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1.
BMC Pediatr ; 23(1): 9, 2023 Jan 05.
Artigo em Inglês | MEDLINE | ID: mdl-36600189

RESUMO

BACKGROUND: Pseudoaneurysm is a known complication of penetrating arterial injuries such as catheterization, gunshot wounds, and open fractures. Vaccination is an effective method for preventing multiple, serious, infectious diseases in children. Common adverse reactions related to vaccination include fever, swelling, redness, and pain. Brachial pseudoaneurysm after vaccination has not been previously reported. CASE PRESENTATION: Herein we describe a novel case of brachial pseudoaneurysm after vaccination in a child aged 1 year and 3 months. A pulsatile mass was formed in the medial left arm of the infant 10 days after vaccination at a community hospital and gradually grew larger. Preoperative images depicted an eccentric aneurysm in the brachial artery and a swirling flow pattern in the mass. The pseudoaneurysm was excised, and vein graft interpositioning was successfully performed. There were no short-term or long-term complications during the follow-up period. CONCLUSIONS: Brachial pseudoaneurysm is a rare complication of vaccination via intramuscular injection. Medical staff should avoid puncture wounds to the brachial artery during vaccination, especially in infants.


Assuntos
Falso Aneurisma , Ferimentos por Arma de Fogo , Criança , Humanos , Lactente , Falso Aneurisma/diagnóstico por imagem , Falso Aneurisma/etiologia , Falso Aneurisma/cirurgia , Artéria Braquial/lesões , Artéria Braquial/cirurgia , Ferimentos por Arma de Fogo/complicações , Extremidade Superior , Vacinação/efeitos adversos
2.
Physiol Rep ; 11(1): e15566, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36636769

RESUMO

The main goal was to determine the impact of mental stress (MS) on blood flow regulation in overweight/obese men. Fourteen overweight/obese men (27 ± 7 years; 29.8 ± 2.6 kg/m2 ) participated in two randomized experimental sessions with oral administration of the AT1R blocker Olmesartan (40 mg; AT1RB) or placebo (PL). After 2 h, a 5-min acute MS session (Stroop Color Word Test) was administered. Blood flow was assessed at baseline and during the first 3 min of MS by vascular ultrasound in the brachial artery. Blood was collected before (baseline) and during mental stress (MS) for measurement of nitrite (chemiluminescence) and endothelin-1 (ELISA kit). The AT1R blocker was able to reverse the MS responses observed in the placebo session for retrograde flow (p < 0.01), retrograde SR (p < 0.01) and oscillatory shear index (p = 0.01). Regarding vasoactive substances, no differences were observed in ET-1 (p > 0.05) responses to MS between experimental sessions. However, for nitrite responses, the administration of the AT1R blocker was able to increase circulating levels of NO (p = 0.03) Blockade of AT1R appears to prevent the decrease in endothelial function by reducing low shear stress and maintaining the vasoactive substances balance after MS in overweight/obese men.


Assuntos
Bloqueadores do Receptor Tipo 1 de Angiotensina II , Obesidade , Sobrepeso , Fluxo Sanguíneo Regional , Estresse Psicológico , Humanos , Masculino , Artéria Braquial/fisiologia , Endotélio Vascular/fisiologia , Nitritos , Obesidade/complicações , Sobrepeso/complicações , Fluxo Sanguíneo Regional/fisiologia , Vasodilatação/fisiologia , Adulto Jovem , Adulto , Bloqueadores do Receptor Tipo 1 de Angiotensina II/uso terapêutico
3.
Physiol Rep ; 10(24): e15552, 2022 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-36541342

