scholarly journals P1567 Left atrial function - association with left ventriculoarterial function in hypertensive patients

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
N Georgieva ◽  
A Borizanova - Petkova ◽  
E Kinova ◽  
A Goudev
Keyword(s):  
Arterial Stiffness ◽  
Pulse Wave Velocity ◽  
Left Atrium ◽  
Wave Velocity ◽  
Left Atrial ◽  
Pulse Wave ◽  
Systolic Pressure ◽  
Healthy Controls ◽  
Hypertensive Patients ◽  
Moderate Positive Correlation

Abstract BACKGROUND Vascular stiffness and left atrial volume index (LAVI) are predictors of cardiovascular complications in hypertensive patients. The correlation of left atrium (LA) with left ventricle (LV) – arterial functional changes has not been well established. PURPOSE To investigate the relationship between LA remodeling and ventriculoarterial function. METHODS We studied 70 consecutive middle-aged patients (54 ± 13 years), separated in two groups: 55 with mild to moderate hypertension and duration up to 5 years and 15 healthy controls. All parameters for arterial stiffness – 24-hour central systolic pressure (cSys24h), central pulse pressure (cPP24h), augmentation index 24h (Aix24h) and 24-hour pulse wave velocity (PWV24h) were measured non–invasively with oscillometric method by Mobil-O-graph PWA. All patients underwent standard two-dimentional echocardiography with Spackle tracking analysis for LA and LV global longitudinal strain (GLS). RESULTS Statistically significant differences in parameters of vascular stiffness were found in patients with hypertension in comparison with healthy controls: cSys24h (116.64 ± 10.52 vs. 108.4 ± 6.19 mm Hg, p < 0.001), cPP24h (47.64 ± 9.43 vs. 40.4 ± 4.98 mmHg, p < 0.001), PWV24h (8.59 ± 1.49 vs. 6.29 ± 0.91 m/s, p < 0.0001). Patients with hypertension have higher LV filling pressures: E/e ratio (9.62 ± 3.13 vs. 7.62 ± 1.58, p < 0.006), higher velocities of A–wave transmitral blood flow (85.15 ± 16.88 vs. 64.57 ± 13.76 cm/s, p < 0.0001), dilated LA (LAVI: 33.78 ± 10.68 vs. 24.96 ± 4.89 ml/m², p < 0.001) and reduced LA GLS (29.34 ± 3.45 vs. 41.33 ± 4.37%, p < 0.0001) in comparison to control group. There were no statistically significant differences in Aix24h and cardiac output between the two groups. There is moderate positive correlation between LAVI with cPP24h (r = 0.491, p < 0.0001) and cSys24h (r = 0.366, p < 0.004). We found moderate positive correlation between LAVI and LV mass index (r = 0.386, p < 0.002). PWV24h correlated moderately and positively with LAVI (r = 0.404, p< 0.0001), and negatively with LA GLS (r = -0.471, p < 0.0001). CONCLUSION: LA remodeling is determined by the high 24-hour values of non-invasively measured central systolic pressure and pulse wave velocity. The parameters of arterial stiffness - cSys24h, cPP24h correlate positively with LA. PWV24h correlates negatively with reservoir strain of the left atrium. Using the method in clinical practice can improve risk stratification and therapeutic management. Further investigations are needed for prognostic and therapeutic value of LA remodeling.

Is 24 hour central aortic pressure superior to single measurement of central aortic pressure in well controlled hypertensive patients

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
N Georgieva ◽  
A Borizanova-Petkova ◽  
E Kinova ◽  
A Goudev
Keyword(s):  
Arterial Stiffness ◽  
Pulse Wave Velocity ◽  
Wave Velocity ◽  
Pulse Wave ◽  
Systolic Pressure ◽  
Aortic Pressure ◽  
Single Measurement ◽  
Hypertensive Patients ◽  
Non Invasive ◽  
Central Aortic Pressure

