Air pollution is a major risk factor for cardiovascular disease, of which ozone is a major contributor. Several studies have found associations between ozone and cardiovascular morbidity, but the results have been inconclusive. We investigated associations between ozone and changes across biological pathways associated with cardiovascular disease. Using a panel study design, 13 participants with coronary artery disease were assessed for markers of systemic inflammation, heart rate variability and repolarization, lipids, blood pressure, and endothelial function. Daily measurements of ozone and particulate matter (PM2.5) were obtained from central monitoring stations. Single (ozone) and two-pollutant (ozone and PM2.5) models were used to assess percent changes in measurements per interquartile ranges of pollutants. Per interquartile increase in ozone, changes in tissue plasminogen factor (6.6%, 95% confidence intervals (CI) = 0.4, 13.2), plasminogen activator inhibitor-1 (40.5%, 95% CI = 8.7, 81.6), neutrophils (8.7% 95% CI = 1.5, 16.4), monocytes (10.2%, 95% CI = 1.0, 20.1), interleukin-6 (15.9%, 95% CI = 3.6, 29.6), large-artery elasticity index (−19.5%, 95% CI = −34.0, −1.7), and the baseline diameter of the brachial artery (−2.5%, 95% CI = −5.0, 0.1) were observed. These associations were robust in the two-pollutant model. We observed alterations across several pathways associated with cardiovascular disease in 13 coronary artery disease patients following ozone exposures, independent of PM2.5. The results support the biological plausibility of ozone-induced cardiovascular effects. The effects were found at concentrations below the EPA National Ambient Air Quality Standards for both ozone and PM2.5.

/pdf/ozone-exposure-is-associated-with-acute-changes-in-3vkmga3ipa.pdf

Ozone exposure is associated with acute changes in inflammation, fibrinolysis, and endothelial cell function in coronary artery disease patients.

The objective is to evaluate the association of arterial stiffness [brachial-ankle pulse wave velocity (ba-PWV)] with glycemic control and duration of type 2 diabetes in diabetic subjects with or without hypertension. One thousand Chinese diabetic patients (562 with hypertension, 438 without hypertension) were included in this study. All patients underwent ba-PWV and biochemical measurements. Ba-PWV was significantly higher in diabetic subjects with hypertension than those without hypertension (1779 ± 341 vs. 1691 ± 342 cm/s, P 7.0%, respectively, P 10 years, respectively, P all 10 years, respectively, P = 0.0013). Ba-PWV was higher in diabetic subjects with hypertension than in diabetic subjects without hypertension, suggesting the independent effect of hypertension on arterial stiffness in diabetic subjects. Ba-PWV positively correlated with HbA1c and duration of diabetes in subjects with diabetes and hypertension, suggesting the importance of early glycemic control in the prevention of arterial stiffness and vascular complications.

Association of arterial stiffness with HbA1c in 1,000 type 2 diabetic patients with or without hypertension

Coronary artery disease (CAD) is one of the most common diseases throughout the world. To investigate the relationship between brachial-ankle pulse wave velocity (baPWV) and arterial atherosclerosis and peripheral artery disease (PAD) and its potential diagnostic value in diagnosing arterial sclerosis, a self-designed questionnaire and special machine designed by Colin Corp., Ltd. were implemented to measure the level of baPWV and the ankle-brachial index (ABI) and their relations to coronary and peripheral artery atherosclerosis. The results showed that baPWV and ABI were equally effective at predicting stenosis of the coronary arteries and stenosis of the arteries of the lower extremities. Different levels of baPWV with corresponding ABI can express different degrees of arterial sclerosis and peripheral artery lesion to a certain extent. Measurement of both baPWV and ABI is thus highly recommended in clinical investigation. Arterial wave reflection is a major determinant of left ventricular function, coronary perfusion, and cardiovascular risk. We investigated whether arterial wave velocity can detect atherosclerosis of the coronary arteries and peripheral arteries in patients with documented coronary artery diseases. Our goal was to investigate the relationship between baPWV and arterial atherosclerosis and PAD and their potential diagnostic value. Two hundred and seventy-two patients ranging in age from 45-92 years (mean: 66.87+/-11.42 years) were selected from the Department of Cardiology of our hospital. A carefully designed questionnaire was used to gather baseline data for each patient. All patients underwent cardioangiography and were divided into four groups according to their Gensini scores: a control group, and groups with a mild, moderate, or severe degree of stenosis. One hundred and five of these patients simultaneously underwent angiography of the lower extremities and were divided into four groups according to the degree of artery stenosis: a control group, and groups with a mild, moderate, or severe degree of stenosis. Grouping of baPWV levels was made according to Japanese surveys. Bilateral baPWV and ABI were measured using non-invasive arterial atherosclerosis measuring equipment. In the coronary artery groups based on Gensini score, ABI in the group with a high degree of stenosis was significantly lower than that in the control and moderate stenosis groups, while the baPWV was significantly higher than that in the control and mild stenosis groups. In the grouping of baPWV levels, it was indicated that the ABI level was significantly different between each group. The ABI 2,100 cm/s was higher than that in other groups. In the grouping by angiography of the lower extremities, the ABI level was decreased with increasing degree of artery stenosis while the baPWV levels were increased under the same circumstance (p 1,800 cm/s often follows a severe coronary artery event, while baPWV>2,100 cm/s may be related to potential PAD. baPWV measurement is helpful to make new standard of diagnosing PAD in Chinese cohorts.

