Central and peripheral blood pressures in relation to the triglyceride-glucose index in a Chinese population.

BACKGROUND: The triglyceride-glucose (TyG) index has been proposed as a surrogate marker of insulin resistance. However, the relationship between the TyG index and central blood pressure (BP), has not been well studied in adults. METHODS: A total of 715 Chinese adult participants were enrolled in this study. Anthropometric and BP were assessed. The TyG index was calculated as ln[fasting triglycerides(mg/dL) × fasting glucose(mg/dL)/2]. Central BP was measured using SphygmoCor system. RESULTS: The participants were stratified into three groups based on the TyG index, and significant differences were observed in metabolic and cardiovascular parameters and the prevalence of hypertension among the groups. Both brachial (ß = 1.38, P = 0.0310; group highest vs. lowest, ß = 2.66, P = 0.0084) and aortic (ß = 2.38, P = 0.0002; group highest vs. lowest, ß = 3.96, P = 0.0001) diastolic BP were significantly and independently associated with the TyG index and increasing TyG index tertile. However, there was no independent association between the TyG index and systolic BP. A one-unit increase in the TyG index was associated with a 46% higher risk of hypertension (P = 0.0121), and compared with the lowest group, participants in the highest group had a 95% higher risk of hypertension (P = 0.0057). CONCLUSIONS: Our study demonstrates a significant and independent association between the TyG index and both brachial and aortic diastolic BP in Chinese adults. Furthermore, the TyG index was found to be an independent predictor of hypertension.

Implications of pulse wave velocity and central pulse pressure in heart failure with reduced ejection fraction.

BACKGROUND: Carotid-femoral pulse wave velocity (cfPWV) and central pulse pressure (PP) are recognised as significant indicators of vascular health and predictors of cardiovascular outcomes. In this study, associations between central hemodynamics and left ventricular (LV) echocardiographic parameters were investigated in subjects with heart failure with reduced ejection fraction (HFrEF), comparing the results to healthy individuals. METHODS AND RESULTS: This cross-sectional prospective controlled study included 50 subjects with HFrEF [mean LV ejection fraction (EF) 26 ± 6.5%] and 30 healthy controls (mean LVEF 65.9 ± 5.3%). Pulse wave analysis (PWA) and carotid-femoral pulse wave velocity (cfPWV) were used to measure central hemodynamics and arterial stiffness. The HFrEF group displayed higher cfPWV (8.2 vs. 7.2 m/s, p = 0.007) and lower central (111.3 vs. 121.7 mmHg, p = 0.001) and peripheral (120.1 vs. 131.5 mmHg, p = 0.002) systolic blood pressure. Central pulse pressure (PP) was comparable between the two groups (37.6 vs. 40.4 mmHg, p = 0.169). In the HFrEF group, cfPWV significantly correlated with left ventricular end-diastolic volume (LVEDV) index (mL/m2) and LVEF, with LVEDV index being a significant independent predictor of cfPWV (R2 = 0.42, p = 0.003). Central PP was significantly associated with heart rate, LVEF and LVEDV index, with the latter being a significant independent predictor of central PP (R2 = 0.41, p < 0.001). These correlations were not observed in healthy controls. CONCLUSIONS: Significant associations between central hemodynamic measures and LV echocardiographic parameters were identified, suggesting the potential to use PWA and cfPWV as possible tools for managing HFrEF.

What is the context?Heart failure with reduced ejection fraction (HFrEF) affects millions of people worldwide.Vascular health plays a significant role in the development and progression of HFrEF.This study investigates two indicators of arterial stiffness­pulse wave velocity (PWV) and central pulse pressure (PP)­and their impact on the functioning of the heart in HFrEF patients compared to healthy individuals.What is new?The study found that higher carotid-femoral PWV and central PP, which typically indicate worse vascular health, were associated with better heart function in HFrEF patients. This paradoxical finding suggests that in the context of HFrEF, traditional markers of vascular health may have different implications.The study included non-invasive methods to evaluate these indicators, offering a potential new additional approach for monitoring and managing HFrEF.What is the impact?We could possibly use non-invasively evaluated PWV and central PP (measures of vascular function) as markers of left ventricular function assessment in HFrEF.

S-AMLODIPINE AS A MODERN EFFECTIVE ANTIHYPERTENSIVE AND AN ANTIANGINAL AGENT.

