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Pulse Wave Velocity (pulse + wave_velocity)

Distribution by Scientific Domains

Medical Sciences	96%

Distribution within Medical Sciences

Diabetes	23%
Cardiovascular Disease	10%
10 Other Subdomains	47%

Kinds of Pulse Wave Velocity

brachial-ankle pulse wave velocity

Selected Abstracts

Involvement of Helicobacter pylori Infection and Impaired Glucose Metabolism in the Increase of Brachial,Ankle Pulse Wave Velocity

HELICOBACTER, Issue 5 2007
Hiroyuki Yoshikawa
Abstract Background: The role of Helicobacter pylori in the pathogenesis of atherosclerosis remains controversial. The present study was designed to elucidate the pathogenic role of H. pylori in the early stages of atherosclerosis by measurement of brachial,ankle pulse wave velocity (baPWV) in relation to glucose metabolism. Materials and methods: baPWV level, anti- H. pylori antibody, fasting blood glucose (FBG), and glycosylated hemoglobin A1c (HbA1c) and other conventional risk factors for cardiovascular diseases were measured in 947 subjects who attended their annual medical check-up. Results: Multiple regression analyses indicated that age, gender (male), body mass index, FBG, systolic blood pressure, and smoking habits were each independently related to baPWV values. In younger subjects (30,49 years), H. pylori seropositivity was significantly correlated with an increase of baPWV levels (r = 0.100, p = .0445). baPWV values in the H. pylori- positive subjects with impaired glucose metabolism (IG: FBG , 110 mg/dL and/or HbA1c , 5.9%) were significantly greater than those in the H. pylori- negative subjects with IG (p = .0078). Furthermore, H. pylori- positive subjects with IG were at higher risk for increase of baPWV, in younger (r = 0.203, p < .0001) as well as in older subjects (50,69 years, r = 0.099, p = .0009). Conclusions: These results suggest that H. pylori seropositivity is a potential risk factor for increased baPWV levels, and that H. pylori infection accelerates the effect of IG on an increase of baPWV, especially in younger subjects. Thus, the possible interaction between H. pylori infection and IG may contribute to the early development of atherosclerosis. [source]

Variations in carotid arterial compliance during the menstrual cycle in young women

EXPERIMENTAL PHYSIOLOGY, Issue 2 2006
Koichiro Hayashi
The effect of menstrual cycle phase on arterial elasticity is controversial. In 10 healthy women (20.6 ± 1.5 years old, mean ±s.d.), we investigated the variations in central and peripheral arterial elasticity, blood pressure (carotid and brachial), carotid intima,media thickness (IMT), and serum oestradiol and progesterone concentrations at five points in the menstrual cycle (menstrual, M; follicular, F; ovulatory, O; early luteal, EL; and late luteal, LL). Carotid arterial compliance (simultaneous ultrasound and applanation tonometry) varied cyclically, with significant increases from the values seen in M (0.164 ± 0.036 mm2 mmHg,1) and F (0.171 ± 0.029 mm2 mmHg,1) to that seen in the O phase (0.184 ± 0.029 mm2 mmHg,1). Sharp declines were observed in the EL (0.150 ± 0.033 mm2 mmHg,1) and LL phases (0.147 ± 0.026 mm2 mmHg,1; F= 8.51, P < 0.05). Pulse wave velocity in the leg (i.e. peripheral arterial stiffness) did not exhibit any significant changes. Fluctuations in carotid arterial elasticity correlated with the balance between oestradiol and progesterone concentrations. No significant changes were found in carotid and brachial blood pressures, carotid artery lumen diameter, or IMT throughout the menstrual cycle. These data provide evidence that the elastic properties of central, but not peripheral, arteries fluctuate significantly with the phases of the menstrual cycle. [source]

Pulse wave velocity and cerebral infarction

INTERNAL MEDICINE JOURNAL, Issue 8 2007
W. Liang
No abstract is available for this article. [source]

2325: Dynamic retinal vessel analysis , how different parameters create the whole picture

