Aortic Root Dimensions and Pulse Wave Velocity in Young Competitive Athletes

The assessment of aortic root dimensions is a cornerstone in cardiac pre-participation screening as dilation can result in severe cardiac events. Moreover, it can be a hint for an underlying connective tissue disease, which needs individualized sports counseling. This study examines the prevalence of aortic root dilatation in a cohort and its relationship to arterial stiffness as an early marker of cardiovascular risk due to vascular aging. From May 2012 to March 2018, we examined 281 young male athletes (14.7 ± 2.1 years) for their aortic root dimension. Moreover, we noninvasively assessed arterial stiffness parameter during pre-participation screening. Mean aortic diameter was 25.9 ± 3.1 mm and 18 of the 281 (6.4%) athletes had aortic root dilation without other clinical evidence of connective tissue disease. After adjusting for BSA, there was no association of aortic root diameter to pulse wave velocity (p = −0.054 r = 0.368) nor to central blood pressure (p = −0.029 r = 0.634). Thus, although a significant proportion of young athletes had aortic root dilatation, which certainly needs regular follow up, no correlation with arterial stiffness was found. It could be suggested that a dilated aortic root in young athletes does not alter pulse waveform and pulse reflection, and thus there is no increased cardiovascular risk in those subjects.

Download Full-text

AB0691 INCREASED CARDIOVASCULAR RISK IN MIXED CONNECTIVE TISSUE DISEASE: EVALUATION OF MACROVASCULAR INVOLVEMENT AND ITS PREDICTORS BY AORTIC PULSE WAVE VELOCITY

10.1136/annrheumdis-2019-eular.4495 ◽

2019 ◽

Cited By ~ 1

Author(s):

Konstantinos Triantafyllias ◽

Michele De Blasi ◽

Freya Lütgendorf ◽

Lorenzo Cavagna ◽

Marco Stortz ◽

...

Keyword(s):

Cardiovascular Risk ◽

Connective Tissue ◽

Pulse Wave Velocity ◽

Connective Tissue Disease ◽

Wave Velocity ◽

Mixed Connective Tissue Disease ◽

Pulse Wave ◽

Aortic Pulse Wave Velocity

Download Full-text

Elevated levels of urine isocitrate, hydroxymethylglutarate, and formiminoglutamate are associated with arterial stiffness in Korean adults

Scientific Reports ◽

10.1038/s41598-021-89639-w ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Ji-Hee Haam ◽

Young-Sang Kim ◽

Doo-Yeoun Cho ◽

Hyejin Chun ◽

Sang-Woon Choi ◽

...

Keyword(s):

Risk Factors ◽

Cardiovascular Risk ◽

Arterial Stiffness ◽

Pulse Wave Velocity ◽

Cardiovascular Risk Factors ◽

Wave Velocity ◽

Pulse Wave ◽

Urinary Metabolites ◽

Metabolic Disturbances ◽

Liquid Chromatograph

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.

Download Full-text

Brachial-ankle pulse wave velocity in healthy Japanese adolescents: reference values for the assessment of arterial stiffness and cardiovascular risk profiles

Hypertension Research ◽

10.1038/s41440-019-0370-z ◽

2019 ◽

Vol 43 (4) ◽

pp. 331-341 ◽

Cited By ~ 2

Author(s):

Yukiko Sougawa ◽

Nobuyuki Miyai ◽

Miyoko Utsumi ◽

Kazuhisa Miyashita ◽

Shintaro Takeda ◽

...

Keyword(s):

Cardiovascular Risk ◽

Arterial Stiffness ◽

Pulse Wave Velocity ◽

Wave Velocity ◽

Reference Values ◽

Pulse Wave ◽

Risk Profiles ◽

Japanese Adolescents

Download Full-text

Increased Arterial Stiffness in Adolescents With Obesity

Global Pediatric Health ◽

10.1177/2333794x19831297 ◽

2019 ◽

Vol 6 ◽

pp. 2333794X1983129

Author(s):

Yvette E. Lentferink ◽

Lisa A. J. Kromwijk ◽

Marloes P. van der Aa ◽

Catherijne A. J. Knibbe ◽

Marja M. J. van der Vorst

Keyword(s):

Insulin Resistance ◽

Cardiovascular Disease ◽

Risk Assessment ◽

Cardiovascular Risk ◽

Arterial Stiffness ◽

Pulse Wave Velocity ◽

Wave Velocity ◽

Pulse Wave ◽

Augmentation Index ◽

Cardiovascular Risk Assessment

Increased arterial stiffness (AS) is an early sign of cardiovascular disease. Influence of weight, puberty, and insulin resistance (IR) on AS in adolescents is unclear. Therefore, this study compared AS, assessed with pulse wave velocity (PWV) and augmentation index (AIx), of adolescents with and without obesity and evaluated the influence of puberty and IR on AS. Sixty-two lean and 61 adolescents with obesity were included. Significantly higher PWV was observed in adolescents with obesity (4.1 ms−1 [2.4 to 5.6 ms−1] vs 3.6 ms−1 [0.4 to 6.1 ms−1]; P = .01), while AIx was not significant different. However, significantly higher AIx was observed in adolescents with obesity and IR (3.0 [−17.5% to 28.5%] vs −3.0 [−19.0% to 13.0%]; P = .01). For Tanner stages, no differences were observed. The higher PWV in adolescents with obesity and higher AIx in adolescents with obesity and IR both indicate an increased AS. Consequently, measurement of AS should be considered in adolescents with obesity and IR as part of cardiovascular risk assessment.

