scholarly journals Impaired subendocardial perfusion in patients with metabolic syndrome

2021 ◽  
Vol 18 (6) ◽  
pp. 147916412110471
Author(s):  
Francesco Fantin ◽  
Anna Giani ◽  
Ludovico Gasparini ◽  
Andrea P Rossi ◽  
Elena Zoico ◽  
...  
Keyword(s):  
Metabolic Syndrome ◽  
Mean Arterial Pressure ◽  
Arterial Stiffness ◽  
Arterial Pressure ◽  
Pulse Wave ◽  
Applanation Tonometry ◽  
Noninvasive Estimation ◽  
Subendocardial Viability Ratio ◽  
Study Population ◽  
Metabolic Syndrome Components

Background Metabolic Syndrome (MS) is associated to vascular damage, increased arterial stiffness, and impaired myocardial perfusion. Subendocardial viability ratio (SEVR) is a noninvasive estimation of myocardial workload, oxygen supply, and perfusion. The aim of the study was to describe the relation between arterial stiffness, SEVR, and cardio-metabolic risk factors. Methods A cohort of 55 patients, aged 59.9 ± 10.8 years, was studied; 28 subjects (50.9%) had metabolic syndrome. All patients underwent a clinical evaluation and blood venous sampling, to assess glico-lipid profile. Applanation tonometry was performed, to obtain pulse wave analysis and SEVR values. Results In the overall study population, SEVR showed negative associations with mean (r = −0.301; p = 0.026) and systolic (borderline relation, r = −0.257; p = 0.058) arterial pressure. Metabolic syndrome patients presented lower level of SEVR ( p = 0.012), even after adjusting for age, sex, and mean arterial pressure ( p = 0.040). Subdividing the study population by the number of metabolic syndrome components, SEVR significantly decreased as the number of Metabolic Syndrome components increased ( p for trend 0.005). In a logistic backward regression analysis, both metabolic syndrome and mean arterial pressure resulted significant predictors of SEVR, accounting for 18% of variance. Conclusion The reduced SEVR in metabolic syndrome patients could be an important pathophysiological determinant of the increased cardiovascular risk.

scholarly journals Migraine and Arterial Stiffness in the Brazilian Longitudinal Study of Adult Health: ELSA-Brasil

2020 ◽  
Vol 33 (5) ◽  
pp. 458-464 ◽  
Author(s):  
Patricia Noemi Apelbaum ◽  
Alessandra Carvalho Goulart ◽  
Itamar de Souza Santos ◽  
Paulo Andrade Lotufo ◽  
Cristina Pellegrino Baena ◽  
...  
Keyword(s):  
Longitudinal Study ◽  
Mean Arterial Pressure ◽  
Arterial Stiffness ◽  
Arterial Pressure ◽  
Pulse Wave Velocity ◽  
Wave Velocity ◽  
Sex Education ◽  
Pulse Wave ◽  
International Headache Society ◽  
Adult Health

Abstract Background The mechanisms that underlie the link between migraine and cardiovascular diseases are not clear and arterial stiffness could play a role in that association. We analyzed the association between migraine and vascular stiffness measured by carotid-to-femoral pulse wave velocity (PWV-cf). Methods In a cross-sectional analysis of a well-defined population from the Longitudinal Study of Adult Health (ELSA-Brasil) with complete and validated information about migraine and aura according to the International Headache Society criteria, the association between arterial stiffness measured by PWV-cf was tested with multiple linear regression models [β (95% CI)] comparing migraine without aura (MO) and migraine with aura (MA) to the reference group no-migraine (NM). Subsequent adjustments were made for mean arterial pressure, age, sex, education level, physical activity, alcohol use, diabetes mellitus, smoking, antihypertensive medication, body mass index, waist circumference, triglycerides, and LDL-c level to test the independence of the association between migraine status and pulse wave velocity. Results We studied 4,649 participants, 2,521 women (25.7% MO and 15% MA) and 2,128 men (11% MO and 4.3% MA). In NM, MO, and MA standard PWV-cf were 8.67 (±1.71) 8.11 (±1.31) and 8.01 (±1.47) m/s, respectively. Unadjusted PWV-cf differed between NM, MA, and MO (P < 0.001). After adjustment for mean arterial pressure PWV-cf in NM did not differ anymore from MA (P = 0.525) and MO (P = 0.121), respectively. Fully adjusted models also yielded nonsignificant coefficients β (95% CI) −0.079 (−0.280; 0.122) and −0.162 (−0.391; 0.067) for MO and MA, respectively. Conclusion In this large cohort of middle-aged adults, aortic PWV was not associated with migraine.

