Reliability of arterial stiffness indices at rest and following a single bout of moderate‐intensity exercise in older adults

Perissiou, Maria; Bailey, Tom G.; Windsor, Mark; Leicht, Anthony S.; Golledge, Jonathan; Askew, Christopher D.

doi:10.1111/cpf.12537

Cited by 9 publications

(9 citation statements)

References 46 publications

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“…However, in the current study the between day CV% for patients with AAA was excellent (5.9 AE 3.1%), similar to that in the healthy adults (6.2 AE 4.2%), and in line with previous published work from the authors' laboratory (5.0 AE 4.1%). 23 With large AAAs there is an increase in PWV measurement error, 31 and thus the present findings may not be generalisable to those with large AAA. This study only included patients with small (<45 mm) asymptomatic AAA who had been cleared to exercise by a cardiologist.…”

Section: Limitationsmentioning

confidence: 60%

“…22 The reliability of the post-exercise arterial stiffness indices was recently established in older adults. 23…”

Section: Aortic and Systemic Arterial Stiffness Measurementsmentioning

confidence: 99%

“…26 Statistical analysis. Based on previous reports in patients with cardiovascular disease and hypertension, 17 and the established variance of the outcome measures, 23 the sample size estimates revealed that 18 participants per group would be required to detect differences in the post-exercise PWV response of 1.2 AE 2.0 m$s À1 between the AAA and healthy groups, assuming an alpha level of .05 and > 80% power. Normality of the outcome data was confirmed based on kurtosis and skewness analyses.…”

Section: Pulse Wave Velocitymentioning

confidence: 99%

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Aortic and Systemic Arterial Stiffness Responses to Acute Exercise in Patients With Small Abdominal Aortic Aneurysms

Perissiou

Bailey

Windsor

et al. 2019

European Journal of Vascular and Endovascular Surgery

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WHAT THIS PAPER ADDS Elevated arterial stiffness is associated with aneurysm progression and probably contributes to the high cardiovascular risk of patients with abdominal aortic aneurysms (AAA). It is demonstrated herein that the changes in aortic and systemic arterial stiffness are lower in patients with AAA after exercise compared with seated rest. This effect was most marked following higher intensity interval exercise. This attenuation in arterial stiffness suggests there may be an acute cardiovascular benefit of exercise in patients with AAA. The findings support the use of interval based high intensity exercise as a safe intervention to improve cardiovascular function in patients with AAA and adds to the evidence that exercise prescription should be part of the routine care of patients with AAA.Objective/background: Elevated arterial stiffness is a characteristic of abdominal aortic aneurysm (AAA), and is associated with AAA growth and cardiovascular mortality. A bout of exercise transiently reduces aortic and systemic arterial stiffness in healthy adults. Whether the same response occurs in patients with AAA is unknown. The effect of moderate-and higher intensity exercise on arterial stiffness was assessed in patients with AAA and healthy adults. Methods: Twenty-two men with small diameter AAAs (36 AE 5 mm; mean age 74 AE 6 years) and 22 healthy adults (mean age 72 AE 5 years) were included. Aortic stiffness was measured using carotid to femoral pulse wave velocity (PWV), and systemic arterial stiffness was estimated from the wave reflection magnitude (RM) and augmentation index (Alx75). Measurements were performed at rest and during 90 min of recovery following three separate test sessions in a randomised order: (i) moderate intensity continuous exercise; (ii) higher intensity interval exercise; or (iii) seated rest. Results: At rest, PWV was higher in patients with AAA than in healthy adults (p < .001), while AIx75 and RM were similar between groups. No differences were observed between AAA patients and healthy adults in post-exercise aortic and systemic arterial stiffness after either exercise protocol. When assessed as the change from baseline (delta, D), post-exercise DAIx75 was not different to the seated rest protocol. Conversely, post-exercise DPWV and DRM were both lower at all time points than seated rest (p < .001). DPWV was lower immediately after higher intensity than after moderate intensity exercise (p ¼ .015). Conclusion: High resting aortic stiffness in patients with AAA is not exacerbated after exercise. There was a similar post-exercise attenuation in arterial stiffness between patients with AAA and healthy adults compared with seated rest. This effect was most pronounced following higher intensity interval exercise, suggesting that this form of exercise may be a safe and effective adjunctive therapy for patients with small AAAs.

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Section: Limitationsmentioning

confidence: 60%

“…22 The reliability of the post-exercise arterial stiffness indices was recently established in older adults. 23…”

Section: Aortic and Systemic Arterial Stiffness Measurementsmentioning

confidence: 99%

Section: Pulse Wave Velocitymentioning

confidence: 99%

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Aortic and Systemic Arterial Stiffness Responses to Acute Exercise in Patients With Small Abdominal Aortic Aneurysms

Perissiou

Bailey

Windsor

et al. 2019

European Journal of Vascular and Endovascular Surgery

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“…Indices of peripheral and central blood pressure, wave reflection characteristics and pulse wave velocity were measured in the supine position using the SphygmoCor XCEL device (AtCor Medical, West Ryde, NSW, Australia). These tests have previously been described in detail (Perissiou et al 2018 ) and were conducted in accordance with standardised guidelines (Townsend et al 2015 ). Blood pressure was measured in triplicate on the right arm, with the first assessment discarded and the average of the last two used.…”

