Aortic Distensibility in Patients with Cerebrovascular Disease

1995 ◽  
Vol 89 (3) ◽  
pp. 247-253 ◽  
Author(s):  
E. D. Lehmann ◽  
K. D. Hopkins ◽  
R. L. Jones ◽  
A. G. Rudd ◽  
R. G. Gosling

1. Non-invasive aortic compliance measurements have been used previously to assess the distensibility of the aorta in several pathological conditions associated with increased cardiovascular risk. We set out to establish whether aortic compliance is abnormal in patients with stroke. 2. Pulse wave velocity measurements of thoracoabdominal aortic compliance were made in 20 stroke patients and 25 age- and sex-matched hospitalized, non-stroke control subjects putatively free of cardiovascular disease. Since compliance varies with non-chronic changes in blood pressure, a blood pressure corrected index of aortic distensibility, Cp, was calculated. 3. Aortic compliance was significantly reduced in patients with stroke compared with non-stroke control subjects (0.46 ± 0.27 versus 0.86 ± 0.34%/10 mmHg, P < 0.0002), corresponding with higher values for pulse wave velocity. Stroke patients also had significantly higher systolic and diastolic blood pressures (P < 0.02 and P < 0.002 respectively) and total cholesterol levels (P < 0.004) than the control subjects. Calculation of Cp did not alter the observation of stiffer aortas in the stroke cohort (P < 0.0007). 4. In both stroke patient and control cohorts, as expected, inverse trends were observed between aortic compliance and blood pressure. Also as expected, in the control group Cp values did not show a relationship with blood pressure (r = 0.02, P = 0.092, not significant). However, in the stroke cohort a marked dependence of Cp on blood pressure was observed (r = −0.48, P = 0.03). 5. Transoesophageal echocardiographic studies have recently identified advanced atherosclerosis in the ascending aorta as a possible source of cerebral emboli and an independent risk factor for ischaemic stroke. Our observations of significantly stiffer thoracoabdominal aortas in patients with stroke lead us to hypothesize that a totally non-invasive assessment of aortic compliance may potentially prove a useful surrogate marker of such atherosclerotic risk. 6. Blood pressure-corrected indices of arterial elastic properties based on normotensive models are widely applied in the literature. Our observation that these indices exhibit a considerable blood pressure dependence leads us to urge caution in the use of such corrections, especially in hypertensive patients.

2020 ◽  
Vol 25 (12) ◽  
pp. 4036
Author(s):  
H. Yilmaz Ak ◽  
Y. Ozsahin ◽  
N. Baskurt Aladag ◽  
F. Gencoglu ◽  
B. Sahin Yildiz ◽  
...  

Aim. Patients with chronic inflammatory diseases (CID), such as rheumatoid arthritis (RA) and familial Mediterranean fever (FMF) are more likely to have higher risk of cardiac events. Pulse wave velocity (PWV) can be used to measure the aortic dis-tensibility and it is known as inversely related to the arterial compliance. Increased aortic stiffness which is assessed by PWV, is seem to be associated with arterial blood pressure. In this study, we investigated the arterial compliance by PWV in patients with CID including RA and FMF.Material and methods. We studied 25 patients with RA, 33 patients with FMF and 31 healthy subjects without a history of any cardiovascular risk factors such as hypertension, diabetes mellitus, hyperlipidaemia (89 subjects in total). We measured the arterial compliance by automatic carotid-femoral (aortic) PWV using Complior Colson (France) device. PWV (m/s) = distance (m)/transit time(s).Results. It is seen that, patients with CID have higher carotid-femoral (aortic) PWV (8,76±2,09 vs 8,07±0,94 m/s) compared to control groups (p=0,03). There were significant correlations between PWV and age, body-mass index, systolic blood pressure, diastolic blood pressure and mean blood pressure. (p<0,001, r=0,65; p<0,001, r=0,36; p<0,001, r=0,42; p<0,001, r=0,46; p<0,001, r=0,48, respectively).Conclusion. Arterial compliance, which is assessed by carotid-femoral (aortic) PWV, is decreased in patients with CID such as RA and FMF when it is compared to healthy control group.


