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1 PWV has been established as an independent predictor of cardiovascular mortality and is consequently used for diagnosis and prognosis in patients at risk of atherosclerotic cardiovascular disease. + 623 word(s) 623 2020-07-09 08:37:00 |
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Pulse Wave Velocity
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Pulse wave velocity (PWV) is a simple, reproducible and non-invasive technique to assess arterial stiffness. It estimates the velocity of arterial wave propagation to travel a known distance between two anatomic sites within the arterial system [1]. PWV has been established as an independent predictor of cardiovascular mortality and is consequently used for diagnosis and prognosis in patients at risk of atherosclerotic cardiovascular disease [2]; however, PWV's significance relies on the fact that arterial stiffness, specially of muscular arteries can be modified by interventions that improve endothelial function such as exercise training, which makes PWV an important tool for cardiovascular risk management [3].

pulse wave velocity cardiovascular risk arterial stiffness vascular function
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1. Definition

Pulse wave velocity (PWV) is a simple, reproducible and non-invasive technique to assess arterial stiffness. It estimates the velocity of arterial wave propagation to travel a known distance between two anatomic sites within the arterial system [1]. PWV has been established as an independent predictor of cardiovascular mortality and is consequently used for diagnosis and prognosis in patients at risk of atherosclerotic cardiovascular disease [2]; however, PWV's significance relies on the fact that arterial stiffness, specially of muscular arteries can be modified by interventions that improve endothelial function such as exercise training, which makes PWV an important tool for cardiovascular risk management [3].

2. Introduction

Pulse wave velocity (PWV) is considered the gold standard method for assessing aortic stiffness [4][5]. Arterial stiffness measures, and carotid femoral PWV (cfPWV) in particular, are being included in the routine clinical assessment of patients and within the framework of large-scale clinical studies [4] as new instrumental solutions that allow the PWV assessment, such as photoplethysmography or magnetic resonance emerge [6] (Table 1). Nevertheless, an introduction into clinical practice has not been implemented further due to the fact that there is a lack of established reference values based on a large population and due to the absence of a standardized methodology for PWV assessment [7].

3. Methods used to Determine PWV

Table 1. Methods used to determine PWV. aPWV: aortic pulse wave velocity; baPWV: brachial-ankle pulse wave velocity; cfPWV: carotid-femoral pulse wave velocity; DVP: digital volume pulse; ECG: electrocardiogram; PWV: pulse wave velocity.

 

Method

Description

Measure

Non-invasive methods

Applanation tonometry

Apply a pressure sensor through the skin and applanate a superficial artery by applying a downward pressure sufficient to flatten the artery.

baPWV, cfPWV

Computerized oscillometry

Simultaneous acquisition and analysis of the pulsation of the artery, which is caused by the heart, as the pressure oscillation in the cuff.

Heart-brachial PWV, heart-ankle PWV, brachial-ankle PWV,

cfPWV

Mechanotransducer

Two dedicated piezoelectric pressure mechanotransducers directly applied to the skin in a simultaneous measurement of pressure pulses

carotid–femoral, carotid–brachial or femoral–dorsalis pedis PWV

Ultrasound

Doppler pulses are recorded sequentially in 2 different arterial sites and compared

using the R-wave of the ECG

baPWV, cfPWV

Photoplethysmography

DVP measured by the photoplethysmography transducer

DVP associated with aPWV

Magnetic Resonance Imaging

Assessment of the blood flow velocity with an enough temporal and spatial resolution to study the propagation of the aortic systolic flow wave

Local PWV

Invasive methods

Aortic angiography

Intra-aortic catheter measurements

Local PWV

Previous meta-analyses have attempted to calculate quantitative estimates of the predictive value of PWV for different outcomes. However, to the best of our knowledge, no previous meta-analysis has estimated the predictive performance (diagnostic odds ratio (dOR), sensitivity, specificity, positive likelihood ratio (PLR), and negative likelihood ratio (NLR)) of PWV considering the thresholds for a higher risk of cardiovascular or all-cause mortality estimated using hierarchical summary receiver operating characteristic (HSROC) models. Moreover, reference values for PWV have been established through cross-sectional studies [7] or expert consensus [8], in which subjects by age and blood pressure categories with no additional identified cardiovascular risk factors were considered.

