-
Views
-
Cite
Cite
Michael F. O’Rourke, Clinical Assessment of Arterial Stiffness: , American Journal of Hypertension, Volume 20, Issue 8, August 2007, Page 839, https://doi.org/10.1016/j.amjhyper.2007.04.011
Close - Share Icon Share
Extract
The past 20 years have seen reintroduction of older (noncuff) techniques for measurement of arterial stiffness, including pulse-wave velocity (PWV) from delay of the wave foot (as used by Nobel Laureate A.V. Hill), and pulse-waveform analysis, as applied by Marey, Mahomed, and Mackenzie more than 100 years ago.1 A recent consensus document2 summarizes the present status, with aortic PWV regarded as “gold standard,” and pulse-waveform analysis as a simple useful adjunct in epidemiologic and drug studies and in clinical practice.
This work has been extended to generate central aortic pressure waves as more precise indices of aortic stiffening and the effects of stiffening on cardiac and arterial function.3
Cuff methods have also been extended in recent times, so as to generate new indices of arterial stiffness, which may be useful in predicting risk and in epidemiologic studies. These were aided by introduction of ambulatory blood-pressure (BP) monitoring during a full 24-h period. The best-tested index is the “ambulatory arterial stiffness index (AASI),” which relates cuff systolic to diastolic pressures. The AASI has been shown well correlated with “aortic” PWV and an independent predictor of mortality. In this issue of the journal, Gosse and colleagues4 compare AASI with two other cuff methods for gauging arterial stiffness—the relation of pulse pressure to mean pressure (PP/MBP slope) and the “QKD100-60,” which is a time delay between the onset of the electrocardiogram (ECG) QRS and the last Korotkov sound at the brachial cuff, after multiple adjustments. Potential of the methods is apparent as their relationship with each other, with cardiovascular events in univariate analysis, and QKD100-60 with events in multivariate analysis.