RESUMO

SARS-CoV-2 infection is known to instigate a range of physiologic perturbations, including vascular dysfunction. However, little work has concluded how long these effects may last, especially among young adults with mild symptoms. To determine potential recovery from acute vascular dysfunction in young adults (8 M/8F, 21 ± 1 yr, 23.5 ± 3.1 kg⋅m-2 ), we longitudinally tracked brachial artery flow-mediated dilation (FMD) and reactive hyperemia (RH) in the arm and hyperemic response to passive limb movement (PLM) in the leg, with Doppler ultrasound, as well as circulating biomarkers of inflammation (interleukin-6, C-reactive protein), oxidative stress (thiobarbituric acid reactive substances, protein carbonyl), antioxidant capacity (superoxide dismutase), and nitric oxide bioavailability (nitrite) monthly for a 6-month period post-SARS-CoV-2 infection. FMD, as a marker of macrovascular function, improved from month 1 (3.06 ± 1.39%) to month 6 (6.60 ± 2.07%; p < 0.001). FMD/Shear improved from month one (0.10 ± 0.06 AU) to month six (0.18 ± 0.70 AU; p = 0.002). RH in the arm and PLM in the leg, as markers of microvascular function, did not change during the 6 months (p > 0.05). Circulating markers of inflammation, oxidative stress, antioxidant capacity, and nitric oxide bioavailability did not change during the 6 months (p > 0.05). Together, these results suggest some improvements in macrovascular, but not microvascular function, over 6 months following SARS-CoV-2 infection. The data also suggest persistent ramifications for cardiovascular health among those recovering from mild illness and among young, otherwise healthy adults with SARS-CoV-2.


Assuntos
COVID-19 , Hiperemia , Humanos , Adulto Jovem , Antioxidantes , Óxido Nítrico/metabolismo , Vasodilatação/fisiologia , SARS-CoV-2/metabolismo , Artéria Braquial/diagnóstico por imagem , Artéria Braquial/fisiologia , Inflamação/metabolismo , Endotélio Vascular/metabolismo , Fluxo Sanguíneo Regional/fisiologia
4.
Int J Mol Sci ; 23(23)2022 Dec 02.
Artigo em Inglês | MEDLINE | ID: mdl-36499475

RESUMO

Elevated circulating platelet-derived extracellular vesicles (pEVs) have been associated with arterial hypertension. The role of hypertension-mediated organ damage (HMOD) to induce EV release is still unknown. We studied the micro- and macro-vascular changes (retinal vascular density and pulse wave velocity), endothelial function (flow-mediated vasodilation of brachial artery and finger plethysmography), and assessed the psychosocial status (anxiety and depression) in hypertensive patients to determine their relationship with EV release. Pulse wave velocity showed a significant positive correlation with pEVs (r = 0.33; p = 0.01). Systolic blood pressure (SBP) negatively correlated with retinal vascularity. The superficial retinal vascular plexus density in the whole image showed a significant negative correlation with 24 h SBP (r = -0.38, p < 0.01), day-SBP (r = -0.35, p = 0.01), and night-SBP (r = -0.27, p = 0.04). pEVs did not show significant associations with microvascular damage (retinal vascular density), endothelial function (flow-mediated vasodilation of brachial artery and finger plethysmography), or psychosocial status (anxiety and depression). Our results indicate that the pEV levels were associated with macrovascular damage measured by PWV, whereas no significant association between pEVs and microvascular damage, endothelial function, or emotional status could be detected. The potential utility of pEV in clinical practice in the context of HMOD may be limited to macrovascular changes.


Assuntos
Vesículas Extracelulares , Hipertensão , Humanos , Análise de Onda de Pulso , Artéria Braquial , Pressão Sanguínea/fisiologia
5.
Br J Nurs ; 31(20): S6-S14, 2022 Nov 10.
Artigo em Inglês | MEDLINE | ID: mdl-36370405

RESUMO

BACKGROUND: Compression therapy is a safe, effective treatment for lower leg conditions such as lymphatic insufficiency and venous hypertension. The most common method of arterial assessment is the calculation of a patient's ankle-brachial pressure index (ABPI). The need for ABPI is highlighted in many best practice statement and local policies. ABPI compares the arterial flow of the arms and the legs, providing a ratio used to determine the presence and severity of peripheral artery disease and assess whether a patient is suitable for compression therapy. AIM: This study critically reviews and analyses findings from contemporary literature with the aim of evaluating the effectiveness of the ABPI screening tool. METHOD: A structured literature review using a narrative approach was carried out. RESULTS: Four studies were identified for inclusion, which involved medical, nursing and allied health professional staff in primary and secondary care, with a total of 51 patients. Analysis generated eight themes: appropriateness of the ABPI tool; clinician education; referral process; access to appropriate equipment; lack of time to conduct the assessment; competence; associated costs; and role definition. CONCLUSION: It is important to undertake a holistic assessment of the patient, incorporating ABPI assessment where not contraindicated. Further research to explore patient experience and safety when assessing a patient's suitability for lower limb compression therapy is required.


