本研究は、NIHの学内研究プログラム、国立老化研究所老化ボルチモア縦断的研究によってサポートされていました。そのサポートの一部は、MedStar研究所と研究開発契約を介していた。標準プロトコルと技術的専門知識はAtCorによって提供された。

1。手順<ol><li>アイコンをダブルクリックしてWindowsデスクトップにショートカットを経由してソフトウェアを起動します。 </li><li>患者用画面をアクティブにするために患者をクリックします。 </li><li>データベースに新しい患者を入力するには、患者の探索領域内の[新規]ボタンをクリックし、新しい患者を入力したいと思います確認するために、[はい]ボタンをクリックしてください。 </li><li>このような姓、名、生年月日、性別などの患者の詳細を入力します。次のステップに進み、[保存]ボタンをクリックします。 </li><li>測定を実行するために、PWAまたはPWVボタンをクリックします。これらのモードの一方のみが利用可能である場合、ボタンをクリックする必要がなく、単に研究の画面に進む。 </li></ol> 2。中央の血圧測定によるパルス波解析（PWA） <ol><li>研究パラメータを入力するための研究ボタンをクリックしてください。校正された血圧計とあなたが含めたいその他の詳細から取ら上腕圧力を入力してください。 </li><li> CLIC測定を続行するためにキャプチャデータ]ボタンをkである。 3 ECG電極を取り付け、ケーブルに示されるように変更されたリードII構成内の患者または患者の手足を使用することにつながる。 </li><li>患者の橈骨動脈を触診。この直後に親指の付け根付近の手首関節より上、手首の横に位置しています。優しく中間および人差し指で下にある骨に対して橈骨動脈を押してください。 </li><li>最強のパルスポイント上眼圧計を配置します。あなたはデータキャプチャ画面に表示された一貫性の圧力波形が表示されるまでそっと眼圧計を下に押します。 </li><li>自動キャプチャ（下記の注を参照）が有効になっている場合、システムは自動的に測定が保存されます。 （使用している場合、フットスイッチやステップ）を手動で分析するための測定を保存するには、キーボードのスペースバーを押してください。 </li><li>繰り返し測定が同じ研究パラメータで必要な場合には、キャプチャして戻るリピートボタンをクリックしてくださいデータ画面と上記の手順2.4から2.5に概説されているような測定を繰り返します。 </li><li>新しい患者の測定を行うために、患者のボタンをクリックして上記の工程1.3に戻る。 </li></ol> 3。動脈硬化の測定によるパルス波速度（PWV） <ol><li>研究パラメータを入力するための研究ボタンをクリックしてください。 </li><li>校正され、血圧計から取った上腕血圧比を入力してください 遠位（大腿パルスに掲胸骨ノッチ）と近位（頸動脈の超相胸骨ノッチ）のサイトで測定した距離を入力してください。必要に応じて薬物療法、メモ、およびOperatorフィールドは、入力してもよい</li><li>測定を続行する[キャプチャ]ボタンをクリックしてください。 </li><li> ECG信号が許容できる品質であることを確認してください。 </li><li>頸動脈パルスを触診。これは、首の喉頭および胸鎖乳突筋の間に位置している。それは側に筋肉を押し、喉頭に対する動脈を押すことで感じることができる。 </li><li&gt;頸動脈に眼圧計を置き、そっとしてデータ収集画面に表示された一貫性の圧力波形を受け取るまで眼圧計を​​下に押します。 </li><li>あなたは一貫性のある波形の13秒の最小値を持っている場合は、[OK]ボタンをクリックするか（使用している場合、フットスイッチ上のキーを押して、）をクリックします。 </li><li>大腿動脈パルスを触診。これは、中間に恥骨結合と前腸骨棘間の腹側の太ももの上に位置しています。 </li><li>大腿動脈に眼圧計を置き、そっと、キャプチャ画面に表示された一貫性の圧力波形を受け取るまで眼圧計を​​下に押します。あなたは一貫性のある波形の13秒の最小値を持っているときは、[OK]ボタンをクリックします（または使用される場合には、フットスイッチで押します）。 </li><li>レポート（単数または複数）は、現在検討することができる。これらの測定は、典型的には3回実施される。ユーザーは頸動脈とラジアル動脈との間PWVを測定したい場合は、単に示すこれらのステップではなく、fで測定することを除いて繰り返されるemoral動脈、ユーザーは橈骨動脈で眼圧計を​​配置します。新しい患者の測定を実行するには、スタディ]ボタンをクリックして、この手順を繰り返すか、または既存の患者を検索する検索機能を使用しています。 </li></ol> 4。シャットダウン<ol><li>ソフトウェアは自動的にすべてのレポートを保存します。ソフトウェアを終了するには、メインメニューから[システム]をクリックし、[終了]をクリックします。ストレージ用のモジュールトレイに眼圧計を配置します。 </li></ol>

