Functional Markers of Vascular Aging: Subendocardial Viability Ratio, Augmentation Pressure, and Augmentation Index...

This study investigated the correlation of functional hemodynamic parameters, including subendocardial viability ratio (SEVR), augmentation pressure (AP) and heart-rate-corrected augmentation index (Aix@75), with age and atherosclerotic cardiovascular disease (ASCVD) risk in a Chinese population. A total of 3,354 participants aged 18-80 years with left ventricular ejection fraction >55% were enrolled in this cross-sectional study. Functional hemodynamic parameters were assessed by pulse wave analysis, and the 10-year ASCVD risk (10Y-ASCVDR) was estimated using the China-PAR model. Multivariable logistic regression was used to identify independent correlates of elevated estimated 10Y-ASCVDR. Results showed that 10Y-ASCVDR was inversely correlated with SEVR (r = -0.171, p < 0.001) and positively correlated with AP (r = 0.452, p < 0.001) and Aix@75 (r = 0.236, p < 0.001). Stepwise multivariable linear regression identified SEVR, AP and Aix@75 as independent correlates of estimated 10-year ASCVD risk (p < 0.001). In conclusion, SEVR, AP and Aix@75 are independent correlates of estimated 10-year ASCVD risk, and together provide a functional hemodynamic profile that independently correlates with estimated risk beyond traditional factors, suggesting their potential role as supplementary tools for cardiovascular risk stratification. These findings offer a valuable supplemental approach for improving cardiovascular risk assessment in clinical practice.