Comparison between apexcardiographic and angiographic indexes of left ventricular performance in patients with aortic incompetence.

Manolas, Jan; Krayenbuehl, H. P.

doi:10.1161/01.cir.57.4.692

Cited by 14 publications

(6 citation statements)

References 23 publications

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“… 35 , 36 Prior studies using a pulse-tracing technology in the apex cardiogram reported that prolonged UT was associated with an increase in left ventricular wall stress and a decrease in left ventricle function. 37 , 38 This age-induced decline in cardiac function probably led to the prolonged UTc in this study.…”

Section: Discussionmentioning

confidence: 66%

Retinal Blood Velocity Waveform Characteristics With Aging and Arterial Stiffening in Hypertensive and Normotensive Subjects

Takizawa

Song

Tani

et al. 2021

Trans. Vis. Sci. Tech.

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Purpose We aimed to explore the velocity waveform characteristics of the retinal artery associated with age and the cardio-ankle vascular index (CAVI) as a conventional arterial stiffness marker by applying the Doppler optical coherence tomography (DOCT) flowmeter. Methods In this cross-sectional study, DOCT flowmeter imaging was performed in 66 participants aged 21 to 83 years (17 men, 49 women) with no history of eye diseases and no systemic diseases, except for hypertension. Retinal blood velocity waveform was analyzed where several parameters in time (upstroke time, T1, T2, T3, and T4) and area under the waveform (area elevation, area declination, A1, A2, A3, and A4) were extracted. Systolic blood pressure–adjusted Pearson's coefficients were calculated to determine the correlations of each parameter with age or CAVI. Results Corrected upstroke time (UTc) was the waveform parameter most positively correlated with age ( r = 0.497, P < 0.001). Area declination was the waveform parameter most negatively correlated with age ( r = −0.682, P < 0.001) and CAVI ( r = −0.601, P < 0.001). Conclusions We extracted the waveform parameters associated with the risks of arterial stiffening. The velocity waveform analysis of the retinal artery with DOCT flowmeter potentially could become a new method for arterial stiffness identification. Translational Relevance DOCT flowmeter could evaluate arterial stiffening in a different way from the conventional method of measuring arterial stiffening using pressure waveform. Because the DOCT flowmeter can easily, quickly, and noninvasively provide a retinal blood velocity waveform, this system could be useful as a routine medical examination for arterial stiffening.

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Section: Discussionmentioning

confidence: 66%

Retinal Blood Velocity Waveform Characteristics With Aging and Arterial Stiffening in Hypertensive and Normotensive Subjects

Takizawa

Song

Tani

et al. 2021

Trans. Vis. Sci. Tech.

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“…It has been demonstrated that left apexcardiogram reflects quantitatively pressure changes within the left heart in a temporal fashion [17], Furthermore, we have shown that time and relative height diastolic indices of apex tracing correlated closely with corresponding intra cardiac measurements of relaxation and compliance using simultaneous high-fidelity tracings during heart catheter ization [18][19][20][21]. In the present study, 30 years after its introduction [22,23], the usefulness of exercise apexcardiography has been reevaluated using new criteria for exactly defining the changes of diastolic indices during low-level isometric stress.…”

mentioning

confidence: 63%

“…On the other hand, it has been noted that the configu ration, time course and slope of the left apexcardiogram are significantly correlated with left ventricular pressure [18,19,[34][35][36][37][38][39]. We have first described the temporal coincidence of the onsets of systolic upstrokes and, in part, also of the diastolic nadirs of apex and left ventricu lar pressure tracings using simultaneous high-fidelity trac ings during diagnostic heart catheterization [17,18].…”

Section: Monolas Types Of Diastolic Dysfunction During Handgripmentioning

confidence: 99%

Clinical Value of Types of Exercise-Induced Diastolic Abnormalities in Patients with Myocardial Disease

