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1.
Life Sci ; 264: 118723, 2021 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-33160988

RESUMO

AIMS: Hypertension (HTN) in pregnancy is a major cause of maternal, foetal and neonatal morbimortality in both developing and developed countries. Arterial stiffness is a predictor of cardiovascular events and can be assessed through augmentation index (AIx) and pulse wave velocity (PWV). This study was intended to analyse the arterial stiffness in three categories, hypertensive pregnant women vs. healthy women (both pregnant and non-pregnant). MAIN METHODS: Between 2018 and 2019, 150 women were prospectively included into three homogenous groups, of equal sizes (N = 50): pregnant women with HTN (group 1), pregnant women without HTN (group 2), and non-pregnant women (group 3). We assessed pregnant women 3 times (in all three trimesters) and six weeks postpartum, and the women from the control group once. KEY FINDINGS: Significant differences (p < 0.001) of the hemodynamic and arterial stiffness parameters and of the heart rate (HR) (p = 0.006) were observed between groups 1 and 2. Women with pregnancy-induced HTN had different values of arterial function parameters long time before the first signs of high blood pressure (BP) occurred. Also, body mass index (BMI) had a deleterious effect in all patients, but especially in pregnant HTN women. Significant differences (p < 0.001) between groups 2 and 3 were observed regarding the BP and aortic PWV (PWVao) and, as well, significant differences (p < 0.05) between BMI, aortic systolic BP (p = 0.02), brachial AIx (p = 0.01) and pulse pressure (PP) (p = 0.049) values. SIGNIFICANCE: The current study emphasizes the importance of the assessment of arterial function parameters and BMI as markers for future BP values and outcomes throughout gestation.


Assuntos
Hipertensão Induzida pela Gravidez/fisiopatologia , Resultado da Gravidez , Rigidez Vascular/fisiologia , Adulto , Índice Tornozelo-Braço , Pressão Sanguínea/fisiologia , Índice de Massa Corporal , Diástole/fisiologia , Feminino , Frequência Cardíaca/fisiologia , Humanos , Gravidez , Análise de Onda de Pulso , Sístole/fisiologia
2.
Medicine (Baltimore) ; 99(48): e23360, 2020 Nov 25.
Artigo em Inglês | MEDLINE | ID: mdl-33235107

RESUMO

In recent studies, vibration-controlled transient elastography (FibroScan) has been reported as an alternative noninvasive approach for measuring liver steatosis and fibrosis. The present study aimed to investigate the feasibility of FibroScan controlled attenuation parameter (CAP) and liver stiffness measurement (LSM) in the detection of increased arterial stiffness in asymptomatic populations in China.A retrospective cohort recruiting 4747 asymptomatic patients with no underlying causes of liver disease and having FibroScan and brachial-ankle pulse wave velocity (baPWV) during wellness check-up was covered. Nonalcoholic fatty liver disease (NAFLD) was defined as a CAP ≥238 dB/m. NAFLD with significant fibrosis was defined as an LSM ≥7.3 kPa in the presence of NAFLD. Increased arterial stiffness was determined as a BaPWV ≥1.4m/second.Among the 4747 study participants, 1596 subjects (33.6%) suffered from increased arterial stiffness. The prevalence of increased arterial stiffness progressively increased across CAP quartiles and LSM quartiles in NAFLD (23.5%, 30.8%, 38.3%, 43.7%, P < .001 and 33.1%, 36.8%, 40.4%, 48.2%, P < .001, respectively). After conventional cardiovascular risk factors were adjusted (age, sex, overweight, diabetes mellitus, hypertension, hypercholesterolemia, and current smoking habits), multivariate logistic regression analysis revealed that CAP (odd ratio [OR] = 1.005; 95% confidence interval [CI]: 1.003-1.006; P < .001), NAFLD (OR = 1.427; 95% CI: 1.212-1.681; P < .001), LSM in NAFLD (OR = 1.073; 95% CI: 1.023-1.125; P = .003), and significant fibrosis in NAFLD (OR = 1.480; 95% CI: 1.090-2.010; P = .012) were independently associated with increased arterial stiffness. Furthermore, in a multivariate logistic regression analysis, OR (95% CI) for the maximal vs. the minimal quartile of CAP was 1.602 (1.268-2.024), and that of LSM in NAFLD was 1.362 (1.034-1.792) after adjustment for the above-mentioned risk factors. Notably, NAFLD and significant fibrosis in NAFLD were significantly correlated only with increased arterial stiffness in subjects without hypertension or diabetes mellitus after adjustment for the above-mentioned risk factors.CAP-defined NAFLD and LSM-defined significant fibrosis in NAFLD showed significant and independent relationships with increased arterial stiffness even after adjustment for conventional cardiovascular risk factors, which can be conducive to stratifying relative risk of subjects having undergone screening assessment for cardiovascular disease.


