Abstract WP485: Racial Differences in the Association Between Central Hemodynamic Parameters and Neuropsychological Assessments

Stroke ◽  
2020 ◽  
Vol 51 (Suppl_1) ◽  
Author(s):  
Joy N Buie ◽  
Gayenell Magwood ◽  
Catrina Sims-Robinson ◽  
Daniel Lackland ◽  
Robert Adams

Introduction: Despite a significantly younger at time of stroke, African Americans are at increased risk for post-stroke cognitive impairment compared to whites. Although central arterial stiffness is a well-established correlate of cognitive function in whites, its predictive value in African Americans is not well characterized. We hypothesized that arterial stiffness measures previously associated with declines in cognition may be more robust in African Americans compared to whites. Methods: We administered the Mini Mental State Examination (MMSE), Trail Making Test Part-A (TMTA) and Part-B (TMTB), and Symbol Digit Modalities Test (SDMT) to 54 stroke-free adults (28 African Americans and 26 whites). Central hemodynamic parameters including carotid-femoral pulse wave velocity (PWV), central systolic blood pressure (cSBP), central pulse pressure (cPP), and heart rate-corrected augmentation index (AIx@75) were recorded for each study participant. Univariate analysis was used to evaluate age, sex and mean arterial pressure (MAP) mean-adjusted differences in central hemodynamics. We also evaluated associations between central hemodynamics and neuropsychological test by race. Results: Mean-adjusted PWV values were significantly higher in African Americans compared to whites with values ranging from 8.8 m/s to 7.8 m/s, respectively. Adjusted mean cSBP and AIx@75 were also significantly increased in African Americans. Among whites, unadjusted PWV values were negatively associated with TMTA and TMTB z-scores. Unadjusted AIx@75 was negatively associated with TMTB z-scores in African Americans but not whites. African Americans with MMSE and SDMT z-scores <0 had higher PWV values compared to whites ((9.4 m/s vs 7.9 m/s) and (9.7 m/s vs 7.7 m/s), respectively) and those with TMTB z-scores <0 had higher cSBP values (123.1 mmHg vs 114.4 mmHg). Conclusion: African Americans had higher arterial stiffness compared to whites. Neuropsychological test were associated with arterial stiffness in white study participants but only arterial wave reflections in African Americans. Longitudinal follow-up is warranted to assess specific central hemodynamic parameters associated with cognitive impairments and dementia in African Americans.

2021 ◽  
Vol 11 (7) ◽  
pp. 3146
Author(s):  
Dongmin Lee ◽  
Kyengho Byun ◽  
Moon-Hyon Hwang ◽  
Sewon Lee

Arterial stiffness is associated with an increased risk of cardiovascular disease. Previous studies have shown that there is a negative correlation between arterial stiffness and variables such as skeletal muscle mass, muscular strength, and anaerobic power in older individuals. However, little research has been undertaken on relationships in healthy young adults. This study presents a preliminary research that investigates the association between arterial stiffness and muscular factors in healthy male college students. Twenty-three healthy young males (23.9 ± 0.5 years) participated in the study. The participants visited the laboratory, and variables including body composition, blood pressure, arterial stiffness, blood parameters, grip strength, and anaerobic power were measured. Measurements of augmentation index (AIx) and brachial-ankle pulse wave velocity (baPWV) were performed to determine arterial stiffness. There were significant positive correlations among skeletal muscle mass, muscle strength, and anaerobic power in healthy young adult males. AIx was negatively associated with a skeletal muscle mass (r = −0.785, p < 0.01), muscular strength (r = −0.500, p < 0.05), and anaerobic power (r = −0.469, p < 0.05), respectively. Likewise, AIx@75 corrected with a heart rate of 75 was negatively associated with skeletal muscle mass (r = −0.738, p < 0.01), muscular strength (r = −0.461, p < 0.05), and anaerobic power (r = −0.420, p < 0.05) respectively. However, the baPWV showed no correlation with all muscular factors. Our findings suggest that maintaining high levels of skeletal muscle mass, muscular strength, and anaerobic power from relatively young age may lower AIx.


2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Merita Rroji (Molla) ◽  
Saimir Seferi ◽  
Majlinda Cafka ◽  
Erjola Likaj ◽  
Vilma Cadri ◽  
...  

