scholarly journals The effects of thyrotoxicosis and its treatment on central arterial stiffness

2002 ◽  
pp. 35-40 ◽  
Author(s):  
K Obuobie ◽  
J Smith ◽  
R John ◽  
JS Davies ◽  
JH Lazarus
Keyword(s):  
Heart Rate ◽  
Arterial Stiffness ◽  
Arterial Pressure ◽  
Pulse Wave ◽  
Augmentation Index ◽  
Significant Rise ◽  
Blood Pressures ◽  
Analysis Design ◽  
Additional Therapy ◽  
Control Study

OBJECTIVE: To assess central arterial stiffness in thyrotoxicosis using the technique of pulse wave analysis. DESIGN: Case control study designed to determine the effect of thyrotoxicosis on central arterial stiffness and at 6 months after radioiodine treatment. PATIENTS: Twenty (18 women and 2 men) thyrotoxic patients and 20 age- and sex-matched controls were studied at baseline. Thyrotoxic patients were re-studied at 6 months following treatment of thyrotoxicosis with 555 MBq (131)I with no additional therapy for the six-month period. MEASUREMENTS: Using the sphygmocor apparatus, peripheral pressure waveforms were recorded non-invasively from the radial artery and central pressure waveforms were generated from these. Indices of arterial stiffness, central augmentation index (AI), augmentation of central arterial pressure (AG) and central blood pressures were derived. AI corrected for heart rate (AIc) was calculated. RESULTS: Thyrotoxic patients recorded a significantly lower AI (means+/-s.e.m.) compared with controls (15.0+/-2.1 vs 28.0+/-2.1%; P<0.0005) even when corrected for differences in heart rate AIc (20.0+/-2.1 vs 28.0+/-2.1%; P<0.005) as well as AG (6.0+/-0.8 vs 10.0+/-1.1 mmHg; P<0.002) but higher pulse pressure (58.0+/-3.5 vs 47.0+/-2.0 mmHg; P<0.02). At 6 months following treatment, a significant rise in AIc (27.0+/-1.8 vs 20.0+/-2.1%; P<0.005) and AG (11.0+/-1.0 vs 6.0+/-0.8 mmHg; P<0.005) was noted. Lipid profiles were comparable between the groups. CONCLUSIONS: These data suggested that subjects with untreated thyrotoxicosis have a decreased augmentation of central arterial pressure or lowered central arterial stiffness that would not appear to contribute to any excess cardiovascular risk in that condition.

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

2016 ◽  
Vol 121 (3) ◽  
pp. 771-780 ◽  
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.

scholarly journals Insulin Increases The Central-To-Peripheral Arterial Stiffness Gradient in Response To Hyperglycemia in Healthy Humans: A Randomized Four-Way Crossover Study

2020 ◽  
Author(s):  
William B Horton ◽  
Linda A Jahn ◽  
Lee M Hartline ◽  
Kevin W Aylor ◽  
Eugene J Barrett
Keyword(s):  
Heart Rate ◽  
Arterial Stiffness ◽  
Pulse Wave Velocity ◽  
Crossover Study ◽  
Wave Velocity ◽  
Pulse Wave ◽  
Augmentation Index ◽  
Healthy Humans ◽  
Subendocardial Viability Ratio ◽  
Peripheral Arterial

Abstract Background: Increasing arterial stiffness is a physiological feature of vascular aging that is accelerated by conditions that enhance cardiovascular risk, including diabetes mellitus. Emerging evidence demonstrates that reversal of the normal central-to-peripheral arterial stiffness gradient predicts adverse cardiovascular consequences, including target organ damage. Preferential stiffening of central over peripheral arteries has been reported in type 2 diabetes, though mechanisms for this remain unclear.Methods: We tested the effect of acutely increasing plasma glucose, plasma insulin, or both on central arterial stiffness (carotid-femoral pulse wave velocity) and peripheral arterial stiffness (radial artery augmentation index) in a randomized, four-way, crossover study of 19 healthy young adults. We also measured myocardial oxygen supply-demand (subendocardial viability ratio) and hemodynamic function. Results: Carotid-femoral pulse wave velocity increased during hyperglycemic-hyperinsulinemia (+0.4 m/s; p=0.02) but not with euglycemia, hyperglycemia, or euglycemic-hyperinsulinemia. There were no significant changes in radial artery augmentation index within any protocol (all p>0.05), though this value trended lower with hyperglycemic-hyperinsulinemia (opposite of the observed effect on carotid-femoral pulse wave velocity). No changes were observed in subendocardial viability ratio within any protocol. Heart rate significantly increased only during hyperglycemic-hyperinsulinemia (+3.62 bpm; p=0.02). There was a significant inverse correlation between peripheral and arterial stiffness during hyperglycemic-hyperinsulinemia. Conclusions: We conclude that combined hyperglycemia and hyperinsulinemia acutely increases aortic stiffness, diminishes the normal central-to-peripheral arterial stiffness gradient, and increases heart rate in healthy humans. (ClinicalTrials.gov number NCT03520569; registered 9 May 2018).Clinical Trial Information: ClinicalTrials.gov identifier NCT03520569 (registered 9 May 2018).