<ol>
	<li>Najjar, S. S., Scuteri, 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=Pulse+wave+velocity+is+an+independent+predictor+of+the+longitudinal+increase+in+systolic+blood+pressure+and+of+incident+hypertension+in+the+Baltimore+Longitudinal+Study+of+Aging.">Pulse wave velocity is an independent predictor of the longitudinal increase in systolic blood pressure and of incident hypertension in the Baltimore Longitudinal Study of Aging.</a> J. Am. Coll. Cardiol. 51 (14), 1377-1383 (2008).</li><li>Doonan, R. J., Scheffler, P., 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=Altered+arterial+stiffness+and+subendocardial+viability+ratio+in+young+healthy+light+smokers+after+acute+exercise.">Altered arterial stiffness and subendocardial viability ratio in young healthy light smokers after acute exercise.</a> PloS one. 6 (10), (2011).</li><li>Laurent, S., Cockcroft, 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=Expert+consensus+document+on+arterial+stiffness:+methodological+issues+and+clinical+applications.">Expert consensus document on arterial stiffness: methodological issues and clinical applications.</a> Eur. Heart J. 27 (21), 2588-2605 (2006).</li><li>Mitchell, G. F., Hwang, S. -. 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=Arterial+stiffness+and+cardiovascular+events:+the+Framingham+Heart+Study.">Arterial stiffness and cardiovascular events: the Framingham Heart Study.</a> Circulation. 121 (4), 505-511 (2010).</li><li>Abbatecola, A. M., Chiodini, P., 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+velocity+is+associated+with+muscle+mass+decline:+Health+ABC+study.">Pulse wave velocity is associated with muscle mass decline: Health ABC study.</a> Age. , (2011).</li><li>Watson, N. L., Sutton-Tyrrell, K., 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=Arterial+stiffness+and+gait+speed+in+older+adults+with+and+without+peripheral+arterial+disease.">Arterial stiffness and gait speed in older adults with and without peripheral arterial disease.</a> Am. J. Hypertens. 24 (1), 90-95 (2011).</li><li>Mackenzie, I. S., Wilkinson, I. B., Cockcroft, J. R. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Assessment+of+arterial+stiffness+in+clinical+practice.">Assessment of arterial stiffness in clinical practice.</a> QJM. 95 (2), 67-74 (2002).</li><li>O'Rourke, M. F., Pauca, A., Jiang, X. J. <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.">Pulse wave analysis.</a> Br. J. Clin. Pharmacol. 51 (6), 507-522 (2001).</li><li>Stoner, L., Young, J. M., Fryer, S. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Assessments+of+arterial+stiffness+and+endothelial+function+using+pulse+wave+analysis.">Assessments of arterial stiffness and endothelial function using pulse wave analysis.</a> Int. J. Vasc. Med. 2012, 903107 (2012).</li><li>Farro, I., Bia, 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+velocity+as+marker+of+preclinical+arterial+disease:+reference+levels+in+a+uruguayan+population+considering+wave+detection+algorithms,+path+lengths,+aging,+and+blood+pressure.">Pulse wave velocity as marker of preclinical arterial disease: reference levels in a uruguayan population considering wave detection algorithms, path lengths, aging, and blood pressure.</a> Int. J. Hypertens. 2012, (2012).</li><li>Lakatta, E. G., Wang, M., Najjar, S. S. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Arterial+aging+and+subclinical+arterial+disease+are+fundamentally+intertwined+at+macroscopic+and+molecular+levels.">Arterial aging and subclinical arterial disease are fundamentally intertwined at macroscopic and molecular levels.</a> Med. Clin. N. Am. 93 (3), 583-604 (2009).</li><li>Ambrose, M. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=.">.</a> Clinical Manual (CVMS) Rev. 2, 1-51 (2011).</li><li>. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Reference+Values+for+Arterial+Stiffness'+Collaboration+Determinants+of+pulse+wave+velocity+in+healthy+people+and+in+the+presence+of+cardiovascular+risk+factors:+'establishing+normal+and+reference+values.">Reference Values for Arterial Stiffness' Collaboration 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., Laurent, S., 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>Scuteri, A., Brancati, A., Gianni, W., Assisi, A., Volpe, M. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Arterial+stiffness+is+an+independent+risk+factor+for+cognitive+impairment+in+the+elderly:+a+pilot+study.">Arterial stiffness is an independent risk factor for cognitive impairment in the elderly: a pilot study.</a> J. Hypertens. 23 (6), 1211 (2005).</li><li>Khoshdel, A. R., Carney, S. L., Nair, B. R., Gillies, A. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Better+management+of+cardiovascular+diseases+by+pulse+wave+velocity:+combining+clinical+practice+with+clinical+research+using+evidence-based+medicine.">Better management of cardiovascular diseases by pulse wave velocity: combining clinical practice with clinical research using evidence-based medicine.</a> Clin. Med. Res. 5 (1), 45-52 (2007).</li></ol>

