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Campitelli R, Ferrario M, Su F, Creteur J, Herpain A, Carrara M. Pulse wave analysis as a tool for the evaluation of resuscitation therapy in septic shock. Physiol Meas 2023; 44:105002. [PMID: 37738987 DOI: 10.1088/1361-6579/acfc94] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Accepted: 09/22/2023] [Indexed: 09/24/2023]
Abstract
Objective. Pulse wave analysis (PWA) can provide insights into cardiovascular biomechanical properties. The use of PWA in critically ill patients, such as septic shock patients, is still limited, but it can provide complementary information on the cardiovascular effects of treatment when compared to standard indices outlined in international guidelines. Previous works have highlighted how sepsis induces severe cardiovascular derangement with altered arterial blood pressure waveform morphology and how resuscitation according to standard haemodynamic targets is not able to restore the physiological functioning of the cardiovascular system. The aim of this work is to test the effectiveness of PWA in characterizing arterial waveforms obtained from a swine experiment involving polymicrobial septic shock and resuscitation with different drugs.Methods. During the experiment, morphological aortic waveform features, such as indices related to the dicrotic notch and inflection point, were extracted by means of PWA techniques. Finally, all the PWA indices were used to compute a clustering classification (mini batch K-means) of the pigs according to the different phases of the experiment. This analysis aimed to test if PWA features alone could be used to distinguish between the different responses to the administered therapies.Results. The PWA indices highlighted different cardiovascular conditions of the pigs in response to different treatments, despite the mean haemodynamic values typically used to guide therapy administration being similar in all animals. The clustering algorithm was able to distinguish between the different phases of the experiment and the different responses of the animals based on the unique information derived from the aortic PWA.Conclusion. Even when used alone, PWA indices were highly informative when assessing therapy responses in cases of septic shock.Significance. A complex pathological condition like septic shock requires extensive monitoring without neglecting important information from commonly measured signals such as arterial blood pressure. Future studies are needed to understand how individual differences in the response to therapy are associated with different cardiovascular conditions that may become specific therapy targets.
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Affiliation(s)
- Riccardo Campitelli
- Department of Electronics, Information, and Bioengineering, Politecnico di Milano, Milan, Italy
| | - Manuela Ferrario
- Department of Electronics, Information, and Bioengineering, Politecnico di Milano, Milan, Italy
| | - Fuhong Su
- Experimental Laboratory of Intensive Care, Université Libre de Bruxelles, Brussels, Belgium
- Department of Intensive Care, Erasme Hospital, ULB, Brussels, Belgium
| | - Jacques Creteur
- Experimental Laboratory of Intensive Care, Université Libre de Bruxelles, Brussels, Belgium
- Department of Intensive Care, Erasme Hospital, ULB, Brussels, Belgium
| | - Antoine Herpain
- Experimental Laboratory of Intensive Care, Université Libre de Bruxelles, Brussels, Belgium
- Intensive care department, St-Pierre University Hospital, Brussels, Belgium
| | - Marta Carrara
- Department of Electronics, Information, and Bioengineering, Politecnico di Milano, Milan, Italy
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2
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Izzo JL, Mukhopadhyay D, Nagpal S, Osmond P. Impact of arterial location, pressure wave indicators, and measurement devices on arterial form factor and mean and central arterial pressure. J Hum Hypertens 2023; 37:891-897. [PMID: 36494516 DOI: 10.1038/s41371-022-00791-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Revised: 11/21/2022] [Accepted: 11/30/2022] [Indexed: 12/13/2022]
Abstract
Mean arterial pressure (MAP) is often estimated from cuff systolic (S) and diastolic (D) blood pressure (BP) using a fixed arterial form factor (FF, usually 0.33). If MAP is measured directly, a true FF can be calculated: FF = [MAP-DBP]/[SBP-DBP]. Because waveform shapes vary, true FF should also vary and MAP accuracy will be affected. We studied factors affecting FF using radial tonography (SphygmoCor, n = 376) or brachial oscillometry (Mobil-O-Graph, n = 157) and to compare devices, 101 pairs were matched precisely for SBP and DBP. SphygmoCor brachioradial FF correlated strongly with central FF (r2 = 0.75), central augmentation index (cAI, r2 = 0.39), and inversely with pulse pressure amplification (PPA) ratio (r2 = 0.44) [all p < 0.000]; brachioradial FF was lower than central (c) FF (0.34 vs. 0.44, 95% CI's [0.23,0.46] and [0.34,0.54], p < 0.000). On forward stepwise regression, brachioradial FF correlated with PPA ratio, age, heart rate, and cAI (multiple-r2 0.63, p < 0.000). With Mobil-O-Graph: brachial FF was fixed, lower than the corresponding cFF [mean(SD)] 0.46(0.00098) vs. 0.57(0.048), p < 0.000], and uncorrelated with clinical characteristics; MAP and cSBP were higher than SphygmoCor by 6.3 and 2.2 mmHg (p < 0.005) at the midpoint with systematic negative biases. We conclude that FF derived from radial tonometry (SphygmoCor) varies with pulse wave morphology within and between individuals and by measurement site, age, and heart rate. With oscillometry (Mobil-O-Graph), brachial FF was fixed and high and unrelated to other clinical variables; MAP and cSBP were higher than tonometry, with systematic negative biases.
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Affiliation(s)
- Joseph L Izzo
- Department of Medicine, Jacobs School of Medicine, State University of New York at Buffalo, New York, NY, USA.
| | - Debduti Mukhopadhyay
- Department of Medicine, Jacobs School of Medicine, State University of New York at Buffalo, New York, NY, USA
| | - Sagar Nagpal
- Department of Medicine, Jacobs School of Medicine, State University of New York at Buffalo, New York, NY, USA
| | - Peter Osmond
- Department of Medicine, Jacobs School of Medicine, State University of New York at Buffalo, New York, NY, USA
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Ko T, Chuang C, Lin M, Chen Y, Chen Y, Huang C, Yeh C, Wang M, Chang K, Ho Y, Kao H. Quantification of cardiac pumping mechanics in TAVI patients: A pilot study utilizing minimally invasive method for pressure-volume analysis. Physiol Rep 2023; 11:e15799. [PMID: 37688417 PMCID: PMC10492004 DOI: 10.14814/phy2.15799] [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: 01/27/2023] [Revised: 08/03/2023] [Accepted: 08/04/2023] [Indexed: 09/10/2023] Open
Abstract
The ventriculo-arterial coupling (VAC) and left ventricle (LV) mechanics are crucial and play an important role in the pathophysiology of aortic stenosis (AS). The pressure-volume (PV) analysis is a powerful tool to study VAC and LV mechanics. We proposed a novel minimally-invasive method for PV analysis in patients with severe AS receiving transcatheter aortic valve implantation (TAVI). Patients with severe AS were prospectively enrolled in a single center. LV pressure and cardiac output were recorded before and after TAVI. We constructed the PV loop for analysis by analyzing LV pressure and the assumed flow. 26 patients were included for final analysis. The effective arterial elastance (Ea) decreased after TAVI (3.7 ± 1.3 vs. 2.9 ± 1.1 mmHg/mL, p < 0.0001). The LV end-systolic elastance (Ees) did not change immediately after TAVI (2.4 ± 1.3 vs. 2.6 ± 1.1 mmHg/mL, p = 0.3670). The Ea/Ees improved after TAVI (1.8 ± 0.8 vs. 1.2 ± 0.4, p < 0.0001), demonstrating an immediate improvement of VAC. The stroke work (SW) did not change (7669.6 ± 1913.8 vs. 7626.2 ± 2546.9, p = 0.9330), but the pressure-volume area (PVA) decreased (14469.0 ± 4974.1 vs. 12177.4 ± 4499.9, p = 0.0374) after TAVI. The SW/PVA increased after TAVI (0.55 ± 0.12 vs. 0.63 ± 0.08, p < 0.0001) representing an improvement of LV efficiency. We proposed a novel minimally invasive method for PV analysis in patients with severe AS receiving TAVI. The VAC and LV efficiency improved immediately after TAVI.
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Affiliation(s)
- Tsung‐Yu Ko
- Division of Cardiology, Department of Internal Medicine and Cardiovascular CenterNational Taiwan University HospitalTaipeiTaiwan
- Graduate Institute of Clinical MedicineNational Taiwan UniversityTaipeiTaiwan
| | - Chia‐Chuan Chuang
- Division of Cardiology, Department of Internal Medicine and Cardiovascular CenterNational Taiwan University HospitalTaipeiTaiwan
| | - Mao‐Shin Lin
- Division of Cardiology, Department of Internal Medicine and Cardiovascular CenterNational Taiwan University HospitalTaipeiTaiwan
| | - Yi‐Chang Chen
- Department of RadiologyNational Taiwan University HospitalTaipeiTaiwan
| | - Ying‐Hsien Chen
- Division of Cardiology, Department of Internal Medicine and Cardiovascular CenterNational Taiwan University HospitalTaipeiTaiwan
| | - Ching‐Chang Huang
- Division of Cardiology, Department of Internal Medicine and Cardiovascular CenterNational Taiwan University HospitalTaipeiTaiwan
| | - Chih‐Fan Yeh
- Division of Cardiology, Department of Internal Medicine and Cardiovascular CenterNational Taiwan University HospitalTaipeiTaiwan
| | - Ming‐Jiuh Wang
- Department of AnesthesiologyNational Taiwan University HospitalTaipeiTaiwan
| | - Kuo‐Chu Chang
- Department of Physiology, College of MedicineNational Taiwan UniversityTaipeiTaiwan
| | - Yi‐Lwun Ho
- Division of Cardiology, Department of Internal Medicine and Cardiovascular CenterNational Taiwan University HospitalTaipeiTaiwan
| | - Hsien‐Li Kao
- Division of Cardiology, Department of Internal Medicine and Cardiovascular CenterNational Taiwan University HospitalTaipeiTaiwan
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Li A, Yan J, Zhao Y, Yu Z, Tian S, Khan AH, Zhu Y, Wu A, Zhang C, Tian XL. Vascular Aging: Assessment and Intervention. Clin Interv Aging 2023; 18:1373-1395. [PMID: 37609042 PMCID: PMC10441648 DOI: 10.2147/cia.s423373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Accepted: 08/06/2023] [Indexed: 08/24/2023] Open
Abstract
Vascular aging represents a collection of structural and functional changes in a blood vessel with advancing age, including increased stiffness, vascular wall remodeling, loss of angiogenic ability, and endothelium-dependent vasodilation dysfunction. These age-related alterations may occur earlier in those who are at risk for or have cardiovascular diseases, therefore, are defined as early or premature vascular aging. Vascular aging contributes independently to cardio-cerebral vascular diseases (CCVDs). Thus, early diagnosis and interventions targeting vascular aging are of paramount importance in the delay or prevention of CCVDs. Here, we review the direct assessment of vascular aging by examining parameters that reflect changes in structure, function, or their compliance with age including arterial wall thickness and lumen diameter, endothelium-dependent vasodilation, arterial stiffness as well as indirect assessment through pathological studies of biomarkers including endothelial progenitor cell, lymphocytic telomeres, advanced glycation end-products, and C-reactive protein. Further, we evaluate how different types of interventions including lifestyle mediation, such as caloric restriction and salt intake, and treatments for hypertension, diabetes, and hyperlipidemia affect age-related vascular changes. As a single parameter or intervention targets only a certain vascular physiological change, it is recommended to use multiple parameters to evaluate and design intervention approaches accordingly to prevent systemic vascular aging in clinical practices or population-based studies.
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Affiliation(s)
- Ao Li
- Queen Mary School, Nanchang University, Nanchang, Jiangxi, 330031, People’s Republic of China
- Aging and Vascular Diseases, Human Aging Research Institute (HARI) and School of Life Science, Nanchang University, and Jiangxi Key Laboratory of Human Aging, Nanchang, Jiangxi, 330031, People’s Republic of China
| | - Jinhua Yan
- Department of Geriatrics, Institute of Gerontology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People’s Republic of China
| | - Ya Zhao
- Aging and Vascular Diseases, Human Aging Research Institute (HARI) and School of Life Science, Nanchang University, and Jiangxi Key Laboratory of Human Aging, Nanchang, Jiangxi, 330031, People’s Republic of China
| | - Zhenping Yu
- Institute of Translational Medicine, School of Life Science, Nanchang University, and Jiangxi Key Laboratory of Human Aging, Nanchang, Jiangxi, 330031, People’s Republic of China
| | - Shane Tian
- Department of Biochemistry/Chemistry, Ohio State University, Columbus, OH, USA
| | - Abdul Haseeb Khan
- Aging and Vascular Diseases, Human Aging Research Institute (HARI) and School of Life Science, Nanchang University, and Jiangxi Key Laboratory of Human Aging, Nanchang, Jiangxi, 330031, People’s Republic of China
| | - Yuanzheng Zhu
- Aging and Vascular Diseases, Human Aging Research Institute (HARI) and School of Life Science, Nanchang University, and Jiangxi Key Laboratory of Human Aging, Nanchang, Jiangxi, 330031, People’s Republic of China
| | - Andong Wu
- Aging and Vascular Diseases, Human Aging Research Institute (HARI) and School of Life Science, Nanchang University, and Jiangxi Key Laboratory of Human Aging, Nanchang, Jiangxi, 330031, People’s Republic of China
| | - Cuntai Zhang
- Department of Geriatrics, Institute of Gerontology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People’s Republic of China
| | - Xiao-Li Tian
- Aging and Vascular Diseases, Human Aging Research Institute (HARI) and School of Life Science, Nanchang University, and Jiangxi Key Laboratory of Human Aging, Nanchang, Jiangxi, 330031, People’s Republic of China
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Choi SO, Choi JG, Yun JY. A Study of Brain Function Characteristics of Service Members at High Risk for Accidents in the Military. Brain Sci 2023; 13:1157. [PMID: 37626513 PMCID: PMC10452066 DOI: 10.3390/brainsci13081157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2023] [Revised: 07/23/2023] [Accepted: 07/29/2023] [Indexed: 08/27/2023] Open
Abstract
Military accidents are often associated with stress and depressive psychological conditions among soldiers, and they often fail to adapt to military life. Therefore, this study analyzes whether there are differences in EEG and pulse wave indices between general soldiers and three groups of soldiers who have not adapted to military life and are at risk of accidents. Data collection was carried out using a questionnaire and a device that can measure EEG and pulse waves, and data analysis was performed using SPSS. The results showed that the concentration level and brain activity indices were higher in the general soldiers and the soldiers in the first stage of accident risk. The body stress index was higher for each stage of accident risk, and the physical vitality index was higher for general soldiers. Therefore, it can be seen that soldiers who have not adapted to military life and are at risk of accidents have somewhat lower concentration and brain activity than general soldiers, and have symptoms of stress and lethargy. The results of this study will contribute to reducing human accidents through EEG and pulse wave measurements not only in the military but also in occupations with a high risk of accidents such as construction.
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Affiliation(s)
| | | | - Jong-Yong Yun
- Department of Protection and Safety Engineering, Seoul National University of Science and Technology, Seoul 01811, Republic of Korea
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6
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Ikebe H, Oi N, Makino A, Kume D, Ishido M, Nakamura T, Nishiwaki M. Effects of acute cervical stretching on arterial wall elastic properties. Front Physiol 2023; 14:1198152. [PMID: 37457027 PMCID: PMC10340542 DOI: 10.3389/fphys.2023.1198152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Accepted: 06/15/2023] [Indexed: 07/18/2023] Open
Abstract
Purpose: Acute (immediate) or regular (mid- or long-term) stretching increases arterial compliance and reduces arterial stiffness. Stretching is widely known to induce arterial functional factor changes, but it is unclear whether stretching alters arterial structural factors. Ultrasound shear wave elastography can quantify the distribution of tissue elastic properties as an index of arterial structural factors. This study thus aimed to examine the effects of acute cervical stretching on arterial wall tissue elastic properties. Methods: Seventeen healthy young adults participated in two different trials for 15 min in random order on separate days: a resting and sitting trial (CON) and a supervised cervical stretching trial (CS). In CS, subjects performed 10 different stretches. At each site, the stretch was held for 30 s followed by a 10-s relaxation period. In CON, subjects rested on a chair for 15 min. Results: After the experiment, carotid arterial compliance, assessed by combined ultrasound imaging and applanation tonometry, was significantly increased in CS, but not in CON. However, there was no significant change in tissue elasticity properties of the arterial wall in either trial, as assessed by ultrasound shear wave elastography. Conclusion: Acute cervical stretching significantly increased carotid artery compliance in young participants, but did not reduce elastic tissue properties (i.e., arterial structural factors) of the carotid artery wall. These results strongly suggest that changes in structural factors have little relation to stretching-induced acute increases in arterial compliance.
