possible mechanisms of the negative stiffness appearance in geomaterials is rotation of non-spherical grains. It is important to emphasize that in this case the descending branch may be reversible given that the testing machine is stiff enough (in general case it means an importance of boundary conditions). Existence of geomaterials with a negative modulus associated with rotations may have significant importance. In particular, important is understanding of the wave propagation in such materials. We study the stability of geomaterials with negative stiffness inclusions and wave propagation in it using two approaches: Cosserat continuum and discrete mass-spring models. In both cases we consider the rotational degrees of freedom in addition to the conventional translational ones. We show that despite non positiveness of the energy the materials with negative stiffness elements can be stable if certain conditions are met. In the case of Cosserat continuum the Cosserat shear modulus (the modulus relating the non-symmetrical part of shear stress and internal rotations) is allowed to assume negative values as long as its value does not exceed the value of the standard (positive) shear modulus. In the case of discrete mass-spring systems (with translational and rotational springs) the concentration of negative stiffness springs and the absolute values of negative spring stiffness are limited. The critical concentration when the system loses stability and the amplitude of the oscillations tends to infinity is equal to 1/2 and 3/5 for two- and three-dimensional cases respectively.

  14. Carotid artery surgery

    Science.gov (United States)

    Carotid endarterectomy; CAS surgery; Carotid artery stenosis - surgery; Endarterectomy - carotid artery ... through the catheter around the blocked area during surgery. Your carotid artery is opened. The surgeon removes ...

  15. Resting and Post-Exercise Ankle-Brachial Index Measurements to Diagnose Asymptomatic Peripheral Arterial Disease in Middle Aged and Elderly Chronic Obstructive Pulmonary Disease Patients: A Pilot Study

    Science.gov (United States)

    Alagiakrishnan, Kannayiram; Brokop, Michael; Cave, Andrew; Rowe, Brian H.; Wong, Eric; Senthilselvan, Ambikaipakan

    2016-01-01

    Background Chronic obstructive pulmonary disease (COPD) patients are at risk for asymptomatic peripheral arterial disease (PAD) because smoking is a risk factor for COPD and PAD. The objectives of this study were to determine the proportion of COPD patients with asymptomatic PAD and to investigate whether the estimated risk of asymptomatic PAD in subjects with COPD differs using resting and exercise ankle-brachial index (ABI) in smokers. Methods Using a cross-sectional study design, consecutive smokers > 50 years old were recruited over 2 months from the inpatient units and the outpatient clinics. Subjects previously diagnosed with PAD, unstable angina, recent (< 3 months) myocardial infarction or abdominal, intracranial, eye or lung surgery, and palliative care patients were excluded. Vascular risk factors, ABI (supine and post-3-minute walk supine), self-reported PAD symptoms, and spirometry were obtained. Two measurements of systolic blood pressure on all limbs were obtained using a sphygmomanometer and a Doppler ultrasound, and the ABI was calculated. Data were expressed as means ± standard deviation (SD). Dichotomous outcomes were assessed using Chi-square statistics; P-values of < 0.05 were considered significant. Results Thirty patients with no previous diagnosis of PAD were recruited. Mean age was 67.7 years (SD: 10.5). Overall, 21 subjects (70%) had spirometry-proven COPD. Significant ABI for PAD (< 0.9) was seen in 7/21 COPD (33.5%) and 0/9 non-COPD subjects in the supine resting position (P = 0.07), and in 9/21 COPD (42.9%) vs. 0/9 non-COPD subjects after exercise (P = 0.03). Conclusions A significant proportion of patients with spirometry-proven COPD screened positive for asymptomatic PAD after exercise. Resting ABI may not be very sensitive to diagnose asymptomatic PAD in COPD subjects. ABI may be a reliable, sensitive and practical screening tool to assess cardiovascular risk in COPD patients. Future large-scale studies are required to confirm this

  16. Single motor–variable stiffness actuator using bistable switching mechanisms for independent motion and stiffness control

    NARCIS (Netherlands)

    Groothuis, S.S.; Carloni, R.; Stramigioli, S.

