• MeSH
• algoritmy MeSH
• krevní tlak MeSH
• manometrie MeSH
• monitorování fyziologických funkcí metody   MeSH
• obstrukční spánková apnoe diagnóza   MeSH
• počítačové zpracování signálu MeSH
• rizikové faktory MeSH

BACKGROUND: Peripheral wave reflection augments central blood pressure and contributes to cardiac load. This pressure augmentation is not quantifiable from brachial cuff pressure but can be determined from carotid pulsations using the augmentation index (AI). However, carotid tonometry is technically challenging and difficult to standardize in practice. We tested whether automated radial pressure analysis provides a viable alternative. METHODS AND RESULTS: Carotid and radial AI (cAI, rAI) were measured in 46 volunteers with a broad range of arterial properties. Data were assessed at rest, during a cold-pressor test, and following 0.4 mg of sublingual nitroglycerin. cAI correlated with rAI independent of age, mean blood pressure (BP), gender or body mass (cAI = 0.79 x rAI - 0.467, r = 0.81, P < 0.00001), with zero mean bias. There was individual variability in the prediction (difference of -4 +/- 23%), though 65% of the estimates fell within 15% of each other. Change in rAI and cAI with provocative maneuvers also correlated (r = 0.77, P < 0.001). Both cAI and rAI were nonlinearly related to late-systolic pressure-time integral (PTI), an index of cardiac load. At cAI < 0.1 or rAI < 0.69, PTI was unaltered, while greater values correlated with increased PTI. rAI accurately predicted this cut-off in 88% of cases, with a 5.5% false negative rate. CONCLUSIONS: Automated rAI analysis is an easily applied method to assess basal and dynamic central pressure augmentation. While individual predictive accuracy of cAI was variable, overall population results were consistent, supporting use of rAI in clinical trials. Its prediction of when AI is associated with greater LV loading (i.e. cardiac risk) is good and may help stratify individual risk along with brachial cuff pressure.

• MeSH
• arteria radialis fyziologie   MeSH
• arteriae carotides fyziologie   MeSH
• dospělí MeSH
• financování organizované MeSH
• hypertenze diagnóza   patofyziologie   MeSH
• kontrakce myokardu fyziologie   MeSH
• krevní tlak fyziologie   MeSH
• lidé středního věku MeSH
• lidé MeSH
• manometrie metody   přístrojové vybavení   MeSH
• měření krevního tlaku metody   přístrojové vybavení   MeSH
• mladiství MeSH
• pružnost MeSH
• pulzatilní průtok fyziologie   MeSH
• rychlost toku krve fyziologie   MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• mužské pohlaví MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• ženské pohlaví MeSH

Background: We tested whether the level of endothelial dysfunction assessed by digital tonometry, and expressed as reactive hyperemia index (RHI), is related to occurrences of a discrepancy between fractional flow reserve (FFR) and the instantaneous wave free ratio (iFR) (ClinicalTrials.gov identifier: NCT03033810).Methods: We examined patients with coronary stenosis in the range of 40-70%, assessed by both FFR and iFR (system Philips-Volcano) for stable angina. We included consecutive patients with FFR and iFR in one native coronary artery, and who had had no previous intervention.Results: We included 138 patients. Out of those, 24 patients (17.4%) had a negative FFR (with an FFR value >0.8) and positive iFR (with a iFR value ≤0.89) - designated the FFRn/iFRp discrepancy group, and 22 patients (15.9%) had a positive FFR (≤0.8) and negative iFR (>0.89) - designated the FFRp/iFRn discrepancy. RHI was higher in the discrepancy groups compared the group without discrepancy (1.73 ± 0.79 vs. 1.48 ± 0.50, p = 0.025). However, this finding was not confirmed in multivariant logistic regression analyses. Patients with any type of discrepancy differed from the agreement group by having a higher occurrence of diabetes mellitus [9 patients (21.4%) vs. 36 patients (39.6%), p = 0.029], active smoking (23 patients or 54.8% vs. 26 patients or 28.6%, p = 0.003) and lower use of calcium channel blockers (9 patients, 21.4%, vs. 43 patients, 46.7%, p = 0.004).Conclusion: The presence of endothelial dysfunction can be associated with a discrepancy in FFR/iFR. However, RHI correlated with risk factors of atherosclerosis, not with FFR or iFR.

