scholarly journals Is augmentation index a good measure of vascular stiffness in the elderly?

2006 ◽  
Vol 36 (1) ◽  
pp. 43-48 ◽  
Author(s):  
F. Fantin ◽  
A. Mattocks ◽  
C. J. Bulpitt ◽  
W. Banya ◽  
C. Rajkumar
Keyword(s):  
Augmentation Index ◽  
The Elderly ◽  
Vascular Stiffness ◽  
Good Measure

Arterial stiffness is a potential mechanism and promising indicator of orthostatic hypotension in the general population

VASA ◽  
2014 ◽  
Vol 43 (6) ◽  
pp. 423-432 ◽  
Author(s):  
Qingtao Meng ◽  
Si Wang ◽  
Yong Wang ◽  
Shixi Wan ◽  
Kai Liu ◽  
...  
Keyword(s):  
General Population ◽  
Arterial Stiffness ◽  
Orthostatic Hypotension ◽  
Operating Characteristic ◽  
Pulse Wave ◽  
Augmentation Index ◽  
Multiple Logistic Regression Analysis ◽  
The Elderly ◽  
Baroreceptor Sensitivity ◽  
Roc Curve Analysis

Background: Orthostatic hypotension (OH) is a disease prevalent among middle-aged men and the elderly. The association between arterial stiffness and OH is unclear. This study evaluates whether arterial stiffness is correlated with OH and tests the usefulness of brachial-ankle pulse wave velocity (baPWV), an arterial stiffness marker, with regard to identifying OH. Patients and methods: A sample of 1,010 participants was recruited from the general population (64.8 ± 7.7 years; 426 men) who attended health check-ups. BaPWV and the radial augmentation index (rAI) were both assessed as the arterial stiffness markers, and OH was determined using blood pressure (BP) measured in the supine position, as well as 30 seconds and 2 minutes after standing. Results: The prevalence of OH in this population was 4.9 %. Compared with the non-OH group, both baPWV (20.5 ± 4.5 vs 17.3 ± 3.7, p < 0.001) and rAI (88.1 ± 10.8 vs 84.2 ± 10.7, p < 0.05) were significantly higher in the OH group. In the multiple logistic regression analysis, baPWV (OR, 1.3; 95 % CI, 1.106–1.528; p < 0.05) remained associated with OH. Moreover, the degree of orthostatic BP reduction was related to arterial stiffness. In addition, increases in arterial stiffness predicted decreases in the degree of heart rate (HR) elevation. Finally, a receiver operating characteristic (ROC) curve analysis showed that baPWV was useful in discriminating OH (AUC, 0.721; p < 0.001), with the cut-off value of 18.58 m/s (sensitivity, 0.714; specificity, 0.686). Conclusions: Arterial stiffness determined via baPWV, rather than rAI, was significantly correlated with the attenuation of the orthostatic hemodynamic response and the resultant OH. The impaired baroreceptor sensitivity might be the mechanism. In addition, baPWV appears to be a relatively sensitive and reliable indicator of OH in routine clinical practice.

MO754THE INTERRELATIONSHIP BETWEEN FLUID OVERLOAD AND VASCULAR STIFFNESS IN HEMODIALYSIS PATIENTS: A SCOPING REVIEW

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Aya Lafta ◽  
Aminu Bello ◽  
Sara Davison ◽  
Stephanie Thompson ◽  
Branko Braam
Keyword(s):  
Pulse Wave Velocity ◽  
Wave Velocity ◽  
Scoping Review ◽  
Observational Studies ◽  
Pulse Wave ◽  
Fluid Overload ◽  
Augmentation Index ◽  
Extracellular Fluid ◽  
Vascular Stiffness

