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1.
Medicina (Kaunas) ; 57(7)2021 Jun 27.
Artigo em Inglês | MEDLINE | ID: mdl-34199107

RESUMO

Background and Objectives: Renal artery denervation (RDN) procedure is a broadly discussed method in the treatment of resistant hypertension. Many studies report short-term (3-12 months) results for blood pressure and arterial stiffness. The primary endpoints were changes in 24 h mean systolic blood pressure (BP) and office systolic BP 48 months after RDN. The secondary endpoints were changes in aortic pulse wave velocity and impact of polypharmacy on these variables. Materials and Methods: Renal artery denervation was performed in 73 patients treated for resistant hypertension; 49 patients remained in final analysis. Patient examination was carried out before the procedure, and subsequently at 3, 6, 12, 24, and 48 months later. Patients' antihypertensive and overall medication regimens were carefully analysed. Results: Mean 24 h arterial blood pressure lowered and was sustained at lower levels for up to 48 months; median (interequartile range-IQR) from 158(23.5)/100(14.2) to 140(26.5)/86(16.2) mmHg. Mean reduction in 24 h ambulatory systolic BP was -11 ± 25 mmHg (95% CI, -20 to -2; p < 0.001), while office systolic BP reduced by -7 ± 23 mmHg (95%CI, -24 to -1; p < 0.02). A significant reduction in median aortic pulse wave velocity 12 months after the procedure (drop from baseline 11.2 [3.15] m/s (95%CI 6.1 to 16.2) to 9.8 [2.1] m/s (95%CI 6.1 to 13.7; p = 0.002)). After 48 months, there was no worsening compared to the baseline level of 10.3 [4.0] m/s (95% CI 6.9 to 17.8) (p > 0.05). The total mean number of antihypertensive drugs remained unchanged: 5.97(±1.1) vs. 5.24 (±1.45). A higher number of pills after 48 months was associated with higher aortic pulse wave velocity (1-5 pill group: 8.1 ± 1.6 m/s; 6-10 pill group: 10.9 ± 1.8 m/s; >11 pill group: 15.1 ± 2.6 m/s) (p = 0.003). Conclusions: Antihypertensive effect after renal denervation lasts up to 48 months with no worsening of arterial stiffness compared to baseline. In our study, polypharmacy was associated with increased arterial stiffness 48 months after the procedure.


Assuntos
Hipertensão , Artéria Renal , Anti-Hipertensivos/uso terapêutico , Pressão Sanguínea , Monitorização Ambulatorial da Pressão Arterial , Denervação , Humanos , Hipertensão/tratamento farmacológico , Análise de Onda de Pulso , Resultado do Tratamento
2.
Int J Mol Sci ; 22(12)2021 Jun 17.
Artigo em Inglês | MEDLINE | ID: mdl-34204250

RESUMO

Supplementation with anthocyanins, which are a type of flavonoids mainly found in various berries, is hypothesized to be a promising approach to lower the risk of developing cognitive decline. The aim of this systematic review was to provide a comprehensive overview of dietary intervention trials describing effects of berry anthocyanins on cognitive performance in humans, while also addressing potential underlying mechanisms. A total of 1197 articles were identified through a systematic search, and 49 studies reporting effects on cognitive performance (n = 18), vascular function (n = 22), or cardiometabolic risk markers (n = 32) were included. Significant improvements were observed on memory, while some of the studies also reported effects on attention and psychomotor speed or executive function. Vascular function markers such as brachial artery flow-mediated vasodilation were also affected and consistent evidence was provided for the beneficial effects of berry anthocyanins on endothelial function. Finally, studies reported improvements in blood pressure, but effects on metabolic risk markers (e.g. carbohydrate and lipid metabolism) were less consistent. In conclusion, this review provides evidence for the beneficial effects of berry anthocyanins on cognitive performance as memory improved. Whether observed anthocyanin-induced improvements in vascular function and blood pressure underlie beneficial effects on cognitive performance warrants further study.


Assuntos
Antocianinas/farmacologia , Biomarcadores , Vasos Sanguíneos/efeitos dos fármacos , Cognição/efeitos dos fármacos , Suplementos Nutricionais , Frutas/química , Antocianinas/administração & dosagem , Atenção/efeitos dos fármacos , Pressão Sanguínea/efeitos dos fármacos , Doenças Cardiovasculares/etiologia , Doenças Cardiovasculares/prevenção & controle , Humanos , Memória/efeitos dos fármacos , Desempenho Psicomotor/efeitos dos fármacos , Análise de Onda de Pulso , Ensaios Clínicos Controlados Aleatórios como Assunto
3.
Artigo em Chinês | MEDLINE | ID: mdl-34304531