Assuntos
Técnicas de Imagem por Elasticidade/métodos , Cirrose Hepática/diagnóstico por imagem , Cirrose Hepática/fisiopatologia , Hepatopatia Gordurosa não Alcoólica/diagnóstico por imagem , Hepatopatia Gordurosa não Alcoólica/fisiopatologia , Rigidez Vascular/fisiologia , Adulto , Fatores Etários , Idoso , Pesos e Medidas Corporais , Feminino , Nível de Saúde , Humanos , Fígado/patologia , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Fatores de Risco , Fatores Sexuais
3.
J Clin Neurosci ; 79: 149-153, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-33070886

RESUMO

The aim of this study was to evaluate arterial stiffness in schizophrenia patients. 28 male patients were included. The intima-media thickness (IMT) of the vessels were taken using high-resolution ultrasonography system. The mean carotid IMT and the mean femoral IMT values of the study group were found to be statistically significantly higher than the values of the control group. As the duration of the disease increased, there was an increase in the carotid IMT, carotid elastic modulus and femoral IMT, whereas there was a decrease in carotid and femoral diastolic wall stress in patients. No statistically significant differences were observed between the groups' carotid and femoral compliance, distensibility and elastic modulus values. The mean systolic arterial blood pressure in the patient group was determined to be lower than that of the control group. The mean diastolic wall stress values in the carotid and femoral arteries were determined to be lower than those of the control group. There was no relationship between antipsychotic dose, blood pressure and arterial stiffness parameters. Schizophrenia patients are more prone to develop arterial stiffness by atherosclerosis either with the effect of the nature of the disease itself or antipsychotic treatment. But evaluation with more parameters (carotid and femoral compliance, distensibility and elastic modulus) did not indicate any difference from the control group in respect of arterial stiffness. Antipsychotic treatment may play a protective role in terms of arterial stiffness by causing a decrease in systolic arterial pressure and carotid and femoral diastolic wall stress.


Assuntos
Esquizofrenia/patologia , Rigidez Vascular , Adulto , Antipsicóticos/uso terapêutico , Pressão Sanguínea/efeitos dos fármacos , Pressão Sanguínea/fisiologia , Artérias Carótidas/efeitos dos fármacos , Artérias Carótidas/patologia , Espessura Intima-Media Carotídea , Humanos , Masculino , Pessoa de Meia-Idade , Esquizofrenia/tratamento farmacológico , Ultrassonografia , Rigidez Vascular/efeitos dos fármacos , Rigidez Vascular/fisiologia
4.
Medicine (Baltimore) ; 99(39): e22219, 2020 Sep 25.
Artigo em Inglês | MEDLINE | ID: mdl-32991415

RESUMO

Short stature is reportedly associated with cardiovascular disease (CVD). However, the mechanism underlying this intriguing epidemiological finding is unclear. Pulse wave velocity (PWV), a marker of vascular stiffness, is a predictor of future CVD. Therefore, PWV may be affected by height even before overt CVD occurs. Here, we investigated the association between adult height and PWV in subjects without overt CVD.A total of 1019 subjects (48 ±â€Š12 years old; 509 men, 21 with diabetes mellitus, 209 with hypertension) without overt CVD were enrolled, all of whom underwent brachial-ankle PWV (baPWV) measurements. The subjects were divided into 3 groups by height. A multiple regression model was used to estimate baPWV values among heights after the adjustment for confounders.Mean baPWV value was highest in the group with the shortest height for both sexes (both P < .001). Bivariate correlation analysis between height and baPWV showed significant correlations in men (r = -0.131, P = .003) and women (r = -0.180, P < .001). In the multiple regression analysis with adjustment for identified confounders, group height was a predictor of baPWV (P for trend = .003) in younger men (<50 years old) but not in older men, while group height was correlated with baPWV in older women (≥50 years old, P for trend = .014) but not in younger women.Height is inversely correlated with baPWV in subjects without overt CVD, especially in younger men and older women. This may explain the historical epidemiological observation of an inverse relationship between height and CVD.


Assuntos
Estatura/fisiologia , Doenças Cardiovasculares/fisiopatologia , Rigidez Vascular/fisiologia , Adulto , Fatores Etários , Índice Tornozelo-Braço , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Análise de Onda de Pulso/estatística & dados numéricos , Fatores Sexuais
5.
Medicine (Baltimore) ; 99(36): e22073, 2020 Sep 04.
Artigo em Inglês | MEDLINE | ID: mdl-32899076

RESUMO

To examine the relationship between self-reported sleep duration and arterial stiffness in a large Chinese population from Kailuan.From July 2010 to December 2015, a total of 17,018 participants aged 18 to 98 years were enrolled after excluding those with a history of cerebrovascular events and coronary artery disease. Participants were divided into 5 categories according to self-reported night sleep duration: ≤5.0, 6.0, 7 (ref), 8, and ≥9.0 hours. A brachial-ankle pulse wave velocity ≥1400 cm/s was considered to represent arterial stiffness. Multivariate logistic regression models were used to calculate the odds ratio (OR) and confidence interval (CI) for arterial stiffness according to the sleep duration.Using 7 hours of sleep as the reference group, the multivariable adjusted ORs (95% CI) for arterial stiffness were 1.00 (0.87-1.16), 1.00 (0.90-1.11), 1.0 (ref), 1.03 (0.93-1.14), and 1.48 (1.05-2.08) from the lowest to highest category of sleep duration, respectively. Secondary analysis showed no evidence of interactions between sleep duration and age/sex on the risk of arterial stiffness (P-interaction = .390/.198).A long night sleep duration was associated with increased arterial stiffness.