ACTA OPHTHALMOLOGICA, Issue 2010
I LANZL
Purpose Dynamic vessel analysis is usually associated with the observation of the reaction of retinal vessels to a defined stimulus. The data which is generated this way may be further analysed with respect to the dynamic unstimulated and stimulated vessel behaviour. Assessment of different parameters may highlight different aspects of the underlying disease. Methods Vessel diameters of retinal vessel segments were assessed by Dynamic Vessel Analyzer (DVA) in healthy volunteers of different age groups and patients with diabetes, glaucoma and systemic hypertension. Mathematical analysis of unstimulated vessels was used to describe vessel wall characteristics. Methods of signal analysis including Fourier Transformation, spectral filtration, auto- and cross correlation were applied to evaluate characteristic oscillations and pulse wave propagation along the vessel. Results Characteristic different vessel behaviour and vessel wall conformation are obtained by dynamic quantitative evaluations from the unstimulated vessels in physiologic aging and disease. Conclusion Dynamic vessel analysis includes information which may lead to further understanding of the vascular status and underlying disease pathology. It is also feasible to assess pulse wave velocities in retinal arterioles und thus clinically characterize the elasticity of the upstream vasculature in health and disease. [source]

Brachial-ankle pulse wave velocity and cardiovascular risk factors in the non-diabetic and newly diagnosed diabetic Chinese: Guangzhou Biobank Cohort Study-CVD

DIABETES/METABOLISM: RESEARCH AND REVIEWS, Issue 2 2010
Lin Xu
Abstract Background Increased arterial stiffness is an important cause of cardiovascular disease (CVD). We examined determinants of arterial stiffness in subjects across strata of glycaemic status. Methods A total of 1249 subjects from a sub-study of the Guangzhou Biobank Cohort Study (GBCS-CVD) had brachial-ankle pulse wave velocity (baPWV) measured by automatic oscillometric method. Major cardiovascular risk factors including glycosylated haemoglobin A1c (HbA1c), high sensitivity C-reactive protein (hsCRP), fasting triglyceride, low- and high-density lipoprotein cholesterol and both fasting and post 2-h oral glucose-load glucose, systolic and diastolic blood pressure were assessed. Results In all, 649, 479 and 121 subjects were classified into normoglycaemia, impaired glucose metabolism (IGM) and newly diagnosed diabetes groups, respectively. Both age and systolic blood pressure were significantly associated with increased baPWV in all three groups (all p < 0.001). In both normoglycaemic and IGM groups, hsCRP and HbA1c were positively associated with baPWV (p from 0.04 to < 0.001), whereas current smoking and triglyceride were associated with baPWV in the normoglycaemic and IGM group, respectively (p = 0.04 and 0.001). No gender difference in baPWV was observed in the normoglycaemic or IGM groups. However, in the newly diagnosed diabetes group, men had higher baPWV than women (p = 0.01). Conclusions In the normoglycaemic and IGM subjects, after adjusting for age, blood pressure and other confounders, increasing HbA1c was associated with increased baPWV, suggesting a pathophysiological role of chronic glycaemia that can contribute to vascular disease risk in persons without diabetes. Copyright © 2010 John Wiley & Sons, Ltd. [source]

Higher arterial stiffness, greater peripheral vascular resistance and lower blood flow in lower-leg arteries are associated with long-term hyperglycaemia in type 2 diabetic patients with normal ankle-brachial index

DIABETES/METABOLISM: RESEARCH AND REVIEWS, Issue 4 2009
Eiji Suzuki
Abstract Background Higher arterial stiffness and greater peripheral vascular resistance reduce blood flow in lower-leg arteries and contribute to the development of ischaemic limb in diabetic patients even without peripheral artery occlusive disease. The aim of this study was to clarify whether these vascular parameters are associated with long-term hyperglycaemia in diabetic patients. Methods We examined 45 type 2 diabetic patients and 38 age-matched nondiabetic subjects without peripheral artery occlusive disease assessed by ankle-brachial index consecutively admitted to our hospital, and followed them over a 3-year period (3.7 ± 0.7 years) with no vasodilative medication. Blood flow and resistive index, a measure of peripheral vascular resistance, at the popliteal artery were evaluated using gated two-dimensional cine-mode phase-contrast magnetic resonance imaging. Brachial-ankle pulse wave velocity was measured to assess arterial stiffness. Results At baseline, consistent with our previous report, diabetic patients showed higher brachial-ankle pulse wave velocity (p < 0.0001) and resistive index (p < 0.0001) and lower flow volume (p = 0.0044) than those of nondiabetic subjects. Stepwise multiple regression analysis revealed that duration of diabetes, mean HbA1c during the study, use of renin-angiotensin system inhibitors and change per year in resistive index were identified as significant independent variables predicting change per year in blood flow (r2 = 0.733, p < 0.0001) in diabetic patients. Mean HbA1c during the study was positively correlated with changes per year in brachial-ankle pulse wave velocity (p = 0.00007) and resistive index (p = 0.0014) and was negatively correlated with that in blood flow (p < 0.0001) in diabetic patients. Conclusions Long-term hyperglycaemia is a major cause of impaired peripheral circulation in lower-leg arteries in diabetic patients without peripheral artery occlusive disease. Copyright © 2009 John Wiley & Sons, Ltd. [source]

