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Abstract Type 2 diabetes mellitus (T2DM) is a major cause of microvascular dysfunction. However, its effect on blood flow patterns during ischemic demand has not been adequately elucidated. In this study, we investigated the hypothesis that microvascular dysfunction in patients with T2DM manifests as brachial reactive hyperemia (BRH), defined as the ratio of peak blood flow velocities in a brachial artery before and after forearm cuff occlusion. The study enrolled 943 subjects (men, n = 152 [T2DM] and n = 371 [non‐T2DM]; women, n = 107 [T2DM] and n = 313 [non‐T2DM], respectively) with no history of cardiovascular disease. Semiautomatic measurements were obtained three times at 1.5‐year intervals to confirm the reproducibility of factors involved in BRH for each sex. An age‐adjusted mixed model demonstrated attenuated BRH in the presence of T2DM in both men (p = 0.022) and women (p = 0.031) throughout the study period. Post hoc analysis showed that the estimated BRH was significantly attenuated in patients with T2DM regardless of sex, except at baseline in women. In multivariate regression analysis, T2DM was a negative predictor of BRH at every measurement in men. For women, BRH was more strongly associated with alcohol consumption. Repeated measurements analysis revealed that T2DM was associated with attenuated postocclusion reactive hyperemia.

Light to moderate alcohol consumption has protective effects on all-cause death and coronary artery disease in women. It is thought that light to moderate alcohol consumption has a beneficial effect on vascular function in women. We measured flow-mediated vasodilation (FMD) in 702 women aged 17-86 years who provided information on alcohol consumption. We divided the subjects into four groups: non-drinkers (0 g/week), light drinkers (>0 to 140 g/week), moderate drinkers (>140 to 280 g/week) and heavy drinkers (>280 g/week). There was no significant difference in FMD among the four groups. Multivariate regression analysis revealed that alcohol consumption in non-drinkers and light drinkers was not an independent predictor of FMD (β = -0.001, P = 0.98). We compared 50 moderate drinkers and 50 non-drinkers matched for age and medical histories and 22 heavy drinkers and 22 non-drinkers in matched pair analysis. There was no significant difference in FMD between moderate drinkers and non-drinkers (8.2±4.3% vs. 8.1±3.5, P = 0.91), while FMD in heavy drinkers was significantly lower than that in non-drinkers (5.9±2.5% vs. 8.9±3.5%, P = 0.002). These findings suggest that heavy alcohol consumption is associated with endothelial dysfunction but that light to moderate alcohol consumption is not associated with endothelial dysfunction in women. Clinical trial registration information This study was approved by principal authorities and ethical issues in Japan (University Hospital Medical Information Network UMIN000012952, 01/12/2009). www.umin.ac.jp/.

Background Diagnostic criteria of flow‐mediated vasodilation (FMD), an index of endothelial function, and nitroglycerin‐induced vasodilation (NID), an index of vascular smooth muscle function, of the brachial artery have not been established. The purpose of this study was to propose diagnostic criteria of FMD and NID for normal endothelial function and normal vascular smooth muscle function. Methods and Results We investigated the cutoff values of FMD and NID in subjects with (risk group) and those without cardiovascular risk factors or cardiovascular diseases (no‐risk group) in 7277 Japanese subjects (mean age 51.4±10.8 years) from the Flow‐Mediated Dilation Japan study and the Flow‐Mediated Dilatation Japan Registry study for analysis of the cutoff value of FMD and in 1764 Japanese subjects (62.2±16.1 years) from the registry of Hiroshima University Hospital for analysis of the cutoff value of NID. Receiver‐operator characteristic curve analysis of FMD to discriminate subjects in the no‐risk group from patients in the risk group showed that the optimal cutoff value of FMD to diagnose subjects in the no‐risk group was 7.1%. Receiver‐operator characteristic curve analysis of NID to discriminate subjects in the no‐risk group from patients in the risk group showed that the optimal cutoff value of NID to diagnose subjects in the no‐risk group was 15.6%. Conclusions We propose that the cutoff value for normal endothelial function assessed by FMD of the brachial artery is 7.1% and that the cutoff value for normal vascular smooth muscle function assessed by NID of the brachial artery is 15.6% in Japanese subjects. Clinical Trial Registration www.umin.ac.jp Unique identifiers: UMIN000012950, UMIN000012951, UMIN000012952, and UMIN000003409

