Pulse wave velocity predicts cardiovascular mortality: findings from the Hawaii-Los Angeles-Hiroshima study.
ABSTRACT Arterial stiffness measurements, generally from pulse wave velocity (PWV), are widely used with little knowledge of their relationship to long-term cardiovascular mortality in general populations.
We studied a cohort of 492 Japanese-Americans living in Hawaii (mean age: 63.7 +/-8.8 years) to assess the relationship between PWV and cardiovascular disease mortality and all-cause mortality. During the 10-year follow-up, 43 patients died (14 from cardiovascular events). The cohort was divided into 2 groups by the cut-off value of PWV (9.9 m/s) represented in the receiver operating characteristic curve. The risk ratio for PWV values >9.9 m/s to all-cause mortality was 1.28 [95% confidence interval (CI): 1.14-1.42], and adjusted for other risk factors this ratio was 1.42 (95% CI: 0.96-2.11). The corresponding risk ratios for cardiovascular mortality was 4.46 (95% CI: 1.61-12.32) and 4.24 (95% CI: 1.39-12.96), respectively.
The present study demonstrated that an increased PWV value is associated with future cardiovascular disease death in Japanese-Americans living in Hawaii.
Article: Determinants of pulse wave velocity in healthy people and in the presence of cardiovascular risk factors: 'establishing normal and reference values'.European Heart Journal 10/2010; · 10.48 Impact Factor
Article: Availability of cardio-ankle vascular index (CAVI) as a screening tool for atherosclerosis.[show abstract] [hide abstract]
ABSTRACT: A novel index, the cardio-ankle vascular index (CAVI), which reflects the stiffness of the aorta, femoral artery, and tibial artery, was recently developed by measuring brachial - ankle pulse wave velocity and blood pressure. In the present study 1,014 Japanese adults from the general population were screened to clarify the correlation between CAVI and other existing markers related to atherosclerosis, including carotid intima - media thickness (CIMT) and homocysteine (HCY). CAVI was strongly associated with age in both men and women. After adjustment for age and sex, CAVI was correlated with systolic and diastolic blood pressures. In addition, CAVI was significantly correlated with total cholesterol hemoglobin A(1c) and total HCY, as well as CIMT. CAVI is an appropriate screening tool for atherosclerosis, but further studies are needed to establish a convenient and effective screening system using it.Circulation Journal 03/2008; 72(2):304-8. · 3.77 Impact Factor
Article: Magnetic resonance assessment of aortic pulse wave velocity, aortic distensibility, and cardiac function in uncomplicated type 2 diabetes mellitus.[show abstract] [hide abstract]
ABSTRACT: Type 2 diabetes mellitus (DM2) may augment arterial stiffening and thereby modulates left ventricular (LV) function. Cardiovascular magnetic resonance (CMR) is well suited to assess aortic pulse wave velocity (PWV) and aortic distensibility, both markers of arterial stiffness, without the use of geometric assumptions. Furthermore, CMR is a reliable method for assessing left ventricular (LV) function. The purpose of this study was to assess LV function, PWV, and aortic distensibility in patients with DM2 using MR. Fourteen patients with well controlled, uncomplicated DM2, and 16 age and gender matched healthy subjects were included. PWV was calculated based on MR velocity mapping at two predefined aortic locations. Aortic distensibility was measured in the mid ascending aorta. LV volumes were measured by fast gradient-echo imaging to assess systolic function. Furthermore, mitral inflow was measured by MR velocity mapping to assess diastolic LV function. Mean PWV was higher in patients as compared to healthy subjects (6.83 +/- 1.60 m/s vs. 5.65 +/- 0.75 m/s, p < 0.05). This difference was independent of blood pressure. PWV correlated significantly (p < 0.05) with fasting plasma glucose and insulin levels. Aortic distensibility was lower in patients as compared to healthy subjects (4.50 x 10(- 3)+/- 2.24 x 10(- 3) mmHg(- 1) vs. 7.42 x 10(- 3)+/- 3.34 x 10(- 3) mmHg(- 1), p < 0.05). Distensibility correlated negatively with PWV and positively with LV diastolic function (p < 0.05). A combined CMR assessment of aortic PWV, aortic distensibility, and heart function reveals abnormal PWV and distensibility in patients with DM2, independent of blood pressure. Furthermore, aortic distensibility correlates with diastolic left ventricular function.Journal of Cardiovascular Magnetic Resonance 02/2007; 9(4):645-51. · 3.72 Impact Factor