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Gašparini D, Zuljani A, Wensveen FM, Turk Wensveen T. A cross-sectional study in type 2 diabetes patients reveals that elevated pulse wave velocity predicts asymptomatic peripheral arterial disease associated with age and diabetes duration. IJC HEART & VASCULATURE 2023; 49:101308. [PMID: 38173786 PMCID: PMC10761307 DOI: 10.1016/j.ijcha.2023.101308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Revised: 11/08/2023] [Accepted: 11/15/2023] [Indexed: 01/05/2024]
Abstract
Background Peripheral arterial disease (PAD) reduces functional capacity and raises cardiovascular risks, but underdiagnosis is common, resulting in less comprehensive care than other cardiovascular conditions. While diabetes has long been viewed as a key risk factor for PAD, recent studies indicate that its impact is influenced by the presence of concurrent cardiovascular risk factors. The aim of this study is to elucidate the intricate relationship between the prevalence of PAD, diabetic complications, and cardiovascular risk factors among asymptomatic patients with type 2 diabetes mellitus (T2DM). Methods Ninety-one patients with T2DM and no symptoms or previous diagnosis of PAD were recruited from the outpatient diabetic clinic. Clinical data were extracted from electronic medical records, and the screening for PAD was conducted using MESI mTABLET. Results Screening for PAD among asymptomatic individuals with T2DM revealed that 5.49 % of patients exhibit a low ankle-brachial index (ABI). Patients who had previously experienced major adverse cardiovascular events or exhibited albuminuria displayed lower ABI values. Furthermore, a striking 45.05 % of the participants displayed an abnormally high carotid-femoral pulse wave velocity (cfPWV) value, with elevated PWV values correlating with advanced age and longer diabetes duration. Conclusions The prevalence of elevated cfPWV is more pronounced than that of decreased ABI in T2DM patients with asymptomatic PAD and is associated with older age and longer diabetes duration, therefore measurement of both ABI and PWV is crucial for the cardiovascular risk assessment protocol for patients with T2DM and timely PAD diagnosis.
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Affiliation(s)
- Dora Gašparini
- Center for Diabetes, Endocrinology and Cardiometabolism, Special Hospital for Medical Rehabilitation of Cardiac, Pulmonary and Rheumatic diseases Thalassotherapia Opatija, Maršala Tita 188/1, 51410 Opatija, Croatia
- Department of Histology and Embryology, Faculty of Medicine, University of Rijeka, Braće Branchetta 20/1, 51000 Rijeka, Croatia
| | - Anamaria Zuljani
- Department of Emergency Medicine, Clinical Hospital Center Rijeka, Tome Strižića 3, 51000 Rijeka, Croatia
| | - Felix M. Wensveen
- Department of Histology and Embryology, Faculty of Medicine, University of Rijeka, Braće Branchetta 20/1, 51000 Rijeka, Croatia
| | - Tamara Turk Wensveen
- Center for Diabetes, Endocrinology and Cardiometabolism, Special Hospital for Medical Rehabilitation of Cardiac, Pulmonary and Rheumatic diseases Thalassotherapia Opatija, Maršala Tita 188/1, 51410 Opatija, Croatia
- Department of Internal Medicine, Faculty of Medicine, University of Rijeka, Braće Branchetta 20/1, 51000 Rijeka, Croatia
- Department of Endocrinology, Diabetes and Metabolic Diseases, Clinical Hospital Center Rijeka, Krešimirova 42, 51000 Rijeka, Croatia
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Wang Q, Xu X, Geng X, Hu H, Cui W. Brachial-ankle pulse wave velocity increasing with heart rate accelerates. Front Cardiovasc Med 2023; 10:1280966. [PMID: 38028478 PMCID: PMC10652409 DOI: 10.3389/fcvm.2023.1280966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Accepted: 10/20/2023] [Indexed: 12/01/2023] Open
Abstract
