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Measurement of carotid-femoral pulse wave velocity (PWV). Carotid and femoral pulse waves were obtained with pressure sensitive transducers attached over the carotid and femoral arteries. The pulse transit time (Δt) is the time interval between the onset of the carotid and femoral pulse wave upstroke (foot-to-foot method). The pulse wave travel distance (D), between the carotid and femoral pulse wave recording point, is measured over the body surface with a tape measure.
Source publication
A significant association between increased arterial stiffness and the development of cardiovascular disease has led to the increased use of arterial stiffness in the clinical assessment of cardiovascular risk. Various methods are currently available. With advances in technology, the assessment methods have become easy to use and more acceptable to...
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... RAD was determined by acquiring waveforms at the right and left renal arteries. Three measurements were acquired from each kidney, and the mean values for right and left kidneys were recorded for further analysis [24]. ...
Background
Subclinical hyperthyroidism (SCH) is found to be associated with renal dysfunction. Hyperthyroidism is a well-known cause of secondary systolic hypertension. However, the effect of SCH on the kidney and its vasculature is still unknown.
Aim
To assess the presence of renal function changes and renal vasodysfunction in SCH patients and their relation to hypertension.
Methods
The study included 321 patients with SCH and 80 healthy matched controls. Laboratory investigations included thyroid function tests, anti-TSH receptor antibody (TRAb), creatinine, estimated glomerular filtration rate (eGFR), serum osmolarity (S. Osmol), urine osmolarity (U. Osmol), Fractional Excretion of Sodium (FeNa), Fractional Excretion of Potassium (FeK), copeptin (CPP), and aldosterone/renin ratio (ARR). Ultrasound for the thyroid gland, echocardiography, total peripheral resistance (TPR), flow-mediated dilatation (FMD), and Renal Arterial distensibility (RAD) was also done.
Results
Serum creatinine was significantly lower while eGFR was significantly higher in SCH patients compared to euthyroid subjects (mean 0.59 ± 0.11 mg/dl Vs mean 0.8 ± 0.1 mg/dl, p = 0.001 and mean 128.28 ± 14.69 ml/min/1.73m2 Vs mean 100.49 ± 14.9 ml/min/1.73m2, p = 0.013, respectively). The TPR and FMD showed a significant decrease in SCH group compared to controls (mean 975.85 ± 159.33 mmHg.min/L Vs mean 1120.24 ± 135.15 mmHg.min/L, p = 0.045 and mean 7.03 ± 4.02% Vs mean 13.48 ± 4.57%, p = 0.003, respectively). RAD was significantly higher in hypertensive SCH patients compared to normotensive SCH patients (mean 17.82 ± 2.46 mmHg Vs mean 11.98 ± 3.21 mmHg, p = 0.001).
Conclusion
SCH patients showed vascular resistance reduction. Alterations in thyroid hormones and blood pressure could be the driving mechanisms for the change in renal functions in patients with SCH.
... Similar to this, a 3D model of the arterial wall was created using a uniform wall thickness of 0.7 mm to mimic the elastic artery. [44][45][46]. Figure 2 shows the steps involved in generating a meshed carotid artery model used in this study. Both models were meshed using ten nodes tetrahedral elements for both fluid and solid models. ...
Atherosclerosis is a localized complication dependent on both the rheology and the arterial response to blood pressure. Fluid–structure interaction (FSI) study can be effectively used to understand the local haemodynamics and study the development and progression of atherosclerosis. Although numerical investigations of atherosclerosis are well documented, research on the influence of blood pressure as a result of the response to physio–social factors like anxiety, mental stress, and exercise is scarce. In this work, a three-dimensional (3D) Fluid–Structure Interaction (FSI) study was carried out for normal and stenosed patient-specific carotid artery models. Haemodynamic parameters such as Wall Shear Stress (WSS) and Oscillatory Shear Index (OSI) are evaluated for normal and hypertension conditions. The Carreau–Yasuda blood viscosity model was used in the FSI simulations, and the results are compared with the Newtonian model. The results reveal that high blood pressure increases the peripheral resistance, thereby reducing the WSS. Higher OSI occurs in the region with high flow recirculation. Variation of WSS due to changes in blood pressure and blood viscosity is important in understanding the haemodynamics of carotid arteries. This study demonstrates the potential of FSI to understand the causes of atherosclerosis due to altered blood pressures.
... Although it is not a new method, it has adequacy of accessible opportunity, non-invasive feature, and does not require high-technical equipment. As a result, this procedure is easily performed in the clinical setting to analyze the arterial stiffness index 3 . ...