Indoles are formed from dietary tryptophan by tryptophanase-positive bacterium. A few amounts of indole are excreted in the urine. On the other hand, cigarette smoke contains indoles, which could also change the urine indole levels. This study sought to elucidate the relationship between urine indole levels and smoking habits. A total of 273 healthy men (46 ± 6 years old) were enrolled in the study. Fasting urine and blood samples were obtained in the morning. The indole concentration was measured by a commercialized kit with a modified Kovac’s reagent. The relationship with smoking status was evaluated. The median value of the urine indole test was 29.2 mg/L (interquartile range; 19.6–40.8). The urine indole level was significantly elevated in the smoking subjects (non-smoking group, 28.9 (20.9–39.1) mg/L, n = 94; past-smoking group, 24.5 (15.7–35.5) mg/L, n = 108; current-smoking group, 34.3 (26.9–45.0) mg/L, n = 71). In the current-smoking group, urine indole levels correlated with the number of cigarettes per day (ρ = 0.224, p = 0.060). A multivariate regression test with stepwise method revealed that the factors relating to urine indole level were current smoking (yes 1/no 0) (standardized coefficient β = 0.173, p = 0.004), blood urea nitrogen (β = 0.152, p = 0.011), and triglyceride (β = −0.116, p = 0.051). The result suggests that smoking is associated with increased urine indole levels. The practical test might be used as a screening tool to identify the harmful effect of smoking.

Background The difference in the predictive ability of the brachial‐ankle pulse wave velocity (baPWV) and its stiffness index β‐transformed value (β‐baPWV, ie, baPWV adjusted for the pulse pressure) for the development of pathophysiological abnormalities related to cardiovascular disease or future occurrence of cardiovascular disease was examined. Methods and Results In study 1, a 7‐year prospective observational study in cohorts of 3274 men and 3490 men, the area under the curve in the receiver operator characteristic curve analysis was higher for baPWV than for β‐baPWV for predicting the development of hypertension (0.73, 95% CI=0.70 to 0.75 versus 0.59, 95% CI=0.56 to 0.62; P

Background Endothelial insulin resistance is insulin‐insensitivity in the vascular endothelium and can be observed in experimental models. This study aimed to investigate endothelial insulin resistance in patients with suspected coronary artery disease. To this end, a novel method of obtaining freshly isolated arterial endothelial cells from a radial catheter sheath was developed. Methods and Results Freshly isolated arterial endothelial cells were retrieved from catheter sheaths placed in radial arteries for coronary angiography (n=69, patient age 64±12 years). The endothelial cells were divided into groups for incubation with or without insulin, vascular endothelial growth factor, or acetylcholine. The intensity of phosphorylated endothelial nitric oxide synthase at Ser1177 (p‐eNOS) was quantified by immunofluorescence microscopy. The percentage increase of insulin‐induced phosphorylated endothelial nitric oxide synthase correlated negatively with derivatives of reactive oxygen metabolites, an oxidative stress test (r=−0.348, n=53, P=0.011), E/E′, an index of left ventricular diastolic dysfunction in Doppler echocardiography (ρ=−0.374, n=49, P=0.008), and log‐transformed brain natriuretic peptide (r=−0.266, n=62, P=0.037). Furthermore, percentage increase of insulin‐induced p‐eNOS was an independent factor for the cardio‐ankle vascular index (standardized coefficient β=−0.293, n=42, P=0.021) in the multivariate regression analysis of adaptive least absolute shrinkage and selection operator. Conclusions Our results suggested that endothelial insulin resistance is associated with oxidative stress, left ventricular diastolic dysfunction, heart failure, and arterial stiffness.

