Abstract
Background: Pulse wave velocity (PWV) is an indicator of arterial stiffness, and predicts cardiovascular events independently of blood pressure. Currently, PWV is commonly measured by the foot-to-foot technique thus giving a global estimate of large arterial stiffness. However, and despite its importance, methods to measure the stiffness of the ascending aorta are limited. Objective: To introduce a method for calculating local PWV in the human ascending aorta using non-invasive ultrasound measurements of its diameter (D) and flow velocity (U). Approach: Ten participants (four females) were recruited from Brunel University students. Ascending aortic diameter and velocity were recorded with a GE Vivid E95 equipped with a 1.5–4.5 MHz phased array transducer using M-mode in the parasternal long axis view and pulse wave Doppler in the apical five chamber view respectively. Groups of six consecutive heartbeats were selected from each 20 s run based on the most similar cycle length resulting in three groups for D and three for U each with six waveforms. Each D waveform was paired with each U waveform to calculate PWV using ln(D)U-loop method. Main results: The diastolic portions of the diameters or velocities waveforms were truncated to allow the pairs to have equal length and were used to construct ln(D)U-loops. The trimmed average, excluding 10% of extreme values, resulting from the 324 loops was considered representative for each participant. Overall mean local PWV for all participants was 4.1(SD = 0.9) m s−1. Significance: Local PWV can be measured non-invasively in the ascending aorta using ultrasound measurements of diameter and flow velocity This should facilitate more widespread assessment of ascending aortic stiffness in larger studies.
Highlights
Pulse wave velocity (PWV) is an indicator of arterial stiffness, and predicts cardiovascular events independently of blood pressure
Arterial stiffness is most commonly assessed by measuring pulse wave velocity (PWV), which, through Bramwell–Hill equation (Bramwell and Hill 1922), is inversely proportional to distensibility
D was recorded in the parasternal long axis view (PLAX) to ensure the measurements were perpendicular to the vessel center-line
Summary
Pulse wave velocity (PWV) is an indicator of arterial stiffness, and predicts cardiovascular events independently of blood pressure. Despite its importance, methods to measure the stiffness of the ascending aorta are limited. Objective: To introduce a method for calculating local PWV in the human ascending aorta using non-invasive ultrasound measurements of its diameter (D) and flow velocity (U). Hypertension, is a common risk factor for cardiovascular disease. Increased arterial stiffness especially the stiffening of the ascending aorta, contributes to hypertension, in older people (Laurent et al 2001, Boutouyrie et al 2002). Increased arterial stiffness predicts cardiovascular disease independently of blood pressure (Ben-Shlomo et al 2014). Arterial stiffness is most commonly assessed by measuring pulse wave velocity (PWV), which, through Bramwell–Hill equation (Bramwell and Hill 1922), is inversely proportional to distensibility. Moens and Korteweg derived independently a related equation which expresses PWV in terms of vessel properties, i.e. proportional to the elastic modulus, and wall thickness, and inversely proportional to vessel radius and blood density (Tijsseling and Anderson 2012)
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