OBJECTIVE: The aim: Study of the clinical and hemodynamic effects of S-amlodipine in patients with arterial hypertension associated with coronary artery disease, in individuals with preserved LV systolic function. PATIENTS AND METHODS: Materials and methods: The study includes 51 patients with arterial hypertension associated with coronary artery disease, who were treated with S-amlodipine. RESULTS: Results: This study shows the high clinical effectiveness of the use of S-amlodipine in patients with arterial hypertension associated with coronary artery disease. We reveal that treatment of hypertensive patients with coronary artery disease with S-amlodipine leads to improvement of LV diastolic dysfunction, bringing it closer to normal values. CONCLUSION: Conclusions: Clinical effectiveness was associated with positive changes in hemodynamics, and was expressed in the normalization of the left ventricle diastolic function parameters, about which indirectly indicates decreasing of end-diastolic pressure.

[Evaluation of the efficiency and safety of pain relief in the postoperative period in children after urological interventions].

INTRODUCTION: Urinary tract disorders are one of the most common pathologies in children, regardless of age, and every year their prevalence is growing. Our study is dedicated to improvement of postoperative pain management after pediatric urologic procedures and to implementation of modern approaches for enhanced recovery. AIM: To develop optimal methods of postoperative pain relief for moderate and severe intensity of pain syndrome in children undergoing urological procedures. MATERIALS AND METHODS: The study involved 34 patients who were undergone to urological procedures. For an objective assessment of the quality of anesthesia, the following research methods were used: clinical study with the determination of the pain intensity on a visual analogue scale (VAS) and the determination of systolic and diastolic blood pressure, pulse oximetry and echocardiographic study. RESULTS: The analysis of the postoperative period with monitoring of blood pressure, oxygen saturation, pulse oximetry, subjective assessment of the pain intensity on the VAS and the echocardiographic study showed that the relative stability of the condition was associated with an adequate pain relief. The use of a combination of infulgan, which caused an early analgesic effect, with tramadol realizing its action later, provides a prolongation of analgesia. A combination of tramadol with infulgan was several times more efficient than ketorolac. CONCLUSIONS: The use of a combined analgesia after urological procedures, including ketorolac, provides a hemodynamically stability in the entire postoperative period.

IMPROVEMENT OF CARDIAC FUNCTION AFTER WEIGHT LOSS PROGRAM AMONG YOUNG WOMEN.

OBJECTIVE: The aim: To determine the difference between body composition and hemodynamics indices at baseline and after the weight loss program. PATIENTS AND METHODS: Materials and methods: The subject of this study was 13 young women. The weight and body composition were measured by the bio-impedance method. Hemodynamics indices were measured by the method of the thoracic rheography. The measurement of body composition and indices of hemodynamics were performed at the beginning of the weight loss program and 2 months later. The participants underwent 45 minutes per day of moderate-intensity physical activity 3 times a week. RESULTS: Results: The percentage of body fat decreased in 3.9±0.37% from baseline (p=0.01) and the level of visceral fat - 1.54±0.14 units (p=0.001) respectively. Indices of hemodynamics were improved after the weight loss program. Firstly, the index of cardiac output was reduced in 1.43±1.09 l/min (p=0.019) after 2 months of the weight loss program. Secondly, the indices of peripheral resistance also have been improved. Moreover, the index of workload of left ventricle has decreased from 3.56 to 2.7 kg/m/m2 (p=0.035). CONCLUSION: Conclusions: Our results demonstrated the improvement of indices of hemodynamics due to the normalization of body composition among young women after weight loss program.

Moderately increased alcohol consumption is associated with higher pressure wave reflections and blood pressure in men.

BACKGROUND AND AIMS: Increased alcohol consumption has been associated with CVD risk. Subclinical arterial damage (SAD) precedes the onset of cardiovascular disease (CVD), and allows early identification and study of the pathophysiology of CVD. Reliable, noninvasive vascular biomarkers are available for the early detection of SAD and reclassification of CVD risk. To investigate the association of alcohol consumption with multiple SAD biomarkers and central hemodynamics in a large sample of Greek adults with CVD risk factors. METHODS AND RESULTS: This cross-sectional study was conducted with 938 participants (43.5% men) and collected data on SAD biomarkers, central hemodynamics, and dietary intake. Multiple linear regression analysis was performed according to sex after adjusting for several confounders. In men, alcohol consumption of 20-30 g/d was positively associated with mean, diastolic, and peripheral systolic blood pressure (BP). The consumption of >30 g/d was positively associated with the augmentation index. In women, no statistically significant associations were found between alcohol consumption and BP or SAD indices. No statistically significant associations were found between alcohol consumption and arterial compliance or distensibility in both sexes. CONCLUSION: In men even a small deviation from the current recommendation for alcohol consumption is associated with both higher BP indices and pressure wave reflections. The absence of association in women might be due to very low alcohol intake, even in the high consumption group. More studies are needed to verify our findings and establish the above associations in each sex.

[Relationships between aging indicators, central hemodynamics and arterial stiffness in men in the European North of Russia.]

