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Objective Using the function of 256-layer iCT in the determination of cardiac function and arterial elasticity index, to compare the arterial elasticity, left ventricular function and their correlation between patients with aortic dissection and non-dissected controls, and to provide a reference for the clinical treatment of patients with aortic dissection. Methods This study selected 36 cases in our emergency department,with chest, back or abdominal pain, whose clinical symptoms were highly suggestive of aortic dissection, and plain or enhanced diagnosis confirmed aortic dissection as a case group. At the same time, we randomly selected 40 cases without aortic dissection as the control group. All subjects underwent CTA one-stop scanning and measurement of elastic and cardiac function at the same level. According to the measurement results, the arterial elasticity indexes and the measured cardiac function of the case group and the control group were evaluated and compared so that to evaluate the arterial elasticity and its correlation with left ventricular function in patients with aortic dissection. Results patients's arterial expansion and compliance in patients with aortic dissection were significantly lower than the control group (P＜0.05) . The mean diameter change rate and stiffness of the patients with dissection were significantly lower than those in the control group (P＞0.05) . The difference was not statistically significant. The mean stiffness in patients with aortic dissection was significantly higher than non-aortic dissection patients. In patients with aortic dissection, the mean arterial diameter change rate, expandability and arterial stiffness showed a highly negative correlation. There was no significant correlation between arterial elasticity index and cardiac function in patients with Stanford type A and Stanford type B aortic dissection. There was no significant correlation between each elasticity index and cardiac function in the control group (r＜0.3) . Conclusion CTA one-stop scan can be used as an important measure of arterial elasticity, cardiac function and other parameters in patients with aortic dissection. Significantly lower aortic expansion and compliance, increased stiffness, insignificant changes in cardiac function, and insignificant correlation between cardiac function and each elasticity index in patients with early aortic dissection all have a clinical significance.
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Cardiovascular risk is increased in HIV-infected patients and has become a leading cause of morbimortality in this population. The purpose of this study is to compare HIV-infected patients on antiretroviral therapy (ART) and ART-naïve HIV-infected patients regarding arterial elasticity. From September 2010 to September 2015, 105 HIV-infected subjects were enrolled, 41 ART-naïve and 64 on ART with stable viral suppression. Elasticity of large and small arteries (LAE and SAE) was assessed by analysis of radial pulse waveforms using a calibrated device. A single set of measurements was performed. Multivariate linear regression models were constructed to estimate independent correlates of arterial elasticity. On-ART and ART-naïve patients were similar with respect to gender, age, body mass index, Framingham cardiovascular risk score, smoking habits, and CD4+ counts. Median time on treatment was 60 months and 79% of patients were on regimens based on non-nucleoside reverse-transcriptase inhibitors. No significant differences in LAE and SAE assessments were found between groups. However, time on ART and cholesterol levels were independently associated with LAE impairment. No association between arterial elasticity and CD4+ counts was found. We conclude that cumulative exposure to ART may play a role on LAE impairment and deserves further investigation.
El riesgo cardiovascular está incrementado en los pacientes HIV seropositivos y se ha convertido en una de las principales causas de morbimortalidad en esta población. El objetivo de este estudio fue comparar la elasticidad de grandes y pequeñas arterias (LAE y SAE) en pacientes infectados por HIV con y sin terapia antirretroviral. De septiembre de 2010 a septiembre de 2015 se enrolaron 105 pacientes con infección por HIV, 41 vírgenes de antirretrovirales y 64 con tratamiento estable en supresión viral. LAE y SAE fueron evaluados mediante análisis de la onda de pulso radial. Se construyeron modelos de regresión lineal múltiple para evaluar los predictores independientes de la elasticidad arterial. Los grupos en tratamiento y naïve fueron similares con respecto al sexo, edad, índice de masa corporal, índice de Framingham, tabaquismo y recuento de CD4+. La mediana de tiempo en tratamiento antirretroviral fue 60 meses y el 79% de los pacientes recibieron inhibidores no nucleosídicos. No hubo diferencias significativas entre los grupos en los valores de LAE y SAE. Sin embargo, el tiempo en tratamiento y el nivel de colesterol plasmático se asociaron independientemente con deterioro de LAE. No observamos asociaciones entre la elasticidad arterial y los recuentos de CD4+. Concluimos que la exposición acumulada al tratamiento antirretroviral podría contribuir al deterioro de la LAE. Este hallazgo merece ulterior investigación.