scholarly journals Acute Effect of Moderate-Intensity Aerobic Exercise on Arterial Stiffness in Fine Particulate Matter Environment: A Pilot Study

2021 ◽  
Vol 30 (2) ◽  
pp. 257-263
Author(s):  
Jin-Su Kim ◽  
Moon-Hyon Hwang
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Arterial Stiffness ◽  
Aerobic Exercise ◽  
Pulse Wave ◽  
Augmentation Index ◽  
Fine Particulate Matter ◽  
Moderate Intensity ◽  
Fine Particulate ◽  
Pm2.5 Exposure

PURPOSE:This study aimed to examine the effect of one bout of moderate-intensity aerobic exercise on arterial stiffness under ambient fine particulate matter (PM2.5) exposure.METHODS: In a randomized crossover design, seven healthy young men performed 30 minutes of treadmill running at 70% of heart rate peak under high PM2.5 and low PM2.5 exposure. Arterial stiffness was assessed by measuring the carotid-femoral pulse wave velocity and augmentation index, a measure of pulse wave reflection before and after each exercise intervention.RESULTS: Regardless of the PM2.5 exposure, brachial systolic blood pressure and heart rate increased in response to one bout of moderate-intensity aerobic exercise (<i>p</i><.05). However, the augmentation index adjusted at a heart rate of 75 beats/min, central diastolic blood pressure, central mean arterial pressure, and brachial diastolic blood pressure were increased after one bout of moderate-intensity aerobic exercise under the high PM2.5 condition (<i>p</i><.05).CONCLUSIONS: Moderate-intensity aerobic exercise at the high PM2.5 level may result in acute negative arterial stiffness and blood pressure responses even in healthy young men.

scholarly journals MON-LB52 Evaluation of Arterial Stiffness in Acromegaly Patients

2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
sevil alagüney ◽  
Goknur Yorulmaz ◽  
Toygar Ahmet Kalkan ◽  
Kadir Ugur Mert ◽  
Muhammet Dural ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Arterial Stiffness ◽  
Pulse Wave Velocity ◽  
Wave Velocity ◽  
Pulse Wave ◽  
Augmentation Index ◽  
Morbidity And Mortality ◽  
Increased Risk ◽  
Study Results ◽  
Blood Pressures

Abstract Acromegaly is associated with increased morbidity and mortality primarily attributed to cardiovascular and cerebrovascular diseases, thus demonstrating the negative arterial impact of chronic GH and IGF-1 excess. There are limited and conflicting data regarding coronary artery disease (CAD) in acromegaly that consists mainly of heterogeneous cohorts and pathological reviews of old case series. Increased arterial stiffness is associated with an increased risk of cardiovascular events such as myocardial infarction. Arterial stiffness may measured from pulse wave velocity(PWV). In this study we aimed to evaluate the association between pulse wave velocity and aortic augmentation index in acromegalic patients. Methods: Our study population consists of a consecutive subset of 32 acromegalic patients and 19 control. Acromegalic patients IGF 1 levels were noted. All patients BMI, age, blood pressure, gender also were noted. Also pulse pressure, central blood pressures were measured by non-invasive central blood pressure measurement device (SphygmoCor). Pulse wave velocity and aortic augmentation index were measured by the same device. Results: A total of 32 acromegalic patients and 19 control were enrolled in the study. Body mass index and gender were not significantly different between the groups. Aortic augmentation index (5 vs. 6, p =0,685) variables weren’t significantly different in the study. Systolic and diastolic blood pressures were significantly high in the acromegalic group. (130/82 vs. 120/70) PWV was significantly high in the acromegalic group. (13 vs 11,5 p=0,002)Conclusions: Our study results suggest that acromegaly patients have worse arterial stiffness due to increased pulse wave velocity. Acromegaly is associated with increased morbidity and mortality primarily attributed to cardiovascular problems. We thought that it may be a guiding method in disease management since it can be an early marker of cardiovascular risk.Keywords: acromegaly, pulse wave velocity, aortic augmentation index

