Expert Consensus on the Clinical Use of Pulse Wave Velocity in Asia

Abstract

Arterial stiffness is a progressive aging process that predicts cardiovascular disease. Pulse wave velocity (PWV) has emerged as a noninvasive, valid, and reliable measure of arterial stiffness and an independent risk predictor for adverse outcomes. However, up to now PWV measurement has mostly been used as a tool for risk prediction and has not been widely used in clincial practice. This consensus paper aims to discuss multiple PWV measurements currently available in Asia and to provide evidence-based assessment together with recommendations on the clinical use of PWV. For the methodology, PWV measurement including the central elastic artery is essential and measurements including both the central elastic and peripheral muscular arteries, such as brachial-ankle PWV and Cardio-Ankle Vascular Index, can be a good alternative. As Asian populations are rapidly aging, timely detection and intervention of "early vascular aging" in terms of abnormally high PWV values is recommended. More evidence is needed to determine if a PWV-guided therapeutic approach will be beneficial to the prevention of cardiovascular diseases beyond current strategies. Large-scale randomized controlled intervention studies are needed to guide clinicians.

Association between arterial stiffness and autonomic dysfunction in participants underwent treadmill exercise testing: a cross-sectional analysis

“…However, it has been reported that baPWV correlated well with cfPWV 36 and invasive data 24 . Additionally, the clinical values of baPWV have been shown in many clinical studies 4 , 6 , 8 . Moreover, baPWV is more suitable as a screening tool because it is simpler and more convenient to measure than cfPWV 6 .…”

“…To assess multicollinearity among explanatory variables, the variance inflation factor (VIF) was introduced. Multiple binary logistic regression analyses were conducted to evaluate whether a higher baPWV (≥ 1400 cm/s), indicative of abnormal arterial stiffening 8 could predict lower HRR (< 26 beats/min, the median value). The same confounders were controlled for as those used in the multiple linear regression analysis.…”

“…Thus, baPWV may be more advantageous for risk stratification in mass screenings. Recently, baPWV has been widely used to evaluate CV risk among many participants, especially in Asian countries 8 .…”

Integrating Ultrasound-Derived Carotid Artery Stiffness in the Assessment of Cardiovascular Risk

“…Cardiovascular risk and all-cause mortality, in particular, increase as much as 15% each with a 1 m/s elevation in PWV [ 5 , 10 ]. Quantification of PWV can be compromised by several common cardiovascular disease states, including AAA and peripheral arterial occlusive disease [ 11 , 12 ], so pursuance of a more reliable technique, with fewer confounding comorbidities, can amplify access to vascular stiffness measurements and potentially direct medical therapy titration in clinical scenarios known to promote stiffness, such as hypertension.…”

Editorial: Widely used and novel approaches of the measurement of arterial stiffness and central hemodynamic parameters: Is there a consensus on the horizon?

“…The evaluation of vascular biomarkers can help to identify patients with high cardiovascular risk providing opportunity for early preventive interventions to avoid clinical endpoints like cardiovascular morbidity and mortality. Recently a consensus paper was published on the clinical use of pulse wave velocity (PWV) (Park et al, 2022) suggesting that in the near future the importance of PWV measurements in everyday clinical practice will increase (Vlachopoulos et al, 2015).…”