Prognostic significance of the timing in the cardiac cycle of the first (TP1) and second (TP2) systolic peak of the central aortic pulse wave is ill-defined. Incidence rates and standardized multivariable-adjusted hazard ratios (HRs) of adverse health outcomes associated with TP1 and TP2, estimated by the SphygmoCor software, were assessed in the International Database of Central Arterial Properties for Risk Stratification (IDCARS) (n = 5529). Model refinement was assessed by the integrated discrimination (ID) and net reclassification (NR) improvement. Over 4.1 years (median), 201 participants died and 248 and 159 patients experienced cardiovascular or cardiac endpoints. Mean TP1 and TP2, standardized for cohort, sex, age, and heart rate, were 103 and 228 ms. Shorter TP1 and TP2 were associated with higher mortality and shorter TP1 with a higher risk of cardiovascular and cardiac endpoints (trend p ≤ 0.004). The HRs relating total mortality and cardiovascular endpoints to TP2 were 0.82 (95% confidence interval [CI]: 0.72-0.94) and 0.87 (0.77-0.98), respectively. The HR relating cardiac endpoints to TP1 was 0.81 (0.68-0.97). For total mortality and cardiovascular endpoints in relation to TP2, NRI was significant (p ≤ 0.010), but not for cardiac endpoints in relation to TP1. Integrated discrimination improvement (IDI) was not significant for any endpoint. The HRs relating total mortality to TP2 were smaller (p ≤ 0.026) in women than men (0.67 vs. 0.95) and in older (≥ 60 years) versus younger (< 60 years) participants (0.80 vs. 0.88). Our study adds to the evidence supporting risk stratification based on aortic pulse analysis by showing that TP2 and TP1 carry prognostic information.

• MeSH
• analýza pulzové vlny * metody   MeSH
• aorta patofyziologie   MeSH
• hodnocení rizik metody   statistika a číselné údaje   MeSH
• hypertenze epidemiologie   mortalita   patofyziologie   MeSH
• kardiovaskulární nemoci * mortalita   epidemiologie   MeSH
• lidé středního věku MeSH
• lidé MeSH
• prognóza MeSH
• rizikové faktory MeSH
• senioři MeSH
• srdeční frekvence fyziologie   MeSH
• systola fyziologie   MeSH
• tuhost cévní stěny fyziologie   MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

BACKGROUND: Kidney transplantation is the preferred treatment for patients with end-stage renal disease, significantly preserving kidney function and patient quality of life. However, post-transplant diabetes mellitus (PTDM) is a common complication, occurring in approximately one-third of renal transplant recipients. This study aims to evaluate the role of pulse wave parameters in predicting PTDM and to identify other pre-transplant risk factors. METHODS: This prospective cohort study included 105 patients on the kidney transplant waiting list from 2017 to 2022. Exclusion criteria included any pre-existing diabetes mellitus. Patients underwent physical examinations, laboratory analyses, and pulse wave analysis before transplantation and one year post-transplant. PTDM diagnosis followed International Consensus Guidelines. Data were analyzed using Wilcox test, Bonferroni correction, May-Whitney U-test, and Fisher's exact test, with p < 0.05 considered statistically significant. RESULTS: Post-transplant, 21% of patients were diagnosed with PTDM, increasing to 35% 3months post-transplant and 43% at one year post-transplant. Significant findings included: Pre-transplat risk factors for developing PTDM: Proteinuria (p = 0.037, OR = 3.942) and perioperative hyperglycemia (p = 0.003, OR = 4.219 at 3 months; p = 0.001, OR = 4.571 at 1 year). Pulse wave parameters for developing PTDM: Pre-transplant Aortic PP > 45 mmHg (AUC = 0.757) and PWV > 8.5 m/s (AUC = 0.730) were strong predictors of the development of PTDM after 3 months (p < 0.0001). Moreover, we found significant improvements in aortic pulse pressure (Aortic PP) and pulse wave velocity (PWV) post-transplant (p < 0.0001). CONCLUSION: Our study confirms that pulse wave parameters, such as Aortic PP and PWV, are significant predictors of PTDM in kidney transplant recipients (KTR). These findings support incorporating pulse wave analysis into routine pre-transplant evaluations to identify high-risk patients. Additionally, monitoring these parameters post-transplant may aid in early intervention and prevention of PTDM, ultimately improving patient outcomes. TRIAL REGISTRATION: Ethical approval was obtained from the Ethics Committee of Medical faculty and University Hospital Olomouc (approval no. 94/15).

