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Cardiovascular Diabetology Mar 2019Exercise, when performed on a regular basis, is a well-accepted strategy to improve vascular function in patients with type 2 diabetes. However, the exercise intensity... (Comparative Study)
Comparative Study Randomized Controlled Trial
BACKGROUND
Exercise, when performed on a regular basis, is a well-accepted strategy to improve vascular function in patients with type 2 diabetes. However, the exercise intensity that yields maximal adaptations on structural and functional indices in patients with type 2 diabetes remains uncertain. Our objective was to analyze the impact of a 1-year randomized controlled trial of combined high-intensity interval training (HIIT) with resistance training (RT) vs. a combined moderate continuous training (MCT) with RT on structural and functional arterial indices in patients with type 2 diabetes.
METHODS
Patients with type 2 diabetes (n = 80) were randomized into an exercise intervention with three groups: control, combined HIIT with RT and combined MCT with RT. The 1-year intervention had 3 weekly exercise sessions. High-resolution ultrasonography of the common carotid artery and central and peripheral applanation tonometry were used to assess the changes in structural and functional arterial indices. Generalized estimating equations were used to model the corresponding outcomes.
RESULTS
After adjusting the models for sex, baseline moderate-to-vigorous physical activity, and mean arterial pressure changes, while using the intention-to-treat analysis, a significant interaction was observed on the carotid intima-media thickness (cIMT) for both the MCT (β = - 4.25, p < 0.01) and HIIT group (β = - 3.61, p < 0.01). However, only the HIIT observed favorable changes from baseline to 1-year on peripheral arterial stiffness indices such as carotid radial arterial pulse wave velocity (β = - 0.10, p = 0.044), carotid to distal posterior tibial artery pulse wave velocity (β = - 0.14, p < 0.01), and on the distensibility coefficient (β = - 0.00, p < 0.01). No effect was found for hemodynamic variables after the intervention.
CONCLUSIONS
Following a 1-year intervention in patients with type 2 diabetes, both the MCT and HIIT group reduced their cIMT, whereas only the HIIT group improved their peripheral arterial stiffness indices and distensibility coefficient. Taken together, HIIT may be a meaningful tool to improve long-term vascular complications in type 2 diabetes. Trial registration clinicaltrials.gov ID: NCT03144505.
Topics: Antihypertensive Agents; Arterial Pressure; Brachial Artery; Carotid Arteries; Carotid Intima-Media Thickness; Diabetes Mellitus, Type 2; Diabetic Angiopathies; Hemodynamics; High-Intensity Interval Training; Humans; Hypoglycemic Agents; Manometry; Portugal; Pulse Wave Analysis; Resistance Training; Time Factors; Treatment Outcome; Vascular Stiffness
PubMed: 30885194
DOI: 10.1186/s12933-019-0840-2 -
Annals of Vascular Surgery Apr 2022Endovascular access is usually achieved through the common femoral artery due to its large size and accessibility. Access through the upper extremity can however be...
BACKGROUND
Endovascular access is usually achieved through the common femoral artery due to its large size and accessibility. Access through the upper extremity can however be necessary due to anatomic reasons, obesity, or peripheral arterial disease. The 2 main methods of access are surgical cutdown and percutaneous puncture. In this single-centre retrospective cohort study we compared complication risks for both surgical cutdown and percutaneous puncture of an upper arm approach.
MATERIALS AND METHODS
Data was obtained from patients receiving endovascular access through the brachial or axillary artery between 2005 and 2018. A total of 109 patients were included. Patient demographics including age, sex, medical history, smoking status, and actual medication were registered, as well as postoperative complications including hematoma, thrombosis, dissection, infection, pseudoaneurysm, nerve injury, reoperation, and readmission.
RESULTS
Access was achieved through surgical cutdown in 53% (n = 58) and through percutaneous puncture in 47% (n = 51) of patients. Fifty-eight percent (n = 63) received access via the brachial artery (BA) and 42% (n = 46) via the axillary artery. Complication rate was 25.0% (3 of 12) for surgical cutdown via the BA, 29.4% (15 of 51) for percutaneous puncture via the BA, and 10.9% (5 of 46) for surgical cutdown via the axillary artery. Major complication rate was 8.3% (1 of 12) for surgical cutdown via the BA, 13.7% (7 of 51) for percutaneous puncture via the BA, and 4.3% (2 of 46) for surgical cutdown via the axillary artery. There was no association between baseline patient characteristics and complication rate.
CONCLUSIONS
In this nonrandomized retrospective study, surgical cutdown via the axillary artery was the safest option with fewest complications, but selection of patients may have blurred the results. Surgical cutdown and percutaneous puncture seem equally safe in terms of complication rate in the BA.
