Predictive value of estimated pulse wave velocity for cardiovascular and all-cause mortality in individuals with obesity

Abstract

Background Estimated pulse wave velocity (ePWV) has revealed excellent performance in predicting cardiovascular disease (CVD) risk. However, whether ePWV predicts all-cause mortality and CVD mortality in populations with obesity remains elusive. Methods We performed a prospective cohort including 49,116 participants from the National Health and Nutrition Examination Survey from 2005 to 2014. Arterial stiffness was evaluated by ePWV. Weighted univariate, multivariate Cox regression and receiver operating characteristic curve (ROC) analysis was used to assess the effects of ePWV on the risk of all-cause and CVD mortality. In addition, the two-piecewise linear regression analysis was used to describe the trend of ePWV affecting mortality and identify the thresholds that significantly affect mortality. Results A total of 9929 participants with obesity with ePWV data and 833 deaths were enrolled. Based on the multivariate Cox regression results, the high ePWV group had a 1.25-fold higher risk of all-cause mortality and a 5.76-fold higher risk of CVD mortality than the low-ePWV group. All-cause and CVD mortality risk increased by 123% and 44%, respectively, for every 1 m/s increase in ePWV. ROC results showed that ePWV had an excellent accuracy in predicting all-cause mortality (AUC = 0.801) and CVD mortality (AUC = 0.806). Furthermore, the two-piecewise linear regression analysis exhibited that the minimal threshold at which ePWV affected participant mortality was 6.7 m/s for all-cause mortality and 7.2 m/s for CVD mortality. Conclusions ePWV was an independent risk factor for mortality in populations with obesity. High ePWV levels were associated with an increased all-cause and CVD mortality. Thus, ePWV can be considered a novel biomarker to assess mortality risk in patients with obesity.

The Role of Carotid-Femoral Pulse Wave Velocity in a Metabolic Syndrome Patient with Sudden Cardiac Arrest: A Case Report

“…Compared with the mean PWV of 5.4 m/s for the age range of 45 to 50 [16], the mean PWV of 7.7 m/s of the presented case may indicate low vessel compliance due to a long-term exposure to components of MetS. The study of Li et al demonstrated a positive correlation between the estimated pulse wave velocity (ePWV) and all-cause mortality when the ePWV is greater than 6.7 m/s [12]. It is also important to note that a traditional 10 year Systematic Coronary Risk Evaluation (SCORE) scale may potentially underestimate cardiovascular risk in patients with diabetes, central obesity, low HDL, and elevated triglyceride levels [17,18].…”

“…Kim et al investigated 848,498 people with MetS who underwent health screenings, and showed that a high serum gamma-glutamyl transferase associated with an impaired aortic elasticity in MetS, which accounts for a 50% increased risk of sudden cardiac death [11]. Similarly, Li et al, contingent on the National Health and Nutrition Examination Survey, reported that obesity as a single MetS component increased the PWV and elevated 5.76-fold the risk of cardiovascular mortality [12]. Moreover, Masrouri also reported a MetS population with a 1.4-to 1.6-fold increased risk of cardiac sudden death [13].…”

Estimated Pulse Wave Velocity as a Novel Non-Invasive Biomarker for Metabolic Syndrome Among People Living with HIV

“…ePWV integrates age and blood pressure parameters, offering an accessible means to evaluate AS when compared to the complexities and expenses associated with cf-PWV. 36 Blood pressure and age represent readily accessible parameters that can be measured conveniently within community hospitals or even at home. This accessibility renders them particularly well-suited for risk assessment and healthcare management among individuals living with HIV.…”

System inflammation response index: a novel inflammatory indicator to predict all-cause and cardiovascular disease mortality in the obese population

“…The BMI cut-off of 30 kg/m 2 universally identifies obesity and offers significant specificity. As such, this cut-off value continues to be used as a benchmark for statistical identification and classification of obesity in reports published by the WHO, the CDC, and the NIH, as well as in many studies [ 1 , 2 , 86 , 87 ]. This study also used this criterion to identify obesity, with a particular emphasis on the prognostic value of SIRI and SII on all-cause and CVD mortality in this population.…”