RESUMO

Objective:To examine the changes of carotid artery elasticity in patients with obstructive sleep apnea(OSA) before and after continuous positive airway pressure(CPAP) treatment by ultrafast pulse wave velocity(UFPWV) technique,and to explore the influencing factors of carotid artery elasticity in OSA patients,and to provide guidance for clinical prevention and treatment of cardiovascular complications. Methods:Fifty cases of moderate and severe OSA patients diagnosed with PSG monitoring from January 2020 to December 2020 were collected as the OSA group,at the same time,40 healthy subjects who participated in physical examination and matched with OSA group in age and gender were selected as the control group.The OSA group was treated with CPAP for 12 weeks.Clinical indicators,carotid intima-media thickness(IMT),and pulse wave velocity at the beginning of systole(PWVBS) and pulse wave velocity at the end of systole(PWVES) were recorded in the control group,and the above data were collected in the OSA group before and after treatment.The changes of various indicators between the control group and the OSA group,and between the OSA group before and after treatment were compared.The correlative factors and influencing factors of PWVBS and PWVES are analyzed. Results:The serum lipid indexes,IMT,PWVBS and PWVES in OSA group were higher than those in control group(P<0.05).Comparison between post-treatment and pre-treatment with CPAP in OSA group:PWVBS,PWVES,apnea hypopnea index(AHI),blood oxygen saturation(SaO2) less than 90% of the time,the percentage of monitoring time when SaO2 was less than 90%(T90),low density lipoprotein cholesterol(LDL-C)and triglyceride(TG) were decreased(P<0.05).Lowest blood oxygen saturation(LSaO2) and high density lipoprotein cholesterol(HDL-C) increased(P<0.05).Age,systolic blood pressure,IMT,AHI,T90 and time of oxygen saturation below 90% were positively correlated with PWVBS and PWVES,while HDL-C and LSaO2 were negatively correlated with them(P<0.05).The risk factors of PWVBS and PWVES included systolic blood pressure,AHI,TC,T90.Conclusion:Moderate and severe OSA can reduce arterial elasticity.CPAP can improve carotid artery elasticity function in patients with OSA.UFPWV technique is more sensitive to quantitatively evaluate the changes of arterial elasticity in patients with OSA than traditional two-dimensional ultrasound.


Assuntos
Pressão Positiva Contínua nas Vias Aéreas , Apneia Obstrutiva do Sono , Artérias Carótidas/diagnóstico por imagem , Espessura Intima-Media Carotídea , Elasticidade , Humanos , Lactente , Análise de Onda de Pulso , Apneia Obstrutiva do Sono/terapia , Ultrassom
4.
Sensors (Basel) ; 21(10)2021 May 19.
Artigo em Inglês | MEDLINE | ID: mdl-34069396

RESUMO

The availability of simple, accurate, and affordable cuffless blood pressure (BP) devices has the potential to greatly increase the compliance with measurement recommendations and the utilization of BP measurements for BP telemonitoring. The aim of this study is to evaluate the correlation between findings from routine BP measurements using a conventional sphygmomanometer with the results from a portable ECG monitor combined with photoplethysmography (PPG) for pulse wave registration in patients with arterial hypertension. METHODS: The study included 500 patients aged 32-88 years (mean 64 ± 7.9 years). Mean values from three routine BP measurements by a sphygmomanometer with cuff were selected for comparison; within one minute after the last measurement, an electrocardiogram (ECG) was recorded for 3 min in the standard lead I using a smartphone-case based single-channel ECG monitor (CardioQVARK®-limited responsibility company "L-CARD", Moscow, Russia) simultaneously with a PPG pulse wave recording. Using a combination of the heart signal with the PPG, levels of systolic and diastolic BP were determined based on machine learning using a previously developed and validated algorithm and were compared with sphygmomanometer results. RESULTS: According to the Bland-Altman analysis, SD for systolic BP was 3.63, and bias was 0.32 for systolic BP. SD was 2.95 and bias was 0.61 for diastolic BP. The correlation between the results from the sphygmomanometer and the cuffless method was 0.89 (p = 0.001) for systolic and 0.87 (p = 0.002) for diastolic BP. CONCLUSION: Blood pressure measurements on a smartphone-case without a cuff are encouraging. However, further research is needed to improve the accuracy and reliability of clinical use in the majority of patients.


Assuntos
Hipertensão , Fotopletismografia , Pressão Sanguínea , Determinação da Pressão Arterial , Eletrocardiografia , Humanos , Hipertensão/diagnóstico , Análise de Onda de Pulso , Reprodutibilidade dos Testes , Smartphone
5.
Medicina (Kaunas) ; 57(5)2021 May 06.
Artigo em Inglês | MEDLINE | ID: mdl-34066447

RESUMO

Background and Objectives: Cardiovascular morbidity and mortality are increased in patients with chronic kidney disease (CKD). It is likely that the accumulation of uremic toxins resulting in increased oxidative stress (OS) is a major contributing factor, but no clear link has been identified. The purpose of this research is to establish if advanced oxidation protein product (AOPP) levels in the serum of predialysis patients are a contributing factor to vascular calcification and increased arterial stiffness. Materials and Methods: After obtaining the informed consent, 46 predialysis patients (CKD stages G3-G5) were included in the study. In order to identify vascular calcifications, hand and pelvic radiographs were performed. Valvular calcifications were identified using cardiac ultrasound. AOPP were measured using a commercially available ELISA kit. The relationships between serum AOPP values and biochemical parameters relevant in the evaluation of CKD patients were analyzed. In addition to identifying the differences in AOPP levels between patients with/without vascular or valvular calcifications, the research focused on describing the relationship between OS and arterial stiffness assessed by oscillometric pulse-wave velocity (PWV) measurement. Results: No significant relationship between serum AOPP and vascular or valvular calcifications was highlighted, but significant correlations of AOPP with C-reactive protein (p = 0.025), HDL-cholesterol levels (p = 0.04), HbA1c (p = 0.05) and PWV values (p = 0.02) were identified. Conclusions: The usefulness of (OS) measurement in clinical practice remains debatable; however, the relationship between AOPP and arterial stiffness could be valuable in improving cardiovascular risk assessment of patients with CKD.