Topics: Axillary Artery; Brachial Artery; Catheterization, Peripheral; Endovascular Procedures; Femoral Artery; Humans; Retrospective Studies; Treatment Outcome
PubMed: 34775017
DOI: 10.1016/j.avsg.2021.09.052 -
American Journal of Physiology.... Dec 2021This study sought to compare the brachial and carotid hemodynamic response to hot water immersion (HWI) between healthy young men and women. Ten women (W) and 11 men (M)... (Comparative Study)
Comparative Study
This study sought to compare the brachial and carotid hemodynamic response to hot water immersion (HWI) between healthy young men and women. Ten women (W) and 11 men (M) (24 ± 4 yr) completed a 60-min HWI session immersed to the level of the sternum in 40°C water. Brachial and carotid artery hemodynamics (Doppler ultrasound) were measured at baseline (seated rest) and every 15 min throughout HWI. Within the brachial artery, total shear rate was elevated to a greater extent in women [+479 (+364, +594) s] than in men [+292 (+222, +361) s] during HWI ( = 0.005). As shear rate is inversely proportional to blood vessel diameter and directly proportional to blood flow velocity, the sex difference in brachial shear response to HWI was the result of a smaller brachial diameter among women at baseline ( < 0.0001) and throughout HWI (main effect of sex, < 0.0001) and a greater increase in brachial velocity seen in women [+48 (+36, +61) cm/s] compared with men [+35 (+27, +43) cm/s] with HWI ( = 0.047) which allowed for a similar increase in brachial blood flow between sexes [M: +369 (+287, +451) mL/min, W: +364 (+243, +486) mL/min, = 0.943]. In contrast, no differences were seen between sexes in carotid total shear rate, flow, velocity, or diameter at baseline or throughout HWI. These data indicate the presence of an artery-specific sex difference in the hemodynamic response to a single bout of HWI.
Topics: Adult; Blood Flow Velocity; Brachial Artery; Carotid Artery, Common; Female; Hemodynamics; Hot Temperature; Humans; Hyperthermia, Induced; Immersion; Male; Regional Blood Flow; Sex Factors; Time Factors; Ultrasonography, Doppler; Young Adult
PubMed: 34643115
DOI: 10.1152/ajpregu.00110.2021 -
European Journal of Vascular and... Jan 2021
Topics: Aged; Arm Injuries; Brachial Artery; COVID-19; Humans; Male; Quarantine; SARS-CoV-2; Suicide, Attempted; Tomography, X-Ray Computed; Treatment Outcome; Wounds, Gunshot
PubMed: 32900584
DOI: 10.1016/j.ejvs.2020.08.017 -
European Journal of Applied Physiology Jul 2021Measures of arterial stiffness (AS) and central blood pressure (BP) are indicators for cardiovascular health and possess a high prognostic value in the prediction of...
PURPOSE
Measures of arterial stiffness (AS) and central blood pressure (BP) are indicators for cardiovascular health and possess a high prognostic value in the prediction of cardiovascular events. The effects of physical training are widely unexplored in the context of competitive, high-performance sports. Therefore, we aimed to present possible reference values of brachial and central BP and of AS of adult elite athletes compared to a control group.
METHODS
A total of 189 subjects participated in this cross-sectional study. Of these were 139 adult elite athletes (70 male, 69 female) performing on top-national and international level, and 50 control subjects (26 male, 24 female). Resting brachial and central BP and aortic pulse wave velocity (PWV) were measured and were compared in terms of sex, sport category, and age of the athletes.
RESULTS
Results show no difference between athletes and controls in any parameter. Women exhibit lower brachial and central BP and AS values compared to men. PWV is positively correlated with age. Evaluation of the parameters according to the different sport categories showed that endurance athletes exhibit lower BP and PWV compared to other athletes.
CONCLUSIONS
This study presents brachial and central BP and PWV values of athletes, suggesting that high-performance sport does not negatively impact AS. The proposed reference values might support a more detailed evaluation of elite athlete's cardiovascular and hemodynamic system and a better assignment to possible risk groups.
Topics: Adolescent; Adult; Athletes; Blood Pressure; Brachial Artery; Cross-Sectional Studies; Female; Humans; Male; Physical Conditioning, Human; Risk Factors; Vascular Stiffness
PubMed: 33713201
DOI: 10.1007/s00421-021-04662-z -
Journal of Vascular Surgery Nov 2015
Topics: Arteriovenous Shunt, Surgical; Blood Vessel Prosthesis Implantation; Brachial Artery; Female; Forearm; Humans; Male; Renal Dialysis; Veins
PubMed: 26254824
DOI: 10.1016/j.jvs.2015.06.193 -
Journal of Vascular Surgery Jun 2015
Topics: Arteriovenous Shunt, Surgical; Blood Vessel Prosthesis Implantation; Brachial Artery; Female; Humans; Male; Renal Dialysis; Ultrasonography, Doppler, Duplex; Upper Extremity
PubMed: 26004329
DOI: 10.1016/j.jvs.2015.01.063 -
Advances in Clinical and Experimental... Mar 2022Blood flow-mediated dilation (FMD) is a noninvasive assessment of vascular endothelial function in humans. The study of the FMD in hypertensive (HT) patients is an...
