Echocardiographic Assessment of Aortic Pulse-Wave Velocity: Validation against Invasive Pressure Measurements

Echocardiographic Assessment of Large Artery Stiffness

“…Importantly, helical and vortical flow patterns are particularly prevalent in the ascending aorta; therefore, the LV outflow tract (rather than the ascending aorta itself) may represent a more suitable location for assessing the proximal timing of the onset of flow, when the ascending aorta needs to be included in the segment being interrogated (Figure 1). Despite the excellent correlation and average agreement between echocardiography-based PWV and invasive PWV in the study by Styczynski et al, 15 it is likely that a combination of various sources of error mentioned above is responsible for the important differences (up to ∼2 m/sec) between the 2 measurements observed in a minority of subjects in this study.…”

“…To conclude, the contribution by Styczynski et al 15 is a significant step forward and should promote the application of echocardiography to phenotype the arterial system, allowing a more widespread application of the study of arterial stiffness and arterial load, not only in mechanistic, clinical and epidemiologic research but also in the translation of this important phenotype to clinical practice.…”

“…15 report the results of a prospective study in which noninvasive Doppler ultrasound-based measurements of PWV between the aortic arch and the external iliac artery were compared with invasive catheter-based measurements. In this study, 45 subjects underwent simultaneous catheter-based and ultrasound-based measurements during a clinically indicated cardiac catheterization procedure.…”

“…Despite the great potential of echocardiography to interrogate key aortic segments, more research is needed to develop and validate algorithms to estimate path lengths of these segments on the basis of a combination of surface and on the basis of a combination of surface and 2D-ultrasound-derived distances. In the meantime, approaches such as the one described by Styczynski et al 15 or the approach previously described by Bonapace et al 20 (which was shown to predict adverse outcomes in heart failure with reduced ejection fraction) represent readily implementable techniques that can add important information and minimal additional scanning time during transthoracic echocardiographic examinations.…”

“…Similarly, the method to assess the timing of the foot of the flow wave is not trivial. Although Styczynski et al 15 used a simple visual assessment of the foot with caliper-based time measurements to maximize the simplicity of the method, this approach may introduce significant limitations in special circumstances, such as instances in which there is floor noise in flow measurements, significant flow reversal in end-diastole, or when time delays are particularly short (because of extremely high PWV values or relatively short arterial segments).…”