BACKGROUNDPulse wave velocity and flow-mediated vasodilation (FMD) are widely used as noninvasive modalities for evaluating atherosclerosis. However, it is not known whether pulse wave velocity is related to FMD in patients with coronary artery disease (CAD). Therefore, the present study was designed to investigate the alteration in brachial-ankle pulse wave velocity (baPWV) and endothelial function in CAD patients.

METHODSThirty-three patients with CAD and thirty control subjects were recruited for this study. baPWV was measured non-invasively using a VP 1000 automated PWV/ABI analyzer (PWV/ABI, Colin Co. Ltd., Komaki, Japan). Endothelial function as reflected by FMD in the brachial artery was assessed with a high-resolution ultrasound device.

RESULTSbaPWV was increased in CAD patients compared with control subjects [(1756.1 +/- 253.1) cm/s vs (1495.3 +/- 202.3) cm/s, P < 0.01]. FMD was significantly reduced in CAD patients compared with control subjects [(5.2 +/- 2.1)% vs (11.1 +/- 4.4)%, P < 0.01]. baPWV correlated with FMD (r = -0.68, P < 0.001). The endothelium-independent vasodilation induced by sublingual nitroglycerin in the brachial artery was similar in the CAD group compared with the control group.

CONCLUSIONSCAD is associated with increased baPWV and endothelial dysfunction. Increased baPWV parallels diminished endothelial function. Our data therefore suggest that baPWV can be used as a noninvasive surrogate index in clinical evaluation of endothelial function.

Aged ; Ankle ; blood supply ; Blood Flow Velocity ; physiology ; Brachial Artery ; physiopathology ; Coronary Artery Disease ; physiopathology ; Endothelium, Vascular ; physiopathology ; Female ; Humans ; Male ; Middle Aged ; Vasodilation

According to the pulse-wave theory, the authors developed a new non-invasive instrument for measuring arterial elastic function. It collects the pulse waveforms from the arteries of four limbs as well as from the radial arteries of carpus. After signal pre-processing, it calculates the arterial elastic parameters by the pre-prepared algorithm and program. Individual parameters such as pulse wave velocity (PWV), ankle-brachial index (ABI), systolic blood pressure (SBP), diastolic blood pressure (DBP) and heart rate (HR)can be obtained. At the same time, a series of clinical trials were conducted with reference to PWV and ABI, which confirmed the validity, accuracy and reliability of the instrument. The instrument can be used to determine the differences between cardiovascular patients and normal persons, as well as the extent of atherosclerosis. At the same time it can reflect the situation of vascular obstruction and screen the peripheral arterial disease. Therefore, it is of some value to the epidemiological study, prevention and early detection of cardiovascular disease.
Aging ; physiology ; Ankle ; blood supply ; Arteries ; physiopathology ; Arteriosclerosis ; physiopathology ; Blood Pressure ; physiology ; Brachial Artery ; physiopathology ; Elasticity ; physiology ; Humans ; Hypertension ; physiopathology ; Pulsatile Flow ; physiology ; Pulse ; Systole

The key of Ankle-brachial index (ABI) measurement is the synchronous measurement of four limbs' systolic blood pressures. In this paper is analyzed the inadequacy of the modern blood pressure measurement technologies used in the ABI measurement process. Special emphasis is laid on the principles and characteristics of the double-layer cuffs technology. The research orientation, the existing problems, and the way toward improvement are discussed.
Ankle ; blood supply ; Ankle Brachial Index ; instrumentation ; methods ; Automation ; Blood Pressure ; physiology ; Blood Pressure Determination ; methods ; Brachial Artery ; physiology ; Humans ; Peripheral Vascular Diseases ; diagnosis ; physiopathology ; Regional Blood Flow

We measured the ankle-brachial index (ABI) and brachial-ankle pulse wave velocity (baPWV) and ABI in 97 ischemic stroke patients and 93 control subjects to investigate the relationship between baPWV, ABI and risk factors of ischemic stroke. The stroke patients were grouped according to the results of MRA and Carotid artery color Doppler ultrasound. The correlation of baPWV and ABI to the arteriosclerosis was discussed. There was a significant difference in the patients with hypertension, diabetes mellitus, baPWV and ABI between ischemic stroke patients and control subjects. baPWV was the most sensitive risk factor for ischemic stroke. ABI and diabetes mellitus were the relatively sensitive risk factors for ischemic stroke. baPWV were found to have a positive correlation with common carotid arteriosclerosis (gamma=0.215, P=0.048), while ABI had a negative correlation with intracranial arteriosclerosis (gamma=-0.237, P<0.05). BaPWV and ABI may closely relate to severity of ischemic stroke. Simple measurements of baPWV and ABI in patients could be a useful tool for evaluating the risk of ischemic stroke.
Aged ; Ankle ; blood supply ; Ankle Brachial Index ; Arteriosclerosis ; physiopathology ; Blood Flow Velocity ; Brachial Artery ; physiopathology ; Brain ; blood supply ; pathology ; Brain Ischemia ; complications ; Carotid Arteries ; physiopathology ; Female ; Humans ; Male ; Middle Aged ; Pulsatile Flow ; Pulse ; Risk Factors ; Stroke ; diagnosis ; etiology ; physiopathology

