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Ochiai R, Terada T, Sakamoto N. Comparative evaluation of stroke volume variation measured by pulse wave transit time and arterial pressure wave. Technol Health Care 2024; 32:651-662. [PMID: 37483029 PMCID: PMC10977375 DOI: 10.3233/thc-220849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2022] [Accepted: 05/15/2023] [Indexed: 07/25/2023]
Abstract
BACKGROUND Several monitors have been developed that measure stroke volume (SV) in a beat-to-beat manner. Accordingly, Stroke volume variation (SVV) induced by positive pressure ventilation is widely used to predict fluid responsiveness. OBJECTIVE The purpose of this study was to compare the ability of two different methods to predict fluid responsiveness using SVV, stroke volume variation by esCCO (esSVV) and stroke volume variation by FloTrac/VigileoTM (flSVV). METHODS esSVV, flSVV, and stroke volume index (SVI) by both monitoring devices of 37 adult patients who underwent laparotomy surgery, were measured. Receiver operating characteristic (ROC) analysis was performed. RESULTS The area under the ROC curve (AUC) of esSVV was significantly higher than that of flSVV (p= 0.030). esSVV and flSVV showed cutoff values of 6.1% and 10% respectively, to predict an increase of more than 10% in SVI after fluid challenge. The Youden index for esSVV was higher than flSVV, even with a cutoff value between 6% and 8%. CONCLUSION Since esSVV and flSVV showed significant differences in AUC and cutoff values, the two systems were not comparable in predicting fluid responsiveness. Furthermore, it seems that SVV needs to be personalized to accurately predict fluid responsiveness for each patient.
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Affiliation(s)
| | - Takashi Terada
- Department of Anesthesiology, Japan Community Health Care Organization Mishima General Hospital, Fujikubo, Mishima, Japan
| | - Noriaki Sakamoto
- Department of Anesthesiology, Toho University Omori Medical Centre, Oota, Japan
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Current Evidence of Watermelon ( Citrullus lanatus) Ingestion on Vascular Health: A Food Science and Technology Perspective. Nutrients 2022; 14:nu14142913. [PMID: 35889869 PMCID: PMC9318495 DOI: 10.3390/nu14142913] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Revised: 07/12/2022] [Accepted: 07/13/2022] [Indexed: 01/09/2023] Open
Abstract
The amino acid L-arginine is crucial for nitric oxide (NO) synthesis, an important molecule regulating vascular tone. Considering that vascular dysfunction precedes cardiovascular disease, supplementation with precursors of NO synthesis (e.g., L-arginine) is warranted. However, supplementation of L-citrulline is recommended instead of L-arginine since most L-arginine is catabolized during its course to the endothelium. Given that L-citrulline, found mainly in watermelon, can be converted to L-arginine, watermelon supplementation seems to be effective in increasing plasma L-arginine and improving vascular function. Nonetheless, there are divergent findings when investigating the effect of watermelon supplementation on vascular function, which may be explained by the L-citrulline dose in watermelon products. In some instances, offering a sufficient amount of L-citrulline can be impaired by the greater volume (>700 mL) of watermelon needed to reach a proper dose of L-citrulline. Thus, food technology can be applied to reduce the watermelon volume and make supplementation more convenient. Therefore, this narrative review aims to discuss the current evidence showing the effects of watermelon ingestion on vascular health parameters, exploring the critical relevance of food technology for acceptable L-citrulline content in these products. Watermelon-derived L-citrulline appears as a supplementation that can improve vascular function, including arterial stiffness and blood pressure. Applying food technologies to concentrate bioactive compounds in a reduced volume is warranted so that its ingestion can be more convenient, improving the adherence of those who want to ingest watermelon products daily.
