Selected Abstracts from Artery 21

doi:10.1007/s44200-021-00008-4

2021-12-01 00:00:00

Artery Research (2021) 27:S1–S36 Artery Research https://doi.org/10.1007/s44200-021-00008-4 Open Access ABSTR AC T S Thursday 21 – Saturday 23 October 2021, Hôpital Européen Georges-Pompidou, Paris, France All content was reviewed and approved by the Society Committee, which held full responsibility for the abstract selections. 1.1 Central pulse pressure in adolescence is more strongly associated with future cardiovascular health than peripheral pulse pressure 1 1 1 2 Dr Chloe Park , Dr Siana Jones , Dr Hannah Taylor , Dr Laura Howe , 2 1 Professor Abigail Fraser , Professor Nish Chaturvedi , Professor Alun Hughes 1 2 UCL, London, United Kingdom, Univeristy of Bristol, Bristol, United Kingdom Conclusion: Adolescent cPP is more closely associated with future Background: Increased left ventricle mass (LVM), arterial stiffness and LVM, cfPWV and cIMT than bPP. These results suggest that central carotid intima-media thickness (cIMT) are predictors of cardiovascu- rather than peripheral blood pressure may be a better measure of lar disease independent of blood pressure. Cross-sectional investi- future risk in adolescence. gation in adolescence has shown that central pulse pressure (cPP) is more closely associated with target organ damage than peripheral 1.2 pulse pressure (pPP) (1). Longitudinal follow-up of these adolescents New carotid stiffness population centiles in the young is required to determine if pPP or cPP is more closely associated with and association with measures of general and abdominal obesity future cardiovascular health. 1,2 1 Mrs. Julia Charlotte Büschges , Angelika Schaffrath Rosario , Dr. 1,2 1 3 Methods: 3898 participants (2173 female) in the Avon Longitudinal Giselle Sarganas , Dr. Anja S chienkiewitz , Dr. Karsten Königstein , Dr. 3 1,2 Study of Parents and Children (ALSPAC) underwent repeat meas- Arno SchmidtT ‑ rucksäss , Dr. Hannelore Neuhauser urements of pPP and cPP (SphygmoCor), LVM (echocardiography 1 2 UCL, London, United Kingdom, Univeristy of Bristol, Bristol, United n = 1346), carotid-to-femoral pulse wave velocity (cfPWV n = 1596, Kingdom, Department of Epidemiology and Health Monitoring, Robert Vicorder) and cIMT (n = 1520) aged 17 years and 24 years. LVM was 1.7 Koch‑Institute,, Germany, DZHK (German Centre for Cardiovascular indexed to height (LVMI). Multivariable linear regression was used to Research), Germany, Department of Sport, Exercise and Health, Division assess longitudinal associations between pPP/cPP aged 17 years and Sports and Exercise Medicine, University of Basel, Basel, Siwtzerland LVMI, cfPWV and cIMT aged 24 years. Data for sexes were pooled and adjusted for age, sex and parental socioeconomic position (model 1). Background: Data on carotid stiffness (cS) in unselected adoles- Bootstrapping (10,000 replications) was used to compare pPP and cPP cents and young adults are scarce. To validly investigate associations associations. with established risk factors, centiles are needed by age and growth. Results: Aged 17 years, the difference between pPP and cPP was Although evidence has accumulated linking obesity in the young marked (mean difference (95% CI) = 20.7 (20.5, 21.0) mmHg). pPP to elevated cIMT, studies rarely included cS or compare obesity and cPP were both positively associated with future LVMI cfPWV and parameters. cIMT aged 24 years (Table 1) but associations were stronger for cPP (bootstrap p < 0.0001 for all). Differences in strength of associations Methods: The KiGGS cohort 11-year-follow-up included high-resolu- remained after adjustment (model 1). tion B-mode CCA-sonography with semi-automated edge-detection and automatic electrocardiogram-gated real-time quality control. Dis- tensibility coefficient, stiffness index ß, Young’s and Peterson’s elastic modulus were assessed in 4,305 participants aged 14–28 years. Fol- lowing cS and CIMT centile estimation with GAMLSS models, associa- tions were investigated using log-binominal regression models with cS and CIMT ≥ 90th centile as outcomes and covariates including © The Author(s) 2021. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. Artery Research (2021) 27:S1–S36 S2 obesity measures (BMI, waist circumference WC, waist-to- height ratio, 1.4 fat mass and fat free mass) and a risk score from added z-scores of tri- Ethnic variations in body composition may help to explain glycerides, total/HDL-cholesterol-ratio and HbA1c. differences in arterial stiffness: a UK cross‑sectional study Results: Multivariable models show a pattern of associations of obe- in hypertension sity measures with various cS parameters with mostly moderate effect 1 1 1 Dr Luca Faconti , Mr Ryan McNally , Miss Bushra Farukh , Professor Phil estimates, but consistent direction (relative risks between 1 and 2). Chowienczyk This holds for longitudinal analyses and cross-sectional analyses, e.g. King’s College London, London, United Kingdom RR of 1.72 (CI 1.22–2.42) for baseline BMI ≥ P90 on elevated ß stiffness Background:: Ethnic disparities in arterial stiffness have been index. Associations with elevated CIMT are pointing in the same direc- reported in Europe although it is unclear if these are independent of tion, but are mostly not statistically significant. traditional cardiovascular risk factors including fat mass which a more Conclusions: Using third-generation sonography and centiles com- accurate measure of the metabolic phenotype compared to body puted with novel statistical methods, this study confirms that adi- mass index (BMI). Here we test if the difference in body composition posity in childhood is linked to subclinical atherosclerosis in young (rather than BMI) explains any difference in arterial stiffness in a bi-eth- adulthood. The results emphasize the importance of interventions in nic cohort of hypertensive individuals in the UK. adolescence to delay the development of vascular alterations. Methods: Anthropometric data, biochemistry (including aldosterone/ 1.3 renin ratio (ARR)), arterial stiffness (carotid femoral pulse wave velocity (cf- Does sex and calibration influence cardiovascular risk prediction PWV)) and multi-frequency bioelectrical impedance analysis (BIA) were from central systolic blood pressure? measured in subjects with hypertension free from cardiovascular disease. 1 3 Results: 177 black (55% male) and 142 white (71% male) subjects were Dr Florence Lamarche , Dr Mohsen Agharazii , Dr Siegfried 4 4 recruited. Black individuals had higher blood pressure (mean ± SE) Wassertheurer , Dr Bernhard Hametner , Dr Annie‑Claire 2 1 1 (152 ± 1.48/93 ± 0.95 vs 143 ± 1.17/89 ± 0.9) and higher prevalence of Nadeau‑Fredette , Dr François Madore , Dr Remi Goupil 1 2 diabetes (13% vs 3%, P < 0.05). BMI was higher in black subjects com- Hopital de Sacré‑coeur de Montréal, Hôpital Maisonneuve‑Rosemont, 2 2 3 4 pared to white (30.08 ± 0.34 kg/m vs 28.81 ± 0.49 kg/m , P = 0.038) CHU de Québec, Austrian Institute of Technology and BIA revealed a higher percentage of fat mass (30.18 ± 0.71% vs Background: The accuracy of central BP is usually improved from cali- 27.26 ± 0.77% respectively, P = 0.006). Unadjusted cf-PWV was higher bration with MAP and DBP (C2SBP) compared to calibration with SBP in black vs white individuals (10.21 ± 0.17 m/s vs 9.35 ± 0.16, P = 0.035) and DBP (C1SBP). While preliminary data suggest C2SBP may have the After adjustment for age, gender, blood pressure, heart rate, creati- best accuracy in females, we aimed to assess whether this could trans- nine, ARR, prevalence of diabetes, dyslipidaemia, antihypertensive use late into improved cardiovascular (CV ) risk prediction. and BMI, the difference persisted (P = 0.031). However, when fat mass was substituted for BMI, significance was lost. Methods: 12,927 participants free of baseline CV disease, with pro- Conclusions: Difference in body composition may help to explain spective follow-up from administrative databases and central BP meas- ethnic differences in arterial stiffness in hypertensive subjects living in urements were included. C1SBP was estimated with SphygmoCor Px the Northern Hemisphere. devices. C2SBP was derived from unprocessed radial pressure wave- forms recalibrated with DBP and 40% form factor derived MAP. Partici- pants with heart rate < 60 were excluded due to incomplete waveforms. 1.5 Major adverse CV events (MACE) comprised myocardial infarction, Central‑to‑peripheral pulse amplification and stiffness gradient stroke, heart failure with hospitalization and CV death. Multivariable determine dicrotic wave: Mediation by triphasic flow fluctuation Cox regressions, differences in area under the curve, net reclassification 1,2 1 Prof. Junichiro Hashimoto , Dr. Kaname Tagawa , Dr. Berend index and integrated discrimination index were calculated comparing 3 2,4 Westerhof , Prof. Sadayoshi Ito C2SBP to C1SBP and to bSBP, with and without stratification for sex. 1 2 Miyagi University of Education Medical Center, Sendai, Japan, Tohoku Results: Over a median follow-up of 10.1 years (IQR 9.9–10.3), 2125 University Graduate School of Medicine, Sendai, Japan, Vrije Universiteit MACE (723/7013 females and 860/5934 males) occured. All BP param- Amsterdam, Amsterdam, Netherlands, Katta General Hospital, Shiroishi, Japan eters were significantly associated with MACE, regardless of sex. In the Purpose: Blood pressure fluctuates during diastole creating a dicrotic overall cohort, risk prediction metrics marginally favored C2SBP com- wave, but the mechanistic origin remains poorly understood. We pared to bSBP, but were similar to C1SBP. No significant improvement sought to investigate hemodynamic determinants of this pressure of CV risk prediction was found in sex-stratified analyses (see Table). fluctuation, focusing particularly on its association with diastolic flow Conclusions: C2SBP marginally improved CV risk prediction when fluctuation. compared to bSBP but not to C1SBP in the overall cohort only. All three BP parameters were similarly predictive in both sex, although Methods: Using tonometry and ultrasound, pulse waveforms were this analysis possibly lacked power. This may be related to the FF- recorded on the femoral artery in 592 patients (age: 55 ± 14 years) to derived MAP (rather than oscillometric MAP), which is highly depend- estimate the diastolic pressure fluctuation as a residual wave amplitude ent on the brachial SBP. against the mono-exponential decay and the diastolic flow fluctua- 1,2 tion as a bidirectional (forward and reverse) velocity pulse height. The radial, carotid, and dorsal pedis waves were also recorded to measure the peripheral/aortic pulse pressure (PP) and pulse wave velocity (PWV) ratios. Results: In the femoral waveforms, the beginning of diastole cor- responded with the reverse velocity peak, after which the dicrotic notch appeared. The femoral pressure and flow fluctuations were mutually correlated in amplitude as indexed to the total pulse height (r = 0.63), although the latter preceded the former. In multivariate- adjusted models, higher peripheral/aortic PP and PWV ratios indepen- dently correlated with greater pressure and flow fluctuation indices (P < 0.001). Mediation analysis revealed that the relationship between PP and PWV ratios and the pressure fluctuation index was mediated by the flow fluctuation index (indirect/total effect ratio: 57 [95% confi- dence interval, 42–80]% and 54 [30–100]%, respectively). Conclusions: These results suggest that central-to-peripheral PP amplification and stiffness gradients produce triphasic flow Artery Research (2021) 27:S1–S36 S3 fluctuations and thereby generate dicrotic pressure waves. Diminished 1.7 pressure and stiffness gradients caused by aortic stiffening may thus Acute effect of heat‑not‑burn versus standard cigarette smoking reduce diastolic runoff leading to ischemic organ damage. on arterial stiffness and wave reflections in young smokers 1 1 Research Associate Eleni Emmanouil , MD Nikolaos Ioakeimidis , MD 1.6 1 1 Dimitrios Terentes‑Printzios , MD Ioanna Dima , MD Konstantinos Differences in systolic‑diastolic distensibility indicate carotid wall 1 1 Aznaouridis , Professor Dimitris Tousoulis , Professor Charalambos viscosity in healthy controls, patients with hypertension and type 1 Vlachopoulos 2 diabetes 1 Hypertension and Cardiometabolic Syndrome Unit and Smoking 1 2 Cessation Unit, 1st Cardiology Department, Athens Medical School, Mr Alessandro Giudici , Professor Carlo Palombo , Mrs Michaela 3 2 3 Hippokration Hospital, Athens, Greece Kozakova , Dr Carmela Morizzo , Professor Giuseppe P enno , Dr Giuli 4 4,5 4 Purpose: The aim of this study was to compare the acute effects of Jamagidze , Mr Daniele Della Latta , Professor Dante Chiappino , 6 1 heat-not-burn cigarette (HNBC) and standard tobacco cigarette (TC) Professor J. Kennedy Cruickshank , Professor Ashraf W. Khir 1 smoking on arterial stiffness, assessed by carotid-femoral pulse wave Brunel Institute for Bioengineering, Brunel University London, Uxbridge, 2 velocity (c-fPWV), brachial-ankle (b-a) PWV and augmentation index United Kingdom, Department of Surgical, Medical, Molecular Pathology 3 (AIx). and Critical Area Medicine, University of Pisa, Pisa, Italy, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy, 4 Methods: We studied 22 current smokers (age: 33 ± 5 years, 55% G. Pasquinucci Heart Hospital, G. Monasterio Foundation, Pisa, Italy, 5 6 females, no other risk factors, or any medications) on three different TeraRecon, Durham, USA, School of Life‑Course/Nutritional Sciences, smoking sessions: a) HNBC heat stick, b) standard TC and c) sham ciga- King’s College, St. Thomas’ & Guy’s Hospitals, London, United Kingdom rette. The mean nicotine content for both cigarette forms was 0.5 mg. Background: Soft tissues, as the arterial wall, exhibit viscoelastic behav- Heart rate (HR), blood pressure (BP), AIx corrected for HR (AIx@75), iours (1). Consequently, pressure (P)-diameter (D) loops show hysteresis, c-fPWV and b-aPWV were assessed immediately before and after i.e., different loading and unloading paths. Arterial distensibility (Ds ), an smoking, and then at 5, 10, 20 and 30 min. established predictor of cardiovascular risk, is related to the slope of the Results: Both brachial and aortic systolic BP increased immediately P-D relationship and may, hence, differ between the systolic ejection after the end of TC smoking (by 11.5 and 10.5 mmHg, P < 0.001 and ( Ds) and diastolic recoil ( Ds) due to wall viscosity. This study aimed to s d P < 0.01, respectively) and HNBC use (by 7.5 and 6 mmHg, all P < 0.01). characterise differences between Ds and Ds in a cohort of healthy con- s d Responses from baseline between the two smoking forms were not sta- trols, and hypertensives and type-2 diabetic (T2DM) patients. tistically significant at any time point throughout the entire study period (all P > 0.05). Compared to sham smoking, cfPWV, baPWV and AIx@75 Methods: P and D waveforms were acquired simultaneously at the increased immediately after the end of TC smoking (by 0.29 m/s, 93 cm/s left and right common carotid artery, respectively, in n = 35 controls, and 3.3%, respectively) and remained increased after 5 min. Likewise, n = 113 T2DMs, and n = 41 hypertensives. Ds and Ds were estimated s d 2 HNBC smoking induced a significant increase in cfPWV, baPWV, AIx@75 via a linear regression of the P-D relationship in the range of end dias- (by 0.30 m/s, 86 cm/s and 3.5%, respectively). (Figure). tolic (DBP)-dicrotic notch pressures in the respective arms of the loop: Conclusion: TC and HNBC smoking acutely increased BP and arterial where D is the diameter at DBP. Wall viscosity was evaluated as the stiffness in young smokers, which is likely mediated, at least in part, by hysteresis area (H ) enclosed in the PD-loop (2). nicotine. This similar effect is questioning the characterization of HNBC smoking as a risk-reduction product, at least in the short-term. (1,2). 2.1 Prediction of long‑term outcomes by arterial stiffness and pressure wave reflections in patients with acute stroke: the Athens Stroke Registry −1 Results: Ds was 36.1 ± 13.2 MPa in controls, not significantly 1,2 3 Mrs Stamatia Samara , Mrs Anastasia Vemmou , Mrs Aikaterini −1 different from either hypertensives (28.3 ± 11.7 MPa ) or T2DMs 3 3 3 Kyrkou , Mr Christos Papamichael , Dr Eleni Korompoki , Dr George −1 (31.4 ± 13.8 MPa ). However, while Ds = ( Ds– Ds)/ Ds was only 5.8% 4 3 3 s d d Ntaios , Dr Efstathios Manios , Dr Kimon Stamatelopoulos , Dr Athanasios in controls, it was higher at 9.3% (p = 0.12) and 13.2% (p = 0.007) in 2 3 Protogerou , Dr Konstantinos Vemmos T2DMs and hypertensives, respectively (Figure). Similarly, H was 1 2 Laiko General Hospital, Athens, Greece, Cardiovascular Prevention much higher in hypertensives at 0.96 ± 0.85 mmHg mm than controls & Research Unit, Clinic & Laboratory of Pathophysiology, Department (0.32 ± 0.34 mmHg mm, p < 0.001), with T2DMs exhibiting intermedi- of Medicine, National and Kapodistrian University of Athens, Athens, ate values (0.63 ± 0.63 mmHg mm). Greece, Therapeutic Clinic, Department of Medicine, National Conclusion: Increasing distensibility differences between early sys- and Kapodistrian University of Athens, Athens, Greece, Department tole and late diastole are due to elevated viscous properties of the of Internal Medicine, Faculty of Medicine, School of Health Sciences, carotid wall in hypertension. University of Thessaly, Larissa, Greece, Larissa, Greece Background: Stroke patients’ management might be improved by addressing the role of aortic stiffness (carotid-femoral Pulse Wave Velocity—cfPWV) and pressure wave reflections (PWRs, augmentation index—AIx) in their pathogenesis and outcome . Artery Research (2021) 27:S1–S36 S4 Methods: We tested the hypothesis that cfPWV and AIx, separately Science, University of Sao Paulo,, Brazil, Departament de Farmacologia, and combined , predict long-term outcomes [all-cause mortality, de Terapèutica i de Toxicologia, Facultat de Medicina, Institut de incidence of cardiovascular events, stroke recurrence and disability Neurociències, Universitat Autònoma de Barcelona,, Spain, Laboratory defined by modified Ranking Scale (mRS) ≥ 3] in patients with acute of Experimental Cardiology, August Pi i Sunyer Biomedical Research stroke, using data from the “Athens Stroke Registry”. We analyzed data Institute (IDIBAPS), Hospital Clinic Cardiovascular Institute,, Spain from 552 patients (70% men, mean age: 66.1 10.4 years, mean follow- The contribution of sympathetic nervous system overactivation to up 68.4 41.4 months, 13.4% deaths from any cause, 21.2% cardiovas- aging-associated cardiovascular dysfunction in postmenopausal cular events, 14.1% stroke recurrences and 20.1% poor mRS). women is controversial . We tested the hypothesis that the alpha 1A Results: (a) high aortic stiffness (cfPWV > 13 m/sec) alone is an inde- (α ) adrenoceptor, an α‐adrenergic receptor subtype, regulates 1A 2+ pendent predictor of all-cause mortality and CV events, but not of calcium (Ca ) influx and prostanoids release, contributing to com- stroke recurrence and poor functional outcome; (b) evaluated sepa- mon carotid artery dysfunction in female senescence-accelerated rately form aortic stiffness, neither low nor high PWRs have any prog- mice. Eight-month-old senescence-accelerated (SAMP8) and control nostic value; (c) even after multiple adjustments, patients with both (SAMR1) mice were used to evaluate the carotid function. Binding high aortic stiffness (cfPWV > 13 m/sec) and low PWRs (AIx < 22%) have assay with [3H] prazosin was used to determine the adrenergic recep- almost twofold higher odds ratio, not only for all-cause mortality and tor density. COX-1 protein expression was determined by western CV events but also for stroke recurrence and poor functional outcome. blot and prostanoids levels by ELISA. Results are presented as the Conclusions: In the latter subgroup of stroke patients, increased cer- mean ± SEM, n = 4–6. Statistical analysis: One-way ANOVA, followed ebrovascular morbidity could be attributed to excessive pressure pul- by Bonferroni and p < 0.05. SAMP8 mice exhibited increased phenyle- satility in brain microcirculation, as a consequence of increased arterial phrine-induced vasoconstriction vs. SAMR1 [Rmax (% of 60 mM KCl- stiffness combined with abnormally very low PWRs generated proxi- induced responses): 109 ± 3 vs. 81 ± 1, respectively)]. An α1A receptor mally to the microcirculation, resulting in loss of pulsatility buffering . antagonist, but not an α1D antagonist, abrogated the increased carotid contractions in SAMP8 (Rmax: 87 ± 4) vs. SAMR1 (89 ± 3) mice. 2+ The adrenergic receptor density and C a influx were higher in SAMP8 2.2 2+ arteries vs. SAMR1 arteries. An anti-α1A antibody reduced Ca influx Respective roles of hemodynamic conditions and inflammatory in vascular smooth muscle cells of SAMP8. Prostacyclin (PGI ), but not status in the degradation of endothelial glycocalyx in adults. thromboxaneA (TXA ) levels, and COX-1 protein expression were 2 2 1 1 Phd Jeremy Lagrange , PharmD PhD Simon Toupance , Arthur decreased in phenylephrine-stimulated carotids of SAMP8 vs. SAMR1 1 1 1 Thomas , PhD Carlos Labat , PhD Véronique R egnault , MD PhD Athanase carotids. Our data suggest that the α1A adrenoreceptor subtype medi- 1 1 2+ Benetos , MD PhD Patrick Lacolley ates common carotid artery dysfunction in aging by increasing Ca INSERM 1116, Vandoeuvre‑lès‑Nancy, France influx and promoting COX-1-mediated prostanoids unbalance. Background and objectives: Interactions between blood compo- nents and the vascular wall involve the glycocalyx, a thin layer of Financial Support: FAPESP, Brazil (2017/25116–2). carbohydrates covering endothelial cells. Glycocalyx is implicated in processes such as circulating cells adhesion, inflammation, and coagu- 2.4 lation regulation and can be damaged in some pathologies. The pre- Vascular Ageing Glossary: unifying language for knowledge vailing hypothesis is that hypertension is the primary factor involved diffusion in the glycocalyx degradation. However, our preliminary results chal- 1,2 3,4,5 6 lenge this view and point to a more important role of inflammation. Dr Peter Charlton , Dr Rachel Climie , Dr Christopher Clemens Mayer , 7 8 9 The objective of this study was to assess the respective roles of inflam- Dr Manasi Nandi , Dr Arno Schmidt‑ Trucksäss , Dr Patrick Segers , Dr 10 11 mation and hemodynamic on the endothelial glycocalyx degradation. Dimitrios Terentes‑Printzios , Dr Bianchini E. for VascAgeNet The Department of Public Health and Primary Care, University Methods and results: Plasma concentrations of syndecan-1 and of Cambridge, Cambridge, UK, Research Centre for Biomedical thrombomodulin, two glycocalyx degradation markers, were quan- Engineering, City, University of London, London, UK, Menzies Institute tified by ELISA in 327 atherosclerotic and non-atherosclerotic par - for Medical Research, University of Tasmania, Hobart, Australia, Baker ticipants (62 ± 14 years) of the TELARTA cohort (telomere in arterial Heart and Diabetes Institute, Melbourne, Australia, Université de Paris, aging). Syndecan-1 was positively associated with circulating IL-6 INSERM, U970, Paris Cardiovascular Research Center (PARCC), Paris, France, (p < 0.001), IL-8 (p = 0.002), and IL-10 concentrations (p = 0.006) and AIT Austrian Institute of Technology, Center for Health & Bioresources, with adhesion molecules ICAM-1 and VCAM-1 (p < 001). By contrast, Vienna, Austria, Faculty of life sciences and medicine, King’s Collège no relation was observed between glycocalyx degradation markers London., London, UK, MD. Division of Sports and Exercise Medicine, and the hemodynamic parameters (systolic, diastolic and pulse pres- Department of Sport, Exercise and Health, Medical Faculty, University sure, pulse wave velocity), thus confirming the major role of inflamma- of Basel, Basel, Switzerland, Institute for Biomedical Engineering tory status in the degradation of endothelial glycocalyx. Interestingly, and Technology (IBiTech), Ghent University, Ghent, Belgium, First subjects with higher plasma concentration of syndecan-1 (third tertile) Department of Cardiology, Hippokration Hospital, Medical School, were more prone to present clinical manifestation of atherosclerosis National and Kapodistrian University of Athens, Athens, Greece, Institute (65 vs 42%; p < 0.001) than those with lower concentration (first tertile). of Clinical Physiology, CNR, Pisa, Italy Conclusions: Inflammatory status appears as the major responsible of Purpose: VascAgeNet is a European multidisciplinary collaborative endothelial glycocalyx degradation in atherosclerosis. Deciphering the network on vascular ageing funded by the European Cooperation in processes involved in this degradation and the possible treatment to Science and Technology (COST, CA18216). Multidisciplinary collabora- limit it would be of interest in the next future. tions benefit from a common language and collective understanding of fundamental principles, concepts and techniques to strengthen communication among researchers within and outside the network 2.3 and to improve readability of scientific outputs and their impact on Apha1A‐adrenoceptor‑induced increased calcium influx the society [1]. and prostanoids unbalance promote carotid artery dysfunction in senescence‑accelerated (SAMP8) female mice Methods: The network agreed on the need for a vascular ageing glos- 1 1 1 Dr Tiago J. Costa , M.S. Paula R. Barros , Dr Diego Ângelo Duarte , sary to promote a common language across the field. Experts from the 1 2 M.S. Júlio A. da Silva‑Neto , Dr Renèe de Nazaré Oliveira‑ da‑Silva , network identified an initial list of terms and preliminary definitions. 