Occupational sitting and work engagement among university employees.

Objective: This study sought to determine the relationship between occupational sitting and work engagement among university employees. Participants: Participants included 103 university employees (age: 48.5 ± 10.4 years, 80% female, 77% staff). Methods: Participants completed an online survey based on the Utrecht Work Engagement Survey (UWES) and the Occupational Sitting and Physical Activity Questionnaire (OSPAQ). The UWES assessed elements of work engagement. The OSPAQ assessed time spent sitting, standing, walking, and in heavy labor during a workday. Results: Compared to staff members, faculty members self-reported less time seated during the workday (373.8 ± 109.7 min/day vs. 321.1 ± 97.3 min/day, p = 0.03). Work engagement was comparable among faculty and staff members (vigor: p = 0.44; absorption: p = 0.68; dedication: p = 0.71). Associations of work engagement with occupational sitting were not significant. Conclusions: These pilot findings suggest that university staff tend to engage in more occupational sitting compared to faculty. Being absorbed and engaged at work is not associated with occupational sitting.

Impact of Acute Uninterrupted Sitting on Cerebrovascular Hemodynamics.

Reductions in brain blood flow are associated with reduced cognitive function and cerebrovascular disease. Acute periods of uninterrupted sitting can lead to endothelial dysfunction, namely due to a reduction in shear stress and subsequent reduction in nitric oxide bioavailability. Little is known of the impact of sitting on brain health. The purpose was to determine the total brain blood flow response following a 60-minute bout of uninterrupted sitting. Using a parallel design, this study evaluated the impact of 60-minutes of sitting on total brain blood flow. Fifteen participants (n=15; age=24 ± 1yr; BMI=25 ± 1 kg/m2) sat, uninterrupted, for 60-minutes during the SIT protocol. To ascertain the contribution of blood pooling effects on total brain blood flow, ten participants (n=10; age=23±2yr; BMI=27±4 kg/m2) sat in a modified sitting (MOD) for 60-minutes. Finally, thirteen participants (n=13; age=23±3yr; BMI=26±4 kg/m2) remained supine for the duration of the 60-minutes as a time-control (TC). Brain blood flow was quantified through Doppler-ultrasound measurements of blood flow through the internal carotid (ICA) and vertebral (VA) arteries: (ICA blood flow + VA blood flow) × 2. Following the 60-minutes of sitting (SIT), there was a significant reduction in brain blood flow with time (p=0.001, η p 2 =0.05). Total brain blood flow did not significantly change in MOD (p=0.69, η p 2 =0.05) or TC (p=0.06, η p 2 =0.58) conditions. These findings indicate 60-minutes of sitting may alter cerebrovascular hemodynamics characterized by a reduction in total brain blood flow.

Impact of a Novel Training Approach on Hemodynamic and Vascular Profiles in Older Adults.

Exercise training beneficially moderates the effects of vascular aging. This study compared the efficacy of Peripheral Remodeling through Intermittent Muscular Exercise (PRIME), a novel training regimen, versus aerobic training on hemodynamic profiles in participants ≥70 years at risk for losing functional independence. Seventy-five participants (52 females, age: 76 ± 5 years) were assessed for hemodynamic and vascular function at baseline, after 4 weeks of either PRIME or aerobic training (Phase 1) and again after a further 8 weeks of aerobic and resistance training (Phase 2). Data were analyzed using 2 × 2 repeated-measures analysis of variance models on the change in each dependent variable. PRIME demonstrated reductions in brachial and aortic mean arterial pressure and diastolic blood pressure (p < .05) from baseline after Phase 1, which were sustained throughout Phase 2. Earlier and greater reductions in blood pressure following PRIME support the proposal that peripheral muscular training could beneficial for older individuals commencing an exercise program.

A Primer on Repeated Sitting Exposure and the Cardiovascular System: Considerations for Study Design, Analysis, Interpretation, and Translation.

