In vivo repeatability of the pulse wave inverse problem in human carotid arteries

Accurate arterial stiffness measurement would improve diagnosis and monitoring for many diseases. Atherosclerotic plaques and aneurysms are expected to involve focal changes in vessel wall properties; therefore, a method to image the stiffness variation would be a valuable clinical tool. The pulse wave inverse problem (PWIP) fits unknown parameters from a computational model of arterial pulse wave propagation to ultrasound-based measurements of vessel wall displacements by minimizing the difference between the model and measured displacements. The PWIP has been validated in phantoms, and this study presents the first in vivo demonstration. The common carotid arteries of five healthy volunteers were imaged five times in a single session with repositioning of the probe and subject between each scan. The 1D finite difference computational model used in the PWIP spanned from the start of the transducer to the carotid bifurcation, where a resistance outlet boundary condition was applied to approximately model the downstream reflection of the pulse wave. Unknown parameters that were estimated by the PWIP included a 10-segment linear piecewise compliance distribution and 16 discrete cosine transformation coefficients for each of the inlet boundary conditions. Input data was selected to include pulse waves resulting from the primary pulse and dicrotic notch. The recovered compliance maps indicate that the compliance increases close to the bifurcation, and the variability of the average pulse wave velocity estimated through the PWIP is on the order of 11%, which is similar to that of the conventional processing technique which tracks the wavefront arrival time (13%).     

Existence of two types of postjunctional alpha-adrenoceptors in the isolated canine internal carotid artery

The pharmacological characteristics of postjunctional alpha-adrenoceptors in isolated canine internal carotid arteries were investigated by the use of selective agonists and antagonists for alpha 1- and alpha 2-adrenoceptors. Norepinephrine, phenylephrine, and xylazine caused concentration-dependent contractions in the helical strips. The contraction induced by 10(-4)M xylazine was significantly smaller than that produced by 10(-4)M norepinephrine or 10(-4)M phenylephrine. The contraction induced by 10(-4)M phenylephrine was almost the same value as that induced by 10(-4)M norepinephrine. Phentolamine (10(-8) and 10(-7)M) caused a parallel shift to the right of the concentration-response curve to norepinephrine. The contractile responses to low concentrations of norepinephrine were significantly suppressed by pretreatment with an alpha 2-antagonist such as yohimbine (10(-9) and 10(-8)M) or DG5128 (10(-7) and 10(-6)M). On the other hand, the responses to higher concentrations of norepinephrine were mainly reduced by low concentrations of an alpha 1-antagonist, prazosin (3 x 10(-10) and 3 x 10(-9)M). These results suggest that both alpha 1- and alpha 2-adrenoceptors are located on the plasma membrane of smooth muscle cells in canine internal carotid arteries and that the norepinephrine-induced contractions at low and high concentrations are mainly mediated by activation of alpha 2- and alpha 1-adrenoceptors, respectively.     

Arterial pulse attenuation prediction using the decaying rate of a pressure wave in a viscoelastic material model

The present study examines the possibility of attenuating blood pulses by means of introducing prosthetic viscoelastic materials able to absorb energy and damp such pulses. Vascular prostheses made of polymeric materials modify the mechanical properties of blood vessels. The effect of these materials on the blood pulse propagation remains to be fully understood. Several materials for medical applications, such as medical polydimethylsiloxane or polytetrafluoroethylene, show viscoelastic behavior, modifying the original vessel stiffness and affecting the propagation of blood pulses. This study focuses on the propagation of pressure waves along a pipe with viscoelastic materials using the Maxwell and the Zener models. An expression of exponential decay has been obtained for the Maxwell material model and also for low viscous coefficient values in the Zener model. For relatively high values of the viscous term in the Zener model, the steepest part of the pulse can be damped quickly, leaving a smooth, slowly decaying wave. These mathematical models are critical to tailor those materials used in cardiovascular implants to the mechanical environment they are confronted with to repair or improve blood vessel function.     

Oscillatory pressure wave transmission from the upper airway to the carotid artery.

Snoring-associated vibration energy transmission from the upper airway to the carotid artery has been hypothesized as a potential atherosclerotic plaque initiating/rupturing event that may provide a pathogenic mechanism linking snoring and embolic stroke. We examined transmission of oscillatory pressure waves from the pharyngeal lumen to the common carotid artery wall and lumen in seven male, anesthetized, spontaneously breathing New Zealand White rabbits. Airflow was monitored via a pneumotachograph inserted in series in the intact trachea. Fifteen 20-s runs of, separately, 40-, 60-, and 90-Hz oscillatory pressure waves [pressure amplitude in the trachea (Ptr(amp)), amplitude 2-20 cmH(2)O] were generated by a loudspeaker driven by a sine wave generator and amplifier and superimposed on tidal breathing via the cranial tracheal connector. Pressure transducer-tipped catheters measured pressure amplitudes in the tissues adjacent to the common carotid artery bifurcation (Pcti(amp)) and within the lumen (carotid sinus; Pcs(amp)). Data were analyzed using power spectrum analysis and linear mixed-effects statistical modeling. Both the frequency (f) and amplitude of the injected pressure wave influenced Pcti(amp) and Pcs(amp), in that ln Pcti(amp) = 1.2(Ptr(amp)) + 0.02(f) - 5.2, and ln Pcs(amp) = 0.6(Ptr(amp)) + 0.02(f) - 4.9 (both P < 0.05). Across all frequencies tested, transfer of oscillatory pressure across the carotid artery wall was associated with an amplitude gain, as expressed by a Pcs(amp)-to-Pcti(amp) ratio of 1.8 +/- 0.3 (n = 6). Our findings confirm transmission of oscillatory pressure waves from the upper airway lumen to the peripharyngeal tissues and across the carotid artery wall to the lumen. Further studies are required to establish the role of this incident energy in the pathogenesis of carotid artery vascular disease.     

Noninvasive determination of local pulse wave velocity and wave intensity: changes with age and gender in the carotid and femoral arteries of healthy human

We recently introduced noninvasive methods to assess local pulse wave velocity (PWV) and wave intensity ((n)dI) in arteries based on measurements of flow velocity (U) and diameter (D). Although the methods were validated in an experimental setting, clinical application remains lacking. The aim of this study was therefore to investigate the effect of age and gender on PWV and (n)dI in the carotid and femoral arteries of an existing population. We measured D and U in the carotid and femoral arteries of 1,774 healthy subjects aged 35-55 yr, a subgroup of the Asklepios population. With the use of the lnDU-loop method, we calculated local PWV, which was used to determine arterial distensibility ((n)Ds). We then used the new algorithm to determine maximum forward and backward wave intensities ((n)dI(+max) and (n)dI(-min), respectively) and the reflection index ((n)RI). On average, PWV was higher, and (n)Ds was lower in the femoral than at the carotid arteries. At the carotid artery, PWV increased with age, but (n)Ds, (n)dI(+max), and (n)dI(-min) decreased; (n)RI did not change with age. At the femoral artery, PWV was higher, and (n)Ds was lower in male, but all parameters did not change significantly with age in both women and men. We conclude that the carotid artery is more affected by the aging process than the femoral artery, even in healthy subjects. The new techniques provide mechanical and hemodynamic parameters, requiring only D and U measurements, both of which can be acquired using ultrasound equipment widely available today, hence their advantage for potential use in the clinical setting.     

Modeling carotid and radial artery pulse pressure waveforms by curve fitting with Gaussian functions

Modeling arterial pressure waveforms holds the potential for identifying physiological changes. There is a clinical need for a simple waveform analysis method with a high accuracy in reproducing the original waveforms. The aim of this study was to determine the accuracy of modeling carotid and radial pulses using Gaussian functions, making no physiological assumptions. Carotid and radial pulses were recorded from 20 normal volunteers. Ten consecutive beats from each volunteer were analyzed to determine beat-to-beat variability. Each pulse was decomposed using seven combinations of up to three Gaussian functions. The first function was always positive, but the second or third could be either positive or negative. Three positive Gaussian functions reproduced the original waveforms best with a mean absolute error (MAE) of 1.2% and 1.3% for the carotid and radial pulses respectively, and a maximum residual error of only 4.1% for both. This model had significantly smaller errors than any of the other six (all P < 0.001). Four positive Gaussian functions were then used to test the stability of this model. An insignificant change of the mean MAE (1.2% for both carotid and radial pulses) was obtained, showing that the stability has been reached with three positive Gaussian functions. The variability of MAE calculated as the standard deviation (SD) over the 10 beats was small at 0.2% for both pulses confirming the repeatability of using three positive Gaussian functions.     

Parameters describing the pulse wave

Pulse wave analysis permits non-invasive assessment of arterial elasticity indices. The contour varies in different parts of the circulation. It depends on physiological or pathophysiological conditions of the organism. The pathological events like arteriosclerosis or diabetes have a primary effect to the artery elasticity. Hypertension or some heart diseases also influence the pulse wave velocity and resulted in earlier wave reflections. There are several methods of pulse wave measurements based on different principles and depending on the type of measured pulse wave. The evaluation parameters can be assessed from the time domain, derivations, velocity or frequency domain. The main aim of this review article is to offer a recent overview of pulse wave measurement parameters and main results obtained. The principles of pulse wave measurement and current experience in clinical practice are shortly discussed too.     

Surface artery volume pulse wave measurement - verification of a new method

The aim of this paper is to prove the possible reproducibility of measurement with a new developed device for artery elasticity monitoring and determining the standard of major pulse wave parameters. As a measurement sensor, a conic probe with thin convex membrane was used. This technique allows setting an arbitrary pressure to a measured surface artery. We measured pulse waves on the radial arteries of 108 individuals. We expected similar features in arterial wall elasticity. We concentrated primarily on the amount of subcutaneous fat. For the measured waves we evaluated five following pulse wave parameters: relative crest time, elasticity index, dicrotic wave attenuation, dicrotic wave time and interwave distance. There were no significant differences in measured pulse wave parameters among the tested groups of subjects.     

Carotid artery pulse wave time characteristics to quantify ventriculoarterial responses to orthostatic challenge.

Central blood pressure waveforms contain specific features related to cardiac and arterial function. We investigated posture-related changes in ventriculoarterial hemodynamics by means of carotid artery (CA) pulse wave analysis. ECG, brachial cuff pressure, and common CA diameter waveforms (by M-mode ultrasound) were obtained in 21 healthy volunteers (19-30 yr of age, 10 men and 11 women) in supine and sitting positions. Pulse wave analysis was based on a timing extraction algorithm that automatically detects acceleration maxima in the second derivative of the CA pulse waveform. The algorithm enabled determination of isovolumic contraction period (ICP) and ejection period (EP): ICP=43+/-8 (SD) ms (4-ms precision), and EP=302+/-16 (SD) ms (5-ms precision). Compared with the supine position, in the sitting position diastolic blood pressure (DBP) increased by 7+/-4 mmHg (P<0.001) and R-R interval decreased by 49+/-82 ms (P=0.013), reflecting normal baroreflex response, whereas EP decreased to 267+/-19 ms (P<0.001). Shortening of EP was significantly correlated to earlier arrival of the lower body peripheral reflection wave (r2=0.46, P<0.001). ICP increased by 7+/-7 ms (P<0.001), the ICP-to-EP ratio increased from 14+/-3% (supine) to 19+/-3% (P<0.001) and the DBP-to-ICP ratio decreased by 7% (P=0.023). These results suggest that orthostasis decreases left ventricular output as a result of arterial wave reflections and, presumably, reduced cardiac preload. We conclude that CA ultrasound and pulse wave analysis enable noninvasive quantification of ventriculoarterial responses to changes in posture.     

Energy dissipation in the brown fatty tissue of warm-blooded animals

The uncoupling mechanism of respiration and phosphorylation in brown adipose tissue as well as factors affecting this process are discussed. An assumption has been suggested and substantiated experimentally that the uncoupling of respiration and phosphorylation in liver mitochondria caused by vitamin K alimentary deficit may have mechanism similar to the unique uncoupling mechanism of brown fat mitochondria.     

Energy dissipation and radical scavenging by the plant phenylpropanoid pathway

Environmental stresses such as high light, low temperatures, pathogen infection and nutrient deficiency can lead to increased production of free radicals and other oxidative species in plants. A growing body of evidence suggests that plants respond to these biotic and abiotic stress factors by increasing their capacity to scavenge reactive oxygen species. Efforts to understand this acclimatory process have focused on the components of the 'classical' antioxidant system, i.e. superoxide dismutase, ascorbate peroxidase, catalase, monodehydroascorbate reductase, glutathione reductase and the low molecular weight antioxidants ascorbate and glutathione. However, relatively few studies have explored the role of secondary metabolic pathways in plant response to oxidative stress. A case in point is the phenylpropanoid pathway which is responsible for the synthesis of a diverse array of phenolic metabolites such as flavonoids, tannins, hydroxycinnamate esters and the structural polymer lignin. These compounds are often induced by stress and serve specific roles in plant protection, i.e. pathogen defence, ultraviolet screening, antiherbivory, or structural components of the cell wall. This review will highlight a novel antioxidant function for the taxonomically widespread phenylpropanoid metabolite chlorogenic acid (CGA; 5-O-caffeoylquinic acid) and assess its possible role in abiotic stress tolerance. The relationship between CGA biosynthesis and photosynthetic carbon metabolism will also be discussed. Based on the properties of this model phenolic metabolite, we propose that under stress conditions phenylpropanoid biosynthesis may represent an alternative pathway for photochemical energy dissipation that has the added benefit of enhancing the antioxidant capacity of the cell.     

A morphometric study of age-related changes in the elastic systems of the common carotid artery and internal carotid artery in humans

The present study aims to quantify the distribution of the elastic fiber system in the walls of the common carotid artery and the internal carotid artery in humans. In order to identify specific fibers, segments of carotid arteries were stained using the Verhoeff (for elastic fibers), Weigert (for elastic and elauninic fibers) and Weigert-oxone (for elauninic and oxytalanic fibers) methods. A histomorphometric study was undertaken in order to estimate the linear density (LV) of the fibrous components present in the elastic system and determine the total length of these components in each segment. Microscopic fields were sampled using a test system in which the colors and bands defined in the current study were superimposed on the histological preparations. Data were analyzed through linear regression using first-order rate equations and computer software. The internal carotid artery can be loosely defined as muscular in nature. In order to classify common carotid arteries, it is necessary to consider subject age. From 0 to 30 years of age, the LV of mature elastic fibers does not change significantly in either (left or right) common carotid artery, although a significant reduction in the LV of this type of fiber occurs in the right internal carotid artery. The most marked reduction in oxytalanic and elauninic fibers occurs between 0 and 10 years of age, becoming less intense between the ages of 10 and 30.     

Appearance of the flutter on the pulse wave

This work deals with the liquid flow in an elastic blood vessel. The mechanism of the initiation of standing waves was studied. Results of model experiments, both on the hydrodynamic stand and in the aorta of the living dog are presented.     

Measurement of the velocity of the pulse wave

Pulse wave transmission rate has been measured "in vivo" in 6 male anaesthetized Wistar rats, by means of cannulae, inserted both in carotid and femoral arteries. The measure has been done by calculating the time delay of several corresponding levels in the two pressure pulses: at the foot, during the ascending phase, at the peak. Three different intervention have been carried out: Ach, NA, blood transfusion. The transmission rate outcame higher at the pulse foot than at the peak, in control animals and in Ach and blood transfusion interventions. The NA intervention inverted this behaviour, where the increase in transmission rate did not correspond to the rate of pressure growing. The possible influences of a vegetative component on arterial viscoelastic behaviour are discussed.