bluuebunny/crossref_metadata_2025 huggingface dataset:
P57 In Patients with Chronic Descending Aorta Dissection the Maximum Systolic Flow Deceleration Rate in the False Lumen is Associated with Aortic Dilatation: a 4D-flow MRI Study
Authors: Guala Andrea , Ruiz-Muñoz Aroa , Duz-Santoy Lydia , Teixido-Tura Gisela , Granato Chiara , Sao-Aviles Augusto , La Mura Lucia , Lopez-Sainz Angela , Servato Maria Luz , Evangelista Arturo , Ferreira Ignacio , Rodriguez-Palomares Jose
Published: March 2020

Background

Aortic type B dissection is a life-threating condition in which blood flows between aortic wall layers. Despite a role for morphological variables, such as entry tear location and dimension, in the prediction of progressive false lumen (FL) dilation has been suggested, the role of flow characteristics has not been studied due to the unavailability of proper flow descriptions. Now that 4D phase-contrast magnetic resonance imaging (4D-flow MRI) allows for the evaluation of flow field with unprecedented detail, we tested whether flow deceleration in the FL, being a marker of occluded flow exit, is related to FL dilation.

Methods

In 29 patients with a patent FL and with a retrospective CT-based follow-up >3 years underwent 4D-flow MRI. Flow acceleration in the FL was calculated in a standardized sub-volume of the descending aorta. The maximum systolic flow deceleration rate (MSDR) was quantified as maximum minus minimum acceleration during systole divided by the corresponding time interval (Figure 1a).

Results

Demographic and clinical variables were similar among growth-rate (GR) tertiles. MSDR was statistically different in patients with a GR <1 mm/year (group 1) compared to fast-dilating patients (groups 2, 3) (Figure 1c). MSDR showed a positive linear correlation with GR (R = 0.48; p = 0.008) (Figure 1b).

Conclusion

The intensity of flow deceleration in the FL of chronic type B dissection is related to its retrospective growth rate. If confirmed in prospective studies, this marker may be useful to discriminate aorta enlargement and identify high-risk patients.
P60 Invasive Validation of Antares, a New Algorithm to Calculate Central Blood Pressure from Oscillometric Upper Arm Pulse Waves
Authors: Doerr Marcus , Richter Stefan , Eckert Siegfried , Ohlow Marc-Alexander , Hammer Fabian , Hummel Astrid , Dornberger Vivien , Genzel Elisabeth , Baulmann Johannes
Published: March 2020

Background

Antares is an algorithm for pulse wave analysis (PWA) by oscillometric blood pressure monitors in order to estimate central (aortic) blood pressure (cBP). Antares aims to enable brachial cuff-based blood pressure (BP) monitors to be type II-devices, determining absolute cBP values independently of potential peripheral BP inaccuracies. The present study is an invasive validation of the Antares algorithm.

Methods

We followed entirely the 2017 ARTERY protocol for validation of non-invasive cBP devices, the 2013 ANSI/AAMI/ ISO 81060-2 and 2018 AAMI/ESH/ISO validation standard protocols. In total, 191 patients undergoing cardiac catheterization were included, of which 145 patients entered analysis. Invasive cBP recordings were prospectively compared to simultaneous non-invasive cBP estimations using Antares, integrated into an oscillometric BP monitor. Antares analyses pulse waves during deflation of the cuff (patent of Redwave Medical GmbH). Generally speaking, pulse waves of a normal oscillometric BP measurement are taken for PWA with no need for altering standard BP pump operation.

Results

Mean difference between invasive and non-invasively estimated systolic cBP was 0.71 mmHg with standard deviation of 5.95 mmHg, fulfilling the highest validation criteria. Bland-Altman plot reveals good limits of agreement.

Conclusion

Antares is the first algorithm for estimation of cBP that entirely fulfills the 2017 ARTERY and AAMI/ESH/ISO validation protocols including criteria for high accuracy devices. The Antares algorithm turns the oscillometric upper arm blood pressure monitor into a type II-device for estimation of true cBP. Integration of Antares into BP monitors could enable the measurement of PWA parameters in virtually every practice in future.
P65 A Beat-to-Beat Quality Indicator Based on Piecewise Spatiotemporal Estimates of Carotid Pulse Wave Velocity Improves Correlation with Pulse Pressure
Authors: Beutel Fabian , Chris Van Hoof , Hermeling Evelien
Published: March 2020

Background

Local carotid pulse wave velocity (PWV) estimation is challenging due to a complex anatomy and associated wave reflections [1]. Wave interference is both blood pressure (BP) and position dependent, hence causing nonlinearity in the spatiotemporal PWV estimation [2]. In lack of beat-to-beat quality assessment [3], we propose a method to quantify this nonlinearity and thereby introduce a quality indicator (QI) for reliable PWV estimation.

Methodology

Carotid artery ultrasound (Vantage64, VerasonicsInc., USA) was acquired from 10 subjects (38 ± 10 years) in six repeated measurements. Simultaneously, ECG (ECG100C, BIOPACInc., USA) and noninvasive BP (NOVA, FinapresMedicalSystems B.V., NL) were recorded. Signals were processed into distension waveforms to extract systolic foot (SF) and dicrotic notch (DN) fiducials [4]. Beat-to-beat PWV estimates at SF (PWVSF) and DN (PWVDN) were obtained via spatiotemporal fitting of respective fiducial timings against transducer element distances. The proposed nonlinearity QI was quantified as standard deviation of the error between full-length PWV estimate and piecewise PWV estimates from the proximal, middle and distal subset of transducer elements. Linear regression was performed between independent pulse pressure (PP, in 2 [mmHg] intervals) and dependent PWV (means of all estimates) to validate QI according to Bramwell-Hill [5].

Results

When qualifying PWV estimates with QI ≤1 [m/s] we observed a significant R2 increase for both PWVSF (0.22 to 0.41, with decreased RMSE from 0.47 to 0.42 [m/s]) and PWVDN (0.21 to 0.53, although with constant RMSE of 0.32 [m/s]) as shown in annexed figure.

