Relation Between Number of Cardiovascular Risk Factors/Events and Noninvasive Doppler Ultrasound Assessments of Aortic Compliance

Lehmann, Eldon D.; Hopkins, KD; Rawesh, A.; Joseph, Ramina C.; Kongola, K; Coppack, Simon W.; Gosling, R. G.

doi:10.1161/01.hyp.32.3.565

Cited by 149 publications

(97 citation statements)

References 37 publications

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“…Arterial stiffness, assessed by the AIx and PWV, correlated with the CRP level. In addition, in a multiple regression analysis conducted with combined data from patients and control subjects, we were able to confirm the independent association between these measures of stiffness and the CRP level, as well as with known confounding factors such as MAP, age, sex, and heart rate (25)(26)(27)(28)(29). Taken together, these data suggest not only that arterial stiffness and inflammation are related, but also that arterial stiffness may itself be a modifiable parameter.…”

Section: Discussionsupporting

confidence: 57%

Inflammation and arterial stiffness in systemic vasculitis: A model of vascular inflammation

Booth¹,

Wallace²,

McEniery³

et al. 2004

Arthritis & Rheumatism

217

122

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Objective. Arterial stiffness, an independent determinant of cardiovascular risk, is regulated by both structural and functional factors, including endothelium-derived nitric oxide. Endothelial dysfunction is associated with acute and chronic systemic inflammation. However, the role of systemic inflammation in arterial stiffening has not been determined. The aim of this study was to investigate the relationship between inflammation and arterial stiffness in patients with antineutrophil cytoplasmic antibody-associated systemic vasculitis (AASV) as a model of systemic inflammation.Methods. Thirty-one patients with AASV (15 with active disease) and 32 age-matched controls were studied. Pulse wave velocity (PWV) and the augmentation index (AIx) were assessed noninvasively and related to serum levels of C-reactive protein (CRP), interleukin-6, and tumor necrosis factor ␣.Results. In subjects with active disease, the AIx, PWV, and level of CRP were elevated compared with that in controls (mean ؎ SEM 31 ؎ 3% versus 22 Conclusion. These data indicate that AASV is associated with increased arterial stiffness, and that stiffness correlates with the degree of active inflammation.

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Section: Discussionsupporting

confidence: 57%

Inflammation and arterial stiffness in systemic vasculitis: A model of vascular inflammation

Booth¹,

Wallace²,

McEniery³

et al. 2004

Arthritis & Rheumatism

217

122

View full text Add to dashboard Cite

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“…20 Age-related stiffening of elastic arteries, particularly the aorta, is accelerated in the presence of risk factors for cardiovascular disease. 7,8 Aortic stiffness, estimated from carotid-femoral PWV, by contrast with the stiffness of muscular arteries, is highly predictive of cardiovascular events and mortality. [2][3][4] In the present study, we examined the effects of inhibition of basal NO synthesis on carotid-femoral PWV in healthy men with the use of norepinephrine and dobutamine to control for the effects on MAP.…”

Section: Discussionmentioning

confidence: 99%

“…In addition, carotid-femoral PWV might serve as an integrated measure of the impact of cardiovascular risk factors on age-related changes in aortic structure. 4,7,8 In muscular arteries, stiffness is influenced by mean arterial blood pressure (MAP, a determinant of transmural distending pressure) and by the tone of arterial smooth muscle (which influences the elastic properties of the arterial wall). In the ovine iliac artery, basal release of nitric oxide (NO) contributes to the functional regulation of stiffness.…”

mentioning

confidence: 99%

Effects of Inhibition of Basal Nitric Oxide Synthesis on Carotid-Femoral Pulse Wave Velocity and Augmentation Index in Humans

