Reference intervals of aortic pulse wave velocity assessed with an oscillometric device in healthy children and adolescents from Argentina

Abstract Objectives Assessment of carotid-femoral pulse wave velocity by applanation tonometry independently predicts all-cause and cardiovascular mortality. However, there has been a need for a simpler, user-independent measurement with a validated device, that is applicable even in the primary care setting. Methods and subjects 4146 subjects (49% men) aged 35–75 years were measured in multiple centers in Hungary. Subjects visited the outpatient department of these centers on their own initiative. The measurement of aortic pulse wave velocity (PWVao) with Arteriograph was performed in addition to taking past medical history, physical examination and laboratory tests. The mean follow-up time of the study was 5.5 years. The number of events (all cause mortality) were provided by the Hungarian National Health Insurance Fund. Cox regression analyses were used to identify predictive factors for this endpoint. Results The mean age of the study population was 53 years, brachial systolic and diastolic blood pressure were 137±20 and 82±11 mmHg, and heart rate was 70±10 1/min. The mean value of SCORE was 3 in this large cohort. 410 subjects had a registered cerebro-or cardiovascular event before the measurement, the number of smokers was 656 (16%), 1974 subjects were treated with at least one anti-hypertensive drug (48%), while the number of subjects on lipid-lowering, antidiabetic or antiplatelet medication were 807 (19%), 352 (8%) and 398 (17%), respectively. There were 116 fatal events during a mean follow-up of 5.5 years. According to the Cox regression, PWVao is a significant and independent predictor of all cause-mortality and in univariate analysis, a 1.0 m/s increase in PWVao was associated with HR 1.7 [1.47–1.98; p<0.001], for this endpoint. Conclusion Aortic pulse wave velocity measured by an invasively validated, simple, oscillometric device predicted all-cause mortality in a large cohort of relatively young subjects of the general population that may improve risk stratification even in the everyday clinical practice or primary care setting.

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[OP.7C.07] REFERENCE VALUES FOR AORTIC PULSE WAVE VELOCITY IN PORTUGUESE CHILDREN AND ADOLESCENTS - THE PORTUGUESE VASCULAR PHENOTYPE IN CHILDREN AND ADOLESCENTS (PORT-VASPH) COHORT

Journal of Hypertension ◽

10.1097/01.hjh.0000523166.98738.83 ◽

2017 ◽

Vol 35 ◽

pp. e72-e73

Author(s):

T. Pereira ◽

J. Maldonado ◽

J. Martins ◽

M. Carvalho

Keyword(s):

Pulse Wave Velocity ◽

Children And Adolescents ◽

Wave Velocity ◽

Reference Values ◽

Pulse Wave ◽

Aortic Pulse Wave Velocity ◽

Vascular Phenotype

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P1.26 AORTIC PULSE WAVE VELOCITY IN OBESE CHILDREN AND ADOLESCENTS

Artery Research ◽

10.1016/j.artres.2012.09.063 ◽

2012 ◽

Vol 6 (4) ◽

pp. 158

Author(s):

K.N. Hvidt ◽

J.C. Holm ◽

M.H. Olsen ◽

H. Ibsen

Keyword(s):

Pulse Wave Velocity ◽

Children And Adolescents ◽

Wave Velocity ◽

Pulse Wave ◽

Aortic Pulse Wave Velocity ◽

Obese Children

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Physiological Age- and Sex-Related Profiles for Local (Aortic) and Regional (Carotid-Femoral, Carotid-Radial) Pulse Wave Velocity and Center-to-Periphery Stiffness Gradient, with and without Blood Pressure Adjustments: Reference Intervals and Agreement between Methods in Healthy Subjects (3–84 Years)

Journal of Cardiovascular Development and Disease ◽

10.3390/jcdd8010003 ◽

2021 ◽

Vol 8 (1) ◽

pp. 3

Author(s):

Daniel Bia ◽

Yanina Zócalo

Keyword(s):

