bluuebunny/crossref_metadata_2025 huggingface dataset:
P6 CFD Modelling of Arterialized Venous Flap
Authors: Andreia Serrano , Diogo Casal , Goyri O’Neill João , Valentina Vassilenko
Published: March 2020

The knowledge about the required quantity of blood to irrigate an angiosome is important on ischemia (disruption on blood perfusion) prediction, diagnosis and treatment. An angiosome (or flap) is an anatomic unity (or flap) of tissue, it is constituted by skin, subcutaneous tissue and muscle, it is irrigated by an artery and drain by specific veins [1]. Since 70’s, flaps have been used on clinical practice for reconstruction of complex anatomical structures. Different model configurations have been created, to find a flap’s model that allows a better flap perfusion. In previous work [2] the four models with an average flap survival area of 76.86% ± 13.67% were tested in 53 male rats: I - conventional model of flap’s blood supply formed by femoral and epigastric arteries; II — Arterialized Venous Flap (AVF) produced by femoral side-to-side anastomosis; III - AVF produced by femoral side-to-side anastomosis and proximal ligation of the femoral vein; IV - AVF produced by terminal lateral anastomosis of the epigastric vein to the femoral artery). The experimental results have shown that the AVFs in group IV represent an optimized model of unconventional perfusion flap. In the present work the Computational Fluid Dynamics (CFD) methods, an ANSYS®-Fluent code, were used for simulating a blood flow and flap perfusion in AVFs of group IV in order to find an optimum geometry for lateral anastomosis of the epigastric vein to the femoral artery with an angle variation from 90,0º to 45,0º. We find that the optimum angle is 86,5º. Three other models, conventional and unconventional, was also tested by CFD, finding that unconventional AVF of group III provides a greater blood flow through the epigastric vein, allowing a better perfusion of the flap.
P7 Assessing Vascular Age from Peripheral Pulse Waves: a Study of Existing Indices, and Directions for Future Research
Authors: Charlton Peter , Aresu Maria , Spear Jeanette , Chowienczyk Phil , Alastruey Jordi
Published: March 2020

Purpose

Vascular age may be a better marker of cardiovascular risk than age. It has been proposed that vascular age could be assessed easily and inexpensively from the photoplethysmogram (PPG) pulse wave, which is measured by pulse oximeters and fitness bands. Our aim was to assess the performance of existing PPG-derived indices and provide directions for future research.

Methods

Two datasets were used. The Airwave dataset [1] contains finger PPG pulse waves alongside brachial-femoral pulse wave velocities (PWVs) from police employees: high quality data from 4,378 subjects aged 20 to 66 were used in this study. The arterial pulse wave database [2] contains simulated PPG pulse waves for 3,837 virtual subjects aged 25 to 75 exhibiting healthy ageing and normal variation in cardiovascular properties. Pulse wave features were derived, and the following indices were assessed: the ageing index (AGI) [3], modified AGI [4], informal AGI [5], and a novel AGI obtained by fitting a linear regression model to the five features most strongly correlated with age.

Results

See Figure 1. Existing indices correlated weakly with age. The new AGI was more strongly correlated with age on both datasets. It was weakly correlated with PWV and BP on Airwave, but strongly correlated with PWV on simulated data.

Conclusion

The improved performance of the new AGI indicates that there is scope for improving PPG-derived indices of vascular ageing. Indices appear to be correlated with age, PWV and BP, indicating that with further research they could be useful markers of cardiovascular risk.
P8 O-GlcNAcylation Increases Constriction in Common Carotid Artery of Senescent-Accelerated Female Mice
Authors: Costa Tiago J. , Silva Josiane F. , da Silva Renée de Nazaré O. , Barros Paula R. , Bolsoni Juliana , Rodrigues Daniel , Akamine Eliana H. , Tostes Rita
Published: March 2020

The glycosylation with O-linked-N-acetylglucosamine (O-GlcNAc) is an enzymatic process found on nuclear and cytoplasmic proteins. Augmented levels of O-GlcNAc-modified proteins have been associated to cardiovascular disease (CD) in male. However, the association of O-GlcNAc and CD in females it’s not understood. Increased risk of CD in women is linked to menopause and occurs about 10 years later than in men. We tested the hypothesis that aging in females promotes vascular dysfunction, which is aggravated by augmented O-GlcNAc. We used 8-month-old female senescence-mice (SAMP8) and control (SAMR1). After euthanasia, the carotid artery (CA) was carefully removed and cleaned. The segments of CA were incubated for 24h in DMEM containing vehicle/or/Thiamet G (10−6 M), a potent inhibitor of the O-GlcNAcase. Vessels from both groups were carefully mounted as ring preparations in standard organ chambers. Concentration-response curves to U46619 and phenylephrine (PE) (10−10 to 10−4M) were performed in vessels with endothelium in the presence or not of a COX inhibitor. Results are presented as mean ± SEM, n = 6. Statistical analysis: ANOVA One-way, followed Bonferroni. p < 0.05. CA of SAMP8 (Rmax127 ± 10) exhibited increased PE-induced vasoconstriction, compared to SAMR1 (Rmax77 ± 5), which was abolished in the presence of the COX inhibitor. mRNA expression of COX-1/COX-2 was similar in both groups, but the eNOS decreased in CA of SAMP8. O-GlcNAcylation increased vasoconstriction in SAMP8 but not in SAMR1 female mice, indicating an important correlation between O-GlcNAcylation and aging process. Conclusion: the senescence is associated with vascular dysfunction mediated by abnormal activity of COX and eNOs, which is aggravated by augmented O-GlcNAcylation. FAPESP (2017/25116-2).
P13 Role of Adipose Tissue and Skeletal Muscle in Peripheral Arterial Disease
Authors: Ferreira Joana , Cunha Pedro , Carneiro Alexandre , Cunha Cristina , Silva Cristina , Vila Isabel , Mesquita Amílcar , Cotter Jorge
Published: March 2020

Background

Peripheral arterial disease (PAD) is a manifestation of atherosclerosis. Adipose tissue (AT) and skeletal muscle (SM) are endocrine organs with vascular effects. The objective is to compare the quantity and function of AT and SM between two groups: intermittent claudication (IC) and critical limb ischemia (CLI).