Abstract P457: Hypertensive, Type II Diabetic and Obese Patients, Are Better Controlled and Reduce the Number of Drugs When Empagliflozin is Added to Standard Treatment Improving Also Arterial Stiffness and Central Blood Pressures

Hypertension ◽  
2017 ◽  
Vol 70 (suppl_1) ◽  
Author(s):  
Ricardo Cabrera-Sole ◽  
Caridad Turpin Lucas ◽  
Liliana Urrera Rivera ◽  
Santiago Garcia Ruiz ◽  
Manuel Aguilera
Keyword(s):  
Blood Pressure ◽  
Arterial Stiffness ◽  
Standard Treatment ◽  
Pulse Wave ◽  
Antihypertensive Drugs ◽  
Augmentation Index ◽  
P Value ◽  
Channel Blockers ◽  
Blood Pressures ◽  
Central Systolic Blood Pressure

Introduction: It is known the difficulty of adequate control of blood pressure (BP) with a single drug, being necessary in most use 2 or more antihypertensive drugs. If they are also obese and diabetic, require even more drugs so we present our experience of adding empagliflozin to the treatment of patients with these characteristics. Objectives: To assess the benefits of metabolic ,BP and arterial stiffness parameters introducing empagliflozin in obese ,hypertensive and diabetics patients (PHTAD). Material and Methods: we studied 32 PHTAD receiving at least 3 drugs (ACE inhibitors, calcium channel blockers, hydrochlorothiazide) and two or more anti diabetic drugs (metformin, glimepirina, sitagliptin, insulin and Statins) for controlling their pathologies). We checked number of drug, BP, glicosylated hemoglobin (A1cHb), BMI and arterial stiffness measured by augmentation index (AI) and pulse wave velocity (PWV) and central systolic blood pressure (SBPc). Patients were followed for 32 weeks, adding to the beginning of the study empagliflozina .Every two months we checked them . The beginning and the end results were compared and are set out in the following table. *means p value less than 0.05 Conclusions: According to our data, the introduction of empagliflozin to the treatment of PHTAD significantly improves metabolic parameters and helps to reduce the number of antihypertensive and antidiabetic drugs they are taking, improving the arterial stiffness indexes and the central pressure values, obtaining a clear improvement in the control of their cardiovascular risk . So it should be thought about this group of drugs when it comes to medicating PHTAD.

scholarly journals Insulin Increases Central Aortic Stiffness in Response To Hyperglycemia in Healthy Humans: A Randomized Four-Way Crossover Study

2020 ◽  
Author(s):  
William B Horton ◽  
Linda A Jahn ◽  
Lee M Hartline ◽  
Kevin W Aylor ◽  
Eugene J Barrett
Keyword(s):  
Heart Rate ◽  
Arterial Stiffness ◽  
Pulse Wave Velocity ◽  
Crossover Study ◽  
Wave Velocity ◽  
Aortic Stiffness ◽  
Pulse Wave ◽  
Augmentation Index ◽  
Healthy Humans ◽  
Peripheral Arterial

Abstract Increasing arterial stiffness is a feature of vascular aging that is accelerated by conditions that enhance cardiovascular risk, including diabetes mellitus. Emerging evidence demonstrates that reversal of the normal lower central to higher peripheral arterial stiffness gradient predicts adverse cardiovascular consequences, including target organ damage. Preferential stiffening of central over peripheral arteries has been reported in type 2 diabetes, though mechanisms for this remain unclear. We tested the effect of acutely increasing plasma glucose, plasma insulin, or both on hemodynamic function, central aortic stiffness (carotid-femoral pulse wave velocity), and peripheral arterial stiffness (augmentation index) in a randomized, four-way, crossover study of 19 healthy young adults. Carotid-femoral pulse wave velocity increased only during hyperglycemic-hyperinsulinemia (+0.4 m/s; p=0.02), while augmentation index did not change significantly within any intervention (all p>0.05). Heart rate significantly increased only during hyperglycemic-hyperinsulinemia (+3.62 bpm; p=0.02). There was a significant inverse correlation between the changes of central and peripheral arterial stiffness only during hyperglycemic-hyperinsulinemia. We conclude that combined hyperglycemia and hyperinsulinemia acutely increased aortic stiffness, changed the normal central-to-peripheral arterial stiffness gradient, and increased heart rate in healthy humans. (ClinicalTrials.gov number NCT03520569; registered 9 May 2018).

