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Measuring the Carotid to Femoral Pulse Wave Velocity (Cf-PWV) to Evaluate Arterial Stiffness
Published on: May 3, 2018
The effect of heart rate on wave reflections may be determined by the level of aortic stiffness: clinical and
Theodore G Papaioannou1, Charalambos V Vlachopoulos, Nikolaos A Alexopoulos
1First Department of Cardiology, Unit of Biomedical Engineering and Hypertension Unit, Hippokration Hospital, Medical School, National & Kapodistrian University of Athens, Greece. theopap@mail.ntua.gr
Insights
Augmentation Index (AIx) correlates more strongly with heart rate in individuals with stiffer aortas. This suggests that aortic stiffness influences the relationship between AIx and heart rate, impacting cardiovascular risk assessment.
Area of Science:
- Cardiovascular Physiology
- Arterial Hemodynamics
- Biomedical Engineering
Background:
- Augmentation Index (AIx) is a recognized marker associated with cardiovascular diseases, risk, and mortality.
- While AIx is known to correlate with heart rate, the influence of aortic stiffness on this relationship remains understudied.
Purpose of the Study:
- To investigate the relationship between Augmentation Index (AIx) and heart rate across varying levels of aortic stiffness.
Main Methods:
- The study included 425 participants who were normotensive and untreated hypertensive.
- Wave reflections and pulse-wave velocity (PWV) were measured using the Sphygmocor and Complior systems.
Main Results:
- AIx showed independent associations with heart rate, age, gender, height, mean blood pressure, and effective reflection site distance.
- Significant differences in the regression lines of AIx versus heart rate were observed between tertiles of PWV, even after adjustments for covariates.
Conclusions:
- A stronger correlation between AIx and heart rate was found in individuals with higher aortic stiffness.
- The findings suggest that the adjustment of AIx for heart rate may need to consider aortic stiffness levels.
- This has implications for interventional studies targeting central hemodynamics that also influence heart rate.
Background:
Augmentation Index (AIx) is related to cardiovascular diseases, risk, and mortality. AIx is associated with heart rate but the effect of aortic stiffness on this relationship has not been studied. The purpose of our study was to investigate the relationship between AIx and heart rate at different aortic stiffness levels.
Methods:
The study consisted of 425 normotensive and untreated hypertensive subjects. Wave reflections and pulse-wave velocity (PWV) were determined by the Sphygmocor and the Complior systems, respectively.
Results:
AIx was independently associated with heart rate, age, gender, height, mean blood pressure (BP) and the effective reflection site distance (ERD). The population was divided into three groups of those with different PWV levels (tertiles). The regression lines for AIx with heart rate differed significantly between the 3rd and the other two tertiles of PWV (P = 0.039 for slopes and P = 0.002 for intercepts). This difference remained significant even after adjustment for age, gender, height, mean BP, and distance of wave reflections.
Conclusions:
A significantly stronger correlation of AIx with heart rate was observed in subjects with higher levels of aortic stiffness as compared to those with lower levels; namely, the same increase in the heart rate between subjects, induced a greater decrease in the AIx at higher compared to lower PWV levels. The correction of AIx for heart rate should be reconsidered based on the aortic stiffness level. This finding has implications for interventional studies that aim to improve central hemodynamics but simultaneously affect heart rate. Further studies that show acute modifications of heart rate at different arterial stiffness levels are required to support these findings.
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