Assuntos
Insuficiência Renal Crônica , Calcificação Vascular , Rigidez Vascular , Produtos da Oxidação Avançada de Proteínas , Humanos , Análise de Onda de Pulso , Insuficiência Renal Crônica/complicações , Calcificação Vascular/diagnóstico por imagem , Calcificação Vascular/etiologia
6.
Artigo em Inglês | MEDLINE | ID: mdl-34155045

RESUMO

INTRODUCTION: We aimed to investigate the individual and combined effects of age-specific and sex-specific pulse pressure (PP) and brachial-ankle pulse wave velocity (baPWV) on the incidence of new-onset diabetes mellitus. RESEARCH DESIGN AND METHODS: Participants in the Kailuan study cohort who were ≥20 years old, participated in follow-up assessments and underwent baPWV measurements in 2010-2011, 2012-2013, and 2014-2015 were studied. The participants were allocated to four groups according to their PP and baPWV status, each categorized as high or normal, according to age-specific and sex-specific median values. Cox proportional hazards models were used to explore the individual and combined effects of PP and baPWV on the incidence of diabetes mellitus. RESULTS: There were 18 619 participants who were followed for 4.27±1.91 years. A total of 877 new cases of diabetes were identified, and the incidence density was 11.03/1000 per year. Using the normal PP and normal baPWV group as the reference group, the multivariable-adjusted HRs and 95% CIs for diabetes mellitus in the high PP and high baPWV groups were 1.08 (0.93 to 1.25) and 1.64 (1.41 to 1.90), respectively. Compared with the normal PP/baPWV group, the HR and 95% CI for diabetes in the normal PP/high baPWV, the high PP/normal baPWV, and high PP/baPWV groups were 1.66 (1.35 to 2.05), 1.09 (0.86 to 1.37), and 1.74 (1.43 to 2.13), respectively. CONCLUSIONS: High baPWV was independently associated with a higher risk of diabetes mellitus, and individuals with both high baPWV and high PP were at a still higher risk of diabetes mellitus.


Assuntos
Índice Tornozelo-Braço , Diabetes Mellitus , Adulto , Fatores Etários , Pressão Sanguínea , Diabetes Mellitus/diagnóstico , Diabetes Mellitus/epidemiologia , Feminino , Humanos , Masculino , Análise de Onda de Pulso , Fatores de Risco , Adulto Jovem
7.
Aging (Albany NY) ; 13(11): 15114-15125, 2021 06 03.
Artigo em Inglês | MEDLINE | ID: mdl-34081619

RESUMO

We aim to investigate the risk of incident arterial stiffness according to metabolically healthy obese (MHO) phenotype in Chinese population. 37,180 participants with at least one-time measurement of branchial-ankle pulse wave velocity (baPWV) were included in the cross-sectional analysis, and 16,236 participants with repeated measurement of baPWV during the follow-ups were included in the longitudinal study. Cross-classification of body mass index (BMI) categories and metabolic health status created six groups. Linear and logistic regression analyses were used. The results of cross-sectional and longitudinal investigation were essentially the same, as the abnormality of baPWV increased with BMI categories in metabolically healthy participants, while the increasing tendency disappeared in metabolically unhealthy participants. A 1.4-fold, 2.2-fold increased risk for the new occurrence of arterial stiffness were documented in MHO and metabolically unhealthy obese participants compared to metabolically healthy normal-weight controls in the fully adjusted model. Further stratified analysis showed that metabolic health status was an interaction factor between BMI and arterial stiffness in all study populations (P=0.0001 for cross-sectional study and P=0.0238 for longitudinal study). In conclusion, metabolic health status and BMI categories contribute to the progression of arterial stiffness, while BMI is positively associated with arterial stiffness only in metabolically healthy participants.


Assuntos
Obesidade/epidemiologia , Obesidade/fisiopatologia , Rigidez Vascular/fisiologia , Índice Tornozelo-Braço , Índice de Massa Corporal , Intervalos de Confiança , Estudos Transversais , Feminino , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Razão de Chances , Fenótipo , Análise de Onda de Pulso , Fatores de Risco
8.
FASEB J ; 35(7): e21732, 2021 07.
Artigo em Inglês | MEDLINE | ID: mdl-34143450

RESUMO

Acid ceramidase (murine gene code: Asah1) (50 kDa) belongs to N-terminal nucleophile hydrolase family. This enzyme is located in the lysosome, which mediates conversion of ceramide (CER) into sphingosine and free fatty acids at acidic pH. CER plays an important role in intracellular sphingolipid metabolism and its increase causes inflammation. The mammalian target of rapamycin complex 1 (mTORC1) signaling on late endosomes (LEs)/lysosomes may control cargo selection, membrane biogenesis, and exosome secretion, which may be fine controlled by lysosomal sphingolipids such as CER. This lysosomal-CER-mTOR signaling may be a crucial molecular mechanism responsible for development of arterial medial calcification (AMC). Torin-1 (5 mg/kg/day), an mTOR inhibitor, significantly decreased aortic medial calcification accompanied with decreased expression of osteogenic markers like osteopontin (OSP) and runt-related transcription factor 2 (RUNX2) and upregulation of smooth muscle 22α (SM22-α) in mice receiving high dose of Vitamin D (500 000 IU/kg/day). Asah1fl/fl /SMCre mice had markedly increased co-localization of mTORC1 with lysosome-associated membrane protein-1 (Lamp-1) (lysosome marker) and decreased co-localization of vacuolar protein sorting-associated protein 16 (VPS16) (a multivesicular bodies [MVBs] marker) with Lamp-1, suggesting mTOR activation caused reduced MVBs interaction with lysosomes. Torin-1 significantly reduced the co-localization of mTOR vs Lamp-1, increased lysosome-MVB interaction which was associated with reduced accumulation of CD63 and annexin 2 (exosome markers) in the coronary arterial wall of mice. Using coronary artery smooth muscle cells (CASMCs), Pi -stimulation significantly increased p-mTOR expression in Asah1fl/fl /SMCre CASMCs as compared to WT/WT cells associated with increased calcium deposition and mineralization. Torin-1 blocked Pi -induced calcium deposition and mineralization. siRNA mTOR and Torin-1 significantly reduce co-localization of mTORC1 with Lamp-1, increased VPS16 vs Lamp-1 co-localization in Pi -stimulated CASMCs, associated with decreased exosome release. Functionally, Torin-1 significantly reduces arterial stiffening as shown by restoration from increased pulse wave velocity and decreased elastin breaks. These results suggest that lysosomal CER-mTOR signaling may play a critical role for the control of lysosome-MVB interaction, exosome secretion and arterial stiffening during AMC.


