P1830 Single-beat aortic arch pulse wave velocity by dual-gate simultaneous Doppler technique: a novel method for arterial stiffness evaluation

Abstract Background Guidelines recommend increased aortic stiffness as a negative prognostic factor to be considered in primary and secondary prevention. Pulse wave velocity (PWV) is a frequently employed surrogate marker of aortic stiffness. Carotid-femoral PWV is the most common index in research and clinical practice, but recently several velocity-encoded magnetic resonance imaging (MRI) techniques have been used for the evaluation of regional aortic arch PWV, where the stiffness seems to be particularly relevant from a prognostic point of view. Purposes. We developed a new ultrasound method for the assessment of aortic arch PWV, using a single-beat dual-gate simultaneous pulsed wave Doppler tracing. The aim of the study is to evaluate the feasibility of this new technique in a group of healthy volunteers. Methods We examined 126 healthy volunteers (81 females, 45 males, mean age 42 + 15 years, range 13-83 years) using a commercially available machine equipped with simultaneous dual-gate pulsed Doppler. Using the suprasternal approach, the first sample volume was placed in ascending aorta and the second one in descending aorta. The distance between the two sites was directly measured with a curvilinear tracing in the middle of the vessel, following the shape of the aortic arch. PWV was calculated as the ratio of distance (in millimiters) and the transit time (in milliseconds) measured using the "foot-to-foot" method. The results are then easily transformed, simplifying in the commonly unit of meters/second. Results Feasibility was 99%; in one case it was not possible to measure accurately the aortic arch PWV due to unfavorable suprasternal acustic window. The procedure time was very fast, requiring 2 + 1 minutes. Intraobserver and interobserver variability were 7% and 9% respectively. Aortic arch PWV, as expected, showed a strong correlation with age in males as well as in females (r= 0.71 and r = 0.60 respectively, p < 0.001 for both); there was also a significant correlation with body mass index (r = 0.31; p < 0.001). Aortic arch PWV values ranged from 3.1 to 8.5 m/s, showing a substantial overlap with normal values reported in MRI studies. Conclusions The direct measurement of aortic arch PWV is feasible and reproducible with ultrasound, using the novel single-beat dual-gate simultaneous pulsed wave Doppler tracing. This technique could be implemented in a standard echo examination, that is much more available than MRI studies. Further studies are needed to evaluate if Doppler-derived aortic arch PWV could provide additional prognostic information. Abstract P1830 Figure. Aortic Arch PWV

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A high ankle-brachial index is associated with increased aortic pulse wave velocity: the Czech post-MONICA study

European Journal of Cardiovascular Prevention & Rehabilitation ◽

10.1177/1741826711398840 ◽

2011 ◽

Vol 18 (6) ◽

pp. 790-796 ◽

Cited By ~ 12

Author(s):

Peter Wohlfahrt ◽

Daniel Palouš ◽

Michaela Ingrischová ◽

Alena Krajčoviechová ◽

Jitka Seidlerová ◽

...

Keyword(s):

Cardiovascular Risk ◽

Pulse Wave Velocity ◽

Wave Velocity ◽

Aortic Stiffness ◽

Pulse Wave ◽

Population Sample ◽

Ankle Brachial Index ◽

Aortic Pulse Wave Velocity ◽

Left Ventricular ◽

History Of

Background: Ankle brachial index (ABI) has been increasingly used in general practice to identify individuals with low ABI at high cardiovascular risk. However, there has been no consensus on the clinical significance of high ABI. The aim of our study was to compare aortic stiffness as a marker of cardiovascular risk in individuals with low (<1.0), normal (1.0–1.4), and high ABI (>1.4). Methods: A total of 911 individuals from the Czech post-MONICA study (a randomly selected 1% representative population sample, aged 54 ± 13.5 years, 47% of men) were examined. ABI was measured using a handheld Doppler and aortic pulse wave velocity (aPWV) using the Sphygmocor device. Results: Of the 911 individuals, 28 (3.1%) had low ABI and 23 (2.5%) high ABI. There was a U-shaped association between aPWV and ABI. aPWV was significantly higher in individuals with low and high ABI compared with the normal ABI group (11.1 ± 2.8, 8.3 ± 2.3, p < 0.001; 10.8 ± 2.5, 8.3 ± 2.3 m/s, p < 0.001, respectively). In a model adjusted for age, sex, systolic, diastolic, mean blood pressure and examiner, aPWV remained increased in both extreme ABI groups compared with the normal ABI group. In logistic regression analysis, aPWV together with glucose level, male sex, and a history of deep venous thrombosis were independent predictors of high ABI, while cholesterol was not. Conclusion: This is the first study showing increased aortic stiffness in individuals with high ABI, presumably responsible for increased left ventricular mass described previously in this group. These findings suggest increased cardiovascular risk of high ABI individuals.