Higher carotid-radial pulse wave velocity in healthy offspring of patients with Type 2 diabetes

DIABETIC MEDICINE, Issue 3 2004
O. D. McEleavy
Abstract Aims, To determine whether carotid-radial pulse wave velocity (crPWV), a simple non-invasive measurement of muscular artery structure and function, is increased in offspring of patients with Type 2 diabetes compared with well-matched controls with no family history of diabetes. Serum levels of intercellular adhesion molecule-1 (sICAM-1) were also examined. Methods, Offspring (n = 19, M = 8) were recruited via contact with patients attending clinics. Controls (n = 19, M = 8) were recruited by advertisement. crPWV was measured using COMPLIOR. Blood pressure and heart rate were determined and fasting blood taken for measurement of metabolic and endothelial parameters. Results, Offspring and controls were well matched [mean (sd)] for age [33.1 (9.6) vs. 32.8 (9.5) years], body mass index [24.8 (4.9) vs. 24.3 (3.4) kg/m2], waist circumference [78.3 (2.3) vs. 76.3 (2.5) cm], and systolic blood pressure [120 (9.3) vs. 119 (14.2) mmHg]. crPWV was 10% higher in the offspring [9.94 (1.3) m/s] compared with controls [9.01 (1.2) m/s, P = 0.02] despite similar pulse pressure [52 (10.5) vs. 53.5 (9.3) mmHg] and resting heart rate [71 (8.7) vs. 69 (14.0) beats/min]. They also showed a trend toward higher sICAM-1 [217 (55) vs. 188 (40) ng/ml, P = 0.07] concentrations which were also strongly correlated to crPWV in offspring (r = 0.63, P = 0.004). Conclusions, Vascular dysfunction in the form of increased muscular artery stiffness is present from an early stage in subjects at higher risk of developing diabetes. This may be secondary to impaired activation of endothelial signalling pathways in the context of inherited insulin resistance. [source]

Brachial-ankle pulse wave velocity measured automatically by oscillometric method is elevated in diabetic patients with incipient nephropathy

DIABETIC MEDICINE, Issue 11 2003
H. Yokoyama
Abstract Aims To examine whether brachial-ankle pulse wave velocity (baPWV), a possible early marker of atherosclerotic vascular damage, is associated with albuminuria in patients with Type 2 diabetes. Methods BaPWV was measured by automatic oscillometric method in 346 Type 2 diabetic patients with normoalbuminuria (a mean level of three times measurements of albumin-to-creatinine (ACR) < 30 µg/mg creatinine; n = 200), incipient nephropathy (a mean level of ACR , 30 and < 300 µg/mg creatinine; n = 119), and clinical nephropathy (a mean level of ACR , 300 µg/mg creatinine; n = 27), and without peripheral vascular disease. Results BaPWV (cm/s) was significantly higher in patients with incipient nephropathy (1722 ± 382) and clinical nephropathy (1763 ± 322) than in patients with normoalbuminuria (1559 ± 343, P < 0.0001, respectively). By univariate analysis it correlated significantly with age (r = 0.44, P < 0.0001), systolic blood pressure (r = 0.55, P < 0.0001), diastolic blood pressure (r = 0.42, P < 0.0001), albuminuria (r = 0.24, P < 0.0001) and HbA1C (r = 0.11, P < 0.05). Albuminuria revealed an independent significant association with baPWV (P < 0.01) after adjustment for age, sex, smoking, BMI, HbA1C, hyperlipidemia, and hypertension. Multiple regression analysis showed age, diastolic blood pressure and albuminuria were independently associated with baPWV (adjusted R2 = 0.42, P < 0.0001). Conclusions The results might indicate a possible link between the pathogenesis of atherosclerosis and diabetic nephropathy. Future studies are needed to clarify the usefulness and its predictable value. [source]

