Prediction of severe aortic stenosis using peripheral arterial waveforms during brachial-ankle pulse wave velocity...

Area of Science:

• Cardiology
• Medical Diagnostics
• Biomedical Engineering

Background:

• Early identification of severe aortic stenosis (AS) is vital for timely intervention, especially with the rise of minimally invasive therapies.
• The slow upstroke waveform (Tardus) in carotid artery analysis is a known AS marker, characterized by prolonged ejection time (ET) and upstroke time (UT).
• The clinical utility of ET and UT measured during brachial-ankle pulse wave velocity (baPWV) for AS assessment was previously unclear.

Purpose of the Study:

• To develop a predictive model for screening severe AS using parameters derived from baPWV.
• To investigate the correlation between echocardiography-derived peak aortic valve velocity (peak V) and baPWV parameters (ET, UT, PEP).
• To assess the potential of baPWV-derived metrics as noninvasive indicators for severe AS.

Main Methods:

• 117 patients with mild to severe AS and 76 controls were enrolled.
• AS severity was determined by echocardiography (peak V).
• Correlations between peak V and baPWV parameters (ET, UT, PEP) were analyzed, and a predictive model was developed.

Main Results:

• Peak V showed significant correlations with ET, pre-ejection time (PEP), PEP/ET, and mean UT (p < 0.001).
• A predictive model incorporating age, BMI, corrected ET, corrected mean UT, and %MAP demonstrated strong predictive value (AUC = 0.872).
• baPWV-derived parameters were found to be significantly associated with AS severity.

Conclusions:

• baPWV-derived parameters, including ET and UT, can serve as valuable noninvasive indicators for screening severe AS.
• The developed predictive model shows good potential for identifying patients with severe AS.
• This study highlights the clinical relevance of baPWV measurements in the noninvasive assessment of aortic stenosis severity.