Conclusion

The proposed beat-to-beat QI accounts for significant variability in the PWV-PP relation, albeit at substantial data reduction. Therefore, the QI may facilitate real-time quality assessment towards reliable local PWV estimation. The unexplained variability remainder requires further investigations for confounding variables.
P69 The Initial Upstroke Time is Most Strongly Associated with the Severity of as Among Brachial Pulse Wave Parameters
Authors: Takahashi Masao , Fukatani Kyohei , Kabutoya Tomoyuki , Hoshide Satoshi , Yoneyama Tatsuya , Ito Tetsuya , Kario Kazuomi
Published: March 2020

Background

Aortic valve stenosis (AS) is the most common valve disease in an elderly population, therefore, simple screening examination for AS is needed. Although a prolonged carotid upstroke time (UT), and prolonged ejection time (ET) of a brachial pulse wave (BPW) have been observed in severe AS patients, it has been unclear which BPW parameters have a better correlation with the severity of AS. The aim of this study was to examine which BPW parameters are most relevant to the severity of AS.

Methods

Sixty-five Consecutive moderate and severe AS patients who were evaluated by trans-thoracic echocardiography were enrolled in this study. Control patients who were adjusted for age, gender, and blood pressure among outpatients were enrolled (N = 110). UT, ET, initial upstroke time (iUT), and half rise time of upstroke (1/2 hrUT) were evaluated correlations between mean pressure gradient (mPG) among AS patients.

Results

iUT and 1/2 hrUT have significant correlations with mPG among AS patients (iUT: R = 0.50, 95% CI = 0.29–0.67, p < 0.0001; 1/2 hrUT: R = 0.41, 95% CI = 0.19–0.60, p < 0.001), whereas UT and ET did not. Multivariate logistic regression analysis showed area under curve (AUC) of iUT and 1/2 hrUT were higher than UT and ET to predict mPG >40 mmHg (AUC: iUT vs 1/2 hrUT vs UT vs ET = 0.90 vs 0.89 vs 0.69 vs 0.77).

Conclusion

The severity of AS appeared strongly in the first half of the BPW upstroke. iUT and 1/2 hrUT may be a simple and useful screening test to assess the severity of AS.
P71 The Interrelationship Between the Alteration of Arterial Markers and Left Ventricular Diastolic Dysfunction in Metabolic Syndrome Subjects
Authors: Solovjova Svetlana , Ryliskyte Ligita , Celutkiene Jelena , Badariene Jolita , Laucevicius Aleksandras
Published: March 2020

We aimed to determine how the alteration of arterial stiffness (AS) affects the dynamics of left ventricular (LV) diastolic dysfunction (DD) in metabolic syndrome (MetS) subjects during longitudinal observation (3.8 ± 0.6 years).

Methods

A follow-up study was carried out in 573 (53.4 ± 5.8 years, 211 men [36.8%]) MetS subjects without overt atherosclerotic disease. Carotid-to-femoral pulse wave velocity (cfPWV), augmentation index (AIxHR75), mean aortic pressure (mAP), central pulse pressure(cPP) were assessed by applanation tonometry. Diastolic function (LVDF) was defined according to the 2016ESC Guidelines for diagnosis of acute and chronic heart failure.

Results

Depending on the LVDD dynamics analysis focused on the comparison of arterial markers in 2 subgroups (Figure 1): GRI (LVDD improved: 22%, n = 126) and GRIII (LVDF worsened: 19.2%, n = 110). After 3 years in both groups (all p < 0.05): decreased HR (GRI 66.27 ± 10.09 to 62.15 ± 8.86 b/min; GRIII 65.17 ± 9.41 to 62.07 ± 8.51 b/min) and mAP (GRI 107.60 ± 10.89 to 100.48 ± 16.55 mmHg; GRIII 104.07 ± 10.94 to 99.73 ± 13.17 mmHg). cfPWV and AIx significantly increased only in GRIII (cfPWV: 8.25 ± 1.36 to 8.68 ± 1.73 m/s; AIx 23.16 ± 9.94 to 25.16 ± 10.08%). These results confirm, that the negative dynamics of LVDF is associated with the progression of the arterial stiffening. For more accurate evaluation of the relationship between alterations of AS indices and the dynamics of LVDD the conditional random forests analysis was performed. Random forests analysis demonstrated that cfPWV, BMI, weight had prognostic significance for the worsening of LVDF.

Conclusion

In conclusion, the increase of cfPWV and AIx are significantly associated with negative dynamics of LVDF. In MetS subjects progression in arterial stiffening, assessed as an increase in cfPWV, significantly predicts the worsening of the LVDF. Our findings suggest that increased arterial stiffness is a pathogenetic factor of LVDD.
P77 Long-term Effects of LDL Apheresis on Carotid Arterial Atherosclerosis in Two Severe Heterozygous Familial Hypercholesterolemic Patients
Authors: Diószegi Ágnes , Juhász Lilla , Nádró Bíborka , Paragh György , Oláh László , Páll Dénes , Balla József , Harangi Mariann
Published: March 2020

The long-term effects of low-density lipoprotein (LDL) apheresis (LA) on the progression and regression of atherosclerosis were evaluated by carotid ultrasonography in two severe heterozygous familial hypercholesterolemic patients with carotid artery stenosis. Furthermore, the lipid-lowering efficacy of LA was evaluated. A 63-year-old male and a 64-year-old female patient have been followed for severe heterozygous FH, being treated by LA for 5 years continuously, at 4-week intervals, added on a standard high-dose statin and ezetimibe therapy. The regular LA treatment significantly decreased the levels of total cholesterol (by −58.1 and −53.8%) and LDL-C (by −69 and −66%), while the HDL-C levels did not change significantly. The time-averaged LDL-C (TAL) levels were also significantly decreased (by 20.8 and 30.1%). Still, we could not achieve the 1.8 mmol/L LDL-C goal values (average TAL levels were 4.1 and 5.1 mmol/L). Carotid ultrasonography was performed in every 6 months; internal carotid arteries (ICA) and common carotid arteries (CCA) were evaluated on both sides. Although during the 5-year follow-up we found a progression in the left ICA of the male patient (from 20% to 45%), all the other parameters showed the slow up of the atherogenesis in the studied arteries. The results suggest that monthly LA-treatment can significantly delay the progression of the atherosclerotic process in FH patients, however, it is not adequate to stop progression in every case because of TAL levels exceeding the LDL-C goal value. LA treatment twice a month or PCSK9 inhibitor therapy should be considered to further lower LDL-C.
P79 Non-invasive Estimation of Central Pressures in Abdominal Aortic Aneurysm Patients and Changes in PWV After EVAR
Authors: Holewijn Suzanne , van de Velde Lennart , Vermeulen Jenske , Reijnen Michel
Published: March 2020

Background

Abdominal aortic aneurysm (AAA) disease is mainly treated by endovascular aneurysm repair (EVAR) and PWV has been shown to increase after EVAR. Arterial stiffness is predictive of cardiovascular disease, but has not been investigated in AAA-patients. We investigated if central pressures (CP) can be estimated correctly in AAA-patients and changes over time in pulse wave velocity (PWV), since PWV-changes during follow-up are currently unknown.