Pulse wave velocity (PWV) indicates the degree of vascular stiffness. This study aimed to explore the association between heart rate (HR) and brachial-ankle (ba)-PWV in patients with pacemaker implantation. This retrospective observational study included patients who underwent permanent pacemaker implantation at the Second Hospital of Hebei Medical University between December 2018 and December 2021. All patients were pacemaker-dependent, and the ba-PWV values were collected during HR setted from 60 to 100 bpm. A total of 68 patients (34 males, aged 65.97 ± 9.90 years) were included in this study. There were significant difference of ba-PWV and diastolic blood pressure (DBP) among different HR (both P < 0.001). After adjusted systolic blood pressure (SBP), DBP, age, and sex, the generalized estimating equation showed ba-PWV was independently associated with HR, with increased HR showed higher coefficient: 70 bpm: β = 42.26 (95% CI: 15.34-69.18, P = 0.002), 80 bpm: β = 84.16 (95% CI: 52.48-115.84, P < 0.001), 90 bpm: β = 129.27 (95% CI: 52.48-115.84, P < 0.001), and 100 bpm: 186.31 (95% CI: 137.02-235.59, P < 0.001). The results demonstrate that changes in HR may affect the ba-PWV, the ba-PWV values tend to be higher when HR accelerates.
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Affiliation(s)
- Qian Wang
- Department of Cardiovascular Medicine, The Second Hospital of Hebei Medical University, Shijiazhuang, China
| | - Xinxin Xu
- Department of Cardiovascular Medicine, Cangzhou People’s Hospital, Cangzhou, China
| | - Xue Geng
- Department of Cardiovascular Medicine, The Second Hospital of Hebei Medical University, Shijiazhuang, China
| | - Haijuan Hu
- Department of Cardiovascular Medicine, The Second Hospital of Hebei Medical University, Shijiazhuang, China
| | - Wei Cui
- Department of Cardiovascular Medicine, The Second Hospital of Hebei Medical University, Shijiazhuang, China
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Aristizábal-Ocampo D, Espíndola-Fernández D, Gallo-Villegas J. Pulse wave velocity reference values in 3,160 adults referred to a hypertension clinic for 24-hour ambulatory blood pressure monitoring. Clin Exp Hypertens 2018; 41:759-765. [PMID: 30501425 DOI: 10.1080/10641963.2018.1545853] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Background: Carotid-femoral pulse wave velocity (PWV) is a direct measure of aortic stiffness used in the stratification of cardiovascular risk. Its clinical application in Latin America has been limited by the absence of reference values. The objective of this study was to establish PWV reference values among adults referred to a specialized cardiology center for 24-hour ambulatory blood pressure monitoring (ABPM) in Medellín, Colombia.Methods: A descriptive study of 3,160 records of adult (older than 18 years) patients without pharmacological treatment assessed for PWV using a Mobil-O-Graph® 24-hour PWA device (IEM, Stolberg, Germany) and 24-hour ABPM with hemodynamic parameters based on suspected hypertension or hypotension was conducted. Patient records were categorized by decade of age and sub-divided based on the following 24-hour ABPM categories: normal (< 130/80 mmHg), grade I hypertension (between 130-150/80-90 mmHg), and grade II hypertension (> 150/90 mmHg).Results: PWV increased with age (r = 0,894; p < 0,001) and blood pressure category (ρ = 0,081; p < 0,001); the age-related increase was more pronounced among the patients in the higher blood pressure categories. Measures of central tendency and dispersion regarding PWV are presented, and reference values are proposed from the 90th percentile based on the age and 24-hour ABPM categories.Conclusions: PWV is directly related to age and blood pressure and can be predicted using a simple equation that includes these two variables. To stratify the cardiovascular risk of patients and make clinical decisions, the 90th percentile based on the age and 24-hour ABPM categories is recommended as a cut-off.