Sedentary behavior, particularly sitting, is ubiquitous in many contemporary societies. This is a major societal concern considering the evidence for a strong association between sitting behavior and cardiovascular disease morbidity and mortality. Unsurprisingly, leading public health agencies have begun to advocate "reduction" in sitting behavior. Though, the guidelines are typically vague and non-specific. The lack of specific guidelines for prolonged sitting is attributable to the absence of available evidence to facilitate guideline development. To inform policy, well-designed randomized controlled trials are required to test the efficacy of specific and translatable sitting reduction strategies. To guide the design of randomized controlled trials, this review postulates that several gaps in the literature first need to be filled. Following a general discussion of the importance of sitting behavior to contemporary societies, each of the following are discussed: (i) acute sitting exposure and systems physiology; (ii) recommendations for a systems physiology toolbox; (iii) study design considerations for acute sitting exposure; and (iv) translation of sitting-focused research.

Central and peripheral arterial stiffness responses to uninterrupted prolonged sitting combined with a high-fat meal: a randomized controlled crossover trial.

Independently, prolonged uninterrupted sitting and the consumption of a meal high in saturated fats acutely disrupt normal cardiovascular function. Currently, the acute effects of these behaviors performed in combination on arterial stiffness, a marker of cardiovascular health, are unknown. This study sought to determine the effect of consuming a high-fat meal (Δ = 51 g fat) in conjunction with prolonged uninterrupted sitting (180 min) on measures of central and peripheral arterial stiffness. Using a randomized crossover design, 13 young healthy males consumed a high-fat (61 g) or low-fat (10 g) meal before 180 min of uninterrupted sitting. Carotid-femoral (cf) and femoral-ankle (fa) pulse wave velocity (PWV), aortic-femoral stiffness gradient (af-SG), superficial femoral PWV beta (ß), and oscillometric pulse wave analysis outcomes were assessed pre and post sitting. cfPWV increased significantly more following the high-fat (mean difference [MD] = 0.59 m·s-1) meal than following the low-fat (MD = 0.2 m·s-1) meal, with no change in faPWV in either condition. The af-SG significantly decreased (worsened) (ηp2 = 0.569) over time in the high- and low-fat conditions (ratio = 0.1 and 0.1, respectively). Superficial femoral PWVß significantly increased over time in the high- and low-fat conditions (ηp2 = 0.321; 0.8 and 0.4 m·s-1, respectively). Triglycerides increased over time in the high-fat trial only (ηp2 = 0.761). There were no significant changes in blood pressure. Consuming a high-fat meal prior to 180 min of uninterrupted sitting augments markers of cardiovascular disease risk more than consuming a low-fat meal prior to sitting.

Arterial stiffness responses to prolonged sitting combined with a high-glycemic-index meal: a double-blind, randomized crossover trial.

Regular exposure to uninterrupted prolonged sitting and the consumption of high-glycemic-index (HGI) meals is independently associated with increased cardiovascular disease risk. Sitting for as little as 1 h can impair the health of both peripheral and central arteries. However, it is currently unknown whether combined acute exposure to uninterrupted prolonged sitting and an HGI meal is more detrimental to global (peripheral and central) vascular health. The purpose of this study was to investigate the effect of prolonged sitting (3 h), following the consumption of an HGI or a low-glycemic-index (LGI) meal, on global pulse wave velocity (G-PWV). Eighteen healthy participants [70% female, mean (standard deviation, SD) age = 22.6 (3.1) yr, body mass index (BMI) = 25.5 (6.1) kg/m2] sat for 3 h after consuming an HGI or LGI meal. G-PWV was assessed by incorporating three PWV measures (carotid-femoral, brachial-femoral, and femoral-ankle). The effects of time (PRE vs. POST) and condition (LGI vs. HGI) were analyzed using linear mixed models. Following prolonged sitting, G-PWV increased by 0.29 m/s (i.e., PRE vs. POST). However, the condition (P = 0.987) and time × condition (P = 0.954) effects were nonsignificant. The current findings support previous research showing an increase in arterial stiffness with prolonged sitting. However, in young and healthy adults, the arterial stiffness response was not worsened through HGI meal consumption.NEW & NOTEWORTHY We used novel statistical techniques and study design characteristics to examine how the cardiovascular disruptions due to prolonged sitting are changed after the consumption of low- and high-glycemic-index meals. The current study indicates that changes in arterial stiffness due to prolonged sitting are not worsened in young, healthy adults after the consumption of a high-glycemic-index meal.

Cerebrovascular function response to prolonged sitting combined with a high-glycemic index meal: A double-blind, randomized cross-over trial.