• MeSH
• analýza pulzové vlny * MeSH
• chronické selhání ledvin chirurgie   etiologie   MeSH
• diabetes mellitus * etiologie   epidemiologie   MeSH
• dospělí MeSH
• kohortové studie MeSH
• lidé středního věku MeSH
• lidé MeSH
• pooperační komplikace * etiologie   diagnóza   MeSH
• prospektivní studie MeSH
• proteinurie etiologie   MeSH
• rizikové faktory MeSH
• transplantace ledvin * škodlivé účinky   MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

Pulse Wave Velocity (PWV) is widely used to assess arterial elasticity and is an independent risk factor for cardiovascular disease, but it is influenced by multiple factors. Objective is to assess the impact of blood pressure and heart rate on PWV. Twenty healthy young individuals were enlisted as subjects. Real-time blood pressure monitoring was performed by non-invasive continuous blood pressure measuring instrument during the detection of subjects' carotid PWV. During real-time blood pressure monitoring, exercise load caused fluctuations in blood pressure and heart rate, and PWV changes of each subject under different blood pressure and heart rate conditions were recorded simultaneously. Among the 20 subjects, PWV was associated with blood pressure in four subjects and heart rate in one subject. PWV increased with rising blood pressure when the systolic pressure fluctuation range was >=30mmHg, diastolic pressure fluctuation range was >=18mmHg, and mean arterial pressure fluctuation range was >=20mmHg. PWV increased with rising heart rate, when the heart rate fluctuation range was >30 beats/min. Blood pressure and heart rate have some influence on PWV. However, the fluctuation range of blood pressure and heart rate should reach a certain value, the impact is significant. Keywords: Pulse wave velocity, Blood pressure, Heart rate.

• MeSH
• analýza pulzové vlny * metody   MeSH
• dospělí MeSH
• krevní tlak * fyziologie   MeSH
• lidé MeSH
• měření krevního tlaku metody   MeSH
• mladý dospělý MeSH
• srdeční frekvence * fyziologie   MeSH
• tuhost cévní stěny fyziologie   MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• mladý dospělý MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

Pulse pressure amplification (PPA) is the brachial-to-aortic pulse pressure ratio and decreases with age and cardiovascular risk factors. This individual-participant meta-analysis of population studies aimed to define an outcome-driven threshold for PPA. Incidence rates and standardized multivariable-adjusted hazard ratios (HRs) of cardiovascular and coronary endpoints associated with PPA, as assessed by the SphygmoCor software, were evaluated in the International Database of Central Arterial Properties for Risk Stratification (n = 5608). Model refinement was assessed by the integrated discrimination (IDI) and net reclassification (NRI) improvement. Age ranged from 30 to 96 years (median 53.6). Over 4.1 years (median), 255 and 109 participants experienced a cardiovascular or coronary endpoint. In a randomly defined discovery subset of 3945 individuals, the rounded risk-carrying PPA thresholds converged at 1.3. The HRs for cardiovascular and coronary endpoints contrasting PPA < 1.3 vs ≥1.3 were 1.54 (95% confidence interval [CI]: 1.00-2.36) and 2.45 (CI: 1.20-5.01), respectively. Models were well calibrated, findings were replicated in the remaining 1663 individuals analyzed as test dataset, and NRI was significant for both endpoints. The HRs associating cardiovascular and coronary endpoints per PPA threshold in individuals <60 vs ≥60 years were 3.86 vs 1.19 and 6.21 vs 1.77, respectively. The proportion of high-risk women (PPA < 1.3) was higher at younger age (<60 vs ≥60 years: 67.7% vs 61.5%; P < 0.001). In conclusion, over and beyond common risk factors, a brachial-to-central PP ratio of <1.3 is a forerunner of cardiovascular coronary complications and is an underestimated risk factor in women aged 30-60 years. Our study supports pulse wave analysis for risk stratification.

