Accurate quantitative measurements of brachial artery cross-sectional vascular area and vascular volume elastic modulus using automated oscillometric measurements: comparison with brachial artery ultrasound.

Increasing vascular diameter and attenuated vascular elasticity may be reliable markers for atherosclerotic risk assessment. However, previous measurements have been complex, operator-dependent or invasive. Recently, we developed a new automated oscillometric method to measure a brachial artery\u27s estimated area (eA) and volume elastic modulus (VE). The aim of this study was to investigate the reliability of new automated oscillometric measurement of eA and VE. Rest eA and VE were measured using the recently developed automated detector with the oscillometric method. eA was estimated using pressure/volume curves and VE was defined as follows (VE=Δ pressure/ (100 × Δ area/area) mm Hg/%). Sixteen volunteers (age 35.2±13.1 years) underwent the oscillometric measurements and brachial ultrasound at rest and under nitroglycerin (NTG) administration. Oscillometric measurement was performed twice on different days. The rest eA correlated with ultrasound-measured brachial artery area (r=0.77, P<0.001). Rest eA and VE measurement showed good reproducibility (eA: intraclass correlation coefficient (ICC)=0.88, VE: ICC=0.78). Under NTG stress, eA was significantly increased (12.3±3.0 vs. 17.1±4.6 mm(2), P<0.001), and this was similar to the case with ultrasound evaluation (4.46±0.72 vs. 4.73±0.75 mm, P<0.001). VE was also decreased (0.81±0.16 vs. 0.65±0.11 mm Hg/%, P<0.001) after NTG. Cross-sectional vascular area calculated using this automated oscillometric measurement correlated with ultrasound measurement and showed good reproducibility. Therefore, this is a reliable approach and this modality may have practical application to automatically assess muscular artery diameter and elasticity in clinical or epidemiological settings.Hypertension Research advance online publication, 19 February 2015; doi:10.1038/hr.2015.6

Vascular Elasticity Measured by Novel Brachial Artery Vascular Volume Elastic Modulus With Automated Oscillometry Reflects Molecular Determinant of Vascular Fibrosis

Background: Simple vascular functional measurements are desirable for atherosclerosis risk assessments. Recently, we developed a novel modality of automated oscillometric method to measure a brachial artery’s vascular elastic modulus (VE). Galectin-3 (Gal-3) expressed in endothelial cells regulates vascular fibrosis and is a molecular determinant of vascular stiffness. We aimed to clarify whether VE selectively correlates with marker of vascular stiffness in chronic kidney disease (CKD). Methods: 12 moderate-to-severe CKD (mean eGFR 25.9±23.5mL/min/1.73m2) and 15 controls were studied. Rest VE in brachial artery was measured by new automated oscillometric detector. VE was defined as follows [VE =ΔPressure/(100XΔarea/Area) mmHg/%]. Using ultrasound, the brachial artery’s reactive hyperemia [flow mediated dilatation (FMD)] was measured. Gal-3 and interleukin-6 were measured by enzyme-linked immunosorbent assay.Results: CKD had lower FMD (4.86±3.37 vs 9.05±2.98 %, P=0.003) and had attenuated VE than control (1.08±0.26 vs 0.83±0.17 mmHg/%, P=0.002). CKD had higher interleukin-6 (0.67±0.29 vs 0.29±0.33 pg/mL, P=0.003) and Gal-3 (20.0±12.4 vs. 5.84±2.83 pg/mL, P<0.001). VE was correlated negatively with %FMD (r=-0.46, P=0.015) and positively with Gal-3 (r=0.40, P=0.036) but not with interleukin-6 (r=0.21, P=0.28).Conclusions: Attenuated vascular elasticity detected by this novel approach closely correlated with increase in Gal-3 and reduced FMD in CKD. This may indicate that the attenuated vascular elasticity selectively reflects vascular fibrosis as evidenced by Gal-3 and subsequent endothelial responses to vascular stiffness.第80回日本循環器学会学術集

Novel Arterial Vascular Volume Elastic Modulus with Automated Oscillometric Approach Accurately Detected Endothelial and Endothelial Independent Vascular Function in CKD

