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Comparison of techniques for assessment of venous diameter in vivo
58A ASH XI ABSTRACTS
AJH-APRIL 1996-VOL. 9, NO.4, PART 2
113
114
FAMILY HISTORY OF HYPERTENSION AFFECTS VENOUS PRESSURE-VOLUME RELATIONSHIP.llli • •, MI Ching·, MF Wilson·, M Chawla, S Gudapati, MS Siddiqui, and IL Izzo, Ir· Millard Fillmore Health System and SUNY at Buffalo, Buffalo, NY. To elucidate a potential role for abnormal venous capacitance in the pathogenesis of essential hypertension, we examined venous capacitance in normotensives with (FH +) and without (FH-) a family history of hypertension in at least 1 parent. Venous pressure-volume relationships were determined in 13 FH and 11 FR-. Both groups were comparable in age, gender distribution, body mass index and resting blood pressures (119/72 mmHg for FHvs 123/n mmHg for FH +, p=ns). With subjects supine, right arm was placed on a flat surface at the level of the heart and one of the dorsal hand veins was selected. Venous diameter was measured by ultrasonography using a 7.S MHz linear transducer. Hydrostatic pressure was changed by raising the hand 4, 6, 8, 10 and 12 inches above the heart and by lowering the hand 4 and 8 inches below the heart. Decreases in venous diameters were significantly greater in FH than FH- (p=O.02) when the hand was elevated and venous distension was greater in FH than FH- (p=O.09) when the hand was lowered. Overall, there was a significant pressure-volume curve shift in FH + compared to FH- (p=O.OS). In conclusion, subjects with family history of hypertension showed more venous reactivity to pressure decreases and greater venous distention to pressure increases than FH-. This altered venous pressure-volume relationship predates the development of hypertension in a high risk group and may be&: W1y pathogenetic marker for hypertension. Key or 5: capacitance, veins, family history ofhypertension, hypertension.
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+
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COMPARISON OF TECHNIQUES FOR ASSESSMENT OF VENOUS DIAMETER IN VIVO. MI Chmg·, BH Sung,· MF Wilson,· S Gudapatl, MS Siddtqui, P Dandona, and JL Izzo, Jr.· MIllard Fillmore Hospital and State Uruversity of New York at Buffalo. Buffalo. NY We have estabhshed the value of venous ultrasonography (VUS) in the determmation of absolute venous diameters In vivo This techruque. however, has nOl been compared to existing methods that use the linear variable differential transformer (LVDT) to measure relative changes In venous diameter. Both methods were compared in 20 healthy normotensive volunteers (9 males, II females). With each subject supme, one arm was placed on a support inclined at 30· from horizontal. A pneumatic cuff was apphed 5 em above the elbow. Readings were taken during cuff inflation at 40 mm Hg. LVDT was mounted on the dorsum of the hand WIth tts central core over the vein under study The resultant voltage change was detenmned from displacement quantitated from a standardized stnp chart. Simultaneous venous diameter was measured directly In Mmode with an Atuson TM 128xp ultrasound macJune WIth 7 5 rnfu linear transducer With LVDT, the standard error of measurement of 10 step changes on a precision ealibrator was 1 2% of the mean Its values were found to be reliable within 0.02 mm as delernuned by I.SX baseline dnft during a 5 min recording on 20 subjects With VUS. maximal intra and interobserver variabiltty was 0.1 mm WIth an interobserver coefficient of variation of <5% Mean change 1ft venous diameter during cuff in1lation was 0.9±O.4 mm by VUS and 0.6±O.3 mm by LVDT (r=O.73, p
venous diameter, linear variable differential transformer, Key Words: ultrasonography
115
116