Assuntos
Tornozelo , Doença Arterial Periférica , Humanos , Tornozelo/irrigação sanguínea , Artéria Braquial , Índice Tornozelo-Braço , Extremidade Inferior
6.
Sci Rep ; 12(1): 19763, 2022 Nov 17.
Artigo em Inglês | MEDLINE | ID: mdl-36396796

RESUMO

Cardiovascular diseases are the leading cause of global deaths, making cardiovascular health monitoring important. Measuring blood pressure using an automatic sphygmomanometer is the most widely used method to monitor cardiovascular health due to its accessibility, convenience, and strong correlation with cardiovascular diseases. In this work, in order to estimate brachial artery diameter, stiffness, or thickness using an automatic sphygmomanometer, the correlation between upper arm parameters and the oscillometric signal was intensively investigated through analytical, numerical, and experimental approaches. The parametric studies commonly revealed that the inner radius of the brachial artery is the most influential parameter in determining the amplitude of the oscillometric signal. The experimental results of using a cardiovascular simulator (a virtual patient) combined with upper arm phantoms with various inner radii of the brachial artery showed a 6.5% change in the oscillometric signal amplitude with a 10% artery radius variation. It was concluded that the oscillometric signal can be used to evaluate brachial artery diameter. Based on the clinical relationship between brachial artery diameter and cardiovascular risk factors such as hypertension, diabetes, and obesity, this study showed and verified a novel method to monitor brachial artery diameter and hence, cardiovascular risks while measuring blood pressure.


Assuntos
Braço , Doenças Cardiovasculares , Humanos , Pressão Sanguínea/fisiologia , Doenças Cardiovasculares/diagnóstico , Determinação da Pressão Arterial/métodos , Artéria Braquial
7.
Sci Rep ; 12(1): 19479, 2022 Nov 14.
Artigo em Inglês | MEDLINE | ID: mdl-36376342

RESUMO

The flow-mediated dilation (FMD) test is commonly utilized and is the only technique for the assessment of vascular endothelial cell function. With this test, the augmentation of a brachial artery diameter following reactive hyperemia is measured precisely using ultrasonography by a skilled operator. This is a hospital-only test, and would be more useful if conveniently performed at home. This paper describes a first approach for studying the impact of changes in peripheral arterial elasticity, with prospects towards possible assessment of functional reactivity. A recently developed smartphone-based instrument was used to measure elastic properties of finger and radial arteries, related to stiffness and vasodilatation, as a function of distending pressure derived by photo-plethysmographic volume-oscillometry. Elasticity changes in both arteries before and after a 5-min supra-systolic upper-arm cuff occlusion were successfully obtained in 15 normal volunteers. The index-values of stiffness and vasodilatation showed, respectively, a significant decrease and increase (p < 0.01), demonstrating clearly the expected elasticity changes with hyperemia, which could be consistent with the clinically-stated reaction in an FMD test. The results suggest that this method could easily provide important information of both elasticity and vasodilatation. It appears promising as a convenient assessment method to contribute to arteriosclerotic cardiovascular screening.


Assuntos
Hiperemia , Humanos , Hiperemia/diagnóstico por imagem , Vasodilatação/fisiologia , Oscilometria , Endotélio Vascular , Artéria Braquial , Ultrassonografia , Elasticidade , Fluxo Sanguíneo Regional
9.
J Sci Med Sport ; 25(12): 973-978, 2022 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-36357270

RESUMO

OBJECTIVES: This study aimed to examine the influences of tennis service exercise on cardiac output (CO) and bilateral brachial hemodynamics in young tennis players. DESIGN: Experimental study. METHODS: Ten young male tennis players (21 ±â€¯2 years of age) participated. Each performed 100 tennis services without a return shot for experimental tennis exercise. Cardiovascular hemodynamic variables, including bilateral brachial blood flow (BF), shear rate (SR), blood pressure, and CO, were collected under three conditions: 1) baseline, 2) immediately after the tennis services (post), and 3) 1 h after the tennis services (1-hour). The positive incremental area under the curve (iAUC) for brachial hemodynamic variables was calculated. RESULTS: Immediately after the 100 tennis services, CO, brachial BF, SR, and brachial vascular conductance (VC) in the dominant and non-dominant arms increased (p < 0.05). At the 1-hour condition, CO returned to baseline; the brachial BF, SR, and VC in the non-dominant arm returned to baseline levels, whereas the same variables in the dominant arm remained increased. The iAUC for brachial BF and VC in the dominant arm was higher than that in the non-dominant arm. Furthermore, the brachial BF/CO ratio index in the dominant arm increased at the post and 1-hour conditions, whereas that in the non-dominant arm was unchanged. CONCLUSIONS: Tennis service exercise specifically increases brachial BF, SR, and VC in the dominant arm, independent of increased CO. Our findings contribute to unveiling the underlying mechanisms of brachial artery adaptations in tennis players.


