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1.
Int Heart J ; 61(2): 332-337, 2020 Mar 28.
Artículo en Inglés | MEDLINE | ID: mdl-32132322

RESUMEN

Increased arterial stiffness is strongly associated with cardiovascular morbidity and mortality in dialysis patients. Ischemia-modified albumin (IMA) is a useful biomarker of cardiac ischemia. This study was aimed to explore the association between IMA and arterial stiffness in hemodialysis patients. An observational study was conducted with 120 hemodialysis patients. Clinical data and laboratory characteristics were collected. Arterial stiffness was evaluated by brachial-ankle pulse wave velocity (baPWV). Hemodialysis patients had extensive arterial stiffness and high levels of IMA. Comparing to hemodialysis patients with normal baPWV, those with high baPWV had significantly higher levels of IMA (93.7 ± 8.6 versus 73.1 ± 10.7 Ku/L, P = 0.027). The multiple linear regression analysis showed that IMA was significantly associated with arterial stiffness in hemodialysis patients (ß = 0.43, P < 0.001). Moreover, IMA, with a threshold value of 90.4 Ku/L, provided 77.4% sensitivity and 86.6% specificity for predicting arterial stiffness. Hemodialysis patients with arterial stiffness had high levels of IMA. IMA was a good predictive marker of arterial stiffness for hemodialysis patients.


Asunto(s)
Fallo Renal Crónico/fisiopatología , Rigidez Vascular , Anciano , Biomarcadores/sangre , Femenino , Humanos , Fallo Renal Crónico/sangre , Fallo Renal Crónico/terapia , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Análisis de la Onda del Pulso , Diálisis Renal , Albúmina Sérica Humana
2.
PLoS One ; 15(1): e0228449, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32005035

RESUMEN

OBJECTIVE: The main objective of this study was to evidence the potential impact of the intensity, duration and recurrence of depression on the development of arterial stiffness (AS) leading to left ventricular hypertrophy (LVH) and diastolic dysfunction (DD) in patients with new onset depression (NOD) and recurrent depression (RD) in comparison to 33 control subjects without depression. Another aim was to identify potential predictive factors regarding the occurrence of diastolic dysfunction (DD). METHODS: Our study group included 58 patients diagnosed with NOD and 128 diagnosed with RD, without any previously diagnosed significant heart diseases. The intensity of depression was evaluated by means of the Montgomery-Asberg Depression Rating Scale (MADRS). Assessment of pulse wave velocity (PWV), left ventricular mass index (LVMI) and echocardiographic parameters characterizing DD were performed for each patient. RESULTS: The cardiology evaluations suggested an increased prevalence of AS in all patients, of significantly higher rate than in controls (p<0.001), which was statistically correlated with the severity and duration of depression. Another significant finding was an increased prevalence of DD (29.31% and 63.28%, respectively; p<0.001) correlated with the MADRS score, total duration and number of recurrences/relapses. The multivariate logistic regression analysis identified PWV, the intensity and duration of depression as significant predictive factors for the occurrence of DD. CONCLUSIONS: In our study, diastolic dysfunction was a common finding among patients with RD, but it was also noted, to a lesser extent, in those suffering with NOD. DD was associated with altered AS, and strongly correlated with the intensity and the duration of depressive symptoms. The two latter factors, together with an increased PWV, were strong predictors for the occurrence of DD.


Asunto(s)
Depresión/complicaciones , Hipertrofia Ventricular Izquierda/diagnóstico , Disfunción Ventricular Izquierda/diagnóstico , Adulto , Estudios de Casos y Controles , Depresión/fisiopatología , Femenino , Humanos , Hipertrofia Ventricular Izquierda/etiología , Hipertrofia Ventricular Izquierda/fisiopatología , Modelos Logísticos , Masculino , Persona de Mediana Edad , Análisis de la Onda del Pulso , Recurrencia , Rigidez Vascular , Disfunción Ventricular Izquierda/etiología , Disfunción Ventricular Izquierda/fisiopatología
3.
PLoS One ; 15(2): e0228569, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32053613

RESUMEN

BACKGROUND: Type 1 diabetes mellitus (T1DM) in children and adolescents is associated with significant cardiovascular morbidity and mortality. Early detection of vascular dysfunction is key to patient management yet current assessment techniques are invasive and not suitable for pediatric patient populations. A novel approach using isometric handgrip exercise during magnetic resonance imaging (IHE-MRI) has recently been developed to evaluate coronary endothelial function non-invasively in adults. This project aimed to assess endothelium-dependent coronary arterial response to IHE-MRI in children with T1DM and in age matched healthy controls. MATERIALS AND METHODS: Healthy volunteers and children with T1DM (>5 years) were recruited. IHE-MRI cross-sectional coronary artery area measurements were recorded at rest and under stress. Carotid intima media thickness (CIMT) and aortic pulse wave velocity (PWV) were assessed for comparison. Student's t-tests were used to compare results between groups. RESULTS AND DISCUSSION: Seven children with T1DM (3 female, median 14.8 years, mean 14.8 ± 1.9 years) and 16 healthy controls (7 female, median 14.8 years, mean 14.2 ± 2.4 years) participated. A significant increase in stress-induced cross-sectional coronary area was measured in controls (5.4 mm2 at rest to 6.39 mm2 under stress, 18.8 ± 10.7%, p = 0.0004). In contrast, mean area change in patients with T1DM was not significant (7.17 mm2 at rest to 7.59 mm2 under stress, 10.5% ± 28.1%, p = n.s.). There was no significant difference in the results for neither PWV nor CIMT between patients and controls, (5.3±1.5 m/s vs.4.8±0.7 m/s and 0.4±0.03mm vs.0.46 mm ± 0.03 respectively, both p = n.s.). CONCLUSIONS: Our pilot study demonstrates the feasibility of using a totally non-invasive IHE-MRI technique in children and adolescents with and without T1DM. Preliminary results suggest a blunted endothelium-dependent coronary vasomotor function in children with T1DM (>5 years). Better knowledge and new methodologies may improve surveillance and care for T1DM patients to reduce cardiovascular morbidity and mortality.