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Affiliation(s)
- Harumi Ikebe
- Graduate Course in Applied Chemistry, Environmental and Biomedical Engineering, Osaka Institute of Technology, Osaka, Japan
- Faculty of Human Studies, Taisei Gakuin University, Osaka, Japan
| | - Naoya Oi
- Graduate Course in Applied Chemistry, Environmental and Biomedical Engineering, Osaka Institute of Technology, Osaka, Japan
| | - Akitoshi Makino
- Faculty of Engineering, Osaka Institute of Technology, Osaka, Japan
| | - Daisuke Kume
- Faculty of Information Science and Technology, Osaka Institute of Technology, Osaka, Japan
| | - Minenori Ishido
- Faculty of Engineering, Osaka Institute of Technology, Osaka, Japan
| | | | - Masato Nishiwaki
- Faculty of Engineering, Osaka Institute of Technology, Osaka, Japan
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7
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Manga S, Muthavarapu N, Redij R, Baraskar B, Kaur A, Gaddam S, Gopalakrishnan K, Shinde R, Rajagopal A, Samaddar P, Damani DN, Shivaram S, Dey S, Mitra D, Roy S, Kulkarni K, Arunachalam SP. Estimation of Physiologic Pressures: Invasive and Non-Invasive Techniques, AI Models, and Future Perspectives. SENSORS (BASEL, SWITZERLAND) 2023; 23:5744. [PMID: 37420919 DOI: 10.3390/s23125744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/01/2023] [Revised: 05/25/2023] [Accepted: 06/12/2023] [Indexed: 07/09/2023]
Abstract
The measurement of physiologic pressure helps diagnose and prevent associated health complications. From typical conventional methods to more complicated modalities, such as the estimation of intracranial pressures, numerous invasive and noninvasive tools that provide us with insight into daily physiology and aid in understanding pathology are within our grasp. Currently, our standards for estimating vital pressures, including continuous BP measurements, pulmonary capillary wedge pressures, and hepatic portal gradients, involve the use of invasive modalities. As an emerging field in medical technology, artificial intelligence (AI) has been incorporated into analyzing and predicting patterns of physiologic pressures. AI has been used to construct models that have clinical applicability both in hospital settings and at-home settings for ease of use for patients. Studies applying AI to each of these compartmental pressures were searched and shortlisted for thorough assessment and review. There are several AI-based innovations in noninvasive blood pressure estimation based on imaging, auscultation, oscillometry and wearable technology employing biosignals. The purpose of this review is to provide an in-depth assessment of the involved physiologies, prevailing methodologies and emerging technologies incorporating AI in clinical practice for each type of compartmental pressure measurement. We also bring to the forefront AI-based noninvasive estimation techniques for physiologic pressure based on microwave systems that have promising potential for clinical practice.
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Affiliation(s)
- Sharanya Manga
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN 55905, USA
| | - Neha Muthavarapu
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN 55905, USA
| | - Renisha Redij
- GIH Artificial Intelligence Laboratory (GAIL), Division of Gastroenterology and Hepatology, Department of Medicine, Mayo Clinic, Rochester, MN 55905, USA
| | | | - Avneet Kaur
- Microwave Engineering and Imaging Laboratory (MEIL), Division of Gastroenterology and Hepatology, Department of Medicine, Mayo Clinic, Rochester, MN 55905, USA
| | - Sunil Gaddam
- Microwave Engineering and Imaging Laboratory (MEIL), Division of Gastroenterology and Hepatology, Department of Medicine, Mayo Clinic, Rochester, MN 55905, USA
| | - Keerthy Gopalakrishnan
- GIH Artificial Intelligence Laboratory (GAIL), Division of Gastroenterology and Hepatology, Department of Medicine, Mayo Clinic, Rochester, MN 55905, USA
- Microwave Engineering and Imaging Laboratory (MEIL), Division of Gastroenterology and Hepatology, Department of Medicine, Mayo Clinic, Rochester, MN 55905, USA
| | - Rutuja Shinde
- Department of Medicine, Mayo Clinic, Rochester, MN 55905, USA
| | | | - Poulami Samaddar
- Microwave Engineering and Imaging Laboratory (MEIL), Division of Gastroenterology and Hepatology, Department of Medicine, Mayo Clinic, Rochester, MN 55905, USA
| | - Devanshi N Damani
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN 55905, USA
- Department of Internal Medicine, Texas Tech University Health Science Center, El Paso, TX 79995, USA
| | - Suganti Shivaram
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN 55905, USA
| | - Shuvashis Dey
- Microwave Engineering and Imaging Laboratory (MEIL), Division of Gastroenterology and Hepatology, Department of Medicine, Mayo Clinic, Rochester, MN 55905, USA
- Department of Electrical and Computer Engineering, North Dakota State University, Fargo, ND 58105, USA
| | - Dipankar Mitra
- Microwave Engineering and Imaging Laboratory (MEIL), Division of Gastroenterology and Hepatology, Department of Medicine, Mayo Clinic, Rochester, MN 55905, USA
- Department of Computer Science, University of Wisconsin-La Crosse, La Crosse, WI 54601, USA
| | - Sayan Roy
- Microwave Engineering and Imaging Laboratory (MEIL), Division of Gastroenterology and Hepatology, Department of Medicine, Mayo Clinic, Rochester, MN 55905, USA
- Department of Electrical Engineering and Computer Science, South Dakota Mines, Rapid City, SD 57701, USA
| | - Kanchan Kulkarni
- Centre de Recherche Cardio-Thoracique de Bordeaux, University of Bordeaux, INSERM, U1045, 33000 Bordeaux, France
- IHU Liryc, Heart Rhythm Disease Institute, Fondation Bordeaux Université, Bordeaux, 33600 Pessac, France
| | - Shivaram P Arunachalam
- GIH Artificial Intelligence Laboratory (GAIL), Division of Gastroenterology and Hepatology, Department of Medicine, Mayo Clinic, Rochester, MN 55905, USA
- Department of Radiology, Mayo Clinic, Rochester, MN 55905, USA
- Microwave Engineering and Imaging Laboratory (MEIL), Division of Gastroenterology and Hepatology, Department of Medicine, Mayo Clinic, Rochester, MN 55905, USA
- Department of Medicine, Mayo Clinic, Rochester, MN 55905, USA
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Horiguchi R, Takehara Y, Sugiyama M, Hyodo R, Komada T, Matsushima M, Naganawa S, Mizuno T, Sakurai Y, Sugimoto M, Banno H, Komori K, Itatani K. Postendovascular Aneurysmal Repair Increase in Local Energy Loss for Fusiform Abdominal Aortic Aneurysm: Assessments With 4D flow MRI. J Magn Reson Imaging 2023; 57:1199-1211. [PMID: 35861188 DOI: 10.1002/jmri.28359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Revised: 07/05/2022] [Accepted: 07/05/2022] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND Although endovascular aneurysmal repair (EVAR) is a preferred treatment for abdominal aortic aneurysm (AAA) owing to its low invasiveness, its impact on the local hemodynamics has not been fully assessed. PURPOSE To elucidate how EVAR affects the local hemodynamics in terms of energy loss (EL). STUDY TYPE Prospective single-arm study. FIELD STRENGTH/SEQUENCE A 3.0 T/4D flow MRI using a phase-contrast three-dimensional cine-gradient-echo sequence. POPULATION A total of 13 consecutive patients (median [interquartile range] age: 77.0 [73.0, 78.8] years, 11 male) scheduled for EVAR as an initial treatment for fusiform AAA. ASSESSMENT 4D flow MRI covering the abdominal aorta and bilateral common iliac arteries and the corresponding stent-graft (SG) lumen was performed before and after EVAR. Plasma brain natriuretic peptide (BNP) was measured within 1 week before and 1 month after EVAR. The hemodynamic data, including mean velocity and the local EL, were compared pre-/post-EVAR. EL was correlated with AAA neck angle and with BNP. Patients were subdivided into deformed (N = 5) and undeformed SG subgroups (N = 8) and pre-/post-EVAR BNP compared in each. STATISTICS Parametric or nonparametric methods. Spearman's rank correlation coefficients (r). The interobserver/intraobserver variabilities with Bland-Altman plots. A P value < 0.05 is considered significant. RESULTS The mean velocity (cm/sec) at the AAA was five times greater after EVAR: 4.79 ± 0.32 vs. 0.91 ± 0.02. The total EL (mW) increased by 1.7 times after EVAR: 0.487 (0.420, 0.706) vs. 0.292 (0.192, 0.420). The total EL was proportional to the AAA neck angle pre-EVAR (r = 0.691) and post-EVAR (r = 0.718). BNP (pg/mL) was proportional to the total EL post-EVAR (r = 0.773). In the deformed SG group, EL (0.349 [0.261, 0.416]) increased 2.4-fold to 0.848 (0.597, 1.13), and the BNP 90.3 (53.6, 105) to 100 (67.2, 123) post-EVAR. CONCLUSION The local EL showed a 1.7-fold increase after EVAR. The larger increase in the EL in the deformed SG group might be a potential concern for frail patients. EVIDENCE LEVEL 1 TECHNICAL EFFICACY: Stage 2.
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Affiliation(s)
- Ryota Horiguchi
- Department of Radiology, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan
| | - Yasuo Takehara
- Department of Radiology, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan.,Department of Fundamental Development for Advanced Low Invasive Diagnostic Imaging, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan
| | - Masataka Sugiyama
- Department of Radiology, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan
| | - Ryota Hyodo
- Department of Radiology, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan
| | - Tomohiro Komada
- Department of Radiology, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan
| | - Masaya Matsushima
- Department of Radiology, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan
| | - Shinji Naganawa
- Department of Radiology, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan
| | - Takashi Mizuno
- Department of Medical Technology, Nagoya University Hospital, Nagoya, Aichi, Japan
| | - Yasuo Sakurai
- Department of Medical Technology, Nagoya University Hospital, Nagoya, Aichi, Japan
| | - Masayuki Sugimoto
- Division of Vascular and Endovascular Surgery, Department of Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Hiroshi Banno
- Division of Vascular and Endovascular Surgery, Department of Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Kimihiro Komori
- Division of Vascular and Endovascular Surgery, Department of Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Keiichi Itatani
- Department of Cardiovascular Surgery, Osaka City University, Osaka, Japan
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9
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Du S, Yao Y, Sun G, Wang L, Alastruey J, Avolio AP, Xu L. Personalized aortic pressure waveform estimation from brachial pressure waveform using an adaptive transfer function. Comput Biol Med 2023; 155:106654. [PMID: 36791548 DOI: 10.1016/j.compbiomed.2023.106654] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2022] [Revised: 01/16/2023] [Accepted: 02/08/2023] [Indexed: 02/12/2023]
Abstract
BACKGROUND AND OBJECTIVE The aortic pressure waveform (APW) provides reliable information for the diagnosis of cardiovascular disease. APW is often measured using a generalized transfer function (GTF) applied to the peripheral pressure waveform acquired noninvasively, to avoid the significant risks of invasive APW acquisition. However, the GTF ignores various physiological conditions, which affects the accuracy of the estimated APW. To solve this problem, this study utilized an adaptive transfer function (ATF) combined with a tube-load model to achieve personalized and accurate estimation of APW from the brachial pressure waveform (BPW). METHODS The proposed method was validated using APWs and BPWs from 34 patients. The ATF was defined using a tube-load model in which pulse transit time and reflection coefficients were determined from, respectively, the diastolic-exponential-pressure-decay of the APW and a piece-wise constant approximation. The root-mean-square-error of overall morphology, mean absolute errors of common hemodynamic indices (systolic blood pressure, diastolic blood pressure and pulse pressure) were used to evaluate the ATF. RESULTS The proposed ATF performed better in estimating diastolic blood pressure and pulse pressure (1.63 versus 1.94 mmHg, and 2.37 versus 3.10 mmHg, respectively, both P < 0.10), and produced similar errors in overall morphology and systolic blood pressure (3.91 versus 4.24 mmHg, and 2.83 versus 2.91 mmHg, respectively, both P > 0.10) compared to GTF. CONCLUSION Unlike the GTF which uses fixed parameters trained on existing clinical datasets, the proposed method can achieve personalized estimation of APW. Hence, it provides accurate pulsatile hemodynamic measures for the evaluation of cardiovascular function.
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Affiliation(s)
- Shuo Du
- College of Medicine and Biological Information Engineering, Northeastern University, Shenyang, 110169, Liaoning, China
| | - Yang Yao
- College of Medicine and Biological Information Engineering, Northeastern University, Shenyang, 110169, Liaoning, China
| | - Guozhe Sun
- Department of Cardiology, The First Hospital of China Medical University, Shenyang, 110122, Liaoning, China
| | - Lu Wang
- School of Computer Science and Engineering, Northeastern University, Shenyang, 110169, China
| | - Jordi Alastruey
- Department of Biomedical Engineering, King's College, London, SE1 7EH, United Kingdom
| | - Alberto P Avolio
- Macquarie School of Medicine, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, Australia
| | - Lisheng Xu
- College of Medicine and Biological Information Engineering, Northeastern University, Shenyang, 110169, Liaoning, China; Neusoft Research of Intelligent Healthcare Technology, Co. Ltd, Shenyang, 110169, Liaoning, China.
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10
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Kellett J, Holland M, Candel BGJ. Using Vital Signs to Place Acutely Ill Patients Quickly and Easily into Clinically Helpful Pathophysiologic Categories: Derivation and Validation of Eight Pathophysiologic Categories in Two Distinct Patient Populations of Acutely Ill Patients. J Emerg Med 2023; 64:136-144. [PMID: 36813644 DOI: 10.1016/j.jemermed.2022.12.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Revised: 11/12/2022] [Accepted: 12/13/2022] [Indexed: 02/23/2023]
Abstract
BACKGROUND Early warning scores reliably identify patients at risk of imminent death, but do not provide insight into what may be wrong with the patient or what to do about it. OBJECTIVE Our aim was to explore whether the Shock Index (SI), pulse pressure (PP), and ROX Index can place acutely ill medical patients in pathophysiologic categories that could indicate the interventions required. METHODS A retrospective post-hoc analysis of previously obtained and reported clinical data for 45,784 acutely ill medical patients admitted to a major regional referral Canadian hospital between 2005 and 2010 and validated on 107,546 emergency admissions to four Dutch hospitals between 2017 and 2022. RESULTS SI, PP, and ROX values divided patients into eight mutually exclusive physiologic categories. Mortality was highest in patient categories that included ROX Index value < 22, and a ROX Index value < 22 multiplied the risk of any other abnormality. Patients with a ROX Index value < 22, PP < 42 mm Hg, and SI > 0.7 had the highest mortality and accounted for 40% of deaths within 24 h of admission, whereas patients with a PP ≥ 42 mm Hg, SI ≤ 0.7, and ROX Index value ≥ 22 had the lowest risk of death. These results were the same in both the Canadian and Dutch patient cohorts. CONCLUSIONS SI, PP, and ROX Index values can place acutely ill medical patients into eight mutually exclusive pathophysiologic categories with different mortality rates. Future studies will assess the interventions needed by these categories and their value in guiding treatment and disposition decisions.
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Affiliation(s)
- John Kellett
- Department of Emergency Medicine, University Hospital Odense, Odense, Denmark
| | - Mark Holland
- School of Clinical and Biomedical Sciences, Faculty of Health and Wellbeing, Bolton University, Bolton, UK
| | - Bart G J Candel
- Emergency Department, Maxima Medical Centre, Veldhoven, Noord-Brabant, The Netherlands; Emergency Department, Leiden University Medical Centre, Leiden, Zuid-Holland, The Netherlands
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11
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Tang Q, Xu S, Guo M, Wang G, Pan Z, Su B. Wrist pulse signal based vascular age calculation using mixed Gaussian model and support vector regression. Health Inf Sci Syst 2022; 10:7. [PMID: 35529250 PMCID: PMC9023627 DOI: 10.1007/s13755-022-00172-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Accepted: 03/24/2022] [Indexed: 10/18/2022] Open
Abstract
Purpose Vascular age (VA) is the direct index to reflect vascular aging, so it plays a particular role in public health. How to obtain VA conveniently and cheaply has always been a research hotspot. This study proposes a new method to evaluate VA with wrist pulse signal. Methods Firstly, we fit the pulse signal by mixed Gaussian model (MGM) to extract the shape features, and adopt principal component analysis (PCA) to optimize the dimension of the shape features. Secondly, the principal components and chronological age (CA) are respectively taken as the independent variables and dependent variable to establish support vector regression (SVR) model. Thirdly, the principal components are fed into the SVR model to predicted the vascular aging of each subject. The predicted value is regarded as the description of VA. Finally, we compare the correlation coefficients of VA with pulse width (PW), inflection point area ratio (IPA), Ratio b/a (RBA), augmentation index (AIx), diastolic augmentation index (DAI) and pulse transit time (PTT) with those of CA with these six indices. Results Compared with the CA, the VA is closer to PW (r = 0.539, P < 0.001 to r = 0.589, P < 0.001 in men; r = 0.325, P < 0.001 to r = 0.400, P < 0.001 in women), IPA (r = - 0.446, P < 0.001 to r = - 0.534, P < 0.001 in men; r = - 0.623, P < 0.001 to r = - 0.660, P < 0.001 in women), RBA (r = 0.328, P < 0.001 to r = 0.371, P < 0.001 in women), AIx (r = 0.659, P < 0.001 to r = 0.738, P < 0.001 in men; r = 0.547, P < 0.001 to r = 0.573, P < 0.001 in women), DAI (r = 0.517, P < 0.001 to r = 0.532, P < 0.001 in men; r = 0.507, P < 0.001 to r = 0.570, P < 0.001 in women) and PTT (r = 0.526, P < 0.001 to r = 0.659, P < 0.001 in men; r = 0.577, P < 0.001 to r = 0.814, P < 0.001 in women). Conclusion The VA is more representative of vascular aging than CA. The method presented in this study provides a new way to directly and objectively assess vascular aging in public health.
