0860 Pulse Wave Amplitude Drops During Sleep: Reference Values And Clinical Associations In A General Population

Abstract Study Objectives To explore the clinical significance of pulse wave amplitude (PWA)-drops during sleep as a biomarker for cardiometabolic disorders and describe their main characteristics in a general population sample. Methods Cross-sectional study of HypnoLaus cohort, in which 2162 individuals underwent clinical assessment and in-home full polysomnography. PWA-drops were derived from photoplethysmography and processed using a validated automated algorithm. Associations between PWA-drop features (index, mean duration, and mean area under the curve [AUC]) with hypertension, diabetes, and previous cardiovascular (CV) event were analyzed using multivariable-adjusted logistic regression. Results Two thousand one hundred forty-nine participants (59 ± 11 years, 51% women, 9.9% diabetes, 41.3% hypertension, 4.4% CV event) were included. Mean ± standard deviation (SD) of PWA-drop index, duration, and AUC during sleep were 51.0 ± 20.3 events/hour, 14.0 ± 2.7 seconds, and 527±115 %seconds, respectively. PWA-drop index was lower in women and decreased with age, while its mean duration and AUC increased in men and elderly. Overall, lower PWA-drop index, longer duration and greater AUC were associated with increased odds of hypertension, diabetes, or CV event after adjustment for confounders. Participants in the lowest quartile of mean duration-normalized PWA-drop index had a significantly higher odds ratio (OR) of hypertension (OR = 1.60 [1.19–2.16]), CV event (OR = 3.26 [1.33–8.03]), and diabetes (OR = 1.71 [1.06–2.76]) compared to those in the highest quartile. Similar results were observed for mean AUC-normalized PWA-drop index regarding hypertension (OR = 1.59 [1.19–2.13]), CV event (OR = 2.45 [1.14–5.26]) and diabetes (OR = 1.76 [1.10–2.83]). Conclusions PWA-drop features during sleep seem to be an interesting biomarker independently associated with cardiometabolic outcomes in the general population.

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Normal and reference values for cardiovascular magnetic resonance-based pulse wave velocity in the middle-aged general population

Journal of Cardiovascular Magnetic Resonance ◽

10.1186/s12968-021-00739-y ◽

2021 ◽

Vol 23 (1) ◽

Author(s):

Max J. van Hout ◽

Ilona A. Dekkers ◽

Jos J. Westenberg ◽

Martin J. Schalij ◽

Ralph L. Widya ◽

...

Keyword(s):

Blood Pressure ◽

Cardiovascular Magnetic Resonance ◽

Magnetic Resonance ◽

General Population ◽

Pulse Wave Velocity ◽

Wave Velocity ◽

Reference Values ◽

Pulse Wave ◽

Disease Risk ◽

Cardiovascular Disease Risk

Abstract Background Aortic stiffness, assessed through pulse wave velocity (PWV), is an independent predictor for cardiovascular disease risk. However, the scarce availability of normal and reference values for cardiovascular magnetic resonance imaging (CMR) based PWV is limiting clinical implementation. The aim of this study was to determine normal and reference values for CMR assessed PWV in the general population. Methods From the 2,484 participants of the Netherlands Epidemiology of Obesity (NEO) study that have available CMR-PWV data, 1,394 participants free from cardiovasculard disease, smokers or treatment for diabetes, hypertension or dyslipidaemia were selected (45–65 years, 51% female). Participants were divided into sex, age and blood pressure (BP) subgroups. Normal values were specified for participants with a BP < 130/80 mmHg and reference values for elevated BP subgroups (≥ 130/80 and < 140/90 mmHg; and ≥ 140/90 mmHg). Differences between groups were tested with independent samples t-test or ANOVA. Due to an oversampling of obese individuals in this study, PWV values are based on a weighted analysis making them representative of the general population. Results Normal mean PWV was 6.0 m/s [95% CI 5.8–6.1]. PWV increased with advancing age and BP categories (both p < 0.001). There was no difference between sex in normal PWV, however in the BP > 140/90 mmHg women had a higher PWV (p = 0.005). The interpercentile ranges were smaller for participants < 55 years old compared to participants ≥ 55 years, indicating an increasing variability of PWV with age. PWV upper limits were particularly elevated in participants ≥ 55 years old in the high blood pressure subgroups. Conclusion This study provides normal and reference values for CMR-assessed PWV per sex, age and blood pressure category in the general population.