Methods

A prospective observational study is being performed. A transverse CT image at lower border the third lumbar vertebra was used to quantify the SM, visceral and subcutaneous AT. The SM function was inferred with the determination of hand strength using a Jamar® hydraulic hand dynamometer.

Results

From December 2018 to May 2019, 44 PAD were studied: 31 with IC (24 male; age: 67 10, 29 years) and 13 CLI (7 male; age: 70, 62 6, 74 years). CLI have a lower quantity of subcutaneous AT and higher quantity of visceral and total AT, determined on the CT scan (subcutaneous AT: 16564,75 7600,00 cm2 IC versus 16067,42 10187,33 cm2 CLI p = 0.03; visceral AT: 17212,20 10096, 30 cm2 IC versus 18904,85 10189,04 cm2 CLI p = 0,03; Total AT: 33222,08 15459,33 cm2 IC versus 57320,00 52538,78 cm2 CLI p = 0.03). CLI had lower SM strength and density (muscle strength right hand: 22,62 8,20 Kgf IC versus 16,38 7,84 Kgf CLI p = 0,02; SM strength left hand: 21,98 8,98 Kgf IC versus 16,37 8,35 Kgf CLI p = 0,04; SM density: 20,44 11,73 HU IC versus 9,04 28,47 HU CLI p = 0,01) No differences were found in the SM quantity (15120,87 3199,35 cm2 IC versus 15322,57 5315,31 cm2 CLI p = 0.44).

Conclusion

CLI have a higher quantity of visceral, total AT and lower quantity of subcutaneous AT, SM function and density.
P15 Reference Intervals of 24-hour Central Blood Pressure Assessed with an Oscillometric Device in Healthy Children and Adolescents
Authors: Posokhov Igor , Sharykin Alexandr , Trunina Inna
Published: March 2020

Reference intervals (RI) of 24-h central blood pressure (24CBP) obtained from large healthy population are lacking in Russia. We had to generated 24CBP percentile curves and RI adjusted to each level of age and/or body height and gender of each time of monitoring (24-h, daytime or nighttime). Our database consisted of ABPM files received by the BPLab device (Petr Telegin, Russia). First, we selected ABPM files that corresponded to the normal ambulatory BP according to 2016 European guidelines [1] from our database. Second, we have excluded files that indicate antihypertensive treatment, elevated BMI and any disease in extended BPLab-diary. Third, age specific percentiles curves were generated with LMS Chartmaker Pro (UK). RI of 24CBP (n = 1085) are shown in Figure 1 (image 1). Day-time values of the CBP were higher than those obtained by other oscillometric devices in office conditions [2,3]. This can be explained by the known fact of higher values of BP in ABPM compared with office measurements in the children and adolescents.

Conclusion

We have obtained RI of 24CBP for youth that can be used in routine practice.
P17 Comparisons of Carotid-femoral Pulse Wave Velocity Obtained from the Surface-distance Measurement and from the Population-derived Distance Formula: Associations with Macro- and Microvascular Alterations in Older Adults
Authors: Aizawa Kunihiko , Casanova Francesco , Mawson Dave , Gooding Kim , Elyas Salim , Adingupu Damilola , Strain David , Gates Phillip , Shore Angela
Published: March 2020

Introduction

Inaccurate determination of arterial path-length by surface-distance (SD) measurement is an inherent source of error in calculating carotid-femoral pulse wave velocity (CFPWV). A recent development in calculating arterial path-length by a simple distance formula (DF) for CFPWV has been shown to not only remove intercentre measurement variability but also strengthen the association between CFPWV and traditional cardiovascular risk factors [1]. We determined whether the association of macro- and microvascular alterations with CFPWV derived from the distance formula (CFPWV-DF) would be stronger than that with CFPWV derived from the surface-distance measurement (CFPWV-SD).

Methods

CFPWV-DF and CFPWV-SD were obtained from 489 older adults (67.2 ± 8.8 yrs, 154 F, 244 CVD). Macrovascular [carotid lumen diameter (LD), carotid inter-adventitial diameter (IAD), carotid intima-media thickness (IMT), carotid total plaque area, and ankle-brachial pressure index] and microvascular [reactive hyperaemia index and urinary albumin-creatinine ratio (UACR)] parameters were also obtained.

Results

CFPWV-DF was significantly lower than CFPWV-SD (9.27 ± 2.38 vs 9.88 ± 2.55 m/s, p < 0.001), which resulted from a longer arterial path-length estimated by SD than DF (495.4 ± 44.8 vs 465.3 ± 20.6 mm, p < 0.001). The significant associations observed between CFPWV-SD and LD (r = 0.264), IAD (r = 0.303), and IMT (r = 0.165) were similarly observed between CFPWV-DF and LD (r = 0.253), IAD (r = 0.303), and IMT (r = 0.183, all p < 0.001). This was also the case with UACR (r = 0.163 and r = 0.141, both p = 0.001). Other parameters did not show any association in either CFPWV.

Conclusion

The association of macro- and microvascular alterations with CFPWV-DF was not stronger than that with CFPWV-SD, suggesting that arterial path-length determination methods may not influence interactions between vascular biomarkers and CFPWV.
P20 Spontaneous Recanalization of the Internal Carotid Artery
Authors: Varnai Blanka , Simonyi Gábor , Rapcsányi Andrea , Finta Ervin
Published: March 2020

Objectives

The occlusion of the internal carotid artery (ICA) frequently leads to stroke and develops most commonly as a consequence of arterial embolism or atherosclerotic thrombosis. Following acute care, if the patient’s general condition makes it possible, the patient is emitted from the hospital or, if necessary, his treatment continues in the rehabilitation department. The occlusion is generally considered irreversible. According to recent literature, spontaneous recanalization of the ICA may occur occasionally, calling for regular duplex ultrasonographic (sometimes CT angiographic) control examinations.

Methods

Authors report a case of a 67-year-old man, who suffered a right ICA occlusion and subsequent ichaemic stroke. CT angiography and Doppler ultrasound were used regularly to follow the patient’s condition for 3 years later on.