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Humans , Male , Female , Adult , Arteries/physiopathology , Vascular Resistance/physiology , HIV Infections/physiopathology , Anti-HIV Agents/therapeutic use , Elasticity/physiology , HIV Infections/drug therapy , Cross-Sectional Studies , Antiretroviral Therapy, Highly ActiveABSTRACT
OBJECTIVE:To observe clinical efficacy of Felodipine sustained-release tablets(Ⅱ)in the treatment of elderly es-sential hypertension and its improvement effect on arterial elasticity,left ventricular remodeling and the quality of life. METHODS:A total of 96 elderly patients with essential hypertension in our hospital during Aug. 2014-Dec. 2015 were divided into observation group (50 cases) and control group (46 cases) according to random number table. Observation group was given Felodipine sus-tained-release tablets(Ⅱ)5 mg orally,qd,with empty stomach in the morning;control group was given Irbesartan tablets 150 mg, qd,with empty stomach in the morning. Both groups received treatment for 12 weeks. Clinical efficacies of 2 groups were observed as well as 24 h ambulatory blood pressure (ABP),indexes of arlerial elasticity [carotid-radial pulse wave velocity (CR-PWV),carot-id-femoral pulse wave velocity (CF-PWV)], indexes of left ventricular remodeling [diastolic interventricular septum thickness (IVST),diastolic left ventricular posterior wall thickness(LPWT),left ventricular end diastolic diameter(LVIDd)] before and after treatment. The physiological function (PF),social function (SF),role-physical (RP),body pain (BP),mental health (MH),role-emotional(RE),vitality(VT)and general health(GH)score of SF-36 were observed in 2 groups before and after treatment. The occurrence of ADR was compared between 2 groups. RESULTS:There was no statistical significance in total response rate be-tween 2 groups (P>0.05). There was no statistical significance in 24 hABP,CR-PWV,CF-PWV,IVST,LPWT,LVIDd,SF-36 score between 2 groups before treatment(P>0.05). After treatment,the levels of 24 hSBP,24 hDBP and 24 hMAP in 2 groups were decreased significantly,and 24 hSBP and 24 hMAP of observation groups were significantly lower than those of control group,with statistical significance (P0.05). The levels of CR-PWV,CF-PWV, IVST and LPWT in observation group were decreased significantly,and the levels of CR-PWV and LPWT in control group were also decreased significantly. The levels of CR-PWV,CF-PWV,IVST,LPWT and LVIDd in observation group were significantly lower than control group,with statistical significance (P0.05). CONCLUSIONS:Felodipine sustained-release tablets(Ⅱ)exhibit significant effect and small blood pres-sure fluctuation in the treatment of elderly essential hypertension,and can improve the quality of life with good safety.
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Objective To explore the effect of aerobic exercise training on artery elasticity among patients with essential hypertension.Methods A total of 155 cases of patients with essential hypertension (EH)were selected,and were divided into control group(76 cases)and aerobic exercise group(79 cases).Control group was follow routine drug therapy,and aerobic exercise group was follow aerobic exercise training besides the routine therapy for 12 weeks.CAVI,ABI values,limb blood pressure,TG,TC,LDL -C,HDL -C and U -MA were compared before and after the intervention.Results After the intervention,bilateral CAVI values of aerobic exercise group were 7.76 ±0.15,7.88 ±0.15,8.87 ±0.25 and 8.89 ± 0.22,and lower than those before the intervention(P <0.05).The decline range of bilateral CAVI value(the difference between the mean differences before and after the intervention)were 1.03 ±0.07 and 1.03 ±0.06,significantly wider than the control group of 0.33 ±1.97 and 0.15 ±0.08(P <0.05).After the intervention,limb systolic pressure,diastolic blood pressure and triglyceride,cholesterol decreased in the aerobic exercise group(P <0.05).The limb systolic blood pressure and left limb diastolic blood pressure decreased in the control group after intervention (P <0.05),but the decline range was smaller than the aerobic exercise group(P <0.05 ).Conclusion The aerobic exercise training could significantly improve arterial elasticity among patients with essential hypertension.
