Measurement of pulse wave velocity: site matters.
BACKGROUND
Aortic pulse wave velocity (PWV) predicts mortality from cardiovascular disease, ischaemic heart disease and stroke. However, a comparison of associations between PWV measured at different sites and atherosclerosis in coronary, carotid and femoral arteries has not been made.


METHODS
In 159 men (ages 45-82 years) with and without known coronary artery disease, PWV measurements were made between carotid-femoral, carotid-radial and femoral-posterior tibial sites, using an ultrasound technique. Coronary artery calcification (CAC) scores were measured by multislice computed tomography. Carotid and femoral intima-media thickness (IMT) and presence of plaque were determined by ultrasound. Known coronary artery disease was confirmed by angiography. Participants were grouped into four categories of CAC score: 0-10, 11-100, 101-400, > 400 Hounsfield Units (HU). Measurements of blood pressure, heart rate and fasting bloods were made in all individuals.


RESULTS
Carotid-femoral PWV correlated positively with CAC score and increased with incremental coronary calcification category (median carotid-femoral PWV 16.8 m/s in those with CAC score > 400 HU and 13.8 m/s in those with CAC score < 10 HU; P = 0.003). Carotid-femoral PWV also correlated with carotid and femoral IMT (P < 0.001, P = 0.004, respectively) and with carotid and femoral plaque (P = 0.001, P = 0.038, respectively). Increased carotid-femoral PWV also correlated with increasing age (P < 0.001), systolic blood pressure (P < 0.001), mean arterial pressure and pulse pressure (P < 0.001). Carotid-radial and femoral-posterior tibial PWV were not significantly associated with CAC score, carotid or femoral IMT or carotid plaque.


CONCLUSIONS
Carotid-femoral PWV is a better indicator of atherosclerosis than either carotid-radial or femoral-posterior tibial PWV, and should be used preferentially in studies of atherosclerosis and in stratifying risk in clinical settings.
Tillin
Therese
T
International Centre for Circulatory Health, St Mary's Hospital, Hammersmith Hospital & Imperial College, London, UK. t.tillin@imperial.ac.uk
Chambers
John
J
Malik
Iqbal
I
Coady
Emma
E
Byrd
Sheila
S
Mayet
Jamil
J
Wright
Andrew R
AR
Kooner
Jaspal
J
Shore
Angela
A
Thom
Simon
S
Chaturvedi
Nish
N
Hughes
Alun
A
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D044466:Asian People; D050197:Atherosclerosis / Q000175:diagnosis*; D001794:Blood Pressure; D002114:Calcinosis / Q000175:diagnosis*; D002339:Carotid Arteries / Q000502:physiology; D003324:Coronary Artery Disease / Q000175:diagnosis*; D005263:Femoral Artery / Q000502:physiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011673:Pulsatile Flow / Q000502:physiology*; D017534:Radial Artery / Q000502:physiology; D015203:Reproducibility of Results; D018570:Risk Assessment; D016909:Tibial Arteries / Q000502:physiology; D014655:Vascular Resistance; D044465:White People