Asunto(s)
Vasos Coronarios/diagnóstico por imagen , Diabetes Mellitus Tipo 1/fisiopatología , Ejercicio Físico , Cardiopatías/fisiopatología , Imagen por Resonancia Magnética , Adolescente , Aorta/patología , Grosor Intima-Media Carotídeo , Niño , Diabetes Mellitus Tipo 1/complicaciones , Endotelio Vascular/fisiopatología , Estudios de Factibilidad , Femenino , Fuerza de la Mano , Cardiopatías/complicaciones , Hemodinámica , Humanos , Masculino , Proyectos Piloto , Análisis de la Onda del Pulso , Vasodilatación
4.
Sheng Wu Yi Xue Gong Cheng Xue Za Zhi ; 37(1): 61-70, 2020 Feb 25.
Artículo en Chino | MEDLINE | ID: mdl-32096378

RESUMEN

In order to quantitatively analyze the morphology and period of pulse signals, a time-space analytical modeling and quantitative analysis method for pulse signals were proposed. Firstly, according to the production mechanism of the pulse signal, the pulse space-time analytical model was built after integrating the period and baseline of pulse signal into the analytical model, and the model mathematical expression and its 12 parameters were obtained for pulse wave quantification. Then, the model parameters estimation process based on the actual pulse signal was presented, and the optimization method, constraints and boundary conditions in parameter estimation were given. The spatial-temporal analytical modeling method was applied to the pulse waves of healthy subjects from the international standard physiological signal sub-database Fantasia of the PhysioNet in open-source, and we derived some changes in heartbeat rhythm and hemodynamic generated by aging and gender difference from the analytical models. The model parameters were employed as the input of some machine learning methods, e.g. random forest and probabilistic neural network, to classify the pulse waves by age and gender, and the results showed that random forest has the best classification performance with Kappa coefficients over 98%. Therefore, the space-time analytical modeling method proposed in this study can effectively quantify and analyze the pulse signal, which provides a theoretical basis and technical framework for some related applications based on pulse signals.


Asunto(s)
Frecuencia Cardíaca , Hemodinámica , Análisis de la Onda del Pulso , Procesamiento de Señales Asistido por Computador , Bases de Datos Factuales , Voluntarios Sanos , Humanos
5.
Drug Discov Ther ; 14(1): 21-26, 2020 Mar 08.
Artículo en Inglés | MEDLINE | ID: mdl-32062635

RESUMEN

The pulse wave transit time (PWTT) is easily measured as the time from the R wave of an electrocardiogram to the arrival of the pulse wave measured by an oxygen saturation monitor at the earlobe. We investigated whether the change of PWTT during exercise testing reflects cardiopulmonary function. Eighty-nine cardiac patients who underwent cardiopulmonary exercise testing (CPX) were enrolled. We analyzed the change of PWTT during exercise and the relationship between the shortening of the PWTT and CPX parameters. PWTT was significantly shortened from rest to peak exercise (204.6 ± 33.6 vs. 145.6 ± 26.4 msec, p < 0.001) in all of the subjects. The patients with heart failure had significantly higher PWTT at peak exercise than the patients without heart failure (152.7 ± 27.1 vs. 140.4 ± 24.8 msec, p = 0.031). The shortening of PWTT from rest to peak exercise showed significant positive correlations with the peak O2 uptake (VO2) (r = 0.56, p < 0.001), anaerobic threshold (r = 0.40, p = 0.016), and % increase of systolic blood pressure during exercise (r = 0.75, p < 0.001), and a negative correlation with the slope of the increase in ventilation versus the increase in CO2 output (VE-VCO2 slope) (r = - 0.42, p = 0.010) in the patients with heart failure. PWTT was shortened during exercise as the exercise intensity increased. In the patients with heart failure, the shortening of PWTT from rest to peak exercise was smaller in those with lower exercise capacity and those with higher VE-VCO2 slope, an established index known to reflect the severity of heart failure.