Background: Simple and automated vascular function measurements are desirable for atherosclerosis risk assessments. Vascular elastic modulus (VE) is uninfluenced by blood pressure and is potentially linked to vascular function. Recently, we developed a novel modality of automated oscillometric method to measure a brachial artery´s VE and estimated arterial cross sectional area (eA). We aimed to investigate whether VE and eA response to nitroglycerin (NTG) reflected endothelial and endothelial independent dysfunction related to chronic kidney disease (CKD). Methods: 13 moderate-to-severe CKD (mean estimated glomerular filtration rate [eGFR]: 29.3±25.7 mL/min/1.73m2) and 15 controls were studied. Rest VE and eA response to NTG were measured by novel automated oscillometric detector. eA was estimated using pressure-volume curves and VE was defined as follows [VE=ΔPressure/ (100XΔarea/Area) mmHg/%]. Ultrasound measurements of flow mediated vasodilatation (FMD) and NTG were used as standard.Results: CKD had lower FMD than control (4.97±3.24 vs 9.03±2.98 %, P=0.002) and attenuated VE (1.09±0.25 vs 0.83±0.17 mmHg/%, P=0.003). Rest Ve was negatively correlated with %FMD(r=-0.43, P=0.02). Percent eA increase after NTG was correlated with %vascular diameter increase with ultrasound(r=0.51, P=0.005). However, there was no difference in %NTG(P=0.16) with ultrasound or %eA change (P=0.34) between the two groups.Conclusions: This new automated vascular function measurement using oscillometric measurement reliably detected endothelial dysfunction related to CKD and has potential to detect endothelial independent vasodilator response.第79回日本循環器学会学術集

Vascular Elasticity Measured by Novel Brachial Artery Vascular Volume Elastic Modulus With Automated Oscillometry Correlates With Molecular Determinant of Vascular Fibrosis

Introduction: Simple vascular function measurements are desirable for atherosclerosis risk assessments. Recently, we developed a novel modality of automated oscillometric method to measure a brachial artery’s vascular elastic modulus (VE) and reported that VE is uninfluenced by blood pressure. Galectin-3 (Gal-3) expressed in endothelial cells regulates vascular fibrosis and is a molecular determinant of vascular stiffness. Hypothesis: We aimed to clarify whether VE selectively correlates with marker of vascular stiffness in chronic kidney disease (CKD). Methods: 12 moderate-to-severe CKD pts (mean eGFR 25.9±23.5 mL/min/1.73m2) and 15 controls were studied. Rest VE in brachial artery was measured by new automated oscillometric detector. VE was defined as follows [VE =ΔPressure/ (100XΔarea/Area) mmHg/%]. Using ultrasound, the brachial artery diameter at rest and during reactive hyperemia [flow mediated dilatation (FMD) with endothelial-dependent dilatation] was measured. Gal-3 and interleukin-6 (IL-6), a representative inflammatory marker, were measured by enzyme-linked immune assay.Results: CKD had lower FMD (4.86±3.37 vs 9.05±2.98 %, P=0.003) and had attenuated VE than control (1.08±0.26 vs 0.83±0.17 mmHg/%, P=0.002). CKD had higher IL-6 (0.67±0.29 vs 0.29±0.33 pg/mL, P=0.003) and higher Gal-3 (20.0±12.4 vs. 5.84±2.83 pg/mL, P<0.001). VE was negatively correlated with %FMD (r=-0.46, P=0.015) and correlated with Gal-3 (r=0.40, P=0.036) but not in IL-6 (r=0.21, P=0.28).Conclusions: Attenuated vascular elasticity detected by this novel approach closely correlated with increase in Gal-3 and reduced FMD in CKD. This may indicate that the attenuated vascular elasticity selectively reflects vascular fibrosis as evidenced by Gal-3 and subsequent endothelial responses to vascular stiffness. Thus, this oscillometric measurement may be useful for detecting vascular fibrosis information and dysfunction in endothelium level.American Heart Association scientific session 201