Biomedical subjects

Jonathan S Maltz

Publications and source records attributed to Jonathan S Maltz.

3 recordsLinked to original sources

PubMed2005

Evaluation of arterial endothelial function using transit times of artificially induced pulses.

Impairment of arterial endothelial function is an early event in atherosclerosis and correlates with the major risk factors for cardiovascular disease. The most widely employed non-invasive measure of endothelial function involves brachial artery (BA) diameter measurement using ultrasound imaging before and after several minutes of blood flow occlusion. The change in arterial diameter is a measure of flow-mediated vasorelaxation (FMVR). The high between-laboratory variability of results and cost of instrumentation render this technique unsuitable for routine clinical use. We induce artificial pulses at the superficial radial artery using a linear actuator. An ultrasonic Doppler stethoscope detects these pulses 10-30 cm proximal to the point of pulse induction. The delay between pulse application and detection provides the pulse transit time (PTT). By measuring PTT before and after 5 min of BA occlusion and ensuing reactive hyperemia, FMVR may be measured based on the changes in PTT caused by changes in vessel caliber, smooth muscle tone and wall thickness. We (1) validate the sensitivity of this technique to arterial wall tone using sublingual nitroglycerin and (2) compare measurements of endothelial function to ultrasound BA diameter measurements in 12 human subjects. The PTT-based method is verified to measure arterial wall tone and is shown to provide 37% greater sensitivity (p < 0.05) to FMVR than BA diameter measurements. By measuring the change in pulse transit time before and after endothelial stimulus, a sensitive, reproducible and convenient measure of endothelial function may be obtained at a low cost.

Blood Flow Velocity↗

PubMed2004

Enhanced cutaneous vascular response in AD subjects under donepezil therapy.

OBJECTIVE: Abnormal cutaneous vasodilatory responses to the iontophoresis of vasodilators were previously observed in Alzheimer's disease (AD). We sought to replicate these observations and further identify peripheral vascular components of AD pathology. METHODS: Methacholine chloride (MCh), acetylcholine chloride (ACh), and sodium nitroprusside (SNP) were applied iontophoretically to forearm skin. Laser Doppler imaging of treated areas yielded total perfusion response values. RESULTS: Response to MCh was enhanced 78% ( P=0.003 ) in AD subjects under therapy with the acetylcholinesterase inhibitor (AChEI) donepezil ( N=9 ), relative to age- and sex-matched controls ( N=12 ). Significant increases in perfusion were also observed after application of ACh (68%, P=0.03 ) and SNP (46%, P=0.04 ). CONCLUSIONS: A previous study reported attenuated response to ACh in AD. Paradoxically, we observed a substantially enhanced response that is likely a consequence of donepezil therapy. The increased response to the endothelium-independent vasodilator SNP indicates improved general vasodilatory response, perhaps due to preservation of endogenous ACh by donepezil. Cerebral perfusion in response to functional activation may be improved in this way, suggesting a secondary therapeutic mode of donepezil.

Aged↗

PubMed2002

Parsimonious basis selection in exponential spectral analysis.

Sums of decaying real exponentials (SDREs) are frequently used in models of time-varying processes. First-order compartmental models are widely employed to describe mass transit in chemical and biological systems. In these models the evolution of compartment concentration versus time is represented as the convolution of an input function with an SDRE. In exponential spectral analysis (ESA) the nonlinear problem of estimating the SDRE rate constants is replaced by the linear estimation of the coefficients of a preselected set of exponential basis functions (EBFs). This work addresses the problem of selecting the number of EBFs and the rate constant of each basis element. Basis dimension is established via model selection, in which approximation error and parameter redundancy are the criteria. The latter is estimated via simulation of the fitted model over multiple noise realizations. A constrained Cramér-Rao lower bound is derived for ESA parameters. The resulting parsimonious ESA algorithm (PESA) ameliorates the inherent problem of non-uniqueness in ESA parameters. Consequently, sets of time series may be compared in a statistically meaningfully way in terms of physically or physiologically significant parameters. PESA is applied to compare the retention of two radiotracers in the artificially perfused rabbit heart.

Algorithms↗