scholarly journals The Association Between Arterial Stiffness and Muscle Indices Among Healthy Subjects and Subjects With Cardiovascular Risk Factors: An Evidence-Based Review

2021 ◽  
Vol 12 ◽  
Author(s):  
Amilia Aminuddin ◽  
Muhammad Fakhrurrazi Noor Hashim ◽  
Nur Aina Syazana Mohd Zaberi ◽  
Lee Zheng Wei ◽  
Beh Ching Chu ◽  
...  

Skeletal muscle is one of the major tissues in the body and is important for performing daily physical activity. Previous studies suggest that vascular dysfunction contributes to reduced skeletal muscle mass. However, the association between vascular dysfunction and muscle mass, muscle strength and muscle flexibility are less established. Therefore, the focus of this review was to investigate the association between arterial stiffness (AS) which is a marker of vascular function, and muscle indices among healthy and those with cardiovascular risk factors. Three databases were used to search for relevant studies. These keywords were used: “arterial stiffness” OR “vascular stiffness” OR “aortic stiffness” OR “pulse wave velocity” OR “carotid femoral pulse wave velocity” OR “pulse wave analysis” AND “muscle” OR “skeletal” OR “flexibility” OR “range of motion” OR “articular” OR “arthrometry” OR “strength” OR “hand strength” OR “pinch strength” OR “mass” OR “lean” OR “body composition.” The criteria were; (1) original, full-text articles, (2) articles written in English language, (3) human studies involving healthy adults and/or adults with cardiovascular disease (CVD) or CVD risk factors (4) articles that reported the relationship between AS (measured as carotid-femoral pulse wave velocity or brachial-ankle pulse wave velocity) and muscle indices (measured as muscle mass, muscle flexibility and muscle strength) after adjusting for relevant confounders. The search identified 2295 articles published between 1971 and June 2021. Only 17 articles fulfilled the criteria. Two studies showed an inverse association between AS and muscle strength in healthy subjects, whereas in subjects with CVD risk factors, five out of seven studies found an inverse correlation between the two parameters. Eleven studies showed an inverse association between AS and muscle mass in subjects with CVD and CVD risk factors. The association between AS and muscle flexibility was not studied in any of the articles reviewed. In conclusion, there is an inverse correlation between muscle indices and AS in healthy adults and those with CVD or CVD risk factors. However, most of the studies were cross-sectional studies, hence the need for future prospective studies to address this issue.

Circulation ◽  
2015 ◽  
Vol 131 (suppl_1) ◽  
Author(s):  
Miguel Cainzos-Achirica ◽  
Sanjay Rampal ◽  
Yoosoo Chang ◽  
Seungho Ryu ◽  
Yiyi Zhang ◽  
...  

Introduction: The role of pulse wave velocity (PWV) in assessing cardiovascular disease (CVD) risk in asymptomatic non-elderly adults is unclear. PWV assessment, however, is readily available, non-invasive, cheap, and does not involve radiation exposure. Hypothesis: The aim of our study was to evaluate the hypothesis that brachial-ankle PWV was associated with coronary artery calcium (CAC) in a large sample of young and middle-aged asymptomatic adults, and that PWV increases the predictive value of traditional CVD risk factors for predicting the presence of CAC. Methods: Cross-sectional study of 15,009 asymptomatic men and women without a history of cardiovascular disease who underwent a health screening program that included both PWV and CAC measurements. Brachial-ankle PWV was obtained from bilateral brachial and posterior tibial artery pressure waveforms using the oscillometric method. Robust tobit regression was used to assess the association between PWV and natural log(CAC+1) and logistic regression was used to model the presence of detectable CAC (CAC>0) and CAC>100 adjusting for multiple CVD risk factors. Measures of calibration and discrimination were calculated to test the incremental value of adding PWV to traditional risk factors in predicting prevalent CAC. Results: The mean age of the study participants was 41.6 years (SD 7.2) and 83% (12,452) were men. Subjects with higher PWV had generally less favorable CVD risk profiles. The multivariable-adjusted CAC score ratios (95% confidence interval) comparing quintiles 2 - 5 of PWV to the first quintile were 1.21 (0.78, 1.86), 1.54 (1.01, 2.33), 1.98 (1.30, 3.01), and 2.83 (1.84, 4.37), respectively (P trend 100 were consistent with the results for CAC ratios. The addition of PWV to traditional risk factors significantly improved the discrimination and calibration of models for predicting the prevalence of detectable CAC (net reclassification index [NRI] for predicting detectable CAC and CAC score > 100 of 0.167 and 0.252, respectively; both p<0.001). Conclusions: In this large sample of young and middle-aged asymptomatic adults, brachial-ankle PWV was independently associated with the presence and the extent of CAC. PWV measurements improve the prediction of detectable CAC compared to traditional CVD risk factors and may help identify young and middle-age subjects with increased risk of subclinical disease.