scholarly journals Aerobic exercise training reduces arterial stiffness in metabolic syndrome

2014 ◽  
Vol 116 (11) ◽  
pp. 1396-1404 ◽  
Author(s):  
David A. Donley ◽  
Sara B. Fournier ◽  
Brian L. Reger ◽  
Evan DeVallance ◽  
Daniel E. Bonner ◽  
...  
Keyword(s):  
Metabolic Syndrome ◽  
Exercise Training ◽  
Arterial Stiffness ◽  
Aerobic Exercise ◽  
Aerobic Capacity ◽  
Pulse Wave ◽  
Applanation Tonometry ◽  
Aerobic Exercise Training ◽  
Arterial Stiffening ◽  
Myocardial Efficiency

The metabolic syndrome (MetS) is associated with a threefold increase risk of cardiovascular disease (CVD) mortality partly due to increased arterial stiffening. We compared the effects of aerobic exercise training on arterial stiffening/mechanics in MetS subjects without overt CVD or type 2 diabetes. MetS and healthy control (Con) subjects underwent 8 wk of exercise training (ExT; 11 MetS and 11 Con) or remained inactive (11 MetS and 10 Con). The following measures were performed pre- and postintervention: radial pulse wave analysis (applanation tonometry) was used to measure augmentation pressure and index, central pressures, and an estimate of myocardial efficiency; arterial stiffness was assessed from carotid-femoral pulse-wave velocity (cfPWV, applanation tonometry); carotid thickness was assessed from B-mode ultrasound; and peak aerobic capacity (gas exchange) was performed in the seated position. Plasma matrix metalloproteinases (MMP) and CVD risk (Framingham risk score) were also assessed. cfPWV was reduced ( P < 0.05) in MetS-ExT subjects (7.9 ± 0.6 to 7.2 ± 0.4 m/s) and Con-ExT (6.6 ± 1.8 to 5.6 ± 1.6 m/s). Exercise training reduced ( P < 0.05) central systolic pressure (116 ± 5 to 110 ± 4 mmHg), augmentation pressure (9 ± 1 to 7 ± 1 mmHg), augmentation index (19 ± 3 to 15 ± 4%), and improved myocardial efficiency (155 ± 8 to 168 ± 9), but only in the MetS group. Aerobic capacity increased ( P < 0.05) in MetS-ExT (16.6 ± 1.0 to 19.9 ± 1.0) and Con-ExT subjects (23.8 ± 1.6 to 26.3 ± 1.6). MMP-1 and -7 were correlated with cfPWV, and both MMP-1 and -7 were reduced post-ExT in MetS subjects. These findings suggest that some of the pathophysiological changes associated with MetS can be improved after aerobic exercise training, thereby lowering their cardiovascular risk.

scholarly journals Arterial stiffness as a risk factor for hypotension during induction of general anesthesia

2021 ◽  
Author(s):  
Ianis Siriopol ◽  
Ioana Grigoras ◽  
Dimitrie Siriopol ◽  
Adi Ciumanghel ◽  
Daniel Rusu ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Mean Arterial Pressure ◽  
Arterial Stiffness ◽  
Arterial Pressure ◽  
Pulse Wave Velocity ◽  
General Anaesthesia ◽  
Wave Velocity ◽  
Pulse Wave ◽  
Systolic Arterial Pressure ◽  
Post Induction

IntroductionHypotension after induction of general anaesthesia is identified as an independent factor in predicting adverse clinical outcomes. Preoperative evaluation of arterial stiffness could identify patients with an impaired vascular function and an altered haemodynamic response to induction of general anaesthesia. The purpose of this study is to investigate the relationship between arterial stiffness and blood pressure variation during induction of general anaesthesia.Material and methodsThis was an observational study that included patients who underwent surgical procedures under general anaesthesia. We used several systolic arterial pressure and mean arterial pressure thresholds for defining hypotension. Both absolute thresholds and thresholds relative to a baseline blood pressure were chosen based on the most frequently used definitions. Patient carotid-femoral pulse wave velocity determination, preoperative preparation, and induction of general anaesthesia were standardized.ResultsOur study included 115 patients. Both univariate and multivariate analysis showed that carotid-femoral pulse wave velocity was significantly associated with post-induction hypotension when defined as a systolic arterial pressure decrease of > 30% or > 40% from baseline or as a mean arterial pressure decrease of > 40% from baseline. Also, carotid-femoral pulse wave velocity was positively associated with duration of post-induction hypotension.ConclusionsPreoperative assessment of arterial stiffness identifies patients at risk of a pronounced decrease in blood pressure during induction of general anaesthesia.