Asunto(s)
Prueba de Esfuerzo , Cardiopatías/fisiopatología , Análisis de la Onda del Pulso , Presión Sanguínea , Insuficiencia Cardíaca/fisiopatología , Humanos , Índice de Severidad de la Enfermedad
6.
Am J Physiol Heart Circ Physiol ; 318(3): H581-H589, 2020 03 01.
Artículo en Inglés | MEDLINE | ID: mdl-32004082

RESUMEN

Preeclampsia is associated with the development of cardiovascular diseases later in life. To investigate this phenomenon, we compared established markers of cardiovascular dysregulation between previously preeclamptic women (PPE; n = 12, 13 ± 6 mo postpartum, 34 ± 6 yr) and women who had previously had an uncomplicated pregnancy [control (CTRL); n = 12, 15 ± 4 mo postpartum; 29 ± 3 yr]. We hypothesized that PPE would present with elevated arterial stiffness (assessed as central and peripheral pulse wave velocity) and muscle sympathetic nerve activity (MSNA; microneurography) and blunted baroreflex sensitivity (BRS) relative to CTRL. Blood pressure (Finometer) was similar between PPE and CTRL (mean arterial pressure: 94 ± 11 vs. 89 ± 9, P = 0.16). Central (6.92 ± 0.21 vs. 6.24 ± 0.22 m/s, P = 0.04) but not peripheral arterial stiffness (7.52 ± 0.19 vs. 7.09 ± 0.19 m/s, P = 0.13) was elevated in PPE versus CTRL (values normalized to MAP). MSNA was also elevated in PPE versus CTRL (22 ± 7 vs. 13 ± 5 bursts/min, P = 0.01), although this was independent of arterial stiffness (central: r2 = 0.01, P = 0.74; peripheral: r2 = 0.01, P = 0.74). Cardiovagal BRS was blunted in PPE versus CTRL (15 ± 5 vs. 28 ± 1 ms/mmHg, P = 0.01), whereas sympathetic vascular BRS was similar (-3.2 ± 0.9 vs. -3.1 ± 1.4 bursts·100 hb-1·mmHg-1, P = 0.88). Cardiovagal and sympathetic BRS were inversely correlated in both CTRL (r2 = 0.43; P = 0.05) and PPE (r2 = 0.69; P = 0.04), supporting a compensatory mechanism resulting in normal blood pressures in both groups. Overall, these data indicate that PPE retain their ability to buffer elevated MSNA. We propose that the higher incidence of cardiovascular disease observed later in life in PPE results from this arterial stiffness, combined with the loss of protective vascular mechanisms and the "unmasking" of high MSNA.NEW & NOTEWORTHY We demonstrate that resting muscle sympathetic nerve activity is elevated in women with a recent history of preeclampsia relative to women who have recently had uncomplicated pregnancies and without a history of preeclampsia. Structural changes in the central arteries are associated with arterial stiffness following preeclampsia, independent of changes in the sympathetic nervous system. The structural changes are observed in these relatively young previously preeclamptic women, indicating elevated cardiovascular risk. Our data suggest that with aging (and the gradual loss of vascular protection for women, as established by others), this risk will become exaggerated compared with women who have had normal pregnancies.


Asunto(s)
Músculo Esquelético/inervación , Preeclampsia/fisiopatología , Sistema Nervioso Simpático/fisiopatología , Rigidez Vascular/fisiología , Adulto , Barorreflejo/fisiología , Biomarcadores/sangre , Presión Sanguínea/fisiología , Femenino , Frecuencia Cardíaca/fisiología , Hemodinámica/fisiología , Humanos , Músculo Esquelético/fisiopatología , Embarazo , Análisis de la Onda del Pulso
7.
Vnitr Lek ; 65(12): 770-774, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32013519

RESUMEN

Age can be evaluated according to many criteria. Of course the objective measure is the calendar age which may differ from the biological age. The biological age more or less correlates with the vascular age. The concept of vascular age is based on the statement that “An individual is as old as his blood vessels”. The process of vascular aging already starts in childhood. Arterial aging may essentially be viewed from two standpoints. First, it involves stiffening of arteries and loss of their elasticity; second, degenerative changes and formation of atherosclerotic plaques occur, being the cause of ischemia, especially in case of the development of atherothrombosis. Both these processes can be monitored: The change of elasticity (arteriosclerosis) mainly by examination of pulse wave velocity (PWV), atherosclerosis then primarily with non-invasive methods, ultrasound or CT angiography examination. From the clinical point of view it is particularly important whether we can influence vascular age in some way. Evidence is available now that atherosclerosis can be affected by hypolipidemic treatment, arteriosclerosis then in particular by ACE inhibitors. The aforementioned possibility of influencing vascular age brings us to another problem, which is compliance of patients. With regard to that it is good that in a situation where we have two drugs affecting vascular age, we can use their fixed combination. It is available as a combination of atorvastatin and perindopril.


Asunto(s)
Envejecimiento , Aterosclerosis , Rigidez Vascular , Adolescente , Adulto , Anciano , Envejecimiento/fisiología , Inhibidores de la Enzima Convertidora de Angiotensina , Niño , Elasticidad , Humanos , Persona de Mediana Edad , Perindopril , Análisis de la Onda del Pulso , Adulto Joven
8.
Zhonghua Xin Xue Guan Bing Za Zhi ; 48(1): 66-71, 2020 Jan 24.
Artículo en Chino | MEDLINE | ID: mdl-32008298

