scholarly journals Estimated pulse wave velocity improves risk stratification for all-cause mortality in patients with COVID-19

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Kimon Stamatelopoulos ◽  
Georgios Georgiopoulos ◽  
Kenneth F. Baker ◽  
Giusy Tiseo ◽  
Dimitrios Delialis ◽  
...  
Keyword(s):  
Arterial Stiffness ◽  
Risk Stratification ◽  
Pulse Wave Velocity ◽  
Wave Velocity ◽  
Prognostic Value ◽  
Pulse Wave ◽  
Hospitalized Patients ◽  
Core Model ◽  
Control Group ◽  
The Core

AbstractAccurate risk stratification in COVID-19 patients consists a major clinical need to guide therapeutic strategies. We sought to evaluate the prognostic role of estimated pulse wave velocity (ePWV), a marker of arterial stiffness which reflects overall arterial integrity and aging, in risk stratification of hospitalized patients with COVID-19. This retrospective, longitudinal cohort study, analyzed a total population of 1671 subjects consisting of 737 hospitalized COVID-19 patients consecutively recruited from two tertiary centers (Newcastle cohort: n = 471 and Pisa cohort: n = 266) and a non-COVID control cohort (n = 934). Arterial stiffness was calculated using validated formulae for ePWV. ePWV progressively increased across the control group, COVID-19 survivors and deceased patients (adjusted mean increase per group 1.89 m/s, P < 0.001). Using a machine learning approach, ePWV provided incremental prognostic value and improved reclassification for mortality over the core model including age, sex and comorbidities [AUC (core model + ePWV vs. core model) = 0.864 vs. 0.755]. ePWV provided similar prognostic value when pulse pressure or hs-Troponin were added to the core model or over its components including age and mean blood pressure (p < 0.05 for all). The optimal prognostic ePWV value was 13.0 m/s. ePWV conferred additive discrimination (AUC: 0.817 versus 0.779, P < 0.001) and reclassification value (NRI = 0.381, P < 0.001) over the 4C Mortality score, a validated score for predicting mortality in COVID-19 and the Charlson comorbidity index. We suggest that calculation of ePWV, a readily applicable estimation of arterial stiffness, may serve as an additional clinical tool to refine risk stratification of hospitalized patients with COVID-19 beyond established risk factors and scores.

scholarly journals Prognostic Value of Aortic Pulse Wave Velocity as Index of Arterial Stiffness in the General Population

Circulation ◽  
2006 ◽  
Vol 113 (5) ◽  
pp. 664-670 ◽  
Author(s):  
Tine Willum Hansen ◽  
Jan A. Staessen ◽  
Christian Torp-Pedersen ◽  
Susanne Rasmussen ◽  
Lutgarde Thijs ◽  
...  
Keyword(s):  
General Population ◽  
Arterial Stiffness ◽  
Pulse Wave Velocity ◽  
Wave Velocity ◽  
Prognostic Value ◽  
Pulse Wave ◽  
Aortic Pulse Wave Velocity

Evaluation of arterial stiffness and central blood pressure by oscillometric method in normotensive offspring of hypertensive parents

2021 ◽  
pp. 1-8
Author(s):  
Cansu Sivrikaya Yildirim ◽  
Pelin Kosger ◽  
Tugcem Akin ◽  
Birsen Ucar
Keyword(s):  
Blood Pressure ◽  
Arterial Stiffness ◽  
Pulse Wave Velocity ◽  
Diastolic Blood Pressure ◽  
Wave Velocity ◽  
Pulse Wave ◽  
Pulse Wave Analysis ◽  
Control Group ◽  
Study Group ◽  
Wave Analysis