Purpose/Background/Objective: The usefulness of vascular function tests for management of patients with coronary artery disease (CAD) has not been fully investigated. Methods: We measured flow-mediated vasodilation (FMD) and brachial-ankle pulse wave velocity (baPWV) in 462 patients with CAD for assessment of the predictive value of FMD and baPWV for cardiovascular events in a prospective multicenter observational study. The first primary outcome was coronary events, and the second primary outcome was a composite of coronary events, stroke, heart failure, and sudden death. Results: A median follow-up period was 49.2 months. First primary outcome occurred in 56 patients and the second primary outcome occurred in 66 patients. FMD above the cutoff value of 7.1%, derived from receiver-operator curve analyses for the first and second primary outcomes, was significantly associated with lower risk of the first (hazard ratio [HR], 0.27; 95% confidence interval [CI], 0.06–0.74; P = 0.008) and second (HR, 0.32; 95% CI, 0.09–0.79; P = 0.01) primary outcomes. baPWV above the cutoff value of 1731 cm/s was significantly associated with higher risk of the first (HR, 1.86; 95% CI, 1.01–3.44; P = 0.04) and second (HR, 2.19; 95% CI, 1.23–3.90; P = 0.008) primary outcomes. Among the four groups stratified according to the combination of cutoff values of FMD and baPWV, stepwise increases in the calculated risk ratio for the first and second primary outcomes were observed. Conclusions: Both FMD and baPWV were independent predictors of cardiovascular events in patients with CAD. The combination of FMD and baPWV provided further cardiovascular risk stratification.

Background The usefulness of vascular function tests for management of patients with a history of coronary artery disease is not fully known. Methods and Results We measured flow‐mediated vasodilation (FMD) and brachial–ankle pulse wave velocity (baPWV) in 462 patients with coronary artery disease for assessment of the predictive value of FMD and baPWV for future cardiovascular events in a prospective multicenter observational study. The first primary outcome was coronary events, and the second primary outcome was a composite of coronary events, stroke, heart failure, and sudden death. During a median follow‐up period of 49.2 months, the first primary outcome occurred in 56 patients and the second primary outcome occurred in 66 patients. FMD above the cutoff value of 7.1%, derived from receiver‐operator curve analyses for the first and second primary outcomes, was significantly associated with lower risk of the first (hazard ratio, 0.27; 95% confidence interval, 0.06–0.74; P=0.008) and second (hazard ratio, 0.32; 95% confidence interval, 0.09–0.79; P=0.01) primary outcomes. baPWV above the cutoff value of 1731 cm/s was significantly associated with higher risk of the first (hazard ratio, 1.86; 95% confidence interval, 1.01–3.44; P=0.04) and second (hazard ratio, 2.19; 95% confidence interval, 1.23–3.90; P=0.008) primary outcomes. Among 4 groups stratified according to the combination of cutoff values of FMD and baPWV, stepwise increases in the calculated risk ratio for the first and second primary outcomes were observed. Conclusions In patients with coronary artery disease, both FMD and baPWV were significant predictors of cardiovascular events. The combination of FMD and baPWV provided further cardiovascular risk stratification. Clinical Trial Registration URL: www.umin.ac.jp. Unique identifier: UMIN000012950.

Many compensatory mechanisms exit in hemorrhagic shock (HS). To characterize the efficacy of the new artificial oxygen carrier, liposome-encapsulated hemoglobin (LHb), HS was induced by withdrawing 20% of the total blood volume from rats. Rats received one of five interventions: LHb resuscitation (LHb-G, n = 7), normal saline (Saline-G, n = 7), shed autologous blood (SAB-G, n = 7), volume expander of 5% albumin (Albumin-G, n = 7), or no treatment (Sham-G, n = 7). Heart rate variability (HRV) indices were measured, including low frequency (LF, 0.10–0.60 Hz), high frequency (HF, 0.60–2.00 Hz), and the ratio of LF to HF (LF/HF). LF and LF/HF following HS were lower in the LHb-G and SAB-G groups when compared with the Saline-G, Albumin-G and Sham-G groups. LF and LF/HF following HS in the LHb-G group were comparable with that of the SAB-G group. These data demonstrate that HS-induced changes can be attenuated by resuscitation with LHb as well as SAB. LHb could be used as a substitute for blood transfusion for HS.

Conventional heart rate variability (HRV) indices comprise time domain and frequency domain HRV indices that not only reflect the autonomic control of the heart but also serve as prognostic markers of various cardiovascular disorders. These indices have been extensively investigated as prognostic factors for patients who develop coronary artery diseases including myocardial infarction (MI). Non-linear indices of HRV such as the long (β)- and short (α1 and β2)-term fractal component indices and approximate entropy analysis have been clinically applied. In addition, heart rate turbulence (HRT) and the deceleration capacity (DC) of heart rate have been studied as potential HRV indices for predicting untoward outcomes of cardiovascular diseases. This overview examines HRV indices and their roles in the setting of cardiovascular disorders including sudden cardiac death. We describe changes in HRV indices and clarify the relationship between prognosis and the indices in critically ill patients admitted to intensive care units.