Acute prolonged sitting leads to cerebrovascular disruptions. However, it is unclear how prolonged sitting interacts with other common behaviors, including high- (HGI) and low-glycemic index (LGI) meals. Using a double-blind randomized cross-over design, this study evaluated the effects of prolonged (3 hr) sitting, with a high- (HGI; GI: 100) or low-glycemic index (LGI; GI: 19) meal on total brain blood flow (QBrain ) and executive function. Eighteen young, healthy, active participants (22.6 [3.1] y, 33% F, 24.3 [3.7] kg/m2 ) sat for 3 hr after consuming an HGI or LGI meal. Using Doppler ultrasound to measure internal carotid (ICA) and vertebral (VA) artery blood flow, QBrain was calculated: (ICA blood flow + VA blood flow) × 2. Executive function was assessed using the Stroop Test and Trail Making Test-Part B. Brain fog was measured using a modified Borg Category Scale with Ratio properties (CR10). Following 3 hr of sitting, there was a significant decrease in QBrain with time (p = .001, ES = -0.26), though there were nonsignificant interaction (p = .216) and condition effects (p = .174). Brain fog increased (p = .024, ES = 0.27) and Stroop reaction time worsened with time (p = .001, ES: -0.40), though there were nonsignificant condition effects for brain fog (p = .612) and the Stroop test (p = .445). There was a nonsignificant condition effect (p = .729) for the Trail Making Test-Part B, but completion time improved with time (p = .001, ES = -0.40). In conclusion, 3 hr of prolonged sitting decreases QBrain and executive function independent of glycemic index in young, healthy adults.

The aortic-femoral arterial stiffness gradient: an atherosclerosis risk in communities (ARIC) study.

BACKGROUND: The aortic to femoral arterial stiffness gradient (af-SG) may be a novel measure of arterial health and cardiovascular disease (CVD) risk, but its association with CVD risk factors and CVD status, and whether or not they differ from the referent measure, carotid-femoral pulse-wave velocity (cfPWV), is not known. METHOD: Accordingly, we compared the associations of the af-SG and cfPWV with (i) age and traditional CVD risk factors and (ii) CVD status. We evaluated 4183 older-aged (75.2 ±â€Š5.0 years) men and women in the community-based Atherosclerosis Risk in Communities (ARIC) Study. cfPWV and femoral-ankle PWV (faPWV) were measured using an automated cardiovascular screening device. The af-SG was calculated as faPWV divided by cfPWV. Associations of af-SG and cfPWV with age, CVD risk factors (age, BMI, blood pressure, heart rate, glucose and blood lipid levels) and CVD status (hypertension, diabetes, coronary heart disease, heart failure, stroke) were determined using linear and logistic regression analyses. RESULTS: (i) the af-SG and cfPWV demonstrated comparable associations with age and CVD risk factors, except BMI. (ii) a low af-SG was associated with diabetes, coronary heart disease, heart failure and stroke, whilst a high cfPWV was only associated with diabetes. CONCLUSION: Although future studies are necessary to confirm clinical utility, the af-SG is a promising tool that may provide a unique picture of hemodynamic integration and identification of CVD risk when compared with cfPWV.

Electrically induced cycling and nutritional counseling for counteracting obesity after spinal cord injury: A pilot study.

Objective: The purpose of this pilot study was to determine the preliminary efficacy of interval functional electrical stimulation (FES) cycling combined with nutritional counseling in obese adults with SCI.Setting: Community-based individuals with chronic SCI.Participants: Ten participants with chronic SCI.Interventions: Participants were divided into 2 groups (1) FES cycling and nutritional counseling (FES & Nutri) and (2) nutritional counseling only (Nutri Only). The FES & Nutri group performed high intensity interval FES cycling for 30 min 3 times per week for 8 weeks and received nutritional counseling for 30 min once per week for 8 weeks. The Nutri Only group received the nutritional counseling only.Outcome Measures: Body composition (fat mass, lean mass, body fat percentage), blood glucose levels.Results: Participants in the FES & Nutri group had a statistically significant greater decrease in body fat percentage (M = -1.14) compared to those in the Nutri Only group (M = +0.28) and gained more lean mass in their legs (M = +0.66 kg) compared to the Nutri Only group (M = -1.05 kg).Discussion/Conclusion: The statistically significant decrease in body fat percentage for the FES & Nutri group provides evidence that further study is merited. Future studies should include larger numbers of participants and the possible introduction of a preliminary strengthening program before initiating interval FES cycling. In addition, an increase in exercise volume and a greater role for nutritional counseling should be considered in order to optimize the treatment for obesity.