With age, the incidence of cardiovascular diseases is steadily increasing worldwide. Living in the harsh climatic and geographical conditions of the Arctic is associated with premature aging, earlier and more frequent development of age-associated diseases. Apparently, these processes are caused by functional changes in large vessels, the state of which has not yet been studied. Aim and methods: to identify correlations of aging and biological age indicators with the parameters of central hemodynamics and arterial stiffness measured using applanation tonometry by the «Sphygmocor¼ device in middle-aged men living in the European North of Russia. For the first time, positive associations of parameters of peripheral and central blood pressure, augmentation index, and negative correlation of the time of return of the reflected wave and pulse pressure amplification with indicators of aging were noted, which indicates an age-related decrease in arterial elasticity. There was also a negative association of the subendocardial viability ratio with the northern experience and biological age. Theoretically considered, the results demonstrate the potential involvement of blood vessels in the pathogenesis of premature aging. The practical significance of the work is related to the need to develop preventive measures aimed at controlling blood pressure, reducing arterial stiffness and cardiovascular risk in middle-aged northerners.

Systemic NOS inhibition reduces contracting muscle oxygenation more in intact female than male rats.

Females respond to baroreceptor stimulation with enhanced modulation of heart rate (HR) to regulate blood pressure and also express greater reliance on nitric oxide (NO) for vascular control compared to males. Sex differences in muscle oxygenation consequent to central hemodynamic challenge induced by systemic NO synthase (NOS) inhibition are unknown. We tested the hypotheses that systemic NOS inhibition would induce lower contracting skeletal muscle oxygenation in females compared to males. The spinotrapezius of Sprague-Dawley rats (females (♀) = 9, males (♂) = 9) was surgically exposed and contracted by electrical stimulation (180s, 1 Hz, ~6 V) under pentobarbital sodium anesthesia. Oxyphor G4 was injected into the muscle and phosphorescence quenching was used to measure the interstitial PO2 (PO2is, determined by O2 delivery-to-utilization matching) under control (Krebs-Henseleit solution) and after intra-arterial infusion of nitro-l-arginine methyl ester (l-NAME; NOS blockade; 10 mg kg-1). At rest, females showed a greater PO2is increase (ΔPO2is/ΔMAP) and HR (ΔHR/ΔMAP) reduction than males in response to the elevated MAP induced by systemic NOS inhibition (both p < 0.05). Following l-NAME, during the contracting steady-state, females exhibited lower PO2is than males (♂: 17.1 ± 1.4 vs ♀: 10.8 ± 1.4 mmHg, p < 0.05). The rate pressure product was lower in females than males (♂: 482 ± 14 vs ♀: 392 ± 29, p < 0.05) and correlated with the steady-state PO2is (r = 0.66, p < 0.05). These results support that females express greater reductions in HR than males in response to l-NAME-induced elevation of MAP via the baroreceptor reflex and provide new insights on how central hemodynamics affect skeletal muscle oxygenation in a sex-specific manner.

Acute differences in pulse wave velocity, augmentation index, and central pulse pressure following controlled exposures to cookstove air pollution in the Subclinical Tests of Volunteers Exposed to Smoke (SToVES) study.

Household air pollution emitted from solid-fuel cookstoves used for domestic cooking is a leading risk factor for morbidity and premature mortality globally. There have been attempts to design and distribute lower emission cookstoves, yet it is unclear if they meaningfully improve health. Using a crossover design, we assessed differences in central aortic hemodynamics and arterial stiffness following controlled exposures to air pollution emitted from five different cookstove technologies compared to a filtered air control. Forty-eight young, healthy participants were assigned to six 2-h controlled treatments of pollution from five different cookstoves and a filtered air control. Each treatment had a target concentration for fine particulate matter: filtered air control = 0 µg/m3, liquefied petroleum gas = 10 µg/m3, gasifier = 35 µg/m3, fan rocket = 100 µg/m3, rocket elbow = 250 µg/m3, three stone fire = 500 µg/m3. Pulse wave velocity (PWV), central augmentation index (AIx), and central pulse pressure (CPP) were measured before and at three time points after each treatment (0, 3, and 24 h). Linear mixed models were used to assess differences in the outcomes for each cookstove treatment compared to control. PWV and CPP were marginally higher 24 h after all cookstove treatments compared to control. For example, PWV was 0.15 m/s higher (95% confidence interval: -0.02, 0.31) and CPP was 0.6 mmHg higher (95% confidence interval: -0.8, 2.1) 24 h after the three stone fire treatment compared to control. The magnitude of the differences compared to control was similar across all cookstove treatments. PWV and CPP had no consistent trends at the other post-treatment time points (0 and 3 h). No consistent trends were observed for AIx at any post-treatment time point. Our findings suggest higher levels of PWV and CPP within 24 h after 2-h controlled treatments of pollution from five different cookstove technologies. The similar magnitude of the differences following each cookstove treatment compared to control may indicate that acute exposures from even the cleanest cookstove technologies can adversely impact these subclinical markers of cardiovascular health, although differences were small and may not be clinically meaningful.

