Pulse wave velocity (PWV) has been established as a promising biomarker in
cardiovascular diagnostics, providing deep insights into vascular health and
cardiovascular risk. Defined as the velocity at which the mechanical wave
propagates along the arterial wall, PWV represents a useful surrogate marker for
arterial vessel stiffness. PWV has garnered clinical attention, particularly in
monitoring patients suffering from vascular diseases such as hypertension and
diabetes mellitus. Its utility extends to preventive cardiology, aiding in
identifying and stratifying cardiovascular risk. Despite the development of
various measurement techniques, direct or indirect tonometry, Doppler ultrasound,
oscillometric analysis, and magnetic resonance imaging (MRI), methodological
variability and lack of standardization lead to inconsistencies in PWV
assessment. In addition, PWV can be estimated through surrogate parameters, such
as pulse arrival or pulse transit times, although this heterogeneity limits
standardization and, therefore, its clinical use. Furthermore, confounding
factors, such as variations in sympathetic tone, strongly influence PWV readings,
thereby necessitating careful control during assessments. The bidirectional
relationship between heart rate variability (HRV) and PWV underscores the
interplay between cardiac autonomic function and vascular health, suggesting that
alterations in one could directly influence the other. Future research should
prioritize the standardization and increase comparability of PWV measurement
techniques and explore the complex physiological variables influencing PWV.
Integrating multiple physiological parameters such as PWV and HRV into algorithms
based on artificial intelligence holds immense promise for advancing personalized
vascular health assessments and cardiovascular care.