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Affiliation(s)
- Dagnovar Aristizábal-Ocampo
- Centro Clínico y de Investigación SICOR, Soluciones Integrales de Conocimiento en Riesgo Cardiovascular, Medellín, Colombia
| | - Diego Espíndola-Fernández
- Centro Clínico y de Investigación SICOR, Soluciones Integrales de Conocimiento en Riesgo Cardiovascular, Medellín, Colombia
| | - Jaime Gallo-Villegas
- Centro Clínico y de Investigación SICOR, Soluciones Integrales de Conocimiento en Riesgo Cardiovascular, Facultad de Medicina, Universidad de Antioquia, Medellín, Colombia
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Carotid-femoral pulse wave velocity in a healthy adult sample: The ELSA-Brasil study. Int J Cardiol 2018; 251:90-95. [DOI: 10.1016/j.ijcard.2017.10.075] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2017] [Revised: 09/23/2017] [Accepted: 10/18/2017] [Indexed: 12/22/2022]
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Ben-Shlomo Y, Spears M, Boustred C, May M, Anderson SG, Benjamin EJ, Boutouyrie P, Cameron J, Chen CH, Cruickshank JK, Hwang SJ, Lakatta EG, Laurent S, Maldonado J, Mitchell GF, Najjar SS, Newman AB, Ohishi M, Pannier B, Pereira T, Vasan RS, Shokawa T, Sutton-Tyrell K, Verbeke F, Wang KL, Webb DJ, Willum Hansen T, Zoungas S, McEniery CM, Cockcroft JR, Wilkinson IB. Aortic pulse wave velocity improves cardiovascular event prediction: an individual participant meta-analysis of prospective observational data from 17,635 subjects. J Am Coll Cardiol 2013; 63:636-646. [PMID: 24239664 DOI: 10.1016/j.jacc.2013.09.063] [Citation(s) in RCA: 1234] [Impact Index Per Article: 112.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2013] [Revised: 09/13/2013] [Accepted: 09/22/2013] [Indexed: 02/06/2023]
Abstract
OBJECTIVES The goal of this study was to determine whether aortic pulse wave velocity (aPWV) improves prediction of cardiovascular disease (CVD) events beyond conventional risk factors. BACKGROUND Several studies have shown that aPWV may be a useful risk factor for predicting CVD, but they have been underpowered to examine whether this is true for different subgroups. METHODS We undertook a systematic review and obtained individual participant data from 16 studies. Study-specific associations of aPWV with CVD outcomes were determined using Cox proportional hazard models and random effect models to estimate pooled effects. RESULTS Of 17,635 participants, a total of 1,785 (10%) had a CVD event. The pooled age- and sex-adjusted hazard ratios (HRs) per 1-SD change in loge aPWV were 1.35 (95% confidence interval [CI]: 1.22 to 1.50; p < 0.001) for coronary heart disease, 1.54 (95% CI: 1.34 to 1.78; p < 0.001) for stroke, and 1.45 (95% CI: 1.30 to 1.61; p < 0.001) for CVD. Associations stratified according to sex, diabetes, and hypertension were similar but decreased with age (1.89, 1.77, 1.36, and 1.23 for age ≤50, 51 to 60, 61 to 70, and >70 years, respectively; pinteraction <0.001). After adjusting for conventional risk factors, aPWV remained a predictor of coronary heart disease (HR: 1.23 [95% CI: 1.11 to 1.35]; p < 0.001), stroke (HR: 1.28 [95% CI: 1.16 to 1.42]; p < 0.001), and CVD events (HR: 1.30 [95% CI: 1.18 to 1.43]; p < 0.001). Reclassification indices showed that the addition of aPWV improved risk prediction (13% for 10-year CVD risk for intermediate risk) for some subgroups. CONCLUSIONS Consideration of aPWV improves model fit and reclassifies risk for future CVD events in models that include standard risk factors. aPWV may enable better identification of high-risk populations that might benefit from more aggressive CVD risk factor management.
