Diese Arbeit ist die finanzielle Unterstützung von nationalen zentralen Forschung und Entwicklung Programm von China (Grant No. 2017YFC0111800) und der Shanghai Stadtregierung (Grant ID. 2013ZYJB0902 und 15GWZK1002). Dr. Yi Zhang wurde von der National Natur Science Foundation of China (Grant ID 81300239 und 81670377) unterstützt.

Dieses Protokoll wurde von der Ethik Komitee von Shanghai Zehntel Volks Krankenhaus genehmigt.
1. Rekrutierung der Teilnehmer
<ol><li>Sind Erwachsene mit einer moderaten Herzfrequenz (40 < HR < 160).</li>
	<li>Verwenden Sie die folgende Ausschlusskriterien.<ol>
<li>Schließen Sie aus, die ohne interne arteriovenösen Fistel für Dialyse oder jede andere periphere Arteriovenöse Fistel so.</li>
		<li>Schließen Sie aus, die ohne peripheren arteriellen Krampf, zum Beispiel die Raynaud-Krankheit.</li>
		<li>Schließen Sie aus, die ohne Herzklappenfehler Aortenstenose (Transprosthetic Druck gradient > 60 MmHg).</li>
		<li>Schließen Sie aus, die ohne AV (AV)-Block zweiten oder dritten Grades.</li>
		<li>Schließen Sie aus, die ohne Vorhofflimmern oder Vorhofflimmern flattern.</li>
		<li>Schließen Sie aus, die ohne instabile Karotis arteriosklerotische Plaques, die nach dem Kneten platzen können. (9) ohne kognitive Beeinträchtigung oder nicht in der Lage, zusammenzuarbeiten.</li>
	</ol>
</li>
	<li>Stellen Sie sicher, dass die Teilnehmer Blase leer ist.</li>
	<li>Haben Sie die Teilnehmer, die Rauchen, Tabak oder koffeingebrauch für mindestens 3 Stunden vor der Messung. Verzichten Sie auf Alkohol für mindestens 12 Stunden vor der Messung. Schnell für mindestens 3 Stunden vor der Messung.</li>
</ol>(2) Messungen der vaskulären TOD
Hinweis: Cf-PWV und PWA Messungen, wie konventionelle vier-Limb-Blutdruck-Messungen sind durch eine nicht-invasive Methode der Auswertung durchgeführt. Ein standard-Protokoll ist entscheidend für einen genauen Wert zu erhalten, vor allem, wenn es mehrere Operatoren. Achten Sie darauf, die Methode vor der eigentlichen Operation zu üben. Des Teilnehmers Zusammenarbeit ist der Schlüssel für die Messung von Cf-PWV.
<ol><li>Erklären Sie den Ablauf des Teilnehmers und eine holen Sie Genehmigung ein.</li>
	<li>Messen Sie die Körpergröße und das Gewicht vor dem Beginn der Messungen.</li>
	<li>Erklären Sie, dass der Prozeß 5-10 min dauert und bezieht die Teilnehmer liegen auf dem Bett zu lassen.<ol>
<li>Halten Sie die Haut des Patienten sauber und trocken bei Rückenlage Positionen verschieben. Wenn die Haut des Patienten wegen Schwitzen feucht ist, dann trocknen Sie die Haut.</li>
		<li>Führen Sie die Messungen in einem ruhigen Raum mit einer stabilen Raumtemperatur.</li>
	</ol>
</li>
	<li>Des Teilnehmers Hände neben ihren Körper, um sicherzustellen, gibt es eine glatte, ungestört ECG signal. Schließen Sie bis zu 3-Lead ECG Monitoren, Positionierung von drei Elektroden (RA, LL, LA) entsprechend dem folgenden Diagramm (Abbildung 2). Hinweis: Die Verwendung von Einweg-Elektroden wird empfohlen. Die ECG Leitungen und Kabel können im anderen EKG Zeichengeräte verwendet werden.</li>
	<li>Haben Sie die Patienten mindestens 5 Minuten ruhen in der Rückenlage. Dann Messen Sie der Patient Blutdruck mit einem halbautomatischen oszillometrische Gerät. Hinweis: Gemäß den Empfehlungen der European Society of Hypertension17wird der Blutdruck gemessen.</li>
	<li>Haben Sie die Patienten mindestens 2 Minuten ruhen. Hinweis: Die periphere vaskuläre Dilatation verursacht durch Arterie Okklusion beim brachial Arterie Blutdruck messen ändert die brachial Arterie Impuls Übertragung. Ruhe ist wichtig, unzulässige Abweichung zu vermeiden.</li>
