Abstract
Background. Augmentation index (AIx) is traditionally obtained from pressure waveforms via arterial applanation tonometry. We sought to evaluate the association between AIx obtained from peripheral arterial tonometry (PAT) with cardiovascular risk factors (CRF) and coronary artery disease (CAD). Methods. 186 patients were enrolled in the study. The presence or absence of CRFs and CAD was assessed in each subject. AIx was calculated by an automated algorithm averaging pulse wave amplitude data obtained via PAT. Central blood pressures were assessed in a subset of patients undergoing clinically indicated cardiac catheterization. Results. An association was observed between AIx and age, heart rate, systolic blood pressure, mean arterial pressure, pulse pressure, body weight and body mass index. AIx was significantly lower in patients with <3 CRFs compared to those with >5 CRFs ( P = .02). CAD+ patients had significantly higher AIx compared to CAD− patients ( P = .008). Area under the ROC curve was 0.604 (P < .01). In patients undergoing cardiac catheterization, after adjusting for age, height and heart rate, AIx was a significant predictor of aortic systolic and pulse pressures (P < .05) Conclusion. AIx derived from PAT correlates with cardiac risk factors and CAD. It may be a useful measure of assessing overall risk for coronary artery disease.
Highlights
A portion of the arterial pressure wave travelling towards the extremities is reflected back from peripheral impedance points
The value obtained by Augmentation index (AIx) derived by peripheral arterial tonometry (PAT) correlates with that obtained by conventional radial applanation tonometry; they cannot be used interchangeably since the actual values do not match since they are obtained from two distinct vascular beds via two different methods
A significant association was observed between PATAIx and age (r = 0.265, P < .0001), heart rate (r = −0.299, P < .0001), diastolic blood pressure (r = −0.285, P < .0001), mean arterial pressure (r = 0.170, P < .045), and pulse pressure (r = 0.198, P = .012)
Summary
A portion of the arterial pressure wave travelling towards the extremities is reflected back from peripheral impedance points. The reflected wave arrives at the aorta during systole of the same cardiac cycle augmenting the central blood pressures. It has been demonstrated that AIx can be measured from digital pulse wave volumes by peripheral arterial tonometry (PAT) [6, 7], and that it is associated with ventricular-vascular coupling [8]. We sought to evaluate the association between AIx obtained from peripheral arterial tonometry (PAT) with cardiovascular risk factors (CRF) and coronary artery disease (CAD). In patients undergoing cardiac catheterization, after adjusting for age, height and heart rate, AIx was a significant predictor of aortic systolic and pulse pressures (P < .05) Conclusion. AIx derived from PAT correlates with cardiac risk factors and CAD It may be a useful measure of assessing overall risk for coronary artery disease
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