著者は、彼らが競合する経済的利益を持っていないことを宣言します。著者らは、プロトコル記述と説明し、この製品を製造してSphygmoCorから研究のパフォーマンスの支援を受けた。

脈波伝播速度（PWV）の測定は、比較的単純かつ再現可能な方法3に中心動脈硬化を分析するための非侵襲的方法である。 PWV、（下行大動脈の代理として）頸動脈および大腿パルス波形を評価するためには、高忠実度の眼圧計を用いて取得され、2サイト間のの脈波の到着時間遅延を同時に記録した心電図波に参照すると推定されている動脈系3,10の繁殖モデルに準拠したカスタ?...

A correction was made to <a href="http://www.jove.com/video/50817">Pulse Wave Velocity Testing in the Baltimore Longitudinal Study of Aging</a>. There was an error with the author, Majd AlGhatrif's, name. The author's name has been corrected to:
Majd AlGhatrif
instead of:
Majd al Ghatrif

A correction to the author list has been made for article <a href="http://www.jove.com/video/50817">Pulse Wave Velocity Testing in the Baltimore Longitudinal Study of Aging</a>.

Erratum: Pulse Wave Velocity Testing in the Baltimore Longitudinal Study of Aging

パルス波速度（PWV）は動脈硬化2の評価におけるゴールドスタンダードとみなされている。米国で臨床的に使用されていないが、それは欧州3を通じて検証され、広く臨床現場で使用されてきた。 PWVの変化は、高血圧、肥満、耐糖能障害、及び脂質異常症などの心血管危険因子と相関している。高い大動脈剛性は、末梢動脈疾患6の被験者の最初の心血管イベント4、筋肉量の減少5、およびより遅い歩行速度のリスク増加と関連している。 PWVの評価は、血液のパルスが大腿動脈7に頸動脈から進行する速度を分析することによって達成される。これは、再現性の高い結果と比較的簡単な方法である。技術の進歩は、オペレータ依存性を低減し、に必要な時間の量を減少させる、手順を単純化し続ける受験。我々の研究室で使用されるシステムは、SphygmoCorandによって生成された頸動脈および大腿パルスから波形を取得するEKGと高忠実度の眼圧計を利用しています。ソフトウェアは、パルス波は心電図の波形2への各動脈サイトの相対での圧力波の到着のタイミングを参照することにより、頸動脈および大腿のサイト間を移動するのにかかる時間）を分割推定）1で速度を決定するためにこれらの変数を解析し、推定時間による2拠点間の測定距離。互いに接近してサンプリング地点、精度の低いPWV、大腿骨や頸動脈などの大きな血管には、この方法の使用を制限する。 PWVを決定することに加えて、システムは、吐出時の「中心気圧」であるラジアルパルス8によって生成される波形と最も直接的に影響を与える圧力心臓に伝達関数を適用することによって、上行大動脈内の圧力を計算することができる。この情報は、信頼性があり、非侵襲的に9の左心室に動脈系の効果の評価に役立ちます。エコートラッキング経由など頚動脈伸展性などの血管硬化の検査に使用される代替技術は、技術的な専門知識の多く​​を必要とし、PWVよりも時間がかかる。エコートラッキングはまた、一般に、ビデオ画像解析を利用し、従って、これらの測定値の精度は3制限される。血管の変化を調べるための他の技術は、取得した断面図および横断画像は頸動エラスタンスの粗近似を提供することができるが、より密接に、アテローム性動脈硬化症の進行に関連する結果を提供し、頸動脈内膜肥厚（IMT）の評価が含まれる。この方法は、しかしながら、上述の伸展性研究と同じ制約条件のいくつかに悩まされている。研究者らは、種々の疾患状態における役割動脈硬化の再生を見続けているため、PWVの測定は可能性が高い定量的かつ再現性のあるサロゲートエンドポイントを提供していきます。