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Affiliation(s)
- Yoav Ben-Shlomo
- School of Social and Community Medicine, University of Bristol, Bristol, United Kingdom.
| | - Melissa Spears
- School of Social and Community Medicine, University of Bristol, Bristol, United Kingdom
| | - Chris Boustred
- School of Social and Community Medicine, University of Bristol, Bristol, United Kingdom
| | - Margaret May
- School of Social and Community Medicine, University of Bristol, Bristol, United Kingdom
| | - Simon G Anderson
- Institute of Cardiovascular Sciences, University of Manchester, United Kingdom
| | - Emelia J Benjamin
- National Heart Lung and Blood Institute and Boston University's Framingham Heart Study, Cardiology Section, Department of Medicine, Boston University School of Medicine, Boston, Massachusetts
| | - Pierre Boutouyrie
- INSERM U 970, Paris-Descartes University, Hopital Europeen Georges Pompidou, Assistance Publique Hopitaux de Paris, Paris, France
| | - James Cameron
- Monash Cardiovascular Research Centre, MonashHEART and Monash University Department of Medicine (MMC), Melbourne, Australia
| | - Chen-Huan Chen
- School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - J Kennedy Cruickshank
- King's College & King's Health Partners, St. Thomas' & Guy's Hospital, London, United Kingdom
| | - Shih-Jen Hwang
- Branch of Population Sciences, Division of Intramural Research, National Heart, Lung and Blood Institute, Bethesda, Maryland
| | - Edward G Lakatta
- Laboratory of Cardiovascular Science, National Institute on Aging, National Institutes of Health, Baltimore, Maryland
| | - Stephane Laurent
- INSERM U 970, Paris-Descartes University, Hopital Europeen Georges Pompidou, Assistance Publique Hopitaux de Paris, Paris, France
| | - João Maldonado
- Instituto de Investigação e Formação Cardiovascular, Penacova, Portugal
| | | | - Samer S Najjar
- Laboratory of Cardiovascular Science, National Institute on Aging, National Institutes of Health, Baltimore, Maryland; MedStar Heart Research Institute, Washington, DC
| | - Anne B Newman
- Center for Aging and Population Health, Pittsburgh, Pennsylvania
| | - Mitsuru Ohishi
- Department of Geriatric Medicine, Osaka University, Osaka, Japan
| | - Bruno Pannier
- Centre d'Investigations Preventives et Cliniques, Paris, France
| | - Telmo Pereira
- Escola Superior de Tecnologia da Saúde de Coimbra, Coimbra, Portugal
| | - Ramachandran S Vasan
- National Heart Lung and Blood Institute and Boston University's Framingham Heart Study, Department of Medicine, Boston University, Boston, Massachusetts
| | - Tomoki Shokawa
- Department of Molecular and Internal Medicine, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima, Japan
| | | | - Francis Verbeke
- Department of Nephrology, Ghent University Hospital, Ghent, Belgium
| | - Kang-Ling Wang
- School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - David J Webb
- University/BHF Centre for Cardiovascular Science, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, United Kingdom
| | - Tine Willum Hansen
- Research Center for Prevention and Health, Glostrup Hospital, Glostrup and Steno Diabetes Center, Glostrup, Denmark
| | - Sophia Zoungas
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Carmel M McEniery
- Clinical Pharmacology Unit, University of Cambridge, Cambridge, United Kingdom
| | | | - Ian B Wilkinson
- Clinical Pharmacology Unit, University of Cambridge, Cambridge, United Kingdom
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Abstract
BACKGROUND Increased aortic pulse wave velocity (AoPWV) is an independent predictor of cardiovascular morbidity and mortality. There are, however, no generally accepted limits for defining the normal or reference values. The aim of the present study was to define reference values for AoPWV. PATIENTS AND METHODS AoPWV was assessed using applanation tonometry (PulsePen device) in a community living ambulatory population of 455 individuals aged 60-75 years. AoPWV was studied in a group of 206 individuals without hypertension or diabetes, called the 'reference-values group' (RVG), and in a group of 249 individuals with hypertension or diabetes, called the hypertension-diabetes group (HDG). The 95th percentile of the samples was used to determine the upper limit of AoPWV reference values. RESULTS Mean AoPWV was 8.7+/-2.3 m/s in the RVG and 10.2+/-2.5 m/s in the hypertension-diabetes group (P<0.0001). In the RVG, median AoPWV in the three age subgroups was 8.0 m/s (7.6-8.5) in the 60-64-, 8.0 m/s (7.5-9.0) in the 65-69- and 9.0 m/s (7.9-9.5) in the 70-75-year-old group (NS among groups). In the entire RVG, the upper bounds of the 75th and the 95th percentile of the sample's AoPWV were 10 and 13 m/s, respectively, with no difference between sexes. CONCLUSION In elderly individuals of 60-75 years, an AoPWV value below 10 m/s, measured with the PulsePen device, can be considered as a normal value. Values of 10-13 m/s can be considered as 'high normal' or 'borderline', whereas an AoPWV above 13 m/s is frankly elevated. This study provides, for the first time in the elderly, reference values of AoPWV.
