Modulation of Arterial Stiffness Gradient by Acute Administration of Nitroglycerin

Background: Physiologically, the aorta is less stiff than peripheral conductive arteries, creating an arterial stiffness gradient, protecting microcirculation from high pulsatile pressure. However, the pharmacological manipulation of arterial stiffness gradient has not been thoroughly investigated. We hypothesized that acute administration of nitroglycerin (NTG) may alter the arterial stiffness gradient through a more significant effect on the regional stiffness of medium-sized muscular arteries, as measured by pulse wave velocity (PWV). The aim of this study was to examine the differential impact of NTG on regional stiffness, and arterial stiffness gradient as measured by the aortic-brachial PWV ratio (AB-PWV ratio) and aortic-femoral PWV ratio (AF-PWV ratio).Methods: In 93 subjects (age: 61 years, men: 67%, chronic kidney disease [CKD]: 41%), aortic, brachial, and femoral stiffnesses were determined by cf-PWV, carotid-radial (cr-PWV), and femoral-dorsalis pedis artery (fp-PWV) PWVs, respectively. The measurements were repeated 5 min after the sublingual administration of NTG (0.4 mg). The AB-PWV and AF-PWV ratios were obtained by dividing cf-PWV by cr-PWV or fp-PWV, respectively. The central pulse wave profile was determined by radial artery tonometry through the generalized transfer function.Results: At baseline, cf-PWV, cr-PWV, and fp-PWV were 12.12 ± 3.36, 9.51 ± 1.81, and 9.71 ± 1.89 m/s, respectively. After the administration of NTG, there was a significant reduction in cr-PWV of 0.86 ± 1.27 m/s (p < 0.001) and fp-PWV of 1.12 ± 1.74 m/s (p < 0.001), without any significant changes in cf-PWV (p = 0.928), leading to a significant increase in the AB-PWV ratio (1.30 ± 0.39 vs. 1.42 ± 0.46; p = 0.001) and AF-PWV ratio (1.38 ± 0.47 vs. 1.56 ± 0.53; p = 0.001). There was a significant correlation between changes in the AF-PWV ratio and changes in the timing of wave reflection (r = 0.289; p = 0.042) and the amplitude of the heart rate-adjusted augmented pressure (r = − 0.467; p < 0.001).Conclusion: This study shows that acute administration of NTG reduces PWV of muscular arteries (brachial and femoral) without modifying aortic PWV. This results in an unfavorable profile of AB-PWV and AF-PWV ratios, which could lead to higher pulse pressure transmission into the microcirculation.

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

Journal of Applied Physiology ◽

10.1152/japplphysiol.00445.2016 ◽

2016 ◽

Vol 121 (3) ◽

pp. 771-780 ◽

Cited By ~ 10

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.

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Bilateral And Unilateral Resistance Exercise On Pulse Wave Reflection And Arterial Stiffness

Medicine & Science in Sports & Exercise ◽

10.1249/01.mss.0000682896.26016.75 ◽

2020 ◽

Vol 52 (7S) ◽

pp. 708-708

Author(s):

Erica M. Marshall ◽

Jason C. Parks ◽

Stacie M. Humm ◽

Emily K. Erb ◽

Meredith C. Paskert ◽

...

Keyword(s):

Arterial Stiffness ◽

Resistance Exercise ◽

Wave Reflection ◽

Pulse Wave ◽

Pulse Wave Reflection

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

10.21203/rs.3.rs-72339/v4 ◽

2021 ◽

Author(s):

William B Horton ◽

Linda A Jahn ◽

Lee M Hartline ◽

Kevin W Aylor ◽

James T Patrie ◽

...