Assuntos
Ceramidase Ácida/metabolismo , Exossomos/metabolismo , Mamíferos/metabolismo , Miócitos de Músculo Liso/metabolismo , Osteogênese/fisiologia , Sirolimo/metabolismo , Animais , Aorta/metabolismo , Cálcio/metabolismo , Ceramidas/metabolismo , Subunidade alfa 1 de Fator de Ligação ao Core/metabolismo , Vasos Coronários/metabolismo , Lisossomos/metabolismo , Masculino , Camundongos , Camundongos Endogâmicos C57BL , Camundongos Knockout , Corpos Multivesiculares/metabolismo , Análise de Onda de Pulso/métodos , Transdução de Sinais/fisiologia , Esfingolipídeos/metabolismo , Serina-Treonina Quinases TOR/metabolismo , Calcificação Vascular/metabolismo
9.
BMC Geriatr ; 21(1): 293, 2021 05 06.
Artigo em Inglês | MEDLINE | ID: mdl-33957879

RESUMO

BACKGROUND: Tai Chi exercise has been reported to enhance physical and mental health in the older adults; however, the mechanism remains elusive. TRIAL DESIGN: We recruited 289 older adults practicing Tai Chi for over 3 years, together with 277 age-matched older and 102 young adults as controls. 168 Tai Chi practitioners were successfully matched to 168 older controls aged 60-69 based on a propensity score for statistics. METHODS: Cerebrovascular function was evaluated by measuring the hemodynamics of the carotid artery. Spearman correlation was performed to validate the age-associated physiological parameters. RESULTS: Cerebrovascular function in older adults significantly degenerated compared with the young, and was substantially correlated with age. Compared with the older control group, Tai Chi practitioners showed significant improvements in CVHI (cerebral vascular hemodynamics indices) Score (P = 0.002), mean blood flow velocity (P = 0.014), maximal blood flow velocity (P = 0.04) and minimum blood flow velocity (P < 0.001), whereas the age-related increases in pulse wave velocity (P = 0.022), characteristic impedance (P = 0.021) and peripheral resistance (P = 0.044) were lowered. CONCLUSIONS: These data demonstrate a rejuvenation role of Tai Chi in improving the age-related decline of the cerebrovascular function. TRIAL REGISTRATION: Chinese Clinical Trial Registry (ChiCTR1900025187).


Assuntos
Tai Ji , Idoso , Estudos Transversais , Exercício Físico , Humanos , Análise de Onda de Pulso
10.
Vasc Health Risk Manag ; 17: 175-185, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33953561

RESUMO

Purpose: Arterial stiffness describes the rigidity of the arterial walls and is associated with risk factors for cardiovascular disease (CVD). Arterial stiffness predicts future events and mortality, and the predictive value is stronger in younger versus older subjects. The aims of the present study were, firstly, to present data on physical activity (PA) and time spent sedentary, in the population of Swedish, young adults. Secondly, to explore the association between PA and arterial stiffness. Material and Methods: Self-reported healthy, non-smoking, Swedish, young adults, 18-25 years old, participated in the cross-sectional Lifestyle, Biomarkers and Atherosclerosis (LBA) study. The daily PA was objectively measured with an accelerometer for 1 week. Of the 834 participants, 658 individuals had valid registrations. The arterial stiffness measures, pulse wave velocity (PWV) and augmentation index (AIx) were measured with applanation tonometry. Results: Women were on overall more physically active than men, they spent 214 min/day in light PA (LPA) compared to men who spent 202 min/day. Women took significantly more steps per day than men, 7796 vs 7336 steps/day, and spent less time sedentary, 523 min/day, compared to men who spent 547 min/day sedentary. In total, 76% of the individuals spent on average at least 30 minutes per day in the recommended moderate and vigorous PA (MVPA). Lower arterial stiffness was associated with more MVPA and total PA in the total population. Conclusion: We conclude that in this age group of young, self-reported healthy adults 18-25 years, it is important to highlight the health-enhancing possibilities of time spent in physical activity on the vascular function, measured as PWV and AIx. It is of high relevance in a public health perspective to expand preventive efforts beyond the high-risk groups and encourage young adults to be physically active.