	<li>Während der Teilnehmer beruht, geben Sie die Teilnehmer detaillierte Informationen, einschließlich der Rückenlage Blutdruck, Körpergröße, Körpergewicht und Operatorname, in das Messgerät (Abbildung 3).</li>
	<li>Halten Sie nach der Eingabe der Informationen die Teilnehmer in Rückenlage.</li>
	<li>Messen Sie manuell die folgenden Parameter (mm) (Abbildung 3).<ol>
<li>Messen Sie den Abstand von der Suprasternal Kerbe (SSN) bis zu dem Punkt Fernerkennung (Femoral Arterie).</li>
		<li>Messen Sie den Abstand von der sternalen Kerbe an der proximalen (Arteria carotis) erkennungspunkt.</li>
		<li>Messen Sie den Abstand vom Punkt Fernerkennung (Femoral Arterie), die proximalen (Arteria carotis) erkennungspunkt (Cf-Distanz).</li>
	</ol>
</li>
	<li>Wählen Sie die PWA-Modus. Geben Sie '0' als SSN-Carotis Abstand und 0,8 * Cf-Abstand als SSN-femoralen Abstand. Wenn das Gerät "0" nicht akzeptieren, legen Sie einen anderen Wert als die SSN-Carotis-Entfernung und 80 % Cf Abstand als SSN-femoralen Abstand5fügen Sie diesen Wert hinzu. Hinweis: Der Betreiber sollten eine bequemste Position sitzen.</li>
	<li>Drücken Sie die Taste, um Daten zu erfassen. Setzen Sie das Tonometer auf der radialen Arterie Fluktuation Punkt (ca. 1-2 cm über der radialen styloids Prozess zu einem Zeitpunkt, wo die Fluktuation stark und stabil ist), den zentralen Blutdruck messen.<ol>
<li>Pflegen Sie die Position des Tonometer, eine stetige Wellenform auf dem Computer zu erhalten. Sobald die Qualität und Reproduzierbarkeit der Tonometrie Messungen den Standard erreicht haben, wird die Signalaufzeichnung vom Computer automatisch beendet.</li>
		<li>Halten Sie das Tonometer auf 90°.</li>
		<li>Zur Vermeidung von Parasiten Bewegung immobilisieren Sie das Tonometer in der Nähe der Basis mit den Fingern zu, kleben Sie fest das Tonometer auf der Haut. Hinweis: Die Software zeichnet die Daten automatisch, sobald das Tonometer in Kontakt mit den Messort platziert ist. Die Qualität und Reproduzierbarkeit der Tonometrie Messungen werden automatisch geprüft. Ein Operator Index größer als 80 % gilt als eine zuverlässige Messung. Puls-Druck-Verstärkung (PPA) ist definiert als die Peripherie-mittleren Puls Druckverhältnis und wird berechnet mit der Formel, PPA (brachial SBP - brachial DBP) = / (zentraler SBP-zentralen DBP)-1. PWA kann am Gerät18 (Abbildung 4) beobachtet werden.</li>
	</ol>
</li>
	<li>Wählen Sie die PWV-Modus. Setzen Sie das Tonometer in der Arteria carotis Fluktuation Punkt. Pflegen Sie die Position des Tonometer, eine stetige Wellenform auf dem Computer zu erhalten. Nach der Aufnahme einer stabile Wellenform für 15-20 Sekunden. Einmal die Qualität und Reproduzierbarkeit der Tonometrie Messungen das standard, Ziel manuell aufzeichnen (Abbildung 5) erreichen.</li>
	<li>Setzen Sie das Tonometer in die Femoral Arterie Fluktuation Punkt (1-2 cm unter dem Mittelpunkt der inguinalen Bänder an einem Punkt, wo die Schwankungen stabil ist). Pflegen Sie die Position des Tonometer eine stetige Wellenform aufzeichnen. Nach der Aufnahme einer stabile Wellenform für 15-20 Sekunden, die beenden Sie Aufnahme manuell nach der Qualität und Reproduzierbarkeit der Tonometrie Messungen den Standard erreichen. Die PWV-Wert kann beobachtet werden, auf dem Gerät Cf-PWV ≥ 10 m/s gilt als arterielle Versteifung (Abbildung 5)1.</li>
</ol>