Assuntos
Tênis , Humanos , Masculino , Tênis/fisiologia , Artéria Braquial/fisiologia , Braço , Débito Cardíaco , Hemodinâmica/fisiologia
10.
Jt Dis Relat Surg ; 33(3): 680-685, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36345198

RESUMO

Management of pediatric pulseless supracondylar humerus fractures is a point of continuous debate. In this article, we present three cases admitted to the emergency department with pulseless, but well-perfused hands. The fractures were reduced and fixed using the antecubital approach. Prior to reduction, the brachial arteries of all three patients were entrapped in the cancellous bone of the proximal fragment segment. The arteries could only be released after freeing the adventitia by carefully scraping the adjacent bone with the tip of a hemostat. One case required thrombectomy through an arteriotomy using No. 3 Fogarty catheter. In two cases, the pulse returned after a brief period of waiting with no need for vascular intervention. Proceeding with closed reduction, as proposed by the recent guidelines, would result in further damage to the entrapped vasculature, which may go unnoticed due to collateral circulation.


Assuntos
Artéria Braquial , Fraturas do Úmero , Criança , Humanos , Artéria Braquial/diagnóstico por imagem , Artéria Braquial/cirurgia , Osso Esponjoso , Pulso Arterial , Fraturas do Úmero/complicações , Fraturas do Úmero/diagnóstico por imagem , Fraturas do Úmero/cirurgia , Úmero
11.
Comput Methods Programs Biomed ; 227: 107213, 2022 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-36356386

RESUMO

BACKGROUND AND OBJECTIVE: This paper proposes a novel strategy to localize anomalies in the arterial network based on its response to controlled transient waves. The idea is borrowed from system identification theories in which wave reflections can render significant information about a target system. Cardiovascular system studies often focus on the waves originating from the heart pulsations, which are of low bandwidth and, hence, can hardly carry information about the arteries with the desired resolution. METHODS: Our strategy uses a relatively higher bandwidth transient signal to characterize healthy and unhealthy arterial networks through a frequency response function (FRF). We tested our novel approach on data simulated using a one-dimensional cardiovascular model that produced pulse waves in the larger arteries of the arterial network. Specifically, we excited the blood flow from the brachial artery with a relatively high bandwidth flow disturbance and collected the subsequent pressure waveform at peripheral positions. To better differentiate FRFs of healthy and unhealthy networks, we used a FRF that removes the effects of heart pulsations. RESULTS: Results demonstrate the ability of the proposed FRF to detect and follow-up on the development of a common carotid artery (CCA) stenosis. We tested distinct geometrical variations of the stenosis (size, length and position) and observed differences between the FRFs of healthy and unhealthy networks in all cases; such differences were mainly due to geometrical variations determined by the stenosis. CONCLUSIONS: We have provided a theoretical proof of concept that demonstrates the ability of our novel strategy to detect and track the development of CCA stenosis by using peripheral pressure waves that can be measured non-invasively in clinical practice.


Assuntos
Estenose das Carótidas , Humanos , Constrição Patológica , Artéria Braquial/diagnóstico por imagem , Artéria Braquial/fisiologia , Modelos Cardiovasculares , Simulação por Computador , Pressão Sanguínea/fisiologia , Artérias Carótidas/diagnóstico por imagem , Artérias Carótidas/fisiologia
12.
Sensors (Basel) ; 22(19)2022 Sep 26.
Artigo em Inglês | MEDLINE | ID: mdl-36236381