Results

One year after the full occlusion of the right ICA, a spontaneous recanalization of the occlusion was observed with a 90% stenosis. In spite of the aggressive and continuous pharmacological treatment of the patient, a partial restenosis (95%) was detected a year later, after which a successful endarterectomy was performed with permanent result.

Conclusion

The recognition and appropriate treatment of the spontaneous recanalization of the carotid artery determines the patient’s long term health condition. Prospective studies are necessary to detect the frequency of occurrence of the recanalization and the relation between the therapeutic methods and the following life expectancies.
P21 The Association of Vitamin K Antagonists with Aortic Arch Calcification in Acute Coronary Syndrome Patients
Authors: Gkini Konstantia-Paraskevi , Terentes-Printzios Dimitrios , Vlachopoulos Charalambos , Rigatou Aggeliki , Gardikioti Vasiliki , Sigala Evangelia , Tousoulis Dimitrios
Published: March 2020

Purpose/Background/Objectives

Vitamin K antagonists (VKA) aggravate vascular calcifications burden, especially in haemodialysis patients potentially compounding their cardiovascular risk. We sought to investigate the relationship between VKA intake and aortic arch calcification (AAC) in patients with acute coronary syndrome (ACS).

Methods

Two hundred patients admitted with ACS were included in the study (mean age 66 ± 15 years). The extent of aortic arch calcification (AAC) on a postero-anterior plain chest X-ray was divided into four grades (0 to 3). Grades 0 to 1 and grades 2 to 3 were categorized as lower and higher AAC grade respectively. Anticoagulants were categorized to VKA and to non-VKA anticoagulants including new oral anticoagulants and low-molecular weight heparin.

Results

Twenty-eight (14%) patients at admission were on anticoagulants. Seventeen patients (8.5%) were treated with VKA and 12 patients (6%) with non-VKA anticoagulants. Higher ACC grade was observed in patients treated with VKA after adjustment for age, gender and chronic kidney disease. (Odds ratio [OR] = 3.64, 95% Confidence intervals [CI]: 1.08 to 12.20, p = 0.037). Interestingly, there was a non-statistically significant trend for reduced risk of higher AAC grade in patients treated with non-VKA anticoagulants (OR = 0.24, 95% CI: 0.04 to 1.47, p = 0.12). Age and history of chronic kidney disease were the most potent predictors of higher AAC grade (OR = 1.07, 95% CI: 1.03 to 1.10, p < 0.001 and OR = 6.07, 95% CI: 2.35 to 15.67, p < 0.001, respectively).

Conclusion

Our study shows intake of VKA is associated with higher risk of AAC in ACS patients, while non-VKA anticoagulants might be associated lower AAC grade.
P23 Tadalafil Improves Hemodynamic Parameters and Arterial Stiffness in Patients with Grade I–II Obesity Without Comorbidities
Authors: Larios-Cardenas Mariana , Grover-Páez Fernando , Cardona-Muller David , Cardona Ernesto , Gonzalez-Radillo Oscar I. , Trujillo-Quiros Jonathan , Barocio-Pantoja Marycruz , Quezada-Fernandez Patricia , Ramos-Becerra Carlos G.
Published: March 2020

Background

Obesity is a global health problem, it is associated with diabetes, hypertension, and cardiovascular diseases [1] and negative hemodynamic effects have been observed [2]. Tadalafil has shown an improvement in endothelial function [3] the aim of the present investigation was to evaluate its effects on hemodynamic parameters in patients with grade I–II obesity.

Objective

To evaluate the acute effect of tadalafil on hemodynamic and arterial stiffness parameters.

Methods

A double blind clinical trial, randomized, was carried out in patients with grade I–II obesity. Seventy patients were allocated to receive placebo or a single dose of 20 mg of tadalafil; hemodynamic (Omron HEM 9000, UNEXEF) and arterial stiffness (Omrom VP1000) parameters were determined before and 24 hours after intervention. The values are expressed in mean ± SD. Wilcoxon rank test and U de Mann-Whitney were applied. p < 0.05 was considerated as statistically significant.

Results

Both groups were comparable in the baseline. After the intervention a statistically significant changes were shown in the tadalafil group in the diastolic blood pressure (DBP), (.001); second systolic shoulder 2 (SYS2), (.003); augmentation index (Aix), (.049); and braquial-ankle pulse wave velocity (BAPWV), (.005). After that, changes between groups were analyzed and only DBP (−2.39, p = .017) and BAPWV (p = .028) were statistically significant. No changes were observed in flow mediated dilatation (FMD).

Conclusion

Tadalafil modifies DBP and BAPWV but it had not effect on FMD in the acute administration.
P25 Effect of Live-firefighting on Ventricular-vascular Coupling
Authors: Hibner Brooks , Schroeder Elizabeth , Lefferts Wesley , Hilgenkamp Thessa , Yan Huimin , Horn Gavin , Smith Denise , Fernhall Bo
Published: March 2020

Introduction

Cardiovascular events are the leading cause of death among firefighters, with the greatest risk occurring during or shortly after fire suppression activity. Increased cardiovascular risk potentially manifests from detrimental changes in ventricular function, vascular load, and their interaction described as ventricular-vascular coupling (VVC). Therefore, our objective was to determine the effect of live-firefighting on ventricular systolic function, vascular load, and VVC.

Methods

Forty male (27 ± 6 years, 26.9 ± 4.0 kg·m−2) firefighters completed hemodynamic and cardiac measures before and 10–30 minutes after 3 hours of live-firefighting. Left ventricular function assessed as ejection fraction (EF), fractional shortening (FS), and ventricular elastance (Elv: ESP/end-systolic volume [ESV]) via echocardiography and brachial-estimated ESP. Vascular load assessed as arterial elastance (Ea: end systolic pressure [ESP]/stroke volume [SV]). VVC quantified as the ratio of Ea to Elv and indexed to body surface area (EaI, ElvI).