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Khoshdel AR, Carney SL, Nair BR, Gillies A. Better management of cardiovascular diseases by pulse wave velocity: combining clinical practice with clinical research using evidence-based medicine. Clin Med Res 2007; 5:45-52. [PMID: 17456834 PMCID: PMC1855337 DOI: 10.3121/cmr.2007.708] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Arterial stiffness measured by pulse wave velocity (PWV) is an accepted strong, independent predictor of cardiovascular events and mortality. However, lack of a reliable reference range has limited its use in clinical practice. In this evidence-based review, we applied published data to develop a PWV risk stratification model and demonstrated its impact on the management of common clinical scenarios. After reviewing 97 studies where PWV was measured, 5 end-stage renal disease patients, 5 hypertensives, 2 diabetics, and 2 elderly studies were selected. Pooling the data by the "fixed-effect model" demonstrated that the mortality and cardiovascular event risk ratio for one level increment in PWV was 2.41 (1.81-3.20) or 1.69 (1.35-2.11), respectively. There was a significant difference in PWV between survived and deceased groups, both in the low and high risk populations. Furthermore, risk comparison demonstrated that 1 standard deviation increment in PWV is equivalent to 10 years of aging, or 1.5 to 2 times the risk of a 10 mmHg increase in systolic blood pressure. Evidence shows that PWV can be beneficially used in clinical practice for cardiovascular risk stratification. Furthermore, the above risk estimates could be incorporated into currently used cardiac risk scores to improve their predictive power and facilitate the clinical application of PWV.
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Affiliation(s)
- Ali R Khoshdel
- Department of Nephrology, John Hunter Hospital, The University of Newcastle, NSW 2310, Australia.
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Yokokawa H, Goto A, Watanabe K, Yasumura S. Evaluation of atherosclerosis-associated factors and pulse wave velocity for predicting cerebral infarction: a hospital-based, case?control study in Japan. Intern Med J 2007; 37:161-7. [PMID: 17316334 DOI: 10.1111/j.1445-5994.2006.01278.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND The mortality rate for cerebrovascular diseases is much higher in Japan than in North American and West European countries. The primary aim of this study was to elucidate from an epidemiological perspective, the associations between cerebral infarction and demographic factors, medical history and other clinical measurements including pulse wave velocity, a newly introduced non-invasive measurement procedure used to assess aortic stiffness. METHODS This was a hospital-based, matched case-control study in northern Japan where there is a high incidence of cerebrovascular disease. The study group consisted of 92 matched pairs of cerebral infarction patients (cases) and healthy individuals admitted for a thorough health check-up (controls) at the Southern Tohoku General Hospital in Fukushima Prefecture, Japan. A conditional logistic regression model was used in the statistical analysis. RESULTS In univariate analyses, 14 variables were significantly associated with cerebral infarction, of which four remained significant in the final multivariate model. These were family history of hypertension (odds ratio (OR) = 8.61), cerebrovascular diseases (OR = 13.70), high-density lipoprotein cholesterol of 40 mg/dL or higher (OR = 0.08), and pulse wave velocity over 1600 cm/s (OR = 2.92). CONCLUSION Findings from the study indicate that a high pulse wave velocity, in addition to other traditional risk factors, may be associated with a higher risk of cerebral infarction. Further prospective studies are necessary to evaluate the use of this measure as a predictor of the disease.
