Pulse最新文献

{"title":"Large Artery Stiffness Assessment Using SphygmoCor Technology.","authors":"Mark Butlin,&nbsp;Ahmad Qasem","doi":"10.1159/000452448","DOIUrl":"https://doi.org/10.1159/000452448","url":null,"abstract":"<p><p>Large artery stiffness assessment has been an integral part of the SphygmoCor technology since 1998. Aortic stiffness is approximated with non-invasive measurement of carotid-femoral pulse wave velocity, with improvements made with time to make the assessment procedure quicker and more user independent. Also standard in the devices is the ability to reliably calculate the central aortic waveform shape from a peripheral pressure waveform from either the brachial or radial artery. This waveform contains much information beyond peak and trough (systolic and diastolic pressure). Relative waveform features such as the augmentation index, wave reflection magnitude, reflection time index, and subendocardial viability ratio are parameters that are influenced by the stiffness of systemic arteries. This article briefly describes these parameters related to large artery stiffness and provides reference to validation and repeatability studies relative to the clinical use of the SphygmoCor devices. It is beyond the scope to review here the 424 original research articles that have employed SphygmoCor devices in measuring arterial stiffness. Instead, the method of measurement across the devices is described, including tonometry, volumetric displacement through cuff placement around limbs, and ambulatory monitoring. Key population and subpopulation studies are cited where the average stiffness parameter progression with age and gender, as measured by SphygmoCor devices, is quantified in the healthy and general population. Finally, with reference to guidelines from working groups on arterial stiffness and hypertension, the clinical utility of large artery stiffness measurement is discussed in the context of the arterial stiffness parameters provided by the SphygmoCor systems.</p>","PeriodicalId":29774,"journal":{"name":"Pulse","volume":"4 4","pages":"180-192"},"PeriodicalIF":2.2,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000452448","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34756920","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Arterial Stiffness: Recommendations and Standardization.","authors":"Raymond R Townsend","doi":"10.1159/000448454","DOIUrl":"https://doi.org/10.1159/000448454","url":null,"abstract":"<p><p>The use of arterial stiffness measurements in longitudinal cohorts of normal populations, hypertensive patients, diabetic patients, healthy elderly, and patients on hemodialysis have confirmed the value of this important measure of arterial health, and established its complementary role to measures of blood pressure. Its contribution to understanding cardiovascular and mortality risk beyond blood pressure measurements has moved measures of arterial stiffness into the ranks of factors such as elevated cholesterol, diabetes, and left ventricular hypertrophy in considering cardiovascular risk. The recent international collaboration's publication of reference ranges for normal people and those with hypertension, along with the American Heart Association's recent scientific statement on standardizing arterial stiffness measurements are important aspects to consider in future studies employing these valuable methods, particularly as interventions that not only lower blood pressure but improve arterial function are tested in the clinical arena.</p>","PeriodicalId":29774,"journal":{"name":"Pulse","volume":"4 Suppl 1","pages":"3-7"},"PeriodicalIF":2.2,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000448454","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34796179","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Protocol for Evaluating the Cardio-Ankle Vascular Index to Predict Cardiovascular Events in Japan: A Prospective Multicenter Cohort Study.","authors":"Toru Miyoshi,&nbsp;Hiroshi Ito,&nbsp;Shigeo Horinaka,&nbsp;Kohji Shirai,&nbsp;Jitsuo Higaki,&nbsp;Hajime Orimo","doi":"10.1159/000448464","DOIUrl":"https://doi.org/10.1159/000448464","url":null,"abstract":"<p><strong>Introduction: </strong>The cardio-ankle vascular index (CAVI) was developed in Japan and is a blood pressure-independent index of arterial stiffness from the origin of the aorta to the ankle. In recent years, it has been studied by many researchers worldwide, and it is strongly anticipated that it will play a role as a predictive factor for arteriosclerotic diseases. The objective of this study was to examine the benefits of using CAVI as a predictor of cardiovascular events in high-risk patients.