• MeSH
• cévní endotel patofyziologie   MeSH
• cévní rezistence MeSH
• frakční průtoková rezerva myokardu * MeSH
• koronární stenóza * diagnóza   patofyziologie   MeSH
• laser doppler flowmetrie * přístrojové vybavení   metody   MeSH
• lidé MeSH
• manometrie přístrojové vybavení   metody   MeSH
• mikrocirkulace fyziologie   MeSH
• navrhování softwaru * MeSH
• počítačové zpracování obrazu MeSH
• senioři MeSH
• software MeSH
• zobrazování myokardiální perfuze metody   MeSH
• Check Tag
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• pozorovací studie MeSH

OBJECTIVE: Angiotensin II and aldosterone, generated by the angiotensin-converting enzyme (ACE) and aldosterone synthase (CYP11B2), respectively, not only regulate sodium and water homeostasis, but also influence vascular remodeling in response to high blood pressure. In the European Project on Genes in Hypertension (EPOGH), we therefore investigated whether the ACE I/D and CYP11B2 C-344T polymorphisms influence early arterial wave reflections, a measure of vascular stiffness. METHODS: We measured the peripheral and central augmentation index of systolic blood pressure by applanation tonometry at the level of the radial artery in 622 subjects (160 families and 64 unrelated individuals) randomly recruited from three European populations, whose average urinary sodium excretion ranged from 196 to 245 mmol/day. In multivariate analyses, with sodium excretion analyzed as a continuous variable, we explored the phenotype-genotype associations by means of generalized estimating equations and the quantitative transmission disequilibrium test. RESULTS: The peripheral and central augmentation indexes were significantly higher in CYP11B2 -344C allele carriers than in -344T homozygotes. In offspring, early wave reflections increased with the transmission of the -344C allele. This effect of the CYP11B2 polymorphism occurred in subjects with a higher than median urinary sodium excretion (210 mmol/day). The ACE I/D polymorphism did not influence augmentation of systolic blood pressure. CONCLUSIONS: The CYP11B2 C-344T polymorphism affects arterial stiffness. However, sodium intake seems to modulate this genetic effect.

• MeSH
• alely MeSH
• angiotensin konvertující enzym genetika   MeSH
• arterie patofyziologie   MeSH
• cytochrom P450 CYP11B2 genetika   MeSH
• cytosin MeSH
• delece genu MeSH
• dospělí MeSH
• heterozygot MeSH
• hypertenze genetika   patofyziologie   MeSH
• krevní tlak genetika   MeSH
• lidé středního věku MeSH
• lidé MeSH
• natriuréza MeSH
• polymorfismus genetický MeSH
• thymin MeSH
• transpozibilní elementy DNA MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH

BACKGROUND: We investigated the heritability and familial aggregation of various indexes of arterial stiffness and wave reflection and we partitioned the phenotypic correlation between these traits into shared genetic and environmental components. METHODS: Using a family-based population sample, we recruited 204 parents (mean age, 51.7 years) and 290 offspring (29.4 years) from the population in Cracow, Poland (62 families), Hechtel-Eksel, Belgium (36), and Pilsen, the Czech Republic (50). We measured peripheral pulse pressure (PPp) sphygmomanometrically at the brachial artery; central pulse pressure (PPc), the peripheral augmentation indexes (PAIxs) and central augmentation indexes (CAIxs) by applanation tonometry at the radial artery; and aortic pulse wave velocity (PWV) by tonometry or ultrasound. In multivariate-adjusted analyses, we used the ASSOC and PROC GENMOD procedures as implemented in SAGE and SAS, respectively. RESULTS: We found significant heritability for PAIx, CAIx, PPc and mean arterial pressure ranging from 0.37 to 0.41; P < or = 0.0001. The method of intrafamilial concordance confirmed these results; intrafamilial correlation coefficients were significant for all arterial indexes (r > or = 0.12; P < or = 0.02) with the exception of PPc (r = -0.007; P = 0.90) in parent-offspring pairs. The sib-sib correlations were also significant for CAIx (r = 0.22; P = 0.001). The genetic correlation between PWV and the other arterial indexes were significant (rhoG > or = 0.29; P < 0.0001). The corresponding environmental correlations were only significantly positive for PPp (rhoE = 0.10, P = 0.03). CONCLUSION: The observation of significant intrafamilial concordance and heritability of various indexes of arterial stiffness as well as the genetic correlations among arterial phenotypes strongly support the search for shared genetic determinants underlying these traits.