Methods

Non-invasive (SphygmoCor) and invasive waveform recordings were performed simultaneously before and after EVAR. A generalized ascending-to-abdominal aorta transfer function (GTFAA) was used to estimate CP from the invasively measured abdominal aorta pressure-waveform, and compared to the non-invasively estimated CP. Changes in PWV were evaluated compared to baseline (6-weeks and 1-year).

Results

The mean difference between invasive and non-invasive central systolic pressure was −11.5 mmHg (limits-of-agreement: −63.5; 40.6) before and 0.03 (−33.5; 33.6) after implant. For central diastolic and mean pressure mean difference was −12.2 (−39.3; 14.8) and −9.6 (−45.3; 26.1), respectively. Median (IQR) PWV was 10.5 (9.2; 13.2) at baseline, 10.5 (10.1; 12.4) at discharge, 11.5 (10.6; 12.9) at 6 weeks, and 11.3 (9.9; 13.0) at 1 year follow-up without significant differences over time. Increases in CP were equal to peripheral pressure increases.

Conclusion

Synthesizing CP with non-invasive measurements in combination with the use of a GTFAA in patients with AAA is feasible especially after EVAR. No changes over time in PWV were observed. Current ongoing analyses include evaluation by prosthesis type, wave type, and influence of intra-luminal thrombus (NCT01220245).
P83 Effect of Aging on the Aortic Reservoir and Excess Pressure in Normal Humans
Authors: Yamakado Tetsu , Ko Hideyoshi
Published: March 2020

Background

Reservoir pressure analysis has been newly introduced to analyze arterial waveform and function. There are few data regarding the effect of aging on the aortic reservoir and excess pressures in normal humans.

Objectives and Methods

To investigate this issue, we analyzed high-fidelity aortic pressures, measured by a catheter-tipped manometer in 81 normal subjects who underwent diagnostic cardiac catheterization but proved to have normal coronary artery and LV function. Subjects who had hypertension, diabetes, renal disease or dyslipidemia were excluded. There were 57 men and 24 women, ranging in age from 21 to 80 years. We analyzed the entire AoP and calculated the reservoir pressure (Pr) and the excess pressure (Pex) according to the method by Aguado-Sierra et al., and augmented pressure (AP) was obtained as well.

Results

Systolic AoP and pulse pressure (PP) were significantly increased with age. Pr (amplitude) and Pex (amplitude) were 38.2 ± 6.3 mmHg and 17.8 ± 4.2 mmHg, respectively. Both Pr and Pex showed significant age-related change (Pr: r = 0.40, p < 0.001, Pex: r = 0.26, p < 0.05). Age-related increase in PP or AP was more strongly correlated with the Pr (r = 0.88 and 0.90, both p < 0.001) than the Pex (r = 0.56 and 0.35, both p < 0.001).

Conclusion

We documented the aortic Pr and Pex in normal humans. The Pr and Pex were both roughly but significantly correlated with aging at least until the ninth decade, while the Pr contributes more to age-related change in PP and AP than the Pex. These data may provide reference data about an arterial function in normal and pathological conditions.
P87 Ultra–high Frequency Ultrasound Assessment in Vascular Ehlers Danlos Syndrome: a Validation and Reproducibility Study
Authors: Bruno Rosa Maria , Alexopoulou Magdalini , Khettab Hakim , Jeunemaitre Xavier , Boutouyrie Pierre
Published: March 2020

Background

In patients with Vascular Ehlers-Danlos syndrome (vEDS), an abnormally low carotid intima-media thickness (CIMT) may increase the risk of arterial dissection and rupture. Thus its accurate assessment by ultra–high frequency ultrasound (UHFUS), thanks to its higher spatial resolution, may be clinically relevant.

Aim

To assess the feasibility and reproducibility of carotid parameters, assessed by UHFUS in vESD patients, and to evaluate the agreement with the gold standard technique, echotracking by radiofrequency.

Methods

16 vEDS patients were recruited (6 women, 40 ± 11 years, BP 115 ± 6/62 ± 6 mmHg). Common carotid parameters were assessed by echotracking (Esaote, Artlab software) and UHFUS (VevoMD, Visualsonics; CVSuite software, Quipu srl), to evaluate agreement. The coefficient of variation between two consecutive clips was computed. The results were compared to those of 16 age-, sex- and BP-matched healthy individuals.

Results

In all 16 patients the acquisition and automated analysis of carotid clips was feasible. Correlation between echotracking and UHFUS was satisfactory (diameter r = 0.63, p = 0.001; CIMT r = 0.65, p = 0.006; distension r = 0.84, p < 0.001). Bland-Altman plots showed a good agreement between the two techniques, with a non significant bias either for diameter [110 μm (−184; 404)] or CIMT [27 μm (−10; 75)]. Intra-operator coefficient of variation was 3.26% (diameter), 7.11% (CIMT) and 5.65% (distension). vEDS patients had reduced CIMT (419 ± 85 vs 522 ± 97 μm, p = 0.004) and distension (453 ± 150 vs 613 ± 176 μm, p = 0.01) than controls and tended to have a reduced diameter (6558 ± 525 vs 6945 ± 653 μm, p = 0.08), while carotid-femoral pulse wave velocity was similar (7.38 ± 1.08 vs 7.46 ± 1.396 m/s, p = 0.78).