Arterial stiffness following repeated Valsalva maneuvers and resistance exercise in young men

2007 ◽  
Vol 32 (2) ◽  
pp. 257-264 ◽  
Author(s):  
Kevin S. Heffernan ◽  
Sae Young Jae ◽  
David G. Edwards ◽  
Erin E. Kelly ◽  
Bo Fernhall
Keyword(s):  
Blood Pressure ◽  
Mean Arterial Pressure ◽  
Arterial Stiffness ◽  
Arterial Pressure ◽  
Pulse Wave Velocity ◽  
Resistance Exercise ◽  
Pulse Wave ◽  
Lower Body ◽  
Peripheral Arterial ◽  
Finger Plethysmography

The purpose of this study was to compare arterial stiffness after a bout of resistance exercise (RE) and an experimental condition consisting of repeated Valsalva maneuvers (VMs). Fourteen male participants randomly completed a lower-body, unilateral RE bout and a VM bout designed to alter blood pressure (BP) in a similar pulsatile fashion. Pulse-wave velocity (PWV, measured in metres per second (m·s–1)) was used to measure central and peripheral arterial stiffness and was assessed before and 20 min after each perturbation. Beat-to-beat blood pressure (BP) was assessed during bouts using finger plethysmography. Change in systolic BP, diastolic BP, mean arterial pressure, and pulse pressure were similar during both bouts. Central PWV increased after repeated VMs (7.1 ± 0.3 m/s to 7.8 ± 0.3 m/s), but not after RE (7.2 ± 0.3 m/s to 7.2 ± 0.3 m/s) (interaction, p = 0.032). There was no change in peripheral PWV after VM (8.9 ± 0.3 m/s to 9.3 ± 0.3 m/s) or RE (8.5 ± 0.2 m/s to 8.4 ± 0.2 m/s). Arterial stiffness increased after repeated VM. Even though presented with a similar BP load, arterial stiffness did not increase after acute RE. These findings suggest a role for VM in acutely altering arterial properties.

scholarly journals Regional Arterial Stiffness in Patients with Inflammatory Bowel Disease

2019 ◽  
Vol 29 (3) ◽  
pp. 66-73
Author(s):  
V. V. Genkel ◽  
R. G. Portnova ◽  
T. V. Antipina ◽  
I. I. Shaposhnik
Keyword(s):  
Arterial Stiffness ◽  
Pulse Wave Velocity ◽  
Wave Velocity ◽  
Pulse Wave ◽  
Comparison Group ◽  
Complete Blood Count ◽  
Statistical Significance ◽  
High Sensitivity ◽  
Applanation Tonometry ◽  
Laboratory Research

Aim.  To study muscular (brachial and radial arteries) and elastic (aorta) regional arterial stiffness in IBD patients in comparison with those without IBD, as well as to establish the relationship between arterial stiffness and the characteristics of the IBD course (the duration of illness, severity of attack, activity of systemic inflammation). Materials and methods. The study included 21 IBD patients and 30 patients in the comparison group. The values of regional aortic and muscular arterial stiffness were measured by applanation tonometry. The carotid–femoral pulse wave velocity (cfPWV) and the carotid-radial pulse wave velocity (crPWV) were determined. The laboratory research plan included the analysis of complete blood count, biochemical parameters, fibrinogen and a high sensitivity  C-reactive protein (hsCRP).Results. crPWV, similar to cfPWV, was not significantly different between the groups. At the same time, the proportion of individuals with an increase in the cfPWV of more than 10 m/s was higher in the group of IBD patients. However, these differences did not reach the level of statistical significance. According to the results of the correlation analysis, the increase in cfPWV was associated with an increase in patient age (r = 0.564; p = 0.01), the duration of IBD history (r = 0.628; p = 0.003), fasting plasma glucose (r = 0.367; p = 0.034) and GFR decrease (r = -0.482; p = 0.031). The crPWV also directly correlated with the IBD duration (r = 0.630; p = 0.003). According to the results of the regression analysis, an increase in the IBD duration by 1 year is associated with an increase in cfPWV by 0.205 m/s, i.e. the increase in the IBD duration by 5 years is associated with an increase in the cfPWV of approximately 1 m/s.Conclusion. In IBD patients, the duration of the disease directly correlated with an increase in cfPWV and crPWV. The increase in the IBD duration by 1 year was associated with an increase in cfPWV by 0.205 m/s. The muscular and elastic regional arterial stiffness was not statistically significantly different between IBD patients and the comparison group. 