Download Full-text

Impact of cardiovascular risk factors in vascular remodelling of pregnant women

European Heart Journal ◽

10.1093/eurheartj/ehab724.2901 ◽

2021 ◽

Vol 42 (Supplement_1) ◽

Author(s):

A F Ferreira ◽

M J Azevedo ◽

A P Machado ◽

F A Saraiva ◽

B Sampaio Maia ◽

...

Keyword(s):

Risk Factors ◽

Cardiovascular Risk ◽

Arterial Stiffness ◽

Pulse Wave Velocity ◽

Endothelial Function ◽

Pregnant Women ◽

Cardiovascular Risk Factors ◽

Wave Velocity ◽

Pulse Wave ◽

First Trimester

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<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>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

Download Full-text

SUPERIORITY OF PULSE WAVE VELOCITY FOR CARDIOVASCULAR RISK ASSESSMENT AMONG NONINVASIVE ARTERIAL STIFFNESS PARAMETERS IN THE GENERAL POPULATION

Journal of the American College of Cardiology ◽

10.1016/s0735-1097(13)61431-x ◽

2013 ◽

Vol 61 (10) ◽

pp. E1431

Author(s):

Takenori Ishisone ◽

Masahide Nagano ◽

Masayuki Onodera ◽

Yorihiko Koeda ◽

Kenyu Sato ◽

...

Keyword(s):

Risk Assessment ◽

Cardiovascular Risk ◽

General Population ◽

Arterial Stiffness ◽

Pulse Wave Velocity ◽

Wave Velocity ◽

Pulse Wave ◽

Cardiovascular Risk Assessment

Download Full-text

AB0406 ASSOCIATION OF ENDOTHELIN-1 WITH PULSE WAVE VELOCITY IN SYSTEMIC SCLEROSIS PATIENTS

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2021-eular.304 ◽

2021 ◽

Vol 80 (Suppl 1) ◽

pp. 1231.2-1232

Author(s):

A. Alvarez de Cienfuegos ◽

L. Cantero-Nieto ◽

J. A. García-Gómez ◽

J. L. Callejas-Rubio ◽

J. Martin Ibanez ◽

...

Keyword(s):

Systemic Sclerosis ◽

Connective Tissue ◽

Arterial Stiffness ◽

Pulse Wave Velocity ◽

Wave Velocity ◽

Pulse Wave ◽

Serum Levels ◽

Healthy Controls ◽

Endothelin 1 ◽

Female Patients

Background:Systemic sclerosis (SSc) is a multisystemic disease featured by vascular and immunological disorders along with an excessive accumulation of the components of the connective tissue that cause cutaneous sclerosis and fibrosis of different organs. The occurrence of endothelial dysfunction together with fibrosis indicates that endothelial cell-derived factors, such as endothelin-1 (ET-1), may have an important role in the pathogenesis of SSc. The upregulation of ET-1 activates inflammatory cells and leads to nitric oxide synthase inhibition associated with arterial stiffness.Objectives:The purpose of this study was to evaluate ET-1 serum levels in women with systemic sclerosis (SSc) compared with healthy controls and to examine possible associations between ET-1 and markers of arterial stiffness.Methods:This cross-sectional study was performed in San Cecilio Hospital, Granada (Spain) from November 2017 to May 2019. Sixty-two women with SSc and 62 age and sex matched healthy controls were enrolled in this study. Pulse Wave Velocity (PWV) was measured non-invasively along the carotid–femoral arterial segment. Serum ET-1 was analysed using indirect enzyme-linked immunosorbent assay (ELISA).Results:A total of 62 female patients were included in our study, with a mean (SD) age of 53 ± 10 years. The majority were Caucasian (90.5%). The mean disease duration was 8.8 ± 6.9 years. Forty-four (70.9%) patients had a limited form of the disease and 18 (29.1%) had a diffuse form.There was a significant difference in ET-1 serum levels between SSc female patients and healthy controls (28.4 ± 10.6 vs. 21.1 ± 11.7 pg/ml, p = 0.001). Serum levels of ET-1 were positively associated with PWV (r = 0.26, p < 0.05), within the study group. In addition, in the linear regression model, higher ET-1 concentrations were associated with higher PWV [β = 0.03 95% CI (0.001, 0.060); p < 0.05].Conclusion:This study shows that ET-1 serum levels are associated with PWV in women with SSc. Therefore, drugs that block ET-1 may be effective in reducing large artery stiffness in women with SSc, and thus cardiovascular risk.References:[1]LeRoy EC, Black C, Fleischmajer R, Jablonska S, Krieg T, Medsger TA Jr, et al. Scleroderma (systemic sclerosis): classification, bubsets and pathogenesis. J Rheumatol 1988; 15(2):202-205.[2]Shi-Wen X, Denton CP, Dashwood MR, Holmes AM, Bou-Gharios G, Pearson JD, et al. Fibroblast matrix gene expression and connective tissue remodeling: role of endothelin-1. J Invest Dermatol 2001; 116(3):417–425.[3]Heintz B, Dörr R, Gillessen T, Walkenhorst F, Krebs W, Hanrath P, et al. Do arterial endothelin 1 levels affect local arterial stiffness?. Am Heart J 1993; 126 (4): 987–989.[4]McEniery CM, Qasem A, Schmitt M, Avolio AP, Cockcroft JR, Wilkinson IB. Endothelin-1 regulates arterial pulse wave velocity in vivo. J Am Coll Cardiol 2003; 42 (11): 1975–1981.Disclosure of Interests:None declared