Abstract Background Non-invasive measurements of 24 h ambulatory central aortic systolic pressure (24hCASP) is now feasible method than single measurement of CASP. There is growing interest in CASP as cardiovascular risk marker beyond conventional brachial blood pressure (BP). Pulse wave velocity estimates arterial stiffness, whereas CASP is representative of the BP in major organs. Purpose To evaluate non- invasive parameters for arterial stiffness using oscillometric method and to compare 24hCASP with single measurement of CASP in well-controlled hypertensive patients to detect target organ damage (TOD). Methods A total 95 patients (57±14 years) with hypertension, were separated in two groups: 22 patients with normal EA/Ees ratio (Arterial elastance (EA) and ventricular elastance (Ees)) and 73 hypertensive patients with decrease EA/Ees ratio, marker for ventriculo-arterial coupling. EA and Ees were calculated as and – systolic pressure/stroke volume and end-systolic pressure/end-systolic volume. Parameters for arterial stiffness – 24hCASP, ambulatory central systolic pressure (CASP), 24-hour pulse wave velocity (PWV24h) and ambulatory PWV were measured non-invasively with oscillometric method by Mobil-O-graph PWA. Results Statistically significant differences in parameters of vascular stiffness were found in patients with normal ventriculo-arterial coupling in comparison with disturbed EA/Ees: 24hCASP (107.64±9.19 vs. 116.64±16.7 mm Hg, p=0.02), CAP (117.45±9.26 vs. 128.42±16.15 mm Hg, p<0.0001). There were no statistically significant differences in PWV and PWV24h. Multiple regression analysis demonstrated that CAP (B=−0.264 p=0.003; 95% CI: −0.003–0.014) is independent predictor of TOD in hypertensive patients, than 24 hour central aortic pressure. Conclusion There is no superiority of 24hCASP than single measurment of CASP. CASP could predict preclinical damage and cardiovascular outcome. Funding Acknowledgement Type of funding source: None

scholarly journals COMPARATIVE ANALYSIS OF THE RESULTS IN ARTERIAL STIFFNESS BETWEEN TWO ASSESSMENT METHODS – SPHYGMOCOR AGAINST MOBIL-PULSE WAVE VELOCITY – IN HYPERTENSIVE PATIENTS

2021 ◽  
Vol 39 (Supplement 1) ◽  
pp. e114-e115
Author(s):  
João Marcos De M Zanatta ◽  
Fábio Dos S Ricardi ◽  
Tatiana De A Rubio ◽  
Elizabeth E S Cestário ◽  
Luciana N Cosenso-Martin ◽  
...  
Keyword(s):  
Comparative Analysis ◽  
Arterial Stiffness ◽  
Pulse Wave Velocity ◽  
Wave Velocity ◽  
Pulse Wave ◽  
Assessment Methods ◽  
Hypertensive Patients

scholarly journals Uric Acid and Vascular Damage in Essential Hypertension: Role of Insulin Resistance

Nutrients ◽  
2020 ◽  
Vol 12 (9) ◽  
pp. 2509
Author(s):  
Velia Cassano ◽  
Daniele Crescibene ◽  
Marta Letizia Hribal ◽  
Corrado Pelaia ◽  
Giuseppe Armentaro ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Uric Acid ◽  
Arterial Stiffness ◽  
Pulse Wave Velocity ◽  
Wave Velocity ◽  
Pulse Wave ◽  
Vascular Damage ◽  
Newly Diagnosed ◽  
Hypertensive Patients

Increased levels of uric acid (UA) have been shown to be correlated with many clinical conditions. Uric acid may adversely affect the insulin signalling pathway inducing insulin resistance (IR). Several studies report the association between arterial stiffness (AS), an early indicator of atherosclerosis, and UA. The purpose of the present study was to evaluate the association between UA and AS, considering the potential role of IR. We enrolled 1114 newly diagnosed, never-treated hypertensive patients. Insulin resistance was assessed by the homeostatic model assessment (HOMA) index. Arterial stiffness was evaluated as the measurement of the carotid–femoral pulse wave velocity (PWV). The study cohort was divided into subgroups, according to increasing tertiles of UA. The mean values of UA were 5.2 ± 1.6 mg/dL in the overall population. Pulse wave velocity was linearly correlated with UA (p < 0.0001), HOMA (p < 0.0001), high sensitivity C-reactive protein (p < 0.0001), systolic blood pressure (p < 0.0001) and LDL cholesterol (p = 0.005). Uric acid was the strongest predictor of PWV and was associated with the highest risk for increased AS. The interaction analysis showed that the joint effect of increased UA and HOMA was significantly higher than that expected in the absence of interaction under the additive model, indicating that the two biomarkers synergically interacted for promoting vascular damage. Our data showed that UA interacted with IR to increase AS in a large cohort of newly diagnosed, never-treated hypertensive patients.

Factors associated with increased pulse wave velocity in peritoneal dialysis patients

Open Medicine ◽  
2010 ◽  
Vol 5 (3) ◽  
pp. 381-386 ◽  
Author(s):  
Paweł Stróżecki ◽  
Rafał Donderski ◽  
Magdalena Grajewska ◽  
Elżbieta Marcinkowska ◽  
Michał Kozłowski ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Arterial Stiffness ◽  
Pulse Wave Velocity ◽  
Wave Velocity ◽  
Pulse Wave ◽  
Diabetic Patients ◽  
Healthy Controls ◽  
Dialysis Patients ◽  
Factors Associated ◽  
Peritoneal Transport

