Abstract-Arterial stiffness predicts cardiovascular events beyond traditional risk factors. However, the relationship with aging of novel noninvasive measures of aortic function by MRI and their interrelationship with established markers of vascular stiffness remain unclear and currently limit their potential impact. Our aim was to compare age-related changes of central measures of aortic function with carotid distensibility, global carotid-femoral pulse wave velocity, and wave reflections. We determined aortic strain, distensibility, and aortic arch pulse wave velocity by MRI, carotid distensibility by ultrasound, and carotid-femoral pulse wave velocity by tonometry in 111 asymptomatic subjects (54 men, age range: 20 to 84 years). Central pressures were used to calculate aortic distensibility. Peripheral and central pulse pressure, augmentation index, and carotid-femoral pulse wave velocity increased with age, but aortic strain and aortic arch PWV were most closely and specifically related to aging. Ascending aortic (AA) strain and distensibility decreased, respectively, by 5.3Ϯ0.5% (R 2 ϭ0.54, PϽ0.0001) and 13.6Ϯ1 kPa Ϫ1 ϫ10 Ϫ3 (R 2 ϭ0.62, PϽ0.0001), and aortic arch pulse wave velocity increased by 1.6Ϯ0.13 m/sec (R 2 ϭ0.60, PϽ0.0001) for each decade of age after adjustment for gender, body size, and heart rate. We demonstrate in this study a dramatic decrease in AA distensibility before the fifth decade of life in individuals with diverse prevalence of risk factors free of overt cardiovascular disease. In particular, compared with other measures of aortic function, the best markers of subclinical large artery stiffening, were AA distensibility in younger and aortic arch pulse wave velocity in older individuals. (Hypertension. 2010;55:319-326.) Key Words: MRI Ⅲ aorta Ⅲ aging Ⅲ elasticity Ⅲ pulse wave velocity A ge-related vascular changes in individuals without overt cardiovascular disease and normal blood pressure remain currently undetected. However, the ability to identify individuals having early deterioration of vascular and cardiac function, as well as progressive subclinical arterial disease, would allow to define a target population for preventive therapy in the hope of reducing vascular and cardiac remodeling and dysfunction, as well as preventing lethal or incapacitating events. Arterial stiffness is a main determinant of age-related systolic and pulse pressure increase, a major predictor of stroke and myocardial infarction, and has been associated with heart failure. 1-3 The aorta accounts for most of global arterial stiffening and is central to the onset of atherosclerosis with its subsequent complications. The value of carotid-femoral pulse wave velocity (cfPWV) as a marker of arterial stiffness and a predictor of fatal and nonfatal cardiovascular events over traditional risk factors has been established both in patients and the general population. 4 Similarly, the carotid augmentation index (AIx), a marker of waveform reflection and central pulse pressure (PP), have independent predictive value f...

In middle-aged healthy men, there is no significant correlation between carotid IMT and brachial artery FMD. This finding suggests that these are unique, independent surrogates that measure different aspects and stages of early atherosclerosis. Further studies are needed to define their role in clinical research and in cardiovascular risk assessment.

Compared with TIMI RS, both PURSUIT RS and GRACE RS allow better discrimination for in-hospital and 1 year mortality in patients presenting with a wide range of ACS. All three risk scores confer additional important prognostic value beyond global risk assessment by physicians. These validated risk scores may refine risk stratification, thereby improving patient care in routine clinical practice.