RESUMO

Czech physiologist Penaz tried to overcome limitations of invasive pulse-contour methods (PCM) in clinical applications by a non-invasive method (finger mounted BP cuff) for continuous arterial waveform detection and beat-to-beat analysis. This discovery resulted in significant interest in human physiology and non-invasive examination of hemodynamic parameters, however has limitations because of the distal BP recording using a volume-clamp method. Thus, we propose a validation of beat-to-beat signal analysis acquired by novel a brachial occlusion-cuff (suprasystolic) principle and signal obtained from Finapres during a forced expiratory effort against an obstructed airway (Valsalva maneuver). Twelve healthy adult subjects [2 females, age = (27.2 ± 5.1) years] were in the upright siting position, breathe through the mouthpiece (simultaneously acquisition by brachial blood pressure monitor and Finapres) and at a defined time were asked to generate positive mouth pressure for 20 s (Valsalva). For the purpose of signal analysis, we proposed parameter a "Occlusion Cuff Index" (OCCI). The assumption about similarities between measured signals (suprasystolic brachial pulse waves amplitudes and Finapres's MAP) were proved by averaged Pearson's correlation coefficient (r- = 0.60, p < 0.001). The averaged Pearson's correlation coefficient for the comparative analysis of OCCI between methods was r- = 0.88, p < 0.001. The average percent change of OCCI during maneuver: 8% increase, 19% decrease and percent change of max/min ratio is 35%. The investigation of brachial pulse waves measured by novel brachial blood pressure monitor shows positive correlation with Finapres and the parameter OCCI shows promise as an index, which could describe changes during beat-to-beat cardiac cycles.


Assuntos
Artéria Braquial , Análise de Onda de Pulso , Adulto , Pressão Sanguínea/fisiologia , Determinação da Pressão Arterial/métodos , Artéria Braquial/fisiologia , Estudos de Viabilidade , Feminino , Dedos , Frequência Cardíaca , Humanos , Adulto Jovem
13.
Wiad Lek ; 75(9 pt 1): 2103-2107, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36256936

RESUMO

OBJECTIVE: The aim: To analyze the features of changes in the functional state of the vascular endothelium of handball players in the dynamics of the training process, at different levels of the body's hypoxic state. PATIENTS AND METHODS: Materials and methods: Theoretical methods, the method of Corretti et al. with the use of high-resolution ultrasound, Fisher test with the calculation of the Fisher criterion and the Bland-Altman method. The study of the vasomotor function of the vascular endothelium was carried out of young men 18-20 y.o., who did not go in for sports and which were systematically played handball. The brachial artery diameter, maximum linear blood flow velocity, volumetric blood flow velocity were registered in the state of relative rest after artificially created reactive hyperemia. RESULTS: Results: The primary results obtained showed that in the process of long-term adaptation to systematic muscular work, a pronounced vasodilation effect was observed. Subsequent analyze of changes in the functional state of the vascular endothelium of young sportsmen during the macrocycle preparation different levels of the body's hypoxic state manifested the following. The young men-athletes had more pronounced vasodilation effect, the values of the linear and volumetric blood flow velocity both in the state of relative rest and at the peak of the artificially created hyperemia were significantly higher than in the young men, who did not go in for sports. CONCLUSION: Conclusions: Suggested that the systematic muscular work contributes to a significant intensification of the oxidation pathway of nitric oxide formation from L-arginine with the participation of endothelial NO-synthase.


Assuntos
Endotélio Vascular , Hiperemia , Masculino , Adolescente , Humanos , Óxido Nítrico/metabolismo , Artéria Braquial/diagnóstico por imagem , Artéria Braquial/metabolismo , Vasodilatação , Hiperemia/metabolismo , Arginina/metabolismo
14.
Medicine (Baltimore) ; 101(40): e30484, 2022 Oct 07.
Artigo em Inglês | MEDLINE | ID: mdl-36221367