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Objective To investigate the relationship between arterial elasticity and left ventricular twist in patients with essential hypertension (EH).Methods Sixty patients with EH who were treated in the First Affiliated Hospital of the Medical College of Shihezi University from October 2014 to June 2015 as the EH group,and 60 healthy persons in the same period as the control group.The systolic blood pressure (SBP),diastolic blood pressure (DBP),pulse pressure (PP) were measured.Ascending aortic systolic diameter,diastolic diameter were detected by ultrasonic technology.Aortic strain (AS),aortic stiffness (β) and aortic distensibility (AD) were calculated.Left ventricular basal peak rotation(PBR) and apical peak rotation(PAR) were detected by speckle tracking imaging(STI),and the left ventricular peak twist(Ptw) was calculateby.Results The β,PP and Ptw in EH group were 3.99±0.47,(74.2±10.4) mmHg and (21.73±2.30) °respectively,in the control group were 2.75 ± 0.27,(45.9 ± 5.1) mmHg and (14.04 ± 2.90) ° respectively,and the differences were significant(P=0.000).AS and AD in Eh group were 0.034±0.012,1.00±0.47 respectively,in the control group were 0.106 ± 0.028,4.69 ± 1.37 respectively,and the differences were significant (P =0.000).Pearson correlation analysis showed there were opsitive correlation between β with PBR,PAR and Ptw (correlation coefficient =0.361,0.719,0.730;P＜0.01 or P＜0.05),and negative correlation between AD with PBR,PAR and Ptw(correlation coefficient =-0.279,-0.625,-0.610;P＜0.01 or P＜0.05).Conclusion β,PP and Ptw are high,while AS,AD are poor in patient with EH,and there are associations between β,AD with PBR,PAR and Ptw.
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Objective To evaluate carotid intima-media thickness(IMT) and elasticity in patients with pregnancy-induced hypertension(PIH) using ultrasound radio-frequency data(RF-data) technology.Methods Twenty-seven PIH women(mean brachial blood pressure:108 mm Hg,1 mm Hg=0.133 kPa)were included and thirty age- and gestational week-matched normal pregnant women served as controls.Carotid IMT and stiffness were evaluated using quality IMT(QIMT) and quantitative artery stiffness(QAS)techniques with color Doppler.Results Carotid IMT and elasticity parameters,including pulse wave velocity,pressure at T1,arterial augmented pressure(AP) and arterial augmented pressure index(AIx) were significantly higher in PIH group than in the normal group[IMT:(466.84±118.50)μm vs (386.58±125.79)μm;PWV:(7.09±1.97)m/s vs (5.95±1.11) m/s;PT1:(127.50±14.29) mm Hg vs (105.89±11.02)mm Hg;AP:(5.14±3.39) mm Hg vs (1.98±2.19)mm Hg;AIx:(7.58±8.73)% vs (-4.79±7.92)%)], and there were significant differences(t=2.660,2.660,3.460,3.460,3.460,all P＜0.01).Conclusions PIH women have significantly increased carotid IMT and decreased elasticity compared with normal pregnant women.Radio-frequency technique could reliably reflect the changes of the carotid arterial structure and elasticity in patients with pregnancy-induced hypertension.
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ObjectiveTo test the reproducibility of wave intensity (WI)analysis derived measurements of pulse wave velocity (PWV),and to compare it with the traditional method-applanation tonometry.MethodsOne hundred and ten outpatient volunteers were enrolled in the study.The R-W1 of right brachial artery and right posterior tibial artery were measured through WI in diagnostic ultrasound equipment (Aloka α10),and were used to calculate the right brachial artery PWV which were also measured by tonometry (VP-1000) simutaneously;thus 30 of these volunteers were randomly selected to repeat the above examinations in the same session.Differences between the two methods were investigated by means of a paired t-test,and their linear correlations were also analyzed.Bland-Altman method was used to analyze the agreement between the two methods and their intraobserver intrasession variabilities.ResultsMean baPWVs determined by WI and tonometry were (13.03 ± 1.93) m/s and ( 12.05 ± 2.02) m/s,respectively (P ＜0.001),and the mean of their difference was (0.98 ± 1.1)m/s giving 95 ％ limits of agreement of ( - 1.18 m/s,3.14 m/s).Values of PWV obtained by the two systems were highly correlated( r =0.85,P＜ 0.001 ),with their intraobserver intrasession variabilities being 8.2％ and 7.0％,respectively.ConclusionsWI provides a new noninvasive and convenient method to measure PWV with good agreement and similar reproducibility to the standard tonometry system.