<ol>
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J., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Prevalence,+Correlates,+and+Prognosis+of+Healthy+Vascular+Aging+in+a+Western+Community-Dwelling+Cohort:+The+Framingham+Heart+Study.">Prevalence, Correlates, and Prognosis of Healthy Vascular Aging in a Western Community-Dwelling Cohort: The Framingham Heart Study.</a> Hypertension. 70 (2), 267-274 (2017).</li><li>Reference Values for Arterial Stiffness, C., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Determinants+of+pulse+wave+velocity+in+healthy+people+and+in+the+presence+of+cardiovascular+risk+factors:+'establishing+normal+and+reference+values.">Determinants of pulse wave velocity in healthy people and in the presence of cardiovascular risk factors: 'establishing normal and reference values.</a> Eur Heart J. 31 (19), 2338-2350 (2010).</li><li>Van Bortel, L. M., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Expert+consensus+document+on+the+measurement+of+aortic+stiffness+in+daily+practice+using+carotid-femoral+pulse+wave+velocity.">Expert consensus document on the measurement of aortic stiffness in daily practice using carotid-femoral pulse wave velocity.</a> J Hypertens. 30 (3), 445-448 (2012).</li><li>Salvi, P. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=.">.</a> Pulse waves: how vascular hemodynamics affect blood pressure. , (2011).</li><li>Mancia, G., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=2013+ESH/ESC+Guidelines+for+the+management+of+arterial+hypertension:+the+Task+Force+for+the+management+of+arterial+hypertension+of+the+European+Society+of+Hypertension+(ESH)+and+of+the+European+Society+of+Cardiology+(ESC).">2013 ESH/ESC Guidelines for the management of arterial hypertension: the Task Force for the management of arterial hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC).</a> J Hypertens. 31 (7), 1281-1357 (2013).</li><li>Yamashina, A., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Validity,+reproducibility,+and+clinical+significance+of+noninvasive+brachial-ankle+pulse+wave+velocity+measurement.">Validity, reproducibility, and clinical significance of noninvasive brachial-ankle pulse wave velocity measurement.</a> Hypertens Res. 25 (3), 359-364 (2002).</li><li>Tanaka, H., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Comparison+between+carotid-femoral+and+brachial-ankle+pulse+wave+velocity+as+measures+of+arterial+stiffness.">Comparison between carotid-femoral and brachial-ankle pulse wave velocity as measures of arterial stiffness.</a> J Hypertens. 27 (10), 2022-2027 (2009).</li><li>Lu, Y., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Comparison+of+Carotid-Femoral+and+Brachial-Ankle+Pulse-Wave+Velocity+in+Association+With+Target+Organ+Damage+in+the+Community-Dwelling+Elderly+Chinese:+The+Northern+Shanghai+Study.">Comparison of Carotid-Femoral and Brachial-Ankle Pulse-Wave Velocity in Association With Target Organ Damage in the Community-Dwelling Elderly Chinese: The Northern Shanghai Study.</a> J Am Heart Assoc. 6 (2), (2017).</li><li>D'Agostino, R. B., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=General+cardiovascular+risk+profile+for+use+in+primary+care:+the+Framingham+Heart+Study.">General cardiovascular risk profile for use in primary care: the Framingham Heart Study.</a> Circulation. 117 (6), 743-753 (2008).</li><li>Conroy, R. M., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Estimation+of+ten-year+risk+of+fatal+cardiovascular+disease+in+Europe:+the+SCORE+project.">Estimation of ten-year risk of fatal cardiovascular disease in Europe: the SCORE project.</a> Eur Heart J. 24 (11), 987-1003 (2003).</li><li>Zethelius, B., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Use+of+multiple+biomarkers+to+improve+the+prediction+of+death+from+cardiovascular+causes.">Use of multiple biomarkers to improve the prediction of death from cardiovascular causes.</a> N Engl J Med. 358 (20), 2107-2116 (2008).</li><li>Vernooij, J. W., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Hypertensive+target+organ+damage+and+the+risk+for+vascular+events+and+all-cause+mortality+in+patients+with+vascular+disease.">Hypertensive target organ damage and the risk for vascular events and all-cause mortality in patients with vascular disease.</a> J Hypertens. 31 (3), 492-499 (2013).</li><li>van der Veen, P. H., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Hypertensive+Target+Organ+Damage+and+Longitudinal+Changes+in+Brain+Structure+and+Function:+The+Second+Manifestations+of+Arterial+Disease-Magnetic+Resonance+Study.">Hypertensive Target Organ Damage and Longitudinal Changes in Brain Structure and Function: The Second Manifestations of Arterial Disease-Magnetic Resonance Study.</a> Hypertension. 66 (6), 1152-1158 (2015).</li><li>Ji, H., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Shanghai+Study:+cardiovascular+risk+and+its+associated+factors+in+the+Chinese+elderly-a+study+protocol+of+a+prospective+study+design.">Shanghai Study: cardiovascular risk and its associated factors in the Chinese elderly-a study protocol of a prospective study design.</a> BMJ Open. 7 (3), (2017).</li><li>O'Brien, E., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Practice+guidelines+of+the+European+Society+of+Hypertension+for+clinic,+ambulatory+and+self+blood+pressure+measurement.">Practice guidelines of the European Society of Hypertension for clinic, ambulatory and self blood pressure measurement.</a> J Hypertens. 23 (4), 697-701 (2005).</li><li>Agnoletti, D., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Pulse+wave+analysis+with+two+tonometric+devices:+a+comparison+study.">Pulse wave analysis with two tonometric devices: a comparison study.</a> Physiol Meas. 35 (9), 1837-1848 (2014).</li><li>Ji, H., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Shanghai+Study:+cardiovascular+risk+and+its+associated+factors+in+the+Chinese+elderly-a+study+protocol+of+a+prospective+study+design.">Shanghai Study: cardiovascular risk and its associated factors in the Chinese elderly-a study protocol of a prospective study design.</a> BMJ Open. 7 (3), e013880 (2017).</li><li>Zhang, Y., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Comparison+study+of+central+blood+pressure+and+wave+reflection+obtained+from+tonometry-based+devices.">Comparison study of central blood pressure and wave reflection obtained from tonometry-based devices.</a> Am J Hypertens. 26 (1), 34-41 (2013).</li><li>Sharman, J. E., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Validation+of+non-invasive+central+blood+pressure+devices:+ARTERY+Society+task+force+consensus+statement+on+protocol+standardization.">Validation of non-invasive central blood pressure devices: ARTERY Society task force consensus statement on protocol standardization.</a> Eur Heart J. 38 (37), 2805-2812 (2017).</li><li>Millasseau, S., Agnoletti, D. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Non-invasive+estimation+of+aortic+blood+pressures:+a+close+look+at+current+devices+and+methods.">Non-invasive estimation of aortic blood pressures: a close look at current devices and methods.</a> Curr Pharm Des. 21 (6), 709-718 (2015).</li><li>Olsen, M. 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Die Autoren haben nichts preisgeben.