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Biological Pathways in Adolescent Aortic Stiffness

Journal of the American Heart Association ◽

10.1161/jaha.120.018419 ◽

2021 ◽

Vol 10 (6) ◽

Author(s):

Justin P. Zachariah ◽

Yunfei Wang ◽

Jane W. Newburger ◽

Sarah D. deFerranti ◽

Gary F Mitchell ◽

...

Keyword(s):

Pulse Wave Velocity ◽

Wave Velocity ◽

Aortic Stiffness ◽

Pulse Wave ◽

Low Density Lipoprotein ◽

Density Lipoprotein ◽

Normal Weight ◽

Excess Weight ◽

Low Density ◽

Low Density Lipoprotein Cholesterol

Background Aortic stiffening begins in youth and antedates future hypertension. In adults, excess weight, systemic inflammation, dyslipidemia, insulin resistance, neurohormonal activation, and altered adipokines are implicated in the pathogenesis of increased aortic stiffness. In adolescents, we assessed the relations of comprehensive measures of aortic stiffness with body mass index (BMI) and related but distinct circulating biomarkers. Methods and Results A convenience sample of 246 adolescents (mean age, 16±2 years; 45% female, 24% Black, and 43% Hispanic) attending primary care or preventive cardiology clinics at 2 tertiary hospitals was grouped as normal weight (N=98) or excess weight (N=148, defined as BMI ≥age‐ and sex‐referenced 85th percentile). After an overnight fast, participants underwent anthropometry, noninvasive arterial tonometry, and assays for serum lipids, CRP (C‐reactive protein), glucose, insulin, renin, aldosterone, and leptin. We used multivariable linear regression to relate arterial stiffness markers (including carotid‐femoral pulse wave velocity) to BMI z score and a biomarker panel. Carotid‐femoral pulse wave velocity was higher in excess weight compared with normal weight group (5.0±0.7 versus 4.6±0.6 m/s; P <0.01). After multivariable adjustment, carotid‐femoral pulse wave velocity was associated with BMI z score (0.09 [95% CI, 0.01–0.18]; P =0.04) and with low‐density lipoprotein cholesterol (0.26 [95% CI, 0.03–0.50]; P =0.03). Conclusions Higher BMI and low‐density lipoprotein cholesterol were associated with greater aortic stiffness in adolescents. Maintaining optimal BMI and lipid levels may mitigate aortic stiffness.

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PERFORMANCE OF THE VASCULAR STIFFNESS INDICATORS AND THE PROCESS OF LEFT VENTRICLE REMODELING IN HYPERTENSIVE PATIENTS UNDER RENAL REPLACEMENT THERAPY

The Russian Archives of Internal Medicine ◽

10.20514/2226-6704-2019-9-5-391-398 ◽

2019 ◽

Vol 9 (5) ◽

pp. 391-398

Author(s):

E. A. Praskurnichiy ◽

I. E. Minyukhina

Keyword(s):