RESUMO

Despite similar brachial blood pressure, central hemodynamics could be different. The objective of the present study was to investigate the factors, which could influence the discrepancy between central BP (cBP) and brachial blood pressure. Six hundred forty-seven patients (364 males, 48 ± 12 years old) were enrolled. Using applanation tonometry, cBP was noninvasively derived. The median difference between brachial systolic BP (bSBP) and central systolic BP (cSBP) was 8 mm Hg. We defined the discrepancy between bSBP and cSBP as differences >8 mm Hg. For adjustment of cBP, population was divided into 3 groups according to the cBP: group 1, <140 mm Hg of cSBP; group 2, 140 > cSBP < 160 mm Hg; group 3, =160 mm Hg of cSBP. All the central hemodynamic parameters of the patients, including augmentation pressure, augmentation index (AI), heart rate (75 bpm) adjusted augmentation index (AI@HR75), and subendocardial viability ratio, were measured. Using multivariate logistic regression analysis, we evaluated the factors which could influence the discrepancy between bSBP and cSBP. Age, gender, augmentation pressure, AI, and AI@HR75 were correlated with the discrepancy between bSBP and cSBP. AI@HR75 was significantly correlated with the discrepancy between bSBP and cSBP (ß-coefficient = -0.376, P < .001 in group 1; ß-coefficient = -0.297, P < .001 in group 2; and ß-coefficient = -0.545, P < .001 in group 3). In groups 1 and 2, male gender was significantly correlated with the discrepancy between bSBP and cSBP (ß-coefficient = -0.857, P = .035 in group 1; ß-coefficient = -1.422, P = .039 in group 2). In present study, arterial stiffness might affect the discrepancy between bSBP and cSBP. Also, male gender was closely related to the discrepancy between bSBP and cSBP especially with cSBP <160 mm Hg. Not only cSBP, the discrepancy between cSBP and bSBP should be considered for understanding the central hemodynamics.


Assuntos
Artéria Braquial , Rigidez Vascular , Adulto , Pressão Sanguínea/fisiologia , Determinação da Pressão Arterial , Artéria Braquial/fisiologia , Hemodinâmica , Humanos , Masculino , Pessoa de Meia-Idade , Rigidez Vascular/fisiologia
15.
Eur Rev Med Pharmacol Sci ; 26(18): 6796-6804, 2022 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-36196728

RESUMO

OBJECTIVE: Cardiovascular atherosclerotic comorbidities represent an important cause of morbidity and mortality in patients diagnosed with psoriatic arthritis. In both atherosclerosis and Psoriatic arthritis, inflammation plays a pivotal role. Psoriatic arthritis is considered as an independent risk factor for the development of atherosclerosis with accelerated evolution. Development of atherosclerosis is initiated by the endothelial cell dysfunction along with inflammation and insulin resistance. The main aim of the study was to evaluate the endothelial function in Psoriatic arthritis patients, and to identify if it is related to the insulin resistance and Psoriatic arthritis disease activity. PATIENTS AND METHODS: In this case-control study, a group of 32 age and gender matched healthy controls was formed and compared to the group of 32 Psoriatic arthritis patients. We assessed the following parameters: Disease Activity in Psoriatic Arthritis Score, Homeostatic Model Assessment for Insulin Resistance, serum levels of the tumor necrosis factor alpha (TNFα), and the endothelial dysfunction by means of the flow-mediated dilation at brachial artery. The Student's t-test, the Pearson correlation and the ANOVA test were used to perform the statistical analysis of the data obtained; p-value <0.05 was considered as statistically significant. RESULTS: Compared to the patients in the control group, TNFα and Homeostatic Model Assessment for Insulin Resistance were increased (p-value <0.001), and flow-mediated dilation at brachial artery was decreased (p-value <0.001) in the disease group. In Psoriatic arthritis patients, significant correlations were found between Disease Activity in Psoriatic Arthritis Score and Homeostatic Model Assessment for Insulin Resistance (r=0.8143, p-value <0.001), and between Disease Activity in Psoriatic Arthritis Score and flow-mediated dilation at brachial artery % (r= -0.8376, p-value <0.001). Psoriatic arthritis patients treated with Methotrexate exhibited reduced values of Disease Activity in Psoriatic Arthritis Score and Homeostatic Model Assessment for Insulin Resistance and increased values of flow-mediated dilation at brachial artery, when compared with the untreated patients. CONCLUSIONS: Endothelial dysfunction is present in Psoriatic arthritis patients and has a significant correlation with both, the course of the disease and the insulin resistance.


Assuntos
Artrite Psoriásica , Aterosclerose , Resistência à Insulina , Artéria Braquial , Estudos de Casos e Controles , Endotélio Vascular , Humanos , Inflamação , Metotrexato , Fator de Necrose Tumoral alfa
16.
Port J Card Thorac Vasc Surg ; 29(3): 75-77, 2022 Oct 05.
Artigo em Inglês | MEDLINE | ID: mdl-36197812

RESUMO

Civilian penetrating injuries to the upper extremities are becoming seldom, with few case reports presented in the recent literature. Nevertheless, the brachial artery is the most frequently injured artery, accounting for approximately 30% of all vascular injuries. The authors present two clinical cases of brachial artery penetrating trauma with a stab corrected with an interposition saphenous bypass graft.