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Affiliation(s)
- H Yokokawa
- Department of Public Health, Fukushima Medical University School of Medicine, The Third Department of Internal Medicine, Fukushima, Japan.
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Khoshdel AR, Thakkinstian A, Carney SL, Attia J. Estimation of an age-specific reference interval for pulse wave velocity: a meta-analysis. J Hypertens 2006; 24:1231-7. [PMID: 16794467 DOI: 10.1097/01.hjh.0000234098.85497.31] [Citation(s) in RCA: 59] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
OBJECTIVE To estimate an age-specific reference interval for carotid-femoral pulse wave velocity (PWV), an index of aortic stiffness, and to determine the predictive values of the reference range for detecting those at moderate and high risk of cardiovascular disease (CVD). DESIGN AND METHODS We searched MEDLINE using PubMed from 1995 to 2005 for all studies in which Carotid-Femoral PWV was measured using a Complior (Colson, Paris, France) apparatus in Caucasian non-pregnant adults. Twenty-five studies were included, covering 30 groups of subjects; these groups were classified a priori into low (normal), moderate, and high CVD risk categories, with 2008, 5979, and 180 (total 8167) subjects, respectively. Individual-level data were simulated for each group, and an age-specific reference interval was calculated by using fractional polynomial functions. RESULTS We plotted an age-adjusted normal curve for PWV with 2.5, 5, 50, 90, 95, and 97.5 centile limits. Applying this reference interval to the moderate- and high-risk groups using simulations yielded sensitivities of 34.3 [95% confidence interval (CI) 33.2-35.3] and 57.2 (95% CI 55.2-59.3), respectively, specificities of 95.3 (95% CI 94.8-95.8) and 95.3 (95% CI 94.4-96.2), respectively, and positive likelihood ratios of 7.3 and 12.2, respectively. CONCLUSION We constructed an age-adjusted reference curve for PWV. Using the 95th centile of this curve as a threshold (e.g. 10.94, 11.86, and 13.18 m/s for 20, 40, and 60 years old) shows construct validity, as it appears to identify medium and high CVD risk groups reasonably accurately. This reference range needs to be tested using other datasets.
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Affiliation(s)
- Ali Reza Khoshdel
- John Hunter Hospital, Faculty of Health, The University of Newcastle, New South Wales, Australia.
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Nakano T, Ohkuma H, Suzuki S. Assessment of vascular injury in patients with stroke by measurement of pulse wave velocity. J Stroke Cerebrovasc Dis 2004; 13:74-80. [PMID: 17903953 DOI: 10.1016/j.jstrokecerebrovasdis.2004.02.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2003] [Revised: 01/21/2004] [Accepted: 02/10/2004] [Indexed: 11/17/2022] Open
Abstract
Vascular injury causes various diseases and may be especially important as a risk factor for stroke, and early diagnosis is useful for prevention of stroke. Recently, pulse wave velocity (PWV) has been receiving increasing attention as a noninvasive measurement of vascular injury. In this study, we investigated PWV of patients with stroke to determine the degree of vascular injury. PWV was measured in 114 patients with stroke, and the significance of differences between the PWV of stroke subgroups and that of the control group was investigated in an age- and sex-matched case-control study. In comparison with the control group, PWV was increased significantly in patients with intracerebral hemorrhage (P = .0107) and cerebral infarction (P < .0001). Of risk factors, hypertension and high PWV were independently related to the presence of intracerebral hemorrhage on multivariate analyses. Smoking and high PWV were found to be independent risk factors for cerebral infarction. A strong relationship between stroke and PWV was demonstrated. Measurement of PWV is useful for quantitatively assessing the progression of vascular injury, which may potentially be a risk factor for stroke.
