Pulse最新文献

{"title":"New Epoch for Arterial Stiffness Measurement in the Clinic.","authors":"Jeong Bae Park, Kazuomi Kario","doi":"10.1159/000448497","DOIUrl":"https://doi.org/10.1159/000448497","url":null,"abstract":"Age changes the vascular structure and function in the normal population, but it has a different effect on wave reflection and pulse wave transmission [1, 2] . Many longitudinal studies have found that arterial stiffness measurement among hypertensive patients, diabetic patients, healthy elderly, and people with high cardiovascular (CV) risk will better evaluate arterial health and predict CV events. European guidance for arterial stiffness measurements described in the European consensus document (2006) [3] , the publication of the international reference standards (2010) [4] and the American Heart Association (AHA) scientific statement on arterial stiffness measurements in the USA (2015) have standardized arterial measurement [5] , and thus arterial stiffness measurements have been more widely used in clinical settings. The question now is which measurement of arterial stiffness is more accurate to precisely predict future CV events. Most of the guidelines designated aortic pulse wave velocity (PWV; carotid-femoral PWV) as the golden standard (especially in the Western society) [6] , but in Japan, where arterial stiffness is the most widely used and where they achieved a great amount of data on brachial-ankle PWV and cardio-ankle vascular index (CAVI) [7] , studies found a relationship between organ damage and future CV events. Townsend’s [8] brief review on recommendations and standardization of PWV measurements also justified its clinical and scholarly use. The articles from Korea [9] and Thailand [10] describe CV risk factors and outcomes using the CAVI. The modified RAMA-EGAT score from Thailand combined the conventional risk prevention model with arterial function. It would be helpful to have ageand genderstratified values of the CAVI in healthy Koreans and in high-risk patients of a metabolically risky condition. The study from Thailand developed its own risk prediction model called the RAMA-EGAT score, which proved to be accurate in the prediction of CV risk in patients with intermediate atherosclerotic risk factors in the Thai population [11] , and a further modification of the RAMA-EGAT score with the CAVI enhanced its accuracy. Now they are conducting a long-term prognosis study in patients with diverse risk conditions. The Framingham-CAVI Published online: December 23, 2016 www.karger.com/pls DOI: 10.1159/000448497","PeriodicalId":29774,"journal":{"name":"Pulse","volume":"4 Suppl 1","pages":"1-2"},"PeriodicalIF":2.2,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000448497","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34796178","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":"Assessment of Arterial Stiffness Using the Cardio-Ankle Vascular Index.","authors":"Toru Miyoshi,&nbsp;Hiroshi Ito","doi":"10.1159/000445214","DOIUrl":"https://doi.org/10.1159/000445214","url":null,"abstract":"<p><strong>Background: </strong>Arterial stiffness is an independent predictor of outcomes for patients with cardiovascular disease. Although measurement of pulse wave velocity is a widely accepted, noninvasive approach for the assessment of arterial stiffness, its accuracy is affected by changes in blood pressure.</p><p><strong>Summary: </strong>The cardio-ankle vascular index (CAVI) is an index of the overall stiffness of the artery from the origin of the aorta to the ankle and is theoretically independent of blood pressure at the time of measurement. CAVI increases linearly with age and is elevated even in mild arteriosclerotic disease. It can identify differences in the degree of arteriosclerosis among patients with severe arteriosclerotic disease and better reflects the severity of disease of the coronary artery than does brachial-ankle pulse wave velocity. Patients with higher CAVI values show a poor prognosis compared with those with lower CAVI values. Furthermore, CAVI can be lowered by controlling diabetes mellitus and hypertension.</p><p><strong>Key messages: </strong>The primary aims of assessing arterial stiffness using CAVI are to assist in the early detection of arteriosclerosis, allowing timely treatment and lifestyle modification, and to quantitatively evaluate the progression of disease and the effectiveness of treatment. Whether CAVI-guided therapy can improve prognosis in high-risk patients needs to be further examined to confirm the clinical usefulness of this measure.