Blood Pressure ◽

Arterial Stiffness ◽

Pulse Wave Velocity ◽

Wave Velocity ◽

Pressure Wave ◽

Pulse Wave ◽

Reference Intervals ◽

Physiological Age ◽

Healthy Children ◽

Age And Sex

In addition to being a marker of cardiovascular (CV) aging, aortic stiffening has been shown to be independently associated with increased CV risk (directly and/or indirectly due to stiffness-gradient attenuation). Arterial stiffness determines the rate at which the pulse pressure wave propagates (i.e., pulse wave velocity, PWV). Thus, propagated PWV (i.e., the distance between pressure-wave recording sites divided by the pulse transit time) was proposed as an arterial stiffness index. Presently, aortic PWV is considered a gold-standard for non-invasive stiffness evaluation. The limitations ascribed to PWV have hampered its use in clinical practice. To overcome the limitations, different approaches and parameters have been proposed (e.g., local PWV obtained by wave separation and pulse wave analysis). In turn, it has been proposed to determine PWV considering blood pressure (BP) levels (β-PWV), so as to evaluate intrinsic arterial stiffness. It is unknown whether the different approaches used to assess PWV or β-PWV are equivalent and there are few data regarding age- and sex-related reference intervals (RIs) for regional and local PWV, β-PWV and PWV ratio. Aims: (1) to evaluate agreement between data from different stiffness indexes, (2) to determine the need for sex-specific RIs, and (3) to define RIs for PWV, β-PWV and PWV ratio in a cohort of healthy children, adolescents and adults. Methods: 3619 subjects (3–90 y) were included, 1289 were healthy and non-exposed to CV risk factors. Carotid-femoral (cfPWV) and carotid-radial (crPWV) PWV were measured (SphygmoCor System (SCOR)) and PWV ratio (cfPWV/crPWV) was quantified. Local aortic PWV was obtained directly from carotid waves (aoPWV-Carotid; SCOR) and indirectly (generalized transfer function use) from radial (aoPWV-Radial; SCOR) and brachial (aoPWV-Brachial; Mobil-O-Graph system (MOG)) recordings. β-PWV was assessed by means of cardio-ankle brachial (CAVI) and BP-corrected CAVI (CAVIo) indexes. Analyses were done before and after adjustment for BP. Data agreement was analyzed (correlation, Bland-Altman). Mean and standard deviation (age- and sex-related) equations were obtained for PWV parameters (regression methods based on fractional polynomials). Results: The methods and parameters used to assess aortic stiffness showed different association levels. Stiffness data were not equivalent but showed systematic and proportional errors. The need for sex-specific RIs depended on the parameter and/or age considered. RIs were defined for all the studied parameters. The study provides the largest data set related to agreement and RIs for stiffness parameters obtained in a single population.

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Change in the aortic pulse wave velocity in children with familial hypercholesterolemia

Arterial’naya Gipertenziya (Arterial Hypertension) ◽

10.18705/1607-419x-2020-26-6-640-647 ◽

2021 ◽

Vol 26 (6) ◽

pp. 640-647

Author(s):

L. F. Galimova ◽

D. I. Sadykova ◽

E. S. Slastnikova ◽

D. I. Marapov

Keyword(s):

Arterial Stiffness ◽

Pulse Wave Velocity ◽

Total Cholesterol ◽

Familial Hypercholesterolemia ◽

Wave Velocity ◽

Pulse Wave ◽

Aortic Pulse Wave Velocity ◽

Main Group ◽

Control Group ◽

Healthy Children

Background. Familial hypercholesterolemia (FH) is the genetic disease characterized by an increase in the levels of total cholesterol and low density lipoproteins since childhood. The aim of the study was to assess arterial stiffness in children with heterozygous FH by measuring pulse wave velocity (PWV) in the aorta. Design and methods. The study involved 118 children. Of these, 60 healthy children were in the control group and 58 children with the diagnosis of heterozygous FH were included in the main group. Both groups were divided into 3 age subgroups: from 5 to 7 years old, from 8 to 12 years old and from 13 to 17 years old. The diagnosis of FH was made according to the British criteria by Simon Broome. The lipid profile was determined for all children, blood pressure was monitored daily with the estimate of the minimum, average and maximum PWV (PWVmin, PWVav, PWVmax) in aorta using oscillometric method. Results. In the younger age subgroup (5–7 years), there were no significant differences in PWV between main and control groups. In children aged 8–12 years, the main group was characterized by significantly higher values of maximum PWV compared to healthy peers — 5,1 [4,7–5,8] and 4,6 [4,45–5,05] m/s, respectively (p = 0,041). In group of children with FH aged 13–17 years, compared to the control group, a significant increase in the minimum PWV was observed — 4,7 [4,1–5,1] and 3,9 [3,5–4,1] m/s, respectively (p = 0,009), average PWV — 5,5 [4,8–6,4] and 4,5 [4,2–4,9] m/s, respectively (p = 0,009), and maximum PWV — 6,2 [5,7–7,55] and 5,4 [5,05–5,6] m/s, respectively (p = 0,007). Correlation analysis in patients with FH showed direct correlation between PWVmin, PWVav and PWVmax with total cholesterol (r = 0,46, r = 0,46 and r = 0,464, respectively, p < 0,001). Conclusions. Our study demonstrates an increase in the PWV in the aorta in children with FH compared with healthy peers from 8–12 years of age. There is a further progression of arterial stiffness with an increase in the minimum, average and maximum PWV most significant in the group of 13–17 years.

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