Conclusion

UHFUS is feasible, accurate and reproducible for the evaluation of carotid parameters in vEDS.
P90 Indexing Left Ventricular Mass to Body Size: Which Method is the Most Appropriate in Early Adulthood?
Authors: Taylor Hannah , Park Chloe , Fraser Abigail , Howe Laura , Ferreira Dianna , Timpson Nic , Lawlor Debbie , Davey-Smith George , Chaturvedi Nishi , Hughes Alun
Published: March 2020

Introduction

Left ventricular mass (LVM) predicts cardiovascular risk. In early life, LVM is conventionally indexed to height 2.7 [1], although this may not account for sex differences in growth. We investigated allometric scaling of LVM to height, lean mass (LM) and body surface area (BSA) in a UK birth cohort.

Methods

861 individuals underwent echocardiography to assess LVM at age 17.7 (SD 0.3) years and 24.0 (SD 0.6) years. LM was quantified using dual-energy X-ray absorptiometry. Group and sex-specific allometric relationships were determined by linear regression, following log transformation of x and y variables (log(y) = a + b* log(x)) (b = scaling exponent).

Results

LVM showed a linear relationship with LM and log(height), although the intercepts differed by sex. At age 17, the exponent relating LVM to height in males and females combined was 2.67 (95% CI: 2.41, 2.91), very close to the suggestion of height 2.7. Sex-specific estimates for height were lower and close to the estimate of 1.7 [2], at 1.77 (1.17, 2.37) and 1.83 (1.35, 2.31), for males and females, respectively. The female exponent at age 24 remained close to 1.7, while the male exponent increased to 2.14 (1.54, 2.73). Exponents for LM and BSA remained similar between ages 17 and 24 (see Table 1 for detail).

Conclusion

A universal approach for allometric indexing of LVM may be inappropriate in early adulthood, and indexation may need to be both age- and gender-specific. It remains unclear which indexing method is superior at these ages, although height may be unsuitable. These observations may have important implications for identifying young individuals with cardiac hypertrophy.

Table 1

Height
Lean
BSA

n
Coefficient (+ 95% CI)
p
n
Coefficient (+ 95% CI)
p
n
Coefficient (+ 95% CI)
p

Age 17
Group
861
2.67 (2.41, 2.91)
<0.001
861
0.85 (0.80, 0.91)
<0.001
861
1.76 (1.64, 1.88)
<0.001

Male
333
1.77 (1.17, 2.37)
<0.001
333
1.18 (1.00, 1.36)
<0.001
333
1.69 (1.45, 1.93)
<0.001

Female
528
1.83 (1.35, 2.31)
<0.001
528
1.10 (0.96, 1.24)
<0.001
528
1.36 (1.20, 1.53)
<0.001

Age 24
Group
861
2.97 (2.70, 3.23)
<0.001
861
1.07 (1.01, 1.13)
<0.001
861
1.78 (1.66, 1.90)
<0.001

Male
333
2.14 (1.54, 2.73)
<0.001
333
1.20 (1.05, 1.35)
<0.001
333
1.60 (1.36, 1.84)
<0.001

Female
528
1.65 (1.11, 2.19)
<0.001
528
1.10 (0.98, 1.23)
<0.001
528
1.32 (1.15, 1.50)
<0.001
P92 The Association of Agreeableness and Conscientiousness with 24-Hour Brachial Blood Pressure and Hemodynamic Parameters in Untreated Hypertensive Patients
Authors: Vecsey-Nagy Milán , Kőrösi Beáta , Batta Dóra , Gonda Xénia , Rihmer Zoltán , Nemcsik-Bencze Zsófia , László Andrea , Nemcsik János
Published: March 2020

Background

There is growing evidence that Five Factor Model personality traits (extraversion agreeableness, conscientiousness, neuroticism, and openness) have an impact on cardiovascular (CV) risk. The aim of our study was to evaluate their associations with 24-hour brachial and central hemodynamic parameters and arterial stiffness 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. The Big Five Dimensions were evaluated with the BFI questionnaire. 68 patients were involved into the study (45 men).

Results

Agreeableness was inversely associated with nighttime brachial systolic blood pressure (r = −0.255, p = 0.036), with 24-hour heart rate (r = −0.243, p = 0.046), with 24-hour cardiac output (r = −0.314, p = 0.009) and with daytime cardiac output (r = −0.341, p = 0.004). Conscientiousness was inversely associated with 24-hour heart rate (r = −0.276, p = 0.023) and daytime heart rate (r = −0.283, p = 0.019).

Conclusion

In conclusions, agreeableness and conscientiousness can have an impact on 24-hour hemodynamic parameters in untreated hypertensive patients.
P93 Relationship Between Central Pressure and Urinary Sodium Excretion in a Population-based Study in Salvador, Brazil, Preliminary Results
Authors: de Castro Roberta , Magalhães Lucélia , Brustolim Danielle , Silva Diorlene da , Filho Antonio , Bessa Larissa , Vascor Grupo
Published: March 2020

Introduction

Central pressure (CP) has shown to be more reliable than cardiovascular mortality; salt intake in the diet is directly related to the increase in CP.

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. The central pressure, measured in the radial artery, obtained through aplanation tonometry, using the SphygmoCor® apparatus (XCEL, AtCor Medical, Sydney, Australia, [2] with confidence ≥85%). PC is evaluated directly by the central systolic pressure and diastolic pressure. Collected blood and urine sodium 24 hours were quantified by the ADVIA 1800® selective ion electrode (SiemensHealthcare Japan/Canada), and all participants signed a Free and Informed Consent Form. Mean, standard deviation, Spearman’s linear correlation coefficient between CP and Na+, stratified by age and sex, using STATA v.12 software for treatment and generation of results, and the level of significance statistic of 5%.

Results

For both sexes, were inversely proportional, although not significant.

Conclusion

The results obtained aren’t adequate as evidence in the literature. A larger sample is needed for accuracy in this group.
P98 Impaired Pulmonary Function is Associated with Increased Cardio-ankle Vascular Index in HIV Patients in Ghana
Authors: Yeboah Kwame , Musah Latif , Essel Samuel , Dzudzor Bartholomew , Cruickshank J Kennedy
Published: March 2020

Aim

Patients with HIV have increased cardiovascular risk and pulmonary defects. We investigated the association between impaired pulmonary function (IPF) and arterial stiffening measured by the cardio-ankle vascular index (CAVI) in Ghanaian HIV patients.

