Relation between arterial stiffness and aerobic capacity: Importance of proximal aortic stiffness.

Brachial-ankle pulse wave velocity (baPWV) has become a popular modality of arterial stiffness measurement. However, its projected arterial segment does not include the proximal aorta which plays important roles for attenuating cardiac pulsation and reducing afterload. We hypothesised that aerobic capacity would be more strongly associated with PWV including the proximal aorta than that omitting the proximal aorta. To test our hypothesis, we compared the association between aerobic capacity and arterial stiffness parameters omitting vs. including the proximal aorta (i.e. baPWV vs. heart-ankle PWV [haPWV]) in 82 apparently healthy men (18-64 years). Estimated VO2max significantly correlated with baPWV (r = -0.394, P < .001), and more strongly with haPWV (r = -0.546, P < .001). The forward stepwise multi-regression analysis revealed that haPWV (β = -0.335), as well as age, heart rate, and body mass index (β = -0.280 to -0.297), was a significant independent determinant explaining variance of estimated VO2max. These results suggest that aerobic capacity is influenced more strongly by the proximal aortic stiffness than distal aortic stiffness.