Assessment of aortic stiffness during atrial fibrillation: solutions and considerations

Area of Science:

• Cardiovascular Physiology
• Biomedical Engineering
• Clinical Diagnostics

Background:

• Assessing aortic stiffness is crucial for cardiovascular risk stratification.
• Existing methods for measuring aortic stiffness lack validation in patients with atrial fibrillation (AF).
• Reliable assessment of aortic stiffness in AF is needed to guide treatment and predict outcomes.

Purpose of the Study:

• To evaluate the reliability of different methods for assessing aortic stiffness in patients with persistent AF.
• To compare measurements of pulse wave velocity (PWV), central blood pressure (BP), and augmentation index (AIx) during AF and after cardioversion to sinus rhythm (SR).

Main Methods:

• Carotid-to-femoral and aortic pulse wave velocity (cf/aoPWV), central BP, and AIx were measured using a two-site applanation method and a one-site cuff-based oscillometric method.
• Measurements were performed in 40 patients with persistent AF and repeated after cardioversion to SR.
• Analysis focused on comparing variability and consistency of measurements between the two methods and between AF and SR states.

Main Results:

• The two-site method showed higher variability in PWV during AF compared to SR (SD 2.5 vs. 1.0 m/s).
• The one-site method demonstrated similar PWV values and lower variability (SD 0.7 vs. 0.6 m/s) between AF and SR.
• Both methods indicated higher central BP and lower AIx during AF, with the one-site method requiring fewer repeated measurements.

Conclusions:

• Aortic stiffness can be reliably assessed during AF using appropriate methods.
• The one-site cuff-based oscillometric method is preferable due to lower variability and fewer required measurements compared to the two-site applanation method.
• Findings suggest that central BP and AIx are significantly altered during AF, impacting aortic stiffness assessment.