Method

Spirometry was used to measure pulmonary indices; forced expiratory volume in 1s (FEV1) and forced vital capacity (FVC) in 79 HIV patients on treatment, 75 HIV treatment naïve patients and 78 non-HIV controls. We also used FEV1/FVC < lower limit of normal as a further index. Arterial stiffness was measured as CAVI using the Vasera device.

Results

Compared to non-HIV controls, CAVI was higher in treatment naïve (6.9 ± 1.4 vs 6.3 ± 1.1 units, p < 0.01) and HIV patients on treatment (8.1 ± 1.4, vs 6.3 ± 1.1, p < 0.01). IPF was detected in 12 (15.2%) HIV patients on treatment, 8 (10.7%) treatment naïve HIV patients and 5 (6.4%) non-HIV controls. Compared to those without IPF, IPF patients had higher CAVI in non-HIV controls (6.5 ± 1.1 vs 5.7 ± 0.8, p < 0.01), treatment naïve HIV patients (7.1 ± 1.8 vs 6.6 ± 1.4, p = 0.023) and HIV patients on treatment (7.8 ± 1.4 vs 8.7 ± 1.2, p < 0.01). In multivariable logistic regression analysis, IPF was independently associated with CAVI [adjusted OR = 1.33 (1.15 — 1.89), p = 0.037] after adjustment for age [1.21 (0.98 — 2.14), p = 0.11], male sex [0.42 (0.32 — 0.91), p = 0.035], current/former smoking status [1.43 (0.47 — 4.01), p = 0.75] and history of tuberculosis infection [1.96 (1.08 — 3.12), p < 0.01].

Conclusion

Ghanaian HIV patients have a high prevalence of impaired respiratory function and arterial stiffening, and these indices are associated with each other.
P101 Arterial Stiffness vs Sarcopenia in Portuguese Elderly Population
Authors: Vassilenko Valentina , Serrano Andreia , Ramalho Beatriz , Bonifácio Paulo , Coelho Ana C. , Pimentel-Santos Fernando
Published: March 2020

Aging often results in the appearance of sarcopenia, which is characterized by loss of muscle mass and strength. The incidence of sarcopenia in the elderly is a quite common and leads to weakness and disability, as well as a lower quality of life, also assuming a high social and economic impact. One previous study has shown an independent negative association between arterial stiffness and skeletal muscle mass decline [1], which suggest its relationship with sarcopenia. This work aims to evaluate the relation between sarcopenia and the arterial stiffness, in Portuguese elderly population A cohort of 38 elderly volunteers between 67 and 95 years, with and without Sarcopenia, were selected from nursing homes and day centers of Portuguese charity institution -Santa Casa da Misericórdia de Almada. All volunteers have the same living condition, meals and lifestyle routine, excepting the medications. The diagnosis and degree (severe or moderate) of sarcopenia were performed according to the European consensus on definition and diagnosis of sarcopenia [2] at the same day with arterial stiffnesses measurements assessed by carotid-femoral Pulse Wave Velocity (cfPWV). Our data show a positive correlation for cfPWV with the sarcopenia severity degree, which represents an increasing in arterial stiffness and might be explained by the fact that the loss of muscle mass is often associated with chronic inflammation [3]. Despite of the small cohort size, the male gender held a bigger mean value of cfPWV, with significant p-value (0.014), in comparison to the female gender, which estimates a higher CV risk for the male elders of the region of Almada and Greater Lisbon compared to the female gender. Further investigations would be desirable in order to obtain larger samples and ascertain the estimates for the respective groups.
P105 Photoplethysmographic Signals Analysis Before, During, and After the Finnish Sauna Exposures
Authors: Huotari Matti
Published: March 2020

Wellness and healthiness depend on physiology if no illness exists in the body. As a treatment either in healthy or sick state, we suggest that sauna exposure could be good for cardiovascular disease (CVD) prevention, especially heart and brains arteries. We measured by our photoplethysmographic (PPG) device the responses caused by sauna exposure on the healthy males and females (10 + 7). As a working hypothesis, the sauna exposure could lower blood pressure and refresh the arterial wall facilitating the blood flow. The mechanisms as a whole have not been enough accurately documented. We recorded for 30 min in the 80°C dry sauna conditions the PPG signals for calculation of arterial elasticity (AE), and heart rate (HR) based on inter beat interval (IBI, the first-order difference), inter beat interval variability (IBIV, the second order difference), and heart rate variability (HRV). IBI and IBIV signals were determined on the second order derivatives of photoplethysmographic (SDPPG) waveforms. For the both IBI and IBIV signals, we plotted them as Poincare plots (Figure 1) by OriginPro2019b (OriginLab). Based on the SDPPG signals from the finger and toe maxima A and B (the first maximum and minimum) we calculated both the EA for finger and toe arteries. The PPG waveforms were noiseless because the subjects were at rest and no extra morphologies exists in PPGs during the sauna exposures, like before and after sauna. In our knowledge, this is the first PPGs measured during the actual sauna exposures.
P106 Effect of Açaí-Juçara on Central Pressure in Individuals with Overweight or Obesity
Authors: Ortiz Tainah , Gorski Fernanda , Lehnen Tatiana , Boll Liliana , Eibel Bruna , Lehnen Alexandre , Barbosa Eduardo
Published: March 2020

Introduction

Açaí-juçara is a fruit with a antioxidant content that can modify the vascular environment and attenuate the effects of obesity.

Objective

To evaluate the effect of açaí-juçara on pulse pressure parameters in overweight or obese individuals.

