scholarly journals Arterial stiffness and valvular calcifications in aortic stenosis: caught between a rock and a hard place

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
V Gardikioti ◽  
D Terentes-Printzios ◽  
K Aznaouridis ◽  
E Christoforatou ◽  
G Benetos ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Arterial Stiffness ◽  
Aortic Stenosis ◽  
Pulse Wave Velocity ◽  
Wave Velocity ◽  
Aortic Stiffness ◽  
Pulse Wave ◽  
Group 2 ◽  
Aortic Hemodynamics ◽  
Group 1

Abstract Background/Introduction Arterial stiffness and aortic hemodynamics are independent predictors of adverse cardiovascular events. Indications for transcatheter aortic valve implantation (TAVI) are expanding and aortic valve calcifications (AVC) are an important prognostic factor of the success of TAVI. Purpose We sought to investigate the associations between AVC and aortic vascular function/hemodynamics. Methods Fifty-two high-risk patients (mean age 80.4±8.5 years, 27 male) with severe symptomatic aortic stenosis undergoing TAVI were included. Arterial stiffness was estimated through carotid-femoral pulse wave velocity (cfPWV) and brachial-ankle pulse wave velocity (baPWV). Aortic hemodynamics (aortic pressures, aortic augmentation index corrected for heart rate [AIx@75]) were also measured. Measurements were conducted prior to the implantation and at discharge. In all patients, a native and contrast-enhanced multislice cardiac computed tomography were performed pre-interventionally. AVC were then graded semi-quantitatively as follows: grade 1 – no calcification; grade 2 – mildly calcified (small isolated spots); grade 3 – moderately calcified (multiple larger spots); grade 4 – severely calcified (extensive calcification of all cusps). Results Group 1 (subjects with none/mild AVC, n=29) did not significantly differ in age, gender and body-mass index compared to group 2 (subjects with moderate/severe AVC, n=23). As far as the traditional cardiovascular risk factors were concerned, only hypertension (p=0.008), coronary artery disease (p=0.016), atrial fibrillation (p=0.075) and insulin-dependent diabetes mellitus (p=0.068) were found to be more prevalent in group 2. Group 2 had significantly higher both cfPWV and baPWV (8.3±1.7 vs 7.2±1.2 m/s and 1750±484 cm/s vs. 2101±590 cm/s with p=0.008 and p=0.022 respectively) compared to Group 1 (Figure 1). Even after adjustment for age, gender and systolic blood pressure, aortic stiffness indices were higher in Group 2 compared to Group 1 (p=0.038 and p=0.048, respectively). There was no statistically significant difference in peripheral or aortic pressures as well as in wave reflections indices between the two groups. Conclusion Our study shows that in patients with aortic valve stenosis there is a correlation between increased aortic stiffness and a greater extent of damage of aortic valvular leaflets as well as calcifications. FUNDunding Acknowledgement Type of funding sources: None. Figure 1. PWV and aortic valve calcifications

scholarly journals Correlation between sclerostin and Dickkopf-1 with aortic arterial stiffness in patients with type 2 diabetes: A prospective, cross-sectional study

2018 ◽  
Vol 16 (3) ◽  
pp. 281-288 ◽  
Author(s):  
Hsin-Yu Yang ◽  
Du-An Wu ◽  
Ming-Chun Chen ◽  
Bang-Gee Hsu
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Arterial Stiffness ◽  
Pulse Wave Velocity ◽  
Wave Velocity ◽  
Aortic Stiffness ◽  
Pulse Wave ◽  
Dickkopf 1