    2016-01-01

    This paper presents a proof of concept of a variable stiffness actuator (VSA) that uses only one (high power) input motor. In general, VSAs use two (high power) motors to be able to control both the output position and the output stiffness, which possibly results in a heavy, and bulky system. In thi

  17. Hepatic Hemodynamics and Elevation of Liver Stiffness as Possible Predictive Markers of Late-onset Hepatic Failure.

    Science.gov (United States)

    Kakisaka, Keisuke; Kuroda, Hidekatsu; Abe, Tamami; Suzuki, Yuji; Yoshida, Yuichi; Kataoka, Kojiro; Miyamoto, Yasuhiro; Ishida, Kazuyuki; Takikawa, Yasuhiro

    2016-01-01

    A 52-year-old Japanese woman admitted to our hospital for the treatment of liver dysfunction due to an undetermined cause developed disorientation on the 58th hospital day and was diagnosed with late-onset liver failure. Abdominal ultrasound examinations were performed several times from the admission. Before the disorientation appeared, the results of the examinations revealed that the portal flow decreased, after which the hepatic arterial flow increased and the degree of liver stiffness became elevated. Although the pathophysiology of these changes remains unclear, hemodynamic changes and elevation of liver stiffness might be predictive markers of severe liver tissue damage.

  18. 内脏脂肪指数与冠心病及冠脉病变程度的关系%Association between visceral adiposity index and severity of coronary artery disease

    Institute of Scientific and Technical Information of China (English)

    钟赟; 叶菁; 伍崇海; 李爱群; 刘世明

    2014-01-01

    Objective To investigate the corelation between visceral adiposity index ( VAI) and severity of coro-nary artery disease.Methods In case group, 133 coronary heart disease( CHD) patients were diagnosed by coronary an-giography, while 266 age and gender matched controls were selected as control group.Pearson′s correlation coefficient, lo-gistic regressions and receiver operating characteristic ( ROC) curve were used to analyze the correlations among CHD and different obese indexes, including, VAI and waist circumference ( WC) .Results Compare with control group, VAI were significantly increased in CHD group (P<0.01).ROC curve suggested that VAI and WC were useful in predicting CHD (0.673 and 0.667), especially in lean subjects (0.755 and 0.741).The adjusted odds ratios of CHD associated with VAI, WC, and HDL-C were 4.952, 4.744 and 4.385, respectively.In CHD group, VAI was significantly positively correlated with Gensini scroe (r=0.191, P<0.05).Conclusion VAI, as a new factor representing visceral obesity, is a good predictor for CHD.%目的:探讨内脏脂肪指数( VAI)及其他肥胖指标与冠心病( CHD)及冠脉病变程度的关系。方法选择冠脉造影术证实有冠脉病变的患者133例( CHD组),按1∶2比例匹配年龄、性别,选取非冠心病患者266例为对照组,分析肥胖相关参数及VAI。以ROC曲线分析VAI等参数预测CHD的最佳切点及诊断价值。应用Pearson相关分析和条件logistic回归分析探讨各危险因素与冠脉病变程度的相关性及对CHD的风险。结果CHD组VAI明显高于对照组(P<0.01)。在总人群中VAI与腰围(WC)均可用于预测CHD,两者曲线下面积差异无统计学意义;以BMI为22.31 kg/m2为切点,而在正常偏瘦人群中,VAI与WC预测CHD效能更佳。条件logis-tic回归分析各肥胖指数及血脂等危险因素发现,VAI对CHD影响最大(OR=4.952),其次为WC和高密度脂蛋白胆固醇水平。而在行

  19. [Stiff-person syndrome and related autoantibodies].

    Science.gov (United States)

    Tomioka, Ryo; Tanaka, Keiko

    2013-04-01

    Central nervous system hyperexcitability disorders, known as stiff-man/person syndrome (SPS), are thought to be related to the regulatory disturbance of inhibitory synaptic transmission of motor neurons in the brainstem and spinal cord. SPS is characterized by stiffness and spasms of the axis and limbs and is divided into two clinical subgroups: classic SPS, which affects the lumbar, trunk, and proximal limb muscles, and SPS-plus syndrome. The latter comprises (1) the stiff-limb subtype, in which symptom is limited to the lower limbs; (2) jerking stiff-man syndrome, characterized by chronically progressive stiffness and myoclonus; and (3) acute-onset and progressive encephalomyelitis with rigidity and myoclonus. Almost 80% of patients with classic SPS harbor autoantibodies against glutamic acid decarboxylase 65 (GAD65). In approximately 30-40% of patients, SPS accompanies type I diabetes, and anti-GAD65 antibodies are detected frequently in type I diabetes. However, the antibody-recognizing epitopes might be different between SPS and diabetes. Other autoantibodies against glycine receptor α1 (12% of patients with SPS) and GABA(A)-receptor associated protein (70% of patients with SPS) have been reported. In paraneoplastic SPS, anti-amphiphysin antibodies have been shown in patients with breast cancer or small cell lung cancer. One case of mediastinal tumor with anti-gephyrin antibodies has also been reported. However, the roles of these autoantibodies in the pathomechanisms of SPS have not yet been elucidated.

  20. Big Bang nucleosynthesis with a stiff fluid

    CERN Document Server

    Dutta, Sourish

    2010-01-01

    Models that lead to a cosmological stiff fluid component, with a density $\\rho_S$ that scales as $a^{-6}$, where $a$ is the scale factor, have been proposed recently in a variety of contexts. We calculate numerically the effect of such a stiff fluid on the primordial element abundances. Because the stiff fluid energy density decreases with the scale factor more rapidly than radiation, it produces a relatively larger change in the primordial helium-4 abundance than in the other element abundances, relative to the changes produced by an additional radiation component. We show that the helium-4 abundance varies linearly with the density of the stiff fluid at a fixed fiducial temperature. Taking $\\rho_{S10}$ and $\\rho_{R10}$ to be the stiff fluid energy density and the standard density in relativistic particles, respectively, at $T = 10$ MeV, we find that the change in the primordial helium abundance is well-fit by $\\Delta Y_p = 0.00024(\\rho_{S10}/\\rho_{R10})$. The changes in the helium-4 abundance produced by ad...

  1. Torso flexion modulates stiffness and reflex response.

    Science.gov (United States)

    Granata, K P; Rogers, E

    2007-08-01

    Neuromuscular factors that contribute to spinal stability include trunk stiffness from passive and active tissues as well as active feedback from reflex response in the paraspinal muscles. Trunk flexion postures are a recognized risk factor for occupational low-back pain and may influence these stabilizing control factors. Sixteen healthy adult subjects participated in an experiment to record trunk stiffness and paraspinal muscle reflex gain during voluntary isometric trunk extension exertions. The protocol was designed to achieve trunk flexion without concomitant influences of external gravitational moment, i.e., decouple the effects of trunk flexion posture from trunk moment. Systems identification analyses identified reflex gain by quantifying the relation between applied force disturbances and time-dependent EMG response in the lumbar paraspinal muscles. Trunk stiffness was characterized from a second order model describing the dynamic relation between the force disturbances versus the kinematic response of the torso. Trunk stiffness increased significantly with flexion angle and exertion level. This was attributed to passive tissue contributions to stiffness. Reflex gain declined significantly with trunk flexion angle but increased with exertion level. These trends were attributed to correlated changes in baseline EMG recruitment in the lumbar paraspinal muscles. Female subjects demonstrated greater reflex gain than males and the decline in reflex gain with flexion angle was greater in females than in males. Results reveal that torso flexion influences neuromuscular factors that control spinal stability and suggest that posture may contribute to the risk of instability injury.

  2. Effects of antihypertensives on arterial responses associated with obstructive sleep apneas

    Institute of Scientific and Technical Information of China (English)

    ZHONG Xu; XIAO Yi; Robert C. Basner

    2005-01-01

    Background Many patients with obstructive sleep apnea syndrome (OSAS) have complicated with hypertension and may be prescribed with antihypertension medications to control their blood pressure. But whether antihypertension medications can also decrease arterial stiffness or control the blood pressure increasing following obstructive events is not well described. This study aimed to investigate whether antihypertensive medications can ameliorate the changes in arterial stiffness and blood pressure associated with OSA. Methods Sixty-one OSAS patients [13 women, 48 men, mean age (53.4±12.3) years], 26 normotensive patients (N), 7 hypertensive patients on no antihypertension medications (H), and 28 hypertensive patients on various combination antihypertension therapy (HM), were prospectively diagnosed with standard nocturnal polysomnography. Beat-to-beat blood pressure was continuously recorded from the radial artery by applanation tonometry during baseline sleep. As a measure of arterial stiffness, arterial augmentation index (AAI) was calculated as the ratio of augmented systolic blood pressure (SBP) to pulse pressure and expressed as a percentage for the following conditions: awakening, the first 10 ("early apnea") and last 10 ("late apnea") cardiac cycles of obstructive events (apnea or hypopnea), and the first 15 cardiac cycles following event termination ("post apnea") for all events with nadir O2 saturation ≤89%. Results Systolic blood pressure (SBP) post-apnea [(142.74±13.06) mmHg (N), (137.06±26.56) mmHg (H), (136.94±14.1) mmHg (HM)] was significantly increased from awakening [(135.76±14.76) mmHg (N), (135.58±23.17) mmHg (H), (129.77±14.00) mmHg (HM)], early apnea [(130.53±12.65) mmHg (N),(124.47±24.97) mmHg (H), (126.04±13.12) mmHg (HM)], and late apnea [(129.8±12.68) mmHg(N), (124.78±25.15) mmHg (H),(124.48±13.82) mmHg (HM)] respectively (P<0.001, repeated measures ANOVA). AAI was significantly increased for the N group (P<0.001) from

  3. Indexing Images.

    Science.gov (United States)

    Rasmussen, Edie M.

    1997-01-01

    Focuses on access to digital image collections by means of manual and automatic indexing. Contains six sections: (1) Studies of Image Systems and their Use; (2) Approaches to Indexing Images; (3) Image Attributes; (4) Concept-Based Indexing; (5) Content-Based Indexing; and (6) Browsing in Image Retrieval. Contains 105 references. (AEF)

  4. A Novel Variable Stiffness Mechanism Capable of an Infinite Stiffness Range and Unlimited Decoupled Output Motion

    Directory of Open Access Journals (Sweden)

    Stefan Groothuis

    2014-06-01

    Full Text Available In this paper, a novel variable stiffness mechanism is presented, which is capable of achieving an output stiffness with infinite range and an unlimited output motion, i.e., the mechanism output is completely decoupled from the rotor motion, in the zero stiffness configuration. The mechanism makes use of leaf springs, which are engaged at different positions by means of two movable supports, to realize the variable output stiffness. The Euler–Bernoulli leaf spring model is derived and validated through experimental data. By shaping the leaf springs, it is shown that the stiffness characteristic of the mechanism can be changed to fulfill different application requirements. Alternative designs can achieve the same behavior with only one leaf spring and one movable support pin.

  5. Inverse relationship of cardioankle vascular index with BMI in healthy Japanese subjects: a cross-sectional study

    Directory of Open Access Journals (Sweden)

    Nagayama D

    2016-12-01

    Full Text Available Daiji Nagayama,1,2 Haruki Imamura,2 Yuta Sato,2 Takashi Yamaguchi,2 Noriko Ban,2 Hidetoshi Kawana,2 Masahiro Ohira,2 Atsuhito Saiki,2 Kohji Shirai,3 Ichiro Tatsuno2 1Center of Endocrinology and Metabolism, Shin-Oyama City Hospital, Oyama-City, 2Center of Diabetes, Endocrinology and Metabolism, 3Department of Vascular Function, Sakura Medical Center, Toho University, Sakura-City, Japan Objective: The objective of this study is to investigate the association of body mass index (BMI with arterial stiffness assessed by cardioankle vascular index (CAVI. Subjects and methods: A retrospective cross-sectional study was conducted in 23,257 healthy Japanese subjects (12,729 men and 10,528 women, aged 47.1 ± 12.5 years, BMI 22.9 ± 3.4 kg/m2 who underwent health screening between 2004 and 2006 in Japan. Exclusion criteria were current medication use and a past history of cardiovascular disease, hypertension, stroke, diabetes, and nephritis. Results: Male subjects showed significantly higher BMI, CAVI, and triglycerides and lower high-density lipoprotein (HDL-cholesterol compared with female subjects. Next, the subjects were divided into tertiles of BMI: lower, middle, and upper, in a gender-specific manner. After adjusting for confounders including age, systolic blood pressure, and HDL-cholesterol identified by multiple regression analysis, the mean CAVI decreased progressively as BMI tertile increased in both genders.