BACKGROUND
Blood flow-mediated dilation (FMD) is a noninvasive assessment of vascular endothelial function in humans. The study of the FMD in hypertensive (HT) patients is an important factor supporting the recognition of the early mechanisms of cardiovascular pathologies, and also of the pathogenesis related to hypertension.
OBJECTIVES
To investigate whether FMD measured on the radial artery (FMD-RA) using high-frequency ultrasounds can be used as an alternative to FMD assessed with the lower frequency system on the brachial artery in patients with HT.
MATERIAL AND METHODS
The simultaneous measurements of FMD-RA and FMD measurements in the brachial artery (FMD-BA) were performed on 76 HT patients using 20 MHz and 7-12 MHz linear array probes, and were compared to the FMD measured in healthy groups. All quantitative data are presented as mean ± standard deviation (SD); the p-values of the normality and tests for variables comparisons are listed. The agreement of the FMD-RA and FMD-BA in HT patients was assessed with the Bland-Altman method, and using the intraclass correlation coefficient (ICC). In some statistical calculations, the FMD-RA values were rescaled by dividing them by a factor of 2.
RESULTS
The mean FMD-RA and FMD-BA in HT patients were 5.16 ±2.18% (95% confidence interval (95% CI): [4.50%, 5.82%]) and 2.13 ±1.12% (95% CI: [1.76%, 2.49%]), respectively. The FMD-RA and FMD-BA values of HT patients were significantly different than those in respective control groups. The p-values of Mann-Whitney-Wilcoxon tests were less than 0.05. The Bland-Altman coefficient for both measurement methods, FMD-RA and FMD-BA, was 3%, and the ICC was 0.69.
CONCLUSIONS
Our findings show that FMD-RA, supplementary to FMD-BA measurements, can be used to assess endothelial dysfunction in the group of HT patients. In addition, the FMD-RA measurements met the criteria of high concordance with the FMD-BA measurements.
Topics: Brachial Artery; Dilatation; Endothelium, Vascular; Humans; Hypertension; Radial Artery; Regional Blood Flow; Ultrasonography; Vasodilation
PubMed: 35040291
DOI: 10.17219/acem/144040 -
European Heart Journal Jul 2014Pressure measured with a cuff and sphygmomanometer in the brachial artery is accepted as an important predictor of future cardiovascular risk. However, systolic pressure... (Review)
Review
Pressure measured with a cuff and sphygmomanometer in the brachial artery is accepted as an important predictor of future cardiovascular risk. However, systolic pressure varies throughout the arterial tree, such that aortic (central) systolic pressure is actually lower than corresponding brachial values, although this difference is highly variable between individuals. Emerging evidence now suggests that central pressure is better related to future cardiovascular events than is brachial pressure. Moreover, anti-hypertensive drugs can exert differential effects on brachial and central pressure. Therefore, basing treatment decisions on central, rather than brachial pressure, is likely to have important implications for the future diagnosis and management of hypertension. Such a paradigm shift will, however, require further, direct evidence that selectively targeting central pressure, brings added benefit, over and above that already provided by brachial artery pressure.
Topics: Antihypertensive Agents; Aorta; Blood Pressure; Blood Pressure Determination; Brachial Artery; Cardiovascular Diseases; Humans; Hypertension; Risk Assessment; Sphygmomanometers
PubMed: 24459197
DOI: 10.1093/eurheartj/eht565 -
Bosnian Journal of Basic Medical... Mar 2016This article reviews in detail the superficial brachiomedian artery (arteria brachiomediana superficialis), a very rare variant of the main arterial trunks of the upper... (Review)
Review
This article reviews in detail the superficial brachiomedian artery (arteria brachiomediana superficialis), a very rare variant of the main arterial trunks of the upper limb. It branches either from the axillary artery or the brachial artery, descends superficially in the arm (similar to the course of the superficial brachial artery) and continues across the cubital fossa, runs superficially in the forearm, approaches the median nerve and enters the carpal canal to reach the hand. It usually terminates in the superficial palmar arch. The first drawing was published, in 1830, and the first description was published, in 1844. Altogether, to our knowledge, only 31 cases of a true, superficial brachiomedian artery have been reported (Some cases are incorrectly reported as superficial brachioradiomedian artery or superficial brachioulnomedian artery). Based on a meta-analysis of known, available studies, the incidence is 0.23% in Caucasians and 1.48% in Mongolians. Knowing whether or not this arterial variant is present is important in clinical medicine and relevant for: The catheterization via the radial or ulnar artery; harvesting the vascular pedicle for a forearm flap based on the radial, ulnar or superficial brachiomedian arteries; the possible collateral circulation in cases of the arterial closure; and the surgical management of carpal tunnel syndrome. Its presence can elevate the danger of an injury to the superficially located variant artery or of an accidental injection.
Topics: Axillary Artery; Brachial Artery; Humans
PubMed: 27131025
DOI: 10.17305/bjbms.2016.801