RESUMEN

Objective: To investigate the impact of change of ideal cardiovascular behavior and related factors on healthy vascular aging(HVA). Methods: This study was a multi-center cross-sectional survey. Six thousand three hundred and sixteen participants who underwent at least 2 healthy examinations from 2006 to 2015 at 11 hospitals, including Kailuan Hospital and so on, and examined brachial-ankle pulse wave velocity (baPWV) during 2010 and 2016, with available information about cardiovascular behavior and factors were included. The cardiovascular health score (CHS) was calculated. Basic CHS was collected from the first examination. The second CHS derived from the healthy examination in the same year of baPWV examination. Change of cardiovascular health score (ΔCHS) was calculated. Participants were defined into 5 groups according to ΔCHS, namely ΔCHS≤-2 (n=2 166), ΔCHS=-1 (n=1 284), ΔCHS=0 (n=1 187), ΔCHS=1 (n=860), and ΔCHS≥2 (n=819). Participants' characteristics, value of baPWV and proportion of HVA were compared among different groups. Multiple logistic regression analysis was used to investigate the association between ΔCHS and HVA. The ΔCHS was recalculated and included in multiple logistic regression analysis model again after each component of the cardiovascular health metrics was removed separately in order to investigate effects of removal factors on HVA by observing changes in effect values. Results: The percentage of the participants with HVA in the group of ΔCHS≤-2, ΔCHS=-1, ΔCHS=0, ΔCHS=1 and ΔCHS≥2 were 23.3%(505/2 166), 27.8%(357/1 284), 28.7%(341/1 187),31.9%(274/860) and 33.9%(278/819), respectively. After adjustment for age, sex, income, education, alcohol consumption and the basic CHS, a significant positive association between ΔCHS and proportion of participants with HVA was observed (OR=1.50, 95%CI 1.44-1.56). Multiple regression analysis after removing each single cardiovascular behavior or factor showed that the OR value decreased as follow systolic blood pressure (OR=1.04, 95%CI 1.00-1.09), fasting blood glucose (OR=1.14, 95%CI 1.09-1.18), physical exercise (OR=1.16, 95%CI 1.11-1.21), salt intake (OR=1.17, 95%CI 1.12-1.22), body mass index (OR=1.18, 95%CI 1.13-1.23), smoking(OR=1.18, 95%CI 1.13-1.23) and total cholesterol (OR=1.20, 95%CI 1.16-1.24). Conclusion: The improvement of every ideal cardiovascular behavior and factor is associated with the increase of the proportion of HVA population.


Asunto(s)
Envejecimiento , Enfermedades Cardiovasculares , Análisis de la Onda del Pulso , Índice Tobillo Braquial , Presión Sanguínea , Índice de Masa Corporal , Fenómenos Fisiológicos Cardiovasculares , Estudios Transversales , Humanos , Factores de Riesgo
9.
Medicine (Baltimore) ; 99(3): e18793, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-32011479

RESUMEN

Pulse wave velocity (PWV) is a reliable measurement of arterial stiffness. Our study assesses the association between body mass index (BMI) and brachial-ankle PWV (baPWV) in a healthy cohort and seeks to explain possible mechanisms associated with the obesity paradox.A cross-sectional study was conducted in 578 normal individuals. The mean age was 48.3 ±â€Š14.6 years, and 468 (81.0%) were men. 288 subjects (49.8%) were overweight and obese. baPWV and ankle-brachial index (ABI) were performed to evaluate arterial stiffness and atherosclerosis respectively. Normal weight was defined as 18.5 < BMI <25 kg/m, overweight as 25 ≤ BMI < 28 kg/m and obesity as BMI ≥28 kg/m.The overweight/obese subjects had significantly higher baPWV than the normal-weight group (1490.0 ±â€Š308.0/1445.2 ±â€Š245.2 cm/s vs 1371.2 ±â€Š306.4 cm/s, P < .001). For the whole cohort, baPWV showed a significant positive correlation with BMI (r = 0.205, P < .001). However, baPWV was significantly lower as BMI increased: 1490.0 ±â€Š308.0 cm/s (overweight); 1445.2 ±â€Š245.2 cm/s (obese); P < .001) when adjusted for age, gender, heart rate, mean blood pressure, and cardiovascular risk factors (glucose, cholesterol, triglyceride, and low-density lipoprotein). For the whole cohort BMI was negatively associated with baPWV (ß = -0.06, P = .042). ABI showed no relationship with BMI. In a middle-age healthy Chinese population, arterial stiffness measured as baPWV increased with BMI.Evidence of reduced arterial stiffness with increasing BMI when accounting for all other cardiovascular risk factors may contribute to underlying factors involved in the obesity paradox that becomes more prominent with increasing age.


Asunto(s)
Índice de Masa Corporal , Análisis de la Onda del Pulso , Rigidez Vascular , Factores de Edad , China , Estudios de Cohortes , Estudios Transversales , Femenino , Humanos , Masculino , Persona de Mediana Edad , Sobrepeso/fisiopatología
10.
Medicine (Baltimore) ; 99(3): e18598, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-32011439