AbstractElevated pulse wave velocity (PWV) reflects increased arterial stiffness. Several studies have investigated PWV in peritoneal dialysis (PD) patients, but direct comparisons with healthy controls were not done. The potential influence of peritoneal transport characteristics on arterial stiffness in PD patients was suggested in recent studies. The aims of this study were to compare PWV in PD patients and healthy volunteers, and to investigate factors associated with increased PWV. The carotid-femoral PWV was measured in 28 PD patients and 28 healthy controls, matched for age and gender. A peritoneal equilibration test (PET) was performed in all PD patients. Based on the PET, patients were classified as: high transporters (H) (n=8), high-average (HA) (n=12), low-average (LA) (n=6), and low transporters (L) (n=2). Six of the PD patients were diabetic. PWV was significantly higher in the PD patients than in the controls (9,9±2,4 vs. 8,0±0,9; p=0,0004). In the PD group, PWV was higher in H/HA than in L/LA patients (10,4 ± 2,5 vs. 8,6 ± 1,0; p=0,008), but all the diabetic patients were in the H/HA group. PWV was significantly higher in diabetic than in non-diabetic PD patients (12,8 ± 2,0 vs. 9,1 ± 1,7; p=0,004). In the PD patients, significant positive correlations were found between PWV and: age, pulse pressure, Kt/V, and duration of PD therapy. In conclusion, the carotid-femoral PWV is elevated in peritoneal dialysis patients. Increased PWV in PD patients is associated with age, diabetic status, and longer duration of PD therapy, but not with this type of peritoneal transport.

scholarly journals AB0406 ASSOCIATION OF ENDOTHELIN-1 WITH PULSE WAVE VELOCITY IN SYSTEMIC SCLEROSIS PATIENTS

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 1231.2-1232
Author(s):  
A. Alvarez de Cienfuegos ◽  
L. Cantero-Nieto ◽  
J. A. García-Gómez ◽  
J. L. Callejas-Rubio ◽  
J. Martin Ibanez ◽  
...  
Keyword(s):  
Systemic Sclerosis ◽  
Connective Tissue ◽  
Arterial Stiffness ◽  
Pulse Wave Velocity ◽  
Wave Velocity ◽  
Pulse Wave ◽  
Serum Levels ◽  
Healthy Controls ◽  
Endothelin 1 ◽  
Female Patients

Background:Systemic sclerosis (SSc) is a multisystemic disease featured by vascular and immunological disorders along with an excessive accumulation of the components of the connective tissue that cause cutaneous sclerosis and fibrosis of different organs. The occurrence of endothelial dysfunction together with fibrosis indicates that endothelial cell-derived factors, such as endothelin-1 (ET-1), may have an important role in the pathogenesis of SSc. The upregulation of ET-1 activates inflammatory cells and leads to nitric oxide synthase inhibition associated with arterial stiffness.Objectives:The purpose of this study was to evaluate ET-1 serum levels in women with systemic sclerosis (SSc) compared with healthy controls and to examine possible associations between ET-1 and markers of arterial stiffness.Methods:This cross-sectional study was performed in San Cecilio Hospital, Granada (Spain) from November 2017 to May 2019. Sixty-two women with SSc and 62 age and sex matched healthy controls were enrolled in this study. Pulse Wave Velocity (PWV) was measured non-invasively along the carotid–femoral arterial segment. Serum ET-1 was analysed using indirect enzyme-linked immunosorbent assay (ELISA).Results:A total of 62 female patients were included in our study, with a mean (SD) age of 53 ± 10 years. The majority were Caucasian (90.5%). The mean disease duration was 8.8 ± 6.9 years. Forty-four (70.9%) patients had a limited form of the disease and 18 (29.1%) had a diffuse form.There was a significant difference in ET-1 serum levels between SSc female patients and healthy controls (28.4 ± 10.6 vs. 21.1 ± 11.7 pg/ml, p = 0.001). Serum levels of ET-1 were positively associated with PWV (r = 0.26, p < 0.05), within the study group. In addition, in the linear regression model, higher ET-1 concentrations were associated with higher PWV [β = 0.03 95% CI (0.001, 0.060); p < 0.05].Conclusion:This study shows that ET-1 serum levels are associated with PWV in women with SSc. Therefore, drugs that block ET-1 may be effective in reducing large artery stiffness in women with SSc, and thus cardiovascular risk.References:[1]LeRoy EC, Black C, Fleischmajer R, Jablonska S, Krieg T, Medsger TA Jr, et al. Scleroderma (systemic sclerosis): classification, bubsets and pathogenesis. J Rheumatol 1988; 15(2):202-205.[2]Shi-Wen X, Denton CP, Dashwood MR, Holmes AM, Bou-Gharios G, Pearson JD, et al. Fibroblast matrix gene expression and connective tissue remodeling: role of endothelin-1. J Invest Dermatol 2001; 116(3):417–425.[3]Heintz B, Dörr R, Gillessen T, Walkenhorst F, Krebs W, Hanrath P, et al. Do arterial endothelin 1 levels affect local arterial stiffness?. Am Heart J 1993; 126 (4): 987–989.[4]McEniery CM, Qasem A, Schmitt M, Avolio AP, Cockcroft JR, Wilkinson IB. Endothelin-1 regulates arterial pulse wave velocity in vivo. J Am Coll Cardiol 2003; 42 (11): 1975–1981.Disclosure of Interests:None declared