Hier zeigen wir eine leicht zugänglich Methodik zur Bewertung der Teilnehmer Roman präklinischen vaskulären TOD, arterielle Steifigkeit von Cf-PWV ausgewertet. Um PWs mit geringen hämodynamischen Unterschiede zwischen Messungen vor der Geräte zu vergleichen, nehmen Sie Daten nur an, wenn die brachiale systolische und diastolische BP um weniger als 3 MmHg abwechslungsreich. Dies reduziert die Abweichung verursacht durch menschliche Manipulation. In diesem Protokoll sind die entscheidenden Schritte Patienten Bedingung...

Arterielle Versteifung ist ein guter Marker für vaskuläre Altern Bewertung1,2. Die Messung der arteriellen Versteifung erfolgt traditionell mit einer Puls-Welle Geschwindigkeit (PWV) Methodik, die ist ein wichtiger und verlässlicher Indikator für die arterielle Steifigkeit1,3,4,5. PWV stellt insbesondere die Steifigkeit eines bestimmten arteriellen Segments. Die Pulswelle ist durch die arteriellen Gefäße in einem bestimmten Segment übertragen, und seine Geschwindigkeit ist umgekehrt im Zusammenhang mit der viskoelastischen Eigenschaften der Wand selbst6. PWV-Wert steigt mit dem arteriellen Versteifung.
Karotis-femoralen PWV (Cf-PWV) und brachial-Knöchel PWV (Ba-PWV) sind die 2 am häufigsten angewandten PWV Messungen. Sie sind weit verbreitet in der klinischen Praxis, wo Cf-PWV ist in den westlichen Ländern beliebt und Ba-PWV ist in asiatischen Ländern beliebt. 7 , 8. Cf-PWV wurde In der Tat, als der "Goldstandard" Messung der arteriellen Steifigkeit1betrachtet. Für Cf-PWV, es wird genommen als Vertreter des PWV für die gesamte Aorta. Außerdem gibt es für Ba-PWV, keine wahre arteriellen Pfade verbinden die Messstellen (brachial bis Knöchel). Die geschätzte Ba-PWV repräsentiert die PWV für die Gesamtheit der zentralen und peripheren arteriellen System9. Eine frühere Studie hat berichtet, dass Cf-PWV Ba-PWV in Verbänden mit asymptomatischen Hypertensive Ziel Orgel Schaden (TOD)10 (Abbildung 1) überlegen ist.
Nicht-invasive Geräte für regionale Steifigkeit mit einer spezifischen Tonometer ausgestattet werden zunehmend eingesetzt, um die Steifigkeit der Carotis femoralen Segment1zu messen. In Cf-PWV-Messungen erstellen dieses Gerät und einen handheld Tonometer eine stetige Wellenform auf dem Computer, der Bilder mit hoher Auflösung digitale Wellenform und die spezifischen Werte der PWV (Abbildung 2) aufzeichnen kann. Diese Messungen müssen standardisiert werden. Hier zeigen wir wie man ein guter Qualität Cf-PWV mit dieser nicht-invasiven Tonometrie-basierten Gerät in einer realen Umgebung aufnehmen.
Einige etablierte kardiovaskuläre Risiko Vorhersage-Modelle wie die Framingham-Risiko-Score und die PARTITUR Gefahrenkarten sind vor allem berechnet und sortiert nach konventionellen Risikofaktoren11,12. Jedoch sollten einige neue Biomarker in das risikobewertungsmodell Verbesserung der Gefahr Schichtung13hinzugefügt werden. In der Literatur gilt arterielle Versteifung als einem Zwischenstadium zwischen konventionellen Risikofaktoren und klinische Herz-Kreislauf-Ereignisse14. So möglicherweise hinzufügen Cf-PWV in das risikobewertungsmodell ein Werkzeug für Gefahr Schichtung15,16.
Hier erzeugen wir einen Methodik Plan Teilnehmer Cf-PWV, zusammen mit PWA herstellen ein Standardprotokoll für arterielle Versteifung Bewertung beurteilen.

<table>
	<tbody>
		<tr>
			<td>SphygmoCor tonometry-based device</td>
			<td>AtCor Medical, Australia</td>
			<td></td>
			<td>For central blood pressures and cf-PWV</td>
		</tr>
		<tr>
			<td>Electrodes</td>
			<td>AtCor Medical, Australia</td>
			<td></td>
			<td>To record the ECG</td>
		</tr>
		<tr>
			<td>Semiautomatic Oscillometric device</td>
			<td>OMRON Healthcare, kyoto, Japan</td>
			<td></td>
			<td>To measure brachial BP</td>
		</tr>
	</tbody>
</table>

measuring the carotid to femoral pulse wave velocity (cf-pwv) to evaluate arterial stiffness

Für ältere Menschen, arterielle Versteifung ist ein guter Marker für das Altern Bewertung und es wird empfohlen, dass der arterielle Steifigkeit nicht-invasiv durch die Messung der Karotiden zu femoral Pulswellengeschwindigkeit (Cf-PWV) bestimmt werden (Klasse I; Maß an Beweise A). In der Literatur haben zahlreiche Community-basierte oder krankheitsspezifische Studien berichtet, dass höhere Cf-PWV mit einem erhöhten kardiovaskulären Risiko verbunden ist. Hier diskutieren wir Strategien zur arteriellen Steifigkeit mit Cf-PWV zu bewerten. Im Anschluss an die klar definierte Schritte hier detailliert, z.B., richtige Position Operator, Distanzmessung und Tonometer Stellung erhalten wir einen standard Cf-PWV-Wert zur Beurteilung der arteriellen Steifigkeit. In diesem Papier eine detaillierte schrittweise Methode, um eine gute Qualität PWV und Puls aufzeichnen wave Analyse (PWA) verwenden, die eine nicht-invasive Tonometrie-basierten Gerät diskutiert werden.