<table><tbody><tr><td>SphygmoCor System</td><td>AtCor</td><td>SPT-304, Module EM3</td><td></td></tr></tbody></table>

pulse wave velocity testing in the baltimore longitudinal study of aging

頸動脈-大腿脈波速度は、非侵襲的な方法1で得られた中心動脈の硬さの測定のためのゴールドスタンダードと考えられている。被験者は仰臥位に置き、前の試験開始までに少なくとも10分間静かに休ませている。適切なカフのサイズが選択され、血圧をオシロメトリックデバイスを用いて得られる。安静時血圧が得られたら、圧力波形は右大腿および右総頚動脈から取得する。次に、システムは、自動的に（下行大動脈の代理として頸動脈を使用して）、これら二つの部位間のパルスの通過時間を算出する。体表面の測定は、2つのサンプリング地点間のパルス波が移動した距離を決定するために使用される。この距離は、次いで、脈波伝播速度をもたらすパルス通過時間によって分割される。測定は3回実施し、平均肛門のために使用されるysis。

<html><img alt="表1" fo:content-width="5in" fo:src="/files/ftp_upload/50817/50817table1highres.jpg" src="/files/ftp_upload/50817/50817table1.jpg" /> 表1。 PWVの結果は、メートル毎秒で製造される。健康な被験者では、これらの速度は、（30歳未満の被験者では）平均6.2メートル/秒から10.9メートル/秒の範囲で指定できます（70歳以上の被験者で）。これらの値は、健康な人での記事「...

Watch this Scientific Journal Video about Pulse Wave Velocity Testing in the Baltimore Longitudinal Study of Aging at JoVE.com

Pulse Wave Velocity Testing in the Baltimore Longitudinal Study of Aging

脈波伝播速度（P​​WV）の測定は、動脈圧力波は、一般的にそれが頸動脈を使用して、下行大動脈（から移動するこの波にかかる時間を近似する、動脈樹に沿って進行する速度を計測する眼圧測定ベースのシステムによって動脈硬化性を評価大腿動脈に代用として動脈）。頸動脈 - 大腿PWVは2〜大人の寿命全体で3倍に増加します。

高齢化のボルチモア縦断的研究におけるパルス波速度のテスト

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

pulse-wave-velocity-testing-baltimore-longitudinal-study

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Unit 1

Vital Signs: Pulse

SCIENTISTS IN ACTION

17.0K ビュー.  National Institute of Aging. 脈波伝播速度（P​​WV）の測定は、動脈圧力波は、一般的にそれが頸動脈を使用して、下行大動脈（から移動するこの波にかかる時間を近似する、動脈樹に沿って進行する速度を計測する眼圧測定ベースのシステムによって動脈硬化性を評価大腿動脈に代用として動脈）。頸動脈 - 大腿PWVは2〜大人の寿命全体で3倍に増加します。 

