Cerebrovascular disease is one of the three major causes of death in Korea. Since these diseases are associated with atherosclerosis, the diagnosis of atherosclerotic factors should be presented. In this study, we evaluated the relationship between brachial-ankle arterial pulse wave velocity, cerebral artery vascular stenosis, blood pressure, obesity, and abdominal obesity by age group. The significance of cerebral artery stenosis and age group. The risk factors of atherosclerosis, such as blood pressure, obesity, and abdominal obesity, were significant in all age groups. When the pulse wave velocity of the brachial-ankle artery was increased, the cerebral artery stenosis was distributed in 57.3% of the total test subjects. If the arterial stiffness is suspected during the measurement of the pulse wave velocity of the brachial ankle artery, We recommend suspected vascular stenosis and perform a cerebral artery angiography. It is suggested that the data will be used as a baseline data for similar studies after evaluating the significance of blood pressure, obesity, and abdominal obesity as risk factors of atherosclerosis.
The Journal of the Society of Korean Medicine Diagnostics
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v.10
no.2
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pp.43-53
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2006
Background and Purpose : The Purpose of this study is to review the recent achievements on SDPTG and suggest SDPTG studies. Methods : The study papers related with SDPTC, published in foreign countries and Korea up to the present, were collected by internet search & journal. And then the collected papers were classified and summarized. Results and Conclusion : SDPTG provides informations of arterial elasticity and stiffness. thus, SDPTG could contribute to development of pulse wave diagnosis of oriental medicine.
The Journal of the Society of Korean Medicine Diagnostics
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v.11
no.1
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pp.48-60
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2007
Palpation of the pulse has been used in Korean traditional medicine since ancient times to assess physical health. Pulse wave contour may be obtained by measuring arterial pressure or blood volume change of skin. The latter is called as Photoplethysmography(PPG) or digital volume pulse(DVP). The PPG signal is measured by a device comprising an infrared light sourece and a photodetector. Although less widely used, this technique deserves further consideration because of its simplicity and ease of use. The contour of the PPG is formed as a result of a complex interaction between the left ventricle and the systemic circulation. It usually exhibits an early systolic peak and an early diastolic peak. the first peak is formed mainly by pressure trasmitted along a direct path from the left ventricle to the finger. The second peak is formed in part by pressure transmitted along the aorta and large arteries to sites of impedance mismatch in the lower body. The contour of the PPG is sensitive to changes in arterial tone and is influenced by ageing and large artery stiffness. Measurements taken directly from the PPG or from its second derivative can be used to assess these properties. In some mathematical approaches, the extraction of periodic components using frequency analysis was tried to analysis of the PPG. But we don't understand yet what kind of factor in the cardiovascular system or human body is related with the respective specific Fourier components of PPG. This review describes the background to measurement principles, representative contour, contour analysis and frequency domain analysis of PPG, and current and future.
Soo-Jin Kim;Mei Hua Li;Chung Il Noh;Seong-Ho Kim;Chang-Ha Lee;Ja-Kyoung Yoon
Korean Circulation Journal
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v.53
no.6
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pp.406-417
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2023
Background and Objectives: Pathophysiological changes of right ventricle (RV) after repair of tetralogy of Fallot (TOF) are coupled with a highly compliant low-pressure pulmonary artery (PA) system. This study aimed to determine whether pulmonary vascular function was associated with RV parameters and exercise capacity, and its impact on RV remodeling after pulmonary valve replacement. Methods: In a total of 48 patients over 18 years of age with repaired TOF, pulmonary arterial elastance (Ea), RV volume data, and RV-PA coupling ratio were calculated and analyzed in relation to exercise capacity. Results: Patients with a low Ea showed a more severe pulmonary regurgitation volume index, greater RV end-diastolic volume index, and greater effective RV stroke volume (p=0.039, p=0.013, and p=0.011, respectively). Patients with a high Ea had lower exercise capacity than those with a low Ea (peak oxygen consumption [peak VO2] rate: 25.8±7.7 vs. 34.3±5.5 mL/kg/min, respectively, p=0.003), while peak VO2 was inversely correlated with Ea and mean PA pressure (p=0.004 and p=0.004, respectively). In the univariate analysis, a higher preoperative RV end-diastolic volume index and RV end-systolic volume index, left ventricular end-systolic volume index, and higher RV-PA coupling ratio were risk factors for suboptimal outcomes. Preoperative RV volume and RV-PA coupling ratio reflecting the adaptive PA system response are important factors in optimal postoperative results. Conclusions: We found that PA vascular dysfunction, presenting as elevated Ea in TOF, may contribute to exercise intolerance. However, Ea was inversely correlated with pulmonary regurgitation (PR) severity, which may prevent PR, RV dilatation, and left ventricular dilatation in the absence of significant pulmonary stenosis.