Assuntos
Aterosclerose/prevenção & controle , Exercício Físico , Estilo de Vida Saudável , Comportamento de Redução do Risco , Rigidez Vascular , Adolescente , Adulto , Fatores Etários , Aterosclerose/diagnóstico , Aterosclerose/epidemiologia , Aterosclerose/fisiopatologia , Estudos Transversais , Feminino , Humanos , Masculino , Fatores de Proteção , Análise de Onda de Pulso , Medição de Risco , Fatores de Risco , Fatores Sexuais , Suécia/epidemiologia , Fatores de Tempo , Adulto Jovem
11.
Medicine (Baltimore) ; 100(20): e25936, 2021 May 21.
Artigo em Inglês | MEDLINE | ID: mdl-34011069

RESUMO

ABSTRACT: In this observational study, by the use of a multiplex proteomic platform, we aimed to explore associations between 92 targeted proteins involved in cardiovascular disease and/or inflammation, and phenotypes of deteriorating vascular health, with regards to ethnicity.Proteomic profiling (92 proteins) was carried out in 362 participants from the Sympathetic activity and Ambulatory Blood Pressure in Africans (SABPA) study of black and white African school teachers (mean age 44.7 ±â€Š9.9 years, 51.9% women, 44.5% Black Africans, 9.9% with known cardiovascular disease). Three proteins with <15% of samples below detectable limits were excluded from analyses. Associations between multiple proteins and prevalence of hypertension as well as vascular health [Carotid intima-media thickness (cIMT) and pulse wave velocity (PWV)] measures were explored using Bonferroni-corrected regression models.Bonferroni-corrected significant associations between 89 proteins and vascular health markers were further adjusted for clinically relevant co-variates. Hypertension was associated with growth differentiation factor 15 (GDF-15) and C-X-C motif chemokine 16 (CXCL16). cIMT was associated with carboxypeptidase A1 (CPA1), C-C motif chemokine 15 (CCL15), chitinase-3-like protein 1 (CHI3L1), scavenger receptor cysteine-rich type 1 protein M130 (CD163) and osteoprotegerin, whereas PWV was associated with GDF15, E-selectin, CPA1, fatty acid-binding protein 4 (FABP4), CXCL16, carboxypeptidase B (CPB1), and tissue-type plasminogen activator. Upon entering ethnicity into the models, the associations between PWV and CPA1, CPB1, GDF-15, FABP4, CXCL16, and between cIMT and CCL-15, remained significant.Using a multiplex proteomic approach, we linked phenotypes of vascular health with several proteins. Novel associations were found between hypertension, PWV or cIMT and proteins linked to inflammatory response, chemotaxis, coagulation or proteolysis. Further, we could reveal whether the associations were ethnicity-dependent or not.


Assuntos
Arteriosclerose/epidemiologia , Hipertensão/epidemiologia , Proteômica/métodos , Adulto , Grupo com Ancestrais do Continente Africano/estatística & dados numéricos , Arteriosclerose/sangue , Arteriosclerose/diagnóstico , Arteriosclerose/imunologia , Biomarcadores/sangue , Espessura Intima-Media Carotídea , Grupo com Ancestrais do Continente Europeu/estatística & dados numéricos , Feminino , Fatores de Risco de Doenças Cardíacas , Humanos , Hipertensão/sangue , Hipertensão/diagnóstico , Hipertensão/imunologia , Inflamação/sangue , Inflamação/diagnóstico , Inflamação/imunologia , Masculino , Pessoa de Meia-Idade , Prevalência , Análise de Onda de Pulso , Medição de Risco/métodos , Adulto Jovem
12.
Adv Exp Med Biol ; 1269: 393-397, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33966248

RESUMO

INTRODUCTION: Pulse wave velocity imaging (PWVi) is a novel technology developed by our group for real-time assessment of ischemia. The objectives of this proof-of-concept study included (1) remote detection of blood flow pulse and (2) assessing the feasibility of pulse wave velocity (PWV) imaging. METHODS: PWVi is based on a 12-bit RGB camera (Basler acA-2000-165uc) capturing videos at up to 1000 fps. Videos of the hands of healthy individuals were taken, segmented, and processed to assess pulse wave velocity (PWV) and photoplethysmographic (PPG) signals. RESULTS: PWV and PPG waveforms were readily collected for multiple segments. The PWVi device performed well, even without an external source of illumination. Mean PWV of 341.3 (±151.0) cm/s was obtained. CONCLUSIONS: PWVi is a portable, accessible, and cost-effective technology for assessing physiological parameters remotely.


Assuntos
Diagnóstico por Imagem , Análise de Onda de Pulso , Velocidade do Fluxo Sanguíneo , Estudos de Viabilidade , Frequência Cardíaca , Humanos
13.
Kidney Int ; 99(6): 1478-1486, 2021 06.
Artigo em Inglês | MEDLINE | ID: mdl-34023029

RESUMO

Cardiovascular disease is the leading cause of death for patients receiving hemodialysis. Since exercise mitigates many risk factors which drive cardiovascular disease for these patients, we assessed effects of a program of intra-dialytic cycling on left ventricular mass and other prognostically relevant measures of cardiovascular disease as evaluated by cardiac MRI (the CYCLE-HD trial). This was a prospective, open-label, single-blinded cluster-randomized controlled trial powered to detect a 15g difference in left ventricular mass measured between patients undergoing a six-month program of intra-dialytic cycling (exercise group) and patients continuing usual care (control group). Pre-specified secondary outcomes included measures of myocardial fibrosis, aortic stiffness, physical functioning, quality of life and ventricular arrhythmias. Outcomes were analyzed as intention-to-treat according to a pre-specified statistical analysis plan. Initially, 130 individuals were recruited and completed baseline assessments (65 each group). Ultimately, 101 patients completed the trial protocol (50 control group and 51 exercise group). The six-month program of intra-dialytic cycling resulted in a significant reduction in left ventricular mass between groups (-11.1g; 95% confidence interval -15.79, -6.43), which remained significant on sensitivity analysis (missing data imputed) (-9.92g; 14.68, -5.16). There were significant reductions in both native T1 mapping and aortic pulse wave velocity between groups favoring the intervention. There was no increase in either ventricular ectopic beats or complex ventricular arrhythmias as a result of exercise with no significant effect on physical function or quality of life. Thus, a six-month program of intradialytic cycling reduces left ventricular mass and is safe, deliverable and well tolerated.


