The Effects of Below-Knee Medical Compression Stockings on Pulse Wave Velocity of Young Healthy Volunteers

Objective. The objective of our study was to compare the performance of vascular stiffness (VS) and the left ventricular (LV) remodeling process indicators in patients with arterial hypertension (AH) under renal replacement therapy (RRT), and patients with essential hypertension.Design and methods. 158 people were included in the study, divided into 4 comparable age groups: 32 patients receiving programmed hemodialysis (PH), 37 recipients of renal transplant (RT), 69 patients with essential AH and 20 healthy volunteers. All the patients underwent 24-hour blood pressure (BP) monitoring with an assessment of VS and central BP (SBPao) and echocardiography (EchoCG).Results. The patients under PH and after RT did not have any significant differences in the values of central and peripheral BP. Comparing the groups of patients under RRT with the group of essential AH, the office systolic (SBP) and diastolic (DBP) BP values did not differ significantly. Аlthough, at night, considerably higher DBP(n) and SBPao(n) values were detected in patients under RRT, and in the patients after RT SBP(n) and PP(n) values were also increased. An increase in the SBPao values of more than 10 m/sec was detected only in the groups of patients under RRT. In all the groups with hypertension all indicators of daily VS differed significantly from the group of healthy volunteers. PTIN (Pulse Time Index of Norm) in the studied groups had more evident differences: in the healthy volunteers it was in the range of 80-90%, in the patients with essential hypertension — 50-60%, and in the patients under PH and after RT — 20-40%. In all groups of patients with AH, the average the posterior wall thickness (PWT) of the LV and the interventricular septum thickness (IVST) were close to the upper limit of the norm. In the groups of patients with AH an increase in the relative wall thickness (RWT) of the LV was also detected. Furthermore, considerably higher the values of ILVmass, IVST were found in the group of patients on PH in comparison with the patients after RT. In addition, in all the groups of patients with AH, there was a tendency to LV spherification in comparison with the healthy volunteers, and in the group of essential AH the difference was more pronounced compared with the group under RRT.Conclusion. In the patients with arterial hypertension who undergo renal replacement therapy, higher average values of central BP, higher vascular stiffness (daily pulse wave velocity in the aorta and a longer period of pulse wave velocity increase in the aorta during the day (PTIN)) and less pronounced left ventricular spherification are recorded in comparison with the patients with essential hypertension while office BP values remained consistent.

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P1830 Single-beat aortic arch pulse wave velocity by dual-gate simultaneous Doppler technique: a novel method for arterial stiffness evaluation

European Heart Journal - Cardiovascular Imaging ◽

10.1093/ehjci/jez319.1173 ◽

2020 ◽

Vol 21 (Supplement_1) ◽

Author(s):

F Antonini-Canterin ◽

A Pepe ◽

M Strazzanti ◽

D Rivaben ◽

E Nicolosi ◽

...

Keyword(s):

Pulse Wave Velocity ◽

Healthy Volunteers ◽

Aortic Arch ◽

Wave Velocity ◽

Aortic Stiffness ◽

Pulse Wave ◽

Surrogate Marker ◽

Mri Studies ◽

Pulsed Wave Doppler ◽

Dual Gate

Abstract Background Guidelines recommend increased aortic stiffness as a negative prognostic factor to be considered in primary and secondary prevention. Pulse wave velocity (PWV) is a frequently employed surrogate marker of aortic stiffness. Carotid-femoral PWV is the most common index in research and clinical practice, but recently several velocity-encoded magnetic resonance imaging (MRI) techniques have been used for the evaluation of regional aortic arch PWV, where the stiffness seems to be particularly relevant from a prognostic point of view. Purposes. We developed a new ultrasound method for the assessment of aortic arch PWV, using a single-beat dual-gate simultaneous pulsed wave Doppler tracing. The aim of the study is to evaluate the feasibility of this new technique in a group of healthy volunteers. Methods We examined 126 healthy volunteers (81 females, 45 males, mean age 42 + 15 years, range 13-83 years) using a commercially available machine equipped with simultaneous dual-gate pulsed Doppler. Using the suprasternal approach, the first sample volume was placed in ascending aorta and the second one in descending aorta. The distance between the two sites was directly measured with a curvilinear tracing in the middle of the vessel, following the shape of the aortic arch. PWV was calculated as the ratio of distance (in millimiters) and the transit time (in milliseconds) measured using the "foot-to-foot" method. The results are then easily transformed, simplifying in the commonly unit of meters/second. Results Feasibility was 99%; in one case it was not possible to measure accurately the aortic arch PWV due to unfavorable suprasternal acustic window. The procedure time was very fast, requiring 2 + 1 minutes. Intraobserver and interobserver variability were 7% and 9% respectively. Aortic arch PWV, as expected, showed a strong correlation with age in males as well as in females (r= 0.71 and r = 0.60 respectively, p < 0.001 for both); there was also a significant correlation with body mass index (r = 0.31; p < 0.001). Aortic arch PWV values ranged from 3.1 to 8.5 m/s, showing a substantial overlap with normal values reported in MRI studies. Conclusions The direct measurement of aortic arch PWV is feasible and reproducible with ultrasound, using the novel single-beat dual-gate simultaneous pulsed wave Doppler tracing. This technique could be implemented in a standard echo examination, that is much more available than MRI studies. Further studies are needed to evaluate if Doppler-derived aortic arch PWV could provide additional prognostic information. Abstract P1830 Figure. Aortic Arch PWV

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