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Background: Aortic stiffness is an independent predictor of cardiovascular events which is increased in rheumatoid arthritis (RA). It can be measured by carotid-femoral pulse wave velocity (cfPWV). Phase angle (PhA) is lower in patients with cardiovascular disease and may be informative in assessing the clinical course of RA. Materials and Methods: In this observational and cross-sectional study, all RA patients referred to the Imam Khomeini Hospital rheumatology clinic between September 2022 and March 2023 were included in the study. RA activity was assessed using the DAS28 criteria. In the patients, PhA and cfPWV were measured using Inbody-s10 and PulsePen tonometer instruments. The relationships between PhA, cfPWV, clinical course of RA, and CRP were evaluated using regression analysis. Results: 53 patients were included in the study (83% female, mean age 46.5 years). Significant inverse relationships existed between PhA, CRP, and age (P value = 0.003, 0.0001, R: 0.69, respectively). People with aortic stiffness had a lower mean PhA (P value = 0.05). In patients with RA duration of less than 10 years, the cfPWV percentile and the prevalence of rheumatoid factor (RF) and anti-cyclic citrullinated peptide (anti-CCP) positive cases were higher than in patients with RA duration >10 years (P values = 0.02, 0.01, respectively). Conclusions: With increasing duration of RA, aortic stiffness and positive serology cases decreased. PhA and cfPWV may be useful in assessing the clinical course of RA to prevent cardiovascular events.

Purpose: To evaluate the association between serum 25-hydroxy vitamin D level and arterial stiffness in type 2 diabetes patients with intermediate chronic kidney disease (CKD). Methods: The serum 25-hydroxy vitamin D level and various parameters of vascular functions were assessed in type 2 diabetes patients with intermediate CKD (stages 3a and 3b). The carotid-femoral pulse wave velocity (cfPWV) among vitamin D-deficient, -insufficient, and normal patients was compared. Results: One hundred and twenty-one patients were included. The cfPWV in the vitamin D-deficient group (1190.32 ± 256.95 cm/s) was significantly higher (p < 0.05) than that in the vitamin D-insufficient (1053.74 ± 138.96 cm/s) and normal (1038.45 ± 171.08 cm/s) groups. Similarly, the aortic augmentation pressure (13.29 ± 5.18 mm Hg) in the vitamin D-deficient group was significantly higher (p < 0.05) than that in the vitamin D-insufficient (10.01 ± 5.12 mm Hg) and normal groups (9.27 ± 4.97 mm Hg). Furthermore, the augmentation index was 24.66 ± 8.84% in the vitamin D-deficient (p < 0.05) as compared to 20.11 ± 8.12% in the vitamin D-insufficient group and 20.36 ± 6.14% in the normal group. Other vascular parameters were not significantly different among the groups. Conclusion: Different parameters of arterial stiffness, such as cfPWV, aortic augmentation pressure, and augmentation index, were significantly higher in the vitamin D-deficient group as compared to those in the vitamin D-insufficient and normal groups among type 2 diabetes patients with intermediate CKD. [ABSTRACT FROM AUTHOR]

Background: Aortic stiffness is an independent predictor of cardiovascular events which is increased in rheumatoid arthritis (RA). It can be measured by carotid-femoral pulse wave velocity (cfPWV). Phase angle (PhA) is lower in patients with cardiovascular disease and may be informative in assessing the clinical course of RA., Materials and Methods: In this observational and cross-sectional study, all RA patients referred to the Imam Khomeini Hospital rheumatology clinic between September 2022 and March 2023 were included in the study. RA activity was assessed using the DAS28 criteria. In the patients, PhA and cfPWV were measured using Inbody-s10 and PulsePen tonometer instruments. The relationships between PhA, cfPWV, clinical course of RA, and CRP were evaluated using regression analysis., Results: 53 patients were included in the study (83% female, mean age 46.5 years). Significant inverse relationships existed between PhA, CRP, and age ( P value = 0.003, 0.0001, R: 0.69, respectively). People with aortic stiffness had a lower mean PhA ( P value = 0.05). In patients with RA duration of less than 10 years, the cfPWV percentile and the prevalence of rheumatoid factor (RF) and anti-cyclic citrullinated peptide (anti-CCP) positive cases were higher than in patients with RA duration >10 years ( P values = 0.02, 0.01, respectively)., Conclusions: With increasing duration of RA, aortic stiffness and positive serology cases decreased. PhA and cfPWV may be useful in assessing the clinical course of RA to prevent cardiovascular events., Competing Interests: There are no conflicts of interest., (Copyright: © 2024 Advanced Biomedical Research.)