Assuntos
Sono/fisiologia , Rigidez Vascular/fisiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Índice Tornozelo-Braço , China , Estudos Transversais , Feminino , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Razão de Chances , Estudos Prospectivos , Análise de Onda de Pulso , Fatores de Risco , Fatores de Tempo , Adulto Jovem
6.
Medicine (Baltimore) ; 99(30): e21227, 2020 Jul 24.
Artigo em Inglês | MEDLINE | ID: mdl-32791697

RESUMO

Variability of blood pressure (BP) is known as a prognostic value for the subsequent target organ damage in hypertensive patients. Arterial stiffness is a risk factor for cardiovascular morbidity and mortality. The relationship between the arterial stiffness and the BP variability has been controversial. The objective of the present study was to investigate the relationship between arterial stiffness and home BP variability in patients with high normal BP and new onset hypertension (HTN).Four hundred sixty three patients (252 males, 49 ±â€Š12 year-old) with high normal BP or HTN were enrolled. Using radial applanation tonometry, pulse wave analysis (PWA) was performed for evaluation of systemic arterial stiffness. All patients underwent both home BP monitoring (HBPM) and PWA. Home BP variability was calculated as the standard deviation (SD) of 7 measurements of HBPM. Multiple linear regression analysis was performed to estimate and test the independent effects of home BP variability on the arterial stiffness.Mutivariate analysis showed that both systolic and diastolic morning BP variabilities were correlated with arterial stiffness expressed as augmentation pressure (AP, ß-coefficient = 1.622, P = .01 and ß-coefficient = 1.07, P = .035). The SDs of systolic and diastolic BP of evening were also associated with AP (ß-coefficient = 1.843, P = .001 and ß-coefficient = 1.088, P = .036). The SDs of morning and evening systolic BP were associated with augmentation index (AI, ß-coefficient = 1.583, P = .02 and ß-coefficient = 1.792, P = .001) and heart rate (75 bpm) adjusted AI (ß-coefficient = 1.592, P = .001 and ß-coefficient = 1.792, P = .001).In present study, the variability of systolic BP was closely related with arterial stiffness. The home BP variability might be important indicator of arterial stiffness.


Assuntos
Monitorização Ambulatorial da Pressão Arterial , Hipertensão/fisiopatologia , Rigidez Vascular/fisiologia , Adulto , Pressão Sanguínea/fisiologia , Ritmo Circadiano/fisiologia , Feminino , Humanos , Hipertensão/diagnóstico , Masculino , Pessoa de Meia-Idade , Análise de Onda de Pulso , Reprodutibilidade dos Testes , Fatores de Risco
7.
PLoS One ; 15(7): e0236413, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32735567

RESUMO

OBJECTIVE: Although a number of modifiable and non-modifiable causes were implicated in arterial stiffness, its pathogenesis remains elusive, and very little is known about aortic elasticity in supraventricular arrhythmias. The potential role of disturbed kynurenine metabolism in the pathogenesis of cardiovascular disease has been recently suggested. Thus, we studied the correlations of aortic stiffness and echocardiographic parameters with biochemical markers and serum level of kynurenic acid (KYNA), an endothelial derivative of tryptophan, formed along the kynurenine pathway, among patients with atrial fibrillation (AF). METHODS: Study cohort comprised 100 patients with persistent AF (43 females/57 males). Arterial stiffness index (ASI), structural and functional indices of left atrium (LA) and left ventricle (LV) were evaluated electrocardiographically. Biochemical analyses included the measurements of serum KYNA (HPLC) and of the selected markers of lipids and glucose metabolism, thyroid status, kidney function, inflammation and coagulation. RESULTS: KYNA (ß = 0.389, P = 0.029), homocysteine (ß = 0.256, P = 0.40), total cholesterol (ß = 0.814; P = 0.044), LDL (ß = 0.663; P = 0.44), TSH (ß = 0.262, P = 0.02), fT3 (ß = -0.333, P = 0.009), fT4 (ß = -0.275, P = 0.043) and creatinine (ß = 0.374, P = 0.043) were independently correlated with ASI. ASI was also independently associated with LV end-systolic diameter (LVEDd; ß = 1.751, P = 0.045), midwall fractional shortening (mFS; ß = -1.266, P = 0.007), ratio mFS/end-systolic stress (mFS/ESS; ß = -0.235, P = 0.026), LV shortening fraction (FS; ß = -0.254, P = 0.017), and LA volume index (LAVI; ß = 0.944, P = 0.022). CONCLUSIONS: In patients with AF, aortic stiffness correlated positively with KYNA, biochemical risk factors of atherosclerosis and with the indices of diastolic dysfunction of LV and LA. Revealed relationship between ASI and KYNA is an original observation, suggesting a potential role of disturbed kynurenine metabolism in the pathogenesis of arterial stiffening. KYNA, synthesis of which is influenced by homocysteine, emerges as a novel, non-classical factor associated with ASI in patients with AF.