Assuntos
Traumatismos do Braço , Lesões do Sistema Vascular , Ferimentos Penetrantes , Artéria Braquial/diagnóstico por imagem , Humanos , Extremidade Superior/lesões , Procedimentos Cirúrgicos Vasculares , Lesões do Sistema Vascular/diagnóstico por imagem , Ferimentos Penetrantes/diagnóstico
17.
Med Eng Phys ; 108: 103886, 2022 10.
Artigo em Inglês | MEDLINE | ID: mdl-36195359

RESUMO

Viscoelasticity may be an important physical index for diagnosing vascular diseases, but wall viscosity has received less attention than elasticity due to difficulties in measurement in clinical scenarios. In this study, viscoelastic parameters were estimated from the pressure diameter relationship using carotid artery ultrasound images and brachial artery pressure waveforms of the patients. Carotid artery diameter waveforms were obtained by analyzing wall motion in ultrasound cine images, and carotid pressure waveforms were estimated from brachial waveforms using a transfer function. The estimated viscoelastic parameters quantitatively agreed with the published data, and three viscous parameters (viscous index, energy dissipation ratio, and phase lag between pressure and diameter waveforms) showed good positive correlations with each other. No significant difference in wall elasticity was found between the no plaque (NP) and low plaque (LP) groups, whereas viscous parameters were lower in the NP group than the LP group. This result suggests that the viscous parameters may be a new mechanical index for detecting early atherosclerosis.


Assuntos
Artéria Braquial , Placa Aterosclerótica , Pressão Sanguínea , Artéria Braquial/diagnóstico por imagem , Artérias Carótidas/diagnóstico por imagem , Artéria Carótida Primitiva , Humanos , Viscosidade
18.
Exp Physiol ; 107(12): 1440-1453, 2022 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-36114662

RESUMO

NEW FINDINGS: What is the central question of this study? What are the contributions of shear stress and adrenergic tone to brachial artery vasodilatation during hypercapnia? What is the main finding and its importance? In healthy young adults, shear-mediated vasodilatation does not occur in the brachial artery during hypercapnia, as elevated α1-adrenergic activity typically maintains vascular tone and offsets distal vasodilatation controlling flow. ABSTRACT: We aimed to assess the shear stress dependency of brachial artery (BA) responses to hypercapnia, and the α1-adrenergic restraint of these responses. We hypothesized that elevated shear stress during hypercapnia would cause BA vasodilatation, but where shear stress was prohibited (via arterial compression), the BA would not vasodilate (study 1); and, in the absence of α1-adrenergic activity, blood flow, shear stress and BA vasodilatation would increase (study 2). In study 1, 14 healthy adults (7/7 male/female, 27 ± 4 years) underwent bilateral BA duplex ultrasound during hypercapnia (partial pressure of end-tidal carbon dioxide, +10.2 ± 0.3 mmHg above baseline, 12 min) via dynamic end-tidal forcing, and shear stress was reduced in one BA using manual compression (compression vs. control arm). Neither diameter nor blood flow was different between baseline and the last minute of hypercapnia (P = 0.423, P = 0.363, respectively) in either arm. The change values from baseline to the last minute, in diameter (%; P = 0.201), flow (ml/min; P = 0.234) and conductance (ml/min/mmHg; P = 0.503) were not different between arms. In study 2, 12 healthy adults (9/3 male/female, 26 ± 4 years) underwent the same design with and without α1-adrenergic receptor blockade (prazosin; 0.05 mg/kg) in a placebo-controlled, double-blind and randomized design. BA flow, conductance and shear rate increased during hypercapnia in the prazosin control arm (interaction, P < 0.001), but in neither arm during placebo. Even in the absence of α1-adrenergic restraint, downstream vasodilatation in the microvasculature during hypercapnia is insufficient to cause shear-mediated vasodilatation in the BA.


