Flow-mediated changes in pulse wave velocity: a new clinical measure of endothelial function

Introduction.Flow-mediated dilation (FMD), low flow-mediated constriction (L-FMC), and reactive hyperemia-related changes in carotid-to-radial pulse wave velocity (ΔPWVcr%) could offer complementary information about both “recruitability” and “resting” endothelial function (EF). Carotid-to-femoral pulse wave velocity (PWVcf) and pulse wave analysis-derived parameters (i.e., AIx@75) are the gold standard methods for noninvasive evaluation of aortic stiffness and central hemodynamics. If healthy pregnancy is associated with both changes in resting and recruitable EF, as well as in several arterial parameters, it remains unknown and/or controversial.Objectives.To simultaneously and noninvasively assess in healthy pregnant (HP) and nonpregnant (NP) women central parameters in conjunction with “basal and recruitable” EF, employing new complementary approaches.Methods.HP (n=11, 34.2 ± 3.3 weeks of gestation) and age- and cardiovascular risk factors-matched NP (n=22) were included. Aortic blood pressure (BP), AIx@75, PWVcf, common carotid stiffness, and intima-media thickness, as well as FMD, L-FMC, and ΔPWVcr %, were measured.Results.Aortic BP, stiffness, and AIx@75 were reduced in HP. ΔPWVcr% and FMD were enhanced in HP in comparison to NP. No differences were found in L-FMC between groups.Conclusion.HP is associated with reduced aortic stiffness, central BP, wave reflections, and enhanced recruitable, but not resting, EF.

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AS-261: Relationship between Noninvasive Predictors of Atherosclerosis: Endothelial Function, Carotid Artery Intima Media Thickness, Pulse Wave Velocity, and Nitroglycerin-Induced Headache in Patients with Chest Pain

The American Journal of Cardiology ◽

10.1016/j.amjcard.2009.01.318 ◽

2009 ◽

Vol 103 (9) ◽

pp. 110B

Author(s):

Suk Hee Cho ◽

Myung Ho Jeong ◽

Sang Chun Lim ◽

Young Ja Choi ◽

In Hyae Park ◽

...

Keyword(s):

Chest Pain ◽

Carotid Artery ◽

Pulse Wave Velocity ◽

Endothelial Function ◽

Wave Velocity ◽

Pulse Wave ◽

Intima Media Thickness ◽

Media Thickness

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Carotid-radial pulse wave velocity as an alternative tool for the evaluation of endothelial function during pregnancy: Potential role in identifying hypertensive disorders of pregnancy

2012 Annual International Conference of the IEEE Engineering in Medicine and Biology Society ◽

10.1109/embc.2012.6347264 ◽

2012 ◽

Cited By ~ 3

Author(s):

J. Torrado ◽

I. Farro ◽

F. Farro ◽

D. Bia ◽

Y. Zocalo ◽

...

Keyword(s):

Pulse Wave Velocity ◽

Endothelial Function ◽

Wave Velocity ◽

Potential Role ◽

Pulse Wave ◽

Radial Pulse ◽

Hypertensive Disorders Of Pregnancy ◽

Hypertensive Disorders

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Insulin Enhances Endothelial Function Throughout the Arterial Tree in Healthy But Not Metabolic Syndrome Subjects

The Journal of Clinical Endocrinology & Metabolism ◽

10.1210/jc.2015-3293 ◽

2016 ◽

Vol 101 (3) ◽

pp. 1198-1206 ◽

Cited By ~ 30

Author(s):

Linda A. Jahn ◽

Lee Hartline ◽

Nagashree Rao ◽

Brent Logan ◽

Justin J. Kim ◽

...

Keyword(s):