"Supranormal" Cardiac Function in Athletes Related to Better Arterial and Endothelial Function

ECHOCARDIOGRAPHY, Issue 6 2010
Maria Florescu M.D.
Objective: Athlete's heart is associated with left ventricular (LV) hypertrophy (LVH), and "supranormal" cardiac function, suggesting that this is a physiological process. Hypertrophy alone cannot explain increase in cardiac function, therefore, other mechanisms, such as better ventriculo-arterial coupling might be involved. Methods: We studied 60 male (21 ± 3 years) subjects: 27 endurance athletes, and a control group of 33 age-matched sedentary subjects. We assessed global systolic and diastolic LV function, short- and long-axis myocardial velocities, arterial structure and function and ventriculo-arterial coupling, endothelial function by flow-mediated dilatation, and amino-terminal pro-brain natriuretic peptide (NT-proBNP) and biological markers of myocardial fibrosis and of oxidative stress. Results: Athletes had "supranormal" LV longitudinal function (12.4 ± 1.0 vs 10.1 ± 1.4 cm/s for longitudinal systolic velocity, and 17.4 ± 2.6 vs 15.1 ± 2.4 cm/s for longitudinal early diastolic velocity, both P < 0.01), whereas ejection fraction and short-axis function were similar to controls. Meanwhile, they had better endothelial function (16.7 ± 7.0 vs 13.3 ± 5.3%, P < 0.05) and lower arterial stiffness (pulse wave velocity 7.1 ± 0.6 vs 8.8 ± 1.1 m/s, P = 0.0001), related to lower oxidative stress (0.259 ± 0.71 vs 0.428 ± 0.88 nmol/mL, P = 0.0001), with improved ventriculo-arterial coupling (37.1 ± 21.5 vs 15.5 ± 13.4 mmHg.m/s3× 103, P = 0.0001). NT-proBNP and markers of myocardial fibrosis were not different from controls. LV longitudinal function was directly related to ventriculo-arterial coupling, and inversely related to arterial stiffness and to oxidative stress. Conclusions: "Supranormal" cardiac function in athletes is due to better endothelial and arterial function, related to lower oxidative stress, with optimized ventriculo-arterial coupling; athlete's heart is purely a physiological phenomenon, associated with "supranormal" cardiac function, and there are no markers of myocardial fibrosis. (Echocardiography 2010;27:659-667) [source]

Importance of arterial stiffness as cardiovascular risk factor for future development of new type of drugs

FUNDAMENTAL & CLINICAL PHARMACOLOGY, Issue 3 2008
Pierre Boutouyrie
Abstract Cardiovascular risk prediction relies on classical risk factors such as age, gender, lipids, hypertension, smoking and diabetes. Although the value of such scales of risk is high for populations, its value for individual is reduced and too much influenced by non-modifiable risk factors (age and gender). Biomarkers of risk have been deceiving and genome wide scan approach is too recent. Target organ damage may help in selecting patients at high risk and in determining intervention. Aortic pulse wave velocity, an index of aortic stiffness, has been widely validated as providing additional risk predictions beyond and above classical risk factors, and has now entered into official guidelines. Many interventions (dietary, behaviour, drug treatment) were shown to influence arterial stiffness positively, but little evidence of a direct effect of intervention on arterial stiffness independent of blood pressure is available. New pharmacological targets and new drugs need to be identified. To become a surrogate endpoint for drug development, there is a need to demonstrate that regression arterial stiffness is associated with improved outcome. In parallel to this demonstration, points to be improved are the homogenization and spreading of the technique of measurement, the establishment of a reference value database. [source]

Relation of hypertension and glucose tolerance impairment in elderly people to the development of arteriosclerosis: Investigation using pulse wave velocity,