</p><p><strong>Methods and design: </strong>This prospective multicenter study to evaluate the usefulness of the CAVI to predict cardiovascular events in Japan (CAVI-J) is a cohort study with central registration. Participants (n = 3,000) will be scheduled to enroll and data will be collected for up to 5 years from entry of participants into the study. To be eligible to participate in the CAVI-J study, individuals have to be aged between 40 and 74 years and have at least one of the following risk factors for arteriosclerosis: (1) type 2 diabetes mellitus; (2) high-risk hypertension; (3) metabolic syndrome; (4) chronic kidney disease (stage 3), or (5) history of coronary artery disease or noncardiogenic cerebral infarction. The primary endpoints of this study are cardiovascular death, nonfatal myocardial infarction, and stroke. The secondary endpoints are composite cardiovascular events including all cause death, angina pectoris with revascularization, new incidence of peripheral artery disease, abdominal aortic aneurysm, aortic dissection, heart failure requiring hospitalization, and deterioration in renal function. The cutoff for CAVI against the incidence of cardiovascular events will be determined.</p>","PeriodicalId":29774,"journal":{"name":"Pulse","volume":"4 Suppl 1","pages":"11-16"},"PeriodicalIF":2.2,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000448464","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34796181","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between Beta-Fibrinogen C148T Gene Polymorphism and Risk of Ischemic Stroke in a North Indian Population: A Case-Control Study.","authors":"Amit Kumar,&nbsp;Shubham Misra,&nbsp;Pradeep Kumar,&nbsp;Ram Sagar,&nbsp;Kameshwar Prasad","doi":"10.1159/000449361","DOIUrl":"https://doi.org/10.1159/000449361","url":null,"abstract":"<p><strong>Background and purpose: </strong>Stroke is a multifactorial disease influenced by both genetic and environmental factors. The aim of this case-control study was to determine the association between β-fibrinogen C148T (rs1800787) gene polymorphism and susceptibility to ischemic stroke (IS) in a North Indian population.</p><p><strong>Methods: </strong>In the present case-control study, genotyping was performed using the PCR-RFLP (polymerase chain reaction-restriction fragment length polymorphism) method on 250 IS patients and 250 age- and sex-matched controls. Frequency distributions of genotypes and alleles were compared between the cases and controls by conditional logistic regression.</p><p><strong>Results: </strong>Hypertension, diabetes, dyslipidemia, low socioeconomic status, and family history of stroke were found to be independent risk factors for IS. The mean age of the cases and controls was 52.83 ± 12.59 and 50.97 ± 12.70 years, respectively. Multivariate logistic regression analysis showed an independent association between β-fibrinogen C148T (rs1800787) polymorphism and risk of IS in dominant (OR = 2.19; 95% CI 1.23-3.90; p = 0.007) and allelic (OR = 1.66; 95% CI 1.19-2.33; p = 0.002) models. Based on the Trial of Org 10172 in Acute Stroke Treatment (TOAST) classification, an independent association of small vessel disease with risk of IS was observed in the dominant (OR = 2.09; 95% CI 1.10-3.96; p = 0.02) and allelic (OR = 1.75; 95% CI 1.12-2.75; p = 0.01) models, and a significant association of cardioembolic stroke with risk of IS was seen in the allelic model (OR = 2.11; 95% CI 1.07-4.17; p = 0.02). All the genotype frequencies observed were in accordance with Hardy-Weinberg equilibrium in both cases and controls.</p><p><strong>Conclusion: </strong>The findings of the present study suggest that polymorphism in the C148T position of the β-fibrinogen gene might be a risk factor for IS mainly for the small vessel disease stroke subtype in a North Indian population. Further, large prospective studies are required to confirm these findings.</p>","PeriodicalId":29774,"journal":{"name":"Pulse","volume":"4 4","pages":"165-171"},"PeriodicalIF":2.2,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000449361","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34756917","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cardio-Ankle Vascular Index in a Thai Population.","authors":"Teerapat Yingchoncharoen,&nbsp;Piyamitr Sritara","doi":"10.1159/000448490","DOIUrl":"https://doi.org/10.1159/000448490","url":null,"abstract":"<p><p>Arterial stiffness as measured by the cardio-ankle vascular index (CAVI) is a widely available method in Thailand. Data from a large cross-sectional study revealed a significant correlation of CAVI and the presence of coronary artery disease as detected from 64-slice coronary computed tomography arteriography. Futhermore, CAVI was shown to predict long-term cardiovascular events in the patients with intermediate cardiovascular risk.</p>","PeriodicalId":29774,"journal":{"name":"Pulse","volume":"4 Suppl 1","pages":"8-10"},"PeriodicalIF":2.2,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000448490","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34796180","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Estimated Pulse Wave Velocity Calculated from Age and Mean Arterial Blood Pressure.","authors":"Sara V Greve,&nbsp;Stephan Laurent,&nbsp;Michael H Olsen","doi":"10.1159/000453073","DOIUrl":"https://doi.org/10.1159/000453073","url":null,"abstract":"<p><p>In a recently published paper, Greve et al [J Hypertens 2016;34:1279-1289] investigate whether the estimated carotid-femoral pulse wave velocity (ePWV), calculated using an equation derived from the relationship between carotid-femoral pulse wave velocity (cfPWV), age, and blood pressure, predicts cardiovascular disease (CVD) as good as the measured cfPWV. Because ePWV predicts CVD as good as cfPWV, some might wonder whether ePWV could be replaced by cfPWV, which is a time-consuming measurement requiring an expensive apparatus. This question is addressed in this mini-review.