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Cardiovascular diseases are a growing epidemiological burden in today's society. A great deal of effort has been made to find solutions able to perform non-invasive monitoring and early diagnosis of such pathologies. The pulse wave velocity and certain waveform characteristics constitute some of the most important cardiovascular risk indicators. Optical sensors are an attractive instrumental solution in this kind of time assessment applications due to their truly non-contact operation capability and better resolution than commercial devices. This study consisted on the experimental validation and a clinical feasibility for a non-invasive and multi-parametric optical system for evaluation of the cardiovascular condition. Two prototypes, based on two different types of photodetectors (planar and avalanche photodiode) were tested in a small group of volunteers, and the main hemodynamic parameters were measured, such as pulse wave velocity and indexes of pulse waveform analysis: the Augmentation Index, Subendocardial Viability Ratio and Ejection Time Index. The probes under study proved to be able to measure the pulse pressure wave in a reliable manner at the carotid site, and demonstrated the consistency of the parameters determined using dedicated algorithms. This study represents a preliminary evaluation of an optical system devoted to the clinical evaluation environment. Further development to take this system to a higher level of clinical significance, by incorporating it in a multicenter study, is currently underway.

The pulse pressure waveform has, for long, been known as a fundamental biomedical signal and its analysis is recognized as a non-invasive, simple, and resourceful technique for the assessment of arterial vessels condition observed in several diseases. In the current paper, waveforms from non-invasive optical probe that measures carotid artery distension profiles are compared with the waveforms of the pulse pressure acquired by intra-arterial catheter invasive measurement in the ascending aorta. Measurements were performed in a study population of 16 patients who had undergone cardiac catheterization. The hemodynamic parameters: area under the curve (AUC), the area during systole (AS) and the area during diastole (AD), their ratio (AD/AS) and the ejection time index (ETI), from invasive and non-invasive measurements were compared. The results show that the pressure waveforms obtained by the two methods are similar, with 13% of mean value of the root mean square error (RMSE). Moreover, the correlation coefficient demonstrates the strong correlation. The comparison between the AUCs allows the assessment of the differences between the phases of the cardiac cycle. In the systolic period the waveforms are almost equal, evidencing greatest clinical relevance during this period. Slight differences are found in diastole, probably due to the structural arterial differences. The optical probe has lower variability than the invasive system (13% vs 16%). This study validates the capability of acquiring the arterial pulse waveform with a non-invasive method, using a non-contact optical probe at the carotid site with residual differences from the aortic invasive measurements.

Aquatic physical exercise programs have become progressively more popular among elderly people. Some of the major physical exercise program disadvantages on land are minimized due to the specific properties of the aquatic environment. The purpose of the present randomized controlled study is to verify the effects of different aquatic physical exercise programs on body composition, functional fitness and cognitive function in non-institutionalized elderly people. For this study, 102 elderly individuals were randomly allocated into four different groups: AerG (n = 25, 71.44 ± 4.84 years); IntG (n = 28, 72.64 ± 5.22 years); ComG (n = 29, 71.90 ± 5.67 years) and CG (n = 20, 73.60 ± 5.25 years). Individuals from the groups AerG, IntG and ComG participated in three different aquatic physical exercise programs for a period of 28 weeks. The CG participants kept to their usual routines. All participants were evaluated for body composition, functional fitness and cognitive function at two time moments, i.e., pre- (M1) and post-intervention (M2). Significant differences for body composition were found between M1 and M2 for FM (p < 0.001), LBM (p < 0.001) and WCir (p < 0.01) in the AerG, for BMI (p < 0.05), FM (p < 0.05), LBM (p < 0.001) and LCir-R (p < 0.05) in the IntG, and for WGT (p < 0.01), FM (p < 0.05), LBM (p < 0.01), LCir-R (p < 0.05) and LCir-L (p < 0.01) in the ComG groups. For functional fitness, differences were found between M1 and M2 for 2m-ST (p < 0.000), 30s-CS (p < 0.000), 30s-AC (p < 0.05), HG-T-R (p < 0.000) and HG-T-L (p < 0.000) in the AerG, for 2m-ST (p < 0.05), BS-R (p < 0.05), 30s-CS (p < 0.000), 30s-AC(p < 0.01), HG-T-R (p < 0.000) and HG-T-L (p < 0.000) in the IntG, and for 30s-CS (p < 0.000), HG-T-R (p < 0.000) and HG-T-L (p < 0.000) in the ComG groups. The present study evidenced the beneficial effects of physical exercise in an aquatic environment on body composition, functional fitness and cognitive function in non-institutionalized elderly adults. The ComG water-based exercise program showed more beneficial effects in the improvement of body composition and cognitive function variables, while the IntG and AerG programs were more effective in the improvement of functional fitness.