Abstract Children with a family history of hypertension have higher blood pressure and hypertensive pathophysiological changes begin before clinical findings. Here, the presence of arterial stiffness was investigated using central blood pressure measurement and pulse wave analysis in normotensive children with at least one parent with essential hypertension. Twenty-four-hour ambulatory pulse wave analysis monitoring was performed by oscillometric method in a study group of 112 normotensive children of hypertensive parents aged between 7 and 18 comparing with a control group of 101 age- and gender-matched normotensive children of normotensive parents. Pulse wave velocity, central systolic and diastolic blood pressure, systolic, diastolic and mean arterial blood pressure values were higher in the study group than the control group (p < 0.001, p = 0.002, p = 0.008, p = 0.001, p = 0.005, p = 0.001, p = 0.001, respectively). In all age groups (7–10, 11–14, and 15–18 years), pulse wave velocity was higher in the study group than the control group (p < 0.001). Pulse wave velocity was higher in children whose both parents are hypertensive compared to the children whose only mothers are hypertensive (p = 0.011). Pulse wave velocity values were positively correlated with age, weight, height, and body mass index (p < 0.05). Higher pulse wave velocity, central systolic and diastolic blood pressure values detected in the study group can be considered as early signs of hypertensive vascular changes. Pulse wave analysis can be a reliable, non-invasive, and reproducible method that can allow taking necessary precautions regarding lifestyle to prevent disease and target organ damage by detecting early hypertensive changes in genetically risky children.

scholarly journals Change in the aortic pulse wave velocity in children with familial hypercholesterolemia

2021 ◽  
Vol 26 (6) ◽  
pp. 640-647
Author(s):  
L. F. Galimova ◽  
D. I. Sadykova ◽  
E. S. Slastnikova ◽  
D. I. Marapov
Keyword(s):  
Arterial Stiffness ◽  
Pulse Wave Velocity ◽  
Total Cholesterol ◽  
Familial Hypercholesterolemia ◽  
Wave Velocity ◽  
Pulse Wave ◽  
Aortic Pulse Wave Velocity ◽  
Main Group ◽  
Control Group ◽  
Healthy Children

Background. Familial hypercholesterolemia (FH) is the genetic disease characterized by an increase in the levels of total cholesterol and low density lipoproteins since childhood. The aim of the study was to assess arterial stiffness in children with heterozygous FH by measuring pulse wave velocity (PWV) in the aorta. Design and methods. The study involved 118 children. Of these, 60 healthy children were in the control group and 58 children with the diagnosis of heterozygous FH were included in the main group. Both groups were divided into 3 age subgroups: from 5 to 7 years old, from 8 to 12 years old and from 13 to 17 years old. The diagnosis of FH was made according to the British criteria by Simon Broome. The lipid profile was determined for all children, blood pressure was monitored daily with the estimate of the minimum, average and maximum PWV (PWVmin, PWVav, PWVmax) in aorta using oscillometric method. Results. In the younger age subgroup (5–7 years), there were no significant differences in PWV between main and control groups. In children aged 8–12 years, the main group was characterized by significantly higher values of maximum PWV compared to healthy peers — 5,1 [4,7–5,8] and 4,6 [4,45–5,05] m/s, respectively (p = 0,041). In group of children with FH aged 13–17 years, compared to the control group, a significant increase in the minimum PWV was observed — 4,7 [4,1–5,1] and 3,9 [3,5–4,1] m/s, respectively (p = 0,009), average PWV — 5,5 [4,8–6,4] and 4,5 [4,2–4,9] m/s, respectively (p = 0,009), and maximum PWV — 6,2 [5,7–7,55] and 5,4 [5,05–5,6] m/s, respectively (p = 0,007). Correlation analysis in patients with FH showed direct correlation between PWVmin, PWVav and PWVmax with total cholesterol (r = 0,46, r = 0,46 and r = 0,464, respectively, p < 0,001). Conclusions. Our study demonstrates an increase in the PWV in the aorta in children with FH compared with healthy peers from 8–12 years of age. There is a further progression of arterial stiffness with an increase in the minimum, average and maximum PWV most significant in the group of 13–17 years.

