Measure Of Central Arterial Stiffness Research Articles

Assessment of central and peripheral arterial stiffness: Studies indicating the need to use a combination of techniques

Several new techniques exist for measuring arterial stiffness, but their association with central pulse wave velocity (PWV), an established measure of central arterial stiffness, has not been compared in the same study. The aim of this study was to compare the agreement of the new techniques with central PWV. Fifteen men with coronary artery disease (59 +/- 2 years of age) and 15 healthy men (28 +/- 1 years of age) were recruited. The following measures were performed in a random sequence and repeated after 1 week: central and distal pulse wave velocity (PWV), large and small artery compliance (C1 and C2, respectively), and stroke volume/pulse pressure (SV/PP) (measured by HDI/PulseWave CR-2000), augmentation index (AIx) and central pulse pressure (CPR) (Sphygmocor), stiffness index (SI) (Micro Medical Pulse Trace), systemic arterial compliance (SAC) (area method), and brachial PP (Dinamap). Methods were compared using correlation coefficients and Bland-Altman analysis. Although all measures of arterial stiffness except PWV correlated significantly with central PWV (P < .01 for each), Bland-Altman analysis showed poor agreement (confidence interval [CI] >3 Z-scores) between central PWV and C1, C2, SV/PP, and SAC). There was good agreement (CI > 2 Z-scores) between central PWV and SI, AIx, CPP, and brachial PP. The coefficient of variation was lowest with central PWV (7.6%), brachial PP (8.0%), and SV/PP (8.6%) and was significantly higher (P < .05) in increasing order with C1 (11.3%), C2 (15.6%), SI (17.8%), SAC (19.3%), AIx (22.4%), and CPP (25.3%). Based on our study findings, C1, C2, SV/PP, and SAC show poor agreement with central PWV, an established measure of central arterial stiffness. Indices of this type should therefore be useful in providing a more complete understanding of arterial stiffness. In comparison, SI, AIx, and CPP are more closely related to central arterial stiffness.

Absence of age-related increase in central arterial stiffness in physically active women.

Increased arterial stiffness is thought to contribute to the increased incidence of cardiovascular disease with age. Little, however, is known about the influence of aging on central and peripheral arterial stiffness in females. Moreover, it is unknown whether physical activity status influences age-related increases in arterial stiffness in females. Arterial pulse wave velocity (PWV) and augmentation index (AI, applanation tonometry) were measured in 53 healthy females, including 10 premenopausal (Pre-S) and 18 postmenopausal (Post-S) sedentary women, and 9 premenopausal (Pre-PA) and 16 postmenopausal (Post-PA) physically active women. In the sedentary women, there were no age-related differences in arterial blood pressure, but aortic PWV and carotid AI (measures of central arterial stiffness) were higher (P<.01) in Post-S versus Pre-S (1065+/-110 versus 690+/-80 cm/sec and 16.5%+/-1.8% versus 0.3%+/-1.6%, respectively); however, there were no significant differences in leg and arm PWV (measures of peripheral arterial stiffness). Systolic and mean arterial blood pressures were higher (P<.05) in Post-PA versus Pre-PA. Despite this and in contrast to the sedentary women, aortic PWV and AI were not different in Post-PA versus Pre-PA. Stepwise multiple regression indicated that maximal oxygen consumption, plasma total cholesterol, and plasma LDL-cholesterol were significant independent predictors and together explained up to 50% of the variability in central arterial stiffness. We concluded that (1) central, but not peripheral, arterial stiffness increases with age in sedentary healthy females in the absence of age-related increases in arterial blood pressure; (2) significant age-related increases in central arterial stiffness are not observed in highly physically active women; and (3) aerobic fitness and plasma total cholesterol and LDL-cholesterol levels are significant independent physiological correlates of central arterial stiffness in this population.