Essential Hypertension ◽

Renal Replacement Therapy ◽

Pulse Wave Velocity ◽

Arterial Hypertension ◽

Healthy Volunteers ◽

Replacement Therapy ◽

Wave Velocity ◽

Pulse Wave ◽

Left Ventricular ◽

Vascular Stiffness

Objective. The objective of our study was to compare the performance of vascular stiffness (VS) and the left ventricular (LV) remodeling process indicators in patients with arterial hypertension (AH) under renal replacement therapy (RRT), and patients with essential hypertension.Design and methods. 158 people were included in the study, divided into 4 comparable age groups: 32 patients receiving programmed hemodialysis (PH), 37 recipients of renal transplant (RT), 69 patients with essential AH and 20 healthy volunteers. All the patients underwent 24-hour blood pressure (BP) monitoring with an assessment of VS and central BP (SBPao) and echocardiography (EchoCG).Results. The patients under PH and after RT did not have any significant differences in the values of central and peripheral BP. Comparing the groups of patients under RRT with the group of essential AH, the office systolic (SBP) and diastolic (DBP) BP values did not differ significantly. Аlthough, at night, considerably higher DBP(n) and SBPao(n) values were detected in patients under RRT, and in the patients after RT SBP(n) and PP(n) values were also increased. An increase in the SBPao values of more than 10 m/sec was detected only in the groups of patients under RRT. In all the groups with hypertension all indicators of daily VS differed significantly from the group of healthy volunteers. PTIN (Pulse Time Index of Norm) in the studied groups had more evident differences: in the healthy volunteers it was in the range of 80-90%, in the patients with essential hypertension — 50-60%, and in the patients under PH and after RT — 20-40%. In all groups of patients with AH, the average the posterior wall thickness (PWT) of the LV and the interventricular septum thickness (IVST) were close to the upper limit of the norm. In the groups of patients with AH an increase in the relative wall thickness (RWT) of the LV was also detected. Furthermore, considerably higher the values of ILVmass, IVST were found in the group of patients on PH in comparison with the patients after RT. In addition, in all the groups of patients with AH, there was a tendency to LV spherification in comparison with the healthy volunteers, and in the group of essential AH the difference was more pronounced compared with the group under RRT.Conclusion. In the patients with arterial hypertension who undergo renal replacement therapy, higher average values of central BP, higher vascular stiffness (daily pulse wave velocity in the aorta and a longer period of pulse wave velocity increase in the aorta during the day (PTIN)) and less pronounced left ventricular spherification are recorded in comparison with the patients with essential hypertension while office BP values remained consistent.

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Abstract WP265: Association Between Brachial-Ankle Pulse Wave Velocity and Aortic Atheroma in Acute Ischemic Stroke

Stroke ◽

10.1161/str.51.suppl_1.wp265 ◽

2020 ◽

Vol 51 (Suppl_1) ◽

Author(s):

Jaewook Jeong ◽

Jin Kyo Choi ◽

Young Dae Kim ◽

Ji Hoe Heo ◽

Hyo Suk Nam

Keyword(s):

Ischemic Stroke ◽

Pulse Wave Velocity ◽

Acute Ischemic Stroke ◽

Wave Velocity ◽

Aortic Stiffness ◽

Pulse Wave ◽

Mean Value ◽

Noninvasive Technique ◽

Aortic Atheroma ◽

Aortic Plaques

Background and Purpose: Aortic plaques are associated with both larger artery and small artery atherosclerosis. However, association between aortic plaque and aortic stiffness in ischemic stroke is unknown. Brachial-ankle pulse wave velocity (baPWV) is a noninvasive technique to measure aortic stiffness. In the present study, we hypothesized that presence of aortic plaques is associated with increased baPWV. Methods: We reviewed 1099 patients diagnosed with acute ischemic stroke, who had both transesophageal echocardiography (TEE) and brachial-ankle pulse wave velocity (baPWV) measurements. Aortic plaques were classified as complex aortic plaques (CAP) or simple aortic plaques (SAP). CAP were defined as plaques protruding into the lumen ≥4 mm and of mobile lesions located in the proximal aorta. SAP represented plaques <4 mm in the proximal aorta and plaques located in the descending aorta of any sizes. Patients were classified into 4 groups; patients who have CAP only, those who have SAP only, those who have both CAP and SAP, and those without aortic plaques. Results: Among the 1099 patients, aortic atheroma was found in 689 (62.7%) patients. Twenty one (1.9%) patients had only CAP, 142 (12.9%) patients had both SAP and CAP, while 526 (47.9%) patients had SAP without CAP. Mean value of baPWV was 1982±580 cm/sec. baPWV was significantly increased in patients with any aortic atheromas than those without atheromas (2095±577 cm/sec vs. 1793±535 cm/sec, p <0.001). Analysis of variance showed that baPWV was significantly increased in patients with SAP only (p<0.001) and SAP and CAP (p<0.001) compared to those without any aortic atheroma, whereas CAP only patients were not associated with baPWV (p = 0.131). Conclusion: We found that baPWV was associated with SAP but not CAP in acute ischemic stroke patients. These feature suggests that SAP represent generalized atherosclerosis and aortic stiffness, whereas CAP represent the sole mechanism of stroke.

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Association of Brachial-Ankle Pulse Wave Velocity and Cardiomegaly With Aortic Arch Calcification in Patients on Hemodialysis

Medicine ◽

10.1097/md.0000000000003643 ◽

2016 ◽

Vol 95 (19) ◽

pp. e3643 ◽

Cited By ~ 7

Author(s):

Ming-Chen Paul Shih ◽

Mei-Yueh Lee ◽

Jiun-Chi Huang ◽

Yi-Chun Tsai ◽

Jui-Hsin Chen ◽

...