Maternal arterial stiffness in pregnancies affected by preeclampsia

2009 ◽  
Vol 297 (2) ◽  
pp. H759-H764 ◽  
Author(s):  
Christina Kaihura ◽  
Makrina D. Savvidou ◽  
James M. Anderson ◽  
Carmel M. McEniery ◽  
Kypros H. Nicolaides
Keyword(s):  
Arterial Stiffness ◽  
Pulse Wave Velocity ◽  
Wave Velocity ◽  
Wave Reflection ◽  
Pulse Wave ◽  
Augmentation Index ◽  
Applanation Tonometry ◽  
Control Group ◽  
Arterial Tree ◽  
Cross Sectional

Preeclampsia (PE) is characterized by an aberrant maternal cardiovascular adaptation to pregnancy and increased cardiovascular risk later on in life. The aim of this study was to compare the maternal wave reflections and arterial stiffness in women with established PE and those with normotensive pregnancies, after systematic adjustment for known confounders. This was a cross-sectional study involving 69 normotensive, pregnant women and 54 women with established PE. Maternal wave reflection (augmentation index) and pulse wave velocity of the carotid-radial and carotid-femoral parts of the arterial tree were assessed noninvasively using applanation tonometry. The measurements were adjusted for maternal age, heart rate, mean arterial pressure, and aortic time to wave reflection and expressed as multiples of the median (MoM) of the control group. In the PE group, compared with controls, there was an increase in the median pulse wave velocity of both the carotid to femoral [1.1, interquartile rage (IQR) 1.0–1.3 MoM vs. 0.9, IQR 0.9–1.0 MoM; P < 0.0001] and carotid to radial (1.0, IQR 0.9–1.1 MoM vs. 0.9, IQR 0.9–1.0 MoM; P = 0.01) parts of the arterial tree. In contrast, there were no significant differences between the two groups in the median augmentation index (0.9, IQR 0.7–1.1 MoM vs. 1.0, IQR 0.5–1.8 MoM; P = 0.46). In conclusion, we found that established PE is characterized by increased maternal arterial stiffness but not altered maternal wave reflection.

The evaluation of arterial stiffness of essential hypertension and white coat hypertension in children: a case-control study

2017 ◽  
Vol 28 (3) ◽  
pp. 403-408 ◽  
Author(s):  
Semiha Terlemez Tokgöz ◽  
Dilek Yılmaz ◽  
Yavuz Tokgöz ◽  
Bülent Çelik ◽  
Yasin Bulut
Keyword(s):  
Essential Hypertension ◽  
Arterial Stiffness ◽  
Pulse Wave Velocity ◽  
Wave Velocity ◽  
Pulse Wave ◽  
Augmentation Index ◽  
White Coat ◽  
White Coat Hypertension ◽  
Control Group ◽  
Healthy Children

AbstractBackgroundThe aim of this study was to determine and compare cardiovascular risks by assessing arterial stiffness in children with essential hypertension and white coat hypertension.MethodsPaediatric patients followed up with essential hypertension and white coat hypertension diagnoses and with no established end organ damage were involved in the study. Arterial stiffness in children included in the study was evaluated and compared by using the oscillometric device (Mobil-O-Graph) method.ResultsA total of 62 essential hypertension (34 male, 28 female), 38 white coat hypertension (21 male, 17 female), and 60 healthy controls (33 male, 27 female) were assessed in the present study. Pulse wave velocity of the essential hypertension, white coat hypertension, and control group was, respectively, as follows: 5.3±0.6 (m/s), 5.1±0.4 (m/s), 4.3±0.4 (m/s) (p<0.001); augmentation index outcomes were, respectively, determined as follows: 21.3±6.5, 19.3±6.4, 16.0±0.3 (p<0.001). Pulse wave velocity and augmentation index values of children with essential hypertension and white coat hypertension were found to be higher compared with the control group. This level was identified as correlated with the duration of hypertension in both patient groups (p<0.01).ConclusionArterial stiffness in children with essential hypertension and white coat hypertension was impaired compared with healthy children. This finding has made us think that white coat hypertension is not an innocent clinical situation. This information should be taken into consideration in the follow-up and treatment approaches of the patients.

scholarly journals Body Mass Index or Waist-Hip Ratio, Which Correlated With Arterial Stiffness Based on Brachial-Ankle Pulse Wave Velocity in Chinese Rural Adults With Hypertension?