Abstract Background and Aims Fluid overload and vascular stiffness are two independent predictors of cardiovascular events in hemodialysis (HD) patients. To date, observational and interventional studies that investigated the effect of inter- and intradialytic fluid overload changes on vascular stiffness in HD patients are very limited. We performed a scoping review to explore existing reports about effects of fluid overload on vascular stiffness in adults receiving HD treatment and to identify knowledge gaps for future research. Method We followed the framework originally developed by Arksey and O’Malley. We searched Medline, Embase, CINAHL, and Cochrane Database of systematic reviews from inception to October 29, 2019. References of review papers were screened for relevant studies not identified from the initial search until saturation is achieved. Results Of 666 eligible studies, nineteen studies met the inclusion criteria. These included clinical observational studies (n=16) and randomized controlled trials (n=3). In general, most of the identified studies had small sample size and short term of follow up. Studies use different definitions of fluid overload and vascular stiffness. Measures of relative fluid overload like the ratio of extracellular fluid/intracellular fluid, fluid overload/extracellular fluid, and/or extracellular fluid/total body fluid were used as a representative of fluid status. Pulse wave velocity and augmentation index were used interchangeably as vascular stiffness measures. The accumulated findings were inconsistent and inconclusive. There was no consensus whether intradialytic fluid volume changes affected vascular stiffness. In the majority of the observational studies, a decrease in pulse wave velocity or augmentation index correlated with a decrease in blood pressure after fluid correction by HD treatment. The randomized clinical trials used different methods and technologies for the correction of fluid overload, thereby, results were conflicting. Conclusion Current literature is insufficient to justify whether fluid overload changes have a direct effect on vascular stiffness in HD patients. The findings were conflicting which limits the comparisons of studies and generalization of findings. These knowledge gaps urge the need for further clinical studies to enhance the understanding and to improve the quality of research in this topic. This includes standardized definitions and methodologies as well as longer term of follow up.

Abstract 062: Aortic Stiffness, Blood Pressure Progression and Incident Hypertension: The Framingham Heart Study

Circulation ◽  
2012 ◽  
Vol 125 (suppl_10) ◽  
Author(s):  
Bernhard M Kaess ◽  
Jian Rong ◽  
Martin G Larson ◽  
Naomi M Hamburg ◽  
Joseph A Vita ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Brachial Artery ◽  
Aortic Stiffness ◽  
Wave Amplitude ◽  
Augmentation Index ◽  
Vascular Stiffness ◽  
Flow Mediated Dilation ◽  
Forward Wave ◽  
Incident Hypertension

Background: Increased vascular stiffness and excessive blood pressure (BP) pulsatility are important risk factors for age-related morbidity. Vascular stiffness and BP pulsatility are related, with a prevailing view that hypertension antedates and contributes to premature vascular aging and a secondary increase in vascular stiffness. However, temporal relations between comprehensive vascular measures and BP elevation have not been fully delineated in a large community-based sample. Methods: We examined longitudinal relations of BP and 3 measures of vascular stiffness and pressure pulsatility derived from arterial tonometry (carotid-femoral pulse wave velocity [CFPWV], forward wave amplitude and augmentation index) over a 7-year period in 1,898 Framingham Offspring participants (mean age 60 yrs, 1,057 women). We also examined relations between measures of microvascular and endothelial function derived from brachial artery Doppler and future progression of BP or vascular stiffness. Results: In multivariable-adjusted regression models, baseline tonometry measures were separately and jointly associated with higher systolic and pulse pressure and incident hypertension ( Table ). Conversely, higher baseline BP was associated with higher forward wave amplitude and augmentation index (all p<0.05) but not CFPWV at follow-up. Higher baseline resting brachial artery flow and lower flow-mediated dilation were associated with incident hypertension in models that included BP and tonometry measures ( Table ). Conclusion: Higher aortic stiffness (CFPWV), pressure pulsatility (forward wave amplitude), and wave reflection (augmentation index) and lower flow-mediated dilation are associated with blood pressure progression and incident hypertension. Our findings support the notion of aortic stiffness as a precursor of hypertension and further suggest a vicious cycle of increasing pressure pulsatility with advancing age. Table. Correlates of incident hypertension. Predictor Variables (baseline) OR 95% CI P Systolic BP 3.24 (2.17; 4.84) <0.0001 Diastolic BP 1.47 (1.13; 1.92) 0.0042 CFPWV 1.30 (1.02; 1.67) 0.037 Forward wave amplitude 1.66 (1.32; 2.09) <0.0001 Augmentation index 1.78 (1.45; 2.17) <0.0001 Brachial artery baseline flow 1.23 (1.05; 1.45) 0.013 Flow-mediated dilation 0.83 (0.70; 0.98) 0.029 Results of a single multivariable model that further adjusted for age,sex, BMI, height and triglycerides in 1,019 participants free of hypertension at baseline who experienced 337 cases of incident hypertension during follow-up. OR expressed per 1 SD of the independent variable.