Self-reported sleep quality is associated with central hemodynamics in healthy individuals.

BACKGROUND: Insufficient sleep is associated with arterial stiffness and elevated cardiovascular disease risk. Central hemodynamics are influenced by arterial stiffness, yet independently predict cardiovascular risk. Relationships between sleep characteristics and central hemodynamic parameters are largely unexplored. We aimed to characterize the relationship between self-reported sleep quality and central hemodynamics in healthy individuals. To explore the secondary hypothesis that impairments in glucose metabolism may underlie relationships between sleep and central hemodynamic variables, we also explored associations between self-reported sleep quality and fasting blood glucose values. METHODS: Thirty-one healthy study subjects (20 to 69 years, 17 men) were free from metabolic or cardiovascular disease and did not take sleep medication. Self-reported sleep quality was obtained using the Pittsburgh Sleep Quality Index (PSQI) with normal sleepers defined by PSQI scores 0-5 and poor sleepers by PSQI score > 5. Relationships were assessed between PSQI, central hemodynamic profiles (systolic and diastolic blood pressures, pulse and augmentation pressures, augmentation index) estimated from oscillometric pulse wave analysis, and blood glucose values. RESULTS: Central pulse pressure was significantly elevated in poor (PSQI score > 5) compared with that in normal (PSQI scores 0-5) sleepers (P < 0.05). Linear regression models, adjusted for age, gender, and body mass index, demonstrated PSQI score to be an independent predictor (P < 0.05) of both central pulse (ß = 0.469) and augmentation (ß = 0.364) pressures. Global PSQI scores were not related to fasting blood glucose values (r = 0.045; P > 0.05). CONCLUSIONS: Significant relationships between central pulse and augmentation pressures and self-reported sleep quality highlight the importance of considering sleep when examining lifestyle contributors to central hemodynamics.

Central hemodynamics in relation to low-level environmental lead exposure.

Purpose: Arterial stiffness predicts cardiovascular complications. The association between arterial stiffness and blood lead (BL) remains poorly documented. We aimed to assess the association of central hemodynamic measurements, including pulse wave velocity (aPWV), with blood lead in a Flemish population.Materials and Methods: In this Flemish population study (mean age, 37.0 years; 48.3% women), 267 participants had their whole BL and 24-h urinary cadmium (UCd) measured by electrothermal atomic absorption spectrometry in 1985-2005. After 9.4 years (median), they underwent applanation tonometry to estimate central pulse pressure (cPP), the augmentation index (AI), pressure amplification (PA), and aPWV. The amplitudes of the forward (Pf) and backward (Pb) pulse waves and reflection index (RI) were derived by a pressure-based wave separation algorithm.Results: BL averaged 2.93 µg/dL (interquartile range, 1.80-4.70) and UCd 4.79 µg (2.91-7.85). Mean values were 45.0 ± 15.2 mm Hg for cPP, 24.4 ± 12.4% for AI, 1.34 ± 0.21 for PA, 7.65 ± 1.74 m/s for aPWV, 32.7 ± 9.9 mm Hg for Pf, 21.8 ± 8.4 mm Hg for Pb, and 66.9 ± 18.4% for RI. The multivariable-adjusted association sizes for a 2-fold higher BL were: +3.03% (95% confidence interval, 1.56, 4.50) for AI; -0.06 (-0.08, -0.04) for PA; 1.02 mm Hg (0.02, 2.02) for Pb; and 3.98% (1.71, 6.24) for RI (p ≤ .045). In 206 participants never on antihypertensive drug treatment, association sizes were +2.59 mm Hg (0.39, 4.79) for cPP and +0.26 m/s (0.03, 0.50) for aPWV. Analyses adjusted for co-exposure to cadmium were consistent.Conclusion: In conclusion, low-level environmental lead exposure possibly contributes to arterial stiffening and wave reflection from peripheral sites.

The peculiarities of the body's external structure and indicators of central hemodynamics of volleyball players of different positions.