Sleep apnea syndrome (SAS) can exacerbate cardiovascular disease by augmenting activity of the sympathetic nervous system. One method of treating SAS is via modulation of body posture. Therefore, the goal of the present study was to investigate whether assuming the lateral position during sleep can influence autonomic nervous system activity, as assessed by measurement of heart rate variability (HRV). Six patients with coronary artery disease (CAD) complicated by SAS underwent serial measurements of HRV and arterial blood oxygen saturation (SPO2) during sleep. Online analyses for HRV was performed using five consecutive RR intervals from electrocardiography using the modified Maximum Entropy Method. Low frequency spectra (LF, 0.04–0.15 Hz), high frequency spectra (HF, 0.15–0.40 Hz) and the ratio of low and high frequency spectra (LF/HF ratio) were continuously calculated. HRV and SPO2 measurements were performed after 30 min of sleep in different sleeping positions (supine vs. lateral) with or without supplementary oxygen administration by nasal cannula. The LF and LF/HF ratio were significantly smaller in the lateral position with and without oxygen when compared with the supine position with or without oxygen (LF: Supine to Lateral position, from 673 ± 643 ms2/Hz to 201 ± 221 ms2/Hz, P < 0.05; Supine to Lateral position with supplementary oxygen, from 617 ± 511 ms2/Hz to 288 ± 389 ms2/Hz, P < 0.05; LF/HF ratio: Supine to Lateral position, from 9.4 ± 643 to 2.9 ± 1.9, P < 0.05; Supine to Lateral position with supplementary oxygen, from 6.1 ± 3.5 to 2.3 ± 1.5, P < 0.05). Further, arterial blood oxygen saturation was higher in the lateral position than in the supine position and was higher with supplementary oxygen than without supplementary oxygen (Supine, 86.7 ± 4.3%; Lateral, 94.5 ± 0.8%; Supine + O2, 93.2 ± 4.5%; Lateral + O2, 98.2 ± 1.5%). In conclusion, the lateral position during sleep attenuated sympathetic nervous system activity and improved oxygenation in patients with concomitant CAD and SAS.

Objective: In Japan, the number of elderly people with cerebral vascular disease (CVD) and dementia is increasing, resulting in increased expenditures to treat such patients. Reports indicate that music therapy can reduce anxiety in patients with myocardial infarction. However, it is unclear whether music therapy can have beneficial effects on very elderly patients with CVD and dementia, as these conditions may influence cardiac autonomic nerve functions. Therefore, we investigated the effects of music therapy on the autonomic nerve system in elderly patients with CVD and dementia, using an ambulatory Holter ECG system. Methods and Results: The subjects were 12 elderly patients aged ≥75 years, hospitalized for CVD and dementia. We measured their heart rate variability (HRV) indices of power domain and frequency domain analysis. The mean RR significantly increased during music therapy, from 842 ± 174 to 1022 ± 284 (p < 0:05), and decreased to 820 ± 284 ms after music therapy. HF significantly increased during music therapy, from 59 ± 41 to 127 ± 97 ms2 (p < 0:01), and decreased to 77 ± 60 ms2 after music therapy. LF/HF decreased from 2:2 ± 1:3 to 1:7 ± 1:3 during music therapy (p < 0:10), and increased to 2:0 ± 1:1 after music therapy. Time domain (HRV) indices increased during music therapy and decreased after music therapy: RMSSD increased from 19:4 ± 11 to 39:8 ± 17 ms, and then decreased to 19:4 ± 8:3 ms; pNN50 increased from 3:6 ± 3:2 to 16:1 ± 13:3%(p < 0:01), and then decreased to 4:3 ± 4:2%. Conclusions: Music therapy enhanced parasympathetic activity and decreased sympathetic activity in elderly patients with CVD and dementia. These findings suggest that music therapy is useful for alleviating anxiety, increasing comfort and facilitating relaxation for elderly patients with CVD and dementia.