• MeSH
• analýza pulzové vlny MeSH
• arteria brachialis fyziologie   MeSH
• dospělí MeSH
• kardiovaskulární nemoci * patofyziologie   MeSH
• krevní tlak * fyziologie   MeSH
• lidé středního věku MeSH
• lidé MeSH
• rizikové faktory kardiovaskulárních chorob MeSH
• rizikové faktory MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• metaanalýza MeSH

OBJECTIVES: We aimed to evaluate cardiovascular (CV) risk in patients with idiopathic inflammatory myopathies (IIM) compared with healthy controls (HC) and to assess its association with disease-specific features. METHODS: Ninety IIM patients and 180 age-/sex-matched HC were included. Subjects with a history of CV disease (angina pectoris, myocardial infarction and cerebrovascular/peripheral arterial vascular events) were excluded. All participants were prospectively recruited and underwent examinations of carotid intima-media thickness (CIMT), pulse wave velocity (PWV), ankle-brachial index (ABI), and body composition. The risk of fatal CV events was evaluated by the Systematic COronary Risk Evaluation (SCORE) and its modifications. RESULTS: Compared with HC, IIM patients had a significantly higher prevalence of traditional CV risk factors, carotid artery disease (CARD), abnormal ABI and PWV. After propensity score matching (using traditional CV risk factors), the prevalence of CARD and pathological PWV remained significantly higher in IIM than HC. No significant difference in SCORE was observed. The most unfavourable CV risk profile was observed in patients with necrotizing myopathy, especially in statin-induced anti-HMGCR+ patients. The calculated CV risk scores by SCORE, SCORE2 and SCORE multiplied by the coefficient 1.5 (mSCORE) were reclassified according to CIMT and the presence of carotid plaques. SCORE was demonstrated to be most inaccurate in predicting CV risk in IIM. Age, disease activity, lipid profile, body composition parameters and blood pressure were the most significant predictors of CV risk in IIM patients. CONCLUSION: Significantly higher prevalence of traditional risk factors and subclinical atherosclerosis was observed in IIM patients compared with HC.

• MeSH
• analýza pulzové vlny MeSH
• intimomediální šíře tepenné stěny MeSH
• kardiovaskulární nemoci * epidemiologie   etiologie   MeSH
• lidé MeSH
• myozitida * epidemiologie   MeSH
• nemoci arterie carotis * MeSH
• rizikové faktory kardiovaskulárních chorob MeSH
• rizikové faktory MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH

Poslední data ukazují, že stojíme na prahu pandemie demence. Významným rizikovým faktorem tohoto dosud neléčitelného ireverzibilního onemocnění je hypertenze. Pozornost vědců se nyní upírá na záchyt jedinců se zvýšeným rizikem zhoršení kognitivních funkcí nebo s časným stadiem kognitivního deficitu. Kromě testů kognitivních funkcí a zobrazovacích vyšetření dosud nemáme k dispozici vhodné biomarkery k identifikaci těchto osob. Potenciálně využitelnými biomarkery by mohly být hemodynamické parametry. Prof. Cunha prezentoval na kongresu ESH 2022 dosavadní poznatky, které ukazují, že pokles kognitivních funkcí by mohl souviset s variabilitou krevního tlaku mezi návštěvami u lékaře, tloušťkou intima­‐medie karotických tepen a tuhostí aorty měřené pomocí rychlosti šíření pulzní vlny (PWV). V současné době probíhá studie CEREBRO, která hodnotí prevalenci kognitivní dysfunkce u pacientů s hypertenzí a hledá časné cévní biomarkery, které korelují s poklesem kognitivních funkcí. Časný záchyt kognitivního zhoršení by vedle včasné a těsné kompenzace hypertenze mohl být cestou, jak v budoucnu snížit prevalenci pokročilých stadií demence.