RESUMEN

A large interarm and interleg systolic blood pressure (SBP) difference and ankle-brachial index (ABI) <0.9 were associated with peripheral artery disease and left ventricular hypertrophy. These 3 parameters were derived from 4-limb SBP data. However, there is no study to assess clinical significance of SBP heterogeneity in 4 limbs. The aim of this study was to evaluate the association of 4-limb SBP standard deviation (SD) with peripheral vascular parameters and echocardiographic data in patients with or without clinical findings of peripheral artery disease.A total of 1240 patients were included, of whom 1020 had no clinical evidence of overt peripheral artery disease. The 4-limb blood pressures, brachial-ankle pulse wave velocity, and ABI were measured simultaneously by an ABI-form device.In the multivariable linear regression analysis, increased left ventricular mass index (LVMI), ABI < 0.9, interarm SBP difference >10 mm Hg, and interleg SBP difference >15 mm Hg (P ≤ .030) were associated with increased 4-limb SBP SD. Additionally, a subgroup multivariable linear regression analysis in 1020 patients without ABI < 0.9, interarm SBP difference >10 mm Hg, and interleg SBP difference >15 mm Hg found 4-limb SBP SD still had a positive correlation with LVMI (P < .001).In addition to significant association with ABI < 0.9, interarm SBP difference >10 mm Hg, and interleg SBP difference >15 mm Hg, 4-limb SBP SD was positively correlated with LVMI in the multivariable linear regression analysis in all study patients. Furthermore, in the subgroup of patients without clinical evidence of peripheral artery disease, 4-limb SBP SD still had a positive correlation with LVMI. Hence, assessment of 4-limb SBP heterogeneity is useful in identification of high-risk group of peripheral artery disease and/or increased LVMI, irrespective of the presence of overt peripheral artery disease.


Asunto(s)
Presión Sanguínea/fisiología , Ecocardiografía/métodos , Extremidades/fisiopatología , Hipertrofia Ventricular Izquierda/fisiopatología , Enfermedad Arterial Periférica/fisiopatología , Índice Tobillo Braquial , Femenino , Humanos , Modelos Lineales , Masculino , Enfermedad Arterial Periférica/diagnóstico , Análisis de la Onda del Pulso
11.
J Physiol Anthropol ; 39(1): 4, 2020 Feb 21.
Artículo en Inglés | MEDLINE | ID: mdl-32085811

RESUMEN

BACKGROUND: Recently, attempts have been made to use the pulse rate variability (PRV) as a surrogate for heart rate variability (HRV). PRV, however, may be caused by the fluctuations of left ventricular pre-ejection period and pulse transit time besides HRV. We examined whether PRV differs not only from HRV but also depending on the measurement site. RESULTS: In five healthy subjects, pulse waves were measured simultaneously on both wrists and both forearms together with single-lead electrocardiogram (ECG) in the supine and sitting positions. Although average pulse interval showed no significant difference from average R-R interval in either positions, PRV showed greater power for the low-frequency (LF) and high-frequency (HF) components and lower LF/HF than HRV. The deviations of PRV from HRV in the supine and sitting positions were 13.2% and 7.9% for LF power, 24.5% and 18.3% for HF power, and - 15.0% and - 30.2% for LF/HF, respectively. While the average pulse interval showed 0.8% and 0.5% inter-site variations among the four sites in the supine and sitting positions, respectively, the inter-site variations in PRV were 4.0% and 3.6% for LF power, 3.8% and 4.7% for HF power, and 18.0% and 17.5% for LF/HF, respectively. CONCLUSIONS: These suggest that PRV shows not only systemic differences from HRV but also considerable inter-site variations.


Asunto(s)
Electrocardiografía/métodos , Frecuencia Cardíaca/fisiología , Análisis de la Onda del Pulso/métodos , Dispositivos Electrónicos Vestibles , Adulto , Femenino , Antebrazo/irrigación sanguínea , Humanos , Masculino , Postura/fisiología , Procesamiento de Señales Asistido por Computador , Muñeca/irrigación sanguínea , Adulto Joven
12.
Vasc Health Risk Manag ; 16: 29-39, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32021226