2 2 Dr Rosangela A. Santos‑Eichler , Dr Eliana H. Akamine , Dr Francesc A dedicated team, including representatives from all Working Groups, 3 4 1 Jiménez‑Altayó , Dr Ana Paula Dantas , Dr Rita C. Tostes was created to design the glossary development process, to facilitate Department of Pharmacology, Ribeirão Preto Medical School, University its implementation [2] and to maximize outreach and dissemination. of Sao Paulo,, Brazil, Department of Pharmacology, Institute of Biological Artery Research (2021) 27:S1–S36 S5 Results: Regular meetings of the dedicated team were conducted, 3.1 and main decisions were agreed by all members. The key steps of The aortic‑femoral arterial stiffness gradient is blood the process for managing the creation and maintenance of the glos- pressure independent in older adults: an atherosclerosis risk sary were to determine: (1) the target audience; (2) a list of priority in communities (ARIC) study terms; (3) a template structure for definitions; (4) methods for collect - 1 2 2 Miss Jillian Poles , Mr. Keeron Stone , Dr. Simon F ryer , Dr. James ing expert feedback; and (5) the dissemination plan. An implementa- 3 4 5 Faulkner , Dr. Michelle Meyer , Dr. Kevin Heffernan , Dr. Anna tion strategy was provided by the team for each point (Figure). Small 6 1 2 Kucharska‑Newton , Mr. Gabriel Zieff , Mr. Craig P aterson , Dr. Kunihiro groups of terms will be released on a regular basis and published 7 8 9 1 Matsushita , Dr. Timothy Hughes , Dr. Hirofumi Tanaka , Dr. Lee Stoner openly at https:// vasca genet. eu/. Department of Exercise and Sport Science, University Of North Carolina Conclusions: The strategy for the first Vascular Ageing Glossary has at Chapel Hill, Chapel Hill, United States, School of Sport and Exercise, been successfully designed and developed within VascAgeNet. It will University of Gloucestershire, Gloucester, United Kingdom, Department be a living document, available to the scientific community, which of Sport, Exercise & Health, University of Winchester, Winchester, United aims to unify the vascular ageing language. Kingdom, Department of Emergency Medicine, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, United States, 2.5 Department of Exercise Science, Syracuse University, Syracuse, United Acute and long‑term effects of aortic banding on central States, Department of Epidemiology, The Gillings School of Global hemodynamics Public Health, University of North Carolina at Chapel Hill, Chapel Hill, 1 2 1 United States, Department of Epidemiology, Johns Hopkins Bloomberg Stamatia Pagoulatou , Dionysios Adamopoulos, Vasiliki Bikia , Georgios 1 1 School of Public Health, Baltimore, United States, Section of Gerontology Rovas , Nikolaos Stergiopulos and Geriatric Medicine, Department of Internal Medicine, Wake Forest Laboratory of Hemodynamics and Cardiovascular Technology, Lausanne, School of Medicine, Winston Salem, United States, Department Switzerland, Department of Cardiology, Geneva University Hospitals, of Kinesiology and Health Education, The University of Texas at Austin, Geneva, Switzerland Austin, United States Background: Aortic compliance is an important determinant of car- Background: Aortic arterial stiffness is a strong independent predic - diac afterload and a contributor to cardiovascular morbidity. The aim tor of cardiovascular disease (CVD), however its dependence on mean of the present study was to provide in-silico insights into the acute arterial pressure (MAP) limits its clinical utility. The aortic-femoral arte- as well as long-term effects of aortic compliance decrease on central rial stiffness gradient (af- SG), a novel marker of CVD risk, may be a hemodynamics by means of a 1D, validated mathematical model of promising alternative, but its dependence on MAP is not known. The the cardiovascular system. aim of this study was to determine the relationship between MAP and the af-SG. Methods: Three hemodynamic states were simulated to represent a) a healthy young adult (baseline), b) acutely after banding of the Methods: We evaluated the dependency of the af-SG on MAP in proximal aorta, c) after the heart remodeled itself due to the increased healthy older adults (n = 694, aged 74 ± 5 years), and adults with afterload. The simulated pressure and flow waves were used for subse - hypertension (n = 2040, aged 76 ± 5 years), and diabetes (n = 1405, quent pulse wave and wave separation analysis. aged 75 ± 5 years) as part of the community- based Atherosclerosis Results: Aortic banding induced hypertension, which was sustained Risk in Communities (ARIC) Study. Carotid-femoral pulse-wave velocity after LV remodeling. The main mechanism that drove hypertension (cfPWV), femoral-ankle PWV (faPWV), and blood pressure were meas- was the enhancement of the forward wave, which became even more ured using standardized protocols. The af-SG was calculated as faPWV significant after LV remodeling (forward amplitude 30 mmHg at base - divided by cfPWV. Multivariable regression analysis was performed to line vs 60 mmHg acutely after banding vs 64 mmHg after remodeling). test the independent association of MAP with af-SG, with adjustments Accordingly, the forward wave’s contribution to the total pulse pres- for known confounders including age, sex, body mass index, blood sure increased throughout this process. Finally, LV remodeling was glucose and heart rate. accompanied by a decrease in augmentation index (AIx 13% acutely Results: There was no significant relationship between the af-SG after banding vs -3% after remodeling) and a change of the central and MAP in healthy (β = 0.002, p = 0.301), hypertension (β = − 0.001, pressure wave phenotype from the characteristic Type A (“old”) to p = 0.298) or diabetes (β = − 0.001, p = 0.063) population groups, Type C (“young”) phenotype (Fig. 1). Simulated pressure phenotypes with MAP explaining < 0.1, < 0.1 and 0.2% of the variance in the af-SG, were in close agreement with previous experimental findings (1). respectively. Conclusion: These findings highlight the importance of the forward Conclusions: These findings suggest that the af-SG may be regarded pressure wave in the development of hypertension and provoke us to as a MAP independent index of arterial health and CVD risk in older reconsider our understanding of AIx as a solely arterial parameter. adults. 3.2 Arterial stiffness is associated with impaired orthostatic diastolic blood pressure reaction and increased central blood pressure: A prospective population‑based study 1 1 Dr. Madeleine Johansson , Prof. Peter M Nilsson , Prof. Gunnar 1 1 Engström , Assoc Prof. Viktor Hamrefors Lund University, Malmö, Sweden Background: Arterial stiffness is independently associated with orthostatic hypotension. We aimed to investigate the relationship between orthostatic blood pressure reaction and arterial stiffness as well as central hemodynamics in younger subjects from the general population. Methods: We analyzed a large prospective cohort study of 3756 individuals from the general population (mean age 41.9 ± 14.5 years, Fig. 1 Acute and long-term changes of central aortic pressure and flow 52.1% women) in the Malmö Ospr ff ing Study (MOS), Sweden. Assess- due to aortic banding. (left) Baseline. (center) Acutely after banding. ment of arterial stiffness and central hemodynamics was made (right) After LV remodeling under the form of concentric hypertrophy. by measurement of carotid-femoral pulse wave velocity (c-f PWV) Artery Research (2021) 27:S1–S36 S6 (Sphygmocor AtCor, Australia) and pulse wave analysis (PWA) at the Methods: 17 patients affected by hypoparathyroidism and 17 healthy arteria radialis in relation to an orthostatic blood pressure reaction controls (matched for age, sex, blood pressure and risk factors) were after 5 min standing using linear regression models. studied to obtain carotid-femoral PWV, carotid and digital intima- Results: We found a significant association between orthostatic dias- media thickness and stiffness by standard and ultra-high frequency tolic blood pressure reaction and c-f PWV levels, that is, increased c-f ultrasound respectively. In the patients affected by hypoparathy - PWV as observed in arterial stiffness, was associated with lower dias- roidism, complete calcium-phosphorus metabolism blood tests were tolic blood pressure increase upon standing after adjusting for age taken. and sex (p = 0.016). Moreover, we observed that increased systolic Results: Carotid distensibility was significatively lower in the patients blood pressure on standing was associated with a higher central blood group (18.7 ± 6.0 vs 39.4 ± 10.5 p < 0.001), with a marked increase pressure in the ascending aorta after adjusting for age, sex, hemo- in carotid stiffness (7.6 ± 1.3 vs 5.3 ± 0.9 m/s, p < 0.001). No signifi- globin A (HbA ) levels, and current smoking (p = 0.006). cant difference was reported in PWV and central pressure among the 1C 1c Conclusions: Our preliminary findings suggest that orthostatic groups. A reduced digital artery diameter was present (mean diameter hypotension, which is commonly observed in older individuals, is 0.8 ± 0.1 vs 1.0 ± 0.2 mm p = 0.005), with a reduced stiffness (5.6 ± 2.5 associated with markers of arterial stiffness (vascular ageing) and vs 9.2 ± 4.9 m/s p < 0.05). A positive correlation between carotid artery hemodynamic changes also in a younger population. stiffness and Calcium–Phosphorus product was found in the patients group (r = 0.661 p = 0.037). Conclusions: Hypoparathyroidism is characterized by increased 3.3 carotid artery stiffness. Digital stiffness (UFHS) is paradoxically reduced The effect of mRNA vaccine against COVID‑19 on endothelial (possibly as compensatory mechanism), with hypotrophic remodeling. function and arterial stiffness Our data support altered calcium-phosphorus metabolism as mecha- 1 1 Dr. Dimitrios Terentes‑Printzios , Dr. Vasiliki Gardikioti , Dr. Eirini nism of arterial damage. 1 1 1 Solomou , Mrs Elena Emmanouil , Dr. Ioanna Gourgouli , Dr. Panagiotis 1 1 1 Xydis , Mrs. Georgia Christopoulou , Dr. Christos Georgakopoulos , Dr 3.5 1 1 1 Ioanna Dima , Mrs Antigoni Miliou , Dr. Georgios Lazaros , Dr. Maria Associations of lower limb atherosclerosis and arteriosclerosis 2 1 1 Pirounaki , Prof. Konstantinos Tsioufis , Prof. Charalambos Vlachopoulos with cardiovascular risk factors and disease in older adults: First Department of Cardiology, Hippokration Hospital, Athens Medical, the ARIC study Athens, Greece, Second Department of Medicine, University of Athens, 1 2 2 3 Medical School, Hippokration General Hospital, Athens, Greece, Athens, Patricia Pagan Lassalle , Keeron Stone , Simon Fryer , James Faulkner , 1 4 1,5 GreeceMichelle Meyer , Kevin Heffernan , Anna Kucharska‑Newton , Gabriel 1 2 6 7 Purpose/background/objectives: To fight the COVID-19 pandemic, Zieff , Craig P aterson , Kunihiro Matsushita, Timothy Hughes , Hirofumi 8 1 messenger RNA (mRNA) vaccines were the first to be adopted by vac - Tanaka , Lee Stoner cination programs worldwide. We sought to investigate the short-term The University Of North Carolina At Chapel Hill, Chapel Hill, United effect of mRNA vaccine administration on endothelial function and States, University of Gloucestershire, Gloucestershire, United Kingdom, 3 4 arterial stiffness. University of Winchester, Winchester, United Kingdom, Syracuse University, Syracuse, United States, University of Kentucky, Lexington, 6 7 Methods: Thirty-two participants (mean age 37 ± 8 years, 20 men) United States, Johns Hopkins, Baltimore, United States, Wake Forest, that received the BNT162b2 mRNA COVID-19 vaccine were studied Winston Salem, United States, The University of Texas, Austin, United in 3 sessions in a sequence-randomized, sham-controlled, assessor- States blinded, cross-over design. Primary outcome was endothelial function Background: Atherosclerosis and arteriosclerosis contribute to assessed by brachial artery flow-mediated dilatation (FMD), and sec - advanced vascular aging and cardiovascular disease (CVD) risk. Both ondary outcomes were aortic stiffness, evaluated with carotid-femoral processes can be assessed simply in the lower-limbs and reflect sys- pulse wave velocity (PWV), and inflammation measured by high-sensi- temic pathology. However, only atherosclerosis is routinely assessed, tivity C- reactive protein (hsCRP) in blood samples. The outcomes were typically via ankle-brachial index (ABI). Arteriosclerosis can be assessed assessed prior to, and at 8 h, 24 h post the 1st dose of vaccination, and using femoral-ankle pulse- wave velocity (faPWV), but no studies have 8 h, 24 h and 48 h post the 2nd. identified whether ABI and faPWV similarly associate with overt CVD Results: There was an increase in hsCRP that was apparent at 24 h and risk factors, nor whether faPWV confers additional information. after both the 1st dose (− 0.60 [95% confidence intervals [CI] − 1.60 to − 0.20], p = 0.013) and the 2nd dose (max median difference at 48 h − Objectives: i) Compare independent associations of ABI and faPWV 6.60 [95% CI − 9.80 to − 3.40], p < 0.001) compared to sham. The vac- with traditional CVD risk factors, including age, sex, systolic blood cine did not change PWV. FMD remained unchanged during the 1st pressure (SBP), high-density lipoprotein (HDL), total cholesterol (TC), dose but decreased significantly by 1.5% (95% CI 0.1–2.9%, p = 0.037) smoking, and diabetes. ii) Determine the independent and additive at 24 h post the 2nd dose. FMD values returned towards baseline at associations of ABI and faPWV with a composite measure of prevalent 48 h. CVD status. Conclusions: Our study shows that the mRNA vaccine causes a Methods: We evaluated 4,330 older-aged (75.3 ± 5.0 years) adults prominent increase in inflammatory markers, especially after the 2nd using an oscillometric device. Associations between ABI and faPWV dose and a transient deterioration of endothelial function at 24 h that with CVD risk factors and CVD were determined using mixed-model returns towards baseline at 48 h. These results confirm the short-term linear- and logistic-regression analyses. cardiovascular safety of the vaccine. Results: Both ABI and faPWV were associated with age, HDL, and smoking. ABI was associated with sex, TC, diabetes. faPWV was associ- ated with SBP. Both ABI and faPWV were inversely associated with CVD. 3.4 In categorical analysis low ABI (≤ 0.9 vs. > 0.9) and low faPWV (≤ 9.94 Early vascular ageing in patients with hypoparathyroidism vs. > 9.94) increased the odds of CVD by 2.41-fold (95% CI 1.85, 3.17) 1,2 1 1 Mr Saverio Fabbri , Mr Pierre Bout ouyrie , Mr Hakim Kettab , Mr and 1.46-fold (95% CI 1.23, 1.74), respectively. The inverse association 1 1 1 Gérard Maruani , Mr Pascal Houillier , Ms Rosa Maria Bruno between faPWV and CVD was independent of ABI and CVD risk factors. 1 2 University of Paris, Paris, France, University of Perugia, Perugia, Italy Conclusion: Both ABI and faPWV are independently associated with Objectives: Hypoparathyroidism may induce arterial damage, but CVD risk factors and prevalent CVD. The assessment of faPWV may underlying mechanisms are not well established. Few papers have confer additional risk information beyond ABI. addressed the topic, reporting an increase in central values and in carotid intima-media thickness [1][2]. The aim of this study was to determine the presence of early vascular ageing signs in large and small arteries. Artery Research (2021) 27:S1–S36 S7 3.6 heart-to-brachial (L ) path lengths [3], allow estimation of: a weighted hb Developing a questionnaire on the knowledge and perceptions average of which yields Given P = 0.55·DBP + 0.45·SBP [4]. notch of people working with vascular ageing Results: Choosing SBP/DBP = 120/80 mmHg and = 10 yielded tb = 0.048 s, tba = 0.187 s, w = 0.908 and w = 0.092, implying 1 2 3 1 2 Prof. Areti Triantafyllou , Ms Stavria Artemis Elia , Chloe Park , Rachel that DBP and SBP account for 91% and 9% of PhaPWV, respec- 4 5 2 Climie , Christopher C. Mayer , Andrie G. Panayiotou tively (Fig. B). This was only marginally influenced by BP: e.g., SBP/ 3rd Dep. of Internal Medicine, Aristotle University of Thessaloniki, DBP = 160/90 mmHg yielded w = 0.912 and w = 0.088. 2 1 2 Thessaloniki, Greece, Cyprus University Of Technology, Limassol, Cyprus, 3 4 University College London, London, UK, BAKER HEART AND DIABETES INSTITUTE, Melbourne, Australia, AIT Austrian Institute of Technology GmbH, Vienna, Austria Objective: Vascular ageing (VA) is an emerging cardiovascular dis- ease risk predictor, and an appealing therapeutic target, however, it remains underused in clinical practice. We aimed to create a question- naire to investigate awareness and perceptions of healthcare provid- ers and people working in the field of VA. Conclusions: DBP offers a more accurate approximation of P Methods: An online qualitative questionnaire with open-ended ques- haPWV than P , supporting the utility of CAVI as an enhancement of CAVI. tions was developed based on key questions that were identified by m. 0 an expert working group in the Network for Research in Vascular Age- ing (VascAgeNet) COST Action/CA18216. The questionnaire was dis- 3.8 tributed to participants working in the field of VA. The questions were Antithrombotic therapy in secondary and tertiary prevention intentionally left open-ended to assess knowledge and perceptions, for peripheral arterial disease: a network meta‑analysis without guiding answers. 1 1 2 Dr Loes Willems , Ms Dominique Maas , Dr Michel Reijnen , Dr Niels Results: Out of the 127 responses, 104 questionnaires were complete. 1 3 1 Riksen , Dr Hugo Ten Cate , Dr Rozemarijn Van der Vijver‑Coppen , Dr. The mean age of participants was 42.5 ± 10.5 years, 60.6% male, 54.8% 4 1 1 Clark Zeebregts , Dr. Gerjon Hannink , Dr. Michiel Warlé were academics and/or researchers, 14.4% clinical doctors, and 9.6% Radboud University Medical Center, Nijmegen, The Netherlands, worked in the industry. 67.3% reported that VA is important to them. 2 3 Rijnstate Hospital, Arnhem, The Netherlands, Maastricht University For an explanation of importance, 14.4% reported personal/research Medical Center, Maastricht, The Netherlands, University Medical Center interest, and 46.2% reported a combination of the following: improved Groningen, Groningen, The Netherlands primary prevention-CV risk evaluation/treatment strategies, marker Purpose/Background/Objectives: recent trials demonstrate the of overall health, and underlying cause of diseases. 16.4% and 53.9% superiority of acetylsalicylic acid (ASA) with low-dose rivaroxaban in reported using VA measurements in clinical practice and research, 1–2 peripheral arterial disease (PAD), compared to ASA monotherapy. respectively. Amongst the most frequently reported limiting factors An important question remains how the efficacy of ASA + rivaroxa- were time, lack of reimbursement of tests, cost of equipment, and lack ban relates to clopidogrel, as the first choice antithrombotic therapy of guidelines for VA measurements. in PAD. Therefore, we conducted a network meta-analysis on the effi- Conclusion: Regardless of occupation and specialty, the overall per- cacy of all antithrombotic regimens. ceptions of participants were positive. Future work will investigate why, despite the positive perceptions regarding VA measurements, the Methods: A systematic search was conducted of randomized con- use of VA measures in clinical practice remains low. trolled trials, published between 1995 and 2020. ASA was the universal comparator. The primary endpoint was major adverse cardiovascular 3.7 events (MACE) and the safety endpoint was major bleeding. Second- The VaSera heart‑to‑ankle pulse wave velocity is a nearly diastolic ary endpoints were all-cause mortality (ACM), major adverse limb wave speed metric events (MALE) and acute limb events (ALI). 1,2 2 Results: Twenty-eight randomized controlled trials were identified Mr Alessandro Giudici , Professor Ashraf W. Khir , Professor Koen D. 1 1 1,3 including 49.434 patients. Compared to ASA, MACE was less preva- Reesink , Professor Tammo Delhaas , Professor Bart Spronck lent with clopidogrel [RR0.78, 95% CI 0.66–0.93], ASA + ticagrelor Department of Biomedical Engineering, CARIM School for Cardiovascular [RR0.79 95% CI 0.64–0.97], ticagrelor [RR0.79, 95% CI 0.65–0.97], and Diseases, Maastricht University, Maastricht, Netherlands, Biomedical ASA + rivaroxaban [RR0.84, 95% CI 0.76–0.93] (A). Major bleedings Engineering Research Group, Brunel University London, Uxbridge, United occurred more frequently with ASA + rivaroxaban [RR1.46, 95% CI Kingdom, Department of Biomedical Engineering, School of Engineering 1.18–1.80], rivaroxaban [RR1.47, 95% CI 1.06–2.05], vitamin K antago- and Applied Science, Yale University, New Haven, USA nists [RR1.93, 95% CI 1.41–2.64], ASA + vitamin K antagonists [RR2.77, Background: Estimation of heart-to-ankle arterial stiffness, as quan- 95% CI 1.93–3.97] and ASA + cilostazol [RR2.88, 95% CI 0.12—67.41] tified by heart-to-ankle pulse wave velocity (haPWV), relies on the (B). All regimens were non-superior to ASA concerning ACM (C) and summation of the time differences between: 1) the aortic valve clos- MALE (D). ASA + rivaroxaban was more effective in preventing ALI ing sound and notch of the brachial pressure waveform (tb), and 2) the [RR0.67, 95% CI 0.55–0.80] (E). feet of brachial and ankle pressure waveforms (tba). Cardio-ankle vas- Conclusion: Both clopidogrel and ASA + rivaroxaban were more cular index (CAVI) and CAVI aim to normalise haPWV for blood pres- effective than ASA in secondary prevention, however, ASA + rivaroxa- sure (BP) at the time of measurement. As tb and tba are determined ban increases the risk of major bleeding. Concerning tertiary preven- at diastolic (DBP) and dicrotic notch (P ) BP, respectively (Fig. A), notch tion, information on clopidogrel is lacking, while ASA + rivaroxaban is the choice of the haPWV-relevant normalisation pressure (P ) is haPWV more effective in preventing ALI. not trivial and represents a major difference between CAVI , assuming P = DBP, and CAVI, assuming P P = (SBP + DBP)/2 (SBP: sys- haPWV haPWV m tolic BP). We aimed to analytically estimate P . haPWV Methods: Consistent with CAVI/CAVI assumptions, the arterial tree was modelled as a system of tubes with exponential pressure- diameter relationship and uniform stiffness index. PWV then follows from [1,2]: where P = {DBP , P }, P = 100 mmHg and = 1050 kg/ notch ref m . The resulting PWVs, together with the heart-to-ankle (L ) and ha Artery Research (2021) 27:S1–S36 S8 HIIT + RT: high-intensity interval training combined with resistance training; MICT + RT: moderate-intensity continuous training combined with resistance training; RT: resistance training alone; Asterisk indicates significant difference from before training (*: P = 0.01; **: P = 0.001). 3.10 Evaluation of hemodynamic and vascular responses after a continuous exercise session of moderate intensity and high intensity intervals in individuals with normal and high normal blood pressure 3.9 Superior effect of community‑based high‑intensity interval 1 1 1 Miss Sara Rodrigues , Miss Renata Verardino , Mr Marcel Costa , Miss exercise for reducing blood pressure and arterial stiffness 1 1 1 Valéria Costa‑Hong , Miss Maria Alves , Mr Luiz Bor tolotto in low‑income older women InCor HC FM USP, São Paulo, Brazil 1 1 1 Purpose: Physical exercise (PE) prevents cardiovascular diseases . Mrs. Vanessa Amaral , Mr Gabriel Zanini , Ms Isabela Roque Marçal , 1 1 There is no consensus if different intensities of PE changes arterial stiff- Miss Bianca Fernandes , Mr. Lucas Bueno Gimenez , Miss Fernanda 1 1 ness—by pulse wave velocity (PWV) and augmentation index (AIx) -, a Bianchi Souza , Mr Gabriel Locato , PhD Student Awassi Yuphiwa 1 1 marker of cardiovascular risk , related to blood pressure (BP). Ngomane , Dr. Emmanuel Gomes Ciolac Universidade Estadual Paulista, Bauru, Brazil Objective: In normotensive—normal BP (120–129/80–84 mmHg) and Aim: To assess the effect of different community-based exercise pro - high normal BP (130–139/85–89 mmHg), compare: 1st) arterial stiff- grams on blood pressure, arterial stiffness, and functional capacity in ness after one session of moderate-intensity continuous PE (MICPE) low-income older women. and high-intensity interval PE (HIIPE). 2nd) BP after MICPE and HIIPE. Methods: PE intensity and equalized energy expenditure defined by Methods: 92 insufficiently active low-income older women cardiopulmonary exercise test. Individuals randomized to PE sessions, (71.2 ± 5.21 years) were randomly assigned to community-based high- performed in cross-over fashion. PWV and AIx were measured at rest, intensity interval training combined with resistance training (HIIT + RT, immediately after and 24 h after HIIPE and MICPE, compared among n = 34), moderate-intensity continuous training combined with resist- all moments (baseline, immediately and 24 h after each session). ance training (MICT + RT, n = 38) or resistance training alone (RT, Ambulatory BP monitoring-24 h (ABPM-24 h) was performed after rest n = 20) for nine months. Anthropometric (weight, waist circumference and each session, using the first two hours for comparison. and body mass index [BMI]), hemodynamic (resting blood pressure Results: Individuals (N = 29; 76%women; age = 48 ± 7 years; [BP], heart rate and arterial stiffness [carotid-femoral pulse wave veloc - BMI = 28.3 ± 4 kg/m ; SBP = 126 ± 9; DBP = 84 ± 4 mmHg) had lower ity—PWV]), and functional capacity (handgrip strength and 6-min (p < 0.01) AIx after MICPE (27.1 ± 2.0) and HIIPE (22.7 ± 2.2), than walking test [6MWT]) were assessed before, nine months after train- baseline (33.0 ± 1.8). AIx after MICPE (27.1 ± 2.0) was lower (p < 0.05) ing, and three months after training interruption. than MICPE24h (30.6 ± 2.3). AIx after HIIPE (22.7 ± 2.2) was lower Results: Significant improvements (P < 0.05) on waist circumference, (p = 0.01) than MICPE (27.1 ± 2.0), and than HIIPE24h (32.2 ± 1.9). Sys- handgrip strength and 6MWT were found after both HIIT-RT (waist tolicBP (2 h) reduced after both sessions –MICPE (128 ± 2) and HIIPE circumference: − 3 cm; handgrip strength: + 4 kgf; 6MWT: + 83 m) (127 ± 2 mmHg), compared to baseline (131 ± 2 mmHg; p = 0.02). and MICT-RT (waist circumference: − 3 cm; handgrip strength: 4 kgf; There was no difference in PWV among times, and between individu- 6MWT: + 46 m), while only handgrip strength (+ 4 kgf) and 6MWT als with normal BP and high normal BP. (+ 42 m) improved after RT. However, systolic BP and PWV reduced Conclusion: In normotensive, one PE session, regardless of inten- (P < 0.01) only after HIIT-RT (− 7 mmHg and − 0.6 m/s, respectively). sity, reduces systolicBP during the first 2 h and AIx immediately after, In addition, waist circumference, handgrip strength, 6MWT and PWV returning to baseline values 24 h after PE session. (Fig. 1) improvements were maintained (at least in part) three months after HIIT + RT interruption, while only waist circumference and hand- grip improvements were maintained after MICT + RT interruption, and no improvements were maintained after RT interruption. Conclusion: Community-based HIIT + RT was superior to other exer- cise interventions for improving systolic BP and arterial stiffness of low-income older women. Fig. 1 Arterial stiffness before, nine months after training and three months after training interruption. Artery Research (2021) 27:S1–S36 S9 7.1 obtain beat-to-beat pulse arrival time (PAT), converted to PWV via arte- Pulse Wave Velocity for 24‑h Ambulatory Blood Pressure rial path length (L). PWV and heart rate (HR) data was smoothed using a Monitoring 1-h moving average window and values were extracted corresponding to simultaneously acquired intermittent ABPM readings (Suntech Medical 1,2 2 2 M.Sc. Fabian Beutel , B.Eng. Chaim Zax , B.Eng. Jesse Kling , B.Eng. Inc.,USA). Mean values were subtracted per subject to obtain changes per 2 1,3 Anthony van der Heijden , Ph.D. Chris Van Hoof , Ph.D. Evelien variable (D). Unbiased multivariate regression models were generated to Hermeling estimate DSBP and DDBP responses from DPWV and DHR predictors. 