Results

Following firefighting, both EF and FS significantly decreased (p < 0.05) with no change in Elv (p = 0.49) EaI significantly increased (p < 0.01), driven by EDV-mediated decreases in SV (p < 0.05) and unaltered ESP (p = 0.99). These disparate changes resulted in an increase in VVC (p < 0.01) post firefighting.

Conclusion

Our findings suggest firefighting does not alter ventricular elastance but increases arterial load among healthy firefighters; resulting in an uncoupling of the heart and vascular systems. This undesirable increase in VVC and concomitant reduction in ventricular systolic function may contribute to increased cardiovascular risk following firefighting.

Changes in cardiovascular parameters pre/post firefighting activity

Pre
Post
p

Weight* (kg)
88.9 ± 14.0
88.0 ± 14.0
<0.001

SBP (mmHg)
135 ± 16
135 ± 16
0.992

DBP (mmHg)
80 ± 8
80 ± 10
0.868

MAP (mmHg)
98 ± 7
98 ± 10
0.868

HR (bpm)
70 ± 11
90 ± 13
<0.001

SV (ml)
84.7 ± 20.1
71.1 ± 21.8
<0.001

EDV (ml)
144.1 ± 37.0
132.3 ± 37.9
0.003

ESV* (ml)
59.3 ± 24.6
61.2 ± 24.5
0.506

ESP (mmHg/ml)
121.3 ± 8.0
121.3 ± 14.2
0.992

EF (%)
59.7 ± 9.2
54.3 ± 9.4
0.004

FS (%)
32.6 ± 6.3
28.6 ± 6.0
0.002

EaI*
0.73 ± 0.46
1.89 ± 0.67
0.001

ElvI*
1.15 ± 0.53
1.12 ± 0.58
0.487

VVC*
0.72 ± 0.30
0.91 ± 0.48
0.002

*p-value obtained from transformed variable. SBP, systolic blood pressure; DBP, diastolic blood pressure; MAP, mean arterial pressure; HR, heart rate; SV, stroke volume; EDV, end diastolic volume; ESV, end systolic volume; ESP, end systolic pressure; EF, ejection fraction; FS, fractional shortening; EaI, arterial elastance indexed to body surface area; ElvI, ventricular elastance indexed to body surface area; VVC, ventricular-vascular coupling.
P26 Ascending Aorta Longitudinal Strain is not Altered in Bicuspid Aortic Valve Patients
Authors: Guala Andrea , Dux-Santoy Lydia , Teixido-Tura Gisela , Ruiz-Muñoz Aroa , Madrenas Laura , Gandara Minerva , Sao-Aviles Augusto , Valente Filipa , Galian-Gay Laura , Gutierrez Laura , Gonzalez-Alujas Teresa , Ferreira Ignacio , Evangelista Arturo , Rodriguez-Palomares Jose
Published: March 2020

Background

Impaired ascending aorta (AAo) longitudinal strain, a marker of AAo deformation due to aorto-ventricular mechanical interaction, is related to progressive dilation and aortic events in Marfan syndrome [1]. Whether the high prevalence of dilation in bicuspid aortic valve (BAV) is due to intrinsically-altered aortic wall properties [2] or hemodynamic [3] is widely-discussed [4]. Whether AAo longitudinal strain is altered in BAV patients has never been assessed.

Methods

One-hundred five BAV patients, 47 patients with AAo dilation and tricuspid aortic valve (TAV) and 31 healthy volunteers, free from previous cardiac/aortic surgery, dissection and moderate/severe valvular disease had cine MR images to compute AAo longitudinal strain [1].

Results

Compared to healthy volunteers, the 25 non-dilated (z-score < 2) BAV patients were older (p < 0.001), had higher systolic blood pressure (SBP, p = 0.001), clinically-meaningless (BAV z-score = 0.74 ± 1.1) larger AAo diameter (p < 0.001) and similar diastolic blood pressure (DBP), BSA, stroke volume and heart rate. AAo longitudinal strain was lower in non-dilated BAV compared to healthy volunteers (13.7 vs 10.3%, p = 0.008) but this difference was not significant after correction for age. Compared to dilated TAV, dilated BAV patients were younger (p < 0.001), had lower BSA (p = 0.010) and AAo diameter (p = 0.003), higher DBP (p = 0.032) and similar SBP, stroke volume and heart rate. AAo longitudinal strain was higher in dilated BAV compared to dilated TAV (10 vs 7.2%, p < 0.001) but this difference was not significant after correction for age, BSA and DBP.

Conclusion

AAo longitudinal strain is similar in BAV and TAV matched for aortic dilation.
P31 Aldosterone and Cardiovascular Function in a Young Cohort: The African-PREDICT Study
Authors: Van Rooyen Johannes , Gafane-Matemane Lebo , Huisman Hugo , Mels Carina , Schutte Alta
Published: March 2020

Objectives

High levels of aldosterone may contribute to early development of hypertension. The aim was to evaluate the influence of high serum aldosterone on cardiovascular function in healthy black and white South Africans.

Methods

This study was embedded in the African-PREDICT study, included 233 black and 217 white participants aged 20–30 years. Cardiovascular-and biochemical variables were measured with known methods.

Results

The ABPM night DBP is significantly higher in the black high aldosterone participants (58 vs 60 mmHg). The ABPM day SBP is significantly lower (125 vs 122 mmHg) in the white participants. The SV in the white participants is significantly lower (95 vs 90 ml) compared to the low aldosterone group. The vascular compliance is also significantly lower (2.4 vs 2.5 ml/mmHg) in the white participants. The angiotensin II are significantly higher in the black (47.6 vs 87.5 pmol/l) and white (85.6 vs 145.2 pmol/l) high aldosterone groups. NT-proBNP (36.4 vs 24.8 pmol/l) is significantly lower in the black high aldosterone group. Partial correlations in the black high aldosterone group revealed positive associations with vascular compliance (r = 0.22; p = 0.004), angiotensin II (r = 0.49; p = <0.001) as well as with CRP (r = 0.16; p = 0.031) and in the whites with angiotensin II (r = 0.27; p = <0.001) and CRP (r = 0.15; p = 0.041). Regression analysis revealed that the angiotensin II contributes to aldosterone in the blacks and ROS only in whites.