Assuntos
Análise de Onda de Pulso , Qualidade de Vida , Terapia por Exercício , Humanos , Estudos Prospectivos , Diálise Renal/efeitos adversos
14.
Sleep Med ; 83: 222-229, 2021 07.
Artigo em Inglês | MEDLINE | ID: mdl-34049040

RESUMO

BACKGROUND: Arterial stiffness and increased blood pressure variability (BPV) are important subclinical cardiovascular diseases (CVDs). Evidence is accumulating that poor sleep is associated with subclinical CVDs. The purpose of our study was to investigate how sleep was related to arterial stiffness and BPV. We also explored whether sleep moderated the association between arterial stiffness and BPV. METHODS: We conducted a cross-sectional study including 78 healthy adults aged between 35 and 64 years. Variables of interest were: 1) objective seep characteristics, assessed with a wrist actigraphy for two consecutive nights; 2) arterial stiffness, measured by carotid-femoral pulse wave velocity (cfPWV); and 3) BPV, measured using an ambulatory blood pressure monitor over 24 h and estimated by average real variability. RESULTS: Lower sleep efficiency was an independent predictor of higher cfPWV and higher systolic BPV, while longer wake after sleep onset (WASO) was an independent predictor of higher cfPWV only. In addition, cfPWV showed a positive relationship with systolic BPV, and this relationship was moderated by sleep efficiency and WASO, respectively. The relationship between cfPWV and systolic BPV became stronger among individuals who had a level of sleep efficiency lower than 84% and who had WASO higher than 67 min, respectively. CONCLUSION: Our study showed that poor sleep not only directly linked with arterial stiffness and BPV but also moderated the relationship between these two subclinical CVDs. These findings suggest that improving sleep quality could be a target intervention to promote cardiovascular health in clinical practice.


Assuntos
Rigidez Vascular , Adulto , Pressão Sanguínea , Monitorização Ambulatorial da Pressão Arterial , Estudos Transversais , Humanos , Pessoa de Meia-Idade , Análise de Onda de Pulso , Sono
15.
Nutr Metab Cardiovasc Dis ; 31(6): 1774-1781, 2021 06 07.
Artigo em Inglês | MEDLINE | ID: mdl-33975738

RESUMO

BACKGROUND AND AIMS: The new visceral adiposity index (NVAI) is an indirect marker of visceral adipose tissue recently developed using a Korean population. Here we examined the association of NVAI with coronary artery calcification and arterial stiffness in asymptomatic Korean patients. METHODS AND RESULTS: We analyzed data from 60,938 asymptomatic Korean adults. Odds ratios and 95% confidence intervals (CIs) for coronary artery calcification score (CACS) > 100 and brachial-ankle pulse wave velocity (baPWV) ≥14 m/s were calculated across NVAI tertiles using multiple logistic regression analysis. Receiver operating characteristic (ROC) and area under the curve (AUC) analyses were used to assess the ability of NVAI to predict moderate to high risk of cardiovascular disease. The prevalence of moderate and high risk of cardiovascular disease increased significantly as the NVAI tertile increased. The odds ratio (95% CI) of the highest NVAI tertile for CACS >100 was 5.840 (5.101-6.686) for men and 18.916 (11.232-31.855) for women, after adjusting for confounders. All NVAI AUC values were significantly higher than the AUC values for other visceral adiposity markers. CONCLUSIONS: This study provides the evidence that NVAI is independently and positively associated with coronary calcification and arterial stiffness in asymptomatic Korean adults.


Assuntos
Adiposidade , Doença da Artéria Coronariana/diagnóstico , Gordura Intra-Abdominal/fisiopatologia , Calcificação Vascular/diagnóstico , Rigidez Vascular , Adulto , Idoso , Índice Tornozelo-Braço , Angiografia por Tomografia Computadorizada , Angiografia Coronária , Doença da Artéria Coronariana/epidemiologia , Doença da Artéria Coronariana/fisiopatologia , Estudos Transversais , Feminino , Fatores de Risco de Doenças Cardíacas , Humanos , Gordura Intra-Abdominal/diagnóstico por imagem , Masculino , Pessoa de Meia-Idade , Tomografia Computadorizada Multidetectores , Valor Preditivo dos Testes , Prevalência , Prognóstico , Análise de Onda de Pulso , Sistema de Registros , República da Coreia/epidemiologia , Estudos Retrospectivos , Medição de Risco , Calcificação Vascular/epidemiologia , Calcificação Vascular/fisiopatologia
16.
J Appl Physiol (1985) ; 131(1): 277-289, 2021 07 01.
Artigo em Inglês | MEDLINE | ID: mdl-34013754