Abstract Background and Aims The mortality rate is extremely high in chronic kidney disease (CKD), primarily due to the high prevalence of cardiovascular disease (CVD). Increased pulse pressure (PP), defined as the difference between inappropriately elevated systolic blood pressure (SBP) and reduced diastolic blood pressure (DBP) at any value of mean arterial pressure (MAP), is a surrogate measure of increased arterial stiffness of central elastic arteries (aorta and its major branches). CKD-MBD anomalies leading to calcification contribute to increased arterial stiffness and pulse pressure. This study aimed to evaluate the relationship of pulse pressure parameter with valve calcification and abdominal aortic calcification in hemodialysis patients and its impact on cardiovascular mortality. Method We performed a prospective case series study with 3 years follow- up. Plain X-ray images of the lateral lumbar spine from all subjects were studied to obtain images of the lower abdominal aorta using semiquantitative scores as described by Kauppila et al. Cardiac valve calcifications were evaluated by two-dimensional echocardiography with an HDI 5000 Sono CT echocardiographic machine with a 3.3-MHz multiphase array probe in subjects lying in the left decubitus position an according to the recommendations of the European Association of Echocardiography. The patient was evaluated as having vascular calcification if he had the presence of calcification in at least one of the site examined: a mitral valve, aortic valve or abdominal aorta. Results We studied 85 chronic stable hemodialysis patients. Mean age and meantime is therapy was 49.9±12.4 years and 51.5±28.7 months, respectively. Mean pulse pressure was 55.72±14.2 mmHg. Fifty-nine patients (69.4%) were identified with aortic abdominal calcification, and the mean Kauppila score was 4.91 ± 4.05. Sixty patients (70.5%) had at least one valve calcified, while thirty-three patients (38.8%) had both valves calcified. Univariate analysis revealed that every 1 mmHg increase in pulse pressure was associated with increased cardiovascular calcification risk p=0.020. In multivariate analysis, after adjustment for age, gender, diabetes mellitus, cholesterol, and triglyceride serum levels, the association also remained strong, where every increase of 1 mm Hg in pulse pressure was associated with increased risk for cardiovascular calcification (HR 1.02, 95% CI (1.00-1.03), p= 0.038). Besides, pulse pressure was an independent predictor for cardiovascular mortality (HR 1.03, 95% CI (1.02-1.05), p=0.002). Conclusion Pulse pressure may identify hemodialysis patients with subclinical cardiovascular calcification who need further evaluation. Wide pulse pressure is associated with increased cardiovascular mortality.


2012 ◽  
Vol 2012 ◽  
pp. 1-11 ◽  
Author(s):  
Ryta E. Rzheutskaya

Purpose. To define specific features of central hemodynamic parameter changes in patients with isolated severe traumatic brain injury (STBI) and in patients with clinically established brain death and to determine the required course of treatment for their correction.Data and Research Methods. A close study of central hemodynamic parameters was undertaken. The study involved 13 patients with isolated STBI (group STBI) and 15 patients with isolated STBI and clinically established brain death (group STBI-BD). The parameters of central hemodynamics were researched applying transpulmonary thermodilution.Results. In the present study, various types of hemodynamic reaction (normodynamic, hyperdynamic, and hypodynamic) were identified in patients with isolated STBI in an acute period of traumatic disease. Hyperdynamic type of blood circulation was not observed in patients with isolated STBI and clinically established brain death. Detected hemodynamic disorders led to the correction of the ongoing therapy under the control of central hemodynamic parameters.Conclusions. Monitoring of parameters of central hemodynamics allows to detect the cause of disorders, to timely carry out the required correction, and to coordinate infusion, inotropic, and vasopressor therapy.


2020 ◽  
Vol 36 (3) ◽  
pp. 498-507
Author(s):  
Metin Coksevim ◽  
Murat Akcay ◽  
Serkan Yuksel ◽  
Mustafa Yenercag ◽  
Bugra Cerik ◽  
...  

2020 ◽  
Vol 11 ◽  
Author(s):  
Junhao Huang ◽  
Jingwen Liao ◽  
Yang Fang ◽  
Hailin Deng ◽  
Honggang Yin ◽  
...  

PurposeObesity in children and in adolescents can lead to adult cardiovascular diseases, and the gut microbiota plays a crucial role in obesity pathophysiology. Exercise and diet interventions are typical approaches to improve physical condition and to alter the gut microbiota in individuals with obesity. However, whether central hemodynamic parameters including subendocardial viability ratio, the augmentation index standardized to a heart rate of 75/min (AIx75), resting heart rate, and blood pressure, correlate with gut microbiota changes associated with exercise and diet is unclear.MethodsAdolescents (n = 24, 12.88 ± 0.41 years) with obesity completed our 6-week program of endurance and strength exercises along with dietary restriction. Blood and fecal samples were collected, and physical parameters were measured before and 24 h after the last session of the intervention program. Pulse wave analysis using applanation tonometry provided the subendocardial viability ratio, a surrogate measure of microvascular myocardial perfusion, and AIx75, a measure of arterial stiffness and peripheral arteriolar resistance. Correlation analysis detected any associations of anthropometric or central hemodynamic parameters with gut microbiome composition.ResultsExercise and diet interventions significantly reduced body weight, body mass index, body fat, and waist-to-hip ratio, and lowered levels of fasting blood glucose, serum triglycerides, and high-density lipoprotein cholesterol. AIx75 and resting heart rate were also significantly reduced after the intervention without changes to systolic or diastolic blood pressure. The ratio of intestinal microbiota Firmicutes to Bacteroidetes displayed a marked increase after intervention. Interventional changes in gut microbiota members were significantly associated with anthropometric and metabolic parameters. Microbial changes were also significantly correlated with central hemodynamic parameters, including subendocardial viability ratio, AIx75, and resting heart rate.ConclusionExercise and diet interventions significantly improved measures of central hemodynamics, including subendocardial viability ratio, AIx75, and resting heart rate, which were correlated with altered gut microbiota in adolescents with obesity. Our findings shed light on the effects and mechanisms underlying exercise and diet interventions on obesity and suggest this approach for treating patients with both cardiovascular disease and obesity.