ビデオ: Pulse Wave Velocity Testing in the Baltimore Longitudinal Study of Aging

Biomarkers in an Animal Model for Revealing Neural, Hematologic, and Behavioral Correlates of PTSD

Identification of biomarkers representing the evolution of the pathophysiology of Post Traumatic Stress Disorder (PTSD) is vitally important, not only for objective diagnosis but also for the evaluation of therapeutic efficacy and resilience to trauma. Ongoing research is directed at identifying molecular biomarkers for PTSD, including traumatic stress induced proteins, transcriptomes, genomic variances and genetic modulators, using biologic samples from subjects' blood, saliva, urine, and postmortem brain tissues. However, the correlation of these biomarker molecules in peripheral or postmortem samples to altered brain functions associated with psychiatric symptoms in PTSD remains unresolved. Here, we present an animal model of PTSD in which both peripheral blood and central brain biomarkers, as well as behavioral phenotype, can be collected and measured, thus providing the needed correlation of the central biomarkers of PTSD, which are mechanistic and pathognomonic but cannot be collected from people, with the peripheral biomarkers and behavioral phenotypes, which can.
Our animal model of PTSD employs restraint and tail shocks repeated for three continuous days - the inescapable tail-shock model (ITS) in rats. This ITS model mimics the pathophysiology of PTSD 17, 7, 4, 10. We and others have verified that the ITS model induces behavioral and neurobiological alterations similar to those found in PTSD subjects 17, 7, 10, 9. Specifically, these stressed rats exhibit (1) a delayed and exaggerated startle response appearing several days after stressor cessation, which given the compressed time scale of the rat's life compared to a humans, corresponds to the one to three months delay of symptoms in PTSD patients (DSM-IV-TR PTSD Criterian D/E 13), (2) enhanced plasma corticosterone (CORT) for several days, indicating compromise of the hypothalamopituitary axis (HPA), and (3) retarded body weight gain after stressor cessation, indicating dysfunction of metabolic regulation.
The experimental paradigms employed for this model are: (1) a learned helplessness paradigm in the rat assayed by measurement of acoustic startle response (ASR) and a charting of body mass; (2) microdissection of the rat brain into regions and nuclei; (3) enzyme-linked immunosorbent assay (ELISA) for blood levels of CORT; (4) a gene expression microarray plus related bioinformatics tools 18. This microarray, dubbed rMNChip, focuses on mitochondrial and mitochondria-related nuclear genes in the rat so as to specifically address the neuronal bioenergetics hypothesized to be involved in PTSD.

We describe a rat model of post traumatic stress disorder (PTSD) that reveals the persistent alterations in neuroendocrine function and the delayed long-term, exaggerated fear response, characteristic of PTSD patients. The animal model and methods described here are useful for correlating biomarkers in brain nuclei, which are mechanistic but cannot be measured in patients, with biomarkers in peripheral white blood cells, which can.

PTSDの、ニューラル血液学的および行動的相関関係を明らかにするための動物モデルにおけるバイオマーカー

Identification of biomarkers representing the evolution of the pathophysiology of Post Traumatic Stress Disorder (PTSD) is vitally important, not only for ...

医学

Tilt Testing with Combined Lower Body Negative Pressure: a "Gold Standard" for Measuring Orthostatic Tolerance