Arterial stiffness is a potential mechanism and promising indicator of orthostatic hypotension in the general population

VASA ◽  
2014 ◽  
Vol 43 (6) ◽  
pp. 423-432 ◽  
Author(s):  
Qingtao Meng ◽  
Si Wang ◽  
Yong Wang ◽  
Shixi Wan ◽  
Kai Liu ◽  
...  
Keyword(s):  
General Population ◽  
Arterial Stiffness ◽  
Orthostatic Hypotension ◽  
Operating Characteristic ◽  
Pulse Wave ◽  
Augmentation Index ◽  
Multiple Logistic Regression Analysis ◽  
The Elderly ◽  
Baroreceptor Sensitivity ◽  
Roc Curve Analysis

Background: Orthostatic hypotension (OH) is a disease prevalent among middle-aged men and the elderly. The association between arterial stiffness and OH is unclear. This study evaluates whether arterial stiffness is correlated with OH and tests the usefulness of brachial-ankle pulse wave velocity (baPWV), an arterial stiffness marker, with regard to identifying OH. Patients and methods: A sample of 1,010 participants was recruited from the general population (64.8 ± 7.7 years; 426 men) who attended health check-ups. BaPWV and the radial augmentation index (rAI) were both assessed as the arterial stiffness markers, and OH was determined using blood pressure (BP) measured in the supine position, as well as 30 seconds and 2 minutes after standing. Results: The prevalence of OH in this population was 4.9 %. Compared with the non-OH group, both baPWV (20.5 ± 4.5 vs 17.3 ± 3.7, p < 0.001) and rAI (88.1 ± 10.8 vs 84.2 ± 10.7, p < 0.05) were significantly higher in the OH group. In the multiple logistic regression analysis, baPWV (OR, 1.3; 95 % CI, 1.106–1.528; p < 0.05) remained associated with OH. Moreover, the degree of orthostatic BP reduction was related to arterial stiffness. In addition, increases in arterial stiffness predicted decreases in the degree of heart rate (HR) elevation. Finally, a receiver operating characteristic (ROC) curve analysis showed that baPWV was useful in discriminating OH (AUC, 0.721; p < 0.001), with the cut-off value of 18.58 m/s (sensitivity, 0.714; specificity, 0.686). Conclusions: Arterial stiffness determined via baPWV, rather than rAI, was significantly correlated with the attenuation of the orthostatic hemodynamic response and the resultant OH. The impaired baroreceptor sensitivity might be the mechanism. In addition, baPWV appears to be a relatively sensitive and reliable indicator of OH in routine clinical practice.

Markers of arterial stiffness in peripheral arterial disease

VASA ◽  
2015 ◽  
Vol 44 (5) ◽  
pp. 341-348 ◽  
Author(s):  
Marc Husmann ◽  
Vincenzo Jacomella ◽  
Christoph Thalhammer ◽  
Beatrice R. Amann-Vesti
Keyword(s):  
Arterial Stiffness ◽  
Peripheral Arterial Disease ◽  
Pulse Wave ◽  
Augmentation Index ◽  
Arterial Disease ◽  
Care Physician ◽  
Additional Information ◽  
Non Invasive ◽  
Assessment Techniques ◽  
Peripheral Arterial

Abstract. Increased arterial stiffness results from reduced elasticity of the arterial wall and is an independent predictor for cardiovascular risk. The gold standard for assessment of arterial stiffness is the carotid-femoral pulse wave velocity. Other parameters such as central aortic pulse pressure and aortic augmentation index are indirect, surrogate markers of arterial stiffness, but provide additional information on the characteristics of wave reflection. Peripheral arterial disease (PAD) is characterised by its association with systolic hypertension, increased arterial stiffness, disturbed wave reflexion and prognosis depending on ankle-brachial pressure index. This review summarises the physiology of pulse wave propagation and reflection and its changes due to aging and atherosclerosis. We discuss different non-invasive assessment techniques and highlight the importance of the understanding of arterial pulse wave analysis for each vascular specialist and primary care physician alike in the context of PAD.

