bluuebunny/crossref_metadata_2025_split huggingface dataset:
P22 Central and Peripheral Contributions to Submaximal Exercise Performance in Older Adults in the SouthAll and Brent REvisited (SABRE) Study
Authors: Jones Siana , Schultz Martin , Tillin Therese , Williams Suzanne , Chaturvedi Nishi , Hughes Alun 
Published: March 2020

Abstract
Background
Functional capacity declines with age leading to disability and increased cost of health and social care. In older adults, factors that influence the ability to sustain sub-maximal exercise (a marker of functional capacity) are not well defined. We aimed to determine the contribution of cardiac function, skeletal muscle oxygen desaturation, extraction and oxidative capacity to sub-maximal exercise performance in a population-based sample of older adults.

Methods
Participants in the SABRE study undertook a 6-minute stepper test (6MST). Sub-maximal exercise performance was assessed as the highest achieved whole-body oxygen uptake (VO2) during the 6MST. Near Infrared Spectroscopy (NIRS) was used to locally assess skeletal muscle oxygen extraction, desaturation and maximum oxidative capacity. Echocardiography was used to measure cardiac function. Analysis was by multiple linear regression adjusted for confounders: age, sex, ethnicity, diabetes and obesity.

Results
395 participants (73.0 ± 6.3 years old, male; n = 229) undertook the 6MST, skeletal muscle desaturation measurements and echocardiography. Skeletal muscle desaturation and cardiac output were independently associated with whole-body VO2 (standardized β: −0.20, p < 0.001 & 0.47, p < 0.001, respectively). Local skeletal muscle oxygen extraction was independently associated with whole-body VO2 (standardized β adjusted for confounders & cardiac output: 0.32, p < 0.001). Maximum oxidative capacity was not associated with VO2 (β (95% CI: 0.02 (−0.01, 0.04), p = 0.152).

Conclusion
Local oxygen extraction and desaturation in skeletal muscle are independent predictors of sub-maximal exercise performance in older adults. These associations persist with adjustment for cardiac output suggesting local capacity to extract oxygen could be a major limiting factor functional capacity in older adults.
P24 Restored Physiological Local Carotid Pulse Wave Velocity After Bariatric Surgery in Obese Subjects
Authors: Giudici Alessandro , Morizzo Carmela , Kozakova Michaela , Losso Lorenzo , Palombo Carlo , Cruickshank Kennedy J. , Khir Ashraf 
Published: March 2020

AbstractObesity is a risk factor for cardiovascular events and is associated with increased arterial stiffness [1,2]. However, the effect of drastic changes in Body Mass Index (BMI) on arterial mechanics has not been fully investigated. Our study aimed at evaluating changes in local carotid PWV (cPWV) in obese patients before and 6 months after bariatric surgery. N = 20 obese subjects free of cardiovascular events and diabetes (44 ± 9 years, 5 men, BMI = 48.8 ± 7.5 kg/m2) undergoing bariatric surgery were recruited in the Pisa University Hospital (Italy). Flow and diameter waveforms were acquired by ultrasound scanner (Aloka Alpha10, Hitachi Group, Japan) (1 kHz) at the right common carotid artery at baseline, after a 32.4 ± 7.6 days diet period, and 6.5 ± 2.7 months post-intervention. The lnDU-loop method was used for the estimation of cPWV [3]. Basal cPWV was 6.05 ± 1.21 m/s. The 1-month diet period produced a 2 kg/m2 reduction in BMI, while cPWV decreased by approx. 0.6 m/s. 6–7 months after bariatric surgery, BMI dropped to 35.3 ± 6.5 kg/m2 and cPWV furtherly decreased of approx. 0.9 m/s reaching a mean value of 4.57 ± 1.02 m/s (76% of the basal value) (Figure 1). Bariatric surgery and the consequent intensive weight loss produced a significant decrease of arterial stiffness and restored cPWV to physiological values of age-matched healthy subjects [4]. The fast reversal of increased arterial stiffness suggests a functional mechanism possibly related to a reduced haemodynamic load. Moreover, while having a small effect on the BMI, 1-month diet regulation effectively decreased cPWV by 10%, possibly indicating the short-term positive effects of a healthy lifestyle on haemodynamics.
P36 Leukocyte Telomere Length is Inversely Associated with Wave Reflection in 566 Normotensive and Never-treated Hypertensive Subjects
Authors: Pörsti Ilkka , Honkonen Milja , Vääräniemi Kati , Saijonmaa Outi , Tikkakoski Antti , Koskela Jenni , Eräranta Arttu , Kähönen Mika , Mustonen Jukka , Fyhrquist Frej 
Published: March 2020