In this paper, we correct pulse wave velocity(PWV) with heart-rate and derive regression equations to estimate intima-media thickness(IMT). Widely used methods for diagnosis of arteriosclerosis are IMT and PWV. Arterial wall stiffness determines the degree of energy absorbed by the elastic aorta and its recoil in diastole but there is not correlation between sclerosis and IMT in an existing study. In this study, we will correct PWV with heart-rate and get regression equation to estimate IMT using heart-rate correction index(HCI). We executed experiments for this study. Made up question of physical condition and measured electrocardiogram(ECG), photoplethysmogram (PPG) of finger-tip and toe-tip and ultrasound image of carotid artery. Calculated PWV and IMT using ECG, PPG and ultrasound image. We found that every p-value between PWV and IMT is not significant(<0.05). But p-value between IMT and HCI which is a corrected PWV using heart-rate is significant(>0.01). We use HCI and various measured parameter for estimating regression equation and apply backward estimation to select parameters for regression analysis. Result of backward estimation, found that only HCI is possible to derive proper regression equation of IMT. Relationship between PWV and IMT is the second order. Result of regression equation of E-H PWV is $R^2$=0.735, adj $R^2$=0.711. This is the best correlation value. We calculate error of its analysis for verification of earlobe PWV regression equation. Its result is RMSEP=0.0328, MAPE(%) = 4.7622. Like this regression analysis, we know that HCI is useful parameter and relationship between PWV, HCI and IMT. In addition, we are able to suggest possibility which is that we can get different parameter of prediction throughout just one measurement.
The Journal of the Society of Korean Medicine Diagnostics
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v.9
no.1
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pp.112-124
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2005
Background: PWV is determined by dividing the distance by the time taken for the pulses traveling between two measuring sites, used as a marker of arterial stiffness and an important indicator for cardiovascular disease. Methods: A PWV measurement system, which offers a non-invasive, simple method of measurement, and simultaneous recording of six signlas(ECG, PCG and four pulse waves from carotid, femoral, radial and dorsalis pedis arteries) was developed. Seventeen healthy subjects with a mean age of 33 years(22 to 52) without any cardiovascular disease were participated for the experiment. Two observers(A and B) performed two consecutive measurements from the same subject in a random order. For the evaluation of stability and accuracy of the PWV measurement system, reproducibility of PWV from between-observer were also evaluated. Results: PWV $values(Mean{\pm}SD)$ measured by A were $7.07{\pm}1.48m/s$, $8.43{\pm}1.14m/s$ , $8.09{\pm}0.98m/s$ for aorta, arm, and leg, respectively. The values obtained from B were $6.76{\pm}1.00m/s$, $7.97{\pm}0.80m/s$, and $7.97{\pm}0.72m/s$ for aorta, arm, and leg, respectively. Between-observer $differences(mean{\pm}SEM)$ from the aorta, arm and leg were $0.14{\pm}0.15m/s$, $0.18{\pm}0.10m/s$ and $0.07{\pm}0.10m/s$. Reproducibility coefficients(2SD) from the aorta, arm, and leg were 0.62m/s, 0.84m/s and 0.86m/s. Correlation coefficients were significantly higher in aortic PWV, 0.93, compared to the coefficients for arm and leg. Coefficient of variance which reflects the reproducibility of the system ranged from $4.4{\sim}5.8%$ in all regional PWV. , Conclusion: Reproducibility of PWV in the study shows that the developed system has reliable and reproducible characteristics. The PWV measurement system used for the study offers comfortable and simple operation and provides accurate analysis and results with high reproducibility. Results of the PWV measurement system could contribute to various clinical applications in the future.
Journal of the Korea Academia-Industrial cooperation Society
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v.20
no.2
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pp.673-680
/
2019
This study was conducted to investigate the effects of plasma homocysteine concentration on the brachial-ankle pulse wave velocity between the normal homocysteine group and the asymptomatic high homocysteine group. 435 subjects who visited the general health examination center from April 1 to October 31, 2016, as well as to compare the direct correlation of the brachial-ankle pulse wave velocity, which indirectly reflects the homocysteine test and arterial stiffness, as a predictor of future cardiovascular outcome. As a result of the study, age, waist circumference, BUN, and plasma creatinine were significantly higher, and HDL was significantly lower in the high homocysteine group (> $15{\mu}mol/L$) than in the normal homocysteine group (< $15{\mu}mol/L$) (p=0.05). In addition, homocysteinemia was associated with smoking and drinking (p<0.001) and was significantly higher in males (p<0.001). The right and left brachial-to-ankle pulse wave velocities were significantly higher in the high homocysteine group (right p<0.001, left p=0.003) before calibrating the relevant variables. There was no significant difference between right and left brachial-to-ankle pulse wave velocities after calibrating the relevant variables. Therefore, further studies on the independent association of lowering homocysteine concentration and prevention of cardiovascular disease and the relationship between homocysteine and renal function are needed.