Keyword(s):

Diabetes Mellitus ◽

Blood Pressure ◽

Arterial Stiffness ◽

Pulse Wave Velocity ◽

Diastolic Blood Pressure ◽

Wave Velocity ◽

Wave Reflection ◽

Pulse Wave ◽

Augmentation Index ◽

Healthy Humans

Abstract Introduction: Increasing arterial stiffness is a feature of vascular aging that is accelerated by conditions that enhance cardiovascular risk, including diabetes mellitus. Multiple studies demonstrate divergence of carotid-femoral pulse wave velocity and augmentation index in persons with diabetes mellitus, though mechanisms responsible for this are unclear.Materials and Methods: We tested the effect of acutely and independently increasing plasma glucose, plasma insulin, or both on hemodynamic function and markers of arterial stiffness (including carotid-femoral pulse wave velocity, augmentation index, forward and backward wave reflection amplitude, and wave reflection magnitude) in a four-arm, randomized study of healthy young adults.Results: Carotid-femoral pulse wave velocity increased only during hyperglycemic-hyperinsulinemia (+0.36 m/s; p=0.032), while other markers of arterial stiffness did not change (all p>0.05). Heart rate (+3.62 bpm; p=0.009), mean arterial pressure (+4.14 mmHg; p=0.033), central diastolic blood pressure (+4.16 mmHg; p=0.038), and peripheral diastolic blood pressure (+4.09 mmHg; p=0.044) also significantly increased during hyperglycemic-hyperinsulinemia.Conclusions: We conclude that the acute combination of moderate hyperglycemia and hyperinsulinemia preferentially stiffens central elastic arteries. This effect may be due to increased sympathetic activity. (ClinicalTrials.gov number NCT03520569; registered 9 May 2018).

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No significant association of serum klotho concentration with blood pressure and pulse wave velocity in a Chinese population

Scientific Reports ◽

10.1038/s41598-021-82258-5 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Wan-Ying Liang ◽

Li-Hong Wang ◽

Jian-Hang Wei ◽

Qing-Lu Li ◽

Qi-Yan Li ◽

...

Keyword(s):

Blood Pressure ◽

Arterial Stiffness ◽

Pulse Wave Velocity ◽

Wave Velocity ◽

Chinese Population ◽

Pulse Wave ◽

Enzyme Linked Immunosorbent Assay ◽

Oscillometric Device ◽

Median Serum ◽

Generalized Transfer Function

AbstractKlotho, an important anti-aging protein, may be related to elevated blood pressure (BP) and arterial stiffness. We aimed to investigate associations between the serum klotho concentration and peripheral/central BP and arterial stiffness based on the carotid–femoral pulse wave velocity (cfPWV) in a Chinese population. We invited all inhabitants aged ≥ 18 years in two Dali communities for participation. The SphygmoCor system was used to record radial arterial waveforms. Aortic waveforms were derived using a generalized transfer function. The central BP was assessed by calibrating the brachial BP, which was measured using an oscillometric device. The serum klotho concentration was measured using an enzyme-linked immunosorbent assay and logarithmically transformed. Of the 716 participants (mean age: 51.9 ± 12.6 years), 467 (65.2%) were women. The median serum klotho concentration was 381.8 pg/mL. The serum klotho concentration did not significantly differ between patients with and without hypertension (P > 0.05) and between those with and without arterial stiffness (cfPWV ≥ 10 m/s) (P > 0.05). After adjusting for confounders, the serum klotho concentration was not significantly associated with the peripheral or central BP (P > 0.05) and cfPWV (P > 0.05). Our data indicated that the serum klotho concentration was not associated with BP or cfPWV in the general Chinese population.

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Sex Difference On Arterial Stiffness And Measures Of Pulse Wave Reflection Response To Weight Machines

Medicine & Science in Sports & Exercise ◽

10.1249/01.mss.0000675536.21787.84 ◽

2020 ◽

Vol 52 (7S) ◽

pp. 187-188

Author(s):

Rebecca Schmidt ◽

Erica M. Marshall ◽

Jason C. Parks ◽

Derek J. Kingsley

Keyword(s):

Arterial Stiffness ◽

Sex Difference ◽

Wave Reflection ◽

Pulse Wave ◽

Pulse Wave Reflection

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Arterial Stiffness in Hypertension and Function of Large Arteries

American Journal of Hypertension ◽

10.1093/ajh/hpz193 ◽

2020 ◽

Vol 33 (4) ◽

pp. 291-296 ◽

Cited By ~ 1

Author(s):