GERIATRICS & GERONTOLOGY INTERNATIONAL, Issue 1 2005
Takeshi Isobe
Background: The aim of the present study was to determine the correlation between the combination of hypertension and diabetes mellitus and arteriosclerosis using pulse wave velocity (PWV). Methods: The subjects were 186 men over the age of 60 years (mean age: 68.8 ± 5.8 years). PWV, systolic blood pressure (SBP), diastolic blood pressure, body mass index, fasting blood sugar (FBS), total cholesterol, triglyceride and HDL cholesterol were measured in all subjects. The subjects were divided into three groups on the basis of FBS level: a normal group (FBS < 110 mg/dL), an impaired fasting glucose group (110 , FBS < 126 mg/dL) and a diabetes mellitus group (FBS , 126 mg/dL or taking antidiabetics). The subjects were also divided into two groups on the basis of blood pressure level: a hypertension (HT) group (SBP , 140 mmHg and/or diastolic blood pressure , 90 mmHg or taking antihypertensives) and a normotension group (other subjects). Results: PWV showed positive correlations with SBP and FBS (r = 0.499 and r = 0.300, respectively). In all three groups classified by FBS level, PWV was higher in subjects with HT than in subjects with normotension (P < 0.01 in all three groups). In the HT group, PWV had already increased at the stage of impaired fasting glucose and was significantly higher in the diabetes mellitus group than in the normal FBS group (P = 0.002). In multiple regression analysis using PWV as a dependent variable, SBP and FBS were selected as independent variables. Conclusions: Even in the elderly, strict control of blood pressure and blood sugar level may be necessary in order to prevent the development of arteriosclerotic diseases. [source]

Involvement of Helicobacter pylori Infection and Impaired Glucose Metabolism in the Increase of Brachial,Ankle Pulse Wave Velocity

Late-Life Depression is Associated with Arterial Stiffness: A Population-Based Study

JOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 8 2003
Henning Tiemeier MD
Objectives: To determine whether arterial stiffness is associated with depression in the elderly. Design: Population-based cross-sectional study. Setting: In Ommoord, a suburb of Rotterdam, the Netherlands. Participants: Three thousand seven hundred four subjects of the Rotterdam Study aged 60 and older. Measurements: Arterial stiffness was assessed using the distensibility of the carotid artery and the carotid-femoral pulse wave velocity. All participants were screened for depressive symptoms with the Center for Epidemiologic Studies,Depression scale. Those with depressive symptoms had a psychiatric evaluation to establish a diagnosis of depressive disorders according to Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) criteria. Results: Participants with increased arterial stiffness were more likely to have depressive symptoms. Odds ratios (ORs) for depressive symptoms were 1.24 (95% confidence interval (CI) = 1.01,1.52) per standard deviation decrease in carotid distensibility and 1.17 (95% CI = 1.00,1.38) per standard deviation increase in aortic pulse wave velocity. The association was stronger for depressive disorders meeting DSM-IV criteria (OR = 1.44, 95% CI = 1.03,2.03; OR = 1.48, 95% CI = 1.16,1.90, respectively). Control for atherosclerosis, as measured by the ankle-to-brachial index or presence of plaques in the carotid artery, did not change the associations. Conclusion: This study shows an association between arterial stiffness and depression in the elderly. The findings are compatible with the vascular depression hypothesis. These data suggest that arterial stiffness may partly cause the proposed relationship between vascular factors and depression. [source]

Study of arteriosclerosis in patients with hiatal hernia and reflux esophagitis

JOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY, Issue 11 2007
Kenji Furuta
Abstract Background and Aim:, It has been reported that the prevalence of hiatal hernia (HH) and reflux esophagitis (RE) increases with age, as does the degree of arteriosclerosis. However, it has not been investigated whether or not arteriosclerosis is correlated with the presence of HH and RE. Therefore, we prospectively investigated the degree of arteriosclerosis in patients with HH and RE compared with subjects without HH and RE. Methods:, We prospectively enrolled 1683 people who visited Shimane Environment and Health Public Corporation for annual medical check-ups. All subjects were investigated by upper gastrointestinal endoscopy for the possible presence of HH and RE. Factors used for assessing cardiovascular risk were sex, age, body mass index (BMI), smoking and drinking habits, serum total cholesterol, triglyceride (TG), and high-density lipoprotein cholesterol (HDLC). Arteriosclerosis was investigated by measuring systolic blood pressure, heart-carotid pulse wave velocity (HCPWV), bilateral ankle brachial index (ABI) and heart-ankle PWV (HAPWV). Results:, The number of patients with HH and RE was 624 (37.1%) and 143 (8.5%), respectively. The HDLC level of the patients with HH was significantly lower, and the levels of BMI, TG and arteriosclerotic parameters were higher than those of the subjects without HH after adjusting for confounding factors (sex, age and smoking and drinking habits). Cardiovascular and arteriosclerosis parameters except for TG did not differ between the subjects with and without RE. Conclusion:, Levels of arteriosclerosis parameters in patients with HH were higher than in those without HH. However, the association between arteriosclerosis and presence of RE was not clarified. [source]