Background: Sclerostin and Dickkopf-1 are extracellular inhibitors of the canonical Wnt/β-catenin signalling pathway, which is implicated in the development of arterial stiffness. However, the correlation between aortic stiffness and sclerostin or Dickkopf-1 levels in patients with type 2 diabetes mellitus is unknown. Methods: Fasting blood samples were collected from 125 patients with type 2 diabetes mellitus. Aortic stiffness was measured by carotid–femoral pulse wave velocity, and high aortic stiffness was defined by a carotid–femoral pulse wave velocity of >10 m/s. The serum sclerostin and Dickkopf-1 concentrations were determined using commercially available enzyme-linked immunosorbent assays. Results: In total, 46 patients with type 2 diabetes mellitus (36.8%) had high levels of aortic stiffness. Compared to the control group without aortic stiffness, this group was significantly older, had higher systolic and diastolic blood pressures, had higher blood urea nitrogen, creatinine, urinary albumin-to-creatinine ratio and serum sclerostin levels, and had significantly lower high-density lipoprotein cholesterol levels and estimated glomerular filtration rates. After adjusting for confounders, serum sclerostin [odds ratio = 1.005 (1.002–1.007), p = 0.002] levels remained an independent predictor of aortic stiffness. Multivariate analysis showed that the serum sclerostin level ( β = 0.374, adjusted R2 change = 0.221, p < 0.001) was positively associated with carotid–femoral pulse wave velocity. Conclusion: Serum levels of sclerostin, but not Dickkopf-1, are positively correlated with carotid–femoral pulse wave velocity and independently predict aortic stiffness in patients with type 2 diabetes mellitus.

scholarly journals The Effect of Antihypertensive Drugs on Arterial Stiffness and Central Hemodynamics: Not All Fingers are Made the Same

2013 ◽  
Vol 5 (1) ◽  
pp. 75-81 ◽  
Author(s):  
M. Doumas ◽  
E. Gkaliagkousi ◽  
N. Katsiki ◽  
A. Reklou ◽  
A. Lazaridis ◽  
...  
Keyword(s):  
Arterial Stiffness ◽  
Pulse Wave Velocity ◽  
Wave Velocity ◽  
Aortic Stiffness ◽  
Pulse Wave ◽  
Antihypertensive Drugs ◽  
Augmentation Index ◽  
Beta Blockers ◽  
The Other ◽  
Central Hemodynamics

Arterial stiffness and central hemodynamics attract increasing scientific interest within the hypertensive community during the last decade. Accumulating evidence indicates that aortic stiffness is a strong and independent predictor of cardiovascular events and all-cause mortality in hypertensive patients, and its predictive value extends beyond traditional risk factors. The role of central hemodynamics and augmentation index (a marker of reflected waves), remains less established and requires further investigation. Several lines of evidence indicate that antihypertensive therapy results in significant reductions of pulse wave velocity and central hemodynamics. However, beta-blockers seem to be the only exception with significant within-class differences. Conventional beta-blockers, although equally effective in reducing pulse wave velocity, seem to be less beneficial on central hemodynamics and augmentation index than the other antihypertensive drug categories, whereas the newer vasodilating beta-blockers seem to share the benefits of the other antihypertensive drugs. In conclusion, aortic stiffness seems ready for ‘prime-time’ in the management of essential hypertension, while further research is needed for central hemodynamics and augmentation index.

scholarly journals Cross-Sectional Relationship between Carotid-Femoral Pulse Wave Velocity and Biomarkers in Vascular-Related Diseases

2020 ◽  
Vol 2020 ◽  
pp. 1-8
Author(s):  
Jinbo Liu ◽  
Kuanting Wang ◽  
Huan Liu ◽  
Hongwei Zhao ◽  
Wei Huang ◽  
...  
Keyword(s):  
Pulse Wave Velocity ◽  
Wave Velocity ◽  
Healthy Subjects ◽  
Pulse Wave ◽  
Cross Sectional ◽  
Entire Study ◽  
Urine Albumin ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