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Abstract P294: Greater Peripheral Vasoconstriction During Mental Stress Predicts Adverse Cardiovascular Outcomes

Circulation ◽

10.1161/circ.137.suppl_1.p294 ◽

2018 ◽

Vol 137 (suppl_1) ◽

Author(s):

Jeong Hwan Kim ◽

Muhammad Hammadah ◽

Ibhar Al Mheid ◽

Kobina Wilmot ◽

Ronnie Ramadan ◽

...

Keyword(s):

Mental Stress ◽

Wave Amplitude ◽

Pulse Wave ◽

Smoking Status ◽

Left Ventricular ◽

Cardiovascular Outcomes ◽

Peripheral Vasoconstriction ◽

Pulse Wave Amplitude ◽

Digital Pulse ◽

Peripheral Arterial

Introduction: Peripheral arterial vasoconstriction during mental stress (MS) has been associated with mental stress-induced myocardial ischemia, which in turn has been linked with worse cardiovascular outcomes. It is unknown whether the magnitude of peripheral vasoconstriction with MS is predictive of long term outcomes. Hypothesis: We hypothesized that greater peripheral arterial vasoconstriction during MS would be associated with adverse events among patients with coronary artery disease (CAD). Methods: Four hundred sixty-three patients with stable CAD and normal left ventricular function, (age 63±9, 75% male, 27% Black, EF 60±8 %) underwent MS testing with a standardized public speaking stressor. Digital pulse wave amplitude was continuously measured at baseline and during MS using peripheral arterial tonometry (PAT), and the PAT ratio of pulse wave amplitude (during mental stress/ baseline) was calculated. Cox proportional hazard models were calculated to examine the association between the PAT ratio and outcomes. Results: Median PAT ratio during MS was 0.68, indicating 32% average constriction with MS compared to rest. Subjects with greater peripheral constriction [low (<median) PAT ratio] were more likely to be male (80% vs. 70%, P=0.008) compared to those with PAT ratio ≥median, but their risk factor profiles were similar. During 2.8±0.5 year follow-up, 64 patients had adverse cardiac events including 7 cardiovascular deaths, 19 MI, and 54 revascularization events. After adjusting for age, sex, race, hypertension, diabetes, current smoking status, and prior MI, those with low PAT ratio had a greater risk of CV death/MI (HR[hazard ratio] 2.49, 95% CI [1.04-5.99]) and CV death/MI/revascularization (HR 1.77, 95% CI [1.03-3.04]) compared to those with high PAT ratio. Conclusion: Greater peripheral arterial vasoconstriction with MS is associated with a higher risk of adverse cardiovascular outcomes in patients with CAD.

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Plethysmographic pulse wave amplitude and future leg arteriosclerosis

Atherosclerosis ◽

10.1016/0021-9150(94)05427-k ◽

1995 ◽

Vol 113 (1) ◽

pp. 55-62 ◽

Cited By ~ 6

Author(s):

M Ögren

Keyword(s):

Wave Amplitude ◽

Pulse Wave ◽

Pulse Wave Amplitude

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Environmental noise-induced cardiovascular responses during sleep

SLEEP ◽

10.1093/sleep/zsab302 ◽

2021 ◽

Author(s):

Bastien Lechat ◽

Hannah Scott ◽

Felix Decup ◽

Kristy L Hansen ◽

Gorica Micic ◽

...

