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Central and peripheral pulse wave velocity and subclinical myocardial stress and damage in older adults

Shuiqing Liu1, Esther D Kim1, Aozhou Wu1

  • 1Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America.

Plos One
|February 28, 2019
PubMed

Insights

Central arterial stiffness, measured by pulse wave velocity (PWV), is linked to myocardial stress biomarker NT-proBNP in older adults without heart disease. Peripheral stiffness showed inverse associations.

Area of Science:

  • Cardiovascular physiology
  • Biomarker research
  • Geriatric cardiology

Background:

  • Arterial stiffness is a key predictor of cardiovascular disease.
  • Limited research exists on central and peripheral pulse wave velocity (PWV) associations with myocardial stress (NT-proBNP) and damage (hs-cTnT) in individuals without pre-existing cardiac conditions.

Purpose of the Study:

  • To investigate the relationship between central and peripheral arterial stiffness (PWV) and cardiac biomarkers (NT-proBNP, hs-cTnT) in older adults without diagnosed heart disease.
  • To determine if central or peripheral hemodynamics are more closely associated with myocardial stress or damage.

Main Methods:

  • Analysis of 3,348 participants (aged 67-90) from the Atherosclerosis Risk in Communities (ARIC) Study (2011-2013).
  • Cross-sectional evaluation of central (carotid-femoral, heart-carotid, heart-femoral) and peripheral (femoral-ankle) PWV quartiles against NT-proBNP and hs-cTnT levels.
  • Statistical models accounted for potential confounding factors and traditional cardiovascular risk factors.

Main Results:

  • Central PWV measures exhibited J- or U-shaped associations with NT-proBNP and hs-cTnT.
  • Higher central PWV (Q4 vs. Q2) correlated with elevated NT-proBNP, an association less pronounced for hs-cTnT.
  • These links weakened after adjusting for cardiovascular risk factors, though the heart-carotid PWV-NT-proBNP association remained borderline significant.
  • Peripheral PWV showed inverse associations with NT-proBNP, with higher NT-proBNP in the lowest PWV quartile.

Conclusions:

  • Central arterial stiffness measures are more strongly associated with cardiac biomarkers, particularly NT-proBNP, than peripheral measures in older adults without heart disease.
  • Findings support the concept of ventricular-vascular coupling.
  • Central arterial hemodynamics appear more closely related to myocardial stress than myocardial damage.
Abstract

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