</p>","PeriodicalId":29774,"journal":{"name":"Pulse","volume":"4 4","pages":"175-179"},"PeriodicalIF":2.2,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000453073","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34756919","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Application of the Cardio-Ankle Vascular Index in Asymptomatic Healthy Koreans.","authors":"Su-Yeon Choi","doi":"10.1159/000448462","DOIUrl":"https://doi.org/10.1159/000448462","url":null,"abstract":"<p><strong>Background: </strong>Arterial stiffness has been established as a surrogate marker for the prognosis of cardiovascular disease. Arterial stiffness is also a predictor of future cardiovascular events, and is the earliest detectable manifestation of adverse structural and functional changes to blood vessel walls.</p><p><strong>Summary and key messages: </strong>The cardio-ankle vascular index (CAVI) is an index representing the stiffness of the entire arterial segments from the aorta to the ankle independent of the blood pressure at the time of the measurement. This paper provides an overview of the clinical application of arterial stiffness measurement by CAVI in asymptomatic Koreans. It includes the association between cardiometabolic risk factors and CAVI, and the relation between CAVI and asymptomatic coronary artery disease.</p>","PeriodicalId":29774,"journal":{"name":"Pulse","volume":"4 Suppl 1","pages":"17-20"},"PeriodicalIF":2.2,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000448462","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34796182","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness of Vitamin D Supplementation for Cardiovascular Health Outcomes.","authors":"Panagiota Veloudi,&nbsp;Graeme Jones,&nbsp;James E Sharman","doi":"10.1159/000452742","DOIUrl":"https://doi.org/10.1159/000452742","url":null,"abstract":"<p><p>There is a plausible physiological theory, supported by many observational studies, that vitamin D supplementation should be effective for improving cardiovascular end points, such as blood pressure (BP), large artery stiffness, atherosclerosis, endothelial function and clinical events. However, results from randomised controlled trials (RCTs) have been inconsistent. In this review, we evaluated the evidence regarding the effectiveness of vitamin D supplementation for cardiovascular surrogate and hard clinical end points. RCTs were assessed in terms of sample size, duration of supplementation, baseline vitamin D level inclusion criteria (i.e., absence of vitamin D deficiency), dosage of vitamin D and population under investigation. Forty-five RCTs were identified. Eight RCTs with BP and 6 RCTs with large artery stiffness as the end points were found to comply with guidelines for the optimal design of clinical trials evaluating nutrient effects. Only 2 of the RCTs with an optimal design were effective in decreasing BP with vitamin D supplementation, although these were of moderate sample size (<150) and very short duration (8 weeks for both), whilst no RCT was effective in reducing large artery stiffness. Similar results were observed for atherosclerotic and endothelial function markers as end points. Only 1 RCT reported cardiovascular events as an end point and found neither increased nor decreased incident cardiovascular events over 7 years of follow-up. In conclusion, results from published RCTs indicate that vitamin D supplementation is ineffective in improving cardiovascular health among various patient populations, including in the presence or absence of vitamin D deficiency.</p>","PeriodicalId":29774,"journal":{"name":"Pulse","volume":"4 4","pages":"193-207"},"PeriodicalIF":2.2,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000452742","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34756851","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cardiovascular Effects of Long-Term Vitamin D Supplementation: Summarised by Many but Studied by Few.","authors":"Mark Butlin,&nbsp;Alberto P Avolio","doi":"10.1159/000452939","DOIUrl":"https://doi.org/10.1159/000452939","url":null,"abstract":"Vitamin D supplementation has been primarily studied for its effect on mineral metabolism and, therefore, bone resorption. Vitamin D is also known to play a role in the reninangiotensin-aldosterone system [1] and in inflammation [2] and is produced by vascular endothelial cells [3] . It is, therefore, a strong hypothesis that plasma vitamin D levels influence cardiovascular factors in terms of blood pressure, vascular function and