RESUMEN

Objective: We suggested: 1) patients with idiopathic pulmonary hypertension (IPAH) have active factors which could damage not only the pulmonary but systemic arteries too as in arterial hypertensive patients; 2) if these changes were present, they might correlate with other parameters influencing on the prognosis. This study is the first attempt to use cardio-ankle vascular index (CAVI) for the evaluation of systemic arterial stiffness in patients with IPAH. Methods: A total of 112 patients were included in the study: group 1 consisted of 45 patients with new diagnosed IPAH, group 2 included 32 patients with arterial hypertension, and in the control group were 35 healthy persons adjusted by age. Right heart catheterization, ECG, a 6-minute walk test (6MWT), echocardiography, blood pressure (BP) measurement and ambulatory BP monitoring, pulse wave elastic artery stiffness (PWVe; segment carotid-femoral arteries) and muscular artery stiffness (PWVm; segment carotid-radial arteries), CAVI, and N-terminal pro-B-type natriuretic peptide (NT-proBNP) level were provided. The Spearman correlation, a linear regression and multivariable binary logistic analysis were performed to indicate the predictors associated with PWV and CAVI. Results: The groups were adjusted for principal characteristics influenced on arterial stiffness. IPAH patients had significantly (P<0.001 for all) shorter 6MWT distance and higher Borg dyspnea score than the patients with arterial hypertension (systolic/diastolic BP = 146.1±10.7/94.2±9.8 mmHg) and the control group = 330.2±14.6 vs 523.8±35.3 and 560.9±30.2 m respectively and 6.2±1.8 vs 1.2±2.1 and 0.9±2.8 points. The PWVm and PWVe were the highest in hypertensive patients (10.3±1.5 and 11.42±1.70 m/s). The control group and IPAH did not have significant differences in aorta BP, but PWVm/PWVe values were significantly (P<0.003/0.008) higher in IPAH patients than in the control group (8.1±1.9/8.49±1.92 vs 6.63±1.34/7.29±0.87 m/s). The CAVIs on both sides were significantly lower in the healthy subjects (5.91±0.99/5.98±0.87 right/left side). Patients with IPAH did not differ from the arterial hypertension patients by CAVIs in comparison with the control group (7.40±1.32/7.22±1.32 vs 7.19±0.78/7.2±1.1 PWVe) did not correlate with any parameters except uric acid. PWVm correlated with uric acid (r=0.58, P<0.001), NT-proBNP (r=0.33, P=0.03) and male gender (r=0.37, P=0.013) at Spearman analysis, but not at multifactorial linear regression analysis. The CAVI correlated with age and parameters characterized functional capacity (6MWT distance) and right ventricle function (NT-proBNP, TAPSE) at Spearman analysis and with age and TAPSE at multifactorial linear regression analysis. At binary logistic regression analysis CAVI > 8.0 at right and/or left side had a correlation with age, 6MWT distance, TAPSE, but an independent correlation was only with age (ß=1.104, P=0.008, CI 1.026-1.189) and TAPSE (ß=0.66, P=0.016, CI 0.474-0.925). Conclusion: In spite of equal and at normal range BP level, the age-adjusted patients with IPAH had significantly stiffer arteries than the healthy persons and they were comparable with the arterial hypertensive patients. Arterial stiffness evaluated by CAVI correlated with age and TAPSE in IPAH patients. Based on our results it is impossible to conclude the pathogenesis of arterial stiffening in IPAH patients, but the discovered changes and correlations suggest new directions for further studies, including pathogenesis and prognosis researches.


Asunto(s)
Presión Arterial , Arterias Carótidas/fisiopatología , Hipertensión Pulmonar Primaria Familiar/fisiopatología , Arteria Femoral/fisiopatología , Arteria Pulmonar/fisiopatología , Rigidez Vascular , Adulto , Índice Vascular Cardio-Tobillo , Estudios de Casos y Controles , Estudios Transversales , Hipertensión Pulmonar Primaria Familiar/diagnóstico , Femenino , Humanos , Masculino , Persona de Mediana Edad , Pronóstico , Análisis de la Onda del Pulso
13.
Int J Sports Med ; 41(4): 227-232, 2020 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-31935779

RESUMEN

The present study aimed to evaluate the effectiveness of a school-based multi-activity HIIT on aerobic fitness (AF) and hemodynamic parameters in children. 46 students were randomized into an intervention group (INT) (N=22) and a control group (CON) (N=24). Throughout a 3-month intervention period, both INT and CON participated in the regular physical education classes (PE) twice a week. Only INT received an instructed HIIT during the first 20 min of the PE. In addition to an AF-test, peripheral (pBP) and central (cBP) blood pressure, augmentation pressure (AP), and aortic pulse wave velocity (aPWV) were assessed. Significant differences in intervention effects in favor of INT were detected for AF (7.73, P=0.007), peripheral systolic BP (-6.13 mmHg, P=0.038), central systolic BP (-5.19 mmHg, P = 0.041), AP (-2.02 mmHg, P=0.013), and aPWV (-0.19 m/sec, P=0.031). The regular HITT intervention showed beneficial effects on AF, BP, and parameters of vascular stiffness already in children.


Asunto(s)
Capacidad Cardiovascular/fisiología , Hemodinámica/fisiología , Entrenamiento de Intervalos de Alta Intensidad , Educación y Entrenamiento Físico/métodos , Presión Sanguínea/fisiología , Niño , Femenino , Humanos , Masculino , Análisis de la Onda del Pulso , Rigidez Vascular/fisiología
14.
Ultrasonics ; 102: 106064, 2020 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-31955815

RESUMEN

Currently, pulse wave velocity (PWV) is an important physical index for characterizing the mechanical properties of arteries. Carotid-femoral PWV (cfPWV) is a clinically-approved parameter for evaluating the cardiovascular risk and therapeutic efficacy. However, cfPWV only provides global information about vessel properties. Many recent studies have indicated that local PWV measurements provide precise evaluation of artery conditions. Here, an ultrasound (US) method based on a novel vessel displacement waveform correction, is proposed for improving the accuracy of local carotid PWV measurement. A programmable US device and a commercial array transducer were used, which allow a user to excite transducer and receive US signals arbitrarily with different beam settings. The local PWV measurement accuracy was verified using a phantom. The number of US beams used for PWV measurements was also considered, which indicates that eight elements is the acceptable setting. Subsequently, local carotid PWV and cfPWV were measured in 35 healthy human subjects (age: 21.9 ± 2.4 years) by using the US method and SphygmoCor device, respectively. The cfPWV and local carotid PWV were 6.65 ± 0.74 and 4.63 ± 0.57 m/s, respectively. A good linear correlation was observed between the two aforementioned methods (r = 0.8) for the subjects. All the results indicated that when few US beams were used, the proposed method exhibited a reliable measurement of local PWV.


