Pulse wave amplitude is associated with brachial artery diameter: implications for gender differences in
Kevin S Heffernan1, Richard H Karas, Paula J Mooney
1Vascular Function Study Group, Department of Medicine, Division of Cardiology, Tufts Medical Center, Boston, MA 02111, USA. kheffernan@tuftsmedicalcenter.org
Vascular Medicine (London, England)
|December 23, 2009
Summary
Brachial artery diameter influences microvascular endothelial function measurements. Adjusting for artery size is crucial when comparing pulse wave amplitude reactive hyperemia index (PWA-RHI) between genders to avoid confounding results.
Area of Science:
- Cardiovascular Research
- Vascular Physiology
- Medical Diagnostics
Background:
- Microvascular endothelial function is assessed non-invasively using the pulse wave amplitude reactive hyperemia index (PWA-RHI).
- The influence of upstream conduit vessel structure, specifically brachial artery diameter (BAD), on downstream microvascular function (PWA-RHI) is not well understood.
- Potential confounding effects of vessel structure on PWA-RHI, particularly in gender-based comparisons, require investigation.
Purpose of the Study:
- To test the hypothesis that digital pulse wave amplitude (PWA) is influenced by brachial artery diameter (BAD).
- To determine if the association between BAD and PWA influences comparisons of PWA-RHI between genders.
- To investigate the role of BAD as a potential confounder in PWA-RHI assessments.
Main Methods:
- Vascular structure and microvascular function were assessed in 115 patients with diverse cardiovascular risk profiles.
- Pulse wave amplitude (PWA) was measured using plethysmography at baseline and after brachial artery occlusion.
- Brachial artery diameter (BAD) was evaluated using high-resolution ultrasonography.
Main Results:
- A significant negative association was found between brachial artery diameter (BAD) and PWA-RHI (r = -0.34, p < 0.05).
- Women exhibited higher PWA-RHI and smaller BAD compared to men (p < 0.05).
- Gender differences in PWA-RHI disappeared when accounting for BAD, and were absent in BAD-matched, non-CAD subgroups.
Conclusions:
- PWA-RHI, a measure of microvascular endothelial function, is significantly associated with brachial artery diameter (BAD).
- Brachial artery diameter (BAD) acts as a confounder in gender comparisons of PWA-RHI.
- Future studies on gender differences in microvascular function using PAT should consider and correct for BAD.
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