Assessing normal pulse wave velocity in the proximal pulmonary arteries using transit time: A feasibility, repeatability, and observer reproducibility study by cardiovascular magnetic resonance

JOURNAL OF MAGNETIC RESONANCE IMAGING, Issue 5 2007
MRCP, William M. Bradlow BM
Abstract Purpose To calculate pulse wave velocity (PWV) in the proximal pulmonary arteries (PAs) by cardiovascular magnetic resonance (CMR) using the transit-time method, and address respiratory variation, repeatability, and observer reproducibility. Materials and Methods A 1.9-msec interleaved phase velocity sequence was repeated three times consecutively in 10 normal subjects. Pulse wave (PW) arrival times (ATs) were determined for the main and branch PAs. The PWV was calculated by dividing the path length traveled by the difference in ATs. Respiratory variation was considered by comparing acquisitions with and without respiratory gating. Results For navigated data the mean PWVs for the left PA (LPA) and right PA (RPA) were 2.09 ± 0.64 m/second and 2.33 ± 0.44 m/second, respectively. For non-navigated data the mean PWVs for the LPA and RPA were 2.14 ± 0.41 m/second and 2.31 ± 0.49 m/second, respectively. No statistically significant difference was found between respiratory non-navigated data and navigated data. Repeated on-table measurements were consistent (LPA non-navigated P = 0.95, RPA non-navigated P = 0.91, LPA navigated P = 0.96, RPA navigated P = 0.51). The coefficients of variation (CVs) were 12.2% and 12.5% for intra- and interobserver assessments, respectively. Conclusion One can measure PWV in the proximal PAs using transit-time in a reproducible manner without respiratory gating. J. Magn. Reson. Imaging 2007;25:974,981. © 2007 Wiley-Liss, Inc. [source]

Estimation of pulse wave velocity in main pulmonary artery with phase contrast MRI: Preliminary investigation

JOURNAL OF MAGNETIC RESONANCE IMAGING, Issue 6 2006
Hsu-Hsia Peng MS
Abstract Purpose To assess the feasibility and reproducibility of a noninvasive MRI method to measure pulse wave velocity (PWV) in the main pulmonary artery (MPA). Materials and Methods A total of 17 subjects without history of pulmonary diseases (38.2 ± 18.4 years) participated in this study. Series of MR velocity maps of the MPA were acquired at 2 cm above the pulmonary valves using a two-dimensional phase-contrast sequence. Effective temporal resolution was 11 msec after interleaving two dynamic series with different values of electrocardiograph (ECG) trigger delay. PWV was derived as the rate of MPA flow variations per unit change in MPA cross-sectional area, during early systole. Seven healthy subjects underwent three repetitive examinations to investigate intrascan and interscan reproducibility. Results Flow vs. area was highly linear in the MPA during early systole, with Pearson's coefficients ranging from 0.982 to 0.999, rendering derivation of PWV with little difficulty. Average value of PWV in MPA was 1.96 ± 0.27 m/second, in good agreement with literature values measured using invasive means. The percentage intra- and interscan differences were 5.46% and ,10.86%, respectively. Conclusion Phase-contrast MRI to noninvasively measure PWV in the MPA is feasible with good reproducibility. J. Magn. Reson. Imaging 2006. © 2006 Wiley-Liss, Inc. [source]

Relationship between vascular calcification, arterial stiffness and bone mineral density in a cross-sectional study of prevalent Australian haemodialysis patients

