Textbook of Arterial Stiffness and Pulsatile Hemodynamics in Health and Disease

Textbook of Arterial Stiffness and Pulsatile Hemodynamics in Health and Disease

1st Edition - March 28, 2022

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  • Editor: Julio Chirinos
  • Hardcover ISBN: 9780323913911
  • eBook ISBN: 9780323916486

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Description

Textbook of Arterial Stiffness and Pulsatile Hemodynamics in Health and Disease, Two Volume Set covers the principles, physiology, biologic pathways, clinical implications and therapeutics surrounding arterial stiffness and pulsatile hemodynamics, along with a thorough overview of the field. The book presents complex engineering concepts in a way that those in science and medicine can more easily understand. It includes detailed illustrations, animations and slideshows. Additionally, it presents advanced bioengineering concepts in boxes for readers who wants more in-depth biophysical knowledge. This is a must-have reference for students, researchers and clinicians interested in learning more about this field.

Key Features

  • Incorporates case studies and calculations/worked examples with mathematical principles explained in a conceptual manner without complicated formulas
  • Features chapter contributions from leading international researchers and clinicians
  • Covers principles, physiology, biologic pathways, clinical implications and therapeutics

Readership

Researchers, clinicians (cardiologists, hypertension specialists, general internists, nephrologists, neurologists, geriatricians) and bioengineers interested in physiology, arterial stiffness and pulsatile hemodynamics