Assuntos
Aterosclerose/sangue , Fibrilação Atrial/sangue , Biomarcadores/sangue , Ácido Cinurênico/sangue , Adulto , Aorta/diagnóstico por imagem , Aorta/patologia , Aterosclerose/diagnóstico por imagem , Aterosclerose/patologia , Fibrilação Atrial/fisiopatologia , Estudos Transversais , Ecocardiografia , Feminino , Ventrículos do Coração/diagnóstico por imagem , Ventrículos do Coração/metabolismo , Ventrículos do Coração/patologia , Humanos , Cinurenina/sangue , Masculino , Pessoa de Meia-Idade , Análise de Regressão , Fatores de Risco , Rigidez Vascular/fisiologia
8.
PLoS One ; 15(8): e0236667, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32756570

RESUMO

BACKGROUND: Obstructive sleep apnea (OSA) is associated with cardiovascular co-morbidities and mortality. Arterial stiffness is an independent predictor of cardiovascular risk and mortality, and is influenced by the presence of OSA and related comorbidities. There is a paucity of data regarding long-term evolution of arterial stiffness in CPAP-treated OSA patients. We aimed to prospectively study long term PWV variations and determinants of PWV deterioration. METHODS: In a prospective obese OSA cohort, at time of diagnosis and after several years of follow-up we collected arterial stiffness measured by carotid-femoral pulse wave velocity (PWV), clinical and metabolic parameters, and CPAP adherence. Univariate and multivariate analyses were performed in order to determine contributing factors. RESULTS: Seventy two OSA patients (men: 52.8%, median age: 55.8 years and median BMI of 38.5 kg/m2) with a prevalence of hypertension: 58.3%, type 2 diabetes: 20.8%, hypercholesterolemia: 33.3%, current or past smoking: 59.7%, were evaluated after a median follow-up of 7.4 [5.8; 8.3] years. Over the period of follow-up, the median increase in PWV was 1.34 [0.10; 2.37] m/s. In multivariate analysis, the increase in PWV was associated with older age (10 extra years was associated with a 5.24 [1.35; 9.12] % increase in PWV) and hypertension (a significant increase in PWV of 8.24 [1.02; 15.57] %). No impact of CPAP adherence on PWV evolution was found. CONCLUSION: PWV progression in CPAP-treated OSA patients is mainly related to pre-existing cardio-metabolic comorbidities and not influenced by CPAP adherence. In this high cardiovascular risk population, it is crucial to associated weight management and exercise with CPAP treatment.


Assuntos
Doenças Cardiovasculares/fisiopatologia , Pressão Positiva Contínua nas Vias Aéreas/efeitos adversos , Obesidade/fisiopatologia , Apneia Obstrutiva do Sono/terapia , Rigidez Vascular/fisiologia , Monitorização Ambulatorial da Pressão Arterial , Doenças Cardiovasculares/diagnóstico por imagem , Doenças Cardiovasculares/epidemiologia , Doenças Cardiovasculares/etiologia , Estudos de Coortes , Pressão Positiva Contínua nas Vias Aéreas/métodos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Obesidade/complicações , Obesidade/diagnóstico por imagem , Obesidade/epidemiologia , Polissonografia , Fatores de Risco , Apneia Obstrutiva do Sono/complicações , Apneia Obstrutiva do Sono/diagnóstico por imagem , Apneia Obstrutiva do Sono/fisiopatologia
9.
PLoS One ; 15(8): e0236834, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32780748

RESUMO

PURPOSE: Pulse wave velocity (PWV), an indicator of vascular stiffness, increases with age and is increasingly recognized as an independent risk factor for cardiovascular disease (CVD). Although many mechanical and chemical factors underlie the stiffness of the elastic artery, genetic risk factors related to age-dependent increases in PWV in apparently healthy people are largely unknown. The transcription factor nuclear factor E2 (NF-E2)-related factor 2 (Nrf2), which is activated by unidirectional vascular pulsatile shear stress or oxidative stress, regulates vascular redox homeostasis. Previous reports have shown that a SNP in the NRF2 gene regulatory region (-617C>A; hereafter called SNP-617) affects NRF2 gene expression such that the minor A allele confers lower gene expression compared to the C allele, and it is associated with various diseases, including CVD. We aimed to investigate whether SNP-617 affects vascular stiffness with aging in apparently healthy people. METHODS: Analyzing wide-ranging data obtained from a public health survey performed in Japan, we evaluated whether SNP-617 affected brachial-ankle PWV (baPWV) in never-smoking healthy subjects (n = 642). We also evaluated the effects of SNP-617 on other cardiovascular and blood test measurements. RESULTS: We have shown that not only AA carriers (n = 55) but also CA carriers (n = 247) show arterial stiffness compared to CC carriers (n = 340). Furthermore, SNP-617 also affected blood pressure indexes such as systolic blood pressure and mean arterial pressure but not the ankle brachial pressure index, an indicator of atherosclerosis. Multivariate analysis showed that SNP-617 accelerates the incremental ratio of baPWV with age. CONCLUSIONS: This study is the first to show that SNP-617 affects the age-dependent increase in vascular stiffness. Our results indicate that low NRF2 activity induces premature vascular aging and could be targeted for the prevention of cardiovascular diseases associated with aging.