RESUMO

Regular exposure to passive heat stress improves vascular function, but the optimal heating prescription remains undefined. Local limb heating is more feasible than whole body heating, but the evidence demonstrating its efficacy is lacking. The purpose of this study was to determine whether acute improvements in vascular function can be achieved with lower limb heating in 16 young healthy individuals (8 female, 8 male). In separate visits, participants underwent 45 min of ankle- and knee-level hot water immersion (45°C). A subset of seven participants also participated in a time-control visit. Endothelial function was assessed through simultaneous brachial and superficial femoral artery flow-mediated dilation (FMD) tests. Macrovascular function was quantified by %FMD, whereas microvascular function was quantified by vascular conductance during reactive hyperemia. Arterial stiffness was assessed through carotid-femoral and femoral-foot pulse wave velocity (PWV). Plasma concentrations of interleukin-6 and extracellular heat shock protein-72 (eHSP72) were used as indicators of inflammation. Our findings showed that 45 min of lower limb heating-regardless of condition-acutely improved upper limb macrovascular endothelial function (i.e., brachial %FMD; Pre: 4.6 ± 1.7 vs. Post: 5.4 ± 2.0%; P = 0.004) and lower limb arterial stiffness (i.e., femoral-foot PWV; Pre: 8.4 ± 1.2 vs. Post: 7.7 ± 1.1 m/s; P = 0.011). However, only knee-level heating increased upper limb microvascular function (i.e., brachial peak vascular conductance; Pre: 6.3 ± 2.7 vs. Post: 7.8 ± 3.5 mL/min â‹… mmHg; P ≤ 0.050) and plasma eHSP72 concentration (Pre: 12.4 ± 9.4 vs. Post: 14.8 ± 9.8 ng/mL; P ≤ 0.050). These findings show that local lower limb heating acutely improves vascular function in younger individuals, with knee-level heating improving more outcome measures.NEW & NOTEWORTHY This study demonstrates that lower limb hot water immersion is an effective strategy for acutely improving vascular function in young, healthy males and females, thereby encouraging the development of accessible modes of heat therapy for vascular health.


Assuntos
Análise de Onda de Pulso , Rigidez Vascular , Artéria Braquial , Endotélio Vascular , Feminino , Calefação , Humanos , Extremidade Inferior , Masculino , Vasodilatação
17.
Am J Physiol Heart Circ Physiol ; 320(6): H2429-H2437, 2021 06 01.
Artigo em Inglês | MEDLINE | ID: mdl-33961508

RESUMO

Another type of natural wave, traced from longitudinal wall motion and propagation along the artery, is observed in our in vivo human carotid artery experiments. We coin it as extension wave (EW) and hypothesize that EW velocity (EWV) is associated with arterial longitudinal stiffness. The EW is thus assumed to complement the pulse wave (PW), whose velocity (PWV) is tracked from the radial wall displacement and linked to arterial circumferential stiffness through the Moens-Korteweg equation, as indicators for arterial mechanical anisotropy quantification by noninvasive high-frame-rate ultrasound. The relationship between directional arterial stiffnesses and the two natural wave speeds was investigated in wave theory, finite-element simulations based on isotropic and anisotropic arterial models, and in vivo human common carotid artery (n = 10) experiments. Excellent agreement between the theory and simulations showed that EWV was 2.57 and 1.03 times higher than PWV in an isotropic and an anisotropic carotid artery model, respectively, whereas in vivo EWV was consistently lower than PWV in all 10 healthy human subjects. A strong linear correlation was substantiated in vivo between EWV and arterial longitudinal stiffness quantified by a well-validated vascular-guided wave imaging technique (VGWI). We thereby proposed a novel index calculated as EWV2/PWV2 as an alternative to assess arterial mechanical anisotropy. Simulations and in vivo results corroborated the effect of mechanical anisotropy on the propagation of spontaneous waves along the arterial wall. The proposed anisotropy index demonstrated the feasibility of the concurrent EW and PW imaged by high frame-rate ultrasound in grading of arterial wall anisotropy.NEW & NOTEWORTHY An extension wave formed by longitudinal wall displacements was observed by high-frame-rate ultrasound in the human common carotid artery in vivo. A strong correlation between extension wave velocity and arterial longitudinal stiffness complements the well-established pulse wave, which is linked to circumferential stiffness, to noninvasively assess direction-dependent wall elasticity of the major artery. The proposed anisotropy index, which directly reflects arterial wall microstructure and function, might be a potential risk factor for screening (sub-) clinical cardiovascular diseases.


Assuntos
Anisotropia , Artéria Carótida Primitiva/fisiologia , Rigidez Vascular/fisiologia , Adulto , Artéria Carótida Primitiva/diagnóstico por imagem , Feminino , Análise de Elementos Finitos , Voluntários Saudáveis , Humanos , Masculino , Modelos Cardiovasculares , Análise de Onda de Pulso , Ultrassonografia , Adulto Jovem
18.
J Appl Physiol (1985) ; 131(1): 229-237, 2021 07 01.
Artigo em Inglês | MEDLINE | ID: mdl-34043475

RESUMO

Regular exposure to uninterrupted prolonged sitting and the consumption of high-glycemic-index (HGI) meals is independently associated with increased cardiovascular disease risk. Sitting for as little as 1 h can impair the health of both peripheral and central arteries. However, it is currently unknown whether combined acute exposure to uninterrupted prolonged sitting and an HGI meal is more detrimental to global (peripheral and central) vascular health. The purpose of this study was to investigate the effect of prolonged sitting (3 h), following the consumption of an HGI or a low-glycemic-index (LGI) meal, on global pulse wave velocity (G-PWV). Eighteen healthy participants [70% female, mean (standard deviation, SD) age = 22.6 (3.1) yr, body mass index (BMI) = 25.5 (6.1) kg/m2] sat for 3 h after consuming an HGI or LGI meal. G-PWV was assessed by incorporating three PWV measures (carotid-femoral, brachial-femoral, and femoral-ankle). The effects of time (PRE vs. POST) and condition (LGI vs. HGI) were analyzed using linear mixed models. Following prolonged sitting, G-PWV increased by 0.29 m/s (i.e., PRE vs. POST). However, the condition (P = 0.987) and time × condition (P = 0.954) effects were nonsignificant. The current findings support previous research showing an increase in arterial stiffness with prolonged sitting. However, in young and healthy adults, the arterial stiffness response was not worsened through HGI meal consumption.NEW & NOTEWORTHY We used novel statistical techniques and study design characteristics to examine how the cardiovascular disruptions due to prolonged sitting are changed after the consumption of low- and high-glycemic-index meals. The current study indicates that changes in arterial stiffness due to prolonged sitting are not worsened in young, healthy adults after the consumption of a high-glycemic-index meal.