1 2 KU Leuven, Leuven, Belgium, imec The Netherlands, Eindhoven, The Results: BP tracking errors were conform with AAMI standard error cri- Netherlands, imec, Leuven, Belgium teria (5 mmHg and SD 8 mmHg) (3), achieving = − 0.2/0.0 mmHg and Background: Ambulatory blood pressure monitoring (ABPM) is a much SD = 7.6/6.0 mmHg for SBP/ DBP. Accounting for the subtracted means stronger cardiovascular risk predictor than office BP, allowing for identifi- demonstrated accurate estimations over a wide absolute range (55– cation of white-coat and borderline hypertensives (1), and prognostically 105 mmHg mean BP) and a 90% classification accuracy for diagnostic relevant patterns of nocturnal surges (2). However, ABPM availability in hypertension thresholds, contrasting 62% if BP was assumed constant. clinical practice is limited and causes patient discomfort from frequent cuff Conclusion: The proposed system demonstrates significant predic - inflations (1). Therefore, we propose a wearable, cuff-less system to track BP tive utility for BP changes and may facilitate unobtrusive and cuff- less changes from inherently related arterial pulse wave velocity (PWV). ABPM at high temporal resolution. Methods: Data was acquired from 10 subjects (35 ± 7 years) over 24 h in free living conditions. The novel wearable system (imec,NL) combines electrocardiogram (ECG) and photoplethysmogram (PPG) signals to Measurementsetup SignalprocessingExample single subject SBP HTN2 :::i SBPHTN 1 Cl) SBPElevated :::J .:!:::! a. <( rn -5 I 100 E DBP HTN2 0 2 4 .s DBPHTN 1 D. .... 5 m :::i -g 0 .:!:::! a. <( -5 10 21 11 2 4 Time [s] Time [h] Artery Research (2021) 27:S1–S36 S10 7.2 Direct noninvasive measurement of C is not feasible in the clinical Intra‑Operative Video‑Based Measurement of Biaxial Strains practice. Previous methods for indirect C estimation require nonin- of the Ascending Thoracic Aorta vasive, yet complex and expensive, recordings of the central pressure and flow (3,4). 1 2 2 MSc Shaiv Parikh , MSc Berta Ganizada , Mr. Gijs Debeij , Dr. Ehsan Methods: This study introduces a novel, noninvasive method for esti- 2 2 1 Natour , Prof. Dr. Jos Maessen , Dr. Bart Spronck , Prof. Dr. Leon mating C from a single carotid waveform measurement using neural 3 1 1 Schurgers , Prof. Dr. Tammo Delhaas , Dr. Wouter Huberts , Dr. Elham networks. Features were extracted from the carotid wave and were 2 1 Bidar , Dr. Koen Reesink combined with demographic data. A prediction pipeline was adopted Department of Biomedical Engineering, CARIM School for Cardiovascular for estimating C using (i) firstly, a feature-based analysis (ANN ), and T FB Diseases, Maastricht University, Maastricht, Netherlands, Department (ii) secondly, the raw carotid pulse wave (ANN ) as input. The meth- RAW of Cardiothoracic Surgery, Heart & Vascular Centre, Maastricht University odology was evaluated using the large Asklepios cohort (n = 2256). Medical Centre, Maastricht, Netherlands, Department of Biochemistry, Results: Accurate estimates of C were yielded for both prediction CARIM School for Cardiovascular Diseases, Maastricht University, schemes (Figure); namely, r = 0.83/normalized- RMSE = 9.6% for Maastricht, Netherlands ANN , and r = 0.83/normalized-MSE = 9.7% for ANN , respectively. FB RAW Background: Local biaxial deformation measurements are essential for the in-depth investigation of tissue properties and remodeling of the ascending thoracic aorta, particularly in aneurysm f ormation . Cur- rent clinical imaging modalities pose limitations around the resolution 2−4 and tracking of anatomical markers . Methods: We evaluated a new intra-operative video-based method to assess local biaxial strains of the ascending thoracic aorta (Figure A). In patients undergoing open-thorax surgery, two pairs of diamet- rically opposite felt markers were sutured on the adventitial surface of the aorta after the sternotomy (Figure B). Videos of markers were captured at low- and high- pressure conditions (Figure C), and marker tracking was performed using an in-house tracking algorithm to deter- mine local biaxial strains. We obtained in 30 patients repeated biaxial strain measurements, for each pressure condition. (Figure D, E). Results: Precision was acceptable, with coefficients of variation for biaxial strains remaining below 20% and the magnitude of strains we obtained (range: 0.02–0.05) is in line with previous reports, using clini- cal imaging. Interestingly, with our four-marker arrangement, we were able to detect significant local differences in longitudinal strain as well as in circumferential strain (Figure D, E). Conclusions: The method may allow for easily applicable and con- venient CT monitoring. Such an approach could suggest promising applications, ranging from fast and cost-efficient hemodynamical monitoring by the physician to integration in wearable technologies. 7.4 Assessing radiotherapy‑induced carotid vasculopathy using ultrasound after unilateral irradiation 1 1 1 MD Judith Pruijssen , MD PhD Joyce Wilbers , MD Ashwin Wenmakers , 1 1,2 MD PhD Jacqueline L oonen , Prof Dr Chris de Korte , Prof MD PhD 1 1 Johannes Kaanders , PhD Hendrik Hansen 1 2 Radboud University Medical Center, Nijmegen, Netherlands, University of Twente, Twente, Netherlands Background: Improved diagnostic and therapeutic regimens have increased head and neck cancer (HNC) survival. However, the younger, growing survivor population is prone to long-term treatment-related Conclusion: The proposed method enables the assessment of local vascular complications. Irradiated patients have a minimally twofold aortic biaxial strains and may enable new, clinically informed mecha- stroke risk compared to the general population (1). However, the nistic studies using biomechanical modeling as well as mechanobio- pathophysiology of radiation- induced vasculopathy is unclear. Vas- logical profiling. cular stiffness might be a biomarker of this injury. We investigated whether irradiated compared to unirradiated carotids in unilaterally 7.3 irradiated patients showed alterations in stiffness-related parameters, On the estimation of arterial compliance from carotid pressure shear wave velocity (SWV) and pulse wave velocity (PWV), and intima- waveform media thickness (IMT ). 1 2 1 Ms Vasiliki Bikia , Professor Patrick Segers , Mr Georgios Rovas , Ms 1 1 Methods: Twenty-six patients (41 ± 9 years), median 7 years after Stamatia Pagoulatou , Professor Nikolaos Stergiopulos 1 unilateral radiotherapy for head and neck tumors underwent bilateral École Polytechnique Fédérale De Lausanne, Lausanne, Switzerland, 2 carotid ultrasounds with an Aixplorer Ultimate system (Supersonic IBiTech, University of Ghent, Ghent, Belgium Imagine, France) with SL18-5 and SL10-2 transducers. IMT, begin- and Abstract end-systolic PWV, and average SWV were assessed in the proximal-, mid-, and distal common (CCA) and internal carotid artery (ICA). Three Background: Total arterial compliance (C ) is a biomechanical prop- consecutive measurements were averaged. Differences between erty of the arterial tree with great pathophysiological importance irradiated and unirradiated carotids were tested using Wilcoxon (1,2) and thus its estimation via a simple, accurate method is valuable. Artery Research (2021) 27:S1–S36 S11 signed-rank tests. Radiation dose–effect relations were explored with Results: There was significant increase in RBFV at 4th and 5th min linear regression. (1.96 1.25 vs 1.60 0.99 vs1.89 0.97 vs 1.80 0.89 vs 2.38 1.33 vs 2.67 Results: CCA-IMT was higher in the irradiated than unirradiated carot- 1.27 cm/s) and RBF at 5th min (0.32 0.22 vs 0.23 0.16 vs 0.27 0.19 vs ids (Table 1). Although overall stiffness seemed higher in irradiated 0.41 0.32 vs 0.48 0.32 cm /s) after nitrate ingestion. ABFV showed a sig- carotids, differences were only statistically significant for anterior mid- nificant decrease from baseline to 5th min (10.6 4.0 vs 8.92 4.09 vs 7.66 CCA and posterior ICA SWV. A dose–effect relation seemed apparent 3.31 vs 6.73 2.63 vs 7.11 vs 2.80 vs 7.12 2.60 cm/s), while ABF decreased for end-systolic PWV (β = 0.051/Gray, p = 0.07), not for IMT or SWV. from baseline to 3rd min and then increased again at 4th and 5th min Conclusion: Some IMT and stiffness increases were observed in irradi- (1.33 0.53 vs 1.23 0.57 vs 1.11 0.53 vs 1.06 0.43 vs 1.20 0.56 vs 1.20 0.48 ated carotids. To further investigate vascular stiffness as a biomarker cm /s). for radiation-induced vasculopathy a larger, typical HNC cohorts Conclusions: A paradoxical increase in RBF is seen with nitroglycerine (higher age/radiation doses/number of cardiovascular risk factors) is ingestion which may be a result of acute-reflex mediated decrease in required. aortic distensibility. Alternatively, persistence of increase in RBF may be a possible mechanism for nitrate-induced endothelial dysfunction and needs to be investigated. P.1 Higher systolic blood pressure in females compared to males with similar brachial cuff systolic blood pressure: an effect mediated by height 1 1 Ms Yasmine Abbaoui , Dr Florence Lamarche , Dr Annie‑Claire 2 1 3 Nadeau‑Fredette , Dr François Madore , Dr Mohsen Agharazii , Dr Remi Goupil 1 2 Hopital de Sacré‑Coeur de Montréal, Hôpital Maisonneuve‑Rosemont, CHU de Québec Background: Females have higher risks of cardiovascular events com- pared to males with similar BP. We assessed whether the accuracy of non-invasive BP measurements towards aortic BP could be influenced by biological sex. 7.5 Sublingual nitroglycerine ingestion is associated with an increase Methods: We enrolled 500 patients undergoing coronary angiogra- rather than decrease in brachial‑artery retrograde blood flow phy for simultaneous measurements of invasive aortic BP with non- in healthy human subjects invasive BP (Mobil-o-Graph device). Linear regression and mediation analyses were used to adjust for potential confounders in the relation- 1 1 1 Dr Smriti Badhwar , Dr. Dinu Chandran , Prof Ashok Jar yal , Prof Rajiv ship between biological sex and brachial cuff BP accuracy. 1 1 1 Narang , Prof Chetan Patel , Prof Kishore Kumar D eepak Results: Of 500 participants, 145 were females. Several characteris- All India Institute of Medical Sciences, New Delhi, India tics were different in males and females (Table). Brachial cuff SBP was Background: Nitroglycerine can reduce left ventricular afterload by identical in both groups whereas aortic SBP was 6.2 mmHg higher in decreasing amplitude of wave reflections (1). Increase in brachial- females (p < 0.001). As such, the brachial cuff appreciably underes- artery retrograde flow is associated with endothelial dysfunction. It timated aortic SBP in females but not in males. In an adjusted linear was hypothesized that nitroglycerine mediated reduction in periph- regression model, only height and pulse pressure were independently eral wave reflections would reduce brachial-artery retrograde flow. The associated with the accuracy of brachial cuff SBP. This effect of sex on current study aimed to evaluate effect of nitroglycerine on brachial- accuracy was mostly mediated by height (3.5 mmHg; 95% CI 1.4 to 5.6; artery retrograde flow. 57% mediation) to an extent that the direct effect of sex became non- significant (2.9 mmHg; 95% CI -0.3 to 6.2). Methods: Brachial artery retrograde flow velocity and diameter were Conclusion: Females have higher aortic SBPs than males with identi- measured in duplex mode using Pulsed-wave doppler (M7, MindRay) cal brachial cuff SBP, which is mostly mediated by a lower height. This at baseline and 5 min after sublingual Isosorbide dinitrate (5 mg) unrecognized higher aortic SBP provides indirect evidence to support ingestion in 32 healthy subjects. Time-averaged mean anterograde the increased cardiovascular risk of females compared with males with and retrograde blood flow velocity (ABRV and RBFV) were measured, similar brachial cuff SBP. and blood flows (ABF and RBF) were calculated from the velocities and corresponding diameters. Artery Research (2021) 27:S1–S36 S12 Methods: cwPWV was measured with carotid artery and wrist cuffs. P.2 PWV was continuously obtained, with pulse wave transit time Agreement of non‑invasive blood pressure‑ and standard NIBP measured as the delay between the R wave of the electrocardiogram oscillometry‑derived pulse wave velocities and the foot of the finger cuff pressure wave. Measurements were 1 1 1 2 N Nathan Adams , J Jillian Poles , G Gabriel Zieff , K Keeron Stone , C made twice in the supine posture, and then once in the seated posi- 2 2 1 1 Craig Paterson , S Simon Fryer , M Michelle L. Meyer , L Lee Stoner tion. The seated posture was used as an orthostatic challenge, to cause University of North Carolina at Chapel Hill, Chapel Hill, United States, vascular changes for ascertainment of repeated-measures agree- University of Gloucestershire, Gloucester, United Kingdom ment. Mixed model regression was used to calculate overall agree- We assessed the overall and repeated measures agreement between a ment (independent of posture), and repeated-measures correlation criterion measure of carotid-wrist pulse wave velocity (cwPWV) and a was used to determine whether changes in the two measures agree. PWV measure derived from a continuous non-invasive blood pressure Acceptable intraclass correlation coefficient (ICC) agreement was set device (PWV ). A continuous method of PWV velocity would allow at 0.70. NIBP for the detection of acute changes in arterial stiffness. Artery Research (2021) 27:S1–S36 S13 Results: Complete data was collected for all 20 subjects (age: time course of longitudinal changes in aPWV have not been investi- 22.5 ± 2.7 years, 14 female). The overall agreement between PWV gated in COPD. This study aimed to compare changes in aPWV over NIBP and cwPWV was acceptable (ICC: 0.78, 95% CI [0.66, 0.86]). The a 2-year and 6-year period, in patients with COPD and aged-matched repeated-measures agreement was weak (ICC: 0.30, 95% CI [0.05, controls. 0.51]). Conclusions: Acceptable overall agreement between PWV and Methods: This longitudinal study included patients with COPD NIBP cwPWV indicates that individual PW V may be useful for the and age-matched controls from the ARCADE study. Measurements NIBP determination of peripheral arterial stiffness. Repeated-measures included aPWV using the SphygmoCor system. Lung function was agreement was weak, potentially due to lack of change in either assessed by forced expiratory volume in the first second/forced vital measurement. Further research assessing different peripheral arterial capacity (FEV /FVC) using spirometry. Self-reported history of CVD and changes may be necessary to determine whether PWV can accu- use of cardiovascular acting medications were recorded. NIBP rately track vascular changes. Results: Data were available in seventy-five patients with COPD and seventy-one controls (mean age 65 ± 7 years) at baseline, 2- and 6-years follow up. At each assessment time-point, patients with COPD P.3 had higher aPWV, lower FEV /FVC, and greater use of cardiovascular Analysis of wave intensity using non‑invasive pressure waveform acting medications than controls (all at p < 0.05). Both groups showed only: application to people with type 2 diabetes a similar increase in aPWV over the 6 years (annual increase of 0.2 m/s/ 1 2 1 Dr Kunihiko Aizawa , Prof. Alun D Hughes , Dr Francesco Casanova , year, p = 0.560). 1 1 1 Mr David M M awson , Dr Kim M Gooding , Dr W David Strain , Dr Phillip E Conclusion: The similar relative change in aPWV observed in both 1 3,4 3 5 Gates , Prof. Isabel Gonçalves , Prof. Jan N ilsson , Prof. Faisel Kahn , Prof. groups may be explained by the progression in age. However, the 6 7 8 Helen M Colhoun , Prof. Carlo Palombo , Prof. Kim H P arker , Prof. Angela higher baseline levels of aPWV in COPD were maintained and tracked C Shore over the 6-years, even in the presence of additional cardiovascular act- NIHR Exeter Clinical Research Facility, University of Exeter Medical ing medications, suggesting a premature and consistently elevated School, Exeter, United Kingdom, Institute of Cardiovascular Science, vascular ageing process in COPD patients. University College London, London, United Kingdom, Department of Clinical Sciences, Lund University, Malmö, Sweden, Department P.5 of Cardiology, Skåne University Hospital, Malmö, Sweden, Division Assessment of vascular markers of large artery dysfunction of Systems Medicine, University of Dundee, Dundee, United Kingdom, and circulating biomarkers of endothelial dysfunction Centre for Genomic and Experimental Medicine, University of Edinburgh, and thromboinflammation in patients with psoriasis Edinburgh, United Kingdom, Department of Surgical, Medical, Molecular 8 1 1 1 and Critical Area Pathology, University of Pisa, Pisa, Italy, Department Dr Panagiota Anyfanti , Dr Anastasia Margouta , Dr Antonios Lazaridis , 1 2 1 of Bioengineering, Imperial College, London, United Kingdom Dr Eleni Gavriilaki , Dr Efi Yiannaki , Dr Barbara Nikolaidou , Dr Areti 1 3 1 Background: Analysis of wave intensity provides valuable information Triantafyllou , Dr Elizabeth Lazaridou , Dr Stella Douma , Dr Aikaterini 3 1 about wave propagation in the arterial circulation. However, the need Patsatsi , Dr Eugenia Gkaliagkousi to measure both pressure and flow hinders its widespread use in large 3rd Department of Internal Medicine, Papageorgiou Hospital, scale studies. A recently proposed method enables estimation of wave Aristotle University of Thessaloniki, Thessaloniki, Greece, Department intensity patterns from non-invasive pressure waveforms. We applied of Hematology, Theagenion Cancer Center, Thessaloniki, Greece, this method in type 2 diabetes (T2DM) to determine 1) whether it is 2nd Department of Dermatology and Venereology, General Hospital feasible in T2DM, 2) whether wave intensity patterns differed between "Papageorgiou", Medical School Aristotle University of Thessaloniki,, people with and without T2DM, and 3) whether the trajectories of Thessaloniki, Greece those patterns, measured 3 years apart differed between cohorts. Purpose/background/objectives: Cardiovascular risk is increased in psoriasis. Endothelial (EMVs), platelet (PMVs) and erythrocyte (ErMVs) Methods: We studied 227 individuals with T2DM (66.9 ± 7.9 years, microvesicles represent novel biomarkers of endothelial dysfunction 87F) and 99 without T2DM (66.0 ± 9.0 years, 43F). Radial pressure and thromboinflammation. Pulse wave velocity (PWV) and carotid waveforms were recorded using a SphygmoCor system and aortic intima-media thickness (IMT) are robust measures of arterial stiffness pressure waveforms were derived; these were analysed using custom- and atherosclerosis. We tested whether the above markers of micro- written software to calculate wave intensity. and microcirculation are impaired in psoriasis. Results: Wave intensity showed the typical pattern, and the mag- nitude of the forward compression and decompression waves were Methods: Patients with psoriasis without cardiovascular diseases and similar in both cohorts. However, the area of backward compression controls matched for cardiovascular risk factors were studied. Pso- wave was smaller in people with T2DM than those without (152 × 10 riasis severity was assessed with PASI (Psoriasis Area Severity Index). 4 2 vs 180 × 10 J/m , p = 0.025), and wave reflection index was reduced Microvesicles were measured by a standardized flow cytometry pro - 3,4 (0.25 vs 0.29 au, p = 0.050). Both cohorts showed slightly upward tra- tocol. Carotid IMT and PWV were assessed with carotid ultrasound. jectories in wave intensity patterns over 3 years, and the changes in Results: Patients with psoriasis (n = 41) presented increased lev- magnitude of wave intensity were similar in both cohorts. els of both PMVs [354.9 (468) vs 151.0 (202)/μL, p < 0.001] and ErMVs Conclusions: It is feasible to estimate wave intensity using the pres- [19.8 (96.4) vs 15.0 (25)/μL, p = 0.046] compared to controls (n = 41), sure-only method in T2DM. Using the method, wave reflection was whereas EMVs did not significantly differ. Nonsignificant differences smaller in people with T2DM compared with those without T2DM. were observed in carotid PWV and cIMT. Patients with higher PASI score (≥ 10) presented increased ErMVs compared to those with lower PASI score (< 10) [41.3 (123.5) vs 12.9 (98)/μL, p = 0.047]. Multivariate P.4 analysis showed that psoriasis independently predicted both PMVs Longitudinal changes in aPWV in chronic obstructive pulmonary (p < 0.001) and ErMVs (p = 0.043), while age (p = 0.005) and hyperten- disease sion (p < 0.001) were independently associated with EMVs. 1,2 2 2 Mrs Mahfoudha AL Shezawi , Maggie Munnery, Laura Watkeys , John Conclusions: Circulating biomarkers of thromboinflammation, spe - 2 1 2 Cockcroft , Nichola Gale , Barry McDonnell cifically PMVs and ErMVs, were increased in psoriasis before the clinical 1 2 Cardiff University, Cardiff, UK, Cardiff Metropolitan University, Cardiff, UK onset of overt cardiovascular complications and correlated with clini- Introduction: Chronic Obstructive Pulmonary Disease (COPD) is char- cal disease activity. By contrast, vascular biomarkers of atherosclerosis acterised by irreversible airflow obstruction, chronic inflammation, and arterial stiffness were not increased. Further studies are needed to increased cardiovascular disease (CVD) risk and mortality. Increased address the prognostic potential of microvesicles in psoriasis in terms arterial stiffness measured by aortic pulse wave velocity (aPWV) may of cardiovascular disease prediction. reflect subclinical CVD and is increased in COPD patients. However, the References Artery Research (2021) 27:S1–S36 S14 1. Masson W, Lobo M, Molinero G. Psoriasis and Cardiovascular Risk: A P.7 Comprehensive Review. Adv Ther. 2020;37:2017–2033. https:// doi. org/ Heart rate modulates the relationship of augmented systolic 10. 1007/ s12325- 020- 01346-6 blood pressure with the blood natriuretic peptide levels 2. Lipets EN, Antonova OA, Shustova ON, Losenkova K V., Mazurov Professor Hirofumi Tomiyama A V., Ataullakhanov FI. Use of Thrombodynamics for revealing the Tokyo Medical University participation of platelet, erythrocyte, endothelial, and monocyte Aims: The present study examined whether the association of the microparticles in coagulation activation and propagation. PLoS One. Central systolic blood pressure (cSBP) with the the serum N-terminal 2020;15(5):e0227932. https:// doi. org/ 10. 1371/ journ al. pone. 02279 32 fragment B-type natriuretic peptide (NT-proBNP) levels might differ 3. Gkaliagkousi E, Gavriilaki E, Vasileiadis I, et al. Endothelial Microvesi- between subjects with high and low HRs. cles Circulating in Peripheral and Coronary Circulation Are Associated with Central Blood Pressure in Coronary Artery Disease. Am J Hyper- Methods: In 2257 middle-aged healthy Japanese men, serum NT- tens. 2019;32(12):1199–1205. https:// doi. org/ 10. 1093/ ajh/ hpz116 proBNP levels, radial augmentation index (radial AI), and the first and 4. Gkaliagkousi E, Nikolaidou B, Gavriilaki E, et al. Increased erythro- second peaks of the peripheral systolic blood pressure (SP1 and SP2, cyte- and platelet-derived microvesicles in newly diagnosed type 2 markers of the cSBP) were measured. diabetes mellitus. Diabetes Vasc Dis Res. 2019;16(5):458–465. https:// Results: The serum NT-proBNP levels among three groups classified by doi. org/ 10. 1177/ 14791 64119 844691 the HR (i.e., ≤ 69, 70–79, and ≥ 80). While the serum NT-proBNP levels were similar among the three groups, the radial AI increased and the SBP1-2 (SBP1 minus SBP2, i.e., a low SBP1-2 corresponds to augmen- P.6 tation of the cSBP relative to the bSBP) decreased significantly with Males with abdominal aortic aneurysm have reduced left decreasing HR. In multivariate linear regression analyses, the SBP2 ventricle function showed a significant association with the serum NT-proBNP levels in 1 1 2,3 Mrs Ida Åström Malm , Dr Rachel De Basso , Professor Jan Engvall , Dr the overall study population. However, in subgroup analyses, the SBP2 1,4 Peter Blomstrand showed a significant association with the serum NT-proBNP levels only Department of Natural Sciences and Biomedicine, School of Health in subjects with HR ≤ 69 beats/minute. and Welfare, Jönköping University, Jönköping, Sweden, Department Conclusion: In middle-aged Japanese men, the relationship between of Clinical Physiology and Department of Health, Medicine and Caring the cSBP and the cardiac afterload appears to differ depending on Sciences, Linköping University, Linköping, Sweden, Center for Medical the heart rate; the results of our analysis showed that the relationship Image Science and Visualization, Linköping University, Linköping, between the cSBP and cardiac overload may be more pronounced and Sweden, Department of Clinical Physiology, County Hospital Ryhov, strongly significant in patients with low HRs as compared to patients Jönköping, Sweden with high HRs. Introduction: Abdominal aortic aneurysm (AAA) is a common disease in the ageing population with a prevalence of approximately 1.5–3% P.8 of males aged 65–70 years in Europe (1, 2). AAA is mostly an asymp- Carotid enlargement is associated with the presence and severity tomatic disease, however, if the AAA ruptures it is a life-threatening of coronary artery disease assessed by Gensini Score in patients event. Even without a rupture, AAA increases the risk of developing submitted to coronary angiography chronic heart failure and other major cardiovascular events. 