Augmentation index is associated with cardiovascular risk

Nürnberger, Jens; Keflioglu-Scheiber, Ayten; Saez, Anabelle Opazo; Wenzel, René R.; Philipp, Thomas; Schäfers, Rainhild

doi:10.1097/00004872-200212000-00020

Cited by 383 publications

(298 citation statements)

References 27 publications

Supporting

Mentioning

254

Contrasting

Unclassified

Order By: Relevance

“…6,36 Our finding of a strong relation between DBP and two measures of arterial stiffness in young, healthy males are consistent with the data from the Framingham study 37 and a report by Khattar et al, 38 suggesting that DBP may be a better measure of cardiovascular risk than SBP or pulse pressure in young, healthy males. The characteristic of aortic pressure amplification in young subjects may explain why DBP may be a better predictor of cardiovascular risk than SBP or PP in younger subjects.…”

Section: Discussionsupporting

confidence: 90%

Diastolic blood pressure is an important determinant of augmentation index and pulse wave velocity in young, healthy males

Nürnberger¹,

Dammer²,

Saez

et al. 2003

J Hum Hypertens

116

View full text Add to dashboard Cite

Pulse wave velocity (PWV) and augmentation index are widely used measures of arterial stiffness. The purpose of this study was to evaluate the role of blood pressure as a determinant of both indices independent of potentially confounding factors including gender, age and cardiovascular disorders. A total of 77 young, healthy subjects were investigated under resting conditions. Augmentation index was derived by pulse wave analysis using carotid applanation tonometry. PWV was determined from pressure tracing over the carotid and femoral artery. The relations between stiffness markers and haemodynamic parameters were analysed by simple (r) and multiple (b) regression analysis. Using simple regression analysis, augmentation index was correlated to age (r ¼ 0.292, P ¼ 0.0105), diastolic blood pressure (DBP, r ¼ 0.483, Po0.0001), mean arterial blood pressure (MAP, r ¼ 0.381, P ¼ 0.0007), pulse pressure (r ¼ À0.414, P ¼ 0.0002) and total peripheral resistance (r ¼ 0.266, P ¼ 0.0204). After multiple regression analysis, augmentation index remained significantly correlated only to DBP (b ¼ 0.347, P ¼ 0.0051). Using simple regression analysis, PWV was correlated to age (r ¼ 0.304, P ¼ 0.0067), systolic blood pressure (r ¼ 0.280, P ¼ 0.0129). DBP (r ¼ 0.455, Po0.0001), MAP (r ¼ 0.446, Po0.0001) and heart rate (r ¼ 0.348, P ¼ 0.0018). After multiple regression analysis, PWV remained correlated only to age (b ¼ 0.218, P ¼ 0.0422) and DBP (b ¼ 0.4105, P ¼ 0.0316). In summary, DBP is an important determinant of augmentation index and PWV in young, healthy males. Further studies are needed to characterize the impact of blood pressure on arterial stiffness in other populations including females and older subjects.

show abstract

Section: Discussionsupporting

confidence: 90%

Diastolic blood pressure is an important determinant of augmentation index and pulse wave velocity in young, healthy males

Nürnberger¹,

Dammer²,

Saez

et al. 2003

J Hum Hypertens

116

View full text Add to dashboard Cite

show abstract

“…indicative of cardiovascular risk in healthy subjects, 35 and in patients with coronary artery disease 36 and end-stage renal failure. 37 Chronic dynamic training is associated with lower central AS in young men 38 and coronary patients, 39 whereas chronic resistance exercise results in stiffer large arteries in both young men 40 and athletes.…”

Section: Lydakis Et Almentioning

confidence: 99%

Changes of central haemodynamic parameters during mental stress and acute bouts of static and dynamic exercise

