Fibrinogen and d-dimer in contrasting relation with measures of wave reflection and arterial stiffness

The relationship between the results of coagulation tests and measures of arterial stiffness or wave reflection has been investigated in different diseases. This exploratory study aimed at the evaluation of similar associations in healthy individuals.

Pulse wave analysis of reconstructed aortic pressure waveform for the central augmentation index, augmentation pressure and pulse pressure, and digital volume pulse for the stiffness index were measured at supine rest in 91 healthy volunteers (54.1 ± 8.5 years; 56 female). Standard coagulation tests for the d-dimer and fibrinogen concentrations were performed in fasting venous blood.

In univariate linear regression d-dimer and fibrinogen concentrations were significantly and positively, although weakly, associated with measures related to pulse wave analysis. Multivariate linear regression adjusted to subjects' age, resting pulse rate and mean blood pressure showed that the d-dimer concentration was significantly related to central augmentation index (p = 0.014), augmentation pressure (p = 0.003) and pulse pressure (p = 0.029) whereas fibrinogen was linked to the stiffness index (p = 0.04). Higher concentrations of d-dimers and fibrinogen are associated with increased arterial stiffness and faster pulse wave propagation in healthy people and the observed associations are independent of typical determinants of the shapes of pulse pressure waveforms like age, pulse rate and mean blood pressure.

The independent relationships between the results of the coagulation tests and pulse wave analysis suggest that the existence of such associations may indicate a biologically plausible phenomenon.