CF-PWV (mit dieser Methode) und Ba-PWV (mit anderen Methode10) wurden in alle 2098 Teilnehmer vom nördlichen Shanghai Studie19durchgeführt. Cf-PWV und Ba-PWV wurden in der gleichen logistische Regressionsmodell verwendet. In diesem Modell wurden Alter und Geschlecht angepasst. Die Ergebnisse zeigten, dass nur Cf-PWV, aber nicht Ba-PWV, war signifikant assoziiert mit erhöhten IMT und arterielle Plaque, die die Überlegenheit der Cf-PWV üb...

Watch this Scientific Journal Video about Measuring the Carotid to Femoral Pulse Wave Velocity Cf-PWV to Evaluate Arterial Stiffness at JoVE.com

Measuring the Carotid to Femoral Pulse Wave Velocity Cf-PWV to Evaluate Arterial Stiffness

Dieses Protokoll beschreibt eine Methode, um die Messungen der Karotis-femoralen pulswellenlaufzeit auszuwertende arteriellen Steifigkeit zu standardisieren.

Messung der Karotiden zu Femoral Pulswellengeschwindigkeit (Cf-PWV), arteriellen Steifigkeit zu bewerten

For the elderly, arterial stiffening is a good marker for aging evaluation and it is recommended that the arterial stiffness be determined noninvasively ...

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Unit 1

Measuring the Carotid to Femoral Pulse Wave Velocity (Cf-PWV) to Evaluate Arterial Stiffness

Vital Signs: Pulse

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Serie: Measuring the Carotid to Femoral Pulse Wave Velocity Cf-PWV to Evaluate Arterial Stiffness

The Measurement and Treatment of Suppression in Amblyopia

Amblyopia, a developmental disorder of the visual cortex, is one of the leading causes of visual dysfunction in the working age population. Current estimates put the prevalence of amblyopia at approximately 1-3%1-3, the majority of cases being monocular2. Amblyopia is most frequently caused by ocular misalignment (strabismus), blur induced by unequal refractive error (anisometropia), and in some cases by form deprivation.
Although amblyopia is initially caused by abnormal visual input in infancy, once established, the visual deficit often remains when normal visual input has been restored using surgery and/or refractive correction. This is because amblyopia is the result of abnormal visual cortex development rather than a problem with the amblyopic eye itself4,5 . Amblyopia is characterized by both monocular and binocular deficits6,7 which include impaired visual acuity and poor or absent stereopsis respectively. The visual dysfunction in amblyopia is often associated with a strong suppression of the inputs from the amblyopic eye under binocular viewing conditions8. Recent work has indicated that suppression may play a central role in both the monocular and binocular deficits associated with amblyopia9,10 .
Current clinical tests for suppression tend to verify the presence or absence of suppression rather than giving a quantitative measurement of the degree of suppression. Here we describe a technique for measuring amblyopic suppression with a compact, portable device11,12 . The device consists of a laptop computer connected to a pair of virtual reality goggles. The novelty of the technique lies in the way we present visual stimuli to measure suppression. Stimuli are shown to the amblyopic eye at high contrast while the contrast of the stimuli shown to the non-amblyopic eye are varied. Patients perform a simple signal/noise task that allows for a precise measurement of the strength of excitatory binocular interactions. The contrast offset at which neither eye has a performance advantage is a measure of the "balance point" and is a direct measure of suppression. This technique has been validated psychophysically both in control13,14 and patient6,9,11 populations.
In addition to measuring suppression this technique also forms the basis of a novel form of treatment to decrease suppression over time and improve binocular and often monocular function in adult patients with amblyopia12,15,16 . This new treatment approach can be deployed either on the goggle system described above or on a specially modified iPod touch device15.

Amblyopia is a developmental disorder of the visual cortex that is often accompanied by strong suppression of one eye. We present a new technique for measuring and treating interocular suppression in patients with amblyopia that can be deployed using virtual reality goggles or a portable iPod Touch device.

Die Messung und Behandlung von Unterdrückung in Amblyopie

Amblyopia, a developmental disorder of the visual cortex, is one of the leading causes of visual dysfunction in the working age population. Current ...

Forschung

Medizin

Pulse Wave Velocity Testing in the Baltimore Longitudinal Study of Aging

Carotid-femoral pulse wave velocity is considered the gold standard for measurements of central arterial stiffness obtained through noninvasive methods1.&#160;Subjects are placed in the supine position and allowed to rest quietly for at least 10 min prior to the start of the exam. The proper cuff size is selected and a blood pressure is obtained using an oscillometric device. Once a resting blood pressure has been obtained, pressure waveforms are acquired from the right femoral and right common carotid arteries. The system then automatically calculates the pulse transit time between these two sites (using the carotid artery as a surrogate for the descending aorta). Body surface measurements are used to determine the distance traveled by the pulse wave between the two sampling sites. This distance is then divided by the pulse transit time resulting in the pulse wave velocity. The measurements are performed in triplicate and the average is used for analysis.

Pulse wave velocity (PWV) measurement assesses arterial stiffness by a tonometry-based system that measures the speed with which arterial pressure wave travels along the arterial tree, typically approximating the time that it takes this wave to travel from the descending aorta (using the carotid artery as a surrogate) to the femoral artery. Carotid-femoral PWV increases two- to threefold across the adult lifespan.