Conclusion

The lower NT-proBNP in the blacks has a stabilizing role against volume overload while in the white participants ROS may contribute to early vascular changes.
P34 24-Hour Ambulatory Brachial Versus Aortic Systolic Blood Pressure: Relationship with Left Ventricular Mass Significantly Differs. Pooled Results from the International 24 Hour Aortic Blood Pressure Consortium (i24ABC)
Authors: Wassertheurer Siegfried , Protogerou Athanase , Sharman James , Sala Enrique Rodilla , Jankowski Piotr , Muiesan Maria Lorenza , Giannattasio Cristina , Hametner Bernhard , Pascual Jose Maria , Zweiker Robert , Argyris Antonio , Paini Anna , Wilkinson Ian , Czarnecka Danuta , Salvetti Massimo , Maloberti Alessandro , McEniery Carmel , Li Yan , Nemcsik Janos , Pucci Giacomo , Ablasser Cornelia , Blacher Jacques , Valleé Alexandre , de la Sierra Alejandro , Zhang Yi , Ji Hongwei , McDonnell Barry , Mota Marco , Paiva Annelise , Brandao Andrea , Weber Thomas
Published: March 2020

Background

There is evidence of a closer relation between 24 hour aortic systolic blood pressure (aSBP) and left ventricular mass (LVM) compared with 24 hour brachial SBP. However, sample sizes are relatively small and there is some inconsistency in findings. We sought to address this by pooling data from 16 centers in Asia, Europe and Latin America to determine the relationship between LVM and brachial office, as well as brachial and aortic 24 hour ambulatory SBP.

Methods

In all centers, brachial and aortic SBP was measured with the same validated oscillometric device, using a transfer function for aortic pressure, and mean/diastolic pressure calibration. LVM was determined by echocardiography.

Results

We studied 2092 participants (972 women) with a mean age of 52 years. Mean brachial office BP was 137/84 mmHg, and mean 24 hour bSBP and aSBP was 126 [118;134] and 131 [120;137] mm Hg, respectively. Mean LVM indexed to body surface area was 88.4 g/m and 27.2% of participants had left ventricular hypertrophy (LVH). The correlation coefficients between LVM and brachial office SBP, 24 hour bSBP, and 24 hour aSBP were 0.24, 0.35, and 0.43, respectively (p < 0.001 for differences). The areas under the curve for prediction of LVH were 0.62, 0.67, and 0.70 for brachial office SBP, 24 hour bSBP, and 24 hour aSBP, respectively (p < 0.001 for differences).

Conclusion

In this pooled analysis of international data, we demonstrate that aortic ambulatory SBP, measured with an oscillometric cuff, shows a significantly closer association with hypertensive cardiac organ damage (left ventricular mass and hypertrophy) than brachial office/brachial ambulatory systolic blood pressure.
P35 Education Level may Modify the Association Between Cardiac Index and Cognitive Function Among Elders with Normal Ejection Function
Authors: Hao-Min Cheng , Shao-Yuan Chuang , Yu-Ting Ko , Chao-Feng Liao , Wen-Harn Pan , Wen-Ling Liu , Chen-Ying Hung , Chen-Huan Chen
Published: March 2020

Background

Lower cardiac index (CI) in elders without clinical heart disease has been associated with impaired cognitive function and incident dementia. In the present study, we investigated the modulating effects of education level and arterial stiffness on the association between CI and cognitive function among older adults.

Methods

A total of 723 elders (≥60 years, 50.1% female) with normal left ventricular ejection-fraction (≥50%) were identified from the Cardiovascular Diseases Risk Factor Two-Township Study. CI was calculated from the Doppler-derived stroke volume. We evaluated arterial stiffness by measuring carotid-femoral pulse wave velocity (CFPWV) and global cognitive function by using the Mini-Mental Short Examination (MMSE). Education level was determined by years of formal education.

Results

In linear regression analysis adjusting for age, sex, formal years of education and CFPWV, CI was significantly positively associated with MMSE (BETA = 0.344 0.130, p = 0.0082). In logistic regression analysis adjusting for age, sex, formal years of education and CFPWV, subjects with a CI 75 percentile had a significantly lower risk of low MMSE (<26) (OR = 0.495, 95% CI = 0.274–0.896, p = 0.02). In subgroup analysis, higher CI was significantly associated with higher MMSE and lower risk of low MMSE only in elders with 9 years of formal education. Causal mediation analysis suggests that higher CI maintains higher MMSE in elders with lower education levels whereas higher CFPWV causes lower MMSE in all elders.

Conclusion

In elders with normal ejection fraction, a higher CI was associated with a lower risk of cognitive function impairment, independent of arterial stiffness, mainly in subjects with a lower education level and possibly a smaller cognitive reserve.
P37 Increased Pressure Dependency of Pulse Wave Velocity with Age
Authors: Boguslavskyi Andrii , Gu Haotian , Fang Lingyun , Cabrito Cobaco Ana Rita , Chowienczyk Philip
Published: March 2020

Background

Arterial stiffness, as measured by pulse wave velocity (PWV) is dependent on arterial blood pressure but whether this dependence varies with age is unknown. The objective of this study was to determine to what degree pressure-dependence varies with age.

Methods

83 heathy (43 females) normotensive volunteers from three different age groups (young: 18–30, middle aged: 31–55, older: 56–70 years) were recruited for this study. Aortic PWV (aPWV) was measured at different level of aortic transmural pressure (aTMP). aTMP was calculated as difference between mean arterial pressure and mouth pressure (which is almost equal to intrathoracic pressure). Acute modulation of aTMP was achieved by performing respiratory manoeuvres (Valsalva and Muller manoeuvres) against a mouthpiece with a small leak.

Results

aPWV was higher in older compare to younger subjects (6.6 ± 1.4 vs 5.3 ± 0.9 m/s, p < 0.001). Changes of aTMP in response to respiratory manoeuvres were similar across all age groups. However, changes of aPWV induced by acute modulation of aTMP were age-dependent, with aPWV increasing by 1.7 m/s per 10 mmHg increase in aTMP in older subjects compared to 0.4 m/s per 10 mmHg of aTMP change in younger subjects (p < 0.001).

