Original Article
Journal of Human Hypertension (2008) 22, 24–31; doi:10.1038/sj.jhh.1002259; published online 28 June 2007
Brachial-ankle vs carotid-femoral pulse wave velocity as a determinant of cardiovascular structure and function
W-C Yu1, S-Y Chuang2, Y-P Lin1 and C-H Chen3,4,5
- 1Department of Internal Medicine, Taipei Veterans General Hospital, National Yang-Ming University, Taipei, Taiwan
- 2Institute of Biomedical Sciences, Academia Sinica, Taipei, Taiwan
- 3Medical Research and Education, Taipei Veterans General Hospital, National Yang-Ming University, Taipei, Taiwan
- 4Department of Social Medicine, National Yang-Ming University, Taipei, Taiwan
- 5Cardiovascular Research Center, National Yang-Ming University, Taipei, Taiwan
Correspondence: Professor C-H Chen, Department of Medical Research and Education, Taipei Veterans General Hospital, No. 201, Sec. 2, Shih-Pai Road, Taipei, Taiwan. E-mail: chench@vghtpe.gov.tw
Received 18 February 2007; Revised 29 May 2007; Accepted 30 May 2007; Published online 28 June 2007.
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.
Keywords:
pulse wave velocity, arterial stiffness, ventriculo-arterial coupling
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