Orthostatic tolerance (OT) refers to the ability to maintain cardiovascular stability when upright, against the hydrostatic effects of gravity, and hence to maintain cerebral perfusion and prevent syncope (fainting). Various techniques are available to assess OT and the effects of gravitational stress upon the circulation, typically by reproducing a presyncopal event (near-fainting episode) in a controlled laboratory environment. The time and/or degree of stress required to provoke this response provides the measure of OT. Any technique used to determine OT should: enable distinction between patients with orthostatic intolerance (of various causes) and asymptomatic control subjects; be highly reproducible, enabling evaluation of therapeutic interventions; avoid invasive procedures, which are known to impair OT1.
In the late 1980s head-upright tilt testing was first utilized for diagnosing syncope2. Since then it has been used to assess OT in patients with syncope of unknown cause, as well as in healthy subjects to study postural cardiovascular reflexes2-6. Tilting protocols comprise three categories: passive tilt; passive tilt accompanied by pharmacological provocation; and passive tilt with combined lower body negative pressure (LBNP). However, the effects of tilt testing (and other orthostatic stress testing modalities) are often poorly reproducible, with low sensitivity and specificity to diagnose orthostatic intolerance7.
Typically, a passive tilt includes 20-60 min of orthostatic stress continued until the onset of presyncope in patients2-6. However, the main drawback of this procedure is its inability to invoke presyncope in all individuals undergoing the test, and corresponding low sensitivity8,9. Thus, different methods were explored to increase the orthostatic stress and improve sensitivity.
Pharmacological provocation has been used to increase the orthostatic challenge, for example using isoprenaline4,7,10,11 or sublingual nitrate12,13. However, the main drawback of these approaches are increases in sensitivity at the cost of unacceptable decreases in specificity10,14, with a high positive response rate immediately after administration15. Furthermore, invasive procedures associated with some pharmacological provocations greatly increase the false positive rate1.
Another approach is to combine passive tilt testing with LBNP, providing a stronger orthostatic stress without invasive procedures or drug side-effects, using the technique pioneered by Professor Roger Hainsworth in the 1990s16-18. This approach provokes presyncope in almost all subjects (allowing for symptom recognition in patients with syncope), while discriminating between patients with syncope and healthy controls, with a specificity of 92%, sensitivity of 85%, and repeatability of 1.1&plusmn;0.6 min16,17. This allows not only diagnosis and pathophysiological assessment19-22, but also the evaluation of treatments for orthostatic intolerance due to its high repeatability23-30. For these reasons, we argue this should be the "gold standard" for orthostatic stress testing, and accordingly this will be the method described in this paper.

We describe a "gold standard" for evaluating orthostatic tolerance (OT) using tilt testing with combined lower body negative pressure (LBNP). This can be combined with non-invasive evaluations of cardiovascular reflex control. Normal and abnormal responses are defined.

コンバインド下半身陰圧とチルト試験：起立耐性を測定するための &quot;ゴールドスタンダード&quot;

Orthostatic tolerance (OT)  refers to the ability to maintain cardiovascular stability when upright,  against the hydrostatic effects of gravity, and ...

Orthotopic Aortic Transplantation in Mice for the Study of Vascular Disease

Vascular procedures involving anastomoses in the mouse are generally thought to be difficult and highly dependent on the skill of the individual surgeon. This is largely true, but there are a number of important principles that can reduce the difficulty of these procedures and enhance reproducibility. Orthotopic aortic transplantation is an excellent procedure in which to learn these principles because it involves only two end-to-end anastomoses, but requires good suturing technique and handling of the vessels for consistent success. This procedure begins with the procurement of a length of abdominal aorta from a donor animal, followed by division of the native aorta in the recipient. The procured aorta is then placed between the divided ends of the recipient aorta and sutured into place using end-to-end anastomoses. To accomplish this objective successfully requires a high degree of concentration, good tools, a steady hand, and an appreciation of how easily the vasculature of a mouse can be damaged, resulting in thrombosis. Learning these important principles is what occupies most of the beginner's time when learning microsurgery in small rodents. Throughout this protocol, we refer to these important points. This model can be used to study vascular disease in a variety of different experimental systems1-8. In the context shown here, it is most often used for the study of post-transplant vascular disease, a common long-term complication of solid organ transplantation in which intimal hyperplasia occurs within the allograft. The primary advantage of the model is that it facilitates quantitative morphometric analyses and the transplanted vessel lies contiguous to the endogenous vessel, which can serve as an additional control9. The technique shown here is most often used for mice weighing 18-25 grams. We have accumulated most of our experience using the C57BL/6J, BALB/cJ, and C3H/HeJ strains.