2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1430.2-1431
Author(s):  
M. Schubertová ◽  
A. Smržová ◽  
P. Horak ◽  
M. Skácelová ◽  
E. Lokočová ◽  
...  

Background:Cardiovascular disease (CVD) is one of the most common causes of death in Rheumatoid arthritis patients. Increased arterial stiffness is considered as an independent risk factor of development CVD and a predictor of all-cause morbidity and mortality. Increased arterial stiffness, due to premature vascular ageing, can be observed in patients with chronic inflammatory diseases as well as in RA patients.Objectives:To evaluate arterial stiffness determined as carotid – femoral pulse wave velocity in rheumatoid arthritis patients. The comparison of traditional and nontraditional risk factor of CVD, disease activity and laboratory findings connected with subclinical atherosclerotic changes.Methods:We evaluated data of 50 patients with rheumatoid arthritis (39 females, 11male, mean age 57, mean duration of disease of 13years). The arterial stiffness, measured as carotid – femoral pulse wave velocity (PWV), was established with the SphygmoCor system. This non-invasive technique uses the principle of applanation tonometry. Our control group counted 25 heathy male and females with no history of CVD or autoimmune disease. We evaluated the influence of traditional risk factors for CVD as age, smoking, BMI, lipid profile, diabetes mellitus, history of CV and cerebrovascular morbidity to PWV in RA patients. Non-traditional risk factors contained Adiponectin, Fetuin A, Endothelin-1 and Asymmetric dimethylarginine. To measure disease activity was used DAS 28 and inflammatory parameters as a marker of current disease activity. For chronic changes was used X-ray of small joints. Results were correlated with PWV and statistically evaluated.Results:Mean PWV in Rheumatoid arthritis patients was significantly higher (9.7 m/s) than that in healthy control group (6.7m/s). 49% of RA patients (n= 24) had increased arterial stiffness according to their age. 32% patients (n=16) with PWV over 10m/s that indicates aortal function alteration. We didn´t find correlation between arterial stiffness and traditional and non-traditional CVD risk factors. Increased PWV was not associated with high disease activity. Patients with higher arterial stiffness according to their age had longer RA history, higher level of rheumatoid factor, were more frequently anti-citrullinated protein antibodies (ACPA) negative and were more frequently treated with biological therapy.Conclusion:Rheumatoid arthritis patients are in increased risk of CV disease. PWV is considered as an independent risk factor of CVD. We proved increased arterial stiffness and vascular ageing in comparison to healthy controls. We did not find correlation between increased arterial stiffness and disease activity. All CVD risk factor intervention is necessary to improve the prognosis of patients. Further investigation is needed to establish the role of increased PWV in RA patients.References:[1]Reference Values for Arterial Stiffness’ Collaboration. Determinants of pulse wave velocity in healthy people and in the presence of cardiovascular risk factors: ‘establishing normal and reference values’.Eur Heart J. 2010;31(19):2338–2350.[2]Pasquale Ambrosino, Marco Tasso, Roberta Lupoli, Alessandro Di Minno, Damiano Baldassarre, Elena Tremoli & Matteo Nicola Dario Di Minno. Non-invasive assessment of arterial stiffness in patients with rheumatoid arthritis: A systematic review and meta-analysis of literature studies, Annals of Medicine, 2015; 47:6, 457-467.Acknowledgments:IGA_LF_2019_006, MZ Č-RVO (FNOL-00098892, 87-21)Disclosure of Interests:Markéta Schubertová: None declared, Andrea Smržová: None declared, Pavel Horak Speakers bureau: Pfizer, Abbvie, Eli lilly. Novartis, Roche, Sanofi, Martina Skácelová: None declared, Eva Lokočová: None declared, Zuzana Heřmanová: None declared, František Mrázek: None declared


2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Ji-Hee Haam ◽  
Young-Sang Kim ◽  
Doo-Yeoun Cho ◽  
Hyejin Chun ◽  
Sang-Woon Choi ◽  
...  