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Affiliation(s)
- Takahiro Nakano
- Department of Neurosurgery, Hirosaki University School of Medicine, Hirosaki, Japan.
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Xu J. Do we need a better approach for measuring pulse-wave velocity? ULTRASOUND IN MEDICINE & BIOLOGY 2003; 29:1373. [PMID: 14553816 DOI: 10.1016/s0301-5629(03)00923-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
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Ogawa O, Onuma T, Kubo S, Mitsuhashi N, Muramatsu C, Kawamori R. Brachial-ankle pulse wave velocity and symptomatic cerebral infarction in patients with type 2 diabetes: a cross-sectional study. Cardiovasc Diabetol 2003; 2:10. [PMID: 12969516 PMCID: PMC194759 DOI: 10.1186/1475-2840-2-10] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2003] [Accepted: 08/28/2003] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Recently a new automatic device that measures brachial-ankle pulse wave velocity using an oscillometric method has been developed. However, the practical significance of brachial-ankle pulse wave velocity measurement remains uncertain. The purpose of this study was to examine the association between brachial-ankle pulse wave velocity and symptomatic cerebral infarction in patients with type 2 diabetes. METHODS One thousand sixty six patients with type 2 diabetes were studied cross-sectionally. Measurements of brachial-ankle pulse wave velocity were made using the automatic device. Logistic regression analysis was used to calculate the odds ratio for cerebral infarction. RESULTS The presence of symptomatic cerebral infarction was confirmed in 86 patients. In these patients brachial-ankle pulse wave velocity was found to be significantly higher than in patients without cerebral infarction (18.94 +/-; 4.95 versus 16.46 +/-; 3.62 m/s, p < 0.01). The association between brachial-ankle pulse wave velocity and cerebral infarction remained significant after adjustment for traditional risk factors. There was an increasing odds ratio for each tertile of brachial-ankle pulse wave velocity, from the second tertile (odds ratio, 2.28; 95% confidence interval, 1.05 to 4.94), to the third (odds ratio, 2.53; 95% confidence interval, 1.09 to 5.86). CONCLUSION Overall, we conclude that an increase in brachial-ankle pulse wave velocity is associated with symptomatic cerebral infarction in patients with type 2 diabetes.
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Affiliation(s)
- Osamu Ogawa
- Department of Medicine, Metabolism and Endocrinology, Juntendo University School of Medicine, 2-1-1 Hongo Bunkyo-ku, Tokyo, 113-8421, Japan
| | - Tomio Onuma
- Department of Medicine, Metabolism and Endocrinology, Juntendo University School of Medicine, 2-1-1 Hongo Bunkyo-ku, Tokyo, 113-8421, Japan
| | - Sayaka Kubo
- Department of Medicine, Metabolism and Endocrinology, Juntendo University School of Medicine, 2-1-1 Hongo Bunkyo-ku, Tokyo, 113-8421, Japan
| | - Naomi Mitsuhashi
- Department of Medicine, Metabolism and Endocrinology, Juntendo University School of Medicine, 2-1-1 Hongo Bunkyo-ku, Tokyo, 113-8421, Japan
| | - Chie Muramatsu
- Department of Medicine, Metabolism and Endocrinology, Juntendo University School of Medicine, 2-1-1 Hongo Bunkyo-ku, Tokyo, 113-8421, Japan
| | - Ryuzo Kawamori
- Department of Medicine, Metabolism and Endocrinology, Juntendo University School of Medicine, 2-1-1 Hongo Bunkyo-ku, Tokyo, 113-8421, Japan
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