The variability of pulse wave velocity and long-term cardiovascular outcomes

Area of Science:

• Cardiovascular Medicine
• Vascular Biology
• Clinical Risk Assessment

Background:

• Pulse wave velocity (PWV) is a key indicator of arterial stiffness and cardiovascular risk.
• Current assessments typically use a single PWV value, potentially missing crucial prognostic information.
• The prognostic utility of visit-to-visit variability in brachial-ankle PWV (baPWV) remains underexplored.

Purpose of the Study:

• To investigate whether variability in baPWV measurements over time provides additional predictive value for long-term cardiovascular outcomes.
• To assess the association between baPWV variability and the occurrence of major adverse cardiovascular events (MACE).

Main Methods:

• A prospective, single-center study involving 794 participants who underwent serial baPWV measurements at baseline and 1, 6, and 12 months.
• Arterial stiffness variability was quantified using the coefficient of variation (CV) of baPWV.
• Major adverse cardiovascular events (MACE) were tracked over a median follow-up of 6.31 years.

Main Results:

• Participants experiencing MACE exhibited significantly higher baPWV CV (11.25% ± 6.87%) compared to those without events (7.45% ± 5.16%).
• Kaplan-Meier analysis revealed a stepwise decrease in MACE-free survival with increasing baPWV CV tertiles.
• Higher baPWV CV was independently associated with an increased risk of MACE (HR 2.38; 95% CI 1.18-4.79) after multivariable adjustment.

Conclusions:

• Longitudinal variability in arterial stiffness, as measured by baPWV CV, offers prognostic information beyond single measurements.
• Monitoring temporal changes in arterial stiffness may improve cardiovascular risk stratification.
• Assessing baPWV variability could be a valuable addition to routine cardiovascular risk assessment.