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Resting Systolic Blood Pressure and Body Mass Index but Not Aortic Stiffness Independently Predict Systolic Blood Pressure Response to Maximal Exercise in Healthy Adults

Exaggerated systolic blood pressure (BP) response to maximal exercise is associated with incident hypertension and cardiovascular disease (CVD) death.   Aortic stiffness, measured by carotid-femoral pulse wave velocity (cfPWV), is a robust predictor of CVD and is related to systolic BP at the 2nd stage of a graded exercise treadmill test.  However, because stage 2 of a graded exercise test represents a different relative workload (% of maximal exercise oxygen uptake, VO2max) for each participant, differences in submaximal exercise systolic BP response may be related to variation in VO2max rather than cfPWV.  Therefore, we hypothesized that systolic BP at maximal exercise would be associated with cfPWV independent of VO2max in healthy adults.

Aortic Stiffness, Obesity and Left Atrial Volume in Older Participants in the Age, Gene/Environment Susceptibility—Reykjavik Study

Larger left atrial volume (LAV) is associated with increased risk for atrial fibrillation, stroke, and other cardiovascular diseases. Relations of LAV with obesity and various hemodynamic measures have been investigated separately. We evaluated the combined relations of LAV with obesity, volume load on the heart, and aortic stiffness in order to determine whether relations between obesity and LAV are attributable to hemodynamic abnormalities.

The Effects of High-Intensity Aerobic Interval versus Moderate-Intensity Continuous Aerobic Exercise on Post-Exercise Cardiovascular Responses

After an acute bout of moderate-intensity continuous aerobic exercise (CAE), leg blood flow (LBF) and vascular conductance (LVC) remain elevated contributing to a corresponding decrease in arterial blood pressure (ABP).  However, little is known about the vascular and ABP response following high-intensity interval aerobic exercise (HIAE).  The current study tested the hypothesis that HIAE, matched for total work to CAE, would elicit greater post-exercise reductions in ABP and larger increases in LBF and LVC. 

Carotid Arterial Circumferential Strain Has a Greater Association to Vascular Aging than Conventional Carotid Arterial Stiffness

Arterial stiffness is closely related to the risks of CVD and increases with aging. Functional impairment of the arterial wall can occur before structural changes and can be detectable before CVD symptoms. The elastic properties of the carotid arterial wall during the cardiac cycle can be evaluated by either standard 2-dimensional (2D) ultrasound longitudinal or 2D ultrasound circumferential imaging of vascular deformation (Strain) using speckle tracking. The purpose of this study was to compare standard longitudinal scans with 2D circumferential ultrasound imaging of vascular tissue motion and Strain using speckle tracking with in young and old people.

Forward Wave Amplitude Is Not Solely Dependent on Proximal Aortic Properties: Importance of Wave Reflections
2016 Early Investigator Award Winner

The contribution of proximal aortic properties and wave reflections to increased pulse pressure with aging remains controversial. The forward wave amplitude (FWA) paradigm proposes an important role for mismatch between flow and proximal aortic properties. This proposition assumes that the morphology and amplitude of the forward wave depend exclusively on the aortic root. This is unlikely, since FWA depends on the LV ejection pattern, which itself is sensitive to wave reflections.

Effect of Nitrate Ingestion on Central Hemodynamics in Hypoxia   2016 Best Abstract Award Winner

Acute hypoxia results in local vasodilation that may temporarily unload the left ventricle (LV) through nitric-oxide (NO)-mediated mechanisms.  Whether increasing NO levels augments LV unloading and improves ventricular-vascular coupling in hypoxia remains unknown. 

Estimations of Total Arterial Compliance from Carotid vs. Generalized Transfer Function-Derived Central Pressure Waveforms

Generalized transfer functions from radial pressure waveforms are often used to estimate the peak central aortic pressure. However, time-resolved information in the waveform can also be used to assess the total arterial compliance, using central pressure and flow waveforms. Although carotid waveforms are preferred over peripheral arterial waveforms, high quality carotid waveform recordings are difficult to obtain in multicenter studies.

Endogenous Hydrogen Sulfide Mediated Cutaneous Vasodilation is Attenuated in Essential Hypertensive Humans

Hydrogen sulfide (H2S) is an endothelium-dependent hyperpolarizing factor (EDHF) implicated in the pathogenesis of hypertension-induced vascular dysfunction.  H2S is synthesized enzymatically through cystathione-γ-lyase (CSE) and 3-mercaptopyruvate transferase (MPST) in the cutaneous vasculature and induces vasodilation directly and through nitric oxide synthase (NOS)-dependent mechanisms. 