2021 ◽  
Author(s):  
Feng Hu ◽  
Rihua Yu ◽  
Fengyu Han ◽  
Juan Li ◽  
Wei Zhou ◽  
...  
Keyword(s):  
Arterial Stiffness ◽  
Pulse Wave Velocity ◽  
Wave Velocity ◽  
Central Obesity ◽  
Pulse Wave ◽  
Control Group ◽  
Forest Plot ◽  
General Obesity ◽  
Waist Hip Ratio ◽  
Rural Adults

Abstract Background: The aim of this study was to investigate the association betweenbody mass index (BMI), waist-hip ratio (WHR) and arterial stiffness (AS) based on brachial-ankle pulse wave velocity (baPWV) in Chinese rural adults with hypertension.Methods: In this analysis, selected 5,049 Chinese rural adults with hypertension were divided into three groups according to BMI ( <24 kg/m2, control; 24‐28 kg/m2, overweight; and ≥28 kg/m2, obesity), WHR ≥0.9 for male and ≥0.85 for female was defined as central obesity, while baPWV ≥18.0 m/s was considered as increased AS. Multivariate analysis was used to examine the association between BMI, WHR (central obesity) and AS based on baPWV in different models. Furthermore, the generalized additive model and smooth curve fitting was used to visually show the relationship between BMI or WHR with baPWV. Finally, to ensure the robustness between BMI group or central obesity with increased AS, we also did the subgroup analyses that were performed using stratified multivariate regression and interaction analyses and presented in tabulated form or forest plot.Results: The prevalence of overweight, general obesity, central obesity and increased AS were 32.62%, 8.58%, 63.85% and 44.01%, respectively. In comparsion with control group, there are a statistically significant lower prevalence of increased AS in population with overweight or general obesity (adjusted-OR: 0.78, 95% CI 0.65 to 0.92, P <0.001; adjusted-OR: 0.54, 95% CI 0.40 to 0.72, P <0.001, respectively; P for trend <0.001). Whereby in comparsion with non-central obesity group, there are an statistically significant higher prevalence of increased AS in population with central obesity (adjusted-OR: 1.54, 95% CI 1.30 to 1.83, P <0.001). The multivariate analyses indicated that BMI was negatively associated with baPWV (adjusted-β per SD increase: -0.49, 95% CI -0.60 to -0.38, P <0.001). In comparsion with control group, there are an statistically significant inversely relationship between BMI and baPWV in population with overweight or general obesity (adjusted-β: -0.55, 95% CI -0.75 to -0.35, P <0.001; adjusted-β: -1.00, 95% CI -1.32 to -0.67, P <0.001, respectively; P for trend <0.001). On the contrary, WHR was positively associated with baPWV (adjusted-β per SD increase: 0.27, 95% CI 0.17 to 0.38, P <0.001). In comparsion with non-central obesity group, there are a statistically significant positively relationship between WHR and baPWV in population with central obesity (adjusted-β: 0.55, 95% CI 0.34 to 0.75, P <0.001).Conclusion: We found that there was an inversely relationship between BMI and baPWV or increased AS, whereas WHR or central obesity is positively associated with baPWV and increased AS in Chinese rural adults with hypertension.

scholarly journals Assessment of arterial stiffness affected by atorvastatin in coronary artery disease using pulse wave velocity

2009 ◽  
Vol 32 (6) ◽  
pp. 238 ◽  
Author(s):  
Xiao Meng ◽  
Liangyi Qie ◽  
Yuanyuan Wang ◽  
Ming Zhong ◽  
Li Li
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Arterial Stiffness ◽  
Pulse Wave Velocity ◽  
Wave Velocity ◽  
Pulse Wave ◽  
Density Lipoprotein ◽  
Lipid Lowering ◽  
Control Group ◽  
Artery Disease