AbstractRecent evidence suggests that cellular perturbations play an important role in the pathogenesis of cardiovascular diseases. Therefore, we analyzed the association between the levels of urinary metabolites and arterial stiffness. Our cross-sectional study included 330 Korean men and women. The brachial-ankle pulse wave velocity was measured as a marker of arterial stiffness. Urinary metabolites were evaluated using a high-performance liquid chromatograph-mass spectrometer. The brachial-ankle pulse wave velocity was found to be positively correlated with l-lactate, citrate, isocitrate, succinate, malate, hydroxymethylglutarate, α-ketoisovalerate, α-keto-β-methylvalerate, methylmalonate, and formiminoglutamate among men. Whereas, among women, the brachial-ankle pulse wave velocity was positively correlated with cis-aconitate, isocitrate, hydroxymethylglutarate, and formiminoglutamate. In the multivariable regression models adjusted for conventional cardiovascular risk factors, three metabolite concentrations (urine isocitrate, hydroxymethylglutarate, and formiminoglutamate) were independently and positively associated with brachial-ankle pulse wave velocity. Increased urine isocitrate, hydroxymethylglutarate, and formiminoglutamate concentrations were associated with brachial-ankle pulse wave velocity and independent of conventional cardiovascular risk factors. Our findings suggest that metabolic disturbances in cells may be related to arterial stiffness.


Circulation ◽  
2016 ◽  
Vol 133 (suppl_1) ◽  
Author(s):  
Margaret A Crawford ◽  
Matthew A Allison ◽  
Michael H Criqui ◽  
Britta A Larsen

Introduction: Higher volume of coronary arterial calcium (CAC) and abdominal aortic calcium (AAC) are predictive of incident CVD, while higher density of CAC and AAC are associated with lower risk. The purpose of the present study was to determine the associations of abdominal lean muscle mass (ALMM) with CAC volume, CAC density, AAC volume, and AAC density. Hypothesis: We hypothesized that abdominal muscle mass would be negatively associated with CAC and AAC volume but positively associated with CAC and AAC density. Methods: The current study analyzed data from the Multi-Ethnic Study of Atherosclerosis (MESA) in those participants who underwent abdominal computed tomography (CT) to assess for AAC, which was also analyzed for volumes of fat (visceral and subcutaneous) and ALMM (psoas, rectus abdominis, obliques, and paraspinus). CAC and AAC were scored separately, for density and for volume. Results: Analyses were restricted to participants who had non-zero CAC or AAC volumes. The sample sizes for the CAC analyses and AAC analyses were 963 and 1283 subjects, respectively. For the CAC analyses, 39.4% (379 of 963) were female and the mean age was 66.4 years. Mean ± SD CAC volume was 218.52 ± 344.19 (range 2.34- 3244.77 mm 3 ) ; Mean ± SD CAC density was 2.70 ± .72 (range 0.83- 4.0 Hu category units). Mean ± SD AAC volume was 1402.33 ± 1888 (range 4.68- 15822.2 mm 3 ); mean ± SD AAC density was 3.02 ± .63 (range 0.83- 4.0 Hu category units). In multivariable linear regression models that controlled for age, race, gender, CVD risk factors, visceral fat, and liver and kidney markers, both CAC and AAC density were found to be significantly associated with abdominal lean muscle mass. For every 100 cm 2 increase of ALMM, CAC density decreased by .35 Hu category units (p < .05). For every 100 cm 2 increase of ALMM, AAC density decreased by .26 Hu category units (p < .05). Conversely, CAC and AAC volume were not significantly associated with abdominal lean muscle mass in final models. Conclusion: Higher levels of ALMM were associated with lower CAC and AAC density, but not volume. Contrary to expectation, we found an inverse association of ALMM with CAC and AAC density, independent of relevant CVD risk factors.


2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
A F Ferreira ◽  
M J Azevedo ◽  
A P Machado ◽  
F A Saraiva ◽  
B Sampaio Maia ◽  
...  