</p>","PeriodicalId":29774,"journal":{"name":"Pulse","volume":" ","pages":"11-23"},"PeriodicalIF":2.2,"publicationDate":"2016-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000445214","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34624855","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":"Carotid Stiffness: A Novel Cerebrovascular Disease Risk Factor.","authors":"Thomas T van Sloten,&nbsp;Coen D A Stehouwer","doi":"10.1159/000445354","DOIUrl":"https://doi.org/10.1159/000445354","url":null,"abstract":"<p><p>Carotid stiffening is considered an important element in the pathogenesis of cerebrovascular diseases. These include stroke as well as vascular dementia and depression. However, results of individual studies evaluating the association between carotid stiffening and incident stroke have been inconsistent. Therefore, we have conducted a systematic review and meta-analysis, showing that carotid stiffening is associated with incident stroke independently of cardiovascular risk factors and aortic stiffness. In addition, carotid stiffening improved stroke risk prediction beyond the Framingham stroke risk factors and aortic stiffness. Other studies have shown that carotid stiffening is associated with a higher incidence of vascular dementia and depressive symptoms. This suggests that carotid stiffness is a potential separate target for prevention strategies of cerebrovascular disease. </p>","PeriodicalId":29774,"journal":{"name":"Pulse","volume":" ","pages":"24-7"},"PeriodicalIF":2.2,"publicationDate":"2016-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000445354","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34624856","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":"Relation of Habitual Chocolate Consumption to Arterial Stiffness in a Community-Based Sample: Preliminary Findings.","authors":"Georgina E Crichton,&nbsp;Merrill F Elias,&nbsp;Ala'a Alkerwi,&nbsp;Saverio Stranges,&nbsp;Walter P Abhayaratna","doi":"10.1159/000445876","DOIUrl":"https://doi.org/10.1159/000445876","url":null,"abstract":"<p><strong>Background: </strong>The consumption of chocolate and cocoa has established cardiovascular benefits. Less is known about the effects of chocolate on arterial stiffness, a marker of subclinical cardiovascular disease. The aim of this study was to investigate whether chocolate intakes are independently associated with pulse wave velocity (PWV), after adjustment for cardiovascular, lifestyle and dietary factors.</p><p><strong>Methods: </strong>Prospective analyses were undertaken on 508 community-dwelling participants (mean age 61 years, 60% women) from the Maine-Syracuse Longitudinal Study (MSLS). Habitual chocolate intakes, measured using a food frequency questionnaire, were related to PWV, measured approximately 5 years later.</p><p><strong>Results: </strong>Chocolate intake was significantly associated with PWV in a non-linear fashion with the highest levels of PWV in those who never or rarely ate chocolate and lowest levels in those who consumed chocolate once a week. This pattern of results remained and was not attenuated after multivariate adjustment for diabetes, cardiovascular risk factors and dietary variables (p = 0.002).</p><p><strong>Conclusions: </strong>Weekly chocolate intake may be of benefit to arterial stiffness. Further studies are needed to explore the underlying mechanisms that may mediate the observed effects of habitual chocolate consumption on arterial stiffness.</p>","PeriodicalId":29774,"journal":{"name":"Pulse","volume":" ","pages":"28-37"},"PeriodicalIF":2.2,"publicationDate":"2016-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000445876","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34624857","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":"The J-Curve Phenomenon in Hypertension.","authors":"Yuan-Yuan Kang,&nbsp;Ji-Guang Wang","doi":"10.1159/000446922","DOIUrl":"https://doi.org/10.1159/000446922","url":null,"abstract":"<p><p>Almost immediately after antihypertensive therapy was proven effective in preventing cardiovascular events, the J-curve issue emerged as a hot topic. The Hypertension Optimal Treatment (HOT) trial attempted to address this question (diastolic blood pressure <80, <85, and <90 mm Hg) but ended up with a post hoc analysis indicating a nadir of 138.5 mm Hg systolic and 82.6 mm Hg diastolic blood pressure. Nevertheless, this observational finding was supported by the results of observational studies in the general population and by post hoc analyses of antihypertensive treatment trials. The currently ongoing Systolic Hypertension Optimal Treatment (SHOT) trial investigates whether the relationship between systolic blood pressure and stroke recurrence is linear or J-shaped by treating systolic blood pressure to <125, <135, and <145 mm Hg in patients with a history of recent stroke. This trial may provide additional but probably inconclusive evidence, because optimal blood pressure might differ between individuals and across outcomes. Nevertheless, a universal beneficial, instead of optimal, level of blood pressure for antihypertensive treatment may exist approximating 130/80 mm Hg and should be investigated by comparing 130/80 mm Hg with 140/90 mm Hg as a target blood pressure in hypertensive patients with the simultaneous use of modern blood pressure measuring techniques, such as home and ambulatory blood pressure