title: Brachial-ankle vs carotid-femoral pulse wave velocity as a determinant of cardiovascular structure and function.
abstract: Carotid-femoral pulse wave velocity (cf-PWV) is a validated marker of arterial stiffening over the central arteries. Brachial-ankle pulse wave velocity (ba-PWV) integrates the mechanical properties from both the central and peripheral arteries and may be more representative than cf-PWV as arterial load for left ventricle (LV). We compared ba-PWV with cf-PWV for the association of cardiovascular structure and function in 320 subjects with various degrees of abnormality in cardiac structure and function. ba-PWV (by oscillometric technique) and cf-PWV (by tonometric technique) were measured simultaneously, and were highly correlated (r=0.79, P<0.001). Both ba-PWV and cf-PWV were significantly correlated with LV mass, but the correlation was better with ba-PWV (r=0.29 vs r=0.22, P=0.0219). While ba-PWV and cf-PWV were similarly significantly correlated with LV end-systolic elastance and mitral E/A ratio, ba-PWV had better correlation with isovolumic relaxation constant (r=0.34 vs r=0.27, P=0.0202) than cf-PWV. In addition, the correlation was also significantly stronger with ba-PWV than with cf-PWV for other indices of arterial stiffness, including carotid incremental modulus (r=0.59 vs 0.50, P=0.0013), effective arterial elastance (r=0.41 vs r=0.33, P=0.0081) and carotid augmentation index (r=0.38 vs r=0.32, P=0.0368). In conclusion, ba-PWV correlates better with LV mass and diastolic function and other indices of arterial function than cf-PWV, probably because ba-PWV encompasses a greater territory of arterial tree than cf-PWV.
authors.affiliation: Department of Internal Medicine, Taipei Veterans General Hospital, National Yang-Ming University, Taipei, Taiwan.
authors.forename: W-C
authors.initials: WC
authors.lastname: Yu
authors.forename: S-Y
authors.initials: SY
authors.lastname: Chuang
authors.forename: Y-P
authors.initials: YP
authors.lastname: Lin
authors.forename: C-H
authors.initials: CH
authors.lastname: Chen
mesh_terms: D000328:Adult; D000368:Aged; D001158:Arteries / Q000503:physiopathology; D001783:Blood Flow Velocity; D001916:Brachial Artery; D018376:Cardiovascular Abnormalities / Q000175:diagnosis* / Q000503:physiopathology; D002339:Carotid Arteries; D003936:Diagnosis, Computer-Assisted; D004452:Echocardiography; D004548:Elasticity; D005260:Female; D005263:Femoral Artery; D006321:Heart / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results