P2.12 INFLUENCE OF THE CENTRAL TO PERIPHERAL ARTERIAL STIFFNESS GRADIENT ON TIMING AND AMPLITUDE OF WAVE REFLECTIONS

Abstract. Increased arterial stiffness results from reduced elasticity of the arterial wall and is an independent predictor for cardiovascular risk. The gold standard for assessment of arterial stiffness is the carotid-femoral pulse wave velocity. Other parameters such as central aortic pulse pressure and aortic augmentation index are indirect, surrogate markers of arterial stiffness, but provide additional information on the characteristics of wave reflection. Peripheral arterial disease (PAD) is characterised by its association with systolic hypertension, increased arterial stiffness, disturbed wave reflexion and prognosis depending on ankle-brachial pressure index. This review summarises the physiology of pulse wave propagation and reflection and its changes due to aging and atherosclerosis. We discuss different non-invasive assessment techniques and highlight the importance of the understanding of arterial pulse wave analysis for each vascular specialist and primary care physician alike in the context of PAD.

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Characterization and clinical implications of peripheral arterial involvement in transthyretin cardiac amyloidosis cardiomyopathy

European Heart Journal ◽

10.1093/ehjci/ehaa946.3247 ◽

2020 ◽

Vol 41 (Supplement_2) ◽

Author(s):

K Stamatelopoulos ◽

D Delialis ◽

D Bampatsias ◽

M.E Tselegkidi ◽

I Petropoulos ◽

...

Keyword(s):

Risk Factors ◽

Clinical Significance ◽

Vascular Involvement ◽

Control Group ◽

Peripheral Vascular ◽

Cvd Risk Factors ◽

Wave Reflections ◽

Cvd Risk ◽

Arterial Involvement ◽

Peripheral Arterial

Abstract Background The sporadic form of transthyretin amyloidosis cardiomyopathy (ATTR-CM) is underdiagnosed but its prevalence is increasing due to the aging population. Given the poor prognosis of ATTR-CM understanding the underlying pathophysiologic mechanisms of the disease is imperative in order to improve strategies for early diagnosis and risk stratification and to develop new effective therapeutic options. ATTR-CM is associated with hypotension and there is preliminary experimental evidence of vascular involvement but its presence and clinical significance remains unknown. Purpose To characterize peripheral arterial involvement and explore its clinical role in ATTR-CM. Methods We consecutively recruited 28 previously untreated patients with newly diagnosed ATTR-CM and 34 elderly controls >70 years old, without ATTR-CM or heart failure. In both groups, flow-mediated dilatation (FMD) and intima-media thickness (IMT) in the carotid arteries were measured by high-resolution ultrasonography as markers of peripheral vascular reactivity and of subclinical atherosclerosis, respectively. Carotid-femoral pulse wave velocity (PWV) was measured as a marker of arterial stiffness. Aortic blood pressure (BP) and augmentation index (AI) using applanation tonometry were measured as markers of arterial wave reflections, peripheral arterial resistance and central hemodynamics. Echocardiography was performed in all ATTR patients. All cardiovascular (CV) measurements were performed before administration of any ATTR-specific therapy. Results ATTR patients were older and had lower prevalence of hypertension and male gender (p<0.05 for all) than the control group. Aortic and peripheral BP (p=0.016–0.088) and AI (p=0.003) were lower in ATTR patients. IMT in the common (cc) and internal carotid (ic) as well as in the carotid bulb (cb) were significantly higher in ATTR patients (p=0.001–0.042). After multivariable adjustment for traditional CV disease (CVD) risk factors, the ATTR group was independently associated with AI and IMT in cc, cb and ic (p<0.05 for all). In a subgroup of subjects with similar age between groups (n=13 and n=33 and 74.5±2.9 vs. 75.6±3.6 years, for ATTR vs. controls, respectively) differences in AI and cbIMT remained significant. Interestingly, AI was strongly and inversely associated with interventricular wall thickness (IVwt) in ATTR patients (spearman rho=−0.651, p=0.001). After adjustment for traditional CVD risk factors this association remained significant. Conclusion ATTR-CM is associated with lower aortic wave reflections, which correlate with more advanced structural cardiac disease, as assessed by IVwt. Further, ATTR-CM patients present accelerated subclinical carotid atherosclerosis as compared to elderly control subjects. These findings suggest that in ATTR-CM there is disease-specific peripheral vascular involvement in parallel to cardiac involvement. The clinical significance of these findings merits further investigation. Funding Acknowledgement Type of funding source: None