Background: We aimed to evaluate the relationship between arterial stiffness and left ventricular diastolic dysfunction (LVDD) in metabolic syndrome (MetS) patients.Methods: A cross-sectional study was conducted in 1208 subjects without overt atherosclerotic disease. According to the cardiac ultrasound, patients were divided into two groups: with LVDD (LVDD+,n = 1119) and without LVDD (LVDD–,n = 89). Arterial stiffness parameters [carotid–femoral pulse wave velocity (cfPWV) and aortic augmentation index (AIxHR75)] were assessed by applanation tonometry.Results: In comparison to LVDD–, LVDD + patients were older (55 ± 6 vs 51 ± 6 years,p < 0.001), and had higher cfPWV (8.8 ± 1.6 vs 7.9 ± 1.34 m/s,p < 0.001), AIxHR75 (24.7 ± 10.2 vs 19.7 ± 10,p < 0.001), mean arterial pressure (108 ± 12 vs 101 ± 10 mmHg,p < 0.001), heart rate (66 ± 10 vs 61 ± 9 bpm,p < 0.001), left ventricular mass index (LVMI) (109 ± 24 vs 97 ± 22,p < 0.001) and body mass index (BMI) (32 ± 5 vs 30 ± 4 kg/m2,p < 0.001). We found significant correlations between cfPWV, AIxHR75 and the ratio of early to late transmitral velocities (E/A) (rcfPWV = –0.19,rAIxHR75 = –0.15,p < 0.001), early diastolic mitral annular velocity (E′) (rcfPWV = –0.25,rAIxHR75 = –0.18,p < 0.05) and E/E′ ratio (rcfPWV = 0.17,rAIxHR75 = 0.14,p < 0.001). Univariate analysis revealed that the presence of LVDD is associated with age [odds ratio (OR) 1.84], BMI (OR 1.63), waist circumference (WC) (OR 1.52), cfPWV (OR 2.18), AIxHR75 (OR 1.55), mean aortic blood pressure (OR 1.94), aortic pulse pressure (OR 1.78), mean common carotid artery intima–media thickness (OR 1.16), heart rate (OR 1.4) and LVMI (OR 1.79) (allp < 0.05). After performing stepwise multiple logistic regression analysis, only cfPWV and BMI or WC remained significant predictors of the presence of LVDD (p < 0.05).Conclusion: cfPWV is a significant determinant of LVDD in subjects with MetS. [ABSTRACT FROM PUBLISHER]

Objectives: This study sought to investigate the association of local and segmental arterial stiffness with incident cardiovascular events and all-cause mortality. Background: The association of different stiffness indices, in particular of carotid, brachial, and femoral stiffness, with cardiovascular disease and mortality is currently unknown. Methods: In a population-based cohort (n = 579, mean age 67 years, 50% women, 23% with type 2 diabetes [by design]), we assessed local stiffness of carotid, femoral, and brachial arteries (by ultrasonography), carotid-femoral pulse wave velocity (cfPWV), aortic augmentation index, and systemic arterial compliance. Results: After a median follow-up of 7.6 years, 130 participants had a cardiovascular event and 96 had died. The hazard ratios (HRs) (95% confidence intervals [CIs]) per 1 SD for cardiovascular events and all-cause mortality, respectively, were HR: 1.22 (95% CI: 0.95 to 1.56) and 1.51 (95% CI: 1.11 to 2.06) for lower carotid distensibility; HR: 1.19 (95% CI: 1.00 to 1.41) and 1.28 (95% CI: 1.07 to 1.53) for higher carotid elastic modulus; HR: 1.08 (95% CI: 0.88 to 1.31) and 1.43 (95% CI: 1.10 to 1.86) for lower carotid compliance; HR: 1.39 (95% CI: 1.06 to 1.83) and 1.27 (95% CI: 0.90 to 1.79) for lower femoral distensibility; HR: 1.25 (95% CI: 0.96 to 1.63) and 1.47 (95% CI: 1.01 to 2.13) for lower femoral compliance; and HR: 1.56 (95% CI: 1.23 to 1.98) and 1.13 (95% CI: 0.83 to 1.54) for higher cfPWV. These results were adjusted for age, sex, mean arterial pressure, and cardiovascular risk factors. Mutual adjustments for each of the other stiffness indices did not materially change these results. Brachial stiffness, augmentation index, and systemic arterial compliance were not associated with cardiovascular events or mortality. Conclusions: Carotid and femoral stiffness indices are independently associated with incident cardiovascular events and all-cause mortality. The strength of these associations with events may differ per stiffness parameter. [Copyright &y& Elsevier]