P1674High intensity interval exercise program in heart failure patients seems to benefit cardiac power along with aorto-ventricular mechanical pump capacity and cardiorespiratory indices

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
C Chrysohoou ◽  
A Angelis ◽  
G Titsinakis ◽  
D Tsiachris ◽  
P Aggelopoulos ◽  
...  
Keyword(s):  
Heart Failure ◽  
Blood Pressure ◽  
Mean Arterial Pressure ◽  
Arterial Pressure ◽  
Pulse Wave Velocity ◽  
Pulse Wave ◽  
Intervention Group ◽  
Control Group ◽  
Interval Exercise ◽  
Cardiac Power

Abstract Background Cardiac power has been suggested as the most power predictor of mortality in heart failure (HF) patients. In those patients aorta elastic properties and compensation is lost, systolic (and pulse) pressure are therefore reduced and associated with a decrease in ejection duration and pump efficiency. Cardiac rehabilitation programs have showed enhancement in cardiac performance and quality of life in HF patients. Aim Aim of this work was to evaluate the effect of high-intensity interval exercise (i.e., 30 sec at 100% of max workload, followed by 30 sec at rest, on a day-by-day 30 minutes working-out schedule for 12 weeks), on cardiac power, diastolic function indices, right ventricle performance and cardiorespiratory parameters among chronic HF patients. Methods 72 consecutive HF patients (NYHA class II-IV, ejection fraction <50%) who completed the study (exercise training group, n=33, 63±9 years, 88% men, and control group, n=39, 56±11 years, 82% men), underwent cardiopulmonary stress test, non-invasive high-fidelity tonometry of the radial artery, pulse wave velocity measurement using a SphygmoCor device, and echocardiography before and after completion of the training program. Cardiac power output (CPO) (W) was calculated as mean arterial pressure × CO/451, where mean arterial pressure = [(systolic blood pressure − diastolic blood pressure)/3] + diastolic blood pressure. Results Both groups reported similar medical characteristics and physical activity status. General mixed effects models revealed that the intervention group increased 6MWT (by 13%, p<0.05); increased cycle ergometry WRpeak (by 25%, p<0.01), showed higher O2max by 31% (p<0.001) and lower VE/VCO2 (p=0.05), whereas patients in the control group showed nosignificant changes in the aforementioned indices. Also, in the intervention group Emv/Vp was decreased by 14% (p=0.06); E to A ratio by 24% (p=0.004) and E to Emv ratio by 8% (p=0.05); while Stv increased by 25% (p=0.01). Most importantly, the intervention group reduced pulse wave velocity by 9% (p=0.05) and increased augmentation index by 26%; and VTI by 4% (p=0.05); Those parameters were not significantly changed on control group (all p>0.05). Conclusion Hight intensity exercise rehabilitation program revealed beneficial effect on left ventricular diastolic indices and right ventricle performance. As, in those patients compensation of the aorta is also lost and the LV cannot generate the extra force necessary to completely overcome the late systolic augmented pressure, the increase in the augmented pressure (AIa) observed in the intervention group reflects the benefit in aorto-ventricular coupling and cardiac power that boosts systolic pressure and restores a positive influence in pressure, like in early stages of HF. Acknowledgement/Funding None

scholarly journals Associations of Retinal Microvascular Diameters and Tortuosity With Blood Pressure and Arterial Stiffness