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Kaya M, Balasubramanian V, Li JKJ. Inadequacy of Augmentation Index for Monitoring Arterial Stiffness: Comparison with Arterial Compliance and Other Hemodynamic Variables. Cardiovasc Eng Technol 2022; 13:590-602. [PMID: 35102522 DOI: 10.1007/s13239-021-00605-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Accepted: 12/14/2021] [Indexed: 01/09/2023]
Abstract
PURPOSE Augmentation Index (AIx) is used clinically for monitoring both wave reflections and arterial stiffness, which when increased is a risk factor of cardiovascular mortality and morbidity. We hypothesize that AIx is not solely related to vascular stiffness as described by arterial compliance and other hemodynamic parameters since AIx underestimates wave reflections. METHODS Aortic pressure and flow datasets (n = 42) from mongrel dogs were obtained from our experiments and Mendeley Data under various conditions. Arterial compliances based on the Windkessel model (Ct), the stroke volume (SV) to pulse pressure (PP) ratio (Cv = SV/PP), and at inflection pressure point (CPi) were computed. Other relevant hemodynamic factors are also computed. RESULTS AIx was poorly associated with arterial stiffness calculated from Ct (r = 0.299, p = 0.058) or CPi (r = 0.203, p = 0.203), even when adjusted for heart rates. Ct and Cv were monotonically associated. Alterations in inflection pressure (Pi) did not follow the changes in pulse pressure (PP) (r = 0.475, p = 0.002), and Pi was quantitatively similar to systolic pressure (r = 0.940, p < 0.001). CONCLUSION AIx is neither linearly correlated with arterial stiffness, nor with arterial compliance and several cardiac and arterial parameters have to be considered when AIx is calculated.
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Affiliation(s)
- Mehmet Kaya
- Department of Biomedical and Chemical Engineering and Sciences, Florida Institute of Technology, 150 W University Blvd, Melbourne, FL, 32901, USA.
| | - Vignesh Balasubramanian
- Department of Biomedical and Chemical Engineering and Sciences, Florida Institute of Technology, 150 W University Blvd, Melbourne, FL, 32901, USA
| | - John K-J Li
- Department of Biomedical Engineering and Robert Wood Johnson Medical School, Rutgers University, 599 Taylor Road, Piscataway, NJ, 08854, USA
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Wang Y, Meng T, Ruan G, Zheng S, Zhu J, Cen H, Antony B, Wluka AE, Cicuttini F, Winzenberg T, Pelletier JP, Martel-Pelletier J, Ding C. Associations of blood pressure and arterial stiffness with knee cartilage volume in patients with knee osteoarthritis. Rheumatology (Oxford) 2021; 60:4748-4754. [PMID: 33576770 DOI: 10.1093/rheumatology/keab092] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Accepted: 01/21/2021] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVE To describe the associations of blood pressure and arterial stiffness with knee cartilage volume in patients with knee OA. METHODS A secondary analysis was performed on the data from participants in a randomized controlled trial that identified the effects of vitamin D supplementation on knee structures and symptoms among patients with symptomatic knee OA. Brachial and central blood pressure, arterial stiffness indicators and knee cartilage volume were measured at baseline and the 2 year follow-up. Associations were assessed using generalized estimating equations. RESULTS Among 231 participants (average age 63.2 years), 48.9% were females. Higher supine systolic and diastolic pressures were significantly associated with lower tibial cartilage volume (systolic: lateral β -6.23, medial β -5.14, total β -11.35 mm3/mmHg; diastolic: lateral β -10.25, medial β -11.29, total β -21.50 mm3/mmHg). Higher supine systolic pressure was associated with lower femoral cartilage volume (lateral β -17.35, total β -28.31 mm3/mmHg). Central systolic pressure and arterial stiffness indicators (including pulse wave velocity, central pulse pressure and peripheral pulse pressure) were largely not associated with knee cartilage volume; however, higher augmentation index was associated with lower tibial and femoral cartilage volume (tibial: medial β -8.24, total β -19.13 mm3/%; femoral: lateral β -23.70, medial β -26.42, total β -50.12 mm3/%). CONCLUSIONS Blood pressure and arterial stiffness are associated with knee cartilage volume at several sites in knee OA patients. This supports that blood pressure and arterial stiffness may involve in the progression of knee OA.