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Affiliation(s)
- Qingfeng Tang
- The University Key Laboratory of Intelligent Perception and Computing of Anhui Province, Anqing Normal University, 1318 Jixian North Road, Anqing, 246133 China
- School of Public Health, Hangzhou Normal University, 2318 Yuhangtang Road, Hangzhou, 311121 China
| | - Shoujiang Xu
- School of Public Health, Hangzhou Normal University, 2318 Yuhangtang Road, Hangzhou, 311121 China
- Jiangsu Food and Pharmaceutical Science College, Huai’an, 223023 China
| | - Mengjuan Guo
- The University Key Laboratory of Intelligent Perception and Computing of Anhui Province, Anqing Normal University, 1318 Jixian North Road, Anqing, 246133 China
| | - Guangjun Wang
- The University Key Laboratory of Intelligent Perception and Computing of Anhui Province, Anqing Normal University, 1318 Jixian North Road, Anqing, 246133 China
| | - Zhigeng Pan
- School of Public Health, Hangzhou Normal University, 2318 Yuhangtang Road, Hangzhou, 311121 China
- School of Artificial Intelligence, Nanjing University of Information Science and Technology, Nanjing, 210044 China
| | - Benyue Su
- The University Key Laboratory of Intelligent Perception and Computing of Anhui Province, Anqing Normal University, 1318 Jixian North Road, Anqing, 246133 China
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12
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Tang Q, Pan Z, Tao C, Jiang J, Su B, An H, Liu G, Zhigeng Pan. Vascular age acquired from the pulse signal: A new index to screen early vascular aging. Comput Biol Med 2022; 151:106355. [PMID: 36459808 DOI: 10.1016/j.compbiomed.2022.106355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Revised: 10/01/2022] [Accepted: 11/23/2022] [Indexed: 11/27/2022]
Abstract
BACKGROUND Chronological age (CA) has been adopted as an important independent risk factor in cardiovascular risk assessment. However, different individuals with same CA may have distinct actual vascular aging due to various lifestyles. Therefore, it is difficult to fully describe the difference of actual vascular aging by CA. OBJECTIVE This study proposes a new index vascular age (VA) to avoid the limitations of CA. METHOD In this work, VA refers to the sum of CA and lifestyle impact (AgeLI). Firstly, we take the pulse signal features and CA as independent variables and dependent variable respectively, and adopt cross validation to train Support Vector Regression model. Then we acquire the predicted chronological age (PA) of all subjects with the model. Secondly, we obtain the function model between CA and PA, and calculate the expectation of PA (ePA) for each subject. Simultaneously, we take the difference between PA and ePA as the estimated value of AgeLI to further calculate VA. Finally, in order to evaluate the effectiveness of VA, we compare the correlations between CA, PA, VA and 8 objective indices such as augmentation index, pulse transit time, diastolic augmentation index, etc. RESULTS: In general, VA and PA are closer to these 8 objective indices than CA. Moreover, VA is also superior to PA in vascular aging evaluation. CONCLUSION The VA suggested in this study emphasizes the difference of vascular aging in same CA group, which can better reflect the actual vascular aging than CA and PA.
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Affiliation(s)
- Qingfeng Tang
- The University Key Laboratory of Intelligent Perception and Computing of Anhui Province, Anqing Normal University, Anqing, China
| | - Zhiqiang Pan
- The University Key Laboratory of Intelligent Perception and Computing of Anhui Province, Anqing Normal University, Anqing, China
| | - Changlong Tao
- The University Key Laboratory of Intelligent Perception and Computing of Anhui Province, Anqing Normal University, Anqing, China
| | - Jing Jiang
- The University Key Laboratory of Intelligent Perception and Computing of Anhui Province, Anqing Normal University, Anqing, China
| | - Benyue Su
- The University Key Laboratory of Intelligent Perception and Computing of Anhui Province, Anqing Normal University, Anqing, China
| | - Hui An
- Health Management & Physical Examination Center, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, Xiangyang, China.
| | - Guodong Liu
- Cardiovascular Internal Medicine, Anqing First People's Hospital of Anhui Medical University, Anqing, China
| | - Zhigeng Pan
- School of artificial Intelligence, Nanjing University of Information Science and Technology, Nanjing, China.
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13
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Jin Y, Liu S, Lin M, Xu Y, Zhou S, Ye B, Lin S, Guan X, Wang L. High Pulse Pressure Decreases Cardiopulmonary Ability among Older Chinese Patients with Primary Hypertension. Int Heart J 2022; 63:1134-1140. [DOI: 10.1536/ihj.22-378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Affiliation(s)
- Yan Jin
- Department of Rehabilitation, College of Acupuncture and Moxibustion and Massage Health Preservation and Rehabilitation, Nanjing University of Chinese Medicine
| | - Sipei Liu
- Department of Rehabilitation, College of Acupuncture and Moxibustion and Massage Health Preservation and Rehabilitation, Nanjing University of Chinese Medicine
| | - Meilan Lin
- Department of Rehabilitation, College of Acupuncture and Moxibustion and Massage Health Preservation and Rehabilitation, Nanjing University of Chinese Medicine
| | - Yiye Xu
- Division of Cardiovascular Rehabilitation, Rui An Hospital of Traditional Chinese Medicine
| | - Shiwei Zhou
- Division of Cardiovascular Rehabilitation, Rui An Hospital of Traditional Chinese Medicine
| | - Bingbing Ye
- Division of Cardiovascular Rehabilitation, Rui An Hospital of Traditional Chinese Medicine
| | - Shuman Lin
- Division of Cardiovascular Rehabilitation, Rui An Hospital of Traditional Chinese Medicine
| | - Xiafei Guan
- Division of Cardiovascular Rehabilitation, Rui An Hospital of Traditional Chinese Medicine
| | - Lei Wang
- Department of Rehabilitation, College of Acupuncture and Moxibustion and Massage Health Preservation and Rehabilitation, Nanjing University of Chinese Medicine
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14
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Desbiens LC, Goulamhoussen N, Fortier C, Bernier-Jean A, Agharazii M, Goupil R. Enhancing central blood pressure accuracy through statistical modeling: A proof-of-concept study. Front Cardiovasc Med 2022; 9:1048507. [PMID: 36505368 PMCID: PMC9728538 DOI: 10.3389/fcvm.2022.1048507] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Accepted: 10/28/2022] [Indexed: 11/24/2022] Open
Abstract
Background Non-invasive estimation of central blood pressure (BP) may have better prognostic value than brachial BP. The accuracy of central BP is limited in certain populations, such as in females and the elderly. This study aims to examine whether statistical modeling of central BP for clinical and hemodynamic parameters results in enhanced accuracy. Methods This study is a cross-sectional analysis of 500 patients who underwent cardiac catheterization. Non-invasive brachial cuff and central BP were measured simultaneously to invasive aortic systolic BP (AoSBP). Central BP was calibrated for brachial systolic (SBP) and diastolic BP (Type I calibration; C1SBP) or brachial mean and diastolic BP (Type II calibration; C2SBP). Differences between central SBP and the corresponding AoSBP were assessed with linear regression models using clinical and hemodynamic parameters. These parameters were then added to C1SBP and C2SBP in adjusted models to predict AoSBP. Accuracy and precision were computed in the overall population and per age or sex strata. Results C1SBP underestimated AoSBP by 11.2 mmHg (±13.5) and C2SBP overestimated it by 6.2 mmHg (±14.8). Estimated SBP amplification and heart rate were the greatest predictors of C1- and C2-AoSBP accuracies, respectively. Statistical modeling improved both accuracy (0.0 mmHg) and precision (±11.4) but more importantly, eliminated the differences of accuracy seen in different sex and age groups. Conclusion Statistical modeling greatly enhances the accuracy of central BP measurements and abolishes sex- and age-based differences. Such factors could easily be implemented in central BP devices to improve their accuracy.
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Affiliation(s)
| | | | - Catherine Fortier
- Centre Hospitalier Universitaire (CHU) de Québec, Université Laval, Québec City, QC, Canada
| | - Amélie Bernier-Jean
- Department of Medicine, Université de Montréal, Montréal, QC, Canada,Hôpital du Sacré-Cœur de Montréal, Montréal, QC, Canada
| | - Mohsen Agharazii
- Centre Hospitalier Universitaire (CHU) de Québec, Université Laval, Québec City, QC, Canada
| | - Rémi Goupil
- Department of Medicine, Université de Montréal, Montréal, QC, Canada,Hôpital du Sacré-Cœur de Montréal, Montréal, QC, Canada,*Correspondence: Rémi Goupil,
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15
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Ko LW, Chang Y, Lin BK, Lin DS. Vital Signs Sensing Gown Employing ECG-Based Intelligent Algorithms. BIOSENSORS 2022; 12:964. [PMID: 36354473 PMCID: PMC9688187 DOI: 10.3390/bios12110964] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Revised: 07/06/2022] [Accepted: 07/08/2022] [Indexed: 06/16/2023]
Abstract
This study presents a long-term vital signs sensing gown consisting of two components: a miniaturized monitoring device and an intelligent computation platform. Vital signs are signs that indicate the functional state of the human body. The general physical health of a person can be assessed by monitoring vital signs, which typically include blood pressure, body temperature, heart rate, and respiration rate. The miniaturized monitoring device is composed of a compact circuit which can acquire two kinds of physiological signals including bioelectrical potentials and skin surface temperature. These two signals were pre-processed in the circuit and transmitted to the intelligent computation platform for further analysis using three algorithms, which incorporate R-wave detection, ECG-derived respiration, and core body temperature estimation. After the processing, the derived vital signs would be displayed on a portable device screen, including ECG signals, heart rate (HR), respiration rate (RR), and core body temperature. An experiment for validating the performance of the intelligent computation platform was conducted in clinical practices. Thirty-one participants were recruited in the study (ten healthy participants and twenty-one clinical patients). The results showed that the relative error of HR is lower than 1.41%, RR is lower than 5.52%, and the bias of core body temperature is lower than 0.04 °C in both healthy participant and clinical patient trials. In this study, a miniaturized monitoring device and three algorithms which derive vital signs including HR, RR, and core body temperature were integrated for developing the vital signs sensing gown. The proposed sensing gown outperformed the commonly used equipment in terms of usability and price in clinical practices. Employing algorithms for estimating vital signs is a continuous and non-invasive approach, and it could be a novel and potential device for home-caring and clinical monitoring, especially during the pandemic.
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Affiliation(s)
- Li-Wei Ko
- Center for Intelligent Drug Systems and Smart Bio-Devices (IDS2B), Institute of Bioinformatics and Systems Biology, College of Biological Science and Technology, National Yang Ming Chiao Tung University, Hsinchu 300, Taiwan
- Institute of Electrical and Control Engineering, Department of Electronics and Electrical Engineering, National Yang Ming Chiao Tung University, Hsinchu 300, Taiwan
- Drug Development and Value Creation Research Center, Department of Biomedical Science and Environmental Biology, College of Life Science, Kaohsiung Medical University, Kaohsiung 807, Taiwan
- Department of Biological Science & Technology, National Yang Ming Chiao Tung University, Hsinchu 300, Taiwan
| | - Yang Chang
- Center for Intelligent Drug Systems and Smart Bio-Devices (IDS2B), Institute of Bioinformatics and Systems Biology, College of Biological Science and Technology, National Yang Ming Chiao Tung University, Hsinchu 300, Taiwan
| | - Bo-Kai Lin
- Department of Biological Science & Technology, National Yang Ming Chiao Tung University, Hsinchu 300, Taiwan
| | - Dar-Shong Lin
- Department of Pediatrics, Mackay Memorial Hospital, Taipei 104, Taiwan
- Department of Medicine, Mackay Medical College, New Taipei 252, Taiwan
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16
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Pereira MM, Torrado J, Bock J, Sosa C, Diaz A, Bia D, Zócalo Y. Wave separation analysis-derived indexes obtained from radial and carotid tonometry in healthy pregnancy and pregnancy-associated hypertension: Comparison with pulse wave analysis-derived indexes. Front Cardiovasc Med 2022; 9:997452. [PMID: 36386340 PMCID: PMC9664074 DOI: 10.3389/fcvm.2022.997452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Accepted: 10/10/2022] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Increased wave reflections assessed by pulse wave analysis (PWA) was proposed as one of the potential culprits of hypertension seen in women with pregnancy-associated hypertension (PAH). However, this statement has never been confirmed with "Wave Separation Analysis" (WSA), a more sophisticated mathematical approach that analyzes the amplitude and interaction between forward and backward aortic pressure waveform components. OBJECTIVE To characterize potential changes in pressure wave components of PAH compared to healthy non-pregnant (NP) women and women with normal pregnancies (HP) by using WSA and compared these findings with PWA-derived indexes; secondarily, to evaluate differences in WSA-derived indexes between subgroups of PAH (i.e., preeclampsia [PE] and gestational hypertension [GH]). METHODS Using radial and carotid applanation tonometry, we quantified in HP (n = 10), PAH (n = 16), and NP (n = 401): (i) PWA-derived indexes; (ii) WSA-derived indexes: forward (Pf) and backward (Pb) waveform components, backward component arrival time (PbAT), reflection magnitude (RM = Pb/Pf) and index [RIx = Pb/(Pf + Pb)]. RESULTS While PAH was associated with a higher Pf compared to HP and NP, Pb and PbAT were similar between the groups. Both GH and PE showed a higher Pf compared to HP, but only PE had a trend of presenting with higher Pb and lower PbAT compared to the other groups. Finally, PAH showed a trend of having lower RM and RIx compared to NP and HP, with no differences between GH and PE. CONCLUSION PAH was associated with higher Pf, but not higher Pb, compared to NP and HP, although PE also demonstrated a trend of higher Pb.
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Affiliation(s)
- María M. Pereira
- Department of Obstetrics and Gynecology, BronxCare Hospital Center a Clinical Affiliate of Mt Sinai Health Systems and Academic Affiliate of Icahn School of Medicine, Bronx, NY, United States
| | - Juan Torrado
- Department of Internal Medicine, Jacobi Medical Center, Albert Einstein College of Medicine, Bronx, NY, United States
| | - Joshua Bock
- Department of Internal Medicine, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, United States
| | - Claudio Sosa
- Department of Obstetrics and Gynecology “C”, Pereira-Rossell Hospital, School of Medicine, Republic University, Montevideo, Uruguay
| | - Alejandro Diaz
- Consejo Nacional de Investigaciones Científicas y Técnicas, Tandil, Argentina
| | - Daniel Bia
- Centro Universitario de Investigación, Innovación y Diagnóstico Arterial (CUiiDARTE), Department of Physiology, School of Medicine, Republic University, Montevideo, Uruguay
| | - Yanina Zócalo
- Centro Universitario de Investigación, Innovación y Diagnóstico Arterial (CUiiDARTE), Department of Physiology, School of Medicine, Republic University, Montevideo, Uruguay,*Correspondence: Yanina Zócalo,
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17
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Sugawara J, Tarumi T, Xing C, Liu J, Tomoto T, Pasha EP, Zhang R. Aerobic exercise training reduces cerebrovascular impedance in older adults: a 1-year randomized controlled trial. J Appl Physiol (1985) 2022; 133:902-912. [PMID: 36107990 PMCID: PMC9550583 DOI: 10.1152/japplphysiol.00241.2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Revised: 08/17/2022] [Accepted: 09/02/2022] [Indexed: 01/05/2023] Open
Abstract
Older adults have higher cerebrovascular impedance than young individuals which may contribute to chronic brain hypoperfusion. Besides, middle-aged athletes exhibit lower cerebrovascular impedance than their sedentary peers. We examined whether aerobic exercise training (AET) reduces cerebrovascular impedance in sedentary older adults. We conducted a proof-of-concept trial that randomized 73 older adults to 1 yr of AET (n = 36) or stretching and toning (SAT, n = 37) interventions. Cerebrovascular impedance was estimated from simultaneous recordings of carotid artery pressure (CAP) via applanation tonometry and cerebral blood flow velocity (CBFV) in the middle cerebral artery via transcranial Doppler using transfer function analysis. Fifty-six participants completed 1-yr interventions, and 41 of those completed cerebrovascular impedance measurements. AET group showed a significant increase in V̇o2peak after the intervention [estimated marginal mean (95% confidence interval); from 22.8 (21.6 to 24.1) to 24.9 (23.6 to 26.2) mL·kg-1·cm-1, P < 0.001], but not SAT [from 21.7 (20.5 to 22.9) to 22.3 (21.1 to 23.7) mL·kg-1·cm-1, P = 0.114]. Coherence between changes in CBFV and CAP was >0.90 in the frequency range of 0.78-3.12 Hz. The averaged cerebrovascular impedance modulus (Z) in this frequency range decreased after 1-yr AET [from 1.05 (0.96 to 1.14) to 0.95 (0.92 to 1.06) mmHg·s·cm-1, P = 0.023], but not SAT [from 0.96 (0.87 to 1.04) to 1.01 (0.92 to 1.10) mmHg·s·cm-1, P = 0.138]. Reductions in Z were correlated positively with reductions in carotid pulse pressure (r = 0.628, P = 0.004) and inversely with mean CBFV (r = -0.563, P = 0.012) in the AET group. One-year AET reduces cerebrovascular impedance in older adults, which may benefit brain perfusion.NEW & NOTEWORTHY Estimation of cerebrovascular impedance is essential for understanding dynamic cerebral blood flow regulation. This randomized controlled trial demonstrated that aerobic exercise training reduced cerebrovascular impedance in older adults, which may benefit brain perfusion.