1 1 1 Professor Luiz Bortolotto , Dra Nadja Mendes , Ms Valeria Costa‑Hong , 1 1 Purpose: Even though AAA may lead to heart failure, no study has pre- Dr Stefano Garzon , Professor Pedro Lemos viously systematically explored the left ventricular function in patients Instituto Do Coração, São Paulo, Brazil with AAA. Thus, the aim of this echocardiographic study is to investi- We evaluated the association of carotid measurements (intima-media gate whether AAA is associated with left ventricular dysfunction. thickness-cIMT, internal diameter and distensibility) obtained by radio- Methods: Echocardiography was performed in 307 males (199 AAA frequency ultrasound (Wall Track S ystem ) with the presence and and 108 controls) aged 55–80 years. The males were recruited from a severity of coronary artery disease (CAD) assessed by Gensini Score regional ultrasound surveillance program of known AAA or an ongo- in 69 patients prospectively submitted to coronary angiography due ing ultrasound screening program during 2011–2016. clinical suspicion of CAD. The presence of CAD was considered when Results: Males with AAA had a 2.2% lower left ventricular ejection the Gensini score ≥ 1. The mean age was 58.4 ± 8 years, 50% men, 85% fraction and 1% lower global longitudinal strain compared to control. arterial hypertension, 37% diabetes and 40% smoking. The presence They had also a significantly thicker septal and posterior wall and a of CAD was observed in 44 patients (63%), with a higher proportion higher E/e’. Ischemic heart disease was reported eight times, hyperten- of men in patients with CAD (59% vs. 28%, p < 0.05). Patients with sion and smoking four times more frequently in participants with AAA CAD had a greater internal diameter of carotid artery [7758.2 (7096.1; compared to controls. 8797.2) µm vs. 7009.0 (6595.5; 7396.0) µm, p = 0.003), while it was not Conclusion: While hypertension, smoking and ischemic heart disease observed differences in cIMT or distensibility. In logistic regression are far more common in males with AAA than controls the difference analysis, the chance of presenting CAD by Gensini score increases by in left ventricular function is only mild. Subjects with AAA have a slight 6.7% at each 100 µm increase in the internal diameter regardless of impaired left ventricular systolic and diastolic function. gender. A significant correlation was observed between the carotid References diameter and Gensini score (r = 0.289, p = 0.02). Among carotid artery 1. Svensjo S, Bjorck M, Gurtelschmid M, Djavani Gidlund K, Hellberg A, measurements obtained by radio-frequency ultrasound, the internal Wanhainen A. Low prevalence of abdominal aortic aneurysm among diameter was the only significantly associated with the presence and 65-year-old Swedish men indicates a change in the epidemiology of severity of CAD estimated by Gensini score. the disease. Circulation. 2011;124(10):1118–23. 2. Lederle FA, Johnson GR, Wilson SE, Chute EP, Littooy FN, Bandyk D, et al. Prevalence and associations of abdominal aortic aneurysm P.9 detected through screening. Aneurysm Detection and Management A novel ultrasound‑based method for heart failure screening (ADAM) Veterans Affairs Cooperative Study Group. Ann Intern Med. 1 1 1 1997;126(6):441–9. Albert Chang , Dhruv Reddy , Shashank Adapa , Anenta Ratneswaren 1,2 2 2 , Ryan Reavette, Peter Weinberg 1 2 Faculty of Medicine, Department of Bioengineering, Imperial College London Background: Heart failure (HF) is prevalent and, although treat- able, has a one-year prognosis of 40%. Moreover, 80% of diagnoses in England are made after a hospital admission despite 40% of patients Artery Research (2021) 27:S1–S36 S15 visiting their GP with symptoms beforehand (1). The most common P.11 symptoms – breathlessness, fatigue and ankle swelling – are nonspe- Poor cardiovascular health is associated with high body fat cific, so patients are not always referred for echocardiography, the and sympathetic tone in obese subjects gold-standard for diagnosis. This motivates improved HF screening in 1 1 1 Mrs Michelle Cunha , Mrs Samanta Mattos , Mrs Thayná Brum , Mrs Primary Care. 1 1 Marcia Klein , Mr Mario Neves State University of Rio de Janeiro, Rio de Janeiro, Brazil Studies have shown that arterial wave intensity is altered in HF (2, 3), Background: According to the American Heart Association, seven but the technique relies on measuring pressure and velocity wave- behaviors and risk factors define metrics of cardiovascular health, clas- forms simultaneously; current methods are invasive, inaccurate or sifying it as ideal, intermediate (iCVH) or poor (pCVH) cumbersome. We propose a noninvasive method that uses ultrafast ultrasound to measure diameter and velocity instead; both variables Objective: To evaluate body adiposity and sympathetic tone in obese can be accurately measured with one scan but give similar clinical individuals with different cardiovascular health classifications. indications. Methods: Cross-sectional study with patients aged 40–70 years and Methods: Patients undergoing echocardiography were recruited body mass index (BMI) ≥ 30 and < 40 kg/m , submitted to sympathetic from outpatient Cardiology clinics, and B-mode ultrasound scans tone assessment by heart rate variability and body composition by were taken of their left carotid, right carotid and left brachial arteries. Dual X-Ray Absorptiometry.2 Patients (n = 57) were divided into two Blood signal was enhanced using spatiotemporal filtering. Velocity groups: iCVH (n = 32) and pCVH (n = 25). and diameter waveforms were obtained using cross-correlation-based Results: The patients were predominantly females in both groups techniques. (66 vs 88%, p = 0.067) with similar age (52 ± 7 vs 51 ± 6 years, Results: Wave intensities have been computed for 100 patients. There p = 0.648). Systolic and diastolic blood pressure presented higher is a significant difference (p < 0.05) in the intensities of waves that rep- values in pCVH group (120 ± 15/76 ± 10 vs 129 ± 13/83 ± 8 mmHg; resent systolic contraction and peripheral reflection between patients p = 0.026/p = 0.06), and no statistical significance in cardiovascu- with HF with reduced ejection fraction and those without symptoms lar risk (9.6 ± 8.8 vs 9.0 ± 6.5 years, p = 0.787). Similar results were of HF or reduced ejection fraction. also observed in BMI (34.2 ± 2.7 vs 34.0 ± 2.8 kg/m , p = 0.784) and Conclusions: Noninvasive wave intensity analysis has potential to waist-hip ratio (0.86 ± 0.07 vs 0.84 ± 0.06 cm, p = 0.306). Total body improve HF screening in Primary Care. fat (40 ± 6 vs 48 ± 6%, p = 0.004) and trunk fat (45 ± 6 vs 53 ± 4%, We gratefully acknowledge support from BHF, Imperial College BHF p = 0.008) were significantly higher in pCVH. There were significant Centre of Research Excellence and EPSRC Impact Acceleration Award. differences in Sympathetic Nervous System Index (iSNS) (0.39 ± 1.05 vs 1.20 ± 1.22, p = 0.050), Parasympathetic (iPNS) (0.13 ± 0.92 vs − P.10 0.39 ± 0.85, p = 0.037), heart rate (62 ± 7 vs 68 ± 8 bpm, p = 0.019), and A comparison of aortic haemodynamic parameters no significance but higher values in Low Frequency-High Frequency between the SphygmoCor CvMS (radial tonometry) device ratio (1.06 ± 0.94 vs 1.65 ± 2.24, p = 0.195) in pCVH group. and the PULSE (brachial oscillometry) device Conclusion: In these obese subjects BMI was not useful to assess 1 2 1 cardiovascular risk, and poor CVH was associated with higher sympa- Mr James Cox , Dr Ahmad Qasem , Dr Isabella Tan , Emeritus Professor 1 1 thetic tone and fat percentage in body composition evaluation. Alberto P. Avolio , Dr Mark Butlin 1 2 Macquarie University, Sydney, Australia, CardieX‑AtCor, Sydney, Australia Background: Current cardiovascular outcomes are based primarily on P.12 the measurement of brachial arterial blood pressure (BP). Whilst this Moderate to severe obstructive sleep apnea associated measurement is acceptable, aortic haemodynamic parameters offer a with early vascular aging and sympathetic hyperactivity in obese more representative assessment of an individual’s cardiac load. Cur- individuals rently, there is a lack in devices assessing aortic parameters. 1 1 Ms Samanta Mattos , Ms Michelle Cunha , Medical Student Larissa 1 1 1 Silva , MD PhD Márcia Klein , MD PhD Mario Neves Objective(s): To compare aortic haemodynamic parameters between State University Of Rio De Janeiro, Rio De Janeiro, Brazil the previously validated SphygmoCor CvMS device and the new con- Introduction: Obstructive sleep apnea (OSA) and obesity may have sumer PULSE device. synergistic effects on the progress of cardiovascular disease. Methods: Sequential randomised measurements were performed in triplicate in a seated position with the SphygmoCor CvMS device Objective: To evaluate sympathetic tone and vascular disease in (radial tonometry) and the PULSE device (brachial oscillometry). A obese patients with moderate and severe OSA. subset of individuals underwent an isometric handgrip exercise to Methods: Individuals of both sexes, aged 40–70 years and body mass compare measured haemodynamic parameters under conditions of index (BMI) ≥ 30 and < 40 kg/m , submitted to assessment of heart elevated BP. Aortic parameters were generated by applying a transfer rate variability (HRV ), endothelial function by flow-mediated dilatation function to the radial and brachial waveforms, respectively, and com- (FMD), central parameters by Mobil-O-Graph and carotid ultrasound. pared using Bland–Altman plots and mean differences. The sleep study was performed through a portable home sleep test Results: Participants’ (n = 41, 20 female, age: 44 ± 19 years) seated device (WatchPAT ). baseline oscillometric brachial systolic and diastolic BP were 122 ± 15 Results: Patients (n = 61) were divided by the apnea–hypopnea index and 76 ± 11 mmHg, respectively. Baseline differences for all aortic (AHI): mild-absent (MA) group (AHI < 15, n = 30) and moderate-severe pressure parameters (systolic BP, diastolic BP, mean BP, pulse pressure, (MS) group (AHI ≥ 15, n = 31). There was no significant difference in augmentation pressure) were equal to or less than 1.4 ± 2.8 mmHg. age (50 ± 6 vs 54 ± 8 years) and BMI (35 ± 3 vs 34 ± 2 kg/m ). MS group The difference in augmentation index between the devices was presented higher neck circumference (38 ± 3 vs 40 ± 4 cm, p = 0.025), 0.1 ± 7.3%. Following a significant increase in BP (p < 0.01) from the waist-hip ratio (0.83 ± 0.07 vs 0.88 ± 0.06 cm, p = 0.005), systolic blood isometric handgrip exercise, aortic pressure parameters were equal pressure (120 ± 13 vs 129 ± 15 mmHg, 0.017), pulse pressure (42 ± 9 vs to or less than 0.9 ± 3.7 mmHg, whilst the difference in augmentation 48 ± 9 mmHg, p = 0.007), cardiovascular risk (6.4 ± 3.8 vs 11.9 ± 9.5%, index between the devices was -1.5 ± 6.0%. p = 0.012). As expected, the oxygen desaturation index (2.5 ± 2.4 vs Conclusions: Aortic haemodynamic parameters measured by the 20.2 ± 14.5 events/h, p = < 0.001) was higher in the MS group, which brachial ocillometry PULSE device were comparable to those meas- also had lower FMD (9.9 ± 6.3 vs 6.9 ± 4.3%, p = 0.032). The low/high ured in the radial tonometry CvMS system under baseline and exercise frequency ratio (0.85 ± 0.53 vs 1.72 ± 2.07ms , p = 0.046), pulse wave conditions. velocity (7.0 ± 0.7 vs 7.8 ± 1.2 m/s, p = 0.004), vascular age (48 ± 7 vs 54 ± 8 years, p = 0.05), mean intimal-media thickness (IMT ) (0.59 ± 0.10 Artery Research (2021) 27:S1–S36 S16 Conclusion: The amount of skin AGE and sRAGE, which prevents dep- vs 0.67 ± 0.12 mm, p = 0.008) and maximum IMT (0.64 ± 0.12 vs osition of AGE into tissues, are important factors contributing to aortic 0.72 ± 0.14 mm, p = 0.023) were significantly higher in the MS group. stiffness over and above serum glucose level. Conclusion: In this sample of obese individuals, moderate to severe OSA was associated with sympathetic hyperactivity, endothelial dys- function and arterial stiffness. P.16 Central arterial pressure changes during and after head‑down tilt bedrest. P.14 Loss of stearoyl‑CoA desaturase 1 induces inflammation 1 2 1,2 Dr Catherine Fortier , Dr Antoine Fayol , Dr Hakim Khettab , Dr and arterial wall remodelling 1,2 1,2 Rosa‑Maria Bruno , Professor Pierre Boutouyrie 1 1 INSERM U970, Paris Cardiovascular Research Center (PARCC), Cellular Dr Anna Filip , Dr hab Pawel Dbrzyn molecular and physiological mechanisms of heart failure ( Team 7), Nencki Institute of Experimental Biology, Polish Academy of Sciences, Paris, France, AP‑HP, Pharmacology Unit, Hôpital Européen Georges Warsaw, Poland, 3 Pasteur Street, Poland Pompidou, Université de Paris, Paris, France The role of stearoyl-CoA desaturase 1 (SCD1) in vascular smooth Background/objectives: Head-down tilt bed rest (HDTBR) induces muscle cells (VSMC) has been studied in the context of vascular dys- a redistribution of blood volume from lower limbs to the upper and function development. The SCD1 and SCD2 control a process of calci- central parts of the body, which mimics physiological changes during fication and regulate lipotoxicity in VSMC. Moreover, the role of SCD1 long-term exposure to microgravity. However, the effects of HDTBR in lipid accumulation in VSMC and foam cell formation from VSMC was on central arterial pressure parameters during bedrest and after the recently revealed [1- 3]. Therefore, the present study aimed to identify return to verticality remain poorly described. the role of SCD1 in VSMC phenotypic and metabolic alteration and the development of vascular dysfunction associated with inflammation. −/− Methods: 20 healthy men (age: 34 ± 8 years) lay supine on a 6-degrees Using the SCD1 mouse model, fed chow or high-fat diet (HFD), we declined bed for 60 days. Brachial blood pressure measurements and have studied (1) inflammation development in blood and aorta, (2) central arterial pressure obtained from carotid arterial tonometry immune cell infiltration toward the aortic wall, (3) VSMC phenotypic were measured before (B0), during bed rest (H52), and after 30 days of alteration, and (4) the regulation of main cellular metabolic pathways. recovery (R30). Pairwise comparisons between times of measurement Obtained results show that (a) SCD1 expression is down-regulated in were assessed using mixed models for repeated measures with Bon- the aorta in WT mice fed HFD; (b) loss of SCD1 expression induced the −/− ferroni correction. inflammation in the blood and aortic wall; (c) SCD1 mice presented Results: From B0 to H52, central systolic pressure (cSP) and central dias- increased recruitment of immune cells toward the aorta; (d) SCD1 defi- tolic pressure (cDP) increased to a similar extent, without reaching sig- ciency affects the VSMC dedifferentiation; (e) SCD1 regulates cell cycle nificance (ΔcSP: 5.8 mmHg, [95% CI − 1.6; 13.2]; ΔcDP: 6.0 mmHg, [95% and PDGF signaling pathway in VSMC in mice fed chow or HFD. Taken CI − 0.9; 12.9]). AIx@75 (− 11 ± 10% vs. 1 ± 11%, p = 0.005) and end-sys- together, our data show that signaling pathways controlled by SCD1 tolic pressure (ESP: 84 ± 9 mmHg to 92 ± 9 mmHg, p = 0.012) increased, represent an important step in the regulation of VSMC phenotype thus while P1 amplitude did not change (29 ± 8 mmHg vs. 27 ± 5 mmHg, vascular wall morphology and function. p = 0.980). At R30, cSP was significantly higher compared to baseline (104 ± 8 mmHg vs. 95 ± 9 mmHg, p = 0.002), but not cDP (71 ± 9 mmHg This work has been supported by the funding from National Sci- vs. 66 ± 10 mmHg, p = 0.093). At R30, AIx@75 (− 4 ± 11%) and ESP ence Centre, Poland grants no UMO-2017/26/D/NZ4/00696 and (92 ± 9 mmHg) did not recover back to baseline values (both p < 0.05). UMO-2016/22/E/NZ4/00650). Conclusions: This study suggest that HDTBR leads essentially to an increased afterload which is not fully corrected after 30 days of P.15 recovery. Skin autofluorescence and serum biomarkers of glucose metabolism: which parameters contribute most to aortic P.17 stiffness? Radial‑digital pulse wave velocity: response of small peripheral Professor Jan Filipovský , Professor Otto Mayer, Associate Professor arteries to nitroglycerin Jitka Seidlerová, Doctor Július Gelžinský 1 1,2 1 Charles‑antoine Garneau , Catherine Fortier , Hasan Obeid , Mathilde Charles University Medical Faculty Pilsen, Czech Republic, Pilsen, Czech 1 1 1,3 Paré , Karine Duval , Dr. Mohsen Agharazii Republic CHU de Québec Research Center‑ Hôtel‑Dieu de Québec Hospital, Background: Impaired glucose metabolism, leading to the deposition Québec, Canada, Paris Cardiovascular Research Center, INSERM U970, of advanced glycation end products (AGE), plays an important role in Paris, France, Division of Nephrology, Department of Medicine, Faculty the stiffening of large arteries. This process is counterbalanced by cir - of Medicine, Université Laval, Québec, Canada culating soluble receptor for AGE (sRAGE). Objectives: We have already demonstrated that nitroglycerin (NTG) induces different regional stiffness response from elastic and muscular Methods: We investigated the association of arterial stiffness with arteries, predisposing small peripheral arteries to increased pulsatility1. several biomarkers and with the degree of skin deposition of AGE in Peripheral smaller arteries may also respond differently to nitroglycerin. a sample of 867 subjects from general population, examined in the The objective of this study is to compare the changes in radial-digital Czech post-MONICA study. Carotid-femoral pulse wave velocity (PWV) pulse wave velocity (RD-PWV) following administration of NTG from was measured by SphygmoCor device (AtCor Medical Ltd.) and skin healthy individuals to those with chronic kidney disease (CKD). AGE were measured using a dedicated autofluorescence method (AGE Reader mu ); the method is quick and easy to use. To quantify the cir- Method: This study was conducted among 36 participants, 27 healthy culating status of AGE, carboxymethyl lysine (CML) was assessed by (56% women, age 48.4 years) and 9 CKD (33% women, age 70.3 years). ELISA; sRAGE concentrations were also assessed by ELISA. Piezoelectric sensors (Complior, France) were placed on the carotid and Results: When analyzing the whole sample using both multiple lin- radial arteries, as well as on the tip of the index finger to obtain the ear and logistic regression models and after adjustment for poten- carotid-radial PWV (CR-PWV) and the RD-PWV. These measurements tial covariates, significant associations of PWV with fasting glycemia, were repeated 4 min after sublingual administration of 0.4 mg NTG. HbA1c, sRAGE, skin AGEs, and the skin AGE- to-sRAGE ratio were Results: At baseline, the CKD group had a significantly lower RD- found. Stepwise models identified strong association with the skin PWV than the healthy group (3.27 ± 1.38 m/s vs. 4.72 ± 1.20 m/s, AGE and the ratio of skin AGE-to- sRAGE, independently of serum glu- p = 0.008). After NTG administration, the RD-PWV of the healthy and cose level, age and mean arterial pressure; this was also true when dia- CKD groups both significantly increased to reach 6.09 ± 2.23 m/s and betic subjects were excluded. In contrast, neither CML, nor its ratio to 4.69 ± 1.87 m/s, respectively (p < 0, 01). However, in both populations, sRAGE showed any association with arterial stiffness. Artery Research (2021) 27:S1–S36 S17 the stiffness of the entire upper limb (carotid-digital PWV) did not of Molecular Medicine, Pavia, Italy, Department of Medical, Surgical change significantly (p = 0.816 and p = 0.169). and Health Sciences, University of Trieste, Trieste, Italy Conclusions: Again, we observed opposite changes in the stiffness Background: Evaluation of the balance between subendocardial oxygen of different vascular territories with vasodilator drug resulting in no supply and demand could be a useful parameter to assess the risk of myo- change in stiffness for the entire upper limb. These are preliminary cardial ischemia. The subendocardial viability ratio (SEVR, also known as results, but this new technique may open up the path for a better Buckberg index) determined by invasive recording of left ventricular and understanding of the consequences of a modified stiffness gradient aortic pressure curves is a valid method to estimate the degree of myo- on the microcirculation. cardial perfusion relative to left ventricular workload. Arterial applanation tonometry allows a non-invasive estimation of SEVR as the ratio of the areas directly beneath the central aortic pressure curves obtained during P.18 diastole (myocardial oxygen supply) and during systole (myocardial oxy- Are arteries designed to minimise variation in arterial pressure gen demand). However, “traditional” non-invasive SEVR is affected by limi- of the blood volume stored during the systole? tations that make it significantly different from the invasive SEVR. Ph.d. Benjamin Gavish Yazmonit Ltd., Jerusalem, Israel Methods: We have developed a new method for evaluation of SEVR Background: Arterial compliance enables arteries to store blood with carotid tonometry by taking into account the intra- ventricu- during the systole (‘pulse volume’). This temporary storage plays the lar diastolic pressure and proper allocation to systole and diastole important role of buffering arterial pressure pulsatility. Arterial compli- of left ventricular isometric contraction and relaxation. SEVR values ance varies with pressure. Here, we investigate the pressure depend- estimated with carotid tonometry (PulsePen, DiaTecne, Italy) by “tra- ence of pulse volume using a model approach. ditional” and “new” method were compared with those evaluated inva- sively by cardiac catheterization. Methods: Expression of the pulse volume using two phenomena Results: The “traditional” method provided significantly higher observed in individuals (figure): i) exponential relationship between SEVR values than the reference invasive SEVR: average of dif- arterial pressure (P) and arterial volume (or cross-sectional area) V, in ferences ± SD = 0.44 ± 0.11 (limits of agreement: 0.23–0.65). normal and high pressures given by P = α + exp(V), where α, and are The non-invasive “new” method showed a much better pressure-independent, and ii) linear relationship of repeated measure- agreement with the invasive determination of SEVR: average of differ - ments of systolic blood pressure SBP and diastolic blood pressure DBP, ences ± SD = 0.00 ± 0.08 (limits of agreement: − 0.15– 0.16). i.e., SBP = A + K DBP, where A and K are constants. Conclusions: Carotid applanation tonometry provides valid non-inva- Results: Taking Vs and Vd to be the arterial blood volumes corre- sive SEVR values only when all the main factors determining myocar- sponding to SBP and DBP, respectively, it is straightforward to show dial supply and demand flow are considered. that K = exp[(Vs-Vd)], where Vs-Vd is the pulse volume. Since K andare constants, this model shows that pulse volume is independent of P.20 blood pressure. Healthy young men show a larger response in carotid artery Conclusions: The model supports the view that the pressure–volume dilation during a cold pressor test compared to age‑ matched relationship in arteries may play a role in regulating blood volume females stored by arteries during the systole. 1 1 1,2 dr. Yvonne Hartman , Daniek Dinnissen , Prof. dr. Dick Thijssen 1 2 Radboudumc, Nijmegen, Netherlands, Liverpool John Moores University, Liverpool, United Kingdom Background: The carotid artery reactivity (CAR) test was recently iden- tified as an early marker of conduit artery vascular health. This study examined potential sex differences in CAR between healthy young men and women. Methods: In this preliminary analysis on data of the ongoing Healthy Brain study (NTR7955), 245 participants (113 males) aged 30–39 were included. Ultrasound was used to measure common carotid artery diameter. After 1 min baseline measurements, a hand was immersed in ice water for 3 min. CAR% was defined as maximal diameter change during cold pressor test compared to baseline. After 4 months, meas- urements were repeated in a subgroup (n = 86, 45 males)). CAR% was compared between males and females, and whether these potential differences remain present across time. Results: Our cross-sectional data revealed a larger CAR% in males compared to females (3.1 ± 3.3 vs 2.2 ± 3.3%, P = 0.043). Males P.19 reported a significantly larger baseline diameter (6.9 ± 0.6 mm vs Comparison between invasive and noninvasive methods 6.3 ± 0.6 mm, P < 0.001). Correcting the CAR% for between group dif- to determine subendocardial oxygen supply and demand ferences in baseline diameter reinforced the larger CAR%. Although imbalance from aortic pressure waveform CAR% increased from baseline to 4 months (2.5 ± 3.5 to 3.4 ± 2.7%, 1,8 3 4 5 Dr. Andrea Grillo , Dr. Filippo Scalise , Dr. Lucia Salvi , Dr. Isabella Tan , P = 0.027), the increase in CAR% did not differ between males and 6 3 6 Dr. Lorenzo De Censi , Dr. Antonio Sorropago , Dr. Giovanni Sorropago , females. 7 1 8 Dr. Francesco M oretti , Dr. Matteo Rovina , Prof. Bruno Fabris , Prof. Renzo Conclusions: Young, healthy men show a consistently higher CAR% 8 5 2,6 2 Carretta , Prof. Alberto Avolio , Prof. Gianfranco Parati , Prof. Paolo Salvi than females. This suggests that young healthy men have better Medicina Clinica, Azienda Sanitaria Universitaria Giuliano Isontina, Trieste, carotid artery vascular health compared to age-matched women. 