Augmentation Index Derived from Peripheral Arterial Tonometry Correlates with Cardiovascular Risk Factors

Background. Augmentation index (AIx) is traditionally obtained from pressure waveforms via arterial applanation tonometry. We sought to evaluate the association between AIx obtained from peripheral arterial tonometry (PAT) with cardiovascular risk factors (CRF) and coronary artery disease (CAD). Methods. 186 patients were enrolled in the study. The presence or absence of CRFs and CAD was assessed in each subject. AIx was calculated by an automated algorithm averaging pulse wave amplitude data obtained via PAT. Central blood pressures were assessed in a subset of patients undergoing clinically indicated cardiac catheterization. Results. An association was observed between AIx and age, heart rate, systolic blood pressure, mean arterial pressure, pulse pressure, body weight and body mass index. AIx was significantly lower in patients with <3 CRFs compared to those with >5 CRFs ( P = .02). CAD+ patients had significantly higher AIx compared to CAD− patients ( P = .008). Area under the ROC curve was 0.604 (P < .01). In patients undergoing cardiac catheterization, after adjusting for age, height and heart rate, AIx was a significant predictor of aortic systolic and pulse pressures (P < .05) Conclusion. AIx derived from PAT correlates with cardiac risk factors and CAD. It may be a useful measure of assessing overall risk for coronary artery disease

High-fat meals do not impair postprandial endothelial function in HIV-infected and uninfected men.

To access publisher's full text version of this article click on the hyperlink at the bottom of the pagePrior studies have demonstrated impaired endothelium-dependent flow-mediated dilation (FMD) in healthy subjects following a high-fat meal. Compared to uninfected individuals, HIV-infected persons have been shown to have impaired FMD. We examined the effect of two different high-fat meals on endothelial function in HIV-infected and uninfected men. We performed a randomized, parallel group crossover study comparing 47 white men [18 HIV-uninfected, 9 HIV-infected and antiretroviral therapy (ART)-naïve, and 20 HIV-infected men on ART]. Fasting participants consumed one of two randomly assigned high-fat meals of either saturated or polyunsaturated fat, followed at least 24 h later by the other meal. Brachial artery ultrasound measurements to assess vascular reactivity were performed before and 3 h after each dietary challenge. There was no significant difference in mean baseline or postprandial FMD between HIV-infected and HIV-uninfected participants (mean baseline FMD±SD, 9.0%±5 vs. 9.2%±5, p=0.9; mean postprandial FMD±SD, 9.0%±4.7 vs. 9.1%±4.7, p=0.96, respectively). No significant difference in baseline or postprandial change in FMD was found between meals or HIV treatment groups. Fasting lipids and glucose, CD4(+) count, and viral load did not predict FMD in HIV-infected participants. In contrast to previous reports, this study did not demonstrate impaired endothelium-dependent vasodilation after high-fat meals in either HIV-infected or HIV-uninfected men. Moreover, HIV infection itself may not be the primary explanation for the abnormal endothelial function reported in HIV-infected individuals