Pulswellengeschwindigkeit Testing in der Baltimore Longitudinal Study of Aging

Carotid-femoral pulse wave velocity is considered the gold standard for measurements of central arterial stiffness obtained through noninvasive ...

Measuring Ascending Aortic Stiffness In Vivo in Mice Using Ultrasound

We present a protocol for measuring in vivo aortic stiffness in mice using high-resolution ultrasound imaging. Aortic diameter is measured by ultrasound and aortic blood pressure is measured invasively with a solid-state pressure catheter. Blood pressure is raised then lowered incrementally by intravenous infusion of vasoactive drugs phenylephrine and sodium nitroprusside. Aortic diameter is measured for each pressure step to characterize the pressure-diameter relationship of the ascending aorta. Stiffness indices derived from the pressure-diameter relationship can be calculated from the data collected. Calculation of arterial compliance is described in this protocol.
This technique can be used to investigate mechanisms underlying increased aortic stiffness associated with cardiovascular disease and aging. The technique produces a physiologically relevant measure of stiffness compared to ex vivo approaches because physiological influences on aortic stiffness are incorporated in the measurement. The primary limitation of this technique is the measurement error introduced from the movement of the aorta during the cardiac cycle. This motion can be compensated by adjusting the location of the probe with the aortic movement as well as making multiple measurements of the aortic pressure-diameter relationship and expanding the experimental group size.

Measuring Ascending Aortic Stiffness In Vivo in Mice Using Ultrasound

We describe a technique for measuring aortic stiffness from its pressure-diameter relationship in vivo in mice. Aortic diameter is recorded by ultrasound and aortic pressure is measured invasively with a solid-state pressure catheter. Blood pressure is changed incrementally and the resulting diameter is measured.

Mess aufsteigende Aorta Steifigkeit<em&gt; In-vivo-</em&gt; In Mäuse Mit Ultraschall

We present a protocol for measuring in vivo aortic stiffness in mice using high-resolution ultrasound imaging. Aortic diameter is measured by ultrasound ...

A Murine Model of Arterial Restenosis: Technical Aspects of Femoral Wire Injury

Cardiovascular disease caused by atherosclerosis is the leading cause of death in the developed world. Narrowing of the vessel lumen, due to atherosclerotic plaque development or the rupturing of established plaques, interrupts normal blood flow leading to various morbidities such as myocardial infarction and stroke. In the clinic endovascular procedures such as angioplasty are commonly performed to reopen the lumen. However, these treatments inevitably damage the vessel wall as well as the vascular endothelium, triggering an excessive healing response and the development of a neointimal plaque that extends into the lumen causing vessel restenosis (re-narrowing). Restenosis remains a major cause of failure of endovascular treatments for atherosclerosis. Thus, preclinical animal models of restenosis are vitally important for investigating the pathophysiological mechanisms as well as translational approaches to vascular interventions. Among several murine experimental models, femoral artery wire injury is widely accepted as the most suitable for studies of post-angioplasty restenosis because it closely resembles the angioplasty procedure that injures both endothelium and vessel wall. However, many researchers have difficulty utilizing this model due to its high degree of technical difficulty. This is primarily because a metal wire needs to be inserted into the femoral artery, which is approximately three times thinner than the wire, to generate sufficient injury to induce prominent neointima. Here, we describe the essential surgical details to effectively overcome the major technical difficulties of this model. By following the presented procedures, performing the mouse femoral artery wire injury becomes easier. Once familiarized, the whole procedure can be completed within 20 min.

The mouse femoral artery wire injury model of restenosis is technically challenging. In this protocol we show the key technical details essential for successfully performing wire injury to induce consistent&#160;neointima for studies of restenosis.

Ein Mausmodell von arterieller Restenose: Technische Aspekte der Femoral Draht Injury

Cardiovascular disease caused by atherosclerosis is the leading cause of death in the developed world. Narrowing of the vessel lumen, due to ...

Ultrasound-based Pulse Wave Velocity Evaluation in Mice

Arterial stiffness can be evaluated by calculating pulse wave velocity (PWV), i.e., the speed with which the pulse wave travels in a conduit vessel. This parameter is being increasingly investigated in small rodent models in which it is used for assessing alterations in vascular function related to particular genotypes/treatments or for characterizing cardiovascular disease progression. This protocol describes an image processing algorithm which leads to non-invasive arterial PWV measurement in mice using ultrasound (US) images only. The proposed technique has been used to assess abdominal aorta PWV in mice and evaluate its age-associated changes.
Abdominal aorta US scans are obtained from mice under gaseous anesthesia using a specific US device equipped with high-frequency US probes. B-mode and Pulse-Wave Doppler (PW-Doppler) images are analyzed in order to obtain diameter and mean velocity instantaneous values, respectively. For this purpose, edge detection and contour tracking techniques are employed. The single-beat mean diameter and velocity waveforms are time aligned and combined in order to achieve the diameter-velocity (lnD-V) loop. PWV values are obtained from the slope of the linear part of the loop, which corresponds to the early systolic phase.
With the present approach, anatomical and functional information about the mouse abdominal aorta can be non-invasively achieved. Requiring the processing of US images only, it may represent a useful tool for the non-invasive characterization of different arterial sites in the mouse in terms of elastic properties. The application of the present technique can be easily extended to other vascular districts, such as the carotid artery, thus providing the possibility to obtain a multi-site arterial stiffness assessment.

