Predictive value of the augmentation index derived vascular age in patients with newly diagnosed atherosclerosis

Abstract

Early detection of atherosclerosis, i.e., in occupational health screening programs could reduce the rate of cardiovascular events in the working population. Changes of the augmentation index (AIX) correlate with changes of the arterial stiffness induced by aging, atherosclerosis, or arterial hypertension and have a prognostic value for cardiovascular events. Their diagnostic yield should be increased by normalizing the AIX to age, in terms of a calculating the vascular age (VA). In this pilot study, 30 patients (mean age 65.3 ± 8.8 years, 21 male) with suspected coronary heart disease underwent a duplex ultrasound of the carotid arteries and a measurement of the ankle brachial index in addition to the coronary angiography. The AIX was recorded with a portable device (Vascular Explorer), and the VA was calculated. Atherosclerosis was found in 24 patients. They were older than the patients without atherosclerosis, but there was no age dependency found for the distribution pattern or severity of atherosclerosis. In patients with findings of atherosclerosis, the calculated VA was higher than the chronological age, and these differences were significant in patients below 65 years of age. Comparing patients in higher blood pressure classes with patients in lower classes, significantly higher AIX, VA, and differences to the chronological age were found. The VA, deduced from the noninvasively obtained AIX, is a promising candidate for screening programs for atherosclerosis, i.e., in occupational health screening programs.

Non-invasive measurements of arterial function: What? When? Why should we use them?

“…Based on the Anglo-Cardiff Collaborative Trial, which examined the pattern of AIx of 4001 individuals from the general population, AIx showed prominent changes in those aged under 50 years, whereas aortic PWV showed prominent changes with age in those over 50 years 46. AIx is elevated in patients with atherosclerosis compared with health controls while aortic PWV remained within normal ranges and did not differ between the groups 47. Aortic wave reflections may offer an early indicator of atherosclerosis compared with PWV which may have prognostic value for CV events in patients with atherosclerosis.…”

Photoplethysmographic Prediction of the Ankle-Brachial Pressure Index through a Machine Learning Approach

“…In this study, the feasibility of predicting ABI from multisite PPG features employing a linear machine learning procedure (i.e., GLM) was investigated. ABI was measured using a commercially available instrument (Enverdis Vascular Explorer, VE) [31,32], which is able to measure the ankle and brachial pressures. GLM was then employed in a supervised learning approach [27] to link different features extracted from the PPG signals at the ankle and at the arm with ABI estimated using the Vascular Explorer (VE-ABI).…”

Pulse Pressure and Upstroke Time Are Useful Parameters for the Diagnosis of Peripheral Artery Disease in Patients With Normal Ankle Brachial Index

“…Although arteriosclerotic disease typified by acute coronary syndrome (ACS) is the main cause of death, it has been reported that the onset age of ACS has also growing order [ 1 ]. Moreover, the relationship between vascular age and arteriosclerotic diseases has also been reported [ 2 ]. Therefore, the prevention and treatment of these arteriosclerotic diseases are important.…”