Methods

Randomized clinical trial with 23 individuals of both sexes, 37.7 ± 1.5 y, body weight 85.0 ± 4.8 kg, BMI 32.4 kg/m2. The volunteers were randomly assigned to: control group (C, n = 10) and açaí-juçara group (AJ, n = 13). Both received hypocaloric diets, representing 20% below the total energy value. AJ received, in the composition of the diet, 200 g of açaí-juçara for daily consumption. The intervention was 12 weeks and the follow-up was performed with weekly meetings. We analyzed parameters of peripheral blood pressure: systolic blood pressure (SBP) and diastolic blood pressure (DBP); parameters of central blood pressure: central pulse pressure (PPc), central systolic blood pressure (SBPc) and pulse wave velocity (PWV) with the oscillometric method (Mobil-O-Graph). Descriptive statistics (mean ± standard deviation) were performed and normality of the data was tested by Shapiro-Wilk. Possible differences were tested by ANOVA of repeated measures (Bonferroni post-hoc) with significance level of 5%. Results: After 12 weeks of intervention, body weight decreased in both groups (C: Δ3.2 kg; p = 0.050; AJ: Δ5.2 kg; p = 0.001). The peripheral SBP, PPc and PWV was lower in both groups (C: Δ3.8 mmHg, p = 0.040, AJ:Δ7.1mmHg, p = 0.031); (C: Δ5.5 unit, p = 0.044; AJ:Δ7.8 unit, p < 0.001); (p = 0.047) with greater effect in the AJ group (Δ0.4 unit; p = 0.006). Both groups reduced SBPc with more effect in the AJ group (Δ6.3 mmHg, p = 0.034).

Conclusion

AJ showed benefits on peripheral SBP, PPc, PWV and SBPc when compared to the control group.
P107 Endothelial Dysfunction Associated with Arterial Stiffness in Postmenopausal Women with Obesity
Authors: Lizette Ramírez Soltero Patricia , Benavides Leonel García , Pantoja Marycruz Barocio , Illescas Vidrio Brandon Giovanni , Müller David Cardona , Cardona Muñoz Ernesto Germán , Totsuka Sutto Sylvia Elena
Published: March 2020

Background

Endothelial dysfunction (ED) represents an initial step of “vascular failure” [1]; several factors affect the functionality of the endothelium. Obesity [2] and estrogen deficiency [3] are independently associated with this. The early detection of ED is essential to intervene and prevent its progression. One of the most promising methods to assess vascular endothelial function is the measurement of endothelium- dependent flow-mediated vasodilation (FMD) [1]. Similarly, pulse wave velocity (PWV) is considered as a predictive value for the stratification of vascular risk [4], however, progression between endothelial events and arterial stiffness continues to be examined.

Objective

To evaluate the association between endothelial dysfunction and arterial stiffness in postmenopausal women with obesity.

Methods

Descriptive study of 19 postmenopausal women with grade I and II obesity, without associated comorbidities. Participants were classified into one of two groups: with ED (FMD < 6%) or non-ED (FMD > 6%). The hemodynamic metabolic, hormonal and arterial stiffness parameters were evaluated.

Results

The group with ED (n = 10) compared to the non-ED group (n = 9) presented age 57.30 ± 4.80 vs 52.40 ± 5.70 years (p = NS); BMI 34.75 ± 2.06 vs 33.06 ± 2.51 kg/m2 (p = NS). Statically significant findings include: FSH 35.43 ± 11.04 vs 55.19 ± 19.27 mUI/ml (p = 0.018); PWV 9.18 ± 1.84 vs 7.52 ± 1.26 m/s (p = 0.041); central SBP 135 ± 15.90 vs 120 ± 18.2 mmHg (p = 0.041). We also measure estradiol, QIMT, SBP, DBP, PP, AIx, LDL-C, HDL-C and triglycerides, no significant differences were observed.

Conclusion

We can conclude that in the group with endothelial dysfunction the PWV and the cSBP are higher with a significant difference.
P108 Relation Between Abdominal Aorta and Carotid Artery Responses to Sympathetic Stimulation using Duplex Ultrasound
Authors: Jansen Anne-Jet , Vermeulen Jenske , Holewijn Suzanne , Thijssen Dick , Reijnen Michel
Published: March 2020

Background

Sympathetic stimulation in central arteries, such as the carotid artery, lead to vasodilation in healthy subjects and vasoconstriction in those with cardiovascular disease. Moreover, this response has independent prognostic value for future events. Whether the aorta demonstrates similar responsiveness is unknown. This is relevant, since this may help to better predict outcomes and progression in abdominal aortic aneurysm (AAA).

Objective

The aim of this explorative study is to investigate the correlation between the magnitude of the abdominal aorta and the carotid artery diameter and blood flow responses during the sympathetic stimulation (using the Cold Pressor Test (CPT)) between healthy young, healthy older and individuals with AAA.

Method

In this explorative study 60 subjects will be included divided into a healthy young group, healthy older group and an AAA group. All subjects will undergo the CPT, while using duplex ultrasound to simultaneously examine the diameter and blood velocity of the abdominal aorta and carotid artery.

Results

We aim to present our first results of the correlation between the abdominal aorta and carotid artery parameters at the conference.

Conclusion

When confirming a correlation between the magnitude of the abdominal aorta and the carotid artery diameter during the CPT, assessment of carotid artery reactivity to CPT may represent a simple, surrogate measure of central (i.e. aorta) endothelial function. This may help in predicting AAA progression and improve decision-making for treatment.
P112 Influence of Cuff Blood Pressure Accuracy on Identification of Isolated Systolic Hypertension
Authors: Picone Dean , Schultz Martin , Armstrong Matthew , Bos Willem , Dwyer Nathan , Lacy Peter , Laugesen Esben , Omboni Stefano , Pucci Giacomo , Roberts-Thomson Philip , Stouffer George , Takazawa Kenji , Weber Thomas , Westerhof Berend , Sharman James
Published: March 2020

Introduction

Isolated systolic hypertension (ISH) is the most common form of hypertension in older people. However, accurate identification of ISH may be hindered because cuff blood pressure (BP) underestimates systolic BP (SBP) and overestimates diastolic BP (DBP). This study aimed to determine the influence of cuff BP accuracy on the identification of ISH.

Methods

Cuff BP and invasive aortic BP were measured simultaneous (or near-simultaneously) in 1737 subjects (63 ± 12 years, 68% male) during coronary angiography. Data was derived from 32 studies, using 20 different cuff BP devices, from the Invasive Blood Pressure Consortium (INSPECT). ISH was defined as ≥140/<90 mmHg according to cuff BP and invasive aortic BP.