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Affiliation(s)
- Yuanyuan Wang
- Department of Health Management, Nanfang Hospital, Southern Medical University, Guangzhou, China.,Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, Australia
| | - Tao Meng
- Department of Rheumatology and Immunology, The Second Hospital of Anhui Medical University, Hefei
| | - Guangfeng Ruan
- Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, Australia.,Clinical Research Centre, Zhujiang Hospital, Southern Medical University, Guangzhou
| | - Shuang Zheng
- Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, Australia
| | - Jimin Zhu
- Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, Australia.,Department of Public Health and General Medicine, School of Life Sciences, Anhui University of Chinese Medicine, Hefei
| | - Han Cen
- Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, Australia.,Department of Preventive Medicine, Medical School, Ningbo University, Ningbo, China
| | - Benny Antony
- Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, Australia
| | - Anita E Wluka
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Flavia Cicuttini
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Tania Winzenberg
- Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, Australia
| | - Jean-Pierre Pelletier
- Osteoarthritis Research Unit, University of Montreal Hospital Research Centre, Montreal, QC, Canada
| | - Johanne Martel-Pelletier
- Osteoarthritis Research Unit, University of Montreal Hospital Research Centre, Montreal, QC, Canada
| | - Changhai Ding
- Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, Australia.,Clinical Research Centre, Zhujiang Hospital, Southern Medical University, Guangzhou
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Pagoulatou S, Adamopoulos D, Rovas G, Bikia V, Stergiopulos N. The effect of left ventricular contractility on arterial hemodynamics: A model-based investigation. PLoS One 2021; 16:e0255561. [PMID: 34339454 PMCID: PMC8328319 DOI: 10.1371/journal.pone.0255561] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Accepted: 07/19/2021] [Indexed: 11/19/2022] Open
Abstract
Ventricular-arterial coupling is a major determinant of cardiovascular performance, however, there are still inherent difficulties in distinguishing ventricular from vascular effects on arterial pulse phenotypes. In the present study, we employed an extensive mathematical model of the cardiovascular system to investigate how sole changes in cardiac contractility might affect hemodynamics. We simulated two physiologically relevant cases of high and low contractility by altering the end-systolic elastance, Ees, (3 versus 1 mmHg/mL) under constant cardiac output and afterload, and subsequently performed pulse wave analysis and wave separation. The aortic forward pressure wave component was steeper for high Ees, which led to the change of the total pressure waveform from the characteristic Type A phenotype to Type C, and the decrease in augmentation index, AIx (-2.4% versus +18.1%). Additionally, the increase in Ees caused the pulse pressure amplification from the aorta to the radial artery to rise drastically (1.86 versus 1.39). Our results show that an increase in cardiac contractility alone, with no concomitant change in arterial properties, alters the shape of the forward pressure wave, which, consequently, changes central and peripheral pulse phenotypes. Indices based on the pressure waveform, like AIx, cannot be assumed to reflect only arterial properties.
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Affiliation(s)
- Stamatia Pagoulatou
- Laboratory of Hemodynamics and Cardiovascular Technology (LHTC), Institute of Bioengineering, Ecole Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland
- * E-mail:
| | | | - Georgios Rovas
- Laboratory of Hemodynamics and Cardiovascular Technology (LHTC), Institute of Bioengineering, Ecole Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland
| | - Vasiliki Bikia
- Laboratory of Hemodynamics and Cardiovascular Technology (LHTC), Institute of Bioengineering, Ecole Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland
| | - Nikolaos Stergiopulos
- Laboratory of Hemodynamics and Cardiovascular Technology (LHTC), Institute of Bioengineering, Ecole Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland
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Pekas EJ, Wooden TK, Yadav SK, Park SY. Body mass-normalized moderate dose of dietary nitrate intake improves endothelial function and walking capacity in patients with peripheral artery disease. Am J Physiol Regul Integr Comp Physiol 2021; 321:R162-R173. [PMID: 34161745 DOI: 10.1152/ajpregu.00121.2021] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Peripheral artery disease (PAD) is characterized by the accumulation of atherosclerotic plaques in the lower extremity conduit arteries, which impairs blood flow and walking capacity. Dietary nitrate has been used to reduce blood pressure (BP) and improve walking capacity in PAD. However, a standardized dose for PAD has not been determined. Therefore, we sought to determine the effects of a body mass-normalized moderate dose of nitrate (0.11 mmol nitrate/kg) as beetroot juice on serum nitrate/nitrite, vascular function, walking capacity, and tissue oxygen utilization capacity in patients with PAD. A total of 11 patients with PAD received either nitrate supplement or placebo in a randomized crossover design. Total serum nitrate/nitrite, resting BP, brachial and popliteal artery endothelial function (flow-mediated dilation, FMD), arterial stiffness (pulse-wave velocity, PWV), augmentation index (AIx), maximal walking distance and time, claudication onset time, and skeletal muscle oxygen utilization were measured pre- and postnitrate and placebo intake. There were significant group × time interactions (P < 0.05) for serum nitrate/nitrite, FMD, BP, walking distance and time, and skeletal muscle oxygen utilization. The nitrate group showed significantly increased serum nitrate/nitrite (Δ1.32 μM), increased brachial and popliteal FMD (Δ1.3% and Δ1.7%, respectively), reduced peripheral and central systolic BP (Δ-4.7 mmHg and Δ-8.2 mmHg, respectively), increased maximal walking distance (Δ92.7 m) and time (Δ56.3 s), and reduced deoxygenated hemoglobin during walking. There were no changes in PWV, AIx, or claudication (P > 0.05). These results indicate that a body-mass normalized moderate dose of nitrate may be effective and safe for reducing BP, improving endothelial function, and improving walking capacity in patients with PAD.