Sensors ◽  
2019 ◽  
Vol 19 (16) ◽  
pp. 3467 ◽  
Author(s):  
Vratislav Fabian ◽  
Lukas Matera ◽  
Kristyna Bayerova ◽  
Jan Havlik ◽  
Vaclav Kremen ◽  
...  

Cardiovascular diseases are one of most frequent cause of morbidity and mortality in the world. There is an emerging need for integrated, non-invasive, and easy-to-use clinical tools to assess accurately cardiovascular system primarily in the preventative medicine. We present a novel design for a non-invasive pulse wave velocity (PWV) assessment method integrated in a single brachial blood pressure monitor allowing for up to 100 times more sensitive recording of the pressure pulsations based on a brachial occlusion-cuff (suprasystolic) principle. The monitor prototype with built-in proprietary method was validated with a gold standard reference technique SphygmoCor VX device. The blood pressure and PWV were assessed on twenty-five healthy individuals (9 women, age (37 ± 13) years) in a supine position at rest by a brachial cuff blood pressure monitor prototype, and immediately re-tested using a gold standard method. PWV using our BP monitor was (6.67 ± 0.96) m/s compared to PWV determined by SphygmoCor VX (6.15 ± 1.01) m/s. The correlation between methods using a Pearson’s correlation coefficient was r = 0.88 (p < 0.001). The study demonstrates the feasibility of using a single brachial cuff build-in technique for the assessment of the arterial stiffness from a single ambulatory blood pressure assessment.


2020 ◽  
Vol 39 (1) ◽  
pp. 117-126
Author(s):  
Bart Spronck ◽  
Isabella Tan ◽  
Koen D. Reesink ◽  
Dana Georgevsky ◽  
Tammo Delhaas ◽  
...  

2021 ◽  
pp. 1-8
Author(s):  
Cansu Sivrikaya Yildirim ◽  
Pelin Kosger ◽  
Tugcem Akin ◽  
Birsen Ucar

Abstract Children with a family history of hypertension have higher blood pressure and hypertensive pathophysiological changes begin before clinical findings. Here, the presence of arterial stiffness was investigated using central blood pressure measurement and pulse wave analysis in normotensive children with at least one parent with essential hypertension. Twenty-four-hour ambulatory pulse wave analysis monitoring was performed by oscillometric method in a study group of 112 normotensive children of hypertensive parents aged between 7 and 18 comparing with a control group of 101 age- and gender-matched normotensive children of normotensive parents. Pulse wave velocity, central systolic and diastolic blood pressure, systolic, diastolic and mean arterial blood pressure values were higher in the study group than the control group (p < 0.001, p = 0.002, p = 0.008, p = 0.001, p = 0.005, p = 0.001, p = 0.001, respectively). In all age groups (7–10, 11–14, and 15–18 years), pulse wave velocity was higher in the study group than the control group (p < 0.001). Pulse wave velocity was higher in children whose both parents are hypertensive compared to the children whose only mothers are hypertensive (p = 0.011). Pulse wave velocity values were positively correlated with age, weight, height, and body mass index (p < 0.05). Higher pulse wave velocity, central systolic and diastolic blood pressure values detected in the study group can be considered as early signs of hypertensive vascular changes. Pulse wave analysis can be a reliable, non-invasive, and reproducible method that can allow taking necessary precautions regarding lifestyle to prevent disease and target organ damage by detecting early hypertensive changes in genetically risky children.


2017 ◽  
Vol 14 (3) ◽  
pp. 254-257 ◽  
Author(s):  
Hsien-Tsai Wu ◽  
Kuan-Wei Lee ◽  
Wen-Yao Pan ◽  
An-Bang Liu ◽  
Cheuk-Kwan Sun