Abstract Introduction Pregnancy is a physiological condition of hemodynamic overload, characterized by a progressive reduction of peripheral vascular resistance, which normalizes postpartum. Purpose To characterize arterial stiffness and endothelial function during pregnancy and postpartum and to investigate the impact of cardiovascular (CV) risk factors. The secondary aim was to explore the potential association between pulse wave velocity (PWV) and risk for preeclampsia. Methods Prospective cohort study including volunteer pregnant women (healthy, obese and/or hypertensive) recruited in a tertiary centre between 2019 and 2020, at their 1st or 3rd trimester of pregnancy. Women were evaluated at the first trimester [10–15 weeks, baseline], third trimester [30–35 weeks, peak of CV remodelling] of pregnancy as well as at the 1st month and 6th month after delivery (CV reverse remodelling stages). The evaluation included clinical characterization through questionnaires as well as arterial stiffness and endothelial assessment by PWV and EndoPAT, respectively. Kruskal-Wallis H test and Friedman test were used as appropriate to between and within groups comparisons. Bonferroni correction was applied. Spearman correlation was performed to determine the relationship between PWV and risk for preeclampsia. Results We included 34 pregnant women with a median age of 34 [26; 41]years, 50% being hypertensive and/or obese. Arterial stiffness decreased significantly from the 1st to the 3rd trimester (6.3 [5.3 to 7.8] cm/s vs 5.6 [4.9 to 7.3] cm/s, p&lt;0.001), normalizing only at the 6th months (5.6 [4.9 to 7.3] cm/s vs 6.3 [5.5 to 8.3] cm/s, p=0.001). A significant deterioration of endothelial function became evident from 1st to 3rd trimester (logarithm of reactive hyperemia index [lnRHI]: 0.74 [0.05 to 1.20] vs 0.45 [0.22 to 0.79], p=0.020). However, its slight amelioration begun only 6 months after delivery (3rd trimester: lnRHI 0.45 [0.22 to 0.79] vs 6 months at postpartum: lnRHI 0.53 [0.10 to 1.01], p&gt;0.99). Compared to the healthy pregnant women, the CV risk factors group showed a higher pulse wave velocity only at the peak of CV remodelling (5.6 [5.3 to 7.3] cm/s vs 5.6 [4.9 to 7.2] cm/s, p=0.016), without any other differences in other parameters of time points evaluated. Pulse wave velocity at the first trimester revealed a positive association with risk for preeclampsia (r=0.485, p=0.026). Conclusion Our cohort presented a significant decrease in vascular resistance during pregnancy and normalization at the 6th month after delivery. Pregnant women with cardiovascular risk factors showed an increased arterial stiffness in the 3rd trimester compared to healthy pregnant women. Pulse wave velocity correlated positively with the risk for preeclampsia. FUNDunding Acknowledgement Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Universidade do Porto/FMUP and FSE-Fundo Social Europeu; FCT - Foundation for Science and Technology


2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 790-790
Author(s):  
Evelien Vandercappellen ◽  
Ronald Henry ◽  
Coen Stehouwer ◽  
Annemarie Koster

Abstract We examined the associations of the amount and the pattern of higher intensity physical activity with arterial stiffness. Data from The Maastricht Study (n=1699; mean age: 60±8 years, 49.4% women, 26.9% type 2 diabetes (T2DM)) were used. Arterial stiffness was assessed by carotid-to-femoral pulse wave velocity (cfPWV). The amount (hours/day) and pattern of higher intensity physical activity were assessed with the activPAL3®. Activity groups were: inactive (&lt;75min/week), insufficiently active (75-150min/week), weekend warrior (&gt;150min/week in ≤2 sessions), and regularly active (&gt;150min/week in ≥3 sessions). After full adjustment, higher intensity physical activity was associated with lower cfPWV (amount: -0.35[-0.65;-0.05], insufficiently active: -0.33[-0.55;-0.11]; weekend warrior: -0.38[-0.64;-0.12] and regularly active: -0.46[-0.71;-0.21] (reference: inactive)). These associations were stronger in those with T2DM. Participating in higher intensity physical activity was associated with lower cfPWV, regardless of the weekly pattern, and may be an important strategy to reduce CVD risk, particularly in T2DM.


Stroke ◽  
2013 ◽  
Vol 44 (suppl_1) ◽  
Author(s):  
Shengxu Li ◽  
Wei Chen ◽  
Camilo Fernandez ◽  
Sathanur R Srinivasan ◽  
Gerald S Berenson

Arterial stiffness is an important risk factor for cardiovascular diseases including stroke. It has been established that childhood cardiovascular (CV) risk factors are predictive of adulthood arterial stiffness as measured by pulse wave velocity. Limited information is available on this relationship such as race- and sex-specific differential effects. This aspect was examined in a black-white, longitudinal cohort of 786 adults (28% blacks, 42% men) aged 23-44 years who were examined as both children (age<18 years) and adults (age≥18 years) for traditional CV risk factors with an average follow-up period of 24.2 years. Multiple childhood measurements were averaged and standardized to age-specific z-scores. Brachial-ankle pulse wave velocity (baPWV) measured by an automatic oscillometric technique was used as an index of arterial stiffness in adults. Systolic blood pressure in childhood was predictive of baPWA in adults (P=0.002) in the total cohort. However, nominally significant (P<0.05) childhood predictors of adult baPWV included body mass index (BMI), low-density lipoprotein cholesterol (LDL-C) and systolic blood pressure in white men; systolic blood pressure in white women; and BMI in black women. For race difference, childhood LDL-C tended to show a stronger effect on baPWA in adults in whites than in blacks (P=0.04). For sex difference, BMI tended to be a stronger predictor and LDL-C a weaker predictor in women than in men (P=0.0002 and P=0.003, respectively). Such differences persisted even after adjustment for adulthood risk factors (P<0.05 in all cases). In conclusion, the predictability of childhood CV risk factors for increased arterial stiffness in adulthood varies by race and sex, and this observation indicates that arterial stiffening is different in blacks vs whites and in men vs women.


