The association between arterial stiffness and socioeconomic status: a cross-sectional study using estimated pulse wave velocity.

BACKGROUND: The impact of socioeconomic status (SES) on arterial stiffness remains unclear. This study aimed to explore the association between both personal and household income, as well as education level, and estimated pulse wave velocity (ePWV). METHODS: A total of 13,539 participants (mean age 52.9 ± 16.7 years; 57.1% women) from the Korean National Health and Nutrition Survey database were analyzed. For SES variables, information on personal and household income and education level was collected using standardized questionnaires. RESULTS: The ePWV did not show significant differences across groups categorized by individual income levels (P = 0.183). However, there was a noticeable trend of decreasing ePWV with increasing household income levels (P < 0.001). Additionally, ePWV demonstrated a significant negative correlation with higher education levels, indicating that ePWV decreased in groups with higher educational attainment (P < 0.001). In multiple linear regression analyses, both household income (ß = -0.055; P < 0.001) and education level (ß = -0.076; P < 0.001) were negatively associated with ePWV, even after adjusting for potential confounders. CONCLUSIONS: Lower household income and lower education levels were associated with higher ePWV, providing further evidence of the influence of SES on arterial stiffness.

Pilot study on the effect of flavonoids on arterial stiffness and oxidative stress in chronic kidney disease.

BACKGROUND: Flavonoids, the main class of polyphenols, exhibit antioxidant and antihypertensive properties. AIM: To prospectively investigate the impact of flavonoids on arterial stiffness in patients with chronic kidney disease (CKD) stages I-IV. METHODS: In this prospective, single-arm study, CKD patients with arterial hypertension and diabetes mellitus were enrolled. Baseline demographic, clinical, and laboratory variables were recorded. Patients received daily treatment with a phenol-rich dietary supplement for 3 months. Blood pressure, arterial stiffness (carotid-femoral pulse wave velocity, central pulse pressure), and oxidative stress markers (protein carbonyls, total phenolic compound, total antioxidant capacity) were measured at baseline and at study end. RESULTS: Sixteen patients (mean age: 62.5 years, 87.5% male) completed the study. Following intervention, peripheral systolic blood pressure decreased significantly by 14 mmHg (P < 0.001). Carotid-femoral pulse wave velocity decreased from 8.9 m/s (baseline) to 8.2 m/s (study end) (P < 0.001), and central pulse pressure improved from 59 mmHg to 48 mmHg (P = 0.003). Flavonoids also reduced oxidative stress markers including protein carbonyls (P < 0.001), total phenolic compound (P = 0.001), and total antioxidant capacity (P = 0.013). CONCLUSION: Flavonoid supplementation in CKD patients shows promise in improving blood pressure, arterial stiffness, and oxidative stress markers.

CRISPR/Cas-Mediated Gene Editing in Plant Immunity and Its Potential for the Future Development of Fungal, Oomycete, and Bacterial Pathogen-Resistant Pulse Crops.

Pulses provide myriad health benefits and are advantageous in an environmental context as a result of their leguminous nature. However, phytopathogenic fungi, oomycetes and bacteria pose a substantial threat to pulse production, at times leading to crop failure. Unfortunately, existing disease management strategies often provide insufficient control, and there is a clear need for the development of new pulse cultivars with durable and broad-spectrum disease resistance. CRISPR/Cas-mediated gene editing has proven its potential for rapidly enhancing disease resistance in many plant species. However, this tool has only very recently been applied in pulse species, and never in the context of plant immunity. In this review, we examine the recent successful utilization of this technology in pulse species for proof-of-concept or the improvement of other traits. In addition, we consider various genes that have been edited in other plant species to reduce susceptibility to pathogens, and discuss current knowledge regarding their roles in pulses. Given the functional conservation of the selected genes across diverse plant species, there is a high likelihood that their editing would elicit similar effects in non-oilseed grain legumes, thus providing a suite of potential targets for CRISPR/Cas-mediated gene editing to promote pulse crop productivity in coming years.

