The “backstage” of augmentation index evaluated by pulse wave analysis

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Aims

To evaluate arterial stiffness by pulse wave analysis (Augmentation Index, AIx) in a population with moderate-high cardiovascular risk.

Methods

N= 118. Type 1 diabetes and latent autoimmune diabetes in adults were excluded. Age: 59.2 (12.9) y.o. 71 males (60.2 %). Hypertensive 87 (73.7%). Hyperglycemia 81 (68.6 %). Type 2 diabetes 46 (39%). Smokers 31 (26.3%). Metabolic Syndrome (MS): ATP-III-2005. Pulse wave analysis by SphygmoCor (AtCor Medical). AIx adjusted to 75 bpm (AIx@75). TG, cholesterol, cHDL, cLDL and uric acid (mg/dl): HITACHI. High-sensitivity C-reactive protein (hsCRP, mg/L): nephelometric. Statistical: mean, standard

Results

As expected, a strong linear correlation /p< 0.001) between AIx@75 and age was found in both males (R2=0.395) and females (R2=0.33. Female sex was associated to a higher AIx@75 in the whole age range: R2=0.443, p< 0.001. After adjustment by sex and age, AIx@75 was significantly associated with smoking (β=3.93; p=0.030; R2=0.468), peripheral diastolic blood pressure (DBP) (β = 0.227; p=0.041. R2=0.465), central systolic blood pressure (SBP) (β=0.133; p=0.029. R2=0.468), central DBP (β= 0.252;

Discussion

The arterial stiffness seems to be a prognostic and independent biomarker of cardiovascular risk. Pulse wave analysis is a non-invasive tool to evaluate arterial stiffness. The increase of stiffness is the result of a series of structural and functional changes taking place in the vessel wall in relation to aging, but whose speed could be modified by genetic aspects, life-style and risk factors. The analysis of the pulse wave morphology estimates carotid pulse from radial artery, providing a

Conclusions

Aging was the main determinant factor of AIx@75. By gender, females showed higher values. After adjustment by sex and age, smoking status, central SBP and central and peripheral DBP significantly contribute to explain variability of AIx@75, but not chronic hyperglycemia, Metabolic Syndrome, hypertension, SBP, nor waist circumference. Now we better know the determinant factors of arterial stiffness.

Keywords

augmentation index; pulse wave analysis; stiffness arterial; cardiovascular risk

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