Download Full-text

Pulse wave velocity and the non-invasive methods used to assess it: Complior, SphygmoCor, Arteriograph and Vicorder

Vascular ◽

10.1258/vasc.2011.ra0054 ◽

2012 ◽

Vol 20 (6) ◽

pp. 342-349 ◽

Cited By ~ 26

Author(s):

Jennifer M Davies ◽

Marc A Bailey ◽

Kathryn J Griffin ◽

D Julian A Scott

Keyword(s):

Cardiovascular Risk ◽

Arterial Stiffness ◽

Pulse Wave Velocity ◽

Wave Velocity ◽

Reference Values ◽

Pulse Wave ◽

The Other ◽

Inclusion Criteria ◽

Poor Agreement ◽

Non Invasive

Pulse wave velocity (PWV) is a known indicator of arterial stiffness and cardiovascular risk. We critically evaluated the evidence supporting the four main non-invasive devices available to assess it: Complior, SphygmoCor, Arteriograph and Vicorder. PubMed and Medline databases (1960–2011) were searched to identify studies reporting carotid–femoral PWV in humans using one or more of the four devices. Of the 183 articles retrieved, 43 met inclusion criteria. The Arteriograph device demonstrated least variance but had poor agreement with the other devices. Undisputable reference values for PWV need to be established and internationally agreed, and a standardized method for superficial distance measurement generated to reduce variability. Further studies comparing all four devices with invasive assessment are necessary.

Download Full-text

Comparison of the Association Between Arterial Stiffness Indices and Heart Failure in Patients With High Cardiovascular Risk: A Retrospective Study

Frontiers in Cardiovascular Medicine ◽

10.3389/fcvm.2021.782849 ◽

2021 ◽

Vol 8 ◽

Author(s):

Chan Joo Lee ◽

Minjae Yoon ◽

Jaehyung Ha ◽

Jaewon Oh ◽

Sungha Park ◽

...

Keyword(s):

Heart Failure ◽

Cardiovascular Risk ◽

Arterial Stiffness ◽

Pulse Wave Velocity ◽

Wave Velocity ◽

Pulse Wave ◽

Stiffness Index ◽

Characteristic Analysis ◽

High Cardiovascular Risk ◽

Significant Difference

Objective: Study findings of the relationship of each arterial stiffness index with incident heart failure (HF) are conflicting. We aimed to compare the association between the indices of arterial stiffness and the risk of HF.Methods: We analysed 3,034 patients from a prospective cohort that enrolled patients with high cardiovascular risk. They underwent brachial-ankle pulse wave velocity (baPWV), brachial pulse pressure (PP), carotid-femoral pulse wave velocity (cfPWV), and central PP measurements.Results: Over a median follow-up of 4.7 years (interquartile range, 3.4–5.8 years), 65 HF events occurred. The incidence rate of HF was 4.7 per 1,000 person-years [95% confidence interval (CI), 3.7–6.0]. There was no difference in baPWV in those with and without HF events (1,561 ± 401 and 1,520 ± 321 cm/s, respectively, P = 0.415); however, there was a significant difference in brachial PP (63.2 ± 16.9 vs. 52.3 ± 11.5 mmHg, P < 0.001), cfPWV (11.0 ± 3.1 vs. 9.4 ± 2.4 m/s, P < 0.001) and central PP (56.6 ± 19.9 vs. 42.9 ± 13.8 mmHg, P < 0.001). In the multivariable-adjusted model, brachial PP [hazards ratio (HR) per standard deviation unit (SDU), 1.48; 95% CI, 1.19–1.84, P < 0.001], cfPWV (HR per SDU, 1.29; 95% CI, 1.02–1.63, P = 0.032) and central PP (HR per SDU, 1.44; 95% CI, 1.17–1.78; P < 0.001) were associated with incident HF, but baPWV was not (HR per SDU, 0.83; 95% CI, 0.63–1.10; P = 0.198). In the receiver operating characteristic analysis, the area under the curve (AUC) of brachial PP (P < 0.001), cfPWV (P = 0.003) or central PP (P = 0.001) was larger than that of baPWV, and there was no difference in the AUCs of brachial PP, cfPWV and central PP.Conclusion: Among arterial stiffness indices, brachial PWV was less associated with the risk of heart failure, and brachial PP and measures representing central hemodynamics were highly associated with incident HF.

Download Full-text