Table of Contents

  • Cover image
  • Title page
  • Table of Contents
  • Copyright
  • Contributors
  • Foreword
  • Preface
  • Acknowledgments
  • Volume 1
  • Section I. Biophysical and technical principles
  • Chapter 1. Basic principles that determine relationships between pulsatile hemodynamic phenomena and function of elastic vessels
  • Introduction
  • Pulsatile phenomena
  • Elastic vessels
  • The arterial vasculature as a distributed system of branching distensible tubes
  • Wave propagation phenomena—pulse wave velocity and arterial stiffness
  • Vascular impedance
  • Summary
  • Chapter 2. Measurements of arterial pressure and flow in vivo
  • Introduction
  • Cuff mercury sphygmomanometry
  • Cuff “oscillometric” blood pressure
  • Radial artery applanation tonometry
  • Cuff central aortic blood pressure
  • Cuffless blood pressure wearables
  • Invasive, intra-arterial blood pressure
  • Summary of blood pressure measurement methods
  • Measurements of arterial flow
  • Supplementary material
  • Chapter 3. Essential principles of pulsatile pressure-flow relations in the arterial tree
  • Introduction
  • Arterial input impedance: a frequency-domain characterization
  • Interpreting input impedance: the windkessel perspective
  • Interpreting input impedance: the wave-system perspective
  • The reservoir-wave concept—overarching paradigm or misleading enigma?
  • Concluding remarks
  • Chapter 4. MRI for the assessment of aortic stiffness and pulsatile hemodynamics
  • Introduction
  • Aortic stiffness assessed by MRI
  • Advanced methodology to assess pulsatile aortic properties using MRI
  • Conclusions
  • Chapter 5. Computed tomography of the aorta
  • Introduction
  • Basics of CT and physics
  • Anatomy of aorta
  • Aortic assessment using CT for characterizing aortic geometry, diameter, centerline length, and shape
  • Changes in aortic geometry with aging
  • Aortic calcification
  • Quantification of aortic calcification
  • Progression of aortic calcification
  • The importance of aortic calcification detection
  • Chapter 6. Radionuclide-based imaging of the aortic wall
  • Introduction
  • Positron emission tomography imaging
  • 18F-fluorodeoxyglucose positron emission tomography
  • 18F-sodium fluoride positron emission tomography
  • Methods of analysis and limitations of positron emission tomography imaging
  • Future directions
  • Conclusion
  • Chapter 7. Arterial wall stiffness: basic principles and methods of measurement in vivo
  • Introduction
  • Arteries—what's inside?
  • Mechanics of arterial tissues: bioengineering principles and perspective
  • Mechanics of arterial tissues: clinical/in vivo perspective
  • From local pressure-diameter to pulse wave velocity
  • Measuring (aortic) pulse wave velocity in vivo
  • Total arterial compliance
  • Concluding remarks
  • Chapter 8. Ambulatory measurement of pulsatile hemodynamics
  • Ambulatory 24-h measurement of brachial blood pressure and heart rate
  • Pulsatile and steady state hemodynamics
  • Techniques and devices for 24-h ambulatory measurement of pulsatile (and steady state) hemodynamics
  • 24-h variability (“dipping”) of pulsatile and steady state hemodynamics
  • 24-h ambulatory measurement of pulsatile (and steady state) hemodynamics—clinical studies
  • 24-h ambulatory measurement of pulsatile (and steady state) hemodynamics—drug trials
  • Summary and outlook
  • Chapter 9. Animal models and methods to study arterial stiffness
  • Introduction
  • In vivo methods to study arterial stiffness
  • Ex vivo methods to study arterial stiffness
  • Mouse models to study arterial stiffness
  • Comparison of methods
  • Section II. Basic and applied physiology
  • Chapter 10. Hemodynamic role of the aorta
  • Introduction
  • Hemodynamic consequences of large artery stiffness
  • Aortic stiffening and its role in target organ damage
  • Mechanisms of arterial stiffening and therapeutic approaches
  • Conclusions
  • Chapter 11. Wave reflection in the arterial tree
  • Introduction
  • Pressure and flow in the absence of wave reflection
  • The basis of wave reflection: impedance mismatching
  • Models of arterial wave reflection
  • Re-reflections and the horizon effect
  • Ventricular wave re-reflection
  • Wave reflection, windkessel function, and diastolic pressure decay
  • Methods for assessing the magnitude and timing of arterial wave reflection
  • Summary
  • Chapter 12. Linking arterial stiffness to microvascular remodeling
  • Motivation
  • A microvascular remodeling view of large arterial stiffening
  • Cell dynamics involved in microvascular growth and remodeling
  • Consideration of microvascular patterning alterations associated with hypertension and aging
  • Circulating factors and hemodynamics as putative links between arterial stiffness and the microcirculation
  • Conclusions and future opportunities
  • Chapter 13. Myocardial function: from myofilaments to cardiac pump
  • The heart is an adaptive pump
  • Cardiac structure is tightly coupled to function
  • The cardiac cycle
  • Electromechanical coupling
  • Mechanisms of myocardial contraction
  • Mechanisms of myocardial relaxation and ventricular filling
  • Cardiac metabolism
  • Cardiac performance is governed by heart rate and loading conditions
  • Functional assessment of the cardiovascular system
  • Assessing intrinsic cardiac performance: contractility, relaxation, and compliance
  • The pressure-volume loop
  • Deriving performance indexes from acute load manipulation
  • Time-varying afterload, wave reflection, and their toll in the heart
  • Conclusions
  • Chapter 14. Systolic–diastolic coupling
  • Historical background