Conclusion

Pressure-dependence of aPWV increases with age. This may contribute to the age related increased in aPWV and, if reversible, have important implications for therapeutic lowering of PWV through anti-hypertensive treatment.
P40 Arteriovenous Fistula, Blood Pressure and Arterial Reservoir-wave Analysis: Lessons From End-stage Renal Disease
Authors: Paré Mathilde , Goupil Rémi , Fortier Catherine , Mac-Way Fabrice , Marquis Karine , Hametner Bernhard , Wassertheurer Siegfried , Schultz Martin , Sharman James E. , Agharazii Mohsen
Published: March 2020

Purpose/Background/Objectives

According to reservoir-wave theory, excess pressure (XSP) is analogous to flow and related to excess cardiac workload. In end-stage renal disease (ESRD) patients, we have shown that XSPI is associated with increased mortality and is higher in patients with arteriovenous fistula (AVF). Recently AVF has been proposed treatment for treatment of resistant hypertension. However, this benefit may be mitigated through an increase in cardiac output. Therefore, we examine whether XSPI increases after creation of an AVF in ESRD patients.

Methods

Hemodynamic assessments were performed within 1 month before and 6 months after creation of AVF in ESRD patients. Carotid pressure waves were recorded using arterial tonometry, calibrated using brachial diastolic and mean arterial pressure. Using pressure only approach, reservoir-wave analysis was used to derive reservoir pressure (RP), XSP and their integrals (RPI, XSPI).

Results

38 patients (63% male, mean age 59 ± 15 years) were assessed 3.9 ± 1.2 months Post-AVF. Carotid RP decreased slightly (115 ± 18 vs 109 ± 24, p = 0.060), due to the reduction of diastolic BP (79 ± 10 vs 73 ± 12 mm Hg, p = 0.003). While, carotid systolic BP (123 ± 20 vs 119 ± 27 mm Hg, p = 0.380) remained unchanged, XSP and XSPI increased (XSP: 14 [12–19] to 17 [12–22] mmHg, p = 0.031; XSPI: 275 [212–335] to 334 [241–349] kPa.s, p = 0.015).

Conclusion

While AVF creation reduced diastolic BP, it resulted in higher XSPI, which has been associated with increased mortality. Therefore, the long-term efficacy of AVF in reducing clinical outcomes should be specifically addressed.
P42 Correlation Between Neck Circumference and Pulse Wave Velocity in a Population Based Study in Salvador-Brazil, Preliminary Results
Authors: Bessa Larissa , Cunha Roberta , Magalhães Lucélia , Silva Diorlene da , Filho Antônio , Lima Rodrigo , Vascor Grupo
Published: March 2020

Introduction

Pulse wave velocity (PWV) is considered a gold standard for assessment of arterial stiffness [1]; neck circumference (NC) is a good anthropometrical indicator of fat accumulation in the upper body region [2].

Methods

A population-based cross-sectional study representative of a neighborhood of Salvador-BA, Brazil, distributed in 12 census tracts according to the Brazilian Institute of Geography and Statistics. The overall sample is randomized in adults from the assigned area, from December 2016 to May 2019 comprise 145 people. Individual and household records are filled out PWV was the measuring velocity between the carotid and right femoral wave, coupled to the electrocardiogram. The committee for research on human subjects of the FTC approved the protocol (No1827621). The measurement equipment was the flattening tonometer SphygmoCor® apparatus (XCEL, AtCor Medical, Sydney, Australia). The NC was obtained by using an inelastic fiberglass tape measure based on the height of the cricothyroid cartilage. The values ≥37 cm for men or ≥34 cm for women were used for their classification [3]. The frequency and descriptive measures, Spearman’s linear correlation coefficient between the laboratory tests and adjusted PWV. STATA v.12 software was used for treatment and generation of results. The level of statistical significance was set at 5%.

Results

There was a predominance of women (70.3%). The correlation is the same for both sexes (r = 0.30), a weak positive, however it was statistically significant for women (p = 0.0031).

Conclusion

The NC and PWV measurements showed a weakly positive. There was a statistically significant correlation for women.
P43 The Association of Irritable Affective Temperament with 24-Hour Brachial and Central Blood Pressure and Hemodynamic Parameters in Untreated Hypertensive Men
Authors: Kőrösi Beáta , Batta Dóra , Vecsey-Nagy Milan , Gonda Xenia , Rhimer Zoltán , Nemcsik-Bencze Zsófia , László Andrea , Nemcsik János
Published: March 2020

Background

Affective temperaments (depressive, irritable, hyperthymic, anxious, cyclothymic) have important role in psychopathology, but cumulating data support their involvement in vascular pathology, especially in hypertension as well. The aim of our study was to evaluate their associations with 24-hour brachial and central hemodynamic parameters in untreated patients who were studied because of elevated office blood pressure.

Methods

Mobil-O-Graph was used to measure the 24-hour brachial and central parameters. Affective temperaments, depression and anxiety were evaluated with TEMPS-A, Beck and HAMA questionnaires, respectively.

Results

84 patients were involved into the study (49 men). Irritable temperament score was associated with nighttime brachial systolic blood pressure (r = 0.279, p = 0.010), with nighttime brachial mean arterial pressure (r = 0.239, p = 0.028), with nighttime central systolic blood pressure (r = 0.288, p = 0.008), with nighttime central diastolic blood pressure (r = 0.238, p = 0.029), with 24-hour cardiac output (r = 0.298, p = 0.006) and inversely with 24-hour reflection magnitude (r = -0.297, p = 0.006). These associations were attenuated after the adjustment of age, depression and anxiety and were absent in women.

Conclusion

In conclusion, affective temperaments, especially irritable temperament can have an impact on 24-hour brachial and central hemodynamics in untreated hypertensive men.
P44 Spureous Systolic Hypertension or a Defined Arterial Stiffness Phenotype
Authors: Forcada Pedro , Sangiovanni Miguel , Pampinella Wanda , Montaña Oscar
Published: March 2020

Background

High systolic blood pressure in young individuals with normal central pressure has been described as “Spureous Systolic Hypertension” and there is a strong controversy if it is a normal or pathologic condition.

