Abstract
Background
Arterial stiffness is a well-established indicator of cardiovascular disease outcome. Pulse Wave Velocity (PWV) is a surrogate for arterial stiffness that is measured either globally using carotid-to-femoral applanation tonometry or locally using biomedical imaging methods. Pulse Wave Imaging (PWI) is an ultrasound-based method for both qualitative visualization of the pulse wave propagation and quantitative estimation of arterial stiffness. The objective of this study is to assess the PWI performance in PWV estimation by comparing local abdominal aortic PWV values obtained by PWI to the carotid-femoral PWV measured by applanation tonometry.
Methods
A total of 18 subjects (age 18–66, 32.5 ± 14.5) with no history of cardiovascular disease were consecutively tested by both PWI and tonometry.
Results
The correlation coefficient r between values estimated with the two methods was found to be equal to 0.68. A linear regression yielded PWVPWI = 1.02* PWVtonometry +0.15. Tukey mean-difference plots indicated that PWVPWI was significantly lower than PWVtonometry (–0.3 m/s) at lower PWV values (PWV ≤ 7 m/s), whereas PWVPWI was significantly higher (+1.4 m/s) than PWVtonometry at higher PWV values (PWV > 7 m/s).
Conclusions
Despite the regional nature of the PWVPWI measurements, as opposed to the global PWVtonometry measurements, abdominal PWVPWI and carotid-femoral PWVtonometry values were found to be similar, with an average bias equal to 0.25 m/s. Such a bias and its variation with PWV may be partially explained by both physiological variations of PWV
Article PDF
References
Blacher J, Guerin A, Pannier B, Marchais S, Safar M, London G. Impact of aortic stiffness on survival in end-stage renal disease. Circulation 1999;99:2434–9.
Boutouyrie P, Tropeano A, Asmar R, Gautier I, Benetos A, Lacolley P, et al. Aortic stiffness is an independent predictor of primary coronary events in hypertensive patients: a longitudinal study. Hypertension 2002;39:10–5.
Gatzka C, Cameron J, Kingwell B, Dart A. Relation between coronary artery disease, aortic stiffness, and left ventricular structure in a population sample. Hypertension 1998;32: 575–8.
Laurent S, Boutouyrie P, Asmar R, Gautier I, Laloux B, Guize L, et al. Aortic stiffness is an independent predictor of all-cause and cardiovascular mortality in hypertensive patients. Hypertension 2001;37:1236–41.
Laurent S, Katsahian S, Fassot C, Tropeano A-I, Gautier I, Laloux B, et al. Aortic stiffness is an independent predictor of fatal stroke in essential hypertension. Stroke 2003;34:1203–6.
Meaume S, Rudnichi A, Lynch A, Bussy C, Sebban C, Benetos A, et al. Aortic pulse wave velocity as a marker of cardiovascular disease in subjects over 70 years old. Journal of Hypertension 2001;19:871–7.
Mitchell G, Hwang S-J, Vasan R, Larson M, Pencina M, Hamburg N, et al. Arterial stiffness and cardiovascular events: the framingham heart study. Circulation 2010; 121: 505–11.
Segers P, Kips J, Trachet B, Swillens A, Vermeersch S, Mahieu D, et al. Limitations and pitfalls of non-invasive measurement of arterial pressure wave reflections and pulse wave velocity. Artery Research 2009;3:79–88.
Nichols W, McDonald D. Wave-velocity in the proximal aorta. Medical and Biological Engineering 1972;10:327–35.
Nichols W, O’Rourke M. McDonald’s blood flow in arteries: theoretical, experimental and clinical principles. 5th ed.; 2005.
Latham R, Westerhof N, Sipkema P. Regional wave travel and reflections along the human aorta: a study with six simultaneous micromanometric pressures. Circulation 1985;72: 1257–69.
Benetos A, Joly L, Perret-Guillaume C, Kearney-Schwartz A, Salvi P, Mandry D, et al. Pulse wave velocity assessment by external noninvasive devices and phase-contrast magnetic resonance imaging in the obese. Hypertension 2009; 54: 421–6.