Hypertension ◽  
2019 ◽  
Vol 74 (6) ◽  
pp. 1383-1390 ◽  
Author(s):  
Robyn J. Tapp ◽  
Christopher G. Owen ◽  
Sarah A. Barman ◽  
Roshan A. Welikala ◽  
Paul J. Foster ◽  
...  
Keyword(s):  
Blood Pressure ◽  
United Kingdom ◽  
Mean Arterial Pressure ◽  
Arterial Stiffness ◽  
Arterial Pressure ◽  
Retinal Vessel ◽  
Vessel Diameter ◽  
Automated Image Analysis ◽  
Stiffness Index ◽  
Arterial Stiffness Index

To examine the baseline associations of retinal vessel morphometry with blood pressure (BP) and arterial stiffness in United Kingdom Biobank. The United Kingdom Biobank included 68 550 participants aged 40 to 69 years who underwent nonmydriatic retinal imaging, BP, and arterial stiffness index assessment. A fully automated image analysis program (QUARTZ [Quantitative Analysis of Retinal Vessel Topology and Size]) provided measures of retinal vessel diameter and tortuosity. The associations between retinal vessel morphology and cardiovascular disease risk factors/outcomes were examined using multilevel linear regression to provide absolute differences in vessel diameter and percentage differences in tortuosity (allowing within person clustering), adjusted for age, sex, ethnicity, clinic, body mass index, smoking, and deprivation index. Greater arteriolar tortuosity was associated with higher systolic BP (relative increase, 1.2%; 95% CI, 0.9; 1.4% per 10 mmHg), higher mean arterial pressure, 1.3%; 0.9, 1.7% per 10 mmHg, and higher pulse pressure (PP, 1.8%; 1.4; 2.2% per 10 mmHg). Narrower arterioles were associated with higher systolic BP (−0.9 µm; −0.94, −0.87 µm per 10 mmHg), mean arterial pressure (−1.5 µm; −1.5, −1.5 µm per 10 mmHg), PP (−0.7 µm; −0.8, −0.7 µm per 10 mmHg), and arterial stiffness index (−0.12 µm; −0.14, −0.09 µm per ms/m 2 ). Associations were in the same direction but marginally weaker for venular tortuosity and diameter. This study assessing the retinal microvasculature at scale has shown clear associations between retinal vessel morphometry, BP, and arterial stiffness index. These observations further our understanding of the preclinical disease processes and interplay between microvascular and macrovascular disease.

Impact of mean arterial pressure on progression of arterial stiffness in peritoneal dialysis patients under strict volume control strategy

2012 ◽  
Vol 77 (02) ◽  
pp. 105-113 ◽  
Author(s):  
Mettem Sezis Demirci ◽  
Ozkan Gungor ◽  
Fatih Kircelli ◽  
Juan Jesus Carrero ◽  
Erhan Tatar ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Mean Arterial Pressure ◽  
Arterial Stiffness ◽  
Arterial Pressure ◽  
Control Strategy ◽  
Volume Control ◽  
Dialysis Patients

The Relationship between Effective Arterial Capacitance and Pulse Wave Velocity is Dependent on Left Ventricular Stroke Volume

Angiology ◽  
2008 ◽  
Vol 60 (1) ◽  
pp. 82-86 ◽  
Author(s):  
Oladipupo Olafiranye ◽  
Ghazanfar Qureshi ◽  
Louis Salciccioli ◽  
Kinda Vernon-Jones ◽  
Charles Philip ◽  
...  
Keyword(s):  
Arterial Stiffness ◽  
Stroke Volume ◽  
Pulse Wave Velocity ◽  
Wave Velocity ◽  
Cardiovascular Events ◽  
Pulse Wave ◽  
Aortic Pressure ◽  
Left Ventricular ◽  
Applanation Tonometry ◽  
The Relationship

Background increased arterial stiffness is a predictor of cardiovascular events. The stroke volume (SV) to pulse pressure (PP) ratio is an estimate of arterial capacitance. Pulse wave velocity (PWV) is a measure of arterial stiffness. This study evaluated the effect of left ventricular (LV) SV on the SV/PP–PWV relationship. Methods 97 patients had applanation tonometry and echocardiography to measure arterial capacitance (SV/PP), PWV, and central aortic pressure. Results 50 patients had normal SV and 47 had low SV. For all patients, PWV inversely correlated with SV/PP. PWV and SV/PP correlated more strongly in the normal SV group than in the low SV group. Aortic PP was significantly correlated with PWV in all patients, in the normal SV group, and in the low SV group. Conclusion effective arterial capacitance correlates with PWV. The presence of decreased SV weakens the relationship.

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