LC-MS/MS and GC-MS/MS Cross-Checking Analysis Method for 426 Pesticide Residues in Agricultural Products: A Method Validation and Measurement of Uncertainty.

A method was developed to analyze residual pesticides in various vegetables using liquid chromatography-tandem mass spectrometry (LC-MS/MS) and gas chromatography-tandem mass spectrometry (GC-MS/MS). A method can analyze over 200 individual compounds, selectively separate peaks within 30 min, and meet various criteria such as those by the Codex Alimentarius Commission (CODEX). Most compounds showed recovery rates between 70 and 120%, and a relative standard deviation was within 20%. Measurement uncertainty, considering various influencing factors such as instrument precision, method sensitivity, experimental conditions, sample handling, and analytical procedures, was meticulously calculated. The expanded uncertainties of cross-checking 33 available pesticides ranged from 10.1 to 26.2 µg/kg at a confidence level of approximately 95%. Risk assessment of detected pesticides in agricultural products indicated a safety range of 0.00003-2.87240%. The developed method effectively analyzes diverse compounds simultaneously, contributing to agricultural product safety.

History and Social Implications of the Pulse Oximeter.

The pulse oximeter is a portable, bedside tool that allows for the measurement of oxygen saturation in a patient's red blood cells. The technology is based on oxygenated and deoxygenated hemoglobin absorbing light at different wavelengths. The device calculates the ratio of oxygenated to deoxygenated hemoglobin in the blood, and an algorithm produces a percentage oxygen saturation value. Due to its portability and ease of use, it is a ubiquitous medical tool that is commonly used in medical practice. This paper reviews the history and evolution of this tool, and the scientific laws behind oximetry. It also introduces the importance of the pulse oximeter and its basic functions. In addition, the limitations of pulse oximetry are discussed, especially as they pertain to pigmented skin.

Pulse oximetry in pediatric care: Balancing advantages and limitations.

BACKGROUND: Pulse oximetry has become a cornerstone technology in healthcare, providing non-invasive monitoring of oxygen saturation levels and pulse rate. Despite its widespread use, the technology has inherent limitations and challenges that must be addressed to ensure accurate and reliable patient care. AIM: To comprehensively evaluate the advantages, limitations, and challenges of pulse oximetry in clinical practice, as well as to propose recommendations for optimizing its use. METHODS: A systematic literature review was conducted to identify studies related to pulse oximetry and its applications in various clinical settings. Relevant articles were selected based on predefined inclusion and exclusion criteria, and data were synthesized to provide a comprehensive overview of the topic. RESULTS: Pulse oximetry offers numerous advantages, including non-invasiveness, real-time feedback, portability, and cost-effectiveness. However, several limitations and challenges were identified, including motion artifacts, poor peripheral perfusion, ambient light interference, and patient-specific factors such as skin pigmentation and hemoglobin variants. Recommendations for optimizing pulse oximetry use include technological advancements, education and training initiatives, quality assurance protocols, and interdisciplinary collaboration. CONCLUSION: Pulse oximetry is crucial in modern healthcare, offering invaluable insights into patients' oxygenation status. Despite its limitations, pulse oximetry remains an indispensable tool for monitoring patients in diverse clinical settings. By implementing the recommendations outlined in this review, healthcare providers can enhance the effectiveness, accessibility, and safety of pulse oximetry monitoring, ultimately improving patient outcomes and quality of care.

Novel techniques for quantifying oxygen pulse curve characteristics during cardiopulmonary exercise testing in tetralogy of fallot.

