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Abstract
BackgroundAortic stiffness, assessed through pulse wave velocity (PWV), is an independent predictor for cardiovascular disease risk. However, the scarce availability of normal and reference values for cardiovascular magnetic resonance imaging (CMR) based PWV is limiting clinical implementation. The aim of this study was to determine normal and reference values for CMR assessed PWV in the general population.MethodsFrom the 2,484 participants of the Netherlands Epidemiology of Obesity (NEO) study that have available CMR-PWV data, 1,394 participants free from cardiovasculard disease, smokers or treatment for diabetes, hypertension or dyslipidaemia were selected (45–65 years, 51% female). Participants were divided into sex, age and blood pressure (BP) subgroups. Normal values were specified for participants with a BP < 130/80 mmHg and reference values for elevated BP subgroups (≥ 130/80 and < 140/90 mmHg; and ≥ 140/90 mmHg). Differences between groups were tested with independent samples t-test or ANOVA. Due to an oversampling of obese individuals in this study, PWV values are based on a weighted analysis making them representative of the general population.ResultsNormal mean PWV was 6.0 m/s [95% CI 5.8–6.1]. PWV increased with advancing age and BP categories (both p < 0.001). There was no difference between sex in normal PWV, however in the BP > 140/90 mmHg women had a higher PWV (p = 0.005). The interpercentile ranges were smaller for participants < 55 years old compared to participants ≥ 55 years, indicating an increasing variability of PWV with age. PWV upper limits were particularly elevated in participants ≥ 55 years old in the high blood pressure subgroups.ConclusionThis study provides normal and reference values for CMR-assessed PWV per sex, age and blood pressure category in the general population.
Highlights
Aortic stiffness, assessed through pulse wave velocity (PWV), is an independent predictor for cardiovascular disease risk
Age and sex specific normal and reference values for PWV are important for personalized cardiovascular disease (CVD) risk assessment, where over the last decades increasing evidence and awareness has emerged towards the difference in cardiovascular aging between men and women [9]
In total 6,671 individuals participated in the Netherlands Epidemiology of Obesity (NEO) study of whom a random subset of 2,484 participants without contraindications for cardiovascular magnetic resonance imaging (CMR) underwent CMR-PWV assessment
Summary
Aortic stiffness, assessed through pulse wave velocity (PWV), is an independent predictor for cardiovascular disease risk. Van Hout et al J Cardiovasc Magn Reson (2021) 23:46 assessed PWV and applanation tonometry based carotidfemoral PWV (cf-PWV) are well-established techniques and independent predictors of cardiovascular disease (CVD) [1, 2]. These two techniques yield different PWV values, most likely due to the inability of cf-PWV to accurately assess aortic length [3] cf-PWV has some other important limitations as it can be difficult to obtain a signal in patients with obesity and local aortic PWV assessment is not possible [3]. For this reason it is imperative to define normal PWV values for patients with normal BP and reference values for patients with elevated blood pressures in a population free of CVD, smokers or known hypertension, dyslipidaemia and diabetes, as has been done for cf-PWV [12]
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