Sarcopenic obesity and arterial stiffness, pressure wave reflection and central pulse pressure: The J-SHIPP study

Studies investigating the relationship between heart rate (HR) and arterial stiffness or wave reflections have commonly induced HR changes through in situ cardiac pacing. Although pacing produces consistent HR changes, hemodynamics can be different with different pacing modalities. Whether the differences affect the HR relationship with arterial stiffness or wave reflections is unknown. In the present study, 48 subjects [mean age, 78 ± 10 (SD), 9 women] with in situ cardiac pacemakers were paced at 60, 70, 80, 90, and 100 beats per min under atrial, atrioventricular, or ventricular pacing. At each paced HR, brachial cuff-based pulse wave analysis was used to determine central hemodynamic parameters, including ejection duration (ED) and augmentation index (AIx). Wave separation analysis was used to determine wave reflection magnitude (RM) and reflection index (RI). Arterial stiffness was assessed by carotid-femoral pulse wave velocity (cfPWV). Pacing modality was found to have significant effects on the HR relationship with ED ( P = 0.01), central aortic pulse pressure ( P = 0.01), augmentation pressure ( P < 0.0001), and magnitudes of both forward and reflected waves ( P = 0.05 and P = 0.003, respectively), but not cfPWV ( P = 0.57) or AIx ( P = 0.38). However, at a fixed HR, significant differences in pulse pressure amplification ( P < 0.001), AIx ( P < 0.0001), RM ( P = 0.03), and RI ( P = 0.03) were observed with different pacing modalities. These results demonstrate that although the HR relationships with arterial stiffness and systolic loading as measured by cfPWV and AIx were unaffected by pacing modality, it should still be taken into account for studies in which mixed pacing modalities are present, in particular, for wave reflection studies.

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Abstract P057: Arterial Stiffness And Pressure Wave Reflection In The Development Of Isolated Diastolic Hypertension

Hypertension ◽

10.1161/hyp.76.suppl_1.p057 ◽

2020 ◽

Vol 76 (Suppl_1) ◽

Author(s):

Hirofumi Tomiyama ◽

Kazuki N Shiina ◽

Taishiro Chikamori ◽

Akira Yamashina

Keyword(s):

Blood Pressure ◽

Arterial Stiffness ◽

Pressure Wave ◽

Wave Reflection ◽

Augmentation Index ◽

Care Center ◽

Estimating Equation ◽

Health Care Center ◽

Diastolic Hypertension ◽

New Onset

Importance: While increased arterial stiffness and augmented pressure wave reflection are thought to be key factors in the development of systolic/diastolic hypertension (SDHT) or isolated systolic hypertension (ISHT) via the elevation of systolic blood pressure, their associations with the development of isolated diastolic hypertension (IDHT) have not been clarified. Objective: To examine the significance of augmented pressure wave reflection in the absence of accompanying increase of the arterial stiffness in the development of IDHT. Design and Setting: The prospective observational study conducted in the employees of a Japanese construction company at its health care center from year 2007 through year 2015 with a mean follow-up of 6.4 years, respectively. Participants: A total of 3022 Japanese male employees without hypertension at the start of this study. Main Outcomes and Measures: The annual assessment of prevalence of any phenotypes of hypertension. The blood pressure, brachial-ankle pulse wave velocity (baPWV), and radial augmentation index (rAI) were measured annually during the study period. Results: At the end of the study period, 129 subjects were diagnosed as having SDHT, 112 as having ISHT, and 74 as having IDHT. Both the baPWV and rAI showed significant individual odds ratios for new onset of SDHT and new onset of ISHT. However, only rAI, but not the brachial-ankle PWV, showed a significant odds ratio (1.44, P<0.01) for new onset of IDHT. This association was significant in subjects without elevated baPWV values at the start of the study (i.e., baPWV < 1224 cm/sec), but not in those with elevated brachial-ankle PWV at the start of the study. Generalized estimating equation analyses demonstrated a significant longitudinal association of the rAI, but not baPWV, with the prevalence of IDHT (estimate = 0.02, P=0.02). Conclusions: While increased arterial stiffness and augmented pressure wave reflection present concomitantly may be associated with the development of SDHT and ISHT, augmented pressure wave reflection alone, which may be related to isolated peripheral vascular damage, in the absence of accompanying increase of the arterial stiffness, may be a significant factor in the development of IDHT.

