Brachial-Ankle Pulse Wave Velocity as a Screen for Arterial Stiffness: A Comparison with Cardiac Magnetic Resonance

PURPOSE: Despite technical simplicity and the low cost of brachial-ankle pulse wave velocity (BA-PWV), its use has been hampered by a lack of data supporting its usefulness and reliability. The aim of this study was to evaluate the usefulness of BA-PWV to measure aortic stiffness in comparison to using cardiovascular magnetic resonance (CMR). MATERIALS AND METHODS: A total of 124 participants without cardiovascular risk factors volunteered for this study. BA-PWV was measured using a vascular testing device. On the same day, using CMR, cross-sectional areas for distensibility and average blood flow were measured at four aortic levels: the ascending, upper thoracic descending, lower thoracic descending, and abdominal aorta. RESULTS: Compared to PWV measured by CMR, BA-PWV values were significantly higher and the differences therein were similar in all age groups (all p<0.001). There was a significant correlation between BA-PWV and PWV by CMR (r=0.697, p<0.001). Both BA-PWV and PWV by CMR were significantly and positively associated with age (r=0.652 and 0.724, p<0.001). The reciprocal of aortic distensibility also demonstrated a statistically significant positive correlation with BA-PWV (r=0.583 to 0.673, all p<0.001). CONCLUSION: BA-PWV was well correlated with central aortic PWV and distensibility, as measured by CMR, regardless of age and sex.

Determinants of Brachial-Ankle Pulse Wave Velocity and Carotid-Femoral Pulse Wave Velocity in Healthy Koreans

The aim of this study was to determine the normal value of brachial-ankle pulse wave velocity (baPWV) and carotid-femoral pulse wave velocity (cfPWV) according to age group, gender, and the presence of cardiovascular risk factors in healthy Koreans, and to investigate the association between PWV and risk factors such as prehypertension, dyslipidemia, smoking, and obesity. We measured an arterial stiffness in 110 normal subjects who were 20 to 69 yr-old with no evidence of cardiovascular disease, cerebrovascular accident or diabetes mellitus. The mean values of baPWV and cfPWV were 12.6 (+/-2.27) m/sec (13.1+/-1.85 in men, 12.1+/-2.51 in women; P=0.019) and 8.70 (+/-1.99) m/sec (9.34+/-2.13 in men, 8.15+/-1.69 in women; P=0.001), respectively. The distribution of baPWV (P<0.001) and cfPWV (P=0.006) by age group and gender showed an increase in the mean value with age. Men had higher baPWV and cfPWV than women (P<0.001). There was a difference in baPWV and cfPWV by age group on prehypertension, dyslipidemia, current smoking, or obesity (P<0.001). In multiple linear regression, age and prehypertension were highly associated with baPWV and cfPWV after adjustment for confounding factors (P<0.001). The present study showed that baPWV and cfPWV are associated with age, gender, and prehypertension in healthy Koreans.

The Effects of Short-duration Exercise on Arterial Stiffness in Patients with Stable Coronary Artery Disease

Arterial stiffness is an important contributor to the development of cardiovascular disease. We investigated the effect of short duration exercise using the treadmill test on arterial stiffness in the presence of coronary artery disease. We enrolled patients with and without coronary artery diseases (CAD and control group, 50 patients each) referred for treadmill testing. Brachial-ankle pulse wave velocity (baPWV) were measured before and after treadmill testing. Values of baPWV were significantly reduced at 10 min after exercise in both groups, more in the CAD group than in the control group (baseline baPWV and post-exercise change [cm/sec]: 1,527+/-245 and -132+/-155 in the CAD group, 1,439+/-202 and -77+/-93 in the control group, respectively, P for change in each group <0.001, P for difference in changes between the two groups <0.001). These findings persisted after adjusting for age, body mass index, systolic blood pressure, mean arterial pressure (MAP), MAP decreases, and baseline baPWV. Significant post-exercise baPWV reductions were observed in both groups, and more prominently in the CAD group. This finding suggests that short-duration exercise may effectively improve arterial stiffness even in patients with stable coronary artery disease.