Objective: Pulse Wave Velocity (PWV) reflects aortic stiffness. High arterial stiffness is a proxy for early vascular aging and an independent predictor of cardiovascular risk. We tested whether Head Down Bedrest protocol, an on-earth simulation of microgravity, could affect arterial stiffness, and whether recovery could be measured at short, medium and long term after return to orthostatism. We aim to describe the evolution of pulse wave velocity during 60 days of bedrest, and 1 week, 4 weeks and 52 weeks after. Design and method: Twenty healthy males without cardiovascular risks or disease were selected for Bedrest study. PWV were assessed with sphygmocor by experienced investigators 6 time during our study: one measure at baseline, 2 measures during bedrest phase and 3 measures at recuperation phase (in 11 subjects at 52 Weeks). PWV evolution was analyzed with a mixed model, adjusted on mean blood pressure (MBP). Results: We observed a significant increase of PWV during bedrest phase compared to baseline, with an average increase of 1.58 m/s (p < 0,001), after adjustment on MBP. All subjects increased PWV. The increase in PWV was significant right after bedrest phase (average increase of 0,73 m/s compared to baseline (p = 0,02), and did not regress more after one month. The increased in PWV was still significant one year after bedrest phase (+ 0,78 m/s (p = 0,03) after adjustment on MBP). One year after bedrest protocol, none of our patients’ PWV value has gone back to baseline value. Conclusions: Our study showed an important, significant increase of pulse wave velocity during and after bedrest study. These modifications were observed one year after bedrest study, which suggests that prolonged bedrest conditions induce early vascular aging and increase the global cardiovascular risk of patient.
Objective: Ankylosing spondylitis (AS) is an inflammatory autoimmune disease. AS is a prototype form of spondyloarthropathies(SpA). The precise etiology of AS has not been fully understood. But Inflammation has a critical role in the pathogenesis of the disease. The immune system by various cells, secreted-mediators and markers manage and regulate the immune responses and inflammation. Every factor which disturbed this regulation and hemostasis can cause chronic inflammation. Extraskeletal organs may also be affected by this disease and is also associated with an increased of cardiovascular risk. The effect of large arteries appears by a stiffness that can be an element of disease monitoring. The aim of this study was to evaluate the finger-toe Pulse Wave Velocity (ftPWV) in patients with AS.Design and method: It was a descriptive and prospective study carried out in patients with ankylosing spondylitis and control subjects. Finger-toe pulse wave velocity (ft-PWV) was measured by pOpmetre® allowed to explore arterial stiffness. Results: The results are expressed as mean ± standard deviation for continuous variables. Demographic and clinical characteristics are presented in Table 1. Twenty-two patients with AS and 24 controls were included in our study, subjects with AS exhibited greater pSBP (p < 0.001), pDBP (p < 0.001), pPP (p < 0.001) and MBP (p < 0.001) compared to controls. Moreover, in the AS group we observed a higher ftPWV with a mean difference of 1.63 (p < 0.006, 95% CI of .50 to 2.7) (Figure 1). No significant difference was observed in pPP. Conclusions: We conclude that individuals with ankylosing spondylitis showed increased ftPWV, central and peripheral blood pressure, this contributes to explain the higher risk of cardiovascular disease in this condition. pOpmètre® is a no operator depender, simple and practical device, highlighted an increase in arterial stiffness in patients with AS by measuring the ft-PWV. It could play a role in this disease monitoring and in prediction of cardiovascular complications.
