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Repeatability of Central and Peripheral Pulse Wave Velocity Measures: The Atherosclerosis Risk in Communities (ARIC)
Michelle L Meyer1, Hirofumi Tanaka2, Priya Palta3
1Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA; mlmeyer@unc.edu.
Insights
Repeatability of pulse wave velocity (PWV) measures, including carotid-femoral (cfPWV), brachial-ankle (baPWV), and femoral-ankle (faPWV), is acceptable for epidemiologic studies and clinical practice. Quantifying measurement variation is crucial for risk assessment in cardiovascular disease.
Area of Science:
- Cardiovascular Physiology
- Biomedical Engineering
- Epidemiology
Background:
- Arterial stiffness is increasingly used for cardiovascular disease (CVD) risk assessment.
- Carotid-femoral pulse wave velocity (cfPWV) measures central arterial stiffness.
- Other measures include femoral-ankle (faPWV) for peripheral stiffness and brachial-ankle (baPWV) for composite stiffness.
Purpose of the Study:
- To compare the repeatability of central, peripheral, and composite pulse wave velocity (PWV) measures.
- To evaluate the reliability of cfPWV, faPWV, and baPWV in a population-based study.
Main Methods:
- Seventy-nine older adults (mean age 75.7 years) from the ARIC study underwent two standardized visits.
- Two PWV measurements (cfPWV, faPWV, baPWV) were taken at each visit using the VP-1000 Plus system.
- Intraclass correlation coefficients (ICCs), minimal detectable change (MDC95), and minimal detectable difference (MDD) were calculated.
Main Results:
- Intraclass correlation coefficients (ICCs) were 0.70 for cfPWV, 0.84 for baPWV, and 0.69 for faPWV.
- MDC95 values were 411.0 cm/s (cfPWV), 370.6 cm/s (baPWV), and 301.4 cm/s (faPWV).
- MDD values were 139.3 cm/s (cfPWV), 172.3 cm/s (baPWV), and 100.4 cm/s (faPWV).
Conclusions:
- Repeatability of all PWV measures (cfPWV, baPWV, faPWV) was acceptable in this older adult population.
- Findings support the use of these PWV measures in epidemiologic studies and for clinical risk stratification.
- Quantifying measurement variation is essential for accurate CVD risk assessment and clinical application.
Background:
Arterial stiffness measures are emerging tools for risk assessment and stratification for hypertension and cardiovascular disease (CVD). Carotid-femoral pulse wave velocity (cfPWV) is an established measure of central arterial stiffness. Other measures of PWV include femoral-ankle (faPWV), a measure of peripheral stiffness, and brachial-ankle PWV (baPWV), a composite measure of central and peripheral stiffness. Repeatability of central, peripheral, and composite PWV measures has not been adequately examined or compared.
Methods:
Participants (n = 79; mean age 75.7 years; USA) from a repeatability study nested within the Atherosclerosis Risk in Communities (ARIC) Study visit 5 (2011-2013) underwent 2 standardized visits, 4-8 weeks apart. Trained technicians obtained 2 PWV measurements at each visit using the VP-1000 Plus system. We calculated the intraclass correlation coefficient (ICC), SE of measurement, and minimal detectable change (MDC95; 95% confidence interval) and difference (MDD).
Results:
The ICCs and 95% confidence intervals (95% CIs) were 0.70 (0.59, 0.81) for cfPWV, 0.84 (0.78, 0.90) for baPWV, and 0.69 (0.59, 0.79) for faPWV. The MDC95 between repeat measures within an individual was 411.0 cm/s for cfPWV, 370.6 cm/s for baPWV, and 301.4 cm/s for faPWV. The MDD for 2 independent samples of 100 per group was 139.3 cm/s for cfPWV, 172.3 cm/s for baPWV, and 100.4 cm/s for faPWV.
Conclusions:
Repeatability was acceptable for all PWV measures in a multicenter, population-based study of older adults and supports its use in epidemiologic studies. Quantifying PWV measurement variation is critical for applications to risk assessment and stratification and eventual translation to clinical practice.