Asunto(s)
Arterias Carótidas/fisiología , Análisis de la Onda del Pulso/métodos , Ultrasonografía/métodos , Velocidad del Flujo Sanguíneo , Femenino , Humanos , Masculino , Transductores , Adulto Joven
15.
J Agric Food Chem ; 68(7): 1871-1876, 2020 Feb 19.
Artículo en Inglés | MEDLINE | ID: mdl-31294557

RESUMEN

Cocoa flavanols (CFs) can improve flow-mediated dilation (FMD), blood pressure, and vascular stiffness in healthy subjects. Endothelial microparticles (EMPs) are markers of endothelial functional integrity, reflecting activation and injury. In plasma samples, we investigated whether age-dependent changes in circulating EMPs exist and whether CFs decrease EMPs in healthy humans. The concentrations of CD31+/41-, CD144+, and CD62e+ EMPs (flow cytometry) were increased in healthy elderly (n = 19) compared to young (n = 20) non-smokers. EMPs correlated with age, systolic blood pressure, and pulse wave velocity. CD31+/41- and CD62e+ EMPs inversely correlated with FMD. Following 2 weeks twice-daily CF consumption (450 mg), CD31+/41- and CD144+ EMPs decreased in both young and elderly subjects compared to the CF-free control. The EMP decrease inversely correlated with FMD improvements. Cardiovascular aging is associated with increased EMPs that can be modulated by dietary flavanols along with improvements in vascular function. This indicates that flavanol consumption can improve endothelial functional integrity in healthy humans.


Asunto(s)
Cacao/metabolismo , Endotelio Vascular/fisiología , Flavanonas/metabolismo , Adulto , Anciano , Anciano de 80 o más Años , Presión Sanguínea , Micropartículas Derivadas de Células/química , Selectina E/metabolismo , Femenino , Humanos , Persona de Mediana Edad , Análisis de la Onda del Pulso , Rigidez Vascular , Vasodilatación , Adulto Joven
16.
Rev Esp Cardiol (Engl Ed) ; 73(1): 43-52, 2020 Jan.
Artículo en Inglés, Español | MEDLINE | ID: mdl-31521574

RESUMEN

INTRODUCTION AND OBJECTIVES: To describe, for the first time, reference values for the cardio-ankle vascular index (CAVI), brachial-ankle pulse wave velocity (BA-PWV), carotid-femoral pulse wave velocity (CF-PWV), and the central augmentation index and to establish their association with cardiovascular risk factors in the Spanish adult population aged 35 to 75 years without cardiovascular disease. METHODS: We conducted a cross-sectional study. Through random sampling stratified by age and sex, we included 501 participants without cardiovascular disease. The mean age was 55.9 years and 50.3% were women. The measurements were taken using the SphigmoCor and Vasera VS-1500 devices. RESULTS: Values for all measures, except those for the central augmentation index, were higher in men and increased with age and blood pressure. The mean values were as follows: CAVI, 8.01±1.44; BA-PWV, 12.93±2.68m/s; CF-PWV, 6.53±2.03 m/s, and central augmentation index, 26.84±12.79. On multiple regression analysis, mean blood pressure was associated with the 4 measures, glycated hemoglobin was associated with all measures except the central augmentation index, and body mass index showed an inverse association with CAVI. The explanatory capacity of age, sex, and mean blood pressure was 62% for BA-PWV, 49% for CF-PWV 49%, 54% for the CAVI, and 38% for the central augmentation index. On logistic regression, hypertension was associated with the CAVI (OR=3.45), VOP-BT (OR=3.44), VOP-CF (OR=3.38) and with the central augmentation index (OR=3.73). CONCLUSIONS: All arterial stiffness measures increased with age. The CAVI and CF-PWV were higher in men and the central augmentation index was higher in women, with no differences in BA-PWV. This study is registered at ClinicalTrials.gov. Identifier NCT02623894.


Asunto(s)
Enfermedades Cardiovasculares/fisiopatología , Vigilancia de la Población , Rigidez Vascular/fisiología , Adulto , Anciano , Índice Tobillo Braquial , Índice de Masa Corporal , Enfermedades Cardiovasculares/diagnóstico , Enfermedades Cardiovasculares/epidemiología , Grosor Intima-Media Carotídeo , Estudios Transversales , Femenino , Humanos , Incidencia , Masculino , Persona de Mediana Edad , Análisis de la Onda del Pulso , Valores de Referencia , Factores de Riesgo , España/epidemiología
18.
Clin Exp Hypertens ; 42(1): 16-23, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-30554536

