scholarly journals Opisthenar microvessel area as a sensitive predictive index of arterial stiffness in hypertensive patients

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Zhen Yi Guo ◽  
Chen Chen ◽  
Xin Jin ◽  
Zai Hao Zhao ◽  
Lan Cui ◽  
...  
Keyword(s):  
Arterial Stiffness ◽  
Pulse Wave ◽  
Ankle Brachial Index ◽  
Significant Risk ◽  
Significant Risk Factor ◽  
Operating Characteristics ◽  
Predictive Index ◽  
Characteristics Analysis ◽  
Receiver Operating Characteristics Analysis ◽  
Exercise Status

AbstractWe aimed to analyze whether opisthenar microvessel area (OMA, measured with Optical Coherence Tomography (OCT) angiography) was associated with blood pressure (BP), arterial stiffness and whether OMA can predict arterial stiffness in hypertensive (HTN) patients. Results from 90 participants showed that BP, brachial-ankle pulse wave velocity (baPWV) and ankle brachial index (ABI) were significantly higher but OMA (in control, with cold- and warm-stimulation, NT, CST, HST and the differences, CSD, HSD) were significantly reduced in HTN group (n = 36) compared to non-HTN (n = 54). NT, CST, HST and HSD showed negative correlations with baPWV and ABI in all participants, female (n = 47) and male group (n = 43), but the correlation was absent when the participants were divided into HTN and non-HTN. Logistic Regression analysis showed that only baPWV was a significant risk factor for HSD (OR 19.7, 95%CI 4.959–78.733, p < 0.0001) but not the age, BMI, smoking, drinking or exercise status (p > 0.05). Receiver Operating Characteristics analysis for HSD was 0.781, 0.804, 0.770, respectively. HSD < 9439.5 μm2 predicted high BP and arterial stiffness (95% CI in all participants: baPWV, 0.681–0.881, SBP, 0.709–0.900, DBP, 0.672–0.867, p < 0.001). These results suggest that OMA is a sensitive index to predict arterial stiffness in HTN population.

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

Circulation ◽  
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

scholarly journals Central Blood Pressure and Chronic Kidney Disease Progression

2011 ◽  
Vol 2011 ◽  
pp. 1-7 ◽  
Author(s):  
Debbie L. Cohen ◽  
Raymond R. Townsend
Keyword(s):  
Risk Factors ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Disease Progression ◽  
Pulse Wave ◽  
Significant Risk ◽  
Significant Risk Factor ◽  
Chronic Kidney Disease Progression ◽  
Patients At Risk ◽  
Kidney Disease Progression

Hypertension, diabetes, and proteinuria are well-recognized risk factors for progressive kidney function loss. However, despite excellent antihypertensive and antidiabetic drug therapies, which also often lower urinary protein excretion, there remains a significant reservoir of patients with chronic kidney disease who are at high risk for progression to end-stage kidney disease. This has led to the search for less traditional cardiovascular risk factors that will help stratify patients at risk for more rapid kidney disease progression. Among these are noninvasive estimates of vascular structure and function. Arterial stiffness, manifested by the pulse wave velocity in the aorta, has been established in a number of studies as a significant risk factor for kidney disease progression and cardiovascular endpoints. Much less well studied in chronic kidney disease are measures of central arterial pressures. In this paper we cover the physiology behind the generation of the central pulse wave contour and the studies available using these approaches and conclude with some speculations on the rationale for why measurements of central pressure may be informative for the study of chronic kidney disease progression.

Gram-Negative Ventriculostomy-Associated Infections Predict Shunt Dependency in Stroke Diagnoses and Other Brain Injuries

2021 ◽  
Author(s):  
Santiago R Unda ◽  
Hamad Mousa ◽  
Kevin Labagnara ◽  
Jessie Birnbaum ◽  
Neranjan de Silva ◽  
...  
Keyword(s):  
Odds Ratio ◽  
Brain Injuries ◽  
Independent Predictor ◽  
Infection Rates ◽  
Operating Characteristics ◽  
Gram Negative ◽  
Characteristics Analysis ◽  
Shunt Dependency ◽  
Receiver Operating Characteristics Analysis ◽  
Placement Type

Abstract BACKGROUND: Several predictors have been studied for shunt dependency after stroke and other brain injuries. However, little is known about the association between ventriculostomy-associated infections (VAIs) and impaired cerebrospinal fluid (CSF) outflow. Moreover, gram-negative (GN) VAIs induce a potent neuroinflammatory process and are clinically challenging to treat. OBJECTIVE: To assess if GN-VAIs predict ventriculoperitoneal shunt (VPS) dependency. METHODS: Retrospective analysis of postprocedure infection rates was performed in 586 patients with external ventricle drainage (EVD) placed on site between 2012 and 2018. We collected sex, age, stroke and nonstroke related, location of EVD placement, type of hospital, EVD duration, and EVD exchange. RESULTS: Among 586 patients requiring an EVD, 55 developed a VAI. Most were caused by gram-positive (GP) pathogens (61.8%). A total of 120 patients required a conversion from EVD to VPS. Patients with VAIs had higher rates of VPS placement (49.09% vs 17.65%, P &lt; .001), whereas patients with GN-VAIs had significantly higher rates of EVD conversion to VPS (77.78% vs 35.29%, P = .012) compared with GP-VAIs. The multivariate analysis showed that GN-VAIs were an independent predictor for shunt dependency (odds ratio = 12.896; 95% CI 3.407-48.82, P &lt; .001). In receiver operating characteristics analysis, those less than 44.5 yr of age and more than 12 d of EVD duration were identified as the best cutoff values to discriminate the development of GN-VAI. CONCLUSION: Patients who experience a GN VAI are in greater risk of impaired CSF outflow, thus requiring VPS placement.