OBJECTIVE: The aim was to determine the main differences in the external structure of the body and the of central hemodynamics parameters in of high-level sports skills volleyball players of the juvenile age with the role of libero, hitters and setters. PATIENTS AND METHODS: Materials and methods: 116 volleyball players of high level athletic skill of the youth age from 16 to 20 years old. The control group included 140 practically healthy girls who were not engaged in sports of the corresponding age. Anthropometric investigation was performed according to Bunak's V.V. and Martirosov's E.G. method, rheographic - according to the method of Ronkin M.A. and Ivanov L.B. The reliability of the difference between independent quantitative values was determined using Mann-Whitney U-test. RESULTS: Results: It was established that volleyball players have significantly higher total, longitudinal, circumferential dimensions of the body, width of distal epiphyses, transverse diameters of the chest and pelvis in comparison with girls, who are not involved in sport. According to the most parameters of the body external structure the hitters are predominate than setters and libero. In hitters and setters, most anthropo-somatotypological parameters are larger than in nonathletes. The stroke and minute volumes, the impact index, the volume velocity of the blood and the capacity of the left ventricle in volleyball players are significantly higher. Specific peripheral resistance is significantly lower than that of girls who are not involved in sports. Between the volleyball players of different positions in the value of the central hemodynamics parameters, there were no significant differences, except for the impact index, which is significantly higher in libero than in the hitters. CONCLUSION: Conclusions: The external structure of the body, anthropometric parameters and indicators of central hemodynamics depend of volleyball player's position and have some peculiarities.

How does empagliflozin improve arterial stiffness in patients with type 2 diabetes mellitus? Sub analysis of a clinical trial.

BACKGROUND: Empagliflozin has been shown to reduce cardiovascular mortality, but the underlying pathogenetic mechanisms are poorly understood. It was previously demonstrated that empagliflozin improved arterial stiffness. METHODS: Our analysis comprising 58 patients with type 2 diabetes mellitus identifies factors triggering the improvement of arterial stiffness. All patients participated in an investigator-initiated, prospective, double-blind, randomized, placebo-controlled, interventional clinical trial ( http://www.ClinicalTrials.gov : NCT02471963, registered 15th June 2015, retrospectively registered) and received either 6-weeks treatment with 25 mg empagliflozin orally once daily or placebo (crossover). Central systolic pressure and central pulse pressure were recorded by the SphygmoCor System (AtCor Medical). Now, we investigated the impact of parameters of glucose metabolism, volume status, sympathetic activation, lipids, uric acid, blood pressure and inflammation on vascular parameters of arterial stiffness using multivariate regression analysis. RESULTS: As previously reported, therapy with empagliflozin improved arterial stiffness as indicated by reduced central systolic blood pressure (113.6 ± 12.1 vs 118.6 ± 12.9 mmHg, p < 0.001), central pulse pressure (39.1 ± 10.2 vs 41.9 ± 10.7 mmHg, p = 0.027) forward (27.1 ± 5.69 vs 28.7 ± 6.23 mmHg, p = 0.031) as well as reflected wave amplitude (18.9 ± 5.98 vs 20.3 ± 5.97 mmHg, p = 0.045) compared to placebo. The multivariate regression analysis included age, sex and change between empagliflozin and placebo therapy of the following parameters: HbA1c, copeptin, hematocrit, heart rate, LDL-cholesterol, uric acid, systolic 24-h ambulatory blood pressure and high sensitive CRP (hsCRP). Besides the influence of age (beta = - 0.259, p = 0.054), sex (beta = 0.292, p = 0.040) and change in systolic 24-h ambulatory blood pressure (beta = 0.364, p = 0.019), the change of hsCRP (beta = 0.305, p = 0.033) emerged as a significant determinant of the empagliflozin induced reduction in arterial stiffness (placebo corrected). When replacing HbA1c with fasting plasma glucose in the multivariate regression analysis, a similar effect of the change in hsCRP (beta = 0.347, p = 0.017) on arterial stiffness parameters was found. CONCLUSION: Besides age and sex, change in systolic 24-h ambulatory blood pressure and change in hsCRP were determinants of the empagliflozin induced improvement of vascular parameters of arterial stiffness, whereas parameters of change in glucose metabolism and volume status had no significant influence. Our analysis suggests that empagliflozin exerts, at least to some extent, its beneficial vascular effects via anti-inflammatory mechanisms. Trial registration http://www.ClinicalTrials.gov : NCT02471963, registered 15th June 2015, retrospectively registered.

Elite athletes as research model: vitamin D insufficiency associates with elevated central blood pressure in professional handball athletes.

