THE INFLUENCES OF CARDIOVASCULAR PROPERTIES ON SUPRASYSTOLIC BRACHIAL CUFF WAVE STUDIED BY A SIMPLE ARTERIAL-TREE MODEL

It has been found that a pronounced secondary systolic peak appears on the oscillometric wave recorded by a brachial oscillometric cuff as cuff pressure is raised to a suprasystolic level. This finding has accordingly motivated some studies aimed to explore the potential value carried by the cuff wave for assessing arterial stiffness. However, so far, there remain considerable controversies in the literature regarding the cardiovascular properties that dominate the characteristics of the cuff wave. In this context, we developed a simple arterial-tree model and applied it to investigate the respective influence on the cuff wave of various cardiovascular properties and the associated wave interaction phenomena. It was found that (1) neither aortic stiffness nor brachial arterial stiffness can uniquely determine the time lag (Δt) between the first and secondary peaks of the cuff wave, although both of them significantly influence Δt; and (2) the BAIx (an index that characterize the height of the secondary peak relative to the first) is sensitive to most of the investigated cardiovascular properties and physiological conditions, such as arterial stiffness, intensity of wave reflection in the lower body and heart rate, etc. These findings suggest that the reliability of assessing aortic stiffness based solely on the timings and heights of the two peaks is limited. Moreover, we argued that the controversial findings presented in previous model-based studies are likely to be caused by limitations related to the research objectives or computation conditions of the studies.

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Maternal arterial stiffness in pregnancies affected by preeclampsia

AJP Heart and Circulatory Physiology ◽

10.1152/ajpheart.01106.2008 ◽

2009 ◽

Vol 297 (2) ◽

pp. H759-H764 ◽

Cited By ~ 61

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.

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Multimodal Assessment of Vascular and Ventricular Function in Children and Adults With Bicuspid Aortic Valve Disease

Frontiers in Cardiovascular Medicine ◽

10.3389/fcvm.2021.643900 ◽

2021 ◽

Vol 8 ◽

Author(s):

Constance G. Weismann ◽

Sara Ljungberg ◽

Anna Åkesson ◽

J Hlebowicz

Keyword(s):

Aortic Valve ◽

Arterial Stiffness ◽

Endothelial Function ◽

Diastolic Dysfunction ◽

Bicuspid Aortic Valve ◽

Aortic Stiffness ◽

Wave Reflection ◽

Pulse Wave ◽

Aortic Distensibility ◽

Cardiovascular Assessment

Background: Bicuspid aortic valve (BAV), the most common congenital cardiac anomaly, has been associated with an aortopathy, increased aortic stiffness and diastolic dysfunction. The involved mechanisms and impact of age remain unclear. It was the aim of this study to characterize arterial and cardiac function, their correlation, and the effect of age in children and adults with a history of BAV.Methods: Multimodal cardiovascular assessment included echocardiography, ascending aortic distensibility, common carotid intima media thickness [cIMT], parameters of wave reflection [central (cAIx75) and peripheral (pAIx75) augmentation index corrected to a heart rate of 75/min, aging index (AI)], carotid-femoral pulse wave velocity [cfPWV], and endothelial function (EndoPAT). Multivariable linear regression and correlation analyses were performed.Results: We included 47 BAV patients and 84 controls (age 8–65 years). Ascending aortic stiffness, pulse wave reflection (cAIx75, pAIx75, and AI) and central blood pressure were significantly increased in patients with BAV. However, PWV, cIMT, and endothelial function were not significantly different from controls. BAV patients had marginally reduced diastolic (E': β = −1.5, p < 0.001) but not systolic function compared to controls. Overall, all parameters of arterial stiffness had moderate-strong correlations with diastolic dysfunction and age. In the BAV group, ascending aortic distensibility had the strongest correlation with diastolic dysfunction.Conclusions: BAV is associated with increased proximal arterial stiffness and wave reflection. However, PWV and cIMT are not increased, and endothelial function is preserved. This suggests that the mechanism of arterial and cardiac stiffening is different from patients with acquired heart diseases.

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A longitudinal analysis of arterial stiffness and wave reflection in preeclampsia: identification of Changepoints

Metabolism ◽

10.1016/j.metabol.2021.154794 ◽

2021 ◽

pp. 154794

Author(s):

Kim Phan ◽

Ian Schiller ◽

Nandini Dendukuri ◽

Yessica-Haydee Gomez ◽

Jessica Gorgui ◽

...