Objective

To compare young adult patients (20–40 y.o.) with isolated systolic hypertension (ISH) with elderly patients (60 to 80 y.o.) with the same condition and analyze the vascular and hemodynamic patterns to find out if the spureous hypertension is truly a hypertensive phenotype and deserves to be treated.

Material and Methods

To analyze the vascular pattern we evaluated the database of NIVE (Phillips IU22® and CAP with Arteriograph®) with 2890 first ever evaluated patients, and analyzed 55 young controls (A), 56 young with ISH (B), 19 elderly controls (C) and 51 elderly with ISH (D). For the Hemodynamic analysis (Impedance Cardiography, Exxer®) the same groups with (A) 115, (B) 59, (C) 50 and (D) 148.

Results

Most of the vascular and hemodynamic findings as expected by age but Group B was similar in terms of the central stiffness (PWV, Ao PP and total Compliance) to the group C meaning EVA. The proportion of p with increased IMT, abnormal PWV and endothelial dysfunction were higher in the B group compared with A and the elderly (Comparison between same age intervals by “t” test and ANOVA for the whole sample. Signification <0.05).

Conclusion

Young hypertensives between 20 and 40 y.o. with ISH seem to be carriers of a defined arterial stiffness hypertensive phenotype rather than an “innocent” spureous phenomena.
P47 Hypertension Prevalence in Health Sciences Students of the University of Guadalajara
Authors: Ruiz Claudia Yanette Galan , Müller David Cardona , Muñoz Ernesto Germán Cardona , Sutto Sylvia Elena Totsuka , Vidrio Brandon Giovany Illescas , Páez Fernando Grover , Becerra Carlos Gerardo Ramos
Published: March 2020

Hypertension (HTN) is considered within the first 9 preventable causes of death in Mexico [1]. In order to estimate HTN prevalence in students a blood pressure (BP) measuring campaign was performed at the University of Guadalajara.

Methods

BP was measured in morning shift students, none with known chronic diseases. Before the measurement a survey was made to identify the cardiovascular risk factors, BP was measured in 3 occasions with an automatized sphygmomanometer (OMRON HEM907XL), according to the recommendations and protocol of international guidelines [2]. The average of the measurements were used to classify the subjects in normotensive (<140/90 mmHg) and hypertensive (≥140/90 mmHg).

Results

881 subjects were included (603 women and 278 men). The hypertension prevalence was 2%. The prevalence was analyzed in subgroups according to the presence of risk factors. Gender, obesity, tobacco use and alcohol consumption were evaluated obtaining the following odds ratio (OR): 6.23 (Confidence interval (CI) 95%: 2.4–16.11); 2.47 (CI 95%: 0.69–8.84) 0.78 (CI 95%: 0.18–3.4); 3.61 (CI 95%: 1.43–9.09).

Conclusion

HTN prevalence in Health Sciences students was 2%. The factors that conferred the highest risk to present HTN were male gender and weekly alcohol consumption.
P48 Effects of Remote Ischaemic Preconditioning on Haemodynamic and Arterial Stiffness Parameters in Patients Undergoing Lower Limb Angiographic Procedure
Authors: Kuusik Karl , Kepler Teele , Zilmer Mihkel , Eha Jaan , Vähi Mare , Paapstel Kaido , Kals Jaak
Published: March 2020

Objectives

Remote ischaemic preconditioning (RIPC) is a phenomenon that promotes protection of tissues and organs against ischaemia-reperfusion injury. RIPC has been shown to reduce myocardial and renal injury but its effect on arterial stiffness in patients undergoing lower limb digital subtraction angiography (DSA) is unknown. The aim of this study was to evaluate the effect of RIPC on arterial stiffness in patients with peripheral arterial disease (PAD) undergoing lower limb DSA.

Methods

In RIPC intervention, the blood pressure cuff on the arm was inflated to 200 mmHg or to 20 mmHg above systolic pressure and in sham intervention, to 20 mmHg, for four 5-minute cycles at 5-minute intervals between the cycles. Changes in heart rate corrected augmentation index (AIx@75), augmentation index (AIx), carotid-femoral pulse wave velocity (PWV) and haemodynamic parameters were measured before and 24 hours after DSA.

Results

111 (RIPC 54, sham 57) patients with symptomatic lower limb PAD scheduled for DSA were randomised. 102 patients (RIPC 47, sham 55) were included in final analysis. RIPC significantly improved AIx (−5.46% in RIPC and −1.45% in sham group; p = 0.045), but not AIx@75 (−4.88% in RIPC and −1.38% in sham group; p = 0.071) or PWV (−0.41 m/s in RIPC and −0.27 m/s in sham group; p = 0.741). In the RIPC group a significant reduction in AIx (p = 0.002) and AIx@75 (p = 0.003) was noted after stenting when compared to the sham intervention.

Conclusion

RIPC improves haemodynamic profile and modulates arterial stiffness following DSA procedure and might be more pronounced in patients after stent placement.
P49 Experimental Flow Visualization of a Flow Diverting Stent in a Popliteal Aneurysm
Authors: van de Velde Lennart , Reijnen Michel , Versluis Michel , Tessarek Joerg , Jebbink Erik Groot
Published: March 2020

Purpose

Flow diverting stents are commonly used in saccular cerebral aneurysms [1]. Their use has not yet been investigated for popliteal aneurysms, which are commonly fusiform in nature and exposed to pulsatile triphasic flows. We have shown the clinical feasibility of flow diverters in a pilot study of 12 patients [2]. To investigate its physiologic mechanism and the optimal flow diverter configuration, flow profiles were investigated in popliteal aneurysm phantoms.

Methods

Six transparent silicone elastomer models were created and integrated in an experimental flow set-up, which reproduced physiologic pulsatile flow conditions. These models covered two idealized anatomies (Figure 1) and three stent configurations (control, single stent [SUPERA, Abbott, Santa Clara, CA] and dual stent). Laser particle image velocimetry was used to investigate two-dimensional flow velocities, shear rates and wall shear stress in the models.