scholarly journals Clinical and functional characteristics of arterial stiffness in elderly

2021 ◽  
Vol 18 (1) ◽  
pp. 31-36
Author(s):  
Ilkhom T. Murkamilov ◽  
Kubanych A. Aitbaev ◽  
Viktor V. Fomin ◽  
Zhamila A. Murkamilova ◽  
Nodira A. Redzhapova ◽  
...  
Keyword(s):  
Arterial Stiffness ◽  
Elderly Women ◽  
Augmentation Index ◽  
The Elderly ◽  
Pulse Frequency ◽  
Stiffness Index ◽  
Hemodynamic Parameters ◽  
Double Product ◽  
Average Value ◽  
Functional Features

Aim. Purpose of the study. To study the clinical and functional features of the parameters of arterial stiffness in the elderly, depending on gender differences. Materials and methods. The study included 497 therapeutic patients aged from 60 to 74 years. The average age of the examined patients was 65.13.9 years. All patients underwent a comprehensive clinical and instrumental examination. The study of the parameters of arterial stiffness and central arterial pressure (BP) was carried out on the AngioScan-01 apparatus (AngioScan-Electronics, Russia). Depending on the sex differences, the entire sample was divided into two age-matched groups: women (n=287) and men (n=210). Results. In the group of women, systolic levels (13820 mm Hg vs 13419 mm Hg; p=0.018), central (13720 mm Hg vs 13319 mm Hg; p=0.024), average (469 mm Hg vs 456 mm Hg; p=0.018), pulse BP (5316 mm Hg vs 5014 mm Hg; p=0.038), the value of the double product (107.423.5 conventional units vs 101.422.5 conventional units; p=0.004), augmentation index (AI) [22.1 (13.5, 31,3)% vs 15.9 (8.8; 24.9)%; p=0.005], the increase index at a pulse frequency of 75 per minute [23.2 (16.0; 30.5)% vs 15.9 (9.2; 23.5)%; p=0.005] and systole duration in percent (35.505.60 vs 34.244.53; p=0.007) were significantly higher than in the group of men. In addition, men showed a statistically significant increase in the average value of the alternative stiffness index (9.762.61 vs 8.172.03; p=0.005) and the dependence of the AI on age (p0.05). At the same time, a statistically more significant correlation of central and peripheral hemodynamic parameters with the presence of elevated AI (p0.05) was recorded in the group of women. Conclusion. In older women, an increase in systolic, central, average, pulse BP is associated with an increase in AI and an increase in the magnitude of the double product. In the group of elderly men, the increase in the alternative vascular stiffness index contributes to an increase in the duration of the pulse wave. Statistically more pronounced correlation relationships between the value of the AI and clinical and hemodynamic parameters were recorded in elderly women.

scholarly journals 192 Study of endothelial function and vascular stiffness in patients affected by dilated cardiomyopathy on treatment with sacubitril/valsartan

2021 ◽  
Vol 23 (Supplement_G) ◽  
Author(s):  
Ludovica Amore ◽  
Fabio Alghisi ◽  
Angelica Cersosimo ◽  
Giuliana Cimino ◽  
Greta Pascariello ◽  
...  
Keyword(s):  
Mitral Regurgitation ◽  
Ejection Fraction ◽  
Arterial Pressure ◽  
Endothelial Function ◽  
Dilated Cardiomyopathy ◽  
Aortic Stiffness ◽  
Augmentation Index ◽  
Left Ventricular ◽  
Vascular Stiffness ◽  
Left Ventricular Ejection

