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Vascular-ventricular coupling is a major determinant of left ventricular load. The aim of our study was to assess non- invasively left ventricular load and its dependency on central hemodynamics. Sixty-five healthy and gender-matched individuals were divided in two groups according to their age: 20y/o and 50y/o. Applanation tonometry was performed using the Sphygmocor device. Central pressures and pulse wave analysis indices were computed. Central systolic (120±3 vs. 98±2 mm Hg) and pulse pressures (43±3 vs. 29±1 mm Hg) as well as the augmentation index (AIx75) (23±3 vs. 6±2%) were significantly higher in the 50y/o group (p<0.01). These parameters are relevant markers of arterial stiffness and evidenced the development of central arterial morphological and functional alterations in the older subjects. The time-tension index (TTI) computed from the systolic pressure area was significantly higher in the 50y/o subjects as compared to the 20y/o group (2378±66 vs. 1954±73 mmHg×s, p<0.01). Moreover, we have shown the presence of significant correlation between TTI and AIx75 (p<0.01) in both age groups. This finding confirmed the contribution of arterial stiffness for the impaired vascular-ventricular coupling. In conclusion, applanation tonometry might be utilized for non-invasive evaluation of the left ventricular load, which is an important parameter of cardiovascular risk.


Introduction. Cardiovascular events represent an important cause of morbidity and mortality in the entire population. Arterial stiffness is currently considered one of the most important risk factors for the development of cardiovascular events. The gold-standard for evaluating arterial stiffness is pulse wave velocity (PWV). Recent studies have demonstrated that PWV is an independent risk factor regarding the development of cardiovascular events, especially in certain categories of patients.

Material and Methods. The development of cardiovascular events was assessed in 174 patients admitted in the Center of Internal Medicine, Fundeni Clinical Institute, between January 2011 – May 2012. Arterial stiffness was evaluated by measuring PWV using the Sphygmocor system (AtCor, Australia), which is based on the principle of applanation tonometry. The patients were monitored for the development of cardiovascular events (ischemic heart disease, heart failure, stroke, acute myocardial infarction) and for death of cardiovascular cause, over a median period of 51.5 months (43-60 months).

Results. Of the 174 patients, 81 (46.6%) were women and 93 (53.4%) were men. Mean age was 55.96 years. 93 of the 174 patients had chronic kidney failure in different stages (47.3% in stage V). Regarding PWV in the patient group, we obtained a mean score of 9.382. We observed a significant difference regarding the PWV level only for acute myocardial infarction and death between patients who developed these events and those who did not.

Conclusions. Our study demonstrates that PWV increase can be positively associated with the occurrence of cardiovascular events, particularly in certain groups of patients

blood pressure measurement and pulse wave analysis - their role in enhancing cardiovascular assessment," Physiological Measurement, 31, R1-R47, 2010. [9] Millasseau S.C., Patel S.J., Redwood S.R., Ritter J.M., Chowienczyk P.J., "Pressure wave reflection assessed from the peripheral pulse: is a transfer function necessary," Hypertension, 41, pp. 1016-1020, 2003. [10] da Fonseca L.J.S., Mota-Gomes M.A., Rabelo L.A., "Radial applanation tonometry as an adjuvant tool in the noninvasive arterial sti_ness and blood pressure assessment," World Journal of Cardiovascular

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stiffness, Task Force III: recommendations for user procedures. Am J Hypertens 2002; 15(5): 445-452. O'Rourke MF, Hashimoto J. Mechanical Factors in Arterial Aging A clinical perspective. J Am Coll Cardiol 2007; 50: 1-13. Hashimoto J, Ito S. Some mechanical aspects of arterial aging: physiological overview based on pulse wave analysis. Ther Adv Cardiovasc Dis 2009; 3: 367-378. Durier S, Fassot C, Laurent S, Boutouyrie P, Couetil JP, Fine E, Lacolley P, Dzau VJ, Pratt RE. Physiological genomics of human arteries: quantitative relationship between gene expression and

References 1. Lee J, Jeon YJ, Lee HJ, Kim JY. Variations in noninvasive radial artery pulse waveform at different measuring positions. Conf Proc IEEE Eng Med Biol Soc. 2008; 2008:1415-8. 2. Duprez DA, Kaiser DR, Whitwam W, Finkelstein S, Belalcazar A, Patterson R, et al. Determinants of radial artery pulse wave analysis in asymptomatic individuals. Am J Hypertens. 2004; 17:647-53. 10.1016/j.amjhyper.2004.03.671 3. Kotecha D, New G, Collins P, Eccleston D, Krum H, Pepper J, et al. Radial artery pulse wave analysis for non-invasive assessment of coronary artery

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validity of central aortic pulse wave analysis. J Hypertens, 2009; 27:1617-1623. Gunther CM, Bórger A, Rickert M, Crispin A, Schulz CU. Grip strength in healthy Caucasian adults: Reference values. J Hand Surg, 2008; 33A:558-565. Hager-Ross C, Rosblad B. Norms for grip strength in children aged 4-16 years. Acta Paediatr, 2002; 91:617-625. Holm I, Fredriksen PM, Fosdahl M, Vollestad N. A normative sample of isotonic and isokinetic muscle strength measurements in children 7 to 12 years of age. Acta Paediatr, 2008; 97:602-607. Hopkins G, Schabort E, Hawley J. Reliability of

, 2 , 3 ] Nevertheless, it has been shown that in ARDS, 30% of them do have a component of hydrostatic lung edema that is shown by an increase of the wedge pressure measured by pulmonary artery catheter above 15 mmHg. [ 4 ] Besides this, the differential diagnosis between ARDS and hydrostatic lung edema remains in some cases very challenging. The transpulmonary thermodilution (TPTD) known as pulse contour cardiac output (PICCO) system or the calibrated pulse wave analysis method (VolumeView™/EV1000™, Edwards Lifesciences, Irvine, CA, USA) is now widely used in