scholarly journals Brachial-Ankle Pulse Wave Velocity Is the Only Index of Arterial Stiffness That Correlates with a Mitral Valve Indices of Diastolic Dysfunction, but No Index Correlates with Left Atrial Size

2013 ◽  
Vol 2013 ◽  
pp. 1-7 ◽  
Author(s):  
Bryan Chow ◽  
Simon W. Rabkin
Keyword(s):  
Mitral Valve ◽  
Arterial Stiffness ◽  
Pulse Wave Velocity ◽  
Diastolic Dysfunction ◽  
Wave Velocity ◽  
Left Atrial ◽  
Pulse Wave ◽  
Ankle Brachial Index ◽  
Left Atrial Volume ◽  
Left Ventricular

The objective of this study was to determine the optimal assessment of arterial stiffness that relates to diastolic dysfunction. Forty-one patients had measurements of brachial-ankle pulse wave velocity (baPWV), carotid-femoral pulse wave velocity (cfPWV), ankle brachial index (ABI), pulse pressure (PP), and augmentation index (AIx). Diastolic dysfunction was evaluated by echocardiographic indices of the ratio of the peak early diastolic mitral valve velocity and the peak late diastolic velocity (E/Aratio), left atrial diameter, and left atrial volume indexes. There was a significant (P<0.05) correlation between baPWV andE/Aratio with an inverse relationship indicating that higher arterial stiffness was associated with greater diastolic dysfunction. In contrast, there was no significant correlation betweenE/Aratio and cfPWV, PP, ABI, or AIx. After multivariate analysis, the relationship between baPWV andE/Aratio remained significant (P<0.05), independent of age and systolic blood pressure (BP). There were no correlations between any index of vascular stiffness and left atrial dimension or volume. In summary, baPWV correlates with diastolic dysfunction, independent of a patient’s age and BP and is a better indicator of diastolic dysfunction than other indicators of arterial stiffness. baPWV has the utility of infering the presence of left ventricular diastolic dysfunction.

scholarly journals Pulse Wave Velocity as a Measure of Arterial Stiffness in Patients with Abdominal Aortic Aneurysm: A Systematic Review and Meta-Analysis

2021 ◽  
Author(s):  
Xiaofeng Chen ◽  
Hongliang Zhang ◽  
Yangyang Shi ◽  
Tingting Chen ◽  
Yang Zhang ◽  
...  
Keyword(s):  
Abdominal Aortic Aneurysm ◽  
Aortic Aneurysm ◽  
Arterial Stiffness ◽  
Pulse Wave Velocity ◽  
Wave Velocity ◽  
Subgroup Analysis ◽  
Pulse Wave ◽  
Meta Analysis ◽  
Healthy Controls ◽  
Abdominal Aortic

Abstract Background and objective: The relationship between pulse wave velocity (PWV) levels and abdominal aortic aneurysm (AAA) remains controversial. A meta-analysis was performed to establish whether vascular pulse wave velocity (PWV) as a measure of arterial stiffness is different in patients with abdominal aortic aneurysms and controls. Methods Pubmed, Embase, Cochrane and China National Knowledge Infrastructure (CNKI) were used for the meta-analysis with articles up to January 1, 2021. To compare PWV levels between AAA patients and healthy controls, pooled weighted mean difference (WMD) and its 95% confidence interval (Cl) were calculated. Subgroup analysis and funnel plots are used to assess the quality of the combined results to ensure a normal distribution of data with minimal bias. Study quality for eligible studies was assessed using the Agency For Health Care Research and Quality (AHRQ) inventory tool. Results Nine cross-sectional studies, which included 439 abdominal aortic aneurysm cases and 382 healthy subjects, met inclusion criteria and were eligible for meta-analysis. We found that PWV levels were significantly higher [WMD(95%Cl): 2.36(2.02,2.70)] in AAA patients than healthy controls. After subgroup analysis, it was found that age, sex, smoking and hypertension had significant effects on the PWV levels. The normal distribution of the Funnel plot analysis suggests a low risk for publication bias. Conclusion PWV levels were elevated in patients with AAA compared to healthy controls, with the effect on PWV altered by age, sex, smoking and hypertension. Our study suggests that abdominal aortic aneurysm is related to increased arterial stiffness.

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