  • Gross cardiac anatomy, ventricular myocyte orientation, and mechanism of contraction
  • Summary
  • Supplementary data
  • Chapter 15. Ventricular–arterial coupling: the pressure–volume plane
  • Introduction
  • Conclusions
  • Chapter 16. Myocardial wall stress and the systolic loading sequence
  • Introduction
  • Quantification of myocardial wall stress
  • Arterial wave reflection
  • Conclusions
  • Chapter 17. Assessment of ventricular arterial interactions via arterial pressure-flow relations in humans
  • Overview of arterial pressure-flow relations
  • Noninvasive assessment of aortic pressure-flow relations
  • Age relations of pressure-flow variables across the lifespan
  • Aortic pressure-flow measures and the heart
  • Pressure-flow measures and cardiovascular disease events
  • Summary
  • Chapter 18. Hemodynamic determinants of myocardial oxygen demand and supply
  • Myocardial O2 demand
  • Myocardial O2 supply
  • Aortic stiffness
  • The myocardial oxygen supply: demand index
  • Buckberg index estimated by arterial tonometry
  • Section III. Biologic pathways leading to arterial stiffness and dysfunctional pulsatile hemodynamics
  • Chapter 19. Role of elastin and elastin-derived peptides in arterial stiffness: from synthesis to potential therapeutic interventions
  • Elastic fibers and elastin
  • Elastin role in arterial function
  • Elastin modifications during aging and pathophysiological consequences
  • Elastin-derived peptides signaling, elastin receptor complex, and pathophysiological consequences
  • Elastin biology-derived therapeutic options
  • Conclusion
  • Chapter 20. Inflammation and arterial stiffness
  • Introduction
  • Arterial stiffness and low-grade inflammation
  • Arterial stiffness in patients with primary vasculitides
  • Arterial stiffness in chronic inflammatory diseases
  • Antiinflammatory treatment for arterial stiffness
  • Mechanisms of inflammation-induced arterial stiffening
  • Increased synthesis of matrix metalloproteinases
  • Conclusion
  • Chapter 21. Mechanisms of calcification in the aortic wall and aortic valve
  • Cardiovascular events associated with calcification in the aortic wall and aortic valve
  • Calcification is a result of multiple synergistic pathogenic processes
  • Experimental approaches in cardiovascular calcification
  • Therapeutic target discovery in cardiovascular calcification
  • Final considerations
  • Chapter 22. Vascular smooth muscle cell dysfunction: role in arterial stiffening and cardiovascular disease
  • Contractile tone of vascular smooth muscle cells
  • Endocytosis and phagocytosis abilities of vascular smooth muscle cells
  • Integrin-mediated and nuclear mechanotransduction in vascular smooth muscle cells
  • Vascular smooth muscle cell plasticity
  • Participation of inflammation and immunity in vascular smooth muscle cell functions
  • Conclusion
  • Chapter 23. Endothelial cell dysfunction and senescence: biologic mechanisms and hemodynamic consequences
  • Introduction
  • In vivo evidence of cellular senescence in age-related diseases
  • Molecular mechanism of cellular senescence
  • Endothelial cell senescence in age-related disorders
  • Antisenescence therapy
  • Conclusion
  • Chapter 24. Autonomic and neuroendocrine modulation of arterial stiffness and hemodynamics
  • Autonomic control of the cardiovascular system
  • Assessing autonomic modulation of large-artery stiffness: methodological considerations
  • Parasympathetic modulation of large-artery stiffness
  • Sympathetic modulation of large-artery stiffness
  • Neuroendocrine modulation of arterial stiffness
  • Summary
  • Chapter 25. Cellular mechanisms of aging and their impact on the aortic/arterial wall
  • Introduction
  • Effects of aging on the arterial tree
  • Cellular and molecular mechanisms of vascular aging
  • Chronic kidney disease as a model of early vascular aging and role of calcification
  • Summary
  • Volume 2
  • Section IV. Clinical significance of arterial stiffness and pulsatile hemodynamics
  • Chapter 26. Normal aging: arterial stiffness and remodeling over the life course
  • Preamble
  • Insights from cross-sectional epidemiological and cohort data
  • Insights from longitudinal cohort data: the early life trajectory
  • Insights from longitudinal cohort data: the adult life trajectory
  • Conclusions
  • Chapter 27. Early vascular aging and supernormal vascular aging: genetics, epigenetics, and the environment
  • The background and characteristics of early vascular aging
  • Atherosclerosis versus arteriosclerosis
  • Structural components of arterial wall aging
  • Cross-talk between the micro- and macrocirculation
  • Vascular aging and target organ damage
  • Genetics and epigenetics
  • Low socioeconomic status and vascular aging
  • Intervention studies on vascular aging and early vascular aging
  • The concept and usefulness of supernormal vascular aging
  • Conclusion
  • Chapter 28. Ethnic differences in arterial stiffness and central aortic hemodynamics
  • Is studying ethnic differences in vascular or any physiological feature or disease useful?
  • Arterial stiffness through the life-course across different ethnic/geographic groups
  • Ethnicity and the menopausal transition
  • The elderly
  • Summary and conclusions
  • Chapter 29. Arterial stiffness and pulsatile hemodynamics in systemic hypertension
  • Introduction
  • Consequence of arterial stiffness on pressure pulsatility
  • Arterial stiffness and wave reflection in systemic hypertension
  • Influence of lumen area on compliance, wave reflection, and pressure pulsatility
  • Peripheral and central blood pressure in aging hypertensives
