Cross-Sectional and Longitudinal Evaluation of Heart-to-Brachium Pulse Wave Velocity for Cardiovascular Disease Risk

BACKGROUND

Heart-brachium pulse wave velocity (hbPWV) is a measure of proximal aortic stiffness and does not require the technical placement of transducers. To characterize age-associated changes and the clinical utilities of heart-brachium pulse wave velocity (hbPWV), we conducted both cross-sectional and longitudinal analyses and used brachial-ankle pulse wave velocity (baPWV) as a comparative measure.

METHODS

Various measures of CVD risk factors and arterial stiffness were obtained in 7,868 adults in the cross-sectional study. In the longitudinal study, 3,710 adults were followed for 9.1 ± 2.0 years. Repeated-measures correlation (rmcorr) and regression analyses were used to characterize associations of PWVs with age and Framingham’s general CVD risk score (FRS).

RESULTS

In the cross-sectional study, hbPWV showed a stronger linear (r=0.796) association with age than baPWV (r=0.554). In the longitudinal study, hbPWV also showed a significantly higher rmcorr coefficient with age than baPWV (r _rm =0.511 vs. 0.307, P<0.0001). Age-related increases in hbPWV were fairly steady starting from young adults while baPWV displayed accelerated increases with age. A receiver operating characteristic curve analysis indicated that hbPWV depicted a more robust ability to stratify general cardiovascular disease (CVD) risk compared with baPWV (AUC=0.913 vs. 0.833, P<0.0001). The results of the 10-year follow-up study were consistent with the findings of the cross-sectional investigation.

CONCLUSIONS

hbPWV exhibits steady and more pronounced increases from an early age and may be more effective in stratifying general CVD risk.

NOVELTY AND RELEVANCE

What Is New?

Using the cross-sectional and longitudinal study designs in a large cohort of middle-aged Japanese workers, we confirmed that hbPWV, a promising method for assessing proximal aortic stiffness, undergoes a linear augmentation with age, commencing from an early life stage onward, rendering it a potential marker for discerning CVD risk.

What Is Relevant?

The stiffening of the arterial wall with advancing age is particularly pronounced in the proximal aorta and contributes importantly to elevated risks of CVD, cardiovascular events, and all-cause mortalities.

Clinical/Pathophysiological Implications?

Early-life assessment of proximal aortic stiffening through hbPWV has the potential to mitigate the pervasive impact of CVD on a global scale.