Longitudinal Changes of Input Impedance, Pulse Wave Velocity, and Wave Reflection in a Middle-Aged Population

Arias, Daimé Campos; Buyzere, Marc L. De; Chirinos, Julio A.; Rietzschel, Ernst; Segers, Patrick

doi:10.1161/hypertensionaha.120.16149

Cited by 29 publications

(28 citation statements)

References 42 publications

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“…Contrary to our study, Campos-Arias et al 5 predicted and observed concomitant increases in niCFPWV but declines in Z c , particularly among younger participants of the Asklepios study. 5 This longitudinal divergence of Z c and niCFPWV was accompanied by increased weight and body mass index over the follow-up period. The authors speculated that remodeling of the aorta to a higher diameter may be sufficient to overcome modest increases in aortic wall stiffness for younger but not older individuals.…”

Section: Arterial Stiffnesscontrasting

confidence: 99%

“…Given these limitations, longitudinal studies with repeated measurements of hemodynamics and stiffness may be required to differentiate between age-related differences and longitudinal changes in arterial function. 5 Thus, we aimed to examine potential discrepancies between observed longitudinal change for various key central hemodynamic and stiffness measures between 2 visits as compared with predicted change based on cross-sectional age relations at an initial visit. We hypothesized that changes in CVD risk factor levels and changes in relations of stiffness measures with various risk factors contribute to discrepancies between observed and predicted change in central hemodynamics measures.…”

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confidence: 99%

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Discrepancies in Observed and Predicted Longitudinal Change in Central Hemodynamic Measures: The Framingham Heart Study

et al. 2021

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Community-based studies have evaluated cross-sectional age relations of aortic stiffness measures, which are not often recapitulated in longitudinal studies. We examined baseline and longitudinal change in aortic stiffness in 5491 participants (mean age, 49.5±14.5 years; 54% women) who attended 2 sequential examinations (6.0±0.6 years apart) of the Framingham Heart Study. Cross-sectional relations of central hemodynamics (mean arterial pressure, central pulse pressure, carotid-femoral pulse wave velocity, and characteristic impedance) with age and risk factors were assessed at visits 1 and 2 (models 1 and 2). We used model 1 coefficients (M 1 ), visit 1 risk factor levels (R 1 ), and age at each visit (A 1 , A 2 ) to estimate values at visits 1 (M 1 R 1 A 1 ) and 2 (M 1 R 1 A 2 ). While using model 1 coefficients, we accounted for age and risk factor level (R 2 ) changes to predict values at visit 2 (M 1 R 2 A 2 ). Using model 2 coefficients (M 2 ) and visit 2 age and risk factor levels, we predicted visit 2 values (M 2 R 2 A 2 ). We calculated predicted change 3 ways: delta1=M 1 R 1 A 2 −M 1 R 1 A 1 , delta2=M 1 R 2 A 2 −M 1 R 1 A 1 , and delta3=M 2 R 2 A 2 −M 1 R 1 A 1 . Delta1 values were biased and correlated poorly with actual changes ( r =−0.02–0.14). For mean arterial pressure, delta1=1.9±0.8 mm Hg ( r =0.14), observed change=−3.3±10.3 mm Hg, and discrepancy=5.2±10.2 mm Hg ( P <0.0001). For characteristic impedance, delta1=7.2±14.7 dyne×sec/cm 5 ( r =0.07), observed change=20.5±68.2 dyne×sec/cm 5 , and discrepancy=−13.3±68.7 dyne×sec/cm 5 ( P <0.0001). Delta2 values were moderately correlated with change ( r =0.17–0.54) but remained biased whereas delta3 values were moderately correlated with change with no bias. Projected change in hemodynamic measures extrapolated from cross-sectional age relations may differ substantially from actual change, particularly for variables with nonlinear age relations.

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Section: Arterial Stiffnesscontrasting

confidence: 99%

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confidence: 99%

Discrepancies in Observed and Predicted Longitudinal Change in Central Hemodynamic Measures: The Framingham Heart Study

et al. 2021

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“…Furthermore, in a large cross-sectional cohort, the relationship of brachial-ankle PWV with age was steeper in women than in men after 58 years of age [47]. Similar data were obtained in an independent cohort with carotid-femoral PWV and confirmed by longitudinal, repeated measurements [48].…”

Section: Epidemiology Of Vascular Ageing In Women and Mensupporting

confidence: 79%

Sex and Gender Aspects in Vascular Ageing – Focus on Epidemiology, Pathophysiology, and Outcomes

