Peripheral augmentation index as a biomarker of vascular aging: an invasive hemodynamics approach

Abstract

We compared two measures of vascular function obtained from digital volume waveforms with measures of target organ damage and novel invasive measures of vascular function as they relate to vascular aging. Aortic pulse pressure amplification, pulsatility, form factor and extent of coronary atherosclerosis (modified Gensini score) were obtained invasively in 59 patients undergoing left heart catheterization. Digital volume waveforms were captured via peripheral arterial tone (PAT) and used to derive augmentation index (AIx) and the pulse wave amplitude-reactive hyperemia index (PWA-RHI). AIx was associated with age (r = 0.50, p < 0.05) and aortic pulsatility (r = 0.45, p < 0.05) and inversely associated with estimated glomerular filtration rate (-0.29, p < 0.05) aortic pulse pressure amplification (r = -0.28, p < 0.05) and aortic form factor (r = -0.38, p < 0.05). AIx was slightly higher in patients with left ventricular hypertrophy (LVH) versus those without left ventricular hypertrophy (30 vs. 14%, p = 0.058). There was no association between AIx and Gensini score. PWA-RHI was not associated with age, estimated glomerular filtration rate or invasive vascular parameters and did not differ in patients with versus without LVH (p = ns). PWA-RHI was inversely associated with Gensini score (r = -0.32, p < 0.05). AIx derived from PAT is correlated with age-associated changes in vascular function and target organ damage but not coronary atherosclerotic burden. PWA-RHI is associated with coronary atherosclerotic burden but is not associated with target organ damage or other measures of vascular aging assessed in this study. Each parameter provides distinct insight into systemic vascular aging and target organ damage.

Ticagrelor Improves Peripheral Arterial Function in Patients with a Previous Acute Coronary Syndrome

“…Age and renal function (GFR) are among the most important factors for peripheral arterial function and have previously been shown to correlate with RHI [34]. In patients not treated with ticagrelor, we could confirm previous findings of a correlation of RHI with both age and GFR.…”

Association between smoking status and the parameters of vascular structure and function in adults: results from the EVIDENT study

“…Furthermore, Janner JH et al and Minami J et al [6,23] analysed the relationship of smoking with CAIx, while in our work we use the radial or peripheral augmentation index. Radial and central AIx are not interchangeable in the clinical practice, although the radial augmentation index has been established as a marker of vascular aging [25]. …”

Endothelial function assessed by peripheral arterial tonometry is not related to cardiovascular risk score in healthy subjects

“…This study is the first to report baseline pulse amplitude correlating with HDL, body weight and lack of regular physical activity. A relation between AI and female gender, age and height has been formerly reported [26][27][28][29]. AI correlating to peripheral systolic blood pressure, diastolic blood pressure, body weight, fat percentage, HDL cholesterol, total/ HDL cholesterol, diagnosed hypertension and a 1st degree family history of CAD has not been published prior to this report.…”