Recent data suggest that we are on the verge of a dementia pandemic. Hypertension is a significant risk factor for this so far untreatable irreversible condition. The attention of researchers is now focused on identifying individuals at increased risk of cognitive decline or with early-stage cognitive deficit. Apart from cognitive function tests and imaging studies, no suitable biomarkers to identify these individuals have been available as yet. Haemodynamic parameters could be potentially useful biomarkers. At the ESH 2022 Congress, Professor Cunha presented the current knowledge suggesting that cognitive decline could be related to visit-to-visit blood pressure variability, carotid artery intima media thickness, and aortic stiffness as measured by pulse wave velocity (PWV). Currently, the CEREBRO study is being conducted to evaluate the prevalence of cognitive dysfunction in patients with hypertension and to search for early vascular biomarkers that correlate with cognitive decline. In addition to early and tight control of blood pressure, early detection of cognitive impairment could be a way to reduce the prevalence of advanced stages of dementia in the future.

• MeSH
• analýza pulzové vlny MeSH
• biologické markery MeSH
• demence * etiologie   MeSH
• hemodynamika MeSH
• hypertenze komplikace   MeSH
• kognitivní dysfunkce etiologie   patofyziologie   MeSH
• lidé MeSH
• tuhost cévní stěny MeSH
• Check Tag
• lidé MeSH

BACKGROUND: Aortic pulse wave velocity (PWV) predicts cardiovascular events (CVEs) and total mortality (TM), but previous studies proposing actionable PWV thresholds have limited generalizability. This individual-participant meta-analysis is aimed at defining, testing calibration, and validating an outcome-driven threshold for PWV, using 2 populations studies, respectively, for derivation IDCARS (International Database of Central Arterial Properties for Risk Stratification) and replication MONICA (Monitoring of Trends and Determinants in Cardiovascular Disease Health Survey - Copenhagen). METHODS: A risk-carrying PWV threshold for CVE and TM was defined by multivariable Cox regression, using stepwise increasing PWV thresholds and by determining the threshold yielding a 5-year risk equivalent with systolic blood pressure of 140 mm Hg. The predictive performance of the PWV threshold was assessed by computing the integrated discrimination improvement and the net reclassification improvement. RESULTS: In well-calibrated models in IDCARS, the risk-carrying PWV thresholds converged at 9 m/s (10 m/s considering the anatomic pulse wave travel distance). With full adjustments applied, the threshold predicted CVE (hazard ratio [CI]: 1.68 [1.15-2.45]) and TM (1.61 [1.01-2.55]) in IDCARS and in MONICA (1.40 [1.09-1.79] and 1.55 [1.23-1.95]). In IDCARS and MONICA, the predictive accuracy of the threshold for both end points was ≈0.75. Integrated discrimination improvement was significant for TM in IDCARS and for both TM and CVE in MONICA, whereas net reclassification improvement was not for any outcome. CONCLUSIONS: PWV integrates multiple risk factors into a single variable and might replace a large panel of traditional risk factors. Exceeding the outcome-driven PWV threshold should motivate clinicians to stringent management of risk factors, in particular hypertension, which over a person's lifetime causes stiffening of the elastic arteries as waypoint to CVE and death.