monitoring. </p>","PeriodicalId":29774,"journal":{"name":"Pulse","volume":" ","pages":"49-60"},"PeriodicalIF":2.2,"publicationDate":"2016-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000446922","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34624859","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":"Anatomical and Functional Estimations of Brachial Artery Diameter and Elasticity Using Oscillometric Measurements with a Quantitative Approach.","authors":"Keiichiro Yoshinaga,&nbsp;Satoshi Fujii,&nbsp;Yuuki Tomiyama,&nbsp;Keisuke Takeuchi,&nbsp;Nagara Tamaki","doi":"10.1159/000444368","DOIUrl":"https://doi.org/10.1159/000444368","url":null,"abstract":"<p><p>Noninvasive vascular function measurement plays an important role in detecting early stages of atherosclerosis and in evaluating therapeutic responses. In this regard, recently, new vascular function measurements have been developed. These new measurements have been used to evaluate vascular function in coronary arteries, large aortic arteries, or peripheral arteries. Increasing vascular diameter represents vascular remodeling related to atherosclerosis. Attenuated vascular elasticity may be a reliable marker for atherosclerotic risk assessment. However, previous measurements for vascular diameter and vascular elasticity have been complex, operator-dependent, or invasive. Therefore, simple and reliable approaches have been sought. We recently developed a new automated oscillometric method to measure the estimated area (eA) of a brachial artery and its volume elastic modulus (VE). In this review, we further report on this new measurement and other vascular measurements. We report on the reliability of the new automated oscillometric measurement of eA and VE. Based on our findings, this measurement technique should be a reliable approach, and this modality may have practical application to automatically assess muscular artery diameter and elasticity in clinical or epidemiological settings. In this review, we report the characteristics of our new oscillometric measurements and other related vascular function measurements. </p>","PeriodicalId":29774,"journal":{"name":"Pulse","volume":" ","pages":"1-10"},"PeriodicalIF":2.2,"publicationDate":"2016-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000444368","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34624854","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":"Within-Home Blood Pressure Variability on a Single Occasion Has Clinical Significance.","authors":"Seiichi Shibasaki,&nbsp;Satoshi Hoshide,&nbsp;Kazuomi Kario","doi":"10.1159/000445837","DOIUrl":"https://doi.org/10.1159/000445837","url":null,"abstract":"<p><p>There is growing evidence that diversely defined blood pressure variability (BPV) is an independent predictor of hypertensive target organ damage (TOD) and cardiovascular events. Several mechanisms have been speculated to underlie episodes of increased BPV, including the impairment of autonomic or hormonal regulation, renal dysfunction, and increased arterial stiffness. Within-home BPV, defined as differences in BP values obtained on a single occasion at home, could have prognostic significance for hypertensive TOD. It is typically thought that BP values are decreased with repeated measurements on a single occasion at home, but in the present subanalysis of 4,149 J-HOP (Japan Morning Surge-Home Blood Pressure) study patients, approximately 20% of the patients' home BP values were increased or unchanged by repeated measurements on a single occasion. In addition, those patients were likely to have hypertensive TOD. Thus, home BP measurement should be taken twice or more to detect the increase trend in home BP, which has been defined as within-home BPV. </p>","PeriodicalId":29774,"journal":{"name":"Pulse","volume":" ","pages":"38-42"},"PeriodicalIF":2.2,"publicationDate":"2016-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000445837","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34624858","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":"New Insight into Effects of β-Blockers on Arterial Functions.","authors":"Kazuo Eguchi","doi":"10.1159/000443615","DOIUrl":"https://doi.org/10.1159/000443615","url":null,"abstract":"<p><p>The effects of β-blockers on arterial properties are not well investigated. In our recent study, we compared the effects of the two β-blockers celiprolol and bisoprolol on blood pressure, baroreflex sensitivity (BRS), flow-mediated vasodilatation, and vascular stiffness. We found that bisoprolol achieved a greater reduction in the pulse rate and improved BRS and vascular stiffness, whereas celiprolol reduced the central blood pressure level. In this review, the mechanisms of different types of β-blockers and their effects on arteries are discussed, and the appropriate use of β-blockers in hypertensive subjects will be proposed. </p>","PeriodicalId":29774,"journal":{"name":"Pulse","volume":"3 3-4","pages":"190-4"},"PeriodicalIF":2.2,"publicationDate":"2016-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000443615","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34497074","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 