Keyword(s):

Wind Farm ◽

Wave Amplitude ◽

Sound Pressure ◽

Noise Exposure ◽

Pulse Wave ◽

Traffic Noise ◽

Cardiovascular Responses ◽

Environmental Noise ◽

Pulse Wave Amplitude ◽

Sound Pressure Levels

Abstract Study Objectives This study was designed to test the utility of cardiovascular responses as markers of potentially different environmental noise disruption effects of wind farm compared to traffic noise exposure during sleep. Methods Twenty participants underwent polysomnography. In random order, and at six sound pressure levels from 33 dBA to 48 dBA in 3 dB increments, three types of wind farm and two types of road traffic noise recordings of 20-sec duration were played during established N2 or deeper sleep, each separated by 20 seconds without noise. Each noise sequence also included a no-noise control. Electrocardiogram and finger pulse oximeter recorded pulse wave amplitude changes from the pre-noise onset baseline following each noise exposure and were assessed algorithmically to quantify the magnitude of heart rate and finger vasoconstriction responses to noise exposure. Results Higher sound pressure levels were more likely to induce drops in pulse wave amplitude. Sound pressure levels as low as 39 dBA evoked a pulse wave amplitude response (Odds ratio [95% confidence interval]; 1.52 [1.15, 2.02]). Wind farm noise with amplitude modulation was less likely to evoke a pulse wave amplitude response than the other noise types, but warrants cautious interpretation given low numbers of replications within each noise type. Conclusion These preliminary data support that drops in pulse wave amplitude are a particularly sensitive marker of noise-induced cardiovascular responses during. Larger trials are clearly warranted to further assess relationships between recurrent cardiovascular activation responses to environmental noise and potential long-term health effects.

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Effect of heat-induced pain stimuli on pulse transit time and pulse wave amplitude in healthy volunteers

Physiological Measurement ◽

10.1088/0967-3334/37/1/52 ◽

2015 ◽

Vol 37 (1) ◽

pp. 52-66 ◽

Cited By ~ 4

Author(s):

Marit H N van Velzen ◽

Arjo J Loeve ◽

Minke C Kortekaas ◽

Sjoerd P Niehof ◽

Egbert G Mik ◽

...

Keyword(s):

Healthy Volunteers ◽

Transit Time ◽

Wave Amplitude ◽

Pulse Wave ◽

Pulse Transit Time ◽

Pulse Wave Amplitude ◽

Pain Stimuli

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Reactions to Cold Exposure Emphasize the Need for Weather Protection in Prehospital Care: An Experimental Study

Prehospital and Disaster Medicine ◽

10.1017/s1049023x00003940 ◽

2006 ◽

Vol 21 (5) ◽

pp. 316-320 ◽

Cited By ~ 7

Author(s):

Niina S. Lintu ◽

M. Health ◽

Matti A.K. Mattila ◽

Jaana A. Holopainen ◽

Mari Koivunen ◽

...

Keyword(s):