Assuntos
Envelhecimento , Fator 2 Relacionado a NF-E2/genética , Rigidez Vascular/fisiologia , Adulto , Alelos , Índice Tornozelo-Braço , Aterosclerose/genética , Aterosclerose/patologia , Pressão Sanguínea , Frequência do Gene , Genótipo , Inquéritos Epidemiológicos , Humanos , Pessoa de Meia-Idade , Análise Multivariada , Polimorfismo de Nucleotídeo Único , Regiões Promotoras Genéticas , Análise de Onda de Pulso , Fumar
11.
Medicine (Baltimore) ; 99(27): e21062, 2020 Jul 02.
Artigo em Inglês | MEDLINE | ID: mdl-32629734

RESUMO

BACKGROUND: The benefits of high-intensity interval training (HIIT) are well-known, there is insufficient evidence about the effects of HIIT on heart failure with preserved ejection fraction (HFpEF). METHOD: Multiple databases include MEDLINE, PubMed, EMBASE, CINAHL, Web of Science, PEDro, Cochrane Library, and Google Scholar are used to search for randomized controlled trials investigating the effects of HIIT on HFpEF. All related articles published with the English language with no time limitation will be included. Two reviews independently conducted the selection, data extraction, and quality assessment. The primary outcome is exercise capacity. The secondary outcomes include quality of life (QoL), blood pressure (BP), ventricular function, and left ventricular diastolic function, symptom improvement, endothelial function, and arterial stiffness. Data analysis is performed with Review Manager Software (Version 5.3). RESULT: This systematic review and meta-analysis aim to evaluate the efficacy of HIIT on HFpEF, its outcome will provide reliable evidence for future studies. CONCLUSION: The findings of this study will be published in a related peer-reviewed journal. REGISTRATION NUMBER: INPLASY202050097.


Assuntos
Insuficiência Cardíaca/reabilitação , Treinamento Intervalado de Alta Intensidade/métodos , Volume Sistólico/fisiologia , Pressão Sanguínea/fisiologia , Diástole/fisiologia , Endotélio Vascular/fisiologia , Estudos de Avaliação como Assunto , Tolerância ao Exercício/fisiologia , Insuficiência Cardíaca/fisiopatologia , Insuficiência Cardíaca/psicologia , Humanos , Qualidade de Vida/psicologia , Ensaios Clínicos Controlados Aleatórios como Assunto , Rigidez Vascular/fisiologia , Função Ventricular Esquerda/fisiologia
12.
Clin Nephrol ; 94(4): 163-172, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32729817

RESUMO

AIM: Aim of the study was to investigate soluble Klotho (sKl), fibroblast growth factor 23 (FGF23) concentrations, and their correlations with cardiovascular complications in children with CKD. MATERIALS AND METHODS: 38 children with CKD stages 2 - 5 were compared to 38 healthy controls in terms of: plasma FGF23, serum sKl, peripheral and central blood pressure, arterial stiffness (pulse wave velocity - (PWV)), carotid intima media thickness (cIMT), left ventricular mass index (LVMI), and diastolic function. Correlations between FGF23, sKl, and cardiovascular parameters were investigated. RESULTS: The CKD group was characterized by higher FGF23, lower sKl concentrations, higher peripheral and central blood pressure, arterial stiffness, cIMT, left ventricular mass index, and decreased E/A ratio compared to the control group. In CKD children, sKl correlated negatively with diastolic blood pressure (DBP), mean arterial pressure (MAP), central systolic, diastolic, and mean blood pressure, PWV, and LVMI. In multivariate analysis, higher sKl was a significant predictor of lower peripheral and central DBP and lower LVMI and E/A, whereas higher FGF23 was a predictor of higher of LVMI. CONCLUSION: (1) In children with CKD, decreased sKl might be a marker of elevated central blood pressure. (2) Both sKl decrease and FGF23 increase could possibly contribute to left ventricular hypertrophy in this group of patients.


Assuntos
Pressão Sanguínea/fisiologia , Glucuronidase/sangue , Insuficiência Renal Crônica , Estudos de Casos e Controles , Criança , Fatores de Crescimento de Fibroblastos/sangue , Humanos , Hipertrofia Ventricular Esquerda/epidemiologia , Hipertrofia Ventricular Esquerda/etiologia , Insuficiência Renal Crônica/complicações , Insuficiência Renal Crônica/epidemiologia , Rigidez Vascular/fisiologia
13.
Rev Med Chil ; 148(4): 488-495, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32730458

RESUMO

Background The ambulatory arterial stiffness index (AASI), derived from 24 h ambulatory blood pressure monitoring (ABPM) can be a good indicator of arterial stiffness. Aim To assess the correlation between AASI and brachial-ankle pulse wave velocity (baPWV), ankle-brachial index (ABI) and cardio-ankle vascular index (CAVI) in patients with type 2 diabetes mellitus without hypertension. Material and Methods Cross sectional study in 28 diabetic patients aged 49 ± 7 years (40% women). AASI was calculated as 1 minus the regression slope of diastolic on systolic blood pressure, using ABPM data. ABPM was measured in the arm using an oscillometric device. ABI was calculated as the ratio between ankle and brachial systolic blood pressure. CAVI was derived from pulse wave velocity using the Vasera VS-1000 device. Correlations were calculated using a bivariate Spearman correlation. Results The mean values for AASI, ABI, baPWV and CAVI were 0.39 ± 0.14, 1.14 ± 0.09, 15.15 ± 2.71 m/s and 7.60 ± 1.90, respectively. There was a significant negative correlation between AASI and ABI (r = -0.491, p < 0.01). Conclusions In these diabetic patients, there was an association between AASI, an arterial stiffness marker and ABI, an indicator for the presence of atherosclerosis.


