Kulthinee Supaporn, Nernpermpisooth Nitirut, Poomvanicha Montatip, Satiphop Jidapa, Chuang-Ngu Thizanamadee, Kaleeluan Napaporn, Thawnashom Kittisak, Manin Anuchit, Kongchan Rosarin, Yinmaroeng Kingkarn, Kitipawong Peerapong, Chotimol Phatiwat
Chulabhorn International College of Medicine, Thammasat University, Pathum Thani, Thailand.
Department of Cardio-Thoracic Technology, Faculty of Allied Health Sciences, Naresuan University, Phitsanulok, Thailand.
Pulse (Basel). 2021 Aug 5;9(1-2):30-37. doi: 10.1159/000517617. eCollection 2021 Sep.
The cold pressor test (CPT) has been shown a potential sympathoexcitatory stimulus which increases aortic pulse wave velocity and the aortic augmentation index, suggesting that noninvasively, arterial stiffness parameters are altered by the CPT. The cardio-ankle vascular index (CAVI) is widely used for reflecting arterial stiffness, and the ankle-brachial index (ABI) for evaluating peripheral artery disease in obesity. We aimed to assess CAVI and ABI in overweight young adults in the context of sympathetic activation by using the CPT.
160 participants were divided into 2 groups: 86 normal-weight (body mass index [BMI] 18.50-22.99 kg/m) and 74 overweight (BMI ≥23 kg/m). The CPT was performed by immersing a participant's left hand into cold water (3-5°C) for 3 min, and CAVI and ABI assessment.
At baseline, the CAVI in the overweight group was significantly less than that in the normal-weight group (5.79 ± 0.85 vs. 6.10 ± 0.85; < 0.05). The mean arterial pressure (MAP) for overweight was significantly greater than that for normal-weight subjects (93.89 ± 7.31 vs. 91.10 ± 6.72; < 0.05). During the CPT, the CAVI increased in both normal-weight and overweight subjects, the CAVI value was greater during the CPT in overweight subjects by 14.36% (6.62 ± 0.95 vs. 5.79 ± 0.85, < 0.05) and in normal-weight subjects by 8.03% (6.59 ± 1.20 vs. 6.10 ± 0.85, < 0.05) than those baseline values. The CPT evoked an increase in systolic blood pressure (SBP), diastolic BP (DBP), heart rate (HR,) and pulse pressure (PP) in both groups. After a 4-min CPT period, the CAVI returned values similar to the baseline values in both groups, and the SBP, DBP, MAP, and PP in overweight participants were significantly higher than those in normal-weight participants. However, there was no significant difference in the ABI at baseline, during CPT, and post-CPT in either group.
Our results indicated that the CAVI was influenced by sympathetic activation response to the CPT in both normal-weight and overweight young adults. Specifically, during the CPT, the percentage change of the CAVI in overweight response was greater in normal-weight participants than baseline values in each group. The ABI was not found significantly associated with CPT. These findings suggesting that sympathoexcitatory stimulus by CPT influence CAVI results.
冷加压试验(CPT)已被证明是一种潜在的交感神经兴奋刺激,可增加主动脉脉搏波速度和主动脉增强指数,这表明CPT可无创地改变动脉僵硬度参数。心踝血管指数(CAVI)广泛用于反映动脉僵硬度,而踝臂指数(ABI)用于评估肥胖患者的外周动脉疾病。我们旨在通过CPT评估超重年轻人在交感神经激活情况下的CAVI和ABI。
160名参与者分为两组:86名正常体重者(体重指数[BMI]18.50 - 22.99 kg/m)和74名超重者(BMI≥23 kg/m)。通过将参与者的左手浸入冷水(3 - 5°C)中3分钟进行CPT,并评估CAVI和ABI。
在基线时,超重组的CAVI显著低于正常体重组(5.79±0.85 vs. 6.10±0.85;P<0.05)。超重者的平均动脉压(MAP)显著高于正常体重者(93.89±7.31 vs. 91.10±6.72;P<0.05)。在CPT期间,正常体重和超重受试者的CAVI均升高,超重受试者在CPT期间的CAVI值比基线值高14.36%(6.62±0.95 vs. 5.79±0.85,P<0.05),正常体重受试者高8.03%(6.59±1.20 vs. 6.10±0.85,P<0.05)。CPT使两组的收缩压(SBP)、舒张压(DBP)、心率(HR)和脉压(PP)均升高。在4分钟的CPT期后,两组的CAVI值均恢复到接近基线值,超重参与者的SBP、DBP、MAP和PP显著高于正常体重参与者。然而,两组在基线、CPT期间和CPT后ABI均无显著差异。
我们的结果表明,正常体重和超重的年轻成年人中,CAVI受CPT交感神经激活反应的影响。具体而言,在CPT期间,超重反应中CAVI的变化百分比在正常体重参与者中比每组的基线值更大。未发现ABI与CPT有显著关联。这些发现表明CPT引起的交感神经兴奋刺激会影响CAVI结果。