/pdf/the-predictive-value-of-brachial-ankle-pulse-wave-velocity-2khfqpirlf.pdf

The Predictive Value of Brachial-Ankle Pulse Wave Velocity in Coronary Atherosclerosis and Peripheral Artery Diseases in Urban Chinese Patients

Arterial stiffening as a possible risk factor for both atherosclerosis and diastolic heart failure

Silent cerebral lesions are increasingly found in mass screenings using MRI and magnetic resonance angiography (MRA). The purpose of this paper is to assess the usefulness of two non-invasive clinical tests-carotid ultrasound examination and brachial-ankle pulse wave velocity (baPWV) measurement-for predicting silent cerebral infarction (SCI) and silent intracranial arterial stenosis. Data were collected on 480 asymptomatic adult subjects who participated in a brain screening program at a single hospital between April 2003 and March 2006. All participants underwent baPWV measurement, B-mode ultrasonography of carotid arteries, MRI, and MRA. Data on 476 (99.1%) subjects were included in the analysis. Among these, 273 (57.4%) were male and the mean age was 51.5 years; 161 (33.8%) had carotid plaque; 33 (6.9%) had increased intima-media thickness (IMT); 99 (20.8%) had SCI; and 7 (1.5%) had intracranial arterial stenosis. The multivariate analysis showed that age (odds ratio [OR]: 1.12; 95% confidence interval [CI]: 1.08-1.17), carotid plaque (OR: 2.69; 1.59-4.56), increased IMT (OR: 2.40; 1.02-5.65), and a history of hypertension treatment (OR 2.22; 1.11-4.43) were significantly associated with SCI. Also, increased IMT (OR 9.70: 1.48-63.71) was related to intracranial arterial stenosis. Brachial-ankle PWV was related to SCI (p<0.01) and intracranial stenosis (p=0.01) in univariate analysis but not in multivariate analysis. The presence of carotid plaque and that of increased IMT on ultrasound examination are useful for assessing the risk of SIC. Increased IMT is also predictive of intracranial arterial stenosis.

/pdf/associations-of-brachial-ankle-pulse-wave-velocity-and-21ziravxp0.pdf

Associations of Brachial-Ankle Pulse Wave Velocity and Carotid Atherosclerotic Lesions with Silent Cerebral Lesions