Cardiovascular Disease ◽

Metabolic Syndrome ◽

Pulse Wave Velocity ◽

Endothelial Function ◽

Wave Velocity ◽

Pulse Wave ◽

Plasma Concentrations ◽

Arterial Tree ◽

Conduit Artery ◽

Insulin Clamp

Abstract Context: Insulin reportedly impairs endothelial function in conduit arteries but improves it in resistance and microvascular arterioles in healthy humans. No studies have assessed endothelial function at three arterial levels in healthy or metabolic syndrome (METSYN) subjects. Objective: The objective of the study was to compare endothelial responsiveness of conduit arteries, resistance, and microvascular arterioles to insulin in healthy and METSYN subjects. Design: We assessed conduit, resistance, and microvascular arterial function in the postabsorptive and postprandial states and during euglycemic hyperinsulinemia (insulin clamp). Setting: The study was conducted at a clinical research unit. Participants: Age-matched healthy and METSYN subjects participated in the study. Interventions: We used brachial flow-mediated dilation, forearm postischemic flow velocity, and contrast-enhanced ultrasound to assess the conduit artery, resistance arteriole, and microvascular arteriolar endothelial function, respectively. We also assessed the conduit artery stiffness (pulse wave velocity and augmentation index) and measured the plasma concentrations of 92 cardiovascular disease biomarkers at baseline and after the clamp. Results: Postabsorptive and postprandial endothelial function was similar in controls and METSYN in all tested vessels. METSYN subjects were metabolically insulin resistant (P < .005). In controls, but not METSYN subjects, during euglycemic hyperinsulinemia, endothelial function improved at each level of arterial vasculature (P < .05 or less for each). Conduit vessel stiffness (pulse wave velocity) was increased in the METSYN group. Twelve of 92 biomarkers differed at baseline (P < .001) and remained different at the end of the insulin clamp. Conclusions: We conclude that insulin enhances arterial endothelial function in health but not in METSYN, and this vascular insulin resistance may underlie its increased cardiovascular disease risk.

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Impact of cardiovascular risk factors in vascular remodelling of pregnant women

European Heart Journal ◽

10.1093/eurheartj/ehab724.2901 ◽

2021 ◽

Vol 42 (Supplement_1) ◽

Author(s):

A F Ferreira ◽

M J Azevedo ◽

A P Machado ◽

F A Saraiva ◽

B Sampaio Maia ◽

...

Keyword(s):

Risk Factors ◽

Cardiovascular Risk ◽

Arterial Stiffness ◽

Pulse Wave Velocity ◽

Endothelial Function ◽

Pregnant Women ◽

Cardiovascular Risk Factors ◽

Wave Velocity ◽

Pulse Wave ◽

First Trimester

Abstract Introduction Pregnancy is a physiological condition of hemodynamic overload, characterized by a progressive reduction of peripheral vascular resistance, which normalizes postpartum. Purpose To characterize arterial stiffness and endothelial function during pregnancy and postpartum and to investigate the impact of cardiovascular (CV) risk factors. The secondary aim was to explore the potential association between pulse wave velocity (PWV) and risk for preeclampsia. Methods Prospective cohort study including volunteer pregnant women (healthy, obese and/or hypertensive) recruited in a tertiary centre between 2019 and 2020, at their 1st or 3rd trimester of pregnancy. Women were evaluated at the first trimester [10–15 weeks, baseline], third trimester [30–35 weeks, peak of CV remodelling] of pregnancy as well as at the 1st month and 6th month after delivery (CV reverse remodelling stages). The evaluation included clinical characterization through questionnaires as well as arterial stiffness and endothelial assessment by PWV and EndoPAT, respectively. Kruskal-Wallis H test and Friedman test were used as appropriate to between and within groups comparisons. Bonferroni correction was applied. Spearman correlation was performed to determine the relationship between PWV and risk for preeclampsia. Results We included 34 pregnant women with a median age of 34 [26; 41]years, 50% being hypertensive and/or obese. Arterial stiffness decreased significantly from the 1st to the 3rd trimester (6.3 [5.3 to 7.8] cm/s vs 5.6 [4.9 to 7.3] cm/s, p<0.001), normalizing only at the 6th months (5.6 [4.9 to 7.3] cm/s vs 6.3 [5.5 to 8.3] cm/s, p=0.001). A significant deterioration of endothelial function became evident from 1st to 3rd trimester (logarithm of reactive hyperemia index [lnRHI]: 0.74 [0.05 to 1.20] vs 0.45 [0.22 to 0.79], p=0.020). However, its slight amelioration begun only 6 months after delivery (3rd trimester: lnRHI 0.45 [0.22 to 0.79] vs 6 months at postpartum: lnRHI 0.53 [0.10 to 1.01], p>0.99). Compared to the healthy pregnant women, the CV risk factors group showed a higher pulse wave velocity only at the peak of CV remodelling (5.6 [5.3 to 7.3] cm/s vs 5.6 [4.9 to 7.2] cm/s, p=0.016), without any other differences in other parameters of time points evaluated. Pulse wave velocity at the first trimester revealed a positive association with risk for preeclampsia (r=0.485, p=0.026). Conclusion Our cohort presented a significant decrease in vascular resistance during pregnancy and normalization at the 6th month after delivery. Pregnant women with cardiovascular risk factors showed an increased arterial stiffness in the 3rd trimester compared to healthy pregnant women. Pulse wave velocity correlated positively with the risk for preeclampsia. FUNDunding Acknowledgement Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Universidade do Porto/FMUP and FSE-Fundo Social Europeu; FCT - Foundation for Science and Technology

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