We describe a technique in which a section of the abdominal aorta from a mouse is transplanted orthotopically to just below the renal arteries in an allogeneic or syngeneic recipient. This technique can be useful in studies in which transplantation of large arteries of uniform size is deemed advantageous.

血管疾患の研究のためのマウスにおける同所性大動脈移植

Vascular procedures involving anastomoses in the mouse are generally thought to be difficult and highly dependent on the skill of the individual surgeon. ...

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.

マウスにおける超音波ベースのパルス波速度の評価

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 ...

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

For the elderly, arterial stiffening is a good marker for aging evaluation and it is recommended that the arterial stiffness be determined noninvasively by the measurement of carotid to femoral pulse wave velocity (cf-PWV) (Class I; Level of Evidence A). In literature, numerous community-based or disease-specific studies have reported that higher cf-PWV is associated with increased cardiovascular risk. Here, we discuss strategies to evaluate arterial stiffness with cf-PWV. Following the well-defined steps detailed here, e.g., proper position operator, distance measurement, and tonometer position, we will obtain a standard cf-PWV value to evaluate arterial stiffness. In this paper, a detailed stepwise method to record a good quality PWV and pulse wave analysis (PWA) using a non-invasive tonometry-based device will be discussed.

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

This protocol describes a method to standardize the measurements of carotid-femoral pulse wave velocity to evaluate arterial stiffness.

大腿部の脈波伝播速度 (Cf PWV) 動脈硬化を評価するために頸動脈を測定

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

Measurement of Pulse Propagation Velocity, Distensibility and Strain in an Abdominal Aortic Aneurysm Mouse Model

An abdominal aortic aneurysm (AAA) is defined as a localized dilation of the abdominal aorta that exceeds the maximal intraluminal diameter (MILD) by 1.5 times of its original size. Clinical and experimental studies have shown that small aneurysms may rupture, while a subpopulation of large aneurysms may remain stable. Thus, in addition to the measurement of intraluminal diameter of the aorta, knowledge of structural traits of the vessel wall may provide important information to assess the stability of the AAA. Aortic stiffening has recently emerged as a reliable tool to determine early changes in the vascular wall. Pulse propagation velocity (PPV) along with the distensibility and radial strain are highly useful ultrasound-based methods relevant for assessing aortic stiffness. The primary purpose of this protocol is to provide a comprehensive technique for the use of ultrasound imaging system to acquire images and analyze the structural and functional properties of the aorta as determined by MILD, PPV, distensibility and radial strain.

This manuscript describes a detailed protocol for using high frequency ultrasound imaging to measure luminal diameter, pulse propagation velocity, distensibility and radial strain on a mouse model of abdominal aortic aneurysm.

腹部大動脈瘤マウスモデルにおける脈拍伝播速度、分解性およびひずみの測定

An abdominal aortic aneurysm (AAA) is defined as a localized dilation of the abdominal aorta that exceeds the maximal intraluminal diameter (MILD) by 1.5 ...

免疫・感染学

<meta charset="utf8"></head><body>超音波BDAT装置を用いた皮質骨評価

Cortical Bone Assessment Using Ultrasonic Guided Waves: A Reproducibility Study in a Healthy Population

Fragility fractures are still a worldwide health burden in the context of population aging. In particular, the global number of hip fractures is expected to double between 2020 and 2050. Therefore, it is essential to detect patients at risk of fragility fracture at the population scale. The current golden standard is dual X-ray absorptiometry (DXA), providing the areal bone mineral density (aBMD). Ultrasonic devices, usually more portable and cheaper than X-ray devices, represent interesting DXA alternatives as screening tools. However, operator dependency is usually recognized as their main drawback. In this study, the measurement protocol of the bi-directional axial transmission (BDAT) ultrasonic device is presented in detail. The dedicated ultrasonic probe is placed at the one-third distal radius of the non-dominant forearm using conventional coupling gel. The guided interface provides in quasi-real time (about 2 Hz) four parameters of interest: velocities of the first arriving signal (vFAS) and the A0 mode (vA0),&#160;cortical thickness (Ct.Th) and porosity (Ct.Po), as well as four quality parameters. The operator moves the probe slowly at the measurement site, carefully observing the feedback provided by the interface until finding a stable position and starting a series of 10 acquisitions. When at least four consistent series are obtained, the measurement ends, and an automatic report is generated. The measurement usually takes about 5 min to complete. To determine the robustness of this protocol, a reproducibility study was conducted among 3 operators (one expert and two novices) and 14 healthy participants (6 women, 8 men, 21-53 years old). The intraclass correlation coefficients (ICC) were found good for vA0 (0.76), Ct.Po (0.80) or excellent for Ct.Th (0.87) and vFAS (0.91). The standard deviations were found to be less than 10% of the total ranges in clinical practice.