Abstract
Background
Telomeres are short segments in chromosome ends, the length of which is reduced during cell life-cycles. We examined the association of leukocyte telomere length and short telomere proportion with hemodynamic variables.

Methods
Altogether 566 subjects (279 women and 287 men) without cardiovascular disease and medications with direct cardiovascular influences were subjected supine recordings for 5 minutes. Haemodynamics were captured using continuous tonometric pulse wave analysis and whole-body impedance cardiography. The analyses were adjusted for age, body mass index (BMI), alcohol use, smoking, plasma chemistry, and estimated glomerular filtration rate (eGFR).

Results
In univariate analyses, leukocyte telomere length correlated with age, BMI, eGFR, aortic blood pressure, augmentation index, pulse wave velocity, and systemic vascular resistance (p < 0.05 for all). Short telomere proportion correlated with age, BMI, eGFR, aortic systolic blood pressure, augmentation index, and pulse wave velocity (p < 0.05 for all). In linear regression analyses of all hemodynamic variables, leukocyte telomere length was only an independent explanatory factor for augmentation index (Beta −0.006, p = 0.032), while short telomere proportion was not an explanatory factor for any of the hemodynamic variables, in contrast to age, BMI and several cardiovascular risk factors.

Conclusion
Augmentation index was predominantly related with chronological aging, but also with leukocyte telomere length, suggesting that this variable of central wave reflection is a moderate marker of vascular biological aging.
P38 Association of Daytime Augmentation Index with Brain-derived Neurotrophic Factor in Untreated Hypertensive Patients
Authors: Nemcsik János , Batta Dóra , Kőrösi Beáta , Nemcsik-Bencze Zsófia , László Andrea , Lénárt Lilla , Fekete Andrea 
Published: March 2020

AbstractBrain-derived neurotrophic factor (BDNF) is a neurotrophic molecule with impact on microvasculature and also with complex psychosomatic connections. The aim of our study was to evaluate its associations with 24-hour brachial and central hemodynamic parameters and arterial stiffness in untreated patients who were studied because of elevated office blood pressure. Mobil-O-Graph was used to measure the 24-hour brachial and central parameters. Serum BDNF was measured with ELISA, depression and anxiety were evaluated with questionnaires (Beck Depression Inventory and Hamilton Anxiety Scale, respectively). 73 patients were involved into the study. The average serum BDNF level was 28610 ± 7965 pg/ml. SeBDNF was correlated with daytime augmentation index (Aix, r = 0.234, p = 0.046). A borderline correlation was found with 24-hour total peripheral resistance (r = 0.227, p = 0.053). In multiple linear regression model the association between Aix and BDNF remained significant after the adjustment for age, depression and anxiety (B = 0.243, p = 0.034), but was attenuated after further adjustment for total vascular resistance (B = 0.186, p = 0.106). In conclusions, the impact of BDNF on microvasculature can have physiological importance as through the mediation of total vascular resistance it can influence pulse wave reflection.
P41 24 h Arterial Stiffness Measurement on Healthy and COPD Patients
Authors: Böcskei R. M. , Benczúr B. , Bikov A. , Böcskei Cs. , Bohács A. , Husznai R. , Cziráki A. 
Published: March 2020

Abstract
Introduction
Chronic obstructive pulmonary disease (COPD) is currently one of the leading causes of death worldwide. COPD frequently occur together with cardiovascular disease. The coexistence of the two diseases are associated with worse outcomes than either condition alone. ABPM and 24 h arterial stiffness parameters were measured in stabile COPD patients, who were free from any cardiovascular disease and control individuals for the detection of increased cardiovascular risk and for the detection of early atherosclerosis in COPD.

Methods
We measured 23 healthy (54 ± 9.1 years) and 26 COPD (57 ± 9 years) subjects in the study. ABPM and 24 h arterial stiffness parameters were oscillometrically measured with Arteriograph 24.

Results
We have found significant higher day- and night averages in systolic blood pressure (SBPbr) {p = 0.032, p < 0.001} systolic aortic blood pressure (SBPao) {p < 0.001, p < 0.001} aortic pulse wave velocity (PWVao) {p < 0.001, p < 0.001} and aortic augmentation index (Aixao) {p < 0.001, p < 0.001} in COPD patients than controls. In 26% of COPD patients did not reduced the nighttime blood pressure compared to daytime systolic blood pressure.

Conclusion
In this study we found elevated day- and night blood pressure and arterial stiffness parameters in COPD patients. These results are indicating the presence of earlier atherosclerosis and higher cardiovascular risk in patients with COPD than in control individuals.
P50 The Administration of Losartan/Amlodipine in Fixed Combination Versus Losartan Improves the Hemodynamic and Arterial Stiffness Parameters in Patients with Systemic Hypertension Grade 1 and 2
Authors: Jimenez Mayra , Grover Fernando , Barocio Marycruz , Cardona Ernesto , Quezada Patricia , Trujillo Jhonatan , Cardona David , Ramos Carlos 
Published: March 2020

Abstract
Purpose/Background/Objectives
Hypertension (HAS) represents 9.4 million deaths from all the cases of cardiovascular disease worldwide [1]. The pulse wave velocity (PWV) and some hemodynamic parameters have been associated with this outcome [2,3]. Losartan, as well as amlodipine, have shown benefits on hemodynamic parameters [4,5] however, it is unknown if losartan/amlodipine combination is better than losartan as a monotherapy. We evaluated losartan/amlodipine effect in a fixed combination versus losartan on hemodynamic and arterial stiffness parameters in patients with systemic arterial hypertension.

Design and Methods
We conducted a randomized, double-blind study in 28 hypertensive patients according to AHA criteria 2017 [6]. 14 patients received losartan 100 mg per day and 14 losartan/amlodipine 100/5 mg per day, for 8 weeks. Hemodynamic parameters and arterial stiffness measurement were performed with a Mobil-O-Graph® [7].

Results
The combination of losartan/amlodipine improved hemodynamic and arterial stiffness parameters compared with losartan, reducing peripheral vascular resistance (RVP) (0.10 ± 0.08 vs 0.05 ± 0.08), PWV (0.52 ± 0.45 vs 0.33 ± 0.359), daytime PWV (7.24 ± 0.90 vs 7.61 ± 1.03), nocturnal PWV (6.86 ± 0.96 vs 7.27 ± 1.17) and diastolic blood pressure (DBP) (11.21 ± 6.15 vs 5.92 ± 7.65).d)

Conclusion
We did not find differences between single or combined medication in terms of BP reduction. However, arterial stiffness parameters were better in the combined therapy.
P52 The Long-term Effects of Transcatheter Aortic Valve Implantation on Aortic Stiffness
Authors: Gardikioti Vasiliki , Terentes-Printzios Dimitrios , Vlachopoulos Charalambos , Toutouzas Konstantinos , Christoforatou Evangelia , Xanthopoulou Maria , Benetos Georgios , Latsios Georgios , Siasos Gerasimos , Mpei Evangelia , Vavuranakis Manolis , Tousoulis Dimitrios 
Published: March 2020

Abstract
Purpose/Background/Objectives
Aortic stiffness and hemodynamics are independent predictors of adverse cardiovascular events. Transcatheter aortic valve implantation (TAVI) is growingly used in high surgical risk patients with aortic valve stenosis. We sought to investigate the effect of TAVI on aortic stiffness.

Methods
Fifty-five high-risk patients (mean age 79.5 ± 8.8 years, 46% males) with severe symptomatic aortic stenosis undergoing TAVI were included. Arterial stiffness was estimated through carotid-femoral pulse wave velocity (cfPWV). Measurements were conducted prior to the implantation, at discharge and 1 year post-TAVI.

Results
Prior to the implantation, cfPWV was 7.5 ± 1.4 m/s for the overall population. There was a statistically significant increase in measurements of aortic stiffness at discharge (7.5 ± 1.4 vs 8.3 ± 1.9 m/s for cfPWV with p = 0.043) without a statistically significant change in SBP (p = NS) (Figure 1). There was also a significant increase in cfPWV (8.7 ± 1.8 m/s) after 1 year compared to the pre-procedural assessment (p = 0.001). We also observed a non-significant increase in peripheral SBP at 1 year compared to SBP measurements at baseline and at discharge (153 ± 24 m/s vs 147 ± 21and 148 ± 22 m/s, respectively; p = 0.319) and these changes were independent of age and gender (Figure 1).

Conclusion
Our study shows that both shortly as well as in the long-term after TAVI subjects experience an increase in aortic stiffness that is independent of changes in SBP. These findings further elucidate the hemodynamic consequences and provide evidence of a possible long-standing repercussion of TAVI.
P54 Age-specific, Pressure-independent Acute Changes in Carotid-femoral Pulse Wave Velocity During Head-up Tilt
Authors: Pucci Giacomo , Avolio Alberto , Spronck Bart , Vaudo Gaetano , Anastasio Fabio , Van den Meiracker Anton H. A. H. , Mattace-Raso Francesco U. S. 
Published: March 2020

Abstract
Introduction
Acute, gravity-induced blood pressure (BP) changes during head-up tilt may generate concomitant variations in carotid-femoral pulse wave velocity (cf-PWV). We aimed to separate the pressure-dependent and -independent components of cf-PWV changes observed during head-up tilt.

Methods
30 healthy individuals (age 48 ± 18 years (mean ± SD), 38% males, BP 130/74 ± 12/8 mmHg) underwent head-up passive tilting at a = 0°, 30°, and 60°. BP was taken at the upper arm, constantly kept at heart level. Aortic BP was reconstructed from radial tonometry (SphygmoCor). Stiffness index b0 was estimated at 0°. 1 Assumptions: [1] from MRI2, the effective cf-PWV travel distance (ETD, 80% of straight carotid-to-femoral distance) begins at heart level; [2] the change in DBP along the aorta is predictable from the hydrostatic pressure gradient (0.73 mmHg/cm) 3; [3] cf-PWV and hydrostatic pressure relate linearly, hence predicted cf-PWV can be calculated as the average of aortic (PWVaorta, using b0 and aortic DBP) and femoral (PWVfem, using b0 and femoral DBP, corresponding to aortic DBP + (ETD × sin(a)*0.73)) PWVs.

Results
Both young (24–48 years) and old (48–82 years) individuals showed increasing trends for peripheral SBP, DBP, PP, and central DBP with tilting; central SBP remained unchanged. Heart rate (HR) and cf-PWV increased with body tilt in both groups (Figure, left). b0 linearly correlated with age (R = 0.70, p < 0.01). After adjustment for HR4, observed-vs-predicted cf-PWV exponentially increased as a function of age (R2 = 0.38, p < 0.01 for quadratic equation, p = 0.04, vs. linear; Figure, right).

Conclusion
With aging, the acute relationship between BP and cf-PWV becomes progressively nonlinear.
P56 Renal Endovascular Interventions in Szeged Nephrology-Hypertension Center Between 2007–2016
Authors: Légrády Péter , Nádasdi Bernadett , Letoha Annamária , Gyói Alexandra , Bajcsi Dóra , Constantinou Kypros , Fejes Imola , Nagy Endre , Szakál Tibor , Vörös Erika , Sonkodi Sándor , Ábrahám György 
Published: March 2020

AbstractThere is no consensus on the antihypertensive effect and on the ability to preserve kidney function of ballon dilatations and/or stent implantation these in renal artery stenosis. From 2007 to 2016 at the 1st Department of Medicine, Nephrology-Hypertension Center, University of Szeged, total of 80 patients were diagnosed with unilateral or bilateral renal artery stenosis (female n = 49; male n = 35) with angiography. 80 of the patients underwent intervention (balloon dilatation n = 13; stent implantation n = 67). Following the intervention blood pressure significantly decreased and during the follow-up (3 months after the procedure, n = 54 patients) the blood pressure remained below the initial level, while the number of antihypertensive drugs did not change significantly. The kidney function was also improved (3 months after the procedure, n = 54 patients), except for patients with bilateral renal artery stenosis. There was a positive correlation between the resting, the separated plasma renin activity and systolic blood pressure. On the contrary, we did not find correlation between the severity of the renal stenosis and the separated renin plasma activity, and between the degree of stenosis and the ultrasound resistance index. Nevertheless, the resistance index correlated with the separated plasma renin activity. According to our results the renin release may depend rather on the state of the intrarenal microvasculature, than the degree of stenosis. Furthermore, the reason why the more severe stenosis is associated with worse kidney function — regardless the state of the microvasculature — may be the reduced kidney blood circulation caused by the stenosis cannot ensure appropriate intraglomerular pressure.
P58 Structured Exercise Training is Associated with Better Post Occlusive Reactive Hyperaemia in Skeletal Muscle Measured using Near Infrared Spectroscopy (NIRS)
Authors: Rao Chirag , Jones Siana , Ezzi Khadija , Hughes Alun 
Published: March 2020

Abstract
Background
Participation in structured exercise training may improve microvascular function. Post occlusive reactive hyperaemia (PORH) is a measure of microvascular function in skeletal muscle and can be assessed using near-infrared spectroscopy (NIRS). We examined PORH following a short and a long arterial occlusion to test whether individuals who participate in more structured exercise have better PORH.

Methods
18 healthy volunteers (mean age = 23.1 (standard deviation (SD) = 4.9 y), male = 12) underwent 30 s and 5 minute arterial occlusions of the left lower leg using a cuff inflated to supra-systolic pressure. Change in oxygenated haemoglobin concentration (oxy-Hb) was measured from the gastrocnemius using NIRS (Artinis, Netherlands). PORH was measured as time to 50% (T50) of peak oxy-Hb following cuff release and a lower T50 indicates a better response. Exercise participation was categorised into high (n = 12) or low (n = 6) based on self-reported hours of structured exercise per week (high ≥4 hr per week). Results are given as median (IQR) and statistical comparison was by the Mann Whitney U-Test.

Results
High exercise participants had a greater PORH response than low exercise participants (T50: 8.0 (6.2, 9.5)s vs 12.5 (8.6, 27.2)s, p = 0.04; Figure 1a). The hyperaemic response to 30 s occlusion was also better in the high exercise group (T50: 2.4 (1.7, 6.6)s vs 4.3 (3.6, 4.9)s p = 0.17; Figure 1b), although this difference was not statistically significant.

Conclusion
Individuals who participate in more structured exercise have evidence of improved microvascular function in skeletal muscle.
P62 Estimation of Wave Intensity in Humans Using only Pressure Waveforms and Reservoir Analysis
Authors: Hughes Alun , Parker Kim , Chaturvedi Nish , Park Chloe 
Published: March 2020

Abstract
Background
Measurement of wave intensity (WI) requires simultaneous or quasi-simultaneous measurement of pressure and flow limiting its use. Previous work in dogs [1] and humans [2] has shown that the excess pressure waveforms calculated using reservoir analysis correspond closely with aortic flow waveforms. This offers a potential method to estimate WI using only pressure waveforms (pWI). We investigated the feasibility of this approach and agreement with established methods.

Methods
262 participants (68.3 (SD = 5.5); 74% male) without aortic stenosis or heart failure were recruited from a UK-based longitudinal study, Southall and Brent Revisited. Central pressure waveforms, aortic flow velocity and carotid WI were measured using tonometry (Sphygmocor, AtCor), echocardiography (iE33, Philips) and ultrasonography (SSD-5500, Aloka) respectively. Reservoir analysis was performed as previously described [2] and excess pressure waveforms were calibrated to flow velocity assuming a peak velocity of 1 m/s. Method agreement was assessed as mean difference (MD), limits of agreement (LOA) and concordance coefficient (CC).