Keyword(s):

Pulse Wave Velocity ◽

Aortic Arch ◽

Wave Velocity ◽

Pulse Wave ◽

Aortic Arch Calcification

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Aortic Stiffness Assessed by Global Pulse Wave Velocity in Postmenopausal Women: An Ultrasonographic Study

Echocardiography ◽

10.1111/j.1540-8175.2012.01786.x ◽

2012 ◽

Vol 29 (10) ◽

pp. 1233-1238 ◽

Cited By ~ 6

Author(s):

Pasquale Palmiero ◽

Maria Maiello ◽

David D. Daly ◽

Marco Matteo Ciccone ◽

Navin C. Nanda

Keyword(s):

Pulse Wave Velocity ◽

Postmenopausal Women ◽

Wave Velocity ◽

Aortic Stiffness ◽

Pulse Wave

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P2.06 RETINAL PULSE WAVE VELOCITY ASSESSMENT FOR IN-VIVO ESTIMATION OF MICROCIRCULATORY ARTERIAL STIFFNESS IN MEDICALLY VALIDATED HEALTHY VOLUNTEERS

Artery Research ◽

10.1016/j.artres.2012.09.087 ◽

2012 ◽

Vol 6 (4) ◽

pp. 165

Author(s):

K. Kotliar ◽

M. Baumann ◽

A. Djimandjaja ◽

I. Lanzl ◽

M. Halle ◽

...

Keyword(s):

Arterial Stiffness ◽

Pulse Wave Velocity ◽

Healthy Volunteers ◽

Wave Velocity ◽

Pulse Wave

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P1001 : Carotid-femoral pulse wave velocity (CF-PWV) as a surrogate marker of advanced liver fibrosis in type-2 diabetic (T2DM) patients evaluated by transient hepatic elastography

Journal of Hepatology ◽

10.1016/s0168-8278(15)31202-2 ◽

2015 ◽

Vol 62 ◽

pp. S722-S723

Author(s):

N.C. Leite ◽

M.T. Ferreira ◽

G. Salles ◽

C.R. Cardoso ◽

C.A. Villela- Nogueira

Keyword(s):

Liver Fibrosis ◽

Pulse Wave Velocity ◽

Wave Velocity ◽

Pulse Wave ◽

Surrogate Marker ◽

Advanced Liver Fibrosis ◽

Type 2 Diabetic

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Normal Pregnancy Is Associated with Changes in Central Hemodynamics and Enhanced Recruitable, but Not Resting, Endothelial Function

International Journal of Reproductive Medicine ◽

10.1155/2015/250951 ◽

2015 ◽

Vol 2015 ◽

pp. 1-10 ◽

Cited By ~ 2

Author(s):

Juan Torrado ◽

Yanina Zócalo ◽

Ignacio Farro ◽

Federico Farro ◽

Claudio Sosa ◽

...

Keyword(s):

Pulse Wave Velocity ◽

Endothelial Function ◽

Wave Velocity ◽

Aortic Stiffness ◽

Pulse Wave ◽

Reactive Hyperemia ◽

Intima Media Thickness ◽

Normal Pregnancy ◽

Low Flow ◽

Central Hemodynamics

Introduction.Flow-mediated dilation (FMD), low flow-mediated constriction (L-FMC), and reactive hyperemia-related changes in carotid-to-radial pulse wave velocity (ΔPWVcr%) could offer complementary information about both “recruitability” and “resting” endothelial function (EF). Carotid-to-femoral pulse wave velocity (PWVcf) and pulse wave analysis-derived parameters (i.e., AIx@75) are the gold standard methods for noninvasive evaluation of aortic stiffness and central hemodynamics. If healthy pregnancy is associated with both changes in resting and recruitable EF, as well as in several arterial parameters, it remains unknown and/or controversial.Objectives.To simultaneously and noninvasively assess in healthy pregnant (HP) and nonpregnant (NP) women central parameters in conjunction with “basal and recruitable” EF, employing new complementary approaches.Methods.HP (n=11, 34.2 ± 3.3 weeks of gestation) and age- and cardiovascular risk factors-matched NP (n=22) were included. Aortic blood pressure (BP), AIx@75, PWVcf, common carotid stiffness, and intima-media thickness, as well as FMD, L-FMC, and ΔPWVcr %, were measured.Results.Aortic BP, stiffness, and AIx@75 were reduced in HP. ΔPWVcr% and FMD were enhanced in HP in comparison to NP. No differences were found in L-FMC between groups.Conclusion.HP is associated with reduced aortic stiffness, central BP, wave reflections, and enhanced recruitable, but not resting, EF.

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