Arterial stiffness is an important contributor to the development of cardiovascular disease. We investigated the effect of short duration exercise using the treadmill test on arterial stiffness in the presence of coronary artery disease. We enrolled patients with and without coronary artery diseases (CAD and control group, 50 patients each) referred for treadmill testing. Brachial-ankle pulse wave velocity (baPWV) were measured before and after treadmill testing. Values of baPWV were significantly reduced at 10 min after exercise in both groups, more in the CAD group than in the control group (baseline baPWV and post-exercise change [cm/sec]: 1,527+/-245 and -132+/-155 in the CAD group, 1,439+/-202 and -77+/-93 in the control group, respectively, P for change in each group <0.001, P for difference in changes between the two groups <0.001). These findings persisted after adjusting for age, body mass index, systolic blood pressure, mean arterial pressure (MAP), MAP decreases, and baseline baPWV. Significant post-exercise baPWV reductions were observed in both groups, and more prominently in the CAD group. This finding suggests that short-duration exercise may effectively improve arterial stiffness even in patients with stable coronary artery disease.
Adult ; Aged ; Ankle/blood supply ; Ankle Brachial Index ; Arteries/*physiopathology ; Blood Flow Velocity ; Brachial Artery/physiology ; Coronary Artery Disease/diagnosis/*physiopathology/therapy ; Elasticity ; *Exercise Therapy ; Female ; Humans ; Male ; Middle Aged ; Predictive Value of Tests

BACKGROUNDCarotid artery intima-media thickness (CIMT) and brachial artery flow-mediated dilation percentage (FMD%) are common parameters used for detecting subclinical atherosclerosis. This study compared subclinical atherosclerosis of the carotid and brachial arteries in rheumatoid arthritis (RA) patients and healthy controls using high resolution ultrasonography. We also investigated their correlation with clinical factors and the association between FMD% and CIMT.

METHODSOne hundred and two RA patients and 46 age-gender matched healthy controls were included in the study. FMD of the brachial artery and CIMT were measured ultrasonographically. Patients with diabetes mellitus, hypertension, renal failure, history of cardiovascular or cerebrovascular disease were excluded. Subjects who were receiving or used high dose steroids were also excluded.

RESULTSThe CIMT was significantly higher in patients than that in the control group ((0.697±0.053) vs. (0.554±0.051) mm, P<0.001), whereas brachial artery FMD% was lower in patients than that in the controls ((5.454±2.653)% vs. (8.477±2.851)%, P<0.001). CIMT was related to age, disease duration, tender and swollen joint score, C-reactive protein, systolic blood pressure and high-density lipoprotein. However, FMD% was only association with systolic blood pressure. There was no significant correlation between CIMT and FMD%.

CONCLUSIONSCompared with the healthy control subjects, RA patients without clinically evident cardiovascular disease had subclinical atherosclerosis in terms of impaired FMD% and increased CIMT. FMD% and CIMT may measure a different stage of subclinical atherosclerosis in RA patients.

Adult ; Arthritis, Rheumatoid ; pathology ; physiopathology ; Atherosclerosis ; pathology ; physiopathology ; Brachial Artery ; physiopathology ; Carotid Intima-Media Thickness ; Case-Control Studies ; Female ; Humans ; Male ; Middle Aged

OBJECTIVETo assess the relationship between visit-to-visit blood pressure (BP) variability (BPV) and vascular endothelial function in a cohort of elderly hypertensive patients.

METHODSA total of 174 elderly patients with essential hypertension were included in the study. The participants had their office BP measured during the 12-month follow-up. Right brachial artery diameter was assessed at rest, during reactive hyperemia (flow-mediated dilation, FMD), and after nitroglycerin administration (nitroglycerin-mediated dilation, NMD). The participants were divided into two groups according to FMD% or FMD/NMD ratio. The correlations between BPV and endothelial function were analyzed by univariate analysis and multiple linear regression analysis.

RESULTSThe participants classified as having a decreased endothelial function according to FMD/NMD ratio had significantly lower FMD% and higher BPV and NMD% (P<0.05). The percentage of CCBs use in normal endothelial function group was significantly higher than that in decreased endothelial function group (79.55% vs 63.95%, P<0.05). Multiple linear regression analysis revealed a significant negative association between FMD/NMD ratio and BPV, and this association remained significant after adjustment for age, body mass index, and mean BP levels.

CONCLUSIONSFMD/NMD ratio is a better marker of endothelial function than FMD, and an increased visit-to-visit variability of BP is associated with a decreased endothelial function.

Aged ; Blood Pressure ; Brachial Artery ; Endothelium, Vascular ; physiopathology ; Essential Hypertension ; Humans ; Hypertension ; Multivariate Analysis ; Nitroglycerin ; Regression Analysis ; Vasodilation

OBJECTIVETo investigate the relationship between angiotensin converting enzyme (ACE) gene and endothelial dysfunction.