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Affiliation(s)
- Jun Sugawara
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, Dallas, Texas
- University of Texas Southwestern Medical Center, Dallas, Texas
- Human Informatics and Interaction Research Institute, National Institute of Advanced Industrial Science and Technology, Tsukuba, Japan
| | - Takashi Tarumi
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, Dallas, Texas
- University of Texas Southwestern Medical Center, Dallas, Texas
- Human Informatics and Interaction Research Institute, National Institute of Advanced Industrial Science and Technology, Tsukuba, Japan
| | - Changyang Xing
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, Dallas, Texas
- University of Texas Southwestern Medical Center, Dallas, Texas
- Department of Ultrasound Diagnostics, Tangdu Hospital, Fourth Military Medical University, Xi'an, People's Republic of China
| | - Jie Liu
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, Dallas, Texas
- University of Texas Southwestern Medical Center, Dallas, Texas
| | - Tsubasa Tomoto
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, Dallas, Texas
- University of Texas Southwestern Medical Center, Dallas, Texas
| | - Evan P Pasha
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, Dallas, Texas
- University of Texas Southwestern Medical Center, Dallas, Texas
| | - Rong Zhang
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, Dallas, Texas
- University of Texas Southwestern Medical Center, Dallas, Texas
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18
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Meng K, Xiao X, Liu Z, Shen S, Tat T, Wang Z, Lu C, Ding W, He X, Yang J, Chen J. Kirigami-Inspired Pressure Sensors for Wearable Dynamic Cardiovascular Monitoring. ADVANCED MATERIALS (DEERFIELD BEACH, FLA.) 2022; 34:e2202478. [PMID: 35767870 DOI: 10.1002/adma.202202478] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Revised: 05/29/2022] [Indexed: 06/15/2023]
Abstract
Continuously and accurately monitoring pulse-wave signals is critical to prevent and diagnose cardiovascular diseases. However, existing wearable pulse sensors are vulnerable to motion artifacts due to the lack of proper adhesion and conformal interface with human skin during body movement. Here, a highly sensitive and conformal pressure sensor inspired by the kirigami structure is developed to measure the human pulse wave on different body artery sites under various prestressing pressure conditions and even with body movement. COMSOL multiphysical field coupling simulation and experimental testing are used to verify the unique advantages of the kirigami structure. The device shows a superior sensitivity (35.2 mV Pa-1 ) and remarkable stability (>84 000 cycles). Toward practical applications, a wireless cardiovascular monitoring system is developed for wirelessly transmitting the pulse signals to a mobile phone in real-time, which successfully distinguished the pulse waveforms from different participants. The pulse waveforms measured by the kirigami inspired pressure sensor are as accurate as those provided by the commercial medical device. Given the compelling features, the sensor provides an ascendant way for wearable electronics to overcome motion artifacts when monitoring pulse signals, thus representing a solid advancement toward personalized healthcare in the era of the Internet of Things.
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Affiliation(s)
- Keyu Meng
- School of Electronic and Information Engineering, Jilin Provincial Key Laboratory of Human Health Status Identification and Function Enhancement, Changchun University, Changchun, 130022, China
- Department of Bioengineering, University of California, Los Angeles, Los Angeles, CA, 90095, USA
| | - Xiao Xiao
- Department of Bioengineering, University of California, Los Angeles, Los Angeles, CA, 90095, USA
| | - Zixiao Liu
- Department of Materials Science and Engineering, University of California, Los Angeles, Los Angeles, CA, 90095, USA
| | - Sophia Shen
- Department of Bioengineering, University of California, Los Angeles, Los Angeles, CA, 90095, USA
| | - Trinny Tat
- Department of Bioengineering, University of California, Los Angeles, Los Angeles, CA, 90095, USA
| | - Zihan Wang
- Tsinghua-Berkeley Shenzhen Institute and Tsinghua Shenzhen International Graduate School, Tsinghua University, Shenzhen, 518055, P. R. China
| | - Chengyue Lu
- Tsinghua-Berkeley Shenzhen Institute and Tsinghua Shenzhen International Graduate School, Tsinghua University, Shenzhen, 518055, P. R. China
| | - Wenbo Ding
- Tsinghua-Berkeley Shenzhen Institute and Tsinghua Shenzhen International Graduate School, Tsinghua University, Shenzhen, 518055, P. R. China
| | - Ximin He
- Department of Materials Science and Engineering, University of California, Los Angeles, Los Angeles, CA, 90095, USA
| | - Jun Yang
- Chongqing Institute of Green and Intelligent Technology, Chinese Academy of Sciences, Chongqing, 400714, P. R. China
| | - Jun Chen
- Department of Bioengineering, University of California, Los Angeles, Los Angeles, CA, 90095, USA
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19
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Tang Q, Tao C, Pan Z, Wang G, Liu K, Pan Z, Liu G, Su B, Liu N. A novel method for vascular age estimation via pressure pulse wave of radial artery. Biomed Signal Process Control 2022. [DOI: 10.1016/j.bspc.2022.103904] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
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20
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Zheng W, Xu H, Wang M, Duan Q, Yuan Y, Wang W, Gao L. On-Skin Flexible Pressure Sensor with High Sensitivity for Portable Pulse Monitoring. MICROMACHINES 2022; 13:mi13091390. [PMID: 36144011 PMCID: PMC9502307 DOI: 10.3390/mi13091390] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Revised: 08/17/2022] [Accepted: 08/21/2022] [Indexed: 06/01/2023]
Abstract
Radial artery pulse pressure contains abundant cardiovascular physiological and pathological information, which plays an important role in clinical diagnosis of traditional Chinese medical science. However, many photoelectric sensors and pressure sensors will lose a large number of waveform features in monitoring pulse, which will make it difficult for doctors to precisely evaluate the patients' health. In this letter, we proposed an on-skin flexible pressure sensor for monitoring radial artery pulse. The sensor consists of the MXene (Ti3C2Tx)-coated nonwoven fabrics (n-WFs) sensitive layer and laser-engraved interdigital copper electrodes. Benefiting from substantially increased conductive paths between fibers and electrodes during normal compression, the sensor obtains high sensitivity (3.187 kPa-1), fast response time (15 ms), low detection limit (11.1 Pa), and long-term durability (20,000 cycles). Furthermore, a flexible processing circuit was connected with the sensor mounted on wrist radial artery, achieving wirelessly precise monitoring of the pulse on smart phones in real time. Compared with the commercial flexible pressure sensor, our sensor successfully captures weak systolic peak precisely, showing its great clinical potential and commercial value.
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Affiliation(s)
- Weihao Zheng
- School of Mechano-Electronic Engineering, Xidian University, Xi’an 710071, China
| | - Hongcheng Xu
- School of Mechano-Electronic Engineering, Xidian University, Xi’an 710071, China
| | - Meng Wang
- School of Mechano-Electronic Engineering, Xidian University, Xi’an 710071, China
| | - Qikai Duan
- School of Automation and Software Engineering, Shanxi University, Taiyuan 030013, China
| | - Yangbo Yuan
- School of Mechano-Electronic Engineering, Xidian University, Xi’an 710071, China
| | - Weidong Wang
- School of Mechano-Electronic Engineering, Xidian University, Xi’an 710071, China
| | - Libo Gao
- Department of Mechanical and Electrical Engineering, School of Aerospace Engineering, Xiamen University, Xiamen 361102, China
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21
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Feasibility of waveform separation of central aortic pressure pulse based on lognormal flow wave approximation. Biomed Signal Process Control 2022. [DOI: 10.1016/j.bspc.2022.103784] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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22
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Kondiboyina A, Harrington HA, Smolich JJ, Cheung MM, Mynard JP. Optimised design of an arterial network model reproduces characteristic central and peripheral hemodynamic waveform features in young adults. J Physiol 2022; 600:3725-3747. [PMID: 35852442 PMCID: PMC9544402 DOI: 10.1113/jp282942] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2022] [Accepted: 07/08/2022] [Indexed: 12/03/2022] Open
Abstract
Abstract The arterial network in healthy young adults is thought to be structured to optimize wave reflection in the arterial system, producing an ascending aortic pressure waveform with three key features: early systolic peak, negative systolic augmentation and diastolic hump. One‐dimensional computer models have provided significant insights into arterial haemodynamics, but no previous models of the young adult have exhibited these three features. Given that this issue was likely to be related to unrepresentative or non‐optimized impedance properties of the model arterial networks, we developed a new ‘YoungAdult’ model that incorporated the following features: (i) a new and more accurate empirical equation for approximating wave speeds, based on area and relative distance to elastic–muscular arterial transition points; (ii) optimally matched arterial junctions; and (iii) an improved arterial network geometry that eliminated ‘within‐segment’ taper (which causes wave reflection in conduit arteries) whilst establishing ‘impedance‐preserving’ taper. These properties of the model led to wave reflection occurring predominantly at distal vascular beds, rather than in conduit arteries. The model predicted all three typical characteristics of an ascending aortic pressure waveform observed in young adults. When compared with non‐invasively acquired pressure and velocity measurements (obtained via tonometry and Doppler ultrasound in seven young adults), the model was also shown to reproduce the typical waveform morphology observed in the radial, brachial, carotid, temporal, femoral and tibial arteries. The YoungAdult model provides support for the concept that the arterial tree impedance in healthy young adults is exquisitely optimized, and it provides an important baseline model for investigating cardiovascular changes in ageing and disease states.
![]() Key points The origin of wave reflection in the arterial system is controversial, but reflection properties are likely to give rise to characteristic haemodynamic features in healthy young adults, including an early systolic peak, negative systolic augmentation and diastolic hump in the ascending aortic pressure waveform, and triphasic velocity profiles in peripheral arteries. Although computational modelling provides insights into arterial haemodynamics, no previous models have predicted all these features. An established arterial network model was optimized by incorporating the following features: (i) a more accurate representation of arterial wave speeds; (ii) precisely matched junctions; and (iii) impedance‐preserving tapering, thereby minimizing wave reflection in conduit arteries in the forward direction. Comparison with in vivo data (n = 7 subjects) indicated that the characteristic waveform features in young adults were predicted accurately. Our findings strongly imply that a healthy young arterial system is structured to optimize wave reflection in the main conduit arteries and that reflection of forward waves occurs primarily in the vicinity of vascular beds.
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Affiliation(s)
- Avinash Kondiboyina
- Heart Research Murdoch Children's Research Institute Parkville VIC Australia
- Department of Paediatrics University of Melbourne Parkville VIC Australia
| | - Hilary A. Harrington
- Heart Research Murdoch Children's Research Institute Parkville VIC Australia
- Department of Cardiology Royal Children's Hospital Parkville VIC Australia
| | - Joseph J. Smolich
- Heart Research Murdoch Children's Research Institute Parkville VIC Australia
- Department of Paediatrics University of Melbourne Parkville VIC Australia
| | - Michael M.H. Cheung
- Heart Research Murdoch Children's Research Institute Parkville VIC Australia
- Department of Paediatrics University of Melbourne Parkville VIC Australia
- Department of Cardiology Royal Children's Hospital Parkville VIC Australia
| | - Jonathan P. Mynard
- Heart Research Murdoch Children's Research Institute Parkville VIC Australia
- Department of Paediatrics University of Melbourne Parkville VIC Australia
- Department of Biomedical Engineering University of Melbourne Parkville VIC Australia
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23
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Liu W, Du S, Zhou S, Mei T, Zhang Y, Sun G, Song S, Xu L, Yao Y, Greenwald SE. Noninvasive estimation of aortic pressure waveform based on simplified Kalman filter and dual peripheral artery pressure waveforms. COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE 2022; 219:106760. [PMID: 35338889 DOI: 10.1016/j.cmpb.2022.106760] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/17/2021] [Revised: 03/06/2022] [Accepted: 03/14/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND AND OBJECTIVE Aortic pressure (Pa) is important for the diagnosis of cardiovascular disease. However, its direct measurement is invasive, not risk-free, and relatively costly. In this paper, a new simplified Kalman filter (SKF) algorithm is employed for the reconstruction of the Pa waveform using dual peripheral artery pressure waveforms. METHODS Pa waveforms obtained in a previous study were collected from 25 patients. Simultaneously, radial and femoral pressure waveforms were generated from two simulation experiments, using transfer functions. In the first, the transfer function is a known finite impulse response; and in the second, it is derived from a tube-load model. To analyze the performance of the proposed SKF algorithm, variable amounts of noise were added to the observed output signal, to give a range of signal-to-noise ratios (SNRs). Additionally, central aortic, brachial and femoral pressure waveforms were simultaneously collected from 2 Sprague-Dawley rats and the measured and reconstructed Pa waveforms were compared. RESULTS The proposed SKF algorithm outperforms canonical correlation analysis (CCA), which is the current state-of-the-art blind system identification method for the non-invasive estimation of central aortic blood pressure. It is also shown that the proposed SKF algorithm is more noise-tolerant than the CCA algorithm over a wide range of SNRs. CONCLUSION The simulations and animal experiments illustrate that the proposed SKF algorithm is accurate and stable in the face of low SNRs. Improved methods for estimating central blood pressure as a measure of cardiac load adds to their value as a prognostic and diagnostic tool.
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Affiliation(s)
- Wenyan Liu
- College of Medicine and Biological and Information Engineering, Northeastern University, Shenyang 110169, China
| | - Shuo Du
- College of Medicine and Biological and Information Engineering, Northeastern University, Shenyang 110169, China
| | - Shuran Zhou
- College of Medicine and Biological and Information Engineering, Northeastern University, Shenyang 110169, China
| | - Tiemin Mei
- School of Automation and Electrical Engineering, Shenyang Ligong University, Shenyang 110159, China.
| | - Yuelan Zhang
- First Hospital of China Medical University, Shenyang 110122, China
| | - Guozhe Sun
- First Hospital of China Medical University, Shenyang 110122, China
| | - Shuang Song
- School of Mechanical Engineering and Automation, Harbin Institute of Technology Shenzhen Graduate School, Shenzhen 518055, China
| | - Lisheng Xu
- College of Medicine and Biological and Information Engineering, Northeastern University, Shenyang 110169, China; Key Laboratory of Medical Image Computing, Ministry of Education, Shenyang 110169, China; Neusoft Research of Intelligent Healthcare Technology, Co. Ltd., Shenyang 110169, China.
| | - Yudong Yao
- College of Medicine and Biological and Information Engineering, Northeastern University, Shenyang 110169, China
| | - Stephen E Greenwald
- Blizard Institute, Barts & The London School of Medicine & Dentistry, Queen Mary University of London, United Kingdom
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24
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Jin J, Zhang H, Geng X, Zhang Y, Ye T. The pulse waveform quantification method basing on contour and derivative. COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE 2022; 220:106784. [PMID: 35405435 DOI: 10.1016/j.cmpb.2022.106784] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Revised: 03/15/2022] [Accepted: 03/29/2022] [Indexed: 06/14/2023]
Abstract
OBJECTIVE Pulse waveform contains abundant physiological and pathological information. The condition of surrounding arteries can be reflected sensitively by the contour and derivative changes of pulse waves. In order to express these changes objectively, the pulse wave needs to be quantified. METHODS This study provides a novel quantification method for pulse waveform in the entire cardiac cycle. It involves two new quantification parameters k1 and k2 to display the waveform change caused by the superimposition of wave reflection in the systolic reflex period, which is the most significant changes period. In this method, multi parameters were fused by Kalman filter to obtain an optimal estimation, involving the new parameters and other parameters: k0 for the early systolic period, C1 and C2 for diastole period, and K for pulse pressure. RESULTS Use correlation analysis to verify the effectiveness of new parameters that the coefficient is 0.7 between them and the typical augmentation index (AIx). The quantification results of 462 single-cycle pulse waves have consistent change trends with aging in 25-75 different age groups. For respiration analysis, the correlation coefficients are all greater than 0.6, even achieved 0.8 in six multi-cycle data between Kalman optimal estimation and breath wave. CONCLUSION This method has quantified the waveform change with physiological status, and these quantification parameters can display the detail of each period. SIGNIFICANCE It will be used to verify waveform recognition accuracy and has a vast potential to detect diseases.
