title: Patient-specific blood pressure correction technique for arterial stiffness: evaluation in a cohort on anti-angiogenic medication.
abstract: Arterial pulse wave velocity (PWV) depends on blood pressure (BP). Correction of PWV for BP is commonly performed using a statistical approach, requiring a patient cohort. We recently developed a mechanistic, model-predictive approach to assess BP-independent changes in carotid PWV (cPWV) at the level of the individual. The goal of the present study is to compare our novel technique to conventional statistical correction, in the context of anti-cancer therapy using anti-angiogenic drugs (AADs). AADs frequently lead to a PWV increase, but also to hypertension, underlining the need for BP correction of PWV measurements. We obtained carotid artery systolic and diastolic cross-sectional areas (echotracking) and corresponding BPs (tonometry) in 48 patients before starting AAD treatment (sorafenib/sunitinib), and at four follow-up visits spaced 2 weeks apart. For each patient, we derived cPWV and a baseline single-exponential BP cross-sectional area curve. Based on these baseline curves and follow-up BPs, we predicted cPWV at follow-up due to BP. By comparing predicted and measured cPWVs at follow-up, we assessed the BP-independent cPWV increase. In the same way, we assessed whether diastolic cross-sectional area (Ad) changed beyond the BP-induced amount. The AAD-induced BP-independent increase in cPWV was 0.43(0.09,0.77) m s-1(mean (95%CI), P=0.014, mechanistic approach) and 0.48(0.14,0.82) m s-1(P=0.006, statistical approach). Adincreased with 1.92(0.93,2.92) mm2(P<0.001) and 2.14(1.06,3.23) mm2(P<0.001), respectively. In conclusion, the present study demonstrates the feasibility and potential of our mechanistic, model-predictive approach to quantify BP-independent effects on arterial stiffness at the level of the individual, in a clinically relevant setting of AAD therapy.
authors.affiliation: Department of Biomedical Engineering, CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, The Netherlands.|Department of Biomedical Sciences, Faculty of Medicine and Health Sciences, Macquarie University, Sydney, NSW, Australia.
authors.forename: Bart
authors.initials: B
authors.lastname: Spronck
authors.affiliation: Department of Biomedical Engineering, CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, The Netherlands.
authors.forename: Tammo
authors.initials: T
authors.lastname: Delhaas
authors.affiliation: Department of Biomedical Engineering, CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, The Netherlands.
authors.forename: Anouk Gw
authors.initials: AG
authors.lastname: De Lepper
authors.affiliation: Department of Medical Oncology, CERIA, Cochin Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France.
authors.forename: Julie
authors.initials: J
authors.lastname: Giroux
authors.affiliation: Department of Medical Oncology, CERIA, Cochin Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France.
authors.forename: François
authors.initials: F
authors.lastname: Goldwasser
authors.affiliation: Department of Pharmacology, Université Paris Descartes, European Georges Pompidou Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France.
authors.forename: Pierre
authors.initials: P
authors.lastname: Boutouyrie
authors.affiliation: Department of Pharmacology, Université Paris Descartes, European Georges Pompidou Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France.
authors.forename: Maureen
authors.initials: M
authors.lastname: Alivon
authors.affiliation: Department of Biomedical Engineering, CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, The Netherlands.
authors.forename: Koen D
authors.initials: KD
authors.lastname: Reesink
mesh_terms: D000328:Adult; D000368:Aged; D000465:Algorithms; D020533:Angiogenesis Inhibitors / Q000009:adverse effects* / Q000627:therapeutic use; D001794:Blood Pressure; D002339:Carotid Arteries / Q000503:physiopathology; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007211:Indoles / Q000009:adverse effects / Q000627:therapeutic use; D008297:Male; D008365:Manometry; D008875:Middle Aged; D008954:Models, Biological; D009369:Neoplasms / Q000188:drug therapy / Q000503:physiopathology; D009536:Niacinamide / Q000009:adverse effects / Q000031:analogs & derivatives / Q000627:therapeutic use; D010671:Phenylurea Compounds / Q000009:adverse effects / Q000627:therapeutic use; D011237:Predictive Value of Tests; D063177:Pulse Wave Analysis; D011758:Pyrroles / Q000009:adverse effects / Q000627:therapeutic use; D000077157:Sorafenib; D000077210:Sunitinib; D059289:Vascular Stiffness
chemical_list: D020533:Angiogenesis Inhibitors; D007211:Indoles; D010671:Phenylurea Compounds; D011758:Pyrroles; D009536:Niacinamide; D000077157:Sorafenib; D000077210:Sunitinib