• MeSH
• aorta fyziologie   MeSH
• arteria brachialis fyziologie   MeSH
• arteria radialis fyziologie   MeSH
• arterie fyziologie   MeSH
• dospělí MeSH
• fenotyp MeSH
• hypertenze genetika   patofyziologie   MeSH
• krevní tlak genetika   MeSH
• lidé středního věku MeSH
• lidé MeSH
• pulzatilní průtok fyziologie   MeSH
• rodina MeSH
• senioři MeSH
• životní prostředí MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Research Support, N.I.H., Extramural MeSH
• Geografické názvy
• Belgie MeSH
• Česká republika MeSH
• Polsko MeSH

While risk scores are invaluable tools for adapted preventive strategies, a significant gap exists between predicted and actual event rates. Additional tools to further stratify the risk of patients at an individual level are biomarkers. A surrogate endpoint is a biomarker that is intended as a substitute for a clinical endpoint. In order to be considered as a surrogate endpoint of cardiovascular events, a biomarker should satisfy several criteria, such as proof of concept, prospective validation, incremental value, clinical utility, clinical outcomes, cost-effectiveness, ease of use, methodological consensus, and reference values. We scrutinized the role of peripheral (i.e. not related to coronary circulation) noninvasive vascular biomarkers for primary and secondary cardiovascular disease prevention. Most of the biomarkers examined fit within the concept of early vascular aging. Biomarkers that fulfill most of the criteria and, therefore, are close to being considered a clinical surrogate endpoint are carotid ultrasonography, ankle-brachial index and carotid-femoral pulse wave velocity; biomarkers that fulfill some, but not all of the criteria are brachial ankle pulse wave velocity, central haemodynamics/wave reflections and C-reactive protein; biomarkers that do no not at present fulfill essential criteria are flow-mediated dilation, endothelial peripheral arterial tonometry, oxidized LDL and dysfunctional HDL. Nevertheless, it is still unclear whether a specific vascular biomarker is overly superior. A prospective study in which all vascular biomarkers are measured is still lacking. In selected cases, the combined assessment of more than one biomarker may be required.

• MeSH
• analýza nákladů a výnosů MeSH
• arteriae carotides ultrasonografie   MeSH
• biologické markery krev   metabolismus   MeSH
• C-reaktivní protein metabolismus   MeSH
• hemodynamika MeSH
• intimomediální šíře tepenné stěny MeSH
• kardiologie normy   MeSH
• kardiovaskulární nemoci krev   diagnóza   MeSH
• lidé MeSH
• primární prevence MeSH
• riziko MeSH
• rozhodování MeSH
• sekundární prevence MeSH
• společnosti lékařské MeSH
• stárnutí MeSH
• tlakový index kotník-paže MeSH
• tuhost cévní stěny MeSH
• ultrasonografie MeSH
• výsledek terapie MeSH
• výzkumný projekt MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH
• Geografické názvy
• Evropa MeSH

Oral contraceptive pills (OCPs) have some strong advantages over more traditional types of contraception, including their consistently high contraceptive effect as well as multiple additional positive side effects. OCPs went through decades of intense pharmaceutical development and current formulas are well optimized - however, a handful of their negative side effects remain, including some that affect cardiovascular system, for example higher risk of hypertension, venous thromboembolism and increased arterial stiffness. The gold standard for arterial stiffness assessment is currently applanation tonometry, a method that relies on arterial pulse wave velocity measurement (PWV). Another possible method for arterial stiffness measurement is the use of the VaSera device, which measures cardio-ankle vascular index (CAVI). The aim of this study was to discover the effect of OCPs use on selected cardiovascular parameters related to arterial stiffness. We measured these cardiovascular parameters in the OCPs using group (OCP) and in the control group (CTRL) using applanation tonometer Sphygmocor and the VaSera device. Comparison of the data from both groups showed us significantly increased diastolic blood pressure (DBP) and carotid-radial pulse wave velocity (crPWV) as well as significantly lower subendocardial viability index (SVI) in the OCP. These results imply a negative effect of hormonal contraceptives on the cardiovascular system with most of the negative changes affecting the peripheral arteries. Despite this evidence supporting the hypothesis of OCPs having a negative effect on cardiovascular health, further research is necessary.