• MeSH
• analýza pulzové vlny škodlivé účinky   MeSH
• aorta MeSH
• arterie MeSH
• hypertenze * diagnóza   epidemiologie   komplikace   MeSH
• kardiovaskulární nemoci * diagnóza   epidemiologie   etiologie   MeSH
• lidé MeSH
• rizikové faktory MeSH
• tuhost cévní stěny * fyziologie   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• metaanalýza MeSH
• práce podpořená grantem MeSH

BACKGROUND: The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) affects the cardiovascular system. The current study investigated changes in heart rate (HR), blood pressure (BP), pulse wave velocity (PWV), and microcirculation in patients recovering from Coronavirus disease 2019 (COVID-19) infection. METHODOLOGY: Out of 43 initially contacted COVID-19 patients, 35 (30 males, 5 females; age: 60 ± 10 years; and body mass index (BMI): 31.8 ± 4.9) participated in this study. Participants were seen on two occasions after hospital discharge; the baseline measurements were collected, either on the day of hospital discharge if a negative PCR test was obtained, or on the 10th day after hospitalization if the PCR test was positive. The second measurements were done 60 days after hospitalization. The vascular measurements were performed using the VICORDER® device and a retinal blood vessel image analysis. RESULTS: A significant increase in systolic BP (SBP) (from 142 mmHg, SD: 15, to 150 mmHg, SD: 19, p = 0.041), reduction in HR (from 76 bpm, SD: 15, to 69 bpm, SD: 11, p = 0.001), and narrower central retinal vein equivalent (CRVE) (from 240.94 μm, SD: 16.05, to 198.05 μm, SD: 17.36, p = 0.013) were found. Furthermore, the trends of increasing PWV (from 11 m/s, SD: 3, to 12 m/s, SD: 3, p = 0.095) and decreasing CRAE (from 138.87 μm, SD: 12.19, to 136.77 μm, SD: 13.19, p = 0.068) were recorded. CONCLUSION: The present study investigated cardiovascular changes following COVID-19 infection at two-time points after hospital discharge (baseline measurements and 60 days post-hospitalization). Significant changes were found in systolic blood pressure, heart rate, and microvasculature indicating that vascular adaptations may be ongoing even weeks after hospitalization from COVID-19 infection. Future studies could involve conducting additional interim assessments during the active infection and post-infection periods.

• MeSH
• analýza pulzové vlny MeSH
• COVID-19 * MeSH
• hypertenze * MeSH
• krevní tlak fyziologie   MeSH
• lidé středního věku MeSH
• lidé MeSH
• mikrocirkulace MeSH
• pilotní projekty MeSH
• SARS-CoV-2 MeSH
• senioři MeSH
• tuhost cévní stěny * fyziologie   MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH

BACKGROUND AND OBJECTIVE: Geometry of aorto-iliac bifurcation may affect pressure and wall stress in aorta and thus potentially serve as a predictor of abdominal aortic aneurysm (AAA), similarly to hypertension. METHODS: Effect of aorto-iliac bifurcation geometry was investigated via parametric analysis based on two-way weakly coupled fluid-structure interaction simulations. The arterial wall was modelled as isotropic hyperelastic monolayer, and non-Newtonian behaviour was introduced for the fluid. Realistic boundary conditions of the pulsatile blood flow were used on the basis of experiments in literature and their time shift was tailored to the pulse wave velocity in the model to obtain physiological wave shapes. Eighteen idealized and one patient-specific geometries of human aortic tree with common iliac and renal arteries were considered with different angles between abdominal aorta (AA) and both iliac arteries and different area ratios (AR) of iliac and aortic luminal cross sections. RESULTS: Peak wall stress (PWS) and systolic blood pressure (SBP) were insensitive to the aorto-iliac angles but sensitive to the AR: when AR decreased by 50%, the PWS and SBP increased by up to 18.4% and 18.8%, respectively. CONCLUSIONS: Lower AR (as a result of the iliac stenosis or aging), rather than the aorto-iliac angles increases the BP in the AA and may be thus a risk factor for the AAA development.