Background: Cardiopulmonary exercise testing (CPET) is used in evaluation of repaired tetralogy of Fallot (rTOF), particularly for pulmonary valve replacement need. Oxygen pulse (O2P) is the CPET surrogate for stroke volume and peripheral oxygen extraction. Objectives: This study assessed O2P curve properties against non-invasive cardiac output monitoring (NICOM) and clinical testing. Methods: This cross-sectional study included 44 rTOF patients and 10 controls. Three new evaluations for O2P curve analysis during CPET were developed. Best fit early and late regression slopes of the O2P curve were used to calculate: 1) the early to late ratio, or "O2 pulse response ratio" (O2PRR); 2) the portion of exercise until slope inflection, or "flattening fraction" (FF); 3) the area under the O2P response curve, or "O2P curve area". Results: rTOF patients (median age 35.2 (27.6-39.4); 61% female) had a lower VO2 max (23.4 vs 45.6 ml/kg/min; p < 0.001) and O2P max (11.5 vs 19.1 ml/beat; p < 0.001) compared to controls. Those with a FF occurring <50% through exercise had a lower peak cardiac index and stroke volume, but not VO2 max, compared to those >50%. FF and O2P curve area significantly correlated with peak cardiac index, stroke volume, left and right ventricular ejection fraction, and right ventricular systolic pressure. Conclusion: CPET remains an integral part in the evaluation of rTOF. We introduce three non-invasive methods to assess exercise hemodynamics using the O2P curve data. These evaluations demonstrated significant correlations with stroke volume, cardiac output, and right ventricular pressure.

Nanoengineered electrochemical sensor for sensitive detection of carbendazim in environmental waters using Er3NbO7/f-CNF nanocomposite.

Water contamination by agricultural chemicals is a pressing environmental issue today. Carbendazim (CBZ), a potent fungicide with broad-spectrum antifungal properties and significant toxicity, poses substantial risks to ecosystems and human health. This study introduces an advanced electrochemical sensor by modifying screen-printed carbon electrodes (SPCEs) with a nanocomposite of erbium niobate (Er3NbO7) and functionalized carbon nanofibers (f-CNF). The Er3NbO7/f-CNF nanocomposite enhances electrochemical performance through its high surface area, excellent electrical conductivity, and catalytic activity. This synergy results in exceptional attributes such as a low detection limit of 6.0 nmolL-1, low quantification limit of 19.98 nmolL-1, sensitivity of 3.522 µAµ(molL-1)-1.cm-2, and precision of 0.05%. The sensor demonstrates a wide linear range from 0.2 to 222 µmolL-1, combined with high selectivity and robust stability, making it suitable for precise CBZ detection. Successful deployment in environmental monitoring underscores its versatility and effectiveness in safeguarding human health and ecological balance, establishing it as a pivotal tool in environmental protection efforts.

Ultrasensitive electrochemical detection of metronidazole using binder-free zinc-4,4'-oxybis(benzoic acid) MOF/GCE in real samples.

A novel electrochemical sensor is constructed by modifying the glassy carbon electrode (GCE) using a binder-free metal-organic framework of V-shaped linker 4,4'oxybis(benzoic acid) (OBA) and various transition metals (M-Zn, Mn, or Ni). The hydrothermally synthesized M-OBA MOFs demonstrated superior electron transfer ability and enhanced electro-reduction behaviour, making it highly effective for metronidazole (MTZ) detection. The optimized sensor demonstrated a linear response from 0.04 to 122.18 µM, a low detection limit (LOD) of 0.009 µM, and high sensitivity (0.48 µA µM-1 cm-2) using cyclic voltammetry (CV) and differential pulse voltammetry (DPV). The sensor also exhibited excellent selectivity in the presence of various ions, organic compounds, and other antibiotics. The Zn-OBA MOF sensor proves practical applicability for detecting MTZ in milk, honey, tap water, and MTZ tablets.

Invasive strategies for rhythm control of atrial fibrillation: a narrative review.