Purpose: Several studies have shown arterial stiffness changes associated with coronary artery disease (CAD). Recently, statins were reported to improve arterial stiffness. The aim of the study was to evaluate the effect of atorvastatin on arterial stiffness in CAD patients using pulse wave velocity (PWV). Methods: We evaluated 63 patients with hyperlipemia and CAD. Forty-three patients were given 10mg atorvastatin daily and 20 patients were assigned to a low-fat diet. Carotid-femoral PWV (PWV-CF), carotid-radial PWV (PWV-CR) and carotid-distal PWV (PWV-CD) were measured in all patients. Results: Compared with baseline, PWV-CF, PWV-CR and PWV-CD decreased after therapy in the atorvastatin group (13.22±3.39 & 11.85±2.87; 11.85±2.72 & 10.73±2.31; and 11.04±1.99 & 10.15±1.75, P < 0.05). There was no difference in the control group (13.29±2.89 & 13.93±2.89; 11.52±2.25 & 12.31±2.22; and 10.46±1.86 & 11.15±1.85, P > 0.05). After treatment, values of total cholesterol, triglyceride and low density lipoprotein (LDL) cholesterol were reduced in the 2 groups (P < 0.05). Conclusions: The study demonstrated that atorvastatin can improve arterial stiffness in CAD patients independent of its lipid-lowering properties.

scholarly journals E-cigarettes and cigarettes worsen peripheral and central hemodynamics as well as arterial stiffness: A randomized, double-blinded pilot study

2018 ◽  
Vol 23 (5) ◽  
pp. 419-425 ◽  
Author(s):  
Klaas Frederik Franzen ◽  
Johannes Willig ◽  
Silja Cayo Talavera ◽  
Moritz Meusel ◽  
Friedhelm Sayk ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Arterial Stiffness ◽  
Pulse Wave Velocity ◽  
Wave Velocity ◽  
Pulse Wave ◽  
Electronic Cigarettes ◽  
Electronic Cigarette ◽  
Control Group ◽  
Cardiovascular Risks

The introduction of electronic cigarettes has led to widespread discussion on the cardiovascular risks compared to conventional smoking. We therefore conducted a randomized cross-over study of the acute use of three tobacco products, including a control group using a nicotine-free liquid. Fifteen active smokers were studied during and after smoking either a cigarette or an electronic cigarette with or without nicotine (eGo-T CE4 vaporizer). Subjects were blinded to the nicotine content of the electronic cigarette and were followed up for 2 hours after smoking a cigarette or vaping an electronic cigarette. Peripheral and central blood pressures as well as parameters of arterial stiffness were measured by a Mobil-O-Graph® device. The peripheral systolic blood pressure rose significantly for approximately 45 minutes after vaping nicotine-containing liquid ( p<0.05) and for approximately 15 minutes after smoking a conventional cigarette ( p<0.01), whereas nicotine-free liquids did not lead to significant changes during the first hour of follow-up. Likewise, heart rate remained elevated approximately 45 minutes after vaping an electronic cigarette with nicotine-containing liquid and over the first 30 minutes after smoking a cigarette in contrast to controls. Elevation of pulse wave velocity was independent from mean arterial pressure as well as heart rate in the electronic cigarette and cigarette groups. In this first of its kind trial, we observed changes in peripheral and central blood pressure and also in pulse wave velocity after smoking a cigarette as well as after vaping a nicotine-containing electronic cigarette. These findings may be associated with an increased long-term cardiovascular risk.

scholarly journals AB0264 ARTERIAL STIFFNESS IN RHEUMATOID ARTHRITIS PATIENTS AS A POTENTIAL PREDICTOR OF EARLY CARDIOVASCULAR AGEING AND MORBIDITY