Despite the advent of drug-eluting stents in Japan, bare metal stents or conventional balloon angioplasty are still indicated in some patients needing elective percutaneous coronary intervention (PCI) and in patients with acute coronary syndrome if these patients develop side effects while taking ticlopidine. In such patients, restenosis is a problem that is difficult to diagnose. To investigate the comparative diagnostic accuracy of the exercise-stress electrocardiogram (ECG) for detecting restenosis after PCI, we measured conventional ST-segment changes and QT dispersion during exercise-stress testing in 173 patients with elective PCI (63 ± 10 years old). Exercise-stress testing was performed 3 to 6 months after successful PCI, and restenosis was confirmed by follow-up coronary angiogram. There were 98 patients with a prior myocardial infarction (prior MI group and 76 patients with no prior myocardial infarction (no MI group). Restenosis was found in 45 patients (46% in the prior MI group and 26 patients (34%) in the no MI group. Conventional ST-segment depression (>1:0 mm, J 60 ms indicating exercise-induced myocardial ischemia had a sensitivity of around 50% and a specificity of around 70% for diagnosing restenosis in both groups. In the prior MI group, QT dispersion was increased by exercise-stress testing in both patients with and without restenosis, whereas in the no MI group, QT dispersion increased only in patients with restenosis. With a cut-off value of >60 ms, QT dispersion had a sensitivity of 54% and a specificity of 68% for detecting restenosis in the no MI group; these values were comparable to those seen with conventional ST-segment changes. In conclusion, due to its low cost, exercise-stress ECG remains useful for diagnosing restenosis following PCI if the clinician understands its limited sensitivity and specificity. The presence of a prior MI must be considered when QT dispersion during exercise-stress testing is used for detecting restenosis.

We report an unexpected sudden cardiac death due to variant angina complicated by ventricular fibrillation occurring during routine ambulatory electrocardiographic monitoring. The patient had one previous episode of ventricular fibrillation before the lethal event. He had no significant coronary artery disease and was asymptomatic throughout his illness. In clinical practice, when an episode of ventricular fibrillation is noted, one should be aware of the risk of sudden cardiac death, even if the patient's vasospastic angina is relatively stable and asymptomatic.

The aim of this study was to identify novel angiogenic mechanisms underlying the regenerative process. To that end, interactions between adipose tissue-derived stromal cells (ASCs) and bone marrow cells (BMCs) were initially investigated using real-time fluorescence optical imaging. To monitor cell behavior in mice, we injected green fluorescent protein-positive (GFP + ) BMCs into the tail vein and injected PKH26-labeled ASCs behind the ears. Angiogenesis and inflammation were observed at these sites via an optical imaging probe. Injected GFP + BMCs migrated from the blood vessels into the tissues surrounding the ASC injection sites. Many of the migrating GFP + BMCs discovered at the ASC injection sites were inflammatory cells, including Gr-1 + , CD11b + , and F4/80 + cells. ASCs cocultured with inflammatory cells secreted increased levels of chemokines such as macrophage inflammatory protein (MIP)-1α, MIP-1β, keratinocyte-derived chemokines, and monocyte chemotactic protein 1. Similarly, these ASCs secreted increased levels of angiogenic growth factors such as hepatocyte growth factor and vascular endothelial growth factor. However, when anti-CXC chemokine receptor type 4 antibody was injected at regular intervals, the migration of GFP + BMCs (especially Gr-1 + and CD11b + cells) to ASC injection sites was inhibited, as was angiogenesis. The collective influence of the injected ASCs and BMC-derived inflammatory cells promoted acute inflammation and angiogenesis. Together, the results suggest that the outcome of cell-based angiogenic therapy is influenced not only by the injected cells but also by the effect of intrinsic inflammatory cells.

This study was investigated the role that endothelial function and systemic vascular resistance (SVR) play in determining cardiac function reserve during exercise by a new ambulatory radionuclide monitoring system (VEST) in patients with heart disease. The study population consisted of 32 patients. The patients had cardiopulmonary stress testing using the treadmill Ramp protocol and the VEST. The anaerobic threshold (AT) was autodetermined using the V-slope method. The SVR was calculated by determining the mean blood pressure/cardiac output. Flow-mediated vasodilation (FMD) was measured in the brachial artery to evaluate endotheilial function. FMD and the percent change f'rom rest to AT in SVR correlated with those from rest to AT in ejection fraction and peak ejection ratio by VEST, respectively. Our findings suggest that FMD in the brachial artery and the SVR determined by VEST in patients with heart disease can possibly reflect cardiac function reserve during aerobic exercise.