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Affiliation(s)
- Ji Jin
- Institute of Microelectronics, Chinese Academy of Sciences, Beijing 100029, P.R. China; School of Microelectronics, University of Chinese Academy of Sciences, Beijing 100049, P.R. China
| | - Haiying Zhang
- Institute of Microelectronics, Chinese Academy of Sciences, Beijing 100029, P.R. China; School of Microelectronics, University of Chinese Academy of Sciences, Beijing 100049, P.R. China.
| | - Xingguang Geng
- Institute of Microelectronics, Chinese Academy of Sciences, Beijing 100029, P.R. China; School of Microelectronics, University of Chinese Academy of Sciences, Beijing 100049, P.R. China
| | - Yitao Zhang
- Institute of Microelectronics, Chinese Academy of Sciences, Beijing 100029, P.R. China; School of Microelectronics, University of Chinese Academy of Sciences, Beijing 100049, P.R. China
| | - Tianchun Ye
- Institute of Microelectronics, Chinese Academy of Sciences, Beijing 100029, P.R. China; School of Microelectronics, University of Chinese Academy of Sciences, Beijing 100049, P.R. China
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25
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Schott A, Kluttig A, Mikolajczyk R, Greiser KH, Werdan K, Sedding D, Nuding S. Association of arterial stiffness and heart failure with preserved ejection fraction in the elderly population - results from the CARLA study. J Hum Hypertens 2022:10.1038/s41371-022-00703-y. [PMID: 35581324 DOI: 10.1038/s41371-022-00703-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Revised: 04/05/2022] [Accepted: 04/22/2022] [Indexed: 11/09/2022]
Abstract
Arterial stiffness has been suspected as a cause of left ventricular diastolic dysfunction and may thereby contribute to the development of heart failure with preserved ejection fraction (HFpEF). However, this association is derived from a small number of studies and application of outdated criteria to diagnose HFpEF. This study aimed to investigate the association of arterial stiffness measured by the augmentation index (AIx) and criteria for diagnosing HFpEF according to the recommended HFA-PEFF score. Our analysis based on data from the first follow-up of the CARdiovascular Disease, Living and Ageing in Halle study. The current analysis included participants with available information about comorbidities and risk factors for HFpEF, parameters for calculation of the HFA-PEFF and noninvasive AIx estimated by applanation tonometry. The association of AIx and HFA-PEFF was investigated through descriptive and inductive statistics. A total of 767 participants were included in the analysis. AIx was associated with E/e', left ventricular wall thickness (LVWT), relative wall thickness, left ventricular mass index (LVMI) and NT-proBNP but not with e' or left atrial volume index. However, after adjustment for confounders, only LVMI and LVWT remained associated with AIx. Males with a high AIx had a 3.2-fold higher likelihood of HFpEF than those with a low AIx. In contrast, that association was not present in females. In summary, AIx is associated with the morphological domain of the HFA-PEFF score represented by LVMI and LVWT. Higher values of AIx are associated with a higher likelihood for HFpEF in elderly males but not in females.
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Affiliation(s)
- Artjom Schott
- Department of Internal Medicine III - Cardiology, Angiology and Internal Intensive Care Medicine, Mid-German Heart Center, University Hospital Halle (Saale), Halle (Saale), Germany.
| | - Alexander Kluttig
- Institute of Medical Epidemiology, Biostatistics, and Informatics, Interdisciplinary Center for Health Sciences, Medical Faculty of the Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
| | - Rafael Mikolajczyk
- Institute of Medical Epidemiology, Biostatistics, and Informatics, Interdisciplinary Center for Health Sciences, Medical Faculty of the Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
| | - Karin Halina Greiser
- Division of Cancer Epidemiology, German Cancer Research Centre, Heidelberg, Germany
| | - Karl Werdan
- Department of Internal Medicine III - Cardiology, Angiology and Internal Intensive Care Medicine, Mid-German Heart Center, University Hospital Halle (Saale), Halle (Saale), Germany
| | - Daniel Sedding
- Department of Internal Medicine III - Cardiology, Angiology and Internal Intensive Care Medicine, Mid-German Heart Center, University Hospital Halle (Saale), Halle (Saale), Germany
| | - Sebastian Nuding
- Department of Internal Medicine III - Cardiology, Angiology and Internal Intensive Care Medicine, Mid-German Heart Center, University Hospital Halle (Saale), Halle (Saale), Germany
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26
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Mazimba S, Mwansa H, Breathett K, Strickling JE, Shah K, McNamara C, Mehta N, Kwon Y, Lamp J, Feng L, Tallaj J, Pamboukian S, Mubanga M, Matharoo J, Lim S, Salerno M, Mwansa V, Bilchick KC. Systemic arterial pulsatility index (SAPi) predicts adverse outcomes in advanced heart failure patients. Heart Vessels 2022; 37:1719-1727. [PMID: 35534640 DOI: 10.1007/s00380-022-02070-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Accepted: 03/31/2022] [Indexed: 11/30/2022]
Abstract
Ventriculo-arterial (VA) coupling has been shown to have physiologic importance in heart failure (HF). We hypothesized that the systemic arterial pulsatility index (SAPi), a measure that integrates pulse pressure and a proxy for left ventricular end-diastolic pressure, would be associated with adverse outcomes in advanced HF. We evaluated the SAPi ([systemic systolic blood pressure-systemic diastolic blood pressure]/pulmonary artery wedge pressure) obtained from the final hemodynamic measurement in patients randomized to therapy guided by a pulmonary arterial catheter (PAC) and with complete data in the Evaluation Study of Congestive Heart Failure and Pulmonary Artery Catheterization Effectiveness (ESCAPE) trial. Cox proportional hazards regression was performed for the outcomes of (a) death, transplant, left ventricular assist device (DTxLVAD) or hospitalization, (DTxLVADHF) and (b) DTxLVAD. Among 142 patients (mean age 56.8 ± 13.3 years, 30.3% female), the median SAPi was 2.57 (IQR 1.63-3.45). Increasing SAPi was associated with significant reductions in DTxLVAD (HR 0.60 per unit increase in SAPi, 95% CI 0.44-0.84) and DTxLVADHF (HR 0.81 per unit increase, 95% CI 0.70-0.95). Patients with a SAPi ≤ 2.57 had a marked increase in both outcomes, including more than twice the risk of DTxLVAD (HR 2.19, 95% CI 1.11-4.30) over 6 months. Among advanced heart failure patients with invasive hemodynamic monitoring in the ESCAPE trial, SAPi was strongly associated with adverse clinical outcomes. These findings support further investigation of the SAPi to guide treatment and prognosis in HF undergoing invasive hemodynamic monitoring.
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Affiliation(s)
- Sula Mazimba
- Division of Cardiovascular Medicine, University of Virginia Health System, 1215 Lee St., PO Box 800158, Charlottesville, VA, 22908-0158, USA.
| | - Hunter Mwansa
- Division of Internal Medicine, University of Illinois College of Medicine, Peoria, IL, USA
| | - Khadijah Breathett
- Division of Cardiovascular Medicine, Indiana University, Indianapolis, IN, USA
| | - Jarred E Strickling
- Division of Cardiovascular Medicine, University of Virginia Health System, 1215 Lee St., PO Box 800158, Charlottesville, VA, 22908-0158, USA
| | - Kajal Shah
- Division of Cardiovascular Medicine, University of Virginia Health System, 1215 Lee St., PO Box 800158, Charlottesville, VA, 22908-0158, USA
| | - Coleen McNamara
- Division of Cardiovascular Medicine, University of Virginia Health System, 1215 Lee St., PO Box 800158, Charlottesville, VA, 22908-0158, USA
| | - Nishaki Mehta
- Division of Cardiovascular Medicine, University of Virginia Health System, 1215 Lee St., PO Box 800158, Charlottesville, VA, 22908-0158, USA
| | - Younghoon Kwon
- Division of Cardiovascular Medicine, University of Washington Medical Center, Seattle, WA, USA
| | - Josephine Lamp
- Division of Cardiovascular Medicine, University of Virginia Health System, 1215 Lee St., PO Box 800158, Charlottesville, VA, 22908-0158, USA
| | - Lu Feng
- Division of Cardiovascular Medicine, University of Virginia Health System, 1215 Lee St., PO Box 800158, Charlottesville, VA, 22908-0158, USA
| | - Jose Tallaj
- Division of Cardiovascular Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Salpy Pamboukian
- Division of Cardiovascular Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Mwenya Mubanga
- Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Solna, Stockholm, Sweden
| | - Jashanjeet Matharoo
- Division of Cardiovascular Medicine, University of Virginia Health System, 1215 Lee St., PO Box 800158, Charlottesville, VA, 22908-0158, USA
| | - Scott Lim
- Division of Cardiovascular Medicine, University of Virginia Health System, 1215 Lee St., PO Box 800158, Charlottesville, VA, 22908-0158, USA
| | - Michael Salerno
- Division of Cardiovascular Medicine, University of Virginia Health System, 1215 Lee St., PO Box 800158, Charlottesville, VA, 22908-0158, USA
| | - Victor Mwansa
- Division of Cardiology, Heartland Regional Medical Group, Marion, IL, USA
| | - Kenneth C Bilchick
- Division of Cardiovascular Medicine, University of Virginia Health System, 1215 Lee St., PO Box 800158, Charlottesville, VA, 22908-0158, USA
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27
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AYADI ASMA, SAHTOUT WASSILA, BALEDENT OLIVIER. COMPARISON BETWEEN TWO NONINVASIVE METHODS USED TO ESTIMATE BIOMECHANICAL PROPERTIES OF THE INTERNAL CAROTID ARTERY. J MECH MED BIOL 2022. [DOI: 10.1142/s0219519422500269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Background: Many cardiovascular diseases modified the arterial wall stiffness. Objectives: This work focuses on the quantification of the elastic biomechanical properties of the internal carotid (ICA) wall by applying the cepstral analysis on healthy volunteers aged from 22 to 86 years old. The purpose of this study is to compare two methods of measurement of arterial compliance ([Formula: see text], arterial distensibility ([Formula: see text], arterial elastance (Eh), and Young’s modulus ([Formula: see text]. Material and methods: First, arterial compliance and arterial distensibility were measured in function of wave speed ([Formula: see text], which is measured in our previous works by using two methods. Second, elastance Eh was estimated through the ratio between diastolic radius ([Formula: see text] and [Formula: see text]. Finally, [Formula: see text] was estimated from a statistical study from the literature on h due to the difficulty of measuring wall thickness ([Formula: see text]. Results: The Student test demonstrated that there is a very significant difference between young and old subjects in terms of elastance, compliance, and Young’s modulus ([Formula: see text]). These findings are in agreement with the reference values reported in the literature. They are very satisfying for distinguishing a pathological change in parietal elasticity. Conclusion: The in vivo application of these methods presents their potential for clinical measurement of arterial stiffness.
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Affiliation(s)
- ASMA AYADI
- Laboratory of Biophysics and Medical Technology, Higher Institute of Biotechnology of Sfax, University of Sfax, Tunisia
| | - WASSILA SAHTOUT
- Laboratory of Biophysics and Medical Technology, Higher Institute of Biotechnology of Sfax, University of Sfax, Tunisia
| | - OLIVIER BALEDENT
- Department of Imaging and Biophysics, University of Picardie Jules Verne, CHU Amiens 80054, France
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28
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Kalenga CZ, Ramesh S, Dumanski SM, MacRae JM, Nerenberg K, Metcalfe A, Sola DY, Ahmed SB. Sex influences the effect of adiposity on arterial stiffness and renin‐angiotensin aldosterone system activity in young adults. Endocrinol Diabetes Metab 2022; 5:e00317. [PMID: 34954909 PMCID: PMC8917865 DOI: 10.1002/edm2.317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Revised: 10/23/2021] [Accepted: 12/04/2021] [Indexed: 11/06/2022] Open
Abstract
Introduction Methods Results Conclusion
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Affiliation(s)
- Cindy Z. Kalenga
- Cumming School of Medicine University of Calgary Calgary Alberta Canada
- Libin Cardiovascular Institute University of Calgary Calgary Alberta Canada
| | - Sharanya Ramesh
- Temerty Faculty of Medicine University of Toronto Toronto Ontario Canada
| | - Sandra M. Dumanski
- Cumming School of Medicine University of Calgary Calgary Alberta Canada
- Libin Cardiovascular Institute University of Calgary Calgary Alberta Canada
- Alberta Kidney Disease Network Calgary Alberta Canada
| | - Jennifer M. MacRae
- Cumming School of Medicine University of Calgary Calgary Alberta Canada
- Libin Cardiovascular Institute University of Calgary Calgary Alberta Canada
| | - Kara Nerenberg
- Cumming School of Medicine University of Calgary Calgary Alberta Canada
- Libin Cardiovascular Institute University of Calgary Calgary Alberta Canada
- O’Brien Institute for Public Health University of Calgary Calgary Alberta Canada
| | - Amy Metcalfe
- Cumming School of Medicine University of Calgary Calgary Alberta Canada
- Libin Cardiovascular Institute University of Calgary Calgary Alberta Canada
- O’Brien Institute for Public Health University of Calgary Calgary Alberta Canada
- Alberta Children's Hospital Research Institute Calgary Alberta Canada
| | - Darlene Y. Sola
- Cumming School of Medicine University of Calgary Calgary Alberta Canada
- Libin Cardiovascular Institute University of Calgary Calgary Alberta Canada
| | - Sofia B. Ahmed
- Cumming School of Medicine University of Calgary Calgary Alberta Canada
- Libin Cardiovascular Institute University of Calgary Calgary Alberta Canada
- Alberta Kidney Disease Network Calgary Alberta Canada
- O’Brien Institute for Public Health University of Calgary Calgary Alberta Canada
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29
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Zócalo Y, Gómez-García M, Torrado J, Bia D. Aging-Related Moderation of the Link Between Compliance With International Physical Activity Recommendations and the Hemodynamic, Structural, and Functional Arterial Status of 3,619 Subjects Aged 3–90 Years. Front Sports Act Living 2022; 4:800249. [PMID: 35265833 PMCID: PMC8899126 DOI: 10.3389/fspor.2022.800249] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Accepted: 01/11/2022] [Indexed: 12/16/2022] Open
Abstract
Background Compliance with physical activity recommendations (CPARs) is associated with better health indicators. However, there are only few studies to date that have comprehensively analyzed the association between CPARs and cardiovascular status “as a whole” (e.g., analyzing hemodynamic, structural, and functional properties, and different arterial territories). The relationship between CPARs and cardiovascular properties could be strongly influenced by the growth and aging process. Aim The goal of the study is to investigate the association between CPAR and cardiovascular properties by placing special emphasis on: (i) identifying if there is an independent association, (ii) if the association is “moderated” by age, and (iii) to what extent the association depends on the arterial parameter (hemodynamic vs. structural vs. functional) and/or the arterial segment (e.g., central vs. peripheral; elastic vs. transitional vs. muscular arteries). Methods A total of 3,619 subjects (3–90 years of age) were studied. Extensive cardiovascular evaluations were performed. Cardiovascular risk factors (CRFs) and physical activity (PA) levels were determined. The subjects were categorized as compliant (n = 1, 969) or non-compliant (n = 1,650) with World Health Organization-related PA recommendations. Correlation and multiple regression models (including CPAR*Age interaction) were obtained, and Johnson-Neyman technique was used to produce regions of significance. Results The independent association between CPARs and cardiovascular characteristics were strongly moderated by age. The moderation was observed on a wide range of age but particularly notorious on the extremes of life. Certain arterial characteristics demonstrated opposite effects in relation to CPAR status depending on the range of age considered. The association between CPAR and cardiovascular characteristics was independent of CRFs and moderated by age. In subjects younger than 45–55 years, CPAR status was associated with lower central and peripheral blood pressure (i.e., the younger the subject, the higher the reduction). During adult life, as age increases in the subjects, CPARs was associated with a beneficial hemodynamic profile, which is not related with variations in pressure but strongly related with lower levels of waveform-derived indexes and ventricular afterload determinants. Conclusions The independent associations between CPARs and arterial properties were strongly moderated by age. Data provided by blood pressure levels and waveform-derived indexes would be enough to evaluate the independent association between CPARs and the vascular system in the general population.