Results
Analysis failed in 9 individuals; results for those with analysable data are shown in Table 1. Aortic pWI was higher than aortic WI but showed good concordance (logW1: MD(LOA) = −0.41(−0.73, −0.09) CC = 0.7; logW2: MD(LOA) = −0.41 (−0.73, −0.09); CC = 0.7). Agreement of pWI with carotid WI showed no bias and concordance was fair to poor (logW1: MD (LOA) = −0.16 (−1.30, 0.99) CC = 0.3; logW2: MD (LOA) = −0.02 (−1.23, 1.2); CC = 0.1).

Conclusion
Estimation of aortic WI from pressure waveforms using reservoir analysis is feasible.
Table1
Results

Variables
N
Median/(%)
p25
p75

Age, y
207
67.9
63.6
71.9

BMI, kg/m2
207
26.6
24.1
30.1

Systolic BP, mmHg
207
139
126
148

Diastolic BP, mmHg
207
76
70
82

Heart rate, bpm
207
66
59
74.5

Male sex, %
150
72.5

Ethnicity

European
88
(42.5%)

South Asian
75
(36.2%)

African Caribbean
44
(21.3%)

Current smoker
18
(8.8%)

Diabetes
65
(31.4%)

Hypertension
130
(62.8%)

Aorta

W1, mmHg.m.s−3
207
7103
5041
9910

W2, mmHg.m.s−3
207
1637
1147
2518

pW1, mmHg.m.s−3
207
10,526
7677
14,336

pW2, mmHg.m.s−3
207
2491
1779
3560

time W1 to W2, s
207
0.25
0.23
0.27

Peak velocity, m/s
207
1.34
1.2
1.46

Variables
N
Median/(%)
p25
p75

Carotid artery

W1, mmHg.m.s−3
207
8714
6550
12,883

W2, mmHg.m.s−3
207
2327
1471
3227

time W1 to W2, s
207
0.29
0.27
0.31

Peak velocity, m/s
207
1.10
0.92
1.30

BMI, body mass index; BP, blood pressure; p25, 25th centile; p75, 75th centile; pW1, peak intensity of initial forward compression wave (W1) estimated using pressure only; pW2, peak intensity of initial forward compression wave (W2) estimated using pressure only; W1, peak intensity of initial forward compression wave (W1) calculated using aortic velocity; W2, peak intensity of initial forward compression wave (W2) calculated using aortic velocity.
P63 Accuracy (Validation) of Central Blood Pressure Measurement Using the Sphygmocor Xcel-cuff Device
Authors: Schultz Martin , Picone Dean , Armstrong Matthew , Black Andrew , Dwyer Nathan , Roberts-Thomson Philip , Sharman James 
Published: March 2020

Abstract
Background
Numerous devices purport to measure central aortic BP as distinct from conventional brachial BP. This study aimed to determine the accuracy (validation) of the Sphygmocor Xcel-cuff device (AtCor Medical, Sydney, Australia) for measuring central BP.

Methods
330 patients (mean age 61.3 ± 10.6 years) undergoing coronary angiography had simultaneous measurement of invasive aortic BP and non-invasive cuff-derived central BP using the Xcel device (total n = 552 individual comparisons). Methods were undertaken according to Artery Society guidelines and several calibration techniques to derive central SBP were examined.

Results
Central SBP was significantly underestimated, and with wide variability, when using the default calibration of brachial cuff SBP/DBP (−7.7 ± 11.0 mmHg). Similar wide variability was observed using other calibration methods (cuff 33% form-factor MAP/DBP, −4.4 ± 11.5 mmHg; cuff 40% form-factor MAP/DBP, 4.7 ± 11.9 mmHg; cuff oscillometric MAP/DBP, −18.2 ± 12.1 mmHg). Only calibration with invasive aortic integrated MAP/DBP resulted in a mean difference ± SD (3.3 ± 7.5 mmHg) within the minimum tolerable error of ≤5 ± ≤8 mmHg. The difference between brachial cuff SBP and invasive aortic SBP was 3.3 ± 10.7 mmHg. A subsample (n = 151) analysis to determine the accuracy of central-to-brachial SBP amplification, showed this to be over-estimated by the Xcel device (4.3 ± 9.1 mmHg, p = 0.02).

Conclusion
Irrespective of calibration technique, the Sphygmocor Xcel-cuff device does not pass the Artery Society accuracy (validation) criteria for non-invasive measurement of central BP. Further accuracy refinements of this device are required.