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Aorta pulse wave velocity and augmentation index: can it be simpler?

Journal of Human Hypertension volume 28, pages 461–462 (2014)Cite this article

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Although arterial blood pressure is a well-established cardiovascular risk factor, it provides only information about the two extreme points of the whole arterial blood pressure waveform. Noninvasive evaluation of vascular health is an increasingly important approach to identifying individuals at risk for cardiovascular morbid events.1 Evaluation of arterial stiffness and its predictors may help identify asymptomatic individuals at risk, before blood pressure is elevated above an ‘arbitrary’ level that we currently identify as hypertension. There are several techniques to estimate arterial stiffness and arterial wave reflections.2 The assessment of aortic pulse wave velocity, a measurement of stiffness of the aorta, and the augmentation index, a measurement of peripheral arterial wave reflections, are the most common studied parameters for arterial function. A large number of studies have provided evidence that aortic pulse wave velocity and augmentation index are predictive for cardiovascular disease events and all-cause mortality in subjects free of overt cardiovascular disease.3, 4, 5

It would be logical that based on the evidence, medicine published data that the assessment of arterial stiffness and arterial wave reflections may be implemented in daily clinical practice to improve early detection of cardiovascular disease. The data of the Anglo-Cardiff Collaborative Trial have suggested that the augmentation index might be a more sensitive marker of arterial stiffening and risk in younger individuals, while aortic pulse wave velocity is likely to be a better measure in older individuals.6 In the past, the assessment of the aortic pulse wave velocity and the augmentation index using the Sphygmocor MM3 (Atcor Medical, Sydney, NSW, Australia) was rather time-consuming, labor intensive and required skilled operators because it required arterial waveform registrations at the radial, carotid and femoral artery. Recently a new SphygmoCor Xcel (Atcor Medical) has been developed, which makes it more convenient to measure the carotid–femoral pulse wave velocity and the augmentation index. The advantage of this new device above the well-known Sphygmocor MM3 (Atcor Medical) is the use of a partially inflated brachial cuff for the measurement of the augmentation index, and for the aorta pulse wave velocity, a partially inflated femoral cuff together with carotid applanation tonometry is used.

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  1. Cardiovascular Division, Medical School, University of Minnesota, Minneapolis, MN, USA

    D A Duprez

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Duprez, D. Aorta pulse wave velocity and augmentation index: can it be simpler?. J Hum Hypertens 28, 461–462 (2014). https://doi.org/10.1038/jhh.2013.146

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