NEPHROLOGY, Issue 1 2009
NIGEL D TOUSSAINT
SUMMARY Background: Cardiovascular disease in dialysis patients is associated with increased vascular calcification (VC) and arterial stiffness, both inversely correlated with bone mineral density (BMD). Few studies have correlated VC in the dialysis population with measurements of BMD and arterial compliance. Methods: We report cross-sectional data on 45 haemodialysis (HD) patients assessing the prevalence of VC and its associations. Patients had computed tomography scans through abdominal aorta and superficial femoral arteries (SFA) to determine VC, pulse wave velocity (PWV) using SphygmoCor device measuring arterial stiffness, and dual-energy X-ray absorptiometry (DXA) to determine BMD. Results: Patients, 64% male, 38% diabetic, had median age 58 years. Mean PWV was 8.7 ± 3.5 m/s and median aortic VC score 488.1 ± 298 Hounsfield units, with 91% having aortic VC present. In univariate linear regression analysis, aortic VC correlated positively with length of HD (P = 0.03) and diabetes (P = 0.06). Increasing PWV was positively associated with age (P = 0.001), diabetes (P = 0.05) and VC (aortic P = 0.08, SFA P = 0.01). In multivariate regression analysis, length of HD and diabetes were significantly associated with aortic VC, whereas age and diabetes were associated with SFA VC and PWV. Mean lumbar spine and femoral neck T-scores on DXA were 0.14 and ,1.66 respectively. Conclusion: Increased VC and reduced arterial compliance, both closely related, are common in Australian HD patients. Both are associated with diabetes and increasing age, and greater aortic VC is seen with longer duration of dialysis. [source]

Vascular Cryografts Offer Better Biomechanical Properties in Chronically Hemodialyzed Patients: Role of Cryograft Type, Arterial Pathway, and Diabetic Nephropathy as Matching Determinants

ARTIFICIAL ORGANS, Issue 8 2010
Yanina Zócalo
Abstract This study aimed to characterize the following: (i) in chronically hemodialyzed subjects (CHDSs), with and without diabetic nephropathy (DN), and in healthy subjects (non-CHDSs) different arterial pathways stiffness to determine potential pathology-dependent, etiology- and/or pathway-dependent differences; and (ii) the biomechanical mismatch (BM) between arteries from non-CHDSs or CHDSs (with and without DN) and arterial cryografts, venous cryografts, and synthetic prosthesis to determine arterial pathway, pathology, and/or etiology-related differences in the substitute of election in terms of BM. Carotid,femoral and carotid,brachial pulse wave velocity (PWV) were measured in 30 non-CHDSs and 71 CHDSs (11 with DN). In addition, PWV was measured in arterial (elastic and muscular) and venous cryografts and in expanded polytetrafluorethylene prosthesis. The arterial pathways regional differences and the subjects' arterial pathways-substitutes BM were calculated. Arterial stiffness levels and regional differences were higher in CHDS than in non-CHDS. Among CHDS, those with DN showed higher stiffness in the aorto,femoral pathway and larger regional differences. Cryografts showed always the least BM. Non-CHDS and CHDS differed in the cryograft of election. In CHDS, the BM was related with the cryograft type, arterial pathway, and renal disease etiology. The BM could be minimized, selecting the most adequate cryograft type, taking into account the recipient specific characteristic (i.e., arterial pathway and renal disease etiology). [source]

Baroreflex Sensitivity of an Arterial Wall During Rotary Blood Pump Assistance

ARTIFICIAL ORGANS, Issue 9 2009
Tomoyuki Yambe
Abstract It is well known that the baroreflex system is one of the most important indicators of the pathophysiology in hypertensive patients. We can check the sensitivity of the baroreflex by observing heart rate (HR) responses; however, there is no simple diagnostic method to measure the arterial behavior in the baroreflex system. Presently, we report the development of a method and associated hardware that enables the diagnosis of baroreflex sensitivity by measuring the responses of both the heart and the artery. In this system, the measurements are obtained by monitoring an electrocardiogram and a pulse wave recorded from the radial artery or fingertip. The arterial responses were measured in terms of the pulse wave velocity (PWV) calculated from the pulse wave transmission time (PTT) from the heart to the artery. In this system, the HR change corresponding to the blood pressure change in time series sequence was observed. Slope of the changes in blood pressure and HR indicated the sensitivity of the baroreflex system of the heart. This system could also measure the sensitivity of the baroreflex system of an artery. Changes in the PWV in response to the blood pressure changes were observed. Significant correlation was observed in the time sequence between blood pressure change and PWV change after calculating the delay time by cross-correlation. The slope of these parameter changes was easily obtained and it demonstrated the sensitivity of the baroreflex system of an artery. We evaluated this method in animal experiments using rotary blood pump (RBP) with undulation pump ventricular assist device, and PTT elongation was observed in response to increased blood pressure with RBP assistance. Furthermore, when tested clinically, decreased sensitivity of the baroreflex system in hypertensive patients was observed. This system may be useful when we consider the ideal treatment and follow-up of patients with hypertension. [source]