2019 ◽  
Vol 110 (1) ◽  
pp. 131-138 ◽  
Author(s):  
Stephanie A Richard ◽  
Benjamin J J McCormick ◽  
Laura E Murray-Kolb ◽  
Gwyneth O Lee ◽  
Jessica C Seidman ◽  
...  

ABSTRACT Background Poor growth in early childhood has been associated with increased risk of mortality and morbidity, as well as long-term deficits in cognitive development and economic productivity. Objectives Data from the MAL-ED cohort study were used to identify factors in the first 2 y of life that are associated with height-for-age, weight-for-age, and body mass index z-scores (HAZ, WAZ, BMIZ) at 5 y of age. Methods A total of 1017 children were followed from near birth until 5 y of age at sites in Bangladesh, Brazil, India, Nepal, Peru, South Africa, and Tanzania. Data were collected on their growth, environmental enteric dysfunction (EED), micronutrient status, enteric pathogen burden, illness prevalence, dietary intake, and various other socio-economic and environmental factors. Results EED biomarkers were related to size at 5 y. Mean lactulose:mannitol z-scores during the first 2 y of life were negatively associated with all of the growth measures (HAZ: −0.11 [95% CI: −0.19, −0.03]; WAZ: −0.16 [95% CI: −0.26, −0.06]; BMIZ: −0.11 [95% CI: −0.23, 0.0]). Myeloperoxidase was negatively associated with weight (WAZ: −0.52 [95% CI: −0.78, −0.26] and BMIZ: −0.56 [95% CI: −0.86, −0.26]); whereas α-1-antitrypsin had a negative association with HAZ (−0.28 [95% CI: −0.52, −0.04]). Transferrin receptor was positively related to HAZ (0.18 [95% CI: 0.06, 0.30]) and WAZ (0.21 [95% CI: 0.07, 0.35]). Hemoglobin was positively related to HAZ (0.06 [95% CI: 0.00, 0.12]), and ferritin was negatively related to HAZ (−0.08 [95% CI: −0.12, −0.04]). Bacterial density in stool was negatively associated with HAZ (−0.04 [95% CI: −0.08, 0.00]), but illness symptoms did not have any effect on size at 5 y. Conclusions EED markers, bacterial density, and iron markers are associated with growth at 5 y of age. Interventions to reduce bacterial burden and EED may improve long-term growth in low-income settings.


SLEEP ◽  
2020 ◽  
Vol 43 (Supplement_1) ◽  
pp. A54-A54
Author(s):  
M N Culver ◽  
A A Flatt ◽  
G J Grosicki

Abstract Introduction Insufficient sleep is associated with arterial stiffness and elevated cardiovascular disease risk. Central hemodynamics are influenced by arterial stiffness, yet independently predict cardiovascular risk. Relationships between sleep characteristics and central hemodynamic parameters are largely unexplored. We aimed to characterize the relationship between self-reported sleep quality and central hemodynamics in healthy individuals. To explore the hypothesis that impairments in glucose metabolism, resulting from lack of sleep, may underlie relationships between sleep and central hemodynamic variables, we also examined associations between self-reported sleep quality and fasting blood glucose values. Methods Thirty-one healthy subjects (14 females /17 males; 20–69 years) that were free from metabolic or cardiovascular disease, and that did not take sleep medication were included in the study. Relationships between self-reported sleep quality, obtained using the Pittsburgh Sleep Quality Index (PSQI), with central hemodynamic profiles(systolic and diastolic blood pressures, pulse and augmentation pressures, augmentation index) estimated from oscillometric pulse wave analysis, and fasting blood glucose values were assessed. Results Central pulse pressure was significantly elevated (P&lt;0.05) in poor (PSQIscore &gt;5) compared to normal (PSQI score 0–5) self-reported sleepers. Linear regression models, adjusted for age, gender, and body mass index, demonstrated PSQI score to be an independent predictor (P&lt;0.05) of both central pulse (β=0.469) and augmentation (β=0.364) pressures. Global PSQI scores were not related to fasting blood glucose values (r=0.045; P&gt;0.05). Conclusion Significant relationships between central pulse and augmentationpressures and self-reported sleep quality highlight the importance of considering sleep when examining lifestyle contributors to central hemodynamics. Support No funding.


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