Atrial fibrillation (AF) is the most common sustained tachyarrhythmia and its increasing prevalence has resulted in a growing healthcare burden. A recent landmark randomized trial, the EAST-AFNET 4 (Early Treatment of Atrial Fibrillation for Stroke Prevention Trial), highlighted the importance of early rhythm control in AF, which was previously underemphasized. Rhythm control therapy includes antiarrhythmic drugs, direct-current cardioversion, and catheter ablation. Currently, catheter ablation is indicated for patients with AF who are either refractory or intolerant to antiarrhythmic drugs or who exhibit decreased left ventricular systolic function. Catheter ablation can be categorized according to the energy source used, including radiofrequency ablation (RFA), cryoablation, laser ablation, and the recently emerging pulsed field ablation (PFA). Catheter ablation techniques can also be divided into the point-by-point ablation method, which ablates the pulmonary vein (PV) antrum one point at a time, and the single-shot technique, which uses a spherical catheter to ablate the PV antrum in a single application. PFA is known to be applicable to both point-by-point and single-shot techniques and is expected to be promising owing to its tissue specificity, resulting in less collateral damage than catheter ablation involving thermal energy, such as RFA and cryoablation. In this review, we aimed to outline catheter ablation for rhythm control in AF by reviewing previous studies.

Towards shorter composite 180° refocusing pulses for NMR.

Novel composite 180° pulses are designed for use in nuclear magnetic resonance (NMR) and verified experimentally using solution-state 1H NMR spectroscopy. Rather than being constructed from 180° pulses (as in much recent work), the new composite pulses are constructed from 90° pulses, with the aim of finding sequences that are shorter overall than existing equivalents. The primary (but not exclusive) focus is on composite pulses that are dual compensated - simultaneously broadband with respect to both inhomogeneity of the radiofrequency field and resonance offset - and have antisymmetric phase schemes, such that they can be used to form spin echoes without the introduction of a phase error. In particular, a new antisymmetric dual-compensated refocusing pulse is presented that is constructed from ten 90° pulses, equivalent to just five 180° pulses.

Intraoperative Doppler flowmetry evaluation of humeral head perfusion after proximal humerus fracture.

Background: Understanding vascularity and assessing the risk of post-traumatic avascular necrosis are crucial for predicting outcomes and identifying optimal treatment options in proximal humerus fractures (PHFs). Until now, Hertel et al have been the only researchers to evaluate the intraoperative perfusion of the humeral head after fracture using Doppler flowmetry in a central single drill hole within the head. This pilot study aims to standardize the evaluation of intraoperative perfusion measurements in different areas of the humeral head in patients with PHF. Methods: In this prospective pilot study, intraoperative semiquantitative Doppler perfusion measurements were conducted during plate osteosynthesis for PHF treatment in our institution between July 2021 and May 2022. The fracture morphology was classified radiologically according to Resch's criteria. Quality of reduction was determined postoperatively to be either anatomical, minor malreduced, or major malreduced according to Peters et al in conventional and computed tomography examinations. Medial hinge integrity and medial metaphyseal extension were assessed radiographically according to Hertel et al. Intraoperatively, after drilling screw holes through the plate, a Doppler probe was inserted through all nine drill holes on the humeral head and at least one on the humeral shaft to successively measure the presence of a pulse to indicate if perfusion is present. Results: A total of ten patients (mean age 59 years, range, 36-83) with a humeral head fracture (2 × 2GL, 3 × 3G, 2 × 4G, 2 × 4GL, 1 × 5aG according to Resch) were included. Nine of the ten patients showed a pulse signal on the humeral shaft. Overall, pulse-synchronous perfusion was detected using Doppler sonography in at least one hole in the humeral head of all patients. In patients with an intact medial hinge (N = 6), pulse-synchronous perfusion could be measured in almost twice as many humeral head holes on average (5.7 vs. 3.0 drill holes) compared to patients with a dislocated medial hinge (N = 4). In patients with metaphyseal extension (N = 3), pulse-synchronous perfusion was measured in an average of 6.7 humeral head holes compared to 3.7 holes in patients without metaphyseal extension (N = 7). Conclusion: Semiquantitative, intraoperative Doppler flowmetry offers a noninvasive and rapid assessment of humeral perfusion which allows an understanding of humeral head perfusion, when used in a standardized fashion to measure flow in different areas of the humeral head.