2 3 Italy, IRCCS Istituto Auxologico Italiano, Milano, Italy, Department Future studies are required to better understand how this difference of Interventional Cardiology, Policlinico di Monza, Monza, Italy, in vascular health may translate to development of cardiovascular Arcispedale S. Maria Nuova, Cardiovascular Medicine, Reggio Emilia, disease. Italy, Macquarie University, Department of Biomedical Sciences, This trial is registered at https:// www. trial regis ter. nl/ trial/ 7955. Faculty of Medicine and Health Science, Sydney, Australia, Department of Medicine and Surgery, University of Milano‑Bicocca, Milano, Italy, Policlinico San Matteo Foundation, University of Pavia, Department Artery Research (2021) 27:S1–S36 S18 P.21 Further research is needed on long term patterns of PWV in AN Longitudinal clinical trajectory analysis of individuals patients, and to understand possible underlying mechanisms. before and after diagnosis of Type 2 Diabetes Mellitus (T2DM) indicates that vascular problems start early P.23 Dynamic time warping for measuring incremental pulse wave Dr Adrian Heald , Professor Simon George Anderson, Professor velocity: demonstration on a porcine model Yonghong Peng, Professor Martin Gibson, Dr Helene Fachim, Professor 1 2 1 Bill Ollier Mr. V Raj , Dr. P M Nabeel , Dr. Jayaraj Joseph 1 2 University of Manchester, Salford, United Kingdom Indian Institute Of Technology Madras, Chennai, India, Healthcare Introduction: Type 2 diabetes mellitus (T2DM) represents a major/ Technology Innovation Centre, Indian Institute of Technology Madras, increasing chronic health burden at a population level. T2DM fre- Chennai, India quently associates with increasing multi-morbidity/treatment Background: While outlining the clinical importance of incremental complexity . Longitudinal clinical histories of individuals both before pulse wave velocity (PWV) (1), attempts were made to measure it by and after diagnosis of T2DM are likely to provide additional insight simultaneously acquiring pressure and diameter from a single arte- into its aetiology and consequences. rial site. Owing to the methodological limitations of such methods (1,2), especially when applied to central arteries, we present a novel Methods: This study utilised diabetes patients and controls enrolled dynamic time-warping- based technique to measure incremental PWV in the DARE (Diabetes Alliance for Research in England). Longitudinal from a pair of identical blood pulse signals captured from two proxi- data of 281 individuals (T2DM n = 237 and matched non-T2DM con- mal sites. trols n = 44) were extracted. Trajectory Analysis over a period of up to 70 years based on calculations of the proportions of most prominent Methods: Its functionality was demonstrated on an anesthetized clinical conditions for each year. swine during baseline condition and infusion of vasoconstritive drugs Results: For individuals who eventually had a diagnosis of T2DM (elevating BP). A pair of pressure waveforms (sampling rate = 20 kHz) made, a number of clinical phenotypes were seen to increase con- was captured from the left common carotid artery using a dual-ele- sistently in the years leading up to diagnosis of T2DM. Of these docu- ment pressure catheter (5F, sensor spacing = 30 mm, Millar SPR-751, mented phenotypes, the most striking were diagnosed hypertension ADInstruments, India), from which beat-to-beat end-diastolic (C ) and (more than in the control group) and asthma. This trajectory over time peak-systolic PWVs (C ) were measured. was much less dramatic in the matched control group. Results: Baseline C and C evaluated from the captured high-reso- D S Immediately prior to T2DM diagnosis a greater indication of ischaemic lution pressure waveforms were repeatable (variability < 4.5%). Both heart disease proportions was observed. Post-T2DM diagnosis, the measures were strongly associated (r > 0.88, p < 0.01) with pressure and proportions of T2DM patients exhibiting hypertension and infection increased (> 2.5 times) with the increment in mean pressure (~ 3 times) continued to climb rapidly before plateauing. Ischaemic heart disease induced by the drug. C measured significantly greater (p < 0.0001) continued to increase in this group as well as retinopathy, impaired than C , 6.1 m/s versus 5.4 m/s during baseline (82/55 mmHg) and renal function and heart failure. 18.9 m/s versus 12.8 m/s during peak-drug-effect (226/184 mmHg). Conclusion: These observations provide an intriguing and novel Conclusions: The method reliably measured the incremental nature insight into the onset and natural progression of T2DM. They suggest of PWV and its inter-beat dependence on blood pressure, invasively. an early phase of potentially-related disease activity well before any Development of an ultrafast-fast ultrasound employing this method is clinical diagnosis of diabetes is made. underway, catering the need for a non-invasive technology that’s ame- nable for clinical settings. P.22 A longitudinal pilot study of pulse wave velocity in female P.24 adolescents with severe anorexia nervosa Changes of fingertip photopletysmography derived parameters 1 1 1 during acute SARS‑CoV‑19 infection in two patients with daily Dr Lee Hudson , Mr Daniel Jacobs , Dr Hind Al‑Khairulla , Ms. Alicia 1 1 1 monitoring Rapala , Professor Russell Viner , Dr Dasha Nicholls , Professor Alun D 1,2 1 1 Hughes Dr. Kulin Dániel , Dr. Zsuzsanna Miklós , Dr. Sandor Kulin Gos Ucl Institute of Child Health, London, United Kingdom Institute of Translational Medicine, Semmelweis University, Budapest, Background: Anorexia Nervosa (AN) is a mental disorder with well- Hungary, E‑Med4All Europe Ltd., Budapest, Hungary established acute cardiovascular complications. Less is known about Purpose/background/objectives: SARS-CoV-2 infection has vari- the impact on arterial stiffening and there are no published longitu- ous effect on the cardiovascular system above respiratory symptoms. dinal studies. Here we present interim data from a pilot longitudinal (1,2) Peripheral pulsewave morphology alterations might reflect these study of Pulse Wave Velocity (PWV ) in underweight young adolescents changes. Our aim is to showcase two patients to demonstrate how with AN admitted to an eating disorder unit in the United Kingdom. these effects can be captured with a remote patient monitor system with daily recordings and to compare the changes of the different Methods: We measured carotid-femoral PWV in all new admissions parameters to start a scientific discussion about the possible clinical to a single eating disorder unit from December 2020 who met inclu- utility of such monitoring in COVID-19 patients. sion criteria: 1) diagnosis of AN; 2) aged 12–18 years; 3) underweight (< 85% of average BMI for age and sex). PWV was measured using Methods: Signals were recorded with a remote patient monitor sys- Vicorder by a single operator at admission and weekly for 12 weeks. tem. (SCN4ALL, E-Med4All Europe Ltd., Hungary) (3) Patients were con- Ethics approval was provided by a London ethics committee. Stand- ducting measurements at rest, placing the device at one of their index ardised PWV Z-score for age (PWVz) was derived from published data. fingers. Results: For 7 participants, baseline mean PWV was 7.19 (SD 0.40) All the parameters collected in the different clinical conditions (pre-;in- m/s. Mean PWVz was 3.81 (SD 0.71, one sample t-test p < 0.01). Mean ;post-COVID) were displayed with a box-plot method. BMI was 15.62 (0.65 SD) kg/m . Baseline PWV and PWVz were not asso- Results: Both subjects had elevated heart rate and decreased oxygen ciated with baseline BMI. In multi-level, mixed effects models PWV and saturation during the acute phase of the disease. There are param- PWVz decreased over time in weeks (coefficient − 0.05, 95% CI − 0.07 eters showing the same patterns during the acute phase (systolic to 0.03; coefficient −0.10, 95% CI − 0.5 to − 0.05 respectively). slope inclination, b/a, early left ventricular ejection time1 and 2, ejec- Conclusions: We have demonstrated feasibility in collecting repeated tion time and crest-time). However, there are certain other parameters PWV measures in this patient group. Interim findings suggest high with discrepancies between subjects. (Stiffness index, reflection index, standardised scores of PWV compared to population normative data, d/a, dicrotic notch index, Ageing index, Left ventricular ejection time and temporal decreases in PWV and PWV z-score during admission. index). Artery Research (2021) 27:S1–S36 S19 Pulse rate variability time domain parameters (SDNN and RMSSD) both exhibited decreased values, as sign of ongoing infection (4). Conclusions: This case presentation demonstrates certain pulsewave analysis based cardiovascular parameter changes during COVID- 19 disease. Well-designed studies are needed to unfold the potential of daily pulsewave monitoring in the outcome prediction, phenotyping and the personalized therapy of COVID-19 and other diseases. P.25 The relationship between intima‑media thickness and global longitudinal strain value measured by 2D‑strain ultrasound in obese patients 1,2 1,3 Angela Cozma , Andrada‑Luciana Lazar , Benjamin Guilherme 1 1 1,2 1,2 Rodrigues , Gaétan Masson , Adela Sitar , Olga Orasan , Adriana 1,4 1,2 Fodor, Vasile Negrean "Iuliu Hațieganu" University Of Medicine And Pharmacy, Cluj‑Napoca, Romania, 4th Medical Department, Cluj‑Napoca, Romania, 3 4 Dermatology Department, Cluj‑Napoca, Romania, Department Fig. 2 Linear regression of GLS and IMT in the overweight population. of Diabetes and Nutrtion, Cluj‑Napoca, Romania Background: There is a strong correlation between intima-media thickness (IMT) and several cardiovascular risk factors, and more importantly with clinical and subclinical atherosclerosis (1). Addi- tionally, IMT assessment represents a valuable tool in order to antici- pate the individual risk of coronary artery disease (2) and impaired left heart function (3). The aim of our study was to evaluate the IMT and global longitudinal strain (GLS) values in obese and overweight patients, compared to normal-weight patients, and to determine a potential relationship between these measurements and the patient’s body mass index (BMI). Methods: A total of 31 patients were included in our study. The sub- jects were assigned to 3 groups as it follows: “obesity” group, “over- weight” group and “normal weight” group. The assessment of left ventricle systolic function was performed by 2D- strain echocardiogra- phy. IMT measurements were also performed. Results: 31 patients were included in our study, 8 (25.81%) had nor- mal weight, 12 (38.71%) were overweight and 11 (35.48%) suffered from obesity. Regarding the relationship between IMT and GLS value in the global population the correlation coefficient was 0.5758, while Fig. 3 Spearman correlation of GLS and IMT in the obese population in the “overweight” group and “obesity” group the R value was equal p = 0.00994. to 0.6243 and 0.735, respectively. Our main results are illustrated in the Conclusions: Overall, our study revealed that the absolute value of following figures. GLS decreases while the measured IMT appears to increase with BMI values. P.26 Back to the future. Cuffless blood pressure estimation in the 1990’s 1 1 1 1 Mr Kyrollos Louka , Mr James Cox , Dr Isabella Tan , Dr Alberto Avolio , 2 1 Mr Michael O’Rourke , Dr Mark Butlin 1 2 Macquarie University, Macquarie Park, Australia, University of New South Wales, Sydney, Australia Background: The new frontier of cuffless blood pressure (BP) may enable widespread, high-frequency BP estimation in the community. The technique, however, is not new. This study investigates the first commercial cuffless BP device, the Casio BP-100 digital watch (Model No. 900), released in 1993. Finger pulse arrival time is measured using finger photoplethysmography and an electrocardiogram. Using a two- point individualised calibration method, systolic BP (SBP) and diastolic BP (DBP) is estimated. Fig. 1 Linear regression of GLS and IMT in the global population. Methods: Twenty participants (11 female) had seated BP measured using the Casio BP-100 and a brachial automatic oscillometric BP device at rest and during a 5-min isometric hand-grip exercise. Results: There was no significant difference between the refer - ence device and the BP-100, but a large bidirectional scatter of BP estimation by the Casio BP-100 (average differences 2 ± 20 and -1 ± 19 mmHg during baseline, and -1 ± 21 and 7 ± 23 mmHg during exercise for SBP and DBP respectively). There was poor correlation for both SBP (R = 0.36, p = 0.13) and DBP (R = 0.044, p = 0.37). Artery Research (2021) 27:S1–S36 S20 Conclusions: Given the size, low processing power, and long battery P.28 life, it is impressive that the Casio BP-100 provided some directional Evaluation of Arterial Pulse Reflection Parameters using information on BP. It is also one of the few commercial devices to this Multi‑Gaussian Decomposition Model: Association with Stiffness day using two-point individualisation calibration. Likely in part due to Markers limitations in the algorithms for finding fiducial waveform points, BP 1 1 2 1 Mr. Rahul Manoj , Mr. V Kiran R aj , Dr. P M Nabeel , Dr. Jayaraj Joseph estimation was poor. As we look to the future of cuffless BP, we should Department of Electrical Engineering, Indian Institute Of Technology emulate the positive aspects of the Casio BP-100 whilst looking at Madras, Chennai, India, Healthcare Technology Innovation Centre—IIT ways to improve accuracy. Madras, Chennai, India Background: Recent methods to quantify arterial wave reflections per - P.27 form wave separation analysis (WSA) based on single-site pressure and Comparison of Quantitative Reflection Indices of Forward– flow information to evaluate reliable metrics: Reflection Magnitude (RM) Backward Pulse Wave Decomposition Techniques: A Virtual and Reflection Index (RI), contrary to conventional augmentation index Subject Study (1). Addressing challenges associated with such methods, we have devel- 1 1 2 1 oped a new WSA technique using Multi-Gaussian Decomposition (MGD). Mr. Rahul Manoj , Mr. Kiran V Raj , Dr. P M Nabeel , Dr. Jayaraj Joseph Department of Electrical Engineering, Indian Institute Of Technology Methods: The MGD model decomposes the diameter-scaled pres- Madras, Chennai, India, Healthcare Technology Innovation Centre‑IIT sure waveform into multiple Gaussians for WSA without requiring flow Madras, Chennai, India information. The method’s functionality was investigated on 100 par- Background: Studies of the forward–backward propagating pulses ticipants (35 ± 10 years, 50 hypertensives) where diameter measured in arterial bed provide novel insights into vascular dynamics and clini- using ARTSENS (2) were used to evaluate RM and RI. RM and RI are vali- cal conditions. The conventional pulse wave separation techniques— dated by their associations with stiffness markers and screening ability. flow-based Wave Separation Analysis (WSAMF) and Wave Intensity Analysis (WIA)—require measured pressure-flow waveforms (1). As alternatives, simplified methods that require pressure wave alone (modelled flow wave (2) or approximated to a triangular wave (WSATF) (3) have gained acceptance. This work compares performance of WIA, WSAMF, and WSATF using established wave reflection indices. Methods: Methods’ performance was evaluated on virtual subjects’ data (4) (N = 500, age: 25–75 years). The pressure and flow waveform were extracted for the left carotid artery. Reflection Magnitude (RM), Reflection Index (RI), Pulse Pressure Backward (ΔPb) and Pulse Pressure Forward (ΔPf ) were obtained and compared for said three methods. Results: Samples of forward–backward pressure waves obtained from all the three methods are illustrated in Fig. 1. The comparative analysis Fig. 1(a). Separated waves using MGD, (b) Box and Whisker plots for is presented in Table I. Largest deviation in RM and RI was observed RM and RI comparing normotensives versus hypertensives. between WSATF and WSAMF (14.7% and 8.71%, respectively), and the Results: Adequately high-quality diameter waveforms were captured. minimum deviation was between WSAMF and WIA (6.66% and 3.71%, The group averages of RM (= 0.69 ± 0.16) and RI (= 40.73 ± 6.1) % were respectively). Deviation for ΔPb and ΔPf among methods ranged comparable with earlier reported WSA studies (3–4). They exhibited between 1.2% – 8.34%, with highest deviations against WSATF. significant correlation (r > 0.5, p < 0.0001) with the stiffness markers: β, elastic modulus, compliance, pulse wave velocity and AIx. Both RM and RI were significantly (p < 0.05) higher for hypertensives than nor- motensives, by 25.20% and 15.4%, respectively. Conclusion: The study demonstrated the method’s functionality in estimating reliable RM and RI that evidently associated with other clinically popular stiffness markers and discriminated between hyper - tensives and normotensives. Given the advantage that the method requires strictly one pulse waveform alone, its potential clinical and research applications are further being explored. 120 0.45 P.29 Vascular function is unaltered after aerobic acute exercise 0.4 Pressure Wave 100 in physically active young and older male adults 0.35 WSA TF Forward 0.3 80 1,2 3 4 WSA-TF Backward Mr. João Luís Marôco , Mr Marco Pinto , Dr. Helena Santa‑Clara , Dr. Bo 0.25 5 1,2 60 0.2 WSA-MF Forward Fernhall , Dr. Xavier Melo 0.15 1 WSA-MF Backward Faculdade de Motricidade Humana‑Universidade de Lisboa, Oeiras,, 0.1 WIA-Forward Portugal, Ginásio Clube Português, Research & Development 0.05 WIA-Backward 0 Department, GCP Lab, Lisboa, Portugal, Faculdade de Medicina da Flow Velocity 4 0 -0.05 Universidade de Lisboa, Lisboa, Portugal, Centro Interdisciplinar de 0 0.1 0.2 0.3 0.4 0.5 0.6 0.7 0.8 0.9 Time (s) Estudo da Performance Humana, Faculdade de Motricidade Humana Fig. 1 Comparison of wave separation in all the methods for a sample – Universidade de Lisboa, Oeiras, Portugal, College of Applied Health subject from database, along with pressure and flow velocity wave - Sciences—University of Illinois at Chicago, Chicago, USA form extracted from left carotid artery. Purpose: Vascular acute responses to successive bouts of exercise may cumulatively induce exercise-related adaptations in an intensity- dependent manner. However, these responses are inconsistent across age groups, and whether there are age or physical activity associated response patterns on brachial artery flow-mediated dilation (FMD) and arterial stiffness indices to high-intensity interval exercise (HIIE) and moderate-intensity continuous exercise (MICE) remains unknown. We compared the response pattern of FMD and arterial stiffness indices, Pressrue (mmHg) Flow Velocity (m/s) Artery Research (2021) 27:S1–S36 S21 10 and 60 min following an acute bout of HIIE and MICE in physically diagnosis and monitoring of cardiovascular risk. Early detection of active young and older adults. vascular alterations in apparently healthy individuals can be imple- mented in large arteries, such as the carotid [2] and usable systems Methods: Twenty four young (20–40 years; n = 12) and older (57– could improve the translation of this approach into clinical practice. 76 years; n = 12) healthy and active male adults performed an iso- Technical validation and usability of an innovative, easy-to-use, and caloric acute bout of HIIE and MICE, or a non-exercise condition, in portable system to assess carotid function and structure by ultrasound a randomized order. Pre-and-post condition changes in FMD, pulse was investigated [3]. wave velocity (PWV), and augmentation index (Aix) were analyzed Methods: The new integrated system is composed of hardware (the with linear mixed models. Interson SP-L01 embedded ultrasound probe) and software measur- Results: Relative FMD was similar between young and older adults ing the instantaneous diameter of the carotid artery in real-time from but time-to-peak was higher in older adults (d = 14; 95% CI: 4 to B-mode ultrasound image sequences (Carotid Studio, by Quipu Srl). 23 s; p < 0.01, h2 = 0.28). Carotid-femoral PWV (cfPWV) (d = 2.16; 95% 12 healthy volunteers were recruited for the pilot technical validation: CI: 1.13 to 3.19 m/s; p < 0.001, h2 = 0.46), and Aix (d = 27.90; 95% intra-operator reproducibility of two acquisitions by an expert opera- CI: 21.27 to 34.50%; p < 0.001, h2 = 0.78) were higher in older com- tor and agreement with state-of-the-art technique (Mylab25 Esaote pared to young adults. FMD (p = 0.84) and cfPWV (p = 0.85) remained and Carotid Studio 4.3) were evaluated. Questionnaires were admin- unchanged following HIIE and MICE in both groups (Figure). istered to operators to assess the usability of the new portable inte- Conclusions: We found no evidence of age-associated response pat- grated system. terns on FMD and cfPWV to a single bout of HIIE or MICE in physically Results: Agreement with state-of-the-art technique was satisfac- active young and older adults. tory, with no significant bias for the 12 subjects recruited (5 men, 44.5 ± 13.6 years). Coefficient of variation was 3.2% (2.5% SD) for Intima-Media Thickness, 0.9% (0.7% SD) for diameter, and 2.5% (2.2% SD) for distension. An average score greater than 4 on a Likert five-point scale positively reported the usability of our system. Conclusions: The innovative prototype for easier assessment of ultrasound carotid parameters of vascular ageing was success- fully designed and developed. Usability in this pilot study was also satisfactory. P.31 Identification of vascular damage in systemic sclerosis: results from a single centre cross‑sectional study 1 1 1 Dr. Carolina Mazeda , Dr. Susana Silva , Dr. Renata Aguiar , Dr. Anabela 1 1 Barcelos , Dr. José Mesquita Bastos Centro Hospitalar Baixo Vouga Aveiro, Portugal Introduction: Systemic Sclerosis (SSc) is a rare connective tissue disease characterized by fibrosis, imune and vascular dysfunction. Classical manifestations include changes in microcirculation, but macrovascular involvement hasn’t fully understood. Arterial stiff- ness, measured using pulse wave velocity (PWV), is dynamic property determined by arterial wall structure, endothelial and vascular smooth Figure Flow-mediated dilation (FMD) and carotid-femoral pulse wave muscle function, and arterial pressure. This measure is an independent velocity (cfPWV) post-exercise response in young and older adults. predictor of cardiovascular events. The aim of study is comparison of Vertical bars correspond to the 95% CI. Open circles correspond to arterial stiffness in SSc patients and healthy controls. individual responses. There were no significant main effects for FMD (time, condition, group) or interaction effects between factors. A sig- Methods: Patients with SSc fulfilled ACR/EULAR 2013 classification nificant group effect for cfPWV was observed (p < 0.001). criteria. Socio-demographic and clinical data were collected. Arterial stiffness studies was performed (PWV and augmentation index (AI)). In P.30 descriptive analysis, ANOVA and Kruskal–Wallis test were used to com- Portable ultrasound‑based system for the assessment of carotid pare continuous variables and Fisher’s exact test for categorical vari- characteristics: a pilot study ables. p-value ≤ 0.05 was statistically significant. 1 2 Results: Twenty-two patients were included (17 female and 5 men; MSc Martina Francesconi , MSc, PhD Maria Raffaella Martina , MSc 1 2 3 mean age 58.95 ± 8.75) and 11 controls (7 female and 6 men; mean Silvia Armenia , MSc Andrea Buzzelli , MD, PhD Gregorio Di Franco , MSc 2 2 age 50.01 ± 10.09). PWV were significantly increased in SSc patients Vincenzo Gemignani , MSc, PhD Elisabetta Bianchini , MD, PhD Rosa compared with controls (PWV: 8.08 ± 1.66 vs 6.85 ± 1.84), with signifi- Maria Bruno cant differences in two groups (p = 0.01). Values of AI as also higher Department of Clinical and Experimental Medicine, University of Pisa, (8.57 ± 7.27 vs 6.26 ± 5.94), however no statistically significant differ - Pisa, Italy, Institute of Clinical Physiology (IFC), National Research Council ences was found (p = 0.35). (CNR), Pisa, Italy, General Surgery Unit, Department of Translational Conclusion: Although we were able to demonstrate significant dif- Research and New Technologies in Medicine and Surgery, University ference in PWV between two groups, but it was insufficient to detect of Pisa, Pisa, Italy, INSERM U970 Paris Cardiovascular Research Centre– difference in AI. This suggests that patients with SSc may have an PARCC, Université de Paris, and AP‑HP, Pharmacology Unit, Hôpital increased prevalence of subclinical atherosclerosis, however more Européen Georges Pompidou, Paris, France studies with larger sample size are warranted and may be beneficial to Abstract assess its evolution over time in order to understand its impact on the clinical outcome. Purpose/background/objectives: Effective strategies to prevent or minimize the burden of cardiovascular events [1] are based on early Artery Research (2021) 27:S1–S36 S22 P.32 P.33 Suitability of a representative aortic flow waveform Correlation between arterial stiffness and nailfold capillary for pressure‑only wave separation in children and adolescents microscopic abnormalities in systemic sclerosis: results 1,2,3 1 1,2,4 A/Prof Jonathan Mynard , Hilary A Harrington , Dr Remi Kowalski , from a single centre cross‑sectional study 1,2 1,2 1,2 Jonathan Glenning , Avinash Kondiboyina , A/Prof Joseph Smolich , 1 1 1 1,2,4 Dr. Carolina Mazeda , Dr. Susana Silva , Dr. Renata Aguiar , Dr. Anabela Prof Michael Cheung 1 1 1 Barcelos , Dr. José Mesquita Bastos Heart Research, Murdoch Children’s Research Institute, Parkville, 1 2 Centro Hospitalar Baixo Vouga, Aveiro, Portugal Australia, Department of Paediatrics, University of Melbourne, Introduction: Systemic Sclerosis (SSc) is a rare connective tissue dis- Parkville, Australia, Department of Biomedical Engineering, University ease with several systemic manifestations characterized by immune of Melbourne, Parkville, Australia, Department of Cardiology, Royal dysfunction, vascular abnormalities and fibrosis. Microvascular dam- Children’s Hospital, Parkville, Australia age represents the earliest morphological and is a prominent feature Background: Wave separation analysis (WSA) reveals the contribu- of SSc easily accessible by nailfold video-capillaroscopy (NVC). While tion of forward and backward waves to the arterial pulse. Although microangiopathy is well-documented, the macrovascular involvement WSA requires both pressure and flow waveforms, it is generally the has not been completely clarified. Arterial stiffness is an independent pressure waveform that varies most between individuals. Therefore, a predictor of cardiovascular events and the carotid-femoral pulse wave synthesized (e.g. triangular) waveform is now commonly used in set- velocity (PWV) are considered the gold standard for your measure- tings where the flow waveform cannot be obtained. However, the ment. The aim of this study is to assess changes in arterial stiffness and most appropriate flow waveform for use in children and adolescent is its relationship with NVC abnormalities in SSc patients. unknown. Methods: All patients included fulfilled ACR/EULAR 2013 classification Methods: Twenty-three children and adolescents (15 years old, 48% criteria for SSc. Each participant underwent arterial stiffness studies male, height 168 15 cm, weight 61 20 kg) attending the Royal Chil- (PWV and augmentation index(AI)) and NVC (nonspecific, early, active dren’s Hospital (Melbourne) for a cardiac MRI were recruited. Only or late). To assess differences of macrovascular indices between NVC patients with a normal left ventricle and aorta were included. Images patterns, Kruskal–Wallis test was used. The Fisher’s exact test was used from phase contrast MRI of the ascending aorta were segmented to for categorical variables. p-value ≤ 0.05 was statistically significant. obtain flow and cross-sectional area waveforms (the latter as a surro - Results: Twenty-two patients were included and clinical character- gate of pressure). Wave separation was performed with a) patient-spe- istics are listed in Table 1. Mean PWV was 8.08 ± 1.66 m/s and AI was cific flow, b) triangular flow waveforms with peak at 25% (Tri25) or 30% 6.85 ± 1.84%. No significant differences