RESUMEN

Objective: The aim of this study was to assess indices of a comprehensive panel of central aortic pressure and arterial stiffness for prediction of cardiovascular events in a hypertensive cohort.Methods: Noninvasive measurements of central aortic blood pressure, brachial pressure, wave reflection augmentation index, pressure amplification, pulse wave velocity (PWV) and carotid intima-media thickness (IMT) were obtained in 675 hypertensive patients (age 61 ± 9 years, 425 males) for a mean follow-up period 25 ± 4 months. The primary endpoints were defined as cardiovascular disease (CVD) events or death from CVD.Results: After adjusting for confounding factors, central systolic (cSBP) and pulse pressure (cPP) showed higher hazard ratios (HR/10 mmHg) for cardiovascular events (CV) compared to peripheral pressure indices (pSBP, pPP) at age >60 years (cSBP: HR = 1.18, pSBP: HR = 1.17, p = 0.034; cPP: HR = 1.28, pPP: HR = 1.2, p = 0.019). Each SD increase in IMT and in central augmented pressure (cAP) entailed a 1.4 times higher risk of increased total events in elderly patients (age >60 years). For males, each SD increase in cAP was associated with 1.36 times higher risk of increased total events. For females, each SD increase in cAIx and cAP was associated with 0.4 and 0.5 times lower risk of increased total and major CV, respectively. This sex difference is most likely due to lack of age-related increase of cAIx in females after age >60 years compared to males.Conclusions: Central pressure improved prediction of CVD compared to peripheral pressure during a relatively short-term follow up of approximately 2 years at age >60 years.


Asunto(s)
Presión Arterial , Hipertensión/fisiopatología , Rigidez Vascular , Anciano , Angina Inestable/epidemiología , Aorta , Determinación de la Presión Sanguínea , Grosor Intima-Media Carotídeo , Puente de Arteria Coronaria/estadística & datos numéricos , Muerte Súbita Cardíaca/epidemiología , Femenino , Estudios de Seguimiento , Hospitalización/estadística & datos numéricos , Humanos , Masculino , Persona de Mediana Edad , Infarto del Miocardio/epidemiología , Intervención Coronaria Percutánea/estadística & datos numéricos , Valor Predictivo de las Pruebas , Modelos de Riesgos Proporcionales , Análisis de la Onda del Pulso , Resucitación/estadística & datos numéricos , Accidente Cerebrovascular/epidemiología
19.
Clin Exp Hypertens ; 42(1): 24-30, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-30626217

RESUMEN

The isometric handgrip training (IHT) has been emerging as an alternative approach for blood pressure (BP) reduction in hypertensive patients. However, the mechanisms underlying the reductions in BP after IHT are poorly known. Thus, the aim of this study was to analyze the vascular effects of IHT in hypertensive patients. A randomized controlled trial was conducted with 33 hypertensive patients (61 ± 2 y.o.; 67% female) who were randomly assigned to two groups: IHT or control group. The IHT group has completed three weekly sessions of isometric handgrip (4 × 2 â€Šmin sets, alternating the hands at 30% of maximal voluntary contraction). Before and after a period of 12 weeks BP, arterial stiffness, central and peripheral pulse wave velocity (PWV) and endothelial function were measured. The IHT approach has significantly decreased systolic (∆ = -16 ± 2 vs. ∆ = -3 ± 3 mmHg, p < 0.001) and diastolic (∆ = -8 ± 2 vs. ∆ = 0 ± 2 mmHg, p = 0.014) BP. Reductions in central PWV (IHT: 9.1 ± 0.5 vs. 8.0 ± 0.3 m/s; Control: 8.8 ± 0.5 m/s, p < 0.05) and shear rate area after occlusion have significantly reduced by using the IHT (37822 ± 6931 vs. 24829 ± 5337 s-1, p < 0.05). In conclusion, 12 weeks of IHT have reduced the BP and arterial stiffness and improved markers of endothelial function in hypertensive patients.


Asunto(s)
Endotelio/fisiopatología , Ejercicio Físico/fisiología , Fuerza de la Mano/fisiología , Hipertensión/fisiopatología , Presión Sanguínea , Femenino , Humanos , Contracción Isométrica , Masculino , Persona de Mediana Edad , Análisis de la Onda del Pulso , Entrenamiento de Resistencia , Rigidez Vascular
20.
J Clin Ultrasound ; 48(1): 38-44, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31297841

RESUMEN

INTRODUCTION: Pulmonary pulse transit time (pPTT) is a novel noninvasive echocardiographic measure to assess pulmonary arterial hemodynamics. It has been shown to be shorter in precapillary pulmonary hypertension (PHT). Mitral stenosis (MS) is one of the causes of postcapillary PHT. We aimed to investigate pPTT in patients with MS and its relationship with symptoms. METHODS: We included 51 patients with MS (25 were asymptomatic, NYHA I, and 26 were symptomatic, NHYA II or III), and 50 controls, and evaluated their demographic characteristics and echocardiographic variables, including pPTT. RESULTS: Baseline characteristics, including age, sex, body mass index, and cardiovascular risk factors, were similar between the MS and the control group. The pPTT was longer in the MS group than in the control group (0.21 ± 0.08 vs 0.15 ± 0.05, P < .001). Patients with symptomatic MS had longer pPTT than asymptomatic patients (P = .005). The pPTT was positively correlated with left atrial volume index and systolic pulmonary artery pressure, and negatively with tricuspid annular plane systolic excursion (r = .432; P < .001, r = .319; P = .001, r = -.293; and P = .003, respectively). CONCLUSION: The measurement of pPTT appears clinically relevant in patients with PHT. Further studies evaluating whether it is useful in distinguishing precapillary from postcapillary PHT are required.


Asunto(s)
Ecocardiografía/métodos , Estenosis de la Válvula Mitral/diagnóstico por imagen , Análisis de la Onda del Pulso , Adulto , Estudios de Casos y Controles , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estenosis de la Válvula Mitral/fisiopatología
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