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C. Zimbalatti

Bio: C. Zimbalatti is an academic researcher. The author has contributed to research in topics: Pulse wave velocity. The author has an hindex of 1, co-authored 1 publications receiving 21 citations.

Papers
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Journal ArticleDOI
TL;DR: In otherwise healthy subjects from lean to morbid obesity, visceral adiposity is associated with increase in CO, BP and carotid stiff- ness and WI analysis, but not established indices of LV performance, discloses an unfavorable VA coupling in obesity.
Abstract: ; BP 126±15/76±10 mm Hg), free of heart disease, HBP, diabetes, dyslipidemia were studied. LV pump function (CO and EF) was assessed by 2D Echo. Arterial mechanics was evaluated at carotid level by vascular ultra- sound (Aloka SSD-5500) implemented with a double beam tracking system providing distension waveforms, diameter-derived pressure and flow. Pres- sure independent stiffness index (s) and pulse wave velocity (PWV) were estimated. By wave intensity analysis (time-dependent product of first de- rivatives of BP and flow), an index of LV inotropic function was obtained by the amplitude of the early-systolic peak (forward compression wave, FCW). Insulin sensitivity was estimated from plasma glucose and insulin responses to O-GTT (OGIS index). Results: Waist to hip ratio (W/H) correlated directly with MBP, CO, PWV, b (r: 0.34-0.41, p<0.01), but not with EF and FCW. OGIS correlated inversely with W/H, CO, MBP (r: -0.45 to -0.47, p<0.005) but not with stiffness. PWV and s correlated directly with age and MBP (r: 0.35-0.63), but not with OGIS. In a sex-adjusted multivariate model, age and MBP were independent pre- dictors of stiffness (adjusted r2: 0.57). Both PWV and s were inversely re- lated to FCW (r: -0.27 for both, p<0.05), but not to CO and EF. Conclusions: In otherwise healthy subjects from lean to morbid obesity, visceral adiposity is associated with increase in CO, BP and carotid stiff- ness. Visceral adiposity and changes in systemic hemodynamics are asso- ciated with IR. Increased carotid stiffness paralleling visceral adiposity re- sults from increased BP more than from an independent effect of IR. WI analysis, but not established indices of LV performance, discloses an unfavorable VA coupling in obesity.

21 citations


Cited by
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Journal ArticleDOI
TL;DR: The feasibility of the novel ARTSENS device in performing accurate in vivo measurements of arterial stiffness is verified, a device for image free, noninvasive, automated evaluation of vascular stiffness amenable for field use.
Abstract: Vascular stiffness is an indicator of cardiovascular health, with carotid artery stiffness having established correlation to coronary heart disease and utility in cardiovascular diagnosis and screening. State of art equipment for stiffness evaluation are expensive, require expertise to operate and not amenable for field deployment. In this context, we developed ARTerial Stiffness Evaluation for Noninvasive Screening (ARTSENS), a device for image free, noninvasive, automated evaluation of vascular stiffness amenable for field use. ARTSENS has a frugal hardware design, utilizing a single ultrasound transducer to interrogate the carotid artery, integrated with robust algorithms that extract arterial dimensions and compute clinically accepted measures of arterial stiffness. The ability of ARTSENS to measure vascular stiffness in vivo was validated by performing measurements on 125 subjects. The accuracy of results was verified with the state-of-the-art ultrasound imaging-based echo-tracking system. The relation between arterial stiffness measurements performed in sitting posture for ARTSENS measurement and sitting/supine postures for imaging system was also investigated to examine feasibility of performing ARTSENS measurements in the sitting posture for field deployment. This paper verified the feasibility of the novel ARTSENS device in performing accurate in vivo measurements of arterial stiffness. As a portable device that performs automated measurement of carotid artery stiffness with minimal operator input, ARTSENS has strong potential for use in large-scale screening.