Safety and preliminary efficacy of functional electrical stimulation cycling in an individual with cervical cord injury, autonomic dysreflexia, and a pacemaker: Case report.

Context: Functional electric stimulation (FES) cycling is a commonly used therapeutic exercise modality after spinal cord injury (SCI); however, additional precautions must be taken in certain situations. The purpose of this study was to develop and apply a safety monitoring protocol for autonomic dysreflexia (AD) during FES cycling and to determine if an interval-FES cycling program can be safe and beneficial to an individual with cervical SCI, a history of AD, and a non-dependent cardiac pacemaker.The participant was a 36-year-old male with C6 AIS-C SCI sustained 9 years earlier, intermittent AD, and implanted cardiac pacemaker. Ten sessions of interval-FES cycling were performed twice weekly for 5 weeks. Rating of perceived exertion (RPE), blood pressure (BP), oxygen saturation (O2sat), and heart rate (HR) were monitored before, after, and every 5 min during cycling. ECG and cardiac pacemaker were evaluated by a cardiologist after ending the program.Findings: The participant reported self-limited chills 27 times over 10 sessions (19 "light", 3 "moderate", 5 "sharp"). Chills coincided with BP increases 59% of the time and their magnitudes moderately correlated (r = 0.32). The ECG was determined to be normal and the pacemaker fully functional at the end of the study, while blood glucose decreased (111-105 mg/dl), HbA1c levels increased (5.5-5.9%), and resting BP decreased (118/84-108/66 mmHg).Conclusion/Clinical Relevance: A person with cervical SCI, symptomatic AD, and a non-dependent pacemaker can safely participate and benefit from the interval-FES cycling program provided adequate monitoring of symptoms and vital signs.

The Effects of Acute Exposure to Prolonged Sitting, With and Without Interruption, on Vascular Function Among Adults: A Meta-analysis.

BACKGROUND: Exposure to acute prolonged sitting can result in vascular dysfunction, particularly within the legs. This vascular dysfunction, assessed using flow-mediated dilation (FMD), is likely the consequence of decreased blood flow-induced shear stress. With mixed success, several sitting interruption strategies have been trialled to preserve vascular function. OBJECTIVES: The objectives of this meta-analysis were to (1) assess the effects of acute prolonged sitting exposure on vascular function in the upper- and lower-limb arteries, and (2) evaluate the effectiveness of sitting interruption strategies in preserving vascular function. Sub-group analyses were conducted to determine whether artery location or interruption modality explain heterogeneity. DATA SOURCES: Electronic databases (PubMed, Web of Science, SPORTDiscus, and Google Scholar) were searched from inception to January 2020. Reference lists of eligible studies and relevant reviews were also checked. STUDY SELECTION: Inclusion criteria for objective (1) were: (i) FMD% was assessed pre- and post-sitting; (ii) studies were either randomised-controlled, randomised-crossover, or quasi-experimental trials; (iii) the sitting period was ≥ 1 h; and (iv) participants were healthy non-smoking adults (≥ 18 years), and free of vascular-acting medication and disease at the time of testing. Additional inclusion criteria for objective (2) were: (i) the interruption strategy must have been during the sitting period; (ii) there was a control (uninterrupted sitting) group/arm; and (iii) the interruption strategy must have involved the participants actively moving their lower- or upper-limbs. APPRAISAL AND SYNTHESIS METHODS: One thousand eight hundred and two articles were identified, of which 17 (22 trials, n = 269) met inclusion criteria for objective (1). Of those 17 articles, 6 studies (9 trials, n = 127) met the inclusion criteria for objective (2). Weighted mean differences (WMD), 95% confidence intervals (95% CI), and standardised mean difference (SMD) were calculated for all trials using random-effects meta-analysis modelling. SMD was used to determine the magnitude of effect, where < 0.2, 0.2, 0.5, and 0.8 was defined as trivial, small, moderate, and large respectively. RESULTS: (1) Random-effects modelling showed uninterrupted bouts of prolonged sitting resulted in a significant decrease in FMD% (WMD = - 2.12%, 95% CI - 2.66 to - 1.59, SMD = 0.84). Subgroup analysis revealed reductions in lower- but not upper-limb FMD%. (2) Random-effects modelling showed that interrupting bouts of sitting resulted in a significantly higher FMD% compared to uninterrupted sitting (WMD = 1.91%, 95% CI 0.40 to 3.42, SMD = 0.57). Subgroup analyses failed to identify an optimum interruption strategy but revealed moderate non-significant effects for aerobic interventions (WMD = 2.17%, 95% CI - 0.34 to 4.67, SMD = 0.69) and simple resistance activities (WMD = 2.40%, 95% CI - 0.08 to 4.88, SMD = 0.55) and a trivial effect for standing interruptions (WMD = 0.24%, 95% CI - 0.90 to 1.38, SMD = 0.16). CONCLUSIONS: Exposure to acute prolonged sitting leads to significant vascular dysfunction in arteries of the lower, but not upper, limbs. The limited available data indicate that vascular dysfunction can be prevented by regularly interrupting sitting, particularly with aerobic or simple resistance activities.

