Reference equations for pulse wave velocity, augmentation index, amplitude of forward and backward wave in a European...

Area of Science:

• Cardiovascular Physiology
• Biostatistics
• Population Health

Background:

• Pulsatile hemodynamics are crucial predictors of cardiovascular events.
• Standardized interpretation of these markers is needed for clinical application.
• Existing reference ranges may not adequately capture population-specific variations.

Purpose of the Study:

• To describe four pulsatile hemodynamic markers: carotid-femoral pulse wave velocity (cfPWV), augmentation index (AIx), forward wave amplitude (Pf), and backward wave amplitude (Pb).
• To develop sex- and age-specific reference equations for these markers using the Lambda-Mu-Sigma (LMS) method.
• To enable standardization and accurate interpretation of pulsatile hemodynamics for assessing vascular aging.

Main Methods:

• Utilized data from 6828 participants in the Austrian LEAD cohort study, excluding individuals with cardiovascular disease or relevant comorbidities.
• Measured cfPWV, AIx, Pf, and Pb across different age categories and sexes.
• Applied the LMS method to create sex- and age-specific reference equations for the hemodynamic parameters.

Main Results:

• All four pulsatile hemodynamic parameters (cfPWV, AIx, Pf, Pb) demonstrated an increase with age.
• Significant sex differences were observed: cfPWV and Pf were higher in males, while AIx was higher in females across all ages.
• Pb was higher in females than males in individuals over 40 years old.
• Developed reference equations and an online tool for calculating sex- and age-standardized z-scores.

Conclusions:

• The derived reference equations provide a robust tool for standardizing pulsatile hemodynamic measurements in a large population.
• These standardized values facilitate accurate interpretation of vascular aging and cardiovascular risk assessment.
• The findings highlight the importance of considering sex and age in the evaluation of pulsatile hemodynamics.