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Progressive Resistance Training Without Volume Increases Does Not Alter Arterial Stiffness and Aortic Wave Reflection

Experimental Biology and Medicine ◽

10.3181/0703-rm-65 ◽

2007 ◽

Vol 232 (9) ◽

pp. 1228-1235 ◽

Cited By ~ 64

Author(s):

Darren P. Casey ◽

Darren T. Beck ◽

Randy W. Braith

Keyword(s):

Resistance Training ◽

Arterial Stiffness ◽

Pressure Wave ◽

Wave Reflection ◽

Augmentation Index ◽

Aortic Pressure ◽

Control Group ◽

Training Volume ◽

Leg Extension ◽

Peripheral Arterial

Endurance exercise is efficacious in reducing arterial stiffness. However, the effect of resistance training (RT) on arterial stiffening is controversial. High-intensity, high-volume RT has been shown to increase arterial stiffness in young adults. We tested the hypothesis that an RT protocol consisting of progressively higher intensity without concurrent increases in training volume would not elicit increases in either central or peripheral arterial stiffness or alter aortic pressure wave reflection in young men and women. The RT group ( n = 24; 21 ± 1 years) performed two sets of 8–12 repetitions to volitional fatigue on seven exercise machines on 3 days/week for 12 weeks, whereas the control group ( n = 18; 22 ± 1 years) did not perform RT. Central and peripheral arterial pulse wave velocity (PWV), aortic pressure wave reflection (augmentation index; AIx), brachial flow–mediated dilation (FMD), and plasma levels of nitrate/nitrite (NOx) and norepinephrine (NE) were measured before and after RT. RT increased the one-repetition maximum for the chest press and the leg extension ( P < 0.001). RT also increased lean body mass ( P < 0.01) and reduced body fat (%; P < 0.01). However, RT did not affect carotid-radial, carotid-femoral, and femoral-distal PWV (8.4 ± 0.2 vs. 8.0 ± 0.2 m/sec; 6.5 ± 0.1 vs. 6.3 ± 0.2 m/sec; 9.5 ± 0.3 vs. 9.5 ± 0.3 m/sec, respectively) or AIx (2.5% ± 2.3% vs. 4.8% ± 1.8 %, respectively). Additionally, no changes were observed in brachial FMD, NOx, NE, or blood pressures. These results suggest that an RT protocol consisting of progressively higher intensity without concurrent increases in training volume does not increase central or peripheral arterial stiffness or alter aortic pressure wave characteristics in young subjects.

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4.3 ABNORMAL PRESSURE WAVE REFLECTION ACCELERATES THE DEVELOPMENT OF HYPERTENSION VIA THE INCREASE OF ARTERIAL STIFFNESS

Artery Research ◽

10.1016/j.artres.2017.10.041 ◽

2017 ◽

Vol 20 (C) ◽

pp. 56

Author(s):

Hirofumi Tomiyama ◽

Akira Yamashina ◽

Shunsuke Komatsu ◽

Kazuki Shiina ◽

Chisa Matsumoto ◽

...

Keyword(s):

Arterial Stiffness ◽

Pressure Wave ◽

Wave Reflection ◽

Abnormal Pressure

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Increased Wave Reflection Rather Than Central Arterial Stiffness Is the Main Determinant of Raised Pulse Pressure in Women and Relates to Mismatch in Arterial Dimensions

Journal of the American College of Cardiology ◽

10.1016/j.jacc.2009.04.068 ◽

2009 ◽

Vol 54 (8) ◽

pp. 695-703 ◽

Cited By ~ 84

Author(s):

Marina Cecelja ◽

Benyu Jiang ◽

Karen McNeill ◽

Bernet Kato ◽

James Ritter ◽

...