Objective: Flow-mediated dilation (FMD) and nitroglycerin-mediated dilation (NMD) in the brachial artery are well-known indices for evaluating endothelial function (ECF). The blood pressure-lowering effects of the combination of losartan (ARB) and low-dose hydrochlorothiazide (H: ARB-H; ARB, 50 mg and H, 12.5 mg) are useful. The aim of the present study was to examine whether the combination of losartan and low-dose hydrochlorothiazide could improve ECF. Methods: To investigate the effect of ARB-H on ECF in patients with uncontrolled hypertension despite the use of amlodipine (2.5 mg daily), we performed a randomized controlled open-labeled study by using the envelope method and assigned 42 patients to either a control (CTRL) group or an ARB-H combination group, both of which received amlodipine 2.5 mg daily during the treatment period. In addition, both the CTRL (n=21, 69±7 years old) and ARB-H groups (n=21, 69±7 years old) received additional behavioral modification. Before and after 8 weeks of therapy, FMD and NMD were measured in both groups using novel FMD equipment (UNEXEF18G). Results: Although baseline FMD was not different between the two groups, post-therapy FMD increased in the ARB-H group (2.97±1.56 to 3.95±1.86%, p<0.05) but did not change significantly in the CTRL group (2.95±1.43 to 3.11±1.27%, NS). No significant change was seen in NMD when comparing baseline and post-therapy values in either group. No treatment complications were observed. Conclusion: A fixed-dose combination of losartan and hydrochlorothiazide enhances ECF, suggesting that this combination might have both anti-hypertensive and anti-atherosclerotic effects in patients with hypertension. [ABSTRACT FROM AUTHOR]

Objective To determine the relationships between flow-mediated vasodilation (FMD) and cardiovascular risk factors, and to evaluate confounding factors for measurement of FMD in a large general population in Japan. Methods This was a cross-sectional study. A total of 5314 Japanese adults recruited from people who underwent health screening from 1 April 2010 to 31 August 2012 at 3 general hospitals in Japan. Patients' risk factors (age, Body Mass Index, blood pressure, cholesterol parameters, glucose level and HbA1c level) and prevalence of cardiovascular disease (coronary heart disease and cerebrovascular disease) were investigated. Results Univariate regression analysis revealed that FMD correlated with age (r=-0.27, p<0.001), Body Mass Index (r=-0.14, p<0.001), systolic blood pressure (r=-0.18, p<0.001), diastolic blood pressure (r=-0.13, p<0.001), total cholesterol (r=-0.07, p<0.001), triglycerides (r=-0.10, p<0.001), high-density lipoprotein cholesterol (r=0.06, p<0.001), low-density lipoprotein cholesterol (r=-0.04, p=0.01), glucose level (r=-0.14, p<0.001), HbA1c (r=-0.14, p<0.001), and baseline brachial artery diameter (r=-0.43, p<0.001) as well as Framingham Risk score (r=-0.29, p<0.001). Multivariate analysis revealed that age (t value=-9.17, p<0.001), sex (t value=9.29, p<0.001), Body Mass Index (t value=4.27, p<0.001), systolic blood pressure (t value=-2.86, p=0.004), diabetes mellitus (t value= -4.19, p<0.001), smoking (t value=-2.56, p=0.01), and baseline brachial artery diameter (t value=-29.4, p<0.001) were independent predictors of FMD. Conclusions FMD may be a marker of the grade of atherosclerosis and may be used as a surrogate marker of cardiovascular outcomes. Age, sex, Body Mass Index, systolic blood pressure, diabetes mellitus, smoking and, particularly, baseline brachial artery diameter are potential confounding factors in the measurement of FMD. [ABSTRACT FROM AUTHOR]

