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dc.contributor.authorHickson, Stacey S.
dc.contributor.authorNichols, Wilmer W.
dc.contributor.authorYasmin
dc.contributor.authorMcDonnell, Barry
dc.contributor.authorCockcroft, John R.
dc.contributor.authorWilkinson, Ian B.
dc.contributor.authorMcEniery, Carmel M.
dc.date.accessioned2017-09-08T11:26:06Z
dc.date.available2017-09-08T11:26:06Z
dc.date.issued2016-10-01
dc.identifier.citationHickson, S.S., Nichols, W.W., Yasmin, McDonnell, B.J., Cockcroft, J.R., Wilkinson, I.B. and McEniery, C.M. (2016) 'Influence of the central-to-peripheral arterial stiffness gradient on the timing and amplitude of wave reflections', Hypertension Research: official journal of the Japanese Society of Hypertension, 39(10), p.723-729en_US
dc.identifier.urihttp://hdl.handle.net/10369/8765
dc.descriptionThis article was published in Hypertension Research in October 2016 available at http://dx.doi.org/10.1038/hr.2016.64en_US
dc.description.abstractIn individuals with compliant aortas, peripheral muscular artery stiffness exceeds central elastic artery stiffness. With ageing, central stiffness increases, with little change in peripheral stiffness, resulting in a reversal of the normal stiffness gradient. This reversal may reduce wave reflection amplitude, due to movement of the major “effective” reflection site further from the heart. To test this, we investigated the relationship among arterial stiffness gradients (normal and reversed), wave reflection amplitude and reflection site distance. Subjects aged ≥50years were recruited from the Anglo-Cardiff Collaborative Trial. Central stiffness was assessed by carotid-femoral pulse wave velocity (cfPWV). In study 1, peripheral PWV was also measured in the arm (carotid-radial, crPWV), and in study 2 in the leg (femoral-dorsalis pedis, fpPWV). Reflection site distance was calculated from cfPWV and reflected wave travel time. Subjects were dichotomized into those with a normal stiffness gradient (peripheral>central PWV), or a reversed gradient (peripheral<central PWV). In study 1, reflection site distance was greater in subjects with a reversed gradient (P<0.01), whereas time to reflection was lower (P<0.001). Both augmentation pressure (P<0.001) and augmentation index (P<0.05) were greater in subjects with a reversed gradient. In study 2, augmentation pressure, augmentation index and reflection site distance were greater in subjects with a reversed stiffness gradient (P<0.01, P<0.05 and P<0.01, respectively), and time to reflection was not different between groups. A reversed arterial stiffness gradient is associated with increased reflection site distance and a paradoxical increase in reflected wave amplitude, and augmentation index.en_US
dc.description.sponsorshipBritish Heart Foundationen_US
dc.description.sponsorshipNational Institute for Health Researchen_US
dc.description.sponsorshipCambridge Commonwealth Trusten_US
dc.language.isoenen_US
dc.publisherNature Publishing Groupen_US
dc.relation.ispartofseriesHypertension Research;
dc.subjectarterial stiffness gradient, augmentation index, pulse wave velocity, wave reflection, central pulse pressureen_US
dc.titleInfluence of the Central to Peripheral Arterial Stiffness Gradient on the Timing and Amplitude of Wave Reflectionsen_US
dc.typeArticleen_US
dc.identifier.doihttp://dx.doi.org/10.1038/hr.2016.64
dcterms.dateAccepted2016-05-05
rioxxterms.funderCardiff Metropolitan Universityen_US
rioxxterms.identifier.projectCardiff Metropolian (Internal)en_US
rioxxterms.versionAMen_US
rioxxterms.licenseref.urihttp://www.rioxx.net/licenses/all-rights-reserveden_US
rioxxterms.licenseref.startdate2017-09-08
rioxxterms.funder.project37baf166-7129-4cd4-b6a1-507454d1372een_US


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