Independent and Combined Effects of Aerobic and Resistance Training on Sarcopenic Indices and Its Associations with Peripheral and Central Blood Pressure

To investigate the effects of aerobic and/or resistance training on sarcopenic indices and associations between changes in appendicular lean mass (ALM) and blood pressure (BP) and heart rate (HR).

The Influence of Body Composition on Arterial Stiffness And Cardiorespiratory Fitness in Young Adults

Carotid-femoral pulse wave velocity (cfPWV) is associated with increased cardiovascular disease risk, which is due, in part, to reduced cardiorespiratory fitness (CRF). The influence of body composition on the relationship between cfPWV and CRF has been equivocal. Thus, identifying the influence of body composition on CRF in young adults for future prevention is clinically relevant.  We hypothesized the inverse relation between cfPWV and CRF is due to greater fat mass (FM) and fat free mass (FFM) in young adult males.

Relationship between Arterial Stiffness and Functional Capacity in Kidney Transplant Patients

While survival rates are much greater in kidney transplant (KT) than in dialysis patients, significant issues remain.   Elevated pulse pressure (PP), carotid beta stiffness, and central pulse wave velocity (cPWV) have all been shown to be associated with cardiovascular disease, which is the main cause of death in kidney transplant patients.

Effects of Hyperphosphatemia on Cerebral Small Vessel Diseases in Chronic Kidney Disease

Chronic kidney disease (CKD) has been recently identified as a significant risk factor for stroke as well as for subclinical vascular diseases such as cerebral small-vessel diseases (CSVD). Endothelial dysfunction is a major contributor to CSVD in CKD. Interestingly, both kidney and cerebral microvasculature share similar anatomical and physiologic characteristics. The goal of this study was to elucidate the effects of hyperphosphatemia in cerebral microvasculature using human brain microvascular endothelial cells (HBMECs) and CKD mice as our models.

CAVI measurements in a North American Normal Population

The Cardio-Ankle Vascular Index (CAVI) represents a promising index of arterial stiffness, however, the measure or its device, the VaSera, have not been extensively tested in North American clinical settings, nor is much known about the pressure independency of the measure and the accuracy of the ankle-brachial index measure when validated by Doppler in North Americans.

Differences in Carotid Arterial Characteristics Based On Years since Diagnosis in Relapsing Remitting Multiple Sclerosis Patients

Persons with multiple sclerosis (MS) experience a decreased life expectancy and greater burden of cardiovascular disease (CVD) compared to age-matched healthy peers.  Carotid artery dysfunction in the form of increased stiffness and reduced compliance are often precursors to the clinical manifestation of CVD.  Carotid artery dysfunction is a common effect of aging, and may occur earlier in those with MS as the progression of CVD may be accelerated in this population. 

Influence of Body Position and Venous Pooling On Aortic Blood Pressure and Wave Reflection in Young Adults

Indices of wave reflection (Augmentation Index, AIx; Augmentation Index at 75 bpm, AIx@75) decrease during a passive head up tilt (HUT). We aimed to examine whether decreases in wave reflection during HUT were a result of venous pooling in the lower limbs, or change in body position (supine vs. 60˚tilt).

Comparison of the Flow-Mediated Dilation Response between the Popliteal and Fibular Arteries

Vascular health is controlled by competing neural sympathetic vasoconstrictor and endothelial-derived vasodilator mechanisms. However, the relationship between these mechanisms is poorly understood. In humans, muscle sympathetic nerve activity (MSNA) is commonly measured in the fibular nerve to assess vasoconstrictor activity, while flow-mediated dilation (FMD) measures of lower-limb endothelial dilatory function are routinely measured in the popliteal artery (PA). Ideally, FMD measures would come from the fibular artery (FA). However, fibular FMD responses are rarely reported and whether it responds similarly to the PA is unknown. Past literature has shown upper limb arteries with a larger baseline diameter exhibit smaller FMD responses, although this relationship isn’t as strong in lower limb arteries (1). The aim of this study was to compare PA and FA FMD and corresponding changes in shear rate.

Independent Modifications to Backward and Forward Pressure Waves Lead to Non-Physiological Aortic Flow

Arterial wave reflections are important contributors to LV afterload. So as to demonstrate the role of increased forward wave amplitude and morphology in late systolic pressure augmentation, a recent study [1] modified backward waves independently of forward waves to form simulated aortic pressure waveforms, without regard for the underlying flow necessary to meet those altered conditions.

