Endothelium function dependence of acute changes in pulse wave velocity and flow-mediated slowing

Abstract

Flow-mediated slowing (FMS), defined as the minimum pulse wave velocity (PWVmin) during reactive hyperemia, is potentially a simple, user-objective test for examining endothelial function. The purpose of the current study was to determine the effects of a known endothelial dysfunction protocol on arm PWV and PWVmin. Complete data were successfully collected in 22 out of 23 healthy adults (23.8 years [SD 4.1], 16 F, 22.8 kg/m2 [SD 2.8]). Local endothelial dysfunction was induced by increasing retrograde shear stress in the upper arm, through inflation of a distal (forearm) tourniquet to 75 mmHg, for 30 min. Pre- and post-endothelial dysfunction, PWV was measured followed by simultaneous assessment of PWVmin and flow-mediated dilation (FMD). PWV was measured between the upper arm and wrist using an oscillometric device, and brachial FMD using ultrasound. FMD (%) and PWVmin (m/s) were calculated as the maximum increase in diameter and minimum PWV during reactive hyperemia, respectively. Endothelial dysfunction resulted in a large effect size (ES) decrease in FMD (∆ = −3.10%; 95% CI: –4.15, –2.05; ES = −1.3), and a moderate increase in PWV (∆ = 0.38 m/s; 95% CI: 0.07, 0.69; ES = 0.5) and PWVmin (∆ = 0.16 m/s; 95% CI: 0.05, 0.28; ES = 0.6). There was a large intra-individual (pre- vs post-endothelial dysfunction) association between FMD and PWVmin ( r = −0.61; 95% CI: –0.82, –0.24). In conclusion, acute change in PWV and PWVmin are at least partially driven by changes in endothelial function.

A Primer on Repeated Sitting Exposure and the Cardiovascular System: Considerations for Study Design, Analysis, Interpretation, and Translation

“…This decreased stroke volume in turn reduces shear stress (17,18), the primary regulator of endothelial function (19). Decreased shear stress promotes oxidative stress, endothelial dysfunction, and acutely increases aortic arterial stiffness (20)(21)(22)(23)(24). As mentioned above, the increased aortic stiffness may exacerbate myocardial burden as a function of the increased speed and amplitude of retrograde pressure waves.…”

“…Arterial stiffness is dependent on the functional and structural characteristics of a vessel (15,22,23). Functionally, acute changes in endothelial function influence arterial stiffness (22,23).…”

Sex differences in the association between PTSD symptoms with cardiac autonomic function and subclinical atherosclerotic risk

“…As such, changes in carotid‐radial PWV measured during reactive hyperaemia following 5 min of regional circulatory arrest/ischaemia (i.e. flow‐mediated slowing) has been suggested as a measure of vasomotor function that is partially driven by changes in endothelial function (Pereira et al., 2018; Stoner et al., 2020). As such, our findings suggest that increasing PTSD symptom severity is associated with peripheral vasomotor dysfunction in women.…”

“…Moreover, we relied on a single resting measure of carotid‐radial PWV (derived from ~10 pairs of carotid‐radial waveforms) and a single postischaemia measure obtained ~ 60 s postcuff release (similarly derived from ~10 pairs of carotid‐radial waveforms) to calculate FMS. Continuous measurement that considers the peak change in PWV, akin to ultrasound methodology that considers peak flow‐mediated dilation, may improve the accuracy and reproducibility of this measure (Stoner et al., 2020). We did not have a clinician perform follow‐up interviews to confirm a diagnosis of PTSD nor did we document the primary traumatic exposure.…”

“…Additionally, carotid‐radial PWV was measured at rest and again approximately 60 s postregional circulatory arrest via cuff inflation around the forearm to a suprasystolic pressure for 5 min (Cauwenberghs et al., 2018). Flow‐mediated slowing (FMS) of carotid‐radial PWV postcuff release was used as a measure of peripheral vasomotor function that is partially mediated by endothelial‐dependent vasodilation (Ellins et al., 2016; Nicholas et al., 2018; Pereira, Almeida, & Conde, 2018; Stoner et al., 2020). Ankle brachial index (ABI) was determined to rule out presence of peripheral artery disease (ABI 0.9‐1.4, normal; ABI < 0.9, peripheral artery disease).…”