Arterial stiffness represents a key factor in cardiovascular disease and pulse wave velocity (PWV) can be considered as a surrogate index for arterial stiffness. This protocol describes an image processing algorithm for calculating PWV in mice based on ultrasound image processing that is applicable at different arterial sites.

Ultraschall-basierte Pulswellengeschwindigkeit Auswertung bei Mäusen

Arterial stiffness can be evaluated by calculating pulse wave velocity (PWV), i.e., the speed with which the pulse wave travels in a conduit vessel. This ...

In Vivo Gene Transfer to the Rabbit Common Carotid Artery Endothelium

The goal of this method is to introduce a transgene into the endothelium of isolated segments of both rabbit common carotid arteries. The method achieves focal endothelial-selective transgenesis, thereby allowing an investigator to determine the biological roles of endothelial-expressed transgenes and to quantify the in vivo transcriptional activity of DNA sequences in large artery endothelial cells. The method uses surgical isolation of rabbit common carotid arteries and an arteriotomy to deliver a transgene-expressing viral vector into the arterial lumen. A short incubation period of the vector in the lumen, with subsequent aspiration of the lumen contents, is sufficient to achieve efficient and durable expression of the transgene in the endothelium, with no detectable transduction or expression outside of the isolated arterial segment. The method allows assessment of the biological activities of transgene products both in normal arteries and in models of human vascular disease, while avoiding systemic effects that could be caused either by targeting gene delivery to other sites (e.g. the liver) or by the alternative approach of delivering genetic constructs to the endothelium by germ line transgenesis. Application of the method is limited by the need for a skilled surgeon and anesthetist, a well-equipped operating room, the costs of purchasing and housing rabbits, and the need for expertise in gene-transfer vector construction and use. Results obtained with this method include: transgene-related alterations in arterial structure, cellularity, extracellular matrix, or vasomotor function; increases or reductions in arterial inflammation; alterations in vascular cell apoptosis; and progression, retardation, or regression of diseases such as intimal hyperplasia or atherosclerosis. The method also allows measurement of the ability of native and synthetic DNA regulatory sequences to alter transgene expression in endothelial cells, providing results that include: levels of transgene mRNA, levels of transgene protein, and levels of transgene enzymatic activity.

In Vivo Gene Transfer to the Rabbit Common Carotid Artery Endothelium

This method is to introduce a transgene into the endothelium of rabbit carotid arteries. Introduction of the transgene allows the assessment of the biological role of the transgene product either in normal arteries or disease models. The method is also useful for measuring activity of DNA regulatory sequences.

In Vivo Gentransfer in die Kaninchen gemeinsame Halsschlagader Endothel

The goal of this method is to introduce a transgene into the endothelium of isolated segments of both rabbit common carotid arteries. The method achieves ...

A Clinical Trial Assessing the Safety, Efficacy, and Delivery of Olive-Oil-Based Three-Chamber Bags for Parenteral Nutrition

Limited evidence exists to precisely estimate efficacy and safety differences between parenteral nutrition (PN) prepared using olive-oil-based three-chamber bags (3CBs) and soybean-oil-based compounded bags (CoBs) in hospitalized adult patients. We designed a multicenter, randomized, prospective, open-label, noninferiority protocol to compare the efficacy, safety, and distribution of olive-oil-based 3CBs and soybean-oil-based CoB formulations in adult Chinese patients requiring PN during surgical intervention. Subjects were randomized to receive either one of the study treatments using an interactive voice or web-based recognition system in accordance with the randomization code. Randomization was further stratified based on the study site and surgical category. Both treatment groups received similar amounts of calories and protein. In addition, the two study treatments contained a similar composition of the amino-acid component. The only difference between the two PN formulations was the lipid constitution. The duration of administration of study treatments was a minimum of 5 days up to a maximum of 14 days after the surgical procedure. The primary efficacy endpoint was serum prealbumin levels on day 5 of the study. Noninferiority was proved if the anti-log of the lower bound of the 95% confidence interval (CI) of the treatment difference was at least 0.80. Other efficacy measures included treatment preparation time; duration to achieve tolerability of oral nutrition; associated infectious complications; length of hospitalization; and laboratory assessment of markers of nutrition, inflammation, metabolism, and oxidative stress. A total of 458 patients were enrolled in the study. The results showed that olive-oil-based 3CBs were non-inferior to soybean-based CoBs, besides being well tolerated. The infection rate was found to be significantly lower in the olive-oil-based 3CB group. Thus, this study may be used as a reference for future research on lipid emulsion and 3CBs.

Here, we present a protocol for a study comparing the efficacy, safety, and delivery of olive-oil-based 3CB and soybean-oil-based CoB formulations in adults requiring parenteral nutrition. The results revealed that olive-oil-based 3CBs is non-inferior and well tolerated compared to soybean formulations.

Eine klinische Studie zur Bewertung der Sicherheit, Wirksamkeit und Lieferung von Dreikammerbeuteln auf Olivenölbasis für die parenterale Ernährung

Limited evidence exists to precisely estimate efficacy and safety differences between parenteral nutrition (PN) prepared using olive-oil-based ...