et al. 2003

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Abstract-Aortic stiffness, as measured by carotid-femoral pulse wave velocity (PWV), is a powerful, independent predictor of vascular risk. PWV in muscular arteries is influenced by basal nitric oxide (NO) release. It is not known whether NO also influences carotid-femoral PWV. We examined the effects of an NO synthase inhibitor, N G -monomethyl-L-arginine (L-NMMA), on carotid-femoral PWV and aortic augmentation index (AIx, an indirect measure of arterial stiffness). To control for effects of L-NMMA on distending pressure, we used doses of norepinephrine and dobutamine that caused similar changes in mean arterial blood pressure (MAP). Healthy men (32 to 48 years old, nϭ8) were studied on 4 occasions and received, in random order, vehicle, L-NMMA (3 mg · kg Ϫ1 by intravenous bolus followed by 3 mg · kg), and dobutamine (2.5 to 10 g · kg Ϫ1 · min Ϫ1), each for 30 minutes. PWV and AIx were measured by carotid-femoral PWV and radial tonometry, respectively. L-NMMA and norepinephrine increased MAP by 7.8Ϯ1.7 and 9.7Ϯ2.1 mm Hg, respectively (each PϽ0.05 vs vehicle) and increased PWV by 0.7Ϯ0.2 and 1.0Ϯ0.3 m · s Ϫ1 (each PϽ0.01 vs vehicle). Dobutamine, at doses that produced a similar increase in MAP (9.6Ϯ2.9 mm Hg), increased PWV by 0.8Ϯ0.2 m · s Ϫ1 (PϽ0.01 vs vehicle). Changes in PWV caused by the 3 pressor agents were closely correlated with changes in MAP (RϾ0.99, PϽ0.0001). L-NMMA and norepinephrine increased AIx, but dobutamine decreased AIx (PϽ0.01 vs norepinephrine and L-NMMA). Effects of inhibition of basal NO release on carotid-femoral PWV can be explained by the change in MAP that this causes rather than any specific effect of NO inhibition within the aorta. Key Words: aorta Ⅲ elasticity Ⅲ endothelium Ⅲ nitric oxide Ⅲ nitric oxide synthase C arotid-femoral pulse wave velocity (PWV), a measure of aortic stiffness, 1 is a powerful, independent predictor of cardiovascular events and mortality. 2-4 Aortic stiffening increases peak systolic pressure at the aortic root as a result of diminished systemic compliance and early return of pressure waves reflected from the periphery. 5,6 This provides a possible mechanism for the increased event rate and mortality associated with aortic stiffening. In addition, carotid-femoral PWV might serve as an integrated measure of the impact of cardiovascular risk factors on age-related changes in aortic structure. 4,7,8 In muscular arteries, stiffness is influenced by mean arterial blood pressure (MAP, a determinant of transmural distending pressure) and by the tone of arterial smooth muscle (which influences the elastic properties of the arterial wall). In the ovine iliac artery, basal release of nitric oxide (NO) contributes to the functional regulation of stiffness. 9 The human aorta is rich in elastin, and with advancing age, increasing relative amounts of collagen, but it also contain vascular smooth muscle, especially in the abdomen. 10 The extent to which aortic stiffness is influenced by vascular tone and in particular, by basal NO, has not previously been examined in the...

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“…[6][7][8][9] In a previous work, including more than 1000 children and teenagers, we provided reference values for pulse wave velocity (PWV), thereby constituting a suitable tool for longitudinal clinical studies assessing subgroups of children who are at long-term risk of cardiovascular disease. 10 A multitude of various methods and techniques have been used to assess PWV in adults such as applanation tonometry, 11,12 ultrasound, 13,14 methods using mechanotransducers 15 and computerized oscillometry; 16 furthermore, a number of comparative studies with diverging results have been published concerning the comparability of the different methods. [17][18][19][20][21] Instruments based on the principle of applanation tonometry (PulsePen (PP) (DiaTecne, Milan, Italy) and Sphygmocor (SC) (AtCor, Sydney, Australia) have been extensively used.…”

Section: Introductionmentioning

confidence: 99%

Measurement of pulse wave velocity in children and young adults: a comparative study using three different devices

et al. 2011

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To estimate the value of pulse wave velocity (PWV) in pediatric cardiovascular disease, prospective studies are needed. Various instruments based on different measurement principles are proposed for use in children, hence the need to test the comparability of these devices in this younger population. The objective of this study was to compare PWV measured by oscillometry (Vicorder (VIC)) with the gold standard of applanation tonometry (PulsePen (PP), Sphygmocor (SC)). PWV was measured in 98 children and young adults (age: 16.7(6.3-26.6) years (median(range)) with the above three devices at the same visit under standardized conditions. Mean PWV measured by VIC was significantly lower than that measured by SC and PP. There was no difference following path length correction of the VIC measurement (using the distance between the jugular notch and the center of the femoral cuff), (PP: 6.12(1.00), SC: 5.94(0.91), VIC: 6.14(0.75) m s À1 ). Velocities measured by the three devices showed highly significant correlations. Bland-Altman analysis revealed excellent concordance between all three devices, however, there was a small but significant proportional error in the VIC measurements showing a trend toward lower PWV measured by VIC at higher PWV values. Our study provides data on the three most frequently used instruments in pediatrics. Following path length correction of the VIC, all three devices provided comparable results. Thus, our work allows extrapolating data between previously established normal PWV values for children and forthcoming studies using these instruments to assess children at long-term risk of cardiovascular disease. The small proportional error of VIC needs additional technical development to improve the accuracy of the measurements.

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Relation Between Number of Cardiovascular Risk Factors/Events and Noninvasive Doppler Ultrasound Assessments of Aortic Compliance

Cited by 149 publications

References 37 publications

Inflammation and arterial stiffness in systemic vasculitis: A model of vascular inflammation

Inflammation and arterial stiffness in systemic vasculitis: A model of vascular inflammation

Effects of Inhibition of Basal Nitric Oxide Synthesis on Carotid-Femoral Pulse Wave Velocity and Augmentation Index in Humans

Measurement of pulse wave velocity in children and young adults: a comparative study using three different devices

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