Relationship of carotid intima-media thickness, pulse wave velocity, and ankle brachial index to the severity of coronary artery atherosclerosis

CLINICAL CARDIOLOGY, Issue 11 2004
Yoshihiro Matsushima M.D.
Abstract Background: Carotid intima-media thickness (IMT), pulse wave velocity (PWV), and the ankle brachial index (ABI) are widely used noninvasive modalities for evaluating atherosclerosis. Hypothesis: The aim of this study was to determine the relationship of carotid IMT, PWV, and ABI with the severity of coronary artery disease (CAD), expressed as the Gensini score, and the presence of coronary risk factors. Methods: We examined 205 consecutive patients (mean age 65 ± 12 years) who were clinically suspected of having CAD and were scheduled to undergo coronary angiography. Carotid intima-media thickness, brachial-ankle PWV (baPWV), and ABI were measured in all subjects before they underwent coronary angiography. Results: Of the 205 patients, 124 patients were diagnosed as having CAD based on the presence of > 50% stenosis in a major coronary artery; the remaining 81 patients did not have CAD. A relatively good correlation was obtained between carotid IMT and the Gensini score (R = 0.411, p < 0.0001), whereas baPWV correlated only weakly with the Gensini score (R = 0.203, p = 0.0035), and ABI did not correlate with it. A multiple regression analysis revealed that the Gensini score correlated significantly and independently with age, male gender, and carotid IMT. Conclusions: Of the three noninvasive methods, carotid IMT may be more useful for determining coronary artery atherosclerosis than baPWV or ABI. [source]

Growth hormone deficiency and vascular risk

CLINICAL ENDOCRINOLOGY, Issue 1 2002
Roland W. McCallum
Summary The importance of growth hormone deficiency (GHD) in adult life has become more apparent over the last decade. As well as a distinct clinical syndrome there is a significant excess risk of cardiovascular disease. Although it is difficult to ascertain what part is played by the original pituitary disorder and the concomitant replacement hormonal therapies, there is clear evidence that GHD is associated with known cardiovascular risk factors such as body shape, lipid profile, insulin resistance, blood pressure, vessel wall morphology and haemostatic factors. Novel means of assessing vascular risk such as pulse wave velocity and flow-mediated dilatation can also estimate the risk without invasive procedures. The role of possible mediators of endothelial function such as nitric oxide and free radicals is being investigated further. Replacement of GH in GH-deficient patients leads to many effects on the above indices, some but not all of which are associated with reduced vascular risk. Long-term follow-up studies of morbidity and mortality are required for an accurate assessment of the beneficial effects of therapy. [source]

Obese children show increased intimal wall thickness and decreased pulse wave velocity

CLINICAL PHYSIOLOGY AND FUNCTIONAL IMAGING, Issue 5 2008
Frida Dangardt
Summary Objective:, Childhood obesity confers an increased risk of vascular changes and adult cardiovascular disease. Using a high-resolution ultrasound technique that enables separation of intimal and medial layers, we examined the intimal thickness (IT) and intimal,medial thickness (IMT) of radial (RA) and dorsal pedal (DPA) arteries and the pulse wave velocity (PWV) in overweight/obese children and adolescents and in healthy subjects. Methods and results:, IT and IMT of RA and DPA and PWV were measured in 33 obese children and adolescents (13·9 ± 1·6 years) and in 18 matched lean controls (14·3 ± 2·2). Increased RA IT was found in the obese group, whereas no differences in RA IMT or medial thickness were observed. Obese females accounted for the entire difference in RA IT (P = 0·04). DPA IT was inversely correlated with HDL cholesterol in the obese group (,0·56, P = 0·0089). PWV was lower in the obese group than in the lean group (6·2 ± 0·8 versus 7·0 ± 0·9 m s,1, respectively; P = 0·001). Conclusions:, Obese children and adolescents, primarily females, present with increased RA IT. The decreased PWV in the obese versus lean subjects might reflect general vasodilatation. [source]