A double-conducting polymer nanowire-based electrochemical aptasensor for highly sensitive and low fouling detection of cortisol in saliva.

A cortisol biosensor was developed based on double-conducting polymer nanowires, which exhibits excellent conductivity, resistance to biological contamination, and outstanding sensing performance. The biosensor employs dual-mode electrochemical techniques, namely, differential pulse voltammetry (DPV) and chronoamperometry (CA), for the sensitive and low fouling detection of the glucocorticoid hormone cortisol. Experimental results demonstrated that the linear detection range of the biosensor in DPV mode was 1.0 × 10-14-1.0 × 10-8 M, with a detection limit of 0.131 × 10-14 M. In CA mode, the biosensor exhibited a detection range of 1.0 × 10-13-1.0 × 10-7 M and a detection limit of 0.313 × 10-13 M. The biosensor was successfully utilized for the rapid detection of cortisol in human saliva. The combination of a high-specificity cortisol aptamer and functionalized double-conducting polymer nanowires ensured the exceptional specificity and sensitivity of the biosensor in detecting real biological samples.

Intelligent MEMS Sensor Based on an Oxidized Medium-Entropy Alloy (FeCoNi) for H2 and CO Recognition.

In this paper, we present the design and evaluation of an intelligent MEMS sensor employing the oxidized medium-entropy alloy (O-MEA) of FeCoNi as the gas-sensing material. Due to the specific catalytic exothermic reaction of the O-MEA on H2/CO, the sensor shows great selectivity for H2 and CO at 150 °C of the integrated microheater in the MEMS device, with the theoretical detection limit of 0.3 ppm for H2 and 0.29 ppm for CO. The MEMS heater, capable of instantaneous temperature changes in pulse operation mode, offers a novel approach for thermal modulation of the sensor, which is crucial for the adsorption and reaction of H2/CO molecules on the sensing layer surface. Consequently, we investigate the gas-sensing capabilities of the sensor under pulse heating modes (PHMs) of the MEMS heater and then propose the gas-sensing mechanism. The results indicate that PHMs significantly not only reduce the operating temperature and power consumption but also enhance the sensor's functionality by providing multivariable response signals, paving the way for intelligent gas detection. Based on the high selectivity to H2 and CO, transforming the transient sensing curves into two-dimensional images via Gramian Angular Field (GAF) model and subsequent modeling using a convolutional neural network (CNN) algorithm, we have realized efficient and intelligent recognition of H2 and CO. This work provides insight for the development of low-power, high-performance MEMS gas sensors and further intelligence of individual MEMS sensors.

Modulation-Enhanced Nearest-Level Quantization for a Wide Output Bandwidth.

Multilevel converters have enabled various applications that are not possible with conventional two-level converters. Many of these applications, however, need a high output bandwidth, often approaching the switching rate limit of the transistors, with high quality, e.g., to actively stabilize and dampen a DC grid or specifically excite certain molecules or neural circuits in medical applications. A high bandwidth approaching the switching rate challenges existing modulation methods: carrier-based switching modulation is fine at low frequencies but experiences interaction between the carrier and the signal at the upper end of the spectrum; fundamental-frequency switching, such as nearest-level modulation (NLM), perform well at high frequencies but cause intolerable distortion for low frequency contents. We propose a hybrid modulation concept that can combine any methods from these two classes. It passes the error of a fundamental frequency method through a filtered switching modulator to combine the high output quality of the latter with the high bandwidth of the former. We optimize the filter to avoid under-modulation of the signal with the carrier of the modulator and to achieve the minimum overall distortion throughout a wide output bandwidth. We demonstrate the performance experimentally with a cascaded-bridge converter and compare it with the best prior arts. This technique ensures a usable output bandwidth up to 100% of the switching rate and maintains a total distortion level below 3%.

Differential contribution of elbow flexion and knee extension on vascular and hemodynamic parameters and arterial stiffness indices after acute strength exercise in young adults.

BACKGROUND: Different types of exercise, performed acutely or chronically, have different repercussions on central hemodynamics, arterial stiffness, and cardiac function. In this study, we aim to compare the effects of acute elbow flexion (EFlex) and knee extension (KExt) exercises on vascular and hemodynamic parameters and arterial stiffness indices in healthy young adults. METHODS: Young adults (20 to 39 years) underwent randomized muscle strength tests to obtain 1 repetition maximum (1RM) for elbow flexion (EFlex) and knee extension (KExt). After a minimum interval of 48 h, cardiovascular parameters were assessed using Mobil-O-Graph® (Mobil-O-Graph, IEM, Germany) at three-time points: at baseline (before exercise), immediately after elbow flexion or knee extension exercises with a load corresponding to 50% of 1RM (T0) and after 15 min of rest (T15). RESULTS: Immediately after exercise (T0), peripheral systolic blood pressure, peripheral pulse pressure, central systolic blood pressure, and central pulse pressure were significantly higher in KExt than EFlex (Δ 3.13; Δ 3.06; Δ 5.65; Δ 5.61 mmHg, respectively). Systolic volume, cardiac output, and cardiac index were significantly higher immediately after KExt when compared with EFlex (Δ 4.2 ml; Δ 0.27 ml/min and 0.14 l/min*1/m2, respectively). The reflection coefficient and the pulse wave velocity were also significantly higher at T0 in KExt compared to EFlex ( Δ 8.59 and Δ 0.12 m/sec, respectively). CONCLUSION: Our results show differential contribution of muscle mass in vascular and hemodynamic parameters evaluated immediately after EFlex and KExt. In addition, our study showed for the first time that the reflection coefficient, an index that evaluates the magnitude of the reflected waves from the periphery, was only affected by KExt.

Assessment of health technology acceptability for remote monitoring of patients with COVID-19: A measurement model for user perceptions of pulse oximeters.

Objective: This study aims to develop a measurement model for health technology acceptability using a theoretical framework and a range of validated instruments to measure user experience, acceptance, usability, health and digital health literacy. Methods: A cross-sectional evaluation study using a mixed-methods approach was conducted. An online survey was administered to patients who used a pulse oximeter in a virtual hospital setting during COVID-19. The model development was conducted in three steps: (1) exploratory factor analysis for conceptual model development, (2) measurement model confirmation through confirmatory factor analysis followed by structural equation modelling and (3) test of model external validity on four outcome measures. Finally, the different constructs of the developed model were used to compare two types of pulse oximeters by measuring the standardised scores. Results: Two hundred and two participants were included in the analysis, 37.6% were female and the average age was 53 years (SD:15.38). A four-construct model comprising Task Load, Affective Attitude, Self-Efficacy and Value of Use (0.636-0.857 factor loadings) with 12 items resulted from the exploratory factor analysis and yielded a good fit (RMSEA = .026). Health and digital health literacy did not affect the overall reliability of the model. Frustration, performance, trust and satisfaction were identified as outcomes of the model. No significant differences were observed in the acceptability constructs when comparing the two pulse oximeter devices. Conclusions: This article proposes a model for the measurement of the acceptability of health technologies used by patients in a remote care setting based on the use of a pulse oximeter in COVID-19 remote monitoring.

A Novel Shunt Zigzag Double-Tap Low-Harmonic Multi-Pulse Rectifier Based on a Three-Stage Power Electronic Phase-Shifting Transformer.

To solve the problem of the large size of traditional industrial frequency phase-shift transformers and the harmonic distortion of multi-pulse wave rectifier systems, this paper proposes a three-stage shunt zigzag power electronic phase-shift transformer based on a double-tap multi-pulse wave rectifier, which combines the power factor correction (PFC) converter with the voltage-type SPWM inverter circuit to form a power electronic converter to realize the frequency boost and power factor correction. Through AC-DC-AC conversion, the frequency of the three-phase AC input voltage is increased, the number of core and coil turns in the transformer is reduced to reduce the size of the phase-shifter transformer, a zigzag structure of the phase-shifter transformer is used to solve the unbalanced distribution of current between the diode bridges, and a passive harmonic suppression method on the DC side is used to generate a loop current by using a group of single-phase rectifier bridges to regulate the input line current of the phase-shifter transformer. The phase-shifted voltage is input into two three-phase diode rectifier bridges to rectify and supply power to the load. Simulation and semi-physical test results show that the proposed method reduces the total harmonic distortion (THD) value of the input current of the phase-shifted transformer to 7.17%, and the THD value of the grid-side input current is further reduced to 2.49%, which meets the harmonic standard and realizes the purpose of power factor correction as well as being more suitable for high-power applications.

Heterogeneity of HPV16 virus-like particles indicates a complex assembly energy surface.

Human Papillomavirus serotype 16 (HPV16) capsid protein (L1) pentamers canonically assemble into T = 7 icosahedral capsids. Such virus-like particles are the basis of the HPV vaccine. We examined assembly of L1 pentamers in response to pH, mild oxidants, and ionic strength and found a mixture of closed, roughly spherical structures from ∼20 to ∼70 nm in diameter, indicating the presence of many kinetically accessible energy minima. Using bulk and single particle techniques we observed that the size distribution changes but does not reach homogeneity. Though heterogenous in size, particles showed uniform responses to low ionic strength dissociation, thermal unfolding, and susceptibility to protease digestion. These assays suggest maturation over time, but at different rates. Cysteine oxidation further stabilized particles at early, but not late, times without changing general characteristics including thermal stability and protease digestion. These data show complex assembly paths to species of different sizes, but with locally similar interactions.

Prognostic significance of the estimated pulse wave velocity in critically ill patients with coronary heart disease: analysis from the MIMIC­IV database.

BACKGROUND: There are currently no specialized risk-scoring systems for critically ill patients with coronary heart disease (CHD). Arterial stiffness, as measured by estimated pulse wave velocity (ePWV), has emerged as a potential indicator of mortality or adverse cardiovascular events in individuals with CHD. This study aimed to evaluate the association between ePWV and all-cause mortality among critically ill patients with CHD beyond traditional risk scores. METHODS: This study included 11 001 participants with CHD from the Medical Information Mart for Intensive Care IV, with a one-year follow-up. The primary endpoint was one-year all-cause mortality, and the secondary endpoint was in-hospital mortality. RESULTS: Elevated ePWV was significantly associated with higher risks of in-hospital (OR 1.15, 95% CI 1.12-1.17, p < 0.001) and one-year (HR 1.21, 95% CI 1.20-1.23, p < 0.001) mortality. These associations remained consistent when adjusted for traditional risk scores and potential confounders. When ePWV was integrated into traditional risk scoring models (OASIS, SOFA score, APSIII, SIRS score, SAPS II, and LODS score), the predictive accuracy (area under the curve: 64.55 to 70.56, 64.32 to 72.51, 72.35 to 75.80, 55.58 to 67.68, 71.27 to 73.53, 67.24 to 73.40, p < 0.001) and reclassification (net reclassification index: 0.230, 0.268, 0.257, 0.255, 0.221, 0.254; integrated discrimination improvement: 0.049, 0.072, 0.054, 0.068, 0.037, 0.061, p < 0.001) of these models significantly improved for one-year mortality. Similar results were also found for in-hospital mortality. CONCLUSIONS: ePWV is a strong independent predictor of both short- and long-term mortality in critically ill patients with CHD. Importantly, integrating ePWV into traditional risk scores significantly boosts the predictive accuracy for one-year and in-hospital all-cause mortality.