Objectives. The present study was done to investigate the relationship between carotid-femoral pulse wave velocity (CFPWV) and biomarkers such as homocysteine (Hcy), N-terminal pro-brain natriuretic peptide (NT-proBNP), and urine albumin (microalbumin) (UAE) in vascular-related diseases. Methods. 656 subjects were enrolled into our study. There were 377 patients with hypertension, 231 with coronary heart disease, 154 with diabetes mellitus, and 186 healthy subjects. They were divided into four groups according to the number of suffered diseases: group 1 had only one of three diseases, group 2 had two, and group 3 had all of three diseases. CFPWV was measured by Complior apparatus. Results. CFPWV was significantly higher in group 3 than in the healthy group, group 1, and group 2 (12.71 ± 2.38 vs 10.11 ± 2.28, 10.70 ± 2.12, and 11.92 ± 2.55, all p<0.05). The level of Hcy was significantly higher in group1, group 2, and group 3 than in healthy subjects, respectively. Levels of Log NT-proBNP and Log UAE were significantly higher in group 3 than in group 1 (2.27 ± 0.4 vs 2.10 ± 0.4, 1.00 ± 0.65 vs 0.68 ± 0.56, both p<0.05). Positive correlation between CFWV and Hcy, Log UAE, and Log NT-proBNP was found in the entire study group (r = 0.109, 0.196, and 0.119, all p<0.05). Multivariate analysis showed that pulse pressure, age, fasting plasma glucose, diastolic blood pressure, body mass index, and Log UAE were independent associating factors of CFPWV in all subjects (β = 0.334, p<0.001; β = 0.333, p<0.001; β = 0.126, p=0.004; β = 0.137, p=0.003; β = −0.142, p=0.002; and β = 0.098, p=0.031). Conclusions. CFPWV was significantly higher in subjects with hypertension, CHD, and DM. There was correlation between CFPWV and biomarkers such as NT-proBNP, Hcy, and urine albumin (microalbumin).

scholarly journals MO147ASSOCIATION OF CHA2DS2-VASC SCORE WITH CAROTID-FEMORAL PULSE WAVE VELOCITY IN CHRONIC KIDNEY DISEASE PATIENTS

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Nina Vodošek Hojs ◽  
Robert Ekart ◽  
Sebastjan Bevc ◽  
Nejc Piko ◽  
Radovan Hojs
Keyword(s):  
Chronic Kidney Disease ◽  
Regression Analysis ◽  
Kidney Disease ◽  
Arterial Stiffness ◽  
Pulse Wave Velocity ◽  
Multiple Regression Analysis ◽  
Multiple Regression ◽  
Wave Velocity ◽  
Pulse Wave ◽  
Group 2

Abstract Background and Aims Chronic kidney disease (CKD) patients suffer from high cardiovascular morbidity and mortality. Arterial stiffness is an important parameter for the evaluation of cardiovascular risk. Carotid-femoral pulse wave velocity (cfPWV) is the gold standard measure for the assessment of arterial stiffness. CHA2DS2-VASc score was originally used to predict cerebral infarction in patients with atrial fibrillation (AF). However, it is also useful in predicting outcome in different cardiovascular conditions, independent of the presence of AF. Therefore, the aim of our research was to assess the association of CHA2DS2-VASc score with cfPWV in CKD patients. Method Eighty-seven non-dialysis CKD patients from our outpatient clinic were included. At the time of inclusion, medical history data and standard blood results were collected, CHA2DS2-VASc score was calculated, cfPWV measurements (SphygmoCor System) were done. Correlation between CHA2DS2-VASc score and cfPWV was assessed. Multiple regression analysis with cfPWV as dependent and CHA2DS2-VASc score, eGFR, urinary albumin/creatinine, haemoglobin, high sensitivity CRP, serum calcium, phosphate and intact PTH as independent variables was performed. Additionally, patients were divided into two groups according to median value of CHA2DS2-VASc score (group 1: CHA2DS2-VASc score ≤2, group 2: CHA2DS2-VASc score &gt;2). Data of both groups were compared by t-test or Mann-Whitney test. Results CHA2DS2-VASc score correlated with cfPWV (r=0.380, p=0.001). In multiple regression analysis only CHA2DS2-VASc score was significantly associated with cfPWV (p=0.001). Data of both groups of patients divided according to median value of CHA2DS2-VASc score are presented in table 1. cfPWV was significantly higher in group 2 (13.40±3.50 vs 10.46±2.93, p=0.001). Groups of patients also differed significantly in age, presence of diabetes, eGFR and serum phosphate. Conclusion CHA2DS2-VASc score is associated with cfPWV in CKD patients. Patients with a higher CHA2DS2-VASc score have stiffer arteries.

