Total vascular resistance, augmentation index, and augmentation pressure increase in patients with peripheral artery disease

Takemoto, Rika; Uchida, Haruhito A.; Toda, H.; Okada, Ken; Otsuka, Fumio; Ito, Hiroshi; Wada, Jun

doi:10.1097/md.0000000000026931

Cited by 5 publications

(3 citation statements)

References 35 publications

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“…High TVR is associated with mortality, heart failure, and cardiovascular events [38]. Another study utilizing the Mobil-O-Graph device reported a higher TVR in patients with peripheral arterial disease (PAD), which is atherosclerosis of the extremities and is associated with cardiovascular events [39]. While TVR did not show a significant increase in the hypertensive or non-dipping groups in the present study, the positive correlation between nocturnal TVR and albuminuria confirms its association with vascular disease.…”

Section: Discussionsupporting

confidence: 60%

Ambulatory blood pressure parameters and their association with albuminuria in adolescents with type 1 diabetes mellitus

Sołtysiak,

Skowrońska,

Maćkowiak-Lewandowicz

et al. 2024

Pediatr Nephrol

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Background This study aimed to evaluate the blood pressure (BP) status, including arterial stiffness parameters, hemodynamic indicators, circadian profile, and its association with albuminuria in adolescents with type 1 diabetes mellitus (DM1). Methods The analysis included 46 patients, with diabetes duration of 7.38 ± 3.48 years. Ambulatory blood pressure monitoring (ABPM) was conducted using an oscillometric device, the Mobil-O-Graph, which is a Pulse Wave Analysis Monitor. Results Hypertension (HT) was diagnosed in 31 adolescents (67% of patients), primarily due to isolated nocturnal BP (21 cases, 68% of HT cases). The HT group exhibited significantly increased diastolic load (DL). Pulse wave velocity (PWV, a measure of arterial stiffness) values showed a strong correlation with both peripheral systolic BP (r = 0.954) and central systolic BP (r = 0.838). Additionally, non-dipping status was found in 61% of the HT group. Urinary albumin excretion (UAE) was positively correlated with diastolic BP (particularly nocturnal) peripheral and central BP, DL, heart rate, augmentation index (AIx@75), and nocturnal total vascular resistance (TVR). Diastolic non-dippers exhibited a significant increase in UAE. Conclusions Hypertension is a common complication in adolescents with type 1 diabetes mellitus, primarily caused by elevated nocturnal diastolic BP. Albuminuria is mainly associated with diastolic BP, especially during the nocturnal period and in cases of diastolic non-dipping status. The association of UAE with AIx@75 and nocturnal TVR suggests the presence of early-stage vascular disease in diabetic adolescents. Graphical abstract

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Section: Discussionsupporting

confidence: 60%

Ambulatory blood pressure parameters and their association with albuminuria in adolescents with type 1 diabetes mellitus

Sołtysiak,

Skowrońska,

Maćkowiak-Lewandowicz

et al. 2024

Pediatr Nephrol

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show abstract

“…High TVR is associated with mortality, heart failure, and cardiovascular events [24]. Another study utilizing the Mobil-O-Graph device reported a higher TVR in patients with peripheral arterial disease (PAD), which is atherosclerosis of the extremities and is associated with cardiovascular events [25]. While TVR did not show a signi cant increase in the hypertensive or non-dipping group in the present study, the positive correlation between nocturnal TVR and albuminuria con rms the association with vascular disease.…”

Section: Discussionmentioning

confidence: 99%

Blood pressure parameters and its association with albuminuria in adolescents with type 1 diabetes mellitus and ABPM using Mobil-O-Graph.