The objective of this study was to investigate an association between major cardiovascular risk factors and each of brachial-ankle pulse wave velocity (baPWV), ankle-brachial index (ABI), capacitive arterial compliance (C1), and oscillatory arterial compliance (C2) in elderly patients with arteriosclerosis. We analyzed 160 elderly patients with arteriosclerosis. Vessel wall properties were assessed by baPWV and ABI using a VP-1000 Automatic Arteriosclerosis Measurement System, and C1 and C2 were measured using a DO-2020 Cardiovascular Profiling Instrument. In multiple regression analysis, baPWV was significantly correlated with systolic blood pressure (SBP), mean artery pressure, pulse pressure, diastolic blood pressure (DBP), age, and heart rate (r = 0.670, 0.627, 0.580, 0.523, 0.490, 0.200; p < 0.05), ABI was significantly correlated with pulse pressure, SBP and age (r = -0.250, -0.206, -0.168; p < 0.05), C1 was significantly correlated with pulse pressure, SBP, mean artery pressure, age, DBP and heart rate (r = -0.481, -0.469, -0.363, -0.356, -0.239, -0.188; p < 0.05), and C2 was significantly correlated with age, SBP, pulse pressure, DBP, fasting blood glucose, mean artery pressure and heart rate (r = -0.411, -0.395, -0.383, -0.277, -0.213, -0.183, -0.173; p < 0.05). There were no close correlations between baPWV, ABI, or C1 and fasting blood glucose, total cholesterol, triglycerides, or body mass index. Moreover, there were significant correlations between baPWV and C1 (r = -0.444, p < 0.001), and between baPWV and C2 (r = -0.257, p < 0.01). In conclusion, these findings underscore the efficacy of baPWV and ABI in identifying the vascular damage of the aged.

/pdf/correlation-between-brachial-ankle-pulse-wave-velocity-and-nyfydbxex1.pdf

Correlation between brachial-ankle pulse wave velocity and arterial compliance and cardiovascular risk factors in elderly patients with arteriosclerosis.

OBJECTIVE To understand the aortic pulse wave velocity (PWV) in mid-aged and elderly populations and to study the correlation between gender and PWV and the tendency of PWV on different age groups. METHODS According to the clinical trial guideline, we selected 545 healthy subjects (age, 31-85 years, 395 men and 150 women), and measured carotid-femoral PWV, using Complior. RESULTS The average value of PWV in Chinese healthy subjects was 11.62 +/- 2.97 m/s. There was no significant difference in the PWV values between males and females who were older than 40 years, but the values of PWV were lower in females than in males in the 30-39 year-old group. PWV was positively correlated with age. In the present study, the reference values of PWV were established in the different age groups, based on the regression equations between PWV and age. CONCLUSION Aortic pulse wave velocity seemed to be influenced by age but hardly influenced by gender in healthy subjects, so that the reference value of PWV should be established according to the different age groups. When aorta got stiffer, the value PWV got larger accordingly when age was increasing.

Determination of the aortic pulse wave velocity in 545 healthy subjects

To obtain reliable data on the epidemiology of arteriosclerosis and the comorbidities in patients with hypertension (HP), coronary heart disease (CHD), type 2 diabetes mellitus (T2DM) and stroke, we evaluated the clinical significance of pulse wave velocity (PWV) as an indicator of arteriosclerosis and its comorbidities in Chinese patients. A total of 910 subjects, including 748 Chinese patients with one or more cardiovascular risk factors (80.2% male, mean age 73.69±5.03 years) and 162 healthy volunteers (78.4% male, mean age 73.60±5.32 years) were recruited into the study. PWV was measured in 910 subjects, and large artery arteriosclerosis was defined as PWV ≥12 m/s. Multivariable logistic regression analyses were performed to identify risk factors associated with arteriosclerosis. The prevalence of large artery arteriosclerosis in the patients overall was 67.4%, and the prevalence was higher in patients with than in those without HP (63.3% vs. 34.0%; odds ratio [OR]: 3.451), T2DM (24.8% vs. 11.1%; OR: 2.854), CHD (56.1% vs. 45.1%; OR: 1.246) and stroke (26.6% vs. 19.2%; OR: 1.236), but the OR values of CHD and stroke did not differ significantly (p>0.05). After multiple logistic regression analysis, female sex, older age, HP and T2DM were risk factors for large artery arteriosclerosis. In conclusion, PWV can be used as a routine measurement to scan arteriosclerosis in patients with HP or T2DM.

/pdf/pulse-wave-velocity-as-a-marker-of-arteriosclerosis-and-its-2moc79jv5k.pdf

Pulse wave velocity as a marker of arteriosclerosis and its comorbidities in Chinese patients.

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Papers

Correlation between brachial-ankle pulse wave velocity and arterial compliance and cardiovascular risk factors in elderly patients with arteriosclerosis.

Determination of the aortic pulse wave velocity in 545 healthy subjects

Pulse wave velocity as a marker of arteriosclerosis and its comorbidities in Chinese patients.