53 citations

Journal ArticleDOI
TL;DR: The results support a link between systemic vascular health and neurocognitive function in older Asian adults and subclinical noninvasive measures of arterial stiffness and reactivity may identify individuals vulnerable to cognitive impairment.
Abstract: Background Few studies have comprehensively evaluated the relationship between vascular disease and cognition of older adults without cardiac disease. Objective We explored the associations of structural atherosclerosis, vascular stiffness, and reactivity with global, memory, attention, language, visuospatial ability, and executive function in community-dwelling, non-demented older Asians without cardiac diseases. Methods Cognition was assessed by Mini-Mental State Examination (MMSE) (n = 308) and detailed neuropsychological tests (n = 155). Vascular measures included carotid intima-media thickness; aortic stiffness [carotid-femoral pulse wave velocity (CFPWV), aortic augmentation index (AI), and aortic pulse pressure (PP)]; carotid stiffness [elasticity modulus (Ep), beta index (β), arterial compliance (AC), carotid AI]; and endothelial function [reactive hyperemia index (RHI)]. Multivariable analyses controlled for potential confounding by demographics, apolipoprotein E genotype and cardiovascular risk factors. Results The participants' mean age was 63.0 ± 6.1 years. Inverse associations with MMSE were found for AC (β= 0.128, p = 0.019), Ep (β= -0.151, p = 0.008), β index (β= -0.122, p = 0.029), carotid stiffness z-score (β= -0.154, p = 0.007); with executive function for CFPWV (β= -0.209, p = 0.026), AC (β= 0.214, p = 0.005), Ep (β= -0.160, p = 0.050), β index (β= -0.165, p = 0.041), and both aortic (β= -0.229, p = 0.010) and carotid (β= -0.208, p = 0.010) stiffness z-scores; with verbal memory for AI (β= -0.229, p = 0.004) and aortic (β= -0.263, p = 0.004) stiffness z-score; with language for AI (β= -0.155, p = 0.025), aortic stiffness z-score (β= -0.196, p = 0.011). RHI positively correlated with visuospatial ability (β= 0.195, p = 0.013) and executive function (β= 0.151, p = 0.045). Conclusion The results support a link between systemic vascular health and neurocognitive function in older Asian adults. Subclinical noninvasive measures of arterial stiffness and reactivity may identify individuals vulnerable to cognitive impairment.

41 citations

Journal ArticleDOI
TL;DR: The results indicate that age-related arterial changes, at least in middle-aged males, can be reversed, and short-term treatment with a low-dose fluvastatin/valsartan combination resulted in a large and long lasting improvement of arterial function.

40 citations

Proceedings ArticleDOI
03 Jul 2013
TL;DR: The ability of ARTSENS to detect artery anatomy and measure compliance was verified by in-vivo measurements conducted on 106 subjects, and the accuracy of compliance estimates were evaluated by comparison with a state of art imaging system.
Abstract: Evaluation of arterial compliance is significant in cardiovascular diagnosis for early detection of coronary heart disease. We present ARTSENS, an image-free system for non-invasive evaluation of arterial compliance in-vivo. The system utilizes a single element ultrasound probe with intelligent measurement algorithms to ensure accurate evaluation of local arterial compliance without an image. The ability of the system to detect artery anatomy and measure compliance was verified by in-vivo measurements conducted on 106 subjects. The accuracy of compliance estimates were evaluated by comparison with a state of art imaging system. The measurements made using ARTSENS showed strong correlation with those made using the imaging system. The ability of ARTSENS to detect age-related trends in arterial compliance was also investigated.

20 citations

Journal ArticleDOI
TL;DR: In healthy middle-age males, a low impact of traditional risk factors on the studied variables is found, providing a deepened understanding of arterial wall properties and could help to improve cardiovascular risk stratification.
Abstract: The arterial wall possesses several functional and structural properties that define arterial health. Once they become impaired, cardiovascular risk increases. We aimed to ascertain the pattern of correlations among different arterial wall properties and to explore their relations to traditional risk factors and cardiovascular risk stratification. To allow such an investigation a middle-aged healthy population was recruited. This cross-sectional study included 100 healthy males (aged 41.9 ± 6.4 years). Pulse wave velocity (PWV), β-stiffness and intima-media thickness (IMT) of the carotid artery, and brachial artery flow-mediated dilation (FMD) were measured by a standardized ultrasound approach. No correlation between FMD and IMT was found; only relatively poor correlations between PWV (or β-stiffness) and FMD existed, as well as between PWV (or β-stiffness) and IMT. PWV and β-stiffness highly correlated. Unexpectedly, only weak associations between PWV, β-stiffness, FMD, IMT and traditional risk factors were revealed. Hence, traditional risk factors (mainly age) explained only 10-50% of variability for PWV, β-stiffness, FMD and IMT. Although the subjects had low cardiovascular risk according to their Framingham score, their arterial wall properties were already impaired, particularly FMD. In healthy middle-age males we found: i) absent or poor correlations among arterial stiffness, IMT and endothelial function; ii) a low impact of traditional risk factors on the studied variables, and iii) the presence of impaired arterial wall properties despite low calculated cardiovascular risk. These results provide a deepened understanding of arterial wall properties and could help to improve cardiovascular risk stratification.

18 citations