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クラウド カーディオロジ スマホ 富士の国 心電図伝送

スキー&スノーボード2004-2005

Arterial Stiffness

Obtaining arterial stiffness indices from simple arm cuff
measurements: the holy grail?
Pierre Boutouyriea,b, Miriam Reverac,d and Gianfranco Paratic,d
Journal of Hypertension 2009, 27:2159–2161
aUniversite´ Paris Descartes; INSERM, U970, bDepartment of Pharmacology,
Assistance Publique-Hoˆ pitaux de Paris, Hoˆ pital Europe´en Georges Pompidou,
Paris, France, cDepartment of Clinical Medicine and Prevention, Milano-Bicocca
University and dDepartment of Cardiology, IRCCS San Luca Hospital, Istituto
Auxologico Italiano, Milan, Italy
Correspondence to Professor Gianfranco Parati, MD, Department of Cardiology,
San Luca Hospital, Istituto Auxologico Italiano, Via Spagnoletto 3, 20149 Milan,
Italy
Tel: +39 02 6191 12890; fax: +39 02 6191 12956;
e-mail: gianfranco.parati@unimib.it
See original paper on page 2186
Precise assessment of cardiovascular risk factors is a
necessary step for the identification of patients at high
risk of developing cardiovascular events. When setting
the operating curve of the risk function, measurement of
blood glucose and lipids, estimation of blood pressure
(BP) levels, identification of smoking status, and assessment
of existing organ damage represent the main determinants
of the tendency to develop cardiac and vascular
problems over and above the impact of nonmodifiable
factors such as age and sex. Each of these classical risk
factors is included in a risk function specific to a given
population and aimed at yielding absolute quantitative
values of cardiovascular risk [1,2]. Such an approach
# by suwataisya | 2014-05-28 17:28 | 動脈硬化

Arterial Stiffness

Assessment of arterial stiffness in hypertension: comparison of oscillometric (Arteriograph), piezoelectronic (Complior) and tonometric (SphygmoCor) techniques.
Abstract
BACKGROUND
Arterial stiffness, measured as aortic pulse wave velocity (PWV), and wave reflection, measured as augmentation index (AIx), are independent predictors for total and cardiovascular morbidity and mortality. The aim of this study was to compare a new device, based on oscillometric pressure curves (Arteriograph), which simultaneously measures PWV and AIx, with standard techniques for measuring PWV (Complior) and AIx (SphygmoCor) in untreated hypertensive patients.
METHODS
We compared PWV and AIx measured using the Arteriograph with corresponding Complior and SphygmoCor measurements in 254 untreated hypertensive patients, age 48 +/- 14 years (mean +/- SD, range 17-85 years).
RESULTS
Arteriograph PWV and AIx were closely related with Complior (r = 0.60, P < 0.001) and SphygmoCor (r = 0.89, P < 0.001), respectively. Using stepwise regression analysis, the independent determinants of Arteriograph PWV were age, mean arterial pressure, heart rate and sex (r(2) = 0.44, P < 0.0001) and for AIx were age, weight, mean arterial pressure, heart rate and sex (r(2) = 0.65, P < 0.0001). The bias between the different techniques was determined by age and sex for PWV and age, body weight, sex, heart rate and mean arterial pressure for AIx. Bland-Altman plots showed that although the techniques were closely related, the limits of agreement were wide.
CONCLUSION
Although Arteriograph values and the determinants of PWV and AIx are in close agreement with corresponding parameters obtained by Complior and SphygmoCor, respectively, the techniques are not interchangeable.
# by suwataisya | 2014-05-28 17:27 | 動脈硬化