Assuntos
Tornozelo/irrigação sanguínea , Artérias/fisiopatologia , Pressão Sanguínea/fisiologia , Artéria Braquial/fisiopatologia , Diabetes Mellitus Tipo 2/complicações , Rigidez Vascular/fisiologia , Adulto , Idoso , Índice Tornozelo-Braço , Monitorização Ambulatorial da Pressão Arterial , Artérias Carótidas/diagnóstico por imagem , Estudos Transversais , Diabetes Mellitus Tipo 2/sangue , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Análise de Onda de Pulso
14.
Clin Interv Aging ; 15: 1035-1043, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32636618

RESUMO

Background: Geriatric rehabilitation programs primarily aim at an increase of mobility and functional autonomy of the elderly. The cardiovascular effects of these programs, however, remain elusive. Since regular physical exercise is associated with numerous beneficial cardiovascular effects including a reduction of blood pressure (BP), the present prospective study investigates the hemodynamic effects of a representative standardized rehabilitation program. Methods: A total of 74 subjects who were hospitalized in a German university hospital for geriatric rehabilitation were enrolled in the study. Peripheral BP, central aortic BP, 24h-ambulatory BP, heart rate and pulse wave velocity as a measure of arterial stiffness were assessed at admission and before discharge from the hospital. The program contained 4-5 sessions of physical activity of individualized intensity per week (≥30 min/session, eg, walking, cycling, stair rising). Results: The mean age of the study population was 82.4±6.9 years; all patients suffered from arterial hypertension (stage 2-3) with a median number of three antihypertensive drugs. The most frequent cause for admission was injurious falls. The mean duration of the rehabilitation program was 17 days and comprised at least 20 physical activity sessions including occupational therapy. The program led to a significant improvement of mobility (Timed Up & Go 29.5±18.5 vs 19.1 ±9.3 s, p<0.001) and Barthel index of activities of daily living score (46.6±19.1 vs 69.8±16.5, p<0.001). Peripheral systolic BP decreased from 135.4±19.0 mmHg at baseline to 129.0±18.4 mmHg at follow-up (p=0.03), whereas peripheral diastolic BP, central aortic BP, 24h-ambulatory BP, heart rate and pulse wave velocity as a measure of arterial stiffness were not significantly altered (p>0.05 each). Conclusion: The present representative standardized geriatric rehabilitation program was able to improve mobility, which showed a mild effect on systolic BP but did not affect 24h-ambulatory BP.


Assuntos
Exercício Físico , Hemodinâmica , Hipertensão/reabilitação , Resistência Física/fisiologia , Idoso , Idoso de 80 Anos ou mais , Anti-Hipertensivos/uso terapêutico , Pressão Sanguínea/fisiologia , Feminino , Humanos , Hipertensão/fisiopatologia , Masculino , Estudos Prospectivos , Análise de Onda de Pulso , Rigidez Vascular/fisiologia
15.
Am J Physiol Cell Physiol ; 319(4): C611-C623, 2020 10 01.
Artigo em Inglês | MEDLINE | ID: mdl-32667866

RESUMO

The primary biomechanical driver of pathological glaucomatous cupping remains unknown. Finite element modeling indicates that stress and strain play key roles. In this article, primarily a review, we utilize known biomechanical data and currently unpublished results from our lab to propose a three-stage, tissue stiffness-based model to explain glaucomatous cupping occurring at variable levels of translaminar pressure (TLP). In stage 1, a short-term increase in TLP gradient induces a transient increase in lamina cribrosa (LC) strain. Beyond a critical level of strain, the tissue stiffness rises steeply provoking cellular responses via integrin-mediated mechanotransduction. This early mechanoprotective cellular contraction reduces strain, which reduces tissue stiffness by return of the posteriorly deflected LC to baseline. In stage 2 a prolonged period of TLP increase elicits extracellular matrix (ECM) production leading to fibrosis, increasing baseline tissue stiffness and strain and diminishing the contractile ability/ability to return to the baseline LC position. This is supported by our three-dimensional collagen contraction assays, which show significantly reduced capacity to contract in glaucoma compared with normal LC cells. Second, 15% cyclic strain in LC cells over 24 h elicits a typical increase in ECM profibrotic genes in normal LC cells but a highly blunted response in glaucoma LC cells. Stage 3 is characterized by persistent fibrosis causing further stiffening and inducing a feed-forward ECM production cycle. Repeated cycles of increased strain and stiffness with profibrotic ECM deposition prevent optic nerve head (ONH) recoil from the new deflected position. This incremental maladaptive modeling leads to pathological ONH cupping.


Assuntos
Fibrose/fisiopatologia , Glaucoma/fisiopatologia , Disco Óptico/fisiologia , Rigidez Vascular/fisiologia , Fenômenos Biomecânicos , Matriz Extracelular/metabolismo , Matriz Extracelular/fisiologia , Fibrose/terapia , Análise de Elementos Finitos , Glaucoma/terapia , Humanos , Modelos Teóricos , Disco Óptico/patologia
16.
Environ Health Perspect ; 128(6): 67014, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-32589457