METHODSOne hundred and ten type 2 diabetic patients without angiopathy were selected randomly, and PCR technique was used to determine their ACE genotypes. High resolution ultrasonography was performed to measure the changes in brachial artery diameter at rest, after reactive hyperemia (with increased flow producing an endothelium-dependent dilation) and after sublingual glyceryltrinitrate (GNT, an endothelium-independent dilator). Meanwhile, 50 healthy individuals were selected randomly as controls.

RESULTSIn type 2 diabetes mellitus and control groups, the percentages for flow-mediated arterial dilation in patients with DD genotypes were 3.38% and 3.67% respectively, which were significantly lower than those in patients with II genotypes (4.12% and 4.68% respectively, P<0.05). The baseline blood vessel size, baseline blood flow and GNT induced dilation in both groups showed no significant differences among ACE genotypes (P>0.05). By multiple stepwise regression analysis, reduced flow-mediated arterial dilation was associated with age, baseline vessel size, low density lipoprotein cholesterol(LDL-C), Lp(a), D allele, fasting blood glucose (FBG), postparandial blood glucose (PPBG), HbA1c, duration of diabetes in type 2 diabetic patients (P<0.0005).

CONCLUSIONACE DD genotype is related to endothelium-dependent arterial dilation in the early stage of type 2 diabetes mellitus and in healthy individuals.

Adult ; Aged ; Brachial Artery ; physiopathology ; Diabetes Mellitus, Type 2 ; enzymology ; genetics ; physiopathology ; Diabetic Angiopathies ; genetics ; physiopathology ; Endothelium, Vascular ; physiopathology ; Female ; Humans ; Male ; Middle Aged ; Peptidyl-Dipeptidase A ; genetics ; Polymerase Chain Reaction

PURPOSE: The aim of this study was to evaluate the effects of a smoking cessation education on endothelial function and carboxyhemoglobin levels in smokers with variant angina. METHODS: A nonequivalent control group pretest-posttest design was used. Participants were 60 male smokers with variant angina admitted to one hospital: the control group (30) between September and December, 2009, and the experimental group (30) between February and May, 2010. Endothelial function, as defined by flow-mediated vasodilation (FMD) of the brachial artery, and serum carboxyhemoglobin (COHb) were determined at baseline and at 3 months after the initiation of education in both groups. RESULTS: Three months after the program, smoking cessation was successful in 22 of the 30 smokers in the experimental group, but only in 4 of 30 smokers in the control group (p<.001). After the education, the experimental group showed a significant increase in FMD, and a significant decreased in serum COHb compared with the control group. CONCLUSION: The findings indicate that this smoking cessation education program is effective for hospitalized smokers with variant angina.
Adult ; Angina Pectoris, Variant/blood/*physiopathology ; Brachial Artery/physiology ; Carboxyhemoglobin/*analysis ; Endothelium, Vascular/*physiology ; Humans ; Male ; Middle Aged ; *Program Evaluation ; Smoking/psychology ; *Smoking Cessation ; Vasodilation

The aim of this study was to determine the normal value of brachial-ankle pulse wave velocity (baPWV) and carotid-femoral pulse wave velocity (cfPWV) according to age group, gender, and the presence of cardiovascular risk factors in healthy Koreans, and to investigate the association between PWV and risk factors such as prehypertension, dyslipidemia, smoking, and obesity. We measured an arterial stiffness in 110 normal subjects who were 20 to 69 yr-old with no evidence of cardiovascular disease, cerebrovascular accident or diabetes mellitus. The mean values of baPWV and cfPWV were 12.6 (+/-2.27) m/sec (13.1+/-1.85 in men, 12.1+/-2.51 in women; P=0.019) and 8.70 (+/-1.99) m/sec (9.34+/-2.13 in men, 8.15+/-1.69 in women; P=0.001), respectively. The distribution of baPWV (P<0.001) and cfPWV (P=0.006) by age group and gender showed an increase in the mean value with age. Men had higher baPWV and cfPWV than women (P<0.001). There was a difference in baPWV and cfPWV by age group on prehypertension, dyslipidemia, current smoking, or obesity (P<0.001). In multiple linear regression, age and prehypertension were highly associated with baPWV and cfPWV after adjustment for confounding factors (P<0.001). The present study showed that baPWV and cfPWV are associated with age, gender, and prehypertension in healthy Koreans.
Adult ; Age Factors ; Aged ; *Ankle Brachial Index ; Blood Pressure ; Brachial Artery/*physiology ; Cardiovascular Diseases/diagnosis/etiology/physiopathology ; Carotid Arteries/*physiology ; Female ; Femoral Artery/*physiology ; Humans ; Male ; Middle Aged ; Obesity/physiopathology ; Prehypertension/physiopathology ; Pulsatile Flow ; *Pulse Wave Analysis ; Republic of Korea ; Risk Factors ; Sex Factors ; Smoking ; Vascular Stiffness/physiology