BACKGROUND: Carotid-femoral pulse wave velocity (cfPWV) is the gold standard for noninvasive arterial stiffness assessment, an independent predictor of cardiovascular disease, and a potential parameter to guide therapy. However, cfPWV is not routinely measured in clinical practice due to the unavailability of a low-cost, operator-friendly, and independent device. The current study validated a novel laser Doppler vibrometry (LDV)-based measurement of cfPWV against the reference technique. METHODS: In 100 (50 men) hypertensive patients, cfPWV was measured using applanation tonometry (Sphygmocor) and the novel LDV device. This device has 2 handpieces with 6 laser beams each that simultaneously measure vibrations from the skin surface at carotid and femoral sites. Pulse wave velocity is calculated using ECG for the identification of cardiac cycles. An ECG-independent method was also devised. Cardiovascular risk score was calculated for patients between 40 and 75 years old using the WHO risk scoring chart. RESULTS: LDV-based cfPWV correlated significantly with tonometry (r=0.86, P <0.0001 ECG-dependent [cfPWV LDV_ECG ] and r=0.80, P <0.001 ECG-independent [cfPWV LDV_w/oECG ] methods). Bland-Altman analysis showed nonsignificant bias (0.65 m/s) and acceptable SD (1.27 m/s) between methods. Intraobserver coefficient of variance for LDV was 4.7% (95% CI, 3.0%–5.5%), and interobserver coefficient of variance was 5.87%. CfPWV correlated significantly with CVD risk (r=0.64, P <0.001; r=0.41, P =0.003; and r=0.37, P =0.006 for tonometry, LDV-with, and LDV-without ECG, respectively). CONCLUSIONS: The study demonstrates clinical validity of the LDV device. The LDV provides a simple, noninvasive, operator-independent method to measure cfPWV for assessing arterial stiffness, comparable to the standard existing techniques. REGISTRATION: URL: https://clinicaltrials.gov/study/NCT03446430 ; Unique identifier: NCT03446430.
Background Magnetic resonance imaging (MRI) offers the possibility to measure local and regional indices of aortic function. However calculations of these indices usually require blood pressure (BP) values. Up to now, because of its easier availability, brachial BP was used instead of local aortic pressure. The SphygmoCor Xcel system (AtCor Medical, Australia) estimates aortic pressure noninvasively. It consists in a MRI compatible brachial cuff connected via a hose to a recording unit and computer. The aim of this study was to compare brachial and central BP values given by SphgymoCor Xcel with the standard 2 meters hose and a 6 meters hose more suitable for central BP assessment during MRI.
Objective: Triple signal (TS) is a subclinical lesion were found in the common carotid artery of individuals with renal fibromuscular dysplasia (FMD), However, the mechanisms underlying this alteration in FMD patients are still unknown and might involve endothelial and/or smooth muscle cell dysfunction. We aimed at investigated whether FMD or triple signal, is associated with systemic vascular dysfunction. Design and method: The MEDYA study is a case-control, cross-sectional study, enrolling 47 individuals with renal FMD,47 matched individuals with essential hypertension (HT) and 50 healthy controls (C). All individuals underwent an assessment of endothelium-dependent dilation (EDD) of the brachial artery by the flow-mediated dilation technique and endothelium-independent dilation (EID) by sublingual administration of glyceryl trinitrate 150 mcg. EDD and EID were allometrically corrected for baseline diameter. Triple signal score was also computed in the common carotid arteries bilaterally, based on B-mode and RF images. A cut-off of 8 was used to discriminate TS carriers. Results: FMD, but not HT, showed impaired EID in comparison to controls (p = 0.003). FMD (but not TS) was among the determinants of EID_corr in a multiple linear regression model (beta = −0.03, p = 0.005). TS prevalence (FMD 48.9%, HT 31.9%, C 16.0%) was higher in FMD than in C (p < 0.001), but tended to be increased in HT as well (p = 0.07). In a multiple logistic regression model adjusted for confounders, FMD (OR 4.54, CL95% 1.56–13.23) but not HT, was independently associated with TS. In the FMD subgroup, TS was associated with older age, higher peak shear stress and lower EDD. EDD was still reduced in FMD patients with TS after correction for confounders (1.14 ± 3.59 vs 3.55 ± 4.18, p = 0035). In the HT subgroup, TS was independently associated only with older age and hypercholesterolemia. Conclusions: FMD is characterized by impaired smooth muscle cell function and increased TS prevalence, subclinical alterations independent from each other. TS might have a different pathophysiological significance in FMD and HT. Indeed, among FMD patients TS is associated with impaired endothelial function. Conversely, in HT TS seems to be associated only with classical CV risk factors.