Abstract Aims It has already been demonstrated the efficacy of sacubitril/valsartan in the treatment of heart failure with reduced ejection fraction, but many of its properties are still unknown especially regarding its effects on endothelial dysfunction and arterial stiffness. Methods and results To this purpose, a longitudinal study involving 15 patients with dilated cardiomyopathy with reduced left ventricular ejection fraction (LVEF) was started; the purpose was collecting at the beginning and at the end of the study blood pressure measurements, transthoracic echocardiography images, parameters of endothelial function with peripheral arterial tonometry (EndoPAT®), and non-invasive evaluation of the aortic stiffness parameters by using applanation tonometry (SphygmoCor® Px system). Aortic stiffness parameters weren’t different at 6 months, compared to baseline. There was a slight, not significant increase in augmentation pressure (P = 0.889), augmentation index (P = 0.906), and sphygmic wave velocity (P = 0.263). Systolic, diastolic, and differential central arterial pressure didn’t change. RHI (reactive hyperaemia index) increased significantly after 6 months (P = 0.001) as well as augmentation index corrected for 75 b.p.m. Ejection fraction (32.21% ± 5.7 to 38.43% ± 8.4; P = 0.010) and diastolic dysfunction degree (P = 0.021) improved significantly. Mitral regurgitation improvement wasn’t statistically significant (P = 0.116). Tricuspid annular plane systolic excursion didn’t change while pulmonary systolic arterial pressure increased, although not significantly (22.83 mmHg ± 4 to 27.33 mmHg ± 6; P = 0.068) and within the normal range values. Conclusions Sacubitril/valsartan can improve endothelial function significantly in patients with dilated cardiomyopathy and reduced LVEF. It can also improve left ventricular function, mitral regurgitation, and diastolic function. Conversely, this drug seems to have no effects on vascular stiffness.

scholarly journals Vitamin K Supplementation to Improve Vascular Stiffness in CKD: The K4Kidneys Randomized Controlled Trial

2020 ◽  
Vol 31 (10) ◽  
pp. 2434-2445
Author(s):  
Miles D. Witham ◽  
Jennifer S. Lees ◽  
Myra White ◽  
Margaret Band ◽  
Samira Bell ◽  
...  
Keyword(s):  
Vascular Calcification ◽  
Vitamin K ◽  
Pulse Wave ◽  
Augmentation Index ◽  
Meta Analysis ◽  
Vitamin K2 ◽  
Vascular Stiffness ◽  
Vascular Health ◽  
Ckd Stage ◽  
To Receive

BackgroundVascular calcification, a risk factor for cardiovascular disease, is common among patients with CKD and is an independent contributor to increased vascular stiffness and vascular risk in this patient group. Vitamin K is a cofactor for proteins involved in prevention of vascular calcification. Whether or not vitamin K supplementation could improve arterial stiffness in patients with CKD is unknown.MethodsTo determine if vitamin K supplementation might improve arterial stiffness in patients in CKD, we conducted a parallel-group, double-blind, randomized trial in participants aged 18 or older with CKD stage 3b or 4 (eGFR 15–45 ml/min per 1.73 m2). We randomly assigned participants to receive 400 μg oral vitamin K2 or matching placebo once daily for a year. The primary outcome was the adjusted between-group difference in carotid-femoral pulse wave velocity at 12 months. Secondary outcomes included augmentation index, abdominal aortic calcification, BP, physical function, and blood markers of mineral metabolism and vascular health. We also updated a recently published meta-analysis of trials to include the findings of this study.ResultsWe included 159 randomized participants in the modified intention-to-treat analysis, with 80 allocated to receive vitamin K and 79 to receive placebo. Mean age was 66 years, 62 (39%) were female, and 87 (55%) had CKD stage 4. We found no differences in pulse wave velocity at 12 months, augmentation index at 12 months, BP, B-type natriuretic peptide, or physical function. The updated meta-analysis showed no effect of vitamin K supplementation on vascular stiffness or vascular calcification measures.ConclusionsVitamin K2 supplementation did not improve vascular stiffness or other measures of vascular health in this trial involving individuals with CKD.Clinical Trial registry name and registration numberVitamin K therapy to improve vascular health in patients with chronic kidney disease, ISRCTN21444964 (www.isrctn.com)

scholarly journals Arterial Stiffness and Vascular Aging: Effects of Hypertension

2021 ◽  
Vol 11 (3) ◽  
pp. 196-202
Author(s):  
E. S. Fomina ◽  
V. S. Nikiforov
Keyword(s):  
Cardiovascular Risk ◽  
Arterial Stiffness ◽  
Arterial Hypertension ◽  
Augmentation Index ◽  
Target Organ Damage ◽  
Ankle Brachial Index ◽  
Vascular Stiffness ◽  
Vascular Aging ◽  
Aging Effects ◽  
Functional Changes