  • Interaction between hypertension and arterial stiffness
  • High central blood pressure, hypertension-mediated organ damage, and cardiovascular complication
  • Predictive value of arterial stiffness and wave reflection in hypertensives
  • The particular case of very elderly hypertensives
  • Conclusion
  • Chapter 30. Arterial stiffness and pulsatile hemodynamics in diabetes and obesity
  • Introduction
  • Pathophysiologic role of diabetes mellitus in the development of increased arterial stiffness
  • Epidemiologic association of diabetes mellitus with the development of increased arterial stiffness
  • Epidemiologic association of obesity and the metabolic syndrome with the development of increased arterial stiffness
  • Increased arterial stiffness as a potential contributor to the development of diabetes mellitus
  • Conclusions and future directions
  • Chapter 31. Cardiovascular risk prevention in clinical medicine: current guidelines in the United States and in Europe
  • Epidemiology of hypertension
  • Cardiovascular risk assessment in the management of hypertension
  • Therapeutic goals in the management of hypertension
  • Additional therapeutic considerations for hypertension management in current guidelines
  • How do large artery stiffness and pulsatile hemodynamics factor into guideline recommendations for the treatment of other cardiovascular risk factors?
  • Summary
  • Chapter 32. Cardiovascular risk prevention in clinical medicine: current guidelines in Asia
  • Cardiovascular risk prevention in clinical practice: current guidelines in Asia
  • Chapter 33. Arterial stiffness for cardiovascular risk stratification in clinical practice
  • Introduction
  • Arterial stiffness
  • Central pressure and wave reflection indices
  • Conclusions/future perspectives
  • Chapter 34. Role of the heart and arterial tree in physiologic adjustments during exercise
  • Cardiac output
  • Exercise hemodynamics
  • Pulmonary hemodynamics during exercise
  • Central hemodynamics during exercise
  • Blood flow redistribution
  • Exercise hyperemia
  • Cardiovascular limitations to exercise
  • Summary
  • Chapter 35. Invasive hemodynamic assessments during exercise: normal patterns and clinical value
  • Introduction
  • Physiology of invasive hemodynamic assessment
  • Measurement of flow
  • Vascular load
  • Assessment during exercise
  • Clinical utility in the evaluation of suspected heart failure
  • More advanced assessment
  • Conclusion
  • Chapter 36. Arterial stiffness and pulsatile hemodynamics in heart failure
  • Introduction
  • Heart failure: definition and classification
  • The arterial tree in HF
  • Therapeutic implications
  • Conclusions
  • Chapter 37. Ventricular–arterial coupling and arterial load in aortic valve disease
  • Introduction
  • Anatomical interaction between the LV, aortic valve, and aortic root
  • Functional interaction between the left ventricle, aortic valve, and aorta
  • Interaction between LV outflow tract and aortic valve
  • Interaction between aorta and aortic valve in aortic valve disease
  • Interaction between aorta, aortic valve, and LV in AS
  • Impact of arterial load following aortic valve replacement
  • Conclusion
  • Chapter 38. Arterial stiffness and atherosclerosis: mechanistic and pathophysiologic interactions
  • Introduction
  • Vascular failure: interaction between atherosclerosis and arterial stiffness
  • Interaction between vascular disease and hemodynamic stress
  • Conclusion
  • Chapter 39. Arterial stiffness and pulsatile hemodynamics in coronary artery disease and other forms of atherosclerotic vascular diseases
  • Introduction
  • Coronary artery disease
  • Peripheral artery disease
  • Aortic calcification
  • Stroke and cerebrovascular disease
  • Perspectives
  • Chapter 40. Arterial stiffness and pulsatile hemodynamics in renal disease
  • Importance of kidney disease
  • Unique features of the kidney circulation
  • Role of known factors for chronic kidney disease progression
  • Clinical epidemiology of large artery stiffness in chronic kidney disease
  • Clinical pulsatility indices and kidney function
  • Mechanisms of increased arterial stiffness in chronic kidney disease
  • Vascular calcification
  • Therapies
  • Chapter 41. Arterial stiffness, pulsatile hemodynamics, and the vascular contributions to dementia
  • Introduction
  • Conclusions
  • Chapter 42. Arterial stiffness and pulsatile hemodynamics in pregnancy and pregnancy-related vascular complications
  • Healthy pregnancy
  • Pregnancy complications
  • Exercise in pregnancy
  • Concluding remarks
  • Chapter 43. Arterial stiffness and pulsatile hemodynamics in pediatric populations
  • Introduction
  • Vascular effects of various disease states
  • Methods and normal values in children
  • Future directions
  • Chapter 44. Aortopathies and arteriopathies
  • Introduction
  • Approaches to defining the genetic contributions to arterial and aortic disease
  • Pathogenic mechanisms
  • Arteriopathies with limited aortic involvement
  • Disorders that primarily involve the aorta with arterial involvement
  • Disorders that primarily affect the aorta
  • Precision medicine
  • Chapter 45. Arterial stiffness and pulsatile hemodynamics in thoracic aortopathies
  • Epidemiology and sex differences of thoracic aortic disease
  • Clinical management of thoracic aortic aneurysm
  • Histopathological links between thoracic aortic aneurysms and arterial aging
  • Aortic wall structure, aortic stiffness, and arterial biomechanics in thoracic aortic aneurysm
  • Measures of aortic stiffness and pulsatile hemodynamic as markers of disease activity and thoracic aortic aneurysm–related risk