• MeSH
• analýza pulzové vlny MeSH
• aneurysma břišní aorty * MeSH
• aorta abdominalis * MeSH
• arteria iliaca fyziologie   MeSH
• hemodynamika MeSH
• lidé MeSH
• modely kardiovaskulární MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH

Úvod: Měření práce myokardu (myocardial work, MW) představuje novou echokardiografickou metodu založenou na sledování smyčky tlak-deformace srdeční komory, což umožňuje kvantifikovat výkonnost srdce. Na druhé straně rychlost pulsní vlny (pulse wave velocity, PWV) určuje tuhost tepen na základě poznatku, že se zvyšující se tuhostí tepny se zvyšuje i rychlost anterográdního a retrográdního přenosu sfygmické vlny. Cíl: Cílem této studie bylo stanovit korelaci mezi parametry MW a PWV. Metody: Do studie jsme zařazovali všechny po sobě následující pacienty bez kardiovaskulárního onemocnění, kteří v období mezi červnem 2021 a červencem 2022 absolvovali transtorakální dopplerovské echokardio- grafické vyšetření. Hodnoty MW byly vypočítány ze smyčky tlak-deformace srdeční komory, do níž byly začleněny hodnoty neinvazivního vyšetření tepenného tlaku podle doporučení pro standardní echokardiogracfické vyšetření metodou "speckle tracking". Hodnota PWV se měřila tonometrem na úrovni společné karotidy a společné femorální tepny. Výsledky: Celkem bylo do studie zařazeno 66 pacientů průměrného věku 30,7 ± 8,6 roku. Byla nalezena statisticky významná negativní korelace mezi PWV a celkovou zbytečně vynaloženou energií (global wasted energy, GWE) (r = -0,317; p < 0,01) při korelaci s celkovou zbytečně vynaloženou prací (global wasted work, GWW) (r = 0,324; p < 0,01). Statisticky významná korelace přetrvávala v podskupinách žen i mužů u GWE (ženy: r = -0,280; p < 0,05; muži: r = -0,362; p < 0,05) i u GWW (ženy: r = 0,359; p < 0,05; muži: r = 0,359; p < 0,05). Závěr: Vztah mezi MW a PWV jako projev součinnosti mezi levou komorou a velkými tepnami může potenciálně představovat užitečný nástroj pro časné odhalení subklinické dysfunkce kardiovaskulárního systému.

Introduction: The myocardial work (MW) is a new echocardiographic method, based on the pressure-strain loop, which allows quantifying the cardiac performance. On the other hand, the pulse wave velocity (PWV) evaluates arterial stiffness, knowing that as the stiffness of an artery increases, the transmission velocity of the anterograde and the retrograde sphygmic wave increases. Purpose: The aim of the study is to evaluate the correlation between MW and PWV parameters. Methods: We enrolled consecutively all patients without cardiovascular disease who underwent transthora- cic Doppler echocardiography between June 2021 and July 2022. The MW parameters were derived from the strain-pressure loop, including in its calculation the measurement non-invasive arterial pressure, according to standard speckle tracking echocardiography recommendations. The PWV measurement was obtained by tonometry at the level of the common carotid artery and the common femoral artery. Results: We enrolled 66 patients (mean age: 30.7±8.6 years). There was a significant inversely proportio- nal correlation between PWV and GWE (r = –0.317; p <0.01) meanwhile there was a directly proportional correlation with GWW (r = 0.324; p <0.01). The statistically significant correlation remained in the female and male subgroups for GWE (female: r = –0.280; p <0.05; male: r = –0.362; p <0.05) and GWW (female: r = 0.359; p <0.05; male: r = 0.359; p <0.05). Conclusion: The relationship between MW and PWV as a demonstration of ventricular arterial coupling may potentially be a useful tool in the early recognition of subclinical cardiovascular dysfunction.

• MeSH
• analýza pulzové vlny * metody   přístrojové vybavení   MeSH
• dopplerovská echokardiografie metody   přístrojové vybavení   MeSH
• dospělí MeSH
• korelace dat MeSH
• lidé MeSH
• mladý dospělý MeSH
• srdce * fyziologie   MeSH
• statistika jako téma MeSH
• tuhost cévní stěny fyziologie   MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• mladý dospělý MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• klinická studie MeSH
• Geografické názvy
• Itálie MeSH