Arterial Stiffness

Abstracts of the American Society of Hypertension, Inc.
28th Annual Scientific Meeting and Exposition, San Francisco, USA May 15-18, 2013
The Journal of Clinical Hypertension, 2013, Volume 15,
May 2013 Abstract Supplement
28th Annual Scientific Meeting and Exposition
San Francisco, USA May 15-18, 2013.
________________________________________
Acute Coronary Syndrome Patients: How Stiff are their Arteries?
Deaconu Alexandru Ioan 1 , Tautu Oana Florentina 1 , Fruntelata Ana Gabriela 2 , Dorobantu Maria 1
1 Emergency Hospital of Bucharest, Bucharest, Romania;
2 Monza Cardiovascular Center, Bucharest, Romania
Several non-invasive methods are currently used to assess vascular stiffness. Pulse wave velocity (PWV) and the augmentation index (AIx) are the two major non-invasive methods of assessing arterial stiffness. A large amount of evidence indicates that carotid-femoral PWV is an intermediate endpoint for cardiovascular (CV) events, either fatal or non-fatal. Central AIx and pulse pressure have shown an independent predictive value for CV events in hypertensives and patients with coronary disease. Studies of arterial stiffness in patients with cardiovascular emergencies and acute coronary syndromes, respectively, are missing.
We performed measurements of arterial stiffness parameters using the TensioMed Arteriograph in 34 patients admitted for acute coronary syndromes (ACS), 24 hours after admission. The study group included 28 males (82.4%) and mean age was 61.7 ± 14.07 years. Arterial stiffness parameters as aortic PWV, aortic AIx, central systolic blood pressure (aortic SBP), central pulse pressure (aortic PP) were analyzed in relation to clinical, historical and paraclinical parameters in order to describe particularities in this patient population. We compared the results with an age and sex adjusted population of 34 controls randomly selected from the most recent Romanian cross-populational statistical survey, SEPHAR II.
In our group, 45.7% of patients were hypertensive and 37.1% were diabetic. Most of the patients were on treatment with ACE inhibitors (91.4%) and beta-blockers (80%), while 71.1% were on intravenous or oral nitrates. Mean stiffness parameters in this group were: aortic AIx=28.51 + 10.81, with only 14.8% of patients showing normal values; aortic PWV = 9.71 ± 1.82 m/s; aortic SBP = 121.71 ± 21.07 mm Hg; aortic PP = 44.39 ± 13.74 mm Hg. No correlations were identified in this small group between arterial stiffness parameters and treatment, history of hypertension or diabetes, type of ACS and angiographic coronary anatomy. While aortic AIx was clearly abnormal, reflecting changes in endothelial function and waves’ reflection, the other parameters of arterial stiffness were not different from other patient populations.
Aortic AIx is abnormally increased in patients with acute coronary syndromes. Parameters of arterial stiffness in patients with ACS are not related to treatment, type of coronary disease or previous patient history.
# by suwataisya | 2014-05-28 17:26 | 動脈硬化

Arterial Stiffness

Invasive Validation of Arteriograph Estimates of Central Blood Pressure in Patients With Type 2 Diabetes
1.Niklas Blach Rossen1,2,
2.Esben Laugesen2,
3.Christian Daugaard Peters3,
4.Eva Ebbehøj2,
5.Søren Tang Knudsen2,
6.Per Løgstrup Poulsen2,
7.Hans Erik Bøtker4 and
8.Klavs Würgler Hansen1
+ Author Affiliations
1.1 Department of Medicine, Silkeborg Regional Hospital, Silkeborg, Denmark;
2.2 Department of Endocrinology and Internal Medicine, Aarhus University Hospital, Aarhus, Denmark;
3.3 Department of Renal Medicine, Aarhus University Hospital, Aarhus, Denmark;
4.4 Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark.
1.Correspondence: Niklas Blach Rossen (niklas.rossen@rm.dk).
Received April 15, 2013.
Revision received August 6, 2013.
Accepted August 7, 2013.
Abstract
BACKGROUND Central blood pressure (BP) has attracted increasing interest because of a potential superiority over brachial BP in predicting cardiovascular morbidity and mortality. Several devices estimating central BP noninvasively are now available. The aim of our study was to determine the validity of the Arteriograph, a brachial cuff-based, oscillometric device, in patients with type 2 diabetes.
METHODS We measured central BP invasively and compared it with the Arteriograph-estimated values in 22 type 2 diabetic patients referred to elective coronary angiography.
RESULTS The difference (invasively measured BP minus Arteriograph-estimated BP) in central systolic BP (SBP) was 4.4±8.7mm Hg (P = 0.03). The limits of agreement were ±17.1mm Hg.
CONCLUSIONS Compared with invasively measured central SBP, we found a systematic underestimation by the Arteriograph. However, the limits of agreement were similar to the previous Arteriograph validation study and to the invasive validation studies of other brachial cuff-based, oscillometric devices. A limitation in our study was the large number of patients (n = 14 of 36) in which the Arteriograph was unable to analyze the pressure curves. In a research setting, the Arteriograph seems applicable in patients with ty
# by suwataisya | 2014-05-28 17:25 | 動脈硬化