Arterial stiffness is an independent prognostic factor for predicting adverse cardiovascular outcomes in hypertensive patients. This study aimed to investigate the rate of increase in arterial stiffness index and the relationship between the ambulatory arterial stiffness index (AASI) with some cardiovascular risks and the change of AASI after 3 months of treatment with perindopril/indapamide (PER/IND). We conducted this research on 75 untreated hypertensive patients at Can Tho University of medicine and pharmacy, Viet Nam. AASI and pulse pressure (PP) were calculated from 24-hour ambulatory blood pressure results. Our study showed that the mean AASI is 0.44±0.14. Female’s increased AASI is capable of 4.38 times as much as the male. Left ventricular hypertrophy (LVH) can increase arterial stiffness index about 3.93 times as much as the non-hypertrophy group (p<0.05). AASI is positively correlated with mean pulse pressure and age with r=0.37 and r=0.3 (p<0.05). After 3 months of treatment, results analysis of the subgroup revealed that AASI decreased 0.06±0.15 in women (p<0.05). AASI reduced significantly in the group of people aged 65 or more with a mean change to 0.11±0.12 (p<0.05). Moreover, the group of patients with grade 2 hypertension also indicated that AASI reduced 0.05±0.14 in post- treatment. In conclusion, AASI has been associated with several cardiovascular risk factors such as female, age, nocturnal non-dipper blood pressure, left ventricular hypertrophy, and increased mean pulse pressure. PER/IND has effectively reduced arterial stiffness in Vietnamese patients with primary hypertension, especially women, the elderly, and grade 2 hypertension.
... It happens as a result of the mechanical wear of the arterial wall, in which connective tissue changes. Increased AS represented by pulse wave velocity (PWV) is usually associated with cardiovascular disease (CVD) and might result in death [3,4]. At the same time, it appears to be a precursor of hypertension [5], with aging having a greater effect on central, rather than peripheral, arterial hemodynamics [6,7]. ...
Resistance training (RT) and exercise is useful for preventing cardiovascular disease, systolic hypertension and stroke, which are associated with the stiffening of the larger central arterial system. The aim of this systematic review was to (a) understand the changes in arterial stiffness (AS) in various parts of the body measurement after acute RT bout and long-term RT, and (b) to determine the impact of exercise intensity on these changes in healthy individuals. A systematic computerized search was performed according to the PRISMA in PubMed, Scopus and Google Scholar with final selection of 23 studies. An acute RT bout led to a temporary increase in pulse wave velocity (PWV) regardless of the measurement method or intensity. A long-term RT at above an 80% repetition maximum (RM) have an ambiguous effect on PWV. A low-intensity RT or whole-body vibration training program decreased carotid–femoral PWV and brachial–ankle PWV (d = 1.02) to between 0.7 ± 1.4 ms−1 (p < 0.05) and 1.3 ± 1.07 ms−1 (p < 0.05) and improved other cardiac functions. A long-term RT of moderate (60–80% 1RM) or low intensity (<60% one-repetition maximum (1RM)) can decrease AS. Low and moderate intensity RT is beneficial to reduce high AS to prevent cardiovascular diseases.
... mm range. The thickness of the arterial wall in this study was believed to be 0.7 mm [36][37][38]. The arterial model is generated using the fluid model with Materialise 3 Matic software, by offsetting the fluid domain by 0.7 mm to represent the arterial thickness. ...
Atherosclerosis is one of the most common cardiovascular diseases leading to high morbidity. The study of arterial dynamics using fluid–structure interaction (FSI) technique by taking into account the physiology of flow, the critical hemodynamic parameters can be determined which plays a crucial role in predictive medicine. Due to advances in the computational facilities, coupled field analysis such as FSI can facilitate understanding of the mechanics of stenosis progression and its early diagnosis. In this study a two-way FSI analysis is carried out using modified Navier–Stokes equations as the governing equations of blood flow for determining hemodynamic parameters. The arterial wall has been described at different linear elastic modulus and compared with hyperelastic Mooney–Rivlin model to evaluate the effect of different arterial stiffness on hemodynamics. The Mooney–Rivlin model predicts flow reduction with the severe backflow at arterial bifurcation resulting in decreased shear stress and oscillatory behavior. Furthermore, these findings may be used in understanding the advantages and disadvantages of using hyperelastic artery model in numerical simulations to better understand and predict the variable that causes cardiovascular diseases and as a diagnostic tool. In the present study, variation due to change in arterial wall properties such as linear elastic and Mooney Rivlin hyperelastic and its influence on hemodynamics are investigated.
... A medida que estas ondas retornan a la aorta central aumenta la presión diastólica y el flujo sanguíneo coronario. 4 La rigidez arterial es una manifestación temprana de los cambios estructurales y funcionales dentro de la pared del vaso sanguíneo. Estos cambios estructurales degenerativos llamados arterioesclerosis deben diferenciarse de la ateroesclerosis, la cual se refiere a la oclusión del vaso resultante de la enfermedad inflamatoria endovascular, oxidación lipídica y formación de placas. ...