Objective: This study aimed at validating photoplethysmography for assessing bilateral blood pressure differences through investigating the correlations of digital volume pulse with arteriosclerosis risk. Methods: Totally, 111 subjects (70 healthy and 41 diabetic) were recruited. Demographic, blood pressure and anthropometric data were recorded. Blood was collected for determining serum cholesterol, total triglyceride, total cholesterol, high-/low-density lipoprotein cholesterol, fasting blood sugar and glycated haemoglobin concentrations. Arterial stiffness was assessed with electrocardiogram-based pulse wave velocity, crest time and inter-digital volume pulse differences. Results: Receiver operating characteristic curve demonstrated high inter-digital volume pulse difference sensitivity to glycated haemoglobin level over 6.5%. Linear regression analysis demonstrated significant correlation between inter-digital volume pulse difference and electrocardiogram-based pulse wave velocity ( r = 0.692, p < 0.001). Compared with electrocardiogram-based pulse wave velocity, inter-digital volume pulse difference exhibited highly significant correlations with age, glycated haemoglobin level, pulse pressure, total cholesterol/high-density lipoprotein ratio, crest time, high-density lipoprotein and systolic blood pressure (all ps < 0.001). Conclusion: In conclusion, the results not only demonstrated successful application of a novel non-invasive waveform contour index, inter-digital volume pulse difference, in differentiating young from aged subjects and patients with good diabetic control from those with poor diabetic control but also validated its use in identifying arteriosclerosis risks. The results, therefore, endorse its domestic application as non-invasive tool for arteriosclerosis risk screening.


Author(s):  
Noah Manring ◽  
Mouayed Al-Toki

Abstract Aortic compliance has been well established as an independent predictor of cardiovascular morbidity and mortality. The current "gold standard" for assessing aortic compliance is to use the carotid-femoral pulse-wave velocity (PWV) as a surrogate; however, PWV alone has been discussed in the literature as being inadequate for assessing compliance, especially for elderly patients and others who have a stiff aorta. In this paper an equation for the aortic compliance is developed using two approaches: 1) lumped-parameter modeling based on blood-pressure data and 2) distributed modeling based on the PWV. In-vitro experiments are conducted using a silicone-rubber tube which simulates the aorta, and an actual aorta harvested from a 1-year old, Holstein heifer. For both the rubber aorta and the Holstein aorta, a comparison is made between the blood-pressure model and the PWV model. In conclusion it is shown that good agreement exists between the two models, suggesting that either model may be used depending upon the available data. Furthermore, due to differences in material properties, it is shown that the compliance of the rubber aorta increases with mean arterial-pressure, while the compliance of the Holstein aorta decreases with mean arterial-pressure. Clinical implications of this research are also discussed.


2018 ◽  
Vol 23 (5) ◽  
pp. 419-425 ◽  
Author(s):  
Klaas Frederik Franzen ◽  
Johannes Willig ◽  
Silja Cayo Talavera ◽  
Moritz Meusel ◽  
Friedhelm Sayk ◽  
...  

The introduction of electronic cigarettes has led to widespread discussion on the cardiovascular risks compared to conventional smoking. We therefore conducted a randomized cross-over study of the acute use of three tobacco products, including a control group using a nicotine-free liquid. Fifteen active smokers were studied during and after smoking either a cigarette or an electronic cigarette with or without nicotine (eGo-T CE4 vaporizer). Subjects were blinded to the nicotine content of the electronic cigarette and were followed up for 2 hours after smoking a cigarette or vaping an electronic cigarette. Peripheral and central blood pressures as well as parameters of arterial stiffness were measured by a Mobil-O-Graph® device. The peripheral systolic blood pressure rose significantly for approximately 45 minutes after vaping nicotine-containing liquid ( p<0.05) and for approximately 15 minutes after smoking a conventional cigarette ( p<0.01), whereas nicotine-free liquids did not lead to significant changes during the first hour of follow-up. Likewise, heart rate remained elevated approximately 45 minutes after vaping an electronic cigarette with nicotine-containing liquid and over the first 30 minutes after smoking a cigarette in contrast to controls. Elevation of pulse wave velocity was independent from mean arterial pressure as well as heart rate in the electronic cigarette and cigarette groups. In this first of its kind trial, we observed changes in peripheral and central blood pressure and also in pulse wave velocity after smoking a cigarette as well as after vaping a nicotine-containing electronic cigarette. These findings may be associated with an increased long-term cardiovascular risk.


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