Distance measurement for pulse wave velocity estimation in pediatric age: Comparison with intra-arterial path length

Area of Science:

• Pediatric Cardiology
• Vascular Physiology
• Biomedical Engineering

Background:

• Central pulse wave velocity (PWV) is a key indicator of arterial stiffness.
• Accurate distance measurement for PWV calculation in children remains inconsistent.
• This study addresses the need for a reliable method to assess distance in pediatric PWV measurements.

Purpose of the Study:

• To determine the most reliable method for assessing distance in pediatric pulse wave velocity (PWV) measurements.
• To compare the subtractive and direct methods for calculating carotid-femoral PWV in children.
• To validate distance measurements using magnetic resonance imaging (MRI).

Main Methods:

• Carotid-femoral PWV was measured in 988 healthy children (6.5-19.9 years) using applanation tonometry.
• Two distance methods were evaluated: subtraction (suprasternal notch to femoral minus carotid to suprasternal notch) and direct (80% of carotid to femoral distance).
• MRI was used to validate actual path length in 31 children.

Main Results:

• The subtractive and direct methods showed good agreement in children under 14 years.
• In children aged 14 years and older, a significant difference was observed between the methods (-45 ± 28 mm).
• The direct method overestimated distance by 10% in older children, leading to significantly higher PWV values (p < 0.0001), confirmed by MRI.

Conclusions:

• The subtractive method for distance measurement demonstrates greater reliability in children compared to the direct method.
• This finding has implications for accurate assessment of arterial stiffness in pediatric populations.
• Standardizing distance measurement is essential for consistent and reliable PWV assessment in children.