Manolas¹

1993

Am J Noninvas Cardiol

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It has recently been demonstrated that the handgrip-apexcardiographic test (HAT) represents a low-level (40% of maximal voluntary contraction) isometric stress test of short duration (2 min) by which one can assess early occurring silent left ventricular diastolic abnormalities in coronary patients. The aim of this study is to determine the pattern of these exerciseinduced diastolic abnormalities and to assess its potential diagnostic as well as prognostic significance in patients with various myocardial disease states. HAT was performed in 242 healthy subjects and 155 patients; 15 patients with previous infarction without symptoms (group 1), 40 patients with prior infarction and angina pectoris (group 2), 74 patients with typical angina pectoris without infarction (group 3), and 26 patients with congestive heart failure (group 4). As index of compliance served the relative A wave to the total height (A/H) of apexcardiogram, and as indices of relaxation the total apexcardiographic relaxation time (TART) and TART corrected for the duration of diastole (TARTI). The following three types of handgrip-induced changes of these diastolic indices were observed: (1) the compliance (C)-type, which was present when A/H increased during and/or after handgrip >21 % (= largest individual value in controls); (2) the relaxation (Retype being present when TART during handgrip >TART at rest >143 ms or/and TARTI <0.14 (= lowest individual value in controls), and (3) the mixed (RC)-type which is defined by the presence of both the criteria of R- and C-types. These 3 types showed a different distribution in the four groups of patients. The C-type was predominant in groups 2 and 4 (73 and 58%, respectively), whereas in group 3 all three types showed a similar distribution (C-type: 31%, R-type: 27% and RC-type: 34%). In contrast, in group 1 the C-type was absent and the R- as well as RC-types were rare (13 and 7%, respectively). During a clinical follow-up period of 20 ± 2 months, patients with C-type of dysfunction had a less favorable outcome (7% deaths, 6% new infarctions and 4% acute lung edema). According to our present data derived from HAT in patients with myocardial disease, it can be concluded that: (1) three different types of diastolic abnormalities are present during isometric stress; (2) there is a different distribution of these patterns depending on the presence of previous infarction, angina pectoris or heart failure, and (3) the C-type is probably associated with the worst long-term prognosis. Thus, this study introduces the 3-type concept of exercise-induced diastolic abnormalities and demonstrates their potential diagnostic and prognostic significance in clinical practice.

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“…In addition, UT could be a parameter of left ventricular function and geometry [30,44,45]. Abnormal cardiac function, including left ventricular hypertrophy, reduced left ventricular ejection fraction, and increased left ventricular filling pressure and wall stress, have been associated with poor cardiovascular outcomes in patients with CKD [46][47][48].…”

Section: Discussionmentioning

confidence: 99%

Upstroke Time as a Novel Predictor of Mortality in Patients with Chronic Kidney Disease

et al. 2020

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Upstroke time (UT), measured from the foot-to-peak peripheral pulse wave, is a merged parameter used to assess arterial stiffness and target vascular injuries. In this study, we aimed to investigate UT for the prediction of cardiovascular and all-cause mortality in patients with chronic kidney disease (CKD). This longitudinal study enrolled 472 patients with CKD. Blood pressure, brachial pulse wave velocity (baPWV), and UT were automatically measured by a Colin VP-1000 instrument. During a median follow-up of 91 months, 73 cardiovascular and 183 all-cause mortality instances were recorded. Multivariable Cox analyses indicated that UT was significantly associated with cardiovascular mortality (hazard ratio (HR) = 1.010, p = 0.007) and all-cause mortality (HR = 1.009, p < 0.001). The addition of UT into the clinical models including traditional risk factors and baPWV further increased the value in predicting cardiovascular and all-cause mortality (both p < 0.001). In the Kaplan–Meier analyses, UT ≥ 180 ms could predict cardiovascular and all-cause mortality (both log-rank p < 0.001). Our study found that UT was a useful parameter in predicting cardiovascular and all-cause mortality in CKD patients. Additional consideration of the UT might provide an extra benefit in predicting cardiovascular and all-cause mortality beyond the traditional risk factors and baPWV.

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Comparison between apexcardiographic and angiographic indexes of left ventricular performance in patients with aortic incompetence.

Cited by 14 publications

References 23 publications

Retinal Blood Velocity Waveform Characteristics With Aging and Arterial Stiffening in Hypertensive and Normotensive Subjects

Retinal Blood Velocity Waveform Characteristics With Aging and Arterial Stiffening in Hypertensive and Normotensive Subjects

Clinical Value of Types of Exercise-Induced Diastolic Abnormalities in Patients with Myocardial Disease

Upstroke Time as a Novel Predictor of Mortality in Patients with Chronic Kidney Disease

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