Results

The introduction of a flow diverter stent led to a two-time reduction in aneurysm flow velocities for single-layer stents, and a three-time reduction for double layer stents (Figure 2), with higher reduction factors for the bent inlet model. Forward flow was optimally diverted, whereas backward flow was deflected into the aneurysm by the unceasing momentum of the forward jet. Nonetheless, both flow velocities, shear rates (1.3–2x decrease) and wall shear stress (2.8–4.5x decrease) were strongly reduced by the double-layer configuration.

Conclusion

This study demonstrates the ability of a double-layer flow diverter stent for reducing flow velocities in popliteal aneurysms, supporting its clinical use in terms of its fluid mechanical effects.
P51 Effects of Pulsatile Exercise-induced Shear Stress on eNOS, SOD, VCAM-1, and ICAM-1 mRNA Expression of Human Carotid Artery Endothelial Cells
Authors: Morales-Acuna Francisco , Gurovich Alvaro
Published: March 2020

Exercise-induced endothelial shear stress (ESS) has been proposed as a molecular mechanism that regulates the expression of genes involved in the protection against atherosclerosis. However, research on this topic has not considered the pulsatile nature of blood flow for in vivo ESS estimations.

Purpose

To analyze the effect of pulsatile exercise-induced ESS on endothelial nitric oxide synthase (eNOS), superoxide dismutase (SOD), vascular cell adhesion molecule 1 (VCAM-1), and intercellular adhesion molecule 1 (ICAM-1) mRNA expression of human carotid artery endothelial cells.

Methods

First, 24 apparently healthy young subjects (14 females and 10 males) performed an exercise test on cycle ergometer at low, moderate, and high intensity in which ESS where estimated from the left common carotid artery through Doppler-ultrasound for each condition. Thereafter, commercially available cultured human carotid artery endothelial cells were exposed to pulsatile flow inside a chamber system (Ibidi) for 4 hours, simulating 1 hour of exercise-induced ESS and 3 hours of resting ESS. Finally, eNOS, SOD, VCAM-1, and ICAM-1 mRNA expression were compared between groups, using GAPDH as the housekeeping gene.

Results

ESS showed an intensity-dependent increment to exercise. A significant increment on eNOS mRNA expression (p < 0.05) and a significant reduction on SOD mRNA expression (p < 0.05) were observed on those cells exposed to moderate and high intensity exercise-induced ESS compared to resting ESS. No significant differences were detected on mRNA expression of VCAM-1 and ICAM-between groups.

Conclusion

Pulsatile ESS generated during moderate and high intensity cycling might favor the upregulation of eNOS and the downregulation of SOD.
P53 More than 2-Year Follow-up of Resistant Hypertensive Patients with Neurovascular Decompression of the Brain Stem on the Left Side
Authors: Fejes Imola , Vörös Erika , Barzó Pál , Bajcsi Dóra , Letoha Annamária , Sonkodi Sándor , Ábrahám György , Légrády Péter
Published: March 2020

In the background of resistant hypertension (RHT) the neurovascular pulsatile compression (NVPC) of the left rostral ventrolateral medulla may play a role. In these cases, a neurosurgical decompression (NVD) decreased the blood pressure (BP) and the antihypertensive medication became more effective. The aim of this work was to compare BP values recorded at the farthest time from the time of the NVD, up to maximum 31 December 2016. Earlier we published first 2-year follow-up data of 9 operated patients. In this work we retrospectively collected these 9 patients’ data from the clinical center’s patient management system. We analyzed BP values recorded before NVD, 1 and 24 months after NVD and the last recorded ones. The NVDs of these patients were performed between 2000 and 2004. The mean follow-up time was 11 years (minimum 3 years, maximum 16 years). Both the systolic and the diastolic BP decreased significantly in all cases after the NVD and at the last record they were significantly lower than before the NVD. Last recorded BP values compared to the 24-month data also were lower (148/96 mmHg vs. 135/81 mmHg). In 5 cases the number of antihypertensives increased and the mean number of combinations was higher compared to 24-month data (5.7 vs. 6.7). These results confirmed our previous opinion that in severe hypertension not responding to conventional therapy the NVD of the left side NVPC could guarantee a long-lasting BP reduction. An NVD may have increased the sensitiveness for antihypertensive medication.
P55 Remote Ischaemic Preconditioning Reduces Cardiac Biomarkers During Vascular Surgery
Authors: Kepler Teele , Kuusik Karl , Lepner Urmas , Starkopf Joel , Zilmer Mihkel , Eha Jaan , Paapstel Kaido , Kals Jaak
Published: March 2020

Objectives

The primary aim of this study was to evaluate the effects of remote ischaemic preconditioning (RIPC) on preventing the leakage of cardiac damage biomarkers in patients undergoing vascular surgery.

Methods

Randomised, sham-controlled, double-blinded, single-centre study has been carried out. In recruitment patients undergoing open abdominal aortic aneurysm repair, surgical lower limb revascularisation surgery or carotid endarterectomy were enrolled non-consecutively. The RIPC protocol consisting of 4 cycles of 5 minutes of ischaemia, followed by 5 minutes of reperfusion, was applied. A RIPC or a sham procedure was performed noninvasively at the same time as the patient was prepared for anaesthesia. High sensitivity troponin T level was measured preoperatively as well as 2, 8 and 24 hours after surgery and pro b-type natriuretic peptide was measured preoperatively and 24 hours after surgery.

Results

There was significantly higher leakage of high sensitivity troponin T (peak change median 2 ng/L, IQR 0.9–6.2 ng/L vs 0.6 ng/L, IQR 0.7–2.1 ng/L, p = 0.0002) and pro b-type natriuretic peptide (change median 144 pg/mL, IQR 17–318 pg/mL vs 51 pg/mL, IQR 12–196 pg/mL, p = 0.02) in the sham group compared to the RIPC group.

Conclusion

RIPC reduces the leakage of high sensitivity troponin T and pro b-type natriuretic peptide. Therefore, it may reduce cardiac damage in patients undergoing non-cardiac vascular surgery. The clinical significance of RIPC has to be evaluated in larger studies excluding the factors known to influence its effect.