Using a Knee Arthrometer to Evaluate Tissue-specific Contributions to Knee Flexion Contracture in the Rat

Normal knee range of motion (ROM) is critical to well-being and allows one to perform basic activities such as walking, climbing stairs and sitting. Lost ROM is called a joint contracture and results in increased morbidity. Due to the difficulty of reversing established knee contractures, early detection is important, and hence, knowing risk factors for their development is essential. The rat represents a good model with which the effect of an intervention can be studied due to the similarity of rat knee anatomy to that of humans, the rat's ability to tolerate long durations of knee immobilization in flexion, and because mechanical data can be correlated with histologic and biochemical analysis of knee tissue.
Using an automated arthrometer, we demonstrate a validated, precise, reproducible, user-independent method of measuring the extension ROM of the rat knee joint at specific torques. This arthrometer can be used to determine the effects of interventions on knee joint ROM in the rat.

The goal of the protocol is to measure the extension range of motion of the rat knee. The effects of various diseases that increase the stiffness of the knee joint and the effectiveness of treatments can be quantified.

Verwenden ein Knie Arthrometer auszuwertende gewebespezifischen Beiträge zum Knie Beugung Kontraktur in der Ratte

Normal knee range of motion (ROM) is critical to well-being and allows one to perform basic activities such as walking, climbing stairs and sitting. Lost ...

Improved Renal Denervation Mitigated Hypertension Induced by Angiotensin II Infusion

The benefits of renal sympathetic denervation (RDN) on blood pressure have been proved in a large number of clinical trials in recent years. However, the regulatory mechanism of RDN on hypertension remains elusive. Thus, it&#39;s essential to establish a simpler RDN model in mice. In this study, osmotic mini pumps filled with Angiotensin II were implanted in 14-week-old C57BL/6 mice. One week after the implantation of the mini-osmotic pump, a modified RDN procedure was performed on bilateral renal arteries of the mice using phenol. Age-sex-matched mice were given saline and served as sham group. Blood pressure was measured at baseline and every week subsequently for 21 days. Then, renal artery, abdominal aorta and heart were collected for histological examination using H&#38;E and Masson staining. In this study, we present a simple, practical, repeatable, and standardized RDN model, which can control hypertension and alleviate cardiac hypertrophy. The technique can denervate peripheral renal sympathetic nerves without renal artery damage. Compared to previous models, the modified RDN facilitates the study of the pathobiology and pathophysiology of hypertension.

Here, we present a protocol for renal sympathetic denervation (RDN) in mice with hypertension induced by Angiotensin II infusion. The procedure is repeatable, convenient and allows to study the regulatory mechanisms of RDN on hypertension and cardiac hypertrophy.

Verbesserte renale Denervierung milderte Hypertonie durch Angiotensin-II-Infusion

The benefits of renal sympathetic denervation (RDN) on blood pressure have been proved in a large number of clinical trials in recent years. However, the ...

Network Pharmacology Prediction and Experimental Validation of Trichosanthes-Fritillaria thunbergii Action Mechanism Against Lung Adenocarcinoma

We aimed to study the mechanism of Trichosanthes-Fritillaria thunbergii in treating lung adenocarcinoma (LUAD) based on network pharmacology and experimental verification. The effective components and potential targets of Trichosanthis and Fritillaria thunbergii were collected by high-throughput experiment and reference-guided (HERB) database of traditional Chinese medicine and a similarity ensemble approach (SEA) database, and the LUAD-related targets were queried by the GeneCards and Online Mendelian Inheritance in Man (OMIM) databases. A drug-component-disease-target network was constructed by Cytoscape software. Protein-protein interaction (PPI) network, gene ontology (GO) function, and Kyoto encyclopedia of genes and genomes (KEGG) pathway enrichment analyses were conducted to obtain core targets and key pathways. An aqueous extract of Trichosanthes-Fritillaria thunbergii and A549 cells were used for the subsequent experimental validation. Through the HERB database and literature search, 31 effective compounds and 157 potential target genes of Trichosanthes-Fritillaria thunbergii were screened, of which 144 were regulatory targets of Trichosanthes-Fritillaria thunbergii in the treatment of lung adenocarcinoma. The GO functional enrichment analysis showed that the mechanism of action of Trichosanthes-Fritillaria thunbergii against lung adenocarcinoma is mainly protein phosphorylation. The KEGG pathway enrichment analysis suggested that the treatment of lung adenocarcinoma by Trichosanthes-Fritillaria thunbergii mainly involves the PI3K/AKT signaling pathway. The experimental validation showed that an aqueous extract of Trichosanthes-Fritillaria thunbergii could inhibit the proliferation of A549 cells and the phosphorylation of AKT. Through network pharmacology and experimental validation, it was verified that the PI3K/AKT signaling pathway plays a vital role in the action of Trichosanthes-Fritillaria thunbergii in treating lung adenocarcinoma.

Network Pharmacology Prediction and Experimental Validation of Trichosanthes-Fritillaria thunbergii Action Mechanism Against Lung Adenocarcinoma

This study reveals the mechanism of Trichosanthes-Fritillaria thunbergii in treating lung adenocarcinoma based on network pharmacology and experimental verification. The study also demonstrates that the PI3K/AKT signaling pathway plays a vital role in the action of Trichosanthes-Fritillaria thunbergii in treating lung adenocarcinoma.

Netzwerkpharmakologische Vorhersage und experimentelle Validierung des Wirkungsmechanismus von Trichosanthes-Fritillaria thunbergii gegen Lungenadenokarzinome