STRUCTURAL AND FUNCTIONAL VASCULAR CHANGES IN HIGH NORMAL ARTERIAL PRESSURE

2020 ◽  
Vol 23 (1) ◽  
pp. 7-11
Author(s):  
P. Nikolov
Keyword(s):  
Arterial Pressure ◽  
Pulse Wave Velocity ◽  
Wave Velocity ◽  
Pulse Pressure ◽  
Pulse Wave ◽  
Augmentation Index ◽  
Aortic Pressure ◽  
Large Arteries ◽  
Central Aortic Pressure ◽  
Significant Difference

The PURPUSE of the present study is changes in function and structure of large arteries in individuals with High Normal Arterial Pressure (HNAP) to be established. MATERIAL and METHODS: Structural and functional changes in the large arteries were investigated in 80 individuals with HNAP and in 45 with optimal arterial pressure (OAP). In terms of arterial stiffness, pulse wave velocity (PWV), augmentation index (AI), central aortic pressure (CAP), pulse pressure (PP) were followed up in HNAP group. Intima media thickness (IMT), flow-induced vasodilatation (FMD), ankle-brachial index (ABI) were also studied. RESULTS: Significantly increased values of pulse wave velocity, augmentation index, central aortic pressure, pulse pressure are reported in the HNAP group. In terms of IMT and ABI, being in the reference interval, there is no significant difference between HNAP and OAP groups. The calculated cardiovascular risk (CVR) in both groups is low. CONCLUSION: Significantly higher values of pulse wave velocity, augmentation index, central aortic pressure and pulse pressure in the HNAP group are reported.

scholarly journals Association of changes of pulse wave velocity and augmentation index after isometric handgrip exercise with coronary lesion extent and revascularization

2021 ◽  
Vol 27 (1) ◽  
Author(s):  
Seong Taeg Kim ◽  
Yeekyoung Ko ◽  
Jong-Wook Beom ◽  
Ki Yung Boo ◽  
Jae-Geun Lee ◽  
...  
Keyword(s):  
Arterial Stiffness ◽  
Pulse Wave Velocity ◽  
Iliac Artery ◽  
Pulse Wave ◽  
Augmentation Index ◽  
Coronary Revascularization ◽  
External Iliac Artery ◽  
Handgrip Exercise ◽  
Isometric Handgrip ◽  
Isometric Handgrip Exercise

Abstract Background Arterial stiffness is associated with myocardial ischemia and incident coronary artery disease (CAD), and indexes of arterial stiffness are usually increased in patients with CAD. However, these indexes are often increased in elderly without CAD. Arterial stiffness in patients with CAD may become more evident after isometric handgrip exercise which increases systolic pressure and ventricular afterload. We investigated the association of the change of stiffness indexes after isometric handgrip exercise with the lesion extent of CAD and the necessity for coronary revascularization. Methods Patients who were scheduled a routine coronary angiography via a femoral artery were enrolled. Arterial waveforms were traced at aortic root and external iliac artery using coronary catheters at baseline and 3 min after handgrip exercise. Augmentation index (AIx) was measured on the recorded aortic pressure waveform, and pulse wave velocity (PWV) was calculated using the ECG-gated time difference of the upstroke of arterial waveforms and distance between aortic root and external iliac artery. Results Total 37 patients were evaluated. Both PWV and AIx increased after handgrip exercise. ΔPWV was significantly correlated with ΔAIx (r = 0.344, P = 0.037). Patients were divided into higher and lower ΔPWV or ΔAIx groups based on the median values of 0.4 m/sec and 3.3%, respectively. Patients with higher PWV had more 2- or 3-vessel CAD (69% vs. 27%, P = 0.034), and underwent percutaneous coronary intervention (PCI) more frequently (84% vs. 50%, P = 0.038), but higher ΔAIx was not associated with either the lesion extent or PCI. Area under curve (AUC) of ΔPWV in association with PCI by C-statistics was 0.70 (95% confidence interval [CI] 0.51–0.88; P = 0.056). In multiple logistic regression analysis, ΔPWV was significantly associated with PCI (odds ratio 7.78; 95% CI 1.26–48.02; P = 0.027). Conclusions Higher ΔPWV after isometric handgrip exercise was associated with the lesion extent of CAD and the necessity for coronary revascularization, but higher ΔAIx was not.

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