RESUMO

BACKGROUND: Arterial stiffness, and its progression with age, is an important indicator of cardiovascular aging. Greenspace exposure may protect against arterial stiffness by promoting physical activity, fostering social cohesion, and reducing stress and exposure to air pollution and noise. OBJECTIVES: The aim of this study was to investigate the association of long-term exposure to outdoor greenspace with arterial stiffness and its progression over time. METHODS: This prospective cohort study was based on 4,349 participants (55-83 years of age) of the Whitehall II Study, United Kingdom. Arterial stiffness was assessed in two medical examinations (2007-2009 and 2012-2013) by measuring the carotid-femoral pulse wave velocity (cf-PWV). Residential surrounding greenspace was characterized using satellite-based indices of greenspace including normalized difference vegetation index (NDVI), enhanced vegetation index (EVI), and vegetation continuous fields (VCF) across buffers of 500 and 1,000m surrounding the participants' residential locations at each follow-up. The association between the greenspace indicators and baseline cf-PWV and 4-year progression of cf-PWV was assessed using linear mixed-effects models with the participant as a random effect, controlling for demographic, lifestyle, and (individual and area) socioeconomic factors. RESULTS: No statistically significant associations were observed between residential surrounding greenspace and baseline or 4-y progression of cf-PWV; interquartile range (IQR) increases in NDVI, EVI, and VCF in the 500-m buffer were associated with -0.04m/s [95% confidence interval (CI): -0.12, 0.04], -0.03m/s (95% CI: -0.10, 0.05), and -0.02m/s (95% CI: -0.08, 0.04) in baseline cf-PWV and 0.06m/s (95% CI: -0.02, 0.14), 0.05m/s (95% CI: -0.03, 0.14), and 0.00m/s (95% CI: -0.09, 0.09) in 4-y progression in cf-PWV, respectively. The associations were similar when using 1,000-m buffers. CONCLUSIONS: We did not observe any consistent association between residential surrounding greenspace and arterial stiffness. https://doi.org/10.1289/EHP6159.


Assuntos
Ambiente Construído , Exposição Ambiental/estatística & dados numéricos , Rigidez Vascular/fisiologia , Idoso , Idoso de 80 Anos ou mais , Poluição do Ar , Feminino , Humanos , Estilo de Vida , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Análise de Onda de Pulso , Reino Unido
17.
Clin Exp Hypertens ; 42(8): 728-732, 2020 Nov 16.
Artigo em Inglês | MEDLINE | ID: mdl-32574091

RESUMO

BACKGROUND: Aging increases the risk of chronic diseases, especially cardiovascular diseases, leading to changes in cardiovascular anatomy and physiology even in the absence of other comorbidities. Numerous cardiovascular risk factors (CVRFs), such as diabetes mellitus (DM) and systemic arterial hypertension (SAH), can modify the functional and structural properties of large vessels, increasing arterial stiffness. OBJECTIVE: To determine whether elderly patients with hypertension with DM have greater central arterial stiffness than elderly patients with SAH without DM. METHODS: The Study of Pulse Wave Velocity in the Elderly in an Urban Area in Brazil (EVOPIU) included 1,192 patients aged ≥ 60 years who underwent applanation tonometry (AT) to evaluate carotid-femoral pulse wave velocity (cfPWV). From this database, 1,133 patients were selected from 6 groups: NDN (nondiabetic normotensives; n: 127); DN (diabetic normotensives; n: 64); NDCH (nondiabetic controlled hypertensives; n: 168); DCH (diabetic controlled hypertensives; n: 275); NDH (nondiabetic hypertensives; n: 217) and DH (diabetic hypertensives; n: 282). All groups underwent AT to obtain cfPWV and central and peripheral arterial pressures. RESULTS: The pulse wave velocities found were as follows: NDN vs DN (8.9 ± 0.2 m/s vs 9.4 ± 0.2; P = .103); NDCH vs DCH (9.0 ± 0.2 m/s vs. 9.6 ± 0.1 m/s; P= .04) and NDH vs DH (9.2 ± 0.1 m/s vs. 9.6 ± 0.1 m/s; P= .045). When the diabetic groups were compared, there were no differences in cfPWV values, and the same occurred when the nondiabetic groups were compared. CONCLUSIONS: Elderly patients with diabetes and hypertension have greater central arterial stiffness than patients without diabetes and hypertension, regardless of systemic blood pressure control. The central arterial stiffness caused by vascular aging seems to be a common factor among all the studied groups.


Assuntos
Hipertensão/fisiopatologia , Rigidez Vascular , Idoso , Idoso de 80 Anos ou mais , Pressão Sanguínea , Humanos , Pessoa de Meia-Idade , Análise de Onda de Pulso , Rigidez Vascular/fisiologia
18.
Artigo em Inglês | MEDLINE | ID: mdl-32560524

RESUMO

The present study aimed to explore the relationship between electrocardiographic (ECG) and pulse wave analysis variables in patients with hypertension (HT) and high normal blood pressure (HNBP). A total of 56 consecutive, middle-aged hypertensive and HNBP patients underwent pulse wave analysis and standard 12-lead ECG. Pulse wave velocity (PWV), heart rate, intrinsic heart rate (IHR), P wave and QT interval durations were as follows: 7.26 ± 0.69 m/s, 69 ± 11 beats/minute, 91 ± 3 beats/minute, 105 ± 22 mm and 409 ± 64 mm, respectively. Significant correlations were obtained between PWV and IHR and P wave duration, respectively, between early vascular aging (EVA) and P wave and QT interval durations, respectively. Linear regression analysis revealed significant associations between ECG and pulse wave analysis variables but multiple regression analysis revealed only IHR as an independent predictor of PWV, even after adjusting for blood pressure variables and therapy. Receiver-operating characteristic (ROC) curve analysis revealed P wave duration (area under curve (AUC) = 0.731; 95% CI: 0.569-0.893) as a predictor of pathological PWV, and P wave and QT interval durations were found as sensitive and specific predictors of EVA. ECG provides information about PWV and EVA in patients with HT and HNBP. IHR and P wave durations are independent predictors of PWV, and P wave and QT interval may predict EVA.