Endothelium function dependence of acute changes in pulse wave velocity and flow-mediated slowing.

Flow-mediated slowing (FMS), defined as the minimum pulse wave velocity (PWVmin) during reactive hyperemia, is potentially a simple, user-objective test for examining endothelial function. The purpose of the current study was to determine the effects of a known endothelial dysfunction protocol on arm PWV and PWVmin. Complete data were successfully collected in 22 out of 23 healthy adults (23.8 years [SD 4.1], 16 F, 22.8 kg/m2 [SD 2.8]). Local endothelial dysfunction was induced by increasing retrograde shear stress in the upper arm, through inflation of a distal (forearm) tourniquet to 75 mmHg, for 30 min. Pre- and post-endothelial dysfunction, PWV was measured followed by simultaneous assessment of PWVmin and flow-mediated dilation (FMD). PWV was measured between the upper arm and wrist using an oscillometric device, and brachial FMD using ultrasound. FMD (%) and PWVmin (m/s) were calculated as the maximum increase in diameter and minimum PWV during reactive hyperemia, respectively. Endothelial dysfunction resulted in a large effect size (ES) decrease in FMD (∆ = -3.10%; 95% CI: -4.15, -2.05; ES = -1.3), and a moderate increase in PWV (∆ = 0.38 m/s; 95% CI: 0.07, 0.69; ES = 0.5) and PWVmin (∆ = 0.16 m/s; 95% CI: 0.05, 0.28; ES = 0.6). There was a large intra-individual (pre- vs post-endothelial dysfunction) association between FMD and PWVmin (r = -0.61; 95% CI: -0.82, -0.24). In conclusion, acute change in PWV and PWVmin are at least partially driven by changes in endothelial function.

Acute cardiovascular response to unilateral, bilateral, and alternating resistance exercise with blood flow restriction.

AIM: Blood flow restriction (BFR) exercise is a common alternative to traditional high-load resistance exercise used to increase muscle size and strength. Some populations utilizing BFR at a low load may wish to limit their cardiovascular response to exercise. Different contraction patterns may attenuate the cardiovascular response, but this has not been compared using BFR. PURPOSE: To compare the cardiovascular response to unilateral (UNI), bilateral (BIL), and alternating (ALT) BFR exercise contraction patterns. METHODS: Twenty healthy participants performed four sets (30 s rest) of knee extensions to failure, using 30% one-repetition maximum, 40% arterial occlusion pressure, and each of the three contraction patterns (on different days, at the same time of day, separated by 2-10 days, randomized). Cardiovascular responses, presented as pre- to post-exercise mean changes (SD), were measured using pulse wave analysis and analyzed with Bayesian RMANOVA. RESULTS: ALT caused greater changes in: aortic systolic [ΔmmHg: ALT = 21(8); UNI = 13(11); BIL = 15(8); BF10 = 29.599], diastolic [ΔmmHg: ALT = 13(8); UNI = 7(11); BIL = 8(8); BF10 = 5.175], and mean arterial [ΔmmHg: ALT = 19(8); UNI = 11(11); BIL = 13(7); BF10 = 48.637] blood pressures. Aortic [ΔmmHg bpm: ALT = 4945(2340); UNI = 3294(1408); BIL = 3428 (1461); BF10 = 113.659] and brachial [ΔmmHg bpm: ALT = 6134(2761); UNI = 4300(1709); BIL = 4487(1701); BF10 = 31.845] rate pressure products, as well as heart rate [Δbpm: ALT = 26(14); UNI = 19(8); BIL = 19(11); BF10 = 5.829] were greatest with ALT. Augmentation index [Δ%: UNI = -6(13); BIL = - 7(11); ALT = - 5(16); BF10 = 0.155] and wave reflection magnitude [Δ%: UNI = - 5(9); BIL = - 4(7); ALT = - 4(7); BF10 = 0.150] were not different. CONCLUSION: Those at risk of a cardiovascular event may choose unilateral or bilateral BFR exercise over alternating until further work determines the degree to which it can be tolerated.