Objectives: The purpose of this study was to determine the relationships between uric acid, endothelial function and cardiovascular risk factors and to investigate whether menopausal status was associated with the relationship between uric acid and endothelial function in women. Design: Cross-sectional study. Setting: 3 general hospitals in Japan. Participants: 749 Japanese women aged 30-74 years recruited from people who underwent health-screening examinations with agreement for measurement of vascular function. Measures: We measured serum concentrations of uric acid and flow-mediated vasodilation (FMD). Percentage of FMD (peak diameter-baseline diameter/baseline diameter) was used for analysis. Endothelial dysfunction was defined as FMD ≤4.90%, division point for the lowest tertile and the middle tertile of FMD. Menopause women were defined as participants without menstruation for over 1 year or participants with a history of hysterectomy or bilateral oophorectomy. Results: Of the 749 participants, 368 (49.1%) were premenopausal women and 381 (50.9%) were postmenopausal women. Age, body mass index, systolic blood pressure, total cholesterol, triglycerides, glucose, estimated glomerular filtration rate and Framingham risk score were significantly correlated with serum uric acid level. FMD showed a gradual decrease in accordance with the serum uric acid level in the entire study population (<4 mg/dL, 6.85±3.65%; 4 to <5 mg/dL, 6.79±3.60%; 5 to <6 mg/dL, 6.24±3.58%; ≥6 mg/dL, 5.27±3.18%; p=0.01). Multivariate analysis revealed that uric acid was a significantly independent risk factor for endothelial dysfunction in postmenopausal women (OR 1.23, 95% CI 1.01 to 1.50), but not in premenopausal women. Conclusions: These findings suggest that uric acid can be used as a risk marker of endothelial dysfunction in a female population, and particularly as an independent risk factor in postmenopausal women but not in premenopausal women. [ABSTRACT FROM AUTHOR]

BACKGROUND: Repeated application of whole-body periodic acceleration (WBPA) upregulates endothelial nitric oxide synthase and improves brachial artery endothelial function (BAEF) as assessed by measurement of flow-mediated vasodilatation (FMD). However, the acute effect of a single application of WBPA on BAEF has not been fully characterized. In addition, although a novel semi-automatic vessel chasing system (UNEXEF18G) has now been developed in Japan, the direct comparison of UNEXEF18G with a conventional method for FMD measures has not been conducted even if UNEXEF18G has already been utilized in a relatively large scale study. METHODS: We have developed a novel semi-automatic vessel chasing system (UNEXEF18G) that can measure FMD on-line, identify time to peak vasodilatation (TPV), and determine the area under the vasodilatation curve (AUC). Thus, 45 min of WBPA was applied in 20 healthy volunteers (age, 34+13 years), and BAEF was measured by UNEXEF18G before and after WBPA. Also, UNEXEF18G measured FMD was compared with those of a conventional FMD measurement method at rest in order to validate a novel UNEXEF18G measured FMD. RESULTS: Single WBPA resulted in a significant increase in FMD (from 6.4 ± 3.4 to 10.7 ± 43%, p < 0.01), a significant decrease in TPV and a significant increase in AUC. In the validation study for UNEXEF18G, Bland and Altman analysis showed that UNEXEF18G measured FMD was almost identical to those of the conventional method at rest. CONCLUSION: These data suggest the usefulness of a new UNEXEF18G and that single application of WBPA results in acute improvement in BAEF in humans. [ABSTRACT FROM AUTHOR]

We developed a novel non-contact monitoring system to measure the vital signs of casualties inside a moving ambulance. This system was designed to prevent exposure of patients to infectious organisms under biochemical hazard conditions. The system consists of two microwave radars: a 10-GHz respiratory-monitoring radar is positioned 20 cm away from the surface of the isolator. The 24-GHz cardiac-monitoring radar is positioned below the stretcher underneath the isolator. The subject (22.13 ± 0.99 years) was placed inside the isolator on a stretcher in the simulated ambulance. While the ambulance was in motion at a speed of approximately 10 km/h, the heart rates determined by the cardiac-monitoring radar correlated significantly with those measured by ECG ( r = 0.69, p < 0.01), and the respiratory rates derived from the respiratory-monitoring radar correlated with those measured by the respiration curves ( r = 0.97, p < 0.0001). The proposed system appears promising for future on-ambulance monitoring of the vital sign of casualties exposed to toxins. [ABSTRACT FROM AUTHOR]