PURPOSE: Low vitamin D levels have been associated with elevated blood pressure in the general population. Prospective studies, however, have produced conflicting evidence about the blood pressure-lowering effects of vitamin D supplementation. Cardiorespiratory fitness may modulate the vitamin D-blood pressure association. We therefore examined this association in professional athletes, whose high training load serves as a biological control for physical fitness. METHODS: 50 male professional handball players (age 26 ± 5 years) were examined. We assessed the central aortic pressure parameters using transfer function-based analysis of oscillometrically obtained peripheral arterial waveforms. Serum 25-OH vitamin D concentrations were determined by chemiluminescent immunoassay. The threshold for insufficiency was set at values of < 30 ng/mL. RESULTS: Central blood pressure (cBP) was 98 ± 7/60 ± 10 mmHg. The aortic pulse wave velocity (PWV) was 6.3 ± 1.0 m/s. Nine athletes (18%) displayed insufficient 25-OH vitamin D levels and had a significantly (p < 0.01) higher cBP compared with the 41 (82%) athletes with sufficient 25-OH vitamin D levels (106 ± 5/68 ± 8 vs. 97 ± 7/58 ± 9 mmHg). Central systolic blood pressure (cSBP) in vitamin D-sufficient athletes was significantly lower in comparison to the healthy reference population (97 mmHg vs. 103 mmHg, p < 0.001). This significance of difference was lost in vitamin D-insufficient athletes (106 mmHg vs. 103 mmHg, p = 0.12). CONCLUSION: Significantly raised central systolic and diastolic blood pressure in vitamin D-insufficient elite athletes implicates vitamin D as a potential modifier of vascular functional health.

Central hemodynamics in relation to blood lead in young men prior to chronic occupational exposure.

Background: Aortic pulse wave velocity (aPWV) predicts cardiovascular complications, but the association of central arterial properties with blood lead level (BL) is poorly documented. We therefore assessed their association with BL in 150 young men prior to occupational lead exposure, using baseline data of the Study for Promotion of Health in Recycling Lead (NCT02243904). Methods: Study nurses administered validated questionnaires and performed clinical measurements. Venous blood samples were obtained after 8-12 h of fasting. The radial, carotid and femoral pulse waves were tonometrically recorded. We accounted for ethnicity, age, anthropometric characteristics, mean arterial pressure, heart rate, smoking and drinking, and total and high-density lipoprotein serum cholesterol, as appropriate. Results: Mean values were 4.14 µg/dL for BL, 27 years for age, 108/79/28 mm Hg for central systolic/diastolic/pulse pressure, 100/10% for the augmentation ratio/index, 1.63 for pressure amplification, 5.94 m/s for aPWV, 27/11 mm Hg for the forward/backward pulse pressure height, and 43% for the reflection index. Per 10-fold BL increase, central diastolic pressure and the augmentation ratio were respectively 5.37 mm Hg (95% confidence interval [CI], 1.00-9.75) and 1.57 (CI, 0.20-2.94) greater, whereas central pulse pressure and the forward pulse pressure height were 3.74 mm Hg (CI, 0.60-6.88) and 3.37 mm Hg (CI, 0.22-6.53) smaller (p ≤ .036 for all). The other hemodynamic measurements were unrelated to BL. The reflected pulse peak time was inversely correlated with diastolic pressure (r = -0.20; p ≤ .017). Conclusion: At the exposure levels observed in our current study, aPWV, the gold standard to assess arterial stiffness, was not associated with BL. Increased peripheral arterial resistance, as reflected by higher diastolic pressure, might bring reflection points closer to the heart, thereby moving the backward wave into systole and increasing the augmentation ratio in relation to BL.

[Peculiarities of hemodynamics and heart rhythm in males with increased arterial pressure depending on initial vegetative tone and age.]

Central hemodynamics and vegetative regulation of heart rhythms in males depending on age were studied. To evaluate and estimate vegetative regulation a method of variative pulsometry was used. It was used on the basis of analysis of variable heart rhythm (temporary and spectral). Certain tendencies of changes of central hemodynamics and indicators of variable heart rhythm in different age periods were revealed. SDNN, RMSSD and power in HF-range decreased. Baevsky's index of tension and VLF-output increased. This shows that persons with initial domination of parasympathetic part of the vegetative nervous system have changes in vegetative balance toward activation of sympatoadrenal link, increase of activity of the central contour of management of heart rhythm and tension of regulatory systems of the human body.

The cardiovascular system in patients with functional and inflammatory bowel diseases.