between PWV and AI with NVC (Tri30) of ejection time, and c) a representative waveform obtained by patterns (p = 0.36 and p = 0.39). Digital ulceration, disease subtype, averaging individual waveforms after amplitude and time normalisa- pulmonary involvement and anti-topoisomerase-I antibodies were tion and forcing late-diastolic flow to zero with a weighting function found statistically correlated with microangiopathic severity identified (Fig. 1). in NVC (p < 0.05), but no association was found between these findings Results: Normalised flow waveforms were highly consistent (Fig. 1). and macrovascular indices. Compared with reflection magnitude (ratio of backward/forward wave Conclusion: Despite small sample size, wall stiffness parameters amplitude) using patient-specific flows (0.58 0.17), Tri25 and Tri30 dif- measurements don’t seem to correlate to microangiopathic features. fered by –13.2 7.5% (P < 0.001) and –6.1 9.8% (P = 0.003), but the repre- More studies with larger samples are needed, as well as understanding sentative waveform was no different (0.6 5.3%, P = 0.7). the evolution of stiffness parameters over time. Conclusions: A representative population flow waveform is suitable for wave separation in children and adolescents, and provides superior accuracy compared with the triangulation approach. Artery Research (2021) 27:S1–S36 S23 P.34 Cross‑sectional comparison of office and ambulatory pulse Conclusions: HxPE is associated with greater large artery stiffness and wave velocity by two methods, and their changes after lifestyle attenuation of the CCA/aortic stiffness gradient. This may contribute in or medical interventions in hypertension part to distal transmission of pulsatile pressure, reduced microvascular perfusion, and target-organ damage in women with hxPE. 1 1 1 MD, Phd János Nemcsik , MD Dóra Batta , MD Beáta Zita Kőrösi , Helga 1 1 2 Gyöngyösi , Zsófia Nemcsik‑Bencze , MD, PhD Andrea László , MD, PhD 1 1 P.36 Numerical assessment of carotid‑femoral pulse wave velocity Orsolya Cseprekál , MD, PhD András Tislér 1 2 in end‑stage renal disease setting Semmelweis University, Budapest, Hungary, Jula/Schindler praxis, 1,2 4 2,3 Nurenberg, Germany Dr Hasan OBEID , Mrs Vasiliki BIKIA , Mrs Catherine FORTIER , Mrs 1,2 1,2 4 Objective: Pulse wave velocity (PWV), the most accepted biomarker Mathilde PARE , Mrs Karine DUVAL , Pr. Nikos STERGIOPULOS , Dr. 1,2 of arterial stiffening can be measured by different methods and in the Mohsen AGHARAZII 1 2 past decade its 24-h monitoring has also become available. The aim of University Laval, Quebec, Canada, CHU de Québec Research Center‑ our study was to compare office and ambulatory PWVs and in a pro - L’Hôtel‑Dieu de Québec Hospital, Quebec, Canada, INSERM, UMR‑970, portion of patients to compare the changes of PWVs after the initia- Paris Cardiovascular research Center, PARIS 15, France, Laboratory tion of lifestyle modifications or antihypertensive medication. of Hemodynamics and Cardiovascular Technology, Swiss Federal Institute of Technology, Lausanne, Switzerland Methods: Office carotid-femoral PWV was measured with the tono - Background: Through deregulation of various biological mecha- metric PulsePen device (PP PWV), office and 24-h ambulatory oscil- nisms, the uremic milieu plays a significant role in the cumulative vas- lometric PWVs were evaluated with Mobil-O-Graph (MOB office PWV cular damage that results in aortic stiffness. Kidneys are high flow and and MOB 24 h PWV, respectively). In new hypertensive patients the low resistant organs, and their “absence” could significantly alter car - measurements were repeated 3 months after the initiation of antihy- diovascular physiology in a way that could affect aortic stiffness based pertensive medication. In white-coat hypertensive patients after life- purely on a biomechanical analysis of the cardiovascular system. style modifications the measurements were repeated at 12 months. Results: 105 patients were involved with 22 new hypertensive (HT) Methods: We used a detailed 1D arterial network model (143 arterial and 22 white-coat hypertensive (WhHT) subjects. PP PWV (8.7 (7.3– segments) coupled with heart model. The cfPWV was determined by 9.9) m/s) differed from MOB office PWV (7.3 (6.5–8.8) m/s) and MOB measuring the foot-to-foot pulse transit time (PTT) between the pres- 24 h PWV (7.4 (6.4–8.8) m/s) as well (p < 0.05). PP PWV significantly sure signals at the carotid and the femoral arteries (cfPTT). We calcu- decreased both in HT (by 0.9 (0.4–1.5) m/s, p < 0.05) and WhHT patients lated cfPWV in four different settings. Setting 1: the right and left renal (by 0.3 (− 0.1–1) m/s, p < 0.05). MOB office PWV did not change sig- arteries were present in the 1D model (healthy subject), setting 2: the nificantly neither in HT, nor in WhHT. MOB 24 h PWV decreased only in left renal arteries were removed from the model (kidney -donor sub- HT patients (by 0.2 (0–0.6) m/s), which was less pronounced compared ject), setting 3: both right and left renal arteries were removed from with PP PWV (p < 0.05). the model (end stage kidney failure), setting 4: both right and left Conclusions: The significant differences observed both in the cross- renal arteries were removed, right renal arteries were attached on the sectional and in the prospective parts of our study suggests that the external iliac artery (transplanted subject). two methods are not interchangeable. Results: In this numerical model, output cfPTT’s were 110, 102, 99 and 101 ms respectively for setting 1, 2, 3 and 4. The cfPWV’s were P.35 Attenuation of the carotid‑aortic stiffness gradient 4.82, 5.19, 5.35 and 5.25 m/s respectively for setting 1, 2, 3 and 4. This is associated with reduced microvascular perfusion in women shows that numerical cfPWV increases in case of kidney disease and with a history of preeclampsia decreases for transplanted subjects. Conclusions: The numerical assessment of cfPWV in ESRD setting is 1 1 2 1 Virginia Nuckols , Amy Stroud , Debra Brandt , Lyndsey DuBose , Mark feasible using a 1D model of the arterial network. Further analyses are 2 1,3 Santillan , Gary Pierce needed to mimic more realistic setting for the ESRD patients. Department of Health and Human Physiology, Iowa City, United States, Department of Obstetrics and Gynecology, Iowa City, United States, P.37 The systolic rise time measured wih ppg to screening Department of Internal Medicine, Iowa City, United States peripheral artery disease: application to the pOpmètre Background: Women with a history of preeclampsia (hxPE), a hyper- 1 2 2 tensive pregnancy disorder, exhibit greater aortic stiffness postpar - Mrs Anissa Benbia , Dr Magid Hallab , Mrs Kornelia Eveilleau , Dr Hasan 2 2 3 1 tum compared with healthy pregnancy (HP). Greater relative carotid OBEID , Dr Imad Abi‑Nasr , Dr. Majid Tayyarah , Pr. Georges Leftheriotis artery (CCA) compared with the aorta maintains a stiffness gradient Service de Médecine Vasculaire, CHU de Nice‑France, Nice, France, that attenuates propagation of deleterious pulsatile pressure into the Service de Cardiologie, Clinique Bizet, Paris‑France, Paris, France, microcirculation.1 However, the relation between large artery stiffness, Vascular Surgeon, Southern California Permanente Medical Group pulsatile hemodynamics and microvascular function among women and Assistant Professor of Clinical Surgery, Loma Linda University School with hxPE is unknown. of Medicine, Southern California, USA, California, USA Introduction: Screening for Peripheral Artery Disease (PAD) remains Methods: Women with hxPE (N = 33) and HP controls (N = 46) were a challenge in the prevention and care of patients with arteriosclero- assessed 18 ± 6 months postpartum. Aortic stiffness was measured as sis. The Ankle Brachial Index (ABI) is currently the gold standard. How- carotid-femoral pulse wave velocity (cfPWV) by applanation tonom- ever, ABI is time consuming and requires some expertise to perform etry. CCA stiffness was assessed as characteristic impedance (Zc), the which is a limiting factor for global screening. The measurement of the CCA pressure/flow ratio in early systole without the influence of wave Systolic Rise Time (SRT) of the pulse wave of the lower limb may pro- reflection, using Doppler ultrasound.1 A single-point carotid-PWV was vide an easier alternative to detect PAD. In a retrospective pilot study, derived from stiffness parameters (Bramwell-Hill eq)2 for direct com- we analyzed the possibility of detecting PAD using the SRT of the toe parison to aortic (cfPWV). Sublingual microvessel perfusion (red blood waveform using the Photo-PlethysmoGraphic signal (PPG). cell filling) was assessed by sidestream dark- field imaging. Results: Women with hxPE had greater CCA-Zc (3562 ± 202 vs Methods: We measured 79 subjects (41 patients diagnosed with dif- 2850 ± 142 DSC) compared with controls but cfPWV did not dif- ferent stages of PAD and 38 healthy volunteers without known PAD). fer independent of mean arterial pressure (6.1 ± 0.2 vs 5.5 ± 0.1 m/s, In each subject, at least one lower limb was assessed with classical P = 0.55). In HP, carotid-PWV exceeded cfPWV (= 0.4 m/s, P = 0.005) ABI (minimum of 2 tibial arteries using a Doppler probe). All subjects whereas in women with hxPE, carotid-PWV did not differ from cfPWV underwent a PPG assessment on the finger and the toe simultane - (= − 0.1 m/s, P = 0.60). CCA-Zc was associated with augmented carotid ously using pOpmètre (Axelife—France). In-house software (JAVA) pressure pulsatility index (r = 0.36, P = 0.005) and reduced microvascu- was used to calculate the SRT of all recorded signals. lar perfusion (r =− 0.26, P = 0.03). Artery Research (2021) 27:S1–S36 S24 Results: From the 154 lower limbs recorded, 8 were excluded for Research Center, 75,015, Paris, France, AP‑HP, Pharmacology Unit, Hôpital technical reasons: problematic cuff measurement of the ABI (in very Européen Georges Pompidou, Université de Paris, Paris, France severe PAD, medial calcification & amputation) or bad quality of the Purpose/background/objectives: Aortic stiffness (AS) has been asso - PPG signal with very low amplitude. Finally, 146 lower limbs were ana- ciated with accelerated cognitive decline, possibly due to increased lyzed including 72 healthy and 74 subjects with PAD. The mean age cerebral blood flow (CBF) pulsatility and resulting microcirculatory of the population was 69 ± 12 years with 75% men, 28% diabetics, damage. Hence, this study aimed to examine the association between 47% hypertensive, 49% without clinical PAD defined as stage 0 in this aortic and carotid stiffness and their impact on the CBF pulsatility in study; 16% in stage 1; 32% in stage 2; 2% in stage 3 and 1% in stage 4 a group of subjects composed of healthy controls and patients with according to the Leriche classification. The SRT cut-off value of 160 ms chronic kidney disease (CKD), covering a wide range arterial stiffness identifies PAD according to Leriche starting at stage 1 with a sensitivity measures. of 78% vs 73% for ABI < 0.9 and a specificity of 86% vs 87%; a positive predictive value (PPV) of 85% vs 86% and a negative predictive value Methods: In 19 participants aged 61 19 years (12 male, 13 CKD), we (NPV) of 79% vs 75%. In addition, the ratio between toe-SRT and fin- evaluated AS by carotid-femoral pulse wave velocity (CF-PWV). Com- ger-SRT cut-off value of 1 identifies PAD with a sensitivity of 76% and a mon carotid diameter and distention (echotracking) and local pulse specificity of 74%. pressure (tonometry) were used to derive carotid pulse wave velocity Conclusion: SRT measured using a PPG pulse signal of the toe is (C-PWV) based on the Bramwell-Hill equation. Middle cerebral artery promising as a facile non-invasive method to diagnose PAD (dura- blood flow velocity (MCAv) was determined using transcranial Dop - tion < 14 s) and determine PAD stages 1 to 4 with similar specificity pler ultrasound. MCAv pulsatility index (PI) was computed as (systolic and sensitivity as the reference method. These results need to be con- MCAv—diastolic MCAv/mean MCAv. Spearman-rho correlation coef- firmed through a prospective study. ficients were examined to assess the extent of associations between stiffness parameters and MCAv PI. Results: The CF-PWV and C-PWV were respectively 11.1 [9.4–12.8] and P.38 7.8–2.9 m/s. Mean MCAv was 67.3–18.8 cm/s, systolic MCAv 96.1–25.3, Eec ff t of long term calorie restriction on transglutaminase‑2 diastolic MCAv 47.2–15.3 and MCAv PI was 0.75–0.21 cm/s. MCAv PI protein levels and microRNA expression of mice was significantly associated with C-PWV (r = 0.645, p = 0.004), how- 1 2 2 Elif Oztemiz , Prof. Dr. Soner Dogan , Atakan Ayden , Assoc. Prof. Bilge ever the association with CF-PWV did not reach significance (r = 0.447, Guvenc Tuna p = 0.055). There was no association between MCAv PI and aortic-to- Yeditepe University, Medicine Faculty, Biophysics Department, Istanbul/ carotid PWV ratio (r = − 0.257, p = 0.303). Conclusions: This prelimi- TURKEY, Istanbul, Turkey, Yeditepe University, Medicine Faculty, nary data shows a strong correlation between carotid stiffness and Medicinal Biology Department, Istanbul, Turkey CBF pulsatility. Background: Transglutaminase-2 (TG2) is one of the important mod- ulator of vascular health (1–3). This study aims to evaluate the protec- tive effect of calorie restriction (CR) on vascular health through TG2 protein levels and microRNA (miRNA) expression targeting TG2 gene. Methods: MMTV-TGF-α mice fed ad libitum (AL) divided into 3 groups; ad libitum(AL), chronic CR fed with %15 restriction of AL group, inter- mittent CR group fed AL for 3 weeks (ICR-ReFeed) which followed by %60 restriction for 1 week (ICR- Restricted). Mice euthanized at 10, 17/18 and 49/50 weeks and blood and aorta were collected respec- tively. Blood miRNA profile obtained by microarray (n = 3). Differen- tially expressed miRNAs were analyzed and miRNAtap package was used to obtain miRNAs targeting TG2 gene. TG2 levels of aorta were P.40 Smooth muscle cells express stronger traction forces in aortic determined by western blot (n = 4). thoracic aneurysms Results: Compared to AL group at week 10, TG2 targeting miRNAs: 1 1 miR-484, miR-700-5p and miR-423-5p were expressed statistically Ms Claudie Petit , Mr Ali‑Akbar Karkhaneh Yousefi , Ms Olfa Ben 1 3 2 significant increase in ICR-R group at week 49/50. 17 weeks AL mice Moussa , Mr Jean‑Baptiste Michel , Mr Alain Guignandon , Mr Stéphane had increased TG2 protein levels compared to 10 weeks. However, Avril the levels were decreased at 50 weeks group compared to both time Mines Saint‑Etienne, Université de Lyon, INSERM, U 1059 SAINBIOSE, points. CCR group had increased TG2 levels with ageing. ICR-R groups F—42,023 Saint‑Etienne, France, Université Jean Monnet, Université remained lower than CCR at both 17/18 and 49/50 week. de Lyon, INSERM, U 1059 SAINBIOSE, F—42,023 Saint‑Etienne, France, Conclusion: These results may provide a translational insight for Laboratory for Translational Vascular Science, and Paris 7‑ Denis Diderot understanding the roles of TG2 in vascular ageing and mechanism of University, Xavier Bichat HospitalInserm UMR 1148, 75,018 Paris, FRANCE epigenetic regulations by CR on providing better vascular health. In Introduction: SMC have the ability to modulate their phenotype in future studies, miRNAs that evaluated in this study will be validated in response to pathological conditions, as occurs in ascending thoracic aorta samples to have more perception. aortic aneurysms (ATAA) (1–3). In fact, it was previously shown that mis-sensing of mechanical stimuli play a major role in ATAA (2,4). Accordingly, there is a pressing need to quantify the mechanobiologi- P.39 Carotid stiffness and cerebral pulsatility index cal effects of the changes operating at single cell level. 1,3,4 3,4 5,6 Ms Mathilde Paré , Mr. Marc‑Antoine Roy , Dre Catherine Fortier , 3,4 3,4 1 Ms Audrey Drapeau , Ms Lawrence Labrecque , Ms Karine Duval , Dr. Methods: To address this need, we applied a previously developed 3,4 1,2 Patrice Brassard , Dr. Mohsen Agharazii Traction Force Microscopy (TFM) technique (5,6) on primary human Division of Nephrology, Faculty of Medicine, Université Laval, Québec, aortic SMC, extracted from three healthy and three aneurysmal donors QC, Canada, Québec, Canada, CHU de Québec Research Center, with matching age and gender. We measured the cell basal tone by L’Hôtel‑Dieu de Québec Hospital, Quebec, Canada, Research Center measuring the traction forces applied by each SMC onto compli- of the Institut Universitaire de Cardiologie et de Pneumologie de Québec, ant hydrogels of different stiffness (4, 8, 12, 25 kPa), with embedded Québec, Canada, Department of kinesiology, Faculty of Medicine, fluorescent microbeads (Matrigen, Softwell 24, collagen pre-coated, Université Laval, Québec, Canada, INSERM, UMR‑970, Paris Cardiovascular Softrack 0.2 µm Y/G). Results: Although the range of measured force suggested some het- erogeneity, we observed that: 1. the traction forces increased with the Artery Research (2021) 27:S1–S36 S25 substrate stiffness; 2. For aneurysmal SMC, traction forces were sig- We also found a strong association between the time from infec- nificantly higher than for healthy ones. We also found the existence of tion, and variability of pulse wave velocity or end-systolic pressure larger traction forces in the aneurysmal SMC were related to the larger (Kendall’s_τ ≥ 0.418, p ≤ 0.035). For several measures, the intensity of size of these cells (6). changes depended on age. Conclusion and perspectives: We conclude that there is a reduced Conclusions: The results suggest widespread, complex changes in expression of elongated and contractile SMCs in ATAA. This tends vascular biomarkers after the COVID-19 infection. While small sample to promote stronger SMCs, which are less responsive to vasoactive size limits the certainty of our findings, overall the study prompts for agents. Future work aims at understanding further these alterations in implementation of powered, larger studies with adequate follow up to aortic aneurysms. fully assess the effect of COVID-19 disease on vascular aging. P.41 Roughness analysis of coronary artery stents and bypass grafts P.43 Prevalence of fibromuscular dysplasia in radial arteries for diabetes mellitus patients of cerebral aneurysms through ultra‑high frequency ultrasound: a radiomic approach Dr. Senol Piskin 1 1 2 6 Department of Mechanical Engineering, Istinye University, Zeytinburnu, Biomedical engineer Federica poli , Francesco Faita , Silvia Armenia , 5 5,6 5 TurkeyMichelangelo Mancuso , Paolo P errini , Lorenzo Ghiadoni , Mirco 4 1,3 Purpose/background/objectives: Atherosclerosis in coronary artery Cosottini , Rosa Maria Bruno disease (CAD) or carotid artery disease is treated by implementing a Paris Cardiovascular Research Center (PARCC)‑INSERM UMR‑970, Paris, stent through interventional cardiology or by deploying a bypass France, Institute of Clinical Physiology, National Research Council, graft through open-heart surgery. Diabetes mellitus (DM) is one of the Pisa, Italy, AP‑HP, Hôpital Européen Georges Pompidou, Université de most common comorbid conditions in patients with coronary artery Paris, Paris, France, Department of Translational Research and New disease, which is important in determining the severity of the disease, Technologies in Medicine and Surgery, University of Pisa, Pisa, 5 6 treatment strategy, and the prognosis of patients [1]. Italy, University of Pisa, Pisa, Italy, Azienda Ospedaliero Universitaria Pisana, Pisa, Italy Here, we aim to analyze and compare the DM patients’ flow dynam- Objectives: Cerebral aneurisms are present in up to 12.9% patients ics to healthy control using a computational model. We also aim to with fibromuscular dysplasia (FMD) (1). We recently identified a pat - find out the effects of wall roughness on the WSS for the DM patient tern of vascular wall disarray and remodeling in radial arteries strongly model. and specifically associated with FMD. The aim of this study was to Methods: Two different in silico models have been generated and determine the prevalence of this pattern in radial arteries of patients simulated using computational fluid dynamics (CFD). For simplicity with cerebral aneurysms. and isolate the geometrical contribution into the hemodynamics, ide- alized coronary artery models have been designed. Methods: 10 end-diastolic frames (5 left, 5 right) of the radial arteries Results: WSS is higher at the proximity of the wall compared to the of 30 patients with aneurisms and 24 healthy controls were obtained center of the artery for all cases: healthy control, DM patient and rough by VevoMD (70 MHz probe, FUJIFILM, VisualSonics, Toronto, Canada). and smooth wall. Preliminary results of our study show that the natu- 74 radiomic features and 4 engineered parameters were extracted: ral wall roughness does not cause any SAWSS change for neither DM inner and outer layer thickness, and presence of adjunctive acous- patients nor healthy subjects. But when the wall roughness is around tic interfaces (triple signal). The same logistic regression (LR) model –4 3∙10 m, the SAWSS decreases moderately. developed to discriminate FMD patients was used in this cohort. The Discussion: After deployment, stents can have and cause roughness possible association between this classification and the presence [2]. Actually, these roughness values can be changed by designing of ruptured aneurysm, multiple aneurysm and aneurysm size were novel stents or bypass grafts. Decreasing the WSS values around the investigated. stenosis region could help to improve the outcome of interventions or Results: Inner layer (196 ± 51 vs 160 ± 39 mm, p =) and outer layer surgical operations. thickness (115 ± 45 mm vs 101 ± 41 mm, p =) were significantly higher in aneurysms than in controls. Triple signal was also more frequent in aneurysm than in control images (p =). 17 patients with aneurysms P.42 Eec ff t of COVID‑19 disease on vascular aging: a pilot study (56.6%) were classified as FMD by the LR model. There was no signifi- with before‑and‑after comparison in persons who have had cant association between classification as FMD and ruptured, multiple COVID19. 1 2 1 2 2 1 aneurysms, aneurysm size. Podrug M , Koren P , Šunjić B , Mudnic I , Boban M , Jerončić A 2 1 Conclusions: More than half patients with cerebral aneurysm showed University of Split School of Medicine, University of Split Department a radial artery pattern associated with FMD; this finding suggest that a of Health Studies non-negligible proportion of patients with cerebral aneurysms may be Background: While respiratory symptoms dominate clinical manifes- part of the socalled FMD spectrum. tations of COVID-19 disease, the disease also affects the cardiovascular system at multiple levels. The aim of this study was to evaluate indi- vidual before-and-after COVID19-induced changes in vascular-aging P.44 Validation and feasibility of an automated system biomarkers. for the assessment of vascular structure and mechanical properties in the digital arteries through ultra‑high frequency ultrasound Methods: Previously, we collected data on baseline values of arterial 1 1 Biomedical engineer Federica Poli , Catherine Fortier , Hakim stiffness and central and peripheral hemodynamic measures; in partic - 3 2 4 4 Khettab , Francesco Faita, Saverio Vitali , Giacomo Aringhieri , Lorenzo ipants who were afterwards infected with SARS-CoV-2. Fifteen (7 men) 5 5 3 3 Ghiadoni, Stefano Taddei , Laurence Amar , Aurelien Lorthioir , Pierre agreed to an additional visit that was scheduled at median 2.4 months 1,3 1,3 Boutouyrie , Rosa Maria Bruno (range 1.8–3.1) after person acquired infection (determined by the Paris Cardiovascular Research Center (PARCC)‑INSERM UMR‑970 positive PCR test). SphygmoCor-CvMS and Arteriograph were used to and Université de Paris, 75,015, Paris, France, Paris, France, Institute acquire the data in duplicate. of Clinical Physiology, National Research Council, Pisa, Italy, Pisa, Italy, Results: The median age of participants was 35 years (range 24–61), AP‑HP, Hôpital Européen Georges Pompidou, Université de Paris, Paris, and median time-span between the visits was 5 months (3–16). France, Paris, France, Diagnostic and Interventional Radiology, University Regardless of limited sample size, we showed that after COVID-19 Hospital of Pisa, Pisa, Italy, Pisa, Italy, University of Pisa, Pisa, Italy, Pisa, Italy infection there was a significant mean increase of diastolic (5 mmHg, Objective: The validation of a semi-automatic software to quan- 95%CI 0.6–9) and mean arterial pressure (4 mmHg, 95%CI 0.1–8) tify vascular structure and mechanical properties of digital arteries recorded with Arteriograph; and median increase in aortic AIx (4%, acquired using ultra high frequency ultrasound (UHFUS). 95%CI -2%_to_6%) recorded with SphygmoCor (p < 0.05 for all). Artery Research (2021) 27:S1–S36 S26 Methods: UHFUS 5-s longitudinal scans of digital arteries of the hand P.46 The Role of Blood Pooling during Prolonged Sitting on Cerebral of 15 patients with vascular diseases and 15 healthy controls were Arterial Stiffness obtained by VevoMD (70 MHz probe, FUJIFILM, VisualSonics, Toronto, 1 1 1 Alexander Pomeroy , Katie Stanford , Dr. Lee Stoner Canada) and analyzed using the semi-automatic Carotid Studio soft- University of North Carolina At Chapel Hill, Chapel Hill, United States ware (Quipu Srl, Pisa, Italy), using as reference technique a manual Purpose: Vascular dementia (VaD) affects 15% of people 80 + years measurement in a Matlab interface (MathWorks, R2019b). Evaluation old. A primary risk factor for VaD is atherosclerosis of the cerebral of agreement between the two techniques for measures of diameters arteries. Prolonged sitting has been associated with precursors of ath- (systolic,diastolic), distension and intima-media thickness (IMT) were erosclerosis, including arterial stiffening (AS) and acute reductions in made using Bland–Altman analyses; inter- and intra-operator repro- cerebral blood flow (CBF), but the mechanism for cerebral hemody - ducibility was carried out using coefficients of variation (CV ). namic changes is unclear. Venous blood pooling (VBP) in the calves Results: No trend or significant bias were observed between Carotid due to gravity has been suggested as a potential cause for acute Studio and Matlab manual analysis for diastolic diameter, disten- hemodynamic changes in the central vasculature, but the claim hasn’t sion, and IMT. All limits of agreement were acceptable. Intra-observer been evaluated in the cerebral vasculature. CV of diastolic diameter and IMT were 4.1%, and 4.2% respectively. Inter-observer CV for diastolic diameter, and IMT were 7.3% and 5.4% Methods: 5 participants (n = 5, 23.6 [5.3] y, 40% F, 23.1 [3.2] kg/m ) respectively. Intra- and inter- observer CV for distension were higher underwent two conditions, both with a two-hour sitting bout: CUFF, (25.7% and 26.7% respectively). where bilateral occlusive cuffs were applied to the legs to induce Conclusions: Carotid Studio software is a valid and reproducible tool venous pooling and NON-CUFF, which was a control condition. Cer- for the assessment of vascular structure and mechanical properties in ebral AS was measured with Heart-MCA pulse wave velocity (hmPWV ), UHFUS scans of digital arteries. and CBF was measured with mean volumetric blood flow through the common carotid artery. Results were analyzed using a random-effects P.45 Simulating the impact of parameter changes on the reservoir mixed model and Cohen’s d for effect size. model Results: hmPWV had a significant effect for time (ß = − 97.17, ES = 1.55), but not for condition (p = 0.636). The interaction between Di Anna Pölz time and condition was significant (ß = 35.91, ES = 1.00) for CBF. Introduction: The impact of alterations in arterial flow and pressure Conclusions: CBF decreased in the CUFF condition more than NON- on the derived reservoir and excess pressure are not fully understood CUFF over time, so VBP may be a driver of hemodynamic changes in yet. The aim of this work was to generate pressure waveforms using a the cerebral vasculature. 