EFFECT OF BLOOD PRESSURE AND HEART RATE PROFILE ON VASCULAR COMPLIANCE OF LARGE AND SMALL ARTERIES. B Drieghe. ~' M De Buyzere. DL Clement·, S Finkelstein, C Chesney, and J Cohn·. University Hospital, Genl, Belgium and University of Minnesota. Minneapohs, MN, USA. We evaluated the influence of blood pressure (BP) and heart rate (HR) profile on vascular compliance of the large and small arteries and to study the influence of postural changes on arterial compliance. Twelve normotensive subjects (6 M, 6 F ; 138±SnS±2 mm Hg ; mean±s.e.m.) underwent 24 h BP and HR monitoring at 30 min intervals (SpaceLabs) during daily activities. In supine and standing positions we determined (proximal) capacitive (CI), (distal) oscillatory (C2) compliances and blood volume inertance (L) from noninvasive pulse wave forms recorded at the radial arlery and calculated from a modified winkessel model. (. p <0.05) Supine Standing CI(mVmmHg) I.7I±O.16 I.43±O.13· C2 (mllmm Hg) 0.OS4±0.OO6 0.04I±O.OO7 L (ml.mm Hg·l.s·2) O.II±O 02 0.06S±O.010· 77±4· HR (beats/min) 67±2 Mean systolic, diastolic BP (mm Hg) and HR (beats/min) resp. were (128±2, 76±2, 75±3) for 24 hr. (\34±2, 82±2, 81±3) for day-time and (I 22±3, 70±2, 70±2) for night-time. In supine position CI was significantly (p
DIFFERENT CARDIOVASCULAR PATTERNS DETERMINED BY THE INTERACTION BETWEEN CENTRAL·TYPE OBESITY AND ARTERIAL HYPERTENSION: AN ECHOCARDIOGRAPHIC STUDY. ~ S. Arnone, S Paterna, V Amato, A LIcata, G. AmiCO, R. Scagltone, G Ucata Inst,luleofInlemal Medicme, UmversltyofPalermo, "a/y The purpose of our study was to evaluate the effects on cardiovascular pattem of the interaction between obesity 01 central type and hypertension. We selected 32 obese subJects (16m/16w) but otherwise healthy subjects, aged 53 t 11 yrs and having I BMI and WHR indicating the presence of cenlral type obesity according to the "a/ian Consensus Conference guidelines. We selected 32 obeses affected by hypertension; each 01 them was matched to a normotensive obese subject for gender, Ige, 8MI, WHR, Ind family history of hypertension and obesity. Moreover, we selected other two groups 01 lean subjects, normotensive or hypertensive, n order to evaluate by a wider point 01 view, the effects 01 obesity and hypertension on cardiovascular parameters. All the subjects were stricUy matched for the above mentioned variables. All those subject~ with other associated diseases had been excluded /rom the study. A standard M-mode, two-dImensional and Doppler echoeardiographic examination was carried out on each subject. We considered the following parameters: diastolic ventricular septal thickness (IVS), diastolic posterior waD thickness (PWT), diastolic Ind systolic left ventricular (LV) internal diameters, LV mass, and LV mass normalised to height, LV ejection fracbon, peak E and A veloclbes 01 the Iransmitral flow, the AlE rabo, the Icceleration, and the deceleration, Ind the acceleration half time, and the decelerabon half time of the earty Iransmitlal flow, the sistemic vascular resistance index (SVRI) and the relative wall thickness (RWT). The discriminant analysis was performed to individuate the variables that characterize the lour studied groups. Discriminant analysis showed thaI SVRI, IVS, mean-RWT, PWT and AlE ratio were correlated to the first canonical function (correlation a 0.55; p< 0.001) explaining 62% of variance, and left strium dimension was correlated to the second canonical Junction (correlation. 0.43; p< 0.05) explaining 33% of variance. In conclusion our data individuate the meaningful variables influenced by obe~lty of central type and hypertension, able to explain the different eardlovascular patterns in the studied groups.
Key Words: ambulatory blood pressure, arterial compliance, large arteries, postural changes
Key Words: obesity, hyp..rtension, echocardiography, cardiovascular
pattern.