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Objective The present study was performed to evaluate changes of arterial elasticity in elderly patients with metabolic syndrome and its influence factors. Methods Using modified Windkessel model of the circulation and pulse waveform analysis,large artery elasticity indices(C1) and small artery elasticity indices (C2) of 221 old metabolic syndrome patients(the experimental group) and 206 old healthy subjects (the control group) were measured. Correlation of arterial elasticity changes with systolic blood pressure (SBp), diastolic blood pressure (DBp), mean blood pressure (MBp),pulse pressure (Pp), body weight indexes(BMI),body adipic weight, level of serum total cholesterol(TC), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C) and glucose was also analyzed. Results C1 and C2 reduced in the experimental, but SBp, DBp, MBp, Pp, BMI, body adipic weight, level of serum total cholesterol ( TC ), triglyceride (TG), low density lipoprotein cholesterol (LDL-C)and glucose were higher. There was a negative association between C1 and C2 and age, SBp, DBp, MBp and Pp and positive correlation with body weight indexes. But C1 and C2 were not correlated with body adipic weight, TG and HDL-C. Conclusions Arterial elasticity of elderly patients with metabolic syndrome were reduced. Arterial elasticity assessment offers a means of risk stratification for the clinical evaluation of vascular structural and functional injuries.
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0.05).Heart rate was significantly slow in bisoprolol group(after treatment:66?4 vs before treatment:74?7 beats/min,P
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Objective To evaluate the effects of Xin-ke-shu and Betaloc on arterial elasticity of coronary heart disease(CHD).Methods According to the results from coronary angiography,50 patients who were taking long-term treatment of coronary artery obstructions were enrolled and divided into two groups in equal number at random.They were divided into Xin-ke-shu group(n=25)and Betaloc group(n=25).The Xin-ke-shu group received Xin-ke-shu(12/d)individually and the Betaloc group received Betaloc(50mg/d)for eight weeks.Patient's heart rate was measured by the doctor.Brachial blood pressure was measured by standardized mercury cuff sphygmomanometer.Automatic pulse wave velocity(PWV)measurement system and Complior Colson device and DO-2020 were applied to examine the carotid-radial artery PWV(PWVcr)and the large arterial elastic indexes(C1 and C2)respectively.Results After eight weeks of treatment.All patient's heart rate showed significant decrease.The Betaloc group,after excluded the betaloc effect,showed significant decrease of blood pressure.The Xin-ke-shu group showed significant increase of C1 and C2,and PWVcr slowed down obviously.Conclusion Xin-ke-shu improves the small and large arterial elasticity,and attenuates the wave reflex amplitude.
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Objective To investigate the vascular compliance markers (C1 and C2) and pulse wave velocity in relative with other physiological indexes in a cohort of young normotensive people in Beijing. Methods Two hundred and seventy normotensive volunteers (112 men and 158 women aged 16 to 30 years) were invovled,completed questionnaires of demographic information. Large (C1) and small (C2) arterial compliance were derived from arterial pulse wave contour analysis. Pulse wave velocity(carotid-femoral PWV and carotid-radial PWV)was determined by Complior SP. Results In both male and female C1 correlated positively with height and weight,and negatively with systolic(SBP),mean arterial blood pressure(MAP),pulse pressure(PP),and heart rate(HR),in which PP showed the best correlation with C1;C2 was inversely related with SBP,diastolic blood pressure(DBP),MAP and HR,in which SBP showed the best correlation with C2;cfPWV correlated positively with DBP and age,crPWV correlated positively with age,DBP,height and weight. Conclusion Blood pressure,heart rate were the important influential factors of large and small arterial compliance in both males and females,while diastolic blood pressure was determinant for pulse wave velocity.
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0.05].Sao and Eao was significantly different between CHD group and the control group,but Aao has not significant different.③Sao positively correlated with ascending aortic distensibility coefficient(D)(r=0.73,P=0.03),and negatively correlated with aortic stiffness(?)(r=-0.68,P=0.03).Conclusion:Elastic properties of the aorta can directly be assessed by measuring the movements in the upper wall of the aorta with DTI.Reduced aortic S-velocity is significantly correlated with Ascending aortic distensibility coefficient(D) and stiffness index beta(?),which are important factors in assessing the changes of the aortic distensibility.