• MeSH
• analýza pulzové vlny * MeSH
• arteriae carotides MeSH
• arteriální tlak MeSH
• hormonální antikoncepce * škodlivé účinky   MeSH
• krevní tlak fyziologie   MeSH
• lidé MeSH
• mladiství MeSH
• pilotní projekty MeSH
• tuhost cévní stěny * fyziologie   MeSH
• Check Tag
• lidé MeSH
• mladiství MeSH
• Publikační typ
• časopisecké články MeSH

OBJECTIVES: Our aim was to assess endothelial function in physically healthy patients with schizophrenia and related psychoses and to compare the results with healthy controls. Endothelial dysfunction was shown to predict future cardiovascular events in general population so we assumed to find a higher prevalence of endothelial dysfunction in patients with psychosis, as their cardiovascular morbidity is markedly higher than in general population, and to confirm the referred correlation with the traditional cardiovascular (CV) risk factors. DESIGN: We assessed the traditional CV risk factors and endothelial function using non-invasive peripheral arterial tonometry (EndoPAT2000) in 50 stabilized and medicated schizophrenic patients (aged between 18 and 50 years) without any history of cardiovascular diseases and compared the results with 50 age-matched healthy controls. SETTING: Psychiatric Clinic, University Hospital, Hradec Kralove and 2nd Department of Internal Medicine, General University Hospital, Prague, Czech Republic RESULTS: There was no difference in relative hyperaemia index as an endothelial function measure between patients and controls (2.19±0.68 vs. 1.98±0.57, p=NS) and there were also no correlations between reactive hyperaemia index and the traditional CV risk factors, illness duration or psychotic symptoms. On the other hand, the two study groups differed significantly in almost all traditional CV risk factors.

• MeSH
• biologické markery MeSH
• cévní endotel fyziologie   MeSH
• dospělí MeSH
• kardiovaskulární nemoci epidemiologie   MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• prediktivní hodnota testů MeSH
• prevalence MeSH
• psychotické poruchy epidemiologie   MeSH
• rizikové faktory MeSH
• schizofrenie epidemiologie   MeSH
• studie případů a kontrol MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH

Syndróm obštrukčného spánkového apnoe je formou poruchy dýchania viazanej na spánok. Dochádza pri ňom k opakovanej redukcii prietoku vzduchu v horných dýchacích cestách. Intermitentné striedanie desaturácie krvi kyslíkom a následnej resaturácie hrá v patofyziológii syndrómu spánkového apnoe významnú úlohu. Intermitentná hypoxia pri syndróme spánkového apnoe spôsobuje obmedzenie dostupnosti endoteliálneho oxidu dusnatého, následné zhoršenie cievnej dilatácie závislej od endotelu a má tým kľúčový význam pre vznik endoteliálnej dysfunkcie. Endoteliálna dysfunkcia predstavuje úvodný krok v procese aterogenézy, ktorej dôsledkom sú všeobecne známe klinické komplikácie, cerebrovaskulárne ochorenia nevynímajúc.

Obstructive sleep apnea syndrome is form of a sleep-related breathing disorder. It is characterised by repetitive upper airways obstruction. Intermittent changes of the oxygen desaturation of the blood and subsequent oxygen resaturation play a significant role in the pathophysiology of the obstructive sleep apnea syndrome. Intermittent hypoxia in sleep apnea syndrome restricts the availability of endothelial nitric oxide, causes consequent worsening of the vascular endothelium-dependent dilation and has thus a key importance for the development of the endothelial dysfunction. Endothelial dysfunction represents an initial step in the process of atherogenesis, which leads to the well-known clinical complications, including cerebrovascular diseases.