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Peripheral arterial stiffness during electrocutaneous stimulation is positively correlated with pain-related brain activity and subjective pain intensity: an fMRI study

Scientific Reports ◽

10.1038/s41598-021-83833-6 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Toshio Tsuji ◽

Fumiya Arikuni ◽

Takafumi Sasaoka ◽

Shin Suyama ◽

Takashi Akiyoshi ◽

...

Keyword(s):

Arterial Stiffness ◽

Pain Intensity ◽

Brain Activity ◽

Brain Regions ◽

Anterior Cingulate ◽

Electrocutaneous Stimulation ◽

Pain Matrix ◽

Fmri Study ◽

Subjective Pain ◽

Peripheral Arterial

AbstractBrain activity associated with pain perception has been revealed by numerous PET and fMRI studies over the past few decades. These findings helped to establish the concept of the pain matrix, which is the distributed brain networks that demonstrate pain-specific cortical activities. We previously found that peripheral arterial stiffness $${\beta }_{\text{art}}$$ β art responds to pain intensity, which is estimated from electrocardiography, continuous sphygmomanometer, and photo-plethysmography. However, it remains unclear whether and to what extent $${\beta }_{\text{art}}$$ β art aligns with pain matrix brain activity. In this fMRI study, 22 participants received different intensities of pain stimuli. We identified brain regions in which the blood oxygen level-dependent signal covaried with $${\beta }_{\text{art}}$$ β art using parametric modulation analysis. Among the identified brain regions, the lateral and medial prefrontal cortex and ventral and dorsal anterior cingulate cortex were consistent with the pain matrix. We found moderate correlations between the average activities in these regions and $${\beta }_{\text{art}}$$ β art (r = 0.47, p < 0.001). $${\beta }_{\text{art}}$$ β art was also significantly correlated with self-reported pain intensity (r = 0.44, p < 0.001) and applied pain intensity (r = 0.43, p < 0.001). Our results indicate that $${\beta }_{\text{art}}$$ β art is positively correlated with pain-related brain activity and subjective pain intensity. This study may thus represent a basis for adopting peripheral arterial stiffness as an objective pain evaluation metric.

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Central and peripheral arterial stiffness responses to uninterrupted prolonged sitting combined with a high-fat meal: a randomized controlled crossover trial

Hypertension Research ◽

10.1038/s41440-021-00708-z ◽

2021 ◽

Author(s):

Simon Fryer ◽

Keeron Stone ◽

Craig Paterson ◽

Meghan Brown ◽

James Faulkner ◽

...

Keyword(s):

Arterial Stiffness ◽

Cardiovascular Health ◽

Pulse Wave ◽

Disease Risk ◽

Cardiovascular Disease Risk ◽

High Fat ◽

Low Fat ◽

Peripheral Arterial ◽

Fat Meal ◽

Over Time

AbstractIndependently, prolonged uninterrupted sitting and the consumption of a meal high in saturated fats acutely disrupt normal cardiovascular function. Currently, the acute effects of these behaviors performed in combination on arterial stiffness, a marker of cardiovascular health, are unknown. This study sought to determine the effect of consuming a high-fat meal (Δ = 51 g fat) in conjunction with prolonged uninterrupted sitting (180 min) on measures of central and peripheral arterial stiffness. Using a randomized crossover design, 13 young healthy males consumed a high-fat (61 g) or low-fat (10 g) meal before 180 min of uninterrupted sitting. Carotid-femoral (cf) and femoral-ankle (fa) pulse wave velocity (PWV), aortic-femoral stiffness gradient (af-SG), superficial femoral PWV beta (β), and oscillometric pulse wave analysis outcomes were assessed pre and post sitting. cfPWV increased significantly more following the high-fat (mean difference [MD] = 0.59 m·s−1) meal than following the low-fat (MD = 0.2 m·s−1) meal, with no change in faPWV in either condition. The af-SG significantly decreased (worsened) (ηp2 = 0.569) over time in the high- and low-fat conditions (ratio = 0.1 and 0.1, respectively). Superficial femoral PWVβ significantly increased over time in the high- and low-fat conditions (ηp2 = 0.321; 0.8 and 0.4 m·s−1, respectively). Triglycerides increased over time in the high-fat trial only (ηp2 = 0.761). There were no significant changes in blood pressure. Consuming a high-fat meal prior to 180 min of uninterrupted sitting augments markers of cardiovascular disease risk more than consuming a low-fat meal prior to sitting.

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Prognostic Impact of Arterial Stiffness in Patients with Symptomatic Peripheral Arterial Disease

Journal of Vascular Surgery ◽

10.1016/j.jvs.2014.07.029 ◽

2014 ◽

Vol 60 (3) ◽

pp. 808

Author(s):

J. Kals ◽

J. Lieberg ◽

P. Kampus ◽

M. Zagura ◽

J. Eha ◽

...

Keyword(s):

Arterial Stiffness ◽

Peripheral Arterial Disease ◽

Arterial Disease ◽

Prognostic Impact ◽

Peripheral Arterial

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Abstract 3077: Cross-Sectional Associations of Arterial Stiffness Measures and Ankle-Brachial Index: The Multi-Ethnic Study of Atherosclerosis (MESA)

Circulation ◽

10.1161/circ.118.suppl_18.s_810-b ◽

2008 ◽

Vol 118 (suppl_18) ◽

Author(s):

John T Wilkins ◽

Mary M McDermott ◽

Kiang Liu ◽

Cheeling Chan ◽

Michael Criqui ◽

...

Keyword(s):

Arterial Stiffness ◽

Mechanical Characteristics ◽

Pulse Wave ◽

Ankle Brachial Index ◽

Arterial Disease ◽

Cross Sectional ◽

Men And Women ◽

Independent Variables ◽

Vascular Impedance ◽

Peripheral Arterial

The association between tonometry-derived measures of arterial stiffness and peripheral arterial disease (PAD) is unclear. Using baseline data from 2847 female and 2614 male participants of the NHLBI-funded MESA study, we conducted linear regression analyses adjusted for age, demographics and risk factors. Ankle-brachial index (ABI) was the dependent variable and measures of large (C1) and small artery elasticity (C2) and total vascular impedance (TVI), all measured from radial artery tonometry, were the independent variables in separate models. In men and women, lower C1 and C2 values were associated with lower ABI. Higher TVI was associated with lower ABI in men and women [P<0.001]. Significant trends for C1, C2 and TVI were observed across clinical strata of ABI (Table ). In pairwise analyses, compared with participants with a normal ABI (1.1 to <1.3), those with ABI <1.1 tended to have significantly lower C2. Additionally, women with high ABI (1.3–1.5) tended to have significantly higher C2 values. Pairwise comparisons of lower and higher ABI groups compared with normal groups did not yield consistent findings for C1. Significantly higher TVI levels with lower ABI group were noted mostly in women (Table ). We observed a continuum of arterial mechanical characteristics across clinical ABI values, indicating that measures of arterial stiffness are significantly associated with ABI and severity of PAD. These results suggest that changes in C2 occur in patients with advanced lower extremity large-vessel atherosclerotic disease. Of note, female participants with high ABI between 1.3–1.5 had a significantly higher C2, arguing against the accepted “non-compressible” or “calcified arterial disease” explanation for high ABI in women. Associations Between ABI and Pulse Wave Analysis Measurements when adjusted for age, cigarette smoking, diabetes, hypertension, and creatinine level

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