AIM: Identification of subclinical and metamanifests state changes of cardiovascular system in patients with functional and inflammatory bow- el diseases (IBD) without a background of cardiac pathology. MATERIALS AND METHODS: Was examined 79 patients with colon diseases, 20 patients were diagnosed with irritable bowel syndrome (IBS) with diarrhea, a 37 - undifferentiated colitis (UdC) and 22 patients with ulcerative colitis (UC). As a control group were examined in 50 healthy subjects. All patients received treatment in accordance with international and national guidelines. Prescribed medications had effect on the function of the cardiovascular system. Patients with contacting the hospital and against the onset of remission was performed ultrasound of the heart. Determines the size of the left atrium, heart rate, end-diastolic volume, end-systolic volume, ejection fraction (EF), cardiac index (CI), to- tal peripheral vascular resistance, the presence of right heart failure, blood flow, the area of the right atrium and right ventricle in systole and diastole, and calculated the proportion of contractility of the right atrium and right ventricle. Determined systolic pressure in PA (SPPA), the average pressure in PA (SPPA). RESULTS: Clinical manifestations of cardiac syndrome was identified in 75,0% of patients with IBS, 54,1% of patients NK and 68,2% patients with UC. When performing correlation analysis in the patients with UdC and UC was noted the relationship of hemodynamic parameters and disease severity was more pronounced in UC. So, when comparing the duration of the disease and levels of the MLC - r=0,52 and r=0,73 (p<0,05), EF - r=-0,51 and r=-0,71 (p<0,05), CI - r=0,49 and r=0,70 (p<0,05), heart rate - r=0,47, r=0,68 (p<0,05); duration of stay in hospi- tal and the magnitudes of MLC - r=0,54 and r=0,77 (p<0,05), EF - r=-0,51 and r=-0,71 (p<0.05), CI - r=0,55 and r=0,73 (p<0,05), heart rate - r=0,47, r=0,63 (p<0,05). For patients with UC, we noted the presence of correlation when the average frequency of exacerbations per year and the values of the MLC - r=0,53 (p<0,05), EF - r=-0,55 (p<0,05), heart rate: r=0,54 (p<0,05); severity of UC and EF (r=-0,67; p<0,05). A statistically significant correlation of changes in EF and value SPPA and APPA, aggravated by the deepening severity of the disease. So, for IBS - r=-0,46, and r=-0,48 (p<0,05); for NK - r=-0,51 and r=-0,59 (p<0,05); for the UC - r=-0,62, and r=-0,67 (p<0,05). In the analysis of duration of hospitalization, and values SPPA and APPA for patients with IBS - r=0.48 and r=0.46 (p<0,05); with UdC - r=0,50 and r=0,53 (p<0,05); with UC - r=0,59 and r=0,62 (p<0,05). Sick UC was characterized by the greatest dilatation of RA and RV with access from outside the variations of the norms of 90.9 and 68.2 per cent, a significant decrease dRA and dRV. Discovered correlation of the squares of PP and SDL - r=0,48, r=0,54 and r=0,61 (p<0,05); APPA - r=0,50, r=0,56 and r=0,63 (p<0,05); RV areas and levels SPPA - r=0,45, r=0,50 and r=0.52 (p<0,05); and APPA - r=0,46, r=0,47 r=0,53 (p<0,05). When analyzing the values of the squares of the pancreas and MLC - r=0,47 r=0,54 and r=0,61 (p<0,05), levels of EF and dRV - r=0,41, r=0,50 and r=0,56 (p<0,05). CONCLUSION: Cardiac syndrome in patients with IBS and IBD without a background of cardiac pathology can occur in the form of subclinical or manifested weakly, but persistent changes that may not be recognized, but in the future may complicate the course of the underlying dis- ease, necessitating research to develop tactics to correct them.

Influence of sympathetic nerve activity on aortic hemodynamics and pulse wave velocity in women.

Central (aortic) blood pressure, arterial stiffness, and sympathetic nerve activity increase with age in women. However, it is unknown if the age-related increase in sympathetic activity influences aortic hemodynamics and carotid-femoral pulse wave velocity (cfPWV), an index of central aortic stiffness. The goal of this study was to determine if aortic hemodynamics and cfPWV are directly influenced by sympathetic nerve activity by measuring aortic hemodynamics, cfPWV, and muscle sympathetic nerve activity (MSNA) in women before and during autonomic ganglionic blockade with trimethaphan camsylate. We studied 12 young premenopausal (23 ± 4 yr) and 12 older postmenopausal (57 ± 3 yr) women. These women did not differ in body mass index or mean arterial pressure (P > 0.05 for both). At baseline, postmenopausal women had higher aortic pulse pressure, augmented pressure, augmentation index adjusted for a heart rate of 75 beats/min, wasted left ventricular pressure energy, and cfPWV than young women (P < 0.05). During ganglionic blockade, postmenopausal women had a greater decrease in these variables in comparison to young women (P < 0.05). Additionally, baseline MSNA was negatively correlated with the reductions in aortic pulse pressure, augmented pressure, and wasted left ventricular pressure energy during ganglionic blockade in postmenopausal women (P < 0.05) but not young women. Baseline MSNA was not correlated with the changes in augmentation index adjusted for a heart rate of 75 beats/min or cfPWV in either group (P > 0.05 for all). Our results suggest that some aortic hemodynamic parameters are influenced by sympathetic activity to a greater extent in older postmenopausal women than in young premenopausal women.NEW & NOTEWORTHY Autonomic ganglionic blockade results in significant decreases in multiple aortic pulse wave characteristics (e.g., augmented pressure) and central pulse wave velocity in older postmenopausal women but not in young premenopausal women. Certain aortic pulse wave parameters are negatively influenced by sympathetic activity to a greater extent in older postmenopausal women.