et al. 2008

View full text Add to dashboard Cite

Chronic dynamic (aerobic) exercise decreases central arterial stiffness, whereas chronic resistance exercise evokes the opposite effect. Nevertheless, there is little information available on the effects of acute bouts of exercise. Also, there is limited data showing an increase of central arterial stiffness during acute mental stress. This study aimed to determine the effect of acute mental and physical (static and dynamic exercise) stress on indices of central arterial stiffness. Fifteen young healthy volunteers were studied. The following paradigms were performed: (1) 2 min of mental arithmetic, (2) short bouts (20 s) of static handgrip at 20 and 70% of maximal voluntary contraction (MVC), (3) fatiguing handgrip at 40% MVC and (4) incremental dynamic knee extensor exercise. Central aortic waveforms were assessed using SphygmoCor software. As compared to baseline, pulse wave transit time decreased significantly for all four interventions indicating that central arterial stiffness increased. During fatiguing handgrip there was a fall in the ratio of peripheral to central pulse pressure from 1.69 ± 0.02 at baseline to 1.56±0.05 (Po0.05). In the knee extensor protocol a nonsignificant trend for the opposite effect was noted. The augmentation index increased significantly during the arithmetic, short static and fatiguing handgrip protocols, whereas there was no change in the knee extensor protocol. We conclude that (1) during all types of acute stress tested in this study (including dynamic exercise) estimated central stiffness increased, (2) during static exercise the workload posed on the left ventricle (expressed as change in central pulse pressure) is relatively higher than that posed during dynamic exercise (given the same pulse pressure change in the periphery).

show abstract

“…8,9 As PP is influenced not only by arterial stiffness but also by cardiac factors such as heart rate (HR) and stroke volume, pulse wave velocity (PWV), a direct marker of aortic stiffness, or the carotid augmentation index (AIx), a marker of aortic stiffness and wave reflection, might have better prognostic value than PP. PWV is independently associated with cardiovascular morbidity and mortality in patients with hypertension or diabetes, and in the elderly, [10][11][12] whereas AIx is associated with cardiovascular risk factors (CVR) in the general population 13 and with mortality in patients with end-stage renal failure. 14 All these markers are dependent on time domain parameters and on pressure, [15][16][17][18][19][20][21] which may alter their prognostic value in heart failure.…”

Section: Introductionmentioning

confidence: 99%

Interaction between pulse wave velocity, augmentation index, pulse pressure and left ventricular function in chronic heart failure

Logeart

et al. 2005

J Hum Hypertens

View full text Add to dashboard Cite

Pulse wave velocity (PWV), the carotid augmentation index (AIx), and pulse pressure (PP) may be prognostic factors in heart failure, but the possible influence of the ejection fraction (EF) and other simple haemodynamic variables on them has not been investigated in this setting. Noninvasive methods were used to measure carotid-radial (CR), carotid-femoral (CF) PWV and AIx, and brachial PP, in 135 consecutive patients with stable symptomatic chronic heart failure. The patients were divided into two groups, with preserved (X40%) or reduced (o40%) EF. CF-PWV, AIx and PP were lower in the decreased EF group (8.8572.77 versus 10.6072.75 m/s, Po0.001; 121721 versus 132724, P ¼ 0.009 and 41719 versus 67717 mmHg, Po0.001), but CR-PWV values were similar regardless of the EF status. These results were not modified after adjustment for age and sex. Multiple regression analysis showed that AIx and PP were systematically related to time domain parameters (heart rate or ejection duration) and EF, whatever the group. CF-PWV was weakly related to time domain values and unrelated to mean blood pressure (BP) or EF in the preserved EF group, whereas it was related to both mean BP and EF in the low EF group. In conclusion, whatever the EF level, PP and AIx were strongly modulated in the time domain, by pressure and by the EF level. The same relationships were found with CF-PWV, but only in the reduced EF group. Whether CF-PWV is the best prognostic factor in patients with 'diastolic' heart failure must be confirmed in a prospective study.

show abstract

Augmentation index is associated with cardiovascular risk

Abstract: Our findings suggest that augmentation index may be a useful marker of cardiovascular risk. Further studies are required to investigate the relationship between age and augmentation index in subjects with atherosclerotic disease.

Cited by 383 publications

References 27 publications

Diastolic blood pressure is an important determinant of augmentation index and pulse wave velocity in young, healthy males

Diastolic blood pressure is an important determinant of augmentation index and pulse wave velocity in young, healthy males

Changes of central haemodynamic parameters during mental stress and acute bouts of static and dynamic exercise

Interaction between pulse wave velocity, augmentation index, pulse pressure and left ventricular function in chronic heart failure

Contact Info

Product

Resources

About