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1430.2-1431
Author(s):  
M. Schubertová ◽  
A. Smržová ◽  
P. Horak ◽  
M. Skácelová ◽  
E. Lokočová ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Risk Factors ◽  
Risk Factor ◽  
Arterial Stiffness ◽  
Pulse Wave Velocity ◽  
Disease Activity ◽  
Wave Velocity ◽  
Pulse Wave ◽  
Control Group ◽  
Cvd Risk

Background:Cardiovascular disease (CVD) is one of the most common causes of death in Rheumatoid arthritis patients. Increased arterial stiffness is considered as an independent risk factor of development CVD and a predictor of all-cause morbidity and mortality. Increased arterial stiffness, due to premature vascular ageing, can be observed in patients with chronic inflammatory diseases as well as in RA patients.Objectives:To evaluate arterial stiffness determined as carotid – femoral pulse wave velocity in rheumatoid arthritis patients. The comparison of traditional and nontraditional risk factor of CVD, disease activity and laboratory findings connected with subclinical atherosclerotic changes.Methods:We evaluated data of 50 patients with rheumatoid arthritis (39 females, 11male, mean age 57, mean duration of disease of 13years). The arterial stiffness, measured as carotid – femoral pulse wave velocity (PWV), was established with the SphygmoCor system. This non-invasive technique uses the principle of applanation tonometry. Our control group counted 25 heathy male and females with no history of CVD or autoimmune disease. We evaluated the influence of traditional risk factors for CVD as age, smoking, BMI, lipid profile, diabetes mellitus, history of CV and cerebrovascular morbidity to PWV in RA patients. Non-traditional risk factors contained Adiponectin, Fetuin A, Endothelin-1 and Asymmetric dimethylarginine. To measure disease activity was used DAS 28 and inflammatory parameters as a marker of current disease activity. For chronic changes was used X-ray of small joints. Results were correlated with PWV and statistically evaluated.Results:Mean PWV in Rheumatoid arthritis patients was significantly higher (9.7 m/s) than that in healthy control group (6.7m/s). 49% of RA patients (n= 24) had increased arterial stiffness according to their age. 32% patients (n=16) with PWV over 10m/s that indicates aortal function alteration. We didn´t find correlation between arterial stiffness and traditional and non-traditional CVD risk factors. Increased PWV was not associated with high disease activity. Patients with higher arterial stiffness according to their age had longer RA history, higher level of rheumatoid factor, were more frequently anti-citrullinated protein antibodies (ACPA) negative and were more frequently treated with biological therapy.Conclusion:Rheumatoid arthritis patients are in increased risk of CV disease. PWV is considered as an independent risk factor of CVD. We proved increased arterial stiffness and vascular ageing in comparison to healthy controls. We did not find correlation between increased arterial stiffness and disease activity. All CVD risk factor intervention is necessary to improve the prognosis of patients. Further investigation is needed to establish the role of increased PWV in RA patients.References:[1]Reference Values for Arterial Stiffness’ Collaboration. Determinants of pulse wave velocity in healthy people and in the presence of cardiovascular risk factors: ‘establishing normal and reference values’.Eur Heart J. 2010;31(19):2338–2350.[2]Pasquale Ambrosino, Marco Tasso, Roberta Lupoli, Alessandro Di Minno, Damiano Baldassarre, Elena Tremoli & Matteo Nicola Dario Di Minno. Non-invasive assessment of arterial stiffness in patients with rheumatoid arthritis: A systematic review and meta-analysis of literature studies, Annals of Medicine, 2015; 47:6, 457-467.Acknowledgments:IGA_LF_2019_006, MZ Č-RVO (FNOL-00098892, 87-21)Disclosure of Interests:Markéta Schubertová: None declared, Andrea Smržová: None declared, Pavel Horak Speakers bureau: Pfizer, Abbvie, Eli lilly. Novartis, Roche, Sanofi, Martina Skácelová: None declared, Eva Lokočová: None declared, Zuzana Heřmanová: None declared, František Mrázek: None declared

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