Comparison of central hemodynamic parameters for young basketball athletes and control group.

BACKGROUND: Long-term exercise training may have negative effects on cardiovascular functions. Measurement and calculation of central hemodynamic parameters can comprehensively evaluate the cardiovascular functions. This study aims to compare the central hemodynamics between young basketball athletes and matched controls. METHODS: Total 19 young long-term trained male basketball athletes and 17 matched male recreationally active controls participated. The central hemodynamic parameters such as central blood pressure, pulse pressure, heart rate (HR), augmentation index normalised to 75 bpm (AIx@HR75), augmentation index (AIx), ejection duration (ED), sub-endocardial viability ratio (SEVR) were measured, and total peripheral resistance (TPR), stroke volume (SV) and cardiac output (CO) were calculated. Non-parameter tests and t-test were used to analyse the central hemodynamic parameters between athletes and controls. RESULTS: HR (56 ± 5 bpm versus 79 ± 9 bpm, p < .001), AIx@HR75 (-8 ± 10% versus -1 ± 10%, p < .05), ED (28 ± 2% versus 36 ± 3%, p < .001) and TPR (0.004 ± 0.006 mmHg s/mL versus 0.012 ± 0.006 mmHg s/mL, p < .001) were significantly lower in basketball athletes compared to the controls. SEVR (231 ± 32% versus 159 ± 21%, p < .001) and SV (154 ± 50 mL versus 101 ± 43 mL, p < .01) were significantly higher in basketball athletes than those in the controls. However, there were no significant differences in central blood pressure, pulse pressure, AIx and CO between them. CONCLUSIONS: There is no negative effect on central hemodynamics in young basketball athletes after long-term exercise training. The young basketball athletes have a higher myocardial perfusion, higher efficiency of blood supply, stronger vascular functions and better balance of myocardial oxygen of supply and demand than the controls in this central hemodynamic parameters analysis.

Resveratrol has a positive effect on parameters of central hemodynamics and myocardial ischemia in patients with stable coronary heart disease.

INTRODUCTION: Cardiovascular diseases, and primarily coronary heart disease (CHD), are the leading cause of mortality in the developing countries, including Ukraine. Prognosis for patients with CHD depends mainly on progression of coronary atherosclerosis (ASVD). Molecular mechanisms of atherogenesis are studied in detail in order to find new targets of pharmacological intervention. THE AIM: to study the effect of resveratrol on parameters of central hemodynamics and myocardial ischemia in patients with stable coronary heart disease (CHD). MATERIAL AND METHODS: The research involved 85 patients with CHD: stable angina pectoris, FC II, and 30 healthy individuals made up the control group. Patients with CHD were randomized into the research group (30 people) and the comparison group (55 people). Patients of the comparison group were prescribed the standard therapy (Β-blockers, statins, aspirin). Resveratrol at a dose of 100 mg per os daily was added to standard treatment of the patients of the research group. The day before randomization and 2 months after the prescribing therapy to the patients, echocardiography (echo) and 24 hour Holter ECG monitoring were made. RESULTS: Diastolic dysfunction of the left ventricle (LV) in the form of violation of relaxation (type I) had been found in 100 % of patients with CHD. The 24 hour Holter ECG monitoring revealed episodes of myocardial ischemia (σt ST depr) (11.07+2.81 episodes a day), premature atrial contractions (PACs) and premature ventricular contractions (PVCs) in patients with stable CHD. After a two-month term of therapy in all patients with CHD, left ventricular systolic function in terms of ejection fraction (EF) of LV significantly improved (by 9.7 % in the research group and by 3.2 % in the comparison group). LV diastolic function improved in both groups in terms of the ratio of the phases of the transmitral flow E/A, dominating in the research group (р=0.004). DT value dropped significantly influenced by resveratrol (by 13 %), in the comparison group it didn`t change. In both groups IVRT significance decreased (р < 0.05). According to the 24 hour Holter ECG monitoring, in patients, additionally taking resveratrol, σt ST depr decreased by 45.9 %, that prevailed the result of the comparison group by 25.2 %. Under the influence of resveratrol, unlike in the comparison group, the number of PACs and PVCs was significantly reduced. CONCLUSIONS: The data have shown cardioprotective properties of resveratrol and its applicability in the treatment of patients with CHD.