Keyword(s):

Arterial Stiffness ◽

Pulse Pressure ◽

Wave Reflection ◽

Main Determinant

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Leukocyte telomerase concentration is inversely associated with central wave reflection in patients with hypertension

European Heart Journal ◽

10.1093/eurheartj/ehab724.2277 ◽

2021 ◽

Vol 42 (Supplement_1) ◽

Author(s):

O S Pavlova ◽

T L Denisevich ◽

M I Belskaya ◽

E V Shafranovskaya ◽

S E Ogurtsova ◽

...

Keyword(s):

Family History ◽

Cardiovascular Diseases ◽

Arterial Stiffness ◽

Telomere Length ◽

Pulse Pressure ◽

Wave Reflection ◽

Augmentation Index ◽

History Of ◽

The Mean ◽

Depressive Episodes

Abstract Introduction Telomere length and telomerase are biomarkers of aging and cardiovascular diseases. Arterial stiffness is associated with vascular age and higher risk of cardiovascular diseases. Decreased reparative cell's potential may cause vascular ageing and predispose to the progression of hypertension. Objective To determine association leukocyte telomerase concentration (TC) and relative telomere length (RTL) with arterial stiffness in hypertensive patients. Material and methods The study included 120 people (70 patients with uncomplicated arterial hypertension (AH) and 50 normotensive individuals). Mean age of hypertensives was 54.8±9.3 and of normotensives was 50.2±9.73 years. Dietary habits, smoking, level of physical activity, body mass index, waist circumference, presence of obesity, blood pressure (BP) level, family history of cardiovascular deseases, depressive episodes and psychological stress according the international questionnaires, glucose; cholesterol, angiotensin II, renin and aldosteron in blood were assessed in the participants. Aortic BP, aortic pulse pressure, augmentation index (AIx), AIx adjusted for heart rate 75 beats per minute (Aix@HR75), pulse wave velocity (PWV) were determined by the applanation tonometry. RTL of peripheral blood leukocytes was performed by real-time PCR. The leukocyte TC was measured using the enzyme immunoassay. Results There were no differences between patients with AH and normotensives in both leukocyte TC (4.9 (4.0; 8.0) versus 6.2 (4.1; 9.4), p=0.281) and RTL (0.94 (0.86; 1.0) versus 0.96 (0.83; 1.0), p=0.978). In hypertensive and normotensive groups the mean systolic aortic BP were 130.6±17,7 and 109.9±11.7 mmHg (p<0.001), aortic pulse pressure – 41.5±9,7 and 33.6±10,4 mmHg (p<0.001), Aix@HR75 – 16.0 (7.0; 28.0) and 27.0 (13.0; 35.0)% (p=0.004), PWV –7.9±1.4 and 8.1±1,7 m/s (p=0.409) respectively. In patients with AH the mean leukocyte TC was lower with an increased Aix@75 (>25%) in contrast to the group of patients with normal Aix@75 (4.45 (3.9; 7.8) versus 7.97 (4.6; 10.0) ng/ml; p=0.043). Based on the multivariate logistic regression analysis independent factors influencing on the Aix@75 were leukocyte TC <5 ng/ml with the family history of AH (OR=1.9, 95% CI: 1.1–3.4; p=0.036), the degree of AH combined with decreased salt sensitivity (OR=3.1; 95% CI: 1.3–7.5; p=0.010) and age (OR=1.2; 95% CI: 1.1–1.2; p=0.001). Conclusions Decrease of the leukocyte telomerase concentration associated with the raise of augmentation index in patient with uncomplicated AH. As a parameter of central wave reflection the augmentation index may considered as an early sign of biological and vascular aging in hypertension. FUNDunding Acknowledgement Type of funding sources: Public grant(s) – National budget only. Main funding source(s): The state program of scientific research “Fundamental and applied sciences for medicine”

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