Sitting decreases endothelial microparticles but not circulating angiogenic cells irrespective of lower leg exercises: a randomized cross-over trial.

NEW FINDINGS: What is the central question of this study? What are the cellular and molecular determinants of increased risk for cardiovascular disease from prolonged sitting? What is the main finding and its importance? Prolonged sitting, independent of calf raise interruption strategies, decreases microparticle counts linked to endothelial activation and apoptosis. An acute bout of prolonged sitting appears to promote paradoxical decreases in microparticle counts, but the implications are not yet clear. ABSTRACT: Repeated exposure to prolonged sitting increases the risk for cardiovascular disease. However, the cellular links by which repeated exposure to prolonged sitting lead to increased cardiovascular risk have not been fully elucidated, with markers of vascular damage and repair such as microparticles (MPs) and circulating angiogenic cell (CACs) being promising targets. The objective of the study was to examine the effects of 3 h of sitting with or without intermittent calf raises on annexin V+ /CD34+ , annexin V+ /CD62E+ , and annexin V+ /CD31+ /42b- MP populations linked to CAC paracrine activity, endothelial activation and apoptosis, respectively, as well as CD14+ /31+ , CD3+ /31+ , and CD34+ CACs, which are linked to endothelial repair. In a random order, 20 sedentary participants (14 females, 22 ± 3 years) remained seated for 180 min with or without performing 10 calf raises every 10 min. Blood samples were obtained after 20 min of quiet rest in the supine position before and after sitting. Overall, sitting decreased annexin V+ /CD34+ MPs (-12 ± 5 events µl-1 , P < 0.01), annexin V+ /CD62E+ MPs (-17 ± 4 events µl-1 , P < 0.001), and annexin V+ /CD31+ /42b- MPs (-22 ± 6 events µl-1 , P < 0.001) regardless of condition. There were no differences in endothelin-1 plasma concentration, CD14+ /31+ , CD34+ or CD3+ /31+ CAC frequencies. Sitting did not alter CAC number, but decreased MPs linked to endothelial activation, apoptosis and CAC paracrine activity in a manner that was independent of muscle contraction. These findings support changes in markers of endothelial activation and apoptosis with sedentary behaviour and provide new insights into altered intercellular communication with physical inactivity such as prolonged sitting.

Associations between carotid-femoral and heart-femoral pulse wave velocity in older adults: the Atherosclerosis Risk In Communities study.

BACKGROUND: Carotid-femoral pulse wave velocity (cfPWV) is widely used in epidemiological studies to assess central arterial stiffness. However, despite being superior to traditional risk factors in predicting cardiovascular outcomes, cfPWV is not routinely used in clinical practice. cfPWV assessments require applanation of the carotid artery, which can be cumbersome, and individual-level factors, including carotid artery plaque, may confound the measurements. Heart-femoral PWV (hfPWV) may be a suitable alternative measure of central arterial stiffness. OBJECTIVES: The aim of this study was to estimate the strength of the agreement between hfPWV and cfPWV. METHODS: We evaluated 4133 older-aged [75.2 (5.0) years] African-American and white adults in the community-based Atherosclerosis Risk in Communities (ARIC) Study. cfPWV and hfPWV were measured using an automated cardiovascular screening device. Agreement between the two measurements was determined using Pearson's correlation coefficient (r), standard error of estimate (SEE) and Bland-Altman analysis. RESULTS: There was a strong (r > 0.7) agreement between hfPWV and cfPWV (r = 0.83, 95% CI: 0.82-0.84). Although the mean cfPWV [11.5 m/s (SD: 3.0)] and hfPWV [11.5 m/s (SD: 2.3)] were comparable, the SEE was 1.7 m/s. Inspection of the Bland-Altman plot revealed greater variability and bias for higher PWV values, with higher PWV further away from the regression line. DISCUSSION: Findings suggest good agreement between hfPWV and cfPWV. hfPWV is a simpler alternative to cfPWV that is less likely to be confounded by individual-level factors. Considering the greater variability for higher PWV values, further work is warranted to determine the importance of local artery mechanics to both measures.