scholarly journals Chronic Kidney Disease and Pulse Wave Velocity: A Narrative Review

2019 ◽  
Vol 2019 ◽  
pp. 1-11 ◽  
Author(s):  
Nicole Lioufas ◽  
Carmel M. Hawley ◽  
James D. Cameron ◽  
Nigel D. Toussaint
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Arterial Stiffness ◽  
Pulse Wave Velocity ◽  
Wave Velocity ◽  
Cardiovascular Mortality ◽  
Aortic Stiffness ◽  
Pulse Wave

Chronic kidney disease (CKD) is associated with excess cardiovascular mortality, resulting from both traditional and nontraditional, CKD-specific, cardiovascular risk factors. Nontraditional risk factors include the entity Chronic Kidney Disease–Mineral and Bone Disorder (CKD-MBD) which is characterised by disorders of bone and mineral metabolism, including biochemical abnormalities of hyperphosphatemia and hyperparathyroidism, renal osteodystrophy, and vascular calcification. Increased arterial stiffness in the CKD population can be attributed amongst other influences to progression of vascular calcification, with significant resultant contribution to the cardiovascular disease burden. Pulse wave velocity (PWV) measured over the carotid-femoral arterial segments is the noninvasive gold-standard technique for measurement of aortic stiffness and has been suggested as a surrogate cardiovascular end-point. A PWV value of 10 m/s or greater has been recommended as a suitable cut-off for an increased risk of cardiovascular mortality. CKD is a risk factor for an excessive rate of increase in aortic stiffness, reflected by increases in PWV, and increased aortic PWV in CKD shows faster progression than for individuals with normal kidney function. Patients with varying stages of CKD, as well as those on dialysis or with a kidney transplant, have different biological milieu which influence aortic stiffness and associated changes in PWV. This review discusses the pathophysiology of arterial stiffness with CKD and outlines the literature on PWV across the spectrum of CKD, highlighting that determination of arterial stiffness using aortic PWV can be a useful diagnostic and prognostic tool for assessing cardiovascular disease in the CKD population.

scholarly journals Insulin Increases Central Aortic Stiffness in Response To Hyperglycemia in Healthy Humans: A Randomized Four-Way Crossover Study

2020 ◽  
Author(s):  
William B Horton ◽  
Linda A Jahn ◽  
Lee M Hartline ◽  
Kevin W Aylor ◽  
Eugene J Barrett
Keyword(s):  
Heart Rate ◽  
Arterial Stiffness ◽  
Pulse Wave Velocity ◽  
Crossover Study ◽  
Wave Velocity ◽  
Aortic Stiffness ◽  
Pulse Wave ◽  
Augmentation Index ◽  
Healthy Humans ◽  
Peripheral Arterial

Abstract Increasing arterial stiffness is a feature of vascular aging that is accelerated by conditions that enhance cardiovascular risk, including diabetes mellitus. Emerging evidence demonstrates that reversal of the normal lower central to higher peripheral arterial stiffness gradient predicts adverse cardiovascular consequences, including target organ damage. Preferential stiffening of central over peripheral arteries has been reported in type 2 diabetes, though mechanisms for this remain unclear. We tested the effect of acutely increasing plasma glucose, plasma insulin, or both on hemodynamic function, central aortic stiffness (carotid-femoral pulse wave velocity), and peripheral arterial stiffness (augmentation index) in a randomized, four-way, crossover study of 19 healthy young adults. Carotid-femoral pulse wave velocity increased only during hyperglycemic-hyperinsulinemia (+0.4 m/s; p=0.02), while augmentation index did not change significantly within any intervention (all p>0.05). Heart rate significantly increased only during hyperglycemic-hyperinsulinemia (+3.62 bpm; p=0.02). There was a significant inverse correlation between the changes of central and peripheral arterial stiffness only during hyperglycemic-hyperinsulinemia. We conclude that combined hyperglycemia and hyperinsulinemia acutely increased aortic stiffness, changed the normal central-to-peripheral arterial stiffness gradient, and increased heart rate in healthy humans. (ClinicalTrials.gov number NCT03520569; registered 9 May 2018).

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