Reconciling the Increased Pulse Wave Velocity and Reflected Wave Transit Time Paradox

Previous studies suggest that, despite the clear increase in PWV with aging, reflected wave transit time (RWTT) does not change significantly. This has led to the proposition of a “distal shift” of reflecting sites with aging. This conclusion is critically dependent on the methods to assess RWTT. We aimed to assess how different RWTT measures vary with age and show that increased PWV with age is indeed associated with decreased RWTT when a proper RWTT method is used.

Evaluating the Logical Relationships of Reflected Wave Transit Time with the Complex Global Reflection Coefficient, Height, and Pulse Wave Velocity

Reflected wave transit time (RWTT) represents the time at which arterial wave reflections begin to exert significant effects on aortic pressure and flow. Different methods exist to compute RWTT, each yielding conflicting interpretations regarding underlying cardiovascular changes. RWTT should sensibly correlate with body height and pulse wave velocity (PWV). Furthermore, RWTT should correlate strongly with the phase of the complex global reflection coefficient (Γϕ,1), as this variable describes the time lag between backward and forward waves in the frequency-domain. We evaluated the relationship between RWTT measured with 3 methods and the following 3 variables: height, PWV and Γϕ,1, to determine the method that is most logically consistent.

“Impedance Matching” Between The Aorta And Large Muscular Arteries?  Misinterpretation of Pulse Wave Velocity Gradients

Given the increase in carotid-femoral Pulse Wave Velocity (cfPWV) with aging, without an increase in carotid-radial PWV (CR-PWV), some investigators have suggested an age-related “impedance matching” between the aorta and large muscular arteries, leading to a reduction of reflections arriving at the proximal aorta and a distal shift in reflection sites. However, characteristic impedance is much more sensitive to diameter than wall stiffness and PWV “matching” should not be equated to “impedance matching”. If PWV “matching” indeed produces a distal shift of reflection sites, it should be related to a greater reflected wave transit time (RWTT) for any given PWV.

Transplant Renal Artery Stenosis: A Treatable Cause of Resistant Hypertension and Renal Allograft Dysfunction

Atherosclerosis is the most common cause of transplant renal artery stenosis (TRAS). It is unknown whether therapeutic angioplasty and/or renal-artery stenting is superior to medical management for TRAS. With donor renal vascular manipulation or reconstruction and exposure to immunosuppression, the pathogenesis of RAS in renal transplant recipients may differ from non-transplant patients. We aim to identify potential risk factors of TRAS and outcomes after renal artery angioplasty and/or renal-artery stenting.

Pre-operative Pulse Wave Velocity (PWV) Values and Refractory Systemic Hypotension after Induction of General Anesthesia in Patients Treated with Angiotensin Converting Enzyme Inhibitor: A Pilot Study

During the induction of anesthesia moderate hemodynamic disturbances are common due to concurrent autonomic nervous system suppression and the stress response from endotracheal intubation. Previous studies have shown that patients chronically taking angiotensin converting enzyme (ACE) inhibitors have a higher incidence of developing hypotension under general anesthesia and are refractory to adrenergic vasoconstrictor medications given to help restore blood pressure. We aimed to investigate whether differences in baseline levels of arterial stiffness, as measured by PWV, contribute to this phenomenon.

Blood Pressure is the Strongest Component Associated with Arterial Stiffness in Mexican Patients with Metabolic Syndrome

The prevalence of Metabolic Syndrome (MetS) in Mexico increased from 26.6% to 45% in 2012. Cardiovascular disease is the main cause of death in Mexico and arterial stiffness (AS) is an early subclinical vascular disease marker. The aim of this cross-sectional study was to evaluate the correlation between the components of MetS and AS.

Central Blood Pressure, Wave Reflection and Subendocardial Viability Ratio in Women with a History of Hypertensive Pregnancy

History of hypertensive pregnancy (HTNP) is considered a risk factor for future cardiovascular disease.  However, only some women with a history of HTNP become hypertensive later in life. Higher augmentation index (AIx) is associated with increased cardiovascular risk; additionally, lower (below 50%) subendocardial viability ratio (SEVR) represents subendocardial ischemia and serves as an index of myocardial oxygen supply and demand. Hence, the aim of the study was to determine underlying phenotypes that might differentiate these women. 

Reproducibility of Central Systolic Blood Pressure, Augmentation Index, Measurements Calculated with the Omron HEM-9000AI Device in a Mexican Population of Young Individuals

To assess the agreement and reproducibility of the non-invasive measurement of the central systolic blood pressure (cSBP), second systolic shoulder (SYS2), and augmentation index (AIx) with the HEM-9000AI.