Section: Methodsmentioning

confidence: 99%

Cerebrovascular function and its association with systemic artery function and stiffness in older adults with and without mild cognitive impairment

et al. 2022

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Purpose Our aim was to compare cerebrovascular and systemic vascular function between older adults with and without mild cognitive impairment (MCI), and to determine which measures of vascular function best predict the presence of MCI. Methods In 41 adults with MCI and 33 adults without MCI (control) we compared middle cerebral artery velocity (MCAv) and cerebrovascular pulsatility index (PI) at rest, cerebrovascular reactivity to CO2, and responsiveness to changes in blood pressure (%∆MCAv/%∆MAP). Systemic vascular function was assessed by flow-mediated dilation (FMD) and stiffness by pulse wave velocity (PWV). Results Cerebrovascular PI was higher in MCI compared with control (mean ± SD: 1.17 ± 0.27 vs. 1.04 ± 0.21), and MCI exhibited a lower %∆MCAv/%∆MAP (1.26 ± 0.44 vs. 1.50 ± 0.55%). Absolute (p = 0.76) and relative cerebrovascular reactivity to CO2 (p = 0.34) was similar between MCI and control. When age was included as a covariate the significant difference in cerebral PI between groups was lost. PWV was higher (13.2 ± 2.2 vs. 11.3 ± 2.5 m s−1) and FMD% (4.41 ± 1.70 vs. 5.43 ± 2.15%) was lower in MCI compared with control. FMD% was positively associated with PI across the cohort. Logistic regression analysis indicated that FMD and PWV significantly discriminated between MCI and controls, independent of age, whereas the inclusion of cerebrovascular measures did not improve the predictive accuracy of the model. Conclusion These findings raise the possibility that early changes in systemic vascular stiffness and endothelial function may contribute to altered cerebrovascular haemodynamics and impaired cognitive function, and present potential targets for prevention and treatment strategies in people with MCI.

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“…Both pre-and post-exercise cfPWV was measured via applanation tonometry (SPT-301, Millar Instruments Inc., Houston, TX, United States) on the carotid and femoral arteries on the participant's nonparetic side in a supine position. Post-exercise assessment of cfPWV has previously shown to be reliable in older adults (ICC = 0.84-0.94; Perissiou et al, 2019). In accordance with the ARTERY Society guidelines (Wilkinson et al, 2010), a minimum of 10 consecutive and consistent pulse pressure waveforms were collected simultaneously by two experienced testers (KN and KM).…”

Section: Central Arterial Stiffnessmentioning

confidence: 99%

Prolonged Elevation of Arterial Stiffness Following Peak Aerobic Exercise in Individuals With Chronic Stroke

et al. 2021

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BackgroundStroke is a highly disabling condition and is the second leading cause of death globally. Engaging in aerobic exercise is important for the prevention of a recurrent stroke through improving markers of cardiovascular health such as blood pressure and arterial stiffness. While higher intensities of aerobic exercise generally elicit greater cardioprotective effects, little is known about the acute cardiovascular effects of a single session of high intensity aerobic exercise in people with stroke. The objective of this study was to model the recovery of arterial stiffness (carotid-femoral pulse wave velocity, cfPWV), heart rate and blood pressure following peak intensity aerobic exercise in individuals with chronic stroke.MethodsTen participants with chronic stroke (mean ± SD age = 56.9 ± 11.8 years, median [IQR] years post-stroke = 2.9 [1.9]) performed a symptom-limited cardiopulmonary exercise test (CPET) on a recumbent stepper. Before the CPET, resting cfPWV, heart rate and blood pressure were measured. Immediately following the CPET, all outcomes were measured again continuously for 20 min to use all available observations (n = 245 observations) and capture any potential non-linear changes. Mixed model analyses were then applied to model post-exercise changes of cfPWV, heart rate and blood pressure.ResultsCarotid-femoral pulse wave velocity was increased from rest following the CPET (9.0 ± 0.53 to 9.9 ± 0.52 m/s, p < 0.001) and remained elevated for 20 min into post-exercise recovery, independent of heart rate (p = 0.001). Heart rate also increased from baseline (71.2 ± 3.2 to 77.4 ± 3.1 bpm, p < 0.001) and remained elevated for 10 min post-exercise (p < 0.001). Finger systolic blood pressure was reduced from rest (117.3 ± 4.7 to 111.8 ± 4.6 mmHg, p < 0.001) and remained reduced for 15 min after exercise (p < 0.001). There were no significant differences in finger diastolic or mean arterial pressures from rest.ConclusionThis was the first study to capture continuous changes in cfPWV following peak aerobic exercise in any clinical population. The present study revealed that cfPWV is elevated for 20 min after peak aerobic exercise in individuals with stroke, which was independent of heart rate. These findings suggest there may be autonomic imbalances in large arteries following peak intensity aerobic exercise in individuals with stroke.

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Reliability of arterial stiffness indices at rest and following a single bout of moderate‐intensity exercise in older adults

Cited by 9 publications

References 46 publications

Aortic and Systemic Arterial Stiffness Responses to Acute Exercise in Patients With Small Abdominal Aortic Aneurysms

Aortic and Systemic Arterial Stiffness Responses to Acute Exercise in Patients With Small Abdominal Aortic Aneurysms

Cerebrovascular function and its association with systemic artery function and stiffness in older adults with and without mild cognitive impairment

Prolonged Elevation of Arterial Stiffness Following Peak Aerobic Exercise in Individuals With Chronic Stroke

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