  • Conclusions and future directions
  • Chapter 46. Arterial stiffness and pulsatile hemodynamics in congenital heart disease
  • Background
  • Hypertension after coarctation repair
  • Cardiovascular morbidity
  • Abnormalities of pulsatile hemodynamics
  • What causes the arterial abnormalities arise in coarctation?
  • Vascular abnormalities in other forms of congenital heart disease
  • Conclusions
  • Chapter 47. Infection and arterial stiffness
  • Introduction
  • Arterial stiffness and sepsis
  • Arterial stiffness and human immunodeficiency virus infection
  • Chapter 48. Arterial stiffness, hemodynamics, and microvascular complications in conditions characterized by low arterial pulsatility
  • Introduction
  • Low pulsatile hemodynamics in continuous-flow left ventricular assist device therapy
  • Effects of low pressure and flow pulsatility on the macrocirculation
  • Consequences of low pressure and flow pulsatility on the microcirculation
  • Left ventricular assist device therapy and exercise capacity
  • Conclusions
  • Section V. Therapeutic approaches to improve arterial stiffness and pulsatile hemodynamics
  • Chapter 49. Effects of common antihypertensive treatments on pulsatile arterial hemodynamics
  • Introduction
  • Antihypertensive drug classes and their mechanisms of action
  • Data acquisition, extraction, and analysis
  • Antihypertensive drugs versus placebo or no-treatment
  • Renin-angiotensin-aldosterone inhibitors and calcium-channel blockers versus diuretics, β-blockers, and α-blockers
  • Vasodilating versus nonvasodilating β-blockers
  • Angiotensin receptor neprilysin inhibitor versus angiotensin receptor blocker
  • Organic and inorganic nitrates, soluble guanylyl cyclase stimulators and cyclic guanosine monophosphate (cGMP)-binding phosphodiesterase (PDE5) inhibitors
  • Device-based antihypertensive therapy
  • Conclusions and perspectives
  • Chapter 50. Pharmacologic approaches to reduce arterial stiffness
  • Introduction
  • Potential therapeutic targets for arterial destiffening: preclinical studies
  • Clinical studies on aortic and large artery destiffening
  • Summary
  • Conclusion
  • Chapter 51. Organic and dietary nitrates, inorganic nitrite, nitric oxide donors, and soluble guanylate cyclase stimulation
  • Part 1: introduction
  • Part 2: organic nitrates
  • Part 3: inorganic nitrite
  • Part 4: inorganic (dietary) nitrate
  • Part 5: nitric oxide donors
  • Part 6: soluble guanylate cyclase
  • Conclusions and future directions
  • Chapter 52. Effect of exercise training and weight loss on arterial stiffness and pulsatile hemodynamics
  • Introduction
  • Effect of high cardiorespiratory fitness and habitual aerobic PA on central artery stiffness and pulsatile hemodynamics with aging
  • Effect of aerobic exercise interventions on central artery stiffness and pulsatile hemodynamics in young and MA/O adults with and without hypertension
  • Effect of resistance exercise training on large central artery stiffness and central pulsatile hemodynamics
  • Effect of obesity, weight loss, and weight gain on central arterial stiffness
  • Chapter 53. Dietary salt and arterial stiffness
  • Introduction
  • Dietary salt and blood pressure
  • Dietary salt and cardiovascular outcomes
  • Blood pressure independent effects of dieatary salt
  • Dietary salt and arterial stiffness
  • Lifestyle and dietary salt
  • Conclusion
  • Chapter 54. Role of arterial stiffness and central hemodynamics in personalized medicine in hypertension
  • Introduction
  • Isolated systolic hypertension in the elderly
  • Isolated systolic hypertension in the young
  • Isolated diastolic hypertension
  • Isolated central hypertension and isolated brachial hypertension
  • White coat hypertension
  • Masked hypertension
  • Isolated nocturnal hypertension
  • Exaggerated blood pressure variability
  • Summary and conclusion
  • Section VI. Arterial stiffness and pulsatile hemodynamics in the pulmonary circulation
  • Chapter 55. Pulsatile hemodynamics and ventricular–arterial interactions in the pulmonary circulation: physiologic concepts
  • Introduction
  • Measurements in the pulmonary circulation
  • The pulmonary vasculature
  • The right ventricle
  • Ventriculoarterial coupling
  • Differences between the systemic and pulmonary circulation
  • Normal values in the pulmonary circulation
  • Summary
  • Chapter 56. Pulmonary arterial load and ventricular–arterial coupling in pulmonary hypertension
  • Introduction
  • Pulmonary arterial load in pulmonary hypertension
  • The right ventricular function in pulmonary hypertension
  • The cardiovascular interaction in pulmonary hypertension
  • Summary
  • Chapter 57. Biologic mechanisms and consequences of pulmonary artery stiffening in pulmonary hypertension
  • Pulmonary vascular stiffening and mechanobiological feedback in PH pathogenesis
  • Regulation of smooth muscle contractility and tone
  • Proliferation
  • Inflammation and endothelial dysfunction
  • Endothelial to mesenchymal transition
  • Angiogenesis
  • Metabolic reprogramming and mitochondrial dysregulation
  • Targeting PA stiffness and mechanotransduction in PH
  • Conclusion
  • Chapter 58. Therapeutic approaches to improve pulmonary arterial load and right ventricular–pulmonary arterial coupling
  • Introduction
  • Right ventricular dysfunction and failure
  • The components of right ventricular afterload
  • Approach to the management of right ventricular failure
  • Therapies targeting right ventricular afterload
  • Advanced therapeutic options for treatment of right venrticular failure
  • Emerging therapeutic options
  • Conclusion
  • Index