Laffon E, Marthan R, Montaudon M, Latrabe V, Laurent F, Ducassou D. Feasibility of aortic pulse pressure and pressure wave velocity MRI measurement in young adults. Journal of Magnetic Resonance Imaging 2005;21:53–8.
Redheuil A, Yu W-C, Wu C, Mousseaux E, De Cesare A, Yan R, et al. Reduced ascending aortic strain and distensibility: earliest manifestations of vascular aging in humans. Hypertension 2010;55:319–26.
Rogers W, Hu Y-L, Coast D, Vido D, Kramer C, Pyeritz R, et al. Age-associated changes in regional aortic pulse wave velocity. Journal of the American College of Cardiology 2001;38: 1123–9.
Yu H-Y, Peng H-H, Wang J-L, Wen C-Y, Tseng W- Y. Quantification of the pulse wave velocity of the descending aorta using axial velocity profiles from phase-contrast magnetic resonance imaging. Magnetic Resonance in Medicine 2006;56:876–83.
Markl M, Wallis W, Brendecke S, Simon J, Frydrychowicz A, Harloff A. Estimation of global aortic pulse wave velocity by flow-sensitive 4D MRI. Magnetic Resonance in Medicine 2010; 63:1575–82.
Eriksson A, Greiff E, Loupas T, Persson M, Pesque P. Arterial pulse wave velocity with tissue doppler imaging. Ultrasound Medicine and Biology 2002;28:571–80.
Hermeling E, Reesink K, Reneman R, Hoeks A. Measurement of local pulse wave velocity: effects of signal processing on precision. Ultrasound Medicine and Biology 2007;33:774–81.
Meinders J, Kornet L, Brands P, Hoeks A. Assessment of local pulse wave velocity in arteries using 2D distension waveforms. Ultrasound Imaging 2001;23:199–215.
Couade M, Pernot M, Prada C, Messas E, Emmerich J, Bruneval P, et al. Quantitative assessment of arterial wall biomechanical properties using shear wave imaging. Ultrasound Medicine and Biology 2010;36(10):1662–76.
Fujikura K, Luo J, Gamarnik V, Pernot M, Fukumoto R, Tilson III M, et al. A novel noninvasive technique for pulse-wave imaging and characterization of clinically-significant vascular mechanical properties in vivo. Ultrasound Imaging 2007; 29: 137–54.
Luo J, Konofagou E. A fast normalized cross-correlation calculation method for motion estimation. IEEE Transactions on Ultrasonics, Ferroelectrics, and Frequency Control 2010; 57:1347–57.
Vappou J, Luo J, Konofagou E. Pulse wave imaging for noninvasive and quantitative measurement of arterial stiffness in vivo. American Journal of Hypertension 2010;23: 393–8.
Luo J, Lee W-N, Wang S, Konofagou E. Pulse wave imaging of human abdominal aortas in vivo. Proceedings of IEEE Ultrasonics Symposium 2008; 859–862.
Hoctor R, Dentinger A, Thomenius K. Signal processing for ultrasound-based arterial pulse wave velocity estimation. Proceedings of the IEEE Ultrasonics Symposium 2004; 2: 1492–1497.
Hickson SS, Butlin M, Graves M, Taviani V, Avolio AP, McEniery CM, et al. The relationship of age with regional aortic stiffness and diameter. JACC: Cardiovascular Imaging 2010;3: 1247–55.
Sugawara J, Hayashi K, Yokoi T, Tanaka H. Carotid-femoral pulse wave velocity: impact of different arterial path length measurements. Artery Research 2010;4:27–31.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
This is an open access article distributed under the CC BY-NC license. https://doi.org/creativecommons.org/licenses/by/4.0/
About this article
Cite this article
Vappou, J., Luo, J., Okajima, K. et al. Aortic pulse wave velocity measured by pulse wave imaging (PWI): A comparison with applanation tonometry. Artery Res 5, 65–71 (2011). https://doi.org/10.1016/j.artres.2011.03.002
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1016/j.artres.2011.03.002