Assuntos
Postura Sentada , Rigidez Vascular , Adulto , Glicemia , Estudos Cross-Over , Exercício Físico , Feminino , Índice Glicêmico , Humanos , Masculino , Refeições , Período Pós-Prandial , Análise de Onda de Pulso , Adulto Jovem
19.
Medicine (Baltimore) ; 100(18): e25826, 2021 May 07.
Artigo em Inglês | MEDLINE | ID: mdl-33950991

RESUMO

ABSTRACT: There is evidence that serum 25-hydroxyvitamin D [25-(OH) D] levels may be associated with cardiovascular disease and its risk factors. This study aimed to investigate the relationship between 25-(OH) D levels and blood pressure (BP), blood lipids, and arterial elasticity in middle-aged and elderly cadres in China.In this retrospective study, we included 401 civil servants and cadres aged >42 years who underwent medical examinations at Guiyang Municipal First People's Hospital, China in 2018. The participants were assigned to deficiency (≤20 ng/mL), insufficiency (20-30 ng/mL), and sufficiency (≥30 ng/mL) groups according to 25-(OH) D levels in their blood. Demographics, brachial-ankle pulse wave velocity (baPWV), BP, ankle-brachial index (ABI), and blood lipids were compared among groups. The associations between 25-(OH) D and other parameters were evaluated using linear regression analysis.Median (range) 25-(OH) D levels in the deficiency (n = 162), insufficiency (n = 162), and sufficiency (n = 77) groups were 15.32 (2.93-19.88), 25.12 (20.07-29.91), and 33.91 (30.23-82.42) ng/mL, respectively. There were significant differences in systolic BP, pulse pressure, baPWV (left and right sides), ABI (left side), high-density lipoprotein-cholesterol, and triglycerides (TGs; all P < .05) among groups. Multivariate linear regression revealed that TG, left baPWV, and right baPWV were significantly negatively correlated with 25-(OH) D levels (all P < .05).In this study, 25-(OH) D levels were found to be associated with TG, left baPWV, and right baPWV values. 25-(OH) D deficiency may be associated with reduced arterial elasticity.


Assuntos
Doenças Cardiovasculares/epidemiologia , Deficiência de Vitamina D/epidemiologia , Vitamina D/análogos & derivados , Adulto , Idoso , Índice Tornozelo-Braço , Artérias/fisiopatologia , Pressão Sanguínea/fisiologia , Doenças Cardiovasculares/fisiopatologia , China/epidemiologia , Elasticidade/fisiologia , Feminino , Empregados do Governo/estatística & dados numéricos , Fatores de Risco de Doenças Cardíacas , Humanos , Lipídeos/sangue , Masculino , Pessoa de Meia-Idade , Análise de Onda de Pulso , Estudos Retrospectivos , Vitamina D/sangue , Deficiência de Vitamina D/sangue , Deficiência de Vitamina D/complicações , Deficiência de Vitamina D/diagnóstico
20.
Clin Interv Aging ; 16: 887-895, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34054294

RESUMO

Objective: To investigate the relationship between asymptomatic target organ damage (TOD) and different somatotypes in a population of elderly from Chinese community-dwelling. Methods: A total of 2098 Chinese senior residents from northern Shanghai older than 65 years were recruited in the research. The following somatotype parameters were recorded and analyzed: body mass index, waist circumference, hip circumference, and waist-hip ratio were recorded and calculated. Asymptomatic TOD, including urine albumin/creatinine ratio, estimated glomerular filtration rate (eGFR), intima-media thickness (IMT), left ventricular mass index (LVMI), left ventricular diastolic function, and carotid-femoral pulse wave velocity (PWV) was recorded using the MyLab30 Gold CV system and SphygmoCor. Results: Of all 2098 residents, 817 (38.9%) were overweight and 289 (13.8%) were obese. All somatotype measures were significantly correlated with TOD parameters (p<0.05). After adjustment for age and male gender, in total population, LVMI (p<0.001), cardiac diastolic function (E/Ea, p<0.001), PWV (p<0.001), eGFR (p=0.03), and urine albumin/creatinine ratio (p<0.001) changed gradually and significantly correlated with increasing BMI values. Obesity and overweight were independently related to the incidence of LVH, LVDD, artery stiffness, carotid arterial plaque, and microalbuminuria. Conclusion: The incidence of asymptomatic TOD was significantly correlated with overweight and obesity, especially in women, whereas the underweight may favor in the prevention of TOD.


Assuntos
Espessura Intima-Media Carotídea , Placa Aterosclerótica/diagnóstico , Somatotipos , Idoso , Albuminúria/sangue , Índice de Massa Corporal , China/epidemiologia , Feminino , Taxa de Filtração Glomerular , Humanos , Vida Independente , Testes de Função Renal , Masculino , Placa Aterosclerótica/sangue , Análise de Onda de Pulso , Rigidez Vascular
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