Acute Changes in Carotid-Femoral Pulse-Wave Velocity Are Tracked by Heart-Femoral Pulse-Wave Velocity

Abstract

Background: Carotid-femoral pulse-wave velocity (cfPWV) is the reference standard measure of central arterial stiffness. However, it requires assessment of the carotid artery, which is technically challenging, and subject-level factors, including carotid artery plaque, may confound measurements. A promising alternative that overcomes these limitations is heart-femoral PWV (hfPWV), but it is not known to what extent changes in cfPWV and hfPWV are associated.Objectives: To determine, (1) the strength of the association between hfPWV and cfPWV; and (2) whether change in hfPWV is associated with change in cfPWV when central arterial stiffness is perturbed.Methods: Twenty young, healthy adults [24.0 (SD: 3.1) years, 45% female] were recruited. hfPWV and cfPWV were determined using Doppler ultrasound at baseline and following a mechanical perturbation in arterial stiffness (120 mmHg thigh occlusion). Agreement between the two measurements was determined using mixed-effects regression models and Bland-Altman analysis.Results: There was, (1) strong (ICC > 0.7) agreement between hfPWV and cfPWV (ICC = 0.82, 95%CI: 0.69, 0.90), and, (2) very strong (ICC > 0.9) agreement between change in hfPWV and cfPWV (ICC = 0.92, 95%CI: 0.86, 0.96). cfPWV was significantly greater than hfPWV at baseline and during thigh occlusion (both P < 0.001). Inspection of the Bland-Altman plot, comparing cfPWV and corrected hfPWV, revealed no measurement magnitude bias.Discussion: The current findings indicate that hfPWV and cfPWV are strongly associated, and that change in cfPWV is very strongly associated with change in hfPWV. hfPWV may be a simple alternative to cfPWV in the identification of cardiovascular risk in clinical and epidemiological settings.

A Primer on Repeated Sitting Exposure and the Cardiovascular System: Considerations for Study Design, Analysis, Interpretation, and Translation

“…An alternative PWV measure is heart-femoral PWV, here the "heart" portion can be determined from an electrocardiogram and/or a phonocardiogram. We recently found good (73) (r > 0.75) agreement between hfPWV and cfPWV (r = 0.83) in 4,133 olderaged (75 [SD: 5] years) adults) (74), and we also found that these measures responded similarly (r = 0.92) to an orthostatic challenge (modified tilt-table test), a perturbation known to impact aortic arterial stiffness (75). An additional alternative is brachial-femoral PWV (bfPWV), which can be obtained using oscillometric cuffs placed around the upper arm and upper thigh.…”

Pulse-wave velocity assessments derived from a simple photoplethysmography device: Agreement with a referent device

“…Whereas htPWV demonstrated strong repeated measures agreement with the referent caPWV, there was negligible repeated measures agreement between hfPWV and the referent cwPWV. This is not completely unexpected since the shorter path length of hfPWV is inherently susceptible to greater relative error than that of htPWV, therefor influencing measurement agreement to a greater extent ( 34 ). While a recent study by Ouyang did not compare PPG measures against a referent or use an acute laboratory perturbation, they did observe expected, incremental increases in PPG heart-toe PWV with both increasing age and elevated disease status ( 36 ).…”

“…Last, due to: (i) slightly differing path lengths (D) between PPG and referent devices and (ii) the inclusion of the pre-ejection period in the PPG-based time component (PAT) but not the referent-based time component (TT), we did not expect absolute agreement between devices. Therefore, the above steps were repeated after correcting hfPWV and htPWV using the mixed effects regression model ( 32 – 34 ).…”

One Step Back from Bedside to the Bench—How Do Different Arterial Stiffness Parameters Behave in Relation to Peripheral Resistance?

“…Not surprisingly, as the arterial circulation of extremities is a high resistance system at rest, the external compression of upper and lower extremity arteries did not significantly increase Aix compared to baseline; it just potentiated the high baseline resistance. However, more sophisticated experimental methods revealed earlier wave reflection even if the external compression was lower in intensity or a single extremity was affected [ 21 , 22 ].…”