Assuntos
Artéria Braquial , Hipercapnia , Adulto Jovem , Humanos , Feminino , Masculino , Artéria Braquial/fisiologia , Adrenérgicos , Fluxo Sanguíneo Regional/fisiologia , Vasodilatação/fisiologia , Prazosina , Velocidade do Fluxo Sanguíneo/fisiologia
19.
J Hypertens ; 40(10): 2037-2044, 2022 10 01.
Artigo em Inglês | MEDLINE | ID: mdl-36052526

RESUMO

OBJECTIVE: Accurate measurement of central blood pressure (BP) using upper arm cuff-based methods is associated with several factors, including determining the level of systolic BP (SBP) amplification. This study aimed to determine the agreement between cuff-based and invasively measured SBP amplification. METHODS: Patients undergoing coronary angiography had invasive SBP amplification (brachial SBP - central SBP) measured simultaneously with cuff-based SBP amplification using a commercially available central BP device (device 1: Sphygmocor Xcel; n = 171, 70% men, 60 ±â€Š10 years) and a now superseded model of a central BP device (device 2: Uscom BP+; n = 52, 83% men, 62 ±â€Š10 years). RESULTS: Mean difference (±2SD, limits of agreement) between cuff-based and invasive SBP amplification was 4 mmHg (-12, +20 mmHg, P < 0.001) for device 1 and -2 mmHg (-14, +10 mmHg, P = 0.10) for device 2. Both devices systematically overestimated SBP amplification at lower levels and underestimated at higher levels of invasive SBP amplification, but with stronger bias for device 1 (r = -0.68 vs. r = -0.52; Z = 2.72; P = 0.008). Concordance of cuff-based and invasive SBP amplification across quartiles of invasive SBP amplification was low, particularly in the lowest and highest quartiles. The root mean square errors from regression between cuff-based central SBP and brachial SBP were significantly lower (indicating less variability) than from invasive regression models (P < 0.001). CONCLUSIONS: Irrespective of the difference from invasive measurements, cuff-based estimates of SBP amplification showed evidence of proportional systematic bias and had less individual variability. These observations could provide insights on how to improve the performance of cuff-based central BP.


Assuntos
Pressão Arterial , Determinação da Pressão Arterial , Braço , Pressão Sanguínea/fisiologia , Determinação da Pressão Arterial/métodos , Artéria Braquial/fisiologia , Feminino , Humanos , Masculino
20.
Am J Physiol Regul Integr Comp Physiol ; 323(5): R787-R796, 2022 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-36154488

RESUMO

Intermittent (IH), as opposed to continuous hypoxia (CH), is thought to have beneficial effects on cardiovascular function and health. In the present study, we examined the acute effects of IH and CH (∼80% pulse oxygen saturation via 10% oxygen tank) on peripheral vascular function. Brachial artery flow-mediated dilation (FMD) was used to assess vascular function in 12 young adults (23 ± 5 yr; 8 M/4 F) before and after 50 min of IH (5 cycles; 4-min normoxia/6-min hypoxia per cycle), CH (20-min normoxia followed by 30-min hypoxia), or time control (50-min normoxia) interventions. Brachial artery diameter and velocity were measured using Doppler ultrasound to assess blood flow and shear rate. The total change in shear rate was greater during IH (634 ± 1,073·s-1, P < 0.05) and CH (321 ± 833·s-1, P = 0.05) than during time control (-412 ± 789·s-1). %FMD was reduced following time control (7.4 ± 1.2 to 5.9 ± 1.1%, P < 0.05) but was maintained following both hypoxia trials (IH: 7.2 ± 1.5 to 7.5 ± 1.5%, P = 0.52; CH: 6.9 ± 1.6 to 6.8 ± 1.4%, P = 0.73). Normalized %FMD for shear rate area under the curve (%FMDSRAUC) was reduced following the time control trial (4.2 ± 1.4 to 3.7 ± 0.9%, P < 0.05) with no change observed with CH (4.0 ± 1.5 to 3.9 ± 1.4%, P = 0.71). However, %FMDSRAUC increased with IH (3.8 ± 1.1 to 4.5 ± 1.5%, P < 0.05). Our data suggest that acute exposure to hypoxia (both intermittently and continuously) offsets the decline in vascular function after brief inactivity. The potential beneficial effect of hypoxia on peripheral vascular function observed in the current study may be associated with enhanced brachial artery shear in response to the hypoxic challenge.


Assuntos
Artéria Braquial , Hipóxia , Adulto Jovem , Humanos , Artéria Braquial/diagnóstico por imagem , Dilatação , Oxigênio , Hemodinâmica , Vasodilatação/fisiologia , Velocidade do Fluxo Sanguíneo , Fluxo Sanguíneo Regional/fisiologia , Endotélio Vascular
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