3-element Windkessel model and apply the reservoir algorithm to ana- Source of funding: NONE. lyze the changes in the output by varying the input parameters of flow and Windkessel. P.47 Fabricated data, manufacturer’s tricks, and more: a couple Methods: An artificial flow curve (aF) was built, depending on the of suggestions concerning guidelines for validation of pulse wave height (Fmax), time (tFmax) of its peak, and the ejection duration (ED). velocity measurement devices Pressure curves were afterwards simulated using aF and a 3-element Prof Igor Posokhov Windkessel (peripheral resistance (R), compliance (C), aortic resistance Federal Medical Biophysical Center of Federal Medical Biological Agency, (Z) and asymptotic pressure (P )). The reservoir algorithm then was Moscow, Russian Federation applied to the simulated pressure waves (1). By parameter variation, a Background: Inconsistencies, such as increased PWV in healthy sensitivity analysis on reservoir pressure (P ) and excess pressure (P ) res ex young people, became apparent in research using BPLab/Vasotens. was conducted. If the difference between every respective pair of out - This raised public health concerns. Raw data from validation study (as put curves was below a certain threshold, the curves were counted as stated, according to 2010 ARTERY guidelines) [1] were examined. The not being affected by the parameter variation. raw data were published by me due to their problematic nature [2]. Results: The sensitivity analysis of parameter variations (Fig. 1) shows that P is mostly sensitive towards t , ED, and Z, while P is sen- ex Fmax res Methods: Dataset [2] contains:—files representing BPLab cuff BP sitive towards R, C and P . When varying several parameters at once, oscillations;—several software versions (1999 – 2021) that calculate cancelling effects of certain combinations were found. “vascular parameters” from them;—SphygmoCor measurements;— Discussion/conclusion: The sensitivity analysis revealed that P is res BPLab website screenshots;—fabricated data illustrations. mostly affected by Windkessel parameters, except for Z, while P is ex Results: There were only 2 age bands ‘ < 30’ and ‘ > 60 years’ here. mostly affected by Z and flow parameters. However, P and P also res ex There were signs of hidden editing: height of volunteers and path partly depend on the remaining parameters. The variation of param- length distances went beyond normal human body ratios. For exam- eters also revealed cancelling effects of certain combinations. ple "proximal distance" box was filled with 90 in a volunteer 150 cm tall, or "jugulum-symphysis" with 32 in a volunteer 180 cm tall. Screenshots show that one author is a service engineer of BPLab company. The age dependence (key needed) was the same for software ver- sions from 05.00.03 to 06.04.01. It was very different in the Italian study where version 06.02.?? was used [3]. It seems that 06.02 version was specifically designed to only publish the results. Conclusion: I believe that guidelines should contain requirements for the mandatory publication of raw data as supplement. Research- ers must have an adequate social responsibility, and confirming docu- ments should be published as well. Each new version of software (e.g. 06.04.02, 06.04.03) must be validated in a new study, with new sets of raw data from new institutions. Fig. 1 Results from sensitivity analysis: left P , right P . The y-axis res ex shows the normalized count of pairs of curves that remained simi- lar (mean square error < 1 for P , mean square error < 0.25 for P ), res ex despite changes in the input parameter that are shown on the x-axis. Artery Research (2021) 27:S1–S36 S27 P.48 Development of carotid shear wave elastography for plaque characterization in transverse imaging planes. 1 1 1,2 Mrs. Judith Pruijssen , Dr. Stein Fekkes , Prof. Chris de K orte , Dr. Hendrik Hansen 1 2 Radboud university medical center, University Twente Background: Rupture of carotid artery plaques may lead to stroke. Plaques with a large lipid-rich core are more prone to rupture than predominantly fibrous plaques. Noninvasive detection of lipid-rich cores is challenging, but promising results have been reported using ultrasound shear wave elastography (SWE)(1,2). However, no avail- able SWE method enables stiffness estimation, and thus, lipid-core detection, for the entire circumference. We introduce a SWE method designed for 360°-stiffness mapping and evaluate its performance in a carotid artery phantom. Conclusion: Reliably evaluated VAI from ARTSENS carotid diameter Methods: A vessel-mimicking phantom with a stiff outer and soft demonstrated an age-related trend similar to stiffness markers. This inner layer (lipid-core) was created by freeze-thawing polyvinyl- suggests that the index obtained from diameter alone yields age- alcohol solutions. An Aixplorer Ultimate system (Supersonic Imagine, related modifications of large arteries. However, unlike the stiffness France) with an SL18-5 transducer and research interface was used markers, the rate of increase in VAI was attenuated for the older popu- to perform SWE acquisitions in transverse cross-sections of the phan- lation. Further studies are in progress to assess clinical utility and eval- tom. The 360° circumference was divided in segments. Custom-made uate the predictive capability of VAI for monitoring vascular ageing. software was developed to track the wave circumferentially in every segment, instead of along straight horizontal paths (current SWE P.50 Eec ff t of the pharmacological reduction of heart rate approaches). Additionally, we investigated if segment-wise electronic by ivabradine on arterial wall viscosity in young and middle‑aged ultrasound beam-steering improved tracking. Obtained 360° shear healthy subjects wave velocity (SWV) maps were compared to a reference map con- 1 1 1 structed from SWE data acquired by physical phantom rotation. Dr Frédéric Roca , Dr Michèle Iacob , Mrs Caroline Thill , Pr Jeremy 1 1 Results: Without steering, the new method provided SWV estimates Bellien , Dr Robinson Joannides with a median absolute error of ~ 0.5 m/s for ~ 60% of the circumfer- Rouen University Hospital, Rouen, France ence. With steering, this area increased to 80%. The soft layer could Purpose/background/objectives: Changes in arterial wall viscosity clearly be identified. (AWV), which dissipates the energy stored within the arterial wall, may Conclusions: A novel SWE method was introduced that enabled accu- contribute to the higher cardiovascular risk and arterial stiffening asso - rate SWV estimation in ~ 80% of the cross-section of a vessel-mimick- ciated with high heart rate (HR) and to the controversial benefit of HR ing phantom. Next the method will be tested in real carotid arteries. reduction during aging. We evaluated the effect of ivabradine, a selec - tive HR- lowering agent, on carotid AWV considering changes in arte- rial mechanics and hemodynamics, and aging impact on this effect. P.49 Comparison of artery wall motion‑based vascular index with conventional carotid stiffness markers for detection of vascular Methods: This randomized, placebo-controlled, double-blind, cross- ageing over study, performed in 19 healthy volunteers (8 young and 11 mid- 1 2 1 2 Mrs R Arathy , Mr V Raj , Dr P M Nabeel , Dr Jayaraj Joseph dle-aged), evaluates the effect of ivabradine (5 mg b.i.d, one week) Healthcare Technology Innovation Centre‑IIT Madras, Chennai, India, on carotid AWV, mechanics and hemodynamics and cardiovascular Dept. of Electrical Engineering, Indian Institute of Technology Madras, coupling. AWV was evaluated by the area of the hysteresis loop of the Chennai, India pressure-cross sectional area relationship, representing the energy dis- Background: Large artery stiffness is a proxy for age-related vascu- sipated (W ), and by the relative viscosity ( W /W), with W represent- V V E E lar degradation and related events. Vascular ageing index (VAI), a ing the elastic energy stored. metric of stiffness evaluated by pulse contour analysis of acceleration Results: Ivabradine increased stroke and end-diastolic volumes, aug- plethysmogram, was introduced to assess vascular ageing(1), but com- mentation pressure, augmentation index, Buckberg index and carotid monly used photoplethysmogram do not precisely capture artery wall distensibility compared to placebo. In parallel, W and W increased, V E dynamics. This study explores VAI assessment using precise carotid and W /W remained stable. In middle-aged, baseline arterial stiff- V E diameter recorded using an image-free ultrasound device (ARTSENS ) ness and cardiovascular coupling were less favorable, W was similar (2). but W and thus W /W were lower than in young subjects. Ivabra- V V E dine induced an increase in W /W in middle-aged subjects but not in V E Methods: A cohort of 445 subjects (20–79 years) were recruited. Left young, due to a higher increase in W despite similar increase in W . V, E common carotid diameter and blood pressure were recorded. VAI was Conclusions: Ivabradine-induced HR reduction increases arterial wall estimated from carotid diameter adopting established methods (3). energy dissipation proportionally to the increase in elastic energy Age-trends of VAI were compared with conventional stiffness markers stored. Aging results in a larger than expected relative energy dissipa- (2) for normotensives/hypertensives and males/females. tion, the impact of which should be assessed. Results: Group average VAI (− 0.64 ± 0.48) measured were within Registration: URL: https:// clini caltr ials. gov/ ct2/ show/ NCT02 584439, the expected range (1),(4). Carotid stiffness markers (r > 0.82, p < 0.01) Identifier: 2015/077/HP. and VAI (r = 0.6, p < 0.01) were significantly correlated with subjects’ age. Concomitant with stiffness markers, VAI manifested an increas- P.51 Evaluation of vascular and hemodynamic responses ing age trend (Fig. 1) with more negative values for younger popula- after a continuous exercise session of moderate intensity and high tions. There was no significant difference for VAI (p > 0.05) between intensity intervals in individuals with normal blood pressure normotensive/hypertensive and male/female except for age ≥ 60 and and pre‑hypertension 40–49 year’s group (p < 0.05), respectively. Males showed higher VAI 1 1 1 than females across age groups, whereas the trend was inverted for Miss Sara Rodrigues , Miss Renata Verardino , Mr Marcel Costa , Miss 1 1 1 stiffness markers. Valéria Costa‑Hong , Miss Maria Alves , Mr Luiz Bor tolotto InCor HC FM USP, São Paulo, Brazil Purpose: Physical exercise (PE) prevents cardiovascular diseases 1. There is no consensus if different intensities of PE changes arterial Artery Research (2021) 27:S1–S36 S28 stiffness—by pulse wave velocity (VOP) and augmentation index P.53 Comparison of vascular and hemodynamic responses (AIx), a marker of cardiovascular risk 2, related to blood pressure (BP). between a continuous exercise session of moderate intensity Objective: In normotensive—normal BP (120–129/80–84 mmHg) and and high intensity interval exercise in normotensive individuals. high normal BP (130–139/85–89 mmHg), compare: 1st) arterial stiff- 1 1 1 Miss Sara Rodrigues , Miss Renata Verardino , Mr Marcel Costa , Miss ness after one session of moderate-intensity continuous PE (MICPE) 1 1 1 Valéria Costa‑Hong , Miss Maria Alves , Mr Luiz Bor tolotto and high-intensity interval PE (HIIPE). 2nd) BP after MICPE and HIIPE. InCor HC FM USP, Sao Paulo, Brazil Methods: PE intensity and equalized energy expenditure defined by Introduction: Moderate-intensity continuous aerobic physical exer- cardiopulmonary exercise test. Individuals randomized to PE sessions, cise (MICPE) is known to help prevent hypertension, due to its post- performed in cross-over fashion. PWV and AIx were measured at rest, exercise hypotensive effect 1. High-intensity interval physical exercise immediately after and 24 h after HIIPE and MICPE, compared among (HIIPE) has shown positive results in preventing cardiovascular disease. all moments (baseline, immediately and 24 h after each session). Arterial stiffness, measured by pulse wave velocity (PWV) is a marker Ambulatory BP monitoring-24 h (ABPM-24 h) was performed after rest of cardiovascular risk 2, related to blood pressure (BP). There is no and each session, using the first two hours for comparison. Results: consensus on the possible changes in PWV after a physical exercise Individuals (N = 29; 76%women; age = 48 ± 7y; BMI = 28.3 ± 4 kg/ session. m2; SBP = 126 ± 9; DBP = 84 ± 4 mmHg) had lower (p < 0.01) AIx after MICPE (27.1 ± 2.0) and HIIPE (22.7 ± 2.2), than baseline (33.0 ± 1.8). Objective: In normotensive individuals (BP ≤ 140/90 mmHg), compare AIx after MICPE (27.1 ± 2.0) was lower (p < 0.05) than MICPE24h 1st: PWV responses to an MICPE and HIIPE session, 2nd: systolic BP (30.6 ± 2.3). AIx after HIIPE (22.7 ± 2.2) was lower (p = 0.01) than MICPE (SBP) and diastolic BP (DBP) between an MICPE and HIIPE session. (27.1 ± 2.0), and than HIIPE24h (32.2 ± 1.9). SystolicBP (2 h) reduced Methods: Exercise intensity and calculation for equalizing energy after both sessions –MICPE (128 ± 2) and HIIPE (127 ± 2 mmHg), com- expenditure were defined according to the cardiopulmonary exercise pared to baseline (131 ± 2 mmHg; p = 0.02). There was no difference in test. Individuals were randomized to the sequence of exercise sessions, PWV among times, and between individuals with normal BP and high performed in a cross-over fashion. PWV measurements were analyzed normal BP. at rest, immediately after and 24 h after a session of HIIPE and MICPE in normotensive individuals, and results were compared between all Conclusion: In normotensive, one PE session, regardless of inten- moments (baseline, immediately after and 24 h after each session). sity, reduces systolicBP during the first 2 h and AIx immediately after, Ambulatory BP monitoring 24-h (ABPM-24 h) was performed after the returning to baseline values 24 h after PE session. baseline session and after each exercise session. For comparison analy- ses, the first two hours measured in 24-h ABPM were used. P.52 Comparison of hemodynamic and vascular responses Results: Normotensive individuals (N = 31; 74% women; between a session of continuous moderate‑intensity age = 48 ± 7 years; BMI = 28.4 ± 4 m/kg ; SBP = 124 ± 10 and and high‑intensity interval physical exercise in normotensive DBP = 83 ± 5 mmHg) had lower PWV (p = 0.035) 24 h after the MICPE subjects session (7.0 (6–10) m/s), compared to baseline (8.0 (6–9) m/s) and 24 h 1 1 1 after HIIPE; (8.0 (5–10) m/s). PWV immediately after HIIPE was lower Miss Sara Rodrigues , Miss Renata Verardino , Mr Marcel Costa , Miss 1 1 1 than baseline (8.0 (5–9) vs. 8.0 (6–9) m/s; p = 0.007). There was a signifi- Valéria Costa‑Hong , Miss Maria Alves , Mr Luiz Bortolotto cant reduction (p = 0.02) in SBP (first 2 h) with both exercises—MICPE InCor HC FM USP, São Paulo, Brazil (129 ± 2 mmHg) and HIIPE (127 ± 2 mmHg), compared to baseline Purpose: Physical exercise (PE) prevents cardiovascular diseases1. (131 ± 2 mmHg). The HR was similar after the HIIPE (83 ± 2 bpm) and There is no consensus if different intensities of PE changes arterial stiff- MICPE (83 ± 2 bpm) exercise sessions and higher (p = 0.015) than the ness, by pulse wave velocity (PWV), a marker of cardiovascular risk2, baseline (79 ± 2 bpm). Conclusion: In normotensive individuals, an related to blood pressure (BP). MICPE session reduces PWV after 24 h and SBP decreases for 2 h after an exercise session at both intensities. Objective: In normotensive (BP < 140/90 mmHg), to compare a) PWV responses to an moderate-intensity continuous aerobic physical exer- cise (MICPE) and high-intensity interval physical exercise (HIIPE) ses- P.54 The aortic‑femoral arterial stiffness gradient demonstrates sion; b) BP profile between MICPE and HIIPE session. good between‑day reliability Methods: PE-intensity and equalized energy expenditure were 1 5 5 Ms Jacklyn Rojas , Mr. Keeron Stone , Dr. Simon F ryer , Dr. James defined according to the cardiopulmonary exercise test. Individu- 2 1 3 1 Faulkner , Dr. Michelle Meyer , Dr. Kevin Heffernan , Gabriel Zieff , Craig als were randomized to the sequence of PE sessions, performed in 2 4 1 Peterson , Dr Danielle Lambrick , Dr Lee Stoner a cross-over approach. PWV measurements were analyzed at rest, The University of North Carolina at Chapel Hill, Chapel Hill, United immediately, and 24 h after a session of HIIPE and MICPE, results were 2 3 States, University of Winchester, Winchester, United Kingdom, Syracuse compared among all moments (baseline, immediately after and 24 h University, Syracuse, USA, University of Southampton, Southampton, UK, after each session). Ambulatory BP monitoring (ABPM-24 h) was per- University of Gloucestershire, Gloucestershire, UK formed after baseline and each PE session, using the first two hours BP Background and aims: The aortic-femoral arterial stiffness gradi- values for comparison analyses. ent (af-SG), defined as the ratio of femoral-ankle pulse-wave velocity Results: Normotensive subjects (N = 31; 74% women; (faPWV) to carotid-femoral pulse-wave velocity (cfPWV), is a promis- age = 48 ± 7 years; BMI = 28.4 ± 4 m/kg ; SBP = 124 ± 10 and ing marker of cardiovascular disease (CVD) risk. Yet to be of value in DBP = 83 ± 5 mmHg) had lower PWV (p = 0.035) 24 h after MICPE clinical and research settings, an arterial health assessment tool must session (7.0 (6–10) m/s), compared to baseline (8.0 (6–9) m/s) and be reliable (precise). This study sought to determine the between-day 24 h after HIIPE; (8.0 (5–10) m/s). PWV immediately after HIIPE was reliability of the af-SG. lower than baseline (8.0(5–9) vs. 8.0 (6–9) m/s; p = 0.007). SystolicBP (first 2 h) reduced (p = 0.02) after MICPE (129 ± 2 mmHg) and HIIPE Methods: Twenty-five, non-smoking, young healthy adults (40% (127 ± 2 mmHg), compared to baseline (131 ± 2 mmHg). The heart female, age 22.6 ± 2.7 years, body mass index 23.9 ± 2.8 kg/m ) were rate was similar after HIIPE (83 ± 2 bpm) and MICPE (83 ± 2 bpm) and tested under standardized conditions on three different mornings in a higher (p = 0.015) than baseline (79 ± 2 bpm). Conclusion: In normo- fasted state, separated by a maximum of seven days. In a supine posi- tensive individuals, an MICPE session reduces PWV after 24 h and Sys- tion, measures of cfPWV and faPWV were recorded in triplicate. The tolicBP decreases for 2 h after an exercise session at both intensities. af-SG was calculated as faPWV divided by cfPWV. Intra-class correla- tion coefficient (ICC), standard error of measurement (SEM), and mini- mal detectable change (MDC) were calculated. Results: The af-SG (ICC = 0.77, SEM = 0.08 m/s), cfPWV (ICC = 0.84, SEM = 0.29 m/s) and faPWV (ICC = 0.84, SEM = 0.38 m/s) measures all Artery Research (2021) 27:S1–S36 S29 may ameliorate the detrimental effects of such treatments on muscle demonstrated good between-day reliability, according to accepted function. ICC criteria. The MDC (MDC%) between repeat measures within an individual was 0.22 (13.8%) for af-SG, 0.79 m/s (14.2%) for cfPWV, and Purpose: To examine skeletal muscle tissue oxygenation in active 1.05 m/s (13.8) for faPWV. breast cancer survivors (BCS) compared to inactive BCS during peak Conclusions: These findings indicate that the af-SG demonstrates aerobic exercise. good reliability in young healthy adults. Further research is needed to Methods: Eleven active BCS (48 ± 9 years; 24.8 ± 2.6 kg/m ) and 12 identify if af-SG measurement variability is affected by age or disease. inactive BCS (51 ± 9 years; 26.1 ± 3.1 kg/m ) performed a peak cycle Keywords: Central arterial stiffness, peripheral arterial stiffness, pulse ergometry test (O peak), wherein near infrared spectroscopy (NIRS) wave velocity ratio, repeatability, reproducibility. assessed muscle tissue oxygenation (tissue oxygenation index [TSI]; total [TH], oxygenated [H bO ] and deoxygenated [HHb] hemoglobin) P55. Evaluation of image‑free wall tracking based measurement of the right vastus lateralis. Measurements were taken in the seated of low flow mediated arterial constriction in comparison to B mode position on the cycle ergometer at rest and at O peak (max). Cardiac imaging output was estimated using Doppler echocardiography and indexed 1 2 3 1 to body surface area (Qi). Ms Sakshi Sen , Mr V Raj , Dr P M Nabeel , Dr Dinu S Chandran , Dr Jayaraj 2 1 Results: Self-reported active BCS had a greater decrease in TSI from Joseph , Dr Kishore K Deepak higher values at rest, despite similar peak values (p = 0.04; rest, max; Department of Physiology, All India Institute of Medical Sciences, active: 72 ± 3, 65 ± 5%; inactive: 67 ± 4, 63 ± 4%). Similarly, active BCS New Delhi, India, Dept. of Electrical Engineering, Indian Institute had higher TH and HbO2 overall (p < 0.05), whereas HHb was greater of Technology Madras, Chennai, India, Healthcare Technology Innovation at max for both groups (p = 0.02; active: 45 ± 15, 58 ± 21 µM; inac- Centre‑Indian Institute of Technology Madras, Chennai, India tive: 35 ± 13, 44 ± 16 µM). O peak was significantly higher for the Background: Low flow mediated constriction (LFMC) has been active BCS (active: 32.7 ± 4.3 vs. 21.0 ± 3.1 mL/kg/min), with a greater reported as a promising non-invasive tool for assessing the endothe- increase in Qi (p = 0.02; active: 1.86 ± 0.4, 7.5 ± 2.0 L/min/m ; inactive: lial functioning in resting state (1). LFMC is the constriction shown by a 1.97 ± 0.5, 6.0 ± 1.1 L/min/m ) for the active BCS during peak exercise. peripheral conduit artery in response to decreased blood flow through Conclusion: Physical activity appears to attenuate impairment of the lumen produced by distal circulatory arrest. LFMC is convention- skeletal muscle tissue oxygen extraction in active BCS, which may ally performed with B- mode ultrasound systems that involve record- have implications for future research. ing of the image sequences as DICOM files or video-graphic files and processing them offline. We did a pilot evaluation to assess the correla- tion of imaging free wall tracking based measurements of LFMC with P.57 Accuracy of cuffless blood pressure estimation using that of B mode imaging. photoplethysmography and tonometry from pulse transit time alone Methods: 29 healthy young adults (25.45 ± 2.58 years, 17 men] par- 1 1 1 Mrs Fatemeh Shirbani , Dr Isabella Tan , Prof Alberto Avolio , Dr Mark ticipated in the study. Brachial artery LFMC was measured using simul- Butlin taneous and sequential protocols; imaging (M7, Mind Ray; Nanshan, Macquarie University, Sydney, Australia Shenzhen, China) and wall tracking (ARTSENS ) based measurements Background: Cuffless blood pressure (BP) estimation by pulse transit were done in the same anatomical location with a gap of 30 min time (PTT ) has advantages over standard cuff-based methods as it can between the two measurements (sequential protocol) and imaging be continuous and non-occlusive. However, the need for individual and wall tracking measurements done simultaneously at two contigu- calibration between BP and PTT, and repeatability of calibrations are ous locations (simultaneous protocol). challenging. Results: LFMC responses showed strong positive correlation between ultrasonographic imaging and wall tracking based measurements Objectives: This pilot study investigates the repeatability and accu- when done simultaneously (r = 0.96, p < 0.001) and modest correla- racy of BP estimation from PTT using contact-based photoplethys- tion when done sequentially (r = 0.59, p = 0.02) as shown in Fig. 1. mography (PPG) and tonometry. Conclusion: Wall tracking based measurements of brachial artery Methods: Six subjects performed one-minute seated rest and 3-min LFMC correlates strongly with imaging based measurements when isometric handgrip exercise on two consecutive days. Continuous fin- recorded simultaneously. The study demonstrated that the wall track- ger BP was recorded. A PPG sensor was placed adjacent to a tonom- ing based ARTSENS technology can be reliably employed for per- eter on the temporal pulse and a second PPG sensor on the left index forming LFMC and assessing endothelial dysfunction. finger and tonometer on left radial pulse. Beat-to-beat PTT was calcu- lated for tonometry and PPG as the delay between the foot of tempo- ral and wrist/finger signals. DBP/PTT linear regression on day 1 was used as calibration for prediction of DBP from PTT on day 2, and the regression from day 2 applied retrospectively for day 1. DBP was pre- dicted using every 1, 5, 10, 20 and 30 beats observations. Predicted DBP was compared to measured finger DBP. Results: Isometric exercise successfully increased DBP (aver- age increase 23 ± 11 mmHg). The minimum error of DBP esti- mation from PPG sensors was from 30-beats long observations (MAE ± ESD = 15 ± 0.5 mmHg) and from tonometers was from 20-beats long observations (MAE ± ESD = 13 ± 1 mmHg). Fig. 1 Correlation between %LFMC measured by B mode imaging and Conclusion: Cuffless BP estimated from PTT measured by PPG and image free wall-tracking in sequential and simultaneous protocols. tonometry provide a large error. In comparison, tonometry provides slightly better results as it requires less number of beats for estimation. P.56 Preserved muscle extraction during maximal exercise in active breast cancer survivors. 