2017 ◽  
Vol 131 (13) ◽  
pp. 1483-1493 ◽  
Author(s):  
Susanne Angermann ◽  
Marcus Baumann ◽  
Siegfried Wassertheurer ◽  
Christopher Clemens Mayer ◽  
Dominik Steubl ◽  
...  

Cognitive impairment in hemodialysis patients is common and associated with adverse outcomes. So far, the underlying pathogenesis remains unclear. Therefore, we examined the potential relationship between cognitive impairment and three different categories of risk factors with particular focus on arterial stiffness measured by pulse wave velocity (PWV). A total of 201 chronic hemodialysis patients underwent cognitive testing under standardized conditions using the Montreal Cognitive Assessment (MoCA). Demographic data including cardiovascular risk factors, dialysis-associated factors as well as factors related to chronic kidney disease (CKD) were analyzed. To account for arterial stiffness, PWV was measured by ambulatory blood pressure monitoried with an oscillometric device that records brachial blood pressure along with pulse waves. In our cohort, 60.2% of patients showed pathological MoCA test results indicating cognitive impairment. PWV was significantly associated with cognitive impairment apart from age, educational level, diabetes, and hypercholesterolemia. High prevalence of cognitive impairment in hemodialysis patients was confirmed. For the first time, an association between cognitive impairment and arterial stiffness was detected in a larger cohort of hemodialysis patients. Concerning the underlying pathogenesis of cognitive impairment, current results revealed a potential involvement of arterial stiffness, which has to be further evaluated in future studies.


Author(s):  
Kevin Heffernan ◽  
Lee Stoner ◽  
Michelle L. Meyer ◽  
Adam Keifer ◽  
Lauren Bates ◽  
...  

Introduction: Aortic stiffness offers important insight into vascular aging and cardiovascular disease (CVD) risk. The referent measure of aortic stiffness is carotid-femoral pulse wave velocity (cfPWV). cfPWV can be estimated (ePWV) from age and mean arterial pressure. Few studies have directly compared the association of ePWV to measured cfPWV, particularly in non-White adults. Moreover, whether ePWV and cfPWV correlate similarly with CVD risk remains unexplored. Aim: (1) To estimate the strength of the agreement between ePWV and cfPWV in both Black and White older adults; and (2) to compare the associations of ePWV and cfPWV with CVD risk factors and determine whether these associations were consistent across races. Methods and Results: We evaluated 4478 [75.2 (SD 5.0) years] Black and White older adults in the Atherosclerosis Risk in Communities (ARIC) Study. cfPWV was measured using an automated pulse waveform analyzer. ePWV was derived from an equation based on age and mean arterial pressure. Association and agreement between the two measurements were determined using Pearson’s correlation coefficient (r), standard error of estimate (SEE), and Bland-Altman analysis. Associations between traditional risk factors with ePWV and cfPWV were evaluated using linear mixed regression models. We observed weak correlations between ePWV and cfPWV within White adults (r = 0.36) and Black adults (r = 0.31). The mean bias for Bland-Altman analysis was low at -0.17 m/s (95%CI: -0.25 to -0.09). However, the inspection of the Bland-Altman plots indicated systematic bias (P < 0.001), which was consistent across race strata. The SEE, or typical absolute error, was 2.8 m/s suggesting high variability across measures. In models adjusted for sex, prevalent diabetes, the number of prevalent cardiovascular diseases, and medication count, both cfPWV and ePWV were positively associated with heart rate, triglycerides, and fasting glucose, and negatively associated with body mass index (BMI) and smoking status in White adults (P < 0.05). cfPWV and ePWV were not associated with heart rate, triglycerides, and fasting glucose in Black adults, while both measures were negatively associated with BMI in Black adults. Conclusions: Findings suggest a weak association between ePWV and cfPWV in older White and Black adults from ARIC. There were similar weak associations between CVD risk factors with ePWV and cfPWV in White adults with subtle differences in associations in Black adults. One sentence summary: Estimated pulse wave velocity is weakly associated with measured carotid-femoral pulse wave velocity in older Black and White adults in ARIC.


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