Altered Vessel Hemodynamics at Rest and After Acute Physical Stress in Young Smokers

Long-standing smokers have stiffer arteries at rest; however the extent of the underlying vascular dysfunction in young healthy smokers has not been fully established. We aimed to examine the acute and chronic effect of smoking and nicotine exposure, on arterial stiffness at rest and in response to acute physical stress in young healthy individuals.

Arterial Stiffness and Central Systolic Blood Pressure Response to Dietary Sodium in Young and Middle-Aged Adults

High dietary sodium intake has been associated with the development of hypertension and increased incidence of cardiovascular disease. The aim of this study was to determine the effect of short-term dietary sodium loading on arterial stiffness and central blood pressure in young (YG; 22-40 years old, n=49, 27±1 yrs) and middle-aged (MA; 41-60 years old, n=36, 52±1 yrs) normotensive adults.

Hemodynamic Responses Following 12 Weeks of Home-Based Exercise in Individuals with Multiple Sclerosis: Wave Separation Analysis

Increased inflammation, which is related to cardiovascular disease and altered hemodynamics, is a common condition in individuals with multiple sclerosis (MS). Low to moderate intensity aerobic exercise has shown beneficial effects in reducing inflammation and blood pressure (BP) in individuals without MS. Low to moderate intensity exercise may benefit BP and pulse wave characteristics, in individuals with MS.

Arterial Stiffness throughout Pregnancy in Women Who Conceive Via In Vitro Fertilization

In vitro fertilization (IVF) is an increasingly common method of conception among women. Studies have reported a higher risk in IVF pregnancies for certain cardiovascular-related outcomes, such as pregnancy-induced hypertension. The effect of IVF on arterial structure as a potential underlying mechanism for this increased risk has yet to be explored. Applanation tonometry allows the non-invasive assessment of arterial stiffness, a composite predictor of cardiovascular risk. The objective of this study was to explore the association between IVF and arterial hemodynamic and stiffness parameters in pregnancy.

The Influence of Resting Heart Rate on Low- and Very Low-Frequency Blood Pressure Variability

Low-frequency (LF) blood pressure variability (BPV) is associated with sympathetic modulation of vascular tone, whereas very low-frequency (VLF) BPV reflects myogenic vascular responsiveness to blood pressure oscillations. Heart rate (HR) can affect blood pressure (BP) and is also modulated by sympathetic tone, but whether an equal change in HR affects measures of BPV in individuals with different resting HR levels remains unclear. 

A New Pathway to Increase Arterial Flexibility: Investigating Oils With Repsect To Arterial Flexibility Using Photoplethysmography (The IOWA Study)

The precursor (PSK002) to an investigational new drug (PSK003) was used in a screening experiment (IOWA) to test the ability of a new botanical lipids-based medicament to reduce arterial stiffness utilizing photoplethysmography. Effects were tested following long-term (48 months, N=34) or short-term (8 months, N=16) exposure and in volunteers previously using fish oil who were converted to the medicament short-term (6 months, N=15).

Longitudinal Strain Is Not Associated With Clinic Central Systolic Blood Pressure in a Young Normotensive Population

Increased central systolic blood pressure (cSBP) is associated with target organ damage (TOD) of the heart as traditionally quantified by left ventricular mass (LVM). 1 However, longitudinal strain (LS), a sensitive marker of left ventricular (LV) function, was recently reported as reduced in hypertensive patients with normal LVM. 2 This marker may be a more sensitive indicator of sub-clinical TOD than LVM. The purpose of this study was to determine if cSBP was more strongly associated with LS than LVM in a young normotensive population.

Resting Heart Rate Is a Factor in Acute Blood Pressure Variability Responses to Cycling

Blood pressure variability (BPV) is an indicator of the ability to maintain blood pressure over time and is an indicator of arterial and autonomic health. What is not known is if steady state heart rate (HR) would affect acute measures of BPV. Resting HR is associated with overall sympathetic and vagal modulation. An individual with a lower resting HR should be able to increase sympathetic modulation to a greater extent which peripherally should increase BPV.

The Blood Pressure Variability Responses to Light Cycling in Individuals With Different Resting Heart Rates

Blood pressure variability (BPV) is a non-invasive measure that includes the influence of sympathetic modulation.  There are also other numerous factors contributing to the variability, some of which are not fully understood, such as resting or exercising heart rates. 

Independent and Combined Effects of Aerobic and Resistance Training on Blood Pressure (Art-B)

Objective: To compare the effects of aerobic training only, resistance training only, and a combination of both on blood pressure (BP) and other cardiovascular disease risk factors compared with a non-exercising control group.

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