This review highlights the relationship of age and arterial hypertension observed in the aging process. The main structural and functional changes underlying the increase in vascular stiffness are analyzed. The similarity of vascular changes in aging and arterial hypertension was noted. The negative effect of increased central blood pressure on target organs is considered. Attention is paid to the analysis of arterial stiffness as a marker of vascular aging. The parameters of the carotid-femoral pulse wave propagation velocity, the cardio-ankle vascular index (CAVI), the ankle-brachial index, the finger-brachial index, and the augmentation index were examined separately. The prognostic and clinical value of the parameters of vascular stiffness is considered. In particular, the clinical guidelines for arterial hypertension report the need to use arterial stiffness indicators to improve the accuracy of cardiovascular risk stratification, especially in medium-risk patients. Measurement of vascular stiffness and central aortic pressure should be recommended as one of the methods for stratifying cardiovascular risk in patients with intermediate SCORE risk, as well as in those whose target organ damage was not detected by routine methods. The article also notes the independent diagnostic and prognostic value of the CAVI.

scholarly journals Foci of chronic infection and vascular rigidity in persons of military age

2018 ◽  
Vol 20 (1) ◽  
pp. 149-153
Author(s):  
M E Evsevyeva ◽  
M V Eremin ◽  
E V Italyantseva ◽  
M V Rostovtseva ◽  
O V Sergeeva
Keyword(s):  
Blood Pressure ◽  
Risk Factor ◽  
Chronic Infection ◽  
Inflammatory Diseases ◽  
Augmentation Index ◽  
Young Men ◽  
Left Ventricular ◽  
Vascular Stiffness ◽  
Focal Infection ◽  
Atherosclerotic Cardiovascular Diseases

The role of focal infection as a possible risk factor for development of atherosclerotic cardiovascular diseases is discussed quite intensively now. Estimated some parameters of vascular stiffness in young men of military age with the features of their infectious-inflammatory medical history by the type of foci of chronic infection. It is established that in young men with foci of chronic infection such indicators of vascular stiffness, as peripheral augmentation index, augmentation index, normalized to heart rate, and augmentation index of the aorta were significantly higher than in their peers with a positive history. The differences in the first two indicators have reached a reliable level. It should be emphasized the presence of more low blood pressure in the presence of foci of chronic infection , which eliminates the distortion parameters of vascular status, influenced by the tensile effect from the blood pressure in the time of the study. The obtained data clearly indicate the higher rigidity of the walls of the aorta and large arteries in young men under the influence of their foci of chronic infection. Some tendency to development of left ventricular dysfunction in young people with presence of chronic tonsillitis and other infectious and inflammatory diseases was also revealed. This dysfunction is expressed in reducing the maximum rate of growth of blood pressure and increasing the period of expulsion of the left ventricle. The presented results confirm the concept of lifelong formation of «infectious-inflammatory load» in terms of increasing vascular rigidity and subclinical changes in the functioning of the myocardium at young age, subject to the presence of a focal chronic infection. These data allow us to regard foci of chronic infection as another risk factor of atherosclerosis, which in turn requires consideration when carrying out the relevant preventive measures among young population in the process of health checkups.

scholarly journals The Progression of Diabetic Microvascular Complications and Increased Vascular Stiffness

2014 ◽  
Vol 21 (4) ◽  
pp. 357-361
Author(s):  
Olivia Georgescu ◽  
Gabriel Clătici ◽  
Cătălin Nica ◽  
Simona Fica
Keyword(s):  
Type 2 Diabetes ◽  
Augmentation Index ◽  
Microvascular Complications ◽  
Macrovascular Disease ◽  
Vascular Stiffness ◽  
Therapeutic Interventions ◽  
Non Invasive ◽  
Diabetic Microvascular Complications ◽  
Invasive Techniques

Abstract In patients with type 2 diabetes mellitus it might be helpful to use, for risk stratification, non-invasive techniques as markers of early atherosclerosis. Arterial stiffness shows the functional vascular properties and can be estimated by pulse wave velocity (PWV) and augmentation index (AIX). Typical for type 2 diabetes is premature arterial stiffening which appears before the onset of clinically micro or macrovascular disease and is increased in the presence of microvascular complications. Further studies are needed to determine whether therapeutic interventions for reducing vascular stiffness may decrease the cardiovascular mortality in patients with type 2 diabetes.

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