Yi Zhang ◽

Patrick Lacolley ◽

Athanase D Protogerou ◽

Michel E Safar

Keyword(s):

Arterial Stiffness ◽

Pulse Wave Velocity ◽

Wave Velocity ◽

Pulse Wave ◽

Rigid Wall ◽

Wall Material ◽

Pulsatile Pressure ◽

And Gender ◽

The Right ◽

Stage Renal Disease

Abstract BACKGROUND Arterial stiffness—typically assessed from non-invasive measurement of pulse wave velocity along a straight portion of the vascular tree between the right common carotid and femoral arteries—is a reliable predictor of cardiovascular risk in patients with essential hypertension. METHODS We reviewed how carotid-femoral pulse wave velocity increases with age and is significantly higher in hypertension (than in age- and gender-matched individuals without hypertension), particularly when hypertension is associated with diabetes mellitus. RESULTS From the elastic aorta to the muscular peripheral arteries of young healthy individuals, there is a gradual but significant increase in stiffness, with a specific gradient. This moderates the transmission of pulsatile pressure towards the periphery, thus protecting the microcirculatory network. The heterogeneity of stiffness between the elastic and muscular arteries causes the gradient to disappear or be inversed with aging, particularly in long-standing hypertension. CONCLUSIONS In hypertension therefore, pulsatile pressure transmission to the microcirculation is augmented, increasing the potential risk of damage to the brain, the heart, and the kidney. Furthermore, elevated pulse pressure exacerbates end-stage renal disease, particularly in older hypertensive individuals. With increasing age, the elastin content of vessel walls declines throughout the arterial network, and arterial stiffening increases further due to the presence of rigid wall material such as collagen, but also fibronectin, proteoglycans, and vascular calcification. Certain genes, mainly related to angiotensin and/or aldosterone, affect this aging process and contribute to the extent of arterial stiffness, which can independently affect both forward and reflected pressure waves.

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Maternal arterial stiffness in pregnancies affected by preeclampsia

AJP Heart and Circulatory Physiology ◽

10.1152/ajpheart.01106.2008 ◽

2009 ◽

Vol 297 (2) ◽

pp. H759-H764 ◽

Cited By ~ 61

Author(s):

Christina Kaihura ◽

Makrina D. Savvidou ◽

James M. Anderson ◽

Carmel M. McEniery ◽

Kypros H. Nicolaides

Keyword(s):

Arterial Stiffness ◽

Pulse Wave Velocity ◽

Wave Velocity ◽

Wave Reflection ◽

Pulse Wave ◽

Augmentation Index ◽

Applanation Tonometry ◽

Control Group ◽

Arterial Tree ◽

Cross Sectional

Preeclampsia (PE) is characterized by an aberrant maternal cardiovascular adaptation to pregnancy and increased cardiovascular risk later on in life. The aim of this study was to compare the maternal wave reflections and arterial stiffness in women with established PE and those with normotensive pregnancies, after systematic adjustment for known confounders. This was a cross-sectional study involving 69 normotensive, pregnant women and 54 women with established PE. Maternal wave reflection (augmentation index) and pulse wave velocity of the carotid-radial and carotid-femoral parts of the arterial tree were assessed noninvasively using applanation tonometry. The measurements were adjusted for maternal age, heart rate, mean arterial pressure, and aortic time to wave reflection and expressed as multiples of the median (MoM) of the control group. In the PE group, compared with controls, there was an increase in the median pulse wave velocity of both the carotid to femoral [1.1, interquartile rage (IQR) 1.0–1.3 MoM vs. 0.9, IQR 0.9–1.0 MoM; P < 0.0001] and carotid to radial (1.0, IQR 0.9–1.1 MoM vs. 0.9, IQR 0.9–1.0 MoM; P = 0.01) parts of the arterial tree. In contrast, there were no significant differences between the two groups in the median augmentation index (0.9, IQR 0.7–1.1 MoM vs. 1.0, IQR 0.5–1.8 MoM; P = 0.46). In conclusion, we found that established PE is characterized by increased maternal arterial stiffness but not altered maternal wave reflection.

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