Introducción:
La enfermedad cardiovascular es la principal causa de muerte en el mundo. El sistema arterial sufre cambios estructurales de forma acelerada consecuencia de la hipertensión arterial. La determinación de la presión arterial central a través de las ondas radiales de la presión tiene un importante valor predictivo de complicaciones cardiovasculares.
Material y métodos:
Estudio piloto, prospectivo, descriptivo, longitudinal para evaluar la rigidez arterial por tonometría por aplanamiento radial y la comparación entre los diferentes antihipertensivos.
Resultados:
De los 52 pacientes evaluados, se observó una disminución de la rigidez arterial en los pacientes en quienes se inició tratamiento antihipertensivo con calcioantagonistas de novo de 94.75 ± 24.82% en la medición inicial a 78.38 ± 25.64% en la medición final (p = 0.01).
Conclusiones:
Existe evidencia de la disminución de la rigidez arterial en pacientes en quienes se inicia de novo tratamiento antihipertensivo con calcioantagonistas. Sin embargo, en necesario la realización de estudios posteriores para evaluar el mantenimiento del mismo y el impacto en la disminución del riesgo cardiovascular.
... where Ps and Pd are systolic and diastolic pressures (in mmHg), and Ds and Dd are systolic and diastolic carotid diameters. 20 Ep (kPa), the pressure-strain elasticity modulus, is similar to Young's elastic modulus, regarded as a measure of intrinsic rigidity/stiffness of the arterial wall and inversely related to arterial elasticity 20,21 : ...
... AI, the augmentation index (%), is a simple method commonly used to measure the effects of wave reflection and an indirect index of aortic elasticity 21 : where ΔP is the pressure difference between peak systolic pressure and an early inflection point that indicates the beginning upstroke of the reflected pressure wave, and PP is pulse pressure. 20 Beside these indices we examined the carotid arteries for plaque deposits and wall calcinations with the same ultrasound. ...
Background
The risk for cerebrovascular late effects among childhood cancer survivors is considerable. According to recent studies it is not clear which marker could be reliable for the screening of cerebrovascular diseases among the long-term survivors of childhood cancer. The purpose of this study is to analyse arterial stiffness and intima-media thickness as possible early markers of later occurring stroke in long-term survivors of childhood cancer after neck radiotherapy.
Patients and methods
Twenty-three patients, treated for Hodgkin disease (HD) in childhood, were included. They had received radiation therapy to the neck with 20–65 (median 30) Gy. Twenty-six healthy controls, matched in age, sex, body mass index, arterial hypertension, smoking history and total cholesterol levels were compared. Highresolution colour-coded duplex sonography and power Doppler sonography of the carotid arteries were performed and intima-media thickness, number and quality of plaques were measured. Arterial stiffness indices were calculated.
Results
Plaque deposits and/or arterial wall calcinations were found in 24 out of 43 (55.8%) irradiated vessels in cancer survivors group and 0 out of 52 vessels in the group of healthy controls (p < 0.01). We found significant group differences for all the stiffness parameters we used (P < 0.05), but there was no difference in intima-media thickness between cases and controls (p = 0.92). In a multivariate model, carotid pulse wave velocity was positively associated with smoking.
Conclusions
The arterial stiffness has appeared as a possible surrogate marker for stroke in long-term survivors of childhood cancer. Smoking habit might have an additional negative influence on vascular aging in the group of patients after neck radiotherapy.
... where Ps and Pd are systolic and diastolic pressures (in mmHg), and Ds and Dd are systolic and diastolic carotid diameters. 20 Ep (kPa), the pressure-strain elasticity modulus, is similar to Young's elastic modulus, regarded as a measure of intrinsic rigidity/stiffness of the arterial wall and inversely related to arterial elasticity 20,21 : ...
... AI, the augmentation index (%), is a simple method commonly used to measure the effects of wave reflection and an indirect index of aortic elasticity 21 : where ΔP is the pressure difference between peak systolic pressure and an early inflection point that indicates the beginning upstroke of the reflected pressure wave, and PP is pulse pressure. 20 Beside these indices we examined the carotid arteries for plaque deposits and wall calcinations with the same ultrasound. ...
Background
The risk for cerebrovascular late effects among childhood cancer survivors is considerable. According to recent studies it is not clear which marker could be reliable for the screening of cerebrovascular diseases among the long-term survivors of childhood cancer. The purpose of this study is to analyse arterial stiffness and intima-media thickness as possible early markers of later occurring stroke in long-term survivors of childhood cancer after neck radiotherapy.
Patients and methods
Twenty-three patients, treated for Hodgkin disease (HD) in childhood, were included. They had received radiation therapy to the neck with 20–65 (median 30) Gy. Twenty-six healthy controls, matched in age, sex, body mass index, arterial hypertension, smoking history and total cholesterol levels were compared. Highresolution colour-coded duplex sonography and power Doppler sonography of the carotid arteries were performed and intima-media thickness, number and quality of plaques were measured. Arterial stiffness indices were calculated.