Results

According to cuff BP, 25% of subjects (n = 430) had ISH, however, 37% (n = 648) were identified with ISH from invasive aortic BP. There was 77% concordance between cuff and invasive BP for identifying ISH. Among the 23% (n = 408) of subjects misclassified by cuff BP, 38% (n = 155) of misclassification was from SBP underestimation (mean: −16.6, 95% CI: −18.9 to −13.9 mmHg), whereas 35% (n = 143) was from DBP overestimation (15.6, 11.9 to 19.0 mmHg) and 20% (n = 83) from SBP overestimation (17.6, 14.4 to 20.5 mmHg). Subjects misclassified were on average 2.7 years older and had greater body mass index (0.8 kg/m2) than those correctly classified.

Conclusion

Approximately one quarter of older subjects have ISH misclassified, mostly because of underestimation of cuff SBP and overestimation of cuff DBP. This demonstrates a need to improve the accuracy of cuff BP methods for greater precision in identifying ISH.
P116 Post-stroke White Coat Hypertension/Effect is Associated with Greater Arterial Stiffness
Authors: Kirkham Fran , Saunders A , Nuredini GN , Drazich E , Rankin Philip , Bunting E , Ali K , Okorie M , Rajkumar C
Published: March 2020

Objective

White coat hypertension/effect (WCH/E) describes an elevated clinic blood pressure (BP) with normal daytime ambulatory BP (ABPM) values. It is not clear whether WCH/E is associated with adverse vascular risk. This study aimed to determine the relationship between WCH/E and arterial stiffness in a cohort of patients who had a transient ischaemic attack (TIA) or lacunar stroke (LS).

Design and Method

The Arterial Stiffness In Lacunar Stroke and TIA (ASIST) study recruited 96 patients, aged over 40 years old, with a confirmed diagnosis of TIA or LS in the preceding 14 days. Patients were grouped by BP. Thirty-four patients were excluded (n = 6 declined ABPM, n = 3 masked hypertension and n = 25 sustained hypertension). Thirty-two patients with normal BP (clinic BP < 140/90 mmHg and day-time ABPM < 135/85 mmHg), and 30 patients with WCH/E (clinic BP > 140/90 mmHg and day-time ABPM < 135/85 mmHg) were recruited. Arterial stiffness was measured using carotid-femoral pulse wave velocity (PWV), (Complior®, ALAM Medical) and carotid-ankle vascular index (CAVI), (VaSera VS-1500 N®, Fukuda Denshi).

Results

Compared to patients with normal BP, patients with WCH/E were older, had a higher body mass index (BMI) and higher arterial stiffness measured by CAVI (10.3 ± 1.3 vs 9.4 ± 1.7, p = 0.027), and PWV (11.9 ± 3.0 vs 9.6 ± 2.3 ms−1, p = 0.002). The WCH/E cohort had more lacunar strokes (p = 0.039).

Conclusion

In this population of post-stroke patients, those with WCH/E had greater arterial stiffness and a higher prevalence of lacunar stroke. These results suggest that WCH/E is associated with adverse cardiovascular risk.

Normotension (N = 32)
WCH/E (N = 30)
Statistical significance

Male, n (%)
21(66)
22(73)
0.511

Age (years)
69.9 ± 11.5
75.7 ± 9.3
0.033

BMI (kg/m2)
25 ± 4
28 ± 4
0.014

Anti-hypertensive use, n (%)
19(59)
23(77)
0.146

Clinic systolic BP (mmHg)
125 ± 9
155 ± 13
<0.001

Clinic diastolic BP (mmHg)
75 ± 7
81 ± 8
0.003

Daytime systolic ABPM (mmHg)
114 ± 10
121 ± 10
0.007

Daytime diastolic ABPM (mmHg)
73 ± 7
72 ± 7
0.586

CAVI
9.4 ± 1.7
10.3 ± 1.3
0.027

PWV (ms−1)
9.6 ± 2.3
11.9 ± 3.0
0.002

Stroke type

TIA, n (%)
25(78)
16(53)
0.039

Lacunar, n (%)
7(22)
14(47)

Data expressed as mean ± standard deviation or number (percentage). Significance determined by t-test. Chi-squared used for anti-hypertensive use, gender and stroke type.
P118 Arterial Stiffness in Patients with Arterial Hypertension on Short Term Dual Treatment with Fimasartan/Amlodipine
Authors: Vidrio Brandon Giovany Illescas , Müller David Cardona , Muñoz Ernesto Germán Cardona , Ruiz Claudia Yanette Gálan , Becerra Carlos Gerardo Ramos , Páez Fernando Grover
Published: March 2020

Background

Pulse wave velocity (PWV) reflects arterial stiffness and is an independent predictor of cardiovascular mortality and morbidity. It is important to determine the effect dual therapy has on both BP and PWV.

Methods

A quasi-experimental study was performed in patients with grade 1 and 2 primary hypertension (HTN). Patients received the combination amlodipine/fimasartan (5 mg/60 mg/day) for 8 weeks. Anthropometric and hemodynamic measurements were made after a 2-week washout period and at week 8 of treatment. The brachial-ankle pulse wave velocity (baPWV), SBP, DBP, Pulse pressure (PP), central systolic blood pressure (cSBP) and the augmentation index normalized to 75 bpm (pAIx75) were measured.

Results

We included 42 patients (14 women) aged 56 ± 16 years. We observed a decrease in baVOP, 17.99 ± 2.80 m/s vs 16.14 ± 2.36 m/s, (p < 0.001); SBP 160 ± 18 mmHg vs 138 ± 14 mmHg (p < 0.001); DBP 96 ± 14 mmHg vs 82 ± 10 mmHg, (p < 0.001); PP 63 ± 18 mmHg vs 56 ± 14 mmHg, (p < 0.001); AIx75 85 ± 9% vs 80 ± 10%, (p = 0.002); and cSBP 151 ± 18 mmHg vs 128 ± 15 mmHg (p < 0.001). Before the treatment 71% patients had arterial stiffness and after the treatment only 33% of the patients had it, the BP goal of <130/80 was achieved in only 16%.

