Augmentation index derived from peripheral arterial tonometry correlates with cardiovascular risk factors
Eshan Patvardhan1, Kevin S Heffernan, Jenny Ruan
1Division of Cardiology, Tufts Medical Center, Boston, MA 02111, USA.
Insights
Augmentation index derived from peripheral arterial tonometry (PAT) correlates with cardiovascular risk factors and coronary artery disease (CAD). This non-invasive method may help assess overall CAD risk.
Area of Science:
- Cardiovascular physiology
- Non-invasive hemodynamic assessment
Background:
- Augmentation index (AIx) traditionally measured via applanation tonometry.
- Peripheral arterial tonometry (PAT) offers a non-invasive alternative for AIx assessment.
- Evaluating AIx from PAT in relation to cardiovascular risk factors (CRF) and coronary artery disease (CAD) is crucial.
Purpose of the Study:
- To assess the association between AIx derived from PAT and CRF.
- To determine the relationship between PAT-derived AIx and the presence of CAD.
- To explore the predictive value of PAT-derived AIx for central blood pressures.
Main Methods:
- 186 patients enrolled, assessing CRFs and CAD status.
- AIx calculated using an automated algorithm from PAT data.
- Central blood pressures measured in a subset via cardiac catheterization.
Main Results:
- AIx showed significant associations with age, heart rate, BMI, and other hemodynamic parameters.
- Patients with >5 CRFs had significantly higher AIx than those with <3 CRFs (P=.02).
- AIx was significantly higher in patients with CAD compared to those without (P=.008).
- PAT-derived AIx predicted aortic systolic and pulse pressures in catheterized patients (P<.05).
Conclusions:
- AIx derived from PAT is correlated with established cardiovascular risk factors.
- PAT-derived AIx demonstrates a significant association with the presence of coronary artery disease.
- This non-invasive AIx measurement may serve as a valuable tool for assessing overall CAD risk.
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.
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