1 1,2 1 1 Sara Sherman , Georgios Gr igoriadis , Bo Fernhall, Tracy Baynard Integrative Physiology Lab, University of Illinois at Chicago, Chicago, United States, Department of Physical Therapy, Chicago, United States Introduction: Mitochondrial capacity is pivotal to skeletal muscle function and is altered with breast cancer treatment. Physical activity Artery Research (2021) 27:S1–S36 S30 P.58 Relationship between the parameters of aortic stiffness Results: Participants had a mean age of 54 ± 12 years, 47.1% were and nocturnal dipping status during antihypertensive therapy female, and mean follow-up time was 45 ± 8 months. A total of 431 participants used RAS-inhibitors at follow-up (32.5% RAS-inhibitor Dr. Anna Torunova only, 67.5% combination therapy). Irkutsk State Medical Academy of Postgraduate Education‑Branch Neither ΔPWV nor Δβ was associated with the use of RAS-inhibitors in Campus of the FSBEI FPE RMACPE MOH Russia, Irkutsk, Russian Federation the regression models (p = 0.33, p = 0.68 respectively; Table). The aim: to study the dynamics of the relationship between aortic Conclusion: RAS-inhibitors did not have a favorable effect on arte - stiffness and nighttime BP decrease during the hypertension (HTN) rial stiffness progression compared to other types of antihypertensive treatment. drugs. Our next step is to evaluate cfPWV/β changes in individuals starting RAS-inhibitors. Methods: The 24-h BP monitoring was conducted in 189 patients (101 men and 88 women, aged 50.8 ± 8.3) with untreated HTN. Dip- ping status, central BP (cBP), augmentation index (AIx), carotid-femoral pulse wave velocity (PWV) were determined. Then the patients were assigned to standard antihypertensive therapy. The studies were repeated after 6 months of treatment. Spearman correlations between parameters of aortic stiffness and diurnal index (DI) were calculated twice—at baseline and at the end of follow-up period. Results: During the treatment the average daily BP decreased from 143.6 ± 14.7/88.1 ± 11.1 to 123.9 ± 10.3/76.0 ± 7.2 mmHg, cBP—from 149.8 ± 19.4/98.3 ± 11.6 to 121.3 ± 14.0/83.2 ± 8.7 mmHg, AIx – from 25.9 ± 9.8 to 20.6 ± 12.2% and PWV from 9.2 ± 1.8 to 8.4 ± 1.5 m/s. Initially there were 117 (61.9%) dippers, 42 (22.2%) non-dippers, 22 (11.6%) over-dippers and 8 (4.3%) night-pickers. After 6 months of treatment, the proportion of dippers decreased from 61.9 to 48.1% while nondippers increased from 22.2 to 32.2% (p = 0.01). At baseline, systolic DI correlated with systolic cBP (r = − 0.22, p = 0.002), AIx (r = − 0.15, p = 0.046), PWV (r = − 0.14, p = 0.048). The diastolic DI cor- related with diastolic cBP (r = − 0.23, p = 0.001) and AIx (r = − 0.22, p = 0.003). After 6 months of treatment there were no correlations between aortic stiffness and nocturnal dipping parameters. Conclusion: In untreated HTN patients, the degree of nighttime BP decrease declines as aortic stiffness increases. Antihypertensive ther - apy leads to a loss of this relationship. P.59 The effect of renin‑angiotensin system inhibitors on pulse wave velocity progression in essential hypertension patients: a 3.5‑year follow‑up study P.60 Central arterial pressure: validation of new cost‑effective 1 1 MD Myrthe van der Bruggen , PhD Koen D. Reesink , PhD Alessandro device against sphygmocor 2 1 3 Maloberti , MD, PhD Tammo Delhaas , PhD Casper G. S chalkwijk , 1,2,3 1,2,3 1,2,3 2 4 Dr. Valentina Vassilenko , Andreia Serrano , Filipa Cardoso , Dr. MD, PhD Cristina Giannattasio , MD, PhD Rosa Maria Bruno , PhD Bart 3,4,5 Pedro Cunha Spronck Nova School of Science and Technology, Nova University of Lisbon, Department of Biomedical Engineering, CARIM School 2 3 Caparica, Portugal, NMT, S.A., Caparica, Portugal, Iberian Network For Cardiovascular Diseases, Maastricht University, Maastricht, The on Arterial Structure, Central Hemodynamics and Neurocognition,, Netherlands, School of Medicine and Surgery, Milano‑Bicocca University, Portugal, Internal Medicine Department, Center for the Research Milan and Cardiology 4, Niguarda Hospital, Milan, Italy, Department and Treatment of Arterial Hypertension and Cardiovascular Risk, of Internal Medicine, CARIM School For Cardiovascular Diseases, Guimarães‑Centro Hospitalar do Alto Ave/Minho University, Guimarães, Maastricht University, Maastricht, The Netherlands, French Institute Portugal, Life and Health Science Research Institute (ICVS), School of Health and Medical Research, Paris‑Cardiovascular Research Center of Health Science, University of Minho, Braga, Portugal PARCC‑INSERM, Paris, France Central aortic pressure (CAP) is an important marker to evaluate blood Background: Blood pressure (BP) control is an important treatment pressure to prevent cerebral vessels diseases as the most frequent strategy in reducing arterial stiffness, as with lower BP the cyclical causes of stroke and dementia. pressure-load on the arterial wall is reduced [1]. There is increasing evidence that anti-hypertensive drugs which antagonize the renin- A new small and cost-effective device, recently developed in our angiotensin system (RAS) are superior in reducing arterial stiffness group, uses a novel wireless technology for non- invasive CAP estima- compared to other anti- hypertensive drugs [2]. In the current longitu- tion without special clinical training. Referred device was calibrated dinal follow-up study, we investigated if RAS-inhibitors reduced arte- against invasive CAP measurements in the hemodynamic room. Based rial stiffness more than other types of anti-hypertensive drugs. on European Society Cardiology guidelines [1], its alternative valida- tion was performed by comparison with another clinical device as Methods: Data was obtained from the Hypertensive Unit of two Ital- the reference standard (Sphygmocor), and calibration of both devices ian hospitals (north Italy, n = 447, and Pisa n = 101) [3]. Carotid-femoral with the same brachial blood pressure (BP), to assess inter-device pulse wave velocity (cfPWV), brachial BP, and information on several concordance. confounders were obtained as part of clinical follow-up routine. Associa- The measurements were performed in Hospital Senhora da Oliveira tions between ΔcfPWV and anti-hypertensive drugs class were assessed de Guimarães, Portugal, in a sample of 68 adults, between 20 and using multivariable linear regression analysis adjusting for age, sex, 88 years old with a gender distribution of 46% female and 54% male, Δmean arterial pressure (MAP), Δheart rate, lifestyle factors, and use of over a following range of BP: estimated central SBP was ≤ 100 mmHg other medication. Since cfPWV is intrinsically pressure dependent, we (7% of readings), ≥ 140 mmHg (13% of readings), and ≥ 160 mmHg additionally performed our analysis replacing cfPWV with a pressure- (3% of readings); estimated central DBP was ≤ 60 mmHg (1% of corrected counterpart (carotid-femoral stiffness index β , [1]). 0 Artery Research (2021) 27:S1–S36 S31 (55.0–82.0), 63.0 (53.0–75.0), and 47.1 (39.1–72.3) years, respectively, readings), ≥ 85 mmHg (31% of readings), and ≥ 100 mmHg (3% of and all comparison combinations proved to differ significantly among readings). the 3 methods (p < 0.001). FRS- and SCORE-derived biological age From the analysis of obtained results was concluded that CAP meas- showed strong correlation (r = 0.84), while vascular age based on CACS ured by novel device fulfill the proposed pass criteria [1]: data for moderately correlated with FRS and SCORE (r = 0.50, r = 0.52; respec- mean difference between devices was 0.93 mmHg (< 5 mmHg) and a tively). Based on FRS, SCORE, and CACS 83.4%, 93.8%, and 42.3% of standard deviation of the difference of 7,9 mmHg (< 8 mmHg). From the subjects had increased vascular age compared with chronological another side, the present CAP measurements may contribute to the age (FRS + , SCORE + , CACS +), and 53.2% of the FRS + (107/201) and database of Guimarães/Vizela study on determining blood pressure in 57.1% of the SCORE + (129/226) groups were classified as CACS-. a Portuguese cohort [2]. Conclusions: CACS can be conveniently used to calculate vascular age, however, it demonstrates a tendency of underestimation as com- P.61 Perforator arteries identification: comparison of ultrasound pared to traditional risk equations. Prospective studies are warranted doppler technology and infrared thermography to further evaluate the contribution of CACS-based vascular age calcu- 1,2 1 1,4 lations to coronary risk assessment. Dr. Valentina Vassilenko , Anna Poplavska , Edivaldo Junior , Dr. 3,4 Diogo Casal Nova School of Science and Technology, Nova University of Lisbon, P.63 Carotid artery reactivity to predict cardiovascular events Portugal, Iberian Network on Arterial Structure, Central Hemodynamics in abdominal aortic aneurysm patients: Preliminary results and Neurocognition, Portugal, Plastic and Reconstructive Surgery 1,2 1 Msc. Jenske JM Vermeulen , PhD Suzanne Holewijn , MD PhD, Prof Department and Burn Unit, Centro Hospitalar de Lisboa Central, Lisbon, 1,3 2 Michel MPJ Reijnen , PhD, Prof Dick TH Thijssen Portugal, Anatomy Department, Nova Medical School‑Nova University 1 2 Department of surgery, Rijnstate, Arnhem, Netherlands, Department of Lisbon, Lisbon, Portugal of Physiology, Radboud Institute for Health Sciences, Radboud University Recently an extensive clinical experience on flap surgery has con- Medical Centre, Nijmegen, Netherlands, Multimodality Medical Imaging firmed that its success depends on correct identifying vital perfora- Group, Techmed Centre, University of Twente, Enschede, Netherlands tor vessels [1]. Unfortunately, the perforator vessels frequently have a Background: The SMART risk score calculates the risk to develop variable location. So, the knowledge about perforator anatomy during major cardiovascular events (MACE) in cardiovascular disease patients. preoperative planning is one of the most critical factors. The efficacy of this tool for abdominal aortic aneurysm (AAA) patients is unknown, while they often develop MACE. MACE is strongly linked In this work the principles of two non-invasive technologies with the to vascular health, which can be measured with the carotid artery capability to localize the cutaneous perforators are described and ana- reactivity (CAR)-test. Therefore, this study investigates the predictive lysed: i) ultrasound technology realized in hand-held nondirectional capacity of the CAR-test for the occurrence of MACE in AAA patients Doppler flowmeter, which is widely used in most hospitals and is an compared to the SMART risk score. essential tool where a rapid analysis of the vascular status of a patient is routine; ii) Infrared Thermography (IRT) as an imaging technique Method: In this study, 167 patients who are under surveillance for that can provide indirect and real-time information on skin perfusion AAA were included. All patients underwent the CAR- test to assess by measuring body surface temperature. carotid artery diameter changes to sympathetic stimulation. Follow-up Both technics were applied in this work for the identification of fore - data was obtained including aneurysm progression and MACE. MACE arm cutaneous perforator vessels (CPVs). The reflection of sound was defined as myocardial infarction, transient ischemic attack, angina waves, predominantly from intravascular blood flow of the forearm, pectoris, atrial fibrillation de novo and aortic valve stenosis. was registered by a hand-held BT-200 V Vascular Doppler pan. The Results: This interim analysis had a median follow-up of 44 [29–79] infrared images were obtained by two cameras: FLIR E6 with temper- weeks. Nine patients (5.4%) experienced ≥ 1 MACE, five patients (3.0%) ature sensitivity < 0.06 °C and (320 × 240)-pixel display resolution, and died and 144 patients (86.0%) experienced no event during follow up. Thermal Expert with sensitivity < 0.05 °C and array format 640 × 480 SMART risk score was highest in patients who died (60.9%, [46.8–92.3]) (Super High Resolution). Perforator mapping of the forearm area ware and in the MACE group (48.7%, [40.6–75.0]). The MACE group showed compared for accuracy, timing, and the operator’s skills. the largest dilation during CAR-test (4.5%, [1.7–5.4]) and AAA progres- Obtained results show that IRT images provide valuable real-time sion (6.2 mm/year, [3.0–15.6]). information on the hemodynamic quality of perforators and their Conclusion: In conclusion, these preliminary results suggest a relation accurate location. Its potential to reveal underlying perforator vessels between the CAR-test and the development of MACE in AAA patients. may also be used for postoperative monitoring of flap perfusion [2]. Patients who developed MACE showed an average dilation of the carotid artery in contrast to literature. Completion of this study should P.62 Correlation of coronary artery calcium‑ and different determine whether and to what extent this is a predictor for MACE. cardiovascular risk score‑based methods for the estimation of vascular age P.64 New method to estimate central systolic blood pressure Dr. Milan Vecsey‑Nagy , Dr. János Nemcsik from peripheral pressure 1 2 1 1 1 Heart and Vascular Center of Semmelweis University, Budapest, Hungary Chemla D , Millasseau S , Hamzaoui O, Teboul J , Monnet X , 3 4 Abstract Michard F , Jozwiak M 1 2 3 4 Medical Faculty Paris‑Saclay, Pulse Wave Consulting, MiCo, APHP Background: A number of methods are available for the calculation of Cochin‑Paris University vascular age, including those derived from the Framingham Risk Score Objective: Cardiovascular complications may be more closely related (FRS) and Systematic Coronary Risk Evaluation (SCORE). Recently, coro- to central than peripheral blood pressure (BP). The noninvasive esti- nary artery calcium score (CACS) was proposed as a means of assess- mation of central systolic BP (cSBP) is increasingly performed using ing biological age. Our aim was to compare these approaches for the new devices based on various pulse acquisition techniques and math- assessment of vascular age. ematical analyses. These devices are calibrated assuming unchanged Methods: 241consecutive patients were enrolled who underwent mean (MBP) and diastolic (DBP) BP from aorta to peripheral artery, an coronary CT angiography due to suspected coronary artery. CACS assumption which is evidence-based. We tested the accuracy and pre- was calculated using the Agatston method. FRS-, SCORE-, and CACS- cision of a new empirical formula for the Direct Central Blood Pressure derived vascular age were defined according to previously described estimation of cSBP (DCBP) using MBP and DBP only. methods. Results: The mean age of our patient cohort was 57.4 ± 11.2. The Methods and Results: First, we performed a post-hoc analysis of median vascular age based on FRS, SCORE, and CACS were 68.0 our prospective high-fidelity pressure database (n = 139, age 49 ± Artery Research (2021) 27:S1–S36 S32 aneurysms is critical not only due to the widespread use of quinolones 12 years, 78% males). The measured aortic CSBP was 146.0 ± 31.1 but also due to the severity of the induced disease. Arterial biomarkers mmHg. The error between aortic DCBP and aortic cSBP was − 0.9 ± are established predictors of cardiovascular events. The present study 7.4 mmHg, and there was no bias across the cSBP range (82.5–204.0 is designed to investigate for the first time the effect of quinolones on mmHg). Second, we retrospectively analyzed 64 patients from the only arterial stiffness and aortic size. two independent studies of the literature in whom high-fidelity pres- sures were simultaneously obtained in the aorta and brachial artery. Methods/Design: This will be a randomized, open-label, active-com- The weighed mean error between brachial DCBP and aortic cSBP was parator, assessor-blinded clinical trial of 2 parallel groups of short-term 1.1 mmHg. Finally, 30 intensive care unit patients equipped with radial (<15 days) antibiotic therapy involving quinolones or an alternative intra-arterial fluid-filled catheter were prospectively studied. The cSBP to quinolones antibiotic agent (2 groups of 70 people each, with a (115.7 ± 18.2mmHg) was obtained by carotid tonometry. The error patient allocation ratio of 1: 1). The study will involve individuals > 40 between radial DCBP and carotid cSBP was − 0.4 ± 5.8 mmHg and years of age with an indication for quinolone due to localized infec- there was no bias across the range. tion, but not sepsis, or planned procedure/surgery. The follow-up will Conclusion: Our study shows that cSBP could be reliably estimated last 6 months. The primary endpoint of the study is the estimation from peripheral MBP and DBP without the need for any supplemen- of the mean difference in pulse wave velocity (PWV) between the 2 tary device or waveform recording, providing MBP and DBP measure- groups from baseline (time 0) at 2 months after initial administration ment errors are minimized. of the therapy. Secondary endpoints are PWV values at 6 months, aug- mentation index, central pressures (systolic, diastolic, pulse pressure) P.65 and echocardiographically-assessed aortic root diameter, as well as The effect of FluoRoquinolones on Aortic Growth, aortic stIffness any adverse event (including aortic dissection and aortic rupture) at 2 and wave refLEctionS: Rationale and Design of the FRAGILES Trial 1 1 2 and 6 months after initial treatment. Vasiliki Gardikioti , Christos Georgakopoulos , Dimitris Iliopoulos , 1 1 1 Discussion: To our knowledge, FRAGILES will be the first study to pro - Dimitrios Terentes‑Printzios , Eirini S olomou, Costas Tsioufis , 1 vide insight into the possible effects of quinolones on the aortic func - Charalambos Vlachopoulos 1 tion. It will also investigate the possible value of arterial biomarkers on First Department of Cardiology, Hippokration Hospital, Medical risk assessment for possible aortic dilation in this population. School, National and Kapodistrian University of Athens, Athens, Greece. Laboratory of Experimental Surgery and Surgical Research, Medical School, National and Kapodistrian University of Athens, Athens, Greece. Purpose/background/objectives: The recently established asso- ciation of quinolone use with the formation and rupture of aortic Artery Research (2021) 27:S1–S36 S33 Author Index Cosottini, M P.43 A Costa, M 3.10, P.51, P.52, P.53 A Harrington P.33 Costa, T. J. 2.3 Abbaoui, Y P.1 Costa-Hong, Valéria 3.10, P.8, P.51, P.52, P.53 Abi-Nasr, I P.37 Cox, James P.10, P.26 Adamopoulos, D 2.5 Cozma, Angela P.25 Adams, N P.2 Cruickshank, K. 1.6 Adapa, S P.9 Cseprekál, O P.34 Agharazii, M 1.3, P.1, P.17, P.36, P.39 Cunha, M P.11, P.12 Aguiar, R P.31, P.32 Cunha, P P.60 Aizawa, K P.3 d Akamine, E. H. 2.3 da Silva-Neto, J. A. 2.3 AL Shezawi, O P.4 de Korte, C 7.4, P.48 Al-Khairulla, H P.22 D Alves, M 3.10, P.51, P.52, P.53 Dániel, K P.24 Amar, L P.44 Dantas, A. P. 2.3 Amaral, V 3.9 Dbrzyn, P P.14 Anderson, S. G P.21 De Basso, R P.6 Anyfanti, P P.5 De Censi, L P.19 Arathy, R P.49 Debeij, G 7.2 Aringhieri, G P.44 Deepak, K. K 7.5, P.55 Armenia, S P.30, P.43 Delhaas, Tammo 3.7, 7.2, P.59 Avolio, A P.10, P.19, P.26, P.57 Della Latta, D 1.6 Avril, S P.40 Di Franco, G P.30 Ayden, A P.38 Dima, I 1.7, 3.3 Aznaouridis, K 1.7 Dinnissen, D P.20 Å Dogan, S P.38 Åström Malm, Ida P.6 Douma, S P.5 B Drapeau, A P.39 Badhwar, S 7.5 Duarte, D. A. 2.3 Barcelos, A P.31, P.32 DuBose, L P.35 Barros, P. R. 2.3 Duval, K P.17, P.36, P.39 Batta, D P.34 E Baynard, T P.56 Elia, S. A. 3.6 Bellien, J P.50 Emmanouil, E 1.7, 3.3 Ben Moussa, Olfa P.40 Engström, G 3.2 Benbia, A P.37 Engvall, J P.6 Benetos, A 2.2 Eveilleau, K P.37 Beutel, F 7.1 F Bianchini, E 2.4, P.30 Fabbri, S 3.4 Bidar, E 7.2 Fabris, B P.19 Bikia, V 2.5, 7.3, P.36 Fachim, H P.21 Blomstrand, P P.6 Faconti, L 1.4 Boban, M P.42 Faita, F P.43, P.44 Bortolotto, L 3.10, P.8. P.51, P.52, P.53 Farukh, B 1.4 Boutouyrie, P 3.4, P.16, P.44 Faulkner, J 3.1, 3.5, P.54 Brandt, D P.35 Fayol, A P.16 Brassard, P P.39 Fekkes, S P.48 Brum, T P.11 Fernandes, B 3.9 Bruno, R. M 3.4,P.16,P.30, P.43, P.44, P.59 Fernhall, B P.29, P.56 Büschges, J. C 1.2 Filip, A P.14 Butlin, Mark P.10, P.26, P.57 Filipovský, J P.15 Buzzelli, Andrea P.30 Fodor, A P.25 C Fortier, C P.16,P.17, P.36, P.39, P.44 Cardoso, Filipa P.60 Francesconi, M P.30 Carretta, R P.19 Fraser, A 1.1 Casal, D P.61 Fryer, S 3.1, 3.5, P.2, P.54 Casanova, F P.3 G Chandran, D 7.5, P.55 Gale, N P.4 Chang, A P.9 Ganizada, B 7.2 Charlton, P 2.4 Gardikioti, V 3.3, P.65 Chaturvedi, N 1.1 Garneau, C P.17 Chemla, D P.64 Garzon, S P.8 Cheung, M P.33 Gates, P. E P.3 Chiappino, D 1.6 Gavish, B P.18 Chowienczyk, P 1.4 Gavriilaki, E P.5 Christopoulou, G 3.3 Gelžinský, J P.15 Ciolac, Emmanuel Gomes 3.9 Gemignani, V P.30 Climie, R 2.4, 3.6 Georgakopoulos, C 3.3, P.65 Cockcroft, J P.4 Ghiadoni, L P.43, P.44 Colhoun, H. M P.3 Giannattasio, C P.59 Artery Research (2021) 27:S1–S36 S34 Gibson, M P.21 Lacolley, P 2.2 Gimenez, L. B 3.9 Lagrange, J 2.2 Giudici, A 1.6, 3.7 Lamarche, F 1.3, P.1 Gkaliagkousi, E P.5 Lambrick, D P.54 Glenning, J P.33 László, A P.34 Gonçalves, I P.3 Lazar, A P.25 Gooding, K. M P.3 Lazaridis, A P.5 Goupil, R 1.3, P.1 Lazaridou, E P.5 Gourgouli, I 3.3 Lazaros, G 3.3 Grigoriadis, G P.56 Leftheriotis, G P.37 Grillo, A P.19 Lemos, P P.8 Guignandon, A P.40 Locato, G 3.9 Guvenc T. B P.38 Loonen, J 7.4 Gyöngyösi, H P.34 Lorthioir, A P.44 H Louka, K P.26 Hallab, M P.37 M Hametner, B 1.3 Maas, D 3.8 Hamrefors, V 3.2 Madore, F 1.3, P.1 Hamzaoui, O P.64 Maessen, J 7.2 Hannink, G 3.8 Maloberti, A P.59 Hansen, H 7.4, P.48 Mancuso, M P.43 Hartman, Y P.20 Manios, E 2.1 Hashimoto, J 1.5 Manoj, R P.27, P.28 Heald, A P.21 Marçal, I. R 3.9 Heffernan, Kevin 3.1, 3.5, P.54 Margouta, A P.5 Hermeling, E 7.1 Marôco, João Luís P.29 Holewijn, S P.63 Martina, M. R. P.30 Houillier, P 3.4 Maruani, G 3.4 Howe, L 1.1 Masson, G P.25 Huberts, W 7.2 Matsushita, K 3.1, 3.5 Hudson, L P.22 Mattos, S P.11, P.12 Hughes, A 1.1 P.22, P.3 Mawson, D. M P.3 Hughes, T 3.1, 3.5 Mayer, C. C. 2.4, 3.6 I Mayer, O P.15 Iacob, M P.50 Mayet, J P.9 Iliopoulos, D P.65 Mazeda, C P.31, P.32 Ioakeimidis, N 1.7 McDonnell, B P.4 Ito, S 1.5 McNally, R 1.4 J Melo, X P.29 Jacobs, D P.22 Mendes, N P.8 Jamagidze, G 1.6 Mesquita B. J P.31, P.32 Jaryal, A 7.5 Meyer, M 3.1, 3.5 P.2, P.54 Jerončić, A P.42 Michard, F P.64 Jiménez-Altayó, F 2.3 Michel, J.B. P.40 Joannides, R P.50 Miklós, Z P.24 Johansson, M 3.2 Miliou, A 3.3 Jones, S 1.1 Millasseau, S P.64 Joseph, J P.23, P.27, P.28, P.49, P.55 Monnet, X P.64 Jozwiak, M P.64 Moretti, F P.19 Junior, E P.61 Morizzo, C 1.6 K Mudnic, I P.42 Kaanders, J 7.4 Munnery, M P.4 Kahn, F P.3 Mynard, J P.33 Karkhaneh Yousefi, A P.40 N Kettab, H 3.4, P.16, P.44 Nabeel, P M P.23, P.27, P.28, P.49, P.55 Khir, A. W. 1.6, 3.7 Nadeau-Fredette, A 1.3, P.1 Klein, M P.11, P.12 Nandi, M 2.4 Kling, J 7.1 Narang, R 7.5 Kondiboyina, A P.33 Natour, E7.2 Königstein, Ka 1.2 Negrean, V P.25 Koren, P P.42 Nemcsik, J P.34, P.62 Korompoki, E 2.1 Nemcsik-Bencze, Z P.34 Kőrösi, B. Z P.34 Neuhauser, H 1.2 Kowalski, R P.33 Neves, M P.11, P.12 Kozakova, M 1.6 Ngomane, A.Y 3.9 Kucharska-Newton, A 3.1, 3.5 Nicholls, D P.22 Kulin, S P.24 Nikolaidou, B P.5 Kyrkou, A 2.1 Nilsson, J P.3 L Nilsson, P. M 3.2 Labat, C 2.2 Ntaios, G 2.1 Labrecque, L P.39 Nuckols, V P.35 Artery Research (2021) 27:S1–S36 S35 O Schienkiewitz, A 1.2 Obeid, Hasan P.17, P.36, P.37 Schmidt-Trucksäss, A 1.2, 2.4 Oliveira-da-Silva, R. D. N 2.3 Schurgers, Leon 7.2 Ollier, B P.21 Segers, P 2.4, 7.3 Orasan, O P.25 Seidlerová, J P.15 O’Rourke, M P.26 Sen, S P.55 Oztemiz, E P.38 Serrano, A P.60 P Sherman, S P.56 Pagan L, P 3.5 Shirbani, F P.57 Pagoulatou, S 2.5, 7.3 Shore, A. C. P.3 Palombo, C 1.6, P.3 Silva, L P.12 Panayiotou, A. G. 3.6 Silva, S P.31, P.32 Papamichael, C 2.1 Sitar, A P.25 Parati, G. P.19 Smolich, J P.33 PARE, M P.17,P.36, P.39 Solomou, E 3.3, P.65 Parikh, S 7.2 Sorropago, A P.19 Park, C 1.1, 3.6 Sorropago, G P.19 Parker, K. H. P.3 Souza, F. B. 3.9 Patel, C 7.5 Spronck, Bart 3.7, 7.2, P.59 Paterson, C 3.1, 3.5, P.2 Stamatelopoulos, K 2.1 Patsatsi, A P.5 Stanford, K P.46 Peng, Y P.21 Stergiopulos, Nikolaos 2.5, 7.3, P.36 Penno, G 1.6 Stone, K 3.1, 3.5, P.2, P.54 Perrini, P P.43 Stoner, L 3.1, 3.5, P.2, P.46, P.54 Peterson, C P.54 Strain, D. W. P.3 Petit, C P.40 Stroud, A P.35 Pierce, G P.35 Š Pinto, M P.29 Šunjić, B P.42 Pirounaki, M 3.3 T Piskin, S P.41 Taddei, S P.44 Podrug, M P.42 Tagawa, K 1.5 Poles, J 3.1, P.2 Tan, I P.10, P.19, P.26 P.57 Poli, F P. 43, P.44 Tanaka, H 3.1, 3.5 Pölz, A P.45 Taylor, H 1.1 Pomeroy, A P.46 Tayyarah, M P.37 Poplavska, A P.61 Teboul, J.L. P.64 Posokhov, I P.47 Ten Cate, H 3.8 Protogerou, A 2.1 Terentes-Printzios, D 1.7, 2.4, 3.3, P.65 Pruijssen, J 7.4, P.48 Thijssen, D P.20,P.63 Q Thill, Caroline P.50 Qasem, Ahmad P.10 Thomas, A 2.2 R Tislér, A P.34 Raj, K. V P.23, P.27, P.28, P.49, P.55 Tomiyama, H P.7 Rapala, A P.22 Torunova, A P.58 Ratneswaren, A P.9 Tostes, R. C. 2.3 Reavette, R P.9 Toupance, S 2.2 Reddy, D P.9 Tousoulis, D 1.7 Reesink, K 7.2 Triantafyllou, Areti 3.6, P.5 Reesink, K.D. 3.7, P.59 Tsioufis, Konstantinos 3.3, P.65 Regnault, V 2.2 v Reijnen, Mi 3.8, P.63 van der Bruggen, M P.59 Riksen, Niels 3.8 van der Heijden, A 7.1 Roca, Frédéric P.50 V Rodrigues, B. G. P.25 Van der Vijver-Coppen, R 3.8 Rodrigues, Sara 3.10, P.51, P.52, P.53 Van Hoof, C 7.1 Rojas, J P.54 Vassilenko, V P.60, P.61 Rovas, G 2.5, 7.3 Vecsey-Nagy, M P.62 Rovina, M P.19 Vemmos, Konstantinos 2.1 Rowland, E P.9 Vemmou, A 2.1 Roy, M.A. P.39 Verardino, R 3.10, P.51, P.52, P.53 S Vermeulen, JP.63 Salvi, L P.19 Viner, R P.22 Salvi, P P.19 Vitali, S P.44 Samara, S 2.1 Vlachopoulos, C 1.7, 3.3, P.65 Santa-Clara, H P.29 W Santillan, M P.35 Warlé, M 3.8 Santos-Eichler, R.A. 2.3 Wassertheurer, S 1.3 Sarganas, G 1.2 Watkeys, L P.4 Scalise, F P.19 Weinberg, P P.9 Schaffrath Rosario, A 1.2 Wenmakers, A 7.4 Schalkwijk, C. G. P.59 Westerhof, B 1.5 Artery Research (2021) 27:S1–S36 S36 Wilbers, J 7.4 Willems, L 3.8 Xydis, P 3.3 Yiannaki, E P.5 Zanini, G 3.9 Zax, C 7.1 Zeebregts, C 3.8 Zieff, G 3.1, 3.5, P.2, P.54 Published online: 24 December 2021

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Publisher: Springer Journals
eISSN: 1876-4401
DOI: 10.1007/s44200-021-00008-4
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Selected Abstracts from Artery 21

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Selected Abstracts from Artery 21

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