Increased pulse wave velocity is not associated with elevated augmentation index in patients with diabetes

Lacy, Peter; O'Brien, DG; Stanley, AG; Dewar, MM; Swales, P. D.; Williams, Bryan

doi:10.1097/00004872-200410000-00016

Cited by 160 publications

(137 citation statements)

References 65 publications

Supporting

Mentioning

115

Contrasting

Unclassified

Order By: Relevance

“…We found no significant difference in central augmentation index between patients with or without MNHT, although aortic PWV did differ. This finding is consistent with the previous observation that there is no association between increased aortic PWV and central augmentation index elevation in patients with diabetes [23]. The recent and noteworthy observation that increased central aortic impedance may occur before elevation of aortic PWV in patients with type 1 diabetes [24] remains to be formally tested in patients with type 2 diabetes.…”

Section: Discussionsupporting

confidence: 91%

Masked nocturnal hypertension—a novel marker of risk in type 2 diabetes

et al. 2009

View full text Add to dashboard Cite

Aims/hypothesis This study was designed to evaluate the prevalence of masked nocturnal hypertension (MNHT) and its impact on arterial stiffness and central blood pressure in patients with type 2 diabetes. Methods Middle-aged patients (n=414) with type 2 diabetes underwent clinic and ambulatory BP measurements and applanation tonometry. Results MNHT (clinic BP<130/80 mmHg and night-time BP≥120/70 mmHg) was found in 7.2% of patients (n=30). Compared with patients with both clinical and nocturnal normotension (n=70), patients with MNHT had higher aortic pulse wave velocity (PWV) (10.2±1.8 m/s vs 9.4±1.7 m/s; p=0.03) and higher central BP (117.6±13.9/74.0±9.1 mmHg vs 110.4±16.4/69.7±9.6 mmHg, p=0.04). In patients with clinical normotension, night-time systolic BP correlated significantly with PWV. Conclusions/interpretation Thirty per cent of patients with clinical normotension had nocturnal hypertension. This was accompanied by increased arterial stiffness and higher central BP. We conclude that in clinically normotensive patients with type 2 diabetes, ambulatory BP measurement may help clinicians to identify patients with increased cardiovascular risk.

show abstract

Section: Discussionsupporting

confidence: 91%

Masked nocturnal hypertension—a novel marker of risk in type 2 diabetes

et al. 2009

View full text Add to dashboard Cite

show abstract

“…In light of the findings of our study and previous studies, [11][12][13][14] it seems likely that AI will prove to have limited usefulness as a measure of arterial stiffness or change in arterial stiffness after an intervention in middle-aged and older individuals. It is less certain whether AI (or change in Changes in wave reflection and augmentation.…”

Section: Discussionmentioning

confidence: 64%

“…[11][12][13][14] Changes in AI and carotidfemoral PWV with advancing age were evaluated in a healthy subset of the Framingham offspring cohort. 11 Carotid-femoral PWV and forward wave amplitude, which are related to aortic stiffness, were shown to increase continuously with advancing age.…”

Section: Discussionmentioning

confidence: 99%

“…A cross-sectional comparison of AI in diabetic and nondiabetic individuals found no difference in AI between groups even though carotid-femoral PWV was elevated in the diabetic group. 12 Another study evaluated change in AI during infusion of a ␤-adrenergic agonist in healthy volunteers. AI decreased during the infusion whereas peripheral pulse pressure increased and carotid-femoral PWV was unchanged.…”

Section: Discussionmentioning

confidence: 99%

“…The resulting complex relations between AI and aortic stiffness have generated considerable controversy in the literature regarding the usefulness of AI as a surrogate measure of arterial stiffness. [11][12][13][14] With advancing age, aortic stiffness increases markedly whereas peripheral arterial stiffness changes very little. As aortic stiffness reaches or exceeds peripheral arterial stiffness, the impedance mismatch between aorta and periphery is reduced.…”

mentioning

confidence: 99%

See 2 more Smart Citations

Changes in Aortic Stiffness and Augmentation Index After Acute Converting Enzyme or Vasopeptidase Inhibition

et al. 2005

View full text Add to dashboard Cite

Abstract-Augmentation index (AI), a measure of enhanced wave reflection, has been proposed as a bedside measure of aortic stiffness. However, because AI is potentially sensitive to various factors other than vessel wall stiffness, the utility of AI as a stiffness indicator may be limited. To assess relations between AI and vascular properties, we used arterial tonometry and aortic Doppler flow to evaluate trough (24 hours) and peak (4 hours) pulsatile hemodynamics and pulse wave velocity in 159 individuals with systolic hypertension at the completion of a 12-week period of monotherapy with the vasopeptidase inhibitor omapatrilat (80 mg; nϭ75) or the converting enzyme inhibitor enalapril (40 mg; nϭ84). Characteristic impedance (Z c ) was calculated from the ratio of change in carotid pressure and aortic flow in early systole. Systolic ejection period (SEP), timing of wave reflection, and AI were assessed from the carotid waveform. Comparable acute reductions in mean pressure were associated with greater reductions in peripheral resistance with enalapril, whereas neither drug had an acute effect on Z c . Both drugs reduced AI, but neither drug altered the timing of wave reflection. Both drugs increased heart rate and shortened SEP. Multiple regression analysis demonstrated that the acute reduction in AI was most affected by reductions in SEP and peripheral resistance. Change in AI was inversely related to change in Z c and pulse wave velocity did not enter the model.

show abstract

Tonometry, Arterial

Eckerle¹

2006

Encyclopedia of Medical Devices and Instrumentation

View full text Add to dashboard Cite

Arterial tonometry is a technique that permits the noninvasive monitoring of the pressure within a superficial artery, such as the radial artery at the wrist. The technique is based on an analysis showing that—under the proper conditions—the artery wall does not influence the transmission of arterial pressure to a sensor applied to the skin. Tonometer sensors have been devised that employ various transduction techniques. Perhaps the most advanced sensors include a multiplicity of independent pressure sensors, and are fabricated from silicon. Tonometric measurements have been used to monitor blood pressure during surgery and similar procedures. They have also been used to determine arterial elasticity and pulse wave velocity. Under favorable conditions, the accuracy of tonometric measurements can be described by standard deviations of ∼ 5 mmHg (0.66 kPa).

show abstract

Increased pulse wave velocity is not associated with elevated augmentation index in patients with diabetes

Abstract: PP and PWVcf are increased in people with diabetes, but this is not associated with increased AI. These findings conclusively demonstrate that AI is not a reliable measure of arterial stiffness in people with diabetes.

Cited by 160 publications

References 65 publications

Masked nocturnal hypertension—a novel marker of risk in type 2 diabetes

Masked nocturnal hypertension—a novel marker of risk in type 2 diabetes

Changes in Aortic Stiffness and Augmentation Index After Acute Converting Enzyme or Vasopeptidase Inhibition

Tonometry, Arterial

Contact Info

Product

Resources

About