Tympanic Membrane ◽

Cold Exposure ◽

Room Temperature ◽

Wave Amplitude ◽

Pulse Wave ◽

Prehospital Care ◽

Emg Activity ◽

Pulse Wave Amplitude ◽

Vital Functions ◽

Skin Temperatures

AbstractIntroduction:Exposure to cold temperature is a serious but often neglected problem in prehospital care. It not only is an uncomfortable, subjective experience, but it also can cause severe disturbances in vital functions, gradually leading to hypothermia.Objective:The aim of this study was to examine healthy subjects'physiological and subjective reactions to cold exposure (30 minutes at -5°C in the a climatic chamber) while they were lying in a protective covering.Methods:Healthy volunteers (n = 20) participated in the experiment, which consisted of a 10-minute stabilization period of vital functions at room temperature (23°C), 30 minutes of cold exposure (-5°C), and a 30-minute recovery period at room temperature. Subjects lay supinely in protective covering during the entire experiment. Skin temperatures, oxygen saturation, pulse rates, pulse wave amplitude in the middle finger, and surface electromyography (EMG) activity of the major pectoral muscle were recorded continuously during the test. Before and immediately after the cold exposure, tympanic membrane temperatures were measured. In addition, subjects were asked to estimate cold using a standard scale.Results:During the cold exposure, the decrease in tympanic membrane temperature was not significant.The pulse wave amplitude in the finger decreased sharply upon entering the cold chamber. Skin temperatures, especially of the fingers and toes, decreased during the cold exposure.There were no clear signs of shivering in electromyographic recordings. Subjective cold feelings followed decreasing skin temperatures. Skin temperatures did not return quickly. Even 30 minutes after the exposure, all the skin temperatures still had not returnedto normal levels.However, subjective cold feeling was relieved immediately.Conclusions:Cold exposure provoked immediate protective vasoconstriction in the peripheral compartment, which caused linear decreases of local skin temperatures. This probably was triggered from the unprotected face and upper respiratory areas.

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Pulse wave amplitude reduction as a surrogate for cortical arousal during sleep hypopnea in children

Sleep Medicine ◽

10.1016/j.sleep.2017.02.027 ◽

2017 ◽

Vol 34 ◽

pp. 64-70

Author(s):

Alessandro Amaddeo ◽

Noria Medjahdi ◽

Marta Fernandez-Bolanos ◽

Sonia Khirani ◽

Guillaume Baffet ◽

...

Keyword(s):

Wave Amplitude ◽

Pulse Wave ◽

Cortical Arousal ◽

Pulse Wave Amplitude

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Normal and reference values for MRI-based pulse wave velocity in the middle-aged general population

European Heart Journal ◽

10.1093/ehjci/ehaa946.2319 ◽

2020 ◽

Vol 41 (Supplement_2) ◽

Author(s):

M.J.P Van Hout ◽

I.A Dekkers ◽

J.J.M Westenberg ◽

M.J Schalij ◽

R De Mutsert ◽

...

Keyword(s):

Blood Pressure ◽

General Population ◽

Pulse Wave Velocity ◽

Wave Velocity ◽

Reference Values ◽

Pulse Wave ◽

Funding Source ◽

Clinical Implementation ◽

Research Profile ◽

Cv Disease

Abstract Background Aortic stiffness, assessed through pulse wave velocity (PWV), is an independent predictor for cardiovascular (CV) risk. However, the scarce availability of normal and reference values for magnetic resonance imaging (MRI) based PWV is limiting clinical implementation. Purpose The aim of this study was to determine normal and reference values for MRI-PWV in the general population. Methods From the 2,484 participants of the NEO study that have available MRI-PWV data, we selected 1,639 participants that were free from CV disease or treatment for diabetes, hypertension or dyslipidaemia (age range 45–65 years, 51% male). Participants were categorized by sex, age and blood pressure (BP) subgroups. Normal values were specified for healthy (<130/80 mmHg) and elevated BP (≥130/80 and <140/90 mmHg) and reference values for high BP (≥140/90 mmHg) subgroups. Differences between groups were tested with either an independent samples t-test or ANOVA. Results Overall mean PWV was 6.5 m/s [95% CI 6.4–6.6]. PWV increased significantly with advancing age and BP categories (both p<0.001). There was no difference in PWV between men and women, however a stronger increasing trend for women above 55 years old was observed (figure). The 95% CI's were smaller for participants <55 years old as compared to participants >55, indicating an increasing variability of PWV with age. The elevated PWV upper limits for the higher blood pressure subgroups are particularly evident in participants above 55 years old. Conclusion This study provides normal and reference values for MRI-assessed PWV per sex, age and blood pressure category. PWV percentiles (10, 25, 50, 75 and 90th) Funding Acknowledgement Type of funding source: Public hospital(s). Main funding source(s): The NEO study is supported by the participating departments, the Division and the Board of Directors of the Leiden University Medical Centre, and by the Leiden University, Research Profile Area “Vascular and Regenerative Medicine”

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