Seeland

Nemcsik

Lønnebakken

et al. 2021

Heart, Lung and Circulation

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Sex and gender are important modifiers of cardiovascular system physiology, pathophysiology, and disease development. The atherosclerosis process, together with the progressive loss of arterial elasticity with age, is a major factor influencing the development of overt cardiovascular, renal, and cerebrovascular disease. While differences between women and men in epidemiology and pathophysiology of vascular ageing are increasingly reported, sex-disaggregated data are still scarcely available for prospective studies. A better knowledge of sex differences in physiological ageing as well as in disease-related changes in vascular ageing trajectories is crucial to avoid misdiagnosis and mistreatment. This review presents key concepts and knowledge gaps identified in vascular ageing due to gonadal function, vascular physiology, pathophysiology, psychosocial factors, pregnancy, and prognostic relevance. Gender roles determine the effectiveness of any cardiovascular preventive strategy and acceptance for non-invasive or invasive diagnostics and therapeutics. Gender differences in health behaviour, also due to sociocultural norms conditioned by society, contribute to behaviours that may lead to premature arterial vascular ageing. These include differences in risk behaviours like smoking, diet, exercise, and in stress, but also conditions such as housing, noise pollution, poverty, disability, and any kind of stigmatisation. The VascAgeNet Gender Expert Group aims to advance the use of non-invasive vascular ageing measures in routine clinical settings by providing facts to fill in the gaps concerning sex and gender differences at each step of this process, and to search for solutions.

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“…First, since this is a cross-sectional study, it provides no data on longitudinal age-related variations in waveform-derived indexes. Although useful for quantifying RIs, our data do not allow to determine with certainty the true impact of aging on arterial system properties ( Campos-Arias et al, 2021 ). Second, the outcome data were not considered.…”

Section: Discussionmentioning

confidence: 99%

Central Pressure Waveform-Derived Indexes Obtained From Carotid and Radial Tonometry and Brachial Oscillometry in Healthy Subjects (2–84 Y): Age-, Height-, and Sex-Related Profiles and Analysis of Indexes Agreement

Zócalo

2022

Front. Physiol.

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Aortic blood pressure (aoBP) waveform-derived indexes could provide valuable (prognostic) information over and above cardiovascular risk factors (CRFs). To obtain aoBP waveform-characteristics, several (i) techniques, (ii) recording sites, (iii) pressure-only waveform analysis mathematical approaches [e.g., pulse wave analysis (PWA), wave separation analysis (WSA)], and (iv) indexes [augmentation pressure and index (AP and AIx), forward (Pf) and backward (Pb) components of aoBP, reflection magnitude (RM), and reflection index (Rix)], were proposed. An accurate clinical use of these indexes requires knowing their physiological age-related profiles and the expected values for a specific subject. There are no works that have characterized waveform-derived indexes profiles in large populations considering: (i) as a continuous, data from different age stages (childhood, adolescence, and adulthood), (ii) complementary indexes, (iii) data obtained from different techniques and approaches, and (iv) analyzing potential sex- and body height (BH)-related differences. In addition, (v) there is a lack of normative data (reference intervals, RIs) for waveform-derived indexes.Aims(1) to evaluate the association and agreement between PWA- and/or WSA-derived indexes obtained with different techniques and approaches; (2) to determine the need for sex-, BH-, and/or age-specific RIs; (3) to define RIs for PWA- and WSA-derived indexes in a large cohort of healthy children, adolescents, and adults.Methods3619 subjects (3–90 y) were included; 1688 healthy (2–84 y). AP, AIx, AIx@75, Pf, Pb, RM, and RIx were obtained (carotid and radial tonometry, brachial oscillometry/plethysmography). The association and agreement between indexes were analyzed (Concordance correlation coefficients, Bland–Altman analysis). Mean and SD equations and sex-specific BH- and age-related profiles were obtained (regression methods; fractional polynomials).ResultsWaveform-derived indexes were not equivalent; for a specific index, there were systematic and proportional differences associated with the recording site (e.g., carotid vs. radial) and technique (e.g., tonometry vs. oscillometry). The need for sex-, BH-, or age-specific RIs was dependent on the index and/or age considered. RIs were defined for each index considering differences between recording sites and techniques. Equations for waveform-derived indexes age-related profiles were included, enabling to determine for a specific subject, the expected values and potential data deviations.

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Longitudinal Changes of Input Impedance, Pulse Wave Velocity, and Wave Reflection in a Middle-Aged Population

Cited by 29 publications

References 42 publications

Discrepancies in Observed and Predicted Longitudinal Change in Central Hemodynamic Measures: The Framingham Heart Study

Discrepancies in Observed and Predicted Longitudinal Change in Central Hemodynamic Measures: The Framingham Heart Study

Sex and Gender Aspects in Vascular Ageing – Focus on Epidemiology, Pathophysiology, and Outcomes

Central Pressure Waveform-Derived Indexes Obtained From Carotid and Radial Tonometry and Brachial Oscillometry in Healthy Subjects (2–84 Y): Age-, Height-, and Sex-Related Profiles and Analysis of Indexes Agreement

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