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Affiliation(s)
- Yanina Zócalo
- Departamento de Fisiología, Facultad de Medicina, Centro Universitario de Investigación, Innovación y Diagnóstico Arterial, Universidad de la República, Montevideo, Uruguay
- CUiiDARTE - Movimiento, Actividad, Salud (CUiiDARTE-MAS), Comisión Sectorial de Investigación Científica, Universidad de la República, Montevideo, Uruguay
- *Correspondence: Yanina Zócalo
| | - Mariana Gómez-García
- CUiiDARTE - Movimiento, Actividad, Salud (CUiiDARTE-MAS), Comisión Sectorial de Investigación Científica, Universidad de la República, Montevideo, Uruguay
- Departamento de Educación Física y Salud, Instituto Superior de Educación Física, Universidad de la República, Montevideo, Uruguay
| | - Juan Torrado
- CUiiDARTE - Movimiento, Actividad, Salud (CUiiDARTE-MAS), Comisión Sectorial de Investigación Científica, Universidad de la República, Montevideo, Uruguay
- Department of Internal Medicine, Jacobi Medical Center, Albert Einstein College of Medicine, New York, NY, United States
| | - Daniel Bia
- Departamento de Fisiología, Facultad de Medicina, Centro Universitario de Investigación, Innovación y Diagnóstico Arterial, Universidad de la República, Montevideo, Uruguay
- CUiiDARTE - Movimiento, Actividad, Salud (CUiiDARTE-MAS), Comisión Sectorial de Investigación Científica, Universidad de la República, Montevideo, Uruguay
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Kim YG, Moon JY, Oh B, Chin HJ, Kim DK, Park JH, Shin SJ, Choi BS, Lim CS, Lee SH. Pressure-Natriuresis Response Is Diminished in Old Age. Front Cardiovasc Med 2022; 9:840840. [PMID: 35252404 PMCID: PMC8889037 DOI: 10.3389/fcvm.2022.840840] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Accepted: 01/24/2022] [Indexed: 11/13/2022] Open
Abstract
Background Age-related alterations in renal sodium handling affect blood pressure (BP). We aimed to clarify whether the pressure-natriuresis response changes with age, leading to BP elevation. Methods A total of 4,859 participants with normal renal function from the Korean Genome and Epidemiology Study (KoGES) and 235 patients with non-diabetic chronic kidney disease (CKD) from the ESPECIAL trial were included and divided into the younger and older groups. In ESPECIAL, participants took olmesartan from weeks 0 to 16 and were educated about a low-salt diet (LSD) from weeks 8 to 16. Results In both studies, older participants showed lower estimated glomerular filtration rate (eGFR) and urine concentration index and higher albuminuria. In KoGES, BP was higher and urine sodium was lower in older participants. In ESPECIAL, diastolic BP at 0 week was lower in older participants. Olmesartan reduced BP in both groups, whereas LSD decreased systolic BP only in older participants. Urine sodium increased in younger participants but decreased in older participants after olmesartan use. In KoGES, urine sodium was correlated with BP in both groups after adjusting for age, sex, and eGFR; however, the correlation coefficient was lower in older participants. In ESPECIAL, only younger participants showed a significant positive association between systolic BP and urine sodium in multiple regression analysis. Conclusions The pressure-natriuresis response was diminished in older participants with or without CKD.
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Affiliation(s)
- Yang Gyun Kim
- Division of Nephrology, Department of Internal Medicine, Kyung Hee University College of Medicine, Seoul, South Korea
| | - Ju-Young Moon
- Division of Nephrology, Department of Internal Medicine, Kyung Hee University College of Medicine, Seoul, South Korea
| | - Bermseok Oh
- Department of Biomedical Engineering, School of Medicine, Kyung Hee University, Seoul, South Korea
| | - Ho Jun Chin
- Division of Nephrology, Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, South Korea
| | - Dong Ki Kim
- Division of Nephrology, Department of Internal Medicine, Seoul National University Hospital, Seoul, South Korea
| | - Jung Hwan Park
- Division of Nephrology, Department of Internal Medicine, Konkuk University School of Medicine, Seoul, South Korea
| | - Sung Joon Shin
- Division of Nephrology, Department of Internal Medicine, Dongguk University Ilsan Hospital, Goyang, South Korea
| | - Bum Soon Choi
- Division of Nephrology, Department of Internal Medicine, Eunpyeong St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - Chun Soo Lim
- Division of Nephrology, Department of Internal Medicine, Seoul National University Boramae Medical Center, Seoul, South Korea
| | - Sang Ho Lee
- Division of Nephrology, Department of Internal Medicine, Kyung Hee University College of Medicine, Seoul, South Korea
- *Correspondence: Sang Ho Lee
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Arterial stiffness throughout pregnancy: Arteriograph device-specific reference ranges based on a low-risk population. J Hypertens 2022; 40:870-877. [PMID: 35165246 DOI: 10.1097/hjh.0000000000003086] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The maternal cardiovascular system undergoes significant adaptation during pregnancy. We aimed to examine the changes in arterial stiffness parameters during normal pregnancy and establish reference ranges for the general population. METHODS We performed a prospective cross-sectional observational study at the University Hospitals of Leicester. We included low-risk healthy pregnant women with singleton and viable pregnancies with no evidence of foetal abnormality or aneuploidy. Smokers, women with pre-existing or gestational hypertensive disorders and diabetes, booking BMI at least 30, on medication that could affect cardiac function and/or those who delivered before 37 completed weeks of gestation, and/or a neonate with birthweight less than 10th centile were excluded. Brachial (BrAIx) and aortic augmentation indices (AoAIx), and pulse wave velocity (PWV) were assessed using the Arteriograph. Data were analysed using a linear mixed model. RESULTS We analysed a total of 571 readings from 259 women across different gestational ages and present the 10th, 25th, 50th, 75th and 90th centiles for BrAIx, AoAIx and PWV from 12+0 to 42+0 weeks' gestation. All haemodynamic variables were significantly associated with maternal age and heart rate. BrAIx, AoAIx and PWV demonstrated significant change with gestation, with all reaching their lowest value in the second trimester. CONCLUSION The current study presents reference ranges for BrAIx, AoAIx and PWV in low-risk singleton pregnancies. Further work is required to establish if women in whom measures of arterial stiffness lie above the 90th centile could be at increased risk of adverse pregnancy outcomes and to identify the optimum time for screening.
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Du S, Yao Y, Sun G, Mukkamala R, Xu L. Simultaneous adaption of the gain and phase of a generalized transfer function for aortic pressure waveform estimation. Comput Biol Med 2022; 141:105187. [PMID: 34995874 DOI: 10.1016/j.compbiomed.2021.105187] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2021] [Revised: 12/11/2021] [Accepted: 12/27/2021] [Indexed: 11/17/2022]
Abstract
GOAL This paper proposes and validates a completely adaptive transfer function (CATF) based on an autoregressive exogenous (ARX) model which adjusts the gain and phase of a generalized transfer function (GTF) simultaneously to estimate the aortic pressure waveform from a brachial pressure waveform. METHODS Invasive aortic and brachial pressure waveforms were recorded from 34 subjects for the validation of the proposed method. Individual transfer functions (ITFs) were trained based on the pressure waveforms using an ARX model. The GTF was derived by averaging the ITFs. CATF was then obtained by adjusting both the gain and phase of the GTF using regression formulas calculated from the ITFs and brachial hemodynamic parameters. Meanwhile the quantitative contributions of the adaption of gain and phase of the GTF were investigated respectively. The root-mean-square-error of the total waveform and absolute errors of common hemodynamic indices including systolic and diastolic blood pressures (SBP and DBP, respectively), pulse pressure (PP) and augmentation index were used to evaluate the performance of the proposed method in the data divided into low, middle and high PP amplification groups. RESULTS The CATF achieved lower errors for DBP and PP in the low PP amplification group (1.79 versus 2.10 mmHg and 5.08 versus 6.23 mmHg, respectively, both P < 0.05) and PP in the middle amplification group (1.43 versus 1.92 mmHg, P < 0.05) compared with the GTF. SIGNIFICANCE The proposed method provides a step towards the development of an improved and clinically useful non-invasive approach for estimating the aortic pressure waveform from a peripheral pressure waveform.
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Affiliation(s)
- Shuo Du
- College of Medicine and Biological and Information Engineering, Northeastern University, Shenyang, 110169, China
| | - Yang Yao
- School of Information Science and Technology, ShanghaiTech University, Shanghai, 201210, China
| | - Guozhe Sun
- Department of Cardiology, The First Hospital of China Medical University, Shenyang, 110122, Liaoning, China
| | - Ramakrishna Mukkamala
- Department of Bioengineering and Anesthesiology and Perioperative Medicine, University of Pittsburgh, Pittsburgh, PA, 15260, USA
| | - Lisheng Xu
- College of Medicine and Biological and Information Engineering, Northeastern University, Shenyang, 110169, China.
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Obayashi M, Kobayashi S, Nanno T, Hamada Y, Yano M. Relation between Oscillometric Measurement of Central Hemodynamics and Left Ventricular Hypertrophy in Hypertensive Patients. Pulse (Basel) 2022; 9:116-124. [PMID: 35083178 DOI: 10.1159/000520006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Accepted: 09/28/2021] [Indexed: 12/20/2022] Open
Abstract
Introduction The augmentation index (AIx) or central systolic blood pressure (SBP), measured by radial applanation tonometry, has been reported to be independently associated with left ventricular hypertrophy (LVH) in Japanese hypertensive patients. Cuff-based oscillometric measurement of the AIx using Mobil-O-Graph® showed a low or moderate agreement with the AIx measurement with other devices. Methods The AIx measured using the Mobil-O-Graph was validated against the tonometric measurements of the radial AIx measured using HEM-9000AI in 110 normotensive healthy individuals (age, 21-76 years; 50 men). We investigated the relationship between the central hemodynamics assessed using the Mobil-O-Graph and LVH in 100 hypertensive patients (age, 54-75 years; 48 men), presenting a wall thickness of ≥11 mm and ≥10 mm in men and women, respectively. Results Although the Mobil-O-Graph-measured central AIx showed no negative values, it correlated moderately with the HEM-9000AI-measured radial AIx (r = 0.602, p < 0.001) in the normotensive individuals. The hypertensive patients did not show a significant difference in the central SBP between the sexes, but the central AIx was lower in men than in women. The independent determinants influencing left ventricle (LV) mass index (LVMI) (R2 = 0.362; adjusted R2 = 0.329, p < 0.001) were heart rate (β = -0.568 ± 0.149, p < 0.001), central SBP (β = 0.290 ± 0.100, p = 0.005), and aortic root diameter (β = 1.355 ± 0.344, p = 0.001). Age (β = -0.025 ± 0.124, p = 0.841) and the central AIx (β = 0.120 ± 0.131, p = 0.361) were not independently associated with the LVMI. The area under the receiver operator characteristic curve to evaluate the diagnostic performance of the central AIx for the presence of LVH (LVMI >118 g/m2 in men or >108 g/m2 in women) was statistically significant in men (0.875, p < 0.001) but not in women (0.622, p = 0.132). In men, a central AIx of 28.06% had a sensitivity of 83.3% and specificity of 80.0% for detecting LVH. Conclusions AIx measurement in men provided useful prognostic information for the presence of LVH. Pulse-wave analysis assessed using the Mobil-O-Graph may be a valuable tool for detecting LVH in hypertensive patients.
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Affiliation(s)
- Masakazu Obayashi
- Department of Cardiovascular Medicine, Sanyo-Onoda City Hospital, Sanyo-Onoda, Japan
| | - Shigeki Kobayashi
- Division of Cardiology, Department of Medicine and Clinical Science, Yamaguchi University Graduate School of Medicine, Ube, Japan
| | - Takuma Nanno
- Department of Cardiovascular Medicine, Sanyo-Onoda City Hospital, Sanyo-Onoda, Japan
| | - Yoriomi Hamada
- Department of Cardiovascular Medicine, Sanyo-Onoda City Hospital, Sanyo-Onoda, Japan
| | - Masafumi Yano
- Division of Cardiology, Department of Medicine and Clinical Science, Yamaguchi University Graduate School of Medicine, Ube, Japan
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Zócalo Y, Bia D. Central Pressure Waveform-Derived Indexes Obtained From Carotid and Radial Tonometry and Brachial Oscillometry in Healthy Subjects (2–84 Y): Age-, Height-, and Sex-Related Profiles and Analysis of Indexes Agreement. Front Physiol 2022; 12:774390. [PMID: 35126173 PMCID: PMC8811372 DOI: 10.3389/fphys.2021.774390] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2021] [Accepted: 12/22/2021] [Indexed: 12/11/2022] Open
Abstract
Aortic blood pressure (aoBP) waveform-derived indexes could provide valuable (prognostic) information over and above cardiovascular risk factors (CRFs). To obtain aoBP waveform-characteristics, several (i) techniques, (ii) recording sites, (iii) pressure-only waveform analysis mathematical approaches [e.g., pulse wave analysis (PWA), wave separation analysis (WSA)], and (iv) indexes [augmentation pressure and index (AP and AIx), forward (Pf) and backward (Pb) components of aoBP, reflection magnitude (RM), and reflection index (Rix)], were proposed. An accurate clinical use of these indexes requires knowing their physiological age-related profiles and the expected values for a specific subject. There are no works that have characterized waveform-derived indexes profiles in large populations considering: (i) as a continuous, data from different age stages (childhood, adolescence, and adulthood), (ii) complementary indexes, (iii) data obtained from different techniques and approaches, and (iv) analyzing potential sex- and body height (BH)-related differences. In addition, (v) there is a lack of normative data (reference intervals, RIs) for waveform-derived indexes.
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Zschocke J, Bartsch RP, Glos M, Penzel T, Mikolajczyk R, Kantelhardt JW. Long- and short-term fluctuations compared for several organ systems across sleep stages. FRONTIERS IN NETWORK PHYSIOLOGY 2022; 2:937130. [PMID: 36926083 PMCID: PMC10013069 DOI: 10.3389/fnetp.2022.937130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Accepted: 08/08/2022] [Indexed: 11/13/2022]
Abstract
Some details of cardiovascular and cardio-respiratory regulation and their changes during different sleep stages remain still unknown. In this paper we compared the fluctuations of heart rate, pulse rate, respiration frequency, and pulse transit times as well as EEG alpha-band power on time scales from 6 to 200 s during different sleep stages in order to better understand regulatory pathways. The five considered time series were derived from ECG, photoplethysmogram, nasal air flow, and central electrode EEG measurements from full-night polysomnography recordings of 246 subjects with suspected sleep disorders. We applied detrended fluctuation analysis, distinguishing between short-term (6-16 s) and long-term (50-200 s) correlations, i.e., scaling behavior characterized by the fluctuation exponents α 1 and α 2 related with parasympathetic and sympathetic control, respectively. While heart rate (and pulse rate) are characterized by sex and age-dependent short-term correlations, their long-term correlations exhibit the well-known sleep stage dependence: weak long-term correlations during non-REM sleep and pronounced long-term correlations during REM sleep and wakefulness. In contrast, pulse transit times, which are believed to be mainly affected by blood pressure and arterial stiffness, do not show differences between short-term and long-term exponents. This is in constrast to previous results for blood pressure time series, where α 1 was much larger than α 2, and therefore questions a very close relation between pulse transit times and blood pressure values. Nevertheless, very similar sleep-stage dependent differences are observed for the long-term fluctuation exponent α 2 in all considered signals including EEG alpha-band power. In conclusion, we found that the observed fluctuation exponents are very robust and hardly modified by body mass index, alcohol consumption, smoking, or sleep disorders. The long-term fluctuations of all observed systems seem to be modulated by patterns following sleep stages generated in the brain and thus regulated in a similar manner, while short-term regulations differ between the organ systems. Deviations from the reported dependence in any of the signals should be indicative of problems in the function of the particular organ system or its control mechanisms.