Keyword(s):

Arterial Stiffness ◽

Longitudinal Analysis ◽

Wave Reflection

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ARTERIAL STIFFNESS AND WAVE REFLECTION ANALYSIS IN PATIENTS WITH ACUTE ISCHEMIC STROKE: 3B.06

Journal of Hypertension ◽

10.1097/01.hjh.0000378304.17747.6e ◽

2010 ◽

Vol 28 ◽

pp. e34-e35

Author(s):

A Rojek ◽

D Gasecki ◽

M Kwarciany ◽

W Kucharska ◽

W Nyka ◽

...

Keyword(s):

Ischemic Stroke ◽

Arterial Stiffness ◽

Acute Ischemic Stroke ◽

Wave Reflection

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Abdominal obesity vs general obesity for identifying arterial stiffness, subclinical atherosclerosis and wave reflection in healthy, diabetics and hypertensive

BMC Cardiovascular Disorders ◽

10.1186/1471-2261-12-3 ◽

2012 ◽

Vol 12 (1) ◽

Cited By ~ 74

Author(s):

Jose I Recio-Rodriguez ◽

◽

Manuel A Gomez-Marcos ◽

Maria C Patino-Alonso ◽

Cristina Agudo-Conde ◽

...

Keyword(s):

Arterial Stiffness ◽

Abdominal Obesity ◽

Wave Reflection ◽

Subclinical Atherosclerosis ◽

General Obesity

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Abstract MP100: Arterial Stiffness and Pressure Amplification Associated with Markers of Cerebral Microvascular Disease: The Atherosclerosis Risk in Communities Neurocognitive Study (ARIC-NCS)

Circulation ◽

10.1161/circ.133.suppl_1.mp100 ◽

2016 ◽

Vol 133 (suppl_1) ◽

Author(s):

Priya Palta ◽

Jingkai Wei ◽

Michelle Meyer ◽

Melinda C Power ◽

Jennifer A Deal ◽

...

Keyword(s):

Older Adults ◽

Arterial Stiffness ◽

Pulse Pressure ◽

Aortic Stiffness ◽

Brain Mri ◽

Intracranial Volume ◽

Sampling Weights ◽

Arterial Stiffening ◽

Lacunar Infarcts ◽

Pressure Amplification

Introduction: Small vessel disease is associated with decreased cognitive function, possibly differential by race. Age-related central arterial stiffening increases pulsatility resulting in hypoperfusion, microvascular damage and remodeling in the brain, potentially impairing cognition. We examined if arterial stiffness and pressure amplification are associated with lacunar infarcts and greater volumes of white matter hyperintensities (WMH) in a sample of Caucasian and African American (AA) older adults. Methods: We analyzed a cross-sectional sample of ARIC participants aged 67-90 years (n=1486) from visit 5 (2011-2013), with brain magnetic resonance imaging (MRI). The Omron VP-1000 Plus was used to measure aortic stiffness (carotid-femoral pulse wave velocity [cfPWV]) and pressure amplification measures (pulse pressure amplification [PPA], central pulse pressure [cPP], and estimated central systolic blood pressure [cSBP]). Aortic stiffness and pressure amplification were dichotomized at race-specific 25th percentile cut points. Brain MRI using 3D-1.5T equipment quantified the presence of lacunar infarcts and volumes of WMH following a standardized protocol. Logistic regression, adjusted for age, sex, education, ApoE4, heart rate, smoking and body mass index, was used to quantify the odds of lacunar infarcts in participants with high vs. low cfPWV, cPP, cSBP, and low vs. high PPA. Linear regression models, additionally adjusted for intracranial volume, estimated the difference in log-transformed volumes of WMH among participants with high vs. low cfPWV, cPP, cSBP, and low vs. high PPA. Probability sampling weights for an MRI were included to allow for generalizability to the full visit 5 cohort. Results: Among the 1486 participants with a brain MRI (mean age: 76, 41% male, 26% AA), measures of aortic stiffness and pressure amplification were associated with lacunar infarcts in Caucasians, but not in AAs. Caucasian participants with a high cfPWV had greater odds of lacunar infarcts (Odds Ratio [OR] =2.02, 95% confidence interval [CI]: 1.23, 2.20). Caucasians with high cSBP had higher odds of lacunar infarcts (OR=1.72, 95% CI: 1.10, 2.69). In Caucasians, high cfPWV was associated with a 21% (95% CI: 6, 38) greater volume of WMH as compared to a low cfPWV; high cSBP was associated with a 28% (95% CI: 14, 45) greater volume of WMH compared to a low cSBP. In AAs, high cfPWV was associated with a 32% (95% CI: 7, 62) greater volume of WMH as compared to low cfPWV. Cerebral microvascular imaging markers did not differ quantitatively with measures of PPA and cPP. Conclusions: Central arterial stiffening and pressure amplification are plausible microvascular contributors to cognitive aging, providing new information on modifiable pathways for previously observed associations between cardiovascular disease risk factors and the rates of cognitive decline and dementia among older adults.