Arterial Stiffness

Hypertension Research (2011) 34, 202–208; doi:10.1038/hr.2010.196; published online 21 October 2010
Can arterial stiffness parameters be measured in the sitting position?
Jens Nürnberger1, Rene Michalski2, Tobias R Türk2, Anabelle Opazo Saez1, Oliver Witzke2 and Andreas Kribben2
1.1Department of Nephrology and Dialysis, HELIOS Kliniken Schwerin, Wismarsche Straße, Schwerin, Germany
2.2Department of Nephrology, University Hospital Essen, University Essen-Duisburg, Hufelandstraße, Essen, Germany
Correspondence: Dr J Nürnberger, Department of Nephrology, HELIOS Kliniken Schwerin, Wismarsche Straße 393-397, Schwerin 19049, Germany. E-mail: jens.nuernberger@uni-due.de
Received 2 May 2010; Revised 25 July 2010; Accepted 31 July 2010; Published online 21 October 2010.
Top of page
Abstract
Despite the introduction of arterial stiffness measurements in the European recommendation, pulse wave velocity (PWV) and augmentation index (AI) are still not used routinely in clinical practice. It would be of advantage if such measurements were done in the sitting position as is done for blood pressure. The aim of this study was to evaluate whether there is a difference in stiffness parameters in sitting vs. supine position. Arterial stiffness was measured in 24 healthy volunteers and 20 patients with cardiovascular disease using three different devices: SphygmoCor (Atcor Medical, Sydney, Australia), Arteriograph (TensioMed, Budapest, Hungary) and Vascular Explorer (Enverdis, Jena, Germany). Three measurements were performed in supine position followed by three measurements in sitting position. Methods were compared using correlation and Bland–Altman analysis. There was a significant correlation between PWV in supine and sitting position (Arteriograph: P<0.0001, r=0.93; Vascular Explorer; P<0.0001, r=0.87). There were significant correlations between AI sitting and AI supine using Arteriograph (P<0.0001, r=0.97), Vascular Explorer (P<0.0001, r=0.98) and SphygmoCor (P<0.0001, r=0.96). When analyzed by Bland–Altman, PWV and AI measurements in supine vs. sitting showed good agreement. There was no significant difference in PWV obtained with the three different devices (Arteriograph 7.5±1.6 m s−1, Vascular Explorer 7.3±0.9 m s−1, SphygmoCor 7.0±1.8 m s−1). AI was significantly higher using the Arteriograph (17.6±15.0%) than Vascular Explorer and SphygmoCor (10.2±15.1% and 10.3±18.1%, respectively). The close agreement between sitting and supine measurements suggests that both PWV and AI can be reliably measured in the sitting position.
Keywords:
arterial stiffness; augmentation index; PWV; pluse wave velocity
# by suwataisya | 2014-05-28 17:24 | 動脈硬化


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