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Affiliation(s)
- Johannes Zschocke
- Institute of Medical Epidemiology, Biometrics and Informatics (IMEBI), Interdisciplinary Center for Health Sciences, Martin-Luther-University Halle-Wittenberg, Halle, Germany.,Institute of Physics, Martin-Luther-University Halle-Wittenberg, Halle, Germany
| | - Ronny P Bartsch
- Department of Physics, Bar-Ilan University, Ramat Gan, Israel
| | - Martin Glos
- Interdisciplinary Sleep Medicine Center, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Thomas Penzel
- Interdisciplinary Sleep Medicine Center, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Rafael Mikolajczyk
- Institute of Medical Epidemiology, Biometrics and Informatics (IMEBI), Interdisciplinary Center for Health Sciences, Martin-Luther-University Halle-Wittenberg, Halle, Germany
| | - Jan W Kantelhardt
- Institute of Physics, Martin-Luther-University Halle-Wittenberg, Halle, Germany
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Aghilinejad A, Amlani F, Liu J, Pahlevan NM. Accuracy and applicability of non-invasive evaluation of aortic wave intensity using only pressure waveforms in humans. Physiol Meas 2021; 42. [PMID: 34521071 DOI: 10.1088/1361-6579/ac2671] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Accepted: 09/14/2021] [Indexed: 01/09/2023]
Abstract
Background.Wave intensity (WI) analysis is a well-established method for quantifying the energy carried in arterial waves, providing valuable clinical information about cardiovascular function. The primary drawback of this method is the need for concurrent measurements of both pressure and flow waveforms.Objective. We have for the first time investigated the accuracy of a novel methodology for estimating wave intensity employing only single pressure waveform measurements; we studied both carotid- and radial-based estimations in a large heterogeneous cohort.Approach.Tonometry was performed alongside Doppler ultrasound to acquire measurements of both carotid and radial pressure waveforms as well as aortic flow waveforms in 2640 healthy and diseased participants (1439 female) in the Framingham Heart Study. Patterns consisting of two forward waves (Wf1, Wf2) and one backward wave (Wb1) along with reflection metrics were compared with those obtained from exact WI analysis.Main Results. Carotid-based estimates correlated well for forward peak amplitudes (Wf1,r = 0.85,p < 0.05; Wf2,r = 0.72,p < 0.05) and peak time (Wf1,r = 0.94,p < 0.05; Wf2,r = 0.98,p < 0.05), and radial-based estimates correlated fairly to poorly for amplitudes (Wf1,r = 0.62,p < 0.05; Wf2,r = 0.42,p < 0.05) and peak time (Wf1,r = 0.04,p = 0.10; Wf2,r = 0.75,p < 0.05). In all cases, estimated Wb1 measures were not correlated. Reflection metrics were well correlated for healthy patients (r = 0.67,p < 0.05), moderately correlated for valvular disease (r = 0.59,p < 0.05) and fairly correlated for CVD (r = 0.46,p < 0.05) and heart failure (r = 0.49,p < 0.05).Significance. These findings indicate that pressure-only WI produces accurate results only when forward contributions are of primary interest and only for carotid pressure waveforms. The pressure-only WI estimations of this work provide an important opportunity to further the goal of uncovering clinical insights through wave analysis affordably and non-invasively.
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Affiliation(s)
- Arian Aghilinejad
- Department of Aerospace & Mechanical Engineering, University of Southern California, Los Angeles, United States of America
| | - Faisal Amlani
- Department of Aerospace & Mechanical Engineering, University of Southern California, Los Angeles, United States of America
| | - Jing Liu
- Department of Aerospace & Mechanical Engineering, University of Southern California, Los Angeles, United States of America
| | - Niema M Pahlevan
- Department of Aerospace & Mechanical Engineering, University of Southern California, Los Angeles, United States of America.,Division of Cardiovascular Medicine, Department of Medicine, Keck School of Medicine, University of Southern California, Los Angeles, United States of America
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Tomoto T, Repshas J, Zhang R, Tarumi T. Midlife aerobic exercise and dynamic cerebral autoregulation: associations with baroreflex sensitivity and central arterial stiffness. J Appl Physiol (1985) 2021; 131:1599-1612. [PMID: 34647828 PMCID: PMC8616602 DOI: 10.1152/japplphysiol.00243.2021] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Revised: 10/04/2021] [Accepted: 10/11/2021] [Indexed: 12/20/2022] Open
Abstract
Midlife aerobic exercise may significantly impact age-related changes in the cerebro- and cardiovascular regulations. This study investigated the associations of midlife aerobic exercise with dynamic cerebral autoregulation (dCA), cardiovagal baroreflex sensitivity (BRS), and central arterial stiffness. Twenty middle-aged athletes (MA) who had aerobic training for >10 yr were compared with 20 young (YS) and 20 middle-aged sedentary (MS) adults. Beat-to-beat cerebral blood flow velocity, blood pressure (BP), and heart rate were measured at rest and during forced BP oscillations induced by repeated sit-stand maneuvers at 0.05 Hz. Transfer function analysis was used to calculate dCA and BRS parameters. Carotid distensibility was measured by ultrasonography. MA had the highest peak oxygen uptake (V̇o2peak) among all groups. During forced BP oscillations, MS showed lower BRS gain than YS, but this age-related reduction was absent in MA. Conversely, dCA was similar among all groups. At rest, BRS and dCA gains at low frequency (∼0.1 Hz) were higher in the MA than in MS and YS groups. Carotid distensibility was similar between MA and YS groups, but it was lower in the MS. Across all subjects, V̇o2peak was positively associated with BRS gains at rest and during forced BP oscillations (r = 0.257∼0.382, P = 0.003∼0.050) and carotid distensibility (r = 0.428∼0.490, P = 0.001). Furthermore, dCA gain at rest and carotid distensibility were positively correlated with BRS gain at rest in YS and MA groups (all P < 0.05). These findings suggest that midlife aerobic exercise improves central arterial elasticity and BRS, which may contribute to cerebral blood flow (CBF) regulation through dCA.NEW & NOTEWORTHY Middle-aged athletes (MA) showed intact dynamic cerebral autoregulation (dCA) during sit-stand maneuvers when compared with young (YS) and middle-aged sedentary (MS) adults. Conversely, MA showed the significant attenuation of age-related carotid distensibility and baroreflex sensitivity (BRS) impairments. In MA and YS groups, BRS was positively associated with dCA gain at rest and carotid distensibility. Our findings suggest that midlife aerobic exercise improves BRS by reducing central arterial stiffness, which contributes to CBF regulation through dCA.
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Affiliation(s)
- Tsubasa Tomoto
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, Dallas, Texas
- Department of Neurology, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Justin Repshas
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, Dallas, Texas
| | - Rong Zhang
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, Dallas, Texas
- Department of Neurology, University of Texas Southwestern Medical Center, Dallas, Texas
- Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Takashi Tarumi
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, Dallas, Texas
- Department of Neurology, University of Texas Southwestern Medical Center, Dallas, Texas
- Human Informatics and Interaction Research Institute, National Institute of Advanced Industrial Science and Technology, Tsukuba, Japan
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Pan F, He P, Pu X, Gao H, Chen F, Feng J, Zheng D. Influence of aging and increased blood pressure on oscillometric cuff pressure waveform characteristics. J Hypertens 2021; 39:2157-2163. [PMID: 34149015 DOI: 10.1097/hjh.0000000000002921] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
BACKGROUND The oscillometric blood pressure (BP) measurement technique estimates BPs from analyzing the envelop of oscillometric cuff pressure waveform. The oscillometric waveform envelope shape is associated with physiological changes and influences BP measurement accuracy. The aim of this study was to comprehensively quantify BP- and age-related changes of oscillometric waveform envelope characteristics. METHOD Manual systolic and diastolic BPs were measured from 472 patients (219 female, 253 male), and the cuff pressure were digitally recorded during linear cuff deflation that was used to derive oscillometric waveform envelopes. All patients were divided into different categories according to their BP level and age. The envelope width in high-pressure region (above mean arterial pressure, MAP) and low-pressure region (below MAP) were compared between different BP and age categories to qualify their changes with increased BP and aging. RESULTS The envelop widths increased significantly with increased BPs (P < 0.001 between optimal, normotensive and hypertensive groups) and aging (P < 0.001 for >50 years old group in comparison with younger groups). The envelope widths in high-pressure region were significantly larger than in low-pressure region in normal and hypertensive categories (all P < 0.05) and elderly patients aged over 60 years (all P < 0.001), and the envelope width ratios between them increased with increased BP and aging. CONCLUSION This study has concluded an asymmetrical oscillometric waveform envelope in normotensive and hypertensive categories, as well as in elderly group (aged over 60 years), and their asymmetrical features were significantly more obvious with increased BP and aging.
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Affiliation(s)
- Fan Pan
- College of Electronics and Information Engineering, Sichuan University
| | - Peiyu He
- College of Electronics and Information Engineering, Sichuan University
| | - Xiaobo Pu
- Department of Cardiology, West China Hospital
| | - Hu Gao
- Department of Emergency, West China Second University Hospital, Sichuan University
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu
| | - Fei Chen
- Department of Electrical and Electronic Engineering, Southern University of Science and Technology, Shenzhen
| | - Junfeng Feng
- Brain Injury Center, Neurosurgery Department, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai China
| | - Dingchang Zheng
- Research Centre of Intelligent Healthcare, Faculty of Health and Life Science, Coventry University, Coventry, UK
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The association of elevated blood pressure during ischaemic exercise with sport performance in Master athletes with and without morbidity. Eur J Appl Physiol 2021; 122:211-221. [PMID: 34652528 PMCID: PMC8748359 DOI: 10.1007/s00421-021-04828-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Accepted: 09/29/2021] [Indexed: 11/04/2022]
Abstract
Background An exaggerated exercise blood pressure (BP) is associated with a reduced exercise capacity. However, its connection to physical performance during competition is unknown. Aim To examine BP responses to ischaemic handgrip exercise in Master athletes (MA) with and without underlying morbidities and to assess their association with athletic performance during the World Master Track Cycling Championships 2019. Methods Forty-eight Master cyclists [age 59 ± 13yrs; weekly training volume 10.4 ± 4.1 h/week; handgrip maximum voluntary contraction (MVC) 46.3 ± 11.5 kg] divided into 2 matched groups (24 healthy MA and 24 MA with morbidity) and 10 healthy middle-aged non-athlete controls (age 48.3 ± 8.3 years; MVC 40.4 ± 14.8 kg) performed 5 min of forearm occlusion including 1 min handgrip isometric contraction (40%MVC) followed by 5 min recovery. Continuous beat-by-beat BP was recorded using finger plethysmography. Age-graded performance (AGP) was calculated to compare race performances among MA. Healthy Master cyclists were further grouped into middle-age (age 46.2 ± 6.4 years; N:12) and old-age (age 65.0 ± 7.7 years; N:12) for comparison with middle-aged non-athlete controls. Results Healthy and morbidity MA groups showed similar BP responses during forearm occlusion and AGP (90.1 ± 4.3% and 91.0 ± 5.3%, p > 0.05, respectively). Healthy and morbidity MA showed modest correlation between the BP rising slope for 40%MVC ischaemic exercise and AGP (r = 0.5, p < 0.05). MA showed accelerated SBP recovery after cessation of ischaemic handgrip exercise compared to healthy non-athlete controls. Conclusion Our findings associate long-term athletic training with improved BP recovery following ischaemic exercise regardless of age or reported morbidity. Exaggerated BP in Master cyclists during ischaemic exercise was associated with lower AGP during the World Master Cycling Championships. Supplementary Information The online version contains supplementary material available at 10.1007/s00421-021-04828-9.
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Jo G, Yang TH, Koo JH, Jun MH, Kim YM. A Transfer Function Model Development for Reconstructing Radial Pulse Pressure Waveforms Using Non-Invasively Measured Pulses by a Robotic Tonometry System. SENSORS 2021; 21:s21206837. [PMID: 34696048 PMCID: PMC8540787 DOI: 10.3390/s21206837] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/21/2021] [Revised: 09/24/2021] [Accepted: 10/03/2021] [Indexed: 12/03/2022]
Abstract
The primary goal of this study is to develop a mathematical model that can establish a transfer function relationship between the “external” pulse pressures measured by a tonometer and the “internal” pulse pressure in the artery. The purpose of the model is to accurately estimate and rebuild the internal pulse pressure waveforms using arterial tonometry measurements. To develop and validate a model without human subjects and operators for consistency, this study employs a radial pulse generation system, a robotic tonometry system, and a write model with an artificial skin and vessel. A transfer function model is developed using the results of the pulse testing and the mechanical characterization testing of the skin and vessel. To evaluate the model, the pulse waveforms are first reconstructed for various reference pulses using the model with tonometry data. They are then compared with pulse waveforms acquired by internal measurement (by the built-in pressure sensor in the vessel) the external measurement (the on-skin measurement by the robotic tonometry system). The results show that the model-produced pulse waveforms coinciding well with the internal pulse waveforms with small relative errors, indicating the effectiveness of the model in reproducing the actual pulse pressures inside the vessel.
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Affiliation(s)
- Gwanghyun Jo
- Department of Mathematics, Kunsan National University, 558 Daehak-ro, Gunsan-si 54150, Korea;
| | - Tae-Heon Yang
- Department of Electronic Engineering, Korea National University of Transportation, 50 Daehak-ro, Chungju-si 27469, Korea
- Correspondence: (T.-H.Y.); (Y.-M.K.)
| | - Jeong-Hoi Koo
- Department of Mechanical and Manufacturing Engineering, Miami University, Oxford, OH 45242, USA;
| | - Min-Ho Jun
- Digital Health Research Division, Korea Institute of Oriental Medicine, 1672, Yuseong-daero, Yuseong-gu, Daejeon 34054, Korea;
| | - Young-Min Kim
- Digital Health Research Division, Korea Institute of Oriental Medicine, 1672, Yuseong-daero, Yuseong-gu, Daejeon 34054, Korea;
- Correspondence: (T.-H.Y.); (Y.-M.K.)
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41
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Determination of aortic pulse transit time based on waveform decomposition of radial pressure wave. Sci Rep 2021; 11:20154. [PMID: 34635739 PMCID: PMC8505599 DOI: 10.1038/s41598-021-99723-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Accepted: 09/30/2021] [Indexed: 11/23/2022] Open
Abstract
Carotid-femoral pulse transit time (cfPTT) is a widely accepted measure of central arterial stiffness. The cfPTT is commonly calculated from two synchronized pressure waves. However, measurement of synchronized pressure waves is technically challenging. In this paper, a method of decomposing the radial pressure wave is proposed for estimating cfPTT. From the radial pressure wave alone, the pressure wave can be decomposed into forward and backward waves by fitting a double triangular flow wave. The first zero point of the second derivative of the radial pressure wave and the peak of the dicrotic segment of radial pressure wave are used as the peaks of the fitted double triangular flow wave. The correlation coefficient between the measured wave and the estimated forward and backward waves based on the decomposition of the radial pressure wave was 0.98 and 0.75, respectively. Then from the backward wave, cfPTT can be estimated. Because it has been verified that the time lag estimation based on of backward wave has strong correlation with the measured cfPTT. The corresponding regression function between the time lag estimation of backward wave and measured cfPTT is y = 0.96x + 5.50 (r = 0.77; p < 0.001). The estimated cfPTT using radial pressure wave decomposition based on the proposed double triangular flow wave is more accurate and convenient than the decomposition of the aortic pressure wave based on the triangular flow wave. The significance of this study is that arterial stiffness can be directly estimated from a noninvasively measured radial pressure wave.
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42
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Abstract
The aim of this study was to develop a robust algorithm to quantify pulse sharpness that can complement the limitations of radial augmentation index (rAIx) and explore the role of this quantitative sharpness index in reflecting vascular aging or arterial stiffness. The pulse sharpness index (PSI) was developed by combining the end point angle and virtual height, and 528 radial pulses were analyzed. The PSI could be uniformly applied to various waveform morphologies, even those with no or vague tidal waves, unlike the rAIx. Significant sex differences were identified in the rAIx and PSI (P < 0.01 for both), and significant age-dependent decreases in the PSI were observed (P < 0.01). In addition, the PSI and age were correlated (r = - 0.550) at least as strong as the rAIx and age (r = 0.532), and the PSI had a significant negative correlation with arterial stiffness (r = - 0.700). Furthermore, the multiple linear regression model for arterial stiffness using the PSI, age, sex and heart rate showed the excellent performance (cross-validated R2 = 0.701), and the PSI was found to have the greatest influence on arterial stiffness. This study confirmed that the PSI could be a quantitative index of vascular aging and has potential for use in inferring arterial stiffness with an advantage over the rAIx.
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Affiliation(s)
- Jang-Han Bae
- Digital Health Research Division, Korea Institute of Oriental Medicine, 1672 Yuseong-daero, Yuseong-gu, Daejeon, Republic of Korea
| | - Young Ju Jeon
- Digital Health Research Division, Korea Institute of Oriental Medicine, 1672 Yuseong-daero, Yuseong-gu, Daejeon, Republic of Korea.
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Tomoto T, Liu J, Tseng BY, Pasha EP, Cardim D, Tarumi T, Hynan LS, Munro Cullum C, Zhang R. One-Year Aerobic Exercise Reduced Carotid Arterial Stiffness and Increased Cerebral Blood Flow in Amnestic Mild Cognitive Impairment. J Alzheimers Dis 2021; 80:841-853. [PMID: 33579857 DOI: 10.3233/jad-201456] [Citation(s) in RCA: 43] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND Central arterial stiffness and brain hypoperfusion are emerging risk factors of Alzheimer's disease (AD). Aerobic exercise training (AET) may improve central arterial stiffness and brain perfusion. OBJECTIVE To investigate the effects of AET on central arterial stiffness and cerebral blood flow (CBF) in patients with amnestic mild cognitive impairment (MCI), a prodromal stage of AD. METHODS This is a proof-of-concept, randomized controlled trial that assigned 70 amnestic MCI patients into a 12-month program of moderate-to-vigorous AET or stretching-and-toning (SAT) intervention. Carotid β-stiffness index and CBF were measured by color-coded duplex ultrasonography and applanation tonometry. Total CBF was measured as the sum of CBF from both the internal carotid and vertebral arteries, and divided by total brain tissue mass assessed with MRI to obtain normalized CBF (nCBF). Episodic memory and executive function were assessed using standard neuropsychological tests (CVLT-II and D-KEFS). Changes in cardiorespiratory fitness were measured by peak oxygen uptake (VO2peak). RESULTS Total 48 patients (29 in SAT and 19 in AET) were completed one-year training. AET improved VO2peak, decreased carotid β-stiffness index and CBF pulsatility, and increased nCBF. Changes in VO2peak were associated positively with changes in nCBF (r = 0.388, p = 0.034) and negatively with carotid β-stiffness index (r = -0.418, p = 0.007) and CBF pulsatility (r = -0.400, p = 0.014). Decreases in carotid β-stiffness were associated with increases in cerebral perfusion (r = -0.494, p = 0.003). AET effects on cognitive performance were minimal compared with SAT. CONCLUSION AET reduced central arterial stiffness and increased CBF which may precede its effects on neurocognitive function in patients with MCI.
