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Updated: Aug 25, 2026
Measuring the Carotid to Femoral Pulse Wave Velocity (Cf-PWV) to Evaluate Arterial Stiffness
Published on: May 3, 2018
Cf-PWV Versus ba-PWV in Predicting Cardiovascular Events: Insights From a Community-Based Cohort
Chen Chi1,2, Jiaxin Li1,3, Haotian Yang1
1Department of Cardiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China (C.C., J.L., H.Y., J.T., S.Z., S.Y., J.X., Y.Z.).
Background:
To directly compare the predictive ability of carotid-femoral pulse wave velocity (cf-PWV) and brachial-ankle pulse wave velocity (ba-PWV) for cardiovascular events within the same population.
Methods:
This is a community-based prospective cohort study that included older adults (>65 years). The primary end point was major adverse cardiovascular events (MACEs), including cardiovascular mortality, nonfatal myocardial infarction, and nonfatal stroke.
Results:
A total of 3309 participants (median age [quartiles], 70 [67-75] years; 1434 [43.3%] men) were included. The median follow-up time was 6.40 [6.37-6.41] years. Cf-PWV and ba-PWV were moderately correlated (R=0.588; P<0.001). Participants were divided into 4 groups by quartiles or 2 groups using cutoff values. Aalen-Johansen estimators and Cox regression analyses indicated that both cf-PWV and ba-PWV were associated with an increased rate of MACEs. When cf-PWV and ba-PWV were cross-adjusted, only cf-PWV remained significantly associated with MACEs and mortality (hazard ratio, 1.12 [95% CI, 1.00-1.25]; P=0.048 and 1.16 [95% CI, 1.03-1.29]; P=0.032, respectively) in both full-model and stepwise regressions. Stratification based on cf-PWV and ba-PWV cutoff values further revealed that elevated cf-PWV was associated with a higher risk of MACEs, independent of baseline ba-PWV. Concordance index, net reclassification improvement, and integrated discrimination improvement analyses confirmed the additive value of cf-PWV to conventional cardiovascular risk factors. Other stiffness-related parameters, including pulse pressure and its amplification, were not independently associated with MACEs.
Conclusions:
Both cf-PWV and ba-PWV are associated with cardiovascular events, and cf-PWV demonstrates a higher predictive value compared with ba-PWV.
Registration:
URL: https://www.clinicaltrials.gov; Unique identifier: NCT02368938.