AJH-APRIL 1996-VOL. 9, NO.4, PART 2
113
114
FAMILY HISTORY OF HYPERTENSION AFFECTS VENOUS PRESSURE-VOLUME RELATIONSHIP.llli • •, MI Ching·, MF Wilson·, M Chawla, S Gudapati, MS Siddiqui, and IL Izzo, Ir· Millard Fillmore Health System and SUNY at Buffalo, Buffalo, NY. To elucidate a potential role for abnormal venous capacitance in the pathogenesis of essential hypertension, we examined venous capacitance in normotensives with (FH +) and without (FH-) a family history of hypertension in at least 1 parent. Venous pressure-volume relationships were determined in 13 FH and 11 FR-. Both groups were comparable in age, gender distribution, body mass index and resting blood pressures (119/72 mmHg for FHvs 123/n mmHg for FH +, p=ns). With subjects supine, right arm was placed on a flat surface at the level of the heart and one of the dorsal hand veins was selected. Venous diameter was measured by ultrasonography using a 7.S MHz linear transducer. Hydrostatic pressure was changed by raising the hand 4, 6, 8, 10 and 12 inches above the heart and by lowering the hand 4 and 8 inches below the heart. Decreases in venous diameters were significantly greater in FH than FH- (p=O.02) when the hand was elevated and venous distension was greater in FH than FH- (p=O.09) when the hand was lowered. Overall, there was a significant pressure-volume curve shift in FH + compared to FH- (p=O.OS). In conclusion, subjects with family history of hypertension showed more venous reactivity to pressure decreases and greater venous distention to pressure increases than FH-. This altered venous pressure-volume relationship predates the development of hypertension in a high risk group and may be&: W1y pathogenetic marker for hypertension. Key or 5: capacitance, veins, family history ofhypertension, hypertension.
+
+
+
COMPARISON OF TECHNIQUES FOR ASSESSMENT OF VENOUS DIAMETER IN VIVO. MI Chmg·, BH Sung,· MF Wilson,· S Gudapatl, MS Siddtqui, P Dandona, and JL Izzo, Jr.· MIllard Fillmore Hospital and State Uruversity of New York at Buffalo. Buffalo. NY We have estabhshed the value of venous ultrasonography (VUS) in the determmation of absolute venous diameters In vivo This techruque. however, has nOl been compared to existing methods that use the linear variable differential transformer (LVDT) to measure relative changes In venous diameter. Both methods were compared in 20 healthy normotensive volunteers (9 males, II females). With each subject supme, one arm was placed on a support inclined at 30· from horizontal. A pneumatic cuff was apphed 5 em above the elbow. Readings were taken during cuff inflation at 40 mm Hg. LVDT was mounted on the dorsum of the hand WIth tts central core over the vein under study The resultant voltage change was detenmned from displacement quantitated from a standardized stnp chart. Simultaneous venous diameter was measured directly In Mmode with an Atuson TM 128xp ultrasound macJune WIth 7 5 rnfu linear transducer With LVDT, the standard error of measurement of 10 step changes on a precision ealibrator was 1 2% of the mean Its values were found to be reliable within 0.02 mm as delernuned by I.SX baseline dnft during a 5 min recording on 20 subjects With VUS. maximal intra and interobserver variabiltty was 0.1 mm WIth an interobserver coefficient of variation of <5% Mean change 1ft venous diameter during cuff in1lation was 0.9±O.4 mm by VUS and 0.6±O.3 mm by LVDT (r=O.73, p
venous diameter, linear variable differential transformer, Key Words: ultrasonography
115
116