cardiovascular risk. In this issue of Pulse , Veloudi et al. [4] provide a qualitative review of a selection of randomised controlled trials (RCTs) concerning the effect of vitamin D supplementation on blood pressure and measures of arterial stiffness. They also include a descriptive review of some studies concerning cardiovascular outcomes of low serum levels of vitamin D. The article presents a graphical representation of sample size and study duration of 36 studies investigating peripheral blood pressure and 9 studies investigating arterial stiffness. In so doing, the article highlights that very few of these studies show a beneficial effect of vitamin D supplementation. The graphical presentation of the data also allows a visual representation of the previous finding, demonstrated statistically, that there is no relationship between an increased dose of vitamin D supplement and beneficial cardiovascular effect [5] . The effect of vitamin D supplementation on cardiovascular factors is of great clinical interest, demonstrated by the number of studies identified in meta-analyses in recent years. This year alone, quantitative meta-analyses of arterial stiffness outcomes have been published by Upala et al. [6] and Rodríguez et al. [7] summarising 7 and 18 RCTs, respectively. A recent quantitative meta-analysis on peripheral blood pressure outcomes identified 46 independent vitamin D supplementation trials [5] . These quantitative studies, although not included in the review by Veloudi et al. [4] , support the same conclusion which Veloudi et al. [4] make from a qualitative review of RCTs, namely that vitamin D supplementation has no effect on arterial stiffness or blood pressure. However, Rodríguez et al. [7] surmise that larger, well-designed Received: October 28, 2016 Accepted: October 28, 2016 Published online: December 8, 2016","PeriodicalId":29774,"journal":{"name":"Pulse","volume":"4 4","pages":"172-174"},"PeriodicalIF":2.2,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000452939","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34756918","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Comparative Study on Skin and Plasma Advanced Glycation End Products and Their Associations with Arterial Stiffness.","authors":"Chang-Yuan Liu,&nbsp;Qi-Fang Huang,&nbsp;Yi-Bang Cheng,&nbsp;Qian-Hui Guo,&nbsp;Qi Chen,&nbsp;Yan Li,&nbsp;Ji-Guang Wang","doi":"10.1159/000453581","DOIUrl":"https://doi.org/10.1159/000453581","url":null,"abstract":"<p><strong>Background: </strong>We compared skin and plasma measurements of advanced glycation end products (AGEs), with particular focus on their levels in the presence of hypertension or diabetes and prediabetes and their associations with arterial stiffness in outpatients with suspected or diagnosed hypertension.</p><p><strong>Methods: </strong>Skin AGE accumulation was measured as autofluorescence on the left forearm using the skin autofluorescence Reader and expressed in arbitrary units in the range from 0 to 25. Plasma AGE concentration was measured by the enzyme-linked immunosorbent assay method and logarithmically transformed for statistical analysis. Arterial stiffness was assessed by carotid-femoral pulse wave velocity (cfPWV) using the SphygmoCor system (Sydney, Australia).</p><p><strong>Results: </strong>The 218 participants (96 [44.0%] men, mean age 51.9 years) had a mean skin autofluorescence of 1.89 arbitrary units, plasma AGE concentration of 4.47 μg/ml, and cfPWV of 8.0 m/s. Skin autofluorescence was significantly correlated with plasma AGEs in diabetic or prediabetic patients (<i>n</i> = 31, <i>r</i> = 0.37, <i>p</i> = 0.04) but not in subjects with normoglycemia (<i>n</i> = 187, <i>r</i> = -0.05, <i>p</i> = 0.48). Nonetheless, both measurements were significantly (<i>p</i> ≤ 0.001) higher in men (2.00 arbitrary units and 6.73 μg/ml, respectively) than women (1.81 arbitrary units and 3.60 μg/ml, respectively) and in diabetic or prediabetic (2.03 arbitrary units and 6.61 μg/ml, respectively) than normoglycemia subjects (1.87 arbitrary units and 4.17 μg/ml, respectively), but similar in hypertensive (<i>n</i> = 105) and normotensive subjects (<i>n</i> = 113, <i>p</i> ≥ 0.35). In adjusted multiple regression analyses, plasma AGE concentration, but not skin autofluorescence (<i>p</i> ≥ 0.37), was significantly associated with cfPWV in all subjects (β 0.44 m/s for each 10-fold increase; <i>p</i> = 0.04) and in subgroups of men and diabetes and prediabetes (β 0.12-0.55 m/s for each 10-fold increase; <i>p</i> ≤ 0.02).</p><p><strong>Conclusions: </strong>Although skin and plasma AGEs were similarly associated with gender and diabetes or prediabetes, they might measure something different and have different clinical relevance, such as for arterial stiffness.</p>","PeriodicalId":29774,"journal":{"name":"Pulse","volume":"4 4","pages":"208-218"},"PeriodicalIF":2.2,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000453581","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34756852","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}