Pulse Wave Velocity in Lower-Limb Arteries among Diabetic Patients with Peripheral Arterial Disease.

Yokoyama, Hisayo; Shoji, Tetsuo; Kimoto, Eiji; Shinohara, K.; Tanaka, Shinji; Koyama, Hidenori; Emoto, Masanori; Nishizawà, Yoshiki

doi:10.5551/jat.10.253

Cited by 117 publications

(96 citation statements)

References 21 publications

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“…In light of the BP dependency of arterial stiffness, in the presence of hemodynamically relevant lower limb artery stenosis, the measure of PWV loses its significance as a measure of stiffness. 26 In this present study, as normally observed, limb PWV was higher than aortic PWV, and inclusion criteria required the absence of hemodynamically significant lower limb occlusive lesions.…”

Section: Discussionmentioning

confidence: 67%

Stiffness of Capacitive and Conduit Arteries

et al. 2005

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Abstract-The aorta is the principal capacitive element of the arterial tree and its increased stiffness, determined by measurement of aortic pulse wave velocity (PWV), is a strong independent predictor of cardiovascular mortality in the general population and end-stage renal disease (ESRD) patients. Whether stiffness of ESRD patients' peripheral arteries has the same prognostic value has never been investigated. A cohort of 305 ESRD patients was followed for 70Ϯ49 months (meanϮSD). Ninety-six deaths of cardiovascular origin occurred. At entry into the study, together with standard clinical and biochemical analyses, patients' aortic, brachial artery, and femorotibial PWV were determined. Based on Kaplan-Meier survival curve analyses and Cox proportional hazards analyses, adjusted for age, pulse pressure, and clinical data, aortic PWV was a significant and independent predictor of outcome. Neither brachial artery nor femotibial artery stiffness was able to predict cardiovascular outcome. Receiver operating characteristic curve analysis of aortic PWV indicated the cutoff value of 10.75 m/s, with 84% sensitivity, 73% specificity, 87% negative predictive value, and 72% positive predictive value. These results provide evidence that, in ESRD, increased stiffness of capacitive arteries, like the aorta, is an independent strong predictor of cardiovascular mortality, whereas stiffness of peripheral conduit arteries had no prognostic value. (Hypertension. 2005;45:592-596.)

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Section: Discussionmentioning

confidence: 67%

Stiffness of Capacitive and Conduit Arteries

et al. 2005

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“…The bPEP and bET were measured using an ABI-form device, which automatically and simultaneously measures blood pressures in both arms and ankles using an oscillometric method. [7][8][9] Occlusion and monitoring cuffs were placed tightly around the upper arm without blood access and both sides of the lower extremities in the supine position. The bET was automatically measured from the foot to the dicrotic notch (equivalent to the incisure on the downstroke of the aortic pressure wave contour produced by the closure of the aortic valve) of the pulse volume waveform.…”

Section: Assessment Of Bpep Bet Abi and Brachial-ankle Pulse Wave Vmentioning

confidence: 99%

“…The values of ABI and brachial-ankle pulse wave velocity were also measured, and the measurement method has been reported and validated in earlier studies. [7][8][9] Collection of demographic, medical and laboratory data Demographic and medical data, including age, gender, smoking history (ever vs. never) and comorbid conditions, were obtained from medical records and interviews with patients. The body mass index was calculated as the ratio of weight in kilograms divided by the square of height in meters.…”

Section: Assessment Of Bpep Bet Abi and Brachial-ankle Pulse Wave Vmentioning

confidence: 99%

A new systolic parameter defined as the ratio of brachial pre-ejection period to brachial ejection time predicts overall and cardiovascular mortality in hemodialysis patients

et al. 2010

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Impaired left ventricular systolic function is an important cause of mortality in hemodialysis patients. An increase in the ratio of pre-ejection period (PEP) to ejection time (ET) is associated with a decrease in left ventricular systolic function. Brachial PEP (bPEP) and brachial ET (bET) can be automatically determined from an ankle-brachial index (ABI)-form device. The aim of this study was to investigate whether bPEP/bET was a useful predictor for overall and cardiovascular mortality in hemodialysis patients. We enrolled 212 hemodialysis patients in one regional hospital. The bPEP and bET were measured using an ABI-form device. The mean follow-up period was 28.3 ± 5.7 months. The relative mortality risk was analyzed by Cox-regression methods. Twenty-two deaths were recorded in 212 patients (10.4%). In a multivariate analysis, the bPEP/bET (hazard ratio [HR], 1.055; P¼0.047) and serum creatinine level (P¼0.029) were positively and negatively associated with overall mortality, respectively. In addition, increased bPEP/bET (HR, 1.080; P¼0.017), increased fasting glucose (P¼0.046) and decreased serum creatinine level (P¼0.004) were independent predictors for cardiovascular mortality. Our findings show that bPEP/bET, a surrogate of left ventricular systolic function, is a useful predictor for overall and cardiovascular mortality in hemodialysis patients. Screening hemodialysis patients by means of bPEP/bET may help to identify a high-risk group for increased mortality.

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“…16,17 For measuring baPWV, pulse waves that were obtained from the brachial and tibial arteries were recorded simultaneously, and the transmission time, which was defined as the time interval between the initial increase in brachial and tibial waveforms, was determined. The transmission distance from the arm to each ankle was calculated according to body height.…”

Section: Assessment Of Bapwv Rbpep and Rbetmentioning

confidence: 99%

Impact of a systolic parameter, defined as the ratio of right brachial pre-ejection period to ejection time, on the relationship between brachial-ankle pulse wave velocity and left ventricular diastolic function

et al. 2011

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Arterial stiffness is correlated with left ventricular (LV) diastolic function as well as susceptibility to LV systolic function. Therefore, if LV systolic function is not known, the relationship between arterial stiffness and LV diastolic function is difficult to determine. A total of 260 patients were included in the study. The brachial-ankle pulse wave velocity (baPWV) and the ratio of right brachial pre-ejection period to ejection time (rbPEP/rbET) were measured using an ABI-form device. Patients were classified into four groups. Groups 1, 2, 3 and 4 were patients with rbPEP/rbET and baPWV below the median, rbPEP/rbET above but baPWV below the median, rbPET/rbET below but baPWV above the median, and rbPET/rbET and baPWV above the median, respectively. The LV ejection fractions in groups 1 and 3 were higher than those in groups 2 and 4 (Po0.001 for all). Patients in group 1 had a lower left atrial volume index (LAVI) and higher early diastolic mitral annular velocity (Ea) than patients in the other groups (Pr0.002). Patients in group 2 had a LAVI and ratio of transmitral E wave velocity to Ea that were comparable to those in groups 3 and 4. In conclusion, rbPEP/rbET had an impact on the relationship between baPWV and LV diastolic function. In patients with high rbPEP/rbET but low baPWV, low baPWV may not indicate good LV diastolic function but implies that cardiac dysfunction may precede vascular dysfunction in such patients. When interpreting the relationship between baPWV and LV diastolic function, the rbPEP/rbET value obtained from the same examination should be considered.

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Pulse Wave Velocity in Lower-Limb Arteries among Diabetic Patients with Peripheral Arterial Disease.

Cited by 117 publications

References 21 publications

Stiffness of Capacitive and Conduit Arteries

Stiffness of Capacitive and Conduit Arteries

A new systolic parameter defined as the ratio of brachial pre-ejection period to brachial ejection time predicts overall and cardiovascular mortality in hemodialysis patients

Impact of a systolic parameter, defined as the ratio of right brachial pre-ejection period to ejection time, on the relationship between brachial-ankle pulse wave velocity and left ventricular diastolic function

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