Product details

  • No. of pages: 1032
  • Language: English
  • Copyright: © Academic Press 2022
  • Published: March 28, 2022
  • Imprint: Academic Press
  • Hardcover ISBN: 9780323913911
  • eBook ISBN: 9780323916486

About the Editor

Julio Chirinos

Dr. Julio A. Chirinos, MD, PhD, is an Associate Professor of Medicine and Director of the Arterial Hemodynamics and Cardiac Imaging Quantification Core Laboratory at the University of Pennsylvania Perelman School of Medicine. Dr. Chirinos directs an NIH-funded research program focused on the role of arterial stiffness and ventricular arterial interactions in heart disease, mechanisms of human heart failure and the use of proteomics to discern mechanisms of human heart failure. He currently leads clinical studies and trials designed to therapeutically target the arterial tree in order to reduce maladaptive cardiac remodeling, diastolic dysfunction, and to treat patients with Heart Failure and Preserved Ejection Fraction, an epidemic condition for which no effective proven pharmacologic therapies are currently available. He also leads various cohort studies with deep cardiovascular phenotyping aimed at characterizing phenotypic profiles in humans. Dr. Chirinos also directs a core analysis laboratory for assessments of cardiac and arterial structure and function with non-invasive imaging, which has served as the core lab for various multicenter studies. His laboratory utilizes a combination of imaging modalities (including arterial tonometry, echocardiography and cardiac MRI) coupled with modeling approaches to characterize arterial physiology and ventricular-arterial interactions in humans. Dr. Chirinos has published >200 papers, chapters, reviews, and editorials and has been an invited speaker in >120 scientific sessions. He has participated in various clinical expert committees for the American Heart Association, American Society of Echocardiography, European Society of Cardiology, American Society of Hypertension, European Association of Cardiovascular Imaging and the Lancet Commission for Hypertension. Dr. Chirinos is currently the Vice-President of the North American Artery society, which promotes the study of arterial function as a determinant of cardiovascular disease. He is an Associate Editor of Circulation Heart Failure and a former Editor of the Cochrane Group (Cochrane Collaboration), Senior Consulting Editor of the Journal of the American College of Cardiology – Cardiovascular Imaging, Associate Editor for the Journal of Clinical Hypertension and member of the editorial board of Pulse and the Journal of Geriatric Cardiology. He is also a Visiting Professor at the University of Ghent in Belgium, where he maintains an active collaboration with the Asklepios Investigators aimed at characterizing arterial aging at the population level.

Affiliations and Expertise

Associate Professor of Medicine, University of Pennsylvania Perelman School of Medicine, USA; Director, Arterial Hemodynamics and Cardiac Imaging Quantification Core Laboratory; Visiting Professor, University of Ghent, Ghent, Belgium

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