Sołtysiak,

Skowronska,

Mackowiak-lewandowicz

et al. 2023

Preprint

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Introduction: This study aimed to evaluate the blood pressure (BP) status, including circadian profile, arterial stiffness parameters, and hemodynamic indicators, and its association with albuminuria in adolescents with type 1 diabetes mellitus. Methods: The study included 46 patients, with an average diabetes duration of 7.38 ± 3.48 years. Ambulatory blood pressure monitoring (ABPM) was conducted using an oscillometric device, the Mobil-O-Graph, which is a Pulse Wave Analysis Monitor. Results: Hypertension arterialis (HA) was diagnosed in 30% of the patients, prehypertension (preHA) in 53%, and normal blood pressure (N) in 17%. In most cases, elevated BP was attributed to isolated nocturnal diastolic BP increases (42% in preHA and 50% in HA). The preHA and HA groups exhibited significantly increased pulse wave velocity (PWV), a measure of arterial stiffness. Non-dipping status, characterized by the absence of nocturnal diastolic BP dipping, was only associated with urinary albumin excretion (UAE). UAE was positively correlated with 24-hour diastolic peripheral and central BP, diastolic load, heart rate, augmentation index (AIx@75), and nocturnal total vascular resistance (TVR). Conclusions: Hypertension is a common complication of type 1 diabetes mellitus in adolescents, primarily caused by elevated nocturnal diastolic BP. Arterial stiffness, as indicated by PWV, appears to be the main contributor to increased BP in adolescents with type 1 diabetes mellitus. Albuminuria is mainly associated with diastolic BP, particularly during the nocturnal period, including non-dipping status. The association of UAE with AIx@75 and nocturnal TVR suggests the presence of early-stage vascular disease in diabetic adolescents.

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“…Several papers have reported AIx to be an easy and reproducible parameter for indirect assessment of arterial stiffness. AIx is strongly correlated to direct measurements of arterial distensibility and can thereby be used as a surrogate for arterial stiffness ( Ng et al, 2006 ; Vlachopoulos et al, 2010 ; Takemoto et al, 2021 ).…”

Section: Introductionmentioning

confidence: 99%

Affected Microcirculation and Vascular Hemodynamics in Takayasu Arteritis

et al. 2022

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Introduction: Takayasu arteritis (TAK) is a rare inflammatory disease affecting aorta and its major branches. Ultrasound (US) can detect inflammatory features in the arterial wall, but less is known regarding skin microcirculation and vascular hemodynamics. The aim was to study if assessment of these variables could add valuable information regarding vascular affection in TAK.Methods: 17 patients diagnosed with TAK and 17 age- and sex-matched healthy controls were included. Microcirculatory peak oxygen saturation (OxyP) in the skin after induced ischemia was evaluated with laser Doppler flowmetry/diffuse reflectance spectroscopy. Cerebrovascular reserve capacity (CVR) in the brain was assessed with transcranial Doppler (TCD). Pulse waves were recorded in the radial artery by the aid of applanation tonometry, for calculation of central augmentation index (AIx75). Intima-media thickness (IMT) and stenosis/occlusions were evaluated using US in carotid and central arteries.Results: Reduced OxyP (79 ± 8% vs. 87 ± 4%, p < 0.001) was seen in patients with TAK regardless of significant arterial stenosis/occlusion or not. Increased AIx75 (22.3 ± 13.6 vs. 9.2 ± 16.3, p = 0.01) was seen in TAK patients without significant stenosis/occlusions. No differences were found in CVR, regardless of proximal stenosis. However, signs of a more high-resistance flow profile were seen in arteria cerebri media.Conclusion: Regardless of arterial stenosis or not, impaired microcirculation of the skin and preserved CVR in the brain were found in subjects with TAK. Signs of increased arterial stiffness in the brain and central arteries were observed. The value of these findings for prediction of future cardiovascular events needs to be clarified in further studies.

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Total vascular resistance, augmentation index, and augmentation pressure increase in patients with peripheral artery disease

Cited by 5 publications

References 35 publications

Ambulatory blood pressure parameters and their association with albuminuria in adolescents with type 1 diabetes mellitus

Ambulatory blood pressure parameters and their association with albuminuria in adolescents with type 1 diabetes mellitus

Blood pressure parameters and its association with albuminuria in adolescents with type 1 diabetes mellitus and ABPM using Mobil-O-Graph.

Affected Microcirculation and Vascular Hemodynamics in Takayasu Arteritis

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