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Toward a noninvasive subject-specific estimation of abdominal aortic pressure

AJP Heart and Circulatory Physiology ◽

10.1152/ajpheart.01154.2007 ◽

2008 ◽

Vol 295 (3) ◽

pp. H1156-H1164 ◽

Cited By ~ 2

Author(s):

Carl-Johan Thore ◽

Jonas Stålhand ◽

Matts Karlsson

Keyword(s):

Aortic Pressure ◽

Processing Technique ◽

Distributed Model ◽

Specific Information ◽

Peripheral Artery ◽

Tree Model ◽

Signal Processing Technique ◽

Arterial Tree ◽

One Dimensional ◽

Abdominal Aortic

A method for estimation of central arterial pressure based on linear one-dimensional wave propagation theory is presented in this paper. The equations are applied to a distributed model of the arterial tree, truncated by three-element windkessels. To reflect individual differences in the properties of the arterial trees, we pose a minimization problem from which individual parameters are identified. The idea is to take a measured waveform in a peripheral artery and use it as input to the model. The model subsequently predicts the corresponding waveform in another peripheral artery in which a measurement has also been made, and the arterial tree model is then calibrated in such a way that the computed waveform matches its measured counterpart. For the purpose of validation, invasively recorded abdominal aortic, brachial, and femoral pressures in nine healthy subjects are used. The results show that the proposed method estimates the abdominal aortic pressure wave with good accuracy. The root mean square error (RMSE) of the estimated waveforms was 1.61 ± 0.73 mmHg, whereas the errors in systolic and pulse pressure were 2.32 ± 1.74 and 3.73 ± 2.04 mmHg, respectively. These results are compared with another recently proposed method based on a signal processing technique, and it is shown that our method yields a significantly ( P < 0.01) lower RMSE. With more extensive validation, the method may eventually be used in clinical practice to provide detailed, almost individual, specific information as a valuable basis for decision making.

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Effects of pacing modality on noninvasive assessment of heart rate dependency of indices of large artery function

Journal of Applied Physiology ◽

10.1152/japplphysiol.00445.2016 ◽

2016 ◽

Vol 121 (3) ◽

pp. 771-780 ◽

Cited By ~ 10

Author(s):

Isabella Tan ◽

Hosen Kiat ◽

Edward Barin ◽

Mark Butlin ◽

Alberto P. Avolio

Keyword(s):

Heart Rate ◽

Arterial Stiffness ◽

Pulse Pressure ◽

Wave Reflection ◽

Pulse Wave ◽

Augmentation Index ◽

Large Artery ◽

Rate Dependency ◽

Wave Reflections

Studies investigating the relationship between heart rate (HR) and arterial stiffness or wave reflections have commonly induced HR changes through in situ cardiac pacing. Although pacing produces consistent HR changes, hemodynamics can be different with different pacing modalities. Whether the differences affect the HR relationship with arterial stiffness or wave reflections is unknown. In the present study, 48 subjects [mean age, 78 ± 10 (SD), 9 women] with in situ cardiac pacemakers were paced at 60, 70, 80, 90, and 100 beats per min under atrial, atrioventricular, or ventricular pacing. At each paced HR, brachial cuff-based pulse wave analysis was used to determine central hemodynamic parameters, including ejection duration (ED) and augmentation index (AIx). Wave separation analysis was used to determine wave reflection magnitude (RM) and reflection index (RI). Arterial stiffness was assessed by carotid-femoral pulse wave velocity (cfPWV). Pacing modality was found to have significant effects on the HR relationship with ED ( P = 0.01), central aortic pulse pressure ( P = 0.01), augmentation pressure ( P < 0.0001), and magnitudes of both forward and reflected waves ( P = 0.05 and P = 0.003, respectively), but not cfPWV ( P = 0.57) or AIx ( P = 0.38). However, at a fixed HR, significant differences in pulse pressure amplification ( P < 0.001), AIx ( P < 0.0001), RM ( P = 0.03), and RI ( P = 0.03) were observed with different pacing modalities. These results demonstrate that although the HR relationships with arterial stiffness and systolic loading as measured by cfPWV and AIx were unaffected by pacing modality, it should still be taken into account for studies in which mixed pacing modalities are present, in particular, for wave reflection studies.

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