Scientific evidence has shown that physical exercise is an effective way of improving several cardiovascular disease markers. However, few studies have tested its effectiveness when performed in aquatic environments. The purpose of this study was to test the impact of different aquatic exercise programs on the intima-media thickness of carotid arteries (IMT) and hemodynamic and biochemical markers of cardiovascular diseases in community-dwelling older persons. A total of 102 participants were randomly allocated into four groups: an aerobic exercise group (AerG) (n = 25, 71.44 ± 4.84 years); an aerobic interval group (IntG) (n = 28, 72.64 ± 5.22 years); a combined group (ComG) (n = 29, 71.90 ± 5.67 years); and a control group (CG) (n = 20, 73.60 ± 5.25 years). The AerG, IntG, and ComG participants took part in three different aquatic exercise programs for 28 weeks. The CG participants maintained their usual routines. All participants were evaluated for IMT, blood pressure, lipid profile, and MCP-1 and MIP-1α chemokines, pre- and post-intervention. Significant differences were found in the AerG for diastolic diameter (DD), in the IntG for peak systolic velocity (PSV), and in the ComG for DD and end-diastolic velocity (EDV). Regarding blood pressure, significant differences were found in AerG for systolic blood pressure (SBP) and diastolic blood pressure (DBP); in IntG for DBP; and in ComG for SBP, DBP, and heart rate (HR). Significant differences were found in the AerG and IntG for glucose (GLU). Lower plasma levels of monocyte chemoattractant protein-1 (MCP-1) and macrophage inflammatory protein (MIP-1α) were found in the AerG and in the ComG for MCP-1 after the intervention. Aquatic physical exercise appears to improve cardiovascular health, regardless of the type of the program adopted. Aerobic programs (combined and continuous aerobic exercises) seemed to have a more beneficial effect in reducing important cardiovascular risk markers.

Cardiometabolic diseases are one of the primary causes of mortality and morbidity worldwide and sedentary lifestyles are contributing factors to these pathologies. Physical exercise has been recognized as an important tool in the prevention and treatment of these diseases. However, there are still some doubts about the efficacy of certain type of physical exercise programs for older participants. The main goal of this study is to assess the impact of different aquatic-based physical exercise programs on risk markers of cardiometabolic diseases in older people. The study group will consist of non-institutionalized individuals, within the age group of 65 or older. The sample will be randomly divided into four groups, three experimental groups (EG) and one control group (CG). Participants from the EGs will be exposed to three physical aquatic-based exercise programs for a period of 28 weeks (continuous aerobic, interval aerobic and combined). The evaluated parameters include anthropometry, physical functions, mental health, cognitive function, carotid arteries intima-media thickness, heart rate variability and biochemical markers. The results will allow an interpretation of the impact of different aquatic-based physical exercise programs on cardiometabolic diseases markers and can also be used as a tool for professionals to prescribe adequate and more efficient physical exercise programs.

No abstract

Blood pressure indices can be considered as main risk factors of cardiovascular disease (CVD). This fact highlights the growing awareness that there are more vascular health parameters to assess rather than the maximum and minimum pressures, measured as brachial blood pressure with a sphygmomanometer in the traditional clinical assessment [1].Information about the interaction between the left ventricle ejection and the physical properties of the arterial circulation can be determined by the descriptive and quantitative analysis of the arterial pulse waveform (APW), providing indirect but global markers of arterial stiffness. It is that morphologic features of individual arterial pressure waveforms provide diagnostic clues to various pathologic conditions [2]. Emerging innovations in cardiovascular monitoring are moving away from more invasive technologies to portable and non-invasive solutions [3], particularly those able to perform multi-parameter assessment from the APW analysis. However, all of them establish direct contact with the patient's tissues at the artery site. The clinical application of a non-contact method can overcome practical and technical limitations inherent to the currently used methods, such as arterial applanation tonometry, ultrasound and plethysmography, that require physical contact of the probe with the patient, compress the artery and distort the shape of the pulse curve [4,5]. The non-contact nature of optical technology allows a measurement without distortions in the shape of the arterial pulse.The optical probe used in this work is enclosed in a plastic box that ensures a non-contact signal acquisition, by keeping a small distance between the sensors and skin, 3 mm. This optical system proved to be reliable in detecting the arterial distension waveform. A comparative test between the distension waveform measuring with optical probe at the carotid artery and the invasive profile of the pulse pressure acquired by an intra-arterial catheter showed a strong correlation between the waves, and validates the capability to estimate the APW with a noninvasive way by the contactless optical probe [6]. For these reasons the concept of pulse pressure waveform and distension waveform is used based on their correspondence.In this work, the study protocol was approved by the ethical committee of the Centro Hospitalar e Universitário de Coimbra, Portugal. The patient volunteered and gave a written informed consent. The tests were performed in a patient who had undergone a carotid angiography, and the assessment trials were made before and after the endovascular angioplasty proceeding. The subject under study is a 76-year-old woman with a diagnosis of 90% left internal carotid artery stenosis.Measurements were performed after a rest period (15 min) in a temperature-controlled environment (21°C). Each exam procedure consisted in the acquisition of a set of cardiac cycles at the carotid artery with the optical probe and the patient laid in supine position for 2 min. The carotid artery is the natural p...