Sex- and Age-Related Physiological Profiles for Brachial, Vertebral, Carotid, and Femoral Arteries Blood Flow Velocity Parameters During Growth and Aging (4–76 Years): Comparison With Clinical Cut-Off Levels

Abstract

Ultrasound-derived blood flow velocity (BFV) levels [e.g., peak systolic velocity (PSV)], intrabeat indexes (e.g., resistive), and intersegment ratios [e.g., internal/common carotid artery (ICA/CCA) PSV ratio] are assessed to describe cardiovascular physiology and health status (e.g., disease severity evaluation and/or risk stratification). In this respect, fixed cut-off values (disregard of age or sex) have been proposed to define “significant” vascular disease from BFV-derived data (parameters). However, the use of single fixed cut-off values has limitations. Accurate use of BFV-derived parameters requires knowing their physiological age-related profiles and the expected values for a specific subject. To our knowledge, there are no studies that have characterized BFV profiles in large populations taking into account: (i) data from different age-stages (as a continuous) and transitions (childhood–adolescence–adulthood), (ii) complementary parameters, (iii) data from different arteries, and (iv) potential sex- and hemibody-related differences. Furthermore, (v) there is little information regarding normative data [reference intervals (RIs)] for BFV indexes.Aims: The aims of this study are the following: (a) to determine the need for age-, body side-, and sex-specific profiles for BFV levels and derived parameters (intrabeat indexes and intersegment ratios), and (b) to define RIs for BFV levels and parameters, obtained from CCA, ICA, external carotid, vertebral, femoral, and brachial arteries records.Methods: A total of 3,619 subjects (3–90 years) were included; 1,152 were healthy (without cardiovascular disease and atheroma plaques) and non-exposed to cardiovascular risk factors. BFV data were acquired. The agreement between left and right data was analyzed (Concordance correlation, Bland–Altman). Mean and SD equations and age-related profiles were obtained for BFV levels and parameters (regression methods; fractional polynomials).Results: Left and right body-side derived data were not always equivalent. The need for sex-specific RIs was dependent on the parameter and/or age considered. RIs were defined for each studied artery and parameter. Percentile curves were compared with recommended fixed cut-off points. The equations for sex, body-side, and age-specific BFV physiological profiles obtained in the large population (of children, adolescents, and adults) studied were included (spreadsheet formats), enabling to determine for a particular subject, the expected values and potential data deviations.

Aortic Pressure Levels and Waveform Indexes in People Living With Human Immunodeficiency Virus: Impact of Calibration Method on the Differences With Respect to Non-HIV Subjects and Optimal Values

“…Cardiovascular variables obtained in PLWHIV and non-HIV subjects were expressed as relative difference (%) with respect to age-matched healthy subjects not exposed to CRFs (reference group). To build the reference group, we identified a healthy sub-population from the project database that included subjects who did not meet any of the following exclusion criteria: history of cardiovascular disease, use of baBP-, lipid- or glucose-lowering drugs, hypertension or high baBP levels during the non-invasive evaluation, smoking, diabetes, dyslipidemia, obesity ( 29 – 36 , 41 – 44 ).…”

“…Once the reference group was built, age-related equations were obtained for mean values ( Supplementary Table 5 ). To this end, we implemented parametric regression methods based on various types of mathematical models (e.g., fractional polynomials) ( 29 – 36 , 41 – 44 ). This procedure provides different equations for each model to calculate age-related mean values, then, the most adjusted model was chosen to calculate individual's relative difference between the expected and the measure value: [(measured-expected)/expected] * 100 ( Supplementary Table 6 ).…”

Center-To-Periphery Arterial Stiffness Gradient Is Attenuated and/or Reversed in Pregnancy-Associated Hypertension

“…This was a cross-sectional study involving non-pregnant and pregnant women from our CUiiDARTE Project database (23)(24)(25)(26)(27)(28)(29)(30)(31)(32). The CUiiDARTE Project is a population-based study developed in Uruguay, supported by the National Public Health Ministry and the Agencia Nacional de Investigación e Innovación (ANII).…”

“…The CUiiDARTE Project is a population-based study developed in Uruguay, supported by the National Public Health Ministry and the Agencia Nacional de Investigación e Innovación (ANII). Cardiovascular evaluation in the CUiiDARTE Project involves a stepwise protocol using several equipment and devices that measure central, peripheral, and systemic hemodynamic variables, and structural and functional local, regional, and global properties of elastic, muscular, and transitional arteries (23)(24)(25)(26)(27)(28)(29)(30)(31)(32). All procedures and protocols were conducted in agreement with the Declaration of Helsinki, approved by the Institution's Ethics Committee.…”

“…Left and right common carotid artery (CCA) and left brachial artery (BA) were analyzed using high-resolution ultrasound (6-13 MHz, MicroMaxx/M-Turbo, Sonosite Inc., WA, USA). CCA and BA blood flow velocity levels and indexes were quantified (26). Sequences of images (30 s, B-Mode, longitudinal views) were processed to obtain peak systolic and enddiastolic diameters (SysD, DD) and CCA intima-media thickness (IMT; far wall, end-diastole) (32).…”