Prediction of cardiovascular events and all-cause mortality with central haemodynamics: a systematic review and meta-analysis

Vlachopoulos, Charalambos; Aznaouridis, Konstantinos; O’Rourke, Michael; Safar, Michel E.; Baou, Katerina; Stefanadis, Christodoulos

doi:10.1093/eurheartj/ehq024

Cited by 1,262 publications

(1,019 citation statements)

References 30 publications

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“…3,4 However, concerns have been raised as to whether AIx is a reliable measurement of vascular compliance in the elderly 5,6 due to the curvilinear association between AIx and age. 6,7 Interestingly, findings have been contradictory regarding AIx as predictor of CVD where AIx has been associated with increased risk of CVD in highrisk populations 8,9 and in men, 10,11 while its use as a predictor in women 12,13 and in the general population is less certain. 13,14 The association between AIx and traditional CVD risk factors has been analysed in several studies with different methodology and various findings.…”

Section: Introductionmentioning

confidence: 99%

The association between aortic augmentation index and cardiovascular risk factors in a large unselected population

et al. 2011

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The augmentation index (AIx) is a measure of systemic arterial stiffness, and previous studies have demonstrated an association between AIx and risk factors of cardiovascular disease (CVD). However, there is limited knowledge about the age and gender differences of the observed associations. Therefore, the aim of the present study is to examine the association's consistency at different ages and to see if the associations are the same in men and women. This study is based on 3432 subjects from The Copenhagen City Heart Study, a prospective epidemiological survey of a representative population in Denmark. All subjects had AIx measured non-invasively by the SphygmoCor device (SphygmoCor, West Ryde, Australia). To analyse the association between AIx and CVD risk factors multiple linear regression analyses were used stratified by gender and age.The main determinants of AIx were age, heart rate, height and systolic blood pressure in both age groups with few gender differences. Associations between AIx and cardiovascular risk factors further differed by age: In young subjects AIx was associated with cholesterol, high-sensitive C-reactive protein, current smoking, low weight, poor education and physical inactivity, whereas in subjects above age 60 AIx was associated with weight and current smoking in men. We found a modest association between AIx and traditional CVD risk factors and the association attenuated in subjects 460 years. Further longitudinal studies are needed to determine whether AIx is primarily a marker of CVD in younger subjects.

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Section: Introductionmentioning

confidence: 99%

The association between aortic augmentation index and cardiovascular risk factors in a large unselected population

et al. 2011

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“…[1][2][3][4][5] The AIx, a marker of wave reflection, is influenced by both the magnitude and the timing of the pressure wave reflected from peripheral sites to the aorta. 6 Accordingly, increased AIx has been associated with high rates of cardiovascular morbidity and mortality, 5,7 due to an increased left ventricular afterload. 8 Previous research has demonstrated that the AIx reduces following an acute bout of cycling exercise 9,10 and low-intensity leg resistance exercise in healthy young individuals.…”

Section: Introductionmentioning

confidence: 99%

Impact of passive vibration on pressure pulse wave characteristics

et al. 2011

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The augmentation index (AIx), a marker of wave reflection, decreases following acute leg exercise. Passive vibration (PV) causes local vasodilation that may reduce AIx. This study investigated the effects of acute PV on wave reflection and aortic hemodynamics. In a crossover fashion 20 (M ¼ 9, F ¼ 11) healthy young (22±3 year) participants were randomized to 10 min PV or no vibration control (CON) trials. Subjects rested in the supine position with their legs over a vibration platform for the entire session. Radial waveforms were obtained by applanation tonometry before and after 3 min (Post-3) and 30 min (Post-30) of PV (B5.37 G) or CON. No change in parameters was found at Post-3. We found significant time-by-trial interactions (Po0.01) at Post-30 for augmented pressure, AIx and second systolic peak pressure (P2), such that these parameters significantly (Po0.05) decreased (À2.3 ± 3.0 mm Hg, À7.2 ± 6.9% and À1.5±3.5 mm Hg, respectively) after PV but not after CON. These findings suggest that acute PV applied to the legs decreases AIx owing to a decrease in wave reflection magnitude (P2). Further research is warranted to evaluate the potential clinical application of PV in populations at an increased cardiovascular risk who are unable to perform conventional exercise.

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“…1 For these reasons, central pressure has emerged as an important factor underlying the pathophysiology of cardiovascular disease, arguably more so than brachial (peripheral) BP. 2,3 Central aortic pressure is known to be influenced by the phenomenon of arterial wave reflections returning from the lower body, which can be quantified by augmentation index (AIx). 4,5 During each cardiac cycle, an incident wave generated from the left ventricular contraction in opposition to central aortic impedance travels distally along the arterial tree.…”

Section: Introductionmentioning

confidence: 99%

Association between ankle blood pressure and central arterial wave reflection

2010

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There is an increasing recognition that central aortic pressure is more relevant than brachial measure for the prediction and pathophysiology of cardiovascular disease. Central pressure is influenced by the phenomenon of arterial wave reflections returning from the peripheral vasculature, which can be quantified by augmentation index. Accordingly, the primary aim of this study was to determine the association between central augmentation index and arterial blood pressures (BPs), recorded in both the upper and lower limbs. A total of 833 apparently healthy adults of varying ages were studied. All of the BP (brachial and ankle, systolic, mean, diastolic and pulse) measurements were significantly associated with carotid augmentation index. Among them, ankle mean arterial pressure was the strongest correlate of carotid augmentation index (r ¼ 0.51, Po0.0001). This relation remained highly significant even after the influence of potential confounders was accounted for by the partial correlation analyses. Stepwise regression analyses revealed that ankle mean arterial pressure was the strongest independent predictor of carotid augmentation index. Ankle BP is strongly associated with the augmentation of central BP, and this relation is independent of other BP measures (brachial BP).

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Prediction of cardiovascular events and all-cause mortality with central haemodynamics: a systematic review and meta-analysis

Cited by 1,262 publications

References 30 publications

The association between aortic augmentation index and cardiovascular risk factors in a large unselected population

The association between aortic augmentation index and cardiovascular risk factors in a large unselected population

Impact of passive vibration on pressure pulse wave characteristics

Association between ankle blood pressure and central arterial wave reflection

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