EFFECT OF BLOOD PRESSURE AND HEART RATE PROFILE ON VASCULAR COMPLIANCE OF LARGE AND SMALL ARTERIES. B Drieghe. ~' M De Buyzere. DL Clement·, S Finkelstein, C Chesney, and J Cohn·. University Hospital, Genl, Belgium and University of Minnesota. Minneapohs, MN, USA. We evaluated the influence of blood pressure (BP) and heart rate (HR) profile on vascular compliance of the large and small arteries and to study the influence of postural changes on arterial compliance. Twelve normotensive subjects (6 M, 6 F ; 138±SnS±2 mm Hg ; mean±s.e.m.) underwent 24 h BP and HR monitoring at 30 min intervals (SpaceLabs) during daily activities. In supine and standing positions we determined (proximal) capacitive (CI), (distal) oscillatory (C2) compliances and blood volume inertance (L) from noninvasive pulse wave forms recorded at the radial arlery and calculated from a modified winkessel model. (. p <0.05) Supine Standing CI(mVmmHg) I.7I±O.16 I.43±O.13· C2 (mllmm Hg) 0.OS4±0.OO6 0.04I±O.OO7 L (ml.mm Hg·l.s·2) O.II±O 02 0.06S±O.010· 77±4· HR (beats/min) 67±2 Mean systolic, diastolic BP (mm Hg) and HR (beats/min) resp. were (128±2, 76±2, 75±3) for 24 hr. (\34±2, 82±2, 81±3) for day-time and (I 22±3, 70±2, 70±2) for night-time. In supine position CI was significantly (p
DIFFERENT CARDIOVASCULAR PATTERNS DETERMINED BY THE INTERACTION BETWEEN CENTRAL·TYPE OBESITY AND ARTERIAL HYPERTENSION: AN ECHOCARDIOGRAPHIC STUDY. ~ S. Arnone, S Paterna, V Amato, A LIcata, G. AmiCO, R. Scagltone, G Ucata Inst,luleofInlemal Medicme, UmversltyofPalermo, "a/y The purpose of our study was to evaluate the effects on cardiovascular pattem of the interaction between obesity 01 central type and hypertension. We selected 32 obese subJects (16m/16w) but otherwise healthy subjects, aged 53 t 11 yrs and having I BMI and WHR indicating the presence of cenlral type obesity according to the "a/ian Consensus Conference guidelines. We selected 32 obeses affected by hypertension; each 01 them was matched to a normotensive obese subject for gender, Ige, 8MI, WHR, Ind family history of hypertension and obesity. Moreover, we selected other two groups 01 lean subjects, normotensive or hypertensive, n order to evaluate by a wider point 01 view, the effects 01 obesity and hypertension on cardiovascular parameters. All the subjects were stricUy matched for the above mentioned variables. All those subject~ with other associated diseases had been excluded /rom the study. A standard M-mode, two-dImensional and Doppler echoeardiographic examination was carried out on each subject. We considered the following parameters: diastolic ventricular septal thickness (IVS), diastolic posterior waD thickness (PWT), diastolic Ind systolic left ventricular (LV) internal diameters, LV mass, and LV mass normalised to height, LV ejection fracbon, peak E and A veloclbes 01 the Iransmitral flow, the AlE rabo, the Icceleration, and the deceleration, Ind the acceleration half time, and the decelerabon half time of the earty Iransmitlal flow, the sistemic vascular resistance index (SVRI) and the relative wall thickness (RWT). The discriminant analysis was performed to individuate the variables that characterize the lour studied groups. Discriminant analysis showed thaI SVRI, IVS, mean-RWT, PWT and AlE ratio were correlated to the first canonical function (correlation a 0.55; p< 0.001) explaining 62% of variance, and left strium dimension was correlated to the second canonical Junction (correlation. 0.43; p< 0.05) explaining 33% of variance. In conclusion our data individuate the meaningful variables influenced by obe~lty of central type and hypertension, able to explain the different eardlovascular patterns in the studied groups.
Key Words: ambulatory blood pressure, arterial compliance, large arteries, postural changes
Key Words: obesity, hyp..rtension, echocardiography, cardiovascular
pattern.