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.

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 INTERRELATION BETWEEN POLYFUNCTIONAL MONITORING DATA IN YOUNG MEN WITH PRE- OR MILD HYPERTENSION WITH DIFFERENT BLOOD PRESSURE DAILY PROFILE

2013 ◽  
Vol 19 (1) ◽  
pp. 44-50 ◽  
Author(s):  
E. N. Kazidaeva ◽  
Yu. L. Venevtseva
Keyword(s):  
Blood Pressure ◽  
Power Spectrum ◽  
Mild Hypertension ◽  
Young Men ◽  
Holter Monitoring ◽  
Left Ventricular ◽  
Total Power ◽  
Night Time ◽  
Arterial Blood ◽  
Functional Features

Objective. To examine the clinical signifi  cance of polyfunctional 24-hour Holter monitoring with simultaneous recording of electrocardiogram, blood pressure (BP) and respiratory efforts by respiratory inductance plethysmography (Incart, Russia) and functional features of young men with prehypertension or mild arterial hypertension with different profi  le of night arterial blood pressure (BP) decline («dippers», «non-dippers», «over-dippers»).Design and methods. We examined 43 adolescents and young men aged 16–26 years (mean age 19,4 ± 0,5 years). All of them underwent echocardiography («Vivid 7», GE); 48,8 % of patients were overweight or obese (body mass index, BMI > 24,9 kg/m2), and BMI was comparable in all groups. Results. Breathing disturbances (apnea/hypopnea episodes) were found in 86 % patients and were positively related with high frequency (HF) spectrum power of heart rate variability (HRV) at night-time and were not related with BMI, BP or type of night BP decline. The analysis of echocardiography revealed that in «non-dippers» (n = 18) left ventricular myocardial mass index (LVMMI) was higher (94,3 ± 16,6 g/m2) than in «over-dippers» (n = 15; 77,8 ± 10,3 g/m2, р < 0,001). In daytime «non-dippers» had lower HRV (total power spectrum and power in all three groups) and power spectrum of VLF and LF spectrum at night. The frequency of repolarization instability (transient T-wave inversion) and early repolarization syndrome was higher in «over-dippers» (66,7 %, р < 0,01). Circadian index of HR was also higher (150 %) in «over-dippers». The number of sleep apnea in «non-dippers» and «dippers» was higher (39,7 ± 29,7 and 37,1 ± 18,1 episodes per hour of sleep) than in «over-dippers» (22,3 ± 12,0 episodes per hour of sleep, р < 0,05), but the last group had more hypopneas.Conclusion. Breathing disturbances were a frequent, and, probably, physiological, fi  nding at polyfunctional 24-hour Holter monitoring in young overweight men with pre- or mild hypertension. There is a relationship between LVMMI and nocturnal BP dipping even in young men. Young «non-dippers» demonstrate the same clinical pattern as the older ones. «Over-dipper» type is characterized predominantly by lower HR at night and ECG repolarization abnormalities. 

Abstract 4351: Albuminuria is a Risk Factor for Adverse Events in Heart Failure Independent of the Presence of Chronic Kidney Disease

Circulation ◽  
2008 ◽  
Vol 118 (suppl_18) ◽  
Author(s):  
Adheesh Agnihotri ◽  
Kalkidan Bishu ◽  
James Arnold ◽  
Gary Gustafson ◽  
Inder S Anand
Keyword(s):  
Heart Failure ◽  
Blood Pressure ◽  
Chronic Kidney Disease ◽  
Risk Factor ◽  
Kidney Disease ◽  
Adverse Events ◽  
Systolic Blood Pressure ◽  
Left Ventricular ◽  
Creatinine Ratio ◽  
Albumin Creatinine Ratio

Background : Chronic kidney disease (CKD) is a known risk factor for adverse events in patients with heart failure (HF). Whether albuminuria defined as urine albumin creatinine ratio ≥30 mg/g with or without CKD is also a risk factor for adverse events, is unclear. Methods : Data was abstracted from the electronic medical records of 442 patients admitted to the Minneapolis VA Medical Center with a primary diagnosis of HF, and an outpatient measurement of albumin creatinine ratio between September 2002 and March 2006. Multivariable Cox regression analysis was used to determine the impact of albuminuria on mortality and hospitalizations for HF at 1-year. Results : Albuminuria was seen in 54% (238/442) patients at baseline. Patients with albuminuria were more likely to have edema, higher systolic blood pressure, left ventricular hypertrophy, lower eGFR and use of beta-blockers (all p<0.05). Albuminuria correlated (p<0.05) with serum creatinine (rho=0.23), systolic blood pressure (0.37), and LVEF (0.13). The presence of albuminuria did not increase the risk of death (HR 0.65, 95% CI 0.38 –1.11), but was strongly associated with the risk of hospitalization for HF at 1-year (HR 1.77, 95% CI 1.11–2.82, p=0.017) independent of age, gender, h/o HTN, DM, CAD, PVD, COPD, CKD, atrial fibrillation, EF, use of ACE-I, spironolactone and beta-blocker. Conclusion : The presence of albuminuria is an independent prognostic marker for hospitalizations for heart failure.

