Arterial stiffness is an important cardiovascular risk marker, which can be measured noninvasively with different techniques. To validate such techniques in healthy subjects, we compared the recently introduced oscillometric Arteriograph (AG) technique with the tonometric SphygmoCor (SC) method and their associations with carotid ultrasound measures and traditional risk indicators. Sixty-three healthy subjects aged 20-69 (mean 48 ± 15) years were included. We measured aortic pulse wave velocity (PWVao) and augmentation index (AIx) by AG and SC, and with SC also the PWVao standardized to 80% of the direct distance between carotid and femoral sites (St-PWVaoSC). The carotid strain, stiffness index and intima-media thickness (cIMTmean) were evaluated by ultrasound. PWVaoAG (8.00 ± 2.16 m s(-1)) was higher (P<0.001) than PWVaoSC (6.87 ± 1.47 m s(-1)), but did not differ from St-PWVaoSC (7.68 ± 1.58 m s(-1)), and correlated (P<0.001) with both (r = 0.54 and 0.59). St-PWVaoSC was significantly (P < 0.01) higher than PWVaoAG for values below median (7.4 m s(-1)). PWVao by SC and AG differed significantly in females (P<0.001), but not in males (P=0.40). AIxaoAG (27.5 ± 14.5%) was higher (P < 0.001) than AIxaoSC (20.5 ± 17.4%), but related closely (r=0.97, P<0.001). St-PWVaoSC, PWVao and AIxao by SC, and PWVao and AIxao by AG were all related to serum cholesterol and to cIMTmean (P<0.001). Arterial stiffness indices by AG and SC correlate with vascular risk markers in healthy subjects. AIxao results by AG and SC are closely interrelated, but higher values are obtained by AG. In the lower range, PWVao values by AG and SC are similar, but differ for higher values. Our results imply the necessity to apply one and the same technique for repeated studies.

ObjectivePrimary hyperparathyroidism (PHPT) is associated with cardiovascular morbidity. The extent of cardiovascular abnormalities in patients with mild-asymptomatic disease is unclear. Using sensitive echocardiographic methods, we compared cardiac structure and function in patients with mild PHPT and in healthy controls, and evaluated the changes after parathyroidectomy (PTX).MethodsIn a prospective case–control design, we studied 51 PHPT patients without any cardiovascular risk factors/diseases and 51 healthy matched controls. Cardiac structure, and systolic and diastolic function were evaluated by echocardiography and Doppler tissue imaging (DTI). Blood pressure (BP) and heart rate were measured.ResultsWe observed no differences in systolic or diastolic function or in cardiac morphology between the PHPT patients and the age-matched healthy controls. The regional peak systolic myocardial velocities (S′) measured with DTI decreased at all sites (P<0.05) after PTX (tricuspid annulus 14.23±1.85 to 13.48±1.79, septal 8.48±0.96 to 7.97±0.85, and lateral 9.61±2.05 to 8.87±1.63 cm/s, part of the mitral annulus). At baseline, systolic BP was higher in patients compared to controls (127.6±17.1 vs 119.6±12.6 mmHg, P<0.05). After PTX, both systolic (127.6±17.1 vs 124.6±16.6 mmHg, P<0.05) and diastolic (80.3±9.6 vs 78.4±8.6 mmHg, P<0.05) BP decreased.ConclusionsOur results indicate that patients with PHPT without cardiovascular risk factors have a normal global systolic and diastolic function and cardiac morphology. BP and the systolic velocities were marginally reduced after PTX, but reflected the values of the control group. Our findings warrant further investigation of the clinical and prognostic significance of these possibly disease-related inotropic effects.

The TVE is more sensitive than conventional echocardiography in detecting alterations in diastolic function. Both irbesartan and atenolol improve diastolic function, but through different mechanisms. The improvement in IVRTm was greater with irbesartan, and only irbesartan improved E/Em. This may have implications on the treatment of high risk hypertensive patients.

Ž. Background: Doppler tissue imaging DTI is an echocardiographic technique by which regional contractility, relaxation properties and time intervals are obtained easily. DTI has been reported to be relatively pre-load independent and could, in Ž . comparison with the commonly used mitral pulse wave Doppler MPWD method, be of clinical interest for identification of Ž . patients with diastolic dysfunction. The atrio-ventricular plane displacement AVPD method is an established technique to assess left ventricular systolic function. Aims: To determine the pulsed Doppler DTI-pattern in patients with heart failure and to examine whether it has a similar capacity as MPWD and AVPD to diagnose diastolic dysfunction. Methods: We studied 15 Ž . Ž . controls without congestive heart failure CHF , 15 patients with diastolic EF ) 45% q CHF and 15 patients with systolic Ž . Ž . EF -35% q CHF left ventricular dysfunction and CHF. Results: The DTI maximal velocities during systole s , early filling Ž . Ž . wave e and atrial filling wave a , decrease with reduced left ventricular ejection fraction, r s 0.75, r s 0.56 and r s 0.66 Ž . P -0.001 and regional isovolumetric contraction and intraventricular relaxation time measured by DTI are prolonged, Ž . r s 0.59 and r s 0.73, respectively P-0.001 . The 15 patients with diastolic heart failure were identified by MPWD or DTI Ž . but only 11 by AVPD with 8, 10 and 9 false-positive, respectively P-0.01, P -0.05 and NS . Conclusions: Regional DTI show a consistent pattern in patients with left ventricular dysfunction and heart failure. Regional DTI has similar accuracy as MPWD in identifying diastolic heart failure patients and is superior to the AVPD technique. DTI may be a useful diagnostic tool in diastolic heart failure patients. ᮊ