scholarly journals Late-night and low-dose dexamethasone-suppressed cortisol in saliva and serum for the diagnosis of cortisol-secreting adrenal adenomas

2009 ◽  
Vol 161 (5) ◽  
pp. 747-753 ◽  
Author(s):  
Timo Deutschbein ◽  
Nicole Unger ◽  
Jakob Hinrichs ◽  
Martin K Walz ◽  
Klaus Mann ◽  
...  
Keyword(s):  
Low Dose ◽  
Serum Cortisol ◽  
Cortisol Secretion ◽  
Adrenal Incidentalomas ◽  
Operating Characteristics ◽  
Late Night ◽  
Free Cortisol ◽  
Characteristics Analysis ◽  
Receiver Operating Characteristics Analysis ◽  
Dexamethasone Suppression

ObjectiveIn patients with adrenal incidentalomas, hormonally active masses need to be considered, particularly cortisol-producing adenomas (CPA), aldosterone-producing adenomas, and pheochromocytomas. The screening for hypercortisolism relies on confirming excess cortisol secretion and insufficient suppression after dexamethasone. Because of its high correlation with free cortisol and its stress-free collection, salivary cortisol (SaC) may offer advantages over serum cortisol (SeC). We evaluated the value of SaC and SeC for the diagnosis of CPA.DesignComparative study between 2001 and 2006.MethodsThirty-eight patients with confirmed CPA were compared with 18 healthy subjects as well as 48 control patients suffering from aldosterone-producing adenomas (n=13), pheochromocytomas (n=16), or nonfunctioning adenomas (n=19). Sampling of saliva and serum was performed at 2300 and at 0800 h following low-dose dexamethasone suppression. Receiver operating characteristics analysis was used to calculate thresholds with at least 95% sensitivity for CPA.ResultsRegarding the cutoffs for late-night cortisol, SaC (4.8 nmol/l, sensitivity 97%, specificity 69%) was slightly more specific than SeC (115 nmol/l, sensitivity 97%, specificity 63%). In contrast, the cutoff for dexamethasone-suppressed SaC (3.7 nmol/l, sensitivity 97%, specificity 83%) was slightly less specific than SeC (94 nmol/l, sensitivity 97%, specificity 88%). However, the latter cutoffs demonstrated greater specificity when compared with the cutoffs for late-night cortisol.ConclusionThe diagnostic accuracy of SaC is as good as SeC. Owing to its higher specificity, dexamethasone-suppressed cortisol is preferable to late-night cortisol when screening for Cushing's syndrome in patients with adrenal incidentalomas.

scholarly journals More is not always better–lower estradiol to mature oocyte ratio improved IVF outcomes

2021 ◽  
Author(s):  
Nardin Aslih ◽  
Mediea Michaeli ◽  
Diana Mashenko ◽  
Adrian Ellenbogon ◽  
Oshrit Lebovitz ◽  
...  
Keyword(s):  
Ovarian Response ◽  
Fertilization Rate ◽  
Mature Oocyte ◽  
Clinical Pregnancy ◽  
Receiver Operating Characteristics ◽  
Operating Characteristics ◽  
Frozen Embryos ◽  
Characteristics Analysis ◽  
Receiver Operating Characteristics Analysis ◽  
Receiver Operating

Aim: To find a cutoff ratio of estradiol/metaphase II oocyte (E2/M2) ratio and to evaluate the correlation with patients' characteristics, embryo morphokinetics using EmbryoScope™ and IVF cycle outcomes. Material and Methods: For this retrospective cohort study, records of all fresh cycles that were cultured and scored by EmbryoScope™ were evaluated. The peak E2/M2 ratio was calculated on the day of human chorionic gonadotropin (hCG) administration and correlated to embryo morphokinetic quality and cycle outcomes. A receiver operating characteristics analysis was calculated for the E2/M2 ratio and clinical pregnancy rates. Results: A total of 2461 oocytes were collected from 319 patients. Receiver operating characteristics analysis revealed a cut-off of 204 as a discriminative point to predict clinical pregnancy with a sensitivity of 69.5% and specificity of 62.1% (P<0.001). E2/M2 >204 group were older, had higher E2 concentration, fewer M2 oocytes despite elevated gonadotrophin doses. E2/M2 ratio ≤ 204 was correlated with higher fertilization rate, better embryo quality, higher pregnancy and live birth rates, and more frozen embryos. Conclusion: E2/M2 ratio<204 yielded the best probability to achieve good quality embryos with good morphokinetic scores and better pregnancy outcomes and may be used to predict IVF cycle outcomes. Advanced maternal age and low ovarian response received higher concentrations of gonadotrophins, which resulted in higher E2/M2 ratio. Milder stimulation to those patients may improve their cycle outcomes.

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