Effect of increased preload on the synthesized aortic blood pressure waveform

2010 ◽  
Vol 109 (2) ◽  
pp. 484-490 ◽  
Author(s):  
Kevin S. Heffernan ◽  
James E. Sharman ◽  
Eun Sun Yoon ◽  
Eui Jin Kim ◽  
Su Jin Jung ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Augmentation Index ◽  
Arterial Compliance ◽  
Ventricular Outflow Tract ◽  
Left Ventricular ◽  
Aortic Blood Flow ◽  
Aortic Blood ◽  
Reservoir Function ◽  
Aortic Blood Pressure ◽  
Aortic Reservoir Function

In the present study, we examined the influence of preload augmentation via passive leg elevation (PLE) on synthesized aortic blood pressure, aortic augmentation index (AIx), and aortic capacitance (a reflection of aortic reservoir function). Central and peripheral hemodynamics were measured via tonometry with a generalized transfer function in 14 young, healthy men (age = 24 yr). Aortic blood flow was calculated from the left ventricular outflow tract (LVOT) velocity-time integral (VTI) using standard two-dimensional echocardiographic-Doppler techniques. Measures were made in the supine position at rest (Pre), during PLE, and during recovery (Post). There was a significant increase in LVOT-VTI, synthesized aortic systolic blood pressure (BP) and AIx from Pre to PLE, with values returning to baseline Post ( P < 0.05). There was a reduction in aortic capacitance from Pre to PLE, with values returning to baseline Post ( P < 0.05). There was no change in heart rate, systemic arterial compliance, aortic elastance, aortic wave travel timing, or vascular resistance ( P > 0.05). Change in AIx from Pre to PLE was associated with change in LVOT-VTI ( r = 0.66, P < 0.05) and inversely associated with change in aortic capacitance ( r = −0.73, P < 0.05). These data suggest that in a setting of isolated augmented preload with minimal changes in other potential confounders, the morphology of the synthesized aortic BP waveform and AIx may be related to changes in aortic reservoir function.

Association of left ventricular motion and central augmentation index in healthy young men

2012 ◽  
Vol 30 (12) ◽  
pp. 2395-2402 ◽  
Author(s):  
Kevin Cheng ◽  
James D. Cameron ◽  
Matthew Tung ◽  
Philip M. Mottram ◽  
Ian T. Meredith ◽  
...  
Keyword(s):  
Augmentation Index ◽  
Young Men ◽  
Left Ventricular ◽  
Ventricular Motion

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 Effect of empagliflozin on ketone bodies in patients with stable chronic heart failure

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
R. Pietschner ◽  
J. Kolwelter ◽  
A. Bosch ◽  
K. Striepe ◽  
S. Jung ◽  
...  
Keyword(s):  
Heart Failure ◽  
Blood Pressure ◽  
Chronic Heart Failure ◽  
Pulse Pressure ◽  
Ketone Bodies ◽  
Left Ventricular ◽  
Vascular Stiffness ◽  
Left Ventricular Ejection ◽  
Ventricular Ejection Fraction ◽  
Central Pulse Pressure

Abstract Background Recent studies indicated that sodium glucose cotransporter (SGLT)2 inhibition increases levels of ketone bodies in the blood in patients with type 1 and 2 diabetes. Other studies suggested that in patients with chronic heart failure (CHF), increased myocardial oxygen demand can be provided by ketone bodies as a fuel substrate. Experimental studies reported that ketone bodies, specifically beta-hydroxybutyrate (β-OHB) may increase blood pressure (BP) by impairing endothelium-dependant relaxation, thereby leading to increased vascular stiffness. In our study we assessed whether the SGLT 2 inhibition with empagliflozin increases ketone bodies in patients with stable CHF and whether such an increase impairs BP and vascular function. Methods In a prospective, double blind, placebo controlled, parallel-group single centre study 75 patients with CHF (left ventricular ejection fraction 39.0 ± 8.2%) were randomised (2:1) to the SGLT-2 inhibitor empagliflozin 10 mg orally once daily or to placebo, 72 patients completed the study. After a run-in phase we evaluated at baseline BP by 24 h ambulatory blood pressure (ABP) monitoring, vascular stiffness parameters by the SphygmoCor system (AtCor Medical, Sydney, NSW, Australia) and fasting metabolic parameters, including β-OHB by an enzymatic assay (Beckman Coulter DxC 700 AU). The same measurements were repeated 12 weeks after treatment. In 19 of the 72 patients serum levels of β-OHB were beneath the lower border of our assay (< 0.05 mmol/l) therefore being excluded from the subsequent analysis. Results In patients with stable CHF, treatment with empagliflozin (n = 36) was followed by an increase of β-OHB by 33.39% (p = 0.017), reduction in 24 h systolic (p = 0.038) and diastolic (p = 0.085) ABP, weight loss (p = 0.003) and decrease of central systolic BP (p = 0.008) and central pulse pressure (p = 0.008). The increase in β-OHB was related to an attenuated decrease of empagliflozin-induced 24 h systolic (r = 0.321, p = 0.069) and diastolic (r = 0.516, p = 0.002) ABP and less reduction of central systolic BP (r = 0.470, p = 0.009) and central pulse pressure (r = 0.391, p = 0.033). No significant changes were seen in any of these parameters after 12 weeks of treatment in the placebo group (n = 17). Conclusion In patients with stable CHF ketone bodies as assessed by β-OHB increased after treatment with empagliflozin. This increase led to an attenuation of the beneficial effects of empagliflozin on BP and vascular parameters. Trial registration The study was registered at http://www.clinicaltrials.gov (NCT03128528).

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