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Affiliation(s)
- Tsubasa Tomoto
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, Dallas, TX, USA.,Department of Neurology, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Jie Liu
- Department of Pharmacology, Physiology and Neuroscience, Rutgers University, Newark, NJ, USA
| | - Benjamin Y Tseng
- Department of Health and Kinesiology, The University of Texas at Tyler, Tyler, TX, USA
| | - Evan P Pasha
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, Dallas, TX, USA
| | - Danilo Cardim
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, Dallas, TX, USA.,Department of Neurology, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Takashi Tarumi
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, Dallas, TX, USA.,Department of Neurology, University of Texas Southwestern Medical Center, Dallas, TX, USA.,Human Informatics Research Institute, National Institute of Advanced Industrial Science and Technology, Tsukuba, Ibaraki, Japan
| | - Linda S Hynan
- Department of psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA.,Population and Data Sciences, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - C Munro Cullum
- Department of Neurology, University of Texas Southwestern Medical Center, Dallas, TX, USA.,Department of psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Rong Zhang
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, Dallas, TX, USA.,Department of Neurology, University of Texas Southwestern Medical Center, Dallas, TX, USA.,Internal Medicine University of Texas Southwestern Medical Center, Dallas, TX, USA
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44
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Su J, Simonsen U, Mellemkjaer S, Howard LS, Manisty C, Hughes AD. Limited value of pulse wave analysis in assessing arterial wave reflection and stiffness in the pulmonary artery. Physiol Rep 2021; 9:e15024. [PMID: 34558215 PMCID: PMC8461033 DOI: 10.14814/phy2.15024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Accepted: 08/11/2021] [Indexed: 01/09/2023] Open
Abstract
We explored the use of the augmentation index (AI) based on pulse wave analysis (PWA) in the pulmonary circulation as a measure of wave reflection and arterial stiffness in individuals with and without pulmonary arterial hypertension (PAH) and chronic thromboembolic pulmonary hypertension (CTEPH). Right heart catheterization was performed using a pressure and Doppler flow sensor-tipped catheter to obtain simultaneous pressure and flow velocity measurements in the pulmonary artery in 10 controls, 11 PAH patients, and 11 CTEPH patients. PWA was applied to the measured pressure, while wave intensity analysis (WIA) and wave separation analysis (WSA) were performed using both the pressure and velocity to determine the magnitudes and timings of reflected waves. Type C (AI < 0) pressure waveform dominated in controls and type A (AI > 12%) waveform dominated in PAH patients, while there was a mixture of types A, B, and C among CTEPH patients. AI was greater and the inflection time shorter in CTEPH compared to PAH patients. There was a poor correlation between AI and arterial wave speed as well as measures of wave reflection derived from WIA and WSA. The infection point did not match the timing of the backward compression wave in ~50% of the cases. In patients with type C waveforms, the inflection time correlated well to the timing of the late systolic forward decompression wave caused by ventricular relaxation. In conclusion quantifying pulmonary arterial wave reflection and stiffness using AI based on PWA may be inaccurate and should therefore be discouraged.
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Affiliation(s)
- Junjing Su
- Department of BiomedicineAarhus UniversityAarhusDenmark
- National Heart and Lung InstituteImperial College LondonLondonUK
| | - Ulf Simonsen
- Department of BiomedicineAarhus UniversityAarhusDenmark
| | | | - Luke S. Howard
- National Heart and Lung InstituteImperial College LondonLondonUK
| | - Charlotte Manisty
- MRC Unit for Lifelong Health and AgingInstitute of Cardiovascular ScienceUniversity College LondonLondonUK
| | - Alun D. Hughes
- MRC Unit for Lifelong Health and AgingInstitute of Cardiovascular ScienceUniversity College LondonLondonUK
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45
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Rinkūnienė E, Dženkevičiūtė V, Petrulionienė Ž, Majauskienė E, Ryliškytė L, Puronaitė R, Badarienė J, Navickas R, Laucevičius A. Hypertriglyceridemia impact on arterial parameters in patients with metabolic syndrome. BMC Cardiovasc Disord 2021; 21:393. [PMID: 34388967 PMCID: PMC8361842 DOI: 10.1186/s12872-021-02202-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2020] [Accepted: 06/09/2021] [Indexed: 12/14/2022] Open
Abstract
Background The development of metabolic syndrome (MS) augments risk for atherosclerotic cardiovascular disease (CVD), but pathophysiological mechanisms of this relation are still under discussion. Overlapping CVD risk factors make it difficult to assess the importance of individual elements. This study aimed to analyze subclinical atherosclerosis based on arterial structure and function parameters in patients with MS and different triglycerides levels. Methods Patients (aged 40–65 years) were divided into two groups: patients with MS and with or without hypertriglyceridemia (hTG). Noninvasive assessment of vascular parameters—aortic augmentation index adjusted for heart rate 75 bpm (AIxHR75), pulse wave velocity (PWV), and common carotid artery intima-media thickness (cIMT) were performed. Results Carotid-femoral PWV (cfPWV) and carotid-radial PWV (crPWV) were significantly higher in patients with hTG. After adjusting for age, gender, waist circumference, fasting glucose, smoking status, cardiovascular family history and mean arterial pressure, crPWV (OR 1.150; CI 95% 1.04–1.28), cfPWV (OR 1.283; CI 95% 1.14–1.42) and cIMT (OR 1.13; CI 95% 1.02–1.25) were significantly associated with hTG (p < 0.05), while AIxHR75 did not show significant association. Conclusion Increased triglycerides are independently associated with a cfPWV, crPWV, and cIMT and may modify CVD risk in patients with MS. Supplementary Information The online version contains supplementary material available at 10.1186/s12872-021-02202-3.
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Affiliation(s)
- Egidija Rinkūnienė
- Faculty of Medicine, Vilnius University Hospital Santaros Klinikos, Vilnius University, Santariskiu Str. 2, 08661, Vilnius, Lithuania
| | - Vilma Dženkevičiūtė
- Faculty of Medicine, Vilnius University Hospital Santaros Klinikos, Vilnius University, Santariskiu Str. 2, 08661, Vilnius, Lithuania
| | - Žaneta Petrulionienė
- Faculty of Medicine, Vilnius University Hospital Santaros Klinikos, Vilnius University, Santariskiu Str. 2, 08661, Vilnius, Lithuania
| | - Eglė Majauskienė
- Faculty of Medicine, Vilnius University Hospital Santaros Klinikos, Vilnius University, Santariskiu Str. 2, 08661, Vilnius, Lithuania.
| | - Ligita Ryliškytė
- Faculty of Medicine, Vilnius University Hospital Santaros Klinikos, Vilnius University, Santariskiu Str. 2, 08661, Vilnius, Lithuania
| | - Roma Puronaitė
- Faculty of Medicine, Vilnius University Hospital Santaros Klinikos, Vilnius University, Santariskiu Str. 2, 08661, Vilnius, Lithuania.,Faculty of Mathematics and Informatics, Vilnius University, Vilnius, Lithuania
| | - Jolita Badarienė
- Faculty of Medicine, Vilnius University Hospital Santaros Klinikos, Vilnius University, Santariskiu Str. 2, 08661, Vilnius, Lithuania
| | - Rokas Navickas
- Faculty of Medicine, Vilnius University Hospital Santaros Klinikos, Vilnius University, Santariskiu Str. 2, 08661, Vilnius, Lithuania
| | - Aleksandras Laucevičius
- Faculty of Medicine, Vilnius University Hospital Santaros Klinikos, Vilnius University, Santariskiu Str. 2, 08661, Vilnius, Lithuania.,State Research Institute Centre of Innovative Medicine, Vilnius, Lithuania
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46
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Hungerford SL, Adji AI, Hayward CS, Muller DWM. Ageing, Hypertension and Aortic Valve Stenosis: A Conscious Uncoupling. Heart Lung Circ 2021; 30:1627-1636. [PMID: 34274230 DOI: 10.1016/j.hlc.2021.05.108] [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: 01/15/2021] [Revised: 04/17/2021] [Accepted: 05/18/2021] [Indexed: 10/20/2022]
Abstract
Aortic valve stenosis (AS) is no longer considered to be a disease of fixed left ventricular (LV) afterload (due to an obstructive valve), but rather, functions as a series circuit with important contributions from both the valve and ageing vasculature. Patients with AS are frequently elderly, with hypertension and a markedly remodelled aorta. The arterial component is sizable, and yet, the contribution of ventricular afterload has been difficult to determine. Arterial stiffening increases the speed of propagation of the blood pressure wave along the central arteries (estimated as the pulse wave velocity), which results in an earlier return of reflected waves. The effect is to augment blood pressure in the proximal aorta during systole, increasing the central pulse pressure and, in turn, placing even greater afterload on the heart. Elevated global LV afterload is known to have adverse consequences on LV remodelling, function and survival in patients with AS. Consequently, there is renewed focus on methods to estimate the relative contributions of local versus global changes in arterial mechanics and valvular haemodynamics in patients with AS. We present a review on existing and upcoming methods to quantify valvulo-arterial impedance and thereby global LV load in patients with AS.
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Affiliation(s)
- Sara L Hungerford
- Department of Cardiology, St Vincent's Hospital, Sydney, NSW, Australia; The University of New South Wales, Sydney, NSW, Australia; Victor Chang Cardiac Research Institute, Sydney, NSW, Australia.
| | - Audrey I Adji
- Department of Cardiology, St Vincent's Hospital, Sydney, NSW, Australia; The University of New South Wales, Sydney, NSW, Australia; Victor Chang Cardiac Research Institute, Sydney, NSW, Australia; Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, NSW, Australia
| | - Christopher S Hayward
- Department of Cardiology, St Vincent's Hospital, Sydney, NSW, Australia; The University of New South Wales, Sydney, NSW, Australia; Victor Chang Cardiac Research Institute, Sydney, NSW, Australia
| | - David W M Muller
- Department of Cardiology, St Vincent's Hospital, Sydney, NSW, Australia; The University of New South Wales, Sydney, NSW, Australia; Victor Chang Cardiac Research Institute, Sydney, NSW, Australia
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Three-Dimensional Arterial Pulse Signal Acquisition in Time Domain Using Flexible Pressure-Sensor Dense Arrays. MICROMACHINES 2021; 12:mi12050569. [PMID: 34067840 PMCID: PMC8156466 DOI: 10.3390/mi12050569] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Revised: 05/12/2021] [Accepted: 05/13/2021] [Indexed: 11/17/2022]
Abstract
In this study, we developed a radial artery pulse acquisition system based on finger-worn dense pressure sensor arrays to enable three-dimensional pulse signals acquisition. The finger-worn dense pressure-sensor arrays were fabricated by packaging 18 ultra-small MEMS pressure sensors (0.4 mm × 0.4 mm × 0.2 mm each) with a pitch of 0.65 mm on flexible printed circuit boards. Pulse signals are measured and recorded simultaneously when traditional Chinese medicine practitioners wear the arrays on the fingers while palpating the radial pulse. Given that the pitches are much smaller than the diameter of the human radial artery, three-dimensional pulse envelope images can be measured with the system, as can the width and the dynamic width of the pulse signals. Furthermore, the array has an effective span of 11.6 mm-3-5 times the diameter of the radial artery-which enables easy and accurate positioning of the sensor array on the radial artery. This study also outlines proposed methods for measuring the pulse width and dynamic pulse width. The dynamic pulse widths of three volunteers were measured, and the dynamic pulse width measurements were consistent with those obtained by color Doppler ultrasound. The pulse wave velocity can also be measured with the system by measuring the pulse transit time between the pulse signals at the brachial and radial arteries using the finger-worn sensor arrays.
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48
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49
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Afkhami R, Johnson S. Wave reflection: More than a round trip. Med Eng Phys 2021; 92:40-44. [PMID: 34167710 DOI: 10.1016/j.medengphy.2021.04.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Revised: 04/18/2021] [Accepted: 04/21/2021] [Indexed: 02/06/2023]
Abstract
Reflected pressure waves are key to the understanding of vascular ageing, a prominent factor in major cardiovascular events. Several different metrics have been proposed to index the effect of wave reflection on the pressure waveform and thereby serve as an indicator of vascular ageing. The extent to which these indices are influenced by factors other than vascular health remains a matter of concern. In this paper, we use transmission-line theory to derive a mathematical model for the reflection time (Trefl), and the augmentation index (AI), assuming a general extended model of the arterial system. Then, we test the proposed model against values reported in the literature. Finally, we discuss insights from the model to common observations in the literature such as age-related "shift" in the reflection site, the variation of AI with heart rate, and the flattening of Trefl in older participants.
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Affiliation(s)
- Rashid Afkhami
- School of Engineering, The Unviersity of Newcastle, Australia.
| | - Sarah Johnson
- School of Engineering, The Unviersity of Newcastle, Australia.
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50
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Kawano H, Asaka M, Yamamoto K, Gando Y, Konishi M, Sakamoto S, Miyachi M, Higuchi M. Greater arterial wall viscosity in endurance-trained men. Eur J Appl Physiol 2021; 121:2219-2228. [PMID: 33890159 DOI: 10.1007/s00421-021-04686-5] [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: 11/04/2020] [Accepted: 04/08/2021] [Indexed: 11/28/2022]
Abstract
PURPOSE The age-associated increase in arterial wall viscosity (AWV) is attenuated by high cardiorespiratory fitness level. However, AWV in endurance-trained athletes have not been determined. We designed a cross sectional study to compare central AWV and compliance between endurance-trained young athletes and age-matched control men. METHODS Twenty-one endurance-trained men (age 20.7 ± 0.3 years) and 20 age-matched healthy control men (age 21.6 ± 0.4 years) were studied. The common carotid artery was measured noninvasively by tonometry and automatic tracking of B-mode images to obtain instantaneous pressure and diameter hysteresis loops, and we calculated the dynamic carotid arterial compliance, static (effective and isobaric) compliance, and viscosity index. RESULTS The AWV index in the endurance-trained men was larger than the control peers (2285 ± 181 vs. 1429 ± 124 mmHg·s/mm: P < 0.001). In addition, dynamic and static compliance were not statistically different between both groups. CONCLUSION The present study indicated that the central AWV in endurance-trained athletes was greater than age-matched healthy control men. We believe that the AWV, as well as arterial compliance, is an important element for assessing vascular adaptation to endurance training.
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Affiliation(s)
- Hiroshi Kawano
- Faculty of Letters, Kokushikan University, 4-28-1 Setagaya, Setagaya-ku, Tokyo, 154-8515, Japan. .,Faculty of Sport Sciences, Waseda University, 2-579-15 Mikajima, Tokorozawa, Saitama, 359-1192, Japan.
| | - Meiko Asaka
- Department of Life Sciences, Graduate School of Arts and Sciences, University of Tokyo, 3-8-1 Komaba, Meguro-ku, Tokyo, 153-8902, Japan
| | - Kenta Yamamoto
- Faculty of Pharmaceutical Sciences, Teikyo Heisei University, 4-21-2 Nakano, Nakano-ku, Tokyo, 164-8530, Japan
| | - Yuko Gando
- Department of Physical Activity Research, National Institutes of Biomedical Innovation, Health and Nutrition, 1-23-1 Toyama, Shinjuku, Tokyo, 162-8636, Japan
| | - Masayuki Konishi
- Faculty of Sport Sciences, Waseda University, 2-579-15 Mikajima, Tokorozawa, Saitama, 359-1192, Japan.,Faculty of Health Promotional Sciences, Tokoha University, 1230 Miyakoda-cho, Kita-ku, Hamamatsu, Shizuoka, 431-2102, Japan
| | - Shizuo Sakamoto
- Faculty of Sport Sciences, Waseda University, 2-579-15 Mikajima, Tokorozawa, Saitama, 359-1192, Japan
| | - Motohiko Miyachi
- Department of Physical Activity Research, National Institutes of Biomedical Innovation, Health and Nutrition, 1-23-1 Toyama, Shinjuku, Tokyo, 162-8636, Japan
| | - Mitsuru Higuchi
- Faculty of Sport Sciences, Waseda University, 2-579-15 Mikajima, Tokorozawa, Saitama, 359-1192, Japan
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