Acute Changes in Carotid-Femoral Pulse-Wave Velocity Are Tracked by Heart-Femoral Pulse-Wave Velocity.

Background: Carotid-femoral pulse-wave velocity (cfPWV) is the reference standard measure of central arterial stiffness. However, it requires assessment of the carotid artery, which is technically challenging, and subject-level factors, including carotid artery plaque, may confound measurements. A promising alternative that overcomes these limitations is heart-femoral PWV (hfPWV), but it is not known to what extent changes in cfPWV and hfPWV are associated. Objectives: To determine, (1) the strength of the association between hfPWV and cfPWV; and (2) whether change in hfPWV is associated with change in cfPWV when central arterial stiffness is perturbed. Methods: Twenty young, healthy adults [24.0 (SD: 3.1) years, 45% female] were recruited. hfPWV and cfPWV were determined using Doppler ultrasound at baseline and following a mechanical perturbation in arterial stiffness (120 mmHg thigh occlusion). Agreement between the two measurements was determined using mixed-effects regression models and Bland-Altman analysis. Results: There was, (1) strong (ICC > 0.7) agreement between hfPWV and cfPWV (ICC = 0.82, 95%CI: 0.69, 0.90), and, (2) very strong (ICC > 0.9) agreement between change in hfPWV and cfPWV (ICC = 0.92, 95%CI: 0.86, 0.96). cfPWV was significantly greater than hfPWV at baseline and during thigh occlusion (both P < 0.001). Inspection of the Bland-Altman plot, comparing cfPWV and corrected hfPWV, revealed no measurement magnitude bias. Discussion: The current findings indicate that hfPWV and cfPWV are strongly associated, and that change in cfPWV is very strongly associated with change in hfPWV. hfPWV may be a simple alternative to cfPWV in the identification of cardiovascular risk in clinical and epidemiological settings.

Validity of single-point assessments for determining leg pulse wave velocity in sitting and supine positions.

There has been a great deal of interest into the effects of prolonged sitting on lower limb vascular function. However, most studies use flow-mediated dilation which is technically challenging. A simpler technique is pulse wave velocity (PWV) which can be estimated at any single arterial site of interest using a number of different calculations (Bramwell-hill [PWVBH ], ß-stiffness index [PWVß ] and blood flow [PWVBF ]). Findings from this technique would be better inferred if they compare to a standard criterion 2-point PWV assessment. The current study used ultrasound to determine which estimation of single-point PWV is most valid. The criterion was traditional ECG-gated 2-point (superficial femoral [SF]-posterior tibialis [PT]) PWV. Single-point estimates were calculated at the SF and PT arteries in both supine and seated positions. Single-point PWV was considered valid if the aSEE was <1.0 m·s. Findings show that for both postural positions, the absolute standard error of estimates (aSEE) criterion of <1.0 m·s was not achieved in either the PT or SF arteries using any of the single-point PWV calculations. However, single-point calculations consistently demonstrated the lowest error at the SF artery using PWVß in both supine (SF aSEE = 1.7 vs. PT 2.7 m·s) and seated (SF aSEE = 1.5 vs. PT 3.0 m·s) positions. All single-point ΔPWV (supine - seated) calculations were higher in sitting, with PWVß having the closest agreement (ΔSF aSEE 1.7 m·s) to the 2-point criterion. Single-point PWV calculations do not directly reflect regional 2-point PWV. However, they are sensitive to change when moving from supine to seated positions.