Conclusion

The short term dual therapy with amlodipine/fimasartan significantly decreased baPWV, cSBP, PP, SBP, DBP and pAIx75. Only 16% of the patients achieved the BP goal with this treatment.
P139 Does Early Life Programming Influence Arterial Stiffness and Central Hemodynamics in Adulthood? Could Birth Cohort Effects be of Importance?
Authors: Nilsson Peter , Sperling Johannes
Published: March 2020

Objective

Our aim was to investigate possible associations between birth weight (BW) and adult carotid-femoral Pulse Wave Velocity (cfPWV) and augmentation pressure index (AIx).

Design

This study including 1598 participants, 340 elderly subjects and 1258 young-middle aged subjects from the Malmö Offspring Study with data on birth weight and gestational age (GA). Participants underwent cfPWV and AIx measurements with Sphygmocor® (AtCor, Australia). Analysis of data was performed with multiple linear regression models with adjustments for age, sex, GA, and risk factors. Furthermore, comparisons were made between participants born prematurely or at term, or born small-for-gestational-age (SGA) or appropriate-for-gestational-age (AGA).

Results

Birth weight was positively associated with cfPWV after full adjustment (b = 0.057; p < 0.001), Figure 1, a finding that remained significant in the younger age group 18–27 years (b = 0.138, p = 0.008). Furthermore, birth weight was inversely associated with AIx (b = −0.058, p = 0.001). Subjects born SGA had significantly higher AIx (p = 0.007) and MAP (p = 0.037) compared to AGA born. Preterm-born subjects showed significantly higher systolic blood pressure compared to term-born (p = 0.034). Also, BW was inversely associated with MAP (b = −0.058, p = 0.017) and SBP (b = −0.047, p = 0.031), respectively.

Conclusion

Our findings suggest that changes in total peripheral resistance, rather than decreased arterial stiffness, may explain the observed inverse association between birth weight and SBP. Furthermore, the association between birth weight and cfPWV, shown strongest in the youngest age group (birth cohort), could possibly be explained by increasing maternal overweight/obesity. This calls for screening of risk factors in subjects with adverse conditions at birth.
Validation of a Method to Estimate Stroke Volume from Brachial-cuff Derived Pressure Waveforms
Authors: Weber Thomas , Wassertheurer Siegfried , Middlemiss Jessica , McEniery Carmel Mary , Hametner Bernhard , Mayer Christopher Clemens , Binder Ronald Karl , Feistritzer Hans-Josef , Klug Gert , Metzler Bernhard
Published: March 2020

Background

Steady state hemodynamics [Stroke Volume - SV, cardiac output, peripheral resistance (Rp)] have attracted researchers in hypertension for decades. However, due to technical difficulties, they never entered clinical medicine.

Objective

To investigate the performance of a model-based algorithm, utilizing brachial pressure waveforms obtained with a cuff, to estimate stroke volume. The model combines a modified three-element like Windkessel system and transmission line theory.

Participants and Methods

In study 1, 97 patients with reperfused acute myocardial infarction and two healthy controls underwent cardiac magnetic resonance imaging (1.5 Tesla Magnetom, Siemens, Germany), and SV was measured with standard protocols from short axis cine images (11 slices). In study 2, 19 healthy individuals (12 females) had SVs measured with inert gas rebreathing at rest, and during light exercise (20 watts) on a bicycle ergometer. In both studies, model-based SV, estimated with a brachial cuff, was the comparator.

Results

In study 1, both SVs were moderately correlated (r = 0.54, p < 0.001). Using the method of Bland–Altman, mean difference between both methods was 8.7 ml (1.96 limits of agreement were 36.7 and –19.3 ml), with no systematic bias. In study 2, both SVs were moderately correlated at rest (r = 0.63, p = 0.004) and at light exercise (r = 0.70, p = 0.0057). Using the method of Bland-Altman, mean difference between both methods was 8.6 ml (1.96 limits of agreement were 39.2 and –22.0 ml) at rest, and 42.7 ml (1.96 limits of agreement were 95.4 and –10.1 ml) at light exercise.

Conclusion

Brachial oscillometry and mathematical modeling provide a reasonable estimate of SV under static conditions, which may be a useful addition to 24-h measurements of blood pressure and pulsatile hemodynamics.
Peningkatan Keterampilan ICT untuk Guru melalui Pelatihan Konten Digital Pembelajaran Berbasis Sumber Terbuka (Open Sources)
Authors: Slamet Taufik Ikhsan , Alfiansyah Agung , Al Maki Wikky F , Musyafa Fathoni A , Satyaputra Alfa , Fathoni Patmah , Andayani Shinta S , Melinda Sherly , Oktavianus Dominggus , Yusuf Nuiza P
Published: March 2020

ABSTRAK Pemanfaatan dan pengembangan konten digital adalah persyaratan yang harus terpenuhi untuk menjadi guru profesional Abad 21. Hal ini yang kemudian membuat adanya kebutuhan mendesak dikalangan guru yang sudah lama berkecimpung dalam profesi pendidikan. Berdasarkan survey yang dilakukan melalui kuesioner online (Google Form), responden (n=83) dari beberapa sekolah dan beberapa mata pelajaran mengayatakan bahwa kebutuhan keterampilan pembuatan konten digital pembelajaran merupakan prioritas utama (n=42) dan diikuti kebutuhan pembuatan online classroom and mobile learning (n=38). Artikel ini bertujuan untuk menyampaikan identifikasi masalah, analisa kurikulum, implementasi solusi, dan evaluasi hasi dari kegiatan pengabdian pada masyarakat dalam bentuk pelatihan pengembangan konten digital pembelajaran untuk guru di Kota Tangerang. Kata Kunci: konten digital; pembelajaran informatika; sumber terbuka.ABSTRACT Digital content development and utilization are considered as high requirements that must be mastered by qualified teachers in this 21st century learning. The needs eventually create gaps between prior teachers’ competencies and the requirements for further qualifications. An online survey delivered through Google form was conducted to validate this hypothesis. The survey found that respondents (n=83) who were school teachers from different learning subjects expressed that they demanded new skills on digital content development and utilization. It was considered as the highest priority (n=42) among any others skills related technology enhanced learning, such as online classroom or mobile learning (n=38). This article is aimed to describe the process of problem identification, curriculum analysis, the implementation of solution, and program evaluation of a community service activities entitled ‘Training of Digital Content Development for School Teachers’. Keywords: computer science education; digital content; open sources.