Echocardiographic Assessment of Aortic Pulse-Wave Velocity: Validation against Invasive Pressure Measurements.
Aortic pulse-wave velocity (PWV) is a measure of aortic stiffness that has a prognostic role in various diseases and in the general population. A number of methods are used to measure PWV, including Doppler ultrasound. Although echocardiography has been used for PWV measurement, to the authors' knowledge, it has never been tested against an invasive reference method at the same time point. Therefore, the aim of this study was to compare prospectively an echocardiographic PWV measurement, called echo-PWV, with an invasive study.



Forty-five patients (mean age, 66 years; 60% men) underwent simultaneous intra-arterial pressure recording and echocardiographic Doppler flow evaluation during elective cardiac catheterization. Proximal pressure and Doppler waveforms were acquired in the aortic arch. Distal pressure waveforms were registered in the right and distal Doppler waveforms in the left external iliac artery. Transit time was measured as a delay of the foot of pressure or Doppler waveform in the distal relative to the proximal location. Distance was measured on the catheter for invasive PWV and over the surface for echo-PWV. Echo-PWV was calculated as distance divided by transit time.



In the whole group, mean invasive PWV was 9.38 m/sec and mean echo-PWV was 9.51 m/sec (P = .78). The Pearson' correlation coefficient between methods was 0.93 (P < .0001). A Bland-Altman plot revealed a mean difference between invasive PWV and echo-PWV of 0.13 ± 0.79 m/sec.



Echo-PWV, based on Doppler echocardiography, is a reliable method of aortic PWV measurement, with a close correlation with invasive assessment. Wider implementation of the echo-PWV method for the evaluation of aortic wall stiffness can further expand the clinical and scientific utility of echocardiography.
Department of Internal Medicine, Hypertension and Angiology, Medical University of Warsaw, Warsaw, Poland.
Grzegorz
G
Styczynski
First Department of Cardiology, Medical University of Warsaw, Warsaw, Poland.
Adam
A
Rdzanek
First Department of Cardiology, Medical University of Warsaw, Warsaw, Poland.
Arkadiusz
A
Pietrasik
First Department of Cardiology, Medical University of Warsaw, Warsaw, Poland.
Janusz
J
Kochman
First Department of Cardiology, Medical University of Warsaw, Warsaw, Poland.
Zenon
Z
Huczek
Department of Internal Medicine, Hypertension and Angiology, Medical University of Warsaw, Warsaw, Poland.
Piotr
P
Sobieraj
Department of Internal Medicine, Hypertension and Angiology, Medical University of Warsaw, Warsaw, Poland.
Zbigniew
Z
Gaciong
Department of Internal Medicine, Hypertension and Angiology, Medical University of Warsaw, Warsaw, Poland. Electronic address: cezary.szmigielski@wum.edu.pl.
Cezary
C
Szmigielski
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D062186:Arterial Pressure / Q000502:physiology*; D001783:Blood Flow Velocity / Q000502:physiology*; D001795:Blood Pressure Determination / Q000379:methods*; D002406:Catheterization, Peripheral / Q000379:methods; D004452:Echocardiography / Q000379:methods*; D005260:Female; D006801:Humans; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D008297:Male; D008875:Middle Aged; D063177:Pulse Wave Analysis / Q000379:methods*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D059289:Vascular Stiffness / Q000502:physiology*
Aorta; Doppler echocardiography; Invasive validation; Pulse-wave velocity