Cíl: Studovat tuhost cévní stěny pacientů s ischemickou chorobou srdeční na základě prevalence aterosklerotických změn. Materiál a metody: Do studie bylo zařazeno 90 pacientů s diagnózou nestabilní anginy pectoris třídy II B, kontrolní skupinu tvořilo 27 zdravých osob. Ukazatele tuhosti tepen jako rychlost pulsní vlny (pulse wave velocity, PWV) a index augmentace (augmentation index, AIx) byly hodnoceny metodou aplanační tonometrie s použitím přístroje SphygmoCor (AtCor Medical, Austrálie). Koronarografi cké vyšetření se provádělo přístrojem Allura CV-20 (Philips, Nizozemsko); stav karotid se posuzoval duplexní sonografi í a postižení femorálních tepen se hodnotilo pomocí indexu kotník–paže < 0,9. V případě pochybností absolvoval pacient duplexní ultrazvukové vyšetření. Pacienti v hlavní skupině byli dále rozděleni do tří podskupin: podskupinu A tvořili pacienti s izolovanou koronární lézí; do podskupiny B byli zařazeni pacienti s bifokální aterosklerózou (kombinace změn na koronárních a karotických tepnách, nebo na koronárních a femorálních tepnách); podskupinu C zastupovali pacienti s multifokální aterosklerózou, která byla prokázána v třech cévních řečištích: karotickém, koronárním a femorálním. Výsledky: Hodnoty PWV (11,2 ± 1,5 m/s) a AIx (19,8 ± 5,0 %) u pacientů s ischemickou chorobou srdeční byly 1,5× (p < 0,001), resp. 2,4× (p < 0,001) vyšší než u zdravých osob. Při analýze údajů jednotlivých podskupin bylo zaznamenáno zrychlení PWV ve všech třech podskupinách, přičemž maximálních hodnot bylo dosaženo v podskupině C (13,3 ± 1,5 m/s), což dostatečně spolehlivě překračuje hodnoty tohoto parametru v podskupině A (10,1 ± 0,6; p < 0,01) i B (11,0 ± 0,9; p < 0,05). I hodnota AIx byla byla vyšší v podskupině C (26,8 ± 6,4 %) než v podskupinách A (13,7 ± 2,9 %; p < 0,001) a B (18,9 ± 4,3 %; p < 0,01). Závěr: U pacientů s ischemickou chorobou srdeční byla prokázána zvýšená tuhost cévních stěn projevující se vyšší rychlostí pulsové vlny (p < 0,001) a vyšším augmentačním indexem (p < 0,001) ve srovnání se zdravými jedinci, zatímco u pacientů s multifokální aterosklerózou (koronární, karotické a periferní tepny) byly nalezeny vyšší hodnoty AA (p < 0,05), AIx (p < 0,001), PWV (p < 0,01) a vyšší věk pacienta (p < 0,01). Na základě tohoto zjištění lze hodnocené parametry tuhosti cév považovat za zástupné (náh

Objective: To study the vascular wall stiffness in patients with coronary artery disease based on the prevalence of atherosclerotic lesion. Materials and methods: The study involved 90 patients diagnosed with unstable angina class II B, the control group consisted of 27 healthy individuals. By using the SphygmoCor (AtCor Medical, Australia) apparatus, stiffness indicators, like pulse wave velocity (PWV) and augmentation index (AIx) were studied by means of the applanation tonometry method. Coronary angiography was performed on the Allura CV-20 (Philips, The Netherlands) unit, the state of the carotid arteries was studied by duplex ultrasonography, involvement of femoral arteries was evaluated based on ankle-brachial index < 0.9. In case of doubt, the patients underwent ultrasound duplex scanning. In the main group, patients were divided into 3 subgroups: subgroup A covered patients with isolated coronary lesion; subgroup B covered patients with bifocal atherosclerosis (combined lesion of coronary and carotid arteries or coronary and femoral arteries); subgroup C was represented by multifocal atherosclerosis patients who had atherosclerosis lesion in three vascular basins: carotid, coronary and femoral arteries. Results: Values of PWV (11.2 ± 1.5 m/s) and AIx (19.8 ± 5.0%) in patients with coronary heart disease were 1.5 (p < 0.001) and 2.4 (p < 0.001) times higher than in those in healthy individuals. During the analysis carried out within the groups, the PWV in all three subgroups was accelerated with maximal values in the subgroup C (13.3 ± 1.5 m/s), which with sufficient level of confidence exceeds the value of this index in the subgroups A (10.1 ± 0.6, p < 0.01) and B (11.0 ± 0.9, p < 0.05). The value of AIx was also highest in the subgroup C (26.8 ± 6.4%), relative to the subgroups A (13.7 ± 2.9%, p < 0.001) and B (18.9 ± 4.3%, p < 0.01). Conclusion: Patients with coronary heart disease, have demonstrated growing vascular wall stiffness, which is manifested in higher pulse wave velocity (p < 0.001) and augmentation index (p < 0.001) compared with healthy individuals. Whereas in the multifocal atherosclerosis (coronary, carotid and peripheral arteries) were higher AA (p < 0.05), AIx (p < 0.001), PWV (p < 0.01) and the age of patients (p < 0.01). That allows to consider the studied parameters of vascular stiffness as surrogate markers to assess prevalence and progression of atherosclerosis, as well as the effectiveness of pharmacological interventions.

• MeSH
• analýza pulzové vlny MeSH
• ateroskleróza * patofyziologie   MeSH
• dospělí MeSH
• ischemická choroba srdeční * patofyziologie   MeSH
• klinická studie jako téma MeSH
• koronární angiografie metody   MeSH
• lidé středního věku MeSH
• lidé MeSH
• senioři MeSH
• tuhost cévní stěny * MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH