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Stéphane Laurent - One of the best experts on this subject based on the ideXlab platform.
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Local pulse pressure is a major determinant of large Artery remodelling.
Clinical and Experimental Pharmacology and Physiology, 2001Co-Authors: Stéphane Laurent, Anne-isabelle Tropeano, Agnès Lillo-lelouet, Guillaume Jondeau, Brigitte Laloux, Pierre BoutouyrieAbstract:SUMMARY 1. The aim of the present brief review is to show that the pulsatile component of blood pressure is a stronger determinant of large Artery remodelling than the steady component (i.e. mean blood pressure). 2. Pulse pressure, which is a strong determinant of cardiovascular events, including coronary heart disease and stroke, is increased when large arteries stiffen. Local pulse pressure, measured with applanation tonometry in normotensives and patients with essential hypertension, explains a significant part of the variance of intima–media thickness at the site of the carotied Artery, a proximal elastic Artery, whereas mean blood pressure does not contribute. Local pulse pressure has no influence on intima–media thickness at the site of the radial Artery, a distal Muscular Artery that undergoes very little stroke change in diamter. 3. The decrease in carotid pulse pressure is also a major determinant of the regression of catorid intima–media thickness after antihypertensive treatment. Local pulse pressure can influence not only intima–media thickness, but also internal diameter. Indeed, there is a significant association between the lumen enlargement of the ascending aorta in patients with Marfan syndrome and pulse pressure. In addition, carotid pulse pressure is positively correlated with carotid internal diameter in normotensives and hypertensives, and the decrease in carotid internal diameter during long-term antihypertensive treatment is influenced by the decrease in carotid pulse pressure and not by the reduction in mean blood pressure. 4. We suggest that the effects of pulse pressure on large Artery remodelling may explain part of its predictive value on cardiovascular events.
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local pulse pressure and regression of arterial wall hypertrophy during long term antihypertensive treatment
Circulation, 2000Co-Authors: Pierre Boutouyrie, Caroline Bussy, Brigitte Laloux, Daniel Hayoz, Hans R. Brunner, Jurg Hengstler, Nathalie Dartois, Stéphane LaurentAbstract:Background—Local pulse pressure (PP) is an independent determinant of carotid Artery wall thickness, stronger than mean blood pressure (BP). The present study was designed to assess whether a β-adrenoceptor antagonist–based or an ACE inhibitor–based treatment was able to reduce carotid Artery wall hypertrophy through a reduction in carotid PP rather than by lowering mean BP and whether the influence of local PP reduction could also be detected at the site of a Muscular Artery, the radial Artery. Methods and Results—Ninety-eight essential hypertensive patients were randomized to 9 months of double-blind treatment with either celiprolol or enalapril. Arterial parameters were determined with high-resolution echo-tracking systems. PP was measured locally with applanation tonometry and independently of mean BP. After 9 months of treatment, mean BP, carotid PP, and intimal-medial thickness (IMT) decreased significantly, with no difference between the 2 groups. The reduction in carotid PP but not in mean BP was ...
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association between local pulse pressure mean blood pressure and large Artery remodeling
Circulation, 1999Co-Authors: Pierre Boutouyrie, Caroline Bussy, Xavier Girerd, Patrick Lacolley, Brigitte Laloux, Stéphane LaurentAbstract:Background—The aim of the present study was to determine the respective influences of local pulse pressure and mean blood pressure on arterial remodeling in humans at 2 arterial sites: a central, predominantly elastic Artery (the common carotid Artery) and a peripheral Muscular Artery (the radial Artery). Methods and Results—Forty-three healthy subjects and 124 never-treated hypertensive patients were included in the study. Intima-media thickness and internal diameter of the carotid and radial arteries were noninvasively determined with high-definition echo-tracking devices. Pulse pressure was measured locally with applanation tonometry. Multivariate regression models including mean blood pressure and local pulse pressure were established in the whole population. Carotid internal diameter and intima-media thickness were strongly influenced (P<0.0001) by carotid pulse pressure but not by mean blood pressure or brachial pulse pressure, independently of age and sex. Radial Artery internal diameter was correl...
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increased stiffness of radial Artery wall material in end stage renal disease
Hypertension, 1997Co-Authors: Jeanjacques Mourad, Pierre Boutouyrie, Xavier Girerd, Stéphane Laurent, Michel E Safar, Gerard M LondonAbstract:Abstract The incremental elastic modulus (Einc), which is the slope of the relationship between stress and strain of arteries, is a marker of vascular wall material stiffness. Isobaric Einc is reduced at the site of the radial Artery in patients with essential hypertension and increased at the site of the common carotid Artery in subjects with end-stage renal disease (ESRD). Whether the changes in Einc are influenced by the topography of the vessels, the composition of the arterial wall, and/or by the presence of ESRD is largely ignored. Radial Artery Einc was measured in 19 patients with ESRD and compared with the Einc of 89 subjects with essential hypertension and 20 normotensive control subjects. Transcutaneous measurements of radial Artery internal diameter and wall thickness (echo-tracking device) and digital pulse pressure (Finapres) were allowed to calculate Einc under operational (ie, at the mean arterial pressure of each group) and isobaric (100 mm Hg) conditions, as well as for a given wall stress. Internal diameter and pulsatile changes in diameter were identical in the three groups. Wall thickness and mean blood pressure were significantly elevated in subjects with hypertension but not in ESRD patients. Circumferential wall stress was identical in the three groups. For the same operational wall stress, and therefore at the operational mean arterial pressure of each group, Einc (kPa · 103) was increased in patients with ESRD (5.53±4.0 versus 3.3±2.4 in control subjects; P <.05) and normal in subjects with essential hypertension (3.87±4.0). Under isobaric conditions, Einc was also significantly lower in subjects with hypertension and elevated in patients with ESRD. Thus, at the site of a medium-sized Muscular Artery constantly devoid of atherosclerosis, the stiffness of wall material is increased in patients with ESRD. The demonstrated alterations of the arterial wall are independent of the level of blood pressure and tensile stress and should be related to the status ESRD.
Pierre Boutouyrie - One of the best experts on this subject based on the ideXlab platform.
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Local pulse pressure is a major determinant of large Artery remodelling.
Clinical and Experimental Pharmacology and Physiology, 2001Co-Authors: Stéphane Laurent, Anne-isabelle Tropeano, Agnès Lillo-lelouet, Guillaume Jondeau, Brigitte Laloux, Pierre BoutouyrieAbstract:SUMMARY 1. The aim of the present brief review is to show that the pulsatile component of blood pressure is a stronger determinant of large Artery remodelling than the steady component (i.e. mean blood pressure). 2. Pulse pressure, which is a strong determinant of cardiovascular events, including coronary heart disease and stroke, is increased when large arteries stiffen. Local pulse pressure, measured with applanation tonometry in normotensives and patients with essential hypertension, explains a significant part of the variance of intima–media thickness at the site of the carotied Artery, a proximal elastic Artery, whereas mean blood pressure does not contribute. Local pulse pressure has no influence on intima–media thickness at the site of the radial Artery, a distal Muscular Artery that undergoes very little stroke change in diamter. 3. The decrease in carotid pulse pressure is also a major determinant of the regression of catorid intima–media thickness after antihypertensive treatment. Local pulse pressure can influence not only intima–media thickness, but also internal diameter. Indeed, there is a significant association between the lumen enlargement of the ascending aorta in patients with Marfan syndrome and pulse pressure. In addition, carotid pulse pressure is positively correlated with carotid internal diameter in normotensives and hypertensives, and the decrease in carotid internal diameter during long-term antihypertensive treatment is influenced by the decrease in carotid pulse pressure and not by the reduction in mean blood pressure. 4. We suggest that the effects of pulse pressure on large Artery remodelling may explain part of its predictive value on cardiovascular events.
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local pulse pressure and regression of arterial wall hypertrophy during long term antihypertensive treatment
Circulation, 2000Co-Authors: Pierre Boutouyrie, Caroline Bussy, Brigitte Laloux, Daniel Hayoz, Hans R. Brunner, Jurg Hengstler, Nathalie Dartois, Stéphane LaurentAbstract:Background—Local pulse pressure (PP) is an independent determinant of carotid Artery wall thickness, stronger than mean blood pressure (BP). The present study was designed to assess whether a β-adrenoceptor antagonist–based or an ACE inhibitor–based treatment was able to reduce carotid Artery wall hypertrophy through a reduction in carotid PP rather than by lowering mean BP and whether the influence of local PP reduction could also be detected at the site of a Muscular Artery, the radial Artery. Methods and Results—Ninety-eight essential hypertensive patients were randomized to 9 months of double-blind treatment with either celiprolol or enalapril. Arterial parameters were determined with high-resolution echo-tracking systems. PP was measured locally with applanation tonometry and independently of mean BP. After 9 months of treatment, mean BP, carotid PP, and intimal-medial thickness (IMT) decreased significantly, with no difference between the 2 groups. The reduction in carotid PP but not in mean BP was ...
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association between local pulse pressure mean blood pressure and large Artery remodeling
Circulation, 1999Co-Authors: Pierre Boutouyrie, Caroline Bussy, Xavier Girerd, Patrick Lacolley, Brigitte Laloux, Stéphane LaurentAbstract:Background—The aim of the present study was to determine the respective influences of local pulse pressure and mean blood pressure on arterial remodeling in humans at 2 arterial sites: a central, predominantly elastic Artery (the common carotid Artery) and a peripheral Muscular Artery (the radial Artery). Methods and Results—Forty-three healthy subjects and 124 never-treated hypertensive patients were included in the study. Intima-media thickness and internal diameter of the carotid and radial arteries were noninvasively determined with high-definition echo-tracking devices. Pulse pressure was measured locally with applanation tonometry. Multivariate regression models including mean blood pressure and local pulse pressure were established in the whole population. Carotid internal diameter and intima-media thickness were strongly influenced (P<0.0001) by carotid pulse pressure but not by mean blood pressure or brachial pulse pressure, independently of age and sex. Radial Artery internal diameter was correl...
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increased stiffness of radial Artery wall material in end stage renal disease
Hypertension, 1997Co-Authors: Jeanjacques Mourad, Pierre Boutouyrie, Xavier Girerd, Stéphane Laurent, Michel E Safar, Gerard M LondonAbstract:Abstract The incremental elastic modulus (Einc), which is the slope of the relationship between stress and strain of arteries, is a marker of vascular wall material stiffness. Isobaric Einc is reduced at the site of the radial Artery in patients with essential hypertension and increased at the site of the common carotid Artery in subjects with end-stage renal disease (ESRD). Whether the changes in Einc are influenced by the topography of the vessels, the composition of the arterial wall, and/or by the presence of ESRD is largely ignored. Radial Artery Einc was measured in 19 patients with ESRD and compared with the Einc of 89 subjects with essential hypertension and 20 normotensive control subjects. Transcutaneous measurements of radial Artery internal diameter and wall thickness (echo-tracking device) and digital pulse pressure (Finapres) were allowed to calculate Einc under operational (ie, at the mean arterial pressure of each group) and isobaric (100 mm Hg) conditions, as well as for a given wall stress. Internal diameter and pulsatile changes in diameter were identical in the three groups. Wall thickness and mean blood pressure were significantly elevated in subjects with hypertension but not in ESRD patients. Circumferential wall stress was identical in the three groups. For the same operational wall stress, and therefore at the operational mean arterial pressure of each group, Einc (kPa · 103) was increased in patients with ESRD (5.53±4.0 versus 3.3±2.4 in control subjects; P <.05) and normal in subjects with essential hypertension (3.87±4.0). Under isobaric conditions, Einc was also significantly lower in subjects with hypertension and elevated in patients with ESRD. Thus, at the site of a medium-sized Muscular Artery constantly devoid of atherosclerosis, the stiffness of wall material is increased in patients with ESRD. The demonstrated alterations of the arterial wall are independent of the level of blood pressure and tensile stress and should be related to the status ESRD.
Graullera Sanz B - One of the best experts on this subject based on the ideXlab platform.
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Peripheral vascular reflexes during ventricular overdriving and cardiac ischemia. An experimental study
Revista espanola de cardiologia, 1993Co-Authors: Segui Bonnin J, Cosín Aguilar J, García Civera R, Solaz Mínguez J, Hernándiz Martínez A, Andrés Conejos F, Graullera Sanz BAbstract:The aim of this paper is to analyze the behaviour of the Muscular arteries during ventricular tachycardia in normal and in ischemic hearts. In 19/30 anaesthetized dogs in which a resistance vessel (gracilis muscle Artery) was isolated (while innervation and venous backflow remained intact), we performed transient (20 min) coronary Artery occlusions and ventricular overdriving (30 sec). A systolic left ventricular pressure decrease (144.2 +/- 18.2 mmHg vs 114 +/- 16.1) (p < 0.001) was produced with the coronary circumflex obstruction. Changes in the end-diastolic left ventricular pressure and Muscular Artery pressure were not significant. A new systolic left ventricular pressure decrease (114 +/- 16.1 mmHg vs 64.8 +/- 27) (p < 0.001) was induced when the ventricular overdriving (272.2 +/- 46.1 bpm) was added to the coronary circumflex obstruction. The end-diastolic left ventricular pressure increased (6.8 +/- 10.1 mmHg vs 18.3 +/- 4.8) (p < 0.001) and the Muscular Artery pressure increased (121 +/- 27.3 mmHg vs 158.1 +/- 21.3) (p < 0.01) in these circumstances. When the ventricular overdriving (275 +/- 70.7 bpm) was added to the left descendent anterior coronary occlusion a significative decrease of left systolic ventricular pressure (141 +/- 23 mmHg vs 84.4 +/- 28.4) (p < 0.01) and an increase of the Muscular Artery pressure (124.3 +/- 25 mmHg vs 149 +/- 25.1) (p < 0.01) was produced. Ventricular overdriving-induced hypotension produced an isolated Muscular Artery response with clear vasoconstrictor predominance, which indicates that there is a natural compensatory capacity with predominance of efferent sympathetic activity.(ABSTRACT TRUNCATED AT 250 WORDS)
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Peripheral vascular reflexes in obstructions of the left ventricular outflow tract. Experimental study
Revista espanola de cardiologia, 1992Co-Authors: Segui Bonnin J, Cosín Aguilar J, García Civera R, Solaz Mínguez J, Hernándiz Martínez A, Andrés Conejos F, Graullera Sanz BAbstract:UNLABELLED The aim of this work is to analyze the vascular tone behaviour of the Muscular arteries in relation to the reflexes generated during aortic root obstruction when spontaneous heart rate is permitted and also with induced tachycardia. An experimental model used involved anaesthetized and intubated dogs in which a resistance vessel (gracilis muscle Artery) was isolated, while innervation and venous backflow remained intact. Moderate (54.4 +/- 23.2 mmHg of mean increase in left ventricular pressure) and severe (240.1 +/- 92.5 mmHg) aortic obstructions for 30 s were provoked during spontaneous heart rate (n = 15) and during ventricular overdriving (n = 13) at 200, 250 and 300 bpm for 30 s. Ventricular overdriving at 200, 250, 300 and 400 bpm for 30 s without aortic root obstruction was induced in 20 dogs. Ventricular overdriving in intact hearts produced an initial decrease in the isolated Muscular Artery pressure of 12.0 +/- 7.2 mmHg (p < 0.01), 9.5 +/- 5.7 mmHg (p < 0.001), 13.6 +/- 8.6 mmHg (p < 0.001) and 14.3 +/- 8.7 mmHg (p < 0.01) at 200, 250, 300 and 400 bpm respectively followed by a recovery, so that at the end of overdriving (30 s), exceeded basal values in 11.9 +/- 10.0 mmHg (p < 0.05), 21.1 +/- 12.4 mmHg (p < 0.001), 21.9 +/- 10.4 mmHg (p < 0.001) and 36.1 +/- 21.3 mmHg (p < 0.001) for each overdriving rate respectively. Aortic obstruction during spontaneous heart rate produced and initial decrease in the isolated Muscular Artery pressure of 12.0 +/- 7.3 mmHg (p < 0.01), when the aortic obstruction were moderate, and 31.4 +/- 15.7 mmHg (p < 0.01) when the obstructions were severe, followed by a recovery of its basal values at the end of the obstruction time. Ventricular overdriving with aortic root obstruction did not produced significant changes in the isolated Muscular Artery pressure except in the highest rates of overdriving, that produced an increase of isolated Muscular Artery pressure of 23.9 +/- 16.2 mmHg (p < 0.01). IN CONCLUSION ventricular overdriving-induced hypotension in intact hearts produces an isolated Muscular Artery response with clear vasoconstrictor predominance. Aortic obstruction-induced hypotension does not produce a vasoconstrictor response in the isolated Muscular Artery but rather an initial vasodilation response which does not revert to vasoconstriction at any point during the hypotensive process. Overdriving was not capable of inducing a peripheral vasoconstriction in presence of aortic root obstruction except in the highest rates of overdriving.
Hongmei Wu - One of the best experts on this subject based on the ideXlab platform.
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type 2 diabetes is associated with increased pulse wave velocity measured at different sites of the arterial system but not augmentation index in a chinese population
Clinical Cardiology, 2011Co-Authors: Minghua Zhang, Ping Ye, Wenkai Xiao, Hongmei WuAbstract:Background: Patients with type 2 diabetes have increased stiffness of central elastic arteries. However, whether peripheral Muscular Artery stiffness is equally affected by the disease remains sparsely examined. Moreover, the association between pulse wave velocity (PWV) and augmentation index (AIx) in diabetes is poorly understood. Hypothesis: Type 2 diabetes is associated with the alterations in arterial stiffness (PWV and AIx) in a community-based population. Methods: A total of 79 Chinese patients with type 2 diabetes and 79 sex-, age- (±3 years), and body mass index- (±2 kg/m2) matched healthy controls were studied. Carotid-femoral pulse wave velocity (CF-PWV), carotid-radial pulse wave velocity (CR-PWV), and carotid-ankle pulse wave velocity (CA-PWV) were calculated from tonometry waveforms and body surface measurements, whereas AIx was assessed using pulse wave analyses. Results: In univariate analysis, patients with type 2 diabetes showed increased CF-PWV (P < 0.001), CR-PWV (P = 0.012), and CA-PWV (P = 0.016), and lower AIx (P = 0.017) than the control group. In multiple linear regression models adjusting for covariates, type 2 diabetes remained a significant determinant of CF-PWV. Fasting glucose was associated with CR-PWV but was not related to CA-PWV or AIx. Conclusions: Our findings suggest that patients with type 2 diabetes have increased central and peripheral Artery stiffness, but preserved AIx compared to controls. Diabetes was a predictor of central Artery stiffness, and glucose was a determinant of peripheral Artery stiffness. © 2011 Wiley Periodicals, Inc. This work was supported by a grant from the National Nature Science Foundation of China (30872713), Beijing Natural Science Foundation (7082083), and is a key project of the Capital Development Foundation (2009–2038) of Dr. Ping Ye. The authors have no other funding, financial relationships, or conflicts of interest to disclose. Dr. Zhang and Dr. Bai contributed equally to this work.
Brigitte Laloux - One of the best experts on this subject based on the ideXlab platform.
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Local pulse pressure is a major determinant of large Artery remodelling.
Clinical and Experimental Pharmacology and Physiology, 2001Co-Authors: Stéphane Laurent, Anne-isabelle Tropeano, Agnès Lillo-lelouet, Guillaume Jondeau, Brigitte Laloux, Pierre BoutouyrieAbstract:SUMMARY 1. The aim of the present brief review is to show that the pulsatile component of blood pressure is a stronger determinant of large Artery remodelling than the steady component (i.e. mean blood pressure). 2. Pulse pressure, which is a strong determinant of cardiovascular events, including coronary heart disease and stroke, is increased when large arteries stiffen. Local pulse pressure, measured with applanation tonometry in normotensives and patients with essential hypertension, explains a significant part of the variance of intima–media thickness at the site of the carotied Artery, a proximal elastic Artery, whereas mean blood pressure does not contribute. Local pulse pressure has no influence on intima–media thickness at the site of the radial Artery, a distal Muscular Artery that undergoes very little stroke change in diamter. 3. The decrease in carotid pulse pressure is also a major determinant of the regression of catorid intima–media thickness after antihypertensive treatment. Local pulse pressure can influence not only intima–media thickness, but also internal diameter. Indeed, there is a significant association between the lumen enlargement of the ascending aorta in patients with Marfan syndrome and pulse pressure. In addition, carotid pulse pressure is positively correlated with carotid internal diameter in normotensives and hypertensives, and the decrease in carotid internal diameter during long-term antihypertensive treatment is influenced by the decrease in carotid pulse pressure and not by the reduction in mean blood pressure. 4. We suggest that the effects of pulse pressure on large Artery remodelling may explain part of its predictive value on cardiovascular events.
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local pulse pressure and regression of arterial wall hypertrophy during long term antihypertensive treatment
Circulation, 2000Co-Authors: Pierre Boutouyrie, Caroline Bussy, Brigitte Laloux, Daniel Hayoz, Hans R. Brunner, Jurg Hengstler, Nathalie Dartois, Stéphane LaurentAbstract:Background—Local pulse pressure (PP) is an independent determinant of carotid Artery wall thickness, stronger than mean blood pressure (BP). The present study was designed to assess whether a β-adrenoceptor antagonist–based or an ACE inhibitor–based treatment was able to reduce carotid Artery wall hypertrophy through a reduction in carotid PP rather than by lowering mean BP and whether the influence of local PP reduction could also be detected at the site of a Muscular Artery, the radial Artery. Methods and Results—Ninety-eight essential hypertensive patients were randomized to 9 months of double-blind treatment with either celiprolol or enalapril. Arterial parameters were determined with high-resolution echo-tracking systems. PP was measured locally with applanation tonometry and independently of mean BP. After 9 months of treatment, mean BP, carotid PP, and intimal-medial thickness (IMT) decreased significantly, with no difference between the 2 groups. The reduction in carotid PP but not in mean BP was ...
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association between local pulse pressure mean blood pressure and large Artery remodeling
Circulation, 1999Co-Authors: Pierre Boutouyrie, Caroline Bussy, Xavier Girerd, Patrick Lacolley, Brigitte Laloux, Stéphane LaurentAbstract:Background—The aim of the present study was to determine the respective influences of local pulse pressure and mean blood pressure on arterial remodeling in humans at 2 arterial sites: a central, predominantly elastic Artery (the common carotid Artery) and a peripheral Muscular Artery (the radial Artery). Methods and Results—Forty-three healthy subjects and 124 never-treated hypertensive patients were included in the study. Intima-media thickness and internal diameter of the carotid and radial arteries were noninvasively determined with high-definition echo-tracking devices. Pulse pressure was measured locally with applanation tonometry. Multivariate regression models including mean blood pressure and local pulse pressure were established in the whole population. Carotid internal diameter and intima-media thickness were strongly influenced (P<0.0001) by carotid pulse pressure but not by mean blood pressure or brachial pulse pressure, independently of age and sex. Radial Artery internal diameter was correl...