<meta charset="utf8"></head><body>超音波ガイド波を用いた皮質骨評価:健常者集団における再現性研究

Here, we present the measurement protocol of the bi-directional axial transmission (BDAT) ultrasonic device in detail and test it in a reproducibility study, considering 14 healthy participants and 3 operators. Reliability, measured with the intraclass correlation coefficients (ICC), was good to excellent for four parameters of interest.

超音波ガイド波を用いた皮質骨評価:健常者集団における再現性研究

Fragility fractures are still a worldwide health burden in the context of population aging. In particular, the global number of hip fractures is expected ...

生物工学

トレーニングワークロードにおける脚の血流の評価

Doppler Ultrasound-Based Leg Blood Flow Assessment During Single-Leg Knee-Extensor Exercise in an Uncontrolled Setting

Doppler ultrasound has revolutionized the assessment of organ blood flow and is widely used in research and clinical settings. While Doppler ultrasound-based assessment of contracting leg muscle blood flow is common in human studies, the reliability of this method requires further investigation. Therefore, this study aimed to investigate the within-day test-retest, between-day test-retest, and inter-rater reliability of Doppler ultrasound for assessing leg blood flow during rest and graded single-leg knee-extensions (0 W, 6 W, 12 W, and 18 W), with the ultrasound probe being removed between measurements. The study included thirty healthy subjects (age: 33 &#177; 9.3, male/female: 14/16) who visited the laboratory on two different experimental days separated by 10 days. The study did not control for major confounders such as nutritional state, time of day, or hormonal status. Across different exercise intensities, the results demonstrated high within-day reliability with a coefficient of variation (CV) ranging from 4.0% to 4.3%, acceptable between-day reliability with a CV ranging from 10.1% to 20.2%, and inter-rater reliability with a CV ranging from 17.9% to 26.8%. Therefore, in a real-life clinical scenario where controlling various environmental factors is challenging, Doppler ultrasound can be used to determine leg blood flow during submaximal single-leg knee-extensor exercise with high within-day reliability and acceptable between-day reliability when performed by the same sonographer.

著者スポットライト:脚の血流の測定におけるドップラー超音波の信頼性の評価 

This test-retest study evaluated leg blood flow measured by the Doppler ultrasound technique during single-leg knee-extensor exercise. The within-day, between-day, and inter-rater reliability of the method was investigated. The approach demonstrated high within-day and acceptable between-day reliability. However, the inter-rater reliability was unacceptably low during rest and at low workloads.

高齢化のボルチモア縦断的研究におけるパルス波速度のテスト

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PTSDの、ニューラル血液学的および行動的相関関係を明らかにするための動物モデルにおけるバイオマーカー

コンバインド下半身陰圧とチルト試験：起立耐性を測定するための "ゴールドスタンダード"

血管疾患の研究のためのマウスにおける同所性大動脈移植

マウスにおける超音波ベースのパルス波速度の評価

大腿部の脈波伝播速度 (Cf PWV) 動脈硬化を評価するために頸動脈を測定

腹部大動脈瘤マウスモデルにおける脈拍伝播速度、分解性およびひずみの測定

超音波ガイド波を用いた皮質骨評価:健常者集団における再現性研究

超音波ガイド波を用いた皮質骨評価:健常者集団における再現性研究

超音波ガイド波を用いた皮質骨評価:健常者集団における再現性研究

制御されていない環境での片脚膝伸筋運動中のドップラー超音波ベースの脚の血流評価