Abstract: Background: The methodology of the gold standard for measuring aortic stiffness, carotid–femoral pulse wave velocity (cfPWV), has been revised in respect to the choice of distance measure. In order to clarify whether increased aortic stiffness is present in obese children and adolescents we investigated cfPWV with the previous (cfPWV-subtracted) and a newly revised methodology (cfPWV-direct). Methods: In a cross-sectional design, 104 obese patients with age 10–18 years newly referred to the Children's Obesity Clinic were compared to 50 healthy control individuals. CfPWV was measured non-invasively using the SphygmoCor device, while all distance measures were made with a calliper. Results: Opposite to the direct distance, the subtracted distance differed across study groups in relation to height (P < 0.006). CfPWV-subtracted was significantly higher for the obese (4.5 m/s CI: 4.4–4.6 vs. 4.3 m/s CI: 4.2–4.5, P = 0.03), whereas cfPWV-direct was significantly lower (4.8 m/s CI: 4.7–4.9 vs. 5.1 m/s CI: 4.9–5.3, P = 0.008). In multiple regression, being obese did not significantly influence cfPWV-subtracted (β = 0.126, CI: −0.04–0.29, NS) whereas it significantly reduced cfPWV-direct (β = −0.34, CI: −0.53–0.15, P < 0.001), when adjusting for age, gender, mean arterial blood pressure and heart rate. Both groups had normal values of cfPWV-subtracted in respect to a European reference material. Conclusion: The distance measure of cfPWV-direct was associated similarly to height across study groups. Adjusted for main confounders, cfPWV-subtracted was equal whereas cfPWV-direct was reduced in obese compared to normal weighted children and adolescents. [Copyright &y& Elsevier]

Abstract: Background: The recommendation for carotid–femoral pulse wave velocity (cfPWV) is to use a calliper to measure the aortic length as a straight line. In adults, it has been shown that tape follows the body contours potentially making the distance longer – ultimately a higher cfPWV – interpreted as a higher aortic stiffness. Our objective was to investigate to what extent a tape measurement is influenced by abdominal obesity in children and adolescents. Methods: In a cross-sectional design, 100 obese patients with age 10–18 years were compared to 50 healthy control individuals. CfPWV was measured by applanation tonometry. The aortic length was determined with tape and a calliper (distance-tape and distance-calliper). The bias of the tape measurements was calculated as distance-tape minus distance-calliper. Results: The bias of the tape measurements (mean ± SD) was significant in both the obese (Δ 14.6 ± 11.2 mm, P < 0.0001) and the control group (Δ 5.7 ± 5.8 mm, P < 0.0001), and showed a linear relationship with waist-height ratio in the obese group (obese: β = 96.9, CI: 75.3–118.5, P < 0.0001). Likewise, cfPWV was significantly higher when tape was used for the distance measurements in both groups (P values <0.0001). In multiple regression, however, cfPWV for both tape and calliper were significantly lower in the obese compared to the control group (P values <0.01). Conclusions: The bias of the tape measurements was related to the degree of abdominal obesity. Our results emphasize the importance of the use of a calliper when evaluating cfPWV in obese children and adolescents. [Copyright &y& Elsevier]

This study aimed to develop a fast and effective arterial stiffness monitoring system for diabetic patients using the spring constant method and photoplethysmography (PPG). The experimental group comprised 70 patients (4 type 1 diabetes mellitus patients and 66 type 2 diabetes mellitus patients); 23 participants suffered from atherosclerosis. All were subjected to the measurements of both the carotid–femoral pulse wave velocity (cfPWV) and the spring constants evaluated using the PPG pulse as well as the radial pulse. The control group comprised 70 normal participants (39 men and 31 women) who did not have diabetes mellitus, with an age range of 40–84 years. All control group members were only subjected to the measurement by the spring constant method. For the experimental group, statistical analysis indicated a significantly high correlation between the spring constants computed using PPG and the radial pulse (p < 0.001, correlation coefficient =0.89). The result also showed a significant negative correlation between the cfPWV and the spring constant of PPG (p < 0.001, correlation coefficient = − 0.72); multivariate analysis similarly indicated a close relationship. In addition, we used Student's t test to examine the difference between the experimental and control groups for the spring constant of PPG. A P value less than 0.05 confirmed that the difference between the two groups was statistically significant. In the receiver operating characteristic curve, area under curve (=0.82) indicates a good discrimination, and a spring constant of PPG below 516 (g/s ^2) may imply a risk of arterial stiffness for diabetic patients. These findings imply that the spring constant of PPG could effectively identify normal versus abnormal characteristics of elasticity in normal and diabetic participants. As a result of some excellent characteristics in clinical monitoring, the spring constant computed using PPG shows the effectiveness and feasibility in the monitoring system of arterial stiffness. [ABSTRACT FROM PUBLISHER]

Background: Compare arterial stiffness among law enforcement officers (LEOs) versus general population normative values and identify predictors of arterial stiffness in LEOs., Methods: Seventy male LEOs (age: 24-54 years) completed body composition, blood pressures, physical activity level, and carotid-femoral pulse wave velocity (cfPWV) measurements. T-tests and regression analyses were utilized to compare LEO data to normative data and predict cfPWV, respectively., Results: Compared to similar age strata within the general population, cfPWV was lower among LEO's under 30-years (mean difference = -0.6 m·s -1 ), but higher among LEOs 50-55-years (mean difference = 1.1 m·s -1 ). Utilizing regression, age, relative body fat, and diastolic blood pressure explained the greatest variance in LEO's cfPWV (adj. R 2 = 0.56, p < 0.001)., Conclusion: This investigation demonstrated that arterial stiffness may progress more rapidly in LEOs and LEOs' relative body fat and blood pressure may primarily affect arterial stiffness and risk of CVD.