References

  1. James Oliver; David J. Webb; Noninvasive Assessment of Arterial Stiffness and Risk of Atherosclerotic Events. Arteriosclerosis, Thrombosis, and Vascular Biology 2003, 23, 554-566, 10.1161/01.atv.0000060460.52916.d6.
  2. Tomoki Shokawa; Michinori Imazu; Hideya Yamamoto; Mamoru Toyofuku; Naohito Tasaki; Tomokazu Okimoto; Kiminori Yamane; Nobuoki Kohno; Pulse Wave Velocity Predicts Cardiovascular Mortality. Circulation Journal 2005, 69, 259-264, 10.1253/circj.69.259.
  3. Michael F. O’Rourke; Junichiro Hashimoto; Arterial Stiffness. Journal of Cardiopulmonary Rehabilitation and Prevention 2008, 28, 225-237, 10.1097/01.hcr.0000327179.21498.38.
  4. G. Mancia; G. De Backer; Anna Dominiczak; Renata Cífková; R. Fagard; Giuseppe Germano; Guido Grassi; Anthony Heagerty; S. E. Kjeldsen; Stéphane Laurent; et al. 2007 Guidelines for the management of arterial hypertension: The Task Force for the Management of Arterial Hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). European Heart Journal 2006, 28, 1462-1536, 10.1093/eurheartj/ehm236.
  5. Raymond Townsend; Ian B. Wilkinson; Ernesto L. Schiffrin; Alberto P. Avolio; Julio A. Chirinos; John R. Cockcroft; Kevin S. Heffernan; Edward G. Lakatta; Carmel M. McEniery; Gary F. Mitchell; et al. Recommendations for Improving and Standardizing Vascular Research on Arterial Stiffness: A Scientific Statement From the American Heart Association.. Hypertension 2015, 66, 698-722, 10.1161/HYP.0000000000000033.
  6. Tania Pereira; Carlos Correia; João Cardoso; Novel Methods for Pulse Wave Velocity Measurement. Journal of Medical and Biological Engineering 2015, 35, 555-565, 10.1007/s40846-015-0086-8.
  7. Reference Values for Arterial Stiffness' Collaboration; The Reference Values for Arterial Stiffness' Collaboration; Determinants of pulse wave velocity in healthy people and in the presence of cardiovascular risk factors: 'establishing normal and reference values'.. European Heart Journal 2010, 31, 2338-50, 10.1093/eurheartj/ehq165.
  8. Luc M. Van Bortel; Stéphane Laurent; Pierre Boutouyrie; Phil Chowienczyk; J.K. Cruickshank; Tine De Backer; Jan Filipovsky; Sofie Huybrechts; Francesco U.S. Mattace-Raso; Athanase D Protogerou; et al. Expert consensus document on the measurement of aortic stiffness in daily practice using carotid-femoral pulse wave velocity. Journal of Hypertension 2012, 30, 445-448, 10.1097/hjh.0b013e32834fa8b0.
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View Times: 418
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Update Time: 24 Apr 2021
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    Redondo, I.C. Pulse Wave Velocity. Encyclopedia. Available online: https://encyclopedia.pub/entry/1304 (accessed on 28 September 2022).
    Redondo IC. Pulse Wave Velocity. Encyclopedia. Available at: https://encyclopedia.pub/entry/1304. Accessed September 28, 2022.
    Redondo, Iván Cavero. "Pulse Wave Velocity," Encyclopedia, https://encyclopedia.pub/entry/1304 (accessed September 28, 2022).
    Redondo, I.C. (2020, July 10). Pulse Wave Velocity. In Encyclopedia. https://encyclopedia.pub/entry/1304
    Redondo, Iván Cavero. ''Pulse Wave Velocity.'' Encyclopedia. Web. 10 July, 2020.
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