Results
Plaque deposits and/or arterial wall calcinations were found in 24 out of 43 (55.8%) irradiated vessels in cancer survivors group and 0 out of 52 vessels in the group of healthy controls (p < 0.01). We found significant group differences for all the stiffness parameters we used (P < 0.05), but there was no difference in intima-media thickness between cases and controls (p = 0.92). In a multivariate model, carotid pulse wave velocity was positively associated with smoking.
Conclusions
The arterial stiffness has appeared as a possible surrogate marker for stroke in long-term survivors of childhood cancer. Smoking habit might have an additional negative influence on vascular aging in the group of patients after neck radiotherapy.
... Arterial stiffness is also an useful tool to predict cardiovascular outcome and to evaluate subclinical organ damage in hypertensive patients [26]. Assessment of arterial stiffness can be accomplished by measuring the PWV or augmentation index from noninvasive monitoring of pulse waveforms [27]. Increased arterial stiffness results in increased systolic blood pressure and is independently associated with an increased risk of cardiovascular disease [28]. ...
Background:
Hypertension is a risk factor for coronary heart disease and stroke, and is one of the leading causes of death. Although over a billion people are affected worldwide, only half of them receive adequate treatment. Current guidelines on antihypertensive treatment recommend combination therapy for patients not responding to monotherapy, but as the number of pills increase, patient compliance tends to decrease. As a result, fixed-dose combination drugs with different antihypertensive agents have been developed and widely used in recent years. CCBs have been shown to be better at reducing central blood pressure and arterial stiffness than diuretics. Recent studies have reported that central blood pressure and arterial stiffness are associated with cardiovascular outcomes. This trial aims to compare the efficacy of combination of calcium channel blocker (CCB) or thiazide diuretic with an angiotensin receptor blocker (ARB).
Methods:
This is a multicenter, double-blinded, active-controlled, phase 4, randomized trial, comparing the antihypertensive effects of losartan/amlodipine and losartan/hydrochlorothiazide in patients unresponsive to treatment with losartan. The primary endpoint is changes in mean sitting systolic blood pressure (msSBP) after 4 weeks of treatment. Secondary endpoints are changes in msSBP, mean 24-h ambulatory mobile blood pressure, mean 24-h ambulatory mobile central SBP, mean 24-h ambulatory carotid-femoral pulse wave velocity, ambulatory augmentation index, and microalbuminuria/proteinuria after 20 weeks of treatment. The sample size will be 119 patients for each group in order to confer enough power to test for non-inferiority regarding the primary outcome.
Conclusion:
The investigators aim to prove that combination of a CCB with ARB shows non-inferiority in lowering blood pressure compared with a combination of thiazide diuretic and ARB. We also hope to distinguish the subset of patients that are more responsive to certain types of combination drugs. The results of this study should aid physicians in selecting appropriate combination regimens to treat hypertension in certain populations.
Trial registration:
ClinicalTrials.gov NCT02294539. Registered 12 November 2014.
... Measurements were obtained by positioning two pressure-sensitive transducers (Fukuda, Tokyo, Japan) on to the skin prominent parts of the carotid and femoral arteries to calculate time delay between the two transducers. The distance traveled by the pulse wave was measured over the body surface as the distance between the two recording sites (D), while pulse transit time (t) was measured between the feet of the pressure waveforms recorded at these different points (foot-to-foot method) and was automatically calculated by the device [31]. Measurements were repeated over 10 different cardiac cycles, and the mean was used for the final analysis. ...
Abstract Background Metabolic syndrome (MetS) is associated with structural and functional vascular abnormalities, which may lead to increased arterial stiffness, more frequent cardiovascular events and higher mortality. However, the role played by clustering of risk factors and the combining pattern of MetS risk factors and their association with the arterial stiffness have yet to be fully understood. Age, hypertension and diabetes mellitus seem to be strongly associated with increased pulse wave velocity (PWV). This study aimed at determining the clustering and combining pattern of MetS risk factors and their association with the arterial stiffness in non-diabetic and non-hypertensive patients. Methods Recently diagnosed and untreated patients with MetS (n = 64, 49 ± 8 year, 32 ± 4 kg/m2) were selected, according to ATP III criteria and compared to a control group (Control, n = 17, 49 ± 6 year, 27 ± 2 kg/m2). Arterial stiffness was evaluated by PWV in the carotid-femoral segment. Patients were categorized and analyzed according MetS risk factors clustering (3, 4 and 5 factors) and its combinations. Results Patients with MetS had increased PWV when compared to Control (7.8 ± 1.1 vs. 7.0 ± 0.5 m/s, p