Park, Seong Uk;Jung, Woo Sang;Moon, Sang Kwan;Go, Chang Nam;Cho, Ki Ho;Kim, Young Suk;Bae, Hyung Sup
The Journal of the Society of Stroke on Korean Medicine
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v.6
no.1
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pp.25-32
/
2005
Background and purpose: Arterial stiffness is an important, independent determinant of cardiovascular risk. Pulse wave velocity (PWV) has been used as a valuable index of arterial stiffness and as a surrogate marker for atherosclerosis. The Framingham risk score was developed using categorized risk factors to predict the 10 year absolute risk of developing coronary heart disease (CHD). This algorithm is established using recommended guidelines for blood pressure, total cholesterol, and high density lipoprotein cholesterol in addition to age, smoking history and history of diabetes. Tongxinluo(TXL) has been shown to have anti hyperlipidemic activity and anti atherogenic effects. To determine its efficacy and safety, we examined whether TXL improves PWV, ABI, Framingham score, blood pressure, and lipid profile in high risk group of cardiovascular diseases. Subjects and methods: 49 subjects with the high risk of cardiovascular diseases were recruited. Subjects were administered TXL with the dose of 1110mg three times a day for 8 weeks. baPWV, ABI, Framingham risk score, Blood pressure and serum lipid profile were assessed at baseline and after 4 and 8weeks. Results: Total cholesterol, LDL cholesterol, triglyceride, total lipid and phospolipid significantly decreased after 4 weeks of medication. Total cholesterol, total lipid and phospolipid significantly decreased after 8 weeks of medication. There were no significant changes in Framingham risk scores, ABI, PWV and blood pressure. On safety assessment, there were no adverse effects, hepatic or renal toxicity. Conclusion: We suggest that TXL is a safe and useful herbal medicine for hyperlipidemia and as for anti-atherognic effects, further research would be necessary.
This study aimed to investigate the effects and potential mechanisms of Chikusetsusaponin V (CsV) on endothelial nitric oxide synthase (eNOS) and vascular endothelial cell functions. Different concentrations of CsV were added to animal models, bovine aorta endothelial cells (BAECs) and human umbilical vein endothelial cells (HUVECs) cultured in vitro. qPCR, Western blotting (WB), and B ultrasound were performed to explore the effects of CsV on mouse endothelial cell functions, vascular stiffness and cellular eNOS mRNA, protein expression and NO release. Bioinformatics analysis, network pharmacology, molecular docking and protein mass spectrometry analysis were conducted to jointly predict the upstream transcription factors of eNOS. Furthermore, pulldown and ChIP and dual luciferase assays were employed for subsequent verification. At the presence or absence of CsV stimulation, either overexpression or knockdown of purine rich element binding protein A (PURA) was conducted, and PCR assay was employed to detect PURA and eNOS mRNA expressions, Western blot was used to detect PURA and eNOS protein expressions, cell NO release and serum NO levels. Tube formation experiment was conducted to detect the tube forming capability of HUVECs cells. The animal vasodilation function test detected the vasodilation functions. Ultrasonic detection was performed to determine the mouse aortic arch pulse wave velocity to identify aortic stiffness. CsV stimulus on bovine aortic cells revealed that CsV could upregulate eNOS protein levels in vascular endothelial cells in a concentration and time dependent manner. The expression levels of eNOS mRNA and phosphorylation sites Ser1177, Ser633 and Thr495 increased significantly after CsV stimulation. Meanwhile, CsV could also enhance the tube forming capability of HUVECs cells. Following the mice were gavaged using CsV, the eNOS protein level of mouse aortic endothelial cells was upregulated in a concentration- and time-dependent manner, and serum NO release and vasodilation ability were simultaneously elevated whereas arterial stiffness was alleviated. The pulldown, ChIP and dual luciferase assays demonstrated that PURA could bind to the eNOS promoter and facilitate the transcription of eNOS. Under the conditions of presence or absence of CsV stimulation, overexpression or knockdown of PURA indicated that the effect of CsV on vascular endothelial function and eNOS was weakened following PURA gene silence, whereas overexpression of PURA gene could enhance the effect of CsV upregulating eNOS expression. CsV could promote NO release from endothelial cells by upregulating the expression of PURA/eNOS pathway, improve endothelial cell functions, enhance vasodilation capability, and alleviate vessel stiffness. The present study plays a role in offering a theoretical basis for the development and application of CsV in vascular function improvement, and it also provides a more comprehensive understanding of the pharmacodynamics of CsV.
Even though the blood pressure is one of the most widely used index for the healthcare monitoring of hypertensive and normotensive persons, there is no non-intrusive measurement method which is commercialized until now. Pulse Arrival Time (PAT) is known that it has close relation with the systolic blood pressure (SBP) and arterial stiffness. In this study, SBP estimation methods by non-intrusive measurement of PAT are suggested. For the unconstrained measurement of PAT, the first method used the electrically non contact electrocardiogram (ENC-ECG) technique and the reflective type of Photoplethysmography (PPG) sensor on the computer mouse. In the second method, ENC-ECG and the air pressure sensor in the seat cushion on a chair were measured. The third method used ECG electrodes and PPG sensors on the toilet seat cover. The validation and regression analysis of the relationship of PAT and SBP are summarized. These methods have considerable errors to be used for all people. But these can be applied for each subject after the parameter customization within acceptable error. So, it is feasible for suggested methods to be used for monitoring of SBP in daily life in non-intrusive way when there is personal identification system of each subject.
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