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Affiliation(s)
- Elizabeth J Pekas
- School of Health & Kinesiology, University of Nebraska at Omaha, Omaha, Nebraska
| | - TeSean K Wooden
- School of Health & Kinesiology, University of Nebraska at Omaha, Omaha, Nebraska
| | - Santosh K Yadav
- Department of Biochemistry and Molecular Biology, University of Nebraska Medical Center, Omaha, Nebraska
| | - Song-Young Park
- School of Health & Kinesiology, University of Nebraska at Omaha, Omaha, Nebraska
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Headid RJ, Pekas EJ, Wooden TK, Son WM, Layec G, Shin J, Park SY. Impacts of prolonged sitting with mild hypercapnia on vascular and autonomic function in healthy recreationally active adults. Am J Physiol Heart Circ Physiol 2020; 319:H468-H480. [PMID: 32648821 DOI: 10.1152/ajpheart.00354.2020] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Prolonged sitting, which is known to impair peripheral vascular function, often occurs in spaces (e.g., offices) with mild hypercapnic atmospheres. However, the effects of prolonged sitting in hypercapnic conditions on vascular function are unknown. Therefore, the purpose of this study was to investigate the effects of prolonged sitting in mild hypercapnic conditions on vascular and autonomic function in humans. Twelve healthy young adults participated in two experimental visits that consisted of sitting for 2.5 h in a control condition [normal atmospheric conditions sitting (PSIT)] or a mild hypercapnic condition (HCAP; CO2 = 1,500 ppm). During each visit, heart rate variability (HRV), blood pressure (BP), pulse wave velocity (PWV), augmentation index (AIx), brachial and popliteal artery flow-mediated dilation (FMD), and near-infrared spectroscopy (NIRS) were assessed before and after prolonged sitting. Sitting significantly decreased AIx in both groups (P < 0.05). Brachial and popliteal FMD were reduced with sitting (P < 0.05), and the reduction in popliteal FMD was amplified by HCAP (P < 0.05). Baseline microvascular oxygenation was decreased following sitting in both groups (P < 0.05). However, microvascular reoxygenation upon cuff release was slower only in HCAP (P < 0.05). HRV, HR, BP, and PWV did not significantly change with sitting in either group (P > 0.05). We conclude that prolonged sitting attenuated both brachial and popliteal endothelial function and was associated with perturbed microcirculation. Additionally, mild hypercapnic conditions further impaired peripheral endothelial and microvascular function. Together, these findings suggest that prolonged sitting is accompanied by a host of deleterious effects on the vasculature, which are exacerbated by mild hypercapnia.NEW & NOTEWORTHY The results of this study reveal that prolonged sitting attenuates endothelial function and microvascular function. Additionally, prolonged sitting with mild hypercapnia, which is similar to everyday environments, further exacerbates peripheral endothelial function and microvascular function.
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Affiliation(s)
- Ronald J Headid
- School of Health and Kinesiology, University of Nebraska at Omaha, Omaha, Nebraska
| | - Elizabeth J Pekas
- School of Health and Kinesiology, University of Nebraska at Omaha, Omaha, Nebraska
| | - TeSean K Wooden
- School of Health and Kinesiology, University of Nebraska at Omaha, Omaha, Nebraska
| | - Won-Mok Son
- School of Health and Kinesiology, University of Nebraska at Omaha, Omaha, Nebraska
| | - Gwenael Layec
- Department of Kinesiology, University of Massachusetts, Amherst, Massachusetts.,Institute for Applied Life Sciences, University of Massachusetts, Amherst, Massachusetts
| | - John Shin
- Wiess School of Natural Sciences, Rice University, Houston, Texas
| | - Song-Young Park
- School of Health and Kinesiology, University of Nebraska at Omaha, Omaha, Nebraska
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