Tumor Necrosis Factor-α (-238G/A and -308G/A) Gene Polymorphisms and Risk of Ischemic Stroke: A Meta-Analysis.","authors":"Pradeep Kumar,&nbsp;Shubham Misra,&nbsp;Amit Kumar,&nbsp;Awadh Kishor Pandit,&nbsp;Kamalesh Chakravarty,&nbsp;Kameshwar Prasad","doi":"10.1159/000443770","DOIUrl":"https://doi.org/10.1159/000443770","url":null,"abstract":"<p><p>Tumor necrosis factor-α (TNF-α) is a proinflammatory pleiotropic cytokine which may contribute to the initiation and progression of ischemic stroke (IS). Thus far, numerous studies have been performed to examine the association between -238G/A (rs361525) and -308G/A (rs1800629) polymorphisms in the promoter regions of the TNF-α gene and susceptibility to IS, but results are still conflicting. The aim of this meta-analysis is to provide a relatively comprehensive account of the association between TNF-α -238G/A and -308G/A gene polymorphisms and susceptibility to IS. A literature search for eligible candidate gene studies published before April 20, 2015, was conducted in the PubMed, Medline, EMBASE and Google Scholar databases. The following combinations of main keywords were used: ('Tumor Necrosis Factor-Alpha' or 'TNF-α') and ('ischemic stroke' or 'cerebral infarction' or 'IS') and ('genetic polymorphism' or 'single nucleotide polymorphisms' or 'SNP'). Fixed- or random-effect models were used to estimate the pooled odds ratio (OR) and 95% confidence interval (CI). Meta-analysis was carried out by using RevMan 5.3 software. For TNF-α -238G/A gene polymorphism, 7 case-control studies with a total of 1,846 IS patients and 1,905 controls showed a significant association with susceptibility to IS under a dominant model (AA + GA vs. GG; OR, 1.40; 95% CI, 1.11-1.76; p value 0.004). For TNF-α -308G/A gene polymorphism, 16 case-control studies with a total of 5,651 IS patients and 5,792 controls showed a significant protective association with susceptibility to IS under a dominant model (AA + GA vs. GG; OR, 0.78, 95% CI, 0.63-0.97; p value 0.03). Our meta-analysis shows that TNF-α -238G/A gene polymorphism is more likely to be associated with the risk of IS in Caucasian populations as compared to Asian populations. However, TNF-α -308G/A gene polymorphism is more likely to be protective against IS in Asian populations as compared to Caucasian populations. Further large, well-designed prospective epidemiological studies are needed to confirm these findings. </p>","PeriodicalId":29774,"journal":{"name":"Pulse","volume":"3 3-4","pages":"217-28"},"PeriodicalIF":2.2,"publicationDate":"2016-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000443770","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34498068","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 Gradient.","authors":"Catherine Fortier,&nbsp;Mohsen Agharazii","doi":"10.1159/000438852","DOIUrl":"https://doi.org/10.1159/000438852","url":null,"abstract":"<p><strong>Background: </strong>Aortic stiffness is a strong predictor of cardiovascular mortality in various clinical conditions. The aim of this review is to focus on the arterial stiffness gradient, to discuss the integrated role of medium-sized muscular conduit arteries in the regulation of pulsatile pressure and organ perfusion and to provide a rationale for integrating their mechanical properties into risk prediction.</p><p><strong>Summary: </strong>The physiological arterial stiffness gradient results from a higher degree of vascular stiffness as the distance from the heart increases, creating multiple reflective sites and attenuating the pulsatile nature of the forward pressure wave along the arterial tree down to the microcirculation. The stiffness gradient hypothesis simultaneously explains its physiological beneficial effects from both cardiac and peripheral microcirculatory points of view. The loss or reversal of stiffness gradient leads to the transmission of a highly pulsatile pressure wave into the microcirculation. This suggests that a higher degree of stiffness of medium-sized conduit arteries may play a role in protecting the microcirculation from a highly pulsatile forward pressure wave. Using the ratio of carotid-femoral pulse wave velocity (PWV) to carotid-radial PWV, referred to as PWV ratio, a recent study in a dialysis cohort has shown that the PWV ratio is a better predictor of mortality than the classical carotid-femoral PWV.</p><p><strong>Key messages: </strong>Theoretically, the use of the PWV ratio seems more logical for risk determination than aortic stiffness as it provides a better estimation of the loss of stiffness gradient, which is the unifying hypothesis that explains the impact of aortic stiffness both on the myocardium and on peripheral organs.</p>","PeriodicalId":29774,"journal":{"name":"Pulse","volume":"3 3-4","pages":"159-66"},"PeriodicalIF":2.2,"publicationDate":"2016-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000438852","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34497069","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}