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Comparisons of Proximal Aortic Pulse Wave Velocity Measurements: Carotid‐Femoral vs. Heart‐Brachial PWV
Author(s) -
Sugawara Jun,
Tomoto Tsubasa,
Tanaka Hirofumi
Publication year - 2017
Publication title -
the faseb journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.709
H-Index - 277
eISSN - 1530-6860
pISSN - 0892-6638
DOI - 10.1096/fasebj.31.1_supplement.1017.14
Subject(s) - pulse wave velocity , cardiology , medicine , arterial stiffness , aorta , pulse pressure , hemodynamics , ventricle , blood pressure , arterial tree , ascending aorta , aortic arch , brachial artery
The proximal aorta (e.g., the ascending aorta and aortic arch) is the most elastic segment of the arterial tree directly connected with the left ventricle and plays the dominant role in buffering the cyclic mechanical forces of cardiac pulsations. Carotid‐femoral pulse wave velocity (cfPWV) is considered as the reference standard measurement for large elastic artery stiffness but the most proximal segments of the aorta are omitted in its measurement. The primary aim of the present study was to compare two indices of arterial stiffness that differ in the contribution of proximal aortic segments. To do so, using the cross‐sectional study design, we compared cfPWV (mainly reflecting stiffness of the abdominal aorta) and heart‐brachial PWV (hbPWV; including the proximal aortic stiffness) in relation to aging‐related change and to central hemodynamic indices. In a total of 190 adults (92 men and 98 women) aged 53±15 yrs were studied. Pulse transition times were obtained between carotid and femoral pressure waveforms (via applanation tonometry) for cfPWV and between the second heart sound and the dicrotic notch of brachial pressure waveforms (via air‐plethysmography) for hbPWV, respectively. Arterial path lengths were measured directly by MRI. Central aortic hemodynamic indices were estimated from carotid arterial pressure waveform by general transfer function‐based pulse wave analysis. cfPWV and hbPWV were significantly correlated with age (r=0.68 and r=0.79, both P<0.0001). Aging‐related increases (calculated from the slope of regression lines) were 9.9%/decade in cfPWV and 14.7%/decade in hbPWV. Aortic augmentation index (an index of left ventricular after load) was significantly correlated with cfPWV (r=0.45) and more strongly with hbPWV (r=0.50). Likewise, aortic systolic tension‐time integral and diastolic pressure‐time integral (indices of myocardial oxygen demand and supply) were correlated with hcPWV (r=0.49 and r=0.53, P<0.0001 for both) and more strongly with hbPWV (r=0.50 and r=0.57, P<0.0001 for both). Our findings suggest that a measure of PWV including the ascending aorta exhibits a greater age‐related increase and stronger associations with central hemodynamic indices than cfPWV. Prospective data linking hbPWV to clinical endpoints are needed. Support or Funding Information This study was supported by JSPS KAKENHI Grant Number JP25702045 and JP26670116.