Assuntos
Senilidade Prematura/fisiopatologia , Eletrocardiografia , Frequência Cardíaca , Hipertensão/fisiopatologia , Análise de Onda de Pulso , Doenças Vasculares/fisiopatologia , Adulto , Pressão Sanguínea/fisiologia , Estudos Transversais , Feminino , Frequência Cardíaca/fisiologia , Humanos , Hipertensão/diagnóstico , Masculino , Pessoa de Meia-Idade , Valores de Referência , Rigidez Vascular/fisiologia
19.
Am J Cardiol ; 129: 87-94, 2020 08 15.
Artigo em Inglês | MEDLINE | ID: mdl-32593432

RESUMO

Several studies have reported aortic dilation and increased stiffness of the ascending aorta in patients after repair of congenital heart disease (CHD), which may be a predominant cardiovascular risk. However, the clinical significance has not been described in detail. In this retrospective study, 175 repaired patients with complex CHD achieving biventricular circulation and age-matched 39 control subjects were reviewed (median age: 14.9 and 15.7 years, respectively). We measured the diameters of the ascending aorta and descending aorta from catheterization angiograms to yield Z-scores and stiffness indexes (ß) using diameter fluctuations corresponding to pulsatile pressures. Clinical profile, peak oxygen uptake during the cardiopulmonary exercise test, and incidence of unscheduled hospitalization during follow-up was also reviewed. Compared with controls, patients with complex CHD, except for those with aortic coarctation, exhibited significant dilation and increased stiffness of the aortic root and ascending aorta, but not of the descending aorta. In this CHD population (n = 147, including 112 conotruncal anomalies), exercise capacities correlated independently with the diameter Z-score and stiffness index of the ascending aorta along with the history of repetitive thoracotomies, reduced forced vital capacity, and right ventricular hypertension. During a follow-up period (median 15.6 years), either dilation (Z-score >3.5) or increased stiffness (ß >6.0) of the ascending aorta stratified morbidity, but no synergistic impact was detected. In conclusion, in repaired patients with complex CHD, a stiffened and dilated ascending aorta was frequently found, exerting significant adverse impacts on diminished exercise capacity and morbidity.


Assuntos
Aorta/fisiopatologia , Doenças da Aorta/fisiopatologia , Tolerância ao Exercício/fisiologia , Cardiopatias Congênitas/fisiopatologia , Rigidez Vascular/fisiologia , Adolescente , Coartação Aórtica/fisiopatologia , Coartação Aórtica/cirurgia , Insuficiência da Valva Aórtica/fisiopatologia , Estenose da Valva Aórtica/fisiopatologia , Transposição das Grandes Artérias , Procedimentos Cirúrgicos Cardíacos , Estudos de Casos e Controles , Criança , Dilatação Patológica/fisiopatologia , Dupla Via de Saída do Ventrículo Direito/fisiopatologia , Dupla Via de Saída do Ventrículo Direito/cirurgia , Feminino , Cardiopatias Congênitas/cirurgia , Humanos , Masculino , Estudos Retrospectivos , Tetralogia de Fallot/fisiopatologia , Tetralogia de Fallot/cirurgia , Transposição dos Grandes Vasos/fisiopatologia , Transposição dos Grandes Vasos/cirurgia , Persistência do Tronco Arterial/fisiopatologia , Persistência do Tronco Arterial/cirurgia
20.
Artigo em Inglês | MEDLINE | ID: mdl-32486335

RESUMO

Postmenopausal status is associated with increased risks for cardiovascular diseases (CVD). This study investigated differences in vascular function, lipids, body composition, and physical fitness in elderly postmenopausal women active in combined resistance and aerobic exercise (CRAE) training for 1 year versus a sedentary cohort of similar-in-age counterparts. Elderly postmenopausal women performing habitual CRAE training for 1 year (age ~75 year; CRAE, n = 57) and elderly sedentary postmenopausal women (age ~78 year; SED, n = 44) were recruited. Arterial stiffness (brachial-to-ankle pulse-wave velocity, baPWV), blood pressure, blood lipids, anthropometrics, 2-min walking distance, and muscular strength were assessed for both groups. There were significant differences for baPWV, systolic blood pressure, low-density lipoprotein, and body fat percentage, which were significantly lower (p < 0.05) in CRAE vs. SED, and both 2 min walking distance and muscular strength were significantly greater (p < 0.05) in CRAE vs. SED. These results indicate that elderly postmenopausal women participating in habitual CRAE training may have better protection against risks for CVD and have better physical fitness compared to SED counterparts.


Assuntos
Pressão Sanguínea/fisiologia , Exercício Físico , Hipertensão/terapia , Pós-Menopausa , Treinamento de Resistência/métodos , Rigidez Vascular/fisiologia , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Envelhecimento , Biomarcadores/sangue , Doenças Cardiovasculares/etiologia , Exercício Físico/fisiologia , Terapia por Exercício/métodos , Feminino , Humanos , Hipertensão/complicações , Hipertensão/fisiopatologia , Lipídeos , Pós-Menopausa/sangue , Resultado do Tratamento
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